Type Of Chemotherapy Agent Research Articles

MP56-14 LONG-TERM RENAL FUNCTION IN PATIENTS UNDERGOING TRIMODAL THERAPY FOR BLADDER CANCER

You have accessJournal of UrologyCME1 Apr 2023MP56-14 LONG-TERM RENAL FUNCTION IN PATIENTS UNDERGOING TRIMODAL THERAPY FOR BLADDER CANCER Affan Zafar, Linda Nguyen, Alexandra Hunter, William Shipley, Niall Heney, Anthony Zietman, Matthew Wszolek, Jason Efstathiou, Michael Drumm, Hannah Roberts, and Adam Feldman Affan ZafarAffan Zafar More articles by this author , Linda NguyenLinda Nguyen More articles by this author , Alexandra HunterAlexandra Hunter More articles by this author , William ShipleyWilliam Shipley More articles by this author , Niall HeneyNiall Heney More articles by this author , Anthony ZietmanAnthony Zietman More articles by this author , Matthew WszolekMatthew Wszolek More articles by this author , Jason EfstathiouJason Efstathiou More articles by this author , Michael DrummMichael Drumm More articles by this author , Hannah RobertsHannah Roberts More articles by this author , and Adam FeldmanAdam Feldman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003309.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Trimodal therapy (TMT) is a standard treatment option for select patients with muscle-invasive bladder cancer. The efficacy of TMT has been shown in several randomized trials; however, the long-term effect on renal function has not been investigated. Furthermore, various types of chemotherapy agents (ie. mitomycin, 5-FU, cisplatin) used during TMT are nephrotoxic. As many bladder cancer patients are elderly with significant medical comorbidities, data on long term renal function would aid in management. We sought to evaluate the change in renal function over 10 years in bladder cancer patients who have completed TMT. METHODS: The Massachusetts General Hospital’s institutional TMT database was retrospectively reviewed to obtain baseline renal function (estimated GFR) at time of muscle-invasive bladder cancer (MIBC) diagnosis. The eGFR values were calculated using the CKD-EPI creatinine equation. Interval eGFR was obtained for years 1, 3, 5, and 10 after the date of bladder cancer diagnosis. RESULTS: 287 patients undergoing TMT treatment for muscle invasive bladder cancer were reviewed. Patients were excluded due to incomplete TMT treatment or missing data, resulting in 251 eligible patients for evaluation of baseline mean eGFR. Median follow up was 4.56 years. Baseline mean eGFR was 65.67 mL/min/1.73. Mean eGFR for years 1, 3, 5, and 10 were 58.43 mL/min/1.73, 55.4 mL/min/1.73, 54.54 mL/min/1.73, and 57.3 mL/min/1.73, respectively. CONCLUSIONS: Renal function for bladder cancer patients undergoing TMT declined slightly after 1 year of follow up but remained stable for the remainder of the 10 years of follow up. Further studies are needed to identify predictors of renal decline and compare these results with the overall bladder cancer and general population. Source of Funding: N/A © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e780 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Affan Zafar More articles by this author Linda Nguyen More articles by this author Alexandra Hunter More articles by this author William Shipley More articles by this author Niall Heney More articles by this author Anthony Zietman More articles by this author Matthew Wszolek More articles by this author Jason Efstathiou More articles by this author Michael Drumm More articles by this author Hannah Roberts More articles by this author Adam Feldman More articles by this author Expand All Advertisement PDF downloadLoading ...

