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Buck G, Tomczak P. Prisoners regulating prisons: Voice, action, participation and riot. Criminol Crim Justice 2024; 24:144-163. [PMID: 38249424 PMCID: PMC10798870 DOI: 10.1177/17488958221101997] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
Prisoners are a critical source of prison regulation around the world, but regulation by (rather than of) prisoners remains little analysed. In this article, we utilise the 1990 riots at HMP Strangeways (England), as a case study of prisoners (re)shaping imprisonment. We examine prisoners' roles in these riots and subsequent cross-sectoral regulatory activities. We innovatively use the four-phase process of translation from actor-network theory to guide document analysis of (1) Lord Woolf's official inquiry into the riots and (2) the voluntary organisation Prison Reform Trust's follow-up report. We explore how participatory approaches could inform prison regulation through (former) prisoners partnering with external regulators throughout the processes of identifying problems and solutions to establish broader alliances seeking social change.
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Banwell-Moore R, Tomczak P. Complaints: Mechanisms for prisoner participation? Eur J Criminol 2023; 20:1878-1898. [PMID: 37841107 PMCID: PMC10576193 DOI: 10.1177/14773708221094271] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
In prisons, participatory mechanisms can foster important outcomes including fairness, legitimacy and dignity. Complaints are one significant (symbolic) mechanism facilitating prisoner participation. Ombud institutions/Ombudsmen handle complaints externally, providing unelected accountability mechanisms and overseeing prisons around the world. A fair complaints process can stimulate prisoner voice, agency and rights protection, potentially averting self-harm and violence, and facilitating systemic improvements. However, complaints mechanisms are little studied. Addressing this gap, we: i) contextualise discussion by demonstrating that prisoners' actions have directly shaped complaints mechanisms available today; ii) outline prison complaints mechanisms in the case study jurisdiction of England and Wales; and iii) provide a critical review of literature to assess whether prison complaints systems are, in practice, participatory, inclusive and fair? We conclude that complaints mechanisms hold clear potential to enhance prison legitimacy, facilitate prisoner engagement and agency, and improve wellbeing and safety. However, myriad barriers prevent prisoners from participating in complaints processes, including culture, fear, accessibility, timeliness, emotional repression, and bureaucracy. The process of complaining and experiences of these barriers are uneven across different groups of prisoners. Our article provides a springboard for future empirical research.
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Quinn K, Tomczak P, Buck G. "How you keep going": Voluntary sector practitioners' story-lines as emotion work. Br J Sociol 2022; 73:370-386. [PMID: 35034350 DOI: 10.1111/1468-4446.12914] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 10/10/2021] [Accepted: 12/06/2021] [Indexed: 06/14/2023]
Abstract
The voluntary sector acts as the last line of defense for some of the most marginalized people in societies around the world, yet its capacities are significantly reduced by chronic resource shortages and dynamic political obstacles. Existing research has scarcely examined what it is like for voluntary sector practitioners working amidst these conditions. In this paper, we explore how penal voluntary sector practitioners across England and Scotland marshaled their personal and professional resources to "keep going" amidst significant challenges. Our analysis combines symbolic interactionism with the concept of story-lines. We illuminate the narratives that practitioners mobilized to understand and motivate their efforts amidst the significant barriers, chronic limitations, and difficult emotions brought forth by their work. We position practitioners' story-lines as a form of emotion work that mitigated their experiences of anger, frustration, overwhelm, sadness, and disappointment, enabling them to move forward and continue to support criminalized individuals. Our analysis details three story-lines-resignation, strategy, and refuge-and examines their consequences for practitioners and their capacities to intervene in wicked social problems.
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Affiliation(s)
- Kaitlyn Quinn
- Department of Sociology, University of Toronto, Toronto, Ontario, Canada
| | - Philippa Tomczak
- Department of Sociology and Social Policy, University of Nottingham, Nottingham, UK
| | - Gillian Buck
- Department of Social Work and Interprofessional Education, University of Chester, Chester, UK
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Tomczak P. Highlighting "Risky Remands" Through Prisoner Death Investigations: People With Very Severe Mental Illness Transitioning From Police and Court Custody Into Prison on Remand. Front Psychiatry 2022; 13:862365. [PMID: 35432008 PMCID: PMC9011132 DOI: 10.3389/fpsyt.2022.862365] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 02/21/2022] [Indexed: 11/21/2022] Open
Abstract
Prison suicide/self-inflicted death is an international public health crisis, harming stakeholders including bereaved families, prisoners, prison staff and death investigators. England and Wales' record prison suicide numbers in 2016 cost at least £400 million. Death rates are an indicator of prison safety, and unsafe prisons mean unsafe societies. I present four case studies of people with very severe mental illness who were remanded to prison from police and/or court custody and went on to take their own lives in prison. I use publicly available data from Ombudsman and Coronial death investigations in England and Wales, highlighting that these accessible sources could be more widely mobilized to reduce the substantial harms and costs of prisoner deaths. Case studies include three men (Lewis Francis, Jason Basalat and Dean Saunders) and one woman (Sarah Reed) who took their own lives between January 2016 and April 2017. All four people were clearly very mentally unwell at the time of their alleged offense and remand to prison. I develop the concept of "risky remands" to highlight that people with very severe mental illness being remanded to prison is a particularly problematic practice. I highlight the implications of people with very severe mental illness transitioning into prison in the first place, arguing that being remanded to prison is not an acceptable or safe pathway into healthcare. I illustrate that police custody suites and courts may lack awareness of mechanisms and/ or the practical ability to transfer ill detainees charged with a serious crime to mental health facilities for assessment and/ or treatment. My analysis amplifies and extends recent Criminal Justice Joint Inspection findings that it is unacceptable to use prisons as a "place of safety," and that the Department of Health and Social Care, NHS England and the Welsh Government must increase the supply of medium and high secure beds. Moreover, Ombudsman investigations did not engage with the remand transition, effectively legitimizing this risky practice for very ill people. As such, my analysis also counters the apparent "problem of implementation" in prison oversight, instead questioning what reviewers recommend, based on which evidence.
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Affiliation(s)
- Philippa Tomczak
- prisonHEALTH Research Group, School of Sociology and Social Policy, University of Nottingham, Nottingham, England
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Choueiri T, Tomczak P, Park S, Venugopal B, Symeonides S, Hajek J, Ferguson T, Chang YH, Lee J, Haas N, Sawrycki P, Sarwar N, Gross-Goupil M, Thiery-Vuillemin A, Mahave M, Saretsky T, Zhang P, Willemann-Rogerio J, Quinn D, Powles T. 653O Pembrolizumab (pembro) vs placebo as adjuvant therapy for patients (pts) with renal cell carcinoma (RCC): Patient-reported outcomes (PRO) in KEYNOTE-564. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.049] [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: 10/20/2022] Open
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Evans C, Poku B, Pearce R, Eldridge J, Hendrick P, Knaggs R, Blake H, Yogeswaran G, McLuskey J, Tomczak P, Thow R, Harris P, Conway J, Collier R. Characterising the outcomes, impacts and implementation challenges of advanced clinical practice roles in the UK: a scoping review. BMJ Open 2021; 11:e048171. [PMID: 34353799 PMCID: PMC8344309 DOI: 10.1136/bmjopen-2020-048171] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 06/23/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES In response to demographic and health system pressures, the development of non-medical advanced clinical practice (ACP) roles is a key component of National Health Service workforce transformation policy in the UK. This review was undertaken to establish a baseline of evidence on ACP roles and their outcomes, impacts and implementation challenges across the UK. DESIGN A scoping review was undertaken following JBI methodological guidance. METHODS 13 online databases (Medline, CINAHL, ASSIA, Embase, HMIC, AMED, Amber, OT seeker, PsycINFO, PEDro, SportDiscus, Osteopathic Research and PenNutrition) and grey literature sources were searched from 2005 to 2020. Data extraction, charting and summary was guided by the PEPPA-Plus framework. The review was undertaken by a multi-professional team that included an expert lay representative. RESULTS 191 papers met the inclusion criteria (any type of UK evidence, any sector/setting and any profession meeting the Health Education England definition of ACP). Most papers were small-scale descriptive studies, service evaluations or audits. The papers reported mainly on clinical aspects of the ACP role. Most papers related to nursing, pharmacy, physiotherapy and radiography roles and these were referred to by a plethora of different titles. ACP roles were reported to be achieving beneficial impacts across a range of clinical and health system outcomes. They were highly acceptable to patients and staff. No significant adverse events were reported. There was a lack of cost-effectiveness evidence. Implementation challenges included a lack of role clarity and an ambivalent role identity, lack of mentorship, lack of continuing professional development and an unclear career pathway. CONCLUSION This review suggests a need for educational and role standardisation and a supported career pathway for advanced clinical practitioners (ACPs) in the UK. Future research should: (i) adopt more robust study designs, (ii) investigate the full scope of the ACP role and (iii) include a wider range of professions and sectors.
