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Study Objectives
To determine the maximum tolerated dose and/or optimum biologic dose of MEDI-565 in adult subjects and evaluate the safety profile in adult subjects with advanced gastrointestinal adenocarcinomas who have no available standard or curative treatments.
Intervention / Treatment
DRUG: MEDI-565, DRUG: MEDI-565, DRUG: MEDI-565, DRUG: MEDI-565
| Inclusion Criteria:
* Age ≥ 18 years of age at the time of screening
* Adequate contraception from screening through end of trial
* For the dose-escalation phase, subjects with GI adenocarcinomas with no available standard or curative treatments
* Adequate hematological function
* Adequate organ function
* For subjects who had prior treatment with chemotherapy, biological therapy, radiotherapy, or had prior surgery: eligible for study entry if at least 30 days have passed since their treatment/surgery
* Life expectancy of at least 3 months
* Karnofsky performance status ≥ 70%
* Body weight ≥ 45 kg
Exclusion Criteria:
* Concurrent enrollment in another clinical study
* Employees of the clinical study site or any other individuals involved with the conduct of the study, or immediate family members of such individuals
* Prior treatment with MEDI-565
* History of allergy or reaction to any component of the MEDI-565 formulation
* History of malignancy other than GI adenocarcinoma, within 5 years prior to study entry, with the exception of ductal carcinoma in situ of the breast, basal cell carcinoma of the skin or carcinoma in situ of the cervix successfully treated with curative therapy
* Diagnosis of hepatocellular carcinoma
* Clinical history of significant CNS pathology
* Active bacterial infection or known bacteremia.
* Vaccination within 2 weeks prior to initiation of MEDI-565
* Infection with HIV-1 or HIV-2; chronic infection with hepatitis B or C
* History of primary immunodeficiency
* History of chronic autoimmune disease
* Elective surgery planned during the study period through 30 days after discontinuation of MEDI-*
* Treatment with any chemotherapy, radiotherapy, immunotherapy, biologic, or hormonal therapy for cancer treatment within 30 days prior to study entry and not recovered from treatment
* Treatment with any investigational agent within 30 days prior to initiation of MEDI-565
* Regular dose of systemic corticosteroids during the 30 days prior to initiation of MEDI-565 or anticipated need of corticosteroids exceeding prednisone 40 mg/day of prednisone or equivalent during the trial, or any other systemic immunosuppressive therapy within 30 days prior to study entry (some maintenance doses allowed)
* Contraindication to any protocol-specified concomitant medications administered during this study
* Pregnancy or lactation
* Evidence of any uncontrolled systemic disease (other than GI adenocarcinoma)
* Recent history of cardiac disease, including myocardial infarction, unstable angina pectoris or uncontrolled arrhythmia within 6 months, or evidence of severe congestive heart failure
* A marked baseline prolongation of corrected QT interval interval |
Study Objectives
This is a two-part Phase 1/2 dose escalation and dose expansion study of an Adenovirus Vector (Ad5/3-D24-GMCSF), Expressing GM-CSF (GM-CSF-encoding adenovirus), ONCOS-102, in combination with anti-programmed death ligand-1 (PD-L1) antibody, durvalumab, in adult subjects with peritoneal disease who have failed prior standard chemotherapy and have histologically confirmed epithelial ovarian cancer or metastatic colorectal cancer.
Intervention / Treatment
BIOLOGICAL: ONCOS-102, DRUG: Durvalumab, DRUG: Cyclophosphamide
| Inclusion Criteria:
* Subjects with peritoneal disease who have failed prior standard chemotherapy and have histologic confirmation of epithelial ovarian cancer or metastatic colorectal cancer (CRC) including cancer originating from the appendix.
* Subject is willing to undergo a core needle biopsy during screening and Cycle 2, Study Week * Archival tumor samples are requested but are not required for eligibility.
* Previously treated for advanced cancer with no additional therapy options available known to prolong survival.
* Laboratory parameters for vital functions should be in the normal range or not clinically significant.
* Eastern Cooperative Oncology Group (ECOG) performance status ≤ *
Exclusion Criteria:
* Treatment with an investigational agent within 4 weeks of starting study treatment or prior treatment with a checkpoint inhibitor (cytotoxic T-lymphocyte-associated protein 4 \[CTLA-4\], programmed cell death protein 1 \[PD-1\] or programmed death ligand 1 \[PD-L1\] antibodies).
* Subject has known active central nervous system metastasis, glioma and nervous system malignancies including carcinomatous meningitis. Subjects with asymptomatic brain metastases or spinal cord compression who have been treated, are considered stable, and who have not received corticosteroids or anticonvulsants for at least 28 days prior to screening may be included. Subject has other active malignancy.
* Known immunodeficiency or known to have evidence of acute or chronic human immunodeficiency virus (HIV), Hepatitis B, or Hepatitis C or other uncontrolled inter-current illnesses.
* Ongoing bowel perforation or presence of bowel fistula or abscess or history of small or large bowel obstruction within 3 months of registration, including subjects with palliative gastric drainage catheters. Subjects with palliative diverting ileostomy or colostomy are allowed if they have been symptom-free for more than 3 months.
* Subjects with clinically significant cardiovascular disease, history of organ transplant or allogeneic bone marrow transplant, active known or history of autoimmune disease that might recur or major surgery within 28 days prior to the first dose or still recovering from prior surgery. |
Study Objectives
The trial evaluates the safety and efficacy of MUC-1/WT-1 peptide and/or tumor lysate-pulsed dendritic cell Immunotherapy for the patients with pancreatic cancer
Intervention / Treatment
BIOLOGICAL: Dendritic cells pulsed with tumor lysate, BIOLOGICAL: Dendritic cells pulsed with MUC-1/WT-1 peptides
| Inclusion Criteria:
* histologically or cytologically confirmed pancreatic cancer (adenocarcinoma);
* HLA-A2 expression by tumor cells;
* WT-1/MUC-1 expression by tumor cells.
Exclusion Criteria:
* refuse of patient to participate in the trial;
* pregnancy/lactation;
* intercurrent severe chronic diseases;
* HIV, Hepatites B/C;
* active tuberculosis;
* alcohol use disorder/drug addiction. |
Study Objectives
The main purpose of this research study is to evaluate the effectiveness of "nudges" to clinicians, to patients, or to both in increasing Tobacco Use Treatment Service (TUTS) referral and engagement; and to explore clinician, patient, inner setting (e.g., clinic), and outer setting (e.g., payment structures) mechanisms related to TUTS referral and engagement. The investigators will employ rapid-cycle approaches to optimize the framing of nudges to clinicians and patients prior to initiating the trial and mixed methods to explore contextual factors and mechanisms.
The investigators will conduct a four-arm pragmatic cluster randomize clinical trial to test the effectiveness of nudges to clinicians, nudges to patients, or nudges to both in increasing TUTS referral and engagement in cancer patients who smoke, vs. usual care (UC). The investigators hypothesize that each of the implementation strategy arms will significantly increase TUTS referral and engagement compared to UC and that the combination of nudges to clinicians and to patients will be the most effective.
Intervention / Treatment
OTHER: Clinician Nudge, OTHER: Patient Nudge
| Inclusion Criteria:
Clinician participants must meet the following criteria for inclusion:
* Currently in practice at an Implementation Lab site (UPHS)
* Prescribing authority in Pennsylvania (i.e., physician, nurse practitioner, physician assistant)
* Cared for at least 1 tobacco-using patient in 30 days prior to recruitment
* English-speaking (messages will be in English)
Patient participants must be diagnosed with cancer and report current tobacco smoking (as assessed by an by any staff collecting vital signs or initially rooming the patients such as nurses, front desk staff, MAs, nursing assistants or technicians during an Index Visit). Patients are considered in the analyzable dataset after their Index Visit and after they have a clinic visit with a clinician in the study at which point a nudge may have been delivered (see steps below).
The process by which patients become eligible for inclusion involves a 3-step algorithm employed in the EMR:
Step 1 - All patients seeking care within the participating Abramson Cancer Center programs are screened for tobacco use status in order to ascertain relevance to the project (i.e., tobacco exposure). This screening encounter need not be a visit with a clinician who is in the cluster randomization.
Step 2 - This step occurs at the first visit with a clinician within the cluster randomization. Note that this might be the same encounter in which screening occurs, but does not have to be. At this visit, all patients identified as current smokers are assigned a hidden (i.e., system) variable, the value of which is based on the clinician they are scheduled to meet during that visit (i.e., cluster membership).
Step 3 - The logic is engaged at the next (third in series) visit, wherein the system variable is used to guide the intervention based on the clinician's cohort. There must be this visit to permit the delivery of the nudges (or not, if in usual care arm). The primary outcome is clinician referral for tobacco cessation through the EHR at this visit. Thus, patients eligible for this study are only those who are screened (and positive for tobacco use) and have completed the two visits in their randomly assigned cluster (clinician clusters are the unit of randomization) during the study period.
Outcomes are assessed at the patient level. |
Study Objectives
This study aims to develop a health related quality of life (HRQOL) patient reported outcome (PRO) for patients receiving immune checkpoint modulator (ICM) therapy. This instrument could be used to in clinical trials to evaluate HRQOL for patients treated with novel ICMs and ICM combinations that might ultimately influence decisions about regulatory approval, as well as improved understanding of chronic treatment effects on patient well-being, understanding reasons for treatment non-adherence, and developing strategies to improve adherence and evaluating clinical outcomes.
Intervention / Treatment
OTHER: Focus groups and individual interviews, OTHER: Questionnaire
| Inclusion Criteria:
Patient Criteria
* Cancer diagnosis (any type, advanced or metastatic stage);
* Treatment with an agent or agents that modulate an immune checkpoint (any line of therapy);
* Age ≥ 18;
* English-speaking;
* ECOG PS 0-3
* Able to complete questionnaires independently
* Able to provide informed consent.
* Completed treatment within a year of enrolment
Clinician Criteria
* Must either treat patients with ICMs or manage side effects of patients treated with ICMs
* Be able to attend interviews and participate in discussions as part of the study |
Study Objectives
Phase 3 Study of A-101 Topical Solution in Subjects with Common Warts
Intervention / Treatment
DRUG: Active, OTHER: Vehicle
| Inclusion Criteria:
* Subject or legal guardian is able to comprehend and is willing to sign an informed consent/assent for participation in this study.
* Male or female ≥ 2 years old.
* Subject has a clinical diagnosis of common warts (verruca vulgaris).
* Subject has at least 1 and up to 6 clearly identifiable common warts located on the trunk or extremities that meet the requirements as defined below:
* Have a longest axis that is ≥3 and ≤8 mm and have a thickness of ≤3mm
* Be a discrete lesion, i.e. each wart meeting the entry criteria is clearly separated from other warts.
* Be present for at least 4 weeks
* Not be covered with hair which, in the investigator's opinion, would interfere with the study medication treatment or the study evaluations
* Not be in an intertriginous fold
* Periungual, subungual, genital, anal, mosaic, plantar, flat and filiform warts are excluded from treatment and evaluation. If a subject has these types of warts, but also has warts that meet the inclusion criteria, the subject will NOT be excluded from the study.
* Each common wart identified for treatment must have a PWA ≥ *
* Subject's chemistry and complete blood count results are within normal limits. If any of the laboratory values are outside normal range, the treating investigator must assess the value(s) as NOT clinically significant and document this in the subject's medical chart in order for the subject to be eligible for randomization.
* Subject is in good general health and free of any known disease state or physical condition which, in the investigator's opinion, might impair the evaluation of the identified common warts or which exposes the subject to an unacceptable risk by study participation.
* Subject is willing and able to follow all study instructions and to attend all study visits.
* Subject must be the only individual in a household participating in the study.
Exclusion Criteria:
* Subject has clinically atypical common warts.
* Subject is immunocompromised (e.g., due to chemotherapy, systemic steroids, genetic immunodeficiency, transplant status, etc.).
* Subject has a history of Human Immunodeficiency Virus (HIV) infection.
* Subject has had any Human Papilloma Virus (HPV) vaccine within 6 months prior to Visit *
* Subject has used any of the following intralesional therapies within the specified period prior to Visit 2:
* Immunotherapy (e.g., Candida antigen, mumps antigen, Trichophyton antigen); 8 weeks
* Anti-metabolite therapy (e.g., bleomycin, 5-fluorouracil); 8 weeks
* Subject has used any of the following systemic therapies within the specified period prior to Visit 2:
* Immunomodulatory/immunosuppressant therapy (e.g., etanercept, alefacept, infliximab); 16 weeks
* Glucocorticosteroids (inhaled and intra-nasal steroids are permitted); 28 days
* Subject has used any of the following topical therapies within the specified period prior to Visit 2 on, or in the proximity to any of the common warts identified for treatment, that in the investigator's opinion interferes with the study medication treatment or the study assessments:
* LASER, light or other energy-based therapy (e.g., intense pulsed light \[IPL\], photodynamic therapy \[PDT\]); 180 days
* Immunotherapy (e.g., imiquimod, squaric acid dibutyl ester\[SADBE\], etc.) 12 weeks
* Liquid nitrogen, electrodesiccation, curettage; 60 days
* Hydrogen peroxide; 90 days
* Antimetabolite therapy (e.g., 5-fluorouracil); 8 weeks
* Retinoids; 90 days
* Over-the-counter (OTC) wart therapies and cantharidin; 28 days
* Subject currently has or has had any of the following within the specified period prior to Visit 1 on or in the proximity to any of the common warts identified for treatment that, in the investigator's opinion, interferes with the study medication treatment or the study assessments:
* Cutaneous malignancy; 180 days
* Sunburn; currently
* Pre-malignancy (e.g., actinic keratosis); currently
* Subject has a history of sensitivity to any of the ingredients in the study medications.
* Subject has any current skin or systemic disease (e.g., psoriasis, atopic dermatitis, eczema, sun damage), or condition (e.g., sunburn, excessive hair, open wounds) that, in the opinion of the investigator, might put the subject at undue risk by study participation or interfere with the study conduct or evaluations.
* Participation in another therapeutic investigational drug/device trial in which administration of an investigational treatment occurred with 30 days prior to Visit *
* Subject has an active malignancy.
* Subjects is viewed by the Principal Investigator as not being able to complete the study. |
Study Objectives
Clinical evidence has suggested that sub-antimicrobial doses of doxycycline may have the potential to treat inflammatory lesions of acne. The efficacy of doses below 100 mg/day of doxycycline in the prevention of skin toxicity in patients with treated with Epidermal Growth Factor Receptor (EGFR)-targeted therapies has never been studied. Therefore, the aim of the present study is to describe the efficacy of doxycycline 50 or 100 mg per day in the prevention of skin toxicity in patients with metastatic Colorectal cancer (mCRC) treated with anti-EGFR in combination with chemotherapy.
Intervention / Treatment
DRUG: Doxycycline 50Mg Tablet
| Inclusion Criteria:
* Man or woman at least 18 years old
* Capable of understanding, signing and dating an informed consent approved by an Independent Ethics Committee (IEC)
* Histologically confirmed adenocarcinoma of the colon or rectum in patients with initially unresectable metastatic (M1) disease
* Wild-type RAS tumour status confirmed before study inclusion at local institution
* Patients who have a treatment plan based on FOLFOX + anti-EGFR or FOLFIRI + anti-EGFR, as first-line treatment of mCRC
* Eastern Cooperative Oncology Group (ECOG) performance status ≤2
* Adequate bone marrow function: neutrophils ≥*5 x109/L; platelets ≥100 x109/L; haemoglobin ≥9 g/dL
* Hepatic, renal and metabolic function as follows: Total bilirubin count ≤*5 x upper limit of normal (ULN), Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) <5 x ULN; Renal function, calculated as creatinine clearance or 24-hour creatinine clearance ≥50 mL/min; Magnesium > lower limit of normal (LLN)
Exclusion Criteria:
* History of prior or concurrent central nervous system (CNS) metastases
* History of another primary cancer, except: curatively treated in situ cervical cancer, or curatively resected non-melanoma skin cancer, or other primary solid tumour curatively treated with no known active disease present and no treatment administered for ≥5 years before treatment initiation
* Known hypersensitivity to tetracyclines
* Prior chemotherapy or other systemic anticancer therapy for treatment of metastatic colorectal carcinoma
* Prior adjuvant chemotherapy for colorectal cancer terminated less than 6 months before metastatic disease was diagnosed
* Unresolved toxicities of a previous systemic treatment that, in the opinion of the investigator, cause the patient unfit for inclusion
* Prior anti-epidermal growth factor receptor (EGFR) antibody therapy (e.g., cetuximab), antivascular endothelial growth factor (VEGF) or treatment with small molecule EGFR inhibitors (e.g., erlotinib)
* Prior hormonal therapy, immunotherapy or approved or experimental antibody/proteins ≤30 days before inclusion.
* Significant cardiovascular disease including unstable angina or myocardial infarction within 12 months before initiating study treatment or a history of ventricular arrhythmia
* History of interstitial pneumonitis or pulmonary fibrosis or evidence of interstitial pneumonitis or pulmonary fibrosis on baseline chest computed tomography (CT)
* Treatment for systemic infection within 14 days before the start of study treatment
* Acute or subacute intestinal occlusion and/or active inflammatory bowel disease or other bowel disease that causes chronic diarrhoea (defined as grade ≥ 2 diarrhoea according to Common Terminology Criteria for Adverse Events (CTCAE)
* Clinically significant peripheral sensory neuropathy
* Evidence of previous acute hypersensitivity reaction, of any grade, to any component of the treatment
* History of Gilbert disease or known dihydropyrimidine deficiency syndrome
* Recent gastroduodenal ulcer to be active or uncontrolled
* Recent pulmonary embolism, deep vein thrombosis, or other significant venous event
* Pre-existing bleeding diathesis and/or coagulopathy with exception of well-controlled anticoagulation therapy
* Recent major surgical procedure, open biopsy, or significant traumatic injury not yet recovered from prior major surgery
* History of any disease that may increase the risks associated with study participation or may interfere with the interpretation of study results.
* Known positive test for human immunodeficiency virus infection, hepatitis C virus, chronic active hepatitis B infection
* Any disorder that compromises the patient's ability to provide written informed consent and/or comply with study procedures
* Any investigational agent within 30 days prior to inclusion
* Pregnant or breastfeeding woman
* Surgery (excluding diagnostic biopsy or placement of a central venous catheter) and/or radiotherapy within 28 days prior to inclusion in the study.
* Male or female of childbearing age who do not agree with taking adequate contraceptive precautions, i.e. use contraception double barrier (e.g. diaphragm plus condoms) or abstinence during the course of the study and for 6 months after the last administration of study drug for women and 1 month for men
* The patient is unwilling or unable to meet the requirements of the study. Psychological, geographical, familial or sociological conditions that potentially prevent compliance with the study protocol and follow-up schedule. These conditions should be discussed with the patient before inclusion in the trial. |
Study Objectives
The aim of this study is to compare the two surgical approaches namely laparoscopic pancreatoduodenectomy and open pancreatoduodenectomy for management of periampullary and pancreatic head cancers in terms of parameters like hospital stay, pathological radicality, complication rate, peri-operative and post operative outcomes.
Intervention / Treatment
PROCEDURE: Open surgery, PROCEDURE: Laparoscopic surgery
| Inclusion Criteria:
* Adult males or females with a diagnosis of either of resectable Periampullary and pancreatic head cancers with
* No evidence of metastasis
* Radiological non-involvement of Superior Mesenteric Vein \& Portal Vein
* Preserved fat planes between celiac axis, Hepatic Artery \& Superior Mesenteric Artery
Exclusion Criteria:
* Unresectable Tumor at surgery
* Pancreatoduodenectomy for other diagnosis like cystic tumors or chronic calcific pancreatitis with head mass
* With prior Neoadjuvant treatment |
Study Objectives
Phase II trial to study the effectiveness of CT-2103 in treating patients who have recurrent or persistent ovarian epithelial cancer or primary peritoneal cancer. Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die.
Intervention / Treatment
DRUG: Paclitaxel Poliglumex
| Inclusion Criteria:
* Histologically confirmed recurrent or persistent ovarian epithelial cancer or primary peritoneal cancer after second-line therapy
* Received 1 prior platinum-based first-line chemotherapy regimen and 1 prior second-line (non-platinum, non-taxane) chemotherapy regimen
* At least 1 unidimensionally measurable lesion
* At least 20 mm by conventional techniques OR at least 10 mm by spiral CT scan
* At least 1 target lesion that has not previously been irradiated
* Ineligible for a higher priority GOG protocol (if one exists)
* Ineligible for the currently active phase II cytotoxic protocol for platinum-resistant disease
* Performance status - GOG 0-2
* Absolute neutrophil count at least 1,500/mm\^3
* Platelet count at least 100,000/mm\^3
* No active bleeding
* Bilirubin no greater than *5 times upper limit of normal (ULN)
* SGOT no greater than *5 times ULN
* Alkaline phosphatase no greater than *5 times ULN
* PT or PTT less than ULN
* Creatinine no greater than *5 times ULN
* No uncontrolled hypertension
* No uncompensated congestive heart failure
* No symptomatic coronary artery disease
* No myocardial infarction within the past 6 months
* No sensory or motor neuropathy greater than grade 1
* No active infection requiring antibiotics
* No other invasive malignancy within the past 5 years except nonmelanoma skin cancer
* Not pregnant or nursing
* Negative pregnancy test
* Fertile patients must use effective contraception
* At least 3 weeks since prior biological therapy or immunotherapy directed at the malignancy
* No prior polyglutamate paclitaxel (CT-2103)
* Recovered from prior chemotherapy
* At least 1 week since prior hormonal therapy directed at the malignancy
* Concurrent hormone replacement therapy allowed
* Recovered from prior radiotherapy
* No prior radiotherapy to more than 25% of bone marrow
* Recovered from prior surgery
* At least 3 weeks since other prior therapy directed at the malignancy
* No prior therapy for another malignancy that would preclude this study
* No concurrent amifostine or other protective reagents |
Study Objectives
Euthanasia and assisted dying are of growing interest for patients with incurable diseases. The possible methods are widely discussed by patient-societies, physicians, lawyers, theologians and philosophers. During the last years several opinion-polls were conducted with healthy people or medical stuff, but no surveys were conducted to get the attitude of incurable ill patients.
The hypothesis of the investigators' study is: "Palliative Care Medicine is a better option for incurable ill patients than an assisted suicide."
Intervention / Treatment
| Inclusion Criteria:
* Age >= 18 years
* Incurable illness
* Mental state thet allows to answer a questionnaire
Exclusion Criteria:
* Somnolence
* Low mental state
* Curable disease
* Depression with danger of acute suicide |
Study Objectives
This is an open label, single arm, single center, phase 2 study with the use of the antiangiogenic multikinase inhibitor pazopanib in a population of patients with germ cell tumors who are not cured following first or subsequent chemotherapy lines for metastatic disease, followed by eventual surgery.
Intervention / Treatment
DRUG: Pazopanib
| Inclusion Criteria:
* Male gender.
* Confirmation of GCT histology based on pathologic review at Fondazione INT Milan.
* Unequivocal progression of measurable disease.
* A minimum of 2 and a maximum of 3 platinum-based chemotherapy lines for metastatic disease.
* First-line therapy should consist of at least 3 cycles of cisplatin-based chemotherapy.
* Prior single, tandem or triple high-dose chemotherapy course given as front-line or salvage therapy is allowed.
Exclusion Criteria:
* Failure to meet any of the above inclusion criteria.
* Concurrent treatment with other cytotoxic drugs or targeted therapies.
* Prior radiation therapy within 14 days of trial start. |
Study Objectives
Large-cell B-cell lymphoma (DLBCL) is the most common non-Hodgkin's lymphoma and accounts for about 40% of new cases. Although the DLBCL is a single entity in the WHO classification, several subgroups with different prognoses are recognized. These subgroups take into account the tumor localization (primitive cerebral lymphoma, serous lymphoma, intravascular or exclusive lymph node) or a particular molecular signature (GCB profile, germline center B cell or ABC, activated B cell). Despite the introduction of immunotherapy, treatment failures are common. Overall survival at 5 years is estimated to be between 26 and 73%. This highlights the important heterogeneity of this pathology and therefore the need for biomarkers prognosis. Recently, an increase in monocytes in the blood of DLBCL patients has been proposed as a prognostic factor for independent survival. This marker of poor prognosis is also found in many solid.
Monocytes are effectors of the inflammatory response. They have different functional profiles depending on the level of expression of CD14 and CD16. Four subtypes of monocytes are distinguished: classical (CD14posCD16neg), intermediate (CD14posCD16pos) and non-classical (CD14lowCD16pos); the latter population is divided into two sub-groups depending on the expression of the SLAN protein. The different monocytic subpopulations have very diverse functions ranging from an immunosuppressive profile to an activation of the immune system. CD14posCD16neg monocytes are specialized in phagocytosis, production of oxygen derivatives (ROS) and pro-inflammatory cytokine secretion in response to microbial infection. CD14dimCD16pos monocytes are specialized in immune surveillance and produce proinflammatory cytokines such as TNFα and IL-1β in response to LPS stimulation.7 The Slanpos subpopulation produces IL-12 and thus has pro-inflammatory properties. Finally, CD14posCD16pos monocytes have controversial functions. For some authors, they produce the immunomodulatory cytokine IL-10, inhibit the proliferation of CD4 T lymphocytes and induce the recruitment of regulatory T lymphocytes, while for others they produce TNF-α, a pro- inflammatory.From a practical point of view CD14 and CD16 expression forms a continuum, which translates into complexity in the phenotypic definition of these cells and explains the contradictory data on their functionalities. Interestingly, in a laboratory work and in the course of publication, this fraction is increased in the blood of DLBCL patients compared to healthy donors (manuscript in preparation), on the contrary the monocytic fraction CD14dimCD16 pos is decreased in these patients.
In the end, if the increase in monocytes is known to be poor prognosis in patients with DLBCL, the monocyte fraction involved and the monocytic functions involved in this phenomenon are not known.
Since 2011, the Clinical and Biological Hematology Services have a database from a research protocol (BMS_LyTrans). This protocol includes patients with DLBCL as well as healthy patients, in order to allow the biological characterization of biomarkers in this pathology. Thus, we have blood samples and analysis of certain monocyte subtypes by flow cytometry at diagnosis, in more than 100 patients with DLBCL.
Intervention / Treatment
| Inclusion Criteria:
* Age> or equal to 18 years and <or equal to 70 years
* Large cell diffuse NHL B (WHO)
* Stage I - II bulky with tumor mass> 7cm or stage III or IV of the Ann Arbor classification
* No prior treatment (even corticosteroid therapy)
* HIV negative
* Informed consent signed
* Patient follow-up> 2 years after completion of first-line treatment
Exclusion Criteria:
* Age <18 years or> 70 years
* Aggressive transformation of a known low-grade NHL
* Primary CNS Lymphoma
* MALT transformed lymphoma or Burkitt's lymphoma
* Lymphoma post transplantation
* Stage I or II with tumor mass <or equal to 7cm
* Cancer with the exception of carcinoma in situ of the cervix or non-invasive cutaneous epithelium
* History of cured cancer treated systematically and / or causing secondary complications in the six months prior to inclusion in the protocol
* Pre-treatment
* HIV positive
* Patient with a disability who does not have a good understanding of informed consent
* Unsigned informed consent
* Patient follow-up <2 years after completion of first-line treatment |
Study Objectives
The EORTC QLQ-C30, a patient-reported outcome measure (PROM) that is available in 110 different languages, has been used in thousands of clinical cancer trials worldwide. The QLQ-C30 is composed of six functioning scales (including a measure for global quality of life), three symptom scales, and six single items.
Researchers and regulatory bodies came up with the idea to construct a shortened EORTC questionnaire that solely consists of functioning scales and to use additional symptom items according to the side effect profile of the specific medication under investigation.
This shortened form termed QLQ-F17 includes the Physical Functioning (PF), Role Functioning (RF), Emotional Functioning (EF), Cognitive Functioning (CF), and Social Functioning (SF) scales as well as the Global Health Status/Quality of Life (QL) scale in their original wording. This functioning questionnaire can be amended with symptom-specific items taken from the EORTC item library. This method provides a flexible and economic testing strategy that fits the demands of regulators and users in industry and academia.
It is an open question, however, whether the QLQ-F17 is equivalent to the QLQ-C30 in terms of measurement properties. Based on empirical research on response biases and order effects, one might argue that elimination of the symptoms between RF and CF-Dyspnea (DY), Pain (PA), Fatigue (FA), Insomnia (SL), Appetite (AP), Nausea/Vomiting (NV), Constipation (CO), and Diarrhea (DI)-and of the Financial difficulties (FI) item between SF and QL may alter the manner in which subsequent items are completed.
Thus, from a methodological point of view, it is essential to confirm the psychometric properties of the QLQ-F17 and to present evidence that scale values derived from the QLQ-F17 are equivalent to those of the QLQ-C30. Only in the case of equivalence may studies using either of the two basic questionnaires be compared directly. The present project is designed to address this research question.
This is an international multicenter survey study that will include respondents with cancer from Australia, Finland, France, Germany, Italy, Poland, Romania, Spain, Sweden, and United Kingdom. A randomized cross-over design will be applied, enabling between-patients as well as within-patients comparisons of the QLQ-C30 and the QLQ-F17. One group of respondents will first fill in the QLQ-C30 followed by the QLQ-F17, the other group will start with the QLQ-F17 followed by the QLQ-C30.
A sample size of 1.500 cancer patients is sufficient to get precise estimates with narrow confidence intervals regarding item and scale-level agreement. Thresholds and margins to be used for the analyses in this study will be consented by a statistical advisory group. Reliability and psychometric properties can also be precisely estimated with a sample of this size. The present study is based on the hypothesis that the QLQ-F17 and the QLQ-C30 questionnaires are equivalent.
Intervention / Treatment
| Inclusion Criteria:
Patients suffering from cancer or in remission
Exclusion Criteria:
none |
Study Objectives
The aim of this study is to test the hypothesis, that the order of application of Busulfan (BU) and Cyclophosphamide (CY) has an impact on toxicity after allogeneic Hematopoietic stem cell transplantation (HSCT) and that CY-BU reduces liver toxicity compared to BU-CY.
Intervention / Treatment
DRUG: Busulfan-Cyclophosphamide as Conditioning Regimen before Allogeneic Hematopoietic Stem Cell Transplantation, DRUG: Cyclophosphamide-Busulfan as Conditioning Regimen before Allogeneic Hematopoietic Stem Cell Transplantation
| Inclusion Criteria:
* Patients planned to undergo an allogeneic HSCT with myeloablative conditioning
* Age 18 - 65 years
* Myeloid leukemia respectively related precursor neoplasms (acute myeloid leukemia, chronic myeloid leukemia, myelodysplastic syndrome), or lymphoid neoplasms (acute lymphoblastic leukemia/lymphoma, mature B-/T-/natural killer (NK)-cell neoplasms).
* Human Leukocyte Antigen (HLA)-identical sibling donor or matched unrelated (min. 10/10 Ag matched)
* Patients with a history of hepatitis might be included, if no contraindication for HSCT exists.
* Patient must give written informed consent
Exclusion Criteria:
* Indication other than myeloid leukemia respectively related precursor neoplasms, or lymphoid neoplasms.
* Severe liver damage for > 2 weeks (bilirubin > 3xupper limit normal (ULN) or ASAT/ALAT > 5xULN)
* HIV infection
* Donor other than HLA-identical sibling or min. 10/10 matched unrelated donor
* Pregnant or lactating women
* Lack of written informed consent |
Study Objectives
This phase II trial studies how well dalantercept works in treating patients with endometrial cancer that has come back or is persistent. Dalantercept may stop the growth of endometrial cancer by blocking blood flow to the tumor.
