South Carolina Oncology Associates

Columbia, United States

South Carolina Oncology Associates

Columbia, United States

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Benson A.B.,Northwestern University | Wainberg Z.A.,University of California at Los Angeles | Randolph Hecht J.,University of California at Los Angeles | Vyushkov D.,Budgetary Healthcare Institution of Omsk Region | And 3 more authors.
Oncologist | Year: 2017

Background. The humanized IgG4 monoclonal antibody simtuzumab inhibits the extracellular matrix-remodeling enzyme lysyl oxidase-like 2 maintaining pathological stroma in tumors. Methods. Adult patients withmetastatic pancreatic adenocarcinoma (mPaCa) were randomly assigned to receive intravenous gemcitabine, 1,000 mg/m2, in combination with 200 or 700 mg simtuzumab or placebo. Primary endpoint was progression-free survival (PFS), secondary endpoints included overall survival (OS), objective response rate (ORR), and safety. Results. Of 240 patients, 80 were randomly assigned to gemcitabine/simtuzumab 700 mg, 79 to gemcitabine/simtuzumab 200 mg, and 81 to gemcitabine/placebo. After a median followup of 3.0, 1.9, and 3.4 months for gemcitabine/simtuzumab 700 mg, gemcitabine/simtuzumab 200 mg, and gemcitabine/placebo, respectively, the median PFS was 3.7 months (adjusted hazard ratio [HR], 95% confidence interval [CI], p value vs placebo: 1.09 [0.74-1.61]; p5.73), 3.5 months (1.13 [0.76-1.66], p5.61]), and 3.7 months, respectively. Median OS was 7.6 months (0.83 [0.57-1.22]; p5.28), 5.9 months (1.07 [0.73-1.55]; p5.69), and 5.7 months, respectively. ORRs were 13.9%, 14.5%, and 23.5%, respectively. Simtuzumab was well tolerated. Conclusion. The addition of simtuzumab to gemcitabine did not improve clinical outcomes in patients with mPaCa. © AlphaMed Press 2017.


PubMed | The Oncology Institute of Hope & Innovation, Drug Safety Navigator LLC, Heron Therapeutics Inc., EMB Statistical Solutions LLC and 8 more.
Type: Journal Article | Journal: Future oncology (London, England) | Year: 2016

APF530, extended-release granisetron, provides sustained release for 5 days for acute- and delayed-phase chemotherapy-induced nausea and vomiting (CINV). We compared efficacy and safety of APF530 versus ondansetron for delayed CINV after highly emetogenic chemotherapy (HEC), following a guideline-recommended three-drug regimen.HEC patients received APF530 500 mg subcutaneously or ondansetron 0.15 mg/kg intravenously, with dexamethasone and fosaprepitant. Primary end point was delayed-phase complete response (no emesis or rescue medication).A higher percentage of APF530 versus ondansetron patients had delayed-phase complete response (p = 0.014). APF530 was generally well tolerated; treatment-emergent adverse event incidence was similar across arms, mostly mild-to-moderate injection-site reactions.APF530 versus the standard three-drug regimen provided superior control of delayed-phase CINV following HEC. ClinicalTrials.gov : NCT02106494.


Yang F.,University of South Carolina | Yang X.,Dorn Research Institute | Jiang H.,GraceFlow Technology | Butler W.M.,South Carolina Oncology Associates | Wang G.,University of South Carolina
Technology in Cancer Research and Treatment | Year: 2013

Separation of cancer cells from other biological materials is significant for circulating tumor cell detection in cancer diagnosis and treatment. However, separation of one type of cancer cell from other types of cancer cells can be difficult, since they share similar morphology and biomarkers. In the present work, we have successfully manipulated and isolated LNCaP prostate cancer cells from HCT116 colorectal cancer cells, by dielectrophoresis (DEP) in a microfluidic platform in a continuous operation. In this cell sorter, the prostate cancer cells were treated as target cells and were deflected to a side channel from a main channel as they experienced a negative DEP force, when an AC electric field at the cross-over frequency of the HCT116 cells was supplied. This motion consequently led to the separation of the prostate cancer cells from the colorectal cancer cells. In this manuscript, we report the flow conditions, DEP spectra of the cancer cells and the isolation of LNCaP cells from HCT116 cells. The separation and enrichment factor have been investigated as well. © Adenine Press (2013).