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Affiliation(s)
- Catrin Evans
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Brenda Poku
- School of Sociology and Social Policy, University of Nottingham, Nottingham, UK
| | - Ruth Pearce
- School of Education, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Jeanette Eldridge
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Paul Hendrick
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Roger Knaggs
- School of Pharmacy, University of Nottingham, Nottingham, UK
| | - Holly Blake
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Gowsika Yogeswaran
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - John McLuskey
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Philippa Tomczak
- School of Sociology and Social Policy, University of Nottingham, Nottingham, UK
| | - Ruaridh Thow
- Emergency Department, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Peter Harris
- Health Education England East Midlands, Leicester, UK
| | - Joy Conway
- College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK
| | - Richard Collier
- Centre for Advancing Practice, Health Education England, Leeds, UK
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Evans C, Poku B, Pearce R, Eldridge J, Hendrick P, Knaggs R, McLuskey J, Tomczak P, Thow R, Harris P, Conway J, Collier R. Characterising the evidence base for advanced clinical practice in the UK: a scoping review protocol. BMJ Open 2020; 10:e036192. [PMID: 32439696 PMCID: PMC7247387 DOI: 10.1136/bmjopen-2019-036192] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION A global health workforce crisis, coupled with ageing populations, wars and the rise of non-communicable diseases is prompting all countries to consider the optimal skill mix within their health workforce. The development of advanced clinical practice (ACP) roles for existing non-medical cadres is one potential strategy that is being pursued. In the UK, National Health Service (NHS) workforce transformation programmes are actively promoting the development of ACP roles across a wide range of non-medical professions. These efforts are currently hampered by a high level of variation in ACP role development, deployment, nomenclature, definition, governance and educational preparation across the professions and across different settings. This scoping review aims to support a more consistent approach to workforce development in the UK, by identifying and mapping the current evidence base underpinning multiprofessional advanced level practice in the UK from a workforce, clinical, service and patient perspective. METHODS AND ANALYSIS This scoping review is registered with the Open Science Framework (https://osf.io/tzpe5). The review will follow Joanna Briggs Institute guidance and involves a multidisciplinary and multiprofessional team, including a public representative. A wide range of electronic databases and grey literature sources will be searched from 2005 to the present. The review will include primary data from any relevant research, audit or evaluation studies. All review steps will involve two or more reviewers. Data extraction, charting and summary will be guided by a template derived from an established framework used internationally to evaluate ACP (the Participatory Evidence-Informed Patient-Centred Process-Plus framework). DISSEMINATION The review will produce important new information on existing activity, outcomes, implementation challenges and key areas for future research around ACP in the UK, which, in the context of global workforce transformations, will be of international, as well as local, significance. The findings will be disseminated through professional and NHS bodies, employer organisations, conferences and research papers.
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Affiliation(s)
- Catrin Evans
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Brenda Poku
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Ruth Pearce
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | | | - Paul Hendrick
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Roger Knaggs
- School of Pharmacy, University of Nottingham, Nottingham, Nottinghamshire, UK
| | - John McLuskey
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Philippa Tomczak
- School of Sociology and Social Policy, University of Nottingham, Nottingham, UK
| | - Ruaridh Thow
- Emergency Department, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Peter Harris
- Health Education England East Midlands, Nottingham, UK
| | - Joy Conway
- College of Health and Life Sciences, Brunel University, Uxbridge, UK
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Suárez C, Lee JL, Ziobro M, Gafanov R, Matveev V, Donskov F, Pouliot F, Alekseev B, Wiechno P, Tomczak P, Climent M, Shin S, Kloss Silverman R, Perini R, Schloss C, McDermott D, Atkins M. First-line pembrolizumab (pembro) monotherapy for advanced non-clear cell renal cell carcinoma (nccRCC): Updated follow-up for KEYNOTE-427 cohort B. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz249.044] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Larkin J, Tykodi S, Donskov F, Lee JL, Szczylik C, Malik J, Alekseev B, Matveev V, Gafanov R, Tomczak P, Geertsen P, Wiechno P, Shin S, Pouliot F, Alonso Gordoa T, Kloss Silverman R, Perini R, Schloss C, McDermott D, Atkins M. First-line pembrolizumab (pembro) monotherapy in advanced clear cell renal cell carcinoma (ccRCC): Updated follow-up for KEYNOTE-427 cohort A. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz249.045] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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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Donskov F, McDermott D, Lee J, Szczylik C, Malik J, Alekseev B, Larkin J, Matveev V, Airatovich Gafanov R, Tomczak P, Tykodi S, Geertsen P, Wiechno P, Shin S, Pouliot F, Alonso Gordoa T, Kloss Silverman R, Perini R, Schloss C, Atkins M. KEYNOTE-427 cohort A: Pembrolizumab monotherapy as first-line therapy in advanced clear cell renal cell carcinoma (ccRCC). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy283.080] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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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Ravaud A, Motzer R, Pandha H, Staehler M, George D, Pantuck A, Patel A, Chang YH, Escudier B, Donskov F, Magheli A, Carteni G, Laguerre B, Tomczak P, Breza J, Gerletti P, Lin X, Lechuga M, Martini JF, Patard JJ. genitourinary tumours, non prostate Phase III trial of sunitinib (SU) vs placebo (PBO) as adjuvant treatment for high-risk renal cell carcinoma (RCC) after nephrectomy (S-TRAC). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw435.22] [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: 11/14/2022] Open
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Puszkarski H, Tomczak P. Spin-wave resonance model of surface pinning in ferromagnetic semiconductor (Ga,Mn)As thin films. Sci Rep 2014; 4:6135. [PMID: 25164617 PMCID: PMC4147375 DOI: 10.1038/srep06135] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 07/28/2014] [Indexed: 12/03/2022] Open
Abstract
The source of spin-wave resonance (SWR) in thin films of the ferromagnetic semiconductor (Ga,Mn)As is still under debate: does SWR stem from the surface anisotropy (in which case the surface inhomogeneity (SI) model would apply), or does it originate in the bulk inhomogeneity of the magnetic structure of the sample (and thus requires the use of the volume inhomogeneity (VI) model)? This paper outlines the ground on which the controversy arose and shows why in different conditions a resonance sample may meet the assumptions of either the SI or the VI model.
