1
|
Durani U, Duma N, Frank RD, Goyal G, Yadav S, Mansfield AS, Molina JR, Ailawadhi S, Moynihan TJ, Go RS. Patterns of palliative care utilization in stage IV non-small cell lung cancer in the National Cancer Database. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.10109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
2
|
Kohli M, Hillman DW, Wang L, Li Y, Sicotte H, Carlson R, Tan W, Wu K, Eiken PW, Jimenez RE, Cernigliaro J, Quevedo F, Costello BA, Pitot HC, Moynihan TJ, Ho TH, Bryce AH, Wang L, Dehm S. Association of androgen receptor variant 9 ( AR-V9) mRNA expression levels in metastatic tissue with resistance to abiraterone acetate/prednisone (AA/P). J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.5036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Scott Dehm
- University of Minnesota, Minneapolis, MN
| |
Collapse
|
3
|
Kohli M, Hillman DW, Carlson R, Wang L, Li Y, Tan W, Ho TH, Sicotte H, Wang L, Costello BA, Pitot HC, Quevedo F, Dronca RS, Moynihan TJ, Atwell TD, Eiken PW, McMenomy BP, Bryce AH, Wu K, Dehm S. Association of androgen receptor V9 (ARV9) mRNA expression in metastatic tissue with early resistance to pre-chemotherapy abiraterone acetate/prednisone (AA/P). J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.2_suppl.237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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
237 Background: AA/P is an approved treatment for mCRPC but there are no known predictive markers of response or resistance. We conducted a prospective trial to evaluate if Androgen Receptor (AR) & AR-variant (ARV) expression in tissue metastases can predict resistance to AA/P. Methods: mCRPC stage patients (pts) initiating pre-chemo AA/P underwent metastatic site biopsies prior to (pre-AA/P) and after 12 weeks of treatment. Composite progression at 12 weeks, (primary endpoint) was evaluated with PSA, RECIST, bone scan and symptoms (per PCWG2). mRNA expressions of pre-AA/P ARFL, ARV3, ARV7, ARV9, ARV23, ARV45, four cell cycle division genes, Chromogranin-A (CHGA) together with PSA/testosterone levels, Gleason Score (GS) at initial diagnosis; high versus low volume disease; time from starting hormone therapy to mCRPC stage and serum CHGA levels were evaluated using a logistic regression model for predicting resistance at 12 weeks of therapy. A final multivariate model fitted only those factors thought to be clinically relevant or with an entry threshold of p ≤ 0.3 in univariate analysis. Results: Between 6/2013 & 3/2015, 82 pts were enrolled of which 52 had complete mRNA expression & disease assessment data at the12-week time point for analysis. Median age of the cohort was 72.5 yrs (IQR: 68.5-78); median pre-AA/P PSA was 18 ng/ml (IQR: 8.1- 46.6); GS distribution at initial diagnosis for GS 2-6; 7; 8-10 was 11; 14; 27 respectively. Progression was observed in 21/52 pts after 12 weeks. At the univariate level elevated pre-AA/P expression of ARV3 (p = 0.08), ARV7 (p = 0.26), ARV9 (p = 0.04), and cell division cycle gene CDC45 (p = 0.19) along with GS at diagnosis (p = 0.29) met the threshold for inclusion into multivariate analysis. Elevated expression of pre-therapy ARV9 in metastases alone was associated with progression at 12 weeks (OR: 3.9; CI 1.07 – 14.16; C-Index: 0.63). The 12-week biopsy of pts with progression had increased ARV9 mRNA expression compared to pts responding at 12 weeks (p = 0.14). Conclusions: Increased ARV9 mRNA expression in metastases is associated with early resistance to AA/P. This observation will need further validation in comparable datasets. Clinical trial information: NCT #0195364.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Scott Dehm
- University of Minnesota, Minneapolis, MN
| |
Collapse
|
4
|
