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Study Objectives High-risk patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) suffer from a high ratio of recurrence after liver transplantation (LT). Lenvatinib, as a novel targeted drug, has shown an excellent effect in the treatment of advanced HCC, but there is no study on its effect in preventing HCC recurrence in the patients undergoing transplantation. Therefore, to evaluate the role of adjuvant lenvatinib in preventing recurrence of high-risk LT recipients with HBV-related HCC, the investigators retrospectively analyzed 23 high-risk patients consisting of lenvatinib group (n=14) and control group (n=9) with HBV-related HCC who underwent LT. Disease-free survival (DFS) and HCC recurrence of the two groups were compared. The adverse events (AEs) and drug tolerance of lenvatinib were evaluated. Conditions: Hepatocellular Carcinoma Intervention / Treatment: DRUG: Lenvatinib
Inclusion Criteria: * The recipients who underwent liver transplantation with the pathologic diagnosis of hepatocellular carcinoma.* The extrahepatic metastasis was excluded preoperatively.* The patients were defined as "high-risk" for recurrence according to the following criteria: (1) beyond Milan criteria confirmed either by radiology before LT or by pathology after LT, (2) tumor with intrahepatic vascular invasion, (3) Alpha-fetoprotein (AFP)≥400ng/L before LT, (4) presence of microvascular invasion (MVI), (5) tumor with histological poor differentiation according to Edmondson-Steiner classification system(21), (6) multiple satellite lesions around the largest tumors detected either by radiology before LT or by histology after LT, (7) tumor penetrating hepatic capsule, (8) recurrent HCC after resection. 4. ECOG score between 0-1 within 1 week before took lenvatinib. 5. The patients have received regular antiviral treatment. 6. Life expectancy more than 3 months. Exclusion Criteria: * The patients took lenvatinib before liver transplantation and assessed as SD or PD according to the mRECIST criteria.* The patients suffered from other incurable malignancies within 5 years or at the same time.* Distant metastasis of tumor was confirmed by imaging before or within 1 month after transplantation.* The patients have not received regular antiviral treatment.* The patients had a history of mental illness or abuse of psychoactive drugs.* The patients deemed unsuitable by attending doctors.
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Study Objectives The purpose of this study is to determine whether recombinant human arginase (PEG-BCT-100) is safe and effective in the treatment of advanced hepatocellular carcinoma (HCC). Conditions: Neoplasm, Hepatocellular Carcinoma Intervention / Treatment: BIOLOGICAL: Pegylated Recombinant Human Arginase I, DRUG: Doxorubicin
Inclusion Criteria: * Confirmed diagnosis of HCC according to the European Association for the Study of the Liver criteria * Known underlying HCC etiology specified by hepatitis B, hepatitis C, post alcoholic cirrhosis, or other * HCC lesion(s) which are not resectable and which are measurable by C-T scan * Progression of or non-response of HCC lesions after treatments which are considered best standard of care - surgical resection, radiofrequency ablation, chemoembolization * No cancer treatment or surgery within the prior 4 weeks, either chemotherapy, targeted biologic or enzymes, either approved or investigational; * Males or females from 18 to 75 years-old, inclusive; * Ability and willingness to provide written informed consent; * Karnofsky performance status of 80% or above and expected survival of more than 12 weeks; and, * Negative urine pregnancy test, if female, and willingness to use an effective method of contraception during the entire study period Exclusion Criteria: * Advancing liver failure indicated by uncontrolled ascites, pleural effusions, encephalopathy, or a Child-Pugh score of C * Significant hepatic, renal or bone marrow dysfunction indicated by total bilirubin >40 µmol/L, evidence of bile duct obstruction, serum albumin <30 g/L, serum SGOT >5 x upper limit of normal, ANC <1.0 x 10\^9/L, platelets <100 x 10\^9/L, or INR >2.0 * Significant cardiac or pulmonary disease defined by New York Heart Association (NYHA) Class III or IV, VEF <50% by echo or MUGA, or a history of myocardial infarction within the past 6 months, significant unstable arrhythmia or evidence of ischemia on ECG * Pregnant or nursing women. NOTE: Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control or abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately. * Significant active infection including HIV requiring oral or parenteral anti-infective therapies; * Use of investigational drug(s) within 4 weeks of enrollment; or, * Prior treatment with arginine depleting agent.
5,604
Study Objectives The aims of this trial are to evaluate the efficacy of bendamustin in patients with metastatic soft tissue sarcoma who have progressed after or during an anthracycline-baesd chemotherapy and to assess the treatment of toxicity. Conditions: Sarcoma, Soft Tissue Intervention / Treatment: DRUG: Bendamustin
Inclusion Criteria: * Histologically confirmed metastatic or non-resectable soft tissue sarcoma * Evidence of progression or relapse after an anthracycline-based and/ or ifosfamide-based chemotherapy * At least 1 bidimensionally measurable tumor lesion according to RECIST criteria * No previous radiation therapy on the only measurable lesion * Willingness to receive regular follow-up * Life expectancy more than 3 months * ECOG status >= 2 * Patients aged 18 years and beyond * leucocytes > 2500/µl, thrombocytes > 75000/µl) * Serum creatine < 1,5 times the upper limit of normal value, GFR > 60/ml * Written patient informed consent * Ability to give informed consent Exclusion Criteria: * Previous or concurrent radiation of the index lesion (radiation of single lesion is allowed if not the index lesion) * Insufficient liver function (bilirubin > 1.5 the upper limit of normal, prolongation of PT and aPTT > 1.5 the upper limit of normal; ASAT and ALAT > 3 the upper limit of normal (patients with liver metastases ASAT and ALAT > 5 the upper limit of normal) * Active infection * Prior therapy with Bendamustin hydrochloride * Prior malignancies (other than adequately treated carcinoma in situ (CIS) of the cervix, bladder urothelium, basal cell carcinoma or adenoma of the colon including pTIS,pTIN), unless treated with curative intent and without evidence of disease > 5 years * Symptomatic cardio- and/or cerebrovascular disease (NYHA-Scale III°) * Interval since last chemotherapy < 4 weeks * Evidence of CNS-metastases * Evidence of pregnancy or lactation * Woman of child-bearing potential without reliable methods of birth control
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Study Objectives Researchers at The Ohio State University and the University of Michigan are working together to understand cancer of the cervix. One of the areas they are studying is how stress you may experience in your life effects the way you respond to GARDASIL®. GARDASIL® is a vaccine approved by the Food and Drug Administration (FDA) to prevent some types of Human Papillomavirus (HPV) infection which can cause cancer of the cervix. Participants are being recruited from the Appalachian region of Ohio. Conditions: Uterine Cervical Cancer Intervention / Treatment:
Inclusion Criteria: * Female * 18-26 years of age * Resident of an Appalachian county * Intact cervix * Able to read and understand English * Cognitively able to provide informed consent * Willing to come for four clinic visits Exclusion Criteria: * Prior history of cervical cancer * Prior history of a cervical lesion treated with cryotherapy or any form of surgical removal of a portion of the cervix to treat CIN * No cervix * Pregnant or planning to become pregnant in the next year * History of immune disorder: auto-immune, primary immune or acquired * Any contra-indications for the GARDASIL® vaccine series * Taking immune suppressive medications * Any prior exposure to an HPV vaccine of any type * Planning to move out of the immediate area in the next year
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Study Objectives Thirty to forty percent of breast cancer survivors suffer from persistent fatigue lingering months to years after adjuvant therapy is completed. Although researchers have developed some effective interventions (exercise or group-based holistic program) to treat fatigue, none have addressed the role of the family in the patient's long-term recovery. The investigators hypothesize that a family-focused intervention in combination with a mind-body group intervention will be more effective in reducing fatigue, improving quality of life, and enhancing family relationships for breast cancer survivors than a group intervention with an individual focus. Conditions: Fatigue Intervention / Treatment: BEHAVIORAL: Group based mind body medicine intervention, BEHAVIORAL: Group-based mind body medicine intervention + family focus
Inclusion Criteria: * Stage I-III Breast Cancer * At least 3 months since last breast cancer treatment (excluding hormonal therapy or Herceptin). * 4 week history of persistent moderate to severe fatigue * Competent to sign informed consent * Willing to be randomized Exclusion Criteria: * Metastatic breast cancer
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Study Objectives The endoscopic thyroidectomy approach is gaining popularity in the surgical field. This registry tries to collect the outcomes including quality of life and complication for both endoscopic and conventional thyroidectomy methods. Conditions: Thyroid Nodule, Thyroid Neoplasms, Thyroid Cancer Intervention / Treatment: PROCEDURE: Endoscopic approach thyroidectomy
Inclusion Criteria: * The patients who underwent thyroidectomy at Khon Kaen University Exclusion Criteria: * None
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Study Objectives The main endpoint is physiological rehabilitation after VATS-L under early mobilization. The secondary endpoints are exploring the effect of early mobilization on postoperative physiology. Investigators hypothesis that early mobilization is clearly advantaged to advance the physiological recovery. Conditions: Lung Neoplasm, Physiology, Exercise, Lung Function, Arterial Oxygen Saturation Intervention / Treatment: BEHAVIORAL: Early mobilization
Inclusion Criteria: * VATS lobectomy;* Speak and understand Danish or English;* Informed consent obtained. Exclusion Criteria: * Co-VATS lobectomy (more than one lobe resection);* Supplementary oxygen therapy later 6 h after surgery;* No willing to wear electronic device;* No willing to exam arterial oxygen saturation.
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Study Objectives Pancreaticojejunostomy is the key procedure of pancreaticoduodenectomy. The aim of our study is to investigate a new pancreaticojejunal (PJ) anastomosis procedure named "nonstented stump-closed pancreaticojejunostomy" in pancreatoduodenectomy, which could provide a feasible option to pancreatic surgeons for patients with pancreaticoduodenectomy. Conditions: Pancreatic Neoplasms, Biliary Tract Neoplasms, Pancreatitis, Chronic, Duodenal Neoplasms Intervention / Treatment: PROCEDURE: pancreaticojejunostomy
Inclusion Criteria: * Informed consent * 18-80 years old; * Eastern Cooperative Oncology Group(ECOG) 0-2 * Patients must have undergone pancreaticoduodenectomy. * Preoperative enhanced CT scan shows respectable or borderline resectable neoplasm * Without distal metastasis Exclusion Criteria: * Patients who have had previous pancreatic body tail resection rese * immunodeficiency, people infected with HIV * patients with severe cardiopulmonary function, liver and renal function * infection without control or active infections * Pregnant patients.
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Study Objectives To evaluate the safety and tolerability of the veliparib/TMZ combination in subjects with solid tumors. Conditions: Solid Tumor Cancers Intervention / Treatment: DRUG: veliparib, DRUG: Temozolomide
Inclusion Criteria * Subject has completed study participation in Study M11-846* Eastern Cooperative Oncology Group (ECOG) performance score of 0 to 2.* Subject must have adequate hematologic, renal and hepatic function per institutional normal range as follows: * Bone Marrow: Absolute neutrophil count (ANC ≥ 1,500/mm3 (1.5 × 109/L); Platelets ≥ 100,000/mm3 (100 × 109/L); Hemoglobin ≥ 9.5 g/dL (1.4 mmol/L); * Renal function: Serum creatinine ≤ 1.5 × upper limit of normal (ULN) range OR creatinine clearance ≥ 50 mL/min/1.73 m2 for subjects with creatinine levels above institutional normal; * Hepatic function: AST and ALT ≤ 2.5 × the ULN range. For subjects with liver metastases, AST and ALT < 5 × the ULN range; Bilirubin ≤ 1.5 × the ULN range. * Partial Thromboplastin Time (PTT) must be ≤ 1.5 × the ULN range and INR < 1.5. Subjects on anticoagulant therapy (such as Coumadin) will have an appropriate PTT and INR as determined by the Investigator.* Women of childbearing potential must agree to use adequate contraception (one of the following listed below) prior to study entry, for the duration of study participation and for 90 days following completion of therapy. Women of childbearing potential must have a negative serum pregnancy test within 28 days prior to initiation of treatment and a negative urine pregnancy test on Cycle 1 Day 1 and/or post menopausal women must be amenorrheic for at least 12 months to be considered of non-childbearing potential. * Total abstinence from sexual intercourse (minimum one complete menstrual cycle); * Vasectomized partner; * Hormonal contraceptives (oral, parenteral or transdermal) for at least 3 months prior to study drug administration; * Double-barrier method (condoms, contraceptive sponge, diaphragm or vaginal ring with spermicidal jellies or cream); * IUD (Intrauterine Device). Exclusion Criteria * Subject has received anticancer agent(s) or an investigational agent (except for veliparib) within 28 days prior to study drug administration. Subjects who have not recovered to within one grade level (not to exceed grade 2) of their baseline following a significant adverse event or toxicity attributed to previous anticancer treatment are excluded.* Subject has undergone major surgery within the previous 28 days prior to study drug administration.* Subject has received radiotherapy within 28 days prior to study drug administration.* Clinically significant and uncontrolled major medical condition(s) including but not limited to: * Active uncontrolled infection; * Symptomatic congestive heart failure;* Unstable angina pectoris or cardiac arrhythmia; * Psychiatric illness/social situation that would limit compliance with study requirements; * Any medical condition, which in the opinion of the Study Investigator, places the subject at an unacceptably high risk for toxicities.* Subject is pregnant or lactating.
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Study Objectives This pilot trial studies propranolol hydrochloride in treating patients with locally recurrent or metastatic solid tumors that cannot be removed by surgery. Propranolol hydrochloride may slow the growth of tumor cells by blocking the use of hormones by the tumor cells. Conditions: Male Breast Cancer, Recurrent Melanoma, Stage IV Breast Cancer, Stage IV Melanoma, Stage IV Ovarian Epithelial Cancer, Stage IV Ovarian Germ Cell Tumor, Unspecified Adult Solid Tumor, Protocol Specific, Hepatocellular Carcinoma Intervention / Treatment: DRUG: propranolol hydrochloride, OTHER: Correlative Studies
Inclusion Criteria: * Patients must have histologically-proven locally-recurrent or metastatic solid tumor; the first 10 patients may have cancer of any histology; preference will be given to patients with metastatic ovarian cancer, breast cancer, and malignant melanoma, as these malignancies have been shown to be sensitive to manipulation of the beta-adrenergic receptor; the final twenty-five patients to be accrued must have locally-recurrent or metastatic malignant melanoma that is not surgically resectable. An additional cohort of 10 patients with BCLC stages A to C locally advanced or metastatic hepatocellular carcinoma (HCC) that is not surgically resectable will also be enrolled (See appendix for BCLC staging system). Patients with liver transplantation will not be eligible. * The diagnosis of hepatocellular carcinoma may be made by one of the following methods: 1. Pathologically (histologically or cytologically) proven diagnosis of HCC. 2. At least one solid liver lesion or vascular tumor thrombosis (involving portal vein, IVC and/or hepatic vein) > 1 cm with arterial enhancement and delayed washout on multiphasic computerized tomography (CT) or magnetic resonance imaging (MRI) in the setting of cirrhosis or chronic hepatitis B or C without cirrhosis. 3. For patients whose CURRENT disease is vascular only: Enhancing vascular thrombosis (involving portal vein, IVC and/or hepatic vein) demonstrating early arterial enhancement and delayed washout on multi-phasic CT or MRI, in a patient with known HCC (diagnosed according to criteria in (a) or (b). * Patients may have had any number of prior systemic therapies; patients need not have exhausted standard therapy for their disease, but must be stable and must not have actively progressing * Eastern Cooperative Oncology Group (ECOG) performance status =< 2 * Karnofsky >= 60% * Life expectancy of greater than 6 months * Patients (except for the HCC cohort) must have normal organ and marrow function as defined below: * Leukocytes >= 3,000/mcL * Absolute neutrophil count >= 1,500/mcL * Platelets >= 100,000/mcL * Total bilirubin within normal institutional limits * Aspartate aminotransferase (AST)(serum glutamic oxaloacetic transaminase \[SGOT\])/alanine aminotransferase (ALT)(serum glutamate pyruvate transaminase \[SGPT\]) =< 2.5 X institutional upper limit of normal * Creatinine within normal institutional limits OR * Creatinine clearance >= 60 mL/min/1.73 m\^2 for patients with creatinine levels above institutional normal * Parameters for the HCC cohort: * leukocytes > or = 3000/mcl * absolute neutrophil count > or =1000/mcl * platelets > or = 70,000 * total bilirubin < or = 2mg/dL * AST/ALT <6 times ULN * creatinine within normal institutional limits OR * creatinine clearance > or = 60mL/min/1.73m2 for patients with creatinine levels above institutional normal level * INR < or = 1.7 * The effects of propranolol on the developing human fetus may be detrimental. For this reason, women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation; should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately * Ability to understand and the willingness to sign a written informed consent document * Patients with brain metastases may participate in this clinical study provided that symptoms have been controlled with standard therapies and/or appropriate medications; the principal investigator (P.I.) will carefully evaluate the suitability of patient participation when brain metastases are present Exclusion Criteria: * Patients who have had chemotherapy or radiotherapy within 4 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 4 weeks earlier * Patients may not be receiving any other investigational agents * History of allergic reactions attributed to compounds of similar chemical or biologic composition to propranolol * Uncontrolled hypertension * 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 * Patients with significant lung disease, an ejection fraction less than 40%, or a resting heart rate less than 60/min will not be enrolled * Pregnant women are excluded from this study because propranolol is an agent with the potential for teratogenic or abortifacient effects * Patients who are currently receiving a beta-blocker for another medical condition will be excluded from this study; patients with extremes of blood pressure (e.g., systolic blood pressure \[SBP\] > 150 or < 100) may be excluded from participation if the treating physician feels that this medical condition has not been adequately addressed by the patient's primary care physician * Patients with worsening depression that has not been addressed clinically will be excluded from this study
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Study Objectives The median survival at progression after first-line chemotherapy for metastatic gastric cancer is about 2.5 months. There are no data which a possible benefit of second line therapy. for this reason a trial which investigates a possible benefit or chemotherapy compared to best supportive care as second line treatment is urgently necessary. Irinotecan shows response rates of 20% in the first line therapy with high rates od disease stabilization. There are few trials investigating irinotecan in the second line setting. Response rates of 20% are reported in tis setting. Irinotecan is supplied without costs from the company Pfizer. Conditions: Stomach Neoplasm, Neoplasm Metastasis Intervention / Treatment: DRUG: Irinotecan
Inclusion Criteria: * Patient with histologically proven adenocarcinoma of stomach or the gastro-esophageal junction * Patient with distant metastases laparoscopically proven operative incurability of an locally advanced gastric cancer or patient with a tumor recurrence after gastrectomy * Patient with progressive disease under a palliative first-line chemotherapy or progressive disease within 6 months after termination of a first-line chemotherapy, defined as objective progression by imaging techniques according to WHO criteria * Age 18 and 75 years * Sufficient liver function, defined as serum-bilirubin <1,5 mg/dl (1,5 upper normal limit), ALT und AST < 3x upper normal limit * Sufficient renal function, defined as serum creatinine < 1,25 x upper normal limit or creatinine clearance >60ml/min calculated according to Crockroft-Gault * Contraction for patient with reproductive potential * Karnofsky-Index >60% * Measurable or evaluable tumor manifestation Exclusion Criteria: * Tumor progression later than 6 months after termination of first-line chemotherapy * KI 50% or less * Patient who have already received a second line chemotherapy for the metastatic setting (adjuvant chemotherapy and one line of palliative chemotherapy os allowed, biologic prior therapies are allowed) * Prior or current second malignancy despite of basal carcinoma of the skin and curatively treated carcinoma in situ of the cervix * Uncontrolled infection * CNS metastases * Other severe medical illness * Prior major surgery less than 2 weeks ago * Parallel treatment with another experimental therapy * Parallel treatment with another therapy aiming at tumor reduction * Chronic diarrhea, subileus * Chronic inflammatory bowel disease or intestinal obstruction * Pretreatment with irinotecan
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Study Objectives This study is a prospective open phase-I study to investigate the safety and tolerability for administration of repeated doses of ALECSAT. Each patient will be followed up to 24 weeks from the initial blood donation to the last visit. However, the actual treatment starts on day 26, when the first single dose of ALECSAT is administered. The following administrations are given with 3 weeks intervals, i.e. at week 7 and 10. The patients are attending Kirurgisk afdeling K, Bispebjerg Hospital, and are followed by close examinations during the study period and at regular visits after completing the study as advised by the patient's responsible physician. Conditions: Pancreatic Cancer Intervention / Treatment: BIOLOGICAL: Alecsat
Inclusion Criteria: * Patients suffering from locally advanced pancreatic cancer and have started treatment with Folfirinox but must stop because of side effects or who declined the Folfirinox treatment. * Minimum age of 18 years old and be capable of understanding the information and giving informed consent, * Minimum height of 155 cm, * Expected survival time (life expectancy) of over 6 months, * Adequate performance status £ 2 (see below\*), Exclusion Criteria: * Evident signs of distant metastasis at baseline * Positive tests for anti-HIV-1/2; HBsAg, anti-HBc, Anti-HCV or being positive in a Treponema Pallidum test (syphilis), * Patient´s which have visit an area where there is an outbreak of West Nile virus or Dengue virus within 28 days prior to donation should be excluded, unless the patient has been tested negative, * Concurrent illness, e.g. uncontrolled epilepsy, cardiovascular-, cerebrovascular-, and/or respiratory disease which can worsen or cause complications in connection with blood donation, * Clinically significant autoimmune disorders or conditions of immune suppression, * Haemoglobin count ≤ 7.5 mmol/l (men \& women), * Lymphocytes below 0.3 x 109/l, * Clinically abnormal Erythrocyte Volume Fraction (EVF), * Body weight below 40 kg (men) and 50 kg (women), * Pregnant or breast feeding women. Fertile women can only be included with a negative pregnancy test at screening and must use contraceptives during the study, * Patients with uncontrolled serious bacterial, viral, fungal or parasitic infection, * Blood transfusions within 48 hours prior to donation of blood for ALECSAT production, * Any medical condition that will render participation in the study risky or, according to the investigator will make the assessment of the study endpoints difficult,
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Study Objectives A prospective and retrospective cohort study of patients with a documented pathogenic or likely pathogenic variants of TP53 were identified using blood DNA colection and breast cancer diagnosis by histological confirmation, between 1999 and 2022. All patients were followed by the Hereditary Group of a single cancer center (Instituto do Cancer do Estado de Sao Paulo). Patients were included if they had a histopathological diagnosis of localized invasive carcinoma or in situ carcinoma of the breast and with localized disease. Patients met Revised Chompret criteria, Li Fraumeni like syndrome,family member of carrier TP53 or hereditary breast and ovarian syndrome for germline test. Conditions: Breast Cancer, TP53 R337H, Li-Fraumeni Syndrome, Prognosis Breast Cancer Intervention / Treatment: OTHER: No intervention in this study
Inclusion Criteria: * Breast cancer (histopathological diagnosis of localized invasive carcinoma or in situ carcinoma of the breast) and documented germline pathogenic variants of TP53. Exclusion Criteria: * Patients with only other types of breast cancer such as sarcoma and phyllodes tumor were excluded from the analysis. * Metastatic Breast Cancer at diagnosis ("denovo")
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Study Objectives This is a multi-center, open-label, single-sequence, crossover, drug-drug interaction (DDI) study to assess the effect of the CYP1A2 inhibitor, fluvoxamine, on the PK of dovitinib in patients with advanced solid tumors, excluding breast cancer. The purpose of this study is to evaluate the effect of a CYP1A2 inhibitor, 100 mg fluvoxamine, on the PK of dovitinib when administered at a dose of 300 mg on the dosing schedule, 5 days on/2 days off. The study will consist of 2 phases: a Pharmacokinetic (PK) phase and a clinical treatment phase. The DDI test will be conducted in the PK phase. The DDI test will assess the steady state PK profile of dovitinib when administered alone and in the presence of the CYP1A2 inhibitor, fluvoxamine (AUC 0-24h, AUC 0-72h and Cmax parameters). During the clinical treatment phase patients may continue to receive treatment with TKI258 until disease progression (assessed by RECIST 1.1), unacceptable toxicity, death or discontinuation from the study treatment for any other reason. Conditions: Advanced Solid Tumors, Excluding Breast Cancer Intervention / Treatment: DRUG: dovitinib (TKI258), DRUG: fluvoxamine
Inclusion Criteria: Patients with a cytopathologically or histopathologically confirmed diagnosis of an advanced solid tumor, excluding breast cancer which has progressed despite standard therapy or for which no standard therapy exists - ECOG performance status 0 or 1 and an anticipated life expectancy of ≥3 months- Patient must meet protocol-specific laboratory values Exclusion Criteria: * Patients with brain metastases - Patients who have received or who are expected to receive any prohibited medications and therapies - Patients who have received CYP1A2 or CYP3A inhibitor medications within 5 days prior to start study treatment or are expected to receive during the first 28 days after starting the study treatment - Patients who have received CYP1A2 or CYP3A inducer medications within 30 days prior to start study treatment or are expected to receive during the first 28 days after starting the study treatment - Patients who are actively taking antidepressants, benzodiazepines, serotonergic drugs, and/or monoamine oxidase inhibitors (MAOIs) - Patients who have not recovered from previous anti-cancer therapies - Patient with impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of TKI258 - Patients who have concurrent severe and/or uncontrolled concomitant medical conditions that could compromise participation in the study - Female patients who are pregnant or breast-feeding - Fertile males or women not willing to use highly effective methods of contraception - Other protocol-defined inclusion/exclusion criteria will apply
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Study Objectives The prognosis of peritoneal metastases from colorectal cancer has recently improved with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC). Although outcomes are further improved when early stage peritoneal metastases are treated, adjuvant HIPEC has not yet been thoroughly addressed. This prospective pilot study assessed feasibility, safety and efficacy of HIPEC performed simultaneously with primary curative surgery in colorectal cancer patients with primary tumor-related risk-factors for the development of metachronous peritoneal metastases. Conditions: Colorectal Neoplasm, Metastasis Intervention / Treatment: DRUG: adjuvant HIPEC, PROCEDURE: surgery
Inclusion Criteria: * pathologically confirmed colorectal carcinoma; * curative surgery; * presence of at least one of the following risk-factors for the development of metachronous PM: * minimal synchronous PM (nodules ≤1cm in the omentum and/or close to the primary tumor), completely resected at the same time as primary tumor; * synchronous ovarian metastases, also resected at the same time as primary tumor; * primary tumor either penetrating visceral peritoneum (T4a), * primary tumor directly invading other organs (T4b); * signature of an informed consent form. * intention to start adjuvant systemic therapy and postoperative follow-up; * performance status ≤2 according to the Eastern Cooperative Oncology Group score; * no significant co-morbidities. * no active sepsis * no impaired cardiac function (history of previous cardiac failure, or ejection fraction <40%) * no impaired renal function (serum creatinin > 1.5 normal value or creatinin clearance < 60 mL/min); * no impaired hepatic function (serum glutamic oxaloacetic transaminase, serum glutamic pyruvic transaminase, bilirubin > 1.5 normal value); * no impaired bone marrow function (leucocytes < 4000/mm3 ; neutrophils < 1500/mm3; platelet < 80000/mm3) * no impaired lung function (diagnosis of severe chronic obstructive pulmonary disease , or forced expiratory volume at one second < 50% or a diffusion capacity of lung for carbon monoxide < 40% age adjusted). Exclusion Criteria: * extensive PM (nodules >1cm, and/or nodules outside the omentum and/or beyond the close vicinity of the primary tumor); * extra-abdominal/hepatic metastases; * emergency presentation (bleeding, perforated, or occlusive primary); * bleeding diathesis or coagulopathy * history of previous neoplasm during the past three years, excluding skin spinocellular/basocellular carcinoma; * preoperative pelvic radio-chemotherapy
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Study Objectives The anti-cancer cytotoxic chemotherapy is often the cause of neutropenia of grade IV or febrile neutropenia. Those neutropenia, in addition to being a comorbidity factor, result in dose reductions and/or temporary or permanent stop of chemotherapy, thus impacting clinical response. To avoid those episodes, or to shorten the duration and reduce the associated risk, administration of Granulocyte Colony Stimulating Factor (G-CSF) is recommended. Recombinant G-CSF reproduces the physiological effects of endogenous G-CSF by increasing the proliferation of granulocytes progenitors. Different forms of G-CSF are available: daily administration (such as filgrastim, lenograstim) and a single administration (pegfilgrastim). Various international learned societies offer recommendations for primary care, secondary or curative neutropenia induced by chemotherapy based on G-CSF. However, guidance on the ideal time for the administration of growth factors and duration of administration are not very clear. If it seems clear that the treatment should not be initiated within the first 24 hours following administration of chemotherapy, summaries of the characteristics of different products do not provide evidence to optimize the administration day depending on the kinetics evolution of neutrophils. In addition, no information is given as to the choice of a formulation with respect to the other. The pilot study the investigator propose aims to model the effect of exogenous G-CSF on the evolution of neutrophil function of time and explain the pharmacodynamic variability during the administration of chemotherapy based on eribulin. The description of the evolution of neutrophils when growth factors are administered give the opportunity to streamline administration regimens of these factors and to provide guidance on the circumstances in which they should or should not be given while weekly chemotherapy. Expected benefits and foreseeable risks With the exception of surplus withdrawals during the first 2 cycles of treatment, this study will have no impact on the care of patients. Conditions: Breast Cancer Intervention / Treatment: PROCEDURE: ERIBULIN + G-CSF (Granulocyte-Colony Stimulating Factor)
