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  • 1
    Language: English
    In: Journal of Cancer Research and Clinical Oncology, 2013, Vol.139(10), pp.1771-1775
    Description: Byline: Wolfgang Lamm (1), Johannes Drach (1), Barbara Kiesewetter (1), Christoph C. Zielinksi (1), Marius E. Mayerhofer (2), Leonhard Mullauer (3), Markus Raderer (1) Keywords: Rituximab; Cytarabine; Oxaliplatin; Mantle cell lymphoma; Relapse Abstract: Purpose The management of patients with mantle cell lymphoma (MCL) not eligible for stem cell transplantation in relapse after receiving standard approaches remains challenging, and the search for active and tolerable regimens is still warranted. Patients and methods We have retrospectively analyzed activity of rituximab (375 mg/m.sup.2 i.v. day 1), Ara-C (1,000 mg i.v. total twice daily on day 2) and oxaliplatin (130 mg/m.sup.2 i.v. day 3) (R-ADOx) in 12 patients (median age 69 years) with relapsed MCL. Results Patients had been heavily pretreated (median 3 prior therapies, range 1--9) and had stage III/IV disease. Nine out of 12 patients responded (75 %, 4 CR, 5 PR). Median progression-free survival was 9.3 months, and overall survival has not been reached. Adverse events greater than grade II included anemia (17 %) and thrombocytopenia (33 %). Conclusion R-ADOx is active and well tolerated in heavily pretreated MCL patients. Author Affiliation: (1) Clinical Division of Oncology, Department of Internal Medicine I, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria (2) Department of Radiology, Medical University of Vienna, Vienna, Austria (3) Department of Pathology, Medical University of Vienna, Vienna, Austria Article History: Registration Date: 09/07/2013 Received Date: 20/05/2013 Accepted Date: 09/07/2013 Online Date: 20/07/2013
    Keywords: Rituximab ; Cytarabine ; Oxaliplatin ; Mantle cell lymphoma ; Relapse
    ISSN: 0171-5216
    E-ISSN: 1432-1335
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  • 2
    Language: English
    In: Cancer, 01 February 2011, Vol.117(3), pp.534-44
    Description: Sunitinib and sorafenib are tyrosine kinase inhibitors that have important antitumor activity in metastatic renal cell carcinoma (mRCC). Hypothyroidism constitutes a commonly reported side effect of both drugs, and particularly of sunitinib. The objective of this analysis was to investigate whether the occurrence of hypothyroidism during treatment with sunitinib and sorafenib affects the outcome of patients with mRCC. Eighty-seven consecutive patients with mRCC who were to receive treatment with sunitinib or sorafenib were included in a prospective analysis. Thyroid function was assessed in each patient every 4 weeks during the first 2 months of treatment and every 2 to 4 months thereafter. Assessment included serum levels of thyroid-stimulating hormone (TSH), tri-iodthyronine (T3), and thyroxine (T4). Subclinical hypothyroidism was defined as an increase in TSH above the upper limit of normal (〉3.77 μM/mL) with normal T3 and T4 levels. Subclinical hypothyroidism was evident in 5 patients at baseline and occurred in 30 patients (36.1%) within the first 2 months after treatment initiation. There was a statistically significant correlation between the occurrence of subclinical hypothyroidism during treatment and the rate of objective remission (hypothyroid patients vs euthyroid patients: 28.3% vs 3.3%, respectively; P 〈 .001) and the median duration of survival (not reached vs 13.9 months, respectively; hazard ratio, 0.35; 95% confidence interval, 0.14-0.85; P = .016). In multivariate analysis, the development of subclinical hypothyroidism was identified as an independent predictor of survival (hazard ratio, 0.31; P = .014). The current results indicated that hypothyroidism may serve as a predictive marker of treatment outcome in patients with mRCC. Thus, the interpretation of hypothyroidism during treatment with sunitinib and sorafenib as an unwanted side effect should be reconsidered.
