Optimal treatment of early stage breast cancer remains an active area of study. An expert multidisciplinary committee reviewed clinical data on systemic therapy for early stage, stage I and II breast ...cancer. Guidelines for treatment were developed for Texas Oncology. P.A., the largest private practice group of oncologists in the United States. This group of physicians treats approximately 5000 new breast cancer patients each year and has a major impact on oncology care in the state of Texas. These guidelines identify prognostic factors which help the practitioner in choosing treatment for patients. Subsets of patients are identified for whom no systemic therapy is warrented. Standard chemotherapy and hormonal therapy regimens are outlined for patients with early stage disease at increased risk for relapse. Dose intensification for high risk stage II patients is reviewed. Timing of therapy and the sequencing of chemotherapy and radiation therapy is addressed. Strategies for the follow-up of patients with a history of breast cancer are outlined.
Ocular Metastases from Breast Cancer Mennel, Robert G.
Clinical breast cancer,
2001, 2001-Jan, 2001-1-00, 20010101, Letnik:
1, Številka:
4
Journal Article
Recenzirano
Breast cancer is the most common cancer to metastasize to the eye. This is thought to be a rare occurrence but may be more common than thought. Two cases with eye metastases from breast cancer are ...presented to acquaint physicians with this entity. Other tumors that metastasize to the eye, the anatomic location of metastases in the eye, and the evaluation, treatment, and prognosis of breast cancer metastatic to the eye are discussed.
Purpose To evaluate intravitreal aflibercept for treatment of macular edema secondary to central retinal vein occlusion (CRVO). Design Randomized, double-masked, phase 3 study. Methods A total of 177 ...patients with macular edema secondary to CRVO were randomized to receive 2 mg intravitreal aflibercept (n = 106) or sham (n = 71) every 4 weeks for 20 weeks. From weeks 24 to 48, patients were monitored every 4 weeks; the former group received intravitreal aflibercept as needed (PRN), and the sham group received sham. From weeks 52 to 76, patients were monitored every 8 weeks, and both groups received intravitreal aflibercept PRN. The primary endpoint (proportion of patients who gained ≥15 letters) was at week 24. This study reports exploratory outcomes at week 76. Results The proportion of patients who gained ≥15 letters in the intravitreal aflibercept and sham groups was 60.2% vs 22.1% at week 24 (patients discontinued before week 24 were considered nonresponders; P < .0001), 60.2% vs 32.4% at week 52 (last observation carried forward, P < .001), and 57.3% vs 29.4% at week 76 (last observation carried forward; P < .001). Mean μm change from baseline central retinal thickness was −448.6 vs −169.3 at week 24 ( P < .0001), −423.5 vs −219.3 at week 52 ( P < .0001), and −389.4 vs −306.4 at week 76 ( P = .1122). Over 76 weeks, the most common ocular serious adverse event in the intravitreal aflibercept group was macular edema (3.8%). Conclusions The visual and anatomic improvements seen after fixed, monthly dosing at week 24 were largely maintained when treatment intervals were extended. Patients with macular edema following CRVO benefited from early treatment with intravitreal aflibercept.
A new combination of mitoxantrone, folinic acid (leucovorin), and infusional fluorouracil (5-FU) was administered to 57 previously treated patients with metastatic breast cancer to evaluate the ...response rate, response duration, and toxicity of this regimen. Fifty-three patients who received 313 courses of therapy were assessable for response and toxicity. Median age was 48 years (range, 33 to 80 years), and the patients had received an average of 1.5 chemotherapy regimens before this study. Of 53 assessable patients, 24 (45%, or 42% of all entered patients) experienced partial responses (PRs) with a median duration of 6 months (range, 2 to 13 months). Nine (69%) of 13 assessable patients without prior doxorubicin treatment responded, compared with 15 (38%) of 40 with prior doxorubicin (P less than .05). Toxicity was generally mild with dose reductions necessitated more often by mucositis and/or diarrhea than by myelosuppression. One patient with prior high-dose doxorubicin treatment developed congestive heart failure. The combination of mitoxantrone, leucovorin, and infusional 5-FU is an active and well-tolerated regimen for metastatic breast cancer and deserves further evaluation in patients without prior doxorubicin therapy.