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Affiliation(s)
- H Puszkarski
- Surface Physics Division, Faculty of Physics, Adam Mickiewicz University, ul. Umultowska 85, 61-614 Poznań, Poland
| | - P Tomczak
- Quantum Physics Division, Faculty of Physics, Adam Mickiewicz University, ul. Umultowska 85, 61-614 Poznań, Poland
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Motzer R, Escudier B, Tomczak P, Negrier S, Gore M, Tarazi J, Hariharan S, Rosbrook B, Kim S, Rini B. Axitinib vs Sorafenib for Advanced Renal Cell Carcinoma: Phase III Overall Survival Results and Analysis of Prognostic Factors. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33351-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Escudier B, Loomis A, Kaprin A, Motzer R, Tomczak P, Tarazi J, Kim S, Gao F, Williams J, Rini B. 7103 ORAL Association of Single Nucleotide Polymorphisms (SNPs) in VEGF Pathway Genes With Progression-free Survival (PFS) and Blood Pressure (BP) in Metastatic Renal Cell Carcinoma (mRCC) in the Phase 3 Trial of Axitinib Versus Sorafenib (AXIS Trial). Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)72018-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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15
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Eisen T, Joensuu H, Nathan P, Harper P, Wojtukiewicz M, Nicholson S, Bahl A, Tomczak P, Wagner A, Quinn D. 7141 POSTER Phase II Trial of the Oral Multikinase Inhibitor Regorafenib (BAY 73-4506) as First-line Therapy in Patients With Metastatic or Unresectable Renal Cell Carcinoma (RCC). Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)72056-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Rini BI, Escudier B, Tomczak P, Kaprin A, Hutson TE, Szczylik C, Tarazi JC, Rosbrook B, Kim S, Motzer RJ. Axitinib versus sorafenib as second-line therapy for metastatic renal cell carcinoma (mRCC): Results of phase III AXIS trial. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4503] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [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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Rini BI, Szczylik C, Tannir NM, Koralewski P, Tomczak P, Deptala A, Kracht K, Sun Y, Puhlmann M, Escudier B. AMG 386 in combination with sorafenib in patients (pts) with metastatic renal cell cancer (mRCC): A randomized, double-blind, placebo-controlled, phase II study. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.7_suppl.309] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
309 Background: AMG 386 inhibits angiogenesis by sequestering angiopoietin-1 and -2, thus preventing their interaction with the Tie2 receptor on endothelial cells. Combination with VEGF receptor inhibition has demonstrated additive effects in vivo. The efficacy and tolerability of sorafenib plus AMG 386, an investigational peptide-Fc fusion protein, were evaluated in mRCC pts. Methods: Treatment-naive pts with clear cell mRCC were randomized 1:1:1 to sorafenib 400 mgPO BID plus AMG 386 10 mg/kg (Arm A) or 3 mg/kg (Arm B) QW; or placebo (Arm C) IV QW. Endpoints were progression-free survival (PFS; primary); and (secondary) objective response rate (ORR), change in tumor burden, adverse events (AEs) and pharmacokinetics. Tumor assessment was performed at baseline and every 8 weeks thereafter. Results: 152 pts were randomized: Arms A/B/C, n=50/51/51. 60/61/61% of pts had intermediate and 40/39/37% had low MSKCC risk at baseline. PFS was similar in all 3 arms, whereas ORR was higher in the AMG 386 arms ( Table ). In Arms A/B/C the incidence of grade ≥ 3 AEs was 66/73/86% and serious AEs 36/49/28%. The most common AEs included diarrhea (70/67/56%; grade ≥3 8/10/8%), hand- foot syndrome (52/47/54%; grade ≥3 12/16/28%), alopecia (50/45/50%; grade ≥3 0/0/2%), and hypertension (42/49/46%; grade ≥3 18/20/14%). Median steady-state Cmax and Cmin for AMG 386 were similar to those reported previously. Sorafenib coadministration did not markedly affect AMG 386 exposure. Conclusions: Sorafenib plus AMG 386 was tolerable but did not improve PFS compared with sorafenib plus placebo. Increased ORR and the observed reduction in tumor burden are suggestive of an antitumor effect of AMG 386 in mRCC. [Table: see text] [Table: see text]
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Affiliation(s)
- B. I. Rini
- Cleveland Clinic Taussig Cancer Center, Cleveland, OH; Wojskowy Instytut Medyczny, CSK MON Klinika Onkologii, Warszawa, Poland; University of Texas M. D. Anderson Cancer Center, Houston, TX; Wojewodzki Szpital Specjalistyczny im. L. Rydygiera, Krakow, Poland; Samodzielny Publiczny Szpital Kliniczny Numer 1 Imienia Przemienienia Panskiego Akademii Medycznej, Poznan, Poland; Warszawski Uniwersytet Medyczny and Centralny Szpital Kliniczny MSWiA, Warsaw, Poland; Amgen Inc., Thousand Oaks, CA; Institut
| | - C. Szczylik
- Cleveland Clinic Taussig Cancer Center, Cleveland, OH; Wojskowy Instytut Medyczny, CSK MON Klinika Onkologii, Warszawa, Poland; University of Texas M. D. Anderson Cancer Center, Houston, TX; Wojewodzki Szpital Specjalistyczny im. L. Rydygiera, Krakow, Poland; Samodzielny Publiczny Szpital Kliniczny Numer 1 Imienia Przemienienia Panskiego Akademii Medycznej, Poznan, Poland; Warszawski Uniwersytet Medyczny and Centralny Szpital Kliniczny MSWiA, Warsaw, Poland; Amgen Inc., Thousand Oaks, CA; Institut
| | - N. M. Tannir
- Cleveland Clinic Taussig Cancer Center, Cleveland, OH; Wojskowy Instytut Medyczny, CSK MON Klinika Onkologii, Warszawa, Poland; University of Texas M. D. Anderson Cancer Center, Houston, TX; Wojewodzki Szpital Specjalistyczny im. L. Rydygiera, Krakow, Poland; Samodzielny Publiczny Szpital Kliniczny Numer 1 Imienia Przemienienia Panskiego Akademii Medycznej, Poznan, Poland; Warszawski Uniwersytet Medyczny and Centralny Szpital Kliniczny MSWiA, Warsaw, Poland; Amgen Inc., Thousand Oaks, CA; Institut
| | - P. Koralewski
- Cleveland Clinic Taussig Cancer Center, Cleveland, OH; Wojskowy Instytut Medyczny, CSK MON Klinika Onkologii, Warszawa, Poland; University of Texas M. D. Anderson Cancer Center, Houston, TX; Wojewodzki Szpital Specjalistyczny im. L. Rydygiera, Krakow, Poland; Samodzielny Publiczny Szpital Kliniczny Numer 1 Imienia Przemienienia Panskiego Akademii Medycznej, Poznan, Poland; Warszawski Uniwersytet Medyczny and Centralny Szpital Kliniczny MSWiA, Warsaw, Poland; Amgen Inc., Thousand Oaks, CA; Institut
| | - P. Tomczak
- Cleveland Clinic Taussig Cancer Center, Cleveland, OH; Wojskowy Instytut Medyczny, CSK MON Klinika Onkologii, Warszawa, Poland; University of Texas M. D. Anderson Cancer Center, Houston, TX; Wojewodzki Szpital Specjalistyczny im. L. Rydygiera, Krakow, Poland; Samodzielny Publiczny Szpital Kliniczny Numer 1 Imienia Przemienienia Panskiego Akademii Medycznej, Poznan, Poland; Warszawski Uniwersytet Medyczny and Centralny Szpital Kliniczny MSWiA, Warsaw, Poland; Amgen Inc., Thousand Oaks, CA; Institut
| | - A. Deptala
- Cleveland Clinic Taussig Cancer Center, Cleveland, OH; Wojskowy Instytut Medyczny, CSK MON Klinika Onkologii, Warszawa, Poland; University of Texas M. D. Anderson Cancer Center, Houston, TX; Wojewodzki Szpital Specjalistyczny im. L. Rydygiera, Krakow, Poland; Samodzielny Publiczny Szpital Kliniczny Numer 1 Imienia Przemienienia Panskiego Akademii Medycznej, Poznan, Poland; Warszawski Uniwersytet Medyczny and Centralny Szpital Kliniczny MSWiA, Warsaw, Poland; Amgen Inc., Thousand Oaks, CA; Institut