Butler C.,Medical University of South Carolina | Butler W.M.,South Carolina Oncology Associates | Rizvi A.A.,University of South Carolina
Endocrine Practice | Year: 2010

Objective: To report our experience using kinase inhibition therapy with sorafenib in a patient with advanced adrenocortical carcinoma. Methods: We describe the clinical, laboratory, and radiologic findings of the study patient and discuss the clinical course with sorafenib therapy. Results: A 56-year-old woman presented with rapid development of virilization, cushingoid features, hypertension, weight gain, and abdominal distension. An 8-cm left adrenal lesion was found on computed tomography, removed surgically, and confirmed as adrenal carcinoma on pathologic examination. Postoperative scanning revealed metastases to both lungs and the liver that were confirmed by fine-needle biopsy, thus establishing stage IV disease. Treatment with the adrenolytic agent mitotane failed to halt disease progression. A trial of sorafenib resulted in regression and eventual resolution of bilateral metastatic lung lesions, reduction in size of the hepatic lesion, normalization of androgen hypersecretion, and marked clinical improvement. The radiologic and biochemical remission on sorafenib has continued for 28 months. Conclusion: Multiple kinase inhibitors such as sorafenib provide targeted oncologic treatment and may be effective in treating advanced adrenal cancer. © 2010 AACE.


Reitan J.F.,RJM Group LLC. | Kudrik F.J.,South Carolina Oncology Associates | Fox K.,South Carolina Oncology Associates | Van Breda A.,Van Breda Research LLC. | And 2 more authors.
Journal of Medical Economics | Year: 2013

Objective: The objective is to measure the burden of blood transfusion of Packed Red Blood Cells (PRBCs) in patients with chemotherapy-induced anemia (CIA) on the institutional outpatient transfusion center. Methods: This is a retrospective chart review (starting July 1, 2010, working backwards until 120 evaluable patients are accrued) at a single institutional transfusion center in the US. The mean and standard deviation (SD) were calculated for patient's age, pre-transfusion Hgb level, and other transfusion-related activities. Results: One hundred and twenty records were reviewed. The majority included patients who were female (71%), African American (61%), and had either Medicare (48%) or private insurance (39%). The mean patient age was 59 years and the average pre-transfusion Hgb was 7.9g/dL. The average patient visit to facility ranged from 213min for one PRBC unit to 411 minutes for three PRBC units. The mean staff time for patient evaluation was 66 minutes. Actual time for transfusion was ∼100min for each PRBC unit; 90% of patients received two PRBC units. Staff was engaged in direct patient care for an average of 322min for two PRBC units. The labor cost of transfusion (in 2011 $US) ranged from $46.13-$49.33 per PRBC unit. The estimated fully loaded bundled cost was $596.49 for transfusion of one unit of PRBC. Limitations of the study include: the site included in this study may not be applicable to all sites in practice and the evaluated patient population was varied, with the exception that all patients were treated for some type of malignancy; and the review of blood bank records for 120 patients was not 120 independent events and, as such, may not have adequately captured actual variability. Conclusions: This analysis quantifies expense in terms of time for administration of the transfusion, as well as costs associated with outpatient blood transfusions. © 2013 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted.