Inclusion Criteria: * Women * over 18 years * Patient with locally or metastatic advanced breast cancer histologically documented who received at least one chemotherapy regimen that includes an anthracycline and a taxane unless in patients who can not receive these treatments * Patient to be treated with eribulin * Patient that should preventively receive granulocyte growth factors at the first cycle (patient who already experienced febrile neutropenia, patient with a low neutrophil count at baseline, patient with a Performance Status altered or any other condition requiring administration of granulocyte colony stimulating factor as recommended by the oncologist) * Neutrophils> 1500 / mm3; platelets> 100,000 / mm3 * Dated and signed Informed consent * For patients of childbearing age, effective contraception during treatment and up to 3 months after stopping treatment Exclusion Criteria: * Patient with against-indication to treatment with eribulin such as hypersensitivity to the active substance or to any of the excipients, congenital long QT syndrome * Patient already being treated with eribulin * Patient with clinically detectable brain metastases * Patient with against-indication to treatment with G-CSF such as hypersensitivity to the active substance or to any of the excipients * Pregnant women or nursing * Patient under guardianship or subject to major people protection regime * Patient not affiliated with a social security scheme (beneficiary or beneficiary)
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Study Objectives The purpose of this study is to investigate the effect of 12 weeks systematically training using the Xbox Kinect system. Outcome measures are made on physical function, quality of life, fatigue and metabolic parameters. Conditions: Prostate Cancer Intervention / Treatment: BEHAVIORAL: Home based training using the Xbox Kinect system
Inclusion Criteria: * Prostate cancer requiring androgen deprivation therapy * Androgen deprivation therapy for at least 3 month prior to inclusion * Cognitive well-functioning in order to be able to answer questionnaires and train according to instructions * Signed informed consent Exclusion Criteria: * Prostate cancer with metastasis to other regions than bones * Strength- or cardiovascular training 2 times or more per week prior to inclusion * Haemoglobin percentage less than 6,1 mmol/l * Any mental or physical condition that makes the patient unfit for participation * Men in risk of getting an osteoporotic fracture due to long-term treatment with steroids or earlier fractures due to minimal trauma * Participation in other studies
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Study Objectives This study is for patients up to 21 years of age who have a tumor called a low grade glioma of the central nervous system (brain and spinal cord). The tumor has grown despite attempts to control it with chemotherapy or radiation. Low grade gliomas are a group of tumors that tend to grow slowly and could be cured if every bit of the tumor were surgically removed. These tumors are called Grade I or II astrocytomas. These tumors often grow in parts of the brain that prevent total removal without devastating neurologic complications or death. Although some low grade gliomas never grow, most will and are treated with either chemotherapy or radiation. There is good data showing that the growth of most low grade gliomas can be controlled with chemotherapy or radiation. However, some low grade gliomas in children and young adults grow despite these treatments. Poly-ICLC is a new drug that has been used safely in children and adults with different types of brain tumors. Earlier studies showed that this drug worked better for children and young adults with low grade gliomas than for children with more aggressive brain tumors. The main purpose of this study is to use Poly-ICLC treatment in a larger number of patients to see how well it works and how many side effects occur. As Poly-ICLC is not FDA approved, this study is authorized to use it under Investigational New Drug (IND)# 43984, held by Oncovir. Subjects will get injections of Poly-ICLC into muscle two times weekly. The first treatments will be given in the clinic so allergic or other severe reactions, if any, can be monitored. If subjects tolerate the injections and don't have a severe reaction, then the rest of the injections will be given at home. Subjects/caregivers will be trained to give injections. Treatment will last for about 2 years. Subjects may stay on treatment for longer than 2 years if their tumor shrinks in response to the injections, if study doctors think it is safe, if subjects want to remain on treatment, and if Poly-ICLC is available. Risks: Poly-ICLC has been used safely in children and adults at the dose used in this study, and at higher doses. Frequently seen side effects include irritation of the skin at the injection site and mild flu-like symptoms. These are usually relieved or avoided by use of over-the-counter medicines like acetaminophen (Tylenol). Conditions: Brain Tumors Intervention / Treatment: DRUG: Poly ICLC
Inclusion Criteria: * Age:Patients must be between 0 - 21 years of age when registered on this protocol. * Diagnosis:Patients must have pathologically confirmed low grade glioma with histologic subtypes interpreted as World Health Organization (WHO) grade I and II including: * juvenile pilocytic astrocytoma (JPA) * pleomorphic JPA * diffuse astrocytoma (fibrillary, gemistocytic, giant cell, or pleomorphic xanthoastrocytoma) * low grade oligoastrocytoma * low grade oligodendroglioma * low grade glioma not otherwise specified (NOS) Tumors of all regions of the CNS, with appropriate histology are eligible for study. However patients with tumors intrinsic to the optic nerve and involvement of the optic nerve cannot be biopsied/resected are eligible without histological confirmation. Patients with neurofibromatosis type 1(NF1) are also eligible. Patients must have demonstrated either tumor progression or recurrence by radiographic criteria and/or clinical criteria as defined below: * Patients with progressive non-resectable disease regardless of location in the brain or spine are eligible for this study. Patients with evidence of leptomeningeal dissemination are eligible for this study. Patients do not require biopsy/histologic confirmation at the time of progression or relapse.* Radiographic progression is defined as >40% increase in the product of the three perpendicular diameters of initial tumor relative to the initial baseline measurement - length (L)x width (W) x transverse (T) (current scan) > 1.4 x L x W x T (initial scan), or the development of any new sites of disease independent of the response of the initial tumor. See section 7.1.2 for methodology for tumor measurement.* Post radiation changes are often seen on post-treatment imaging studies, so that classification of a patient as having progressive disease may require several serial MRI's if the child has received radiation within the preceding 12 months.* Tumor volume includes the entire tumor volume seen on gadolinium enhanced T1 MRI plus non-enhancing abnormality seen on T2 or FLAIR.* All tumor cysts will be included in the tumor volume* Clinical progression without radiographic progression includes children with optic pathway gliomas who demonstrate sustained decrease in visual fields and/or acuity in three serial vision examinations. Each of the vision examinations must be performed >2 weeks apart.* Children with previously negative cerebrospinal fluid (CSF) cytology who show evidence of tumor cells in fluid obtained by lumbar puncture can be designated as having progressive disease in the absence of radiographic evidence of progression. Measurable disease: Patients must have measurable disease documented by radiographic criteria prior to enrollment. Performance Level and Life Expectancy:Patients must have a performance status of > 50% (Appendix I). Use Karnofsky for patients > 16 years of age and Lansky for patients ≤ 16 years of age. Patients must have a life expectancy of ≥ 8 weeks. Prior Therapy:Patients must have fully recovered from the acute toxic effects of all prior chemotherapy, immunotherapy, or radiotherapy prior to entering this study and meet time restrictions from end of prior therapy as stated below: * Myelosuppressive chemotherapy patients must have received the last dose of myelosuppressive therapy at least 3 weeks prior to study registration or at least 6 weeks if nitrosourea.* Investigational / Biological agent: Patient must have received the last dose of other investigational or biological agent >7 days prior to study registration* Radiation therapy (XRT): Patients must be ≥ 8 weeks since the completion of radiation therapy.* Study specific limitations on prior therapy: There is no limit on the number of prior treatment regimens or received doses of radiation therapy.* Growth factor(s): Must not have received any hematopoetic growth factors within 7 days of study entry or 21 days for neulasta.* Prior Surgery: Must be ≥ 2 weeks from prior surgery.* Steroids: Must be on a stable steroid dose for 7 days prior to study entry. Organ Function Requirements:All patients must have adequate organ function defined as: Hematologic Function: * Hemoglobin: > 8.0 gm/dl* Absolute neutrophil count (ANC): > 750/mm3 Must be at least 7days after last dose of growth factor* Platelet Count: > 50,000 (transfusion independent; ≥ 7 days from last transfusion) Renal Function: Serum creatinine ≤ 2 x normal for age (see below) or Creatinine clearance/Glomerular filtration rate (GFR) > 60 cc/min/1.73 m2 \[Urine Creatinine (mg/dL)\]\[Volume collected (ml)\]/\[Serum Creatinine 9mg/dL)\]\[Hours x 60\] Age (years) Maximum Serum Creatinine (mg/dL) ≤ 5 0.8 > 5 \& ≤ 10 1.0 > 10 \& ≤ 15 1.2 > 15 1.5 Liver Function: * Total bilirubin < 1.5 x Upper limit of Normal (ULN) for age, AND* alanine transaminase (ALT) < 2.5x ULN* aspartate aminotransferase (AST) < 2.5x ULN Pulmonary Function: No evidence of dyspnea at rest, no exercise intolerance, and a pulse oximetry ≥ 94% if there is clinical indication for determination. Coagulation Function: Normal prothrombin time (PT) and Partial thromboplastin time (PTT) at enrollment per institutional range Reproductive Function:Due to potential teratogenic effects of (poly-ICLC), negative serum beta-human chorionic gonadotropin (HCG) in females, and use of effective contraception in males and females of childbearing potential, IS REQUIRED. Exclusion Criteria: * Pregnant or lactating females. Women of childbearing age will agree to use contraception during the protocol. * Patients receiving other experimental immunotherapy. * Patients may not have fever (38.50C) within 7 days of enrollment. * No concurrent XRT or chemotherapy is allowed. * Patients who, in the opinion of the investigator, may not be able to comply with the safety monitoring requirements of the study.
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Study Objectives This study will explore the safety and efficacy of the oral PanHER inhibitor PF-00299804 in patients with adenocarcinoma of the lung who are either non-smokers (\<100 cigarette, cigar or pipe lifetime) or former light smokers ( less than 10 pack-years and stopped at least 15 years) or have known EGFR activating mutation; or patients with HER 2 amplification or mutation. Conditions: Carcinoma, Non-small Cell Intervention / Treatment: DRUG: Dacomitinib (PF-00299804), DRUG: Dacomitinib (PF-00299804)
Inclusion Criteria: * Advanced adenocarcinoma of lung, measurable disease * Non-smoker, or former light (less than 10 pack years and stopped at least 15 years); OR * patients with known EGFR activating mutation regardless of smoking status * ECOG(Eastern Cooperative Oncology Group) 0-1. Cohort B (select sites only): patients with HER2 amplified or HER2 mutation-positive NSCLC; may have had prior therapy Exclusion Criteria: * Active brain metastases * Prior systemic therapy for advanced disease in Cohort A only. Cohort B can have had any number of prior lines of systemic therapy. * known EGFR wild type NSCLC
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Study Objectives This is a single-arm, open-label, multicenter, efficacy, and safety study of pembrolizumab in adult and pediatric participants with previously untreated advanced Merkel Cell Carcinoma (MCC). The primary objective of the trial is to assess the objective response rate, as assessed by blinded independent central review per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) modified to follow a maximum of 10 target lesions and a maximum of 5 target lesions per organ, following administration of pembrolizumab. Conditions: Merkel Cell Carcinoma Intervention / Treatment: DRUG: Pembrolizumab (MK-3475)
Inclusion Criteria: * Be male or female and at least 12 years of age, at the time of signing the informed consent/assent. * Have histologically confirmed diagnosis of locoregional MCC that has recurred following standard locoregional therapy with surgery and/or radiation therapy and is not amenable to local therapy or metastatic MCC (Stage IV) as per American Joint Committee on Cancer (AJCC) 8th edition guidelines. * Have been untreated for advanced or metastatic disease except as follows: 1. Prior intratumoral therapy will be permitted. 2. Prior adjuvant or neoadjuvant therapy containing systemic chemotherapy will be permitted if treatment concluded at least 3 months prior to Cycle 1 Day 1 (C1D1). 3. Prior adjuvant or neoadjuvant therapy containing anti-PD-1/L1 or anti-CTLA-4 (cytotoxic T-lymphocyte-associated protein 4) therapy will not be permitted. * Have at least 1 measurable lesion by computed tomography (CT) or magnetic resonance imaging (MRI) per RECIST 1.1 criteria as determined by the local site investigator/radiology assessment. * Toxic effect(s) of the most recent prior therapy have resolved to Grade 1 or less (except alopecia). * Contraceptive use by men should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies. * Contraceptive use by women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies. * A female participant is eligible to participate if she is not pregnant or breastfeeding, and at least one of the following conditions applies: * Is not a woman of childbearing potential (WOCBP) * OR * Is a WOCBP and using a contraceptive method that is highly effective (with a failure rate of <1% per year), with low user dependency, or be abstinent from heterosexual intercourse as their preferred and usual lifestyle (abstinent on a long term and persistent basis). * A WOCBP must have a negative highly sensitive pregnancy test (urine or serum as required by local regulations) within 72 hours before the first dose of study intervention. * Have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 or Lansky Play-Performance Scale (LPS) ≥50 for pediatric participants up to and including 16 years of age. * Have adequate organ function Exclusion Criteria: * Has a known additional malignancy that is progressing or has required active treatment within the past 2 years with certain exceptions. * Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis with certain exceptions. * Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of immunosuppressive therapy within 7 days prior to C1D1. * Has severe hypersensitivity (≥Grade 3) to pembrolizumab and/or any of its excipients. * Has an active autoimmune disease that has required systemic treatment in past 2 years (i.e., with use of disease-modifying agents, corticosteroids or immunosuppressive drugs). * Has a history of (non-infectious) pneumonitis/interstitial lung disease that required steroids or has current pneumonitis/interstitial lung disease. * Has an active infection requiring systemic therapy. * Has a known history of human immunodeficiency virus (HIV) infection. * Has a known history of Hepatitis B (defined as Hepatitis B surface antigen \[HBsAg\] reactive) or known active Hepatitis C virus (defined as HCV RNA \[qualitative\] is detected) infection. * Has a known history of active tuberculosis (TB; Bacillus tuberculosis). * Has clinically significant cardiac disease within 6 months of C1D1, including New York Heart Association Class III or IV congestive heart failure, unstable angina, myocardial infarction, cerebral vascular accident, or cardiac arrhythmia associated with hemodynamic instability. * Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the study, interfere with the participant's participation for the full duration of the study, or is not in the best interest of the participant to participate, in the opinion of the treating investigator. * Has a known psychiatric or substance abuse disorder that would interfere with the participant's ability to cooperate with the requirements of the study. * Has not received standard locoregional therapy with surgery and/or radiation therapy for the treatment of local or locoregional disease. Note: This exclusion criterion does not apply to participants who are diagnosed with unresectable or metastatic MCC. * Has received prior therapy with an anti-PD-1, anti-PD-L1, or anti PD-L2 agent or with an agent directed to another stimulatory or co-inhibitory T-cell receptor. * Has received prior systemic anticancer therapy including investigational agents within 12 weeks prior to C1D1. * Has received radiotherapy within 2 weeks prior to start of study intervention. * Has received a live vaccine within 30 days prior to C1D1. * Is currently participating in or has participated in a study of an investigational agent or has used an investigational device within 4 weeks prior to C1D1. * Has had an allogenic tissue/solid organ transplant.
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Study Objectives A phase 2 trial of pre-phase treatment before R-CHOP chemotherapy in elderly patients with newly diagnosed DLBCL Conditions: Diffuse Large B Cell Lymphoma Intervention / Treatment: DRUG: PrednisoLONE 50 MG
Inclusion Criteria: * Histologically the first large-scaled B-cell lymphoma patient* Diagnosis time 65 years old or older* Patients planning R-CHOP chemotherapy* Ann Arbor stage 2 (bulky ≥ diameter of 7cm), stage 3 or stage 4* The International Prognostic Index (IPI) is a high intermediate or high risk* Patients without prior history of lymphoma* The decision to participate voluntarily in this study and the written consent of the patient Exclusion Criteria: * Histologic subtypes other than CD20 positive broad-band macro-B cell lymphoma* Large B-cell lymphoma involving the central nervous system* Inadequate systemic disease A. Patients with clinically significant heart disease (congestive heart failure, symptomatic coronary artery disease, cardiac arrhythmia) or myocardial infarction within the past 6 months B. Serious neurological and psychiatric illness C. Serious active infection D. Other medical illnesses other than clinical trials* If the drug used in this study is allergic* If you do not agree to participate in the study
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Study Objectives The purpose of this study is to measure the level of a specific protein, CXCL1, in the blood of patients with untreated, metastatic (Stage IV) melanoma. These levels will be compared to blood levels in normal controls. If the levels are elevated in metastatic melanoma, further studies to determine if this correlates with presence and extent of disease will be pursued. Conditions: Metastatic Melanoma Intervention / Treatment:
Inclusion Criteria: * Histologic diagnosis of melanoma; primary may be cutaneous, mucosal or ocular.* Evidence of metastatic disease based on standard AJCC staging.* Willing to give written informed consent.* Willing and able to comply with protocol procedures.* At least 18 years of age.* No prior chemotherapy, immunotherapy, or radiotherapy.* Are able to safely donate 50 mL of blood.* Have a central venous catheter in place (this will not be placed for participation in this trial) Exclusion Criteria: * Known diagnosis of a chronic inflammatory disease, ie: Rheumatoid Arthritis, Systemic Sclerosis, Inflammatory bowel disease* Known diagnosis of NYHA class 3 or 4 Congestive Heart Failure* Are unable to safely donate 50 mL blood* Known HIV, Hepatitis B, or Hepatitis C infection.* Any malignancy within 5 years, other than melanoma (for patients); Have any malignancy within the past 5 years including melanoma (for normal controls). Basal cell and squamous cell skin cancers are permitted in all participants.
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Study Objectives Metastatic kidney cancer is usually treated with targeted therapy or immunotherapy which is costly and has low response rate. The current standard care is to perform anatomical imaging studies after a few cycles (months) of treatment to evaluate response. This approach exposes many patients to highly toxic, high expensive treatment without any benefit for months and delays initiation of other effective therapies. The goal of this study is to evaluate a parametric PET method that potentially identify response and assess drug efficacy with a few days to weeks of treatment. Conditions: Genitourinary Cancer Intervention / Treatment: DIAGNOSTIC_TEST: Parametric PET/CT
Inclusion Criteria: * Patients with pathologically confirmed GUC. For those patients whose primary kidney cancer is removed, they must have index metastatic cancer lesion(s) within the PET field of view for 18F-FDG parametric PET/CT analysis to determine response. * Patients are scheduled for targeted cancer therapy, including sunitinib, pazopanib, cabozantinib, everolimus, and others. * Ability to understand and willingness to sign an informed consent form. * Ability to adhere to the study visit schedule and other protocol requirements. * Men and women ≥21 years of age. * Life expectancy ≥ 6months. * Female subjects who are of non-reproductive potential (i.e., post-menopausal by history - no menses for ≥1 year; OR history of hysterectomy; OR history of bilateral tubal ligation; OR history of bilateral oophorectomy). Or, female subjects of childbearing potential must have a negative serum or urine pregnancy test within 72 hours prior to the first drug administration. * Male and female subjects who agree to use highly effective method of birth control (e.g., implants, injectables, birth control pills with two hormones, intrauterine devices \[IUDs\], complete abstinence or sterilized partner, and female sterilization) and a barrier method (e.g., condoms, vaginal ring, sponge, etc.) during the period of therapy and for 90 days after the last dose of drug. * For the minority cohort, subject must be a member of a Federally recognized racial/ethnic minority population to include: African Americans or Black; Native American; Alaska Native; Native Hawaiian or other Pacific Islander; Asian American; Hispanic or Latino. This will be verified through self-reporting by the subject. Exclusion Criteria: * Pregnant or lactating women. * Any condition that would prohibit the understanding or rendering of informed consent. * Any medical condition including additional malignancies, laboratory abnormalities, or psychiatric illness that would prevent the subject from participating and adhering to study related procedures. * Prior treatment with any investigational drug within the previous 4 weeks * Unable to lie supine for 1-hour imaging with PET * Prisoners
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Study Objectives The aim of the REV clinical trial is to evaluate the impact of a virtual reality exposure to decrease patient anxiety before chemotherapy or an invasive act. If positive, the access to virtual reality exposure is aimed to be used as standard of care at Lyon's hospital to improve cancer patient well-being in a drug-free manner. The majority of cancer patients lives with high level of anxiety as soon as diagnosed. This level anxiety is particularly high before invasive acts but also before chemotherapy by side effects anticipation. Hypnosis is a highly interesting drug-free approach to decrease patient's anxiety. It however requires on site specialists to be available whenever needed. Virtual reality provides a distractive environment enabled to shift patient focus. It can support a switch of patient mindset by providing positive emotions. Since 5 years, this disruptive technology is being more and more used as medical support thanks to a new generation of headsets enabling improved performance at cheaper prices. Many publications have now demonstrated the positive impact of virtual reality to take in charge patients' pain or pre-operational anxiety. Conditions: Anxiety, Chemotherapy Effect, Breast Cancer, Head Cancer Neck Intervention / Treatment: BEHAVIORAL: Virtual reality exposure
Inclusion Criteria: For all patients: * Patient Study Information and written informed consent * Social Security Affiliation For breast cancer cohort : * Adult patient (>18 years) * Histological or cytological proven breast cancer * Eligible to an adjuvant or neo-adjuvant IV chemotherapy given every 2 to 3 weeks (with protocol doxorubicin- cyclophosphamide, docetaxel-cyclophosmadide, docetaxel-cyclophosphamide-trastuzumab, docetaxel, carboplatine, trastuzumab, epirubicin-cyclophosphamide, etc) * Therapeutic strategy validated in multidisciplinary meeting * First chemotherapy cure (C1D1) not initiated yet * Patients with a complete healing after resection (for adjuvant chemotherapy) * Patients that do not report residual pain with an intensity > 4. For head, neck and bladder cancer cohort : * Adult patient (>18 years) * Histological or cytological proven head, neck or bladder cancer * Patient eligible for an adjuvant or neoadjuvant based on cisplatin. * Therapeutic strategy validated in multidisciplinary meeting * First chemotherapy cure (C1D1) not initiated yet * Patients with a complete healing after resection. * Patients that do not report residual pain with an intensity > 4. For invasive act leading to potential anxiety cohort : * Adult patient (>18 years) * Histological or cytological proven cancer * Patient with a planned hospitalization at oncological unit * Eupneic patient * Afebrile patient Patient for whom an invasive act leading to potential anxiety is planned (excluding percutaneous implantable chamber) : * Puncture * Deep biopsy * Sounding * Endoscopy without general anesthesia * myelogram Exclusion Criteria: * Patient with a consciousness disturbance or a spatio-temporal disturbance * Claustrophobic patient * Patient with a non-stabilized psychiatric pathology * Patient with seizure crisis background * Patient with a visual or hearing disturbance that is not compatible with video watching and sound listening * Patients with out-of range clinical parameters (arterial pressure, cardiac frequency,..) * Patients with out-of range blood parameters that are not compatible with chemotherapy or an invasive act. * Patient with a life expectancy below 3 months. * Impossibility to track and follow patient (any reason) * Patient deprived of liberty or subjected to guardianship
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Study Objectives The purpose of this study is to determine whether bortezomib, cytarabine, and dexamethasone are effective in the treatment of relapsed or refractory mantle cell lymphoma after 1 to 3 lines of previous treatment. Conditions: Mantle Cell Lymphoma Intervention / Treatment: DRUG: Bortezomib, Cytarabine, Dexamethasone, Pegteograstim
Inclusion Criteria: * Pathologically confirmed mantle cell lymphoma * Relapse or progression after 1-3 lines of previous chemotherapy with or without immunologic agents * ECOG performance status 2 or less * Adequate hematologic, hepatic, and renal function i. White blood cells ≥ 3,000 /ul ii. Absolute neutrophil count ≥ 1,000 /ul iii. Platelets ≥ 50,000 /ul iv. Hemoglobin ≥ 9.0 g/dL v. Total bilirubin < 2 times upper limit of normal vi. AST, ALT < 2.5 times upper limit of normal vii. Serum creatinine < 1.5 times upper limit of normal Exclusion Criteria: * Previously treated with 4 or more lines of chemotherapy with or without immunologic agents * Previously treated with bortezomib * Treated with a cytarabine-containing regimen as the last line and within 6 months before registration * Other cancer diagnosed within 5 years before registration * Uncontrolled symptomatic CNS involvement of mantle cell lymphoma * Uncontrolled systemic infection * Inherited immunodeficiency disease or AIDS * Pregnancy * Breast-feeding * Peripheral neuropathy of grade 3 or higher * Other health conditions considered to be inappropriate for this trial in the primary physician's opinion
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Study Objectives The purpose of this study is to determine whether metformin in combination with gefitinib are effective in patients with previously untreated advanced or metastatic Non-Small-Cell Lung cancer with epidermal growth factor receptor (EGFR) mutations Conditions: NSCLC, EGFR Gene Amplification, Advanced Cancer, Stage IIIB NSCLC, Stage IV NSCLC Intervention / Treatment: DRUG: Gefitinib and Metformin, DRUG: Gefitinib and placebo
Inclusion Criteria: * Patients must have Histologically or cytologically confirmed non small cell carcinoma of the lung who harbors EGFR-mutation and are previously untreated * Patient must have measurable stage IV disease (includes M1a, M1b stages or recurrent disease) (according to the 7th edition of the tumor node metastasis (TNM) classification system). However, patients with T4NX disease (stage III B) with nodule(s) in ipsilateral lung lobe are not eligible, because such patients were not included in historical controls. * Patients be age >18 years and < 75 years. * Patients must have a Life Expectancy of greater than 12 weeks. * Patients must have an electrocorticography (ECOG) performance status 0 or 1 (Karnofsky > 70%). * Patients must have normal organ and marrow function as defined below, within one week prior to randomization: absolute neutrophil count >1,500/mL platelets > 100,000/mL total bilirubin: within normal institutional limits AST(SGOT)/ALT(SGPT) < 2.5 X institutional upper limit of normal creatinine ≤ 1.5 X institutional upper limit of normal urine dipstick for proteinuria of < less than 1+. If urine dipstick is > 1+ then a 24 hour urine for protein must demonstrate < 500 mg of protein in 24 hours to allow participation in the study. * Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately. * Patients must have an international normalized ratio (INR) < 1.5 and a partial thromboplastin time (PTT) no greater than upper limits of normal within 1 week prior to randomization. * Patients with a history of hypertension must be well-controlled (<150 systolic/<100 diastolic) on a stable regimen of anti-hypertensive therapy. * Patients must have the ability to understand and the willingness to sign a written informed consent document. Exclusion Criteria: * Patients with 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 situation that would limit compliance with study requirements. * Patients receiving chronic daily treatment with aspirin (> 325 mg/day) or nonsteroidal anti-inflammatory agents known to inhibit platelet function. Treatment with dipyridamole (Persantine), ticlopidine (Ticlid), clopidogrel (Plavix) and/or cilostazol (Pletal)is also not allowed. * Patients receiving therapeutic anticoagulation. Prophylactic anticoagulation of venous access devices is allowed provided Section 3.10 is met. Caution should be taken on treating patients with low dose heparin or low molecular weight heparin for DVT prophylaxis during treatment with bevacizumab as there may be an increased risk of bleeding. * Prior use of chemotherapy. * Patients receiving immunotherapy, hormonal-therapy and or radiotherapy within 2 weeks prior to entering the study. Note: Those who have not recovered from adverse events due to these agents administered will be considered ineligible. * Patients receiving any other investigational agents. * Patients with uncontrolled brain metastasis. Note: Patients with brain metastases must have stable neurologic status following local therapy (surgery or radiation) for at least 2 weeks, and must be without neurologic dysfunction that would confound the evaluation of neurologic and other adverse events. * Patients with a history of allergic reactions attributed to compounds of similar chemical or biologic composition to metformin and paclitaxel or other agents used in the study are excluded. * Women that are pregnant or breastfeeding Note: Pregnant women are excluded from this study because the agents used in this study may be teratogenic to a fetus. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with paclitaxel, breastfeeding women are also excluded from this study. * Patients that are HIV-positive on combination antiretroviral therapy due to the potential for lethal infections when treated with marrow-suppressive therapy.