| | - K. Kracht
- Cleveland Clinic Taussig Cancer Center, Cleveland, OH; Wojskowy Instytut Medyczny, CSK MON Klinika Onkologii, Warszawa, Poland; University of Texas M. D. Anderson Cancer Center, Houston, TX; Wojewodzki Szpital Specjalistyczny im. L. Rydygiera, Krakow, Poland; Samodzielny Publiczny Szpital Kliniczny Numer 1 Imienia Przemienienia Panskiego Akademii Medycznej, Poznan, Poland; Warszawski Uniwersytet Medyczny and Centralny Szpital Kliniczny MSWiA, Warsaw, Poland; Amgen Inc., Thousand Oaks, CA; Institut
| | - Y. Sun
- Cleveland Clinic Taussig Cancer Center, Cleveland, OH; Wojskowy Instytut Medyczny, CSK MON Klinika Onkologii, Warszawa, Poland; University of Texas M. D. Anderson Cancer Center, Houston, TX; Wojewodzki Szpital Specjalistyczny im. L. Rydygiera, Krakow, Poland; Samodzielny Publiczny Szpital Kliniczny Numer 1 Imienia Przemienienia Panskiego Akademii Medycznej, Poznan, Poland; Warszawski Uniwersytet Medyczny and Centralny Szpital Kliniczny MSWiA, Warsaw, Poland; Amgen Inc., Thousand Oaks, CA; Institut
| | - M. Puhlmann
- Cleveland Clinic Taussig Cancer Center, Cleveland, OH; Wojskowy Instytut Medyczny, CSK MON Klinika Onkologii, Warszawa, Poland; University of Texas M. D. Anderson Cancer Center, Houston, TX; Wojewodzki Szpital Specjalistyczny im. L. Rydygiera, Krakow, Poland; Samodzielny Publiczny Szpital Kliniczny Numer 1 Imienia Przemienienia Panskiego Akademii Medycznej, Poznan, Poland; Warszawski Uniwersytet Medyczny and Centralny Szpital Kliniczny MSWiA, Warsaw, Poland; Amgen Inc., Thousand Oaks, CA; Institut
| | - B. Escudier
- Cleveland Clinic Taussig Cancer Center, Cleveland, OH; Wojskowy Instytut Medyczny, CSK MON Klinika Onkologii, Warszawa, Poland; University of Texas M. D. Anderson Cancer Center, Houston, TX; Wojewodzki Szpital Specjalistyczny im. L. Rydygiera, Krakow, Poland; Samodzielny Publiczny Szpital Kliniczny Numer 1 Imienia Przemienienia Panskiego Akademii Medycznej, Poznan, Poland; Warszawski Uniwersytet Medyczny and Centralny Szpital Kliniczny MSWiA, Warsaw, Poland; Amgen Inc., Thousand Oaks, CA; Institut
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Eisen T, Joensuu H, Nathan P, Harper P, Wojtukiewicz M, Nicholson S, Bahl A, Tomczak P, Wagner A, Quinn D. 7105 Phase II trial of the oral multikinase inhibitor BAY 73–4506 as 1st-line therapy in patients with metastatic or unresectable renal cell cancer (RCC). EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71438-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Eisen T, Joensuu H, Nathan P, Harper P, Wojtukiewicz M, Nicholson S, Bahl A, Tomczak P, Wagner A, Quinn D. Phase II study of BAY 73–4506, a multikinase inhibitor, in previously untreated patients with metastatic or unresectable renal cell cancer. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.5033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [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
5033 Background: BAY 73–4506 is an orally active, potent multikinase inhibitor targeting both tumor cell proliferation and tumor vasculature through inhibition of receptors of tyrosine kinases (VEGFR, KIT, RET, FGFR, and PDGFR) and serine/threonine kinases (RAF and p38MAPK). In tumor xenograft models, BAY 73–4506 demonstrated a broad spectrum of antitumor activity. The results of a phase I study (3 weeks on/1 week off schedule) indicated good tolerability and antitumor activity, including objective responses. Methods: Previously untreated patients with predominantly clear cell renal cell carcinoma (RCC) and measurable disease according to RECIST were enrolled in this multicenter, open-label, phase II study. Eligibility criteria included ECOG performance status 0–1, low or intermediate risk as per Motzer score, and adequate bone marrow and organ function. Treatment consisted of BAY 73–4506 160 mg once daily on a 3 weeks on/1 week off schedule. The primary end point was overall response rate. Results: 49 patients started treatment (accrual completed October 2008): 27 male, 22 female, median age 62 years (range 40–76). All patients were evaluable for safety, 33 patients are currently available for efficacy evaluation. The most common drug-related adverse events (all grades) reported in >20% of patients were hand-foot skin reaction (HFSR) (48%), fatigue (48%), hypertension (43%), mucositis (35%), dysphonia (33%), rash (30%), diarrhea (25%), and anorexia (23%). Grade 3–4 drug related toxicities (in >5% of patients) included HFSR (13%), rash (8%), fatigue (8%), and renal failure (8%). Renal failure occurred only in patients who continued taking study medication despite having inadequate fluid intake and/or diarrhea. Preliminary efficacy data of the 33 patients evaluable for response show a 27% partial response (PR) and a 42% stable disease (SD) rate. Further tumor assessments are scheduled for the patients (n = 35) remaining on study. Conclusions: Preliminary data show promising antitumor activity and good tolerability of BAY 73–4506 in patients with RCC. The observed toxicities were typical of the drug class and were manageable. Updated results will be presented at the meeting. [Table: see text]
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Affiliation(s)
- T. Eisen
- Addenbrooke's Hospital, Cambridge, United Kingdom; Helsinki University Hospital, Helsinki, Finland; Mount Vernon Hospital, Northwood, United Kingdom; Guy's Hospital, London, United Kingdom; Bialostockie Centrum Onkologii, Bialystok, Poland; Leicester Royal Infirmary, Leicester, United Kingdom; Bristol Haematology and Oncology Centre, Bristol, United Kingdom; Szpital Kliniczny Przemienienia, Poznan, Poland; Bayer Schering Pharma, Berlin, Germany; University of Southern California, Los Angeles, CA
| | - H. Joensuu
- Addenbrooke's Hospital, Cambridge, United Kingdom; Helsinki University Hospital, Helsinki, Finland; Mount Vernon Hospital, Northwood, United Kingdom; Guy's Hospital, London, United Kingdom; Bialostockie Centrum Onkologii, Bialystok, Poland; Leicester Royal Infirmary, Leicester, United Kingdom; Bristol Haematology and Oncology Centre, Bristol, United Kingdom; Szpital Kliniczny Przemienienia, Poznan, Poland; Bayer Schering Pharma, Berlin, Germany; University of Southern California, Los Angeles, CA
| | - P. Nathan
- Addenbrooke's Hospital, Cambridge, United Kingdom; Helsinki University Hospital, Helsinki, Finland; Mount Vernon Hospital, Northwood, United Kingdom; Guy's Hospital, London, United Kingdom; Bialostockie Centrum Onkologii, Bialystok, Poland; Leicester Royal Infirmary, Leicester, United Kingdom; Bristol Haematology and Oncology Centre, Bristol, United Kingdom; Szpital Kliniczny Przemienienia, Poznan, Poland; Bayer Schering Pharma, Berlin, Germany; University of Southern California, Los Angeles, CA
| | - P. Harper