Abstract A065: Prospective cohort study of a pharmacist-driven medication management program to improve oral cancer therapy adherence in an underserved, diverse urban setting

Abstract Introduction: Patient adherence is critical to the efficacy of oral cancer chemotherapy. At a major safety net hospital, we sought to define the adherence to oral cancer therapy amongst our diverse and socioeconomically disadvantaged patient population. We designed a high-touch, pharmacist driven program called Boston Medical Center’s Specialty Pharmacy Adherence Program (B-SPAP), to see if this intervention could improve adherence to oral cancer treatment. Methods: We conducted a prospective intervention study of adult patients undergoing treatment with an oral oncology agent for advanced cancer or hematologic malignancy. The intervention incorporated the Multinational Association of Supportive Care in Cancer Oral Agent Teaching Tool by a clinical pharmacist for 30-60 minutes at initial, 3, 6, and 12 month study visits. Patients completed Patient Activation Measure (PAM) and Trust in Physician (TIP) surveys during visits. The primary endpoints were adherence (medication adherence ratio (MAR) (= sum of days’ supply for all fills in period/number of days in period) x100), and persistence (presence or absence of a >/= 45 day treatment gap). We utilized a 2:1 matched historical control design on type of chemotherapy agent. Linear regression models examined differences in adherence and persistence between intervention and controls. Data: There were 218 patients, 74 intervention and 144 historical controls. 54% of patients identified as Black, 28% Caucasian, 7% Asian, 6% other, 17% as Hispanic/Latino. 37% do not use English as their preferred language. 24% reported finishing high school. 30% are on Medicaid, 42% on Medicare, 10% had commercial insurance. The MAR in the intervention group was 92 (SD 14.6) compared with 93 (SD 10.8) in the historical control group (p=0.4). 78% of patients in the intervention group were persistent compared with 80% of historical controls (p=0.9). Non-English speaking patients had higher MAR=94.5 than English speaking patients, MAR=91 (β 3.5, SE 1.7, p=0.04). There were no differences in MAR in relation to age, marital status, or charlson comorbidity index. For the intervention patients, the average TIP Score was 48 (max of 55). TIP score did not differ by race (white=47, non-white 49, p=0.4) or language (English=49, non-English=47, p=0.3). The average PAM score was 43 (max of 52). Conclusions: Adherence to oral cancer therapies amongst our diverse patient population is high, over 90 adherent days in a 100 day period. Our high-touch, pharmacist driven intervention did not improve adherence or persistence between controls and intervention due to high rates in the control population. Interestingly we found that non-English speaking patients were more likely to be adherent than English speaking patients. Our findings suggest that equal access among a diverse patient population at a safety net institution can result in high adherence and positive outcomes despite socio-demographic factors that often lead to disparities in cancer care. Citation Format: Claire E.P. Smith, David Hughes, Scott Gould, Anne Buck, Naomi Y. Ko. Prospective cohort study of a pharmacist-driven medication management program to improve oral cancer therapy adherence in an underserved, diverse urban setting [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A065.

Narrative review of hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with advanced ovarian cancer: a critical reappraisal of the current evidence.

The implementation of hyperthermic intraperitoneal chemotherapy (HIPEC) in the management of advanced stage epithelial ovarian cancer (EOC) as a standard practice remains debatable despite the emerging data supporting its beneficial effect when used to supplement cytoreductive procedures. The aim of the present review was an attempt to accumulate the currently available evidence on the use of HIPEC for patients with primary and recurrent EOC and to address directives of future research. Based on the currently available literature, the progress in cytoreductive surgical procedures and chemotherapy has brought significant improvement in the management and survival outcomes of selected patients with advanced EOC. The addition of HIPEC seems encouraging based on the outcomes of high-quality clinical trials. There are significant parameters on the use of CRS and HIPEC such as patient selection, the sequencing of procedures, the type of chemotherapy agent and time and the temperature of hyperthermic procedures which require additional investigation. Multidisciplinary team management by surgeons, gynaecologists, oncologists, pathologists and radiologists is of critical importance. Also, additional large prospective well-designed randomised studies are needed in order to update our current knowledge and provide guidelines to improve the management of patients with EOC.

Grover Disease Associated With Chemotherapy: Review of Potential Pathophysiology, Current Treatments, and Future Directions.

