Search

Your search keyword '"Janos Revesz"' showing total 5 results
Start Over Author "Janos Revesz"
5 results on '"Janos Revesz"'

1. Correlation between fibroblast growth factor receptor mutation, programmed death ligand-1 expression and survival in urinary bladder cancer based on real-world data

Author

Janos Revesz, Boglarka Posfai, Laszlo Pajor, Timea Papdan, Linda Varga, Viktor R. Paczona, Zoltan Varga, Farkas Sukosd, and Aniko Maraz

Subjects
urinary bladder cancer, fibroblast growth factor receptor, FGFR mutation, programmed death-ligand 1 expression, combined positive score, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282, Pathology, RB1-214
Abstract

Background: Programmed cell death (PD)-1/PD-ligand 1 (PD-L1) inhibitors have made a breakthrough in the therapy of advanced urothelial bladder cancer (UBC). The impact of Fibroblast Growth Factor Receptor 3 (FGFR3) mutation on the effectiveness of PD-L1 treatment remains still unclear. Objective: Our study aimed to investigate the frequency of FGFR mutations at different tumor stages, and their relation to PD-L1 status and survival.Methods: 310 patients with urothelial bladder cancer and subsequent radical cystectomy were included in a retrospective study over a 10-year study period at the University of Szeged, Hungary. FGFR3 mutations from the most infiltrative areas of the tumor were analyzed by targeted next-generation sequencing and PD-L1 (28-8 DAKO) tests (tumor positive score -TPS and combined positives score–CPS). In T0 cases FGFR3 mutations were analyzed from the earlier resection samples. Survival and oncological treatment data were collected from the National Health Insurance Fund (NHIF). Neoadjuvant, adjuvant and palliative conventional chemotherapies were allowed; immunotherapies were not. The relationship between the covariates was tested using chi-square tests, and survival analysis was performed using the Kaplan-Meier model and Cox proportional hazards regression.Results: PD-L1 and FGFR could be tested successfully in 215 of the 310 UBC samples [pT0cyst 19 (8.8%); St.0-I 43 (20%); St.II 41 (19%); St.III-IV 112 (52%)]. Significant pairwise dependency was found between tumor stage, FGFR3 mutation status and PD-L1 expression (p < 0.01). Samples with FGFR mutation were more common in less advanced stages and were also less likely to demonstrate PD-L1 expression. The effect of all investigated factors on survival was found to correlate with tumor stage.Conclusion: FGFR alteration frequency varied between the different stages of cancer. Higher positivity rates were observed at early stages, but lower levels of PD-L1 expression were detected in patients with FGFR mutations across at all stages of the disease.

Published
2023
Full Text
View/download PDF

2. Pembrolizumab alone or combined with chemotherapy versus chemotherapy as first-line therapy for advanced urothelial carcinoma (KEYNOTE-361): a randomised, open-label, phase 3 trial

