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  • 1
    In: European Journal of Cancer, Elsevier BV, Vol. 92 ( 2018-04), p. S105-S106
    Type of Medium: Online Resource
    ISSN: 0959-8049
    RVK:
    RVK:
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2018
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    detail.hit.zdb_id: 1468190-0
    detail.hit.zdb_id: 82061-1
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  • 2
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2017
    In:  Cancer Research Vol. 77, No. 4_Supplement ( 2017-02-15), p. P1-12-10-P1-12-10
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 77, No. 4_Supplement ( 2017-02-15), p. P1-12-10-P1-12-10
    Abstract: Introduction T-DM1 treatment significantly improved overall survival and had a lower incidence of grade ≥3 adverse events (AEs) vs capecitabine plus lapatinib in patients (pts) with HER2-positive advanced breast cancer (BC) in the EMILIA study, including pts with treated, asymptomatic CNS metastases (mets). KAMILLA is an ongoing, single-arm, open-label, phase 3b global safety study of T-DM1 in pts with HER2-positive locally-advanced or metastatic BC (target n=2220). In this interim analysis we describe clinical characteristics, safety, and efficacy in pts with stable CNS mets at baseline (BL). Methods Eligible pts received prior HER2-directed therapy and chemotherapy and progressed on or after most recent treatment for advanced BC, or within 6 months of completing adjuvant therapy. Pts with asymptomatic CNS mets were eligible, including pts with stable CNS disease with prior radiation therapy. Pts received T-DM1 3.6 mg/kg every 3 weeks until unacceptable toxicity, withdrawal of consent, or disease progression. This exploratory analysis describes pts with BL CNS mets. Median progression-free survival (PFS) was estimated using the Kaplan-Meier method. Results As of April 4, 2016, data were available for 2017 treated pts, of whom 399 (20%) had BL CNS mets, with a median follow-up of 33 months. Table 1 presents demographic and BL characteristics. The incidence of AEs was similar between pts with and without BL CNS mets. Serious AEs (SAEs) occurred in 112 pts with BL CNS mets (28%) vs 311 of 1618 pts without BL CNS mets (19%), and the frequency of SAEs was comparable to that observed in EMILIA. However, nervous system disorder SAEs, such as seizure, epilepsy, and brain edema, occurred more frequently in pts with BL CNS mets (30 pts [8%]) vs 18 pts [1%] with no BL CNS mets. Mean T-DM1 treatment duration was 8.0 months (median 8 cycles; range 1–55) in pts with BL CNS mets and 9.4 months (median 9 cycles; range 1–57) in pts with no BL CNS mets. Median PFS was 5.5 months in pts with BL CNS mets vs 7.9 months in pts with no BL CNS mets. A decrease in the size of brain target lesions was observed during T-DM1 treatment in 84 of 126 pts with measurable CNS lesions. Table 1. BL characteristics CNS mets at BL (n=399)No BL CNS mets (n=1618)Median age, yrs (range)52 (28–83)55 (26–88)ECOG performance status, n (%)  0193 (48)929 (57)1174 (44)605 (37)232 (8)83 (5)Hormone receptor status, n (%)  ER and/or PR positive246 (62)992 (61)ER and PR negative149 (37)593 (37)Median time since initial BC diagnosis, yrs (range)4.8 (0–28)5.0 (0–53)Median time since first metastasis, yrs (range)2.4 (0–25)2.6 (0–35)Median number of prior therapies for metastatic BC (range)3 (0– & gt;10)2 (0– & gt;10) Conclusions This subgroup analysis of KAMILLA is the largest reported cohort of pts with CNS mets treated with T-DM1. The overall safety profile of T-DM1 in pts with BL CNS mets was comparable to that of pts without CNS mets. As might be expected in pts with CNS disease, serious neurological AEs occurred more frequently in pts with BL CNS mets vs those without. Response to T-DM1 was seen in the CNS in pts with BL CNS mets, however, median PFS was lower in pts with BL CNS mets vs those without BL CNS mets. Citation Format: Montemurro F, Ellis P, Delaloge S, Wuerstlein R, Anton A, Button P, Lindegger N, Barrios C. Safety and efficacy of trastuzumab emtansine (T-DM1) in 399 patients with central nervous system metastases: Exploratory subgroup analysis from the KAMILLA study [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P1-12-10.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    RVK:
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    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2017
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  • 3
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 77, No. 4_Supplement ( 2017-02-15), p. P4-21-07-P4-21-07
    Abstract: Background: First-line (1L) docetaxel+trastuzumab+pertuzumab (THP) is approved for HER2-positive metastatic breast cancer (MBC), based on superior progression-free (PFS) and overall survival vs TH in the phase III CLEOPATRA trial. Predefined CLEOPATRA subgroup analyses suggested that THP use should not be limited by patient (pt) age: toxicity was increased but efficacy was similar in pts ≥65 vs & lt;65 years. PERUSE (NCT01572038) examined investigator's choice of taxane+HP for HER2-positive locally recurrent (LR)/MBC. We report preliminary safety and efficacy in pts ≥65 and & lt;65 years. Methods: In this multicentre, single-arm phase IIIb study, pts with ECOG PS ≤2 and no prior systemic therapy for LR/MBC (except endocrine therapy) receive investigator's choice of T, paclitaxel (PAC), or nab-PAC + H (8→6 mg/kg q3w) + P (840→420 mg q3w) until disease progression/unacceptable toxicity. The primary endpoint is safety. Secondary endpoints include PFS, estimated using the Kaplan–Meier method. Results: At data cutoff (1 Apr 2016), 1436 pts were included in the safety/ITT populations. 312 pts (22%) were aged ≥65 at study entry; they were more likely to have comorbidities than the & lt;65 group (91% vs 69%, including vascular disorders [56% vs 22%]; most commonly hypertension [51% vs 17%] ) and be ECOG PS 1–2 (50% vs 38%). Proportions of pts with visceral and hormone receptor-positive disease were similar (78% vs 74% and 65% vs 64%, respectively). Median duration of chemotherapy was similar but median exposure to antibodies was shorter in the ≥65 vs & lt;65 group: H 11.7 mo (range & lt;1–45.8) vs 17.5 mo ( & lt;1–45.9); P 11.6 mo ( & lt;1–45.8) vs 17.8 mo ( & lt;1–45.9). Interruptions/discontinuations due to treatment-emergent adverse events (TEAEs) were more common in pts ≥65 compared with pts & lt;65 with respect to taxanes (50% vs 35%), H (41% vs 26%), and P (38% vs 23%). TEAEs related to taxanes, H, and P were generally similar in pts aged ≥65 and & lt;65 (93% each, 67% vs 62%, and 71% vs 70%, respectively). Serious TEAE rates and most common grade ≥3 TEAEs of interest are shown in table 1. Table 1Pts, n (%)  & lt;65  ≥65   n=1124  n=312  TPACNab-PACTPACNab-PAC n=638n=431n=51n=137n=158n=14Serious223 (35)124 (29)18 (35)59 (43)61 (39)3 (21)Grade ≥3      Neutropenia88 (14)18 (4)1 (2)22 (16)13 (8)0Diarrhea45 (7)33 (8)3 (6)17 (12)17 (11)1 (7)Febrile neutropenia67 (11)5 (1)014 (10)2 (1)0Fatigue19 (3)3 (1)1 (2)2 (1)7 (4)0Asthenia9 (1)2 ( & lt;1)07 (5)8 (5)0Peripheral neuropathy8 (1)8 (2)02 (1)7 (4)0Anemia9 (1)4 (1)1 (2)2 (1)8 (5)1 (7)Left ventricular dysfunction05 (1)01 (1)4 (3)1 (7) Preliminary median PFS at the time of this analysis was 23.2 mo in the & lt;65 group (95% CI 20.7–25.3; median follow-up 18 mo) and 14.7 mo in the ≥65 group (95% CI 12.8–20.2; median follow-up 14 mo); 511/1124 (45%) and 116/312 (37%) pts were censored, respectively. Conclusion: Preliminary findings with 1L taxane+HP in this large cohort of LR/MBC pts show that pts aged ≥65 years had more comorbidities and poorer PS at study entry compared with those aged & lt;65, and that serious TEAEs were noted more frequently. Treatment exposure and PFS were shorter for pts aged ≥65. Citation Format: Miles D, Schneeweiss A, Peretz-Yablonski T, Ciruelos E, Puglisi F, Easton V, Lindegger N, Restuccia E, Bachelot T. Preliminary safety and efficacy of first-line pertuzumab combined with trastuzumab and taxane therapy in patients ≥65 years with HER2-positive locally recurrent/metastatic breast cancer: Subgroup analyses of the PERUSE study [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-21-07.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    RVK:
