1
|
Timmins PF, Kredentser D, Hancock KC, Messing M, Boehm KA, Mull S, Ilegbodu D, Asmar L. Preliminary results of an open-label study to evaluate the efficacy and tolerability of aprepitant for the prevention of chemotherapy-induced nausea and vomiting associated with carboplatin-containing chemotherapy regimen in patients with ovarian cancer. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.19652] [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
19652 Background: The use of aprepitant has been shown to offer an advantage in preventing acute and delayed chemotherapy- induced nausea and vomiting (CINV). This study integrates palonosetron and dexamethasone into the regimen to determine the efficacy and safety of this combination. Methods: 50 patients (pts) have enrolled; data has been submitted for 43. Main inclusion criteria were: diagnosis of ovarian (OV), primary peritoneal (PP), fallopian tube (FT) carcinoma Stage I-IV, or papillary serous cancer of the uterus (UPSC); naive to emetogenic chemotherapy Hesketh ≥Level 4, is scheduled to receive paclitaxel 175 mg/m2 IV and carboplatin AUC=6 IV; is able to read and understand the Functional Living Index - Emesis (FLIE) questionnaire. Results: Median age was 61 years, 60% ECOG=0, 86% prior surgery; 68% OV, 14% PP cancers, 7% UPSC, and 5% FT. Metastases were noted in 30% of pts, 21% had visceral metastasis. To date, 70% of patients (32/46) have reported no vomiting, or use of rescue medications during the study and are deemed as complete responders. Based on the 35 pts for whom complete patient diaries have been submitted thus far, the complete response rate is 91% (32/25), compared to 50% (aprepitant alone [The MEC Trial]). No Grade 3–4 treatment related adverse events were reported; Grade 1–2 toxicities included neutropenia (10.5%); anemia, constipation, and nausea (7.9%, each), and fatigue, dyspepsia, and arthralgia (5.3%, each). Some of the toxicities may be related to the chemotherapy, and are not treatment-related to the aprepitant, palonsetron, or dexamethasone. Conclusions: The addition of aprepitant to palonsetron and dexamethasone appears to be very well tolerated. This combination is effective in the prevention of chemotherapy-induced nausea and vomiting when used with emetogenic therapy such as paclitaxel and carboplatin. This research was supported, in part, from a research grant from Merck & Co., Inc. Whitehouse Station, NJ. No significant financial relationships to disclose.
Collapse
Affiliation(s)
- P. F. Timmins
- US Oncology Research, Houston, TX; New York Oncolo, Albany, NY; New York Oncology Hematology, Albany, NY; Texas Oncology, Ft. Worth, TX
| | - D. Kredentser
- US Oncology Research, Houston, TX; New York Oncolo, Albany, NY; New York Oncology Hematology, Albany, NY; Texas Oncology, Ft. Worth, TX
| | - K. C. Hancock
- US Oncology Research, Houston, TX; New York Oncolo, Albany, NY; New York Oncology Hematology, Albany, NY; Texas Oncology, Ft. Worth, TX
| | - M. Messing
- US Oncology Research, Houston, TX; New York Oncolo, Albany, NY; New York Oncology Hematology, Albany, NY; Texas Oncology, Ft. Worth, TX
| | - K. A. Boehm
- US Oncology Research, Houston, TX; New York Oncolo, Albany, NY; New York Oncology Hematology, Albany, NY; Texas Oncology, Ft. Worth, TX
| | - S. Mull
- US Oncology Research, Houston, TX; New York Oncolo, Albany, NY; New York Oncology Hematology, Albany, NY; Texas Oncology, Ft. Worth, TX
| | - D. Ilegbodu
- US Oncology Research, Houston, TX; New York Oncolo, Albany, NY; New York Oncology Hematology, Albany, NY; Texas Oncology, Ft. Worth, TX
| | - L. Asmar
- US Oncology Research, Houston, TX; New York Oncolo, Albany, NY; New York Oncology Hematology, Albany, NY; Texas Oncology, Ft. Worth, TX
| |
Collapse
|
2
|