Author

Thomas Powles, Tibor Csőszi, Mustafa Özgüroğlu, Nobuaki Matsubara, Lajos Géczi, Susanna Y-S Cheng, Yves Fradet, Stephane Oudard, Christof Vulsteke, Rafael Morales Barrera, Aude Fléchon, Seyda Gunduz, Yohann Loriot, Alejo Rodriguez-Vida, Ronac Mamtani, Evan Y Yu, Kijoeng Nam, Kentaro Imai, Blanca Homet Moreno, Ajjai Alva, Diana Vera Cascallar, Mirta Varela, Mauricio Fernandez Lazzaro, Diego Lucas Kaen, Gabriela Gatica, David Hugo Flores, Agustin Falco, Matias Molina, Filip Van Aelst, Brieuc Sautois, Jean-Pascal Machiels, Denis Schallier, Leandro Brust, Liane Rapatoni, Sergio J Azevedo, Gisele Marinho, Joao Paulo Holanda Soares, Carlos Dzik, Jamile Almeida Silva, Andre Poisl Fay, Joel Gingerich, Cristiano Ferrario, Kylea Potvin, Marie Vanhuyse, Mahmoud Abdelsalam, Susanna Cheng, Christian Caglevic, Felipe Reyes, Jose Luis Leal, Francisco Francisco, Carolina Ibanez, Florence Joly, Brigitte Laguerre, Sylvain Ladoire, Aude Flechon, Delphine Topart, Olivier Huillard, Stéphane Oudard, Marine Gross-Goupil, Stephane Culine, Gwenaelle Gravis, Peter Reichardt, Margitta Retz, Jan Herden, David Pfister, Carsten Ohlman, Michael Stoeckle, Manfred Wirth, Anja Lorch, Guenter Niegisch, Peter J Goebell, Martin Boegemann, Axel Merseburger, Georgios Gakis, Jens Bedke, Andreas Neisius, Christian Thomas, Thomas Hoefner, Andras Telekes, Judit Erzsebet Kosa, Janos Revesz, Gyorgy Bodoky, Tibor Csoszi, Andras Csejtei, Lajos Geczi, Agnes Ruzsa, Zsuzsanna Kolonics, Jozsef Erfan, Ray McDermott, Richard Bambury, Avishay Sella, Stephen Jay Frank, Daniel Kejzman, Olesya Goldman, Eli Rosenbaum, Avivit Peer, Raanan Berger, Keren Rouvinov, David Sarid, Satoshi Fukasawa, Gaku Arai, Akito Yamaguchi, Akira Yokomizo, Tatsuya Takayama, Hidefumi Kinoshita, Eiji Kikuchi, Ryuichi Mizuno, Yasuhisa Fujii, Naoto Sassa, Yoshihisa Matsukawa, Kiyohide Fujimoto, Toshiki Tanikawa, Yoshihiko Tomita, Kazuo Nishimura, Masao Tsujihata, Masafumi Oyama, Naoya Masumori, Hiroomi Kanayama, Toshimi Takano, Yuji Miura, Jun Miyazaki, Akira Joraku, Tomokazu Kimura, Yoshiaki Yamamoto, Kazuki Kobayashi, Ronald De Wit, Maureen Aarts, Winald Gerritsen, Maartje Los, Laurens Beerepoot, Adel Izmailov, Sergey Igorevich Gorelov, Boris Yakovlevich Alekseev, Andrey Semenov, Vladimir Anatolyevich Kostorov, Sergey M Alekseev, Alexander Zyryanov, Vasiliy Nikolaevich Oschepkov, Vladimir Aleksandrovich Shidin, Vladimir Ivanovich Vladimirov, Rustem Airatovich Gafanov, Petr Alexandrovich Karlov, David Brian Anderson, Lucinda Shepherd, Graham Lawrence Cohen, Bernardo Louis Rapoport, Paul Ruff, Nari Lee, Woo Kyun Bae, Hyo Jin Lee, Urbano Anido Herranz, Enrique Grande, Teresa Alonso Gordoa, Josep Guma Padro, Daniel Castellano Gauna, Jose Angel Arranz, Jose Munoz Langa, Regina Girones Sarrio, Alvaro Montesa Pino, Maria Jose Juan Fita, Yu-Li Su, Yung-Chang Lin, Wen-Pin Su, Ying-Chun Shen, Yen-Hwa Chang, Yi-Hsiu Huang, Virote Sriuranpong, Phichai Chansriwong, Vichien Srimuninnimit, Pongwut Danchaivijitr, Huseyin Abali, Sinan Yavuz, Ozgur Ozyilkan, Mehmet Ali Nahit Sendur, Meltem Ekenel, Mustafa Ozguroglu, Cagatay Arslan, Mustafa Ozdogan, Alison Birtle, Robert Huddart, Maria de Santis, Anjali Zarkar, Linda Evans, Syed Hussain, Christopher DiSimone, Antonio F Muina, Peter Schlegel, Haresh S Jhangiani, Michael Harrison, Dennis E Slater, David Wright, Ivor J Percent, Jianqing Lin, Clara Hwang, Sumati Gupta, Madhuri Bajaj, Robert Galamaga, John Eklund, James Wallace, Mikhail Shtivelband, Jason Jung-Gon Suh, Nafisa Burhani, Matthew Eadens, Krishna Gunturu, Earle Burgess, John Wong, Arvind Chaudhry, Peter Van Veldhuizen, Stephanie Graff, Christian A Thomas, Ian D Schnadig, Benedito Carneiro, Maha Hussain, Alicia Morgans, John T Fitzharris, Ira A Oliff, Jacqueline Vuky, Ralph Hauke, Ari Baron, Monika Joshi, Britt H Bolemon, Peter Jiang, Anthony E Mega, Maurice Markus, Nicklas Pfanzelter, William Eyre Lawler, Patrick Wayne Cobb, Jay G Courtright, Sharad Jain, Gurjyot Doshi, Vijay K Gunuganti, Oliver Alton Sartor, Scott W Cole, Hani Babiker, Edward M Uchio, Alexandra Drakaki, Heather D Mannuel, Elizabeth Guancial, Chunkit Fung, Anthony Charles, Robert J Amato, Yull Arriaga, Isaac Bowman, Steven Ades, Robert Dreicer, Evan Yu, David I Quinn, Mark Fleming, University of Zurich, Powles, Thomas, KEYNOTE-361 Investigators, UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, UCL - (SLuc) Centre du cancer, and UCL - (SLuc) Unité d'oncologie médicale