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Study Objectives The hypothesis of this proposal is that combining plerixafor, an inhibitor of stromal cell derived factor - 1α (SDF-1α), with decitabine, a DNA methyltransferase inhibitor, as induction and postremission therapy for older patients with Acute Myeloid Leukemia (AML) will improve treatment outcomes via mobilization of leukemia stem cells and alteration of the pharmacodynamics of decitabine. The protocol will establish the safety and feasibility of combining two different doses of plerixafor with a fixed dose and schedule of decitabine. Conditions: Acute Myeloid Leukemia Intervention / Treatment: DRUG: plerixafor, DRUG: decitabine
Inclusion Criteria: * Unequivocal pathologic diagnosis of AML (≥ 20% blasts in the bone marrow based on WHO criteria) excluding: i) acute promyelocytic leukemia t(15;17)(q22;q12); PML-RARA; ii)acute myeloid leukemia with t(8;21)(q22;q22); RUNX1-RUNXT1; iii) acute myeloid leukemia with inv(16)(p13.1;q22) or t(16;16)(p13.1;q22); CBFB-MYH11. * AML patients with an antecedent hematologic disorder or myelodysplastic syndrome (MDS)are eligible for treatment on this trial provided that they have not received prior treatment with decitabine or prior cytotoxic treatment for AML. * AML patients with therapy-related myeloid neoplasms (t-MN) are eligible if they have not received chemotherapy (not including hormonal therapy) for their primary malignancy or disorder for >6 months. * Age ≥ 60 years. * Ability to understand and willingness to sign a written informed consent document. Exclusion Criteria: * Prior treatment with decitabine * Prior treatment with plerixafor * Ongoing treatment for another malignancy. * Patients with good-risk molecular or cytogenetics features * Patient has a medical condition or illness considered by the investigator to constitute an unwarranted high risk for investigational drug treatment. * Patient has a psychiatric disorder or altered mental status that would preclude understanding of the informed consent process and/or completion of the necessary studies. * Patient has an inability or unwillingness, in the opinion of the investigator, to comply with the protocol requirements.
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Study Objectives Prostate cancer is the most common non-cutaneous malignancy in men and is the 2nd leading cause of death from cancer in men. Radical prostatectomy is one of the treatment options available for organ-confined disease. Over 100,000 radical prostatectomies cases (total removal of the cancerous prostate by surgery) are performed in the United States yearly. Unfortunately nearly all of the men undergoing surgery report diminished Quality of Life (QOL) scores due in part due to a postoperative incontinence which may require the use of multiple urinary pads per day. Many of these men also report debilitating irritative voiding symptoms of urinary urgency and frequency, and have overall decreased urinary satisfaction scores. Abatement of these symptoms can take up to one year in men, and in 5-20% of patients symptoms may persist for longer periods. Our recent published findings suggest that instability in the bladder muscle is likely an underlying etiology in postoperative urinary incontinence. This 'Detrusor Muscle' instability results in excess contractions of the urinary bladder ('urgency to urinate'), and can result in the feeling of needing to urinate more frequently. Consistent with this hypothesis of detrusor muscle instability, men with postoperative dribbling had more complaints with urgency, frequency and bother scores when queried with validated questionnaires. We suspect that a transient bladder muscle contraction may overcome the urinary sphincter valve resistance and result in the patient's dribbling of urine. By treating the bladder muscle instability, we expect improved postoperative continence and improved quality of life in patients after undergoing surgery for total removal of a cancerous prostate. This pilot study will assess the statistical requirements for the number of subjects needed for a fully 'powered' randomized prospective study to fully evaluate whether medications such as solifenacin significantly improve patients' quality of urinary life and improve postoperative urinary incontinence after surgery. \*This study has been modified from the original protocol with the clinicaltrials.gov ID: NCT00581061. Conditions: Urinary Incontinence Intervention / Treatment: DRUG: Vesicare
Inclusion Criteria: * Patients that have been diagnosed with prostate cancer and will undergo treatment for the disease as part of standard clinical care * Patients that have multiple pad use a few days after standard of care catheter removal Exclusion Criteria: * Contra-indication to Solifenacin * Narrow angle glaucoma * Hepatic impairment * Renal impairment * CYP3A4 inhibitors (e.g. Ketoconazole) * Gastric Retention (delayed or slow emptying of the stomach) * Lives in a different country
8,220
Study Objectives The goal of this study is to perform imaging of patient's tumors while the chest is open and the tumor is being removed. According to the World Health Organization, lung cancer is the most common cause of cancer-related death in men and women, and is responsible for 1.3 million deaths worldwide annually as of 2004. Surgery remains the best option for patients presenting with operable Stage I or II cancers, however the five year survival rate for these candidates remains at a dismal 53% for Stage I and 32% for Stage II. The high rates of recurrence suggest that surgeons are unable to completely detect and remove primary tumor nodules in a satisfactory manner as well as lingering metastases in sentinel lymph nodes. By ensuring a negative margin through imaging during surgery it would be possible for us to improve the rates of recurrence free patients and thus overall survival. Thoracic malignancies are the ideal disease to investigate intra-operative imaging. Over 85% of lung and pleural malignancies express folate receptor alpha (FRA). It is important to note that FRA is expressed only in the proximal tubules of the kidneys, activated macrophages, and in the choroidal plexus. Thus, the false positive detection rate is expected to be extremely low. A group well known to us in the Netherlands has completed a pilot study utilizing a folate-fluorescein isothiocyanate (folate-FITC) conjugate in 12 patients with ovarian cancer. Another group of investigators in Mayo have subsequently performed this study on 20 more patients without any serious adverse events (personal communication). They report excellent sensitivity and specificity with this technique with only grade 1 side effects (allergic reaction). All side effects reversed when the injection was halted. Patients with a history of allergic reactions to insect bites should not participate (fluorescein is derived from the firefly insect, folate is an essential vitamin). Conditions: Lung and Pleural Malignancies, Neoplasms, Nodules, Adenocarcinoma Intervention / Treatment: DRUG: EC17 imaging contrast agent
Inclusion Criteria: * Adult patients over 18 years of age * Patients presenting with a lung or pleural nodule or mass presumed to be resectable on pre-operative assessment * Good operative candidate * Subject capable of giving informed consent and participating in the process of consent Exclusion Criteria: * Pregnant women as determined by urinary or serum beta human chorionic gonadotropin (hCG) within 72 hours of surgery * Patients with a history of anaphylactic reactions to Folate-FITC or insects * At-risk patient populations: * Homeless patients * Patients with drug or alcohol dependence * Children and neonates * Patients unable to participate in the consent process
19,854
Study Objectives The purpose of this study is to determine if Cediranib when added to chemotherapy is more effective than chemotherapy alone in prolonging life expectancy and slowing disease progression in patients with previously untreated metastatic colorectal cancer. Conditions: Metastatic Colorectal Cancer Intervention / Treatment: DRUG: Cediranib, DRUG: FOLFOX (5-fluorouracil, Leucovorin, Oxaliplatin), DRUG: XELOX (Capecitabine and Oxaliplatin), DRUG: Cediranib Placebo
Inclusion Criteria: * Written Informed Consent * Carcinoma of the colon or rectum * One or more measurable lesions Exclusion Criteria: * Adjuvant/neoadjuvant therapy within 6-12 months of study entry * Untreated unstable brain or meningeal metastases * Specific laboratory ranges * Specific cardiovascular problems * Participation in other trials within 30 days
26,444
Study Objectives The study is an open-label, single arm multicenter Phase II study to evaluate the safety and efficacy of the combination of Abraxane and Avastin as first-line therapy for patients with unresectable metastatic malignant melanoma. The patient sample will be approximately 50 individuals, males and females 18 years of age or older with measurable metastatic melanoma. Patients will be treated with Abraxane administered weekly for 3 weeks via a 30-minute IV infusion at150 mg/m2 followed by 1 week rest (28-day cycle). Avastin will be administered in a dose of 10 mg/kg every 2 weeks (without rest period). Patients will be evaluated for disease progression every 2 months and those who do not have disease progression or unacceptable toxicity will be offered ongoing therapy until they have progressive disease or unacceptable toxicity. Conditions: Metastatic Malignant Melanoma Intervention / Treatment: DRUG: Avastin, DRUG: Abraxane
Inclusion Criteria: * Histologically confirmed, (surgically incurable or unresectable) stage III or IV metastatic malignant melanoma.. * Must be chemo naïve. Surgical adjuvant therapy with interferon, vaccines, or cytokines is permitted. Prior adjuvant therapy with chemotherapeutic agents is not allowed. Prior therapy for metastatic disease that is not chemotherapy is allowed. Must have discontinued prior allowable therapy at least 4 weeks prior to initiation of dosing. * A minimum of 1 measurable lesion according to RECIST criteria. * ECOG performance status of 0-1. * Age ≥ 18 years. * Adequate hematologic, renal and liver function as defined by laboratory values performed within 14 days prior to initiation of dosing. * Patients must have recovered from effects of major surgery. * Women of childbearing potential should be using an effective method of contraception. Women of childbearing potential must have a negative urine or serum pregnancy test up to 28 days prior to commencement of dosing and be practicing medically approved contraceptive precautions for at least 6 months after completion of treatment as directed by their physician. * Men should use an effective method of contraception during treatment and for at least 6 months after completion of treatment as directed by their physician. * Must have recovered from all prior treatment-related toxicities to NCI CTCAE (v 3.0) Grade of 0 or 1, except for toxicities not considered a safety risk such as alopecia. * Before study entry, written informed consent must be obtained. Written informed consent must be obtained from the patient prior to performing any study-related procedures. Exclusion Criteria: * Prior systemic therapy for metastatic disease with chemotherapy. * Psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule; those conditions should be discussed with the patient before trial entry. * Major surgery or radiation therapy within 4 weeks of starting the study treatment. * Known CNS disease. * Previous Grade 2 or higher sensory neuropathy * NCI CTCAE (V 3.0) grade 3 hemorrhage within 4 weeks of starting the study treatment. * History of or known spinal cord compression, or carcinomatous meningitis, or evidence of symptomatic brain or leptomeningeal disease on screening CT or MRI scan. * Any of the following within the 6 months prior to study drug administration: myocardial infarction, severe/unstable angina, coronary/peripheral artery bypass graft, symptomatic congestive heart failure, cerebrovascular accident or transient ischemic attack, or pulmonary embolism. * Ongoing cardiac dysrhythmias of NCI CTCAE Version 3.0 grade ≥ 2. * Inadequately controlled hypertension (defined as systolic blood pressure > 150 and/or diastolic blood pressure > 100 mmHg on antihypertensive medications) * Any prior history of hypertensive crisis or hypertensive encephalopathy * Concurrent treatment on another clinical trial. Supportive care trials or non-treatment trials, e.g. QOL, are allowed. * Other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or study drug administration, or may interfere with the interpretation of study results, and in the judgment of the investigator would make the subject inappropriate for entry into this study. * Previous cancer (unless a DRS interval of at least 5 years) or concurrent malignancies at other sites with the exception of surgically cured carcinoma in-situ of the cervix and basal or squamous cell carcinoma of the skin. * Known clinically uncontrolled infectious disease including HIV positivity or AIDS-related illness. * Pregnant or nursing. Use of effective means of contraception (men and women) in subjects of child-bearing potential. * New York Heart Association (NYHA) Grade II or greater congestive heart failure. * Symptomatic peripheral vascular disease. * Significant vascular disease (e.g. aortic aneurysm, aortic dissection). * Evidence of bleeding diathesis or coagulopathy. * Major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to Day 0, anticipation of need for major surgical procedure during the course of the study * Minor surgical procedures such as fine needle aspirations or core biopsies within 7 days prior to Day 0 * Proteinuria at screening as demonstrated by urine dipstick for proteinuria ≥ 2+ (patients discovered to have ≥ 2+ proteinuria on dipstick urinalysis at baseline should undergo a 24 hour urine collection and must demonstrate ≤ 1g of protein in 24 hours to be eligible). * History of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within 6 months prior to Day 0 * Serious, non-healing wound, ulcer, or bone fracture * Inability to comply with study and/or follow-up procedures
19,704
Study Objectives The goal of this clinical trial is to show that incorporating ofatumumab instead of rituximab in combination with etoposide and cytarabine (OVA) is successful in collecting autologous stem cells for use in an autologous stem cell transplantation (autoSCT) and to examine its effectiveness in eliminating residual diffuse large B-Cell Lymphoma (DLBCL) in patients. Conditions: Diffuse Large Cell Lymphoma Relapsed/Refractory Intervention / Treatment: DRUG: Ofatumumab, DRUG: Etoposide, DRUG: Cytarabine
Inclusion Criteria: * Diagnosis of refractory or relapsed biopsy-proven CD20+ diffuse large B-cell lymphoma or primary mediastinal B-cell lymphoma. * Age 18 years or older * Refractory to or relapse following a rituximab/anthracycline first-line regimen * High-risk disease as defined by one of the following: * First relapse after CR within 12 months of initiation of front-line therapy * Less than CR to front-line therapy * Second-line age-adjusted International Prognostic Index score (sAAIPI) of 1 or higher at the time of relapse * Receipt of no more than three prior chemotherapy regimens. Monoclonal antibody therapy alone and involved field radiotherapy are not included in this number. Prior use of ofatumumab is allowed if there has been no disease progression following that therapy (i.e. ofatumumab-based salvage regimens are allowed) * Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2. Eligibility to proceed to OVA * Chemosensitive disease as defined by at least a partial response to salvage therapy by positron emission tomography/computed tomography (PET/CT) criteria. * Bone marrow with less than 15% lymphoma cells following salvage therapy. No evidence of myelodysplasia. * Patients must have adequate organ function with serum creatinine <2.0 mg/dL, total bilirubin ≤2 times the upper limit of normal (ULN), and aspartate aminotransferase (AST) ≤3 times the ULN. * Neutrophils >1,000/μL and platelets >100,000/μL prior to day 0 * No active uncontrolled infection. Eligibility to proceed to CBV ASCT * Patients must be out of the hospital after OVA for a minimum of 4 weeks. * Adequate peripheral blood stem cell collection with cluster of differentiation 34 (CD34) cell dose ≥2 X 106 /kg (actual body weight). * No evidence of disease progression on day 42 assessment * Approved by the University of California, San Francisco (UCSF) Bone Marrow Transplant Committee to proceed with ASCT. Exclusion Criteria * Presence of disease transformation from a previously diagnosed low-grade lymphoma * Progression following prior ofatumumab-based therapy * Active central nervous system or meningeal involvement by lymphoma. Patients with a history of central nervous system (CNS) or meningeal involvement must be in a documented remission by cerebrospinal fluid (CSF) evaluation and contrast MRI imaging for at least 3 months prior to study entry. * Evidence of myelodysplasia on any bone marrow biopsy. * Treatment with any known non-marketed drug substance or experimental therapy within 5 terminal half-lives or 4 weeks prior to enrollment, whichever is longer, or currently participating in any other interventional clinical study. * Other past or current malignancy. Subjects who have been free of malignancy for at least 3 years, or have a history of completely resected non-melanoma skin cancer, or successfully treated in situ carcinoma are eligible. * Chronic or current infectious disease requiring systemic antibiotics, antifungal, or antiviral treatment such as, but not limited to, chronic renal infection, chronic chest infection with bronchiectasis, tuberculosis and active Hepatitis C. * History of significant cerebrovascular disease in the past 6 months or ongoing event with active symptoms or sequelae * Known HIV infection * Clinically significant cardiac disease including unstable angina, acute myocardial infarction within six months prior to randomization, congestive heart failure (NYHA III-IV), and arrhythmia unless controlled by therapy, with the exception of extra systoles or minor conduction abnormalities. * Significant concurrent, uncontrolled medical condition including, but not limited to, renal, hepatic, gastrointestinal, endocrine, pulmonary, neurological, cerebral or psychiatric disease which in the opinion of the investigator may represent a risk for the patient. * Positive serology for Hepatitis B (HB) defined as a positive test for HbsAg and a detectable hepatitis B virus (HBV) DNA viral load. If negative for HBsAg but HBcAb positive (regardless of HBsAb status), a HBV DNA test will be performed and if positive the subject will be excluded. If HBV DNA is negative, subject may be included but must undergo at least every 2-month HBV DNA polymerase chain reaction (PCR) testing from the start of treatment during the treatment course. Prophylactic antiviral therapy may be initiated at the discretion of the investigator. * Positive serology for hepatitis C (HC) defined as a positive test for hepatitis C antibody (HCAb), in which case reflexively perform a hepatitis C virus (HCV) PCR to confirm the result * Pregnant or lactating women. Women of childbearing potential must have a negative pregnancy test at screening. * Women of childbearing potential, including women whose last menstrual period was less than one year prior to screening, unable or unwilling to use adequate contraception from study start to one year after the last dose of protocol therapy. Adequate contraception is defined as hormonal birth control, intrauterine device, double barrier method or total abstinence. * Male subjects unable or unwilling to use adequate contraception methods from study start to one year after the last dose of protocol therapy. * Subjects who have received live virus vaccination within the 4 weeks prior to planned initiation of study treatment.
27,978
Study Objectives This phase I trial will determine the Maximum Tolerated Dose (MTD) of BKM120 when given together with fulvestrant in treating postmenopausal patients with estrogen receptor-positive (ER+) stage IV breast cancer. The toxicity profile of this combination therapy will also be described. Inhibition of PI3K by BKM120 may enhance programmed cell death (apoptosis) in estrogen receptor positive (ER+) breast cancer cells. Giving fulvestrant together with BKM 120 may enhance this apoptotic effect, providing a novel therapeutic strategy for patients with metastatic ER+ breast cancer. Conditions: Estrogen Receptor-positive Breast Cancer, Recurrent Breast Cancer, Stage IV Breast Cancer Intervention / Treatment: DRUG: BKM120, DRUG: Fulvestrant, PROCEDURE: biopsy
Inclusion Criteria: * Patient must be ≥ 18 years of age * Patient must be a postmenopausal woman, defined by one of the following criteria: * Women ≥ 60 years * Women aged 45-59 years with spontaneous cessation of menses ≥ 12 months prior to registration * Women aged 45-59 years with cessation of menses of duration < 12 months or secondary to hysterectomy AND an follicle-stimulating hormone (FSH) level in the postmenopausal range according to institutional standards (or > 34.4 IU/L if institutional range is not available) prior to registration * Women aged 45-59 years on hormonal replacement therapy who have discontinued hormonal therapy AND an FSH level in the postmenopausal range according to institutional standards (or > 34.4 IU/L if institutional range is not available) prior to registration * Status post bilateral surgical oophorectomy * Patient must have a negative serum pregnancy test within 48 hours before starting study treatment (if a woman of childbearing potential) * Patient must have an Eastern Cooperative Oncology Group (ECOG) performance status =< 2 * Patient must have histologically or cytologically confirmed invasive breast cancer that is stage IV or metastatic (histologic/cytologic confirmation of recurrence preferred, but not required) * Patient must have a representative tumor tissue specimen available; archival tissue is allowed * Either the primary or the metastatic tumor must be positive for estrogen receptor (>= 1% tumor cell staining by immunohistochemistry or an Allred Score of >= 3 by immunohistochemistry) * Patient must have at least one site of measurable disease as per Response Evaluation Criteria In Solid Tumors (RECIST) 1.1 criteria * Patient must have had no more than 3 lines of systemic therapy (including endocrine therapy) for metastatic disease to be eligible for phase IB and the last 10 patients of Cohort C; there is no limitation on the numbers of prior systemic therapies for phase IA and the first 2 patients of Cohort C * Patients who are currently taking fulvestrant without disease progression are eligible * Patient must have a life expectancy of >= 12 weeks * Patient must have adequate oran function as defined as: * Absolute neutrophil count (ANC) >= 1500/uL * Platelet count >= 100,000/uL * Hemoglobin >= 9 g/dL * Serum creatinine =< 1.5 x upper limit of normal (ULN) * Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) within normal range (or =< 3.0 x ULN if liver metastases are present) * Serum bilirubin =< ULN (or =< 1.5 x ULN if liver metastases are present; or total bilirubin =< 3.0 x ULN with direct bilirubin within normal range in patients with well documented Gilbert Syndrome) * Serum amylase =< ULN * Serum lipase =< ULN * Magnesium >= the lower limit of normal * Potassium within normal limits for the institution * Patient must have international normalized ratio (INR) =< 2 * Patient must have fasting plasma glucose =< 120 mg/dL (6.7 mmol/L) * Patient must have total calcium (corrected for serum albumin) within normal limits (bisphosphonate use for malignant hypercalcemia control is not allowed) * Patient must be able and willing to sign the consent form Exclusion Criteria: * Patient must not have received prior treatment with a P13K inhibitor * Patient must not have a known hypersensitivity to BKM120 or to its excipients * Patient must not have untreated brain metastases; however, patients with metastatic central nervous system (CNS) tumors may participate in this trial if the patient is: * 4 weeks from therapy completion (including radiation and/or surgery) * Clinically stable at the time of study entry * Not receiving corticosteroid therapy * Patient must not have acute or chronic liver disease, renal disease, or pancreatitis * Patient must not have any of the following mood disorders as judged by the Investigator or a Psychiatrist * Medically documented history of or active major depressive episode, bipolar disorder (I or II), obsessive-compulsive disorder, schizophrenia, a history of suicidal attempt or ideation, or homicidal ideation (immediate risk of doing harm to others) * Greater than or equal to Common Terminology Criteria for Adverse Events (CTCAE) grade 3 anxiety * Patient must not meet the cut-off score of >= 10 in the Patient Health Questionnaire (PHQ-9) or a cut-off of >= 15 in the Generalized Anxiety Disorder (GAD)-7 mood scale, respectively, or select a positive response of 1, 2, or 3 to question number 9 regarding potential for suicidal thoughts in the PHQ-9 (independent of the total score of the PHQ-9) * Patient must not have >= grade 2 diarrhea * Patient must not have active cardiac disease including any of the following: * Left ventricular ejection fraction (LVEF) < 50% as determined by Multiple Grated acquisition (MUGA) scan or echocardiogram (ECHO) * QTc > 480 msec on screening electrocardiogram (ECG) (using the QTcF formula) * Angina pectoris that requires the use of anti-anginal medication * Ventricular arrhythmias except for benign premature ventricular contractions * Supraventricular and nodal arrhythmias requiring a pacemaker or not controlled with medication * Conduction abnormality requiring a pacemaker * Valvular disease with document compromise in cardiac function * Symptomatic pericarditis * Patient must not have a history of cardiac dysfunction including any of the following: * Myocardial infarction within the last 6 months, documented by persistent elevated cardiac enzymes or persistent regional wall abnormalities on assessment of LVEF function * History of documented congestive heart failure (New York Heart Association functional classification III-IV) * Documented cardiomyopathy * Patient must not have poorly controlled diabetes mellitus or steroid-induced diabetes mellitus (defined by fasting glucose >120 mg/dL or hemoglobin \[Hb\] A1c > 7%) * Patient must not have any other concurrent severe and/or uncontrolled concomitant medical conditions (e.g., active or uncontrolled infection) that could cause unacceptable safety risks or compromise compliance with the protocol * Patient must not have significant symptomatic deterioration of lung function; if clinically indicated, pulmonary function tests including measures of predicted lung volumes; diffusion capacity of carbon monoxide (DLco), oxygen (O2) saturation at rest on room air should be considered to exclude pneumonitis or pulmonary infiltrates * Patient must not have impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of BKM120 (e.g., ulcerative diseases, uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome, or small bowel resection); patients with unresolved diarrhea will be excluded as previously indicated * Patient must not have been treated with any hematopoietic colony-stimulating growth factors (e.g., filgrastim \[G-CSF\], sargramostim \[GM-CSF\]) =< 2 weeks prior to starting study drug; erythropoietin or darbepoetin therapy, if initiated at least 2 weeks prior to enrollment, may be continued * Patient must not have taken herbal medications and certain fruits within 7 days prior to starting study drug; herbal medications include, but are not limited to: St. Johns wort, Kava, ephedra (ma huang), gingko biloba, dehydroepiandrosterone (DHEA), yohimbe, saw palmetto, and ginseng; fruits include the CYP3A inhibitors Seville oranges, grapefruit, pummelos, or exotic citrus fruits * Patient must not be currently receiving treatment with medication with a known risk to prolong the QT interval or inducing Torsades de Pointes unless the treatment can either be discontinued or switched to a different medication prior to starting study drug; please refer to Table 5-2 for a list of prohibited QT prolonging drugs with risk of Torsades de Pointes * Patient must not be receiving chronic treatment with steroids or another immunosuppressive agent; Note: topical applications (e.g. rash), inhaled sprays (e.g. obstructive airways diseases), eye drops or local injections (e.g. intra-articular) are allowed; patients with previously treated brain metastases who are on stable low dose corticosteroids treatment (e.g. dexamethasone 2 mg/day, prednisolone 10 mg/day) for at least 14 days before start of study treatment are eligible * Patient must not be currently treated with drugs known to be moderate or strong inhibitors or inducers of isoenzyme cytochrome P450, family 3, subfamily A (CYP3A) unless the treatment can be discontinued or switched to a different medication prior to starting study drug (please note that co-treatment with weak inhibitors of CYP3A is allowed) * Patient must not have received chemotherapy or targeted anticancer therapy =< 4 weeks (6 weeks for nitrosourea, antibodies or mitomycin-C) prior to starting study drug * Patient with any residual toxicities may not be enrolled unless all toxicities recover to =< grade 1 before starting the trial * Patient must not have received any continuous or intermittent small molecule therapeutics (excluding monoclonal antibodies) =< 5 effective half lives prior to starting study drug; patient must have recovered from side effects of such therapy * Patient must not have received wide field radiotherapy =< 4 weeks or limited field radiation for palliation =< 2 weeks prior to starting study drug; patient must have recovered from side effects of such therapy * Patient must not have undergone major surgery =< 2 weeks prior to starting study drug; patient must have recovered from side effects of such therapy * Patient must not be currently taking therapeutic doses of warfarin sodium or any other Coumadin-derivative anticoagulant * Patient must not have a known diagnosis of human immunodeficiency virus (HIV) infection * Patient must not have a history of another malignancy within 3 years, except cured basal cell carcinoma of the skin or excised carcinoma in situ of the cervix
28,089
Study Objectives The purpose of this study is to define the optimal management of localised transitional cell carcinoma (TCC) of the urinary bladder. The main objective is to evaluate whether chemoradiation is superior to radiotherapy alone. Conditions: Transitional Cell Carcinoma of Urinary Bladder Intervention / Treatment: DRUG: Cisplatin, RADIATION: External beam radiation treatment
Inclusion Criteria: * Histologically proven TCC of the urinary bladder. Mixed tumours comprising predominantly TCC and elements of squamous or adenomatous metaplasia or carcinoma are also eligible. * Clinically and radiologically localised T2, T3 or T4a non-bulky disease (<= 7cm in maximum dimension), N0, M0. If radiological evaluation of a lymph node is interpreted as "positive" this must be evaluated further by either lymph node sampling or percutaneous needle biopsy. Patients with histologically confirmed lymph node metastases will not be eligible. * Maximal TUR. N.B. Previous: * partial cystectomy;* endoscopic resection of bladder tumour/s;* intravesical chemotherapy; or* intravesical BCG does not exclude the patient from being eligible. However, the patient should have an adequate functioning bladder (this should be clarified with the referring Urologist and if need be voiding volumes should be measured). * Creatinine clearance >= 50ml/minute by calculation or measurement. * A white blood cell count >= 3.5 x 10\^9/L with an absolute neutrophil count >= 1.5 x 10\^9/L and a platelet count >= 100 x 10\^9/L. * ECOG status of 0, 1 or 2. * No age limit applies provided the patient is mentally, physically and geographically capable of undergoing treatment and follow-up. * No significant intercurrent morbidity. Exclusion Criteria: * Pure squamous carcinomas or adenocarcinomas. * Extensive or multifocal CIS change in the bladder. * T3 or T4a tumours unsuitable for curative treatment (i.e. > 7cm in any dimension), T4b, node positive and metastatic disease. * Presence of ureteric obstruction due to tumour infiltration at the UO not amenable to stenting. * Previous radiation treatment to the pelvis. * Previous significant pelvic surgery. * Significant bowel or gynaecological inflammatory disease. * Creatinine clearance < 50ml/minute by calculation or measurement. A white blood cell count < 3.5 x 10\^9/L with an absolute neutrophil count < 1.5 x 10\^9L and/or a platelet count < 100 x 10\^9/L. * Other considerations making patient unfit for Cisplatin therapy. * Prior or concurrent malignancy of any other site unless disease-free for greater than 5 years, except for: 1. non-melanoma skin cancer, and/or 2. (a) Stage T1 well differentiated prostatic carcinoma in men, and In situ carcinoma of the cervix in women. * Bladder tumour - biopsy only. These patients must be referred back for more adequate resections or else should not be included
28,714
Study Objectives Treatment of acute lymphoblastic leukemia achieves high cure rate, but is potentially neurotoxic. Long-term neurologic morbidity in survivors and its effect on function are inadequately studied. Neurologic outcomes will be assessed through an investigator administered questionnaire followed by comprehensive neurologic examination by the study neurologist. Conditions: Acute Lymphoblastic Leukemia Intervention / Treatment: OTHER: Neurological Examination/Questionnaires
Inclusion Criteria: * Childhood ALL survivors treated on institutional protocols at * Patient will be at least 5-years from ALL diagnosis. * Patient will be at least one year from completion of cancer therapy. * Absence of recurrent or secondary cancer for at least one year day of enrollment. * Between 6-28 years of age at the time of evaluation. * Patient's or at least one parent's English is proficient enough Questionnaire. * Parent and the child agree to participate. Consent only from will suffice if > 18 years of age at the time of assessment. Exclusion Criteria: * Recurrent tumor or development of secondary cancer * Child or parent refuses to participate * Co-morbid pre-existing disabling neurologic disease, which in the judgment of the principal investigator may compromise clinical observations.