Zhang BY, Mahoney DW, Riska SM, Cerhan JR, Ribeiro RJT, Medeiros R, Monteiro C, Nogueira A, Mauricio J, Fraga AM, Calais-Da-Silva F, Costello BA, Dronca RS, Pitot HC, Moynihan TJ, Quevedo F, Kohli M. Variation in TRMT11 gene as a prognostic marker in advanced-stage castrate-resistant prostate cancer (CRPC) patients. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e16114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | | | - Rui Medeiros
- Molecular Oncology Group, Portuguese Oncology Institute, Porto, Portugal
| | - Catia Monteiro
- Research Department LPCC, Portuguese League Against Cancer, Porto, Portugal
| | - Augusto Nogueira
- Molecular Oncology Group - CI, Portuguese Institute of Oncology, Porto, Portugal
| | - Joaquina Mauricio
- Medical Oncology Department, Portuguese Institute of Oncology, Porto, Portugal
| | - Avelino Manuel Fraga
- Urology Department, Porto Hospital Centre, Sto Antonio Hospital, Porto, Portugal
| | | | | | | | | | | | | | | |
Collapse
|
5
|
Kohli M, Qin R, Wang L, Sicotte H, Carlson R, Tan W, Jimenez RE, Wang L, Eckel-Passow J, Costello BA, Pitot HC, Quevedo F, Dronca RS, Wu K, Moynihan TJ, Ho TH, Bryce AH, Atwell TD, McMenomy BP, Dehm S. A molecular and clinico-pathological model for predicting abiraterone acetate/prednisone (AA/P) efficacy in metastatic castrate resistant prostate cancer (mCRPC). J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.5056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Rui Qin
- Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN, Rochester, MN
| | - Liguo Wang
- Mayo Clinic, Rochester, MN, Rochester, MN
| | | | | | - Winston Tan
- Mayo Clinic, Jacksonville, FL, Jacksonville, FL
| | | | | | | | | | | | | | | | - Kevin Wu
- Mayo Clinic, Jacksonville, FL, Jacksonville, FL
| | | | | | | | | | | | - Scott Dehm
- University of Minnesota, Minneapolis, MN
| |
Collapse
|
6
|
Somlo G, Frankel PH, Luu TH, Ma CX, Arun B, Garcia AA, Cigler T, Cream L, Harvey HA, Sparano JA, Nanda R, Chew HK, Moynihan TJ, Vahdat LT, Goetz MP, Hurria A, Mortimer JE, Gandara DR, Chen AP, Weitzel JN. Efficacy of the PARP inhibitor (PI) ABT-888 (veliparib [vel]) either with carboplatin (carb) or as a single agent followed by post-progression therapy in combination with carb in patients (pts) with BRCA1- or BRCA2- (BRCA)-associated metastatic breast cancer (MBC). J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.520] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | - Banu Arun
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Agustin A. Garcia
- Los Angeles County Hospital/ University of Southern California, Los Angeles, CA
| | | | - Leah Cream
- Penn State College of Medicine, Hershey, PA
| | | | | | | | | | | | | | | | | | | | - David R. Gandara
- University of California Davis Comprehensive Cancer Center, Sacramento, CA
| | | | | |
Collapse
|
7
|
Somlo G, Frankel PH, Luu TH, Ma C, Arun B, Garcia A, Cigler T, Cream L, Harvey HA, Sparano JA, Nanda R, Chew HK, Moynihan TJ, Vahdat LT, Goetz MP, Hurria A, Mortimer JE, Gandara DR, Chen A, Weitzel JN. Phase II trial of single agent PARP inhibitor ABT-888 (veliparib [vel]) followed by postprogression therapy of vel with carboplatin (carb) in patients (pts) with stage BRCA-associated metastatic breast cancer (MBC): California Cancer Consortium trial PHII-96. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.1021] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | - Thehang H. Luu
- City of Hope Cancer Center/Beckman Research Institute, Duarte, CA
| | - Cynthia Ma
- Washington University School of Medicine in St. Louis, St. Louis, MO
| | - Banu Arun
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | - Leah Cream
- Penn State MS Hershey Medical Center, Hershey, PA
| | - Harold A. Harvey
- Hematology/Oncology Division and Penn State Hershey Cancer Institute, Hershey, PA
| | | | | | | | | | | | | | | | | | | | - Alice Chen
- National Cancer Institute, Rockville, MD
| | | |
Collapse
|
8
|