Subjects
Male, medicine.medical_specialty, Time Factors, medicine.medical_treatment, Population, 610 Medicine & health, Pembrolizumab, Antibodies, Monoclonal, Humanized, Deoxycytidine, Gastroenterology, Carboplatin, 03 medical and health sciences, chemistry.chemical_compound, Antineoplastic Agents, Immunological, 0302 clinical medicine, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, Clinical endpoint, medicine, Humans, 030212 general & internal medicine, Progression-free survival, education, Immune Checkpoint Inhibitors, Aged, Chemotherapy, education.field_of_study, business.industry, Carcinoma, Hazard ratio, Middle Aged, Gemcitabine, Progression-Free Survival, Urinary Bladder Neoplasms, Oncology, chemistry, 030220 oncology & carcinogenesis, 10032 Clinic for Oncology and Hematology, Disease Progression, Female, 2730 Oncology, Human medicine, Cisplatin, Urothelium, business, medicine.drug
Abstract

Summary Background PD-1 and PD-L1 inhibitors are active in metastatic urothelial carcinoma, but positive randomised data supporting their use as a first-line treatment are lacking. In this study we assessed outcomes with first-line pembrolizumab alone or combined with chemotherapy versus chemotherapy for patients with previously untreated advanced urothelial carcinoma. Methods KEYNOTE-361 is a randomised, open-label, phase 3 trial of patients aged at least 18 years, with untreated, locally advanced, unresectable, or metastatic urothelial carcinoma, with an Eastern Cooperative Oncology Group performance status of up to 2. Eligible patients were enrolled from 201 medical centres in 21 countries and randomly allocated (1:1:1) via an interactive voice-web response system to intravenous pembrolizumab 200 mg every 3 weeks for a maximum of 35 cycles plus intravenous chemotherapy (gemcitabine [1000 mg/m2] on days 1 and 8 and investigator's choice of cisplatin [70 mg/m2] or carboplatin [area under the curve 5] on day 1 of every 3-week cycle) for a maximum of six cycles, pembrolizumab alone, or chemotherapy alone, stratified by choice of platinum therapy and PD-L1 combined positive score (CPS). Neither patients nor investigators were masked to the treatment assignment or CPS. At protocol-specified final analysis, sequential hypothesis testing began with superiority of pembrolizumab plus chemotherapy versus chemotherapy alone in the total population (all patients randomly allocated to a treatment) for the dual primary endpoints of progression-free survival (p value boundary 0·0019), assessed by masked, independent central review, and overall survival (p value boundary 0·0142), followed by non-inferiority and superiority of overall survival for pembrolizumab versus chemotherapy in the patient population with CPS of at least 10 and in the total population (also a primary endpoint). Safety was assessed in the as-treated population (all patients who received at least one dose of study treatment). This study is completed and is no longer enrolling patients, and is registered at ClinicalTrials.gov , number NCT02853305 . Findings Between Oct 19, 2016 and June 29, 2018, 1010 patients were enrolled and allocated to receive pembrolizumab plus chemotherapy (n=351), pembrolizumab monotherapy (n=307), or chemotherapy alone (n=352). Median follow-up was 31·7 months (IQR 27·7–36·0). Pembrolizumab plus chemotherapy versus chemotherapy did not significantly improve progression-free survival, with a median progression-free survival of 8·3 months (95% CI 7·5–8·5) in the pembrolizumab plus chemotherapy group versus 7·1 months (6·4–7·9) in the chemotherapy group (hazard ratio [HR] 0·78, 95% CI 0·65–0·93; p=0·0033), or overall survival, with a median overall survival of 17·0 months (14·5–19·5) in the pembrolizumab plus chemotherapy group versus 14·3 months (12·3–16·7) in the chemotherapy group (0·86, 0·72–1·02; p=0·0407). No further formal statistical hypothesis testing was done. In analyses of overall survival with pembrolizumab versus chemotherapy (now exploratory based on hierarchical statistical testing), overall survival was similar between these treatment groups, both in the total population (15·6 months [95% CI 12·1–17·9] with pembrolizumab vs 14·3 months [12·3–16·7] with chemotherapy; HR 0·92, 95% CI 0·77–1·11) and the population with CPS of at least 10 (16·1 months [13·6–19·9] with pembrolizumab vs 15·2 months [11·6–23·3] with chemotherapy; 1·01, 0·77–1·32). The most common grade 3 or 4 adverse event attributed to study treatment was anaemia with pembrolizumab plus chemotherapy (104 [30%] of 349 patients) or chemotherapy alone (112 [33%] of 342 patients), and diarrhoea, fatigue, and hyponatraemia (each affecting four [1%] of 302 patients) with pembrolizumab alone. Six (1%) of 1010 patients died due to an adverse event attributed to study treatment; two patients in each treatment group. One each occurred due to cardiac arrest and device-related sepsis in the pembrolizumab plus chemotherapy group, one each due to cardiac failure and malignant neoplasm progression in the pembrolizumab group, and one each due to myocardial infarction and ischaemic colitis in the chemotherapy group. Interpretation The addition of pembrolizumab to first-line platinum-based chemotherapy did not significantly improve efficacy and should not be widely adopted for treatment of advanced urothelial carcinoma. Funding Merck Sharp and Dohme, a subsidiary of Merck, Kenilworth, NJ, USA.