Adams S.A.,University of South Carolina | Butler W.M.,South Carolina Oncology Associates | Fulton J.,South Carolina Comprehensive Breast Center | Heiney S.P.,University of South Carolina | And 4 more authors.
Cancer | Year: 2012

BACKGROUND: Although much has been done to examine those factors associated with higher mortality among African American women, there is a paucity of literature that examines disparities among rural African Americans in South Carolina. The purpose of this investigation was to examine the association of race and mortality among breast cancer patients in a large cohort residing in South Carolina for which treatment regimens are standardized for all patients. METHODS: Subjects included 1209 women diagnosed with breast cancer between 2000 and 2002 at a large, local hospital containing a comprehensive breast center. Kaplan-Meier survival curves were calculated to determine survival rates among African American and European American women, stratified by disease stage or other prognostic characteristics. Adjusting for various characteristics, Cox multivariate survival models were used to estimate the hazard ratio (HR). RESULTS: The 5-year overall all-cause mortality survival proportion was ∼78% for African American women and ∼89% for European American women, P < 0.01. In analyses of subpopulations of women with identical disease characteristics, African American women had significantly higher mortality than European American women for the same type of breast cancer disease. In multivariate models, African American women had significantly higher mortality than European American women for both breast cancer-specific death (HR, 2.41; 95% confidence interval [CI], 1.21-4.79) and all-cause mortality (HR, 1.42; 95% CI, 1.06-1.89). CONCLUSIONS: African American women residing in rural South Carolina had lower survival for breast cancer even after adjustment for disease-related prognostic characteristics. These findings support health interventions among African American breast cancer patients aimed at tertiary prevention strategies or further down-staging of disease at diagnosis. Cancer 2011. © 2011 American Cancer Society. African American women residing in rural South Carolina have poorer 3-year and 5-year breast cancer survival compared with European Americans. A possible biological processing basis may contribute to some of the breast cancer mortality disparities seen in South Carolina. Copyright © 2011 American Cancer Society.


PubMed | Medical University of South Carolina, University of South Carolina, Cancer Center and Alliance Oncology, Mary Bird Perkins Cancer Center and South Carolina Oncology Associates
Type: Journal Article | Journal: Medical physics | Year: 2015

To calculate the output factor (OPF) of any irregularly shaped electron beam at extended SSD.Circular cutouts were prepared from 2.0 cm diameter to the maximum possible size for 15 15 applicator cone. In addition, two irregular cutouts were prepared. For each cutout, percentage depth dose (PDD) at the standard SSD and doses at different SSD values were measured using 6, 9, 12, and 16 MeV electron beam energies on a Varian 2100C LINAC and the distance at which the central axis electron fluence becomes independent of cutout size was determined. The measurements were repeated with an ELEKTA Synergy LINAC using 14 14 applicator cone and electron beam energies of 6, 9, 12, and 15 MeV. The PDD measurements were performed using a scanning system and two diodes-one for the signal and the other a stationary reference outside the tank. The doses of the circular cutouts at different SSDs were measured using PTW 0.125 cm(3) Semiflex ion-chamber and EDR2 films. The electron fluence was measured using EDR2 films.For each circular cutout, the lateral buildup ratio (LBR) was calculated from the measured PDD curve using the open applicator cone as the reference field. The effective SSD (SSDeff) of each circular cutout was calculated from the measured doses at different SSD values. Using the LBR value and the radius of the circular cutout, the corresponding lateral spread parameter [R(z)] was calculated. Taking the cutout size dependence of R(z) into account, the PDD curves of the irregularly shaped cutouts at the standard SSD were calculated. Using the calculated PDD curve of the irregularly shaped cutout along with the LBR and SSDeff values of the circular cutouts, the output factor of the irregularly shaped cutout at extended SSD was calculated. Finally, both the calculated PDD curves and output factor values were compared with the measured values.The improved LBR method has been generalized to calculate the output factor of electron therapy at extended SSD. The percentage difference between the calculated and the measured output factors of irregularly shaped cutouts in a clinical useful SSD region was within 2%. Similar results were obtained for all available electron energies of both Varian 2100C and ELEKTA Synergy machines.