6,867
Study Objectives This trial is a single-center, single-dose, double-blind, parallel-group, randomized, 3-arm PK trial in healthy male volunteers comparing a biosimilar pertuzumab (EG1206A) to a single intravenous (i.v.) infusion to both European Union (EU) and United States of America (US) reference products. Conditions: Breast Cancer Intervention / Treatment: DRUG: 420 mg EG1206A EirGenix Pertuzumab in 14 mL Injection, DRUG: Perjeta (EU origin) 420 mg in 14 mL Injection, DRUG: Perjeta (US origin) 420 mg in 14 mL Injection
Inclusion Criteria: * aged 18 to 55 years * overtly healthy as determined by medical evaluation * Body weight of at least 50 kg and not higher than 105 kg at screening * BMI above/equal to 18.0 and below/equal to 30.0 kg/m2 at screening * Male * Agrees to the following during the treatment period and until 3 months after administration: * Be and remain abstinent from heterosexual intercourse OR agree to use a male condom and female partners of childbearing potential must use an additional highly effective contraceptive method * Abstain from donating sperm. * Signed informed consent * Valid COVID-19 immunization status as per current regulations Exclusion Criteria: * History or evidence of any clinically relevant disease, as judged by the investigator * Any medical disorder, condition, or history of such that would impair the participant's ability to participate or complete this trial in the opinion of the investigator * Pre-existing diseases for which it can be assumed that the absorption, distribution, metabolism, elimination, and effects of the IMP will not be normal * Known or suspected hypersensitivity to the IMPs (active substances, or excipients of the preparations) * Known severe allergies e.g., allergies to more than 3 allergens * Relevant diseases within the last 4 weeks before IMP administration * Febrile illness within 2 weeks before IMP administration. * History of known or suspected malignant tumors * Known or suspected disorder of the liver * Use of systemic/topical medicines/substances which oppose the trial objectives, or which might influence them within 4 weeks before IMP administration * Regular use of therapeutic or recreational drugs or supplements * Use of any herbal products or St. John's wort from 4 weeks before IMP administration * Prior treatment with pertuzumab * Smoking * History of alcohol or drug abuse * Regular daily consumption of more than 500 mL of usual beer or the equivalent quantity of approximately 20 g of alcohol in another form * Intake of alcohol containing food and beverages from 48 h prior to admission to the ward * Regular daily consumption of more than 1 L of methylxanthine-containing beverages * Excluded physical therapies that might alter the PK or safety results of the trial from 7 days before IMP administration until follow-up * Strenuous physical exercise or sauna visit with 72 h before admission to the ward * Donation of more than 100 mL of whole blood or plasma within 4 weeks or approximately 500 mL whole blood within 3 months before IMP administration * Plasmapheresis within 3 months before IMP administration * Previous or concomitant participation in another clinical trial with IMP(s) * Clinically relevant findings in the ECG * LVEF below 55% * Systolic blood pressure below 100 mmHg or above 140 mmHg * Diastolic blood pressure below 50 mmHg or above 90 mmHg * Heart rate below 50 beats/ min or above 90 beats/min * Clinically relevant findings in the physical examination that may affect the objectives of the trial, or the safety of the participant * Poor venous access * Clinically relevant deviations of the screened safety laboratory parameters * Alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, gamma glutamyl transpeptidase, or total bilirubin above 1.2 upper limit of normal * Thyroid disorders as evidenced by assessment of thyroid stimulating hormone (TSH) level outside the normal reference range * Positive results for hepatitis B virus surface antigen, hepatitis C virus antibodies, human immune deficiency virus antibodies, and human immune deficiency virus antigen * Positive urine drug test * Positive alcohol test * Positive cotinine test * Any criteria which, in the opinion of the investigator, preclude participation for scientific reasons, for reasons of compliance, or for reasons of the participant's safety * Close affiliation with the investigational site * Vulnerable participants who are e.g., institutionalized due to regulatory or juridical order dependent on sponsor, site, or investigator or not able to consent, respectively. * History of COVID-19 within 2 months prior to screening * Long COVID-19 syndrome or other clinically relevant COVID-19 related symptoms or sequelae * Positive SARS-CoV-2 viral ribonucleic acid (RNA) test at admission * No SARS-CoV-2 vaccinations should be booked within 14 days before IMP administration and until last trial visit.
18,865
Study Objectives The objective of this multicentre descriptive analysis is to describe the clinical and biological characteristics of patients who have received Programmed cell death 1 (anti-PD1) / (PDL1) Programmed death-ligand 1 (PDL1) immunotherapy outside of a clinical trial in terms of efficacy and safety. Conditions: Malignant Pleural Mesothelioma Intervention / Treatment: OTHER: Data collection
Inclusion Criteria: * Patient over 18 years of age, * Diagnosis of malignant pleural mesothelioma affirmed by the anatomo-pathological analysis report of a histological sample of the tumour (re-read by MESOPATH). * Patient who has received at least one injection of anti-PD1 or anti-PDL1 antibodies Exclusion Criteria: * Explicit refusal by the patient to collect data
3,772
Study Objectives The objective of this study is to assess the efficacy and tolerability of metoclopramide added to standard antiemetic regimen for prophylaxis of cisplatin-induced emesis. Conditions: Cancer Intervention / Treatment: DRUG: metoclopramide, DRUG: placebo
Inclusion Criteria: * schedule to receive first cycle of cisplatin > 50 mg/m\^2 * pathologically or histologically confirmed solid cancer * more than 18 years old * creatinine clearance more than 50 ml/min * aminotransferase less than 2 times of upper normal limit Exclusion Criteria: * pregnant woman * patients with episode of vomiting within 24 hours prior to chemotherapy session * gut obstruction * brain metastasis * abdominal or pelvic irradiation * no history of allergy to study drugs
5,658
Study Objectives Everolimus shows a large interpatient variability with fixed dose administration. These very different exposure levels between individuals can result in supratherapeutic or subtherapeutic exposure levels and consequently in over- or undertreatment, respectively. Dose individualization based on the measured drug concentration could theoretically result in less toxicity and more efficacy. Nowadays everolimus exposure is determined by everolimus concentration in whole blood. Therefore, a vena puncture is always necessary. This is invasive and requires patients to come to the hospital. It would be convenient for patients to have their everolimus blood concentration determined by dried blood spot (DBS) analysis. With DBS only a single drop of blood from the finger is necessary, which can be done at home and sent by regular mail for analysis. Previous studies have shown the feasibility of this approach. In patients with cancer treated with everolimus 10mg once daily, the correlation between everolimus DBS concentrations and whole blood concentration is yet unknown. Therefore, the investigators want to determine the everolimus concentration collected with DBS from a finger prick with everolimus concentration from whole blood and everolimus concentration collected with DBS from whole blood. In addition, possibly a relatively high everolimus concentration in saliva could be correlated with the incidence and severity of oral mucositis. Determination of drug concentration in saliva has also been proven to be feasible before. Therefore, in this study the investigators want to determine whether the everolimus concentration in saliva correlates with the incidence of oral mucositis and how everolimus concentration in saliva correlates with everolimus concentration in whole blood. Conditions: Breast Cancer, Renal Cell Carcinoma Intervention / Treatment: DRUG: Everolimus
Inclusion Criteria: * Patients currently treated with everolimus for any type of cancer * Patients from whom it is possible to collect blood samples * At least 18 years of age * Able and willing to sign the Informed Consent Form prior to study assessments. Exclusion Criteria: * None
3,787
Study Objectives Thoracoabdominal oesophageal resection for cancer is a procedure with high risks for complications, and patients' preoperative status is a crucial factor for outcome. There are only a few studies that evaluate the effect of preoperative intervention, including physical exercises and breathing exercises, after this type of surgery. The aim of the study is therefore to evaluate the effect of a training intervention before resection of the oesophagus. One hundred patients scheduled for oesophagus resection according to Ivor-Lewis from five different hospitals in Sweden will be included. The patients will be randomized to an intervention group or a control group. The training intervention starts directly after preoperative radiotherapy and chemotherapy are given and lasts until three months postoperatively. Intervention includes increased physical activity, strength training and respiratory muscle training. At inclusion and three months after discharge, the patients will undergo tests of physical function and lung function. In addition, they will fill in questionnaires concerning level of physical function, level of physical activity and quality of life. These questionnaires will also be answered one year after surgery. Conditions: Oesophageal Cancer Intervention / Treatment: OTHER: Pretraining, OTHER: Usual care
Inclusion Criteria: * Patients scheduled to undergo thoracoabdominal oesophagus resection at one of the five included centra Exclusion Criteria: * < two weeks between inclusion and surgery * benign reason for surgery * difficulties in speaking and reading Swedish * other injury or disease limiting the ability to perform the intervention.
20,371
Study Objectives Healthy individuals (n=18) will participate in 2 controlled-feeding study periods that are 3 weeks each in length: 1) Control diet 2) Brassica diet. The control diet will consist of typical American foods and will be free of Brassica vegetables and free of glucosinolates and isothiocyanates. The Brassica diet will contain the control diet plus glucosinolate/isothiocyanate treatment foods. There will be a break of 3 weeks in between study periods. Blood, urine, and fecal samples will be collected at the end of each study period. Eligible participants will be selected based on genotype for glutathione S-transferase (GST), which has been shown to influence the potential protective role of dietary Brassicas. Half the participants (n=9) will be GSTM1-positive individuals and half (n=9) will have the GSTM1-null genotype. Conditions: Healthy Volunteers Intervention / Treatment: OTHER: Controlled diet without brassica vegetables, OTHER: Controlled diet with brassica vegetables
Inclusion Criteria: * Between 21 - 70 years of age * Not currently taking glucosinolate/ITC containing supplements * Voluntarily agree to participate and sign an informed consent document * Free of cancer (never diagnosed or cancer-free for at least 5 y) Exclusion Criteria: * Pregnant, lactating, or intend to become pregnant during the study period * Known allergy or intolerance to Brassica vegetables * History of bariatric surgery or nutrient malabsorption disease (such as celiac disease) or other metabolic disorders requiring special diet recommendations * Use of tobacco products * Use of certain medications (prescription or over-the-counter) that may interfere with the study objectives * Type 2 diabetes requiring the use of diabetes pills, insulin, or non-insulin shots * Use of blood-thinning medications such as Coumadin (warfarin), Dicumarol, or Miradon (anisindione) * Unable or unwilling to give informed consent or communicate with study staff * Self-report of alcohol or substance abuse within the past 12 months and/or current acute treatment or rehabilitation program for these problems (long-term participation in Alcoholics Anonymous is not an exclusion) * Other medical, psychiatric, or behavioral factors that in the judgment of the Principal Investigator may interfere with study participation or the ability to follow the intervention protocol
4,688
Study Objectives The purpose of this proposal is to improve our understanding of the role of tryptophan and serotonin in hot flashes. The main hypothesis is that alterations in tryptophan and serotonin levels are involved in the induction of hot flashes in women with breast cancer and genetic variations in the serotonin receptors and transporters also play a role. Conditions: Breast Cancer Intervention / Treatment: DIETARY_SUPPLEMENT: Acute tryptophan depletion, DIETARY_SUPPLEMENT: Half-strength tryptophan depletion (Control)
Inclusion Criteria: * At least 18 years of age * Willing and able to provide informed consent * Reporting daily hot flashes * Able to read, write, and speak English * Postmenopausal to limit sample variability (> 12 months amenorrhea) * Greater then 1 month but < 5 years post-treatment (surgery, radiation, chemotherapy) for non-metastatic breast cancer. * These criteria allow inclusion of women successfully treated for recurrent breast cancer since there is no known reason to exclude them. Menopausal status is assessed using self-reports due to problems in reliably measuring follicle-stimulating hormone levels and estradiol in tamoxifen users. Exclusion Criteria: * Exclusion criteria are current depression, history of migraines or hepatitis, abnormal chemistry profile (e.g., sodium, potassium, glucose), or a positive urine drug screen for illegal substances.
13,365
Study Objectives A multicentre, 2-part study to assess the safety and tolerability of once daily oral doses of AZD2171 when administered with various anticancer regimens (part A) and to confirm the tolerability of its combination with FOLFOX (part B). Conditions: Advanced Solid Tumor Intervention / Treatment: DRUG: AZD2171, DRUG: FOLFOX, DRUG: Pemetrexed, DRUG: Irinotecan (administered with & without Cetuximab), DRUG: Docetaxel
Inclusion Criteria: * histologically confirmed metastatic cancer that is not amenable to surgery or radiation therapy with curative intent * measurable lesion by CT or other techniques according to RECIST Exclusion Criteria: * Inadequate bone marrow reserve * history of poorly controlled hypertension
5,155
Study Objectives This study evaluated the impact of a preoperative carbohydrate oral drink on the postoperative Neutrophil / Lymphocyte Ratio (NLR) and the incidence of postoperative complications after elective open colon surgery compared to the conventional preoperative fasting protocol. Hypothesis was: preoperative carbohydrate loading reduces postoperative NLR value and reduces the incidence and severity of postoperative complications in colorectal surgery. Conditions: Neutrophil, Lymphocyte, Postoperative Complications Intervention / Treatment: DIETARY_SUPPLEMENT: preoperative nutrition
Inclusion Criteria: * participants with diagnosed colorectal carcinoma scheduled for elective open colorectal surgery * aged between 18 years and 70 years * participants with ASA physical status class I-III Exclusion Criteria: * previous treatment of colon, rectum or any other cancer * emergency or palliative colon and rectum surgery * disseminated malignant disease * body mass index below 20 and above 30 kg/mᶺ2 * overall score ≥3 after final assessment of the nutritional status according to Nutritional Risk Screening 2002 (NRS-2002) * disease with increased risk of aspiration * history of diabetes mellitus * history of hematological disease * evidence of systemic inflammation * immunomodulatory therapy * neuromuscular disease * pregnancy * mental disease * allergy to any study drugs * alcoholic or drug abuse * patient's refusal to participate in the study.
22,255
Study Objectives The purpose of this study is to determine which technique in using a vacuum erection device (VED) is best. Erectile dysfunction (ED) after robotic prostate cancer surgery is a concern for both the surgeon and the patient. Recent studies have shown that beginning to use the vacuum pump on a daily basis starting with in 2-8 weeks may help prevent the start of penile shrinkage. This is a potential issue that can occur because of decreased blood flow after prostate cancer surgery. This study will allow researchers to determine and compare vacuum therapy techniques and erectile function outcomes of patients who have prostate cancer surgery Conditions: Male Erectile Disorder, Prostate Cancer, Sexual Dysfunction Intervention / Treatment: OTHER: Sexual Health Inventory for Men (SHIM) questionnaire administration, PROCEDURE: management of therapy complications, PROCEDURE: Daily vacuum therapy
Inclusion Criteria: * Sexually active men without the consistent use of erectile aids pre-operatively (i.e. oral pharmacotherapy, intraurethral prostoglandin E1 \[PGE1\], intracavernosal injection therapy and penile implants) * Undergoing a bilateral nerve sparing robotic prostatectomy * Pre-operative baseline SHIM total score of greater than or equal to 17 * Presence of a female sexual partner * Dexterity necessary to operate vacuum pump Exclusion Criteria: * Has a history of cardiac failure, angina, or life-threatening arrhythmia within the past 6 months * Has taken or has been prescribed nitrate medication in any form in the last 6 months * Has a known sensitivity to Phosphodiesterase type 5 inhibitors such as Sildenafil, Tadalafil or Vardenafil * Men with sickle cell anemia * Men with insufficient manual dexterity to operate vacuum device * Men with a history of known penile deformity or Peyronie's disease * Pre or postoperative androgen therapy * Pre or postoperative radiation therapy to pelvic area * Men actively smoking at time of enrollment, 1 pack per day or more
23,390
Study Objectives This phase I trial is studying the side effects and best dose of suberoylanilide hydroxamic acid when given together with fluorouracil, leucovorin, and oxaliplatin in treating patients with progressive metastatic or unresectable colorectal cancer or solid tumor. Drugs used in chemotherapy, such as suberoylanilide hydroxamic acid, fluorouracil, leucovorin, and oxaliplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Suberoylanilide hydroxamic acid may also stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Giving more than one drug (combination chemotherapy) may kill more tumor cells. Conditions: Recurrent Colon Cancer, Recurrent Rectal Cancer, Stage III Colon Cancer, Stage III Rectal Cancer, Stage IV Colon Cancer, Stage IV Rectal Cancer, Unspecified Adult Solid Tumor, Protocol Specific Intervention / Treatment: DRUG: oxaliplatin, DRUG: leucovorin calcium, DRUG: vorinostat, DRUG: fluorouracil
Inclusion Criteria: * Histologically confirmed colorectal cancer * Metastatic or unresectable disease OR diagnosis of solid tumor * No known brain metastases * ECOG 0-1 OR Karnofsky 70-100% * Life expectancy > 12 weeks * Absolute neutrophil count ≥ 1,500/mm\^3 * WBC ≥ 3,000/mm\^3 * Platelet count ≥ 100,000/mm\^3 * Bilirubin normal * AST and ALT ≤ 3 times upper limit of normal * Creatinine normal OR creatinine clearance ≥ 60 mL/min * No symptomatic congestive heart failure * No unstable angina pectoris * No cardiac arrhythmia * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective contraception during and for 3 months after study participation * No ongoing or active infection * No neuropathy > grade 1 * No history of allergic reaction attributed to compounds of similar chemical or biological composition to study drugs * No psychiatric illness or social situation that would preclude study compliance * No psychiatric illness or social situation that would preclude study compliance * No other uncontrolled illness * Prior bevacizumab and/or cetuximab allowed * No concurrent routine or prophylactic filgrastim (G-CSF) or sargramostim (GM-CSF) * More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin) * More than 4 weeks since prior radiotherapy * Recovered from prior therapy * At least 2 weeks since prior valproic acid * No concurrent combination anti-retroviral therapy for HIV-positive patients * No other concurrent investigational agents * No other concurrent anticancer therapy
38,187
Study Objectives This was an open label, randomized study comparing the efficacy and safety of randomized 2:1 Ruxolitinib tablets versus best-available therapy, as selected by the investigator. The purpose was to compare the efficacy, safety and tolerability of Ruxolitinib (INC424/INCB018424) given twice daily to the best-available therapy, in subjects with primary myelofibrosis (PMF), post polycythemia vera myelofibrosis (PPV-MF) or post essential thrombocythemia myelofibrosis (PET-MF). Conditions: Myelofibrosis Intervention / Treatment: DRUG: Ruxolitinib, DRUG: Best Available Therapy (BAT)
Inclusion Criteria: * Subjects must be diagnosed with PMF, PPV-MF or PET-MF according to the 2008 World Health Organization criteria * Subjects with MF requiring therapy must be classified as high risk OR intermediate risk level 2 according to the prognostic factors defined by the International Working Group * Subjects with an ECOG performance status of 0, 1, 2 or 3 * Subjects with peripheral blood blast count of < 10%. * Subjects who have not previously received treatment with a JAK inhibitor Exclusion Criteria: * Subjects with a life expectancy of less than 6 months * Subjects with inadequate bone marrow reserve as demonstrated by specific clinical laboratory counts * Subjects with any history of platelet counts < 50,000/µL or ANC < 500/µL except during treatment for a myeloproliferative disorder or treatment with cytotoxic therapy for any other reason * Subjects with inadequate liver or renal function * Subjects with clinically significant bacterial, fungal, parasitic or viral infection which require therapy * Subjects with an active malignancy over the previous 5 years except specific skin cancers * Subjects with severe cardiac conditions * Subjects who have had splenic irradiation within 12 months
4,399
Study Objectives 1. Purpose of the study -To compare stent patency and complication rate between endoscopic ultrasound (EUS) guided stent insertion and endoscopic retrograde cholangiopancreatography (ERCP) guided stent insertion for malignant biliary obstruction 2. Subjects of the study -Patients who have biliary obstruction owing to malignant tumors 3. Methods of the study * Prospective randomized controlled study * Patients were enrolled randomly in two groups, EUS guided stent insertion group or ERCP guided stent insertion group * Patients will get assigned procedure (EUS guided stent insertion or ERCP guided stent insertion)for decompression of malignant biliary obstruction * After the procedure, regular follow up, blood test,and imaging test will be done to check sufficient biliary decompression,stent patency and complications. Conditions: Tumor Appearance of Biliary System Obstruction Intervention / Treatment: PROCEDURE: ERCP-guided stent insertion, PROCEDURE: EUS guided stent insertion
Inclusion Criteria: * distal biliary obstruction due to malignant tumor * unresectable tumor * Jaundice Exclusion Criteria: * Children * Hilar obstruction * Active infection * Bleeding tendency
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Study Objectives Surgical resection is the mainstay for gastric cancer. Surgical stress response, like insulin resistance and catabolism, is inevitable and is a risk factor for postoperative outcome. To cope with this stress, the enhanced recovery protocol has been proposed and successfully implemented in clinical practice. Recently, prehabilitation have attracted increasingly attention, which is the preoperative part of enhanced recovery pathway. Prehabtilitation are bundles of evidenced elements in order to improve patient's functional capacity. Patients with gastric cancer are usually suffered from nutritional risk, anxiety and frailty. In this trial, we investigate whether multimodal prehabilitation (exercise, nutrition and psychological support) could improve patient's functional status to better tolerate surgical trauma. Conditions: Stomach Neoplasm Intervention / Treatment: BEHAVIORAL: aerobic exercise; resistance exercise; nutritional support; psychological support
Inclusion Criteria: * Pathologically confirmed gastric cancer, clinical I-III TNM stage (AJCC 8th edition); * Will receive curative-intent surgery; * Life expectance > 6 months; Exclusion Criteria: * Gastric stump cancer or combined with other malignances; * NYHA III, NYHA IV; * Inability to swallow, with gastrostomy, or inability to move because of orthopedic disease or neuromuscular disease; * Psychiatric disorders, COPD, end-stage hepatic or renal disease, uncontrolled cardiac arhythmia or uncontrolled hypertention; * Receiving immunosuppressive therapy; * Emergency surgery because of tumor bleeding or tumor perforation;
29,681
Study Objectives In recent years, more and more people are having lung CT scans performed to screen for various cancers. Many of them have small abnormalities detected, called "nodules", which - for a variety of reasons - doctors are unable to biopsy. As a result, many patients have their CT scans repeated on a regular basis to see if their nodules grow. This process can last several years. Many patients experience significant anxiety during this process, when they are aware of a spot in the lung, but are not told any specific cause. Researchers at Memorial Sloan-Kettering have developed a new way to look at lung nodules in three dimensions. The purpose of this project is to see if any change in the nodules can be detected sooner by this method than by traditional CT scans. Conditions: Undiagnosed Pulmonary Nodules, Lung Nodules Intervention / Treatment: PROCEDURE: CT Scan
Inclusion Criteria: * Referral to the pulmonary or thoracic surgery service for undiagnosed pulmonary nodules. * History of smoking exceeding 10 pack-years (pack year defined as number of packs of cigarettes per day multiplied by the number of years smoked). * Age >18 * Nodule size 5 to 15 mm in diameter. Exclusion Criteria: * Clinical indication for immediate biopsy via bronchoscopy, fine needle aspiration, or video-assisted thoracoscopic Surgery (VATS) * Active lung cancer or metastasis to the lung. * Contraindication to needle biopsy. * Pneumonectomy * Need for supplemental oxygen. * Radiation pneumonitis * Interstitial lung disease.
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Study Objectives Rationale: Initial evaluation usually consists of cross sectional imaging of the urinary tract. When a suspect lesion is seen, an ureterorenoscopy is planned to visualize the lesion and to collect tissue for histopathology. These techniques are considered to be the gold standard in diagnosis of UTUC. CLE, a high resolution imaging technique that can be used in combination with endo-urological procedures, seems promising to improve diagnosis of urothelial cancer. CLE image characteristics for UTUC still have to be defined. Objective: With this IDEAL stage 2b explorative pilot study the investigators aim to assess in-vivo CLE image characteristics of normal urothelium, benign urothelium and urothelial carcinoma (low-grade, high-grade or CIS) of the upper urinary tract by qualitatively comparing CLE images with both histopathology from diagnostic biopsies and pathology from the therapeutic radical nephroureterectomy. Secondary objectives are the development of an imaging atlas and to assess the technical feasibility and procedure related adverse events of CLE. Conditions: Urinary Tract Cancer, Urothelial Carcinoma, Ureter Cancer Intervention / Treatment:
Inclusion Criteria: * Patients >18 years * Suspect upper urinary tract urothelial carcinoma * Scheduled for diagnostic URS * Signed informed consent Exclusion Criteria: * Patients <18 years * Patients with known allergy for fluorescein * Possible pregnancy or lactating women * Patients not eligible for radical treatment of UTUC * No signed informed consent
17,082
Study Objectives This pilot clinical trial studies magnetic resonance imaging (MRI)-guided stereotactic body radiation therapy (SBRT) in treating patients with liver metastases or liver cancer. SBRT is a specialized radiation therapy that delivers a single, high dose of radiation directly to the tumor and may kill more tumor cells and cause less damage to normal tissue. Combining MRI with SBRT may help doctors to highlight the tissues surrounding the tumor better. Conditions: Adult Hepatocellular Carcinoma, Metastatic Malignant Neoplasm in the Liver Intervention / Treatment: RADIATION: Image-Guided Adaptive Radiation Therapy, RADIATION: Stereotactic Body Radiation Therapy
Inclusion Criteria: * Patients may have either metastatic lesions from another primary site or primary hepatocellular carcinoma; patients with one histologically confirmed metastatic lesion of the liver who are presenting for local therapy for lesions concerning for metastases that cannot or should not be biopsied will also be considered for enrollment on a case by case basis; patients can simultaneously receive treatment for multiple hepatic lesions meeting the prior two requirements, at the discretion of the treating radiation oncologist * Karnofsky performance status (KPS) >= 70 * No active infections requiring systemic antibiotics * If a woman is of childbearing potential, a negative urine or serum pregnancy test must be documented; women of childbearing potential must agree to use adequate contraception (hormonal or barrier method of birth control; or abstinence) for duration of study participation and for up to 4 weeks following the study * Ability to understand and willingness to sign a written informed consent Exclusion Criteria: * Pregnant women, or women of childbearing potential who are sexually active and not willing/able to use medically acceptable forms of contraception for the entire study period and for up to 4 weeks after the study * Refusal to sign the informed consent * Patients who are participating in a concurrent treatment protocol * Patients for whom a plan meeting institutional quality criteria cannot be designed for SBRT treatment via the MRI-guided teletherapy unit, but for whom an SBRT plan meeting institutional quality criteria can be designed for a conventional linear accelerator
23,583
Study Objectives The purpose of this study is to determine the safety, tolerability and dose limiting toxicities (DLTs) of VELCADE when administered in combination with interferon-alpha-2b (IFN-α-2b) to patients with metastatic malignant melanoma. Conditions: Melanoma Intervention / Treatment: DRUG: Bortezomib, DRUG: Interferon Alfa-2b
Inclusion Criteria: * must have histological or cytological diagnosis of cutaneous melanoma and clinical evidence of metastatic, non-resectable regional lymphatic, or extensive in transit recurrent disease. Patients who have had resected metastases will also be eligible provided they have measurable disease. * have measurable disease. Measurable disease is defined as the presence of at least one measurable lesion. * ECOG performance status ≤ 2 (Karnofsky ≥ 60%). * Female subjects must be either surgically sterilized or willing to use an acceptable method of birth control (ie, a hormonal contraceptive, intra-uterine device, diaphragm with spermicide, condom with spermicide, or abstinence) for the duration of the study. Male subjects must agree to use an acceptable method for contraception for the duration of the study. * Patients must have normal organ and marrow function. * Prior Therapy: Patients with an ECOG performance status of ≤ 2 will be eligible for this protocol regardless of the number of prior treatments provided they have recovered from the reversible effects of prior therapy. Patients are permitted to have received therapy with adjuvant IFN-α2b, if it was completed > 6 months prior to enrollment in the current study. * Patients with brain metastases are eligible for entry into the study, but must have received definitive therapy consisting of external beam radiation therapy, gamma knife therapy or surgical resection and be clinically stable. Four weeks after the definitive therapy is completed, repeat MRI or CT scans must demonstrate stabilization of disease, and there must be no requirement for Decadron. If the patient does not have brain metastases, then only one brain CT or MRI is required prior to enrollment on study. Exclusion Criteria: * Patients meeting any of the following exclusion criteria are not to be enrolled in the study. * Patient has a platelet count of < 100 × 109/L within 14 days before enrollment. * Patient has an absolute neutrophil count of < 1.0 x 109/L within 14 days before enrollment. * Patient has a calculated or measured creatinine clearance of < 30 mL/minute within 14 days before enrollment. * Patient has history of significant brain metastases or other clinically significant central nervous system disease. * Patient has ≥Grade 2 peripheral neuropathy within 14 days before enrollment. * Patient has hypersensitivity to bortezomib, boron or mannitol. * Patients with evidence of proteinuria on urinalysis. * Female subject is pregnant or breast-feeding. * Received other investigational drugs with 14 days before enrollment. * Serious medical or psychiatric illness likely to interfere with participation in this clinical study. * History of serious psychiatric illness that might be exacerbated by IFN-α-2b.