Kohli M, McDonnell S, Bevan GH, Riska SM, Costello BA, Longenbach S, Dronca RS, Moynihan TJ, Pitot HC, Quevedo F, Tan W, Cerhan JR. Association of germ-line genetic variation with failure of androgen ablation (AA) in hormone-sensitive advanced prostate cancer. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.5082] [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
5082 Background: We evaluated the association of germ-line variation in 10 candidate genes important in prostate cancer biology (NKX3-1, JAK2, SLCO2B1, STAT3, CYP19A1, HSD17B4, TRMT11, PRMT3, HSD17B12, NCOA4) with failure of AA in advanced prostate cancer patients. Methods: Patients (N=619) were enrolled for genotyping at the time of AA failure. Candidate genes were selected from the literature and previous pilot studies in smaller cohorts which had identified variation in TRMT11 and HSD17B12 to be associated with AA failure. Genes were tagged using single nucleotide polymorphisms (SNPs) from HapMap with minor allele frequency of >5% and r2≥0.8. DNA was extracted from peripheral blood and genotyped using Illumina Veracode platform. The primary endpoint was time to failure on AA, defined as time from initiating continuous AA to two serial PSA increases over the nadir or clinical or imaging based progression, whichever came first. Principal component analysis was used for gene-levels tests. Association with the primary endpoint was assessed using proportional hazards regression models at the gene-level and at the SNP level. For SNP level results we estimated per allele (ordinal model) hazard ratios (HR) and 95% confidence intervals (CI) using Cox regression, adjusted for Gleason score (GS). Results: We successfully genotyped 60 SNPs (from 10 genes) in 519 subjects. The median age of the cohort was 71 years (range 43, 92). The GS distribution was 51% subjects with GS≥8; 33% with GS=7 and 17% with GS<7. Median time to AA failure for the cohort was 2.3 years (IQ range: 1.0-4.5). In gene level analyses adjusting for GS, TRMT11 (p=0.004), HSD17B12 (p=0.016), and JAK2 (p=0.044) genes were associated with time to AA failure. Four of the 18 genotyped SNPs in JAK2 were associated with AA failure after adjustment for GS (Table). Conclusions: Variation in the JAK2 gene is significantly associated with time to AA failure. Validation is needed to develop these as predictive biomarkers for AA in advanced prostate cancer. [Table: see text]
Collapse
|
9
|
Somlo G, Frankel PH, Luu TH, Ma C, Arun B, Garcia A, Cigler T, Fleming GF, Harvey HA, Sparano JA, Nanda R, Chew HK, Moynihan TJ, Vahdat LT, Goetz MP, Hurria A, Mortimer JE, Gandara DR, Chen AP, Weitzel JN. Efficacy of the combination of ABT-888 (veliparib) and carboplatin in patients with BRCA-associated breast cancer. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.1024] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [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
1024 Background: The combination of platinum agents and PARP inhibitors may benefit patients (pts) with BRCA-associated metastatic breast cancer (MBC). We report on the response and clinical benefit rates when combining the PARP inhibitor veliparib (V) and carboplatin (carb) in a phase I trial. Methods: BRCA carriers with MBC were eligible. Carb starting at an AUC of 6 was given IV in 21-day cycles (C) and V was given orally twice daily (BID) at dose levels (L) L1 through L5. Results: Twenty-eight pts (26 eligible) carrying BRCA1 (12) or BRCA2 (15), or both (1) mutations were accrued between June 2010 and June 2012. The median age (32-66) was 45 years. The number (#) of prior chemotherapy regimens given for MBC was 1 (0-5); 70% of BCs were ER+, and 7% were HER2+. The schema, dose limiting toxicities (DLT) during C 1, median # of Cs on trial, and maximum tolerated dose (MTD) are shown. There were 3 (12%) complete and 9 (35%) partial responses (PR). Unconfirmed PR or stable MBC (median duration: 8 months [6-10+]) were seen in 7 pts (27%); the clinical benefit rate was74%. The median progression-free