Curative-intent surgery for pancreatic tumors: a review of 3,386 procedures from the brazilian public health system

Sem informação3315Annual Meeting of the American-Society-of-Clinical-Oncology (ASCO) / Clinical Science Symposium on Predicting and Improving Adverse Outcomes in Older Adults with Cance

Gefitinib for patients with advanced non-small cell lung cancer treated on the expanded access program: a single institution experience

Objective: A retrospective analysis of patients with advanced nonsmallcell lung cancer treated with gefitinib on an expanded accessprogram. Methods: Patients with advanced non-small cell lung cancerand Karnofsky performance status ≥ 50% were allowed to enroll. Theyreceived gefitinib 250 mg orally once a day. No other systemic anticancertreatment was allowed during the trial. Results: From June 2002 toApril 2003, 31 patients were included. The age range was 38 to 84years, with 20 men and 11 women. The median Karnofsky performancestatus was 80% and 25 patients had a history of smoking. Thirty patientswere clinical stage IV and one patient was stage IIIB. The objectiveresponse rate was 14%. There was no complete response. An additional36% of patients (n=10) had stable disease for more than 6 months,giving a response plus disease stabilization rate of 50%. The medianprogression free survival was 3.6 months, and the median overallsurvival was 4 months. The one year survival rate was 19%. Toxicitieswere mild in this cohort, with grade 1 (42%) and 2 (11%) diarrhea andgrade 1 rash (16%) being the most commonly observed side effects.Conclusions: Despite the small sample, our data are similar to publishedtrials, confirming efficacy in a setting of pretreated patients and tolerableside effects. In this study patients had to meet only a few essentialeligibility criteria for enrollment, making our data reproducible andapplicable to patients seen in a community setting

Imatinib is active in glioblastoma multiforme expressing platelet-derived growth factor receptor

Objective: To report on 15 patients with recurrent anaplastic astrocytoma (AA) or glioblastoma multiforme (GBM) previously treated with standard therapies and, then, treated with imatinib. Methods: Fifteen consecutive patients with recurrent AA or GBM, positive immunostaining for the PDGF-alpha and progression on previous standard therapies (surgery, radiation and chemotherapy with temozolomide) were treated with imatinib (400 mg/day), administered until progression or unacceptable toxicity. Rresults: One patient achieved a confirmed partial response that lasted for 15 months. In addition, two patients had disease stabilization for eight and 19 months. Treatment was well tolerated and no patient had to be removed due to adverse events. Cconclusions: Imatinib seems to be safe and active in patients with high grade astrocytic tumors that express the PDGF-alpha receptor. Based on these results, we initiated phase II trial of high-dose imatinib (800 mg/day) in patients with recurrent AA or GBM

Liver Metastases in Pancreatic Acinar Cell Carcinoma Treated with Selective Internal Radiation Therapy with Y-90 Resin Microspheres

Background. Pancreatic acinar cell carcinoma (PACC) is a rare tumor. Surgical resection is the treatment of choice when feasible, but there are no clear recommendations for patients with advanced disease. Liver-directed therapy with Y-90 selective internal radiation therapy (SIRT) has been used to treat hepatic metastases from pancreatic tumors. We describe a case of PACC liver metastases treated with SIRT. Case Report. 59-year-old man was admitted with an infiltrative, solid lesion in pancreatic tail diagnosed as PACC. Lymph nodes in the hepatic hilum were enlarged, and many metastatic liver nodules were observed. After partial pancreatectomy, the left and right lobes of the liver were separately treated with Y-90 resin microspheres. Follow-up imaging revealed that all hepatic nodules shrank by at least 50%, and 3 nodules disappeared completely. Lipase concentration was 8407 U/L at baseline, rose to 12,705 U/L after pancreatectomy, and declined to 344 U/L after SIRT. Multiple rounds of chemotherapy in the subsequent year shrank the hepatic tumors further; disease then progressed, but a third line of chemotherapy shrank the tumors again, 16 months after SIRT treatment. Conclusion. SIRT had a positive effect on liver metastases from PACC. In conjunction with systemic therapy, SIRT can achieve sustained disease control

Liver Metastases in Pancreatic Acinar Cell Carcinoma Treated with Selective Internal Radiation Therapy with Y-90 Resin Microspheres

Background. Pancreatic acinar cell carcinoma (PACC) is a rare tumor. Surgical resection is the treatment of choice when feasible, but there are no clear recommendations for patients with advanced disease. Liver-directed therapy with Y-90 selective internal radiation therapy (SIRT) has been used to treat hepatic metastases from pancreatic tumors. We describe a case of PACC liver metastases treated with SIRT. Case Report. 59-year-old man was admitted with an infiltrative, solid lesion in pancreatic tail diagnosed as PACC. Lymph nodes in the hepatic hilum were enlarged, and many metastatic liver nodules were observed. After partial pancreatectomy, the left and right lobes of the liver were separately treated with Y-90 resin microspheres. Follow-up imaging revealed that all hepatic nodules shrank by at least 50%, and 3 nodules disappeared completely. Lipase concentration was 8407 U/L at baseline, rose to 12,705 U/L after pancreatectomy, and declined to 344 U/L after SIRT. Multiple rounds of chemotherapy in the subsequent year shrank the hepatic tumors further; disease then progressed, but a third line of chemotherapy shrank the tumors again, 16 months after SIRT treatment. Conclusion. SIRT had a positive effect on liver metastases from PACC. In conjunction with systemic therapy, SIRT can achieve sustained disease control