16,591
Study Objectives To evaluate the activity and safety of MK-2206 in patients with recurrent or metastatic nasopharyngeal carcinoma (NPC) Conditions: Recurrent Nasopharyngeal Carcinoma Intervention / Treatment: DRUG: MK-2206
Inclusion Criteria: * Aged > 18 year, able to give written informed consent. * History of histologically or cytologically confirmed non-keratinizing NPC that has recurred at locoregional and/or distant sites, and is not amenable to potentially curative radiotherapy or surgery. * Patients must have progressed within 24 months of receiving one or two prior line of chemotherapy for recurrent disease, of which at least one line must contain platinum drugs such as Cisplatin, Carboplatin or oxaliplatin. * Adequate organ reserve: neutrophils >1.5x109/L, platelets ≥100 x109/L, hemoglobin ≥9 g/dL, serum alanine aminotransferase (ALT) < 2.5 x upper limit of normal (ULN) or ALT< 5 x ULN in the presence of liver metastases, serum bilirubin < 2.5 x ULN, serum creatinine < 1.5 x ULN. * Presence of measurable disease as per Response Evaluation Criteria in Solid Tumors (RECIST ver 1.1). Exclusion Criteria: * Chemotherapy, radiotherapy (except to bone metastases) or investigational treatment within 4 weeks of enrollment. * Patients with diabetes or in risk for hyperglycemia should not be excluded from trials with MK-2206, but the hyperglycemia should be well controlled before the patient enters the trial. * Cardiovascular: baseline QTcF > 450 msec (male) or QTcF >470 msec (female) Left bundle branch block, 2nd or 3rd degree AV block, bifascicular block, sick sinus syndrome, Wolff-Parkinson-white syndrome, significant sinus bradycardia (< 50bpm) . However, patients with asymptomatic right bundle branch block or 1st degree AV block, in the absence of known cardiac disease (e.g. coronary, valvular) are NOT excluded.. * Uncontrolled inter-current 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.
29,020
Study Objectives RATIONALE: Bortezomib and thalidomide may stop the growth of multiple myeloma by blocking blood flow to the cancer. Bortezomib may also stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Giving bortezomib together with thalidomide and dexamethasone may kill any cancer cells that remain after high-dose melphalan and stem cell transplant in patients with multiple myeloma. PURPOSE: This phase II trial is studying the side effects of giving bortezomib together with thalidomide and dexamethasone after melphalan and stem cell transplant and to see how well it works in treating patients with stage I-III multiple myeloma. Conditions: Multiple Myeloma and Plasma Cell Neoplasm, Neurotoxicity Intervention / Treatment: DRUG: bortezomib, DRUG: dexamethasone, DRUG: melphalan, DRUG: thalidomide, GENETIC: cytogenetic analysis, GENETIC: fluorescence in situ hybridization, OTHER: laboratory biomarker analysis, OTHER: questionnaire administration, PROCEDURE: autologous hematopoietic stem cell transplantation, PROCEDURE: peripheral blood stem cell transplantation
Inclusion Criteria: * Multiple Myeloma patients with symptomatic disease, stage II or III at diagnosis or progressive stage I requiring chemotherapy and/or radiation therapy (by Salmon-Durie classification), who are not eligible for tandem transplant study using TMI; because of previous radiation or eligibility criteria; documentation of disease staging by both Salmon-Durie classification and International Staging System (ISS) is required * Patients with non-secretory myeloma should have measurable serum free-light chain protein by the Free-lite test or measurable disease such as a soft tissue myeloma * A minimum of 4 x 10\^6 of CD 34 Positive cell/kg has been harvested * A Karnofsky performance status (KPS) of >= 70% is required unless the KPS is impaired due to bone disease * No contraindication to the collection of a minimum of 4 x 10\^6 CD34+ cells/kg by apheresis * All patients must have signed a voluntary, informed consent in accordance with institutional and federal guidelines * Bilirubin =< 1.5 mg/dl * Serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvate transaminase (SGPT) < 2.5 x upper limits of normal * Creatinine clearance of >= 40cc/min * Absolute neutrophil count of > 1000/ul * Platelet count of > 100,000/ul * Cardiac ejection fraction >= 45% by multigated acquisition (MUGA) scan and/or by echocardiogram * Diffusing capacity of the lung for carbon monoxide (DLCO) >= 50% of predicted lower limit * Human immunodeficiency virus (HIV) antibody tests negative * No other medical, or psychosocial problems which in the opinion of the primary physician or principal investigator would place the patient at unacceptably high risk from this treatment regimen Exclusion Criteria: * Presence of peripheral neuropathy >= grade II * Patients with evidence of disease progression (with >= 25% increase in M protein) on bortezomib and or thalidomide therapy prior to transplant * Pregnant or nursing women, as well as women of child bearing age, who are unwilling to use a dual method of contraception and men who are unwilling to use condom * Patients with history of hypersensitivity to bortezomib, boron or mannitol
29,408
Study Objectives This study prospectively recruited esophageal squamous-cell carcinoma patients who received nasogastric tube (NG), gastrostomy feeding and oral intake to compare the changes in nutritional status and quality of life during chemoradiation therapy (CRT). Conditions: Esophageal Squamous Cell Carcinoma, Chemoradiotherapy, Enteral Nutrition Intervention / Treatment: DIETARY_SUPPLEMENT: Dietary guidance
Inclusion Criteria: * Pathologically or cytologically proven esophageal squamous cell carcinoma * Karnofsky performance score(KPS) ≧70 * Concurrent chemoradiotherapy * Hemoglobin≥90.0g/dL,white blood cell count(WBC)≥ 4000 cells/mm³,Platelet count≥100,000 cells/mm³ * Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) < 2.5 times upper limit of normal,bilirubin normal * Creatinine normal OR creatinine clearance ≥ 60 mL/min * Patients have good compliance to treatment and follow-up of acceptance * the functions of the heart, kidney, liver were basically normal, with no chemotherapy and radiotherapy contraindications Exclusion Criteria: * Patients with severely bowel function impaired or can not tolerate enteral nutrition * Patients with serious gastrointestinal obstruction, be unable to take food by mouth and can not / do not want to a feeding tube inserted * Patients who have severe vomiting, gastrointestinal bleeding, intestinal obstruction * Patients who have distant metastasis * The primary tumor or lymph node already received surgical treatment efuse or incapable to sign the informed consent form of participating this trial
21,688
Study Objectives Primary Objective: * To determine the efficacy of the combination of imatinib mesylate and docetaxel in recurrent or metastatic head and neck squamous cell cancer by serial measurements of tumor response (extent, frequency, duration). Secondary Objectives: * To assess the safety and tolerability of imatinib mesylate and docetaxel in patients with recurrent or metastatic head and neck squamous cell cancer. * To explore the biologic effects of imatinib mesylate and docetaxel on tumor tissue by immunohistochemical analysis of microvessel density and phosphorylation of Platelet-derived growth factor receptors (PDGF-R). * To explore the effects of imatinib mesylate and docetaxel on surrogate markers in serum. * To assess the rate of survival. Conditions: Head and Neck Cancer, Squamous Cell Cancer Intervention / Treatment: DRUG: Imatinib Mesylate, DRUG: Docetaxel
Inclusion Criteria: * A written, voluntary informed consent form must be completed prior to beginning any study procedure.* Patients >= 18 years of age.* Histologically documented diagnosis of head and neck squamous cell cancer* At least one measurable site of disease and can be assessed by Response Evaluation Criteria In Solid Tumors (RECIST).* Performance status 0-2 (Eastern Cooperative Oncology Group, ECOG)* Patients must have adequate hepatic, renal, and bone marrow function, defined as the following: (1) total bilirubin < 1.5 \* Upper Limits of Normal (ULN); (2) aspartate aminotransferase (AST or SGOT) and alanine aminotransferase (ALT or SGPT) < 2.5 \* ULN; (3) creatinine < 1.5 \* ULN; (4) ANC > 1.5 \* 10\^9/L; (5) platelets > 100 \* 10\^9/L.* Female patients of childbearing potential must have negative pregnancy test within 7 days before initiation of study drug dosing. Postmenopausal women must be amenorrheic for at least 12 months to be considered of non-childbearing potential. Male and female patients of reproductive potential must agree to employ an effective barrier method of birth control (i.e. condoms, diaphragm) throughout the study and for up to 3 months following discontinuation of study drug.* Patients who have not been treated for recurrent or metastatic head and neck squamous cell carcinomas (HNSCC) (i.e. Patients who have been treated with chemotherapy for induction/adjuvant or concurrent therapy with radiation in the setting of definitive treatment but have now developed recurrent or metastatic disease are eligible). Exclusion Criteria: * Prior exposure to docetaxel or imatinib mesylate.* Patient has received any other investigational agents within 30 days of first day of study drug dosing.* Patients with myocardial infarction within the past 6 months or New York Heart Association class 3 or 4 congestive heart failure.* Female patients who are pregnant or breast-feeding.* Patient has a severe and/or uncontrolled medical disease (i.e., uncontrolled diabetes, chronic renal disease, or active uncontrolled infection (i.e. septic).* Patient has unstable brain metastasis. Unstable brain metastasis is defined as patients on steroid medication to control symptoms or patient with motor neurologic compromise due to brain metastasis. Patients with treated brain metastasis are eligible if they are > 6 weeks out from therapy and off all steroid medication.* Patient has known chronic liver disease (i.e., chronic active hepatitis or cirrhosis).* Patient has a known diagnosis of human immunodeficiency virus (HIV) infection. HIV patients are at much greater risk of infection when receiving highly myelosuppressive agents (docetaxel and imatinib) and for safety reasons are not eligible for this trial.* Patient received chemotherapy within 4 weeks (6 weeks for nitrosourea or mitomycin-C) prior to study entry, unless the disease is rapidly progressing.* Patient previously received radiotherapy to >= 25 % of the bone marrow* Patient had a major surgery within 2 weeks prior to study entry.* Patient with any significant history of non-compliance to medical regimens or with inability to grant reliable informed consent.* Patients must agree not to use herbal remedies or other over-the-counter biologics (i.e. shark cartilage)* History of hypersensitivity to docetaxel or other taxane therapy.* History of severe hypersensitivity reaction to drugs formulated with polysorbate 80.* Patients taking therapeutic levels of warfarin. However, patients receiving 1 mg daily for catheter related anticoagulation are eligible for the study.* Prior pericardial effusion requiring intervention such as pericardiocentesis or pericardial window within 2 months of study entry.* Patient is < 5 years free of another primary malignancy except: if the other primary malignancy is not currently clinically significant nor requiring active intervention, or if other primary malignancy is a basal cell skin cancer or a cervical carcinoma in situ. Existence of any other malignant disease is not allowed.* Patients with a history of Regional Ileitis, Colitis, or Crohn's disease, or any other relevant medical history related to the integrity of the bowel wall as there may be an increased risk of bowel perforation with the combination of Docetaxel and Imatinib.
34,493
Study Objectives The Mother-Daughter Initiative (MDI) will test the feasibility and acceptability of a strategy to deliver comprehensive cervical cancer prevention services in Thailand and the Philippines by integrating the HPV vaccine for girls ages 9-13 into already successful screening and treatment programs for mothers. Conditions: Cervical Cancer Intervention / Treatment: BIOLOGICAL: HPV Vaccine (Gardasil)
Inclusion Criteria: * Age 9-13 at first HPV vaccine dose * Mother/legal guardian and daughter are both interested and willing to have the girl receive the HPV vaccine * Mother/legal guardian and daughter both indicate that they would be able to return to clinic for the three vaccine doses Exclusion Criteria: * Girls with a known history of any allergies or severe reaction to any vaccines, food or medicine * Pregnant adolescents will be excluded. If a girl becomes pregnant after the first dose is administered, she will not be provided with the second or third dose * Girls with moderate or severe illnesses will be asked to postpone vaccination eg. Pneumonia. * Girls with a weakened immune system, cancer, leukemia, AIDS or other immune system problems * Girls with a bleeding disorder or currently taking anticoagulants * Girls that have received any other vaccinations in the past 4 weeks * Girls currently on steroids, such as cortisone, prednisone, or anti-cancer drug.
27,289
Study Objectives This phase Ib trial studies the side effects and best dose of niraparib when given together with radium Ra223 dichloride in treating subjects with prostate cancer that keeps growing even when the amount of testosterone in the body is reduced to very low levels and has spread from the primary site to the bone. Radium Ra 223 dichloride, acts like calcium to target cancer in the bones and may deliver radiation directly to the bone tumors, limiting damage to the surrounding normal tissue. Niraparib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Giving radium Ra 223 dichloride and niraparib may work better in treating subjects with hormone-resistant prostate cancer metastatic to the bone. Conditions: Prostate Carcinoma Metastatic to the Bone, Stage IV Prostate Adenocarcinoma, Hormone-refractory Prostate Cancer Intervention / Treatment: DRUG: Niraparib, RADIATION: Radium Ra 223 Dichloride
Inclusion Criteria: * Histologic or cytologic diagnosis of adenocarcinoma of the prostate without neuroendocrine differentiation or small cell features * Bone metastases * Documented progressive metastatic CRPC based on at least one of the following criteria: * PSA progression defined as a miminum of 2 rising PSA levels with a minimum of a 1 week interval and a minimum PSA of 2 ng/mL -1.0 ng/mL is the minimal starting PSA value if confirmed rise is the only indication of progression * Soft-tissue progression defined as an increase >= 20% in the sum of the longest diameter (LD) of all target lesions based on the smallest sum LD since treatment started or the appearance of one or more new lesions or the appearance of new lesions * Documented appearance of new lesions by bone scan * Agree to undergo a tumor/bone marrow biopsy or submit archival tissue. Note: Tissue sample collected from primary or metastatic site is acceptable on study. Once each stratum begins enrollment at the 300mg dose level, 5 subjects from each stratum will complete a bone marrow biopsy. Due to the dose assignment method used in this study, the 10 subjects requiring a bone marrow biopsy on study will be determined on a case by case basis after consent * Age ≥ 18 years. * Eastern Cooperative Oncology Group (ECOG) performance status of 0-2 * Must have received at least 1 line of AR-targeted therapy or androgen bio-synthesis inhibitor (e.g., abiraterone acetate, enzalutamide, apalutamide) for prostate cancer * Testosterone =< 50 ng/dL; subjects must continue primary androgen deprivation with an luteinizing hormone-releasing hormone (LHRH) analogue (agonist or antagonist) if they have not undergone orchiectomy * Subjects on long term (>= 6 months) first generation anti-androgen therapy (e.g. flutamide, bicalutamide, nilutamide) will need to discontinue anti-androgen therapy for 4 weeks (wash out period) and show evidence of disease progression off the anti-androgen; subjects that have been on a first generation anti-androgen 6 months or less will need to discontinue therapy prior to registration (no wash out period required) * Subjects on second generation anti-androgen therapy (enzalutamide) or androgen bio-synthesis inhibitor (abiraterone acetate) will need to discontinue therapy 2 weeks prior to registration (wash out period) * Subjects on treatment with chemotherapy or any investigational therapeutic agent will need to discontinue therapy 4 weeks prior to registration (wash out period) * Absolute neutrophil count (ANC) >= 1,500/uL * Hemoglobin >= 10 g/dL * Platelet count >= 150,000/uL * Creatinine =< 1.5 x the institutional ULN * Potassium > 3.5 mmol/L (within institutional normal range) * Total Bilirubin =< 1.5 ULN (unless documented Gilbert's disease) * Serum glutamic oxaloacetic transaminase (SGOT) aspartate aminotransferase (AST) =< 2.5 x ULN * Serum glutamate pyruvate transaminase (SGPT) alanine aminotransferase (ALT) =< 2.5 x ULN * Men must agree to use adequate contraception prior to study entry, for the duration of study participation and for at least 6 months after last radium 223 dose * Must be able to take oral medication without crushing, dissolving or chewing capsules * May have received prior radiation therapy or surgery; however, at least 21 days must have elapsed since completion of radiation therapy or surgery and patient must have recovered from all side effects at the time of registration * Ability to understand and the willingness to sign a written informed consent document that is approved by the local institutional review board Exclusion Criteria: * Concurrent treatment with any other investigational therapeutic agents * More than one prior line of chemotherapy * More than one prior line of therapy with a second generation anti-androgen (enzalutamide, ARN-509, etc.) or androgen bio-synthesis inhibitor (abiraterone acetate, TAK 700, etc.); patient may have had one second generation anti-androgen or androgen bio-synthesis inhibitor but not both sequentially; subjects that have received combination therapy with second generation anti-androgen plus an androgen bio-synthesis inhibitor would be eligible (e.g., enzalutamide plus abiraterone acetate as one line of therapy on a clinical trial). Note, subjects who have had one line of therapy in a hormone-sensitive setting or one line of therapy in castrate resistant setting are eligible for study. * Prior isotope therapy with strontium-89, samarium or RAD223 * Subjects with known symptomatic brain metastases * All herbal, alternative and food supplements (i.e. PC-Spes, saw palmetto, St. John's wort, etc.) must be discontinued before registration; Subjects may continue on a daily multi-vitamin, calcium and vitamin D * Pre-planned concurrent cytotoxic chemotherapy, surgery, or radiation therapy during protocol treatment; radiation therapy is not permitted while on study * All hormonal-acting agents (including diethylstilbestrol/DES, aldosterone, and spironolactone) must be discontinued before registration; no washout period will be required for any of these agents * Initiation of bisphosphonate/denosumab therapy during the study; subjects on stable doses of bisphosphonates or the tumor necrosis factor receptor superfamily member 11a, subfamily L (RANK-L) inhibitor, denosumab, which have been started no less than 4 weeks prior to registration, may continue on this medication * Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure (New York Heart Association class III and IV heart failure), unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements or concurrent medications that alter cardiac conduction * Subjects with a "currently active" second malignancy other than non-melanoma skin or superficial urothelial cancers are not eligible; Subjects are not considered to have a "currently active" malignancy if they have completed therapy and are now considered without evidence of disease for 2 years * Subjects with any known history of myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML) * Subjects with known persistent (> 4 weeks) >= grade 2 toxicity from prior cancer therapy * Subjects with known >= grade 3 hematological toxicity lasting greater than 7 days with the last chemotherapy regimen * Subjects with chronic conditions associated with non-malignant abnormal bone growth (e.g., Paget's disease of bone) * Subjects who have used any of the following within 4 weeks prior to registration: blood or platelet transfusions, erythropoietin, and biologic response modifiers such as granulocyte macrophage colony-stimulating factor (GM-CSF) or granulocyte colony-stimulating factor (G-CSF) * Subjects with baseline QT prolongation > 470 msec * Subjects receiving concomitant medications that prolong corrected QT interval (QTc) * Subjects with bulky visceral disease defined as > 4 cm * Known disorder affecting gastrointestinal absorption * Subjects with known allergies, hypersensitivity, or intolerance to niraparib or its excipients * Subjects requiring escalating doses of prednisone or steroids for control of disease at the time of screening. Note: If subjects are receiving prednisone or steroids, they must continue on the same dose they were receiving at the time of screening while being treated on study * HIV positive subjects with 1 or more of the following: * Not receiving highly active antiretroviral therapy * A change in antiretroviral therapy within 6 months of the start of screening (except if, after consultation with the sponsor on exclusion criterion 26c. a change is made to avoid a potential drug-drug interaction with the study drug) * receiving antiretroviral therapy that may interfere with the study drug (consult the sponsor for review of medication prior to enrollment) * CD4 cont <350 at screening * An acquired autoimmunodeficiency syndrome-defining opportunistic infection within 6 months of the start of screening
9,568
Study Objectives The purpose of this study is to determine the effectiveness and safety of epoetin alfa at a starting dose of 60,000 Units (U) once every week (QW) to a target hemoglobin (Hb) of 12 g/dL (Initiation Phase), followed by a dose of 60,000 U once every other week (Q2W) to maintain a Hb range of 11.5 to 12.5 g/dL (Maintenance Phase) in cancer patients receiving chemotherapy. Conditions: Chemotherapy, Anemia, Cancer Intervention / Treatment: DRUG: Epoetin alfa
Inclusion Criteria: * Histologically confirmed diagnosis of non-myeloid malignancy and receiving chemotherapy * Baseline Hb of <= 11 g/dL * Planned chemotherapy for a minimum of 16 weeks to be administered weekly or every 4 weeks * Female patients with reproductive potential must have a negative serum pregnancy test at screening. Exclusion Criteria: * No uncontrolled hypertension or recent history (within 6 months) of uncontrolled cardiac arrhythmias, pulmonary embolism, or thrombosis * No transfusion of white blood cells or packed red blood cells within 28 days of Epoetin alfa treatment * No prior treatment with Epoetin alfa or any other erythropoetic agent within the previous three months
15,988
Study Objectives Preoperative walking's effect of postoperative bowel functions ASA 1 or 2 in patient with gynecologic cancers. Conditions: Postoperative Bowel Functions Intervention / Treatment: OTHER: walking
Inclusion Criteria: * patients with gynecological cancer ASA score 1 or 2 via laparascopy or laparatomy Exclusion Criteria: * ASA score >2 orthopedic problems ileostomy or colostomy >24 hours stay in intensive care unit early postoperative complications (relaparotomy, massive blood transfusion)
9,008
Study Objectives Stereotactic Body Radiotherapy (SBRT) has emerged as a new treatment option for peripherally located lung tumours, offering very high rates of tumour eradication, with minimal side effects. Even though this treatment option is being adopted in more and more cancer centres, there is still no consensus about the optimal schedule for the radiation treatment. Generally speaking, most lung SBRT schedules involve delivering 3-4 days of radiation. At the Sunnybrook Odette Cancer Centre, the lung SBRT policy is to deliver 4 days of radiation over 11 days (each treatment given once very 3rd day). However, some centres deliver the same treatment over 4 days in a row (each treatment given once daily over 4 days). There is no evidence from the published literature to suggest that there is any difference in side effects between delivering the SBRT over 4 days versus 11 days. To confirm this, the investigators propose to conduct a comparative (randomized) study to compare these 2 approaches. Conditions: Peripherally Located Stage I Lung Cancer, Peripherally Located Solitary Lung Metastasis Intervention / Treatment: RADIATION: Stereotactic Body Radiotherapy
Inclusion Criteria: * Pathologic diagnosis of malignancy in the lung (either NSCLC or metastasis) * If pathologic diagnosis is not available, there must be evidence of FDG uptake on PET-CT suggestive of malignancy and/or evidence of tumour growth over serial CT scans * Clinical stage I lung cancer or solitary lung metastasis located in the periphery away from central mediastinal structures and <=5cm in size * Patient deemed suitable for lung SBRT (reasonable performance status, acceptable pulmonary function) by the attending Radiation Oncologist
26,629
Study Objectives The purpose of this study is to determine whether the 585-nm pulse dye laser can decrease the time interval between surgeries and improve voice outcomes in children with severe RRP. Conditions: Recurrent Respiratory Papillomatosis Intervention / Treatment:
Inclusion Criteria: * Immunocompetent children ages 1-12 with symptomatic JORRP requiring operative intervention* Children who have historically required at least four surgeries in the year preceding enrollment to treat laryngeal JORRP Exclusion Criteria: * Children who have required fewer than four procedures to treat laryngeal JORRP in the year prior to enrollment.* Children who are currently receiving adjuvant therapies for JORRP including cidofovir, interferon, indole-3-carbinol or Hsp-E7.* Caregivers who are non-English speaking as the PVRQOL instrument has been validated only in the English language.* Children whose families do not sign an informed consent to enter into the study.* Children whose families anticipate discontinuing care at a participating institution during the study period
11,558
Study Objectives The purpose of this study is to assess the pharmacodynamics, safety and efficacy of omiganan in patients with external genital warts. Conditions: Condylomata Acuminata (External) Intervention / Treatment: DRUG: Omiganan (CLS001) topical gel, DRUG: Vehicle topical gel
Inclusion Criteria: * Healthy male and female subjects ≥ 18 years of age, with external genital warts. The health status is verified by absence of evidence of any clinical significant active or uncontrolled chronic disease other than genital warts following a detailed medical history and a complete physical examination including vital signs and 12-lead ECG. In the case of uncertain or questionable results, tests performed during screening may be repeated before randomization to confirm eligibility or judged to be clinically irrelevant for healthy subjects.* Clinically diagnosed and biopsy confirmed external genital warts. Subject has at least 3 external genital warts.* Willing to give written informed consent and willing and able to comply with the study protocol. Exclusion Criteria: Eligible subjects must meet none of the following exclusion criteria at screening: * Clinically significant abnormalities, as judged by the Investigator, in laboratory test results including haematology, blood chemistry panel, virology or urinalysis. In the case of uncertain or questionable results, tests performed during screening may be repeated before randomization to confirm eligibility or judged to be clinically irrelevant for healthy subjects.* Current clinically significant skin conditions in the anogenital area (e.g. atopic dermatitis, lichen sclerosus, lichen planus or psoriasis).* Pregnant, breast feeding or trying to conceive.* Participation in an investigational drug or device study within 3 months prior to screening or more than 4 times a year.* Loss or donation of blood over 500 mL within three months (males) or four months (females) prior to screening.* Use of active treatment (i.e. cryotherapy, laser therapy, topical medication and/or surgical treatments) for genital warts within 28 days prior to first study drug administration.* Immunosuppressed patients, having an immunodeficiency (primary or secondary, like HIV) or receiving immunosuppressive therapy (i.e. Transplant patients).* Males or Females who received a vaccination with Gardasil or Cervarix.* Any (medical) condition that would, in the opinion of the Investigator, potentially compromise the safety or compliance of the patient or may preclude the patient's successful completion of the clinical trial.