    RVK:
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2017
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    detail.hit.zdb_id: 410466-3
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  • 4
    Online Resource
    Online Resource
    Wiley ; 2014
    In:  The Journal of Clinical Pharmacology Vol. 54, No. 3 ( 2014-03), p. 291-300
    In: The Journal of Clinical Pharmacology, Wiley, Vol. 54, No. 3 ( 2014-03), p. 291-300
    Abstract: Macitentan is under development for the treatment of pulmonary arterial hypertension (PAH). Patients with PAH may suffer from comorbidities such as renal or hepatic impairment. Two prospective, single‐center, open‐label studies evaluated the pharmacokinetics of macitentan and its metabolites (pharmacologically active ACT‐132577 and inactive ACT‐373898) in healthy subjects and in subjects with mild, moderate, and severe hepatic impairment or severe renal function impairment (SRFI). After administering a single oral dose of 10 mg macitentan the pharmacokinetic parameters including area under the curve from zero to infinity (AUC ∞ ) were derived from plasma concentration–time profiles. Exposure to macitentan and ACT‐132577 was lower in hepatically impaired versus healthy subjects, with no correlation with the degree of hepatic impairment. Exposure to ACT‐373898 was lower in subjects with moderate hepatic impairment only. Plasma concentration–time profiles for macitentan and ACT‐132577 (active) were similar in healthy subjects and subjects with SRFI. AUC ∞ of ACT‐373898 (inactive) was 7.3‐fold higher in subjects with SRFI versus healthy subjects. No safety concerns were raised in either study. Based on these observations, pharmacokinetic alterations of macitentan due to hepatic or renal function impairment are not considered clinically relevant and no dose adjustment is necessary in these patients.
    Type of Medium: Online Resource
    ISSN: 0091-2700 , 1552-4604
    URL: Issue
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    Language: English
    Publisher: Wiley
    Publication Date: 2014
    detail.hit.zdb_id: 2010253-7
    SSG: 15,3
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  • 5
    In: Annals of Oncology, Elsevier BV, Vol. 30 ( 2019-10), p. v129-
    Type of Medium: Online Resource
    ISSN: 0923-7534
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2019
    detail.hit.zdb_id: 2003498-2
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  • 6
    Online Resource
    Online Resource
    Informa UK Limited ; 1994
    In:  Chronobiology International Vol. 11, No. 2 ( 1994-01), p. 65-71
    In: Chronobiology International, Informa UK Limited, Vol. 11, No. 2 ( 1994-01), p. 65-71
    Type of Medium: Online Resource
    ISSN: 0742-0528 , 1525-6073
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 1994
    detail.hit.zdb_id: 2026725-3
    SSG: 12
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  • 7
    Online Resource
    Online Resource
    Elsevier BV ; 2008
    In:  Journal of Molecular and Cellular Cardiology Vol. 45, No. 1 ( 2008-07), p. 28-31
    In: Journal of Molecular and Cellular Cardiology, Elsevier BV, Vol. 45, No. 1 ( 2008-07), p. 28-31
    Type of Medium: Online Resource
    ISSN: 0022-2828
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2008
    detail.hit.zdb_id: 1469767-1
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  • 8
    In: Pulmonary Pharmacology & Therapeutics, Elsevier BV, Vol. 29, No. 1 ( 2014-10), p. 41-48
    Type of Medium: Online Resource
    ISSN: 1094-5539
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2014
    detail.hit.zdb_id: 1471690-2
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  • 9
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 77, No. 4_Supplement ( 2017-02-15), p. P4-21-04-P4-21-04
