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Stathopoulos G.P.,First Oncology Clinic | Trafalis D.I.M.,First Oncology Clinic | Athanasiou A.,Oncology Clinic | Bardi G.,Bio Analytica Genotype Molecular Cytogenic Laboratory | Chandrinou H.,First Oncology Clinic
Anticancer Research | Year: 2010

Background: Erlotinib is an oral, small-molecule targeting therapy which inhibits epidermal growth factor tyrosine kinase receptors. Erlotinib has been administered for the treatment of advanced pancreatic cancer and non-small cell lung cancer. Patients and Methods: In the present report, unusual hematologic complications were detected after erlotinib was administered as second-line monotherapy in pretreated patients with advanced non-small cell lung cancer. Four patients pre-treated with cisplatin or its analog-based combinations, were evaluated. Erlotinib was given at a dose of 150 mg daily. In cases of intolerable adverse reactions, the dose was either reduced to 100 mg daily or treatment was interrupted for a maximum of two weeks. Results: Serious hematologic toxicity (or complications) developed in these 4 patients after 4-85 months of treatment. Two patients developed leukemias (AML, CML) and two, myelodysplastic syndrome. Conclusion: Whether or not these hematologic complications were related to erlotinib treatment is comprehensively discussed.

Zaenker K.S.,Witten/Herdecke University | Matthes H.,Oncology Clinic | Bock P.R.,IFAG Basel AG | Hanisch J.,IFAG Basel AG
Journal of Cancer Science and Therapy | Year: 2012

Rationale: In 2009 we reported the results of a pharmaco-epidemiological, retrospective observational cohort study in colorectal carcinoma (CRC) patients UICC stage I-III, receiving chemo- and/or radiotherapy together with European Viscum album L. ("Viscum") extract (Iscador®) as supportive care (n = 429) versus the conventional treatment (n = 375) after R0 resection (J. Soc. Int. Oncol. 7: 173-145). The endpoints have been therapy induced adverse effects, disease symptoms and disease-free survival (DSF). Objective: Here, we present the secondary and confirmatory analysis of this original data set with respect to the host tree specificity of Viscum. Results: Patients receiving the extract from Viscum harvested from oak (Quercus) trees, Iscador® Qu (Isc- Qu), in a supportive care mode simultaneously with chemo- and/or radiotherapy (n = 106) showed a significant improvement in therapy induced adverse effects, and, most remarkable, a significant delay of metastasis formation and longer DFS compared to conventionally treated patients (n = 212) (control). To make the analysis more robust, patients treated by the chemo- and/or radiotherapy protocols were also analyzed and stratified for the UICC I-III stages. Accordingly to the overall Kaplan-Meier analysis result, patients receiving Isc-Qu as supportive care presented significantly longer median time to distant metastases formation (metastasis-free survival, MFS) within the course of the observational cohort study (133+ months (Isc-Qu) versus 94 months (control), p (Log Rank) = 0.002. In the Cox regression analysis, the confounder-adjusted hazard ratio, HR, (95% confidence interval) came up to HR (metastasis) = 0.31 (0.13-0.711), p = 0.006. This result indicates an estimated 69% metastasis-hazardreduction in the Isc-Qu group relative to the controls. In summary, patients concomitantly treated by Iscador® showed fewer persisting disease- and therapy-induced symptoms and the DSF hazard ratio suggested a survival benefit. Clinical implication: This secondary and confirmatory analysis of the original data set suggests that a mistletoe (Viscum) preparation, harvested from oak (Quercus) trees (Isc-Qu), appears to be a naturally tailored molecular composition to target CRC patients by reducing therapy-related adverse effects, improving the cancerrelated symptoms and showing a potential to increasing the metastases-free survival. Limitations: The effect on prolonged survival should be interpreted with some caution because the applied study design shares some potential risk for bias common to all non-randomized observational studies. Also, potential biases were tried to minimize by systematic multivariable adjusting of end point criteria for baseline imbalance, treatment regimen, and other potential confounders. © 2012 Zaenker KS, et al.