Transient acantholytic dermatosis has been frequently reported in patients with malignancies. While paraneoplastic cases have rarely been reported, most eruptions occur in the setting of chemotherapeutic agents. Management is based on limited data and primarily with topical steroids and topical emollients. A subset of patients exhibits recalcitrant disease and require alternate therapeutic approachesMethods: This systematic review consisted of identifying records in PubMed using the medical subject headings (MeSH) terms “chemotherapy” AND “Grover”, “chemotherapy” AND “Grover’s”, “cancer” AND “Grover”, “cancer” AND “Grover’s”, “malignancy” AND “Grover”, “malignancy” AND “Grover’s”, as well as a free text search for “Grover” OR “Grover’s” OR “Grover disease” OR “Grovers disease” OR “Grover’s disease” OR “transient acantholytic dermatosis” OR “transient acantholytic” to identify case reports, case series, systematic reviews, review articles, meta-analyses, clinical trials, brief commentaries, and original articles. The titles and abstracts of all results were reviewed. Full texts of relevant results were then read in their entirety and applicability was determined. Overall, Grover disease has rarely been reported in the setting of malignancy. When it occurs, it is generally in the setting of chemotherapy use. Chemotherapy-associated Grover disease is reported most frequently in association with cytotoxic chemotherapies, followed by small molecule inhibitors. The first line treatment for this complication is the use of topical agents. When these provide inadequate relief, alternate therapies have been rarely reported, with novel treatments proposed based on the type of chemotherapy agent and its mechanism of action. Chemotherapy-associated Grover disease is an uncommon complication of cancer treatment. While most cases of chemotherapy-associated Grover disease can be treated with topical steroids and topical emollients, certain cases require a more specialized approach. This could include adjuvant adjuvant therapies, or novel treatments that are directly related to the mechanism of action of the chemotherapy involved. J Drugs Dermatol. 2020;19(11):1056-1064. doi:10.36849/JDD.2020.5648.

Impact of chemotherapy sequence on the efficacy of scalp cooling devices for alopecia prevention.

e12034 Background: The use of scalp cooling devices (SCD) has been widely adopted for prevention against chemotherapy-induced alopecia (CIA). However, efficacy of SCD varies between different chemotherapy (CT) regimens. The aim of this study was to evaluate the effectiveness of SCD in breast cancer patients with different CT regimens treated in a tertiary cancer center in Monterrey, Mexico. Methods: All consecutive patients who used SCD were included. Data regarding treatment regimens and efficacy outcomes were prospectively collected. A descriptive analysis was performed to compare the effectiveness among the different CT regimens and sequences used. Results: We included a total of 49 patients with SCD usage from July 2016-January 2019. Table summarizes SCD efficacy, toxicities and CT regimens. In our study, 76% of patients had grade ≤1 CIA using SCD. 35% withdrew SCD use, with hair loss being the most common reason. 58% of patients who received upfront anthracycline-cyclophosphamide (AC) experienced grade 2 CIA. In contrast, no patients receiving taxane-only treatment had grade 2 CIA. Notably, only 3 of 16 patients (19%) who received upfront paclitaxel followed by anthracyclines developed grade 2 CIA. Conclusions: SCD proved to be highly effective in preventing grade 2 CIA with different CT regimens, including patients that received anthracycline-based regimens who started treatment with taxanes upfront. Accordingly, our results suggest that CT sequence, rather than type of CT agent may have a significant impact on the efficacy of SCD in CIA prevention. The results of larger studies are required to confirm our findings.[Table: see text]

Analisis Mutasi pada Kodon 531 Pada Gen Rpob Mycobacterium tuberculosis Penyebab Resistensi Rifampisin

