Background: Everolimus/exemestane has been shown to improve progression-free survival in patients with endocrine-resistant metastatic breast cancer. The regimen has been well-accepted despite lack of ...survival benefit. In real-life setting, patients were not well-selected and hence benefit of such treatment may not be as robust. Method: This is a retrospective review of 143 hormone receptor (HR) positive, HER-2 negative MBC patients who progressed on nonsteroidal aromatase inhibitors. Patients who received everolimus/exemestane in any treatment lines (EE group) were compared to patients who never received everolimus (NE group). Primary end point was survival adjusted to prognostic factors. Results: There were 52 patients in EE group and 91 in NE group with mean age of 58.6 years. Median follow-up time was 51 months. Unadjusted median OS was significantly longer in EE 33 vs 25 months, HR 0.66 (95%CI 0.44-0.998); p = 0.049. In univariate analysis, factors affecting survival included numbers of metastatic sites, bone metastasis, EE treatment and numbers of treatment lines. Independent factors that remained significant in multivariate analysis were treatment lines HR 0.71 (95%CI 0.63-0.79); p < 0.05 and numbers of metastatic sites. Median numbers of treatment line after NSAI failure was 5.2 vs 3.6 lines in EE and NE, respectively.Conclusion: In this real-life practice data, pts with HR positive, HER-2 negative MBC who had progressed on NSAI, sequential use of multiple treatment regimens of endocrine and chemotherapy is essential to longer survival. Everolimus/exemestane may have contributed, to a lesser extent, to this improvement in survival.
The aim of this study was to examine the antioxidant activity of ginger extract oral supplement in newly diagnosed cancer patients receiving adjuvant chemotherapy compared to placebo.
Newly diagnosed ...cancer patients receiving moderate-to-high emetogenic potential adjuvant chemotherapy were randomized to receive either a ginger extract (standardized 6-gingerol 20 mg/day) or a placebo 3 days prior to chemotherapy, which they continued daily. Oxidant/antioxidant parameters, including the activities of superoxide dismutase (SOD) and catalase (CAT) and levels of glutathione peroxidase (GPx), total glutathione (GSH/GSSG), lipid peroxidation products detected as malondialdehyde (MDA) and NO
/NO
, were measured at baseline and at days 1, 22, 43 and 64 after undergoing chemotherapy. Two-sided statistical analysis, with
< 0.05, was used to determine statistical significance.
A total of 43 patients were included in the study: 19 and 24 patients were randomly assigned to the ginger group and placebo group, respectively. Antioxidant activity parameters, including SOD, CAT, GPx and GSH/GSSG, were significantly increased at day 64 in the ginger group compared to those in the placebo group, while MDA and NO
/NO
levels were significantly decreased (
< 0.0001). When compared to the baseline, the activities of SOD and CAT and the levels of GPx and GSH/GSSG were significantly higher on day 64 (
= 0.01), while the blood levels of MDA and NO
/NO
were significantly decreased (
< 0.01).
Daily supplement of ginger extract started 3 days prior to chemotherapy has been shown to significantly elevate antioxidant activity and reduce oxidative marker levels in patients who received moderate-to-high emetogenic potential chemotherapy compared to placebo.
Abstract only
e24138
Background: Advance cancer patients frequently have breathlessness and worsening by refractory to conventional therapies, which need adjunctive therapy. Nebulized Fentanyl and ...nebulized furosemide have been identified as a novel symptoms approach. Individual patients with the same breathlessness conditions may respond differently to similar treatments, thus no standard adjunctive treatments. N-of -1 study is a within-patient randomized, double-blind, and crossover trials in 1 patient. This study aims to comparing the efficacy in relief breathlessness. Methods: N-of-1 study which enrolled patients at Ramathibodi hospital who have breathlessness with mMRC scored ≥ 3 from 1
st
Jan 2019 to 31
st
Jan 2020. Study was done as 1 cycle of 3-days of treatment that nebulized fentanyl or furosemide or sterile water (SW). Fentanyl 50 mcg or Furosemide 40 mg or SW that all diluted in SW to be in 6 ml. Jet nebulizer increased delivery of aerosol to lungs that all administered for 4 minutes. Main outcome measured breathlessness intensity Borg scale: 0-10, peripheral capillary O2 saturation, Visual cough score, satisfactions, and adverse events (AEs) that collected at baseline, 15, 30 and 60 minutes post treatment. Type of medication that patients preferred. Results: 19 patients were enrolled; 68.4% were ECOG status 4. All patient previously treated with systemic opioids with dose 29.8±20.9 mg/day. Majority were diagnosed with lung metastatic cancer. Baseline of mean Borg scale were not significant in all groups. All 3 medications significantly reduced Borg scale over time; Fentanyl -2.84 ± 0.17(95% CI -3.19 to -2.49); p = 0.0001, Furosemide -3.05±0.22 (95% CI -3.49 to -2.61); p = 0.0001, and SW -2.52±0.21 (95% CI -2.95 to -2.10); p = 0.0001. No significantly different in reduction of breathlessness, AEs and change in visual cough score in all medications. Most of AEs were mild grade. Majority of patients’ preference was furosemide (42.0%). Conclusions: Adjunctive treatment nebulizer drugs with fentanyl, furosemide and sterile water significantly improve breathlessness symptoms. No significant different in efficacy, adverse events in nebulized fentanyl, furosemide and sterile water. N-of-1 trials may provide a rational and effective method to best choose drugs for individuals with breathlessness.
This study aimed to evaluate the participants' comfort in understanding research papers written in English and discussing such research in English via an Asian online journal club.
A ...self-administered online survey was delivered to seven journal club meeting attendees from July 2020 to July 2021. A customer satisfaction analysis was performed to assess the association between the participants' perspectives on program logistics and satisfaction.
The recovery rate was 37.0% (44/119). After participating in the journal club, the median scores of critical appraisal skills, knowledge and/or pharmaceutical care skills in clinical practice, and discussion skills in English (assessed using a seven-point Likert scale) improved significantly (compared to pre-participation median scores) from 4 (interquartile range IQR: 3-5) to 5 (IQR: 4-6), 5 (IQR: 4-5) to 5 (IQR: 5-6), and 4 (IQR: 2-5) to 5 (IQR: 3-5), respectively (
< 0.0001). The respondents also expressed great appreciation for the benefits and overall qualities of the journal club. Additionally, regarding patient care behavior after participation in the journal club, 34 (77.3%), 17 (38.6%), 16 (36.4%), and 14 (31.8%) respondents reported improvement in "drug information services," "patient assessments," "patient counseling," and "multidisciplinary rounds," respectively. Customer satisfaction analysis revealed that sharing information, mutual discussion, a shift system of presenters and co-chairs, and session duration should be improved as a matter of highest priority.
The findings suggest that our program could be helpful for Asian pharmacists, pharmacy students, and faculty members of the department of pharmacy.
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IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, UKNU, UL, UM, UPUK
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