1,635
Study Objectives PreBioGyn will be compared to market leading vaginal pH buffering gels using established forearm test methods associated with vaginal lubricity sensation in 42 women. Women will also rate each gel for smell and appearance using established methods. The PreBioGyn gel enclosure and intravaginal applicator design will be evaluated for: look and feel, ability to prepare for dosing, ability to expulse dose, and likelihood of future use by subjects. Open-ended feedback on the gel and applicator will occur to gather contributions for each product. Conditions: Sensory Perceptual Characteristics, User Acceptability of Gel Delivery System Intervention / Treatment: OTHER: PreBioGyn Gel, OTHER: Trimosan Gel, OTHER: RepHresh Gel
Inclusion Criteria: * Female * hrHPV positive * 30 years of age or older * Have not received the HPV vaccine * Not pregnant or nursing * Medicaid eligible Exclusion Criteria: * history of skin irritation and/or allergic skin reactions
1,226
Study Objectives This phase II clinical trial studies how well combining different regimens of chemotherapy and gefitinib with radiation therapy work in treating patients with stage III non-small cell lung cancer. Drugs used in chemotherapy work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Biological therapies such as gefitinib may interfere with the growth of tumor cells and slow the growth of non-small cell lung cancer. Radiation therapy uses high-energy x-rays to damage tumor cells. Giving different regimens of combination therapy together with gefitinib and radiation therapy may be an effective treatment for non-small cell lung cancer. Conditions: Adenocarcinoma of the Lung, Adenosquamous Cell Lung Cancer, Bronchoalveolar Cell Lung Cancer, Large Cell Lung Cancer, Squamous Cell Lung Cancer, Stage IIIA Non-small Cell Lung Cancer, Stage IIIB Non-small Cell Lung Cancer Intervention / Treatment: DRUG: paclitaxel, DRUG: carboplatin, DRUG: gefitinib, RADIATION: radiation therapy, OTHER: laboratory biomarker analysis
Inclusion Criteria: * Histologically or cytologically documented non-small cell lung cancer (NSCLC), including squamous cell carcinoma, adenocarcinoma (including bronchoalveolar cell), and large cell anaplastic carcinoma (including giant and clear cell carcinomas) * ELIGIBLE DISEASE STAGES: Inoperable IIIA and selected IIIB * Generally, patients entered must be considered unresectable or inoperable; patients with T1 or T2, N2 disease are eligible; patients with T3, N2 or T4, N0-N2 disease are eligible if based on the closeness to the carina, invasion of the mediastinum or invasion of the chest wall; patients with T3, N0-N1 disease are not eligible; patients must be M0 (M1 patients are not eligible) * Patients with direct invasion of vertebral body are ineligible * Patients with tumors adjacent to a vertebral body are eligible, unless there is demonstrable bone invasion, as long as all gross disease can be encompassed in the radiation boost field in accordance with the homogeneity criteria * Patients with contralateral mediastinal disease (N3) are eligible if all gross disease can be encompassed in the radiation boost field in accordance with the homogeneity criteria; patients with scalene, supraclavicular, or contralateral hilar node involvement are ineligible * Patients with a pleural effusion, which is a transudate, cytologically negative and non-bloody, are eligible if the radiation oncologist feels the tumor can be encompassed within a reasonable field of radiotherapy. Patients with exudative, bloody, or cytologically malignant effusions are not eligible; if a pleural effusion can be seen on the chest computed tomography (CT) but not on chest x-ray (CXR) and is too small to tap, the patient will be eligible; a pleural effusion appearing only after a thoracotomy or other invasive thoracic procedure was attempted will not make a patient ineligible * PATIENTS MUST HAVE MEASURABLE DISEASE * Lesions that can be accurately measured in at least one dimension (longest diameter to be recorded) as >= 20 mm with conventional techniques or as ≥10 mm with spiral CT scan * Lesions that are not considered measurable include the following: * Bone lesions * Leptomeningeal disease * Ascites * Pleural/pericardial effusion * Abdominal masses that are not confirmed and followed by imaging techniques * Cystic lesions * Tumor lesions situated in a previously irradiated area * PRIOR THERAPY * >= 2 weeks since formal exploratory thoracotomy. * No prior chemotherapy or radiation therapy for NSCLC * CTC performance status 0-2 * No "currently active" second malignancy other than non-melanoma skin cancers; patients are not considered to have a "currently active" malignancy if they have completed therapy and are considered by their physician to be at less than 30% risk of relapse * Non-pregnant and non-nursing because of significant risk to the fetus/infant * No patients with 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 * No patients with chronic gastrointestinal disorders including liver disease, diarrheal or emetic disorders, or malabsorptive conditions which could worsen toxicity or limit efficacy of ZD1839 * No cytochrome P450 3A4 (CYP3A4) inducers within 7 days prior to starting protocol therapy and while on protocol treatment. CYP3A4 inducers: phenytoin, carbamazepine, barbiturates, rifampicin, dexamethasone, and St John's Wort; single doses of dexamethasone used as an antiemetic are permitted * No human immunodeficiency virus (HIV)-positive patients receiving combination anti-retroviral therapy * Granulocytes >= 1,500/ul * Platelets >= 100,000/ul * Calculated creatinine clearance >= 20 cc/min * Bilirubin < 1.5 mg/dl * Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase \[SGOT\]) < 2 x upper limit of normal (ULN)
1,008
Study Objectives The study will evaluate the clinical activity of sitravatinib in combination with nivolumab in patients with locally-advanced clear cell renal cell carcinoma (ccRCC) in the neoadjuvant setting prior to nephrectomy. Conditions: Clear Cell Renal Cell Carcinoma Intervention / Treatment: DRUG: Sitravatinib, DRUG: Nivolumab
Inclusion Criteria: * Imaging results consistent with locally-advanced RCC* Candidate for partial or complete nephrectomy as part of treatment plan.* Measurable disease per RECIST version 1.1.* ECOG performance status 0 or 1.* Adequate bone marrow and organ function. Exclusion Criteria: * Prior systemic anti-tumor treatment for RCC.* Patients who are receiving any other investigational agents.* Clinical status indicating that immediate surgery (within 6 weeks) is warranted regardless of whether neoadjuvant therapy is to be administered, as assessed by the treating surgeon.* Inability to undergo baseline tumor biopsy.* Active or prior documented autoimmune or immunocompromising conditions.* Uncontrolled hypertension.
5,477
Study Objectives The primary purpose of the study is to determine the recommended Phase 2 dose (RP2D) and schedule of JNJ-64457107 when administered intravenously (IV) to participants with advanced stage solid tumors in Part 1 and to further characterize the safety of JNJ-64457107 when administered IV to participants with non-small cell lung cancer (NSCLC), pancreatic cancer and cutaneous melanoma in Part 2. Conditions: Advanced Solid Neoplasms Intervention / Treatment: DRUG: JNJ-64457107
Inclusion Criteria: * Part 1: advanced stage solid tumors; Part 2: non-small cell lung cancer (NSCLC), pancreatic cancer and cutaneous melanoma * Eastern cooperative oncology group (ECOG) performance score of 0 or 1 * Adequate organ function as defined in the protocol * A woman of childbearing potential must have a negative highly sensitive serum (beta-human chorionic gonadotropin \[beta-hCG\]) pregnancy test at Screening and a negative urine pregnancy test prior to the first dose of study drug * During the study and for at least 120 days after receiving the last dose of study drug, in addition to the highly effective method of contraception, a man who is sexually active with a woman of childbearing potential must agree to use a barrier method of contraception (example \[eg.\], condom with spermicidal foam/gel/film/cream/suppository), or who is sexually active with a woman who is pregnant must use a condom Exclusion Criteria: * Malignancy other than the disease under study within 2 years before screening (exceptions are squamous and basal cell carcinomas of the skin and carcinoma in situ of the cervix, or malignancy that in the opinion of the investigator, with concurrence with the sponsor's medical monitor, is considered cured with minimal risk of recurrence) * Symptomatic brain metastases; asymptomatic brain metastases are allowed provided that they have been treated, have been stable for greater than (>) 6 weeks as documented by radiographic imaging, and do not require prolonged (>14 days) systemic corticosteroid therapy * Treatment with any local or systemic anti-neoplastic therapy or investigational anticancer agent within 14 days or 4 half-lives, whichever is longer, up to a maximum wash-out period of 28 days prior to the initiation of study drug administration * Toxicities from previous anti-cancer therapies have not resolved to baseline levels or to Grade 1 or less except for alopecia and peripheral neuropathy * Major surgery (eg., requiring general anesthesia) within 3 weeks before screening, or will not have fully recovered from surgery, or has surgery planned during the time the subject is expected to participate in the study
28,977
Study Objectives Study to investigate the effect of two types of radiotherapy on saliva: IMRT versus conventional radiotherapy. In each group, one part will receive normal dental preventive treatment. The other part will use products for treatment of dry mouth (Biotene gamma). Both anorganic and organic components of the saliva will be studied at different time points, combined with bacterial swabs. Conditions: Cancer: Head or Neck Intervention / Treatment: PROCEDURE: IMRT versus conventional radiotherapy
Inclusion Criteria: * > 18 years old * Cancer of head or neck Exclusion Criteria: *
13,847
Study Objectives The purpose of this study is to assess the bioequivalence of subcutaneous Vidaza® and subcutaneous Luitpold Azacitidine pharmacokinetics and to assess the comparative safety of subcutaneous Vidaza® versus subcutaneous Luitpold Azacitidine. Conditions: Myelodysplastic Syndrome, Myelofibrosis, Chronic Myeloid Leukemia, Chronic Lymphocytic Leukemia Intervention / Treatment: DRUG: Luitpold Azacitidine, DRUG: Vidaza®
Inclusion Criteria: * Signed informed consent obtained prior to initiation of any study-specific procedures. * Patients with one of the following - myelodysplastic syndrome of the following French-American- British (FAB) subtypes: refractory anemia (RA), RA with ringed sideroblasts (if accompanied by neutropenia, or thrombocytopenia, or requiring transfusion), RA with excess of blasts (RAEB), RAEB in transformation (RAEB-T), or chronic myelomonocytic leukemia (CMMoL); myelofibrosis; chronic myeloid leukemia; or chronic lymphocytic leukemia who's physician feels should receive azacitidine. * Male or female patients aged at least 18 years. * ECOG Performance Status 0-2. * Life expectancy > or = to 3 months. * Adequate organ function, including the following: Hepatic - Total bilirubin < or = to 1.5 x the upper limit of normal (ULN), aspartate transaminases (AST) and alanine transaminases (ALT) < or = to 2 x ULN and Renal - Serum creatinine < or = to 1.5 x ULN. * Female patients of child-bearing potential must have a negative pregnancy test and must be using at least one form of contraception as approved by the Investigator for 4 weeks prior to the study and 4 months after the last dose of azacitidine. * Male patients must use a form of barrier contraception approved by the investigator during the study and for 4 months after the last dose of azacitidine. Exclusion Criteria: * Hypersensitivity to azacitidine or mannitol. * Anticipated need for RBC or platelet transfusion 2 days prior to or up to 2 days after treatment initiation. * Chemotherapy (excluding previous azacitidine treatment) or radiotherapy within 4 weeks of randomization (6 weeks for nitrosoureas or mitomycin C). * Significant electrophysical abnormalities in pre-trial EKG. * Present history of locally advanced or metastatic malignant disease or leukemia. * Use of recreational drugs or history of drug addiction, within the prior 6 months. * Known history of a positive hepatitis screen, including hepatitis B surface antigens or HCV antibodies. * Known history of HIV or syphilis. * History of clinically significant adverse events due to chemotherapy, radiotherapy or investigational agents. * Presence of an advanced malignant hepatic tumor. * Presence of an ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, symptomatic or poorly controlled cardiac arrhythmia, uncontrolled thrombotic or hemorrhagic disorder, or any other serious uncontrolled medical disorders. * Presence of any significant central nervous system or psychiatric disorder(s) that would hamper the patients compliance. * Treatment with any other investigational agent, or participation in another clinical trial within 28 days prior to study entry. * Pregnant or breast-feeding patients or any patient with childbearing potential not using adequate contraception.
7,574
Study Objectives This phase II trial studies how well Nivolumab, Cisplatin, and Pemetrexed Disodium or Gemcitabine Hydrochloride in treating patients with stage I-IIIA non-small cell lung cancer that can be removed by surgery. Monoclonal antibodies, such as Nivolumab, may interfere with the ability of tumor cells to grow and spread. Drugs used in chemotherapy, such as Cisplatin and Pemetrexed Disodium or Gemcitabine Hydrochloride, 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. Giving Nivolumab, Cisplatin, and Pemetrexed Disodium or Gemcitabine Hydrochloride may work better in treating patients with non-small cell lung cancer. Conditions: Non-Squamous Non-Small Cell Lung Carcinoma, Stage I Non-Small Cell Lung Cancer, Stage IA Non-Small Cell Lung Carcinoma, Stage IB Non-Small Cell Lung Carcinoma, Stage II Non-Small Cell Lung Cancer, Stage IIA Non-Small Cell Lung Carcinoma, Stage IIB Non-Small Cell Lung Carcinoma, Stage IIIA Non-Small Cell Lung Cancer Intervention / Treatment: BIOLOGICAL: Nivolumab, DRUG: Cisplatin, DRUG: Pemetrexed Disodium, DRUG: Gemcitabine Hydrochloride
Inclusion Criteria: * Pathologically confirmed non small cell lung cancer (NSCLC), not previously treated, with a plan to undergo surgery * Stage I-IIIA (stage I tumors must be >= 4 cm) per AJCC 8th edition * Tumor sample must be available for PD-L1 testing; archival tissue within 3 months of study enrollment will be used; if archival tissue is unavailable, a fresh biopsy will be taken * Eastern Cooperative Oncology Group (ECOG) performance status 0-1 * While blood cells 2000/ul or more * Absolute neutrophil count 1500/ul or more * Platelets 100,000/ul or more * Hemoglobin 9 g/dl or more; (transfusion permitted) * Bilirubin less than or equal to 1.5 x the upper limit of normal (except subjects with Gilbert syndrome, who can have total bilirubin < 3 mg/dl) * Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) less than or equal to 3 x the upper limit of normal * Glomerular filtration rate (GFR) greater than or equal to 40 ml/min using the Cockcroft-Gault formula or serum creatinine less than or equal to 1.5 x (ULN) upper limit of normal * Women of reproductive potential should have a negative serum or urine pregnancy test (minimum sensitivity 25 IU/L or equivalent units of human chorionic gonadotropin \[HCG\]) within 21 days of the study enrollment * Women of reproductive potential must use highly effective contraception methods to avoid pregnancy for 23 weeks after the last dose of study drugs; "women of reproductive potential" is defined as any female who has experienced menarche and who has not undergone surgical sterilization (hysterectomy or bilateral oophorectomy) or who is not postmenopausal; menopause is defined clinically as 12 months of amenorrhea in a woman over 45 in the absence of other biological or physiological causes; in addition, women under the age of 55 must have a documented serum follicle stimulating hormone (FSH) level more than 40 mIU/mL * Men of reproductive potential who are sexually active with women of reproductive potential must use any contraceptive method with a failure rate of less than 1% per year; men who are receiving the study medications will be instructed to adhere to contraception for 31 weeks after the last dose of study drugs; men who are azoospermic do not require contraception * All subjects must be able to comprehend and sign a written informed consent document Exclusion Criteria: * Patients who have participated in a study with an investigational agent or device within 2 weeks of enrollment * Any prior radiotherapy to the lung * Any prior treatment for NSCLC * Epidermal growth factor receptor (EGFR) or alkaline phosphatase (ALK) activating alteration * Any prior therapy with anti-PD-1, anti-PD-L2, anti-CTLA-4 antibody, or any other antibody or drug specifically targeting T-cell co-stimulation or immune checkpoint pathways * Any history of a sever hypersensitivity reaction to any monoclonal antibody * Any history of allergy to the study drug components * Any concurrent malignancies- exceptions include- basal cell carcinoma of the skin, squamous cell carcinoma of the skin, superficial bladder cancer or in situ cervical cancer that has undergone potentially curative therapy; patients with a history of other prior malignancy must have been treated with curative intent and must have remained disease-free for 3 years post-diagnosis * Participants with an active autoimmune disease or any other condition requiring systemic treatment with either corticosteroids within 14 days (> 10 mg daily prednisone equivalent) or other immunosuppressive medications within 30 days of randomization. Inhaled or topical steroids, and adrenal replacement steroid doses > 10 mg daily prednisone equivalent, are permitted in the absence of active autoimmune disease. * Participants with type I diabetes mellitus, hypothyroidism only requiring hormone replacement, skin disorders (such as vitiligo, psoriasis, or alopecia) not requiring systemic treatment, or conditions not expected to recur in the absence of an external trigger are permitted to enroll.* Patients with evidence of interstitial lung disease or active, non-infectious pneumonitis. Patients with a history of interstitial lung disease or non-infectious pneumonitis requiring treatment with steroids are also excluded. * Patients with a known human immunodeficiency virus infection (HIV 1/2 antibodies) or acquired immunodeficiency syndrome (HIV/AIDS), active hepatitis B (e.g., hepatitis B surface antigen \[HBsAg\] reactive) or hepatitis C (e.g., hepatitis C virus \[HCV\] ribonucleic acid \[RNA\] \[qualitative\] is detected) * Patients who have received a live vaccine within 30 days prior initiation of the systemic regimen * Patients must not be receiving any other investigational agents * Patients with uncontrolled intercurrent illnesses including, but not limited to an active infection requiring systemic therapy or a known psychiatric or substance abuse disorder(s) that would interfere with cooperation with the requirements of the trial * Women must not be pregnant (as above) or breastfeeding
18,734
Study Objectives A multi-centre, open-label, single-arm, dose-finding phase I/II study to evaluate safety, tolerability, dosing schedule, and preliminary efficacy of carrier-added 4-L-\[131I\]iodo-phenylalanine (131I-IPA), administered as single or repetitive injections in patients with recurrent glioblastoma multiforme (GBM), concomitantly to 2nd line external radiation therapy (XRT) - IPAX-1 Conditions: Glioblastoma Multiforme Intervention / Treatment: RADIATION: 4-L-[131I]iodo-phenylalanine (131I-IPA)
Inclusion Criteria: * Previously confirmed histological diagnosis of GBM, with current clinical or imaging evidence for first recurrence according to modified RANO criteria (2017). History of GBM standard therapy (debulking surgery, followed by radio-chemotherapy (50-60 Gy in 2 Gy fractions, temozolomide)* Interval since end of 1st line XRT ≥6 months* Amino acid-based molecular imaging (preferably 18F-FET-PETor 11C-methionine, as institutionally established) indicating pathologically increased amino acid uptake inside or in the vicinity of the tumour, clearly discernible from background activity.* Current indication for repeat radiation therapy as discussed at the multidisciplinary neuro-oncological tumour board meeting, planned as standard fractionated dose schedule (18\*2 Gy)* Male or female ≥18 years of age.* Karnofsky performance status ≥70. Life expectancy of at least 16 weeks.* Haematological, liver and renal function test results as follows: * WBC: >3\*109/L * Haemoglobin >80 g/L * PLT >100\*109/L * ALT, ALP, AST: ≤5 times upper international limit of normal (UILN) * Bilirubin ≤3 times UILN * Serum creatinine: within normal limits or <120 μmol/L for patients aged 60 years or older * Urine protein dipstick: no protein* Female patients surgically sterile or postmenopausal for at least 2 years. Participants of generative potential agreeing to use effective contraception during the period of therapy and 6 months after the end of study.* Written informed consent Exclusion Criteria: * Primary XRT dose < 60 Gy* Doses to organs at risk defined by Yasar and Tugrul (2005) exceeded or reached by prior radiation therapy; e.g. cumulative total dose on the optical chiasm >54 Gy for 2 Gy/fraction, alphas/beta=2* Multifocal distant recurrence, defined as tumour lesion outside the primary XRT field, as evidenced by amino acid-based PET imaging* Prior treatment with brachytherapy* Prior treatment with bevacizumab* Baseline steroid requirement , exceeding physiologic replacement doses ( <1.5 mg dexamethasone or equivalent per day)* History or evidence of delayed-type hypersensitivity (DTH)-dependent chronic infection (e.g. tuberculosis, systemic fungal or parasitic infection), potentially exacerbating under systemic corticoid therapy* Localisation of tumour related to brain stem or axis, unless sufficient reserve capacity (e.g. remnant resection cavity, marked atrophy) to accommodate possible post-procedural tissue reactions, or pre-therapeutic consent for emergency trepanation* Haemostaseologic conditions, precluding catheterisation or invasive procedures* Clinically significant illness or clinically relevant trauma within 2 weeks before the administration of the investigational product* Known impairment of liver or kidney function or known liver or kidney disease, such as hepatitis, cirrhosis, renal failure* Known human immunodeficiency virus (HIV) positive serology or chronically active hepatitis B or C* Ongoing toxicity > grade 2 NCI-CTC (version 4.03) from previous standard or investigational therapies* Administration of another investigational medicinal product within 90 days prior to screening* Expected non-compliance with longer-term admission at isolated nuclear medicine ward* In pre-menopausal women: Pregnant as evidenced by a positive pregnancy test, or breast-feeding* Patients with known phenylketonuria
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Study Objectives This study is a Phase Ib/II open label, single arm, adaptive multi-centre trial of copanlisib in combination with trastuzumab in pretreated recurrent or metastatic HER2-positive breast cancer. Patients with HER2 positive, metastatic or incurable recurrent breast cancer, following disease progression during, or after, treatment with at least one systemic treatment regimen in the metastatic or recurrent setting, will be treated with copanlisib (at 30, 45 or 60 mg flat dosing IV weekly - depending on the maximum tolerated dose (MTD) determined in the Phase Ib part of the study) plus trastuzumab (4 mg/kg IV Cycle 1 Day 1 and then 2 mg/kg IV weekly starting from day 8). Conditions: HER2 Positive Breast Cancer Intervention / Treatment: DRUG: Copanlisib, DRUG: Trastuzumab
Inclusion Criteria Patients are eligible to be included in the study only if they meet all of the following criteria: * Adult women ≥ 18 years of age.* Histologically confirmed HER2-positive breast cancer: Documented HER2 overexpression by local laboratory (IHC 3+ or FISH or CISH positive). IHC 3+ or FISH/CISH positive on diagnostic breast biopsy or surgical breast resection sample or metastatic disease site biopsy.* Recurrent incurable or metastatic breast cancer: Eligible recurrent disease is recurrent disease that is considered incurable by the treating oncologist. Many local-only recurrences are treated with curative intent; a treatment plan with curative intent for a local-only recurrence would indicate that the patient is not eligible for this clinical trial. A local-only recurrence must be considered incurable by the treating oncologist for the patient to be eligible.* At least one measurable lesion according to RECIST criteria (Version 1.1). Patients with bone only disease are not eligible.* Patient has received at least one trastuzumab-based or T-DM1-based treatment regimen in the setting of metastatic disease or incurable locoregional recurrence. A trastuzumab-based or T-DM1-based treatment regimen is considered as any treatment regimen that includes trastuzumab or T-DM1. Patients must have had at least 1 line of therapy for metastatic and/or incurable locoregional recurrent disease to be eligible. A patient is eligible regardless of the period of time from adjuvant therapy so long as she has disease that is progressing after at least 1 line of trastuzumab-based therapy in the setting of metastatic disease and/or incurable locoregional recurrence.* Disease progression during or following at least 1 prior trastuzumab-based or trastuzumab emtansine (T-DM1) based treatment regimen in the setting of metastatic disease or incurable locoregional recurrence.* ECOG performance status ≤ 2.* Life expectancy of at least 3 months.* Availability of fresh tissue and/or archival tumour tissue at screening.* Women of childbearing potential must agree to use a highly effective method of contraception when sexually active. This applies from signing of the informed consent form until at least 100 days after the last study drug administration. The investigator or a designated associate is required to advise the patient how to achieve an adequate birth control. Highly effective contraception is defined in the study as methods that achieve a failure rate of less than 1% per year when used consistently and correctly. Such methods include: i. Combined (oestrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation (oral, intravaginal, transdermal). ii. Progestogen-only hormonal contraception associated with inhibition of ovulation (oral, injectable and implantable). iii. Intrauterine device (IUD). iv. Intrauterine hormone-releasing system (IUS). v. Bilateral tubal occlusion. vi. Successfully vasectomised partner. vii. Sexual abstinence.* Adequate baseline laboratory values collected no more than 14 days before starting study treatment: Total bilirubin ≤ 1.5 x ULN (< 3 x ULN for patients with metastatic disease in the liver). Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 3.0 x ULN (≤ 5 x ULN for patients with liver involvement from breast cancer). Glomerular filtration rate (GFR) ≥ 30 mL/min/1.73 m2 according to the Modification of Diet in Renal Disease (MDRD) abbreviated formula. If not on target, this evaluation may be repeated once after at least 24 hours either according to the MDRD abbreviated formula or by 24 hour sampling. If the later result is within acceptable range, it may be used to fulfil the inclusion criteria instead. International normalized ratio (INR) and partial thromboplastin time (PTT) ≤ 1.5 x ULN. Patients who are therapeutically treated with an agent such as warfarin or heparin will be allowed to participate provided that no prior underlying coagulopathy disorder. Close monitoring of these patients (Day 15 of Cycle 1 and Day 1 of each cycle) will be performed until INR/PTT is stable based on a measurement that is pre- dose as defined by the local standard of care. Platelet count ≥ 75 x 109/L. For patients with breast cancer bone marrow infiltration, platelet count ≥ 50 x 109/L. Haemoglobin (Hb) ≥ 8 g/dL. Absolute neutrophil count (ANC) ≥ 1 x 109/L. For patients with malignant bone marrow infiltration, ANC count ≥ 0.75 x 109/L. Fasting blood glucose ≤ 6.0 mmol/L if not diabetic or ≤ 8.9 mmol/L if diabetic.* Left ventricular ejection fraction (LVEF), at or above the Institutions lower limit of normal, as determined by ECHO or MUGA.* Patients must have recovered from clinically significant side effects associated with prior radiotherapy and chemotherapy with the exception of fatigue or neuropathy. Exclusion criteria Patients who meet any of the following criteria at the time of screening will be excluded from study registration: * Known breast cancer involvement of the brain, unless adequately controlled based on the clinical judgement of the treating physician.* Congestive heart failure > New York Heart Association (NYHA) class II.* Unstable angina (angina symptoms at rest), new-onset angina (begun within the last 3 months). Myocardial infarction less than 6 months before registration.* Uncontrolled arterial hypertension despite optimal medical management (per investigator's opinion).* Uncontrolled Type I or II diabetes mellitus. Defined as HbA1c > 8.5% as determined during screening laboratory assessments.* Arterial or venous thrombotic or embolic events such as cerebrovascular accident (including transient ischemic attacks), deep vein thrombosis or pulmonary embolism within 3 months before registration.* Non-healing wound, ulcer, or bone fracture.* Active, clinically serious infections > CTCAE Grade 2 (CTCAE v4.0).* Known history of human immunodeficiency virus (HIV) infection.* Hepatitis B (HBV) or hepatitis C (HCV). All patients must be screened for HBV and HCV up to 28 days prior to study drug start using the routine hepatitis virus laboratory panel. Patients who test positive for Hepatitis B surface Antigen (HBsAg) or Hepatitis B core Antibody (HBcAb) will be eligible if they are negative for HBV-DNA; patients who test positive for anti-HCV antibody will be eligible if they are negative for HCV- RNA.* Patients with CMV PCR positive.* Patients with seizure disorder requiring medication.* Patients with evidence or history of bleeding diathesis. Any haemorrhage or bleeding event ≥ CTCAE Grade 3 within 4 weeks prior to the start of study treatment.* Proteinuria of Grade 3 or higher (CTCAE v4.0). Patient will be excluded if > 2+ on urinalysis (unless 24hr collection shows 24 hour urinary protein < 3.5g/24hrs).* History or concurrent condition of interstitial lung disease of any severity, and/or severely impaired lung function (as judged by the investigator).* Concurrent diagnosis of pheochromocytoma.* Pregnant or breast-feeding patients. Women of childbearing potential must have a serum or urine pregnancy test performed a maximum of 7 days before start of treatment, and a negative result must be documented before start of treatment.* Unresolved toxicity higher than CTCAE Grade 1 attributed to any prior therapy/procedure, excluding alopecia, peripheral neuropathy, and bone marrow parameters.* Known hypersensitivity to any of the test drugs, test drug classes, or excipients in the formulation.* Substance abuse, medical, psychological or social conditions that may interfere with the patient's participation in the study or evaluation of the study results.* Any illness or medical conditions that are unstable or could jeopardize the safety of patients and their compliance in the study.* Patients permanently withdrawn from study participation will not be allowed to re- enter the study. Excluded previous therapies and medications:* Treatment with investigational drugs other than PI3K inhibitors less than 28 days before start of treatment.* Ongoing immunosuppressive therapy.* Radiotherapy or immuno-/chemotherapy less than 4 weeks (28 days) before start of treatment.* Myeloid growth factors less than 7 days before start of treatment.* Blood or platelet transfusion less than 7 days before start of treatment.* Ongoing systemic corticosteroid therapy at a daily dose higher than 15 mg prednisone or equivalent. Previous corticosteroid therapy must be stopped or reduced to the allowed dose 7 days before performing the screening CT scan (or PET-CT/MRI as per RECIST 1.1) and again prior to the first study drug administration. If a patient is on chronic corticosteroid therapy, corticosteroids should be de-escalated to the minimum allowed dose before the screening. Patients may continue to use topical or inhaled corticosteroids.* History of having received an allogeneic bone marrow or organ transplant.* Major surgical procedure or significant traumatic injury (as judged by the investigator) less than 28 days before start of treatment. This does not include the study-specific biopsy.* Anti-arrhythmic therapy (beta blockers or digoxin are permitted).* Use of strong inhibitors of CYP3A4 is prohibited from Day -14 of Cycle 1 until the Safety follow up visit.* Use of inducers of CYP3A4 is prohibited from Day -14 of Cycle 1 until the Safety follow up visit. Zoledronate or denosumab for patients with bone metastasis is allowed.
