Background: The aim of the present study was to examine the efficacy of carboplatin in combination with paclitaxel in patients with metastatic castration-resistant prostate cancer pretreated with multiple regimens including docetaxel and androgen receptor-targeted agents. Methods: Clinical data from patients treated with carboplatin plus paclitaxel were collected retrospectively from a single institution. Results: 43 patients with metastatic castration-resistant prostate cancer were identified. Median number of cycles was ten (range: 1 to 23), prostate-specific antigen response was observed in 18 (42%) patients, median progression-free survival was 115 days and median overall survival was 8.1 months. Conclusion: Combination chemotherapy using taxane with carboplatin is an effective and well-tolerated therapy in heavily pretreated patients with metastatic castration-resistant prostate cancer.
- MeSH
- docetaxel terapeutické užití MeSH
- karboplatina terapeutické užití MeSH
- lidé MeSH
- nádory prostaty rezistentní na kastraci * patologie MeSH
- paclitaxel * terapeutické užití MeSH
- prostatický specifický antigen terapeutické užití MeSH
- protokoly protinádorové kombinované chemoterapie škodlivé účinky MeSH
- retrospektivní studie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Sequential administration of single targeted agents has been challenged as the dominant treatment paradigm in patients with metastatic renal cell carcinoma by improved outcomes obtained with combination regimens based on immune checkpoint inhibitors. Most patients treated with sequential monotherapy eventually develop drug resistance and succumb to progressive disease, leading to the search for therapies that would overcome drug resistance and result in a more durable treatment response. Improved outcomes have been demonstrated in Phase III trials in comparison with sunitinib for the combinations of axitinib plus pembrolizumab, axitinib plus avelumab, bevacizumab plus atezolizumab and ipilimumab plus nivolumab. A statistically significant improvement of both progression-free and overall survival has been demonstrated for the axitinib plus pembrolizumab combination.
- MeSH
- axitinib farmakologie terapeutické užití MeSH
- bezpečnost MeSH
- doba přežití bez progrese choroby MeSH
- humanizované monoklonální protilátky farmakologie terapeutické užití MeSH
- inhibitory kontrolních bodů farmakologie terapeutické užití MeSH
- inhibitory proteinkinas farmakologie terapeutické užití MeSH
- karcinom z renálních buněk farmakoterapie mortalita patologie MeSH
- klinické zkoušky, fáze III jako téma MeSH
- lidé MeSH
- míra přežití MeSH
- nádory ledvin farmakoterapie mortalita patologie MeSH
- protokoly protinádorové kombinované chemoterapie farmakologie terapeutické užití MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Introduction: The dominant paradigm of sequential therapy of metastatic renal cell carcinoma (mRCC) with single agents has recently been challenged by improved outcomes obtained with combined regimens with immune checkpoint inhibitors. These combined regimens include the combination of pembrolizumab plus axitinib.Areas covered: Here, we provide a brief overview of the current clinical data on the pembrolizumab plus axitinib combination including mechanism of action, pharmacokinetics, efficacy and safety profile.Expert opinion: Both agents targeting the vascular endothelial growth factor (VEGF) pathway and immune checkpoint inhibitors are active as single agents in mRCC. Improved outcomes have been demonstrated in phase 3 trials in comparison with sunitinib for the combinations of axitinib plus pembrolizumab, axitinib plus avelumab, bevacizumab plus atezolizumab, and ipilimumab plus nivolumab. Among these combinations, an OS benefit has, so far, demonstrated only for the combinations of axitinib with pembrolizumab and ipilimumab with nivolumab. Although there are currently no prospective data comparing the combination of ipilimumab and nivolumab with the combination of immune checkpoint inhibitors and VEGF inhibitors, currently available retrospective analyses indicate that these two approaches achieve comparable outcomes.
- MeSH
- axitinib * škodlivé účinky MeSH
- humanizované monoklonální protilátky * škodlivé účinky MeSH
- karcinom z renálních buněk * farmakoterapie patologie MeSH
- lidé MeSH
- nádory ledvin * farmakoterapie patologie MeSH
- protokoly protinádorové kombinované chemoterapie škodlivé účinky MeSH
- retrospektivní studie MeSH
- vaskulární endoteliální růstový faktor A MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
Purpose: The purpose of this study was to evaluate the influence of 3D brachytherapy planning time on the real dose distribution. Material and methods: 10 patients with cervical cancer were evaluated using 2 computed tomography (CT) scans brachytherapy. The first scan was performed after the insertion of UVAG applicators, and the second was done after creating the treatment plan, just before the irradiation of first and third fraction. Both plans were compared in terms of changes of volumes and differences in the dose for high-risk organs using GEC-ESTRO Working Group parameters. Results: The median planning time was 54 minutes (36-64 minutes). The absolute median change of volume for bladder, rectum, and sigmoid was 32.1 cm3 (1.6-108.6 cm3), 5.6 cm3 (0.4-61.8 cm3), and 8.4 cm3 (0.2-74.1 cm3), respectively. This difference led to an increased dose for bladder and sigmoid for D0.1cc by 46.7 cGy and 25.7 cGy, for D1cc by 59.2 cGy and 11.8 cGy, and for D2cc by 44.7 cGy and 10 cGy, respectively, per each fraction. Measured volume change in case of rectum led to a decreased dose per each fraction for D0.1cc with 7.1 cGy, for D1cc with 3.5 cGy, and for D2cc with 4.8 cGy. We observed that statistically significant dependency between the planning time and the dose was proved for rectum. The longer time for planning, the higher dose for rectum. The correlation coefficient for D0.1cc was 0.6715 (p = 0.0061), for D1cc was 0.6404 (p = 0.011), and for D2cc was 0.5891 (p = 0.0197). Conclusions: Extended treatment planning time for brachytherapy due to the changes in topography of small pelvis can lead to different dose in high-risk organs than previously planned. It seems that the most significant changes are related to rectum.