- Addenbrooke's Hospital, Cambridge, United Kingdom; Helsinki University Hospital, Helsinki, Finland; Mount Vernon Hospital, Northwood, United Kingdom; Guy's Hospital, London, United Kingdom; Bialostockie Centrum Onkologii, Bialystok, Poland; Leicester Royal Infirmary, Leicester, United Kingdom; Bristol Haematology and Oncology Centre, Bristol, United Kingdom; Szpital Kliniczny Przemienienia, Poznan, Poland; Bayer Schering Pharma, Berlin, Germany; University of Southern California, Los Angeles, CA
| | - M. Wojtukiewicz
- Addenbrooke's Hospital, Cambridge, United Kingdom; Helsinki University Hospital, Helsinki, Finland; Mount Vernon Hospital, Northwood, United Kingdom; Guy's Hospital, London, United Kingdom; Bialostockie Centrum Onkologii, Bialystok, Poland; Leicester Royal Infirmary, Leicester, United Kingdom; Bristol Haematology and Oncology Centre, Bristol, United Kingdom; Szpital Kliniczny Przemienienia, Poznan, Poland; Bayer Schering Pharma, Berlin, Germany; University of Southern California, Los Angeles, CA
| | - S. Nicholson
- Addenbrooke's Hospital, Cambridge, United Kingdom; Helsinki University Hospital, Helsinki, Finland; Mount Vernon Hospital, Northwood, United Kingdom; Guy's Hospital, London, United Kingdom; Bialostockie Centrum Onkologii, Bialystok, Poland; Leicester Royal Infirmary, Leicester, United Kingdom; Bristol Haematology and Oncology Centre, Bristol, United Kingdom; Szpital Kliniczny Przemienienia, Poznan, Poland; Bayer Schering Pharma, Berlin, Germany; University of Southern California, Los Angeles, CA
| | - A. Bahl
- Addenbrooke's Hospital, Cambridge, United Kingdom; Helsinki University Hospital, Helsinki, Finland; Mount Vernon Hospital, Northwood, United Kingdom; Guy's Hospital, London, United Kingdom; Bialostockie Centrum Onkologii, Bialystok, Poland; Leicester Royal Infirmary, Leicester, United Kingdom; Bristol Haematology and Oncology Centre, Bristol, United Kingdom; Szpital Kliniczny Przemienienia, Poznan, Poland; Bayer Schering Pharma, Berlin, Germany; University of Southern California, Los Angeles, CA
| | - P. Tomczak
- Addenbrooke's Hospital, Cambridge, United Kingdom; Helsinki University Hospital, Helsinki, Finland; Mount Vernon Hospital, Northwood, United Kingdom; Guy's Hospital, London, United Kingdom; Bialostockie Centrum Onkologii, Bialystok, Poland; Leicester Royal Infirmary, Leicester, United Kingdom; Bristol Haematology and Oncology Centre, Bristol, United Kingdom; Szpital Kliniczny Przemienienia, Poznan, Poland; Bayer Schering Pharma, Berlin, Germany; University of Southern California, Los Angeles, CA
| | - A. Wagner
- Addenbrooke's Hospital, Cambridge, United Kingdom; Helsinki University Hospital, Helsinki, Finland; Mount Vernon Hospital, Northwood, United Kingdom; Guy's Hospital, London, United Kingdom; Bialostockie Centrum Onkologii, Bialystok, Poland; Leicester Royal Infirmary, Leicester, United Kingdom; Bristol Haematology and Oncology Centre, Bristol, United Kingdom; Szpital Kliniczny Przemienienia, Poznan, Poland; Bayer Schering Pharma, Berlin, Germany; University of Southern California, Los Angeles, CA
| | - D. Quinn
- Addenbrooke's Hospital, Cambridge, United Kingdom; Helsinki University Hospital, Helsinki, Finland; Mount Vernon Hospital, Northwood, United Kingdom; Guy's Hospital, London, United Kingdom; Bialostockie Centrum Onkologii, Bialystok, Poland; Leicester Royal Infirmary, Leicester, United Kingdom; Bristol Haematology and Oncology Centre, Bristol, United Kingdom; Szpital Kliniczny Przemienienia, Poznan, Poland; Bayer Schering Pharma, Berlin, Germany; University of Southern California, Los Angeles, CA
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Miles D, Chan A, Romieu G, Dirix LY, Cortes J, Pivot X, Tomczak P, Taran T, Harbeck N, Steger GG. Randomized, double-blind, placebo-controlled, phase III study of bevacizumab with docetaxel or docetaxel with placebo as first-line therapy for patients with locally recurrent or metastatic breast cancer (mBC): AVADO. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.lba1011] [Citation(s) in RCA: 93] [Impact Index Per Article: 5.8] [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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Figlin RA, Hutson TE, Tomczak P, Michaelson MD, Bukowski RM, Négrier S, Huang X, Kim ST, Chen I, Motzer RJ. Overall survival with sunitinib versus interferon (IFN)-alfa as first-line treatment of metastatic renal cell carcinoma (mRCC). J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.5024] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.0] [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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Motzer RJ, Figlin RA, Hutson TE, Tomczak P, Bukowski RM, Rixe O, Bjarnason GA, Kim ST, Chen I, Michaelson D. Sunitinib versus interferon-alfa (IFN-α) as first-line treatment of metastatic renal cell carcinoma (mRCC): Updated results and analysis of prognostic factors. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.5024] [Citation(s) in RCA: 42] [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: 11/20/2022] Open
Abstract
5024 Background: In a randomized phase III trial of patients (pts) with mRCC, sunitinib demonstrated a significant improvement in progression-free survival (PFS) and objective response rate (ORR) compared to IFN-a as first-line therapy (Proc ASCO 2006;24:2s [Abstract LBA3]). We present the most recent data from this trial and an analysis of prognostic factors. Methods: Untreated pts with clear-cell mRCC were randomized 1:1 to receive either sunitinib (repeated 6-week cycles of 50 mg/day orally for 4 weeks, followed by 2 weeks off treatment) or IFN-a (9 MU given subcutaneously three times weekly). The primary endpoint was PFS. Results: A total of 750 pts were randomized: 375 to sunitinib, 375 to IFN-a. The median duration of treatment is 11 months (range: <1–25) for sunitinib vs. 4 months (range: <1–22) for IFN-a. The updated ORR by investigator assessment is 44% (95% CI: 39, 49) for sunitinib vs. 11% (95% CI: 8, 15) for IFN-a (p <0.000001), including 4 complete responses for sunitinib and 2 for IFN-a. The median duration of response in the sunitinib group (n=165) is 12 months (95% CI: 10, 14) vs. 10 months (95% CI: 8, 17) in the IFN-a group (n=43). The median PFS is 11 months (95% CI: 10, 11) for sunitinib vs. 4 months (95% CI: 4, 5) for IFN-a. The median PFS for pts with 0 risk factors is 14 months (95% CI: 11, 16) for sunitinib vs. 8 months (95% CI: 7, 10) for IFN-a; 9 months (95% CI: 8, 11) vs. 4 months (95% CI: 4, 4), respectively, for pts with 1- 2 risk factors; 4 months (95% CI: 2, 10) vs. 1 month (95% CI: 1, 2), respectively, for pts with =3 risk factors. The sunitinib benefit in PFS extends across all MSKCC prognostic risk factor groups (HR=0.488; 95% CI: 0.406, 0.586). The baseline features that predict longer PFS (by investigator assessment) for the sunitinib group are hemoglobin =LLN (p=0.0043), corrected calcium =10 mg/dL (p=0.001), ECOG score of 0 (p=0.0005), number of metastatic sites 0 or 1 (p=0.0064), and time from diagnosis to treatment =1 yr (p=0.0002). Conclusions: Sunitinib is a reference standard for first-line treatment of mRCC, with significant improvement in PFS and ORR compared to IFN-a. The benefit of sunitinib extends across all subgroups of pts with mRCC. Previously defined MSKCC risk factors for mRCC predict longer PFS with sunitinib. No significant financial relationships to disclose.