PubMed | South Carolina Oncology Associates
Type: Journal Article | Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology | Year: 2016

850 Background: Recent literature has supported dose dense therapy in the treatment of adjuvant breast cancer. This study sequences docetaxel(T) followed by doxorubicin(A) and cyclophosphamide(C). Docetaxel has shown to be superior to paclitaxel (P) as recently presented. This design demonstrates the feasibility of the most effective drugs, while minimizing toxicity.T-AC is an open label phase II trial sequencing docetaxel (100mg/mSeventeen of the 32 planned patients (pts.) have been enrolled. The first patient began therapy on 7/15/03. Currently, 3 patients have completed all 8 cycles, 8 have completed at least 4 cycles, and 6 have completed fewer than 4 cycles. The following Grade 3 and 4 toxicities have been experienced: 6 [Leukopenia]; 6 [Neutropenia]; 2 [Hand/Foot Syndrome]; 1 [Elevated ALT]; 1 [Elevated AST]; 1 [Infection with Neutropenia]. The table below shows the incidence of these Grade 3 and 4 Toxicities.One patient was removed from study due to progressive disease and accounts for two of the G4 toxicities and one of the G3 toxicities reported. Another patient was removed from study due to unresolved hand/foot syndrome and this is one of the G3 toxicities. The use of dose dense docetaxel followed by dose dense cyclophosphamide and doxorubicin in the adjuvant setting is feasible with acceptable toxicity based on the enrolled patient population. [Figure: see text] No significant financial relationships to disclose.


PubMed | South Carolina Oncology Associates
Type: Journal Article | Journal: Medical physics | Year: 2016

To demonstrate a quick and comprehensive method verifying the accuracy of the updated dose model by recalculating dose distribution in an anthropomorphic phantom with a new version of the TPS and comparing the results to measured values.CT images and IMRT plan of an RPC anthropomorphic head phantom, previously calculated by Pinnacle 9.0, was re-computed using Pinnacle 9.2 and 9.6. The dosimeters within the phantom include four TLD capsules representing a primary PTV, two TLD capsules representing a secondary PTV, and two TLD capsules representing an organ at risk. Also included were three sheets of Gafchromic film. Performance of the updated TPS version was assessed by recalculating point doses and dose profiles corresponding to TLD and film position respectively and then comparing the results to reported values by the RPC.Comparing calculated doses to reported measured doses from the RPC yielded an average disagreement of 1.48%, 2.04% and 2.10% for versions 9.0, 9.2, 9.6 respectively. Computed doses points all meet the RPCs passing criteria with the exception of the point representing the superior organ at risk in version 9.6. However, qualitative analysis of the recalculated dose profiles showed improved agreement with those of the RPC, especially in the penumbra region.This work has demonstrated the calculation results of Pinnacle 9.2 and 9.6 vs 9.0 version. Additionally, this study illustrates a method for the user to gain confidence upgrade to a newer version of the treatment planning system.


PubMed | South Carolina Oncology Associates
Type: Journal Article | Journal: Medical physics | Year: 2016

To calculate the output factor of irregular shape electron beam at extended SSD using modified lateral build-up-ratio method.Circular cutouts from 2.0cm diameter to maximum possible sizes were prepared for applicator cone size of 1515cm. In addition, different irregular cutouts were prepared. Percentage depth dose (PDD) curves were measured for each cutout using 6, 9, 12 and 16-MeV at the standard SSD of 100cm. The scanning was done using Multidata system and Scanditronix diodes on 2100SC Varian LINAC. In addition, for each cutout and electron beam energy doses were measured at SSD values of 100, 105, 110, 115cm using EDR2 films and diodes.The measured PDD were normalized to the depth of 1.0mm. The lateral build-up-ratio (LBR) and the lateral scatter parameter (sigma) were calculated for each circular cutout using the open 1515-cm2 field as the reference field. Taking the linear increase of sigma with cutout size into account, PDD of the irregular cutouts were calculated at 100 cm SSD. Furthermore, using the dose measured at different SSDs, the effective SSD value for each circular cutout and electron beam energy was determined. Employing the LBR and the effective-SSD values of the circular cutouts along with the calculated PDD of the irregular cutouts, the output factors of the irregular cutout at different extended SSD values were calculated. Finally, the calculated output factors were compared with the measured values.In this research, it is shown that output factor of irregular shape electron beam at extended SSD can be determined by using the LBR and the effective SSD values of circular cutouts. The percentage difference of the calculated output factor from the measured output factor for irregular cutouts at extended SSD were within 3.0%.

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