Published
2021

3. Preliminary safety and efficacy of first-line pertuzumab combined with trastuzumab and taxane therapy for HER2-positive locally recurrent or metastatic breast cancer (PERUSE)

Author

T. Bachelot, E. Ciruelos, A. Schneeweiss, F. Puglisi, T. Peretz-Yablonski, I. Bondarenko, S. Paluch-Shimon, A. Wardley, J.-L. Merot, Y. du Toit, V. Easton, N. Lindegger, D. Miles, Kamel Bouzid, Mario Campone, Bruno Coudert, Zbigniew Nowecki, Hassan Errihani, Florence Dalenc, Ana Ferreira, Max Mano, Francesco Ricci, Haralabos Kalofonos, Claudia Andreetta, Filippo Montemurro, Sophie Barrett, Qingyuan Zhang, Dimitris Mavroudis, Juan Matus, Carlos Beato, Xichun Hu, Rabab Gaafar, Hamdy Abdel Azeem, Christophe Perrin, Johannes Ettl, Istvan Lang, Sunil Verma, Huiping Li, Etienne Brain, Oliver Hoffmann, Anna Cariello, Carlo Tondini, Taher Altwegeiri, Niklas Loman, Michael Lux, Antonio Frassoldati, Zeba Aziz, Fernando Salas, Joanna Streb, Andrzej Wronski, Salomón Menjón Beltrán, Irfan Cicin, Peter Schmid, Robert Laing, Zhongsheng Tong, Katalin Boer, Balazs Juhasz, Luca Gianni, Giuseppe Curigliano, Alejandro Juarez, Snezana Susnjar, Erika Matos, Ruchan Uslu, Hans Wildiers, Marcelo Cruz, Hugues Bourgeois, Raquel von Schumann, Salomón Stemmer, Flavia Morales Vásquez, Adriana Dominguez, Marek Wojtukiewicz, Jasna Trifunovic, Jose Juan Illarramendi, Laura Garcia, Yann Izarzugaza Peron, Maria Jose Echarri, Natliia Voitko, Duncan Wheatley, Simon Waters, Richard De Boer, Guy Jerusalem, Véronique Cocquyt, Carlos Barrios, Lawrence Panasci, Johanna Mattson, Minna Tanner, Michel Gozy, Georgios Vasilopoulos, Janos Revesz, Luciano Latini, Cesare Gridelli, Jesus Lazaro, Antonio Gonzalez, Agusti Barnadas Molins, Eduardo Martinez, Jesús Alarcón, Ana Arance, Leif Klint, Oleksiy Kovalyov, Richard Baird, Belinda Yeo, Nicole McCarthy, Richard Greil, Shusen Wang, Xavier Artignan, Paule Augereau, Ingolf Juhasz-Boess, Roger Ngan, Hadassah Goldberg, Francesco Di Costanzo, Francesco Ferraù, Eduardas Aleknavicius, Kamran Rashid, Luís Costa, Jose Angel Garcia, Luis Ruiz de la Cruz, Rafael López López, Olga Del Val, Ozgur Ozyilkan, Fathi Azribi, Mark Verrill, Nicholas Turner, Jane Beith, Andreas Petzer, Jurandyr Andrade, Vanessa Bernstein, Daniel Rayson, Ibtessam Saad Eldin, Mihaëla Achille, Volkmar Mueller, Alessandra Gennari, Stefano Cascinu, Marwan Ghosn, Nagi El-Saghir, Joan Van den Bosch, Rianne Oosterkamp, Monika Kukulska, Ignacio Pelaez, Carolina Hernandez, Maria del Mar Gordon, Elsa Dalmau, Jose Luis Alonso, Sercan Aksoy, Hasan Senol Coskun, Yaroslav Shparyk, Mohini Varughese, Udaiveer