Intervention / Treatment
BIOLOGICAL: Dalantercept, OTHER: Laboratory Biomarker Analysis
| Inclusion Criteria:
* Patients must have recurrent or persistent endometrial carcinoma; histologic confirmation of the original primary tumor is required
* Patients with the following histologic epithelial cell types are eligible: Endometrioid adenocarcinoma, serous adenocarcinoma, undifferentiated carcinoma, clear cell adenocarcinoma, mixed epithelial carcinoma, adenocarcinoma not otherwise specified (N.O.S.), mucinous adenocarcinoma, squamous cell carcinoma, and transitional cell carcinoma
* All patients must have measurable disease; measurable disease is defined by Response Evaluation Criteria in Solid Tumors (RECIST) (version *1) as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded); each lesion must be >= 10 mm when measured by computed tomography (CT), magnetic resonance imaging (MRI), or caliper measurement by clinical exam; or >= 20 mm when measured by chest x-ray; lymph nodes must be > 15 mm in short axis when measured by CT or MRI
* Patients must have at least one "target lesion" to be used to assess response on this protocol as defined by RECIST version *1; tumors within a previously irradiated field will be designated as "non-target" lesions unless progression is documented or a biopsy is obtained to confirm persistence at least 90 days following completion of radiation therapy
* Patients must not be eligible for a higher priority Gynecologic Oncology Group (GOG) protocol, if one exists; in general, this would refer to any active GOG phase III protocol or rare tumor protocol for the same patient population
* Patients who have received one prior regimen must have a GOG performance status of 0, 1, or 2; patients who have received two prior regimens must have a GOG performance status of 0 or 1
* Recovery from effects of recent surgery, radiotherapy, or chemotherapy
* Patients should be free of active infection requiring antibiotics (with the exception of uncomplicated urinary tract infection \[UTI\])
* Any hormonal therapy directed at the malignant tumor must be discontinued at least one week prior to registration
* Any other prior therapy directed at the malignant tumor, including chemotherapy and immunologic agents, must be discontinued at least three weeks prior to registration; any investigational drug must be discontinued at least 30 days prior to registration
* Any prior radiation therapy must be discontinued at least four weeks prior to registration
* At least 4 weeks must have elapsed since the patient underwent any major surgery (e.g., major: laparotomy, laparoscopy); there is no delay in treatment for minor procedures (e.g., central venous access catheter placement)
* Prior therapy
* Patients must have had one prior chemotherapeutic regimen for management of endometrial carcinoma. Initial treatment may include chemotherapy, chemotherapy and radiation therapy, and/or consolidation/maintenance therapy; chemotherapy administered in conjunction with primary radiation as a radio-sensitizer WILL be counted as a systemic chemotherapy regimen
* Patients are allowed to receive, but are not required to receive, one additional cytotoxic regimen for management of recurrent or persistent disease
* Patients must have NOT received any non-cytotoxic (biologic or targeted) agent(s) for management of recurrent or persistent disease; prior non-cytotoxic (biologic or targeted) agent(s) is allowed as part of initial treatment; prior hormonal therapy is allowed, but must be discontinued at least one week prior to registration
* Absolute neutrophil count (ANC) greater than or equal to 1,500/mcL
* Platelets greater than or equal to 100,000/mcL
* Hemoglobin greater than or equal to 9 g/dL
* Creatinine less than or equal to *5 times institutional upper limit normal (ULN)
* Sodium greater than or equal to 130 mEq/L (Common Terminology Criteria for Adverse Events \[CTCAE\] v. 4, grade 0 or 1)
* Urine protein should be screened by urinalysis; if protein is 2+ or higher, 24-hour urine protein should be obtained and the level should be < 1,000 mg (< *0 g/24 hrs) for patient enrollment
* Bilirubin less than or equal to *5 times ULN
* Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) less than or equal to 3 times ULN
* Alkaline phosphatase less than or equal to 3 times ULN
* Albumin greater than or equal to 3 (CTCAE v. 4, grade 0 or 1)
* Prothrombin time (PT) such that international normalized ratio (INR) is less than or equal to *5 times ULN (or an in-range INR, usually between 2 and 3, if a patient is on a stable dose of therapeutic warfarin)
* Partial thromboplastin time (PTT) less than or equal to *5 times ULN
* Left ventricular ejection fraction (LVEF) greater than 50% (measured by echocardiogram or MUGA \[multi-gated acquisition\] scan)
* Patients must have signed an approved informed consent and authorization permitting release of personal health information
* Patients must meet pre-entry requirements
* Patients of childbearing potential must have a negative serum pregnancy test prior to the study entry and be practicing an effective form of contraception
Exclusion Criteria:
* Patients who have had prior therapy with dalantercept or other inhibitor of the ALK1 pathway
* Patients with a history of other invasive malignancies, with the exception of non-melanoma skin cancer and other specific malignancies, are excluded if there is any evidence of other malignancy being present within the last three years; patients are also excluded if their previous cancer treatment contraindicates this protocol therapy
* Patients who have received prior radiotherapy to any portion of the abdominal cavity or pelvis OTHER THAN for the treatment of endometrial cancer within the last three years are excluded; prior radiation for localized cancer of the breast, head and neck, or skin is permitted, provided that it was completed more than three years prior to registration, and the patient remains free of recurrent or metastatic disease
* Patients who have received prior chemotherapy for any abdominal or pelvic tumor OTHER THAN for the treatment of endometrial cancer within the last three years are excluded; patients may have received prior adjuvant chemotherapy for localized breast cancer, provided that it was completed more than three years prior to registration, and that the patient remains free of recurrent or metastatic disease
* Patients with history or evidence upon physical exam of central nervous system disease (CNS) disease, including primary brain tumor, seizures not controlled with standard medical therapy, or any brain metastases or leptomeningeal disease
* Serious or non-healing wound, ulcer, or bone fracture
* History of abdominal fistula or anastomotic leak, gastrointestinal perforation, or intra-abdominal abscess within 6 months of registration
* Patients requiring parenteral hydration or parenteral/total parenteral nutrition
* No patients with:
* Active bleeding (e.g., active hemoptysis, defined as bright red blood of greater than or equal to ½ teaspoon \[*5 ml\] in any 24-hour period) within 2 weeks prior to registration or gastrointestinal bleeding within 3 months prior to registration
* Hereditary hemorrhagic telangiectasia (HHT)
* Platelet function abnormality
* Autoimmune or hereditary hemolysis
* Coagulopathy, or
* Tumor involving major vessels (defined as any lesion invading or abutting the wall \[i.e., no fat plane evident\] of major blood vessels as assessed by CT or MRI)
* Patients receiving treatment with full-dose aspirin (325 mg oral daily), clopidogrel (Plavix), or dabigatran (Pradaxa)
* Patients with peripheral edema greater than or equal to grade 1 within 4 weeks of registration
* No patients with clinically significant cardiovascular disease:
* Uncontrolled hypertension, defined as systolic > 150 mm Hg or diastolic > 90 mm Hg despite antihypertensive medications
* Evidence of hypertrophic cardiomyopathy
* New York Heart Association (NYHA) class II or greater congestive heart failure (CHF)
* Any of the following within 6 months prior to study registration:
* Bypass surgery
* Stent placement
* Myocardial infarction
* Acute coronary syndrome/unstable angina
* Hospitalization for congestive heart failure (CHF)
* Serious cardiac arrhythmia requiring medication; this does not include asymptomatic atrial fibrillation with controlled ventricular rate
* Prolonged QTc interval > 450 ms
* Prior anthracycline cumulative dose > 450 mg/m\^2
* Patients who are pregnant or nursing
* History of syndrome of inappropriate antidiuretic hormone secretion (SIADH)
* Patients who have undergone a therapeutic paracentesis within 4 weeks of registration
* Known history of positive hepatitis C virus (HCV) antibody, hepatitis B virus (HBV) surface antigen (HBsAg), or HBV core antibody, or human immunodeficiency virus (HIV) antibody results
* History of severe (National Cancer Institute-Common Terminology Criteria for Adverse Events \[NCI-CTCAE\] v.*0 >= grade 3) allergic or anaphylactic reaction or hypersensitivity to recombinant proteins or excipients (10 mM Tris buffered saline) in the investigational agent
* Clinically significant active pulmonary risk including pulmonary hypertension, pulmonary embolism, or history of pulmonary edema |
Study Objectives
The aim of this study is to compare aesthetic results of two different type of sutures (subcuticular versus synthetic glue) in post-thyroidectomy incisions. It is a randomized clinical trial (single blinded) designed as a superiority study, since in the authors' hypotheses glue can give better results compared with subcuticular suture in this particular district. Secondary objective is to investigate if other factors (like the use of cold/warm blade, the sex, the presence of diabetes, the lenght of incision) can influence aesthetic results.
Intervention / Treatment
DEVICE: Octylcyanoacrylate (Dermabond), DEVICE: Subcuticular reabsorbable suture (Caprosyn)
| Inclusion Criteria:
* Patients underwent thyroidectomy, emithyroidectomy, parathyroidectomy
Exclusion Criteria:
* Former neck operations with external incisions
* Post-operative bleeding
* Cervical nodes involvement (with the necessity of widened incisions) |
Study Objectives
patients with refractory /relapsed lymphoma received high-dose etoposide for hematopoietic stem cell (HSC) mobilization.All patients received high-dose etoposide 20-25 mg/kg/d intravenously for two consecutive days followed by rhG-CSF10ug/kg/day subcutaneously at 48 hours after chemotherapy; rhG-CSF was continued until the end of harvesting for HSCs/HPCs. Peripheral blood counts were performed daily for all patients following the initiating of rhG-CSF. Leukapheresis was performed when peripheral blood white blood count exceeded 4×109/L with blood cell The harvested cells reached at least 2\*108/kg for mononuclear cells and/or 2\*106/kg for CD34+ cells with once to twice leukapheresis. The final product was kept frozen in liquid nitrogen.Auto-PBSCT
Intervention / Treatment
DRUG: high-dose etoposide
| Inclusion Criteria:
* relapsed/refractory lymphoma ,siut APBSCT
Exclusion Criteria:
* bone marrow without involvement by lymphoma cells |
Study Objectives
This randomized clinical trial studies a cognitive-behavioral intervention to treat worry, uncertainty, and insomnia in cancer survivors. Counseling may reduce anxiety and insomnia as well as improve the well-being and quality of life of cancer survivors. This study also explores the neuro-immunologic correlates of anxiety and insomnia.
Intervention / Treatment
BEHAVIORAL: Cognitive-behavioral therapy for worry, uncertainty & insomnia
| Inclusion Criteria:
* lung cancer
* stage III or IV colorectal cancer
* pancreatic cancer
* esophageal cancer
* multiple myeloma
* leukemia
* stage IIIC and IV melanoma
* ovarian cancer
* stage III \& IV cervical cancer
* stage III \& IV uterine cancer
* stage IIIB, IIIC, and IV breast cancer
* glioblastoma multiforme
* early relapse (< 1 year) lymphoma
Exclusion Criteria:
* co-morbid immunologic disease (i.e. rheumatoid arthritis, systemic lupus)
* neurologic disease (i.e. multiple sclerosis, Parkinson's, Alzheimer's) that would affect neuro-immune assessment or completion of study questionnaires
* mania (if patient has bipolar disorder)
* active substance abuse disorders such as alcohol dependence and cocaine abuse will also be excluded |
Study Objectives
The goal of this clinical research study is to learn if and how Avastin (bevacizumab) may affect cancer that has spread to the meninges of the brain or the spinal cord. The safety of this drug will also be studied.
Objectives:
1. Primary:
1. Determine preliminary response data of intravenous bevacizumab in patients with NM
a. As measured by clearance of malignant cells from the Cerebrospinal fluid (CSF) at 2, 4, 6, 12, 18, and 24 weeks, then every 8 weeks up to 54 weeks, and
b. Time to neurological progression (TTNP)
2. Secondary:
1. Evaluate the safety of intravenous bevacizumab in patients with NM
2. Further describe the efficacy of this intervention as measured by
1. improvement of MR imaging evidence of disease
2. overall survival
3. maintenance of quality of life
3. Determine effects of systemically administered bevacizumab on CSF, serum, and urine Vascular endothelial growth factor (VEGF)levels levels
4. Correlate changes in CSF VEGF with response measurements.
5. Correlate primary tumor tissue VEGF expression with CSF VEGF levels
6. Correlate urine VEGF levels with serum and CSF VEGF levels
7. Evaluate serum and CSF VEGF index
Intervention / Treatment
DRUG: Bevacizumab
| Inclusion Criteria:
* History of breast cancer, lung cancer or melanoma
* Diagnosis of NM as proven either by: * positive CSF cytology, or * magnetic resonance neuro-imaging, or * both
* Age >/=18 years.
* Routine laboratory studies adequate with bilirubin </= *5 x upper limit of normal (ULN), AST < *5 x ULN, creatinine <*0 x ULN, granulocytes >1500, platelets> 75,000; Hb >/= **
* Patient able to sign informed consent and willing to participate in study primary objectives
* At least 1 week from last intrathecal chemotherapy (>2 weeks if liposomal cytarabine). Patients are allowed to have received prior chemotherapy for their tumor. No limit on prior chemotherapies will be made. Patients who have been treated with tyrosine kinase inhibitors are permitted. Prior anti-VEGF targeted therapy is not permitted, unless patient has been off anti-VEGF therapy for 6 months and did not develop NM while on anti-VEGF therapy
* Karnofsky performance status (KPS) >/= 50%
* Pre-treatment CSF Indium 111 CSF flow study without evidence of obstruction.
* Patients on full-dose anticoagulants (e.g., warfarin) with PT international normalized ratio (INR) >*5 are eligible provided that: * Patients are receiving anticoagulation (warfarin or low molecular weight heparins (LMWH)) only if the patients can be off of warfarin for 4-5 days prior to the LP and placed on LMWH in that interim, and if the 'treatment dose' of LMWH can be safely held for 24 hours before and after the LP.
* ( * continued) INR must be <*2 prior to LP in this circumstance. If patients are receiving thromboprophylaxis dose of LMWH, the patients can be enrolled, but the thromboprophylaxis LMWH must be able to be safely held for 12 hours prior to the LP. * The patient has no active bleeding or pathological condition that carries a high risk of bleeding * There is no evidence of serious or non-healing wound, ulcer or bone fracture
* Ventricular reservoir NOT mandatory
Exclusion Criteria:
* Evidence of active CNS hemorrhage in the brain or tumor lesions
* Besides NM, other known CNS disease, except for treated brain metastases(Patients must be at least 1 month out from brain irradiation and have no evidence of progression or hemorrhage at that time, as ascertained by clinical examination and brain imaging (MRI or CT) during the screening period). Anticonvulsants (stable dose) are allowed. Treatment for brain metastases may include whole brain radiotherapy, radiosurgery or a combination as deemed appropriate by the treating physician.
* (* continued) With respect to irradiation for other purpose (for NM or bone metastases, etc) patients need only 1 week out from the completion of irradiation. Patients with CNS metastases treated by neurosurgical resection or brain biopsy performed within 3 months prior to Day 1 will be excluded.
* Patients with clinically significant cardiovascular disease are excluded 1) Inadequately controlled HTN (SBP > 140 mmHg and/or diastolic blood pressure (DBP) > 90 mmHg despite antihypertensive medication). 2) Prior history of hypertensive crisis or hypertensive encephalopathy. 3) New York Heart Association (NYHA) Grade II or greater congestive heart failure.
* ( * Continued) 4) History of myocardial infarction or unstable angina within 6 months prior to Day * 5) History of stroke or transient ischemic attack within 6 months prior to Day * 6) Significant vascular disease (e.g., aortic aneurysm, requiring surgical repair or recent peripheral arterial thrombosis) within 6 months prior to Day * 7) Clinically significant peripheral vascular disease. 8) Serious and inadequately controlled cardiac arrhythmia
* History of hemoptysis (>/= 1/2 teaspoon of bright red blood per episode) within 1 month prior to Day 1
* Evidence of bleeding diathesis or significant coagulopathy (in the absence of therapeutic anticoagulation)
* Major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to Day 1 or anticipation of need for major surgical procedure during the course of the study
* Core biopsy or other minor surgical procedure, excluding placement of a vascular access device, within 7 days prior to Day * Ventricular reservoir must have been placed more than 28 days prior to Day *
* History of abdominal fistula or gastrointestinal perforation within 6 months prior to Day 1
* Serious, non-healing wound, active ulcer, or untreated bone fracture
* Proteinuria as demonstrated by UPC ratio >/=*0 at screening or by urine dipstick >/= 2+. (Patients discovered to have >/= 2+ proteinuria on urinalysis at baseline should undergo a 24 hour urine collection and must demonstrate </= 1g of protein in 24 hours to be eligible).
* Known hypersensitivity to any component of bevacizumab
* Intrathoracic or extrathoracic lung carcinoma of squamous cell histology. Mixed tumors will be categorized by the predominant cell type unless small cell elements are present, in which case the patient is ineligible; sputum cytology alone is acceptable.
* (* continued) Patients with extrathoracic-only squamous cell NSCLC are eligible. Patients with only peripheral lung lesions (of any non squamous NSCLC histology, except small cell histology) will also be eligible (a peripheral lesion is defined as a lesion in which the epicenter of the tumor is </= 2 cm from the costal or diaphragmatic pleura in a three-dimensional orientation based on each lobe of the lung and is >/= 2 cm from the trachea, main, and lobar bronchi).
* Pregnant (positive pregnancy test) or nursing women. Angiogenesis is critical to fetal development and the inhibition of angiogenesis following administration of AVASTIN is likely to result in adverse effects on pregnancy. There are no adequate and well-controlled studies in pregnant women. Both fertile men and women must agree to use adequate contraceptive measures during study therapy and for at least 2 months after the completion of bevacizumab therapy.
* General Medical Exclusions 1) Inability to comply with study and/or follow-up procedures 2) Life expectancy of less than 6 weeks 3) Current, recent (within 4 weeks of the first infusion of this study), or planned participation in an experimental drug study other than this Genentech supported study 4) Active malignancy, other than superficial basal cell and superficial squamous (skin) cell, or carcinoma in situ of the cervix within the last 5 years |
Study Objectives
This phase I trial studies the safety and best dose of ipilimumab, nivolumab, or both in combination with temozolomide in treating patients with newly diagnosed glioblastoma or gliosarcoma. Monoclonal antibodies, such as ipilimumab and nivolumab, may block tumor growth in different ways by targeting certain cells. Drugs used in chemotherapy, such as temozolomide, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. It is not yet known which combination is a better treatment for glioblastoma or gliosarcoma.
Intervention / Treatment
BIOLOGICAL: Ipilimumab, OTHER: Laboratory Biomarker Analysis, BIOLOGICAL: Nivolumab, DRUG: Temozolomide
| Inclusion Criteria:
* Histopathologically proven diagnosis of glioblastoma or gliosarcoma prior to registration by pathology report
* The tumor must be unifocal, confined to the supratentorial compartment and have undergone a gross total or near gross total resection; this will increase the likelihood that the patient will not require corticosteroids or develop pseudoprogression
* The formalin-fixed, paraffin-embedded (FFPE) tumor tissue block must be available to be sent for retrospective central pathology review after registration
* Patients must be registered within 35 days of completion of chemoradiation
* History/physical examination within 7 days prior to registration
* Patients must have undergone an evaluation by magnetic resonance imaging (MRI) within 35 days of completing radiation and must also be within 7 days prior to registration; MRI must NOT demonstrate tumor progression, but patients with imaging changes consistent with pseudo-progression, stable neurologic function and not needing corticosteroid treatment are eligible
* Karnofsky performance status >= 70 within 7 days prior to registration
* Absolute neutrophil count >= 1,500 cells/mm\^3
* Platelet count >= 100,000 cells/mm\^3
* Hemoglobin (Hgb) > 9 g/dL (can be achieved with transfusion)
* Blood urea nitrogen (BUN) =< 30 mg/dl
* Serum creatinine =< *7 mg/dl
* Total bilirubin (except patients with Gilbert's syndrome, who are eligible for the study but exempt from the total bilirubin eligibility criterion) =< *0 mg/dl
* Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) =< *5 x upper limit of normal (ULN)
* The patient must have completed chemoradiation (all cohorts) within standards of care established by prior Radiation Therapy Oncology Group (RTOG)/Network Radiotherapy Group (NRG) Oncology studies as follows:
* Radiation therapy
* Modality: either 3-dimensional (3D) or intensity-modulated radiation therapy (IMRT), or proton therapy is allowed
* Time to initiation: radiotherapy must be initiated within or equal to 42 days after surgery
* Target volumes: target volume definition will be based upon postoperative-enhanced MRI; preoperative imaging should be used for correlation and improved identification, as necessary
* Dose guidelines: the initial target volume will be treated to 46 Gray (Gy) in 23 fractions; after 46 Gy, the cone-down or boost volume will be treated to a total of 60 Gy, with seven additional fractions of 2 Gy each (14 Gy boost dose)
* Temozolomide during concomitant radiation therapy
* Temozolomide must have been administered continuously from day 1 of radiotherapy to the last day of radiation (+/- 3 days to take into consideration holidays) at a daily oral dose of 75 mg/m\^2 for a maximum of 49 days (except missed doses due to toxicity)
* The patient must not be on a corticosteroid dose greater than physiologic replacement dosing defined as 30 mg of cortisone per day or its equivalent
* The patient must provide study-specific informed consent prior to study entry
* Echocardiogram (ECHO) cardiogram and cardiology consultation required within 7 days prior to registration for patients with a history of congestive heart failure or cardiovascular disease or history of exposure to cardiotoxic agents who are not already excluded
Exclusion Criteria:
* Definitive clinical or radiologic evidence of progressive disease
* Prior placement of Gliadel wafer or local brachytherapy
* Use of an immunotherapy such as a vaccine therapy, dendritic cell vaccine or intracavitary or convectional enhanced delivery of therapy
* Prior invasive malignancy (except non-melanomatous skin cancer) unless disease free for a minimum of 3 years
* Unstable angina within the last 6 months prior to registration
* Transmural myocardial infarction within the last 6 months prior to registration
* Evidence of recent myocardial infarction or ischemia by the findings of S-T elevations of >= 2 mm using the analysis of an electrocardiogram (EKG) performed within 7 days prior to registration
* New York Heart Association grade II or greater congestive heart failure requiring hospitalization within 12 months prior to registration
* History of stroke, cerebral vascular accident (CVA) or transient ischemic attack within 6 months prior to registration
* Serious and inadequately controlled cardiac arrhythmia
* Significant vascular disease (e.g., aortic aneurysm, history of aortic dissection) or clinically significant peripheral vascular disease
* Evidence of bleeding diathesis or coagulopathy
* Serious or non-healing wound, ulcer, or bone fracture or history of abdominal fistula, gastrointestinal perforation, intra-abdominal abscess major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to registration, with the exception of the craniotomy for tumor resection
* Acute bacterial or fungal infection requiring intravenous antibiotics at the time of registration
* Chronic obstructive pulmonary disease exacerbation or other respiratory illness requiring hospitalization or precluding study therapy at the time of registration
* Hepatic insufficiency resulting in clinical jaundice and/or coagulation defects; note, however, that laboratory tests for additional liver function tests and coagulation parameters are not required for entry into this protocol
* Acquired immune deficiency syndrome (AIDS) based upon current Centers for Disease Control and Prevention (CDC) definition; note, however, that human immunodeficiency virus (HIV) testing is not required for entry into this protocol
* Active connective tissue disorders, such as lupus or scleroderma, which in the opinion of the treating physician may put the patient at high risk for immunologic toxicity
* Patients with active autoimmune disease or history of autoimmune disease that might recur, which may affect vital organ function or require immune suppressive treatment including systemic corticosteroids, should be excluded; these include but are not limited to patients with a history of immune related neurologic disease, multiple sclerosis, autoimmune (demyelinating) neuropathy, Guillain-Barre syndrome or chronic inflammatory demyelinating polyneuropathy (CIDP), myasthenia gravis; systemic autoimmune disease such as systemic lupus erythematosus (SLE), connective tissue diseases, scleroderma, inflammatory bowel disease (IBD), Crohn's, ulcerative colitis, hepatitis; and patients with a history of toxic epidermal necrolysis (TEN), Stevens-Johnson syndrome, or phospholipid syndrome should be excluded
* Of note, patients with vitiligo, endocrine deficiencies including thyroiditis managed with replacement hormones including physiologic corticosteroids are eligible; patients with rheumatoid arthritis and other arthropathies, Sjogren's syndrome and psoriasis controlled with topical medication and patients with positive serology, such as antinuclear antibodies (ANA), anti-thyroid antibodies should be evaluated for the presence of target organ involvement and potential need for systemic treatment but should otherwise be eligible
* Any other major medical illnesses or psychiatric impairments that in the investigator's opinion will prevent administration or completion of protocol therapy
* Pregnancy or lactating females; women of childbearing potential must have a negative serum pregnancy test within 7 days prior to registration
* History of severe hypersensitivity reaction to any monoclonal antibody |
Study Objectives
RATIONALE: Giving high-dose chemotherapy before an autologous stem cell transplant stops the growth of cancer cells by stopping them from dividing or killing them. An autologous stem cell transplant may be able to replace the blood-forming cells that were destroyed by the chemotherapy.
PURPOSE: This phase II trial is studying how well giving busulfan together with cyclophosphamide followed by an autologous stem cell transplant works in treating patients with multiple myeloma.
Intervention / Treatment
DRUG: busulfan, DRUG: cyclophosphamide, PROCEDURE: autologous hematopoietic stem cell transplantation
| INCLUSION CRITERIA:
* Patients with a diagnosis of plasma cell myeloma
* Patients with cardiac ejection fraction >= 45% or clearance by Cleveland Clinic Faculty (CCF) cardiologist
* Patients with diffusion capacity of carbon monoxide (DLCO) >= 45% predicted or clearance by CCF pulmonologist
* Patient with previously harvested peripheral blood progenitor cells with a minimum of 2 x 10\^6 CD 34+ cells/kg harvested
EXCLUSION CRITERIA:
* Patients receiving total body irradiation
* Non-myeloablative/reduced-intensity conditioning
* Pregnant and breast feeding patients
* Human immunodeficiency virus (HIV) positive
* Patients with serum creatinine > *0
* Prior Hematopoietic Stem Cell (HSC) transplant |
Study Objectives
This is a pilot, non-randomized, single institution, observational study investigating the effect of dramatic weight loss secondary to bariatric surgery on biomarkers of breast cancer in tissue and blood as well as on imaging in women at elevated risk for breast cancer. Twelve months after bariatric surgery, 50% of excess weight is generally expected. Eligible women at elevated risk for breast cancer who are already planning to undergo bariatric surgery will be consented to undergo imaging (MRI and mammogram), breast tissue biopsy, and fasting blood draw prior to bariatric surgery, approximately 14 days after bariatric surgery, and approximately 1 year after bariatric surgery.
In parallel we will also be assessing 40 normal breast tissue specimens as well as blood samples from the Komen Tissue Bank (elevated risk but normal BMI) to establish a normal BMI, elevated risk control group for our study. The KTB samples will be matched for general risk of breast cancer (\>20%), age, race and menopausal status.
Intervention / Treatment
PROCEDURE: Biopsy, PROCEDURE: Blood draw, PROCEDURE: Mammogram, PROCEDURE: MRI
| Inclusion Criteria
* Patients must be post-menopausal, defined as one of the following:
* Age over 60
* Prior oophorectomy
* No menstrual periods in the past 12 months without a medical procedure such as hysterectomy or uterine ablation
* FSH at castrate levels (> 40IU/L). Patients who do not meet criteria a-c (such as those under age 60 with prior hysterectomy but ovaries remain in place) will need to have an FSH level to confirm menopausal status prior to enrollment.
* Patients must have a BMI ≥ 30 as calculated by the formula:
Weight in pounds / height squared x 703 = BMI
A BMI of:
* *5-*9 is considered normal;
* *0-*9 is considered overweight;
* *0+ is regarded as obese.
* Patients must be planning to undergo primary bariatric surgery (no revisions).
* Patients must be willing to provide a core tissue biopsy at baseline and with repeat tissue collection after 2 weeks and 12 months post-bariatric surgery.
* Patients must be aged 18-75 years at the time of informed consent.
* Patients must be accessible for treatment, adverse event tracking and follow-up as determined by the treating physician.
* Patient consent and authorization for the release of health information must be obtained according to local institutional guidelines.
Exclusion Criteria
* History of any malignancy except: adequately treated non-melanoma skin cancer, curatively treated in-situ cancer of the cervix, or other solid tumors curatively treated with no evidence of disease for ≥ 5 years. History of breast cancer is not allowed.
* Concurrent or planned participation in randomized trials of weight loss or exercise interventions or trials targeting insulin, IGF-1 or their receptors. These interventions would interfere with the endpoints.
* Weight greater than 500 lbs at the time of imaging.
* Known allergy to gadolinium which is used for MRI contrast.
* History of life threatening allergic reaction to local anesthesia (lidocaine, xylocaine).
* For the purposes of invasive breast biopsies, women must not have received therapeutic anticoagulation in the 1 month prior to enrollment, and must have no medical reason why post-operative prophylactic anticoagulation could be held for 12 hours (i.e. atrial fibrillation, history of deep venous thrombosis).
* Prior history of breast irradiation.
* Use of chemopreventatives such as tamoxifen or raloxifene at any time prior to enrollment. |
Study Objectives
This treatment protocol allows doctors to treat advanced kidney cancer with an investigational drug called sorafenib, BAY43-9006, which is being studied in clinical trials for kidney cancer and other kinds of cancer. This treatment protocol is not a clinical trial in which sorafenib is compared to another equal treatment. All patients in this protocol will be treated with sorafenib. In addition, data from the patients who participate in this protocol will provide additional information about the drug.
Intervention / Treatment
DRUG: Sorafenib (Nexavar, BAY43-9006)
| Inclusion Criteria:
* Patients with advanced (unresectable, recurrent or metastatic) RCC
* Patients reasonably likely to benefit from treatment with sorafenib as a single agent therapy
* Patients with an ECOG performance status of 0-2
* Patients who will not require other systemic anticancer therapy (except for bisphosphonates) while taking sorafenib
* Patients with vascular diseases such as wet macular degeneration, vasculitis, or new peptic ulcer, may be enrolled but require close monitoring in accordance with established medical practice
Exclusion Criteria:
* Patients who are currently enrolled in, are eligible for, or have access to, any other sorafenib clinical trial
* Patients who have participated in any other sorafenib trial
* Patients who have had prior therapy with investigational agent(s) within the last four weeks prior to study entry
* Life expectancy of less than two months
* Patients with cardiac arrhythmias greater than grade 1 NCI CTCAE, Version *0
* Patients with active coronary artery disease or ischemia
* Patients with Child-Pugh class C hepatic impairment
* Patients with severe renal impairment or who require dialysis
* Patients with active uncontrolled hypertension
* Patients with recent or active bleeding diathesis |
Study Objectives
Pain after thoracotomy is known to be sever acute pain that is resulted from retraction, resection or fracture of ribs .This pain increases post operative morbidity and if not properly managed peri-operatively, chronic post thoracotomy pain syndrome may develop. Different methods are described to manage post thoracotomy pain.Thoracic epidural analgesia is believed to be the corner stone in the peri-operative care for thoracotomy providing the most effective analgesia. Serratus anterior plane (SAP) block has recently been described as a regional anesthetic technique to provide analgesia for thoracic wall surgeries. During SAP block, local anesthesia are deposited in the fascial plane either superficial to the serratus muscle or deep to the serratus anterior muscle in the mid-axillary line . Serratus anterior block provides analgesia to a hemithorax by blocking the lateral branches of the intercostal nerves. This study aims To compare the effect of superficial, deep serratus plane blocks and thoracic epidural analgesia in maintaining hemodynamic and controlling post thoracotomy pain.