    Keywords: Antineoplastic Agents -- Therapeutic Use ; Benzenesulfonates -- Therapeutic Use ; Carcinoma, Renal Cell -- Complications ; Indoles -- Therapeutic Use ; Kidney Neoplasms -- Complications ; Pyridines -- Therapeutic Use ; Pyrroles -- Therapeutic Use
    ISSN: 0008-543X
    E-ISSN: 10970142
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  • 3
    In: PLoS ONE, 2015, Vol.10(8)
    Description: Objective C-reactive protein (CRP) has previously been shown to serve as a prognostic parameter in women with gynecologic malignancies. Due to the lack of valid prognostic markers for uterine leiomyosarcoma (ULMS) this study set out to investigate the value of pre-treatment CRP serum levels as prognostic parameter. Methods Data of women with ULMS were extracted from databases of three Austrian centres for gynaecologic oncology. Pre-treatment CRP serum levels were measured and correlated with clinico-pathological parameters. Univariate and multivariable survival analyses were performed. Results In total, 53 patients with ULMS were included into the analysis. Mean (SD) CRP serum level was 3.46 mg/dL (3.96). Solely, an association between pre-treatment CRP serum levels and tumor size ( p = 0.04) but no other clinic-pathologic parameter such as tumor stage ( p = 0.16), or histological grade ( p = 0.07), was observed. Univariate and multivariable survival analyses revealed that CRP serum levels ( HR 2 . 7 [1 . 1–7 . 2] , p = 0.037) and tumor stage ( HR 6 . 1 [1 . 9–19 . 5] , p = 0.002) were the only independent prognostic factors for overall survival (OS) in patients with ULMS. Patients with high pre-treatment CRP serum levels showed impaired OS compared to women with low levels (5-year-OS rates: 22.6% and 52.3%, p = 0.007). Conclusion High pre-treatment CRP serum levels were independently associated with impaired prognosis in women with ULMS and might serve as a prognostic parameter in these patients.
    Keywords: Research Article
    E-ISSN: 1932-6203
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  • 4
    In: PLoS ONE, 2014, Vol.9(4)
    Description: Background Endothelial progenitor cells (CEPs) and circulating endothelial cells (CECs) are potential biomarkers of response to anti-angiogenic treatment regimens. In the current study, we investigated the effect of docetaxel and sunitinib on CEP/CEC kinetics and clinical response in castration resistant prostate cancer (CRPC) patients. Patients and methods Chemonaive patients with CRPC were enrolled in this study to receive either sunitinib (37.5 mg/d), in combination with docetaxel (75 mg/m 2 ) or docetaxel alone. CEP and CEC kinetics were analyzed for every cycle. The primary objective was to compare CEP/CEC pharmacodynamics between both treatment arms. We also investigated if CEC/CEP spikes, induced by MTD docetaxel, are suppressed by sunitinib in patients treated with docetaxel/sunitinib relative to docetaxel monotherapy. Results A total of 27 patients were enrolled. We observed a significant increase of CEP/CEC (total/viable) counts over time within each cycle (coefficients 0.29233, 0.22092 and 0.26089, respectively; p〈0.001). However, no differences between the treatment groups, in terms of CEP and CEC kinetics, were detected. In the docetaxel monotherapy arm 4 (30%) patients responded to therapy with a 50% PSA decline, while 9 (64%) patients showed a PSA decline in the combination group (n.s.). The median PFS in the docetaxel monotherapy group was 3.1 months (2.6–3.6 months, 95% CI) and 6.2 months (4.9–7.4 months, 95% CI; p = 0.062) in the combination arm. Sunitinib/docetaxel was reasonably well tolerated and toxicity manageable. Conclusion In summary, no significant differences in CEC and CEP kinetics between the treatment arms were observed, although a highly significant increase of CEPs/CECs within each cycle over time was detected. These results mirror the challenge we have to face when employing anti-angiogenic strategies in CRPC. Additional preclinical research is needed to elucidate the underlying molecular mechanisms. However, docetaxel/sunitinib therapy resulted in a better response in terms of PSA decline and a trend towards improved PFS. Trial Registery clinicaltrialsregister.eu EudraCT 2007-003705-27
    Keywords: Research Article ; Medicine And Health Sciences
    E-ISSN: 1932-6203
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  • 5
    Language: English
    In: Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 01 August 2016, Vol.34(22), pp.2676-7
    ISSN: 0732183X
    E-ISSN: 1527-7755
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  • 6
    Language: English
    In: memo - Magazine of European Medical Oncology, 2013, Vol.6(2), pp.119-122
    Description: We present a case of a 23-year-old female patient with relapsed classical Hodgkin lymphoma in reduced general condition. She was refractory after multiple lines of prior chemotherapy including autologous stem cell transplantation. By applying a targeted therapy concept using brentuximab vedotin (SGN-35), the patient experienced a rapid clinical improvement with loss of B symptoms immediately after the first treatment cycle. Elevated serum levels for C-reactive protein (CRP) and lactate dehydrogenase (LDH) returned to normal, and a significant improvement of hemoglobin levels were observed. Moreover, after administration of 16 cycles, the patient remains in complete remission, lasting now for 〉 15 months. Tolerability of treatment was excellent without evidence of infections or peripheral neuropathy. This case illustrates the clinical potential of brentuximab vedotin in patients with end-stage Hodgkin lymphoma who would otherwise have only limited treatment options.