Tuberculosis (TB) is a serious disesase in the world. According to the WHO, it is estimated more than 3 million people die every year as a result of this infectious disease. One factor that causes diffi culty handling TB chemoteraphy is not effective against the bacteria Mycobacterium tuberculosis that causes TB . Effectiveness of treatment is often hampered by the emergence of bacterial resistance against M. Tuberculosis chemotherapy agents are given. From some research found that bacterial resistance may occur in more one type of chemotherapy agent also known as multi-drug resistance (MDR). Mycobacterium tuberculosis develop resistance mechanisms that are different from other bacteria in general. In prokaryotes, resistance is generally due to the transfer of genetic, either through plasmids,transposons and other. Reference sequence beta sub unit of RNAP protein M. Tuberculosis with accession number NP_215181.1 and M. tucerculosis rpoB gene with accession number NC_000962.3 used to obtain preliminary information from the data base www.ncbi.nlm.gov and www.uniprot.org . Mutation done according to several studies literature. Analysis of the composition, profi le, location and structure of protein using www.expasy.org, TMHMM and http://bioinf.cs.ucl.ac.uk/psipred. The primer design is done with Primer Design Program. Based on the analysis of mutation in the beta subunit of RNAP protein M. Tuberculosis, codon 531 (Ser ->Leu), it is known that mutations cause changes in some properties and structure of proteins. Possible changes affecting the nature of bacterial resistance to antibiotics rifampicin. However, further analysis needs to be done with the analysis of the docking technique.

Abstract PR626

Background & Objectives: The use of total intravenous anesthesia (TIVA) has been shown to improve recovery and lower postoperative pain scores in a number of different types of surgery. In this study we aim to examine the effects of TIVA on the postoperative pain scores after CRS with HIPEC. Materials & Methods: After Institutional Review Board approval, a retrospective review of adult patients undergoing CRS-HIPEC between November 2011 and August 2014 was performed. Patients receiving premedication with celecoxib, pregabalin, and tramadol, followed by intraoperative infusions of propofol, lidocaine, dexmedetomidine, and ketamine were classified under the TIVA-group. Patients receiving a volatile/opioid based anesthetic were classified under the volatile-opioid group (VO-group). Variables including demographics, diagnosis, postoperative pain scores (POD0, POD1, POD2),and opioid use were recorded and analyzed. Results: A total of 213 patient records where reviewed. Seventy four patients received TIVA and 139 patients received volatile (VO) anesthetics. There were no statistical differences in demographics (Table 1), cancer diagnosis (P=0.132), peritoneal carcinomatosis index (P=0.267), or type of chemotherapy agent (P=.933) used. Patients who received TIVA had statistically significant lower postoperative pain scores on the day of surgery and POD1 (Figure 1).Table 1:: Summary of Patient and Clinical Characteristics (Volatile-Opioid vs. TIVA-group)Conclusion: In patients undergoing CRS with HIPEC, the use of TIVA was associated with lower early postoperative pain scores, and less intraoperative and daily IV morphine use.

Abstract B56: Racial disparities in the receipt of adjuvant chemotherapy among stage III colon cancer patients

