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Chilukuri S, Panda P, Ghadyalpatil N, Bang M, Burela N, Raja T, Jalali R, Parikh P. P09.07 Oncologists Practices and Perceptions on Management of Brain Metastases from Non-Small Cell Lung Cancers-: A Nationally Representative Survey. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Biswas B, Ghadyalpatil N, Krishna MV, Deshmukh J. A review on adverse event profiles of epidermal growth factor receptor-tyrosine kinase inhibitors in nonsmall cell lung cancer patients. Indian J Cancer 2018; 54:S55-S64. [PMID: 29292709 DOI: 10.4103/ijc.ijc_589_17] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) have revolutionized the treatment of EGFR-mutant nonsmall cell lung cancer (NSCLC). These EGFR TKIs demonstrate a different adverse event (AE) profile as compared to conventional chemotherapy agents. They are more commonly associated with cutaneous AEs and diarrhea while hematological AEs occurred commonly with chemotherapy agents. These AEs are the extension of pharmacological effect and occur as a result of blockade of EGFR-regulated pathways in the skin and gastrointestinal tract. This review article sheds light on the safety profile of first-, second-, and third-generation EGFR TKIs based on data obtained from several clinical trials conducted in NSCLC patients and highlights trials comparing these agents with the conventional chemotherapy agents. The strategies to manage EGFR TKI-related AEs are also reviewed.
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Affiliation(s)
- B Biswas
- Department of Medical Oncology, Tata Medical Center, Kolkata, West Bengal, India
| | - N Ghadyalpatil
- Department of Medical Oncology, Yashoda Hospitals, Hyderabad, Telangana, India
| | - M V Krishna
- Department of Medical Oncology, Apollo Cancer Institutes, Hyderabad, Telangana, India
| | - J Deshmukh
- Medical Affairs, AstraZeneca Pharma Limited, Bengaluru, Karnataka, India
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Srinivas C, Mohammed N, Subramaniam S, Ghadyalpatil N, Maturu V, Reddy R. EP-1394: SABR for T2 Tumors of Lung. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31703-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Batra U, Parikh PM, Prabhash K, Tongaonkar HB, Chibber P, Dabkara D, Deshmukh C, Ghadyalpatil N, Hingmire S, Joshi A, Raghunath SK, Rajappa S, Rajendranath R, Rawal SK, Singh M, Singh R, Somashekhar SP, Sood R. Oncology Gold Standard™ practical consensus recommendations 2016 for treatment of advanced clear cell renal cell carcinoma. South Asian J Cancer 2016; 5:167-175. [PMID: 28032079 PMCID: PMC5184749 DOI: 10.4103/2278-330x.189933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
The Oncology Gold Standard (OGS) Expert Group on renal cell carcinoma (RCC) developed the consensus statement to provide community oncologists practical guidelines on the management of advanced clear cell (cc) RCC using published evidence, practical experience of experts in real life management, and results of a nationwide survey involving 144 health-care professionals. Six broad question categories containing 33 unique questions cover major situations in the routine management of RCC. This document serves as a ready guide for the standard of care to optimize outcome. The table of "Take Home Messages" at the end is a convenient tool for busy practitioners.
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Affiliation(s)
| | | | - PM Parikh
- Correspondence to: Dr Purvish M. Parikh, Department of Precision Oncology, Asian Cancer Institute, Somaiya Hospital, Sion East, Mumbai. E-mail:
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Parikh PM, Ranade AA, Govind B, Ghadyalpatil N, Singh R, Bharath R, Bhattacharyya GS, Koyande S, Singhal M, Vora A, Verma A, Hingmire S. Lung cancer in India: Current status and promising strategies. South Asian J Cancer 2016; 5:93-5. [PMID: 27606289 PMCID: PMC4991145 DOI: 10.4103/2278-330x.187563] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- P M Parikh
- Asian Cancer Institute, KJ Somaiya Ayurvihar, Mumbai, Maharashtra, India
| | - A A Ranade
- Avinash Cancer Clinic, Pune, Maharashtra, India
| | - Babu Govind
- Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | | | - R Singh
- HCG Cancer Center, New Delhi, India
| | - R Bharath
- Kovai Hospital, Coimbatore, Tamil Nadu, India
| | | | - S Koyande
- Indian Cancer Society, Mumbai, Maharashtra, India
| | - M Singhal
- Indraprastha Apollo Hospital, New Delhi, India
| | - A Vora
- Max Hospital, New Delhi, India
| | - A Verma
- Max Hospital, New Delhi, India
| | - S Hingmire
- Deenanath Mangeshkar Hospital, Pune, Maharashtra, India
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Chilukuri S, Mohammed N, Nalini Y, Kiran K, Ghadyalpatil N, Sreekanth K. P-067 Long term results of a prospective study of dose escalated volumetric modulated arc radiotherapy with concurrent chemotherapy in inoperable squamous cell carcinoma of esophagus. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw199.65] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Bajpai J, Kumar P, Shetty N, Medekar A, Kurkure PA, Ghadyalpatil N, Gupta S, Noronha V, Kanujia A, Parikh P, Banavali SD. Management of febrile neutropenia in malignancy using the MASCC score and other factors: Feasibility and safety in routine clinical practice. Indian J Cancer 2014; 51:491-5. [DOI: 10.4103/0019-509x.175340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Prabhash K, Medhekar A, Ghadyalpatil N, Noronha V, Biswas S, Kurkure P, Nair R, Kelkar R. Blood stream infections in cancer patients: a single center experience of isolates and sensitivity pattern. Indian J Cancer 2010; 47:184-8. [PMID: 20448384 DOI: 10.4103/0019-509x.63019] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Up to 10% of patients who develop a nosocomial blood stream infection (BSI) in the hospital have an underlying malignancy. The treatment of infections in patients with malignancy often relies on the use of established guidelines along with the consideration of the local microbiology and antibiotic sensitivity patterns of possible etiologic agents. AIMS This study attempts to identify the likely etiologic agents and the antibiotic sensitivity profile of BSIs in cancer patients. SETTINGS AND DESIGN This was a retrospective study. METHODS AND MATERIAL The study was conducted at a tertiary care center for cancer patients, in which samples representing blood stream infections sent from the Medical Oncology services of the hospital during the year of 2007 were analysed. The microbiological profile and antibiotic sensitivity pattern of these isolates was studied. RESULTS There were 484 isolates that represented BSIs. The most common bacterial isolates from patients with cancer were Pseudomonas spp. (30.37%), Staphylococcus aureus (12.6%) and Acinetobacter spp. (11.57%). Meropenem was the most effective antibiotic with 71.2% sensitivity to the bacterial isolates it was tested against. Oxacillin resistance was seen in 18% of S. aureus isolates. CONCLUSION Gram-negative bacteria were more common as etiologic agents of BSIs in cancer patients. The poor activity of the primary empirical agents for infections in cancer namely ceftazidime and piperacillin-tazobactam is alarming.Strict regulation of vancomycin use should be considered in areas where there is a low prevalence of methicillin-resistant S. aureus (MRSA).
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Affiliation(s)
- K Prabhash
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
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Ghadyalpatil N, Prabhash K, Menon H, Nair R, Banavali S, Noronha V, Wabale V, Singh R, Goyal G, Ostwal V. Tuberculosis infection in chronic myeloid leukemia (CML) patients treated with imatinib. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.6594] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Ostwal V, Ghadyalpatil N, Prabhash K, Menon H, Nair R, Sengar M, Noronha V, Biswas S, Bhosale B, Banavali S. Reactivation of latent viral hepatitis infection in patients of chronic myeloid leukemia treated with imatinib mesylate: Experience from a tertiary cancer center in India. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.6593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Bajpai J, Prabhash K, Medhekar A, Nair R, Kurkure P, Ghadyalpatil N, Gupta S, Noronha V, Kudale PD, Banavali S. Performance of MASCC score and other factors for identifying low-risk febrile-neutropenic cancer patients. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e19533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Ghadyalpatil N, Banawali S, Kurkure P, Arora B, Bansal S, Amare P, Choughule A, Soy L, Singh R. Efficacy and tolerability of imatinib mesylate in pediatric chronic myeloid leukemia in a large cohort: Results from a tertiary care referral center in India. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.10047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10047 Background: Chronic myeloid leukemia (CML) is a rare disease in children and there is limited data of safety and efficacy of imatinib mesylate (IM) in this age group. Methods: We analyzed the outcomes of 48 consecutive children (September 1998 to December 2008) in chronic phase (CP) or accelerated phase (AP) CML not eligible for Allo-SCT and were treated with IM [Glivec (Novartis), through patient assistance programme GIPAP or Veenat (NATCO), generic brand for GIPAP ineligible patients] within 12 months of diagnosis. The dose of IM was 260 mg/m2(maximum 400 mg) per day. Results: The median age at the time of diagnosis was 12 years (range 3–18 years). Of 48 patients, (34 males and 14 females) 46 were in CP and 2 in AP. Forty-three patients (89.5 %) achieved complete cytogenetic response (CCR) at median time of 10 months (range 3–31 months). Five patients (10 %) had hematological response but did not have CCR, of which 2 progressed to AP and 1 had hematological relapse. One patient had secondary IM resistance and had progressive disease even on dose escalation. Two patients in AP at diagnosis achieved CCR at 5 and 7 months and continue to be in CCR. Thirty-one out of 35 patients on Glivec and 12 out of 13 patients on Veenat achieved CCR. At a median follow up 29 months, the event free survival and overall survival was 74.1% and 100 % respectively. IM was well tolerated with grade III and IV neutropenia and thrombocytopenia seen in 2 and 7 patients respectively. Significant non hematological toxicities were uncommon except for hypopigmentation which was seen in more than half the cohort. Conclusions: Results from this largest single center study indicate that outcome of children with CML receiving IM is similar to adults. This data will be especially useful for financially challenged patients in developing countries where Allo-SCT is still not an affordable option while generic brand of IM seems to be feasible alternative. No significant financial relationships to disclose.