    Keywords: Brentuximab vedotin ; Chemotherapy ; Relapsed refractory CD30-positive disease ; Targeted therapy
    ISSN: 1865-5041
    E-ISSN: 1865-5076
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  • 7
    Language: English
    In: Wiener klinische Wochenschrift, 2015, Vol.127(3), pp.92-97
    Description: In addition to conventional chemotherapeutic regimens and autologous transplantation, novel agents are now part of the treatment armamentarium against multiple myeloma (MM). To evaluate the presumed benefit of novel agents, we performed an analysis of patients with MM at our institution before and after the availability of novel agents.In all, 200 consecutive patients with newly diagnosed MM (male = 119; female = 81; median age: 61.5 years) treated at our institution between June 1993 and December 2008 were included in this retrospective analysis. Patient cohorts were defined according to date of diagnosis (before and after 01-Jan-2000, respectively), treatment received (chemotherapy only vs. therapy including novel agents), risk profile (International Staging System (ISS)-stage), and cytogenetic features. Primary focus of the analysis was overall survival (OS).Median OS for MM patients who received conventional chemotherapy was 45.2 months and for patients who received novel agents 74.6 months (P 〈 0.01). OS for those patients who relapsed after autotransplantation before 2000 was 35.2 months, but 72.7 months (P 〈 0.01) for those patients with a later relapse. Prolongation of survival for patients receiving novel agents was most evident for patients with ISS stage III (median OS 68.4 vs. 11.2 months for patients with chemotherapy only; P 〈 0.01). MM patients with an intermediate risk had a longer median OS when receiving novel agents (47.2 vs. 32.8 months).Treatment with novel agents in MM resulted in a significant prolongation of OS. Benefit of therapy with novel agents was particularly evident for transplant-eligible patients and MM patients with unfavorable prognosis.Zusätzlich zur konventionellen Chemotherapie und der autologen Stammzelltransplantation gehören die sog. neuen Substanzen (Thalidomid, Bortezomib, Lenalidomid) nun zur Standardtherapie in der Behandlung des Multiplen Myeloms (MM). Um den Nutzen gegenüber der alleinigen Chemotherapie zu untersuchen, haben wir die Patienten mit Multiplen Myelom an unserer Institution vor und seit der Einführung der neuen Substanzen evaluiert.200 Patienten mit neudiagnostiziertem MM im Zeitraum zwischen Juni 1993 und Dezember 2008 (119 Männer; 81 Frauen; medianes Alter: 61,5 Jahre) wurden in diese retrospektive Analyse eingeschlossen. Patientenkohorten wurden anhand des Zeitpunkts der Erstdiagnose (vor und nach dem 1. Jänner 2000), der Therapie (alleinige Chemotherapie gegenüber Therapie einschließlich der neuen Substanzen), des Risikoprofils (ISS Stadium) und zytogenetischer Faktoren definiert. Primäres Ziel der Analyse war das Gesamtüberleben.Das mediane Gesamtüberleben für Patienten unter konventioneller Chemotherapie betrug 45,2 Monate gegenüber 74,6 Monate bei Behandlung inklusive neuer Substanzen (p 〈 0,01). Das Gesamtüberleben für Patienten mit Rezidiv nach autologer Transplantation war ebenfalls signifikant unterschiedlich (median 35,2 Monate vs. 72,7 Monate bei Rezidiv vor bzw. nach dem Jahr 2000; p 〈 0,01). Eine Verlängerung des Gesamtüberlebens unter neuen Substanzen war vor allem für Patienten mit hohem Risikoprofil (ISS Stadium III; 68,4 gegenüber 11,2 Monate; p 〈 0,01) zu beobachten. Auch Patienten mit einem intermediären Risikoprofil hatten ein längeres Gesamtüberleben mit den neuen Substanzen (47,2 gegenüber 32,8 Monate).Behandlung mit neuen Substanzen resultiert in einem verlängerten Gesamtüberleben beim MM. Der Nutzen zeigte sich insbesondere bei Patienten im Rezidiv nach autologer Stammzellentransplantation sowie Patienten mit ungünstigem Risikoprofil.