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Affiliation(s)
- R. J. Motzer
- Memorial Sloan-Kettering Cancer Center, New York, NY; City of Hope Comprehensive Cancer Center, Los Angeles, CA; Baylor Charles A. Sammons Cancer Center, Dallas, TX; Klinika Onkologii Oddzial Chemioterapii, Poznan, Poland; Cleveland Clinic Taussig Cancer Center, Cleveland, OH; Hospital Pitie-Salpetriere, Paris, France; Toronto-Sunnybrook Reg Cancer Center, Toronto, ON, Canada; Pfizer Inc., San Diego, CA; Massachusetts General Hospital, Boston, MA
| | - R. A. Figlin
- Memorial Sloan-Kettering Cancer Center, New York, NY; City of Hope Comprehensive Cancer Center, Los Angeles, CA; Baylor Charles A. Sammons Cancer Center, Dallas, TX; Klinika Onkologii Oddzial Chemioterapii, Poznan, Poland; Cleveland Clinic Taussig Cancer Center, Cleveland, OH; Hospital Pitie-Salpetriere, Paris, France; Toronto-Sunnybrook Reg Cancer Center, Toronto, ON, Canada; Pfizer Inc., San Diego, CA; Massachusetts General Hospital, Boston, MA
| | - T. E. Hutson
- Memorial Sloan-Kettering Cancer Center, New York, NY; City of Hope Comprehensive Cancer Center, Los Angeles, CA; Baylor Charles A. Sammons Cancer Center, Dallas, TX; Klinika Onkologii Oddzial Chemioterapii, Poznan, Poland; Cleveland Clinic Taussig Cancer Center, Cleveland, OH; Hospital Pitie-Salpetriere, Paris, France; Toronto-Sunnybrook Reg Cancer Center, Toronto, ON, Canada; Pfizer Inc., San Diego, CA; Massachusetts General Hospital, Boston, MA
| | - P. Tomczak
- Memorial Sloan-Kettering Cancer Center, New York, NY; City of Hope Comprehensive Cancer Center, Los Angeles, CA; Baylor Charles A. Sammons Cancer Center, Dallas, TX; Klinika Onkologii Oddzial Chemioterapii, Poznan, Poland; Cleveland Clinic Taussig Cancer Center, Cleveland, OH; Hospital Pitie-Salpetriere, Paris, France; Toronto-Sunnybrook Reg Cancer Center, Toronto, ON, Canada; Pfizer Inc., San Diego, CA; Massachusetts General Hospital, Boston, MA
| | - R. M. Bukowski
- Memorial Sloan-Kettering Cancer Center, New York, NY; City of Hope Comprehensive Cancer Center, Los Angeles, CA; Baylor Charles A. Sammons Cancer Center, Dallas, TX; Klinika Onkologii Oddzial Chemioterapii, Poznan, Poland; Cleveland Clinic Taussig Cancer Center, Cleveland, OH; Hospital Pitie-Salpetriere, Paris, France; Toronto-Sunnybrook Reg Cancer Center, Toronto, ON, Canada; Pfizer Inc., San Diego, CA; Massachusetts General Hospital, Boston, MA
| | - O. Rixe
- Memorial Sloan-Kettering Cancer Center, New York, NY; City of Hope Comprehensive Cancer Center, Los Angeles, CA; Baylor Charles A. Sammons Cancer Center, Dallas, TX; Klinika Onkologii Oddzial Chemioterapii, Poznan, Poland; Cleveland Clinic Taussig Cancer Center, Cleveland, OH; Hospital Pitie-Salpetriere, Paris, France; Toronto-Sunnybrook Reg Cancer Center, Toronto, ON, Canada; Pfizer Inc., San Diego, CA; Massachusetts General Hospital, Boston, MA
| | - G. A. Bjarnason
- Memorial Sloan-Kettering Cancer Center, New York, NY; City of Hope Comprehensive Cancer Center, Los Angeles, CA; Baylor Charles A. Sammons Cancer Center, Dallas, TX; Klinika Onkologii Oddzial Chemioterapii, Poznan, Poland; Cleveland Clinic Taussig Cancer Center, Cleveland, OH; Hospital Pitie-Salpetriere, Paris, France; Toronto-Sunnybrook Reg Cancer Center, Toronto, ON, Canada; Pfizer Inc., San Diego, CA; Massachusetts General Hospital, Boston, MA
| | - S. T. Kim
- Memorial Sloan-Kettering Cancer Center, New York, NY; City of Hope Comprehensive Cancer Center, Los Angeles, CA; Baylor Charles A. Sammons Cancer Center, Dallas, TX; Klinika Onkologii Oddzial Chemioterapii, Poznan, Poland; Cleveland Clinic Taussig Cancer Center, Cleveland, OH; Hospital Pitie-Salpetriere, Paris, France; Toronto-Sunnybrook Reg Cancer Center, Toronto, ON, Canada; Pfizer Inc., San Diego, CA; Massachusetts General Hospital, Boston, MA
| | - I. Chen
- Memorial Sloan-Kettering Cancer Center, New York, NY; City of Hope Comprehensive Cancer Center, Los Angeles, CA; Baylor Charles A. Sammons Cancer Center, Dallas, TX; Klinika Onkologii Oddzial Chemioterapii, Poznan, Poland; Cleveland Clinic Taussig Cancer Center, Cleveland, OH; Hospital Pitie-Salpetriere, Paris, France; Toronto-Sunnybrook Reg Cancer Center, Toronto, ON, Canada; Pfizer Inc., San Diego, CA; Massachusetts General Hospital, Boston, MA
| | - D. Michaelson
- Memorial Sloan-Kettering Cancer Center, New York, NY; City of Hope Comprehensive Cancer Center, Los Angeles, CA; Baylor Charles A. Sammons Cancer Center, Dallas, TX; Klinika Onkologii Oddzial Chemioterapii, Poznan, Poland; Cleveland Clinic Taussig Cancer Center, Cleveland, OH; Hospital Pitie-Salpetriere, Paris, France; Toronto-Sunnybrook Reg Cancer Center, Toronto, ON, Canada; Pfizer Inc., San Diego, CA; Massachusetts General Hospital, Boston, MA
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Osowiecka K, Litwiniuk M, Tomczak P. P183 Return to work after adjuvant treatment for breast cancer. Breast 2007. [DOI: 10.1016/s0960-9776(07)70243-6] [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: 11/27/2022] Open
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Motzer RJ, Hutson TE, Tomczak P, Michaelson MD, Bukowski RM, Rixe O, Oudard S, Kim ST, Baum CM, Figlin RA. Phase III randomized trial of sunitinib malate (SU11248) versus interferon-alfa (IFN-α) as first-line systemic therapy for patients with metastatic renal cell carcinoma (mRCC). J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.lba3] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
LBA3 Background: Two multicenter phase II trials of 2nd line monotherapy with sunitinib (SU11248) in patients (pts) with mRCC showed a response rate of approximately 40% (JCO 2006;24:16–24; Proc ASCO 23, 380s). This international, randomized phase III trial compared the efficacy and safety of sunitinib to IFN-α in treatment naïve pts with mRCC. Methods: Untreated pts with clear-cell mRCC were randomized 1:1 to receive sunitinib (6-week cycles: 50 mg orally once daily for 4 weeks, followed by 2 weeks off) or IFN-α (6-week cycles: subcutaneous injection 9 MU given three times weekly). The primary endpoint was progression-free survival (PFS). Secondary endpoints included objective response rate, overall survival, and adverse events. Based on a planned sample size of 690 patients, the trial was designed to have 90% power to detect a 35% improvement in median PFS from 20 weeks to 27 weeks (4.6 months to 6.2 months; 2-sided unstratified log-rank test; significance level 0.05). Results of a planned analysis on the primary endpoint, PFS, are presented in this report. Results: From Aug 2004 to Oct 2005, 750 patients were randomized: 375 to sunitinib, 375 to IFN-α. Baseline characteristics were well balanced, and included pooled median age = 60 and prior nephrectomy = 90%. Median PFS assessed by third-party independent review was 47.3 weeks (95% CI 40.9, not yet reached) for sunitinib vs. 24.9 weeks (95% CI 21.9, 37.1) for IFN-α [hazard ratio 0.394 (95% CI 0.297, 0.521) (p < 0.000001)]. The objective response rate by third-party independent review was 24.8% (95% CI 19.7, 30.5) for sunitinib vs. 4.9% (95% CI 2.7, 8.1) for IFN-α (p < 0.000001). The objective response rate by investigator assessment was 35.7% (95% CI 30.9, 40.8) for sunitinib vs. 8.8% (95% CI 6.1, 12.1) for IFN-α (p < 0.000001). 632 pts (85%) are alive, with 49 deaths on sunitinib arm and 65 deaths on IFN-α arm. 8% withdrew from the study due to adverse event on sunitinib arm vs. 13% on IFN-α arm. Conclusions: These results demonstrate a statistically significant improvement in PFS and objective response rate for sunitinib over IFN-α in first-line treatment of pts with mRCC. [Table: see text]
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Affiliation(s)
- R. J. Motzer