Abstract Background: Although the incidence and mortality of colorectal cancer (CRC) in the U.S. has declined over the past two decades, CRC disproportionately affects blacks, who have higher incidence and mortality compared with whites. CRC disparities are partly attributable to differences in risk factors, screening and early detection, and tumor biology; however, variations in treatment may also contribute to mortality differentials. Few studies have evaluated how disparities in CRC treatment have changed over time and across different settings. Using the National Cancer Institute's (NCI) Patterns of Care studies, we examined patterns in the use of adjuvant chemotherapy and differences for non-Hispanic whites and blacks in a population-based sample of stage III colon cancer patients during the period 1990-2010. Methods: Patients diagnosed with stage III colon cancer were randomly sampled from the Surveillance, Epidemiology, and End Results (SEER) program in 1990-91, 1995, 2000, 2005, and 2010. There was oversampling by race in 1995, 2000, 2005, and 2010. Patients were categorized as non-Hispanic white (n=869) or black (n=385). Treatment data were obtained from medical record review with physician verification. All patients in these analyses underwent cancer-directed surgery. Patients who received or were recommended any chemotherapy agents as part of primary therapy were considered to have received chemotherapy. Log-binomial regression models with stratum-specific sample weights were used to estimate the association between race and receipt of adjuvant chemotherapy. Potential confounders included age at diagnosis, sex, insurance, comorbidity, and year of diagnosis. Effect measure modification by insurance was assessed using single referent models. Results: There were few differences in sociodemographic characteristics among whites and blacks in the total study population (n=1,254). A similar proportion of white and black patients had high-risk features (e.g., poorly differentiated histology, bowel obstruction, positive surgical margins). Receipt of adjuvant chemotherapy increased among both white and black patients from 1990/91 (white: 57%, black: 45%) to 2005 (white: 72%, black: 71%) and decreased in 2010 (white: 65%, black: 53%). There were marked racial disparities in receipt of adjuvant chemotherapy in 1990/91 and again in 2010. After adjusting for potential confounders, black patients were less likely to receive adjuvant chemotherapy compared to whites (RR 0.82, 95% CI [0.73, 0.93]). A similar trend was observed when the analysis was limited to “healthy” patients age <75 years and with a comorbidity score of one or less (RR 0.84, 95% CI [0.75, 0.95]). There was no difference in the types of chemotherapy agents or regimens received by race among chemotherapy-treated patients. Single referent models suggested the association of black race with receipt of adjuvant chemotherapy did not differ across insurance categories (private: RR 0.81, 95% CI [0.77, 0.94]; Medicare: RR 0.80, 95% CI [0.59, 1.09]; Medicaid: RR 0.85, 95% CI [0.69, 1.05]), although a larger proportion of black patients had Medicaid in all years of the study compared to whites. Conclusions: The gap in the proportion of white and black stage III colon cancer patients who received adjuvant chemotherapy narrowed after 1990/91, but our findings suggest the disparity reemerged in 2010. The disparity persisted after adjusting for multiple confounders and across insurance types. Recent decreases in chemotherapy use may be due, in part, to the economic downturn and a shift toward greater use of Medicaid coverage. This shift followed the 2008 financial crisis, which may have also resulted in barriers to treatment access. Receipt of chemotherapy decreased more substantially in black patients compared to whites in 2010. Programs to address this treatment disparity are needed to improve quality of care, increase survival, and reduce disparities related to CRC mortality. Citation Format: Caitlin C. Murphy, Linda C. Harlan, Joan L. Warren, Ann M. Geiger. Racial disparities in the receipt of adjuvant chemotherapy among stage III colon cancer patients. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr B56.

Path-breaking directions of nanotechnology-based chemotherapy and molecular cancer therapy

A fundamental question in the field of technological forecasting and foresight is how to detect likely fruitful technological trajectories in new research fields, such as nanomedicine. We confront this question by developing an approach based on trends and networks of vital variables, analyzed by bibliometrics, which endeavours to detect fruitful trajectories of nanotechnology applied to ground-breaking anti-cancer treatments. Results tend to show two main technological waves of cancer treatments by nanotechnology applications. The early technological wave in the early 2000s was embodied in some types of chemotherapy agents with a broad spectrum of application, while after 2006 the second technological wave appeared with new applications of chemotherapy agents and molecular target therapy by nanotechnology. The present study shows new directions of nanotechnology-based chemotherapy and molecular cancer therapy in new treatments for breast, lung, brain and colon cancers. A main finding of this study is the recognition that, since the late 2000s, the sharp increase of several technological trajectories of anticancer drugs applied by nanotechnology seems to be driven by high rates of mortality of some types of cancers (e.g. pancreatic and brain) in order to find more effective anticancer therapies that increase the progression-free survival of patients: the so-called technological trajectories mortality driven. The study also points out that global research leaders tend to specialize in anticancer drugs, via nanotechnology, for specific cancers (e.g. Switzerland in prostate cancer, Japan in colon cancer, China in ovarian cancer and Greece in pancreatic cancer). These ground-breaking technological trajectories are paving new directions in biomedicine and generating a revolution in clinical practice that may lead to more effective anticancer treatments in the not-too-distant future.