Intervention / Treatment
PROCEDURE: Thoracic epidural analgesia , superficial serratus plane block and deep serratus plane block
| Inclusion Criteria:
* ASA(American Society of Anesthesia) class I and II.
* Age ≥ 18 and ≤ 60 Years.
* Patients undergoing thoracic surgery eg: lobectomy, pneumonectomy or pleuro-pneumonectomy
Exclusion Criteria:
* Patient refusal.
* Local infection at the puncture site.
* Coagulopathy with INR ( international normalized ratio ) ≥ *6: hereditary (e.g. hemophilia, fibrinogen abnormalities \& deficiency of factor II) - acquired (e.g. impaired liver functions with prothrombin concentration less than 60 %, vitamin K deficiency \& therapeutic anticoagulants drugs).
* Unstable cardiovascular disease.
* History of psychiatric and cognitive disorders.
* Patients allergic to medication used. |
Study Objectives
Insomnia is very common in cancer patients. When left untreated, insomnia can lead to numerous serious consequences (e.g., psychological disorders) for the individual and significant costs for society (e.g., increased medical consultations). Cognitive-behavioural therapy (CBT), a form of psychotherapy, is now considered the treatment of choice for insomnia and its efficacy has been demonstrated in clinical studies conducted in cancer patients. Unfortunately, CBT for insomnia (CBT-I) is not widely accessible as only a few cancer clinics have mental health professionals formally trained in the administration of this treatment. Innovative models of treatment delivery are therefore needed to make sure that every cancer patient with insomnia receives the care he/she needs. A stepped care approach in which patients only receive the level of treatment that they need, beginning with a minimal, less costly, intervention followed by more intensive treatment if required, has shown some promises for other psychological disorders (e.g., depression). Although its relevance has been emphasized to make CBT-I more accessible, its utility has never been investigated. The main goal of this randomized non-inferiority study is to assess the efficacy and costeffectiveness of a stepped care CBT-I as compared with standard care. Our hypothesis is that a stepped care approach will not be statistically inferior in terms of efficacy as compared to usual care, while being much less costly (better cost-effectiveness ratio). Three hundred cancer patients (mixed cancer sites) with insomnia symptoms will be assigned to: (1) stepped care CBT-I (n = 118) or (2) standard care (n = 59), consisting of 6 weekly sessions administered individually by a professional.
Intervention / Treatment
BEHAVIORAL: Professionally-administered cognitive-behavioral therapy for insomnia (CBT-I), BEHAVIORAL: Web-based cognitive-behavioral therapy for insomnia (CBT-I)
| Inclusion Criteria:
* have received a diagnosis of non-metastatic cancer (any type) in the past -18 months
* to have an ISI score > 7
* to be aged between 18 and 75 years old
* to be readily able to read and understand French
Exclusion Criteria:
* having a life expectancy < 1 year
* having a severe psychiatric disorder (e.g., psychotic, substance use, severe depressive disorder)
* having severe cognitive impairments (e.g., diagnosis of Parkinson's disease, dementia, or Mini-Mental State Examination score < 24)
* having received a formal diagnosis for another sleep disorder (e.g., obstructive sleep apnea, periodic limb movement disorder)
* shift work in the past 3 months or in the next 12 months
* to have received a CBT for insomnia in the past |
Study Objectives
This study will assess the safety and efficacy of imatinib in newly enrolled previously untreated patients with chronic phase CML.
Intervention / Treatment
DRUG: Imatinib
| Inclusion Criteria:
* Diagnosed as Chronic Myelogenous Leukemia in Chronic Phase
* Previously untreated with Interferon-alpha
* Performance status is normal or capable of only limited self-care
Exclusion Criteria:
* Patients who are pregnant or possibly pregnant
* Significant hepatic diseases
* Chronic Myelogenous Leukemia in advanced phase
Other protocol-defined inclusion/exclusion criteria may apply. |
Study Objectives
The purpose of the study is to determine the safe and tolerable doses of sunitinib given together with either cisplatin and capecitabine or oxaliplatin and capecitabine in patients who have advanced gastric cancer who have not received prior chemotherapy for their advanced cancer
Intervention / Treatment
DRUG: capecitabine, DRUG: oxaliplatin, DRUG: sunitinib malate, DRUG: capecitabine, DRUG: cisplatin, DRUG: sunitinib malate
| Inclusion Criteria:
* confirmed diagnosis of stomach cancer
* advanced stomach cancer of stage IV
* adequate blood chemistry, blood counts and kidney function
* willing to participate to study requirements and sign an informed consent document
Exclusion Criteria:
* prior chemotherapy for the stomach cancer in its advanced stage
* excessive toxicities related to prior therapies
* pregnant or breastfeeding patients |
Study Objectives
There is some evidence that vitamin D could be used to reduce breast cancer risk. Randomized controlled trials would provide definitive evidence about this effect. However, trials with breast cancer as outcome are expensive and time-consuming. Use of surrogate outcomes has been advocated to accelerate progress in the identification of interventions that could prevent breast cancer. Mammographic breast density is one of the strongest breast cancer risk indicators and is already used as a surrogate outcome in several breast cancer prevention trials. The aim of this double-blind randomized controlled trial is to determine whether daily oral supplementation with vitamin D3 (1,000, 2,000 or 3,000 IU) over a period of 1 year reduces breast density in premenopausal women compared to placebo. A total of 376 women (94 per arm) who live in Quebec City will be recruited. Showing that vitamin D reduces breast density would provide strong support for the idea that vitamin D can be a safe and inexpensive approach for the prevention of breast cancer.
Intervention / Treatment
DIETARY_SUPPLEMENT: Vitamin D3, DIETARY_SUPPLEMENT: Placebo
| Inclusion Criteria:
* be premenopausal at baseline;
* have breast density of at least 20% at baseline;
* have normal baseline serum calcium (2,12-2,60 mmol/L) and serum creatinine (45-85 μmol/L);
* agree to have her mammogram at 12 months of follow-up at the same mammography clinic (same site) as the one where the mammogram at recruitment was done.
Exclusion Criteria:
* taking > 400 IU/day of supplemental vitamin D and refusing to reduce (≤ 400 IU/day) or cease such intake;
* taking > 600 mg/day of supplemental calcium and refusing to reduce (≤ 600 mg/day) or cease such intake;
* have contra-indications for use of vitamin D supplementation (hypersensitivity to vitamin D or its analogues; a history of renal calculi or hypercalcemia, hypervitaminosis D);
* taking medication suspected to interact with vitamin D: frequent use of antacids containing magnesium or aluminium; regular use of anticonvulsants (phenytoin, phenobarbital), digoxin, cholestyramine, colestipol, orlistat, mineral oil;
* have a personal history of breast cancer;
* have a personal history of cancer other than non-melanoma skin cancer within 5 last years;
* have had breast reduction or augmentation including breast implantation (or planning to undergo such surgery during the trial);
* be pregnant or planning a pregnancy in the next year. |
Study Objectives
Pancreatic cancer is the fourth leading cause of cancer death in the United States and is associated with a poor prognosis. The average life expectancy after diagnosis is approximately 5 to 8 months. At present, successful surgical resection is the only curative therapy that can improve long-term survival. However, it can be achieved only when a tumor is detected at an early stage. Unfortunately, due to non-specific symptoms associated with pancreatic cancer, it is commonly detected in the later stages of the disease.
The investigators hypothesized that pancreatic cancer could be detected by measuring the changes in the early increase in blood supply (EIBS) found in the surrounding normal-appearing duodenal tissue. The investigators tested a device called Four-dimensional Elastic Light-Scattering Fingerprinting (4D-ELF). The device used in this study is considered investigational, which means it has either not been approved by the Food and Drug Administration (FDA) for routine clinical use or for the use described in this study. However the FDA allowed the use of this device in this research study.
Intervention / Treatment
PROCEDURE: EGD with EUS, DEVICE: 4D-ELF
| Inclusion Criteria:
* Age 18 years or older.
* Informed written consent.
* Patient scheduled for previously planned EGD with upper EUS
* Patients with known adenocarcinoma of the pancreas included in the cancer group
* Patients with abdominal imaging studies (e.g., CT abdomen or MRI abdomen) negative for malignancy in past 5 years included in the control group.
Exclusion Criteria:
* Unable to obtain biopsy specimen or fine-needle aspiration results of the pancreas lesion (e.g., coagulation disorder, inadequate sample)
* Presence of malignant lesion in the pancreas or duodenum other than pancreas adenocarcinoma (e.g., neuroendocrine tumor, gastrointestinal stromal tumor)
* Known familial disorder with high risk of pancreas cancer development (e.g., familial adenomatous polyposis syndrome, hereditary non-polyposis colorectal cancer syndrome, juvenile polyposis syndrome)
* Significant family history of pancreatic cancer (at least one first degree relative with pancreatic cancer)
* Presence of premalignant lesions (e.g., duodenal adenoma, pancreas intraductal papillary mucinous neoplasm)
* Active visible inflammation/ulcer in the stomach or the duodenum
* Patients with known chronic pancreatitis were excluded from cancer group. Chronic pancreatitis patients were allowed to be included in the control group only.
* Known pregnancy or sexually active females of childbearing age who are not practicing an accepted form of birth control. |
Study Objectives
The purpose of this study is to determine whether a body weight adjusted dose of thyroxin is superior to treatment guided by laboratory results of thyroxin hormones in patients with central hypothyroidism. Moreover beneficial effects of triiodthyronine supplementation are investigated.
Intervention / Treatment
DRUG: Thyroxin, Triiodothyronine
| Inclusion Criteria:
* hypopituitarism of at least 3 axes (TSH plus gonadotropin, somatotropin, corticotropin or ADH deficiency)
* termination of surgical or radiation treatment of pituitary tumors at least six month before study entry
* BMI of 20 - *9 kg/m2
* non-smoking status.
Exclusion Criteria:
* history of cardiovascular or pulmonary diseases
* current thyroxin dosage > *6 µg/kg bw
* pregnancy
* epilepsy
* cerebrovascular diseases
* nodular goiter |
Study Objectives
This study will examine whether and how levothyroxine (Synthroid, a synthetic thyroid hormone) affects the way the body handles other drugs. If levothyroxine does affect the metabolism of other drugs, the dose of those medications may need to be increased to enhance their action or decreased to avoid adverse reactions.
Patients 18 years of age and older with thyroid cancer who are participating in NIH protocol #77-DK-0096 and are receiving long-term suppression therapy with levothyroxine may be eligible for this study. This is not a study of thyroid cancer or of potential new drugs to treat it. Thyroid cancer patients are being studied because their treatment regimen provides an opportunity to study drug metabolism while patients are both on and off levothyroxine therapy.
Participants come to the NIH Clinical Center on two occasions: once while they are regularly taking their levothyroxine, and once while they are off the medication in preparation for their radioactive iodide diagnostic scan for the procedures outlined below. The time interval between the two clinic visits depends on whether the first visit is while the patient is on or off medication. Participants are asked to fast overnight before each visit and to abstain from certain foods and beverages for 48 to 72 hours before the visit. At each visit, patients undergo the following procedures:
* Medication history, limited physical examination, and blood draw for laboratory tests, including a test to look for genes important in eliminating medications from the body.
* Insertion of a catheter (thin plastic tube) into an arm vein for collecting blood samples.
* Shave skin biopsy (optional) to explore how proteins in the skin that metabolize and transport drugs are affected by thyroid hormone. For this procedure, the skin is cleaned, numbed with medicine, and a small sample of the top layer is removed with a razor blade. The wound heals in 2 to 3 days.
* Medication dosing. Participants take all of the following substances by mouth at the same time: 1) 200 mg of caffeine, a compound commonly found in chocolate, soda/pop, coffee, tea and non-prescription products to prevent sleep; 2) 30 mg of dextromethorphan, a non-prescription cough suppressant; 3) 40 mg of omeprazole, a prescription drug for heartburn and stomach ulcers; 4) 8 mg of midazolam, a prescription drug used to cause relaxation and drowsiness; and 5) 120 mg of fexofenadine, a non-sedating prescription antihistamine used to treat allergies.
* Blood and urine sampling. Fifteen blood samples of about 5 mL (1 teaspoon) each are collected through the catheter and urine is collected over the next 24 hours to determine what happens to the test drugs in the body.
Participants may resume their normal diet 4 hours after taking the study medications.
Intervention / Treatment
PROCEDURE: Skin Biopsy
| INCLUSION CRITERIA:
* Subject has signed the informed consent document;
* Subject is greater than or equal to 18 years of age;
* Subjects diagnosed with thyroid cancer participating in protocol 77DK0096;
* Subjects receiving THST with levothyroxine;
* Serum TSH less than *4 mIU/L while on THST, and more than 20 mIU/L while off THST.
EXCLUSION CRITERIA:
Subject is pregnant, currently breast-feeding, practicing birth control with hormonal contraceptives, or is on hormone replacement therapy (HRT).
Subject is a smoker.
Subject has a confounding medical illness (es) that in the judgement of the investigators would pose an added risk for the subject (e.g. severe respiratory disease).
Subject has a history of substance abuse within the past 5 years or drug or alcohol use, that may affect enzyme levels and function.
Caffeine or caffeine-containing beverages and chocolate bars consumption within 48 hours of scheduled caffeine administration for CYP1A2 phenotyping; scheduled omeprazole administration during or within 14 days of the study; scheduled dextromethorphan administration during or within 30 days of study; scheduled fexofenadine administration during or within 7 days of the study.
AST or ALT greater than or equal to 2 times the upper normal reference limit.
Concurrent administration of known CYP and/or P-gp inducers (barbiturates, phenytoin, carbamazepine, rifampicin) and inhibitors (amiodarone, atorvastatin, chloroquine, cimetidine, co-trimoxazole, cyclosporine, diltazem, erythromycin, fluoxetine fluvoxamine, isoniazid, itrakonazole, ketokonazole, metronidazole, mexiletine, nefazadone, norfloxacin, verapamil) or use of any alternative/complementary therapies for at least 30 days prior to study or during the study. Non-herbal vitamin and mineral preparations will be allowed.
Inability to obtain venous access for sample collection, or basal hemoglobin of equal or less than 10 g/dl.
Patients receiving scheduled therapy with alprazolam, triazolam, clonazepam, diazepam, lorazepam, oxazepam, temazepam or chlorodiazepoxide, during or within 30 days of study.
Patients consuming grapefruit products (juice or the fresh fruit), apple and orange juice during or within 72 hrs of study.
History of intolerance to caffiene, omeprazole, dextromethorphan, midazolam or fexofenadine.
The presence of persistent diarrhea or malabsorption syndromes that would interfere with the patient's ability to adequately absorb drugs; and/or
Patients receiving monoamine oxidase inhibitors (MAOIs) such as phenelzine, tranylcypromine, and isocarboxazid.
Patients with a history of cheloids formation. |
Study Objectives
RATIONALE: Drugs used in chemotherapy, such as fludarabine and cyclophosphamide, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Radiation therapy uses high-energy x-rays to kill cancer cells. An umbilical cord blood transplant may be able to replace blood-forming cells that were destroyed by chemotherapy and radiation therapy. Sometimes the transplanted cells from a donor can make an immune response against the body's normal cells. Giving sirolimus and mycophenolate mofetil after the transplant may stop this from happening.
PURPOSE: This phase II trial is studying how well giving fludarabine and cyclophosphamide together with total-body irradiation followed by an umbilical cord blood transplant, sirolimus, and mycophenolate mofetil works in treating patients with hematologic cancer.
Intervention / Treatment
BIOLOGICAL: anti-thymocyte globulin, DRUG: cyclophosphamide, DRUG: Fludarabine, DRUG: mycophenolate mofetil, PROCEDURE: umbilical cord blood transplantation, RADIATION: total body irradiation, DRUG: Sirolimus
| Inclusion Criteria:
Age, Graft Cell Dose and Graft HLA Criteria
* Subjects must be <70 years old. Subjects ages ≥ 70 and ≤ 75 may be eligible if they have a Co-Morbidity Scoring (HCT-CI) score ≤ *
* The UCB graft is matched at 4-6 HLA-A, B, DRB1 antigens with the recipient.
* Patients co-enrolled in MT-2006-01 Phase I Study of Infusion of Umbilical Cord Blood Derived CD25+CD4+ T-Regulatory (Treg) Cells after Non-Myeloablative Cord\\Blood Transplantation will receive grafts composed of 2 UCB units.
Disease Criteria:
* Acute Leukemias:
* Acute myeloid leukemia: high risk complete remission 1 (CR1) (as evidenced by preceding myelodysplastic syndrome (MDS), high risk cytogenetics such as those associated with MDS or complex karyotype, > 2 cycles to obtain CR or erythroblastic and megakaryocytic); second or greater CR.
* Acute lymphoblastic leukemia/lymphoma: high risk CR1 as evidenced by high risk cytogenetics (e.g. t(9;22), t(1;19),t(4;11), other myeloid/lymphoid or mixed lineage leukemia \[MLL\] rearrangements, hypodiploidy or Ikaros family zinc finger 1 \[IKZF1\]), > 1 cycle to obtain CR or evidence of minimal residual disease (MRD). Patients in second or greater CR are also eligible.
* Burkitt's lymphoma in CR2 or subsequent CR
* Natural Killer cell malignancies
* Chronic myelogenous leukemia: all types except refractory blast crisis. Chronic phase patients must have failed or been intolerant to Gleevec
* Myelodysplastic syndrome:
* Large-cell lymphoma, Hodgkin lymphoma and multiple myeloma with chemotherapy sensitive disease that has failed or patients who are ineligible for an autologous transplant.
* Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), marginal zone B-cell lymphoma, follicular lymphoma, which have progressed within 12 months of achieving a partial or complete remission. Patients who had remissions lasting > 12 months, are eligible after at least two prior therapies. Patients with bulky disease should be considered for debulking chemotherapy before transplant. Patients with refractory disease are eligible, unless has bulky disease and an estimated tumor doubling time of less than one month.
* Lymphoplasmacytic lymphoma, mantle-cell lymphoma, prolymphocytic leukemia are eligible after initial therapy if chemotherapy sensitive.
* Refractory leukemia or MDS.
* Bone marrow failure syndromes, except for Fanconi Anemia
* Myeloproliferative syndromes Patients who have undergone an autologous transplant >12 months prior to allogeneic transplantation
Adequate Organ Function and Performance Status
Exclusion Criteria:
* < 70 years with an available 5-6/6 HLA-A, B, DRB1 matched sibling donor
* Pregnancy or breastfeeding
* Evidence of human immunodeficiency virus (HIV) infection or known HIV positive serology
* Current active serious infection
* Unless in post-chemotherapy and radioimmunoconjugated antibody induced aplasia, when he/she would be eligible for Arm 3, patients with acute leukemia in morphologic relapse/ persistent disease defined as > 5% blasts in normocellular bone marrow OR any % blasts if blasts have unique morphologic markers (e.g. Auer rods) or associated cytogenetic markers that allows morphologic relapse to be distinguished are not eligible.
* Chronic myelogenous leukemia (CML) in refractory blast crisis
* Large cell lymphoma, mantle cell lymphoma and Hodgkin disease that is progressive on salvage therapy. Stable disease is acceptable to move forward provided it is non-bulky.
* Active central nervous system malignancy |
Study Objectives
It is expected that additional support with certain micronutrients may improve prognosis, decrease the frequency of side effects and complications and maintain high relative dose intensity of anticancer treatments. Food supplement ONCOXIN (ONCX) contains amino acids, vitamins, minerals and biologically active substances of natural origin with high immunostimulatory and antioxidant activity. Present study is a real world experience study intended to evaluate the efficacy of ONCX in cancer patients.
Intervention / Treatment
DIETARY_SUPPLEMENT: ONCOXIN®
| Inclusion Criteria:
* Male and female patients who had signed an informed consent.
* Males and females aged 50-70 y/o
* Gastric cancer IIB-IIIC, Non-small cell lung cancer IIB-IIIA
* R0 surgery
* Adjuvant chemotherapy (ACT) required, 2nd and further course of ACT, XELOX regimen of ACT for gastric cancer and paclitaxel+carboplatin regimen for non-small cell lung cancer.
* Body mass index (BMI) ≥ 15, serum albumin ≥ 25 g/l.
* Eastern Cooperative Oncology Group performance status ≤ 2
Exclusion Criteria:
* Severe concomitant diseases or conditions that may complicate or make impossible the patient's participation in the study, or make it difficult to interpret the clinical data (including mental disorders, severe infectious and parasitic diseases and intolerability to any of the ONCX components).
* The patient's family or official relations with a member of staff of the study center.
* The patient's failure to assess his/her physical and/or emotional condition.
* The patient's failure to comply with the study requirements.
* The patient's refusal to participate in the study and pregnancy or lactation. |
Study Objectives
This feasibility pilot study is designed to learn whether patients and their care partners (e.g., family members) are willing and able to complete two study visits at Dartmouth College while receiving cancer care at Dartmouth-Hitchcock Medical Center.
Intervention / Treatment
OTHER: Specialty Palliative Care
| Inclusion Criteria:
* 18 years or older
* Patient: has received a diagnosis of advanced lung or gastrointestinal cancer within the last 24 weeks (note: advanced GI cancer will likely be pancreatic or colorectal)
* Care partner: care partner of a patient who has received a diagnosis of metastatic lung or gastrointestinal cancer who has provided consent for study (either with our without functional MRI study visits)
* Be able to understand study requirements and make an informed decision to participate
* Be able to speak and read English
Exclusion Criteria:
* Life expectancy of <8 weeks
* Known brain metastases
* Claustrophobia
* Both patient and care partner refuse to participate in fMRI scan (ie., either patient or care partner must agree to an fMRI scan in order for either to participate)
* Contraindications to MRI (e.g.: implanted or embedded metal/metal fragments. Metals in the body make the participant unable to undergo an MRI which makes them ineligible for study participation). |
Study Objectives
This phase II trial studies how well total-body irradiation, donor lymphocyte infusion, and cyclophosphamide before donor stem cell transplant works in treating patients with high-risk hematologic malignancies. Giving total-body irradiation, donor lymphocyte infusion, and chemotherapy before a donor stem cell transplant helps stop the growth of cancer and abnormal cells and helps stop the patient's immune system from rejecting the donor's stem cells. When certain stem cells from a donor are infused into the patient they may help the patient's bone marrow make stem cells, red blood cells, white blood cells, and platelets. Sometimes the transplanted cells from a donor can make an immune response against the body's normal cells. Removing the T cells from the donor cells before transplant and giving tacrolimus and mycophenolate mofetil may stop this from happening.
Intervention / Treatment
RADIATION: Total-Body Irradiation (TBI), BIOLOGICAL: Donor Lymphocyte Infusion (DLI), DRUG: Cyclophosphamide, PROCEDURE: Allogeneic hematopoietic stem cell transplantation (HSCT), DRUG: Mycophenolate mofetil
| Inclusion Criteria:
* This treatment is for patients with high risk hematologic malignancies. High risk is defined as:
* Any patient with a hematologic malignancy with residual disease after treatment with 1 or more chemotherapy regimens in whom achievement of remission with additional chemoradiotherapy is felt to be unlikely
* Patients without morphologic evidence of disease but with high risk features which would predict for relapse despite remission at HSCT such as adverse cytogenetics, 3rd or greater CR (complete response), or failure to recover peripheral blood counts to normal ranges. While these patients do not have detectable disease by current methods, like all patients they have non-detectable disease which in their case is highly aggressive.
* Patients must have one related donor who is HLA (human leukocyte antigen) mismatched in the GVHD direction at two or more HLA loci
* Patients must adequate organ function:
* LVEF (left ventricular ejection fraction) of >50 %
* Diffusing capacity of the lungs for carbon monoxide (DLCO) (adjusted for hemoglobin) >50 % of predicted and forced expiration to the full FEV-1 >50 %
* Adequate liver function as defined by a serum bilirubin <*8, AST (aspartate aminotransferase) or ALT (alanine aminotransferase) < *5X upper limit of normal
* Creatinine clearance of > 60 ml/min
* Karnofsky Performance Status (KPS) of > 80% on the modified (KPS) tool
* Patients must be willing to use contraception if they have childbearing potential
* Able to give informed consent
Exclusion Criteria:
* Modified (KPS) Karnofsky Performance status of <80%
* > 5 Comorbidity Points on the Hematopoietic cell transplantation - specific comorbidity (HCT-CI) Index (See Appendix B)
* Class I or II antibodies against donor human leukocyte antigens (HLA)
* HIV positive
* Active involvement of the central nervous system with malignancy
* Psychiatric disorder that would preclude patients from signing an informed consent
* Pregnancy, or unwillingness to use contraception if they have child bearing potential
* Patients with life expectancy of < 6 months for reasons other than their underlying hematologic/oncologic disorder
* Alemtuzumab treatment within 8 weeks of HSCT admission
* Anti-thymocyte globulin (ATG) level of > 2 ugm/ml
* Patients with active inflammatory processes including T max >101 or active tissue inflammation are excluded
* Inability to tolerate cyclophosphamide or undergo total body irradiation at the doses specified in the treatment plan |
Study Objectives
This is a randomized controlled study comparing EUS-FNA with 22 gauge and 25 gauge needles in consecutive patients.
Summary
Background: three needle sizes for endoscopic ultrasonography guided fine needle aspiration (EUS-FNA) are currently available: 22 Gauge (G), 25 G and 19 G. However, well design studies comparing them regarding efficacy and feasibility are lacking.
Aims: to investigate diagnostic yield, specimen adequacy, feasibility and complications of the conventional 22 G compared with the 25 G needle.
Methods: patients ≥ 18 years, referred to EUS-FNA for a solid lesion will be considered for inclusion. Patients with suspected diagnosis of lymphoma, GIST, sarcoidosis, significant coagulopathy (APT \< 50% or platelets \< 50000/mm3), use of warfarin or other anticoagulants, use of clopidogrel within 7 days of EUS, inability or refusal to sign the informed consent and pregnancy or suspected pregnancy will be excluded.
Participants will be randomized to 22 G needle and 25 G FNA. Chi-square test will be used to compare proportions. Continuous variables will be compared using Student´s t test. A two-tailed P values of less than 0.05 will be considered statistically significant. The diagnostic yield of 25 G and 22 G needle will be evaluated by four criteria: sensitivity, specificity, positive predictive value and negative predictive value. An expected rate of 85% diagnostic yield from EUS guided FNA by using 22G needle will be considered. By using a power of 80% and an α value of 0.05 would be necessary 120 patients per group to detect a 15% difference in the rate of diagnostic yield.
Intervention / Treatment
DEVICE: Endosonography guided fine needle aspiration cytology ( Cook Medical, Boston Scientific)
| Inclusion Criteria:
* Consecutive patients referred for EUS-FNA of a solid lesion.
Exclusion Criteria:
* Age < 18 years
* Patients with suspected diagnosis of lymphoma, GIST, sarcoidosis or other lesions in which a large amount of tissue will be required for diagnosis
* Significant coagulopathy (INR > *5, platelets < 50000/mm3
* Use of low molecular weight heparin, use of clopidogrel within 7 days of EUS)
* Cystic lesions
* Inability or refusal to sign the informed consent |
Study Objectives
The objective of this study was to evaluate the efficacy and safety of enzalutamide treatment in patients with progressive metastatic castration-resistant prostate cancer previously treated with abiraterone acetate.
Intervention / Treatment
DRUG: Enzalutamide
| Inclusion Criteria:
* Subject has histologically confirmed adenocarcinoma of the prostate without neuro-endocrine differentiation or small cell features.
* Subject has metastatic disease documented by bone scan or by soft tissue disease observed by Computed Tomography/Magnetic Resonance Imaging (CT/MRI) at screening, or within ≤30 days prior to Day *
* In the setting of castrate levels of testosterone ≤*7 nmol/L (or ≤50 ng/dL), subject has progressive disease at study entry defined as PSA rise determined by a minimum of 2 rising PSA levels with an interval of ≥ 1 week between each assessment. The PSA value at the screening visit should be ≥ 2 ng/mL WITH or WITHOUT:
* Soft tissue disease progression defined by Response Evaluation Criteria In Solid Tumors (RECIST *1) at screening, or within ≤30 days prior to Day * Measurable disease is not required for entry. Lymph nodes ≥ 2 cm are considered measurable disease (Prostate Cancer Clinical Trials Working Group (PCWG2)).
* Bone disease progression defined by at least 2 new lesions on bone scan at screening, or within ≤30 days prior to Day *
* Subject must have received a minimum of 24 weeks of treatment with abiraterone acetate within its approved label indication and has discontinued use at least 4 weeks prior to start of study drug at Day *
* If the subject has received previous treatment with chemotherapy for prostate cancer, this must be limited to no more than one prior line of docetaxel, and must have been used prior to abiraterone acetate therapy.
* Subject receives and will continue to receive ongoing androgen deprivation with Luteinizing-hormone-releasing hormone (LHRH) analogue therapy throughout the course of the study or has had a bilateral orchiectomy.
* Subject is asymptomatic or mildly symptomatic from prostate cancer:
* The score on Brief Pain Inventory - Short Form (BPI-SF) Question #3 must be < *
* No use of opiate analgesics for prostate cancer-related pain currently or anytime within 4 weeks prior to screening.
Exclusion Criteria:
* Subject has prior use of ketoconazole for the treatment of prostate cancer.
* Subject has prior use of cabazitaxel.
* Subject has prior use of enzalutamide.
* Subject has received ANY anti-neoplastic therapy (including antiandrogens and chemotherapy) following abiraterone acetate discontinuation and prior to start of study drug at Day *
* Subject has a known or suspected hypersensitivity to enzalutamide, or any components of the formulation used.
* Subject has known or suspected brain metastases or active leptomeningeal disease.
* Subject has history of seizure or any condition that may predispose to seizure (e.g., prior stroke or significant brain trauma). |
Study Objectives
Patients with advanced gastric cancer are treated with a combination of RAD001 (everolimus) and Mitomycin C.
Intervention / Treatment
DRUG: RAD001 and MitomycinC
| Inclusion Criteria:
* 1 prior platin containing chemotherapy in the palliativ setting or progressive disease under adjuvant or neoadjuvant therapy within 6 months of treatment start date.
* Histological evidence of advanced or metastatic gastric cancer or cancer of the esophageal junction.
* At baseline CT or MRI scan must demonstrate measurable disease by RECIST criteria, i.e., the presence of at least one measurable lesion. Measurable disease lesions must be accurately measured in at least one dimension with longest diameter > 20 mm using conventional techniques or > 10 mm with spiral CT scan (with minimum lesion size no less than double the slice thickness).
* At least one measurable lesion outside of the field of any prior radiation therapy (according to RECIST criteria). Prior radiotherapy to a single index lesion is not allowed.
* Adult male or female patients (≥18 years of age).
* Patients must have disease not amenable to surgery, radiation, or combined modality therapy with curative intent.
* ECOG 0 or 1
* Life expectance >4 months
* Adequate bone marrow function, renal function, liver function
* Women using an acceptable form of contraception prior to receiving RAD001 or women who meet the protocol definition of post-menopausal: 12 months of natural (spontaneous) amenorrhea or 6 months of spontaneous amenorrhea with serum FSH levels >40 mIU/m or 6 weeks post surgical bilateral oophorectomy with or without hysterectomy.
* Fully recovered from any previous surgery, prior chemotherapy or radiation therapy (at least 4 weeks since major surgery or prior myelosuppressive chemotherapy). With the exception of alopecia, patients must have resolution of all acute toxic effects of any prior surgery, radiotherapy, or chemotherapy to NCI CTC (Version *0) grade <=* Patients with rapidly progressive tumors (upon the decision of the investigator) can be treated <4 weeks since last chemotherapy, if they fully recovered from all side effects.