Panwar, Lisa Barraclough, Nicola Levitt, Jonathan Hicks, Anna Rigg, Mark Allen, Cecila Castillo, Luis Enrique Fein, Robin Stuart-Harris, Christian Singer, Herbert Stoeger, Sasha Smiljanic, Jifeng Feng, Miguel Cedeño, Jean Francois Berdah, Hubert Orfeuvre, Anthony Goncalves, Eva-Maria Grischke, Eike Simon, Steffen Wagner, Anna Efremidou, Konstantinos Papazisis, Ella Evron, Moshe Inbar, Noa Ben Baruch, David Geffen, Natalya Karminsky, Enzo Maria Ruggeri, Cavanna Luigi, Donatella Grasso, Elona Juozaityte, Jeronimo Rafael Rodriguez Cid, Henk Roerdink, Neelum Siddiqi, José Luís Passos Coelho, Elisa Garcia Garre, Andres Garcia, Noelia Martínez Jañez, Maria Helena Lopez Ceballos, Mireia Mele, María García, Alberto Arcediano, Karen McAdam, Timothy Perren, Wendy Taylor, Alison Humphreys, Raul Vera, Luis Alberto Kaen, Günther Steger, Johannes Andel, Jacques de Grève, Manon Huizing, Roberto Hegg, Anil Joy, Sandeep Sehdev, Riina Kütner, Johanna Ruohola, Nadine Dohollou, Jessica Grosjean, Philippe Laplaige, Rémy Largillier, Philippe Martin, Virginie Pottier, Jerome Alexandre, Bernd Christensen, Dirk-Michael Zahm, Fariba Khandan, Hans-Joachim Lueck, Georgios Fountzilas, Georgeta Fried, Alice Giacobino, Andrea Bonetti, Yanin Chavarri Guerra, Laurens Van Warmerdam, Annette Van der Velden, Suzan Vrijaldenhoven, Felix de Jongh, Milagros Cavero, Raquel Andres Conejero, Adolfo Murias, Salvador Saura, Amparo Oltra, Andres Redondo, Nuria Ribelles, Kilian Bachmeier, Johnathan Joffe, Prabir Chakraborti, Mark Beresford, Mohammad Butt, Christopher Poole, Gassan Yordi, Natasha Woodward, Gilberto Amorim, Nadia Califaretti, Susan Fox, Andre Robidoux, NanLi Li, Nenxiao Li, Jun Jiang, Tannia Soria, Peeter Padrik, Outi Saarni, Dominique Genet, Stéphanie Catala, Hugues Barletta, Luis Teixeira, Thomas Facchini, Tobias Hesse, Thorsten Kühn, Angelika Ober, Roland Repp, Willibald Schroeder, Dimitrios Pectasides, Gyorgy Bodoky, Zsuzsanna Kahan, Irina Jiveliouk, Ora Rosengarten, Oscar Alabiso, Mario Perez, Yes Van de Wouw, Jolanta Smok-Kalwat, Margarida Damasceno, Gabriela Sousa, Omalkhair Abulkhair, Antonio Antón Torres, Maria Purificación Martinez, Jesús Garcia Mata, Marta Santisteban Jesús Florián Jerico, Antonio Llombart, Rosa Sanchez, Juan Carlos Torrego, Clara Olier Garate, Cesar Rodriguez, Rosa Llorente, Diego Soto de Prado, Javier Cortés, Cristina Llorca, Antonio Galán, Gemma Viñas Villaro, Ulrik Narbe, Helena Granstam Bjömeklett, Sarah Westwell, Jackie Newby, Mariam Jafri, Robinson Rodríguez, Isabel Alonso, Medical Genetics, Clinical sciences, and Laboratory for Medical and Molecular Oncology