A Monte Carlo evaluation of dose enhancement by cisplatin and titanocene dichloride chemotherapy drugs in brachytherapy with photon emitting sources

Some chemotherapy drugs contain a high Z element in their structure that can be used for tumour dose enhancement in radiotherapy. In the present study, dose enhancement factors (DEFs) by cisplatin and titanocene dichloride agents in brachytherapy were quantified based on Monte Carlo simulation. Six photon emitting brachytherapy sources were simulated and their dose rate constant and radial dose function were determined and compared with published data. Dose enhancement factor was obtained for 1, 3 and 5 % concentrations of cisplatin and titanocene dichloride chemotherapy agents in a tumour, in soft tissue phantom. The results of the dose rate constant and radial dose function showed good agreement with published data. Our results have shown that depending on the type of chemotherapy agent and brachytherapy source, DEF increases with increasing chemotherapy drug concentration. The maximum in-tumour averaged DEF for cisplatin and titanocene dichloride are 4.13 and 1.48, respectively, reached with 5 % concentrations of the agents, and (125)I source. Dose enhancement factor is considerably higher for both chemotherapy agents with (125)I, (103)Pd and (169)Yb sources, compared to (192)Ir, (198)Au and (60)Co sources. At similar concentrations, dose enhancement for cisplatin is higher compared with titanocene dichloride. Based on the results of this study, combination of brachytherapy and chemotherapy with agents containing a high Z element resulted in higher radiation dose to the tumour. Therefore, concurrent use of chemotherapy and brachytherapy with high atomic number drugs can have the potential benefits of dose enhancement. However, more preclinical evaluations in this area are necessary before clinical application of this method.

A phase III randomized, placebo-controlled study of topical amitriptyline and ketamine for chemotherapy-induced peripheral neuropathy (CIPN): a University of Rochester CCOP study of 462 cancer survivors

Chemotherapy-induced peripheral neuropathy (CIPN) occurs in as high as 70% of patients receiving certain types of chemotherapy agents. The FDA has yet to approve a therapy for CIPN. The aim of this multicenter, phase III, randomized, double-blind, placebo-controlled trial was to investigate the efficacy of 2% ketamine plus 4% amitriptyline (KA) cream for reducing CIPN. Cancer survivors who completed chemotherapy at least 1 month prior and had CIPN (>4 out of 10) were enrolled (N=462). CIPN was assessed using average scores from a 7-day daily diary that asks patients to rate the average "pain, numbness, or tingling in [their] hands and feet over the past 24 h" on an 11-point numeric rating scale at baseline and 6 weeks post intervention. ANCOVA was used to measure differences in 6-week CIPN with effects including baseline CIPN, KA treatment arm, and previous taxane therapy (Y/N). The KA treatment showed no effect on 6-week CIPN scores (adjusted mean difference=-0.17, p=0.363). This study suggests that KA cream does not decrease CIPN symptoms in cancer survivors.

Path-Breaking Directions of Nanotechnology-Based Chemotherapy and Molecular Cancer Therapy