* Signed informed consent
Exclusion Criteria:
* Anticancer therapy within 3 weeks of enrollment including chemotherapy, hormonal therapy, immunotherapy, or radiotherapy. Patients with rapidly progressive tumors (upon the decision of the investigator) can be treated <4 weeks since last chemotherapy, if they fully recovered from all side effects.
* Prior therapy with RAD001 (everolimus) or other rapamycins (sirolimus, temsirolimus).
* Patients treated with Mitomycin C
* No neurotoxicity >= grade 2 CTC
* No gastric or intestinal obstruction
* Patients taking drugs known to inhibit or induce isoenzyme CYP3A
* Patients with any concurrent major medical condition liable to compromise the patient's participation in the study (e.g known HIV infection, uncontrolled diabetes, serious cardiac dysrhythmia or condition, New York Heart Association classification of III or IV, congestive cardiac failure, myocardial infarction within 6 months, unstable angina, chronic or acute renal or liver disease, uncontrolled serious infections including abscess or fistulae, etc.)
* Patients with a history of another malignancy prior to study entry, except curatively treated non-melanotic skin cancer or carcinoma in-situ cervical cancer unless in complete remission or no evidence of disease and off all therapy for that disease for a minimum of 5 years
* No symptomatic brain metastasis.
* Use of other investigational drugs at the time of enrollment, or within 30 days or 5 half-lives of enrollment, whichever is longer.
* Female patients who are pregnant or breast feeding
* History of hypersensitivity to any of the study drugs or to drugs with similar chemical structures
* History of malignancy of any organ system, treated or untreated, within the past 5 years whether or not there is evidence of local recurrence or metastases, with the exception of localized basal cell carcinoma of the skin |
Study Objectives
The main purpose of this study is to determine the maximum tolerated and efficient dose of GRASPA® in combination with polychemotherapy treatment of elderly patients with ALL, 55 years and over, Philadelphia chromosome-negative (ALL Ph-).
Intervention / Treatment
DRUG: GRASPA
| Inclusion Criteria:
* Patient aged ≥55 years old
* With newly diagnosed ALL without prior treatment
* Capable to receive polychemotherapy (World Health Organization (WHO) performance status ≤2)
* With or without meningeal disease
* Having signed an Informed Consent Form
* Subscribed to social security insurance
Exclusion Criteria:
* ALL translocation(9;22) and/or BCR-ABL (Breakpoint Cluster Region-Abelson) positive
* Performance status incompatible with chemotherapy treatment (WHO score >2)
* Patient presenting with a general or visceral contraindication to intensive treatment including :
* Cardiac insufficiency defined as Left Ventricular Ejection Fraction <50% of the theoretical value
* Plasma creatinine concentration 2 times greater than the upper limit of laboratory ranges, except if related to ALL
* Aspartate aminotransferase (ASAT) or alanine aminotransferase (ALAT) levels 5 times greater than the upper limit of laboratory ranges, except if related to ALL
* Patient with another evolutive cancer other than ALL
* Severe evolutive infection, or Human Immunodeficiency Virus (HIV) seropositive or, active hepatitis related to B or C viral infection
* Prior treatment with L-asparaginase (irrespective of the form)
* History of grade 3 transfusional incident (life threatening)
* Patient presenting rare and/or dangerous anti-erythrocyte antibodies thus leading to the unavailability of phenotype compatible Red Blood Cells Concentrate
* Patient included in another clinical trial during the last 4 weeks |
Study Objectives
The Nordic FLOX-regime consists of a combination of bolus 5-FU, leukovorin and oxaliplatin (Eloxatin®). Cetuximab (Erbitux®) is an antibody against the epidermal growth factor receptor (EGFR). The combination of FLOX and weekly Erbitux has been investigated in the Nordic VII study where 571 patients were randomized to FLOX (regime A) or FLOX + Erbitux (regime B or C). Effect-data has not yet been published but the combination is well tolerated, and other studies have shown that Erbitux administered with chemotherapy seem to be more efficient than chemotherapy alone.
The main purpose with this study is to investigate the effect of FLOX and Erbitux given every second week as first line treatment for patients with metastatic colorectal cancer and K-RAS wildtype tumor.
The latest accessible data regarding treatment towards EGFR and K-RAS mutations shows that patients with K-RAS wildtype responds better to treatment than patients with K-RAS mutations.
Intervention / Treatment
DRUG: Cetuximab (Erbitux), DRUG: Oxaliplatin (Eloxatin) + Fluorouracil + folinic acid
| Inclusion Criteria:
Histology and staging disease:
* Histological proven adenocarcinoma of the colon or rectum
* At least one measurable metastatic lesion according to RECIST criteria
* If only one metastatic lesion, histology is mandatory
Mutation level:
* Tumor tissue (primary or metastasis) typological classified as K-RAS wildtype in codon 12 and 13 in exon 1 at real-time PCR
General conditions:
* Age >18 and < 75 years
* WHO performance status ≤ 2; life expectancy of more than 3 months
* Adequate haematological function: (Hb ≥ *2 μmol/d, ANC ≥ *5 x 109/L, platelets ≥ 100 x 109/L)
* Adequate renal and hepatic functions: total bilirubin ≤ *5 upper normal limit, creatinine ≤ *25 × upper normal limit, ALAT ≤ 3 x upper normal limits, and ≤ 5 x upper normal limits in case of liver metastases
* Written informed consent prior to randomisation must be obtained and documented according to the local regulatory requirements
Other:
* Fertile patients must use adequate contraceptives
Exclusion Criteria:
Prior therapy:
* Prior chemotherapy for advanced/metastatic disease
* Adjuvant chemotherapy must have ended > 6 months before inclusion
* Prior treatment with Eloxatin
* Prior treatment with Erbitux or other treatment to EGFR
Prior or current history:
* Current indication for resection with a curative intent
* Evidence of CNS metastasis
* Current infection, unresolved bowel obstruction or subobstruction, uncontrolled Crohn's disease or ulcerative colitis
* Current history of chronic diarrhea
* Peripheral neuropathy
* Other serious illness or medical conditions (including contraindication to 5 FU e.g.: angor, myocardial infarction within 6 months, contraindications to monoclonal antibodies)
* Past or concurrent history of malignant neoplasm other than colorectal adenocarcinoma within the past five years, except curatively treated non melanoma skin cancer or in situ carcinoma of the cervix
Concomitant treatments:
* Concomitant (or within 4 weeks before randomisation) administration of any other experimental drug under investigation
* Concurrent treatment with any other anti-cancer therapy
Other:
* Pregnant or breast feeding women |
Study Objectives
Tranexamic acid (TXA) is an antifibrinolytic agent that has been shown to reduce blood loss and blood transfusion requirements in the following patient populations: multisystem trauma, liver transplantation, cardiac surgery and spine surgery. Patients undergoing major liver resection are at risk of severe perioperative blood loss and may also benefit from perioperative TXA administration.
This open label, non-randomized study to evaluate the pharmacokinetic and pharmacodynamic properties of two well studied dosing regimens of TXA will provide guidance in determining the optimal TXA dosing regimen for patients undergoing major liver resection. Compelling evidence of the effectiveness of TXA comes from the large multicentred, multi-national CRASH-2 trial where TXA was administered as a 1 g bolus + 1 g infusion over 8 hours. In liver transplant surgery, the following dose regimen has been shown to have great effect:10 mg/kg/h from the start of surgery until 2 hours after reperfusion of the liver transplant.
Although TXA is not currently approved for use in patients undergoing major liver resection, Health Canada has allowed the use of tranexamic acid for use in this research study.
Intervention / Treatment
DRUG: No tranexamic acid, DRUG: Tranexamic Acid
| Inclusion Criteria
* Patient undergoing anticipated open or laparoscopic major liver resection (> 2 hepatic segments), as assessed by the operating surgeon
* Age ≥ 18 years.
Exclusion Criteria
* Previously enrolled in this study
* Platelet count less than 100,000/mm3
* Severe anemia (hemoglobin levels less than 90 g/l)
* Documented arterial or venous thrombosis at screening or in past three months
* Anticoagulants (other than LMWH or heparin in prophylactic doses to prevent deep vein thrombosis), direct thrombin inhibitors or thrombolytic therapy administered or completed within last week
* Hepatectomy associated with planned vascular or biliary reconstruction
* Known disseminated intravascular coagulation
* Severe renal insufficiency (CrCl<30)
* History of seizure disorder
* Pregnant or lactating
* Hypersensitivity to tranexamic acid or any of the ingredients
* Unable to receive blood products (i.e. difficulty with cross matching, refuses blood transfusion, or a past history of unexplained severe transfusion reaction)
* Receipt of chemotherapy within 4 weeks of scheduled operation
* Patients undergoing resection for living donor liver transplant. |
Study Objectives
The purpose of this study is to compare the efficacy and safety of a weekly regimen of two FDA approved drugs in combination versus one FDA approved drug in subjects with advanced non-small cell lung cancer who have received one previous chemotherapy excluding TAXOTERE or HYCAMTIN.
Intervention / Treatment
DRUG: Topotecan/Docetaxel combination, DRUG: Docetaxel
| Inclusion criteria:
* Written informed consent
* At least 18 years old
* Confirmed advanced non-small cell lung carcinoma (NSCLC)
* Received one prior chemotherapy for metastatic NSCLC excluding TAXOTERE or HYCAMTIN. In addition, subjects are allowed to have previously received a non-cytotoxic therapy, such as an endothelial growth factor receptor (EGFR) or angiogenesis inhibitor.
* Presence of either measurable or non-measurable disease by radiologic study or physical examination.
* Full recovery and at least 21 days from prior treatment for NSCLC; 42 days from treatment with mitomycin or nitrosureas and 30 days from prior non-cytotoxic therapy.
* At least 3 weeks since last major surgery (a lesser period is acceptable if deemed in the best interest of the patient).
* At least 7 days since prior radiotherapy.
* A probable life expectance of at least 3 months.
* Adequate bone marrow reserve, CBC/Platelet, kidney and liver function.
Exclusion criteria:
* Concomitant malignancies or other malignancies within the last five years.
* Symptoms of brain metastases requiring treatment with steroids.
* Active infection.
* Severe medical problems other than the diagnosis of NSCLC that would limit the ability of the subject to follow study guidelines or expose the subject to extreme risk.
* Ongoing or planned chemotherapy (other than treatment during this study), immunotherapy, radiotherapy, or investigational therapy for the treatment of NSCLC.
* Use of investigational drug within 30 days or 5 half-lives prior to the first dose of study medication.
* Women who are pregnant or lactating.
* Subjects of child-bearing potential refusing to practice adequate contraception.
* Prior treatment with or history of allergic reaction to either HYCAMTIN or TAXOTERE.
* Subjects who cannot receive steroid premedication. |
Study Objectives
This research study is evaluating the experimental drug palbociclib in combination with another experimental drug PD-0325901 as a possible treatment for cancers with KRAS mutations, particularly for those which started in the lung.
Intervention / Treatment
DRUG: Palbociclib, DRUG: PD-0325901
| Inclusion Criteria:
* Dose-escalation/MTD cohorts, participants must have histologically confirmed malignancy with a RAS mutation that is metastatic or unresectable and for which standard curative or palliative measures do not exist or are no longer effective. For the randomized phase 2 component of the study, participants must have histologically confirmed NSCLC with a confirmed KRAS mutation (via any CLIA-certified method)
* For the dose-escalation component, participants are required to have only evaluable disease. For the MTD cohort and phase 2 component of the study, participants must have measurable disease.
* Participants enrolled to the MTD cohort must agree to pre and on-treatment tumor biopsies if assessable disease is identified.
* Age ≥18 years.
* ECOG performance status ≤ 2 (see Appendix A).
Participants must have normal organ and marrow function as defined below:
* Absolute neutrophils count ≥ 1,500/mcL
* Platelets ≥100,000/mcL
* total bilirubin within normal institutional limits
* AST (SGOT)/ALT (SGPT) ≤ *5 X institutional upper limit of normal (≤ *0 X institutional upper limit of normal permitted if hepatic metastases present)
* Creatinine within *5x the ULN institutional limits.
* Women of child-bearing potential and men must agree to use adequate contraception prior to study entry and for the duration of study participation. Ability to understand and the willingness to sign a written informed consent document.
* QTc ≤480 msec.
* The availability of archival tissue to evaluate retrospectively the participant's Rb status
* Patients must have recovered to ≤ Grade 1 in terms of toxicity from prior treatments (excluding neuropathy which can be ≤ Grade 2).
Exclusion Criteria:
* Participants who have had chemotherapy or radiotherapy within 3 weeks (6 weeks for nitrosoureas or mitomycin C) prior to entering the study or those who have not recovered from adverse events due to agents administered more than 3 weeks earlier.
* Participants may not be receiving any other study agents concurrently with the study drugs.
* Participants with symptomatic brain metastases that require chronic steroids are excluded. Patients with a history of brain metastases are permitted to enroll as long as they have been treated, off of steroids and have been stable for one month on imaging.
* Concurrent use with strong CYP3A4 inhibitors/inducers is prohibited due to drug-drug interactions with palbociclib.
* Due to potential drug interactions between warfarin and PD-0325901, warfarin use is excluded. Other anticoagulants are permitted.
* Uncontrolled intercurrent illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
* Pregnant women are excluded from this study because the study agents have the potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk of adverse events in nursing infants secondary to treatment of the mother with the study agents, breastfeeding should be discontinued.
* For Part II only: Individuals with a history of a different malignancy are ineligible except if they have been disease-free for at least 2 years and are deemed by the investigator to be at low risk for recurrence. Individuals with the following cancers are eligible if diagnosed and treated within the past 5 years: cervical cancer in situ, and basal cell or squamous cell carcinoma of the skin.
* HIV-positive individuals on combination antiretroviral therapy are ineligible because of the potential for pharmacokinetic interactions.
* Evidence of visible retinal pathology on screening ophthalmologic examination that places the participant at an unacceptable risk for ocular toxicity, such as risk factors for retinal vein occlusion, related to PF-* |
Study Objectives
This study will evaluate the maximum tolerated dose (MTD) and dose-limiting toxicity (DLT) of patupilone combined with carboplatin in adult patients with advanced solid tumors who progressed despite standard therapy or for whom no standard therapy exists or who might benefit from treatment with carboplatin
Intervention / Treatment
DRUG: Patupilone
| Inclusion criteria:
* Histologically or cytologically confirmed advanced solid tumors who have progressed despite standard therapy, or for whom no standard therapy exists, or who might benefit from treatment with carboplatin
* A minimum of 4 weeks since the last treatment with chemotherapy
* WHO Performance Status 0 (able to carry out all normal activity without restriction) or 1 (restricted in physically strenuous activity but ambulatory and able to carry out work)
* Age ≥ 18
* Adequate hematological parameters
* No major impairment of renal or hepatic function
* Written informed consent obtained
Exclusion criteria:
* Major surgery less than 4 weeks prior to study entry and/or not fully recovered from surgery
* Chemotherapy or investigational compound less than 4 weeks prior to study entry, or planned while participating in the study
* Prior administration of an epothilone
* Hypersensitivity to carboplatin. Patients resistant to carboplatin are not recommended to enter the trial
* Radiotherapy (RT) less than 4 weeks prior to study entry (except for palliative therapy of distant metastases), or planned RT while participating in the study
* Diarrhea within 7 days prior to start of treatment. Unresolved bowel obstruction
* Peripheral neuropathy > Grade 1 (mild)
* Symptomatic brain metastases
* Colostomy
Other protocol-defined inclusion/exclusion criteria may apply |
Study Objectives
LEP-ETU is a novel, proprietary delivery system of paclitaxel developed by NeoPharm, Inc. Paclitaxel (currently marketed as Taxol) is an anti-microtubular network agent and is active in a broad spectrum of malignancies. Paclitaxel has poor solubility. In order to enhance the solubility, this drug is formulated with polyoxyethylated castor oil, which leading to infusion-related hypersensitivity reactions. The NeoPharm LEP-ETU is formulated with a mixture of well characterized, synthetic phospholipids and cholesterol. This design eliminates the need for the oil. The LEP-ETU formulation has improved safety profile that is necessary for administering higher doses than would commonly be used with Taxol. The clinical evidence obtained from the NeoPharm Phase I study shows LEP-ETU is better tolerated than Taxol, as indicated by a higher maximum-tolerated dose (MTD). The current Phase II study is designed to accomplish the following objectives:
1. Assess the Overall Response Rate (ORR) of patients with metastatic breast cancer after administered over 90 minutes at the dose of 275 mg/m2 LEP-ETU
2. To evaluate the Progression-Free Survival (PFS)
3. To evaluate the safety of LEP-ETU at 275 mg/m2 level, in particular peripheral neuropathy
4. To evaluate the Overall Survival (OS)
Intervention / Treatment
DRUG: LEP-ETU
| Inclusion Criteria:
* Be 18 years or older and female.
* Have histologically or cytologically confirmed diagnosis of invasive adenocarcinoma originating in the breast.
* Have at least one target lesion per RECIST criteria
* If the patient has received adjuvant or neoadjuvant taxane therapy, the patient must not have relapsed with breast cancer within one year of completing this therapy.
* Have received prior chemotherapy in the adjuvant or metastatic setting with an anthracycline unless contraindicated.
* Have no other malignancy within the past five years, except non-melanoma skin cancer, cervical intraepithelial neoplasia (CIN), or in-situ cervical cancer (CIS).
* Have the following hematology levels at Baseline:
* ANC greater than or equal to 1,500 x 106 cells/L;
* Platelets greater than or equal to 100 x 109 cells/L;
* Hgb greater than or equal to 90 g/L.
* Have the following chemistry levels at Baseline:
* AST (SGOT), ALT (SGPT) less than or equal to *5 x ULN if no evidence of liver metastases;
* AST (SGOT), ALT (SGPT) less than or equal to 5 x ULN if liver metastases are present;
* Total bilirubin less than or equal to 26 micromol/L (*5 mg/dL);
* Creatinine less than or equal to 177 micromol/L (2 mg/dL); or 24-hour
* Alkaline phosphatase less than or equal to 5 x ULN (unless bone metastasis is present in the absence of liver metastasis).
* Have a life expectancy of greater than or equal to 12 weeks.
* Have an ECOG Performance status of 0-*
* Patients of child-bearing potential must agree to use acceptable contraceptive methods (e.g., double barrier) during treatment.
* Patient or legal representative must understand the investigational nature of this study and sign an Independent Ethics Committee -approved written informed consent form prior to receiving any study related procedure.
Exclusion Criteria:
* Patient has radiographic evidence of active (symptomatic, untreated) intraparenchymal brain metastases; any leptomeningeal metastases; or asymptomatic untreated intraparenchymal brain metastases requiring treatment.
* Patient has received more than 1 prior treatment with a non-taxane agent in the metastatic setting.
* The only evidence of metastasis is lytic or blastic bone metastases or pleural effusion or ascites.
* Patient has a known infection with human immunodeficiency virus or active viral hepatitis.
* Patient has active heart disease including myocardial infarction or congestive heart failure within the previous 6 months, symptomatic coronary artery disease, or uncontrolled arrhythmias.
* Any condition which in the Investigator's opinion deems the patient an unsuitable candidate to receive study drug (e.g., uncontrolled bleeding or bleeding diathesis).
* Any active infection requiring parenteral or oral antibiotics.
* The patient receives treatment with any:
* Hormonal or other non-investigational agent therapy within 2 weeks prior to first dose of study drug;
* Herceptin, mitomycin, or nitrosoureas therapy within 6 weeks prior to first dose;
* Chemotherapy (except for palliative bisphosphonate therapy for bone pain which can be administered as clinically indicated) within 4 weeks prior to first dose study drug;
* Investigational drug or immunotherapy within 4 weeks prior to first dose study drug;
* Concurrent radiation therapy (except for palliative radiotherapy for
* Radiation therapy within 4 weeks prior to first dose of study drug.
* Patient has pre-existing peripheral neuropathy of NCI-CTCAE Grade >*
* Patient has received paclitaxel, docetaxel, or Abraxane because of metastatic carcinoma.
* Known hypersensitivity to paclitaxel, Cremophor EL, or liposomes.
* Pregnant or nursing female patients.
* Unwilling or unable to follow protocol requirements. |
Study Objectives
The primary Study hypothesis is that the ProLung Test will demonstrate safety and efficacy in the risk stratification of patients with pulmonary lesions identified by CT that are suspicious for lung cancer. A statistically significant result will indicate that patients with a high ProLung Test result have a greater risk of developing lung cancer than patients with a low test result.
There are three Specific Aims of this study:
1. Optimize and confirm the stability of the ProLung Test risk-stratification algorithm in patients with a diagnosis.
2. Externally validate the efficacy of the ProLung Test risk-stratification algorithm by comparing the test result to the conclusive patient diagnosis.
3. Assess the safety and tolerability of the ProLung Test procedures.
Study Design This Study consists of two distinct phases, Stabilization and Validation. The Study will collect data from multiple sites (3 to 12), and each site may enroll patients and collect data for the Stabilization and Validation Phases with a minimum of three sites for the Validation Phase.
Intervention / Treatment
| Inclusion Criteria:
Subjects who meet all of the following criteria may be enrolled in this Study:
* Subject is male or female, age 18 or older.
* Subject has undergone CT scan of the lung(s) that indicates one or more nodules or lesions suspicious for lung cancer.
* Subject's pulmonary nodule or lesion is greater than 4mm. Size is determined by the largest nodule or lesion dimension identified from CT imaging.
* Subject meets one or more of the following conditions:
* indicated for a tissue biopsy
* indicated for surgical resection of the lung
* Subject must be able to receive a ProLung Test
* within 60 days of abnormal CT (Inclusion Criterion 2 \& 3)
* within 60 days prior to the tissue biopsy or surgical resection (Inclusion Criterion 4).
* Subject is capable of understanding and agreeing to fulfill the requirements of this Protocol.
* Subject has signed the IRB/IEC approved Informed Consent Form ("ICF").
Exclusion Criteria
The following criteria will disqualify a subject from enrollment into this Study:
* Subject has an implanted electronic device in the chest.
* Subject receiving therapy for suspected chest infection such as fungal infection or tuberculosis.
* Subject with diagnosed malignancy other than lung cancer, non-melanoma skin cancer or any cancer in which the Principal Investigator does not suspect metastatic disease to the lung, who has 2 or more suspicious pulmonary nodules.
* Subject has received an invasive medical or surgical procedure within the thoracic cavity within 30 days prior to the ProLung Test or within the previous 14 days for a bronchoscopic procedure.
* Subject presents with an anomalous physical or anatomical condition that precludes ProLung Test measurement.
* Subject will have undergone unusually strenuous exercise within 24 hours.
* Subject who has significant systemic diseases such as uncontrolled diabetes, advanced heart failure, or a recent myocardial infarction, or other medical condition such as severe morbid obesity that in the judgment of the Principal Investigator would make him/her unsuitable for the Study. |
Study Objectives
Patients with early cervical cancer are usually treated with radical hysterectomy + pelvic lymph-node dissection. The study randomizes patients in 2 arms. The control arm is the classical surgical treatment including identification of the sentinel nodes, full pelvic lymph-node dissection and radical hysterectomy.
The experimental arm is only sentinel node identification + radical hysterectomy.
Intervention / Treatment
PROCEDURE: identification of sentinel nodes + full pelvic lymph-node dissection, PROCEDURE: only identification of sentinel nodes (without pelvic lymph-node dissection)
| Inclusion Criteria:
* Women 18 years of age or older,
* Absence of contraindication to laparoscopy,
* Uterine cervical carcinoma (every histological type except neuroendocrine),
* Stage IA1 with lymphatic tumor space involvement (LVSI) or IA2 diagnosed on cervical conization; or stage IA2, IB1 or IIA detected by clinical examination, confirmed by biopsy and measured by the MRI, the highest diameter being lower to 4 cm (a preoperative brachytherapy is allowed for tumors 2 to 4 cm in diameter),
* Negative pregnancy test for women able to procreate,
* Having the French National Social Security
* Signed informed consent
Exclusion Criteria:
* Neuroendocrine carcinoma,
* In situ carcinoma or stage IA1 without LVSI,
* Maximal tumoral diameter measured by MRI more than 4 cm,
* Stage IB1 by "down-staging",
* Stage IB2, IIB to IVB, including those who had a response to neoadjuvant treatment (chemotherapy or RT + chemotherapy) ,
* Presence of distant metastases,
* Progression of the cervical cancer or recurrence,
* History of pelvic lymphadenectomy,
* Other cancer diagnosed during the course of treatment,
* Contraindication to the injected products : allergy known to Patent Blue or rhenium sulfide,
* History of severe allergy (history of Quincke's edema, anaphylactic shock),
* Patient who does not understand, speak or write the French language,
* Pregnant woman |
Study Objectives
Self expandable stent (SEMS) constitutes the main palliative treatment in advanced esophageal cancer. The palliative effect of SEMS is immediate when it comes to relief of dysphagia. The duration of this effect is however questionable. The design of SEMS can be of importance since the device can dislodge and as a consequence of that dysphagia recur. The hypothesis has therefore been formulated that a partially covered SEMS is associated with less tendency to dislocate as compared to those SEMS, recently developed, which are covered through their entire length.
Intervention / Treatment
DEVICE: Partially covered SEMS, DEVICE: Fully covered SEMS
| Inclusion Criteria:
* Verified Squamous Cell Carcinoma or Adenocarcinoma of esophagus or Gastro Esophageal Junction (GEJ)
* Age above 18 years.
* Dysphagia scoring grade two or worse
* Not amenable for curative treatment
* Informed consent to participate
Exclusion Criteria:
* Concomitant cancer disease
* Inability to comply with study protocol
* Previous stent treatment
* Proximal location of the tumour in the esophagus.
* Need for more than one stent deployment. |
Study Objectives
Patients with Myelodysplastic Syndromes (MDS) often suffer from low platelet levels which may lead to bleeding complications. Treatment with cytotoxic agents can decrease the platelet levels further. Eltrombopag is a relatively new drug that increases the platelet level in the blood by working directly on the bone marrow. It is available for treatment of the disease Immunological Thrombocytopenic Purpura (ITP). In this study patients with MDS and low platelet levels that are treated with the cytotoxic agent Azacitidine will also receive Eltrombopag. The administration of Eltrombopag to MDS patients treated with Azacitidine may result in less dose reductions and less treatment delays for Azacitidine and may reduce the need for thrombocyte transfusions and lower the risk of bleeding complications.
This is a phase I study, meaning that our major goal is to investigate the safety and tolerability for Eltrombopag in this patient group. It will also generate a basis for a phase II-III-study.
Intervention / Treatment
DRUG: Eltrombopag
| Inclusion Criteria:
* Adult subjects (18 years of age or older) with advanced MDS or sAML/MDS requiring treatment with Azacitidine as approved by EMEA:
* MDS classified as Intermediate 2-risk or high risk according to the international prognostic scoring system (IPSS) or
* Chronic myelomonocytic leukaemia (CMML) with 10-29% bone marrow blasts without myeloproliferative disease or
* Acute myeloblastic leukaemia (AML) with 20-30% bone marrow blasts with multilineage dysplasia according to the WHO classification.
* Platelet counts < 75 x 109 /L at start of Azacitidine treatment.
* Subjects must have platelet count and platelet transfusion data available over a period of 4 weeks prior to inclusion.
* During the 8 weeks prior to inclusion in study, subjects must have a baseline bone marrow examination including all of the following:
* cytomorphology to confirm bone marrow blasts
* cytogenetics
* ECOG Status 0-*
* Subject is able to understand and comply with protocol requirements and instructions.
* Subject has signed and dated informed consent.
* Adequate baseline organ function defined by the criteria below:
* total bilirubin (except for Gilbert's Syndrome) </= *5xULN
* ALT and AST </= 3xULN
* creatinine </= *5 xULN
* Subject is practicing an acceptable method of contraception (documented in CRF).Female subjects (or female partners of male subjects) must either be of non childbearing potential (hysterectomy, bilateral oophorectomy, bilateral tubal ligation or post-menopausal > 1 year), or of childbearing potential and use 1 of the following highly effective methods of contraception (i.e., Pearl Index < *0%) from 2 weeks prior to administration of study medication, throughout the study, and 28 days after completion or premature discontinuation from the study:
* Complete abstinence from intercourse;
* Intrauterine device (IUD);
* Two forms of barrier contraception (diaphragm plus spermicide, and for males condom plus spermicide);
* Male partner is sterile prior to entry into the study and is the only partner of the female;
* Systemic contraceptives (combined or progesterone only).
Exclusion criteria:
* Subjects with a diagnosis of acute promyelocytic leukemia.
* Patients with short life expectancy (less than 3 months)
* Patients with bone marrow fibrosis that does not allow bone marrow aspiration (so-called "dry tap") or fibrosis grade II or III (grading according to European consensus on grading bone marrow fibrosis.
* History of treatment for cancer other than MDS or sAML/MDS with systemic chemotherapy and/or radiotherapy within the last 2 years.
* Patients with clinically significant splenomegaly, or > 16 cm spleen in length measured by ultrasound
* Patients with known liver cirrhosis
* Patients with East Asian ancestry such as Chinese, Japanese, Taiwanese or Korean.
* History of treatment with romiplostim or other TPO-R agonists.
* subjects with a QTc > 450 msec (QTc > 480 msec for subjects with Bundle Branch Block).
* Subjects with known thrombophilic risk factors. Exception: Subjects for whom the potential benefits of participating in the study outweigh the potential risks of thromboembolic events, as determined by the investigator.
* Female subjects who are nursing or pregnant (positive serum or urine Beta-human chorionic gonadotropin \[B-hCG\] pregnancy test) at screening or pre-dose on Day *
* Current alcohol or drug abuse.
* Treatment with an investigational drug within 30 days or 5 half-lives (whichever is longer) preceding the first dose of study medication.
* Active and uncontrolled infections.
* Subjects infected with Hepatitis B, C or Human Immunodeficiency Virus (HIV). |
Study Objectives
Part 1: Dose-Escalation Phase (Phase 1b) The primary objective is to assess the safety and tolerability of increasing doses of D07001 softgel in patients with unresectable locally advanced or metastatic gastrointestinal (GI) cancer.
