June 26th, 2008. Piroxicam and intracavitary platinum-based chemotherapy for the treatment of advanced mesothelioma in pets: preliminary observations
The therapy was able to arrest the effusion in all patients for variable remission times: one dog is still in remission after 3 years, one dog died of progressive disease after 8 months and one cat died due to progressive neoplastic growth after six months, when the patient developed a mesothelial cuirass. The combination showed remarkable efficacy at controlling the malignant effusion secondary to MM in our patients and warrants further investigations.
June 26th, 2008. Induction of apoptosis by intrapleural perfusion hyperthermo-chemotherapy for malignant pleural mesothelioma
Conclusion: In patients with malignant pleural mesothelioma, intrapleural perfusion hyperthermo-chemotherapy induced potent apoptosis of tumor cells, increasing immediately postperfusion and peaking at 24 h.
Conclusion: Sequential administration of MTA and GEM is active, and the schedule of MTA followed by GEM is recommended for treating MPM.
June 24th, 2008. Multimodal Therapy for Malignant Pleural Mesothelioma Including Extrapleural Pneumonectomy
During the follow-up duration of 23 months, 3 patients (18 %) developed distant metastasis and one (6 %) a mediastinal local recurrence. Multimodal therapy of malignant pleural mesothelioma including extrapleural pneumonectomy should only be performed in specialised centres for thoracic surgery where uncomplicated interdisciplinary communication is the rule and which provide the required expertise in patient selection, operative technique and postoperative care.
June 24th, 2008. Chemotherapy of malignant pleural mesothelioma: have we made any progress?
Besides first-line therapy, there are also data to support the efficacy of chemotherapy in pretreated patients. In spite of the various results of preclinical trials which support the prognostic significance of certain targeted structures of intra- and intercellular signal transduction, no relevant efficacy could be shown for targeted therapies in mesothelioma up to now.
June 11th, 2008. Pemetrexed plus carboplatin in elderly patients with malignant pleural mesothelioma: combined analysis of two phase II trials
Apart from slightly worse haematological toxicity, there was no significant difference in outcome or toxicity between age groups. The PC regimen is effective and well tolerated in selected elderly patients with MPM.
June 11th, 2008. Cisplatin and vinorelbine first-line chemotherapy in non-resectable malignant pleural mesothelioma
6%). Cisplatin and intravenous vinorelbine is a highly active regimen in MPM with a response rate and survival comparable to the most active regimens so far reported.
June 6th, 2008. Long-term mortality from pleural and peritoneal cancer after exposure to asbestos: Possible role of asbestos clearance
The risk for pleural cancer, rather than showing an indefinite increase, might reach a plateau when a sufficiently long time has elapsed since exposure. The different trends for pleural and peritoneal cancer might be related to clearance of the asbestos from the workers' lungs.
June 4th, 2008. Ranpirnase as a potential antitumor ribonuclease treatment for mesothelioma and other malignancies
Most clinical studies have been conducted in patients with malignant mesothelioma, and a confirmatory Phase IIIb trial is currently underway for the treatment of this disease. Owing to its selective destruction of malignant cells and favorable toxicology profile, ranpirnase is a promising antitumor agent with ideal attributes that are generally lacking in conventional cytotoxic drugs.
June 4th, 2008. Malignant mesothelioma 2008
Novel therapies including intrapleural chemotherapy, photodynamic therapy and hyperthermic perfusion have also been used with some success. Finally there are several attempts at immunomodulating and targeted treatments, which are in phase I/II trials.
June 4th, 2008. Prophylactic radiotherapy for pleural puncture sites in mesothelioma: the controversy continues
thoracoscopic) pleural puncture sites and reserving treatments to symptomatic deposits may be more appropriate. This strategy would optimize patient care and minimize hospital visits, but allow prompt instigation of treatment if symptoms develop.
May 31st, 2008. mTOR Mediates Survival Signals in Malignant Mesothelioma Grown as Tumor Fragment Spheroids
We propose that mTOR mediates survival signals in many mesothelioma tumors. Inhibition of mTOR may provide a non-toxic adjunct to therapy directed against malignant mesothelioma, especially in those with high baseline expression of p-S6K.
Conclusions: We report that HIPEC with PLD following maximal cytoreduction in patients with advanced abdominal-only gastrointestinal or gynecologic malignancies is well tolerated. Encouraging survival after cytoreduction and HIPEC with PLD suggest that a phase II trial to verify activity is indicated.
May 20th, 2008. The efficacy and safety of weekly vinorelbine in relapsed malignant pleural mesothelioma
Weekly vinorelbine appeared to have a reasonable response rate with an acceptable toxicity profile in the second-line treatment of MPM. Its use should be prospectively evaluated in a randomised trial in the first or second-line therapy of MPM.
Interpretation: The addition of chemotherapy to ASC offers no significant benefits in terms of overall survival or quality of life. However, exploratory analyses suggested that vinorelbine merits further investigation.
Conclusion: In animal studies, improvements in tumour physiology (i.e., increased blood flow, inhibited oxygen consumption, increased oxygenation and decreased tumour hypertension) and selectively enhanced radiation responses (i.e., increased radiation sensitivity and inhibited repair of sublethal and potentially lethal damage) were observed after ranpirnase treatment in preclinical tumour models. Ranpirnase is a promising candidate as an enhancer for radiation- and chemotherapy. Ongoing clinical trials promise to further improve the treatment of mesothelioma and lung cancer.
May 14th, 2008. Molecular targets and targeted therapies for malignant mesothelioma
Alternative approaches are based on inhibitors of the ubiquitin-proteasome pathway and of histone deacetylases which, notwithstanding the functional divergence of the corresponding targets, share the ability to determine a wide modulation of the cancer cell phenotype that can lead to cell cycle arrest, apoptosis and sensitization to different antineoplastic treatments. A recombinant immunotoxin targeted to the membrane antigen mesothelin is an additional agent whose activity is being evaluated in mesothelioma patients.
May 6th, 2008. Overexpression and altered glycosylation of MUC1 in malignant mesothelioma
CA15-3 in effusions could differentiate malignant from benign effusions but were not specific for mesothelioma. Thus, as in other cancers, alterations in MUC1 biology occur in mesothelioma and these results suggest that specific MUC1 characteristics may be useful for mesothelioma diagnosis and should also be investigated as a potential therapeutic target.
May 2nd, 2008. What has the meta-analysis contributed to today’s standard of care in the treatment of thoracic malignancies?
Their results have been used as an effective tool for resolving various clinical questions, providing more reliable evidence for some clinical practice: (neo)adjuvant chemotherapy after surgery for resectable NSCLC, radiochemotherapy for patients with unresectable limited NSCLC and limited SCLC, advantage of chemotherapy for advanced NSCLC and identification of the most active drugs. However, it is important to understand the limits of their methodology in order to avoid inappropriate interpretations.
May 2nd, 2008. Trimodality Treatment of Malignant Pleural Mesothelioma
Conclusions: Trimodality treatment in malignant pleural mesothelioma seems to prolong survival in patients without lymph node metastasis. Novel techniques are needed for preoperative assessment of extrapleural lymph nodes.
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