Subjects
0301 basic medicine, Oncology, Male, Receptor, ErbB-2, first line, chemistry.chemical_compound, 0302 clinical medicine, dual HER2 blockade, Trastuzumab, Antineoplastic Combined Chemotherapy Protocols, Prospective Studies, Neoplasm Metastasis, skin and connective tissue diseases, Aged, 80 and over, Medicine(all), Hematology, Middle Aged, Metastatic breast cancer, Survival Rate, Docetaxel, Paclitaxel, 030220 oncology & carcinogenesis, Female, Taxoids, Pertuzumab, metastatic breast cancer, medicine.drug, Adult, Bridged-Ring Compounds, medicine.medical_specialty, HER2-positive, paclitaxel, pertuzumab, Breast Neoplasms, Antibodies, Monoclonal, Humanized, Loading dose, Breast Neoplasms, Male, 03 medical and health sciences, Young Adult, Internal medicine, medicine, Biomarkers, Tumor, Humans, neoplasms, Aged, Neoplasm Staging, Taxane, business.industry, medicine.disease, 030104 developmental biology, chemistry, Neoplasm Recurrence, Local, business, Febrile neutropenia
Abstract

Background Pertuzumab combined with trastuzumab and docetaxel is the standard first-line therapy for HER2-positive metastatic breast cancer, based on results from the phase III CLEOPATRA trial. PERUSE was designed to assess the safety and efficacy of investigator-selected taxane with pertuzumab and trastuzumab in this setting. Patients and methods In the ongoing multicentre single-arm phase IIIb PERUSE study, patients with inoperable HER2-positive advanced breast cancer (locally recurrent/metastatic) (LR/MBC) and no prior systemic therapy for LR/MBC (except endocrine therapy) received docetaxel, paclitaxel or nab-paclitaxel with trastuzumab [8mg/kg loading dose, then 6mg/kg every 3weeks (q3w)] and pertuzumab (840mg loading dose, then 420mg q3w) until disease progression or unacceptable toxicity. The primary end point was safety. Secondary end points included overall response rate (ORR) and progression-free survival (PFS). Results Overall, 1436 patients received at least one treatment dose (initially docetaxel in 775 patients, paclitaxel in 589, nab-paclitaxel in 65; 7 discontinued before starting taxane). Median age was 54years; 29% had received prior trastuzumab. Median treatment duration was 16months for pertuzumab and trastuzumab and 4months for taxane. Compared with docetaxel-containing therapy, paclitaxel-containing therapy was associated with more neuropathy (all-grade peripheral neuropathy 31% versus 16%) but less febrile neutropenia (1% versus 11%) and mucositis (14% versus 25%). At this preliminary analysis (52 months' median follow-up), median PFS was 20.6 [95% confidence interval (CI) 18.9–22.7] months overall (19.6, 23.0 and 18.1months with docetaxel, paclitaxel and nab-paclitaxel, respectively). ORR was 80% (95% CI 78%–82%) overall (docetaxel 79%, paclitaxel 83%, nab-paclitaxel 77%). Conclusions Preliminary findings from PERUSE suggest that the safety and efficacy of first-line pertuzumab, trastuzumab and taxane for HER2-positive LR/MBC are consistent with results from CLEOPATRA. Paclitaxel appears to be a valid alternative taxane backbone to docetaxel, offering similar PFS and ORR with a predictable safety profile. ClinicalTrials.gov NCT01572038.