Chittoor SR, Berry WR, Loesch DM, Logie KW, Fleagle J, Mull S, Boehm KA, Zhan F, Asmar L. Phase II study of low dose (weekly) docetaxel and estramustine in elderly males (age ≥75 years) with hormone-refractory prostate cancer or patients age 18 to 74 years with an ECOG performance status of 2 or 3. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.4646] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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)
| | | | | | | | | | - S. Mull
- US Oncology Research, Houston, TX
| | | | - F. Zhan
- US Oncology Research, Houston, TX
| | - L. Asmar
- US Oncology Research, Houston, TX
| |
Collapse
|
3
|
Jones SE, Cantrell J, Vukelja S, Pippen J, O’Shaughnessy J, Blum JL, Brooks R, Mull S, Ilegbodu D, Asmar L. The effect of tamoxifen (T) or exemestane (E) on bone mineral density (BMD) after 1 year of adjuvant treatment of postmenopausal women with early breast cancer. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.610] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [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)
| | | | | | | | | | | | | | - S. Mull
- US Oncology, Inc., Houston, TX
| | | | | |
Collapse
|
4
|
Asmar L, Cantrell J, Vukelja SJ, Pippen JE, O'Shaughnessy J, Blum JL, Brooks RJ, Mull S, Guo H, Jones S. A planned comparison of menopausal symptoms during the first year in 1,000 patients receiving either exemestane or tamoxifen in a double-blind adjuvant hormonal study. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.516] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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)
- L. Asmar
- US Oncology Research, Inc, Houston, TX
| | | | | | | | | | | | | | - S. Mull
- US Oncology Research, Inc, Houston, TX
| | - H. Guo
- US Oncology Research, Inc, Houston, TX
| | - S. Jones
- US Oncology Research, Inc, Houston, TX
| |
Collapse
|
5
|
Heinle SK, Noblin J, Goree-Best P, Mello A, Ravad G, Mull S, Mammen P, Grayburn PA. Assessment of myocardial perfusion by harmonic power Doppler imaging at rest and during adenosine stress: comparison with (99m)Tc-sestamibi SPECT imaging. Circulation 2000; 102:55-60. [PMID: 10880415 DOI: 10.1161/01.cir.102.1.55] [Citation(s) in RCA: 128] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Harmonic power Doppler imaging (HPDI) is a novel technique for assessing myocardial perfusion by contrast echocardiography in humans. The purpose of this study was to compare myocardial perfusion by HPDI with that obtained by (99m)Tc-sestamibi single photon emission computed tomography (SPECT) during rest and pharmacological stress. METHODS AND RESULTS HPDI was performed on 123 patients who were referred for SPECT imaging for known or suspected coronary artery disease. Images were obtained at baseline and during adenosine infusion (0.14 mg. kg(-)(1). min(-)(1)x6 minutes) in 3 apical views. Myocardial perfusion by HPDI was graded for each coronary territory as absent, patchy, or full. The persistence of absent or patchy myocardial perfusion by HPDI between rest and adenosine was interpreted as a fixed defect, whereas any decrease in perfusion grade was interpreted as a reversible defect. Overall concordance between HPDI and SPECT was 83 (81%) of 103 for normal versus abnormal perfusion. Agreement between the 2 methods for each of the 3 coronary territories was 81% (kappa=0.57) for the left anterior descending artery, 76% (kappa=0.52) for the right coronary artery, and 72% (kappa=0.40) for the left circumflex artery. Discrepancies between the 2 techniques were most notable in the circumflex territory, where fixed defects were observed in 33% by HPDI but in only 14% by SPECT (chi(2)=15.8, P=0.0001). CONCLUSIONS This study demonstrates that HPDI can reliably detect myocardial perfusion during pharmacological stress, although there was a significantly higher number of falsely abnormal results in the circumflex territory.
Collapse
Affiliation(s)
- S K Heinle
- Department of Internal Medicine, UT Southwestern and Dallas VA Medical Centers, TX 75216, USA
| | | | | | | | | | | | | | | |
Collapse
|