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Affiliation(s)
| | | | | | - B. Arora
- Tata Memorial Hospital, Mumbai, India
| | - S. Bansal
- Tata Memorial Hospital, Mumbai, India
| | - P. Amare
- Tata Memorial Hospital, Mumbai, India
| | | | - L. Soy
- Tata Memorial Hospital, Mumbai, India
| | - R. Singh
- Tata Memorial Hospital, Mumbai, India
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Menon H, Hingmire SS, Bharath R, Jain K, Ghadyalpatil N, Prasad N, Biswas G, Deshmukh C, Sastry P, Parikh PM. Outcome of patients of CML in AP and BC with imatinib: A retrospective analysis of patients from India. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.17531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
17531 Background: Imatinib is a very active agent in advanced phase CML. The present study assesses the impact of Imatinib therapy on the outcome of Indian patients with CML in Accelerated Phase (AP) and Blast Crisis (BC). Methods: Patients of CML in AP or BC who were treated with Imatinib based therapy between 2001 and 2006 were analyzed retrospectively. Results: A total of 65 patients who received Imatinib based treatment for CML in AP or BC were analyzed. Thirty eight (58.46 %) patients diagnosed in chronic phase (CP) were initiated on Imatinib based treatment at time of progression to AP or BC. The remaining 27 (41.53 %) patients had AP or BC of CML at initial diagnosis. At the time of start of Imatinib treatment 36 (55.38 %) patients had AP and 29 (44.61 %) were in BC. Imatinib as a single agent was used in 41 (63.07 %) patients (27 in AP and 14 in BC) and in combination with oral 6-MP and Etoposide was used in 24 (36.92 %) patients (14 in AP and 10 in BC). Hematological response (HR) was seen in 64.61% (42 out of 65) patients, complete HR in 32 (49.23 %) and partial HR in 10 (15.38 %). Cytogenetic response (CR) was noted in 21 (32.31%) patients (Complete -10, Partial -9, and Minor - 2). Twenty eight (43.07%) patients remained progression free (HR+CR in 16 and only HR in 12 patients) till the last date of follow up (median duration of follow-up was 17 months).For the whole group (n=65) the overall survival from the diagnosis of AP or BC after commencing Imatinib treatment was 65.3%, 51.6% and 34.4% at 1, 2 and 3 years respectively. The median survival was 25 months. The median survival and OS at 1 year, as expected, was significantly better for patients in AP (36 months, 77.4 %) as compared to those in BC (11 months, 48.2%)(p=0.004) and both were much longer than previously reported with non-Imatinib therapy. Outcome in patients with AP or BC was not significantly improved by addition of 6-MP and Etoposide. Temporary discontinuation of Imatinb for grade III/IV toxicity was done in 27 (41.53 %) patients for a median duration of 28 days. Conclusions: Imatinib has improved the outcome of patients with advanced phase CML. Our data also documents this in patients from India. However, Imatinib needs to be studied with newer combinations to achieve long term disease control in patients with CML, particularly those in BC. No significant financial relationships to disclose.
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Affiliation(s)
- H. Menon
- Tata Memorial Hospital, Parel, Mumbai, India
| | | | - R. Bharath
- Tata Memorial Hospital, Parel, Mumbai, India
| | - K. Jain
- Tata Memorial Hospital, Parel, Mumbai, India
| | | | - N. Prasad
- Tata Memorial Hospital, Parel, Mumbai, India
| | - G. Biswas
- Tata Memorial Hospital, Parel, Mumbai, India
| | - C. Deshmukh
- Tata Memorial Hospital, Parel, Mumbai, India
| | - P. Sastry
- Tata Memorial Hospital, Parel, Mumbai, India
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