Part 2: Dose-Expansion Phase (Phase 2) The primary objective is to assess the safety and tolerability of D07001 softgel in patients who have achieved stable disease or better following first line chemotherapy or combined chemoradiotherapy (CCRT) for unresectable metastatic or locally advanced biliary tract cancer (BTC)
Intervention / Treatment
DRUG: D07001-softgel capsules
| Inclusion Criteria:
* Provision of a signed and dated written Informed Consent Form (ICF) prior to any study specific procedures
* Male or female patients aged 18 years or older at screening (aged 20 years or older in Taiwan)
* Histopathological or cytologic diagnosis of unresectable, metastatic or locally advanced GI cancer (Part 1) or unresectable metastatic or locally advanced BTC (cholangiocarcinoma or gallbladder cancer; Part 2)
* Part 1 only: Refractory to or have relapsed from all standard therapies of advanced GI malignancy
* Part 2 only:
* Achieved stable disease or better, based on the Investigator's assessment, in response to first line systemic therapy or CCRT, with continued stable disease or better based on imaging studies obtained as part of screening
* Completed first line systemic therapy (with 2-8 cycles of chemotherapy with a gemcitabine based regimen) or CCRT, based on the local standard of care and preferences in the participating countries Note: No more than 30% of patients enrolled in Part 2 will have received CCRT
* No more than 60 days have elapsed between completion of the prior line of chemotherapy or CCRT and enrollment
* Part 2 only: Patient has not received intervening systemic therapy since first line treatment
* Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) of 0-2 in Part 1 and 0-1 in Part 2
* Life expectancy is >12 weeks
* Adequate bone marrow function, demonstrated by:
* Absolute neutrophil count (ANC) ≥1,500 cell/mm3
* Platelet count ≥100,000 cells/mm3
* Hemoglobin ≥9 g/dL
* Adequate liver function, demonstrated by:
* Aspartate transaminase (AST) and alanine transaminase (ALT) ≤*5 x upper limit of normal (ULN), or ≤*0 x ULN in the case of liver metastases
* Total bilirubin ≤*5 x ULN
* Albumin ≥*0 g/dL
* International normalized ratio (INR) <*5
* Adequate renal function, demonstrated by:
* Serum creatinine ≤*5 x ULN
* Creatinine clearance ≥ 60 mL/min calculated by Cockcroft-Gault formula or directly measured with 24 hr urine collection
* If a woman of childbearing potential, the patient has a negative serum pregnancy test at screening and is not breastfeeding
* If a woman of childbearing potential, patient must use a medically acceptable form of contraception as 2 barrier methods (e.g., combination of condom, diaphragm, or intrauterine device), hormonal contraception (estrogen or progesterone agents) or 1 barrier method in combination with spermicide. Birth control is required 1 month prior to screening, for the duration of their study participation, and for 1 month after the end of the study; female partners of male patients must adhere to the same birth control methods.
* Patient is willing to comply with protocol-required visit schedule and visit requirements
Exclusion Criteria:
* Part 2 only: More than one prior chemotherapy regimen for unresectable metastatic or locally advanced BTC Note: prior radiation (with or without radiosensitizing doses of chemotherapy) or fluoropyrimidine chemotherapy are allowed as postsurgical adjuvant therapy.
* Part 2 only: Received any systemic therapy (chemotherapy, biologics, immunotherapy, or investigational agents) for metastatic disease other than gemcitabine based chemotherapy or CCRT for locally advanced BTC
* Diagnosis of active malignancy (other than GI cancer \[Part 1\] or BTC \[Part 2\]) within the past 2 years, except nonmelanoma skin carcinoma and carcinoma-in-situ of uterine cervix treated with curative intent
* Prior discontinuation of gemcitabine because of pulmonary or hepatic toxicity or hemolytic uremic syndrome (HUS) or hypersensitivity, allergic reaction, or intolerance
* Any GI disorder which would significantly impede absorption of an oral agent
* Known brain or leptomeningeal metastases
* Surgery or radiation therapy within the past 28 days
* Part 2 only: Evidence of disease progression, based on the Investigator's assessment, on the screening computed tomography (CT) scan or magnetic resonance imaging (MRI) scan
* Any active disease or condition that would not permit compliance with the protocol
* Residual toxicity from prior chemotherapy or CCRT that is Grade ≥2 (residual Grade 2 neuropathy and alopecia are permitted)
* Clinically significant cardiovascular disease (e.g., uncontrolled hypertension, unstable angina, congestive heart failure, or New York Heart Association \[NYHA\] Grade 2 or greater), or uncontrolled serious cardiac arrhythmia
* Patient has a history of drug or alcohol abuse within last year
* Patient has documented cerebrovascular disease
* Patient has a seizure disorder not controlled on medication (based on decision of Investigator)
* Patient received an investigational agent within 28 days of enrollment
* Patients with uncontrolled active viral, bacterial, or systemic fungal infection
* Patient has known human immunodeficiency virus (HIV) infection
* Patient has hepatitis B virus (HBV) and/or hepatitis C virus (HCV) infection in medical history. If positive results are not indicative of true active or chronic infection, the patient can enter the study after discussion and agreement between the Investigator and the Clinical Research Organization (CRO) Medical Monitor
* Patient has received yellow fever vaccine or other live attenuated vaccine(s) within the 4 weeks prior to screening
* Patient has any other serious medical condition that, in the Investigator's medical opinion, would preclude safe participation in, and compliance with, a clinical trial |
Study Objectives
Phase 3b of the research will be a laboratory experiment that uses an experimental and analytic design that is parallel to that used in Phase 3a, the online experiment. The primary objective of Phase 3b is to assess physiological response (i.e., eye tracking) to different message appeals of the audio-visual messages used in Phase 3a on respondents' behavioral intentions and UV-related behavioral choices post-exposure. Including time for preparation, viewing, and removal of the monitoring equipment, the message viewing session will take about 45 minutes per session.
Intervention / Treatment
BEHAVIORAL: Outdoor Sun Behavior, BEHAVIORAL: Indoor Tanning Behavior
| Inclusion Criteria:
* 18-49 year old non-Hispanic white (NHW) adults
* OR 18-25 year old NHW females who have tanned indoors in the past 12 months
Exclusion Criteria:
* |
Study Objectives
The purpose of this study is to evaluate the feasibility of an mobile-health strategy to improve patient-reported symptoms, promote life-saving medication adherence, and encourage healthy lifestyle behaviors in early stage breast cancer survivors receiving adjuvant Aromatase inhibitors, while beginning to predict psycho-social and demographic characteristics of those who benefit most from this approach. This will provide preliminary experience and evidence for larger, randomized clinical trials evaluating this methodology, which will have immediate and scalable influence on cancer survivor ship.
Intervention / Treatment
DEVICE: LifeExtend-AI
| Inclusion Criteria:
* ≥ 18 years old at the time of informed consent
* Regular access to a smartphone capable of downloading the application
* iOS 11 or later (iPhone5, iPhone SE or newer)
* Android 6 or later (Android 9 is current version)
* History of DCIS, stage I, II, or III invasive breast cancer
* Currently prescribed an aromatase inhibitor (letrozole, anastrozole, exemestane) or planned to be initiated on one by the time of signing informed consent. Patient already on an AI must have been prescribed this medication for a total of 36 months or less.
* Ovarian suppression with AI is allowed in premenopausal patients.
* Prior SERM and now switching to an AI for the first time is allowed.
* Concurrent trastuzumab, pertuzumab, or TDM1 is allowed.
* Concurrent neratinib or other oral cancer directed medication is not allowed.
* ECOG performance status of 0-2
Exclusion Criteria:
* Metastatic breast cancer or other active malignancy
* Locally recurrent breast cancer is allowed if treated with surgical excision and AI is prescribed with curative intent.
* History of prior treated malignancies, other than breast cancer, that are now stable, are in remission, and do not require active therapy, are acceptable
* Unable to read the English language or otherwise participate in the study procedures in the opinion of the treating investigator. |
Study Objectives
The aie of this clinical study is the safety and efficacy of combination therapy for HCC patients.
Intervention / Treatment
DRUG: Bevacizumab Injection, DRUG: Nivolumab
| Inclusion Criteria:
* * Age 18-70 (inclusive), male and female
* HCC was diagnosed by histopathological examination or the guidelines for the diagnosis and treatment of primary liver cancer (2017 edition).
* Stage B (intermediate) or stage C (advanced) HCC was determined according to the Barcelona clinical liver cancer staging (BCLC stage).If it is stage B, the patient must be ineligible for surgery and/or local treatment, or develop disease following surgery and/or local treatment, or the patient rejects surgery and/or local treatment (must be specified and signed).
* I have not received any systemic therapy for HCC (mainly including systemic chemotherapy, anti-vascular therapy, molecular targeted therapy and immunotherapy containing ctla-4, pd-1 / pd-l1 monoclonal antibody).
* according to RECISTv*1 criteria, there were ≥ 1 measurable lesion.Requirements: the selected target lesion had not received local treatment before, or the selected target lesion was located in the previously treated area, and was later confirmed as PD by imaging examination.
* child-pugh liver function grade A, and no history of hepatic encephalopathy. * The ECOG (tumor cooperative group in the eastern United States) physical status score (PS) was 0 to *
* expected survival ≥12 weeks.
* Major organ functions meet the following requirements: no blood transfusion, no use of hematopoietic stimulators (including g-csf, gm-csf, EPO and TPO) and infusion of human albumin preparations within 14 days prior to screening: neutrophil absolute count ≥*5×109/L;Platelet count ≥ 80×109/L;Hemoglobin ≥ 90 g/L;Serum albumin ≥ 29 g/L;Total serum bilirubin ≤*5× upper limit of normal range (ULN);Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 5 × ULN;Serum creatinine (Cr) ≤*5×ULN or Cr clearance ≥40 mL/min (calculated by Cockcroft-Gault formula);International standardized ratio (INR) ≤2 or prothrombin time (PT) exceeding the upper limit of normal range ≤6 seconds;Urine protein \& lt;2+ (if urine protein ≥2+, 24-hour (h) urine protein quantification and 24h urine protein quantification should be performed \<*0g can be enrolled).
* if HBsAg(+) and/or HBcAb(+) are required, HBV DNA must \<500IU/mL (if the lower limit of the minimum detectable value of the local center is higher than 500IU/mL, after discussion with the sponsor, the enrollment can be decided according to the specific situation), and the patients should continue to receive the effective anti-hbv treatment that has been adopted or start to use entecavir or tenofovir throughout the study period. Co-infection with HBV and HCV was excluded. Patients with a history of HCV infection but negative PCR results for HCV RNA may be considered to be free of HCV infection.
* Women of childbearing age must undergo a blood pregnancy test within the first 7 days of randomization with negative results and agree to use a reliable and effective method of contraception during the trial and within 60 days of the last trial drug administration. Male patients whose partners are women of childbearing age must agree to use a reliable and effective method of contraception during the trial and within 60 days of the last trial drug administration.
* Patients voluntarily participated, fully informed consent, and signed written informed consent, with good compliance.
Exclusion Criteria:
* * known as cholangiocarcinoma (ICC) or mixed hepatocellular carcinoma, sarcomatoid hepatocellular carcinoma, and hepatic fibrolamellar carcinoma.
* Had developed malignant tumor other than HCC within 2 to 5 years;However, limited tumors treated by the study were excluded, including carcinoma in situ of the cervix, basal cell carcinoma of the skin, and carcinoma in situ of the prostate.
* had undergone liver surgery and/or local or experimental drug therapy for HCC in the first 4 weeks of randomization;Palliative radiotherapy for bone metastases was performed in the first 2 weeks of randomization.The toxic reaction (except hair loss) caused by previous treatment did not recover to ≤1 (nci-ctc AE v *0).Within 2 weeks prior to randomization, a Chinese medicine preparation with anti-hepatocellular carcinoma effect was received.
* screening is not the control of pericardial effusion, uncontrolled pleural effusion or clinically significant moderate peritoneal effusion, defined as to the following criteria: screening, have clinical symptom and physical examination can detect the thoracic and abdominal cavity effusion or in the process of screening, need for thoracic and abdominal cavity effusion puncture pumping cavities or fluid and medication.
* A history of gastrointestinal bleeding in the first 6 months;In patients with portal hypertension, the researchers concluded that patients with a high risk of bleeding (including moderate to severe esophageal and gastric varices at risk of bleeding, locally active gastrointestinal ulcers, and persistent positive fecal occult blood) should undergo gastroscopy to exclude patients with "red sign".If there is a "red sign" in the history of gastroscopy, it should be excluded from the group.
* Present with grade ≥3 (nci-tc AE v*0) gastrointestinal or non-gastrointestinal fistula.
* The main portal vein tumor thrombus (Vp4) or inferior vena cava tumor thrombus should be excluded.However, patients with a main portal vein tumor thrombus but unobstructed branches of the contralateral portal vein may be admitted.
* Previous history of serious cardiovascular and cerebrovascular diseases: congestive heart failure, unstable angina, myocardial infarction or cerebrovascular accident stroke of New York cardiology association (NYHA) level II or above occurred in the 12 months before enrollment, or poorly controlled arrhythmias.Cardiac ultrasound examination of LVEF (left ventricular ejection fraction) \<50%.Corrected QT interval (QTc) \>480ms (calculated using the Fridericia method, if QTc is abnormal, it can be detected for 3 times at an interval of 2 minutes, and the average value is taken).High blood pressure (systolic blood pressure (BP) ≥150 mmHg and/or diastolic blood pressure ≥100mmHg) (mean of ≥3 BP readings based on ≥2 measurements) that are difficult to control with medication.Hypertensive crisis or hypertensive encephalopathy occurred in the past.
* Significant bleeding disorder or other evidence of significant bleeding tendency: clinically significant hemoptysis or tumor bleeding of any cause occurred within 2 weeks prior to enrollment;Thrombosis or embolism events occurred within 6 months before enrollment;Anticoagulant therapy for therapeutic purposes (except low molecular weight heparin therapy) was used within 2 weeks prior to enrollment;Antiplatelet therapy is required.Current or recent (10 days before enrollment) use of aspirin (\>325 mg/d), clopidogrel (\>75 mg/d) or with dipyridamole, ticlopidine or cilostazol.Patients with metastatic lesions that invade the great vessels, respiratory tract, or mediastinum and are at significant risk of bleeding.
* underwent major surgery in the first 4 weeks of randomization, but did not include diagnostic biopsies.
* There have been CNS metastases * Severe unhealed wounds, active ulcers, and untreated fractures * Live vaccine was administered within 30 days prior to randomization. * An active autoimmune disease (i.e., immunoregulatory drugs, corticosteroids, or immunosuppressive drugs) requiring systemic treatment in the past 2 years;However, alternative therapy (such as thyroxine, insulin, or physiological corticosteroid replacement for adrenal or pituitary insufficiency) is not considered a systemic treatment and is permitted for use and inclusion.
* A history of definite interstitial lung disease or non-infectious pneumonia, unless caused by local radiotherapy;A history of active tuberculosis.
* Any severe acute or chronic infection requiring systemic antimicrobial, antifungal or antiviral treatment at the time of screening, excluding viral hepatitis.
* A history of human immunodeficiency virus (HIV) infection is known. * Previous allogeneic stem cell or solid organ transplantation. * Inability to swallow tablets, malabsorption syndrome, or any condition that affects gastrointestinal absorption.
* A history of severe allergy to any monoclonal antibody, anti-angiogenic target drug is known. |
Study Objectives
This is a prospective, single arm study, which is examining doxorubicin and cyclophosphamide (AC) once every 2 weeks with pegteograstim support in Korean early breast cancer.
Intervention / Treatment
DRUG: Pegfilgrastim, DRUG: Doxorubicin/Cyclophosphamide(AC) treatment
| Inclusion Criteria:
* Histological or cytological diagnosis of a primary breast cancer (stage I-III)
* Age > 18 years of age and Age < 66 years of age
* Eastern Cooperative Oncology Group (ECOG) performance status score 0 - 1
* Patients who have plan to receive neoadjuvant or adjuvant dose-dense AC chemotherapy
* Adequate organ functions
* ANC ≥1500 cells/mm3
* PLT ≥100,000 cells/mm3
* CCr ≥50 mL/min, or Serum Cr <*5 x (upper limit of normal, ULN)
* Total bilirubin ≤*5 x ULN
* AST (SGOT) ≤*5 x ULN
* ALT (SGPT) ≤*5 x ULN
Exclusion Criteria:
* Previous chemotherapy history
* Previous bone marrow transplantation history
* Sickle cell anemia
* Radiation therapy within 4 weeks from enrollment
* Previous pegfilgrastim, filgrastim or other colony-stimulating factor treatment within 4 weeks from enrollment
* Clinically significant systemic illness (serious infection, liver, kidney, heart disease)
* Pregnant, breast feeding women |
Study Objectives
The purpose of this study is to evaluate the efficacy and safety of single-agent MLN0128 and the combination of MLN0128 + MLN1117 compared with everolimus in the treatment of participants with metastatic clear-cell renal cell carcinoma (mccRCC) that have progressed on vascular endothelial growth factor (VEGF)-targeted therapy.
Intervention / Treatment
DRUG: Everolimus, DRUG: MLN0128, DRUG: MLN1117
| Inclusion Criteria:
* Male or female participants aged 18 years or older.
* Histologically confirmed renal cell carcinoma (RCC) with a clear-cell component.
* Evidence that the RCC is advanced or metastatic.
* Radiologic evidence of PD (according to RECIST Version *1) either during or within 6 months after stopping their most recent systemic therapy for RCC before enrollment into this study.
* At least 1, prior line of VEGF-targeted therapy, but not more than 4 total prior lines of systemic therapy. Exposure to more than 1 line of VEGF-targeted therapy is acceptable. Participants may also have received prior therapies with interferon, interleukin 2 (IL-2), anti-PD1 antibodies, cabozantinib or other experimental agents, but not prior therapy with any agent that targets phosphoinositide 3-kinase (PI3K), serine/ threonine-specific protein kinase (AKT), or mechanistic (or mammalian) target of rapamycin (mTOR).
* Karnofsky Performance Status (KPS) greater than or equal to (>=) 70%.
* Life expectancy of >=3 months.
* Female participants who:
* Are postmenopausal for at least 1 year before the screening visit, OR
* Are surgically sterile, OR
* If they are of childbearing potential, agree to practice 1 highly effective method of contraception, and 1 additional effective (barrier) method, at the same time, from the time of signing the informed consent through 90 days (or longer, as mandated by local labelling \[example, United States Prescribing Information (USPI), Summary of Product Characteristics (SmPC), etc;\]) after the last dose of study drug, OR
* Agree to practice true abstinence, when this is in line with the preferred and usual lifestyle of the participant. (Periodic abstinence \[example, calendar, ovulation, symptothermal, postovulation methods\], withdrawal, spermicides only, and lactational amenorrhea are not acceptable methods of contraception. Female and male condoms should not be used together.).
Male participants, even if surgically sterilized (that is, status postvasectomy), who:
* Agree to practice highly effective barrier contraception during the entire study treatment period and through 120 days after the last dose of study drug (or longer, as mandated by local labelling \[example, USPI, SmPC, etc\]), OR
* Agree to practice true abstinence, when this is in line with the preferred and usual lifestyle of the participant (Periodic abstinence \[example, calendar, ovulation, symptothermal, postovulation methods for the female partner\], withdrawal, spermicides only, and lactational amenorrhea are not acceptable methods of contraception. Female and male condoms should not be used together.).
* Agree not to donate sperm during the course of this study or within 120 days after receiving their last dose of study drug.
* Suitable venous access for the study-required blood sampling.
* Screening clinical laboratory values:
* Absolute neutrophil count >=2000 per microliter (/mcL) and platelet count >=100,000/mcL;
* Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) less than or equal to (<=) *5\*the upper limit of normal (ULN);
* Total bilirubin <=*5\*ULN;
* Estimated creatinine clearance by Cockcroft-Gault >=40 milliliter per minute (mL/min) / *73 square meter (m\^2);
* Glycosylated hemoglobin (HbA1c) less than (<) *0%, fasting serum glucose <=130 milligram per deciliter (mg/dL), and fasting triglycerides <=300 mg/dL.
* At least 14 days since the end of prior systemic VEGF-targeted treatment (that is, sunitinib, pazopanib, axitinib, or sorafenib), radiotherapy, or surgical procedure with resolution of all treatment-related toxicity (except alopecia and hypothyroidism) either to Grade 0 or 1 (National Cancer Institute Common Terminology Criteria for Adverse Events \[NCI CTCAE\] Version *03) or to baseline.
* At least 21 days since the last dose of bevacizumab, other antibody, or interferon.
* Voluntary written consent given before performance of any study-related procedure not part of standard medical care, with the understanding that consent may be withdrawn by the participant at any time without prejudice to future medical care.
Exclusion Criteria:
* Central nervous system (CNS) metastasis.
* Other clinically significant co-morbidities, such as uncontrolled pulmonary disease, active CNS disease, active infection, or any other condition that might compromise the participant's participation in the study.
* Known human immunodeficiency virus infection.
* Known hepatitis B surface antigen-positive, or known or suspected active hepatitis C infection.
* Manifestations of malabsorption due to prior gastrointestinal (GI) surgery, GI disease, or for an unknown reason that may alter the absorption of everolimus, MLN0128, or MLN* In addition, participants with enteric stomata are excluded.
* Women who are either breast feeding or pregnant.
* History of any of the following within the last 6 months before administration of the first dose of study drug
* Ischemic myocardial event, including angina requiring therapy and artery revascularization procedures;
* Ischemic cerebrovascular event, including transient ischemic attack and artery revascularization procedures;
* Requirement for inotropic support (excluding digoxin), or serious (uncontrolled) cardiac arrhythmia (including atrial flutter/fibrillation, ventricular fibrillation, or ventricular tachycardia);
* Placement of a pacemaker for control of rhythm;
* New York Heart Association Class III or IV heart failure;
* Pulmonary embolism.
* Significant active cardiovascular or pulmonary disease including:
* Uncontrolled hypertension (that is, either systolic blood pressure greater than \[>\] 160 millimeter of mercury \[mm Hg\]; diastolic blood pressure >95 mm Hg). Use of anti-hypertensive agents to control hypertension before Cycle 1 Day 1 is allowed;
* Pulmonary hypertension.
* Uncontrolled asthma or oxygen saturation <90% by arterial blood gas analysis or pulse oximetry on room air.
* Significant valvular disease; severe regurgitation or stenosis by imaging independent of symptom control with medical intervention; or history of valve replacement.
* Medically significant (symptomatic) bradycardia.
* History of arrhythmia requiring an implantable cardiac defibrillator.
* Baseline prolongation of the rate-corrected QT interval (QTc; example, repeated demonstration of QTc interval >480 millisecond \[ms\], or history of congenital, long-QT syndrome, or torsades de pointes).
* Diagnosed or treated for another malignancy within 2 years before administration of the first dose of study drug, or previously diagnosed with another malignancy and have any evidence of residual disease. Participants with nonmelanoma skin cancer, superficial bladder cancer, very low risk prostate on observation, or carcinoma in situ of any type are not excluded if they have undergone complete resection.
* Prior therapy with agents that target Phosphatidylinositide 3-kinases (PI3K), Protein kinase B (AKT), or mechanistic target of rapamycin (mTOR). Participants with known hypersensitivity to everolimus or rapamycin derivatives are also excluded.
* Any serious medical or psychiatric illness that could, in the investigator's opinion, potentially interfere with the completion of treatment according to this protocol.
* Participants who have taken a proton pump inhibitor (PPI) within 3 days before receiving the first dose of study drug. |
Study Objectives
The purpose of this study is to evaluate the persistence of immune response in subjects who received the HPV-16/18 vaccine, seven to eight years after the last dose of primary vaccination in the HPV-058 study. No new subjects will be enrolled in this extension study.
Intervention / Treatment
PROCEDURE: Blood sampling for antibody determination
| Inclusion Criteria:
* Subjects/subject's parents/legally acceptable representative(s) \[LAR(s)\] who, in the opinion of the investigator, can and will comply with the requirements of the protocol.
* Written informed consent obtained from the subject or subject's parents/LAR(s) prior to performing any study specific procedure.
* Written informed assent obtained from the subjects below the legal age of consent.
* Subjects who received all three doses of the HPV-16/18 vaccine in the HPV-058 study.
* Healthy subjects as established by medical history and clinical examination before entering into the study.
Exclusion Criteria:
* Use of any investigational or non-registered product (drug or vaccine which may have an impact on the study objectives) during the period starting 30 days (Day 29 to Day 1) before the study visit.
* Concurrently participating in another clinical study, in which the subject has been or will be exposed to an investigational or a non-investigational vaccine/product (pharmaceutical product or device).
* Previous vaccination against HPV outside the HPV-058 study.
* Subjects with contraindications related to blood draw such as blood disorders and anticoagulants use. |
Study Objectives
The purpose of this study is to evaluate time to progression (TTP) by PSA in patients with high risk prostate cancer after definitive therapy.
Intervention / Treatment
DRUG: Taxotere
| Inclusion Criteria:
* Patients who have undergone a radical prostatectomy (should have unmeasurable PSA) or radiation therapy for prostate cancer and who have high risk disease as defined by one of the following:
* Node positive disease post-operatively
* Capsule involvement
* Seminal Vesicles involvement
* Gleason score ≥ 8
* >50% of core biopsies that are positive
* Clinical Stage T2c and T3
* Pre-op PSA > 15 plus Gleason score of 7
* Age greater than 18
* ECOG Performance Status 0-1
* Serum creatinine <= *5 mg/dl
* Granulocyte count >= 1500/m3, Hemoglobin > *0 g/dl, and platelet count >= 100,000/m3
* Total bilirubin <= ULN
* AST, ALT and Alkaline Phosphatase must be within the range allowing for eligibility.
* Signed patient informed consent.
* Men of childbearing potential must be willing to consent to using effective contraception while on treatment and for three months thereafter.
Exclusion Criteria:
* Peripheral neuropathy > grade 1
* History of severe hypersensitivity to Taxotere® or other drugs formulated with polysorbate *
* Patients who have received previous chemotherapy or are being treated on another clinical trial using an investigational agent.
* Active infection within 14 days of beginning treatment
* Patients with a serious illness or medical condition, history of significant neurologic or psychiatric or active infection.
* Patients with a current malignancy. Patients with prior a history of in situ lobular carcinoma of the breast, basal or squamous cell skin cancer, are eligible. |
Study Objectives
This is a Phase 2, non-randomised, open-label, multicentric study to investigate the efficacy and safety of pembrolizumab monotherapy in 7 cohorts of patients with specific rare cancers who have unresectable locally advanced or metastatic disease, which is resistant or refractory to standard therapy, or for which standard therapy does not exist, or is not considered appropriate, and for which no other experimental treatment options are available, in order to identify subsets of patients that may benefit from treatment
Intervention / Treatment
DRUG: Pembrolizumab
| Inclusion Criteria:
* Patient information sheet and written informed consent form signed.
* Histologically confirmed diagnosis of a pathology corresponding to one of the following selected cancer types:
* Rare sarcoma: Alveolar soft part sarcoma, Chordoma, Dedifferentiated chondrosarcoma, epithelioid sarcoma, sarcoma with loss of INI1, malignant rhabdoid tumours, myxoid liposarcoma, angiosarcoma of the scalp, radiation induced sarcomas.From the 51st patient included in this cohort, only the following histological types will be selected: Alveolar soft part sarcoma, Chordoma, SMARCA4-malignant rhabdoid tumours and Desmoplastic small-round-cell tumor.
* Rare ovarian cancer: recurrent or relapsed; sex cord tumour, germ cell tumour (immature teratoma, non seminomatous germ cell \& dysgerminoma), low-grade serous carcinoma, mucinous carcinoma, clear cell adenocarcinoma, small cell carcinoma, and carcinosarcoma - with histological confirmation following review by members of the Tumeurs Malignes Rares Gynécologiques (TMRG) network (French rare gynaecological tumour group).From the 51st patient included in this cohort, only the following histological types will be selected: teratoma, low-grade serous carcinoma and ovarian small cell carcinoma hypercalcemic type (SCOOHT).
* Primary central nervous system lymphoma (PCNSL): refractory primary intraocular and CNS lymphoma.From the 51st patient included in this cohort, only CNS lymphoma will be selected.
* Rare thyroid cancer: differentiated thyroid carcinoma (Papillary, follicular, Hurthle cell (oncocytic), poorly differentiated thyroid carcinoma), medullary thyroid carcinoma, anaplastic thyroid carcinoma.
* Rare malignant neuroendocrine tumour: poorly differentiated tumours refractory after 2 lines of chemotherapy, well differentiated tumours refractory after 4 lines of treatment, carcinoid tumours after 2 lines of treatment.
* Germ-cell cancer progressing after standard therapy.
* Natural killer T-cell lymphoma: extranodal NK/T-cell lymphoma regardless of localization that is resistant or refractory to prior L-asparaginase therapy.
* Metastatic disease or unresectable locally advanced malignancy that is resistant or refractory to standard therapy or for which standard therapy does not exist or is not considered appropriate by the Investigator.
* Aged ≥18 years old for cohort 2 to 7 and aged ≥15 years old for patients included in cohort 1 (rare sarcoma).
* Measurable disease according to RECIST v*1 guidelines for solid tumours; or International primary central nervous system lymphoma cooperative group (IPCG) response criteria for patients in the PCNSL cohort. For patients with germ-cell cancer measurable disease is defined as measurable according to RECIST v*1 and / or abnormal levels of alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG) and lactate dehydrogenase (LDH). For patients with NK/T-cell lymphoma measurable disease is defined as focal uptake in at least one nodal or extra-nodal site with a Lugano 5-PS score of 4 or *
* Able to provide a Formalin-fixed/paraffin-embedded (FFPE) biopsy sample of a metastatic site or primitive tumour tissue.
Note: Patients for whom suitable archived biopsy material is not available must be willing to undergo a biopsy of a tumour lesion prior to study entry, unless this is medically contraindicated (e.g. site inaccessible or patient safety concerns).
* Patients must have a mandatory treatment-free interval of at least 21 days following previous systemic anti-cancer treatments.
* Patients who have received previous systemic anticancer treatment and/or radiotherapy should have recovered from any treatment related toxicity, to a level of ≤ grade 1 (according to NCI-CTCAE criteria, v *0) with the exception of Grade 2 alopecia.
* Adequate hematologic function (absolute neutrophil count (ANC) ≥*0 x10⁹/L, platelets ≥100 x10⁹/L, haemoglobin ≥9 g/L) measured within 14 days of treatment initiation.
* Adequate renal function (creatinine clearance ≥50 mL/min using the Modification of Diet in Renal Disease (MDRD) or CKI EPI method) measured within 14 days of treatment initiation.
* Adequate hepatic function (serum bilirubin ≤*5 x the reference upper limit of normal (ULN) unless due to Gilbert's syndrome; aspartate aminotransferase(ASAT) and alanine aminotransferase (ALAT) ≤*5 x ULN) measured within 14 days of treatment initiation. For patients with documented liver metastasis ASAT/ALAT ≤ 5 x ULN is acceptable.
* Strictly normal blood levels of calcium and magnesium, measured within 14 days of treatment initiation.
* Eastern Cooperative Oncology Group (ECOG) Performance Status of ≤*
* Estimated life expectancy ≥90 days.
* Patients who are sexually active must agree to use a medically accepted method of contraception (e.g. implants, injectables, combined oral contraceptives, some intrauterine devices or vasectomized partner, for participating women; condoms for participating men) or practice complete abstinence, beginning 14 days before the first administration of the investigational product (IP), while on treatment and for at least 5 months after the last administration of IP for female patients, and 7 months after the last administration of IP for male patients.
* Women of childbearing potential must have a negative urine or serum pregnancy test within 72 hours prior to the first administration of IP. If urine test results are positive or cannot be confirmed as negative, a serum pregnancy test will be required.
* Women who are breastfeeding should discontinue nursing prior to the first administration of IP and for at least 120 days after the last administration of IP.
* Patients must be affiliated to a Social Security System or equivalent.
Exclusion Criteria:
* Prior treatment with an anti-PD1 or anti-PD-L1 antibody
* Eligible, and willing, to participate in a clinical trial of an alternative anticancer therapy targeting their disease which is open to accrual in France.
* Concurrent steroid medication at a dose greater than prednisone 10 mg/day or equivalent. For patients with PCNSL or germ-cell cancer, concurrent steroid medication at a dose greater than prednisone 20 mg/day or equivalent.
* Has active autoimmune disease that has required systemic treatment in the past 2 years (i.e. with use of disease modifying agents, corticosteroids or immunosuppressive drugs). Replacement therapy (eg., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment.
* History of (non-infectious) pneumonitis that required steroids, or current pneumonitis.
* History of severe hypersensitivity reaction to any monoclonal antibody therapy
* Radiotherapy (except for brain and extremities) within 21 days prior to the first administration of IP.
* Treatment with other investigational drugs or participation in another clinical trial within 21 days prior to the first administration of IP or concomitantly with the trial.
