Neutrophil-guided dosing of anthracycline-cyclophosphamide-containing chemotherapy in patients with breast cancer: a feasibility study

The aim of this study was to investigate whether neutrophil-guided dose escalation of anthracycline–cyclophosphamide-containing chemotherapy (ACC) for breast cancer is feasible, in order to optimize outcome. Breast cancer patients planned for 3-weekly ACC were enrolled in this study. The first treatment cycle was administered in a standard BSA-adjusted dose. The absolute neutrophil count was measured at baseline and at day 8, 11 and 15 after administration of ACC. For patients with none or mild (CTC grade 0–2) neutropenia and no other dose-limiting toxicity, we performed a 10–25 % dose escalation of the second cycle with the opportunity to a further 10–25 % dose escalation of the third cycle. Thirty patients were treated in the adjuvant setting with either FE100C (n = 23) or AC (n = 4), or in the palliative setting with FAC (n = 3). Two out of 23 patients (9 %) treated with FEC did not develop grade 3–4 neutropenia after the first treatment cycle. Dose escalation was performed in these two patients (30 % in one and 15 % in the other patient). During dose escalation, there were no complications like febrile neutropenia. No patients treated with FAC or AC could be escalated, since all of them developed grade 3–4 neutropenia. We conclude that asymptomatic grade 3–4 neutropenia is likely to be achieved in the majority of patients with breast cancer treated with ACC according to presently advocated BSA-based dose levels. Escalation of currently advocated ACC doses without G-CSF, with a target of grade 3–4 neutropenia, is feasible, but only possible in a small proportion of patients. EudraCT 2010-020309-33

Neutrophil-guided dosing of anthracycline–cyclophosphamide-containing chemotherapy in patients with breast cancer: a feasibility study

The aim of this study was to investigate whether neutrophil-guided dose escalation of anthracycline–cyclophosphamide-containing chemotherapy (ACC) for breast cancer is feasible, in order to optimize outcome. Breast cancer patients planned for 3-weekly ACC were enrolled in this study. The first treatment cycle was administered in a standard BSA-adjusted dose. The absolute neutrophil count was measured at baseline and at day 8, 11 and 15 after administration of ACC. For patients with none or mild (CTC grade 0–2) neutropenia and no other dose-limiting toxicity, we performed a 10–25 % dose escalation of the second cycle with the opportunity to a further 10–25 % dose escalation of the third cycle. Thirty patients were treated in the adjuvant setting with either FE100C (n = 23) or AC (n = 4), or in the palliative setting with FAC (n = 3). Two out of 23 patients (9 %) treated with FEC did not develop grade 3–4 neutropenia after the first treatment cycle. Dose escalation was performed in these two patients (30 % in one and 15 % in the other patient). During dose escalation, there were no complications like febrile neutropenia. No patients treated with FAC or AC could be escalated, since all of them developed grade 3–4 neutropenia. We conclude that asymptomatic grade 3–4 neutropenia is likely to be achieved in the majority of patients with breast cancer treated with ACC according to presently advocated BSA-based dose levels. Escalation of currently advocated ACC doses without G-CSF, with a target of grade 3–4 neutropenia, is feasible, but only possible in a small proportion of patients. EudraCT 2010-020309-33

Upregulation of the nitrosylome in bipolar disorder type 1 (BP1) and major depression, but not BP2: Increased IgM antibodies to nitrosylated conjugates are associated with indicants of leaky gut

Upregulation of the nitrosylome in bipolar disorder type 1 (BP1) and major depression, but not BP2: Increased IgM antibodies to nitrosylated conjugates are associated with indicants of leaky gu

The reification of the clinical diagnosis of myalgic encephalomyelitis/ chronic fatigue syndrome (Me/cfs) as an immune and oxidative stress disorder: Construction of a data-driven nomothethic network and exposure of me/cfs subgroups

The reification of the clinical diagnosis of myalgic encephalomyelitis/ chronic fatigue syndrome (Me/cfs) as an immune and oxidative stress disorder: Construction of a data-driven nomothethic network and exposure of me/cfs subgroup

Differentiating head and neck carcinoma from lung carcinoma with an electronic nose: a proof of concept study

Disease specific patterns of volatile organic compounds can be detected in exhaled breath using an electronic nose (e-nose). The aim of this study is to explore whether an e-nose can differentiate between head and neck, and lung carcinoma. Eighty-seven patients received an e-nose measurement before any oncologic treatment. We used PARAFAC/TUCKER3 tensor decomposition for data reduction and an artificial neural network for analysis to obtain binary results; either diagnosed as head and neck or lung carcinoma. Via a leave-one-out method, cross-validation of the data was performed. In differentiating head and neck from lung carcinoma patients, a diagnostic accuracy of 93 % was found. After cross-validation of the data, this resulted in a diagnostic accuracy of 85 %. There seems to be a potential for e-nose as a diagnostic tool in HNC and lung carcinoma. With a fair diagnostic accuracy, an e-nose can differentiate between the two tumor entities. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00405-016-4038-x) contains supplementary material, which is available to authorized users