survival (PFS) is 7.8 months (95% CI 7.3-9.5). The pt with Fallopian tube cancer had a CR. DLTs with C 1 were seen in 2/6 evaluable pts at L1 (1 pt w/grade 3 hyponatremia and dehydration, and 1pt w/grade 4 thrombocytopenia [PLT]), leading to de-escalation of carb. At L2, 1 pt had grade 4 PLT. At L5, 1 pt had grade 4 PLT, and 2 pts grade 3 PLT (1 pt also experienced grade 4 granulocytopenia [ANC]), defining the MTD at carb AUC 5 and V 150 mg BID (L4). Dose delays and/or dose adjustments due to grade ≥ 2 toxicities for ANC or PLT were seen during the first 3 Cs at L1 (100%), L2 (50 %), L3 (67%), L4 (83 %), and at L5 (67%). Conclusions: The combination of carb and V is active, and is associated with substantial clinical benefit rate and managable hematologic toxicities in BRCA carriers with MBC. Further definition of the role of V is warranted. [Table: see text]
Collapse
Affiliation(s)
| | | | | | - Cynthia Ma
- Washington University School of Medicine in St. Louis, St. Louis, MO
| | - Banu Arun
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | | | | | | | | | - Helen K. Chew
- University of California, Davis Cancer Center, Sacramento, CA
| | | | | | | | | | | | - David R. Gandara
- University of California, Davis Comprehensive Cancer Center, Sacramento, CA
| | | | | |
Collapse
|
10
|
Kohli M, McDonnell S, Bevan G, Riska SM, Costello BA, Longenbach S, Dronca RS, Moynihan TJ, Pitot HC, Quevedo F, Cerhan JR. Association of germ-line genetic variation in the NK3 homeobox 1 gene with overall survival in advanced-stage castrate-resistant prostate cancer (CRPC). J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.6_suppl.75] [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
75 Background: We investigated the association of germline variation in ten candidate genes important in prostate cancer biology (NKX3-1, JAK2, SLCO2B1, STAT3, CYP19A1, HSD17B4, TRMT11, PRMT3, HSD17B12, NCOA4) with overall survival (OS) in a cohort of metastatic CRPC stage patients. Methods: Patients (N=497) were enrolled at the time of androgen deprivation therapy failure for D2 stage prostate cancer. Candidate genes were selected from the literature and pilot studies. Genes were tagged using SNPs from HapMap with minor allele frequency (MAF) of >5% and r2≥0.8. DNA was extracted from peripheral blood and genotyped using Illumina Veracode platform. The primary endpoint was OS, defined as time from development of CRPC to death. Principle components analysis was used for gene-levels tests. To account for multiple testing we calculated the false discovery rate (FDR). For SNP level results we estimated per allele (ordinal model) hazard ratios (HR) and 95% confidence intervals (CI) using Cox regression and adjusted for age and Gleason score (GS). Results: We successfully genotyped 60 SNPs (from 10 genes) in 497 Caucasian subjects. The median age of the CRPC cohort was 71 years (range 43,93). The GS distribution was 51% subjects with GS≥8; 32% with GS7 and 17% with GS<7. After a median follow up of 2.1 years (IQ range: 1.2-3.6), 297 subjects had died. In unadjusted gene level analyses, NKX3-1 (p=0.04; FDR=0.03) was associated with OS. After adjusting for age and GS the result remained significant (p=0.03). Two of the 5 genotyped SNPs in this gene were associated with OS after adjustment for age and GS: rs10503733 (dominant model p=0.03, HR=0.77; 95 CI=0.60-0.98; A>C; MAF = 0.22) and rs7005368 (dominant model p=0.05, HR=1.38, 95CI=1.0-1.92; G>A; MAF=0.07). Both SNPs are in Hardy Weinberg Equilibrium and in complete LD (D'=1), although r2 is low (r2=0.025) due to different allele frequencies. Conclusions: Variation in the homeobox NKX-1 gene, a prostate specific tumor suppressor gene involved in prostate development and carcinogenesis is significantly associated with OS in CRPC after accounting for age and GS. Further validation is needed to develop these as prognostic biomarkers.