A fundamental question in the field of technological forecasting and foresight is how to detect likely fruitful technological trajectories in new research fields, such as nanomedicine. We confront this question by developing an approach based on trends and networks of vital variables, analyzed by bibliometrics, which endeavours to detect fruitful trajectories of nanotechnology applied to ground-breaking anti-cancer treatments. Results tend to show two main technological waves of cancer treatments by nanotechnology applications. The early technological wave in the early 2000s was embodied in some types of chemotherapy agents with a broad spectrum of application, while after 2006 the second technological wave appeared with new applications of chemotherapy agents and molecular target therapy by nanotechnology. The present study shows new directions of nanotechnology-based chemotherapy and molecular cancer therapy in new treatments for breast, lung, brain and colon cancers. A main finding of this study is the recognition that, since the late 2000s, the sharp increase of several technological trajectories of anticancer drugs applied by nanotechnology seems to be driven by high rates of mortality of some types of cancers (e.g. pancreatic and brain) in order to find more effective anticancer therapies that increase the progression-free survival of patients: the so-called technological trajectories mortality driven. The study also points out that global research leaders tend to specialize in anticancer drugs, via nanotechnology, for specific cancers (e.g. Switzerland in prostate cancer, Japan in colon cancer, China in ovarian cancer and Greece in pancreatic cancer). These ground-breaking technological trajectories are paving new directions in biomedicine and generating a revolution in clinical practice that may lead to more effective anticancer treatments in the not-too-distant future.

Predictors of chemotherapy-induced peripheral numbness or tingling in patients with cancer.

e19674 Background: Chemotherapy-induced peripheral numbness or tingling (CIPNT) continues to be a substantial problem for many cancer patients. The purpose of this study was to identify the predictors of CIPNT. Methods: This prospective descriptive study was conducted at Adnan Aydiner Oncology Center with 490 cancer patients between December 2005 and January 2011. Personal characteristics, illness related characteristics and symptom severity of the patients were assessed by using Patients Clinical Record Forms. The severity of CIPNT and other chemotherapy related side effects was graded by the NCI Common Toxicity Criteria at each treatment of the patient. Frozen gloves were applied only in hourly taxane based treatment. Descriptive statistics and nonparametric tests were used during the data analysis. Logistic regression analysis was performed to predict the factors affecting the CIPNT. For all statistical analyses, a two-sided p value of less than 0.05 was considered to be statistically significant. Results: Most of the patients were women and their mean age was 55.72±11.63. Most of them had breast (36.9%) and lung (36.1%) cancer diagnosis and 51.8% had received taxan based therapy. Grade 1 CIPNT was found in 288 out of 490 patients (58,8%), grade 2 in 67 (13,7%), and grade 3 in 43 (8,8%) patients. In univariate analysis the factors affecting CIPNT were gender, age, body mass index, occupation, hypertension, primary tumor, stage of disease, type of chemotherapy agent, interval or number of the chemotherapy cycles, and baseline level of leukocyte or hemoglobin. Frozen glove did not prevent CIPNT. A multivariate analysis of 12 out of 22 clinical and biological factors selected after univariate analysis showed a higher risk of CIPNT in patients who had colorectal or ovarian cancer (OR 3,35 [1.82-6.14]), metastatic disease (OR 3,39 [1.87-6.17]), hypertension (OR 4,94 [1.96-12.29]), women (OR 4,34 [2.16-8.71]), weekly-biweekly therapy (OR 2,37 [1.16-4.83]) and old age (OR 1,03 [1.01-1.06]), respectively. Conclusions: Our data showed that many clinical and biological factors of the patients could predict a higher risk of CIPNT. In contrast to our thoughts frozen gloves did not reduced CIPNT associated with taxane.

Risk of subsequent dementia diagnoses does not vary by types of adjuvant chemotherapy in older women with breast cancer

