nextMONARCH Phase 2 randomized clinical trial: overall survival analysis of abemaciclib monotherapy or in combination with tamoxifen in patients with endocrine-refractory HR + , HER2- metastatic breast cancer.

peer reviewed[en] PURPOSE: Resistance to endocrine therapy poses a major clinical challenge for patients with hormone receptor-positive (HR +), human epidermal growth factor receptor 2-negative (HER2-) metastatic breast cancer (MBC). We present the preplanned 24-month final overall survival (OS) results, alongside updated progression-free survival (PFS), and objective response rate (ORR) results. METHODS: nextMONARCH is an open-label, controlled, randomized, Phase 2 study of abemaciclib alone or in combination with tamoxifen in women with endocrine-refractory HR + , HER2- MBC previously treated with chemotherapy. Patients were randomized 1:1:1 to: abemaciclib 150 mg and tamoxifen 20 mg (A + T), abemaciclib 150 mg (A-150), or abemaciclib 200 mg and prophylactic loperamide (A-200). OS was the main prespecified secondary endpoint. PFS, ORR, and safety at 24 months were compared to previously reported primary analysis results. RESULTS: Of the 234 patients enrolled, 12 were receiving study treatment at data cutoff (28Jun2019). Median follow-up was 27.2 months. Median OS was 24.2 months in the A + T arm, 20.8 months in A-150, and 17.0 months in A-200 (A + T versus A-200: HR 0.62; 95%CI [0.40, 0.97], P = 0.03 and A-150 versus A-200: HR 0.96; 95%CI [0.64, 1.44], P = 0.83). PFS and ORR results at 24 months were consistent with the primary analysis. The safety profile corresponded with previous reports. CONCLUSION: The addition of tamoxifen to abemaciclib demonstrated greater OS benefit than monotherapy. This study confirmed the single-agent activity of abemaciclib in heavily pretreated women with endocrine-refractory HR + , HER2- MBC, as well as the previously reported primary PFS and ORR results, with no new safety signals observed. Trial Registration ClinicalTrials.gov Identifier: NCT02747004

Case Report - Hodgkin's disease in an elderly patient with B-Cell chronic lymphocytic leukemia

Chronic lymphocytic leukemia (CLL) is the most common type of leukemia worldwide. It is an indolent disease, almost exclusively of B-cell origin. Some CLLs evolve into a more aggressive lymphoid malignancy. The most common of these is Richter\u2032s syndrome. Transformation to acute lymphoblastic leukemia, plasma cell leukemia, multiple myeloma, or Hodgkin\u2032s disease (HD) may also occur. CLL patients are also at a significantly increased risk of developing a second malignant neoplasm later in life. One of the most common of these is HD. Herein, we report a case of HD in an elderly man with a history of B-cell CLL

Atypical sweet syndrome in the hands of small cell lung cancer patient associated with granulocyte colony-stimulating factor administration

Introduction: Sweet syndrome (SS) characterized by papules, plaques or nodules. SS was divided into three subcategories as classical SS, malignancy associated SS, and drug-induced SS. Case presentation: We present a case of G-CSF-associated Sweet Syndrome (SS) in a 50-year-old man with the diagnosis of extensive stage small cell lung cancer. We started preemptive methylprednisolone with a diagnosis of the sweet syndrome. Conclusion: SS is the insidious complication of G-CSF . Clinical suspicion is the key to the early diagnosis. Keywords: Sweet Syndrome, G-CSF, Lung Cance

Hodgkin's disease in an elderly patient with B-Cell chronic lymphocytic leukemia

Chronic lymphocytic leukemia (CLL) is the most common type of leukemia worldwide. It is an indolent disease, almost exclusively of B-cell origin. Some CLLs evolve into a more aggressive lymphoid malignancy. The most common of these is Richter′s syndrome. Transformation to acute lymphoblastic leukemia, plasma cell leukemia, multiple myeloma, or Hodgkin′s disease (HD) may also occur. CLL patients are also at a significantly increased risk of developing a second malignant neoplasm later in life. One of the most common of these is HD. Herein, we report a case of HD in an elderly man with a history of B-cell CLL