Ellidag H.Y.,Central Laboratories of Antalya Education and Research Hospital | Eren E.,Antalya Public Health Center | Aydin O.,Central Laboratories of Antalya Education and Research Hospital | Yldrm M.,Oncology Clinic | And 2 more authors.
Medical Principles and Practice | Year: 2013

Objective: To investigate the status of the oxidant/antioxidant balance in patients with multiple myeloma compared to healthy controls. Materials and Methods: This study was conducted on 40 multiple myeloma patients and 40 healthy controls of matched age and sex. Serum total thiol, oxidative stress index (OSI), total oxidant status (TOS), and total antioxidant status (TAS) were measured using colourimetric methods; paraoxonase-1 and arylesterase enzyme activities were also quantified. Results: Serum paraoxonase-1 and arylesterase activities and total thiol levels were significantly lower (p = 0.0001, p = 0.036 and p < 0.0001, respectively), whereas TOS and OSI levels were significantly higher (p < 0.0001 for both parameters) in multiple myeloma patients compared to controls. However, no significant differences in TAS were identified when the two groups were compared. Conclusions: Our findings indicate an impaired oxidative/antioxidative balance in multiple myeloma. We recommend further studies with larger groups to investigate the possible relationship between oxidative stress and the aetiopathogenesis of multiple myeloma. © 2013 S. Karger AG, Basel.

Tolia M.,National and Kapodistrian University of Athens | Zygogianni A.,National and Kapodistrian University of Athens | Kouvaris J.R.,National and Kapodistrian University of Athens | Meristoudis C.,National and Kapodistrian University of Athens | And 13 more authors.
Anticancer Research | Year: 2014

The present review aims at providing an assessment of the clinical significance of Biphosphonates (BPs) in the treatment of patients with cancer. Materials and Methods: A systematic literature review was performed based on database search in PubMed/Medline and included articles up to August 2013. Results: BPs can reduce, delay, and prevent complications related to bone metastases. They improve mobility, functionality, pain, and quality of life. They limit survival of any inactive cancer cells in the microenvironment of the bone marrow, contributing to their death from anti-neoplastic treatments. Moreover, they limit and delay bone morbidity due to osteoporosis related to hormonotherapy in breast and prostate cancer. Finally, benefits can be derived from the combination of BPs with radiotherapy in bone density, recalcification, opioid use, and patient's quality of life and performance status. Conclusion: The contribution of BPs in the course of certain neoplasms is preventive and synergistic to other treatments. © 2014, International Institute of Anticancer Research. All rights reserved.

Biganzoli L.,Sandro Pitigliani Medical Oncology Unit | Di Vincenzo E.,Cardiologic Unit | Jiang Z.,307 Hospital | Lichinitser M.,Modality | And 15 more authors.
Annals of Oncology | Year: 2012

Background: There are limited data on treatment outcomes in the growing population of elderly patients with locally recurrent/metastatic breast cancer (LR/mBC). To gain information on first-line bevacizumab combined with chemotherapy in the elderly, we analyzed data from the ATHENA trial in routine oncology practice. Patients and methods: Patients with human epidermal growth factor receptor-2-negative LR/mBC received firstline bevacizumab with standard chemotherapy until disease progression, unacceptable toxicity, or physician/patient decision. We carried out a subgroup analysis of safety and efficacy in patients aged ≥70 years. Possible correlations between tolerability and baseline comorbidities or Eastern Cooperative Oncology Group status were explored. Results: Bevacizumab was combined with single-agent paclitaxel in 46% of older patients. Only hypertension and proteinuria were more common in older than in younger patients (grade ≥3 hypertension: 6.9% versus 4.2%, respectively; grade ≥3 proteinuria: 4.0% versus 1.5%, respectively). Grade ≥3 arterial/venous thromboembolism occurred in 2.9% versus 3.3%, respectively. Further analysis revealed no relationship between baseline presence and severity of hypertension and risk of developing hypertension during bevacizumab-containing therapy. Median time to progression was 10.4 months in patients aged ≥70 years. Conclusions: These findings suggest that bevacizumab-containing therapy is tolerable and active in patients aged ≥70 years. Hypertension was more common than in younger patients but was manageable. We find no evidence precluding the use of bevacizumab in older patients, including those with hypertension, although age may influence chemotherapy choice. © The Author 2011. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.

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