- Memorial Sloan-Kettering Cancer Center, New York, NY; Baylor-Sammons/Texas Oncology, PA, Dallas, TX; Klinika Oncologii Oddzial Chemioterapii, Poznan, Poland; Massachusetts General Hospital, Boston, MA; Cleveland Clinic Foundaton, Cleveland, OH; Hospital Pitie-Salpetriere, Paris, France; Georges Pompidou European Hospital, Paris, France; Pfizer Inc., La Jolla, CA; UCLA, Los Angeles, CA
| | - T. E. Hutson
- Memorial Sloan-Kettering Cancer Center, New York, NY; Baylor-Sammons/Texas Oncology, PA, Dallas, TX; Klinika Oncologii Oddzial Chemioterapii, Poznan, Poland; Massachusetts General Hospital, Boston, MA; Cleveland Clinic Foundaton, Cleveland, OH; Hospital Pitie-Salpetriere, Paris, France; Georges Pompidou European Hospital, Paris, France; Pfizer Inc., La Jolla, CA; UCLA, Los Angeles, CA
| | - P. Tomczak
- Memorial Sloan-Kettering Cancer Center, New York, NY; Baylor-Sammons/Texas Oncology, PA, Dallas, TX; Klinika Oncologii Oddzial Chemioterapii, Poznan, Poland; Massachusetts General Hospital, Boston, MA; Cleveland Clinic Foundaton, Cleveland, OH; Hospital Pitie-Salpetriere, Paris, France; Georges Pompidou European Hospital, Paris, France; Pfizer Inc., La Jolla, CA; UCLA, Los Angeles, CA
| | - M. D. Michaelson
- Memorial Sloan-Kettering Cancer Center, New York, NY; Baylor-Sammons/Texas Oncology, PA, Dallas, TX; Klinika Oncologii Oddzial Chemioterapii, Poznan, Poland; Massachusetts General Hospital, Boston, MA; Cleveland Clinic Foundaton, Cleveland, OH; Hospital Pitie-Salpetriere, Paris, France; Georges Pompidou European Hospital, Paris, France; Pfizer Inc., La Jolla, CA; UCLA, Los Angeles, CA
| | - R. M. Bukowski
- Memorial Sloan-Kettering Cancer Center, New York, NY; Baylor-Sammons/Texas Oncology, PA, Dallas, TX; Klinika Oncologii Oddzial Chemioterapii, Poznan, Poland; Massachusetts General Hospital, Boston, MA; Cleveland Clinic Foundaton, Cleveland, OH; Hospital Pitie-Salpetriere, Paris, France; Georges Pompidou European Hospital, Paris, France; Pfizer Inc., La Jolla, CA; UCLA, Los Angeles, CA
| | - O. Rixe
- Memorial Sloan-Kettering Cancer Center, New York, NY; Baylor-Sammons/Texas Oncology, PA, Dallas, TX; Klinika Oncologii Oddzial Chemioterapii, Poznan, Poland; Massachusetts General Hospital, Boston, MA; Cleveland Clinic Foundaton, Cleveland, OH; Hospital Pitie-Salpetriere, Paris, France; Georges Pompidou European Hospital, Paris, France; Pfizer Inc., La Jolla, CA; UCLA, Los Angeles, CA
| | - S. Oudard
- Memorial Sloan-Kettering Cancer Center, New York, NY; Baylor-Sammons/Texas Oncology, PA, Dallas, TX; Klinika Oncologii Oddzial Chemioterapii, Poznan, Poland; Massachusetts General Hospital, Boston, MA; Cleveland Clinic Foundaton, Cleveland, OH; Hospital Pitie-Salpetriere, Paris, France; Georges Pompidou European Hospital, Paris, France; Pfizer Inc., La Jolla, CA; UCLA, Los Angeles, CA
| | - S. T. Kim
- Memorial Sloan-Kettering Cancer Center, New York, NY; Baylor-Sammons/Texas Oncology, PA, Dallas, TX; Klinika Oncologii Oddzial Chemioterapii, Poznan, Poland; Massachusetts General Hospital, Boston, MA; Cleveland Clinic Foundaton, Cleveland, OH; Hospital Pitie-Salpetriere, Paris, France; Georges Pompidou European Hospital, Paris, France; Pfizer Inc., La Jolla, CA; UCLA, Los Angeles, CA
| | - C. M. Baum
- Memorial Sloan-Kettering Cancer Center, New York, NY; Baylor-Sammons/Texas Oncology, PA, Dallas, TX; Klinika Oncologii Oddzial Chemioterapii, Poznan, Poland; Massachusetts General Hospital, Boston, MA; Cleveland Clinic Foundaton, Cleveland, OH; Hospital Pitie-Salpetriere, Paris, France; Georges Pompidou European Hospital, Paris, France; Pfizer Inc., La Jolla, CA; UCLA, Los Angeles, CA
| | - R. A. Figlin
- Memorial Sloan-Kettering Cancer Center, New York, NY; Baylor-Sammons/Texas Oncology, PA, Dallas, TX; Klinika Oncologii Oddzial Chemioterapii, Poznan, Poland; Massachusetts General Hospital, Boston, MA; Cleveland Clinic Foundaton, Cleveland, OH; Hospital Pitie-Salpetriere, Paris, France; Georges Pompidou European Hospital, Paris, France; Pfizer Inc., La Jolla, CA; UCLA, Los Angeles, CA
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Hudes G, Carducci M, Tomczak P, Dutcher J, Figlin R, Kapoor A, Staroslawska E, O’Toole T, Kong S, Moore L. A phase 3, randomized, 3-arm study of temsirolimus (TEMSR) or interferon-alpha (IFN) or the combination of TEMSR + IFN in the treatment of first-line, poor-risk patients with advanced renal cell carcinoma (adv RCC). J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.lba4] [Citation(s) in RCA: 117] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
LBA4 Background: Temsirolimus (TEMSR, CCI-779) is a specific inhibitor of mTOR, a signaling protein that regulates cell growth and angiogenesis. In a single-agent, phase 2 study, TEMSR administration to heavily pretreated patients (pts, n = 111) with adv RCC resulted in a median overall survival (OS) of 15.0 mos (Atkins et al, J Clin Oncol 2004). Retrospectively, 49 pts were categorized in a poor-risk group (Motzer et al, J Clin Oncol 2002). The TEMSR-treated pts in this group had a 1.7-fold longer median OS than the first-line, IFN-treated, poor-risk group reported by Motzer et al. In a phase 1 study, the maximum tolerated dose of the combination of TEMSR + IFN in adv RCC pts was TEMSR 15 mg intravenously (IV) once/wk + IFN 6 million units (MU) subcutaneously (SC) 3 times weekly (TIW) (Smith et al, Proc ASCO 2004). Thus, this phase 3 study in first-line, poor-risk adv RCC pts was initiated in July 2003. Methods: Pts with adv RCC and no prior systemic therapy were enrolled in this open-label study if they had ≥3 of 6 risk factors (the 5 Motzer criteria and >1 metastatic disease site). Pts were randomized (1:1:1) to arm 1, IFN up to 18 MU SC TIW; arm 2, TEMSR 25 mg IV once/wk; or arm 3, TEMSR 15 mg IV once/wk + IFN 6 MU SC TIW. The primary study endpoint was OS; the study was powered to compare the TEMSR arms with the IFN arm. Results: We report 20 Mar 2006 preliminary data from an interim analysis performed by the IDMC. Of the 626 pts enrolled, 442 deaths occurred. Patients treated with TEMSR had a statistically longer survival than those treated with IFN (Table). OS of patients treated with IFN and TEMSR + IFN were not statistically different. The 3 most frequently occurring adverse events ≥gr 3 were asthenia (arm 1: arm 2: arm 3, 27%: 12%: 30% pts), anemia (24%: 21%: 39% pts), and dyspnea (8%: 9%: 11% pts). Conclusions: Single-agent TEMSR significantly increases the OS of first-line, poor-risk adv RCC pts compared with IFN, with an acceptable safety profile. [Table: see text] [Table: see text]
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Affiliation(s)
- G. Hudes
- Fox Chase Cancer Center, Philadelphia, PA; Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Poznan School of Medicine, Poznan, Poland; Our Lady of Mercy Medical Center, Bronx, NY; University of California, Los Angeles, CA; McMaster University, Hamilton, ON, Canada; Lublin Oncological Center, Lublin, Poland; Wyeth Research, Cambridge, MA
| | - M. Carducci
- Fox Chase Cancer Center, Philadelphia, PA; Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Poznan School of Medicine, Poznan, Poland; Our Lady of Mercy Medical Center, Bronx, NY; University of California, Los Angeles, CA; McMaster University, Hamilton, ON, Canada; Lublin Oncological Center, Lublin, Poland; Wyeth Research, Cambridge, MA
| | - P. Tomczak
- Fox Chase Cancer Center, Philadelphia, PA; Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Poznan School of Medicine, Poznan, Poland; Our Lady of Mercy Medical Center, Bronx, NY; University of California, Los Angeles, CA; McMaster University, Hamilton, ON, Canada; Lublin Oncological Center, Lublin, Poland; Wyeth Research, Cambridge, MA
| | - J. Dutcher
- Fox Chase Cancer Center, Philadelphia, PA; Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Poznan School of Medicine, Poznan, Poland; Our Lady of Mercy Medical Center, Bronx, NY; University of California, Los Angeles, CA; McMaster University, Hamilton, ON, Canada; Lublin Oncological Center, Lublin, Poland; Wyeth Research, Cambridge, MA
| | - R. Figlin