* Has known symptomatic central nervous system (CNS) metastases. Patients with previously treated brain metastases may participate provided they are stable (without evidence of progression by imaging for at least four weeks prior to the first dose of trial treatment and any neurologic symptoms have returned to baseline), have no evidence of new or enlarging brain metastases, and are not using steroids for at least 7 days prior to trial treatment.
* Has known carcinomatous meningitis or a history of leptomeningeal disease, except for patients with primary CNS lymphoma.
* Serum creatinine >*5 x ULN or glomerular filtration rate (GFR) <50 ml/min.
* Other malignancies within the past 5 years other than basal cell skin cancer or in situ carcinoma of the cervix.
* Active serious infections in particular if requiring systemic antibiotic or antimicrobial therapy.
* Active or chronic hepatitis B, hepatitis C and/or human immunodeficiency virus (HIV) infection (HIV 1/2 antibodies), or a known history of active Tuberculosis bacillus.
* Has received a live vaccine within 30 days of planned start of study treatment. Note: Seasonal influenza vaccines for injection are generally inactivated vaccines and are allowed.
* Active alcohol or drug abuse.
* Psychological, familial, sociological or geographical factors potentially hampering compliance with the study protocol and follow-up schedule.
* Any condition which in the Investigator's opinion makes it undesirable for the subject to participate in the trial or which would jeopardize compliance with the protocol. |
Study Objectives
The goal of this clinical research study is to learn if the combination of 2 drugs dabrafenib and trametinib can help to control melanoma that has or has not spread to the brain. The safety of this drug combination will also be studied.
Dabrafenib is designed to block the mutated BRAF protein. This mutation is only found in moles of the skin and in melanoma cells. By blocking the protein, the drug may slow the growth of or kill cancer cells that have the protein.
Trametinib is designed to block certain proteins that cause cancer cells to grow and multiply. This may cause the cancer cells to die.
Intervention / Treatment
DRUG: GSK2118436, DRUG: GSK1120212
| Inclusion Criteria:
* Capable of giving written informed consent, which includes compliance with the requirements and restrictions listed in the consent form.
* Patients must have histologically or cytologically confirmed Stage IV or recurrent or unresectable Stage III melanoma.
* BRAF mutation-positive melanoma (i.e., V600E, V600K or V600D)
* For Cohort A, patients must have easily accessible tumor for a mandatory biopsy. This is not required for patients enrolled on Cohort B.
* Patients must have measurable disease, defined by RECIST *1
* Patients must have tumor lesions which is refractory or resistant to a selective BRAF inhibitor (RO5185426 or GSK2118436).
* Age >/= 16 years.
* Eastern Cooperative Oncology Group (ECOG) performance status 0-1
* Patients must have organ and marrow function as defined below: · absolute neutrophil count >/= 1,500/mcL · platelets >/= 75,000/mcL · total bilirubin </= *5 × institutional upper limit of normal: no restriction to serum bilirubin level if Gilbert's syndrome is diagnosed or suspected · AST(SGOT)/ALT(SGPT) </= *5 × institutional upper limit of normal, (</= 3x upper limit of normal for AST and ALT for those subjects with liver metastasis) · creatinine </= *3 × institutional upper limit of normal OR · creatinine clearance >/= 60 mL/min/*73 m2 for patients with creatinine levels above *3 X institutional upper limit of normal.
* Ability to understand and the willingness to sign a written informed consent document.
* For Cohort B, patients must have at least 1 measureable parenchymal brain metastasis of at least 10 mm in the greatest diameter and no greater than 40 mm diameter. There must be at least one parenchymal brain metastasis that has not received any previous locally-directed treatment (i.e. surgery or radiation), or that has progressed after prior treatment for the brain metastases (i.e. surgery or radiation).
* Male subjects must agree to use contraception, this criterion must be followed from the time of the first dose of study medication until 4 weeks after the last dose of study medication. However, it is advised that contraception be used for a total of 16 weeks following the last dose (based on the lifecycle of sperm).
* A female subject is eligible to participate if she is of: Non-childbearing potential defined as pre-menopausal females with a documented tubal ligation or hysterectomy; or postmenopausal defined as 12 months of spontaneous amenorrhea \[in questionable cases a blood sample with simultaneous follicle stimulating hormone (FSH) > 40 MlU/mL and estradiol < 40 pg/mL (<140 pmol/L) is confirmatory\]. Females on hormone replacement therapy (HRT) and whose menopausal status is in doubt will be required to use contraception if they wish to continue their HRT during the study. Following confirmation of their post-menopausal status, they can resume use of HRT during the study without use of a contraceptive method.
* (cont' from Inclusion #12) * Child-bearing potential and agrees to use one of the contraception methods listed in Section **1 for an appropriate period of time (as determined by the product label or investigator) prior to the start of dosing to sufficiently minimize the risk of pregnancy at that point. Female subjects must agree to use contraception until 4 weeks after the last dose of study medication, and must have a negative serum pregnancy test within 14 days prior to the start of dosing. Note: Oral contraceptives are not reliable due to potential drug-drug interaction.
Exclusion Criteria:
* Currently receiving cancer therapy (chemotherapy, radiation therapy, immunotherapy, or biologic therapy) except a selective RAF inhibitor.
* Patients must not have previously received a selective BRAF inhibitor (RO5185426, GSK2118436) and a selective MEK inhibitor (AZD6244, GSK1120212) concurrently.
* Received an investigational anti-cancer drug within four weeks or five half-lives (whichever is shorter) of study drug administration, other than BRAF inhibitor--at least 14 days must have passed between the last dose of the prior investigational anti-cancer drug and the first dose of study drug. However, there is no required washout period for any BRAF inhibitors at least until the baseline biopsy is performed.
* Current use of a prohibited medication or requires any of these medications during treatment with study drug.
* Any major surgery, within the last 3 weeks. Radiotherapy, or immunotherapy within the last 2 weeks.
* Unresolved toxicity greater than NCI-Common Toxicity Criteria for Adverse Effects (CTCAE) v4 Grade 1 from previous anti-cancer therapy except alopecia and peripheral neuropathy, for which </= grade 2 toxicity is allowed to participate.
* Presence of rheumatoid arthritis.
* History of retinal vein occlusion or central serous retinopathy, or predisposing factors to retinal vein occlusion or central serous retinopathy (e.g. uncontrolled glaucoma or ocular hypertension, uncontrolled systemic disease such as hypertension, diabetes mellitus, or history of hyperviscosity or hypercoagulability syndromes).
* Presence of active gastrointestinal disease or other condition that will interfere significantly with the absorption, distribution, metabolism, or excretion of drugs.
* Brain Metastases a. For cohort A, patients will be excluded if they have brain metastases, unless they have been previously treated brain metastases with surgery or stereotactic radiosurgery and the disease has been confirmed stable (i.e., no increase in lesion size) for at least 4 weeks with MRI scans using contrast prior to Day * Subjects are not permitted to receive enzyme-inducing anti-epileptic drugs and/or steroids to control symptoms/signs of brain metastases. Patients previously treated with whole brain radiation therapy must have confirmed stable disease for at least 12 weeks prior to starting treatment. However, untreated asymptomatic brain metastasis less than 10 mm will be allowed if no steroid and anti-epileptic drugs are used.
* 10 (con't) b. For cohort B, patients may not have any evidence of leptomeningeal disease. Use of corticosteroids is permitted as long as the dose of steroids required for symptom control has been stable or decreasing for at least 3 weeks prior to the first dose of study treatment.
* History of acute coronary syndromes (including myocardial infarction and unstable angina), coronary angioplasty, or stenting within the past 6 months.
* Corrected QT interval (QTc) >/= 480 msec (>/= 500 msec for subjects with Bundle Branch Block).
* Uncontrolled arrhythmias. * Subjects with controlled atrial fibrillation for >1 month prior to study Day 1 are eligible.
* Class II, III, or IV heart failure as defined by the New York Heart Association (NYHA) functional classification system.
* Abnormal cardiac valve morphology (subjects with minimal abnormalities can be entered on study if deemed not clinically significant)
* Known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs chemically related to the study drugs, or excipients. NOTE: To date there are no known FDA approved drugs chemically related to GSK2118436 or GSK*
* Pregnant or lactating female.
* Unwillingness or inability to follow the procedures required in the protocol.
* Uncontrolled diabetes, hypertension or other medical conditions that may interfere with assessment of toxicity
* Subjects with known glucose 6 phosphate dehydrogenase (G6PD) deficiency. |
Study Objectives
The purpose of this study is:
Phase1: To evaluate the safety and determine the recommended dose (RD) Phase2: To evaluate the efficacy
Intervention / Treatment
DRUG: OPB-31121, DRUG: OPB-31121 phase2
| Inclusion Criteria:
* Patients with histopathologically or clinically confirmed diagnosis of hepatocellular carcinoma
* Patients with Child-Pugh classification A or B
* Patients unresponsive to standard therapy or for whom standard therapy is intolerable, or for whom there is no appropriate therapy
* Patients who are able to take oral medication
* Patients age 20 to 79 years (inclusive) at time of informed consent
* Patients with an ECOG performance status score of 0-2
* Patients have the eligible organ function.
Exclusion Criteria:
* Patients with a primary malignant tumor
* Patients with a history of liver transplant
* Patients with brain metastases
* Patients with a complication of uncontrolled
* Patients with a psychiatric disorder that might cause difficulty in obtaining informed consent or in conducting the trial |
Study Objectives
Individuals who are affected with pancreas cancer and melanoma as well as those without either cancer who have been identified as 1st or 2nd degree relatives of family members with pancreas cancer and melanoma will be asked to participate. The participant will be asked to complete a survey about their health and family history of cancer and to give a blood sample for specific gene testing and storage for future research studies.The overall goal of this study is to understand the factors that increase susceptibility and expression of pancreatic cancer and melanoma in high risk families.
Intervention / Treatment
| Inclusion Criteria:
* Individuals who are affected with pancreas cancer and melanoma as well as those without either cancer who have been identified as 1st or 2nd degree relatives of family members with pancreas cancer and melanoma.
Exclusion Criteria:
* Under the age of 18, Non-English speaking or unable to provide informed consent, inmates. |
Study Objectives
This randomized phase III trial was originally designed to compare three different combination chemotherapy regimens to see how well they work. As of September 1, 2004, the study was expanded to a total of 6 arms (the original 3 arms (A, B, C) and 3 additional arms which were the same as the first 3 but with cetuximab) in treating patients who have undergone surgery for stage III colon cancer. Drugs used in chemotherapy, such as irinotecan hydrochloride, fluorouracil, leucovorin calcium, and oxaliplatin, work in different ways to stop tumor cells from dividing so they stop growing or die. Monoclonal antibodies such as cetuximab can locate tumor cells and either kill them or deliver tumor-killing substances to them without harming normal cells. Combining more than one chemotherapy drug with monoclonal antibody therapy and giving them after surgery may kill any remaining tumor cells. It was not known at the time this study was developed which combination chemotherapy regimen is more effective after surgery in treating colon cancer. This study had several key changes, based on the results of other phase III trials. As of 6/1/2005, patients no longer received irinotecan on this study and treatment arms B, C, E, and F were discontinued. Patients on arms B and C crossed to arm A. Patients on arms E and F crossed to arm D. Patients on arms C and F who had not gotten to irinotecan continued on arms A and D, respectively. As of 8/18/2008, pre-screening for Kirsten rat sarcoma (KRAS) status was added with mutant KRAS (or KRAS not evaluable) patients put on arm G and wild-type KRAS patients randomized between arm A and arm D. Patients on arm G were treated per physician discretion and followed for disease and survival status. KRAS was determined in a central laboratory and was process for all patients on this study. The primary endpoint of this study was modified on 8/18/2008 to focus on patients having wild-type KRAS tumors. All modifications were approved by the Central Institution Review Board, local Institutional Review Boards, NCI, and the NCCTG Data Safety Monitoring Board.
Intervention / Treatment
DRUG: irinotecan hydrochloride, DRUG: oxaliplatin, DRUG: leucovorin calcium, DRUG: fluorouracil, BIOLOGICAL: cetuximab, DRUG: Locally Directed Therapy
| Inclusion Criteria:
* Histologically confirmed adenocarcinoma of the colon
* Stage III disease
* No resected stage IV disease
* No rectal cancer
* Gross inferior (caudad) margin of the primary tumor must be ≥ 12 cm from the anal verge by rigid proctoscopy
* Stage III tumor must have been completely resected within the past 56 days
* Must have documented en bloc resection in patients with tumor adherence to adjacent structures
* Tumor-related obstructions and colonic perforation are allowed
* Tumor samples must be available
* At least 1 pathologically confirmed positive lymph node
* No evidence of residual involved lymph node disease
* Synchronous primary colon cancer allowed
* No distant metastatic disease
* Performance status - Eastern Cooperative Oncology Group (ECOG) 0-2
* Absolute neutrophil count ≥ 1,500/mm\^3
* Platelet count ≥ 100,000/mm\^3
* Hemoglobin ≥ 9 g/dL
* Bilirubin ≤ *5 times upper limit of normal (ULN)
* Creatinine ≤ *5 times ULN
* No uncontrolled high blood pressure
* No unstable angina
* No symptomatic congestive heart failure
* No myocardial infarction with the past 6 months
* No New York Heart Association class III or IV heart disease
* No symptomatic pulmonary fibrosis
* No symptomatic interstitial pneumonitis
* No prior allergic reaction (known sensitivity) to chimerized or murine monoclonal antibody therapy
* No known allergy to platinum compounds
* No documented presence of human anti-mouse antibodies (HAMA)
* No active uncontrolled bacterial, viral, or systemic fungal infection
* HIV negative
* No clinically defined AIDS
* Not pregnant or nursing
* Negative pregnancy test
* No men or women of childbearing potential who are unwilling to employ adequate contraception
* No inadequately treated gastrointestinal bleeding
* No ≥ grade 2 pre-existing peripheral sensory or motor neuropathy
* No other malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer, carcinoma in situ of the cervix, or lobular carcinoma in situ in 1 breast
* No other concurrent medical condition that would preclude study participation
* No concurrent biologic therapy
* No prior chemotherapy for colon cancer
* No other concurrent chemotherapy
* No prior radiotherapy for colon cancer
* No concurrent targeted agents
* No prior agents directed against epidermal growth factor-receptor
* No other concurrent anticancer therapy |
Study Objectives
A pilot study of adult (≥ 18 years) women with stage II-III breast cancer who will receive preoperative chemotherapy prior to mastectomy. Patients will have real-time serum glycan profiling, expression of tissue MUC 1 oncoprotein isoforms to predict neoadjuvant chemotherapy response and additional mammography and HD PET/CT examinations to assess response. The investigators hypothesize that a functional tumor assessment utilizing high-definition positron emission tomography/computed tomography (HD PET/CT), real-time serum glycan profiling, and expression of tissue MUC 1 oncoprotein isoforms will predict neoadjuvant chemotherapy response in breast cancer patients.
Intervention / Treatment
DIAGNOSTIC_TEST: HD PET/CT
| Inclusion Criteria:
* Patient must sign informed consent to participate in the study.
* Patient must be ≥ 18 years of age.
* Histologic diagnosis of invasive breast cancer(ductal or lobular)
* Stage II or III breast cancer and considered a candidate for curative mastectomy.
* Selected mastectomy for surgical option of treatment.
* Patient must agree to receive standard or dose-dense adriamycin, cyclophosphamide, and taxane-based chemotherapy given preoperatively.
* Patient must have the following preoperative laboratory values confirmed within 28 days prior to registration: Creatinine ≤ *5 times ULN. Platelets ≥ 90,000/mm* White blood count ≥ 1,500/mm* PT/PTT ≤ the institution ULN. Patients of child-bearing potential must have a negative urine or serum pregnancy test.
* If a patient is a cancer survivor, the patient must have undergone potentially curative therapy for all prior malignancies, with no evidence of prior malignancy for at least 5 years (except for effectively treated basal cell or squamous cell carcinoma of the skin, or carcinoma-in-situ of the cervix treated by surgery alone).
* The primary breast tumor must be detectable by mammogram at the time of diagnosis
* Estimated cardiac ejection fraction ≥ 50% by echocardiogram or MUGA
* ECOG performance status 0-*
Exclusion Criteria:
* Non-invasive breast cancer, benign breast disease, or tumor histology other than stage II or stage III invasive ductal carcinoma, invasive lobular carcinoma, or mixed ductal and lobular carcinoma.
* The patient has known distant metastatic disease.
* The patient wishes to pursue breast conservation.
* The patient is male.
* The patient is receiving preoperative chemotherapy other than adriamycin, cyclophosphamide, and a taxane (ACT) in standard or dose-dense fashion.
* The patient is pregnant or breast feeding.
* The primary tumor is not visualized by mammogram at the time of diagnosis.
* The patient's estimated cardiac ejection fraction is <50% by echocardiogram or MUGA.
* The patient has a documented intravenous contrast allergy or iodine allergy.
* Her-2/neu positive patients by IHC or FISH who receive trastuzumab neoadjuvantly; patients who are Her-2/neu positive but elect not to receive trastuzumab neoadjuvantly are still eligible for participation. |
Study Objectives
The purpose of this study is to determine whether positron emission tomography / computed tomography (PET/CT) using fluorine-18 fluorocholine as an imaging agent can characterize regional responses to anti-androgen therapies in a manner that in the future aid in the customized planning of treatments for patients with androgen-insensitive prostate cancer.
Intervention / Treatment
DRUG: IV administration of fluorine-18 fluorocholine followed by PET/CT imaging
| Inclusion Criteria:
* Provision of written informed consent.
* Men, over 18 years of age, with histologically-confirmed diagnosis of prostate cancer
* History of treatment by complete androgen blockade for greater than 3 months prior to enrollment
* Serum testosterone level < 50 ng/ml. Castrate testosterone levels must be from orchiectomy or current therapy with leutinizing hormone-releasing hormone agonist.
* Progressive disease evidenced by two consecutive rises in prostate specific antigen (PSA) above a nadir value, with the absolute value of the latest PSA > * 0 ng/ml.
* Patient will be undergoing a therapeutic intervention under the supervision of his treating physician (urologist, oncologist).
Exclusion Criteria:
* Other co-existing malignancies or malignancies diagnosed within the last 5 years with the exception of basal cell carcinoma or superficial transitional cell carcinoma of the bladder.
* Serious underlying medical conditions that would otherwise impair the patient's ability to undergo imaging.
* Patient weighs over 350 lbs (due to scanner weight limit).
* Clinical life expectancy < 12 weeks.
* Participated in other radioactive drug studies where estimated total cumulative dose within 1 year is > *05 Sievert for whole body, active blood-forming organs, eye lens, gonads, or *15 Sievert for other organs.
* Concurrent Therapy. Allowed: prior hormonal therapy; concurrent leuteinizing hormone releasing hormone (LHRH) agonist; prior surgery; prior or concurrent bisphosphonate. Not allowed: concurrent anti-androgen or secondary hormonal therapy, prior or concurrent chemotherapy, concurrent radiotherapy or radioisotope therapy (e.g., strontium). Other: Prior radiotherapy or radioisotope therapy must be > 12 weeks since last treatment. |
Study Objectives
Trial of sorafenib versus placebo in the treatment of locally advanced or metastatic differentiated thyroid cancer refractory to radioiodine
Intervention / Treatment
DRUG: Sorafenib (Nexavar, BAY43-9006), DRUG: Placebo
| Inclusion Criteria:
* Locally advanced or metastatic differentiated thyroid cancer (papillary, follicular and Hurthle cell)
* Poorly differentiated and other thyroid variants (e.g. insular, tall cell, etc.) are eligible provided that the histology has no medullary differentiation nor anaplastic features
* Progression within 14 months (RECIST \[Response Evaluation Criteria in Solid Tumors\] should be used as a basis for the assessment of disease progression)
* RAI (radioactive iodine) refractory
Exclusion Criteria:
* Histologic subtypes of thyroid cancer other than differentiated (i.e. like anaplastic and medullary carcinoma, lymphoma or sarcoma)
* Prior anti-cancer treatment with tyrosine kinase inhibitors, monoclonal antibodies (licensed or investigational) that target VEGF (vascular endothelial growth factor) or VEGF Receptors or other targeted agents
* Prior anti-cancer treatment for thyroid cancer with use of chemotherapy (low dose chemotherapy for radiosensitization is allowed) or Thalidomide or any of its derivatives |
Study Objectives
Recent studies have shown that survival after a colorectal cancer diagnosis may be affected by a person's activity level and body size. This research says that for colorectal cancer patients, the less active and more obese they are, the more likely they are to have a cancer recurrence or die from their cancer. Chemotherapy has been shown to reduce activity levels, fitness, and body size in some cancer patients. However, it is not known how chemotherapy specific for colon cancer patients affects their activity levels, fitness, and body size. The main goal of our study will be to look at how chemotherapy treatments affect the fitness, activity levels, and body size in colon cancer patients. In order to do this, we will measure these variables before chemotherapy treatments, and at 1 and 6 months following the end of treatment. Our results will show how chemotherapy affects fitness, activity levels, and body size in colon cancer patients and provide data to help in designing an exercise intervention specifically for colon cancer survivors.
Intervention / Treatment
| Inclusion Criteria:
* histologically confirmed colon cancer (Stage III and those Stage II patients deemed high-risk
* approval of the treating oncologist
* scheduled to received chemotherapy
* able to understand and provide written informed consent in English
* 18+ years of age
* no uncontrolled co-morbidities (including hypertension, cardiac illness, psychiatric condition, etc.)
* negative ECG as assessed during maximal graded exercise test
Exclusion Criteria:
* metastatic or recurrent colon cancer patients
* pregnancy
* any uncontrolled medical condition that would be a contraindication to exercise (assessed by treating oncologist)
* unwilling to attend, travel to or participate in the assessments at all 3 time points
In addition, 10 patients meeting all of the eligibility criteria who are not scheduled to receive chemotherapy will also be recruited to the study to serve as "surgery only" controls. |
Study Objectives
BIBF 1120 is a newly discovered compound that may stop cancer cells from growing abnormally. This drug is currently being used in treatment for other cancers in research studies and information from those other research studies suggests that this agent, BIBF 1120, may help to stop recurrent malignant glioma cells from multiplying and it may also prevent the growth of new blood vessels at the site of the tumor. In this research study, the investigators are looking to see how well BIBF 1120 works in patients with recurrent malignant gliomas.
Intervention / Treatment
DRUG: BIBF 1120
| Inclusion Criteria:
* Histopathologically-confirmed, supratentorial, recurrent glioblastoma; subjects with an initial diagnosis of a lower grade glioma are eligible if a subsequent biopsy is determined to be glioblastoma
* Demonstration of recurrent disease on MRI following prior therapy
* Development of progressive disease after having received prior RT, and must have an interval of at least 12 weeks from the completion of any radiation therapy to study entry (unless progressive tumor growth is outside the radiation field or there is histopathological confirmation of recurrent tumor).
* Bi-dimensionally measurable disease (minimum measurement of 1 cm in one dimension) on MRI performed within 14 days prior to first treatment. (If receiving corticosteroids, participants must be on a stable or decreasing dose of corticosteroids for at least 5 days prior to baseline MRI.)
* Life expectancy of at least 12 weeks
* KPS >/= 60
* Normal organ and marrow function as defined by protocol
* Recovered from toxic effects of prior therapy
* Sufficient tumor availability (at least 15-20 unstained paraffin slides from any prior surgery)
Exclusion Criteria:
* Receiving other investigational agent
* More than 2 prior relapses
* Prior therapy with inhibitor of VEGF, VEGFR, PDGFR, or FGFR (including bevacizumab)
* Pregnant or breast-feeding
* Unwilling to agree to adequate contraception, if subject is of child-bearing potential
* History of allergic reactions attributed to compounds of similar chemical or biologic composition to BIBF 1120
* Use of EIAEDs within 14 days of registration
* Evidence of recent hemorrhage on baseline MRI of the brain
* Uncontrolled intercurrent illness
* Uncontrolled hypertension
* History of hypertensive encephalopathy
* History of any of the following within 6 months prior to enrollment: myocardial infarction or unstable angina, stroke or transient ischemic attack, significant vascular disease or peripheral arterial thrombosis, abdominal fistula, gastrointestinal perforation, or intra-abdominal abcess, intracerebral abscess
* Evidence of bleeding diathesis or coagulopathy
* Major surgical procedure, open biopsy, or significant traumatic injury within 4 weeks prior to the first treatment day, or anticipation of need for major surgical procedure during the course of the study
* Minor surgical procedures, stereotactic biopsy, fine needle aspiration, or core biopsy within 7 days prior to the first treatment day
* Serious non-healing wound, ulcer, or bone fracture
* History of a different malignancy unless disease-free for at least 5 years (unless cervical cancer in situ, or basal cell or squamous cell carcinoma of the skin)
* HIV positive |
Study Objectives
This study will evaluate the efficacy and safety of pasireotide LAR 40 and 60 mg versus octreotide LAR or lanreotide ATG in patients with inadequately controlled acromegaly.
Intervention / Treatment
DRUG: Pasireotide, DRUG: octreotide LAR 30mg, DRUG: lanreotide ATG 120mg
| Inclusion Criteria:
* Patients with written informed consent prior to any study related activity
* Patients who had inadequately controlled acromegaly as defined by a mean GH concentration of a 5-point profile over a 2-hour period > *5 µg/L and sex- and age-adjusted IGF-1 > *3 x upper limit of normal (ULN)
* Patients who had been treated with maximum indicated doses of octreotide LAR or lanreotide ATG for at least 6 months prior to visit 1 (screening). The maximum indicated dose for octreotide LAR was 30mg and for lanreotide ATG iwas120 mg
* Patients who had a diagnosis of pituitary micro- or macro adenoma. Patients could have been previously submitted to surgery
* Patients who completed the 24-week treatment period in core according to the requirements of the core study protocol or corresponding amendments could enter extension
Exclusion Criteria:
* Patients who had received pasireotide (SOM 230) prior to enrolment
* Concomitant treatment with Growth Hormone Receptor (GHR)-antagonist or dopamine agonists unless concomitant treatment was discontinued 8 weeks prior to visit 1 (screening)(8 weeks wash out period). Such patients must have been treated with octreotide LAR 30 mg or lanreotide ATG 120 mg monotherapy continuously for a minimum of 6 months prior to starting combination therapy and they should have been inadequately controlled on monotherapy.
* Patients who had compression of the optic chiasm causing acute clinically significant visual field defects
* Patients who required a surgical intervention for relief of any sign or symptom associated with tumor compression
* Patients who had received pituitary irradiation within 10 years prior to visit 1 (screening).
* Patients who had undergone major surgery/surgical therapy for any cause within 4 weeks prior to visit 1 (screening).
* Patients who were hypothyroid and not adequately treated with a stable dose of thyroid hormone replacement therapy |
Study Objectives
Barrett's esophagus is a condition in which the normal lining of the lower esophagus is replaced with cells that predispose an individual to development of esophageal cancer. Treatment of Barrett's esophagus reduces the risk of progression to cancer. Treatment is provided endoscopically, via a variety of approved techniques including endoscopic mucosal resection, argon plasma coagulation, radiofrequency ablation (RFA), spray cryotherapy ablation and balloon cryotherapy ablation. A common side effect of ablation treatment is pain, thus making pain an important factor when discussing treatment options. It is speculated that balloon cryotherapy causes less pain than RFA but no head-to-head comparison trials exist to date. This multi-center, prospective cohort study aims to compare pre- and post-procedural pain for balloon cryotherapy versus RFA. Providing both patients and clinicians with data from a well-designed prospective study may help guide future physician/patient treatment discussions.
Intervention / Treatment
| Inclusion Criteria:
* Patients with dysplastic Barrett's esophagus (LGD and HGD) naïve to ablation therapy presenting for ablation
* Age ≥ 18
* Ability to sign informed consent
Exclusion Criteria:
* Prior ablation treatment for Barrett's esophagus
* Pregnancy |
Study Objectives
This pilot clinical trial studies how well provider training works in increasing patient tobacco cessation counseling and referrals for patients with cancer undergoing radiation therapy. Health care provider training in motivational interviewing techniques and utilizing tobacco cessation resources may help doctors understand how health care providers can effectively increase their confidence in talking to patients about tobacco cessation counseling.
Intervention / Treatment
OTHER: Communication Skills Training, OTHER: Medical Chart Review, OTHER: Questionnaire Administration, OTHER: Tobacco Cessation Counseling
| Inclusion Criteria:
* MEDICAL CHART REVIEW
* Pre-intervention: 200 patient records between January 1, 2016 and December 31, 2016 are subject to review; the first 50 records with a diagnoses of each cancer type: head and neck, lung, prostate, or breast will be utilized for the review
* Post-intervention: 200 patient records receiving care beginning six months post training are subject to review; the first 50 records with a diagnoses of head and neck, lung, prostate, or breast will be utilized
* PROVIDER TRAINING
* OHSU Radiation Medicine department has agreed to participate as pilot department for this project; all active Radiation Medicine providers are requested to participate in the training; providers have the option to not participate
* TOBACCO CESSATION COACHING
* Patients who are at least 18 years of age
* Speak English
* Report tobacco use within the past 7 days
* Willing to consider quitting smoking
* Patients must be willing to meet four times in person or on the phone to discuss tobacco use
* Patients must be willing to be audio recorded during the sessions
* Patients who meet this criteria will be referred to OHSU Health Promotion Sports Medicine researcher, Carol DeFrancesco, to complete assessment using stages of change tobacco use readiness ruler and question set
* Patient smoking status will be documented in their electronic health record, per routine care
Exclusion Criteria:
* Vulnerable Populations
* The following groups will be excluded from participation:
* Children
* Decisionally impaired adults
* Prisoners
* Pregnant women |
Study Objectives
Cancer is an extremely aggressive disease, anxiety and depression are consequences some patients may develop from diagnosis continuing during treatment. A measures control of the cancer is surgery for removal tumor. The surgical procedure is often a difficult experience for patients and their relatives, and patients in the preoperative period are often psychological symptoms of anxiety and depression. A previous study with the objective analyzing patient's emotional repercussion according the type of transport to the surgical center reached the following result: patients who go to the surgical center feel more relaxed in the preoperative period.
The primary objective is to analyze emotional repercussion of patient diagnosed with cancer classified in Eastern Cooperative Oncology Group (ECOG) Performance Status 0 and 1 according type transport to the surgical center.
Intervention / Treatment
OTHER: Transport on foot
| Inclusion Criteria:
* diagnosed cancer
* Age ≥18 years, ≤ 70 years
* Both sexes
* Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) score 0 or 1
* Patients classified as Zero or Low Risk by the fall risk assessment scale
* Indication elective surgery
Exclusion Criteria:
* Patients who present moments before surgery has an adverse event that could jeopardize the ambulation to the surgical center.
* Patients who are physically disabled and require assistance walking.
* Patients has indication bed in the Intensive Care Unit (UTI)
* Patients has previously diagnosed psychiatric disorders (severe depression, anxiety disorder, panic, among others).
* Patients doens't have an accompanying person on the day of surgery.
* Patients taking anxiolytic and antidepressant medications. |
Study Objectives
The proposed research will develop, demonstrate the feasibility of, and pilot test in a randomized controlled trial a prescription opioid taper support intervention. This intervention aims to prevent opioid misuse and adverse events among patients receiving chronic opioid therapy for chronic non-cancer pain without evidence of current substance abuse.