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Study Objectives This phase IV trial studies how well influenza vaccination works in preventing infections such as influenza in patients with plasma cell disorders. Influenza infections may theoretically support the growth of tumor cells and improving protection against influenza may improve the status of patients' plasma cell disorder. Giving influenza vaccination may reduce influenza-related complications including infections, hospitalizations, and deaths, and improve the status of plasma cell disorders. Conditions: Plasma Cell Neoplasm Intervention / Treatment: BIOLOGICAL: Pneumococcal 13-valent Conjugate Vaccine, BIOLOGICAL: Trivalent Influenza Vaccine
Inclusion Criteria: * Patient must have a plasma cell dyscrasia that fits in the International Myeloma Working Group (IMWG) diagnostic criteria. * Both men and women of all races and ethnic groups are eligible for this study. * Eastern Cooperative Oncology Group (ECOG) performance status ≤ 3 (Karnofsky ≥ 30%) is required for eligibility. * Patient must be eligible to receive standard of care influenza vaccination. If the patient has a history of egg allergy with symptoms more severe than urticaria, e.g. angioedema, respiratory distress, lightheadedness, or recurrent emesis, they remain eligible to receive influenza vaccination but must receive the vaccine in a facility able to recognize and manage severe allergic reactions. Persons who are able to eat lightly cooked egg (e.g., scrambled egg) without reaction are unlikely to be allergic, although egg-allergic persons might tolerate egg in baked products. * Ability to understand and the willingness to sign a written informed consent document. Exclusion Criteria: * Patients who have already received the seasonal influenza vaccine in the current season. * History of Guillain-Barré syndrome. * Patients with a previous severe allergic reaction to influenza vaccination or pneumococcal 13-valent conjugate vaccine (PCV13). * Expected survival < 9 months. * Prisoners.
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Study Objectives Clinical study to evaluate safety (primary objectives) and efficacy (secondary objective) of ET1402L1-ARTEMIS™2 T cells in patients with alpha fetoprotein positive (AFP+ ) hepatocellular carcinoma (HCC). Conditions: Hepatocellular Carcinoma, Liver Cancer, Liver Neoplasms, Metastatic Liver Cancer Intervention / Treatment: BIOLOGICAL: ET1402L1-ARTEMIS™ T cells -IV, BIOLOGICAL: ET1402L1-ARTEMIS™ T cells -intra-hepatic artery, BIOLOGICAL: ET1402L1-ARTEMIS™ T cells -Intratumoral Injections
Inclusion Criteria: * AFP-expressing HCC and serum AFP >100 ng/mL. * Abandon or failure in first or second line treatment * Molecular HLA class I typing confirms participant carries at least one HLA-A02 allele * Child-Pugh score of A or B, Barcelona Clinic Liver Cancer stage of C or D * Life expectancy > 4 months * Karnofsky score ≥70% * Adequate organ function as defined below: 1. Patients must have a serum Total bilirubin ≤2 x Upper Limit of Normal (ULN), Alanine transaminase (ALT) and Aspartate transaminase (AST) ≤5 times the institutional ULN. 2. A pretreatment measured creatinine clearance (absolute value) of ≥ 50 ml/minute 3. Ejection fraction measured by echocardiogram or Multiple gated acquisition scanning (MUGA) >45% (evaluation done with 6 weeks of screening does not need to be repeated) 4. Diffusing Capacity of the Lung for Carbon Monoxide (DLCO) or Forced Expiratory Volume in the first second (FEV1)>45% predicted 5. Absolute neutrophil count (ANC) ≥ 1500/mm3 (10\^9/L) 6. Platelet count ≥ 50,000/mm3 (10\^9/L) * Informed Consent/Assent: All subjects must have the ability to understand and the willingness to sign a written informed consent. Exclusion Criteria: * Patients with decompensated cirrhosis: Child-Pugh Score C * Patients with tumor infiltration in the portal vein, hepatic veins or inferior vena cava that completely blocks circulation in liver. * Patients with an organ transplantation history * Patients with dependence on corticosteroids * Patients with active autoimmune diseases requiring systemic immunosuppressive therapy * Patients who are currently receiving or received within past 30 days anti-cancer therapy, local treatments for liver tumors (radiotherapy, embolism, ablation) or liver surgery * Patients currently receiving other investigational treatments (biotherapy, chemotherapy, or radiotherapy) * Participants with other active malignancies (except non-melanoma skin cancer and cervical cancer) within two years. Patients with a history of successfully-treated tumors with no sign of recurrence in the last two years may be enrolled. * Patients with other uncontrolled diseases, such as active infections * Acute or chronic active hepatitis B or hepatitis C. * Women who are pregnant or breast-feed * HIV-infection
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Study Objectives Trial Design: This is a feasibility randomised controlled trial. Aim: The study aims to test the Healthy Eating and Active Lifestyle After Bowel Cancer - HEAL ABC intervention and HEAL ABC resources for feasibility and will inform a future definitive randomised controlled trial (RCT). Objectives: 1. Is it practical to run HEAL ABC study as a definitive randomised controlled trial? 2. Adherence to intervention, motivations, barriers and facilitators of CRC survivors to follow HEAL ABC. Study Population: Colorectal cancer survivors who completed surgery and/or active treatment. Intervention: The intervention group will use HEAL ABC resource with supportive telephone calls every two weeks during the intervention period and once a month during the follow up period. Control: Participants follow standard care recommendations. Timing and duration: 3 months intervention with 6 months follow up period Conditions: Colorectal Cancer, Survivorship, Behavior, Health Intervention / Treatment: BEHAVIORAL: HEAL ABC
Inclusion Criteria: * Adults, age ≥18 * Minimum 12 weeks post-surgery and/or active treatment * Completed all active anti-cancer treatments, including surgery, radiotherapy or chemotherapy * Body mass index ≥20 kg/m2 and no previous unintentional weight loss ≥5% of body weight in the previous six months. * Identified as living an unhealthy lifestyle based on current recommendations - follow less than four of the WCRF/AICR recommendations on eligibility questionnaire * Ability to work with computer, smart phone or tablet. * Able to give informed consent. Exclusion Criteria: * Receiving treatment for malignancy. * Secondary malignancy. * Having short bowel syndrome, Crohn's disease, ulcerative colitis, diverticulitis or jejunostomy (due to requirement for a very specific diet). * Previous stroke, congested cardiac failure or oedema. * Hepatic or renal failure * Less than 12 weeks post-surgery or active treatment. * Meeting the requirements of a healthy lifestyle (follow four or more of the WCRF/AICR recommendations). * Being on any therapeutic diets, multiple food intolerances or allergies. * Unplanned weight loss of ≥10% in the previous 3-6 months. * Cannot read or communicate in English (due to resource constraints of this PhD study).
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Study Objectives The purpose of this study is to evaluate the safety profile, tolerability, and immunoregulatory (pharmacodynamic; PD) activity of DS-8273a administered in combination with nivolumab (anti-PD-1 antibody) to subjects with unresectable Stage III or Stage IV melanoma. Conditions: Melanoma Intervention / Treatment: BIOLOGICAL: DS-8273a, BIOLOGICAL: Nivolumab
Inclusion Criteria: * 1) Signed Written Informed Consent The signed informed consent form prior to the performance of any study related procedures that are not considered part of standard of care. 2) Target Population 1. Subjects who are ipilimumab naïve with progressive unresectable Stage III or Stage IV melanoma; eligible patients may have had prior adjuvant therapy, but not including ipilimumab, and been treated with up to 3 prior treatments for metastatic melanoma \[eg, chemotherapy, other biologic or targeted therapy or Interleukin-2 (IL-2)\]. 2. Histologic or cytologic confirmation of stage III or stage IV melanoma 3. Measurable disease at baseline as assessed by CT and/or MRI 4. Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1 5. Screening laboratory values must meet the following criteria and should be obtained within 7 days prior to registration * White blood cell (WBC) ≥ 2000/μL * Neutrophils ≥ 1500/μL * Platelets ≥ 100 x103/μL * Hemoglobin > 9.0 g/dL * Serum creatinine ≤ 1.5 x upper limit of normal (ULN) or creatinine clearance (CrCl) ≥ 40 mL/min (if using the Cockcroft-Gault formula below): * Female CrCl = (140 - age in years) x weight in kg x 0.85 * 72 x serum creatinine in mg/dL * Male CrCl = (140 - age in years) x weight in kg x 1.00 * 72 x serum creatinine in mg/dL * Aspartate aminotransferase (AST)/Alanine aminotransferase (ALT) ≤ 3 x ULN Total Bilirubin ≤ 1.5 x ULN (except subjects with Gilbert Syndrome, who can have total bilirubin < 3.0 mg/dL) 3) Age and Reproductive Status Men and women ≥ 18 years old <!-- --> 1. Men and women of childbearing potential (WOCBP) must be using an acceptable method of contraception to avoid pregnancy throughout the study, and for women at least 23 weeks after the last dose of investigational product and for men at least 31 weeks after the last dose of investigational product in such a manner that the risk of pregnancy is minimized. See Section 3.3.3 for the definition of WOCBP. 2. Women must have a negative serum pregnancy test (minimum sensitivity 25 IU/L or equivalent units of HCG) within 24 hours prior to the start of investigational product. Exclusion Criteria: * 1) Target Disease Exceptions a) Subjects with known or suspected brain metastasis, or brain as the only site of disease are excluded with the following exceptions. i) Subjects with controlled brain metastasis (no radiographic progression at least 4 weeks following radiation and/or surgical treatment, off steroids for at least 4 weeks, and have no new or progressing neurological signs or symptoms) will be allowed. b) Subjects with a history of prior malignancy with the exception of carcinoma in situ of the cervix or other malignancy diagnosed > 2 years ago that has undergone potentially curative therapy with no evidence of disease for the last ≥ 2 years and that is deemed by the investigator to be at a low risk of recurrence. 2) Medical History and Concurrent Diseases a) Active autoimmune disease or a history of known or suspected autoimmune disease with the exception of subjects with isolated vitiligo, treated thyroiditis or resolved childhood asthma/atopy. b) Known human immunodeficiency virus (HIV), active hepatitis A, or hepatitis B or C infection. c) Evidence of active infection that requires anti-bacterial, anti-viral, or anti-fungal therapy ≤ 7 days prior to initiation of study drug therapy d) History of acute diverticulitis within the last 6 months, or current chronic diarrhea e) Active peptic ulcer disease even if asymptomatic f) Prior organ allograft or allogenic bone marrow transplantation g) Uncontrolled or significant cardiovascular disease including, but not limited to, any of the following: i) Myocardial infarction within the past 6 months ii) Uncontrolled angina within the past 6 months iii) Any history of clinically significant ventricular arrhythmias (such as ventricular tachycardia, ventricular fibrillation or Torsades de pointes). Controlled atrial fibrillation by itself is not an exclusion criterion. h) Baseline toxicities from prior anti-cancer treatments > Grade 1. i) Inability to be venipunctured and/or tolerate venous access. j) Any major surgery within 4 weeks or a diagnostic procedure (eg incision, needle biopsy) within 1 day of study drug administration. k) Known drug or alcohol abuse. l) Presence of underlying medical condition that in the opinion of the Investigator or Sponsor could adversely affect the ability of the subject to comply with or tolerate study procedures and/or study therapy, or confound the ability to interpret the tolerability of combined administration of DS-8273A and nivolumab in treated subjects. 3) Allergies and Adverse Drug Reaction a) History of allergy to components of nivolumab or DS-8273A, or known allergy to other antibody therapies. 4) Sex and Reproductive Status 1. WOCBP who are unwilling or unable to use an acceptable method to minimize the risk of pregnancy for the entire study period and for at least 23 weeks after the last dose of investigational product. 2. Women who are pregnant or breastfeeding. 3. Women with a positive pregnancy test on enrollment or prior to investigational product administration. 4. Sexually active fertile men not using effective birth control if their partners are WOCBP. 5) Prohibited Prior Treatments and/or Therapies a) Exposure to any investigational drug within 4 weeks of study drug administration. b) Any anti-cancer therapy (eg, chemotherapy, biologics, radiotherapy, or hormonal treatment) within 4 weeks or at least 5 half-lives (whichever is longer) of study drug administration. c) Prior therapy with an anti-PD-1/PD-L1 antibody or a TRAIL-DR5 antibody d) Concurrent chemotherapy, hormonal therapy, immunotherapy regimens, or radiation therapy, standard or investigational. 6) Other Exclusion Criteria 1. Prisoners or subjects who are involuntarily incarcerated 2. Subjects who are compulsorily detained for treatment of either a psychiatric or physical (eg, infectious disease) illness
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Study Objectives The aims of this three-year study are to: 1. From patients and family perspective to explore the needs for home care after receiving TACE, PEI, and RFA 2. Develop a telephone follow-up and consultation program and examine its effect on self-efficacy, anxiety, depression and quality of life in liver cancer patients receiving non-surgical treatment. Conditions: Hepatocellular Carcinoma Intervention / Treatment: BEHAVIORAL: telephone consultations about psychoeducation program
Inclusion Criteria: * Patients with liver cancer in non-surgical treatment * Aged above 18 * Those who are wiling to participate in the research Exclusion Criteria: * None
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Study Objectives The purpose of this study is to assess the safety of combination treatment of GSK2256098 and trametinib in mesothelioma subjects and subjects with other selected tumor types. Also, the study will identify a maximum tolerated combination dose of GSK2256098 and trametinib. This study is a Phase I, open-label, dose-escalation study to determine maximal tolerated dose (MTD) and the recommended Phase 2 dose (RP2D) and regimens for oral MEK inhibitor trametinib (once daily \[OD\]dosing) and the oral FAK inhibitor GSK2256098 (twice daily \[BID\] dosing). The synergy of the combination was observed over a wide range of concentrations and results in several-fold reduction in compound concentration to achieve equivalent biological responses compared to either single agent. The dose and schedule of dosing may be modified based on emerging safety, pharmacokinetic (PK), and pharmacodynamic (PD) data. The study will be conducted in two parts; Part 1 Dose Escalation to determine the MTD and RP2D and Part 2 Expansion Cohort to further evaluate the safety and tolerability of trametinib and GSK2256098 at the RP2D and determine clinical activity. Additionally, in Part 1 Dose Escalation, additional subjects with malignant pleural mesothelioma (MPM) will be recruited at doses that are considered tolerable in order to assess PD in MPM subjects at each dose (the Pharmacodynamic Cohort). The Expansion Cohort will be limited to subjects with MPM who have progressed or are intolerant to first-line therapy. Conditions: Cancer, Neoplasms Intervention / Treatment: DRUG: GSK2256098, DRUG: Trametinib
Inclusion Criteria Part 1 Subject Inclusion Criteria: * Subjects with measurable tumors that may benefit from treatment with GSK2256098 and trametinib. This includes mesothelioma along with tumors with a high likelihood of MAPK pathway activation as reported in the medical literature. Part 2 Subject Inclusion Criteria: * Histologically- or cytologically- confirmed diagnosis of recurrent or progressive, unresectable MPM with measurable lesion. Part 1 and Part 2 Subject Inclusion Criteria: * Written informed consent provided. * Males and females >=18 years of age (at the time consent is obtained). * Performance Status score of 0 or 1 according to the Eastern Cooperative Oncology Group (ECOG) scale. * Able to swallow and retain orally administered study treatment. * Women of childbearing potential must have a negative serum pregnancy test within 7 days prior to the first dose of study treatment and agree to use effective contraception as per study protocol specification. Men with a female partner of childbearing potential must have either had a prior vasectomy or agree to use effective contraception as as per study protocol specification. * Adequate organ system functions as defined in the protocol Exclusion Criteria * Mesotheliomas originating outside of the pleural cavity (e.g., peritoneal mesothelioma) are excluded in the Pharmacodynamic Cohort in Part 1 and Part 2, but are permitted in Dose Escalation Cohorts in Part 1. * Subjects with leptomeningeal or brain metastases or spinal cord compression. * Use of an investigational anti-cancer drug within 28 days or five half-lives with a minimum duration of 10 days from prior therapy preceding the first dose of GSK2256098/trametinib OR Chemotherapy within the last 3 weeks (6 weeks for prior nitrosourea or mitomycin C) OR any major surgery, radiotherapy, or immunotherapy within the last 4 weeks. NOTE: Limited palliative radiation (i.e., duration typically < 15 days) with last dose >=6 weeks preceding the first dose of combination treatment is acceptable provided subject meets all of the other eligibility criteria and radiotherapy port does not encompass all measurable tumor. In addition, prophylactic radiation therapy to the site of tumor biopsies (as per the standard of care) during the current study to prevent seeding of the needle tract/biopsy is acceptable and does not require dose modification. * Known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs chemically related to GSK2256098 or trametinib. * Previous treatment with GSK2256098 or trametinib, as well as other MEK or FAK inhibitors. * Current use of a prohibited medication or requires any of these medications during treatment. * Current use of warfarin for therapeutic anticoagulation. NOTE: Low molecular weight heparin is permitted. PT/PTT must meet the inclusion criteria. * Presence of an active gastrointestinal disease, or other condition known to interfere significantly with the absorption, distribution, metabolism, or excretion of drugs. * History or evidence of cardiovascular risk including any of the following: Left ventricle ejection fraction (LVEF) < lower limit of normal (LLN) per local institutional practice; A QT interval corrected for heart rate using the Fredericia's formula (QTcF) >=480 msec;History or evidence of current clinically significant uncontrolled arrhythmias; Exception: Subjects with controlled atrial fibrillation for >30 days prior to randomization are eligible; History of acute coronary syndromes (including myocardial infarction and unstable angina), coronary angioplasty, or stenting within 6 months prior to randomization; History or evidence of current >= Class II congestive heart failure as defined by New York Heart Association; Treatment refractory hypertension defined as a blood pressure of systolic> 140 millimeter of mercury (mmHg) and/or diastolic > 90 mmHg which cannot be controlled by anti-hypertensive therapy; Patients with intra-cardiac defibrillators or permanent pacemakers; Known cardiac metastases; * Active interstitial lung disease or pneumonitis. * History or current evidence / risk of retinal vein occlusion (RVO) or central serous retinopathy (CSR): History of RVO or CSR, or predisposing factors to RVO or CSR (e.g., uncontrolled glaucoma or ocular hypertension, uncontrolled systemic disease such as hypertension, diabetes mellitus, or history of hyperviscosity or hypercoagulability syndromes); Visible retinal pathology as assessed by ophthalmic exam that is considered a risk factor for RVO or CSR such as: Evidence of new optic disc cupping, Evidence of new visual field defects and Intraocular pressure > 21 mmHg * Known Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV), or Hepatitis C Virus (HCV) infection (subjects with laboratory evidence of cleared HBV and HCV infection will be permitted). * History of another malignancy (excludes non-melanoma skin cancer). Exception: Subjects who have been continuously disease-free for 3 years or who have had complete resection of a non-invasive primary cancer within 3 years of enrollment. Consult GSK Medical Monitor if unsure whether second malignancies meet requirements specified above. * Psychological, familial, sociological, or geographical conditions that do not permit compliance with the protocol. * Concurrent condition that in the Investigator's opinion would jeopardize compliance with the protocol. * Nursing female.
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Study Objectives The goal of this clinical research study to find the highest tolerated dose of anastrozole alone or in combination with either everolimus (Afinitor), sorafenib (Nexavar), erlotinib (Tarceva), fulvestrant (Faslodex), or bevacizumab (Avastin) that can be given to patients with advanced cancer. The safety of these drug combinations will also be studied. Conditions: Solid Tumors, Advanced Cancer Intervention / Treatment: DRUG: Anastrozole, DRUG: Bevacizumab, DRUG: Everolimus, DRUG: Sorafenib, DRUG: Erlotinib
Inclusion Criteria: * Patients with pathologically confirmed advanced or metastatic cancer that is refractory to standard therapy, relapsed after standard therapy, or who have had no standard therapy that induces a CR rate of at least 10% or improves survival by at least three months.* Measurable or non-measurable disease* Patients must have tumors that demonstrate ER/PR+ (positivity by IHC staining >= 1%).* At least 4 weeks since the last dose of chemotherapy, immunotherapy, surgery, or radiation therapy (Exception: patients may have received palliative low dose radiation therapy one week before treatment provided it is not given to the only targeted lesions); at least 6 weeks for therapy which is known to have delayed toxicity (nitrosoureas, mitomycin-C, and liposomal doxorubicin); at least 4 weeks (or 5 half-lives, whichever is shorter) since treatment with biologic/targeted therapies; at least 2 weeks since last hormonal therapy* Eastern Cooperative Oncology Group (ECOG) performance status 0,1, or 2* Patients must have normal organ and marrow function defined as: absolute neutrophil count >= 1,000/mL; platelets >= 50,000/mL; creatinine <= 2 X ULN; total bilirubin <= 2.0; ALT(SGPT) <= 3 X ULN; Exception for patients with liver metastasis: total bilirubin <= 3 x ULN; ALT(SGPT) <= 5 X ULN.* Women of childbearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry, for the duration of study participation, and for 30 days after the last dose.* Ability to understand and the willingness to sign a written informed consent document* Female patients must either be: Post-menopausal women as defined by a. age >= 60 years of age; b. prior bilateral oophorectomy; c. age < 60 with at least 12 months of spontaneous amenorrhea or post-menopausal range FSH and estradiol levels OR Premenopausal women receiving a gonadotropin-releasing hormone agonist. Exclusion Criteria: * Patients with uncontrolled concurrent illness, including but not limited to: ongoing or active infection; altered mental status or psychiatric illness/social situations that would limit compliance with study requirements and/or obscure study results.* Uncontrolled systemic vascular hypertension (systolic blood pressure > 140 mm Hg, diastolic blood pressure > 90 mm Hg on medication).* Patients with clinically significant cardiovascular disease: history of CVA within 6 months, myocardial infarction or unstable angina within 6 months, or unstable angina pectoris.* Women who are pregnant or breastfeeding* Patients with a history of bone marrow transplant within the previous two years.* Patients with a known hypersensitivity to any of the components of the drug products.* Patients unable to swallow oral medications or with pre-existing gastrointestinal disorders that might interfere with proper absorption of oral drugs.* Patients with major surgery within 30 days prior to entering the study.* Age under 18 years.
36,145
Study Objectives This is an exploratory Phase 2 multicenter, randomized, open-label study with a randomization allocation ratio of 1:1 \[abiraterone acetate + prednisone + LHRH-therapy (Arm A) versus abiraterone acetate + prednisone (Arm B)\]. For both groups patients will receive a dose of 1000 mg abiraterone acetate and 10mg prednisone daily (QD). Study drug will be administered as 4 x 250-mg abiraterone acetate tablets and prednisone will be administered as 5 mg orally twice a day (BID). Patients randomized to the LHRH-therapy group will receive the same LHRH-therapy they received prior to entering the trial. 70 medically castrated male patients with metastatic CRPC who have shown tumor progression and are non- or mildly-symptomatic will be enrolled from approximately 12 German study sites. Conditions: Prostate Cancer Intervention / Treatment: DRUG: abiraterone acetate + prednisone + LHRH-therapy, DRUG: abiraterone acetate + prednisone
Inclusion Criteria: * Willing and able to provide written informed consent* Written Data Protection Consent has been obtained* Male aged 18 years and above* Histologically or cytologically confirmed adenocarcinoma of the prostate* Metastatic disease documented by positive CT/MRI and/or bone scan (both must be performed). If lymph node metastasis is the only evidence of metastasis, it must be ≥2 cm in diameter* Prostate cancer progression documented by PSA according to PCWG2 or radiographic progression according to modified RECIST criteria* Asymptomatic or mildly symptomatic from prostate cancer. A score of 0-1 for the question of worst pain within last 24 hours (Appendix 8) will be considered asymptomatic, and a score of 2-3 will be considered mildly symptomatic.* Medically castrated, with testosterone levels of <20-50 ng/dl (< 2.0 nM).* Combined androgen blockade is permitted, but not required. If patients received combined androgen blockade with an anti-androgen they must have shown PSA progression after discontinuing the anti-androgen prior to enrollment (≥4 weeks since last flutamide, ≥6 weeks since last bicalutamide or nilutamide).* Eastern Cooperative Oncology Group (ECOG) Performance Status of ≤2 (Appendix 6)* Hemoglobin ≥9.0 g/dL independent of transfusion* Platelet count ≥100,000 /μl* Serum albumin ≥3.0 g/dl* Serum creatinine < 1.5 x ULN or a calculated creatinine clearance ≥60 ml/min (Appendix 7)* Serum potassium ≥3.5 mmol/l* Liver function: 1. Serum bilirubin <1.5 x ULN (except for patients with documented Gilbert's disease) 2. AST or ALT <2.5 x ULN* Able to swallow the study drug whole as a tablet* Life expectancy of at least 6 months* Patients who have partners of childbearing potential must be willing to use a method of birth control with adequate barrier protection as determined to be acceptable by the principal investigator and sponsor during the study and for 1 week after last study drug administration. Exclusion Criteria: * Surgical castration (i.e. orchiectomy).* Application of any LHRH-therapy (LHRH-analogue or LHRH-antagonist) within 3 months (for patients receiving a 3-months formulation) or 1 months (for patients receiving a 1-month formulation) prior to Cycle 1 day 1.* Patients receiving a 6- or 12-months formulation of LHRH-therapy* Active infection or other medical condition that would make prednisone/prednisolone (corticosteroid) use contraindicated* Any chronic medical condition requiring a higher dose of corticosteroid than 5mg prednisone/prednisolone bid.* Pathological finding consistent with small cell carcinoma of the prostate* Liver or visceral organ metastasis* Known brain metastasis* Use of opiate analgesics for cancer-related pain, including codeine, tramadol, tilidin and others (see Appendix 9), currently or anytime within 4 weeks of Cycle 1 Day 1.* Prior cytotoxic chemotherapy or biologic therapy for the treatment of CRPC* Radiation therapy for treatment of the primary tumour within 6 weeks of Cycle 1, Day 1* Radiation or radionuclide therapy for treatment of metastatic CRPC* Prior treatment with Abiraterone acetate or other CYP17 inhibitors (ketoconazole, TAK700, TOK001) ), Enzalutamide (Xtandi) or investigational agents targeting the androgen receptor for prostate cancer for more than 7 days* Prior systemic treatment with an azole drug (e.g. fluconazole, itraconazole) within 4 weeks of Cycle 1, Day 1* Prior flutamide (Eulexin) treatment within 4 weeks of Cycle 1, Day 1 (patients whose PSA did not decline for three or more months in response to antiandrogen given as a second line or later intervention will require only a two week washout prior to Cycle 1, Day 1)* Bicalutamide (Casodex), nilutamide (Nilandron) within 6 weeks of Cycle 1 Day 1 (patients whose PSA did not decline for three or more months in response to antiandrogen given as a second line or later intervention will require only a two week washout prior to Cycle 1, Day1)* Uncontrolled hypertension (systolic BP ≥160 mmHg or diastolic BP ≥95 mmHg). Patients with a history of hypertension are allowed provided that blood pressure is controlled by anti- hypertensive treatment* Active or symptomatic viral hepatitis or chronic liver disease* History of pituitary or adrenal dysfunction* Clinically significant heart disease as evidenced by myocardial infarction, or arterial thrombotic events in the past 6 months, severe or unstable angina, or New York Heart Association (NYHA) Class II-IV heart disease or cardiac ejection fraction measurement of <50 % at baseline* Any condition that requires treatment with Digoxin, digitoxin, and other digitalis drugs* Atrial Fibrillation, or other cardiac arrhythmia requiring therapy* Other malignancy with a ≥30 % probability of recurrence within 24 months, except non- melanoma skin cancer.* Administration of an investigational therapy within 30 days of Cycle 1, Day 1* Any condition, which, in the opinion of the investigator, would preclude participation in this trial.