Malignant pleural mesothelioma: A single-center experience in Turkey

Background: Malignant pleural mesothelioma is a rare lethal malignancy caused by asbestos exposure. It is more frequently seen in certain regions in Turkey. In this retrospective study, we aimed to analyse demographic, clinical, and pathological data and treatment-related features in 54 patients. Material/ Methods: The study included 54 patients diagnosed with malignant mesothelioma that were followed and treated. Results: Of the 54 patients, 34 (55.6%) were male. The median age in men and women were 60.3 (38.2-77.2) and 65.8 (37.7-77.5) years, respectively. In 35 (64.8%), exposure to asbestosis was present. Epithelial type was found in 27 (50.0%), followed by mixed type in 7 (13.0%) patients, and in 20 (37.0%) patients the subtype could not be determined. The disease was staged as IV in 37 (68.5%) patients. In 28 patients (51.9%), it was right-sided and in 1 (1.9%) it was bilateral. The most frequent metastatic sites (in decreasing order) were lungs, mediastinum, diaphragm, liver, and thoracal wall. Of the 54 patients, 36 (66.6%) received 1st-line chemotherapy and 20 (37%) 2nd-line chemotherapy. Eighteen patients (33.3%) received radiotherapy; 11 (20.3%) with palliative intention and 7 (12.9%) with curative intention. Median overall survival (OS) was 12.03 months (95% CI 7.2-16.8). OS was not affected by sex (p=0.32), smoking history (p=0.51), alcohol consumption (p=0.36), family history (p=0.67), pleural effusion presence (p=0.80), operation (p=0.14), clinical stage (p=0.072), symptom at presentation (p=0.66), having mixed type histology (p=0.079), asbestos exposure (p= 0.06), and type of 1st-line chemotherapy (p=0.161). On the contrary, it may be positively affected by good ECOG PS (0-1) (p<0.01), age below 65 (p=0.03), left-sided disease (p=0.01), receiving chemotherapy (p<0.01), having unilateral pleural effusion (p=0.018), and type of 2nd-line chemotherapy (p=0.025). Conclusions: OS of our patients was better than that found in the literature, seeming to be positively affected by early stages, better ECOG PS, age below 65 years, left side involvement, and having second-line chemotherapy with cisplatin- gemcitabine or 3M. Overall treatment success seems to be comparable to what is currently expected

Health-related quality of life and health care services expectations of the patients with lung cancer

WOS: 000258507500006Non-small cell lung cancer is approximately 80% of all lung cancer. This type of lung cancer is usually presented with advanced stage at diagnosis and have a very poor prognosis. The management of non-small cell cancer at those stages generally is chemotherapy and/or concurrent chemoradiotherapy. However, potent chemotherapeutic agents and radiotherapy have serious adverse effects. This study aimed to determine lung cancer patients' expectations from health care providers, and levels of anxiety and depression besides health-related quality of life. This study was performed on 40 patients diagnosed as advanced stage non-small cell lung cancer at Baskent University hospitals in Turkey. SF-36 questionnaire was used to determine health-related quality of life, Hospital Anxiety and Depression Scale (HAD) was used to determine depression and anxiety level, and ECOG performance scale was used for performance evaluation. SF-36 scale yielded less than 50 points in all subscale evaluations (p < 0.05). The lowest mean scores were observed in emotional and physical role enforsement subscales. Calculations of hospital anxiety and depression scale showed 8.4 +/- 4.16 mean scale for anxiety (at borderline), and 7.6 +/- 4.8 for depression (normal). ECOG performance status was 0 for 20.5%, 1 for 44.1%, 2 for 32.4% and 3 score for 2.5% of the patients. Most of the non-small cell lung cancer patients had poor quality of life, with deterioration of both psychological and physiological function. We observed that those patients could not get necessary health care

Geographic variations of clinical characteristics in breast cancer: Analysis of Turkish National Breast Cancer Registry.

Annual Meeting of the American-Society-of-Clinical-Oncology (ASCO) / Clinical Science Symposium on Predicting and Improving Adverse Outcomes in Older Adults with Cancer -- MAY 29-JUN 02, 2015 -- Chicago, ILWOS: 000358036902450…Amer Soc Clin Onco

Flare Phenomenon in Advanced Colorectal Cancer: Cessation of evacizumab after Predefined Cycles of Therapy may not Affect Outcome

Limited number of experimental and clinical studies showed rapid tumor regrowth after bevacizumab cessation in advanced colorectal cancer. We retrospectively evaluated rapid regrowth phenomenon in 105 patients those who were treated with the predefined number of chemotherapy cycles and grouped according to whether the chemotherapy regimen in the first line setting included bevacizumab (CT-Bev arm) or not (CT arm). Median age was 55 years old. Median overall and progression free survival times were 27 and 11 months, respectively. Rapid progression rates were 42% and 40% in CT arm and CT -Bev arm without no statistically significant difference (p= 0.84). In CT arm, significantly more patients with stable disease (SD) progressed rapidly compared to patients with complete (CR) or partial response (PR) (53% vs. 27%, p= 0.04). This result was also similar in CT-Bev arm (48% vs. 30%, p= 0.27) but could not reach to the significant p-value. Overall survival 2, the time from the end of last dose of chemotherapy +/- bevacizumab to death, was significantly shorter in both CT and CT -Bev arms for patients who showed SD compared to CR or PR (15 vs 38 months) (p< 0.001).Current study supports that withdrawal of bevacizumab after predefined treatment cycles may not have any adverse effect on patients' outcome of advanced CRC. This result is particularly acceptable for the patients who show CR or PR to the treatment