The project will yield information essential to planning a future, larger-scale RCT designed to evaluate: 1) the efficacy of the intervention in preventing prescription opioid abuse, misuse, overdose and other adverse events among patients receiving chronic opioid therapy for chronic non-cancer pain, 2) the effects of the intervention on opioid use, pain, pain related activity interference, and mood. Participants in our pilot study will be limited to those without current opioid abuse or other substance abuse, but past substance abuse will be allowed. This will provide a sample of patients at risk for opioid abuse, misuse and overdose, but who may be able to taper their opioids successfully. Hypothesis: Patients receiving chronic opioid therapy for chronic non-cancer pain who are randomized to the opioid taper support intervention, as compared with patients randomized to usual opioid prescribing care, will have lower opioid average daily doses at 22 and 34 weeks.
Intervention / Treatment
BEHAVIORAL: opioid taper support
| Inclusion Criteria:
* age 18-80 years;
* CNCP, defined as pain on more than half the days in the past six months, where indicated diagnostic workup is complete and treatment is focused on pain;
* currently on COT, defined as self-report of prescribed oral opioid medication use on a daily or near-daily (>90% of days) basis for 90 days or more;
* mean daily opioid dose in the past 30 days of 25 mg MED or greater;
* willing to participate in the study arm to which they are randomly assigned (including opioid taper in-person sessions if randomized to that group);
* able to read, speak, and write English.
Exclusion Criteria:
* currently receiving treatment for cancer (other than non-melanoma skin cancer);
* medical comorbidity with life expectancy less than a year (based on medical record review by the PI);
* recent use (past month) of parenteral, transdermal, or transmucosal opioids,
* currently residing in nursing home;
* currently using intrathecal pump for pain control;
* any current substance abuse according to the DSM-IV checklist (nicotine and marijuana will be allowed since Washington State allows medical marijuana for pain control);
* presence of illicit drug metabolite in baseline urine drug test,
* psychotic symptoms, psychiatric hospitalization or suicide attempts in the past year;
* current suicidal ideation with specific plan or intent;
* significant cognitive impairment (on 6-item screener Scale). |
Study Objectives
The goal of this clinical research study is to test a new way to look for cancer and pre-cancerous tissue changes inside the mouth.
Intervention / Treatment
PROCEDURE: Fluorescence Spectroscopy
| Inclusion Criteria:
* Any person 18 years of age or older with a lesion of the oral mucosa. Persons with changes in existing lesions or those who develop new lesions can be re-evaluated, but it is not required.
Exclusion Criteria:
NA |
Study Objectives
In recent years, the survival of patients has increased with the success of leukemia treatment in children. However, according to the treatment modalities applied, complications such as changes in body composition such as obesity, osteoporosis and impaired bone health such as increased fragility are more frequent after treatment in patients.In this study, virtual reality exercise practices in remission of acute lymphoblastic leukemia cases will prevent negative effects on bone health and body composition and increase the quality of life of patients.
Intervention / Treatment
OTHER: Exercise therapy
| Inclusion Criteria:
* Treatment for acute lymphoblastic leukemia
* At remitted term
* Being between 3 and 18 years
* Healthy cases of age and gender control group cases
Exclusion Criteria:
* Smaller than 3 years old and older than 18 years old
* Having a chronic illness
* Any drug use
* Any developmental anomaly |
Study Objectives
This study will look at the impact of a self-directed walking program on post-chemotherapy survivors experiencing fatigue. It is hypothesized that the walking program will help lessen fatigue.
Intervention / Treatment
BEHAVIORAL: Walk With Ease
| Inclusion Criteria:
* Men and women age 65 years and older
* Histologically or cytologically confirmed cancer (hematologic or solid) at stage considered amenable to cure as assessed by the treating MD
* Within 6 weeks of end of chemotherapy (all participants must have had chemotherapy treatment)
* Any radiation received must also be completed prior to randomization (if radiation treatment follows adjuvant chemotherapy, then the patient must be recruited within 6 weeks of end of radiation)
* Maintenance hormonal therapy in women with breast cancer is allowed; see exclusion criteria regarding hormonal therapy in males with prostate cancer
* Moderate to severe fatigue (>4 on BFI)
* Less than 120 minutes/week of physical activity
* English speaking
* Signed IRB approved written informed consent
* Approval from their treating physician to engage in moderate-intensity physical activity
* Patient-assessed ability to walk and engage in moderate physical activity
* Willing and able to meet all study requirements.
Exclusion Criteria:
* Receiving hormonal therapy for prostate cancer
* Unable to walk or engage in moderate-intensity physical activity
* Have BFI≤*
* Report more than 120 minutes/week of physical activity |
Study Objectives
The aim of the present study is to evaluate the interobserver agreement for FAPI PET/CT interpretations of representative cancer types and compare findings among readers with different levels of experience.
Intervention / Treatment
OTHER: Interpretation of FAPI-PET/CT scans
| Inclusion criteria:
Nuclear medicine physicians or radiologists with a prior experience with 68Ga-FAPI PET/CT from high-volume centers (Essen, Germany; Bologna, Italy; Los Angeles, USA; Munich, Germany, Münster, Germany ) will be prospectively recruited as research observers. Each observer will be asked to report the number of previous clinical 68Ga-FAPI PET/CT scans and then will be classified on the basis of the experience in these three groups:
* Low experience (< 30 prior 68Ga-FAPI PET/CT studies);
* Intermediate experience (30 to 300 studies);
* High experience (> 300 studies) At least three observers will be needed for each group.
Exclusion criteria:
No prior PET/CT experience. |
Study Objectives
The purpose of this study is to see whether three new types of MRI techniques used during magnetic resonance imaging (MRI) of the pelvis to look at rectal cancer can help doctors to tell if the tumor is getting better in response to the radiation and/or chemotherapy treatments.
Intervention / Treatment
PROCEDURE: Advanced MR Imaging
| Inclusion Criteria:
* Patients with primary locally advanced rectal adenocarcinoma (0-18cm from the anal verge) confirmed by MSKCC pathologist and eligible to undergo chemoradiation and surgical resection at MSKCC.
* Written informed consent
* Age equal to or greater than 21 years
* Willing and able to undergo all study procedures
* Patients must have a planned surgical resection of the rectum
Exclusion Criteria:
* Patients younger than 21 years
* Pregnant and nursing women
* Contraindications for MRI (such as claustrophobia, pacemaker, non MR-compatible artificial heart valves, cochlear implants, surgical clips in the brain, metal fragments in eye)
* Estimated GFR (using Cockcroft formula Appendix 2) less than 30 ml/min/*73m2 (FDA advises caution in using gadolinium-based contrast agents in patients with severe renal impairment).
* History of allergic reaction to MR contrast media
* Inability to give informed consent in person |
Study Objectives
The purpose of this study is to evaluate the efficacy of S 95005 in patients with metastatic colorectal cancer (mCRC) who are refractory or intolerant to standard chemotherapies in terms of Progression-Free Survival rate at 2 months in the Russian population.
Intervention / Treatment
DRUG: S95005
| Inclusion Criteria:
* Male or female aged ≥18 years of age
* Has definitive histologically or cytologically confirmed adenocarcinoma of the colon or rectum
* Has received at least 2 prior regimens of standard chemotherapies for metastatic colorectal cancer (including fluoropyrimidines, irinotecan and oxaliplatin and, if accessible, an anti-VEGF monoclonal antibody and at least one of the anti-EGFR monoclonal antibodies for RAS wild-type patients (if RAS mutation status was evaluated)) and was refractory or intolerant to those chemotherapies
* Has Eastern Cooperative Group (ECOG) performance status of 0 or 1
* Has at least one measurable metastatic lesion(s)
* Has adequate organ function
* Female participants of childbearing potential and male participants with partners of childbearing potential must agree to use a highly effective method of birth control during the study and for 6 months after the discontinuation of study medication
Exclusion Criteria:
* Pregnancy, breastfeeding
* Participation in another interventional study within 4 weeks prior to inclusion; participation in non-interventional registries or epidemiological studies is allowed
* Has previously received S95005 or history of allergic reaction attributed to compounds of similar composition to S95005
* Has a serious illness or medical condition(s) as described in the protocol
* Has had certain other recent treatment e.g. major surgery, field radiation, anticancer therapy, within the specified time frames prior to inclusion
* Has unresolved toxicity of greater than or equal to Common Terminology Criteria for Adverse Events (CTCAE) Grade 2 attributed to any prior therapies. |
Study Objectives
This Phase I, dose finding study evaluates the safety and tolerability of lapatinib, a dual tyrosine kinase inhibitor, and GW786034, an anti-angiogenesis agent, when given together. The study first will find the best doses using safety and blood concentration data of both agents. This is done enrolling stepwise, cohorts of 3 patients each and the last patient enrolled must reach at least Day 22 of continuous daily dosing before the next cohort at an increased dose can begin. If a patient in a cohort has a dose limiting toxicity before Day 22, then 3 more patients are studied at that same dose. If 2 of 6 patients have dose limiting toxicities within the first 22 days, the next cohort receives the next lowest dose. Otherwise each cohort has an increasing dose of one of the two agents. The second stage of the study will administer the best doses of the agents to about 16 patients to further study safety and collect more blood concentration data (more blood samples in the second phase compared to the first phase). The second stage has the advantage of using the best dose (decreases chance of receiving a sub-therapeutic dose) while it collects more blood samples and requires slightly more long clinic visits.
Intervention / Treatment
DRUG: GW786034, DRUG: lapatinib
| Inclusion criteria:
* Histologically or cytologically confirmed diagnosis of advanced solid tumor refractory to standard therapy or for whom there is no standard therapy.
* Females are eligible if they are of:
a) Non-childbearing potential (i.e., physiologically incapable of becoming pregnant), including any female who:
* had a hysterectomy.
* had a bilateral oophorectomy (ovariectomy).
* had a bilateral tubal ligation.
* is post-menopausal (a demonstration of total cessation of menses for 1 year).
* childbearing potential, has a negative serum pregnancy test at screening, and agrees to one of the following:
* an IUD with a documented failure rate of less than 1% per year.
* vasectomized partner who is sterile prior to the female patient's entry and is the sole sexual partner for that female.
* complete abstinence from sexual intercourse for 14 days before exposure to investigational product, throughout the clinical trial, and for at least 14 days after the last dose of investigational product.
* double-barrier contraception (condom with spermicidal jelly, foam suppository, or film; diaphragm with spermicide; or male condom and diaphragm with spermicide).
* ECOG (Eastern Cooperative Oncology Group) PS 0 or *
* Adequate bone marrow function.
* Platelets greater than or equal to 75,000/mm*
* ANC greater than or equal to 1,500/mm3 (*5 x 109/L).
* Hgb greater than or equal to 9 g/dL (5 mmol/L).
* CLcr > 50 mL/min as calculated by the Cockcroft-Gault formula.
* Total bilirubin less than or equal to *5 x upper limit of normal.
* PT/INR/PTT less than or equal to *2 x upper limit of normal.
* AST/ALT less than or equal to 3 x upper limit of normal.
* Has LVEF within normal range or above 50% based on MUGA/ECHO.
* Urinalysis for protein is < 2 (negative, trace, or 1). NOTE: If urinalysis is 2 or greater then a 24 hour urine for protein must demonstrate less than 1 gram of protein in 24 hours for patient to be eligible for enrollment.
* Able to swallow and retain oral medication.
* Has a life expectancy of at least 12 weeks.
Exclusion criteria:
* Had prior treatment with either study drug.
* Has brain metastases.
* Uncontrolled hypertension (BP higher than 150/90 SBP/DBP).
* Have heart failure.
* Have DVT (deep vein thrombosis) or arterial thrombosis, MI (myocardial infarction), angina, or has had angioplasty and/or stenting within last 3 months.
* Has allergy to drug similar to lapatinib (e.g. allergic to Iressa(gefitinib) or Tarceva(erlotinib).
* Is using therapeutic doses of anti-coagulant.
* Has had major surgery, hormonal therapy, chemotherapy, radiotherapy, or other investigational agent within last 28 days.
* Pregnant or lactating.
* History or current GI (gastrointestinal) condition that alters stomach or gut emptying from normal (e.g. major surgery on the stomach).
* Bowel obstruction or chronic diarrhea.
* Psychological or geographical conditions that would prevent him/her from being a good candidate.
* Do not have accessible veins for venipuncture.
* History of prolonged QTc on ECG. |
Study Objectives
The purpose of this study is to investigate the efficacy of GV1001 in locally advanced or metastatic HCC. Also the safety of GV1001 and immunogenicity will be evaluated.
Intervention / Treatment
BIOLOGICAL: GV1001
| Inclusion Criteria:
* Hepatocellular carcinoma diagnosis fulfilling one of the following criteria (as per the American Association for the Study of Liver Diseases \[AASLD\] guidelines, see Appendix 5):
* Nodule in a cirrhotic or non-cirrhotic liver with a biopsy showing HCC;
* Nodule in cirrhotic liver where no biopsy is performed:
* Nodules between 1-2 cm in a cirrhotic liver with a typical coincidal vascular pattern of HCC (i.e. hypervascular with washout in the portal/venous phase) in two dynamic studies: either CT scan, contrast ultrasound or MRI with contrast.
* Nodule larger than 2 cm in a cirrhotic liver with a typical vascular pattern of HCC on a dynamic imaging technique.
Please note: HCC in a non-cirrhotic liver can only be diagnosed with a biopsy showing HCC.
* Measurable disease according to modified RECIST (see Appendix 7).
* At least one treatment-naïve target lesion (treatment-naïve being defined as not having been treated with local therapy, such as surgery, radiation therapy, hepatic arterial embolisation, chemoembolisation, radio-frequency ablation or cryo-ablation).
* Barcelona Clinic Liver Cancer (BCLC) stage A, B or C (see Appendix 6) (Stage D is excluded).
* Child-Pugh stage A (see Appendix 8).
* Male or female aged 18 years or older.
* Adequate haematological parameters, as demonstrated by:
* Haemoglobin greater than or equal to *0 g/dL (SI units: *6 mmol/L);
* WBC greater than or equal to *0 x 109/L;
* Platelets greater than or equal to 75 x 109/L.
* ALT and AST ≤ 5 times the upper limit of normal.
* Bilirubin < 2 mg/dL.
* Serum creatinine smaller than or equal to *5 mg/dL (SI units: 132 µmol/L).
* Performance status ECOG 0 or *
* Minimum life expectancy of 3 months at screening.
* Written informed consent given prior to any study specific procedures.
Exclusion Criteria:
* HCC amenable to curative treatment or transplantation.
* History of other malignancies in the last 5 years (10 years in the case of breast cancer), except for adequately treated non-melanoma skin cancers (Basal Cell Carcinoma, Squamous Cell Carcinoma) and carcinoma in situ of the cervix.
* Known history of or co-existing autoimmune disease.
* Known Central Nervous System (CNS) metastases.
* Known history of human immunodeficiency virus (HIV).
* Any medical condition that, in the opinion of the Investigator, may compromise the compliance of the patient to receive study treatment and follow study procedures.
* Treatment with any other IMP within 4 weeks prior to cyclophosphamide administration at Day -*
* Known sensitivity to any components of cyclophosphamide, GV1001 or GM-CSF.
* Concomitant treatment with the following within 4 weeks of pre-treatment with cyclophosphamide:
* Anti-tumour treatment (including radiotherapy, chemotherapy, immunotherapy, endocrine therapy, cytokines, interferons, protease inhibitors, and gene therapy) and vaccines.
* Chronic corticosteroids (inhaled and topical steroids are permitted including low dose steroids at non-immunosuppressive doses e.g. 15 mg prednisolone daily for up to 7 days).
* Herbal medicine either containing hypericum perforacum (e.g., St Johns Wort) or claiming to have anti-tumour effects (e.g., Iscador).
* Pregnancy or lactation.
* Women of childbearing potential not using reliable and adequate contraceptive methods, defined as the use of oral, implanted, injectable, mechanical or barrier products for the prevention of pregnancy; or women who are practising abstinence; or where the partner is sterile, for example a vasectomy.
* Unable for any other reason to comply with the protocol (treatment or assessments). |
Study Objectives
This phase II trial is studying how well oxaliplatin works in treating young patients with recurrent solid tumors that have not responded to previous treatment. Drugs used in chemotherapy, such as oxaliplatin, work in different ways to stop tumor cells from dividing so they stop growing or die.
Intervention / Treatment
DRUG: oxaliplatin
| Inclusion Criteria:
* Histologically confirmed\* solid tumor, including any of the following:
* Ewing's sarcoma/peripheral primitive neuroectodermal tumor (PNET)
* Osteosarcoma
* Rhabdomyosarcoma
* Neuroblastoma
* High-grade astrocytoma
* Low-grade astrocytoma
* Glioblastoma multiforme
* Ependymoma
* Hepatoblastoma
* Germ cell tumors of any site
* Rare tumors of interest, including any of the following:
* Soft tissue sarcoma
* Hepatocellular carcinoma
* Childhood/adolescent colorectal carcinoma
* Childhood/adolescent renal cell carcinoma
* Childhood/adolescent adrenocortical carcinoma
* Childhood/adolescent nasopharyngeal carcinoma
* Recurrent disease OR refractory to conventional therapy
* Measurable disease by clinical exam, CT scan, MRI, or positron emission tomography
* Performance status - Karnofsky 50-100% (for patients over age 10)
* Performance status - Lansky 50-100% (for patients age 10 and under)
* At least 8 weeks
* Absolute neutrophil count ≥ 1,000/mm\^3\*
* Platelet count ≥ 75,000/mm\^3\* (transfusion independent)
* Hemoglobin ≥ *0 g/dL\* (RBC transfusions allowed)
* Granulocytopenia, anemia, and/or thrombocytopenia due to bone marrow metastases or extensive prior radiotherapy allowed provided the above hematological criteria are met
* Bilirubin ≤ 3 mg/dL
* Creatinine based on age as follows:
* ≤ .8 mg/dL (for patients age 5 and under)
* ≤ *0 mg/dL (for patients age 6 to 10)
* ≤ *2 mg/dL (for patients age 11 to 15)
* ≤*5 mg/dL (for patients age 16 to 21)
* Creatinine clearance or radioisotope glomerular filtration rate > 20 mL/min
* No uncontrolled seizure disorder
* No uncontrolled infection
* CNS toxicity ≤ grade 2
* Not pregnant or nursing
* Negative pregnancy test
* Fertile patients must use effective contraception
* Recovered from prior immunotherapy
* At least 7 days since prior anticancer biologic therapy
* More than 1 week since prior growth factors
* At least 6 months since prior allogeneic stem cell transplantation
* No evidence of active graft-vs-host disease
* No concurrent immunomodulating agents
* Recovered from prior chemotherapy
* No prior oxaliplatin
* Prior carboplatin or cisplatin allowed
* More than 3 weeks since prior myelosuppressive chemotherapy (6 weeks for nitrosoureas)
* No other concurrent anticancer chemotherapy
* Concurrent dexamethasone for CNS tumors allowed provided patient has been on a stable or decreasing dose for ≥ 1 week before study entry
* Recovered from prior radiotherapy
* At least 2 weeks since prior local palliative radiotherapy (small port)
* At least 6 months since prior craniospinal radiotherapy
* At least 6 months since prior radiotherapy to ≥ 50% of the pelvis
* At least 6 weeks since other prior substantial radiotherapy to the bone marrow
* Concurrent radiotherapy to localized painful lesions allowed provided ≥ 1 measurable lesion is not irradiated
* No other concurrent investigational agents
* No other concurrent anticancer agents |
Study Objectives
This study aimed to assess efficacy of ArtiSential® in reducing laparoscopic rectal cancer surgery duration. We retrospectively reviewed the data of patients who underwent laparoscopic low or ultralow anterior resection for primary mid-to-low rectal cancer, performed by a single surgeon in 2012-2022. Patients were divided into groups, use group vs. non-use group, based on the use or non-use of the ArtiSential®. The total mesorectal excision quality and resection margin status did not differ between the groups. ArtiSential® reduced operative time without impairing surgical quality or oncologic outcomes.
Intervention / Treatment
DEVICE: ArtiSential®
| Inclusion Criteria:
* mid-to-low rectal caner (witing 10cm of the anal verge)
* laparoscopic surgery
Exclusion Criteria:
* combined surgery
* recurrent rectal cancer surgery |
Study Objectives
Congenital biliary dilatation necessitates timely intervention owing to potential complications. This study endeavors to enhance diagnostic precision using quantitative three-dimensional morphological characteristics. Objectives involve developing models to differentiate congenital from secondary biliary dilatation and identify intrahepatic involvement. Employing machine learning, robust diagnostic models aim to elevate clinical detection rates and improve accuracy.
Intervention / Treatment
OTHER: Contrast-enhanced computed tomography (CECT) and 3D morphological analysis
| Inclusion Criteria:
* The patients with biliary dilation who underwent contrast-enhanced computed tomography (CECT) at Beijing Tsinghua Chang Gung Hospital from 2014 to *
Exclusion Criteria:
* Patients without pre-operative CECT scans or developing cholangiocarcinoma due to congenital biliary dilatation. |
Study Objectives
Epidemiological, prospective and multicenter study to evaluate the utility of the BOMET-QoL questionnaire in patients with breast cancer (BC) and bone metastases (BM).
Intervention / Treatment
DIAGNOSTIC_TEST: BOMET-QoL questionnaire
| Inclusion Criteria:
* Patient over 18 years of age.
* Patient diagnosed with BC and BM.
* Patient who has granted informed consent in writing to participate in the study.
* Patient capable of understanding and completing the questionnaires
Exclusion Criteria:
* Patient with another type of disease that, in the investigator's opinion, could mask the study results.
* Patients with a life expectancy of less than 8 months.
* Patient who is participating in a clinical trial with an unregistered drug at the start of the study. |
Study Objectives
Observational study of prevalence of oral symptoms in patients with advanced cancer using a novel questionnaire ("Oral symptom assessment scale")
Intervention / Treatment
OTHER: Questionnaire
| Inclusion Criteria:
* age > 18yr; diagnosis of locally advanced / metastatic cancer; already known to the specialist palliative care team
Exclusion Criteria:
* inability to give informed consent; inability to complete questionnaires |
Study Objectives
Randomised, double-blind, parallel group study to compare PK and PD profiles between HLX01 and rituximab (MabThera®) in patients with CD20+ B-cell Lymphoma.
Intervention / Treatment
DRUG: HLX01, DRUG: Rituximab
| Inclusion Criteria:
* aged from 18 to 65 years;
* CD20-positive non-Hodgkin's lymphoma (NHL);
* having obtained CR (complete remission) or CRu (uncertain complete remisson) after the prior therapy;
* ECOG performance status of <=1, expected survival of at least >= 3 months;
* Peripheral blood lymphocyte count < 5×10\^9/L
* signed an informed consent form which was approved by the institutional review board of the respective medical center .
Exclusion Criteria:
* Other invasive malignancies within 5 years except for adequately treated basal cell or squamous cell skin cancer, in situ carcinoma of the cervix;
* Chemotherapy within 1 month;
* Had received rituximab or other anti-CD20(+) monoclonal antibody treatment within 1 month before enrollment;
* Had received rituximab or other anti-CD20(+) monoclonal antibody treatment 1 month ago but with ADA(+) before enrollment;
* Blood concentration of Rituximab> 24 μg/ml prior to study entry;
* Had received hematopoitic growth factor within 1 week prior to study entry;
* Receipt of a live/attenuated vaccine within 4 weeks prior to the Screening Visit;
* Recent major surgery (within 8 weeks prior to screening, excluding lymph node biopsy);
* Peripheral or central nervous system disease;
* Serious hematologic dysfunction (white blood cell count of <*0×109/L; absolute neutrophil count of <*5×109/L; platelet count of < 100×109/L; hemoglobin level of < *0 g/dL);
* Hepatic dysfunction (total bilirubin level of > *5 × upper limit of normal (ULN); aspartate amino transferase (AST) and alanine amino transferase (ALT) levels of > *0 × ULN; alkaline phosphatase > *0 × ULN; renal dysfunction (serum creatinine level of > *5×ULN );
* Abnormal thyroid function;
* Seropositive for HIV , HCV antibody; seropositive for hepatitis B virus surface antigen (HBsAg). HBV DNA>*0×103copies/ml;
* Serious underlying medical conditions, could impair the ability of the patient to participate in the trial (including but not limited to ongoing active infection, uncontrolled diabetes mellitus, significant cardiac disease, uncontrolled angina, gastric ulcers, active autoimmune disease);
* Pregnancy or breast feeding. For women of childbearing potential.
* History of a severe allergic reaction or anaphylactic reaction to a biological agent or history of hypersensitivity to any component of the trial drug.
* Subjects had a history of alcoholism or drug abuse;
* Researchers think that do not fit into the group. |
Study Objectives
This is a study where there are no interventions planned. Investigators will only collect data already in the patient's history and analyze it. Particularly, we are interested in molecular data from AML patients.
This means that patients will follow their regular diagnostic and clinical practice. The analyses will be conducted according to the routine diagnostic and clinical practice as well and no additional blood withdrawal will be performed.
Intervention / Treatment
GENETIC: IDH mutation test performed at diagnosis or relapse until January 31st, 2019.
| Inclusion criteria:
* Signed written informed consent according to ICH/EU/GCP and national local laws (if applicable);
* AML patients;
* Age ≥18;
* IDH mutation test performed at diagnosis or relapse until January 31st, *
Exclusion criteria:
* AML M3 subtype according to the FAB classification; |
Study Objectives
The aim of this Study Protocol is to provide a basis for the clinical development of 131I-F16SIP as an anti-cancer therapeutic agent.
The study follows and is greatly motivated by the promising results of a Phase I/II study with a similar investigational drug developed by our Company, 131I-L19SIP, in several Italian centers.
Intervention / Treatment
DRUG: 131I-F16SIP Radioimmunotherapy (RIT)
| Inclusion Criteria:
* Phase I:
Patients with cancer, with progressive disease in pre-study period, refractory to conventional standard treatments.
Solid Tumor: Histologically/cytologically confirmed diagnosis of cancer, preferably lung cancer, prostate cancer or colorectal cancer (CRC). At least one measurable (minimum *0 cm), non irradiated lesion defined according to modified RECIST criteria i.e. whenever the measurable disease is restricted to a solitary lesion, its neoplastic nature need not be confirmed by cytology/histology.
Lymphoproliferative Diseases: Histologically/cytologically confirmed diagnosis of lymphoproliferative disease. At least one measurable (minimum *0 cm) non irradiated lesion defined according to modified RECIST criteria, i.e. whenever the measurable disease is restricted to a solitary lesion; its neoplastic nature needs to be confirmed by cytology/histology.
Phase II:
Patients with lymphoma, breast cancer or lung cancer with progressive disease in pre-study period, refractory to conventional standard treatments, will be enrolled in the study. Presence of brain metastases at time of screening does not represent an exclusion criterion. Lesions will be evaluated according to RECIST for solid tumors or to the Revised response criteria for malignant lymphoma (Cheson BD, JCO 2007, 25, 579-58) for lymphomas.
* ECOG performance status grade 0 or *
* Age ≥*
* Adequate haematological, liver and renal function (haemoglobin ≥ 9 g/dL, absolute neutrophil count (ANC) ≥ *50 x 109/L; platelets ≥ 100 x 109/L, bilirubin within UNL; alkaline phosphatase≤ *5 x UNL; ALT, AST ≤ UNL or ≤ *5 x UNL in case of liver metastases; albumin ≥ *5 g/dL; creatinine ≤ UNL.
* All acute toxic effects (excluding alopecia) of any prior therapy (including surgery radiation therapy, chemotherapy) must have resolved to National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE v.*0) Grade ≤ *
* Negative serum pregnancy test for females of childbearing potential within 14 days of starting treatment.
* If of childbearing potential, agreement to use adequate contraceptive methods (e.g., oral contraceptives, condoms, or other adequate barrier controls, intrauterine contraceptive devices, or sterilization) beginning at the screening visit and continuing until 3 months following last treatment with study drug.
* Evidence of a personally signed and dated IEC-approved Informed Consent indicating that the patient (or legally acceptable representative) has been informed of all pertinent aspects of the study.
* Willingness and ability to comply with the scheduled visits, treatment plan, laboratory tests and other study procedures.
* Life expectancy of at least 3 months.
* Signed and dated informed consent.
Exclusion Criteria:
* Chemotherapy, radiation, hormonotherapy or immunotherapy or participation in any investigational drug study within 4 weeks of RIT treatment at the RD (6 weeks in case of prior nitroureas chemotherapy).
* Prior radiation dose > 30% of bone marrow volume.
* Presence of cirrhosis or active hepatitis.
* Presence of serious cardiac (congestive heart failure, heart insufficiency > grade II NYHA, angina pectoris, myocardial infarction within one year prior to study entry, uncontrolled hypertension or arrhythmia), neurological or psychiatric disorders.
* Presence of uncontrolled intercurrent illness or any condition which in the judgement of the investigator would place the subject at undue risk or interfere with the results of the study.
* Recovery from major trauma including surgery within 4 weeks of administration of study treatment.
* Pregnancy or lactation or unwillingness to use adequate method of birth control.
* Active infection or incomplete wound healing.
* Known history of allergy to intravenously administered proteins / peptides / antibodies.
* Any conditions that in the opinion of the investigator could hamper compliance with the study protocol. |
Study Objectives
The main purpose of this study is to evaluate the safety and effectiveness of the study drug known as abemaciclib in participants with hormone receptor positive breast cancer, non-small cell lung cancer (NSCLC), or melanoma that has spread to the brain.
Intervention / Treatment
DRUG: Abemaciclib
| Inclusion Criteria:
* Have brain metastases secondary to hormone receptor positive breast cancer, NSCLC, or melanoma.
* Have either human epidermal growth factor receptor 2 positive (HER2+) (Study Part A) or negative HER2- (Study Part B) breast cancer.
* Participants in Study Part C must have HR+ breast cancer, NSCLC, or melanoma with brain lesions clinically indicated for surgical resection as well as consent to provide tissue for drug concentration determination after 5 to 14 days of study drug dosing.
* Participants in Part D must have NSCLC of any subtype.
* Participants in Part E must have melanoma of any subtype.
* Participants in Part F must have HR+ breast cancer, NSCLC, or melanoma with leptomeningeal metastases.
* For Parts A, B, D, and E: Must have at least 1 measurable brain lesion ≥10 millimeters (mm) in the longest diameter (LD).
* For Part C (surgical): Have metastatic brain lesion(s) for which surgical resection is clinically indicated.
* Have completed local therapy (surgical resection, whole-breast radiotherapy (WBRT), or SRS) ≥14 days prior to initiating abemaciclib and recovered from all acute effects.
* If receiving concomitant corticosteroids, must be on a stable or decreasing dose for at least 7 days prior to the baseline Gd-MRI.
* Have a Karnofsky performance status of ≥*
* Have a life expectancy ≥12 weeks.
* For HR+ breast cancer participants in part A, B, C, and F: If currently receiving endocrine therapy, a participant may continue to receive the same endocrine therapy provided that extracranial disease is stable for at least 3 months and central nervous system (CNS) disease progression has occurred while on this endocrine therapy. If these conditions are not met, participants must discontinue endocrine therapy prior to initiation of abemaciclib.
* For HER2+ breast cancer participants in parts A, C, and F: participants may receive concurrent treatment (ongoing or initiated simultaneously with abemaciclib) with IV trastuzumab.
* For NSCLC participants in parts C, D, and F: if currently receiving gemcitabine or pemetrexed (single-agent or in combination with another therapy), a participant may continue to receive 1 of these 2 therapies provided that extracranial disease is stable for at least 6 weeks and CNS disease progression has occurred while on this therapy.
* Have adequate organ function.
Exclusion Criteria:
* Require immediate local therapy, including but not limited to WBRT, SRS, or surgical resection, for treatment of brain metastases.
* Are taking concurrent enzyme-inducing antiepileptic drugs (EIAED).