We compared the efficacy and safety of the oral aromatase inactivator exemestane (EXE) with megestrol acetate (MA) in women with metastatic breast cancer. This phase III randomized, double-blind, ...multicenter study was conducted in 769 postmenopausal women who had experienced tamoxifen failure. Treatment arms consisted of EXE 25 mg once daily (n = 366) or MA 40 mg four times daily (160 mg daily; n = 403). Peerreviewed, intent-to-treat analyses demonstrated that EXE induced a trend toward higher rates of complete response (CR) + partial response (PR) (15.0% vs. 12.4%) and of CR + PR + stable disease (SD) ≥ 24 weeks (37.4% vs. 34.6%), but differences were not statistically significant. Statistically significant differences favoring EXE were seen in median duration of CR + PR + SD ≥ 24 weeks (60.1 vs. 49.1 weeks;
P = 0.025), time to tumor progression (20.3 vs. 16.6 weeks;
P = 0.037), time to treatment failure (16.3 vs. 15.7 weeks;
P = 0.042), and overall survival (not reached vs. 123.4 weeks;
P = 0.039). Both treatments were well tolerated, but MA was associated with more grade 3 or 4 weight gain (8% vs. 17%,
P = 0.001); the pain score was similar in both groups. There was a trend toward superiority in treatment-related signs and symptoms (TRSS) with EXE. There was greater improvement in the pain score and TRSS in patients achieving an objective response with EXE vs. MA. Quality of life improved or was similar for EXE in most domains. Exemestane offers an important new treatment option for postmenopausal women with hormone-responsive breast cancer.
Registration of ‘Hardy 2519’ wheat Liu, Limei; Griffey, Carl Allen; Brooks, Wynse S. ...
Journal of plant registrations,
20/May , Letnik:
16, Številka:
2
Journal Article
Recenzirano
Odprti dostop
‘Hardy 2519’ (Reg. no. CV‐1189, PI 692613), a hard red winter (HRW) wheat (Triticum aestivum L.) cultivar, was derived from the cross VA06HRW‐108 × ‘Vision 30’ (PI 661153) using a modified bulk ...breeding method. Hardy 2519 was tested as VA14HRW‐25 in replicated yield trials in Virginia (2015–2018) and in the USDA‐ARS Uniform Bread Wheat Trials (2016–2018) and released by the Virginia Agricultural Experiment Station in 2019. Hardy 2519 is a widely adapted, high‐yielding HRW wheat with 2*, 5+10 gluten subunits. Hardy 2519 is awned, semidwarf (Rht 2 gene) with medium spike emergence, resistant to leaf rust, and moderately resistant to powdery mildew in the mid‐Atlantic region. In the Virginia Bread Wheat Elite Trials from 2018 to 2020, Hardy 2519 produced a mean yield of 5,393 kg ha–1, which was similar to that of the HRW wheat cultivar ‘Vision 45’ (PI 667642) at 5,267 kg ha–1. Hardy 2519 has acceptable milling and baking quality on the basis of comparisons with the HRW wheat check cultivar ‘Jagger’.
Core Ideas
Hardy 2519 is a hard red winter wheat.
Hardy 2519 has high yield potential.
Hardy 2519 resists leaf rust.
Treatment of advanced melanoma has significantly improved with the advent of checkpoint inhibitor therapy. With the widespread use of these agents, side effects are being increasingly recognized, ...including immune-related adverse events. We report the onset of adrenal insufficiency in a patient with advanced melanoma who was exposed to two checkpoint inhibitors: ipilimumab and nivolumab. His symptoms initially resolved with steroid replacement but he was unable to be weaned off hormone replacement and required long-term oral hydrocortisone treatment.
Background. New salvage chemotherapy is needed for metastatic breast cancer. Cisplatin and VP‐16 have activity but considerable toxicity.
Methods. This study determines the response rate, response ...duration, and toxicity of a combination chemotherapy regimen of the better‐tolerated carboplatin plus VP‐16 in a group of patients with metastatic breast cancer and only one prior exposure to cytotoxic chemotherapy.
Results. Twenty‐three patients received an average of 2.8 courses of treatment before a lack of response or progression of disease was noticed. Four patients had evidence of rapidly progressive disease or early death and received only one course. No complete responses occurred, but three patients (13%) experienced partial responses. Mean response duration was 5 months. Metastatic disease which responded included lung, lymph node, and chest wall sites. Toxicity was mainly myelosuppression with 57% of patients having grade 3–4 neutropenia or thrombocytopenia. Two patients (8%) had significant infection with neutropenia requiring hospitalization but no toxic deaths occurred.
Conclusions. Carboplatin and VP‐16 at this dose and schedule was a reasonably well‐tolerated regimen with only modest activity in metastatic breast cancer as second‐line cytotoxic chemotherapy.
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