- Fox Chase Cancer Center, Philadelphia, PA; Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Poznan School of Medicine, Poznan, Poland; Our Lady of Mercy Medical Center, Bronx, NY; University of California, Los Angeles, CA; McMaster University, Hamilton, ON, Canada; Lublin Oncological Center, Lublin, Poland; Wyeth Research, Cambridge, MA
| | - A. Kapoor
- Fox Chase Cancer Center, Philadelphia, PA; Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Poznan School of Medicine, Poznan, Poland; Our Lady of Mercy Medical Center, Bronx, NY; University of California, Los Angeles, CA; McMaster University, Hamilton, ON, Canada; Lublin Oncological Center, Lublin, Poland; Wyeth Research, Cambridge, MA
| | - E. Staroslawska
- Fox Chase Cancer Center, Philadelphia, PA; Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Poznan School of Medicine, Poznan, Poland; Our Lady of Mercy Medical Center, Bronx, NY; University of California, Los Angeles, CA; McMaster University, Hamilton, ON, Canada; Lublin Oncological Center, Lublin, Poland; Wyeth Research, Cambridge, MA
| | - T. O’Toole
- Fox Chase Cancer Center, Philadelphia, PA; Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Poznan School of Medicine, Poznan, Poland; Our Lady of Mercy Medical Center, Bronx, NY; University of California, Los Angeles, CA; McMaster University, Hamilton, ON, Canada; Lublin Oncological Center, Lublin, Poland; Wyeth Research, Cambridge, MA
| | - S. Kong
- Fox Chase Cancer Center, Philadelphia, PA; Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Poznan School of Medicine, Poznan, Poland; Our Lady of Mercy Medical Center, Bronx, NY; University of California, Los Angeles, CA; McMaster University, Hamilton, ON, Canada; Lublin Oncological Center, Lublin, Poland; Wyeth Research, Cambridge, MA
| | - L. Moore
- Fox Chase Cancer Center, Philadelphia, PA; Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Poznan School of Medicine, Poznan, Poland; Our Lady of Mercy Medical Center, Bronx, NY; University of California, Los Angeles, CA; McMaster University, Hamilton, ON, Canada; Lublin Oncological Center, Lublin, Poland; Wyeth Research, Cambridge, MA
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O'Brien MER, Wigler N, Inbar M, Rosso R, Grischke E, Santoro A, Catane R, Kieback DG, Tomczak P, Ackland SP, Orlandi F, Mellars L, Alland L, Tendler C. Reduced cardiotoxicity and comparable efficacy in a phase IIItrial of pegylated liposomal doxorubicin HCl(CAELYX™/Doxil®) versus conventional doxorubicin forfirst-line treatment of metastatic breast cancer. Ann Oncol 2004; 15:440-9. [PMID: 14998846 DOI: 10.1093/annonc/mdh097] [Citation(s) in RCA: 1123] [Impact Index Per Article: 56.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND This study was designed to demonstrate that efficacy [progression-free survival (PFS)] of CAELYX [pegylated liposomal doxorubicin HCl (PLD)] is non-inferior to doxorubicin with significantly less cardiotoxicity in first-line treatment of women with metastatic breast cancer (MBC). PATIENTS AND METHODS Women (n=509) with MBC and normal cardiac function were randomized to receive either PLD 50 mg/m2 (every 4 weeks) or doxorubicin 60 mg/m2 (every 3 weeks). Cardiac event rates were based on reductions in left ventricular ejection fraction as a function of cumulative anthracycline dose. RESULTS PLD and doxorubicin were comparable with respect to PFS [6.9 versus 7.8 months, respectively; hazard ratio (HR)=1.00; 95% confidence interval (CI) 0.82-1.22]. Subgroup results were consistent. Overall risk of cardiotoxicity was significantly higher with doxorubicin than PLD (HR=3.16; 95%CI 1.58-6.31; P<0.001). Overall survival was similar (21 and 22 months for PLD and doxorubicin, respectively; HR=0.94; 95%CI 0.74-1.19). Alopecia (overall, 66% versus 20%; pronounced, 54% versus 7%), nausea (53% versus 37%), vomiting (31% versus 19%) and neutropenia (10% versus 4%) were more often associated with doxorubicin than PLD. Palmar-plantar erythrodysesthesia (48% versus 2%), stomatitis (22% versus 15%) and mucositis (23% versus 13%) were more often associated with PLD than doxorubicin. CONCLUSIONS In first-line therapy for MBC, PLD provides comparable efficacy to doxorubicin, with significantly reduced cardiotoxicity, myelosuppression, vomiting and alopecia.
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Tomczak P, Chajewska-Ciekańska M, Litwiniuk M. 178. Ocena stanu czynnościowego granulocytów obojętnochłonnych u chorych w przebiegu leczenia raka piersi. Rep Pract Oncol Radiother 2003. [DOI: 10.1016/s1507-1367(03)70662-2] [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: 10/18/2022] Open
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Tomczak P, Litwiniuk M, Chajewska-Ciekańska M. 119. Wpływ stosowania bisfosfonianów na wybrane funkcje granulocytów obojętnochłonnych krwi obwodowej. Rep Pract Oncol Radiother 2003. [DOI: 10.1016/s1507-1367(03)70603-8] [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: 10/18/2022] Open
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Milecki P, Golusiński W, Tomczak P. 323. Radioterapia skojarzona z jednoczasową chemioterapią dotętniczą u chorych z zaawansowanym rakiem głowy i szyi: podsumowanie metody. Rep Pract Oncol Radiother 2003. [DOI: 10.1016/s1507-1367(03)70806-2] [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: 11/16/2022] Open
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Tomczak P, Richter J. Thermodynamical properties of the Heisenberg antiferromagnet on the kagomé lattice. Phys Rev B Condens Matter 1996; 54:9004-9006. [PMID: 9984618 DOI: 10.1103/physrevb.54.9004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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Tomczak P, Ferchmin AR, Richter J. Ground state of an antiferromagnetic Heisenberg spin system on a nontranslational lattice of dimension between one and two. Phys Rev B Condens Matter 1996; 54:395-401. [PMID: 9984272 DOI: 10.1103/physrevb.54.395] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Tomczak P. Thermodynamical properties of an antiferromagnetic Heisenberg spin system on a fractal lattice of dimension between one and two. Phys Rev B Condens Matter 1996; 53:R500-R501. [PMID: 9983065 DOI: 10.1103/physrevb.53.r500] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Czub M, Markowska J, Tomczak P, Wiese E, Markowski M. [Survival, complications and quality of life in patients with breast cancer after ovariectomy and hormonal therapy]. Ginekol Pol 1993; 64:149-53. [PMID: 8359743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Seventy one women with breast cancer in clinical stage IIIa were treated by chemotherapy and radical operation on the basis five features, namely: survivals, relapses, metastases, quality of life, and post-therapy complications. The two treatment methods were compared. The dependence between survivals and time elapsed between breast surgery and ovariectomy was evaluated. Women treated by ovariectomy suffer from; menopause symptoms, osteoporosis, blood coagulation distortions more after than women treated by hormonotherapy. Tamoxifen therapy increases the rate of breast cancer relapses and probably it is the cause of breast cancer metastases into liver. Women who underwent hormonal castration are professionally active more after them women treated by ovariectomy. Time elapsed between breast surgery and ovariectomy does not affect survivals in stage IIIa. In stage IIIb however, performing later ovariectomy prolongs survivals.
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Affiliation(s)
- M Czub
- Katedry Onkologii AM, Poznaniu
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Serkowski S, Tomczak P. Über den Einfluß des Kochsalzes auf die Bakterien der Fleischvergiftung. Eur Food Res Technol 1911. [DOI: 10.1007/bf02023678] [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: 10/25/2022]
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