* Have evidence of significant (ie, symptomatic) intracranial hemorrhage.
* For Parts A, B, C, D, E: Have evidence of leptomeningeal metastases. Note: discrete dural metastases are permitted.
* Have experienced >2 seizures within 4 weeks prior to study entry.
* For Parts A, B, D, E, and F: Have previously received treatment with any cyclin dependent kinase 6 (CDK6) inhibitor. For Part C participants may have received prior palbociclib or ribociclib, but not abemaciclib treatment.
* Have known contraindication to Gd-MRI.
* Have a preexisting chronic condition resulting in persistent diarrhea. |
Study Objectives
This project which is fully funded by the European Union FP7 Program is designed to pull together all the information we obtain from scans and x-rays to design a personalised 3-D digital model of each patient, their anatomy and disease. We can then use this as follows: as (i) an aid to surgical planning to enable objective clinical decision making (ii) a decision support tool to communicate the available treatment options to the patient and facilitate shared decision making and provision of personalised care and (iii) to enable standardised objective evaluation of the aesthetic outcome of the treatment procedures. This study aims to demonstrate the ability of the Virtual Physiological Human concept to empower breast cancer patients and assess the impact on their care and quality of life.
Intervention / Treatment
| Inclusion Criteria:
* Women undergoing breast conserving surgery for early breast cancer.
* Willing and able to return for a one-year visit.
* Written informed consent obtained.
Exclusion Criteria:
* Unable to provide written informed consent.
* Younger than 18 years.
* Benign breast disease.
* Women undergoing mastectomy.
* Unable to have an MRI scan (e.g. claustrophobia, too large, etc.). |
Study Objectives
This Phase II study will recruit 40 metastatic non-small cell lung cancer patients who failed treatment with a platinum-containing doublet treatment and an anti-PD1 or PD-L1 immune checkpoint antibody, administered simultaneously or sequentially. All recruited patients will receive AB-16B5 at a dose of 12 mg/kg once weekly combined with docetaxel at a dose of 75 mg/m2 once every 3 weeks.
Intervention / Treatment
DRUG: AB-16B5, DRUG: Docetaxel
| Inclusion Criteria:
* Subjects (male or non-pregnant female) must be ≥ 18 years of age on the day of signing the informed consent.
* Subjects with a histologically or cytologically confirmed diagnosis of (Stage III-IV) non-small cell lung cancer (NSCLC) and with at least one measurable lesion defined by RECIST **
* Subjects must have experienced a disease progression following treatment with an anti-PD1 or PD-L1 immune checkpoint antibody and a platinum-containing doublet treatment, administered simultaneously or sequentially.
* Subjects with a targetable driver mutation in EGFR or ALK gene will be allowed on trial after failing all available targeted therapies and having experienced a disease progression following treatment with an anti-PD1 or PD-L1 immune checkpoint antibody and a platinum-containing doublet treatment, administered simultaneously or sequentially.
* Subjects must have adequate organ and immune function
* Subjects must have a tumor lesion amenable for biopsies with no contraindication for biopsy.
* Subjects must have an Eastern Cooperative Oncology Group (ECOG) performance status of ≤ *
* Subjects must have a life expectancy of at least 3 months.
* Subjects must have recovered from the toxic effects resulting from the most recent cancer treatment to Grade 1 or less. If the subjects underwent major surgery or received radiation therapy, they must have recovered from the complications and/or toxicity.
* Female subjects of childbearing potential must have a negative serum pregnancy test within 72 hours prior to the first dose of study treatment.
* Subjects (both male and female) of reproductive potential must be willing to practice highly effective methods of contraception throughout the study and for up to 90 days after the last dose of study medication. Abstinence is acceptable if this is the subject's usual lifestyle.
* Female subjects are not considered of childbearing potential if they have a history of surgical sterility or evidence of post-menopausal status defined as any of the following:
* ≥ 45 years of age and has not had menses for more than 2 years.
* Amenorrhoeic for less than 2 years without hysterectomy and oophorectomy and a follicle stimulating hormone (FSH) value in the postmenopausal range at screening.
* Post hysterectomy, oophorectomy or tubal ligation. Documented hysterectomy or oophorectomy must be confirmed with medical records of the actual procedure or by ultrasound. Tubal ligation must be confirmed with medical records of the actual procedure.
* Subjects must understand and be able and willing and likely to fully comply with the study procedures, including scheduled follow-up, and restrictions.
* Subjects must have given written personally signed and dated informed consent to participate in the study in accordance with the International Conference on Harmonization (ICH) Good Clinical Practice (GCP) Guidelines, before completing any study related procedures.
Exclusion Criteria:
* Subjects who have received prior therapy with AB-16B*
* Subjects who have received prior therapy with docetaxel for the treatment of NSCLC.
* Subjects who are currently participating or has participated in a study of an investigational agent or using an investigational device within 21 days prior to the first dose of study treatment. The 21-day window should be calculated using the last dose of an antineoplastic investigational agent or last use of an investigational device with antineoplastic intent.
* Subjects who have received any anti-cancer treatment within 3 weeks or radiation therapy within 2 weeks prior to receiving the first dose of study treatment or who have not recovered from adverse events to Grade 1 or less. Subjects with alopecia are eligible to participate.
* Subjects who are expected to require any other form of systemic or localized antineoplastic therapy while on the trial. This includes maintenance therapy with another agent or radiation therapy.
* Subjects who are receiving a dose > 10 mg/day of prednisone (or equivalent) within 7 days prior to the first dose of study treatment or any other form of immunosuppressive medication (corticosteroid pre-treatment and/or post-treatment of docetaxel is allowed).
* Subjects who require treatment with a strong CYP3A4 inhibitor (e.g., ketoconazole, itraconazole, clarithromycin, atazanavir, indinavir, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin and voriconazole). Subjects may be included if there is an alternate treatment with a weak CYP3A4 inhibitor and they are willing to change at least 7 days prior to the first dose of study treatment.
* Subjects who have another malignancy that is progressing or requires active treatment. Exceptions include basal cell carcinoma of the skin, squamous cell carcinoma of the skin or in situ cervical cancer.
* Subjects who have known active central nervous system metastases and/or carcinomatous meningitis. Subjects with previously treated brain metastases may participate if they have been clinically stable for at least 2 weeks prior to the first dose of study treatment, if they have no evidence of new or enlarging brain metastases and if they are not receiving a dose > 10 mg/day of prednisone (or equivalent) within 7 days prior to the first dose of study treatment.
* Subjects with clinically significant ECG abnormalities.
* Subjects who have received or will receive a live vaccine within 30 days prior to the first dose of study treatment.
* Subjects with a known history of human immunodeficiency (HIV).
* Subjects with an active Hepatitis B or C infection.
* Subjects with an active infection requiring antibiotic therapy.
* Subjects with a known history of alcohol or other substance abuse within the last year.
* Subjects with known hypersensitivity to docetaxel.
* Subjects who have a history or current evidence of any condition, therapy or laboratory abnormalities that may confound the results of the trial, interfere with the subject's participation for the full duration of the trial or if it is not in the best interest of the subject to participate in the trial.
* Subjects with medical, social or psychosocial factors that, in the opinion of the treating Investigator, could impact the safety or compliance with study procedures.
* Subjects who are pregnant or lactating or who are expecting to conceive or father children within the projected duration of the trial through 90 days after the last dose of AB-16B5 or the last dose of docetaxel. |
Study Objectives
Protocol G200712 is a Phase II, exploratory study to assess the effects of GTx-758 on serum prostate specific antigen (PSA) response ans serum PSA progression in men with Metastatic Castration Resistant Prostate Cancer (mCRPC) on Androgen Deprivation Therapy (ADT) with luteinizing hormone-releasing hormone (LHRH) agonists, LHRH antagonists, or orchidectomy. This study will also assess the venous thromboembolism (VTE) risk of lower doses of GTx-758.
Intervention / Treatment
DRUG: GTx-758 125 mg, DRUG: GTx-758 250 mg
| Inclusion Criteria:
* Be over age 18 years
* Be able to Communicate effectively with the study personnel
* Have histologically confirmed prostate cancer
* Have castration resistant prostate cancer patients with radiographic evidence of metastatic disease (T any - N any - MI)
* ECOG performance status of 0 to 2
* Have been treated with ADT (chemical or surgical) for at least 6 months
* Have a castrate level of serum total testosterone (< 50ng/dL)
* Have a history of serum PSA response on ADT. A serum PSA response is an undetectable level of serum PSA (≤ *2/mL) or at least a 90% reduction in serum PSA from the serum PSA value prior to the initiation of treatment to < 10ng/mL
* Have a rising serum PSA on two successive assessments at least 2 weeks apart and serum PSA levels ≥ 2ng/mL or > 2 ng/mL and a 25% increase above the nadir from the ADT.
* Be continued on ADT throughout this study
* give written informed consent prior to any study specific procedures
* subjects must agree, if not already on anticoagulation therapy or aspirin, to take 81 mg aspirin daily throughout the duration of their participation in this study and for 30 days after completion of dosing with GTx-*
* Subjects must agree to use acceptable methods of contraception:
* If their female partners are pregnant or lactating, acceptable methods of contraception from the time of the first administration of study medication until 3 months following administration of the last dose of study medication must be used. Acceptable methods are: condom used with spermicidal foam/gel/film/cream/suppository. If the subject has undergone surgical sterilization (vasectomy with documentation of azospermia), a condom with spermicidal foam/gel/film/cream/suppository should be used.
* If the male subject's partner could become pregnant, use acceptable methods of contraception from the time of the first administration of study medication until 3 months following administration of the last dose of study medication.Acceptable methods of contraception are as follows: condom with spermicidal foam/gel/film/cream/suppository \[i.e., barrier method of contraception\], surgical sterilization (vasectomy with documentation of azospermia) and a barrier method {condom used with spermicidal foam/gel/fil/cream/suppository}, the female partner uses oral contraceptives (combination estrogen/progesterone pills), injectable progesterone or subdermal implants and a barrier method {condom used with spermicidal foam/gel/film/cream/suppository}.
* If the female partner has undergone documented tubal ligation (female sterilization), a barrier method {condom used with spermicidal foam/gel/film/cream/suppository} should be used
* If the female partner has undergone documented placement of an intrauterine device (IUD) or intrauterine system (IUS), a barrier method {condom with spermicidal foam/gel/film/cream/suppository} should also be used.
Exclusion Criteria:
* Known hypersensitivity or allergy to estrogen or estrogen like drugs
* Need for urgent chemotherapy, radiation therapy or surgical intervention for prostate cancer in the opinion of the investigator;
* Any disease or condition (medical or surgical) which might compromise the hematologic, cardiovascular, endocrine, pulmonary, renal, gastrointestinal, hepatic, or central nervous system; or other conditions that may interfere with the absorption, distribution, metabolism or excretion of study drug, or would place the subject at increased risk
* Subjects with a personal history of abnormal blood clotting or thrombotic disease (venous or arterial thrombotic events such as history of stroke, deep vein thrombosis (DVT), and or pulmonary embolus (PE)).
* Any subjects, as determined by a central laboratory, with
* a modified activated protein C reaction ratio ≤ *5 and a Factor V Leiden gene mutation,
* an antithrombin level below the lower limit of the normal range,
* an antiphospholipid antibody level that is indeterminate, positive, or outside the normal range,
* or a prothrombin gene mutation
* Symptomatic congestive heart failure (NYHA Class III - IV), unstable angina pectoris, cardiac arrhythmia, or history of atrial fibrillation
* The presence of consistently abnormal laboratory values which are considered clinically significant. In addition, any subject with liver enzymes (ALT or AST) above 2 times the upper limit of normal, total bilirubin above 2 times the upper limit of normal, or serum creatinine above *5 times the upper limit of normal will NOT be admitted to the study.
* Received an investigational drug within a period of 90 days prior to the enrollment in the study.
* Received the study medication GTx-758 previously;
* Currently taking testosterone, testosterone like agents, 5a-reductase inhibitor (finasteride, dutasteride),or antiandrogens (bicalutamide, flutamide or nilutamide). Subjects taking a 5a-reductase inhibitor or one of these antiandrogens may be eligible if the subject undergoes a 6 week washout period after stopping therapy. The subject must have at least two rising serum PSA levels at least 2 weeks apart after therapy with these 5a-reductase inhibitor or these antiandrogens have been stopped (antiandrogen withdrawal)and complete the 6-week washout period to be eligible;
* Have previously taken or are currently taking diethylstilbestrol, other estrogens, abiraterone or ketoconazole or any other inhibitor of CYP17 (17a-hydroxylase/C17,20-lyase);
* Currently having radiation therapy to prostate for cancer control (radiation to bone to relieve pain is acceptable)
* Have previously taken or are currently taking enzalutamide;
* Have previously received cytotoxic chemotherapy for prostate cancer;
* Recent hospitalization (within 30 days of screening);
* Recent surgery (within 30 days of screening);
* Have taken body building or fertility supplements within 4 weeks of admission into the study;
* Have been previously diagnosed or treated for active cancer (other than prostate cancer or non-melanoma skin cancer)within the previous five years;
* Have a BMI > * |
Study Objectives
First in human, open-label, sequential dose escalation and expansion study of AMG 232 in subjects with advanced solid tumors or multiple myeloma
Intervention / Treatment
DRUG: AMG 232
| Inclusion Criteria:
* Men or women > 18 years old
* Pathologically documented, definitively diagnosed, advanced solid tumor that is refractory to standard treatment, or which no standard therapy is available, or the subject refuses standard therapy or multiple myeloma
* Willing to undergo pre-dose core needle tumor biopsies or bone marrow aspirate for subjects with multiple myeloma.
* Ability to take oral medications and willing to record daily adherance to investigational product
* Adequate hematological, renal, hepatic, and coagulation laboratory assessments
Exclusion Criteria:
* Active brain metastases
* For solid tumor-History or presence of hematological malignancies unless curatively treated with no evidence of disease for greater than or equal to 5 years
* Active infection requiring intravenous (IV) antibiotics
* Anti-tumor therapy
* Therapeutic or palliative radiation therapy within 30 days of starting treatment
* Currently enrolled in another investigational device or drug study |
Study Objectives
This phase III trial is studying how well giving combination chemotherapy together with radiation therapy works in treating young patients with newly diagnosed Hodgkin lymphoma. Drugs used in chemotherapy work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Radiation therapy uses high energy x-rays to kill cancer cells. Giving combination chemotherapy together with radiation therapy may kill more cancer cells.
Intervention / Treatment
BIOLOGICAL: bleomycin sulfate, DRUG: doxorubicin hydrochloride, DRUG: liposomal vincristine sulfate, DRUG: vinorelbine tartrate, DRUG: cyclophosphamide, DRUG: etoposide phosphate, DRUG: prednisone, BIOLOGICAL: filgrastim, DRUG: ifosfamide
| Inclusion Criteria:
* Pathologically confirmed newly diagnosed Hodgkin lymphoma (HL) meeting one of the following criteria:
* Classical disease
* Nodular lymphocyte-predominant disease
* Stage III or IV disease with B symptoms, as defined by ≥ 1 of the following:
* Unexplained weight loss > 10% within the past 6 months
* Unexplained recurrent fever > 38°C within the past month
* Recurrent drenching night sweats within the past month
* Creatinine clearance or radioisotope GFR ≥ 70 mL/min OR maximum serum creatinine based on age/gender as follows:
* *4 mg/dL (1 to 5 months)
* *5 mg/dL (6 to 11 months)
* *6 mg/dL (12 to 23 months)
* *8 mg/dL (2 to 5 years)
* 1 mg/dL (6 to 9 years)
* *2 mg/dL (10 to 12 years)
* *5 mg/dL (males) or *4 mg/dL (females) (13 to 15 years)
* *7 mg/dL (males) or *4 mg/dL (females) (≥ 16 years)
* Total bilirubin ≤ *5 times upper limit of normal (ULN) for age
* AST or ALT < *5 times ULN for age
* Shortening fraction ≥ 27% by ECHO OR ejection fraction ≥ 50% by MUGA (unless due to large mediastinal mass from HL)
* FEV_1/FVC > 60% by pulmonary function tests (PFT) (unless due to large mediastinal mass fromHL)
* For children who are unable to cooperate for PFTs, the criteria are:
* No evidence of dyspnea at rest
* No exercise intolerance
* Pulse oximetry > 92% on room air
* Not pregnant or nursing
* Negative pregnancy test
* Fertile patients must use effective contraception
* No pathologic prolongation of QTc interval (> 450 milliseconds) on 12-lead ECG
* No prior chemotherapy, biological response modifiers (e.g., monoclonal antibody therapy), or radiotherapy
* At least 28 days since prior corticosteroids except for emergent treatment for respiratory distress or spinal cord compression, or for treatment of allergy to contrast agent required for CT scan
* No other concurrent cancer chemotherapy or immunomodulating agents (including steroids)
* Concurrent corticosteroid therapy as treatment or prophylaxis for anaphylactic reactions allowed
* No concurrent pegfilgrastim |
Study Objectives
This randomized pilot phase I trial will evaluate if quercetin enhances the uptake of green tea polyphenols in the prostate tissue of men taking green tea extract and undergoing radical prostatectomy. Side effects of green tea extract and quercetin in combination with green tea extract will also be evaluated. In preclinical studies, green tea polyphenols have anticancer and cancer preventative effects in a number of malignancies. Likewise, in preclinical studies quercetin was found to enhance the anticancer effects of green tea. This trial is designed to translate these findings forward in a short-term human intervention trial.
Intervention / Treatment
DIETARY_SUPPLEMENT: green tea extract, DRUG: quercetin, OTHER: placebo, PROCEDURE: therapeutic conventional surgery, OTHER: laboratory biomarker analysis
| Inclusion Criteria:
* Subjects consent to participate in the trial
* The subject has a diagnosis of adenocarcinoma of the prostate
* The subject is scheduled to undergo radical prostatectomy
* The subject agrees to stop consuming tea or tea-containing products and quercetin supplements throughout the entire intervention period except for the green tea extract and quercetin provided during study intervention
Exclusion Criteria:
* History of hepatitis or liver dysfunction
* Ongoing alcohol abuse
* Significant medical or psychiatric conditions that would make the patient a poor protocol candidate
* Prior sensitivity or allergic reaction to tea, tea products or tea and quercetin supplements
* Allergies to multiple food items or nutritional supplements
* Taking luteinizing hormone-releasing hormone (LHRH) agonists, androgen receptor blocking agents, finasteride, or has undergone bilateral orchiectomy |
Study Objectives
This prospective, randomized, open-label and multicenter phase III study is aimed to estimate the survival benefit of Early Palliative Care (EPC) combined with standard oncology care including first-line chemotherapy (experimental arm) over standard oncology care only (standard arm), in patients with metastatic upper gastrointestinal cancers (gastric cancer, pancreatic cancer, biliary tract cancers).
Intervention / Treatment
BEHAVIORAL: Early Palliative Care visit, OTHER: EORTC-QLQ-C30 questionnaire, OTHER: HADS score
| Inclusion Criteria:
* Patients with an upper gastrointestinal metastatic cancer: pancreatic, biliary tract, esophageal or gastric (including junctional Siewert 2 and 3 cancers) cancers.
NB: gastrooesophageal junctional cancers with dysphagia and/or gastric/gastrooesophageal cancers with unknown or positive HER2 status are not eligible.
* Patients planed to be treated with first-line chemotherapy for metastatic disease.
* Age ≥ 18 years
* Life expectancy ≥ 1 month
* Performance status (OMS) ≤ 2
* Good understanding of French language
* Signed and dated informed consent
* Patients covered by government health insurance
Exclusion Criteria:
* Locally advanced cancer
* Junctional Siewert 1 gastrooesophageal cancer
* Gastric or junctional gastrooesophageal cancer with dysphagia (Atkinson>2)
* Gastric or junctional gastrooesophageal cancer with unknown or positive HER2 status (IHC: +++ or IHC ++ and FISH/SISH +)
* Compression of the biliary tract requiring a bypass |
Study Objectives
This is a Phase 1, open-label, two-part study designed to characterize the PK of an IV dose of approximately 12 µg tazemetostat that contains approximately 500 nCi of \[14C\] tazemetostat and the ADME of an oral dose of 800 mg tazemetostat that contains approximately 400 µCi of \[14C\]-labeled tazemetostat in three subjects with B-cell lymphomas or advanced solid tumors.
Intervention / Treatment
DRUG: Tazemetostat and [14C] Tazemetostat
| Inclusion Criteria:
* Male ≥ 18 years of age at time of consent
* Female ≥ 18 years of age at time of consent and of non-childbearing potential. A woman is considered to be of non-childbearing potential if she has reached a postmenopausal state (≥ 12 continuous months of amenorrhea with no identified cause other than menopause) or has undergone surgical sterilization (removal of ovaries and/or uterus). Note: Postmenopausal state will be confirmed with FSH test completed during the screening period.
* Has an Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2
* Has a life expectancy of >3 months
* Has EITHER histologically confirmed B-cell lymphomas including but not limited to diffuse large B-cell lymphoma (DLBCL), follicular lymphoma (FL), primary mediastinal B-cell lymphoma (PMBCL), marginal zone lymphoma (MZL), mantle cell lymphoma (MCL), or Hodgkin lymphoma (HL) and has relapsed or refractory disease following at least two lines of prior standard therapy, including alkylator/anthracycline (unless anthracycline-based chemotherapy is contraindicated)/anti-CD20-based therapy (R-CHOP, rituximab, doxorubicin, cyclophosphamide, vincristine, and prednisolone or dexamethasone, or equivalent for non-Hodgkin lymphoma), AND must be considered unable to benefit from intensification treatment with autologous hematopoietic stem cell transplantation (ASCT) , as defined by meeting at least one of the following criteria:
* Relapsed following, or refractory to, previous ASCT
* Did not achieve at least a partial response to a standard salvage regimen (e.g., R-ICE, rituximab, ifosfamide, carboplatin, etoposide, or R-DHAP, rituximab, dexamethasone, cytarabine, cisplatin)
* Ineligible for intensification treatment due to age or significant comorbidity
* Ineligible for intensification treatment due to failure to mobilize an acceptable number of hematopoietic stem cells
* Refused intensification treatment and/or ASCT
OR
* Histologically and/or cytologically confirmed advanced or metastatic solid tumor that has progressed after treatment with approved therapies or for which there are no standard therapies available
* May have evaluable or measurable disease
* Has all prior treatment (i.e., chemotherapy, immunotherapy, radiotherapy) related clinically significant toxicities resolve to ≤ Grade 1 per CTCAE, version *03 or are clinically stable, at time of consent
* Time between the last dose of the latest therapy and the first dose of study drug:
* Chemotherapy: cytotoxic - at least 21 days
* Chemotherapy: nitrosureas - at least 6 weeks
* Chemotherapy: non-cytotoxic (e.g. small molecule inhibitor) - at least 14 days
* Monoclonal antibody (ies) - at least 28 days
* Immunotherapy (e.g. tumor vaccine) - at least 28 days
* Radiotherapy (RT) - at least 21 days for stereotactic radiosurgery, at least 12 weeks for craniospinal, ≥50% radiation of pelvis, or total body irradiation
* High dose therapy with autologous hematopoietic cell infusion - at least 60 days
* Hematopoietic growth factor - at least 14 days
* Has adequate hematologic (bone marrow \[BM\] and coagulation factors), renal and hepatic function as defined by criteria below:
* Hemoglobin ≥9 g/dL
* Platelet ≥75,000/mm3 (≥75 × 10\^9/L)
* ANC ≥750/mm3 (≥*75 × 10\^9/L)
* PT< *5 ULN
* PTT< *5 ULN
* Creatinine < *0 ULN
* Conjugated bilirubin < *5 × ULN
* AST <3 × ULN I. ALT <3 × ULN NOTE: Laboratory results obtained during screening should be used to determine eligibility criteria. In situations where laboratory results are outside the permitted range, the investigator may retest the subject and the subsequent within range screening result may be used to determine the subject's eligibility
* Subjects with a history of Hepatitis B or C are eligible on the condition that subjects have adequate liver function as defined the protocol and are hepatitis B surface antigen negative and/or have undectable HCV RNA.
* Has a QT interval corrected by Fridericia's formula (QTcF) ≤480 msec
* Subject must have regular bowel movements (minimum of 1 bowel movement every day or every other day; no more than 3 bowel movements per day) for the past 2 weeks without diarrhea (>4 bowel movements per day) or constipation (fewer than 3 bowel movements in 1 week). No known medical history of a disease or syndrome that affects bowel function (e.g., irritable bowel syndrome, inflammatory bowel disease, ulcerative colitis, etc.), fecal incontinence, and no history of significant opioid induced constipation within the past 3 months
* Subject must have the ability to regularly void urine with no current evidence of urinary incontinence, urinary retention, uncorrected congenital defects that interfere with normal urinary system function, chronic urinary tract infections, or other conditions that may interfere with normal urinary bladder emptying. In the past 3 months, no obstructive uropathy, surgery affecting urinary system (e.g., radical prostatectomy, TURP, etc.), urinary tract infection. Subjects with solitary kidney are excluded from the study
* Male subjects must refrain from donating sperm starting at the planned first dose of study drug until 30 days following the last dose of study drug. Male subjects with a female partner of childbearing potential must be vasectomized, or remain abstinent or use a condom as defined in Section **8, starting at the planned first dose of study drug until 30 days following the last dose of study drug. The reliability of sexual abstinence should be evaluated in relation to the duration of the clinical trial and the preferred and usual lifestyle of the patient. Periodic abstinence (e.g., calendar, ovulation, symptothermal, or postovulation methods) and withdrawal are not acceptable methods of contraception. Female partners of male subjects who are of childbearing potential must also adhere to one of the following:
* Placement of an intrauterine device or intrauterine system.
* Established use of oral, injected or implanted hormonal methods of contraception.
* Progesterone only oral contraception, where inhibition of ovulation is not the primary mode of action.
Exclusion Criteria:
Subjects meeting ANY of the following criteria must NOT be enrolled in this study:
* Has participated in a study in which \[14C\] was administered within the last 6 months prior to screening for this study
* Has CNS or leptomeningeal metastasis
* Has had a prior malignancy other than the malignancies under study Exception: Subject who has been disease-free for 3 years, or a subject with a history of a completely resected non-melanoma skin cancer or successfully treated in situ carcinoma are eligible
* Has had major surgery within 3 weeks prior to enrollment NOTE: Minor surgery (e.g., minor biopsy, central venous catheter placement) is permitted within 3 weeks prior to enrollment
* Is unwilling to exclude grapefruit juice, Seville oranges and grapefruit from the diet and all foods that contain those fruits from time of enrollment to while on study
* Has cardiovascular impairment, history of congestive heart failure greater than NYHA Class II uncontrolled arterial hypertension, unstable angina, myocardial infarction, or stroke within 6 months prior to the planned first dose of tazemetostat; or ventricular cardiac arrhythmia requiring medical treatment
* Subjects taking medications that are known potent CYP3A4 inducers/inhibitors (including St. John's Wort) from 14 days prior to the first dose of study medications (see http://www.fda.gov/Drugs/DevelopmentApprovalProcess/DevelopmentResources/DrugInteractionsLabeling/ucm*htm; or http://medicine.iupui.edu/clinpharm/ddis/ for a list of potent CYP3A4 inducers and inhibitors).
* Has an active infection requiring systemic treatment
* Is immunocompromised, including subjects with known history of infection with human immunodeficiency virus (HIV)
* Has known history of chronic infection with hepatitis B virus (hepatitis B surface antigen positive) or hepatitis C virus (detectable HCV RNA)
* Has had a venous thrombosis or pulmonary embolism within the 3 months prior to study enrollment.
NOTE: Subjects with a history of a deep vein thrombosis >3 months prior to study enrollment who are on anticoagulation therapy with low molecular weight heparin are eligible for this study.
* Has known hypersensitivity to any of the components of study drug
* Is unable to take oral medications, malabsorption syndrome or any other uncontrolled gastrointestinal condition (e.g., nausea, diarrhea or vomiting) that might impair the bioavailability of study drug
* Has an uncontrolled intercurrent illness including, but not limited to, uncontrolled infection, or psychiatric illness/social situations that would limit compliance with study requirements
* Is unwilling to adhere to contraception criteria from time of enrollment in study to at least 30 days after last dose of study drug
* Clinical history, current alcohol (ethanol), or illicit drug use which, in the judgment of the investigator, will interfere with the subject's ability to comply with the dosing schedule and protocol-specified evaluations
* A history of bleeding (i.e., hemoptysis, hematuria, GI blood loss, epistaxis, or others with greater than Grade 1 according to National Cancer Institute Common Terminology Criteria Version *0 \[NCI-CTC v*0\]) within 1 month prior to beginning therapy or any clinical indications of current active bleeding |
Study Objectives
The study evaluates the efficacy and tolerability of alternating short cycles of high-dose and conventional chemotherapy in combination with rituximab in CD20 positive patients, followed by local radiation therapy in the case of initial mediastinal or central nervous system (CNS) involvement or a residual tumor after chemotherapy. A dose-reduced regimen is offered for patients estimated to be over 55 years, biologically.
Intervention / Treatment
DRUG: Adriamycin, DRUG: Cyclophosphamide, DRUG: Cytarabine, DRUG: Dexamethasone/Prednisolone, DRUG: VP16, DRUG: Ifosfamide, DRUG: Methotrexate, DRUG: G-CSF, DRUG: Rituximab, DRUG: Vincristine/Vindesine, PROCEDURE: Irradiation (in specific conditions)
| Inclusion Criteria:
* Burkitt's leukemia or Burkitt's lymphoma or primary mediastinal large B-cell lymphoma or B-precursor lymphoblastic lymphoma or large cell anaplastic lymphoma
* Age > 15 years
* Written informed consent
Exclusion Criteria:
* Serious secondary diseases, including psychiatric conditions, under which the required therapy compliance is not to be expected
* HIV infection
* Secondary lymphoma following prior chemotherapy/radiotherapy or active second malignancy
* Known severe allergy to foreign proteins
* Pre-treatment other than 1 cycle CHOP or similar; < 1 week of another chemotherapy.
* Pregnancy or nursing
* Participation in other studies that interfere with study therapy |
Study Objectives
To determine the safety profile of Androxal in men with secondary hypogonadism.
Intervention / Treatment
DRUG: Androxal
| Inclusion Criteria:
* Successful completion of either ZA-301 or ZA-302
Exclusion Criteria:
* Any condition which, in the opinion of the Investigator, would make the Subject an unsuitable candidate for enrollment in the study |
Study Objectives
The purpose of this study is to evaluate the efficacy of Udenafil (Zydena®, Dong-A Pharmaceutical co., Ltd, Seoul, Korea) in treatment of erectile dysfunction after radical resection for sigmoid colon and rectal cancer. In this study, the efficacy of Udenafil will be evaluated in treatment for patient with chronic erectile dysfunction, which developed after radical resection for sigmoid and rectal cancer and continues 12 months after the surgery.
Intervention / Treatment
DRUG: Udenafil
| Inclusion Criteria:
* * Male patients between 19-70 years old in good general health
* Patient willing to treat postoperative erectile dysfunction and participate in the study
* Patient who understands and accepts to sign the informed consent form
* Patient who received radical resection for sigmoid colon and rectal cancer. : erectile dysfunction was developed following operation, not preoperatively
* Scores of IIEF-5 measured at 12 months after surgery is 16 or less
Exclusion Criteria:
* * Documented problem of preoperative erectile dysfunction
* Past history of myocardial infarction, cerebrovascular disease
* Under administration of nitrate
* Liver dysfunction (SGOT or SGPT 100 IU/L or more)
* Kidney dysfunction (serum Creatinine 3mg/dl or more) |