Published
2019

4. Full Body Surface Coverage with Water-Equivalent Bolus as Novel Technique for Total Body Irradiation before Hematopoietic Stem Cell Transplantation in Pediatric Acute Lymphoid Leukemia

Author

Andrea Furka, Zsofia Nagy, Imre Szabó, Gábor Fekete, Ágnes Kelemen, Gábor Bolobás, Gábriel Sebők, Tünde Molnár, János Árvai, Ilona Tornyi, László Kostyál, János Révész, and Peter Hauser

Subjects
acute lymphoid leukemia (ALL), bone marrow transplantation, conditioning regimen, full body bolus, pediatric, total body irradiation, Pediatrics, RJ1-570
Abstract

Background: Total body irradiation (TBI) 2 × 2 Gy for 3 consecutive days followed by chemotherapy for conditioning pediatric patients with acute lymphoid leukemia (ALL) before bone marrow transplantation is superior to chemo-conditioning alone. The globally used anterior-posterior/posterior-anterior (AP/PA) technique is the most referable method, but volumetric modulated arc therapy (VMAT) with modern linear accelerators is more precise in terms of ensuring better dose distribution, especially for skin, and higher protection of organs at risk, resulting in less side effects. Method: For TBI, a modern VMAT technique was used. Whole-body immobilization in the supine position was performed using a vacuum mattress with a full body coverage, with a water-equivalent bolus of 1 cm thickness. The design goal was to achieve dose inhomogeneity of less than ±10%. Results: From 2020 to 2022, we performed TBI for five pediatric patients with ALL, with full body bolus and VMAT, who later received hematopoietic stem cell transplantation. No acute complications related to TBI were observed during the treatment period with a median follow-up of 1.27 (0.43–2.11) years. Conclusion: Using full body water-equivalent bolus with VMAT for TBI provides a safe method for children with a better organ sparing in the short term follow-up.

Published
2022
Full Text
View/download PDF

5. Dose escalation can maximize therapeutic potential of sunitinib in patients with metastatic renal cell carcinoma

Author

Anikó Maráz, Adrienn Cserháti, Gabriella Uhercsák, Éva Szilágyi, Zoltán Varga, János Révész, Renáta Kószó, Linda Varga, and Zsuzsanna Kahán

Subjects
Metastatic renal cell cancer, Sunitinib, Dose escalation, Improved outcome, Toxicity, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Abstract Background In patients with metastatic renal cell cancer, based on limited evidence, increased sunitinib exposure is associated with better outcome. The survival and toxicity data of patients receiving individualized dose escalated sunitinib therapy as compared to standard management were analyzed in this study. Methods From July 2013, the data of metastatic renal cell cancer patients with slight progression but still a stable disease according to RECIST 1.1 criteria treated with an escalated dose of sunitinib (first level: 62.5 mg/day in 4/2 or 2 × 2/1 scheme, second level: 75 mg/day in 4/2 or 2 × 2/1 scheme) were collected prospectively. Regarding characteristics, outcome, and toxicity data, an explorative retrospective analysis of the register was carried out, comparing treatments after and before July 1, 2013 in the study (selected patients for escalated dose) and control (standard dose) groups, respectively. Results The study involved 103 patients receiving sunitinib therapy with a median overall and progression free survival of 25.36 ± 2.62 and 14.2 ± 3.22 months, respectively. Slight progression was detected in 48.5% of them. First and second-level dose escalation were indicated in 18.2% and 4.1% of patients, respectively. The dosing scheme was modified in 22.2%. The median progression free survival (39.7 ± 5.1 vs 14.2 ± 1.3 months (p = 0.037)) and the overall survival (57.5 ± 10.7 vs 27.9 ± 2.5 months (p = 0.044)) were significantly better in the study group (with dose escalation) than in the control group. Patients with nephrectomy and lower Memorial Sloan Kettering Cancer Center (MSKCC) scores showed more favorable outcomes. After dose escalation, the most common adverse events were worsening or development of fatigue, hypertension, stomatitis, and weight loss of over 10%. Conclusions Escalation of sunitinib dosing in selected patients with metastatic renal cell cancer, especially in case of slight progression, based on tolerable toxicity is safe and improves outcome. Dose escalation in 12.5 mg steps may be recommended for properly educated patients.

Published
2018
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results