- Publikační typ
- časopisecké články MeSH
- Publikační typ
- abstrakt z konference MeSH
- MeSH
- imunoterapie metody MeSH
- inhibitory angiogeneze terapeutické užití MeSH
- lidé MeSH
- nádory vaječníků * imunologie terapie MeSH
- PARP inhibitory terapeutické užití MeSH
- receptory vaskulárního endoteliálního růstového faktoru účinky léků MeSH
- vaskulární endoteliální růstové faktory účinky léků MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- práce podpořená grantem MeSH
INTRODUCTION: Sequential administration of single targeted agents has evolved as the dominant paradigm in advanced RCC treatment. Lenvatinib plus everolimus is the first combination therapy in advanced RCC to show improvement in efficacy compared to monotherapy in advanced RCC while maintaining manageable toxicity profile. Areas covered: This review gives a brief overview of the contemporary clinical data on lenvatinib including its mechanism of action, pharmacokinetics, efficacy and safety profile in combination with everolimus. The clinical applications of lenvatinib in combination with everolimus are addressed within the context of the current competitive therapeutic landscape of RCC. Expert commentary: Lenvatinib is a new VEGF receptor-targeted tyrosine kinase inhibitor approved in combination with everolimus for second-line therapy in patients with advanced renal cell carcinoma progressing on a first-line VEGF receptor-targeted tyrosine kinase inhibitor. The combination of lenvatinib with everolimus significantly improved progression-free survival compared with everolimus with a hazard ratio of 0.40 and increased objective response to 43%. Optimal sequence of therapy targeting the tumor and the immune system remains a challenge and further investigation is warranted.
- MeSH
- chinoliny aplikace a dávkování MeSH
- everolimus aplikace a dávkování MeSH
- fenylmočovinové sloučeniny aplikace a dávkování MeSH
- karcinom z renálních buněk farmakoterapie patologie MeSH
- lidé MeSH
- nádory ledvin farmakoterapie patologie MeSH
- přežití bez známek nemoci MeSH
- protokoly protinádorové kombinované chemoterapie škodlivé účinky farmakologie terapeutické užití MeSH
- receptory vaskulárního endoteliálního růstového faktoru antagonisté a inhibitory MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
- srovnávací studie MeSH
- Klíčová slova
- Pertuzumab,
- MeSH
- ado-trastuzumab emtansin terapeutické užití MeSH
- karcinom terapie MeSH
- lapatinib terapeutické užití MeSH
- lidé MeSH
- nádory prsu * terapie MeSH
- protinádorové látky imunologicky aktivní terapeutické užití MeSH
- protinádorové látky terapeutické užití MeSH
- receptor erbB-2 antagonisté a inhibitory účinky léků MeSH
- TOR serin-threoninkinasy antagonisté a inhibitory účinky léků MeSH
- trastuzumab terapeutické užití MeSH
- Check Tag
- lidé MeSH
- MeSH
- chemorezistence MeSH
- fenylmočovinové sloučeniny aplikace a dávkování farmakokinetika škodlivé účinky terapeutické užití MeSH
- inhibitory angiogeneze MeSH
- inhibitory proteinkinas * aplikace a dávkování farmakokinetika škodlivé účinky terapeutické užití MeSH
- klinické zkoušky, fáze III jako téma * MeSH
- lidé středního věku MeSH
- lidé MeSH
- metastázy nádorů * farmakoterapie MeSH
- nádory štítné žlázy * farmakoterapie chirurgie radioterapie MeSH
- niacinamid analogy a deriváty aplikace a dávkování farmakokinetika škodlivé účinky terapeutické užití MeSH
- pozorné vyčkávání MeSH
- proliferace buněk účinky léků MeSH
- protinádorové látky terapeutické užití MeSH
- radioizotopy jodu MeSH
- receptory vaskulárního endoteliálního růstového faktoru antagonisté a inhibitory aplikace a dávkování farmakokinetika terapeutické užití MeSH
- sorafenib MeSH
- udržovací chemoterapie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