Little is known about long-term cognitive side effects of adjuvant chemotherapy for breast cancer. We thus examined incidence of dementia diagnoses in older women diagnosed with breast cancer, stratified by types of chemotherapy regimen. We identified patients with incident dementia diagnoses through Medicare claims linked to the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) tumor registry data. The study population (n = 6,932) consisted of women at least 68 years of age, who were diagnosed with early-stage breast cancer from 1994 through 2002 in one of the SEER areas and received chemotherapy as part of their cancer treatment. Excluded were women with a diagnosis of dementia within the 3 years prior to their cancer diagnosis. Our sample comprised mostly white women. The mean age was 74. Fifty-seven percent were estrogen receptor positive. Over 70% had no comorbidity. The use of taxol and anthracycline-based treatments increased from mid-1990s to early 2000. Increasing age at cancer diagnosis, Black ethnicity, living in a census tract with lower level of education, and increasing number of comorbidities were associated with new claims of dementia diagnoses after chemotherapy. There was no significant association between types of chemotherapy agents and risk of subsequent dementia diagnoses. No association was found between types of adjuvant chemotherapy agents for breast cancer and risk of new dementia diagnoses. Our findings suggest that concerns about post-chemotherapy dementia should not be a major factor in determining type of adjuvant chemotherapy regimen to prescribe for older women with breast cancer.

Chemotherapy‐Related Cardiomyopathy: All That Glitters Is Not Gold

As long-term morbidity with chemotherapeutic exposure becomes a clinical reality, the development of cardiomyopathy with heart failure is rapidly growing. The type of chemotherapy agent, dose, rate of administration, use of combination chemotherapy, and concomitant radiation therapy are major factors that define the propensity to cardiotoxicity. Chemotherapy-related cardiomyopathy is multifactorial in origin and requires a diligent etiologic survey to arrive at the appropriate diagnosis. A contemporary discussion of chemotherapy-related cardiomyopathy with particular emphasis on the pathogenesis and ameliorative targets of this unique clinical disorder are described in this report.

Testis Sperm Extraction (TESE) Is Effective in the Azoospermic Male with a History of Prior Chemotherapy

Objectives: Approximately 50% of the total group of men with non-obstructive azoospermia (NOA) will have sperm found within the testis parenchyma which can be used with ICSI to achieve biological paternity. Questions: what are the rates of sperm retrieval and pregnancy for subgroups with NOA, e.g., post-chemotherapy? The purpose of this study is to define the success of TESE and the pregnancy rates for only those men who are azoospermic due to chemotherapy so as to be able to counsel this type of NOA patient as best possible. Materials and Methods: 7 NOA men subsequent to chemotherapy and who underwent TESE comprise the study group. Harvested tissue was analyzed and cryopreserved if sperm were present and thawed homogenate used for subsequent cycles of ICSI. Age range: 28 to 43 years. legendAge at chemolegendC: cyclophosphamide; V: vincristine; D: doxorubicin; Chl: chlorambucil; Pro: procarbazine; P: prednisone; B: bleomycin; Cis: cisplatin.Reason for chemoChemo agents usedSperm present12Systemic LupusChlNo21Testis CancerCis, V, BNo4Nephrotic SyndromeC, P. ChlNo23Histiocytic lymphomaMechlorethamine, V, Pro, PYesPending24Hodgkin'sV, C, DYes7Twins lost at 25 weeks15Ewing's SarcomaV, D, Actinomycin DYes1Ongoing pregnancy15Testis CancerCis, Vp-16, BYes1Ongoing pregnancylegend C: cyclophosphamide; V: vincristine; D: doxorubicin; Chl: chlorambucil; Pro: procarbazine; P: prednisone; B: bleomycin; Cis: cisplatin. Open table in a new tab Results: Of the 7 men, 4 (57%) had sperm found during TESE. These 4 men were all pubertal or post-pubertal at the time of chemotherapy. The fertilization rate ranged from 58–80%. The twin aborteses were normal in appearance, premature rupture of membranes the cause. Conclusion: For the subgroup of men with NOA due to prior chemotherapy, TESE may be successful and pregnancy can be achieved. These are early and encouraging results but since there are so many types of chemotherapy agents used, large numbers of patients will be needed to give an individual patient an accurate assessment of his chances. In addition, the children will need to be followed carefully as there is no data as to their future health. Data that discusses naturally conceived offspring of post-chemotherapy men cannot be applied to this group as spermatogenesis in these men returned to good levels, unlike this study group who were more severely and permanently affected.