    Abstract: Background: First-line (1L) docetaxel+trastuzumab+pertuzumab (THP) for HER2-positive metastatic breast cancer (MBC) significantly improved progression-free survival (PFS) and overall survival in the phase III CLEOPATRA trial, and led to the approval of this regimen. PERUSE (NCT01572038) was designed to assess the safety and efficacy of investigator's choice of taxane+HP for 1L locally recurrent (LR)/MBC, and allows exploration of safety and efficacy in a larger population. Methods: PERUSE is a multicenter, single-arm phase IIIb study. Patients (pts) with Eastern Cooperative Oncology Group performance status ≤2 and no prior systemic therapy for LR/MBC (except endocrine therapy) receive T, paclitaxel (PAC), or nab-PAC plus H (8 mg/kg→6 mg/kg every 3 weeks [q3w]) and P (840 mg→420 mg q3w) until disease progression (PD) or unacceptable toxicity. The primary endpoint is safety. Secondary endpoints include best overall response (BOR) and PFS. Results: The safety/ITT population includes 1436 pts at data cutoff (1 Apr 2016). Median follow-up was 17.2 mo (range, & lt;1–41.4). The median pt age was 54 years (range 23–87), 64% had hormone receptor-positive disease, 27% received adjuvant H, and 75% had visceral disease. Pts received T, PAC, nab-PAC, H, and P for a median of 3.8 mo (range & lt;1–24.2; n=791), 4.2 mo ( & lt;1–36.6; n=618), 3.9 mo ( & lt;1–17.3; n=73), 16.0 mo ( & lt;1–45.9; n=1435), and 16.1 mo ( & lt;1–45.9; n=1436), respectively. Most pts discontinued taxanes for 'other' reasons (25%), adverse events (AEs; 16%), PD, or investigator decision (15% each); H, for PD or AEs (46% and 7%); and P, for PD or AEs (46% and 8%). Grade ≥3 treatment-emergent AEs (TEAEs) of interest are shown in table 1. Serious TEAEs were reported in 282 (36%) pts on T, 185 (31%) on PAC, and 21 (32%) on nab-PAC. Preliminary efficacy by taxane is shown in table 2. Table 1Pts, n (%)TPACNab-PAC n=775n=589n=65Neutropenia110 (14)31 (5)1 (2)Diarrhea62 (8)50 (8)4 (6)Febrile neutropenia81 (10)7 (1)0Fatigue21 (3)10 (2)1 (2)Asthenia16 (2)10 (2)0Peripheral neuropathy10 (1)15 (3)0Anemia11 (1)12 (2)2 (3)Left ventricular dysfunction1 ( & lt;1)9 (2)1 (2) Table 2 TPACNab-PACBOR, based on pts with measureable disease at baseline, n (%)n=659n=482n=53Complete72 (11)80 (17)4 (8)Partial442 (67)319 (66)38 (72)Stable disease112 (17)62 (13)8 (15)PD18 (3)12 (2)2 (4)Missing15 (2)9 (2)1 (2)PFS, ITT populationn=775n=589n=65Pts with events, n (%)439 (57)324 (55)40 (62)Median, mo (95% confidence interval)19.6 (17.4–22.6)24.8 (20.7–27.0)18.1 (11.9–34.2)25th–75th percentile, mo9.4–not reached (NR)10.2–NR7.9–NR Conclusion: The preliminary findings of this large, single-arm study suggest that safety and efficacy of 1L taxane+HP for HER2-positive LR/MBC are in keeping with the results of the phase III CLEOPATRA study. There was less febrile neutropenia with PAC/nab-PAC+HP compared with THP, and preliminary PFS was similar to that seen in the CLEOPATRA study for all taxane+HP combinations. Citation Format: Bachelot T, Puglisi F, Ciruelos E, Peretz-Yablonski T, Schneeweiss A, Easton V, Lindegger N, Restuccia E, Miles D. Preliminary safety and efficacy of first-line pertuzumab combined with trastuzumab and taxane therapy for HER2-positive locally recurrent/metastatic breast cancer (PERUSE) [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-21-04.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    RVK:
    RVK:
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2017
    detail.hit.zdb_id: 2036785-5
    detail.hit.zdb_id: 1432-1
    detail.hit.zdb_id: 410466-3
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  • 10
    In: British Journal of Surgery, Oxford University Press (OUP), Vol. 110, No. 7 ( 2023-06-12), p. 804-817
    Abstract: Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries.
    Type of Medium: Online Resource
    ISSN: 0007-1323 , 1365-2168
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2006309-X
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