    Keywords: Bortezomib ; Conventional chemotherapy ; Lenalidomide ; Multiple myeloma ; Thalidomide
    ISSN: 0043-5325
    E-ISSN: 1613-7671
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  • 8
    Language: English
    In: Oncology research and treatment, 2018, Vol.41(9), pp.534-538
    Description: For patients aged 60 years or older, the treatment of relapsed aggressive B-cell lymphomas remains challenging. The purpose of this retrospective analysis was to evaluate the results of the R-ICE (rituximab, ifosfamide, carboplatin, etoposide) protocol alone as compared to R-ICE followed by high-dose chemotherapy with autologous transplantation. The 3-year progression-free survival (PFS) and overall survival (OS) rates in 17 patients receiving R-ICE without transplantation were 32% (95% confidence interval (CI): 8.48-55.52) and 35% (95% CI: 11.48-58.52), respectively. Median PFS and OS times were 9 months (95% CI: 2-22) and 12 months (95% CI: 5-19), respectively. In 17 age-matched transplanted patients the respective survival rates were 18% (95% CI: 0.36-35.64) and 24% (95% CI: 4.4-43.6). Median PFS and OS times were 11 months (95% CI: 6-16) and 16 months (95% CI: 13-19), respectively. Thus, R-ICE alone is a reasonable treatment option for elderly patients with relapsed or refractory aggressive B-cell lymphomas.
    Keywords: Autologous Transplantation ; B-Cell Lymphoma ; Diffuse Large B-Cell Lymphoma ; Elderly Patients ; R-Ice ; Relapse ; Antineoplastic Combined Chemotherapy Protocols -- Therapeutic Use ; Lymphoma, B-Cell -- Therapy ; Neoplasm Recurrence, Local -- Therapy ; Stem Cell Transplantation -- Methods
    ISSN: 22965270
    E-ISSN: 2296-5262
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  • 9
    Language: English
    In: BMC Cancer, Sept 7, 2010, Vol.10, p.480
    Description: Background In the era of cytokines, patients with brain metastases (BM) from renal cell carcinoma had a significantly shorter survival than patients without. Targeted agents (TA) have improved the outcome of patients with metastatic renal cell carcinoma (mRCC) however, their impact on patients with BM is less clear. The aim of this analysis was to compare the outcome of patients with and without BM in the era of targeted agents. Methods Data from 114 consecutive patients who had access to targeted agent were analyzed for response rates (ORR), progression free survival (PFS) and overall survival (OS). All patients diagnosed with BM underwent local, BM-specific treatment before initiation of medical treatment. Results Data of 114 consecutive patients who had access to at least one type of targeted agents were analyzed. Twelve out of 114 renal cell carcinoma (RCC) patients (10.5%) were diagnosed with BM. Systemic treatment consisted of sunitinib, sorafenib, temsirolimus or bevacizumab. The median PFS was 8.7 months (95% CI 5.1 - 12.3) and 11.4 months (95% CI 8.7 - 14.1) for BM-patients and non-BM-patients, respectively (p = 0.232). The median overall survival for patients with and without BM was 13.4 (95% CI 1- 43.9) and 33.3 months (95% CI 18.6 - 47.0) (p = 0.358), respectively. No patient died from cerebral disease progression. ECOG Performance status and the time from primary tumor to metastases (TDM) were independent risk factors for short survival (HR 2.74, p = 0.001; HR: 0.552, p = 0.034). Conclusions Although extracerebral metastases determine the outcome of patients with BM, the benefit from targeted agents still appears to be limited when compared to patients without BM.
    Keywords: Antineoplastic Agents -- Dosage And Administration ; Brain Cancer -- Risk Factors ; Brain Cancer -- Diagnosis ; Brain Cancer -- Research ; Renal Cell Carcinoma -- Drug Therapy ; Renal Cell Carcinoma -- Development And Progression ; Renal Cell Carcinoma -- Patient Outcomes ; Renal Cell Carcinoma -- Research
    ISSN: 1471-2407
    Source: Cengage Learning, Inc.
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  • 10
    Language: English
    In: Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 10 February 2016, Vol.34(5), pp.e31-3
    Keywords: Aromatase Inhibitors -- Therapeutic Use ; Granulosa Cell Tumor -- Drug Therapy ; Neoplasm Recurrence, Local -- Drug Therapy ; Peritoneal Neoplasms -- Drug Therapy ; Tamoxifen -- Therapeutic Use
    ISSN: 0732183X
    E-ISSN: 1527-7755
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