Collapse
|
11
|
Fleming GF, Suman V, Goetz MP, Haluska P, Moynihan TJ, Nanda R, Olopade OI, Pluard TJ, Erlichman C, Chen HX, Guo Z, Ellis MJ, Ma CX. A phase I trial of the IGF-1R antibody IMC-A12 in combination with temsirolimus in patients with metastatic breast cancer. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.534] [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
534 Background: mTOR plays a critical role in promoting tumor cell growth. In preclinical studies, the anti-tumor activity of mTOR inhibitors is attenuated by feedback up-regulation of AKT mediated by IGF-1R. We designed a phase I trial to determine the maximum-tolerated dose (MTD), dose-limiting toxicities (DLT) and pharmacodynamic effects of the IGF-1R antibody IMC-A12 in combination with temsirolimus (tem) in patients (pts) with metastatic breast cancer (MBC) where mTOR is frequently activated. Methods: A 3+3 phase I design was chosen. Tem and IMC-A12 were administered IV days (d) 1, 8, 15, and 22 of a 4-week cycle in pts with MBC refractory to standard therapies. Tumor response was evaluated by RECIST. Adverse events (AE) were reported using CTC v3.0. Serum IGF 1 and C-peptide levels on d2 (24h post infusion) and d8 prior to drug infusion were compared to baseline (BL) using paired t-test. Results: Of 26 pts enrolled, 4 did not complete cycle 1 due to progression (3) or co-morbid condition (1). MTD was determined from remaining 22 pts aged 34-72 (median 48) years with ECOG PS 0 (55%) or 1 (45%). 86% had ER+ cancer. Median number of regimens for MBC was 4. Two DLTs at the starting DL (DL 1) necessitated dose de-escalation of tem to 20mg (DL-1), then to 15 mg (DL-2) which was tolerable (Table). Subsequent dose escalation of IMC-A12 led to DLTs in 0 of 6 in DL-2A and 2 of 3 pts in DL-2B. The MTD was defined as DL-2A. Other AEs included gr 1/2 fatigue, neutropenia, anemia, and hyperglycemia. No CR or PR, but 4 SD lasting ≥ 4 months were observed. At DL-2, -2A and -2B, serum IGF 1 levels were significantly elevated on d2 (p <0.002) and d8 compared to BL (p <0.001), but C-peptide levels were not found to differ from BL. Conclusions: The MTD for the combination of IMC-A12 and tem in pts with MBC is lower than that observed for single agents alone. A phase II study is ongoing in MBC. The study is supported in part by ASCO CDA, Komen Craft to CXM, N01-CM62205 and N01-CM-2011-00071. [Table: see text]
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Zhanfang Guo
- Washington University School of Medicine, St. Louis, MO
| | - Matthew James Ellis
- Department of Internal Medicine, Division of Oncology and Siteman Cancer Center, Washington University Medical Center, St. Louis, MO
| | - Cynthia X. Ma
- Washington University School of Medicine, St. Louis, MO
| |
Collapse
|
12
|
Jarabek BR, Jama AA, Cha SS, Ruegg SR, Moynihan TJ, McDonald FS. Use of a palliative care order set to improve resident comfort with symptom management in palliative care. Palliat Med 2008; 22:343-9. [PMID: 18541638 DOI: 10.1177/0269216308090169] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Although one-fourth of all medicare dollars are spent during the last year of life, symptom management for terminal hospitalized patients has continued to be inadequate. Quality end-of-life care is often overlooked, seldom taught and rarely measured within Internal Medicine Residency Programmes. We studied the effects of a palliative care order set and educational e-mail on resident comfort. Survey of residents showed that only 54% were comfortable across nine aspects of palliative care. Three months after release, 88% of residents were using the order set and 63% believed it increased their comfort with palliative care. Resident comfort managing palliative symptoms increased an average 10% (P = 0.02). First-year residents exposed to this order set increased in comfort from 40% to 65% (P < 0.0001), which significantly surpassed the 48% of second-year residents who reported being comfortable (P = 0.002). Introducing a palliative care order set improves resident comfort with symptom management in dying patients.
Collapse
Affiliation(s)
- B R Jarabek
- Internal Medicine Residency Programme, Mayo Clinic, Rochester, MN 55905, USA.
| | | | | | | | | | | |
Collapse
|
13
|
Affiliation(s)
- P R Harnett
- Department of Medical Oncology and Palliative Care, Westmead and Nepean Hospitals, Sydney, Australia.
| | | |
Collapse
|
14
|
Buckner JC, Moynihan TJ. The DNA-repair gene MGMT and the clinical response of gliomas to alkylating agents. N Engl J Med 2001; 344:686; author reply 687-8. [PMID: 11229337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
|
15
|
Affiliation(s)
- T J Moynihan
- Johns Hopkins Oncology Center, Baltimore, Maryland
| | | |
Collapse
|
16
|
Grossman SA, Moynihan TJ. Neoplastic meningitis. Neurol Clin 1991; 9:843-56. [PMID: 1722000] [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: 12/28/2022]
Abstract
Neoplastic meningitis appears to be increasing in frequency with improvements in the treatment of many cancers. It is most often recognized in patients with leukemia, breast cancer, lymphomas, and small-cell cancer of the lung, although it may be seen with virtually any malignancy. Treatment should include intrathecal chemotherapy, radiation therapy to symptomatic areas of the CNS, and optimal therapy of the systemic cancer. New efforts are underway to decrease the toxicity and improve the efficacy of antineoplastic therapy for this devastating complication of cancer.
Collapse
Affiliation(s)
- S A Grossman
- Johns Hopkins Oncology Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | |
Collapse
|