20,322
Study Objectives Children, adolescents and young adults with high risk relapsed or treatment refractory neuroblastoma (rNB) represent a group of patients with dismal prognosis for whom a recommended standard salvage therapy is currently not available. The multimodal metronomic approach combining molecular targeted drugs (rapamycin and dasatinib) with conventional chemotherapy (irinotecan and temozolomide) will be investigated in a randomized fashion as new treatment strategy for patients with rNB. The intention is to assess the therapeutic benefit of molecular targeted drugs for the treatment of rNB. The combination of irinotecan and temozolomide showed activity in the treatment of several solid organ tumors, brain tumors and neuroblastoma. In one study rNB patients received a median of 5 courses of 5 days irinotecan and temozolomide every 3 to 4 weeks with a cumulative dose of 35% lower than in the RIST design. 33% had disease regression with 8% CR or PR. A phase II study in rNB also using irinotecan and temozolomide with a substantially lower intensity showed a response rate of 15%. The combination of a mTOR inhibitor with a multi-kinase inhibitor demonstrated in preclinical studies a synergistic effect on cell cycle arrest, apoptosis and sensitization for radio- and chemotherapy. It is assumed that this combination of molecular targeted drugs with a tolerable conventional chemotherapy consisting of irinotecan and temozolomide can substantially improve the outcome of this patient population. A group of 20 rNB patients treated with the RIST therapy approach in a compassionate use setting showed an overall survival of 55% at a median of 80 weeks with a tolerable adverse event profile. Conditions: Neuroblastoma Recurrent Intervention / Treatment: DRUG: Dasatinib, DRUG: Rapamycin, DRUG: Irinotecan, DRUG: Temozolomide, DRUG: Irinotecan, DRUG: Temozolomide
Inclusion Criteria:Patients with relapsed high-risk neuroblastoma (stage IV and all MYCN pos. stages) or progressive disease during primary treatment (=rNB) and all of the following criteria will be considered for admission to the clinical trial: * Children, adolescents and young adults less than 25 years * Signed written informed consent * Females of childbearing age must have a negative urine pregnancy test prior to starting the study drug. The first pregnancy test must be performed within 10-14 days prior to the start of the study drug and the second pregnancy test must be performed within 24 hours prior to the start of study drug. The subject may not receive the study drug until the investigator has verified that the results of these pregnancy tests are negative. * Females of childbearing age must comply with the institutional standards of birth control with a pearl index <1%. Contraception must be started at least four weeks before the start of the investigational therapy. * Females of childbearing age must be willing to abstain from breastfeeding for the duration of the clinical trial and for at least 30 days after discontinuation of the clinical trial. * Males must agree not to father a child and must use latex condom during any sexual contact with women of childbearing age during and for 6 months after therapy ends or is stopped, even if they have undergone successful vasectomy. * Willing and able to complete the clinical trial procedures, as described in the protocol * Non-smoker for at least the previous 3 months. Smoking is not allowed during the entire study period * Abstain from alcohol within the last 24 hours before screening and before admission to the clinical trial center as well as during the entire clinical trial. The regular daily ethanol intake has to be less than 20g/day for at least the previous three month. * Patients are required to have an absolute neutrophil count (ANC) ≥ 500/µL, hemoglobin ≥8g/dL (transfusion permitted), and an unsupported platelet count ≥30,000/µL unless: 1. extensive bone marrow involvement was documented 2. patient is refractory or relapsed early after primary therapy Exclusion Criteria: * Pregnancy, nursing * Patients who suffered from a thrombotic event and need anticoagulation (i.e. coumadin derivatives or low molecular weight heparin derivatives, LMWH) * Patients with cardiac arrhythmias especially prolonged QT * Patients with chronic inflammatory bowel diseases and/or bowel obstruction * Patients with bilirubin serum levels 1,5 fold above the upper normal limit * Vaccination with a live virus vaccine during the clinical trial * Impaired liver function and/or impaired renal function (hepatic and renal index parameter two times above normal range; see below) * Potentially unreliable subjects, probably non compliant subjects and those judged by the investigator to be unsuitable for the study * Doubts about the patient's cooperation * Any contraindications or known hypersensitivity to the IMPs or to any of the other components: (see SPC ("Fachinformation", appendix) * Known allergic reactions to the treatment medication * Patients who were treated with radiation and/or chemotherapy for any other oncological condition * Participation in any other phase I to III trial * Sexually active patients who refuse to use contraception according to the institutional requirements * Patients with extremely poor general condition (Karnofsky or Lansky score <50%) * Neutrophil count (ANC) <500/µL, hemoglobin <8g/dL (transfusion permitted), and an unsupported platelet count <30 000/µL * 12-lead ECG with QTc>500 msec / QTc>60 msec baseline * Patients with hepatitis B reactivation
25,637
Study Objectives The purpose of this study is to evaluate the efficacy and safety of cilta-cel out-of-specification (OOS). Conditions: Multiple Myeloma Intervention / Treatment: DRUG: Cilta-cel, DRUG: Lymphodepleting Therapy (Cyclophosphamide and Fludarabine)
Inclusion Criteria: * Eligible for treatment with cilta-cel per United States prescribing information (USPI) or locally approved label * Participant is suffering from serious or life threatening multiple myeloma per USPI (or locally approved label, respectively), and re-apheresis, re-manufacturing, or other anti-myeloma directed therapies is not considered feasible or adequate per investigator * Has adequate general health status and organ function per investigator assessment and meets the criteria to receive cilta-cel out-of-specifications (OOS) * Meets the criteria to receive lymphodepleting chemotherapy * A woman of childbearing potential must have a negative highly sensitive serum (beta-human chorionic gonadotropin \[beta-hCG\]) pregnancy test during screening and prior to the first dose of cyclophosphamide and fludarabine Exclusion Criteria: * History of active uncontrolled infection or condition where an administration of cilta-cel OOS constitutes serious health risk to the participant * Known allergies, hypersensitivity, or intolerance to the excipients of cilta-cel OOS including dimethyl sulfoxide (DMSO), dextran 40, or residual kanamycin per USPI * Hepatitis B infection * Hepatitis C infection defined as (anti hepatitis C virus \[HCV\] antibody positive or detectable HCV ribonucleic acid \[RNA\]) or known to have a history of hepatitis C * Seropositive for human immunodeficiency virus (HIV) * Uncontrolled autoimmune disease
22,657
Study Objectives This study evaluates a text messaging intervention through a smokers' quitline. Smokers will either receive 30 weeks of tailored, gain-framed text messages or 30 weeks of tailored, standard care text messages, both combined with standard quitline treatment. We hypothesize that the gain-framed text message intervention will increase cessation rates at 30 weeks as compared to standard care text messages. Conditions: Smoking Intervention / Treatment: BEHAVIORAL: Gain-framed text messages, BEHAVIORAL: Standard care text messages
Inclusion Criteria: * 1) call the Quitline requesting assistance with quitting smoking, 2) be 18+ years old, 3) speak English, 4) have a verified New York address, and 5) opt into the standard Quitline texting protocol. Exclusion Criteria: *
28,895
Study Objectives RAD001 (everolimus) is a novel oral derivative of rapamycin. RAD001 has been in clinical development since 1996 as an immunosuppressant in solid organ transplantation and has obtained marketing authorization (Certican®) for prophylaxis of rejection in renal and cardiac transplantation in a number of countries, including the majority of the European Union. RAD001 has been in development for patients with various malignancies since 2002. RAD001 is being investigated as an anticancer agent based on its potential to act: * Directly on the tumor cells by inhibiting tumor cell growth and proliferation * Indirectly by inhibiting angiogenesis leading to reduced tumor vascularity (via potent inhibition of tumor cell HIF-1 activity, VEGF production and VEGF-induced proliferation of endothelial cells). The role of angiogenesis in the maintenance of solid tumor growth is well established, and the mTOR pathway has been implicated in the regulation of tumor production of proangiogenic factors as well as modulation of VEGFR signaling in endothelial cells. At weekly and daily schedules and at various doses explored, RAD001 is generally well tolerated. The most frequent adverse events (rash, mucositis, fatigue and headache) associated with RAD001 therapy are manageable. Non-infectious pneumonitis has been reported with mTOR inhibitors but is commonly low-grade and reversible. Both FOLFOX and bevacizumab are well established for treatment of metastatic colorectal carcinomas. FOLFOX-6 can be combined safely with Bevacizumab and is currently in phase 3 testing for adjuvant therapy and is commonly used as a first line treatment regimen for metastatic colorectal cancers 25. There is an enhanced interest in development of more effective regimens for colorectal cancers. RAD001 is a mTOR inhibitor that has preclinical and clinical activity in colorectal cancers. RAD001 downregulates the mTOR pathway which can lead to direct antiproliferative effects as well as decreased production of Vascular Endothelial Growth Factor. A combination of RAD001 at 10 mg per day in combination with Bevacizumab 10 mg/kg every 2 weeks has been shown to be efficacious and safe. In another trial, RAD001 was shown to have many patients with stable disease and clearly needs to be given in combination therapy. Conditions: Colorectal Cancer Intervention / Treatment: DRUG: RAD001, DRUG: FOLFOX, DRUG: Bevacizumab
Inclusion Criteria: * Patients with advanced or metastatic colorectal cancers for whom chemotherapy is indicated * Patients must not have had prior chemotherapy for advanced or metastatic disease. Patients could have received adjuvant chemotherapy or adjuvant chemo-radiotherapy * Patients must have at least one measurable site of disease according to RECIST (version 1.1) criteria that has not been previously irradiated. If the patient has had previous radiation to the marker lesion(s), there must be evidence of progression since the radiation * Age ≥ 18 years * Minimum of four weeks since any major surgery, completion of radiation, or completion of all prior systemic anticancer therapy (adequately recovered from the acute toxicities of any prior therapy) * ECOG performance status £ 2 * Adequate bone marrow function as shown by: ANC ≥ 1.5 x 109/L, Platelets ≥ 100 x 109/L, Hgb > 9 g/dL * Adequate liver function as shown by: serum bilirubin ≤ 1.5 x upper limit of normal (ULN), and serum AST and ALT ≤ 2.5 x ULN. With the exception of serum AST and ALT (< 5 x ULN) if the patient has liver metastases * Adequate renal function, serum creatinine < 2 x ULN or creatinine clearance > 50 cc/hr * Fasting serum cholesterol ≤300 mg/dL OR ≤ 7.75 mmol/L AND fasting triglycerides ≤ 2.5 x ULN. NOTE: In cases where one or both of these thresholds are exceeded, the patient can only be included after initiation of appropriate lipid lowering medication * Signed informed consent * INR and PTT < 1.5 (Anticoagulation is allowed if target INR < 1.5 on a stable dose of warfarin or on a stable dose of LMW heparin for > 2 weeks at time of randomization) Exclusion Criteria: * History of severe and uncontrolled allergic reactions to bevacizumab * Symptomatic congestive heart failure of New York heart association Class III or IV * Patients who have received prior treatment with an mTOR inhibitor (sirolimus, temsirolimus, everolimus) * DVT and hypertension controlled < 6 months * Prior treatment with any investigational drug within the preceding 4 weeks * Chronic treatment with systemic steroids or another immunosuppressive agent; topical or inhaled corticosteroids are allowed * Patients should not receive immunization with attenuated live vaccines during study period or within 1 week of study entry * Uncontrolled brain or leptomeningeal metastases, including patients who continue to require glucocorticoids for brain or leptomeningeal metastases * Other malignancies that are active at the time of enrollment/ treatment on the protocol * Patients who have any severe and/or uncontrolled medical conditions or other conditions that could affect their participation in the study such as: * unstable angina pectoris, symptomatic congestive heart failure, myocardial infarction ≤ 6 months prior to first study treatment, serious uncontrolled cardiac arrhythmia or any other clinically significant cardiac disease * severely impaired lung function as defined as spirometry and DLCO that is 50% of the normal predicted value and/or O2 saturation that is 88% or less at rest on room air * uncontrolled diabetes as defined by fasting serum glucose >1.5x ULN * any active (acute or chronic) or uncontrolled infection/ disorders * nonmalignant medical illnesses that are uncontrolled or whose control may be jeopardized by the treatment with the study therapy * known liver disease such as cirrhosis, chronic active hepatitis or chronic persistent hepatitis * A known history of HIV seropositivity * Impairment of gastrointestinal function or gastrointestinal disease that may significantly alter the absorption of RAD001 in the judgment of the investigator (e.g., ulcerative disease, uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome or small bowel resection) * Patients with an active, bleeding diathesis or on oral anti-vitamin K medication (except low dose Coumadin) * Women who are pregnant or breast feeding, or women/men able to conceive and unwilling to practice an effective method of birth control. (Women of childbearing potential must have a negative urine or serum pregnancy test within 7 days prior to administration of RAD001). Oral, implantable, or injectable contraceptives may be affected by cytochrome P450 interactions, and are therefore not considered effective for this study. * Patients with a known hypersensitivity to RAD001 (everolimus) or other rapamycins (sirolimus, temsirolimus) or to its excipients * History of noncompliance to medical regimens * Patients unwilling to or unable to comply with the protocol
34,907
Study Objectives A prospective, double-blinded study. The present study consisted in applying Stroke volume variation fluid guided therapy to old patients (65 years old) undergoing radical resection of colon surgery. The aim of this study is to compare the effects of norepinephrine and phenylephrine in treating perioperative hypotension, and to find the safest and most effective vasopressor for elderly. Conditions: Hypotension, Fluid Therapy Intervention / Treatment: DRUG: phenylephrine, DRUG: Norepinephrine
Inclusion Criteria: * Operation time should be equal or greater than 2h, * Patients older than 65 years old, * ASA Ⅱ or Ⅲ. Exclusion Criteria: * Clear arrhythmia, * Need to apply PEEP, * Peripheral vascular disease and arterial catheter contraindications.
33,562
Study Objectives The objective of this study is to compare radical hysterectomy with trachelectomy on outcomes related to intimacy, sexual health, and mood immediately before, 1 month after, and 6 months after surgery. Conditions: Cervical Cancer Intervention / Treatment:
Inclusion Criteria: * Women who have a diagnosis of cervical cancer* Women who are scheduled for either a radical hysterectomy or radical trachelectomy at the British Columbia Cancer Agency - Vancouver Cancer Centre* Proficient in English Exclusion Criteria: No woman who meets the inclusion criteria will be excluded from participating.
38,019
Study Objectives Characteristics of patients with Neuregulin-1 (NRG1) gene fusion-positive solid tumors treated with afatinib, and characteristics of those treated with another systemic therapy. Conditions: Non-squamous, Non-Small Cell Lung Cancer Intervention / Treatment: DRUG: Afatinib, DRUG: other systemic therapy
Inclusion Criteria: * Adults, 18 years of age or older, at the time of diagnosis with any solid tumor. * Confirmed NRG1 gene fusion in any solid tumor. * Initiated afatinib or other systemic therapy (in any line of therapy) for treatment of a solid tumor with NRG1 gene fusion on or after 01/01/2017 through 03/31/2020. * Followed up for ≥3 months after initiation of afatinib or other systemic therapy (unless deceased prior to 3 months of follow-up). Exclusion Criteria: * Treatment with any Tyrosine kinase inhibitor (TKI)/ErbB-directed therapy other than afatinib
19,110
Study Objectives Purpose of this study is the evaluation of QoL, tolerability and use of Zoladex 10,8 SafeSystem for advanced PCa under naturalistic conditions Conditions: Prostate Carcinoma Intervention / Treatment:
Inclusion Criteria: * Patients with PCa, who will be treated with Zoladex 10,8 SafeSystem based on the current SPC
24,612
Study Objectives Acute bleeding is one of the most frequent intraoperative adverse events and is burdened with a significant morbidity and mortality rate. The only available treatment for severe exsanguination is homologous transfusion, but this is itself complicated by side effects. Nevertheless, systems exist allowing the recovery, treatment and intraoperative reinjection of lost blood, thus limiting transfusions. Conditions: Hemorrhage, Cancer Surgery, Transfusion Intervention / Treatment: DEVICE: Transfusion
Inclusion Criteria: * Surgery at the Centre Léon Bérard in 2021 * transfusion from the day of surgery to the 10th postoperative day Exclusion Criteria: * Digestive endoscopy, interventional radiology, brachytherapy * Vascular access only * Patient refusal
10,600
Study Objectives This research study is evaluating a new way to deliver oncology care for patients with cancer Conditions: Cancer Intervention / Treatment: OTHER: IMPROVED intervention
Inclusion Criteria: * Age 18 or older * Diagnosed with advanced cancer (defined as receiving treatment with palliative intent as per chemotherapy order entry designation, oncology clinic notes, and/or trial consent forms, or not receiving chemotherapy but followed for incurable disease as per oncology clinic notes) * Admitted to the oncology service at Massachusetts General Hospital * Verbal fluency in English Exclusion Criteria: * Unwilling or unable to participate in the study * Admitted electively * Participated during a previous admission
13,206
Study Objectives The purpose of this study is to evaluate the effect of food on the pharmacokinetics (PK) of the experimental drug, entinostat, in women with breast cancer and men and women with non-small cell lung cancer. The safety and tolerability of entinostat will also be evaluated when entinostat is given by itself as well as with the approved drugs, exemestane (Aromasin®) or erlotinib (Tarceva®). A biomarker (chemical "marker" in the blood/tissue that may be related to your response to the study drug) will also be tested. Conditions: Lung Cancer, Non Small Cell Lung Cancer (NSCLC), Breast Cancer, Estrogen Receptor Breast Cancer Intervention / Treatment: DRUG: entinostat, DRUG: entinostat, DRUG: Erlotinib, DRUG: Erlotinib, DRUG: Exemestane, DRUG: Exemestane
Inclusion Criteria: Breast Cancer Patients Only * Postmenopausal female patients * Histologically or cytologically confirmed ER+ breast cancer at initial diagnosis and now has current disease progression and is a candidate to receive exemestane NSCLC Patients Only: * Cytologically or histologically confirmed NSCLC of stage IIIb or IV * Received 1 to 2 prior chemotherapy or chemoradiotherapy regimens for advanced NSCLC (excluding erlotinib and valproic acid) and now has disease progression and is a candidate to receive erlotinib All Patients: * Age ≥ 18 years * Patient must have the following laboratory parameters at study screening: Hemoglobin ≥ 9.0 g/dL; unsupported platelets ≥ 100.0 10-9/L; ANC ≥ 2.0 x 10-9/L; Creatinine less than 2.5 times the upper limit of normal for the institution; AST and alanine transaminase (ALT) < 2.5 times the upper limit of normal for the institution * Patients may have a history of brain metastasis as long as certain criteria are met Exclusion Criteria: * Pregnant or lactating women * Patient has rapidly progressive or life-threatening metastases. * Patient has had previous treatment with entinostat or any other HDAC inhibitor including valproic acid * Patient has a concomitant medical condition that precludes adequate study treatment compliance or assessment, or increases patient risk in the opinion of the investigator, such as but not limited to: MI or arterial thromboembolic events within 6 months, or experiencing severe or unstable angina, New York Heart Association (NYHA) Class III or IV disease and a QTc interval > 0.47 seconds. Uncontrolled heart failure or hypertension, uncontrolled diabetes mellitus, uncontrolled systemic infection. * Patients with another active cancer (excluding adequately treated basal cell carcinoma or cervical intraepithelial neoplasia \[CIN / cervical carcinoma in situ\] or melanoma in situ). Prior history of other cancer is allowed, as long as there is no active disease within the prior 5 years.
32,732
Study Objectives The soft tissue sarcomas (STS) constitute an infrequent group of malignant neoplasms of mesenchymal origin. In Spain, the approximate incidence is of 2 new cases per 100.000 inhabitants every year. In patients with metastatic STS, the average survival is very short, approximately 12 months. The systemic treatment of the metastatic disease has had a very limited development, with few satisfactory results. This facts reflect the urgent need to identify new active agents for treatment of these patients. The molecular pathway of the serine/threonine kinase mammalian target of rapamycin (mTOR) plays a central role in the regulation of the proteins translation, cellular growth and metabolism (Meric-Bernstam F et al. 2009). Currently, the mTOR pathway is considered a relevant target for the development of anti-cancer drugs, as rapamycin. Preliminary results of some clinical trials suggest that mTOR inhibitors could have some clinical activity for different types of sarcoma, including STS (Chawla et al Proc.ASCO 2006; Schuetze et al. Proc.ASCO 2006). Gemcitabine is a chemotherapy antimetabolite agent with a broad antitumoral spectrum. The activity of this drug to treat resistant sarcomas and its reduced toxicity make from gemcitabine an adequate candidate for its study in combination with new drugs addressed to molecular targets in the STS treatment. Pre-clinical studies suggest that mTOR inhibitors could have a potential synergistic or additive effect with some chemotherapy agents. The combination of rapamycin and gemcitabine seems to be a reasonable strategy to explore for the STS treatment. Conditions: Advanced Soft Tissue Sarcoma Intervention / Treatment: DRUG: Gemcitabine + Rapamycin
Inclusion Criteria: * Patients with anatomopathological diagnosis of metastatic or locally advanced unresectable soft tissue sarcoma (STS). Patients with the following STS types will be excluded: chondrosarcoma, Ewing's sarcoma and embryonal or alveolar rhabdomyosarcoma. In phase 1 it will be allowed to include patients having other types of advanced cancer which are resistant to the standard treatment and can benefit from any of the study drugs.* Prior treatment with chemotherapy including doxorubicin and ifosfamide, or contraindication for its administration. The previous treatment with gemcitabine or inhibitors of mTOR is not allowed.* Age ≥ 18 y ≤ 70 years.* ECOG performance status: 0 - 1. In Phase 1 only patients with ECOG 0-1 will be enrolled.* Disease measurable according to RECIST criteria. Proven relapsed disease.* Adequate bone marrow function, defined as neutrophil count ≥ 1.500/mm\^3 and platelets ≥ 100.000/mm\^3.* Adequate renal and hepatic function , defined as calculated creatinine clearance ≥ 60 ml/min, creatinine, total bilirubin, AST and/or ALT ≤ 1,5 times the upper limit of normal (ULN).* Informed consent form signed by the patient prior to the beginning of the treatment. Exclusion Criteria: * History of previous cancer diagnosed or treated in the past 5 years except basal cell carcinoma, cervical carcinoma in situ or superficial bladder cancer.* Presence of brain metastases.* Active infection or other severe concomitant diseases.* Concurrent treatment with other experimental drugs within 30 days prior to study entry.* Pregnancy or breastfeeding.
33,175
Study Objectives Bronchopulmonary cancers or mesothelioma are associated with effort deconditioning due to pathology (chronic inflammation) and also to treatments (surgery, radiotherapy, chemotherapy); it's considerably alters patients quality of life. Investigators want to ensured the feasibility of rehabilitation by effort for these patients. Conditions: Bronchial Cancer, Malignant Mesothelioma Intervention / Treatment: BEHAVIORAL: rehabilitation by effort
Inclusion Criteria: * General condition according to World Health Organisation 0-1 * Age between 18 and 70 years old * Non progressive patients according to RECIST criteria 1.1 after chemotherapy treatment whichever line of treatment * Autonomous patient * Voluntary written informed consent signed * Patients with social security insurance Exclusion Criteria: * Bone metastasis with fracture risk * Significant cardiovascular pathology * Cardiac, vascular, rheumatologic or neurologic contraindication * Patients living far 60 kms from Toulouse * Patients under juridical protection guardianship, or tutelage measure
25,626
Study Objectives This research study was designed to determine the effect on port wine stains (PWS) of liposomal benzoporphyrin derivative monoacid (BPD-MA) termed verteporfin by intravenous (IV) infusion for photodynamic therapy (PDT) or combined PDT and pulsed dye laser (PDL) therapy (PDT + PDL). The standard treatment for PWS is PDL alone. This lightens some PWS but many lesions are not completely removed. PDT uses a medication and light together to cause injury to a target. The medication is given and then light is directed at the desired area of treatment to achieve an effect. PDT has been used to treat some skin conditions including pre-cancers and skin cancers. Using PDT or PDT immediately followed by PDL therapy may improve PWS lightening. At this time, both PDT and PDT + PDL therapy for treatment of PWS is investigational. The type and amount of medication and light which may be used to treat PWS is not known, and is likely to be different than those used for other PDT treatments. Conditions: Port Wine Stains Intervention / Treatment: DRUG: Combined Photodynamic & Pulsed Dye Laser Treatment
Inclusion Criteria: * Adult 18 years and older * Have a PWS on an area other than the face * A negative pregnancy test and non pregnant or nursing Exclusion Criteria: * Under 18 years of age * Have an allergy to verteporfin, porfimer sodium or other porphyrins * Have a history of porphyria (a disease that can cause sensitivity to light) * Have had treatment to the PWS test sites in the last 8 weeks * Have an active uncontrolled infection or other significant disease * Currently using medications that cause sensitivity to light such as tetracyclines, sulfonamides, phenothiazines, sulfonylurea hypoglycemic agents, thiazide diuretics and griseofulvin * Currently using medications that increase bleeding, including aspirin, coumadin or non-steroidal anti-inflammatory drugs * Have very dark skin which is sensitive to laser treatment * Have a positive ANA (lab tests which indicates sensitivity to light)
3,714
Study Objectives Recent data demonstrate that in IDH-mutant gliomas, 2 hydroxy-glutarate production induces a homologous recombination defect that renders tumor cells exquisitely sensitive to poly(adenosine 5'-diphosphate-ribose) polymerase (PARP) inhibitors, including olaparib (Lynparza; AstraZeneca). The aim of this open-label phase 2 study is to evaluate the efficacy of olaparib in in recurrent IDH-mutant high grade gliomas based on 6 months progression-free survival. Conditions: Recurrent IDH, Mutant High Grade Glioma Intervention / Treatment: DRUG: Olaparib 150 MG
Inclusion Criteria: * Affiliation to a French social security system (recipient or assign) excluding AME.* Histological confirmation of grade III or IV high-grade glioma or evidence of anaplastic transformation (based on histological or radiological analysis) of a previous grade II glioma* Tumor is mutated for IDH1 or IDH2 gene (detected by R132HIDH immunochemistry or IDH1/IDH2 sequencing)* Recurrence after radiotherapy and at least one line of alkylating chemotherapy (Temozolomide or PCV (Procarbazine, CCNU, Vincristine) (Surgery at recurrence is allowed before trial inclusion)* Recurrence occurring more than 12 weeks from the end of the radiotherapy or occurring outside the irradiated volume* Provision of informed consent prior to any study specific procedures* Age ≥ 18 years old* Patients must have normal organ and bone marrow function measured within 28 days prior to administration of study treatment as defined below: Haemoglobin ≥ 10.0 g/dL with no blood transfusion in the past 28 days Absolute neutrophil count (ANC) ≥ 1.5 x 109/L Platelet count ≥ 100 x 109/L total bilirubin ≤ 1.5 x institutional upper limit of normal (ULN) Aspartate aminotransferase (AST) (Serum Glutamic Oxaloacetic Transaminase (SGOT)) / Alanine aminotransferase (ALT) (Serum Glutamic Pyruvate Transaminase (SGPT)) ≤ 2.5 x institutional upper limit of normal Patients must have creatinine clearance estimated using the Cockcroft-Gault equation of ≥51 mL/min: Estimated creatinine clearance = (140-age \[years\]) x weight (kg) (x F)a serum creatinine (mg/dL) x 72 a where F=0.85 for females and F=1 for males.* KPS ≥ 70* Patients must have a life expectancy ≥ 16 weeks.* Postmenopausal or evidence of non-childbearing status for women of childbearing potential: negative urine or serum pregnancy test within 28 days of study treatment and confirmed prior to treatment on day 1. Postmenopausal is defined as: Amenorrheic for 1 year or more following cessation of exogenous hormonal treatments Luteinizing hormone (LH) and Follicle stimulating hormone (FSH) levels in the post menopausal range for women under 50 radiation-induced oophorectomy with last menses >1 year ago chemotherapy-induced menopause with >1 year interval since last menses surgical sterilisation (bilateral oophorectomy or hysterectomy)* Male patients and their partners, who are sexually active and of childbearing potential, must agree to the use of two highly effective forms of contraception in combination \[see appendix B for acceptable methods\], throughout the period of taking study treatment and for 3 months after last dose of study drug(s) to prevent pregnancy in a partner.* Patients is willing and able to comply with the protocol for the duration of the study including undergoing treatment and scheduled visits and examinations.* Radiologically measurable disease based on RANO criteria, i. e. at least one lesion (measurable and/or non-measurable) that can be accurately assessed at baseline by MRI and is suitable for repeated assessment. Tumor lesions situated in a previously irradiated area are considered measurable if progression has been demonstrated in such lesions.* Formalin fixed, paraffin embedded (FFPE) tumour sample from the primary cancer must be available for central testing. If there is not written confirmation of the availability of an archived tumour sample prior to enrolment the patient is not eligible for the study.* For inclusion in the optional biomarker research, patients must fulfil the following criteria: Provision of informed consent for biomarker research If a patient declines to participate in the optional exploratory genetic research or the optional biomarker research, there will be no penalty or loss of benefit to the patient. The patient will not be excluded from other aspects of the study. Exclusion Criteria: * Involvement in the planning and/or conduct of the study (applies to both AstraZeneca staff and/or staff at the study site)* Previous enrolment in the present study* Participation in another clinical study with an investigational product during the last month* Any previous treatment with PARP inhibitor, including olaparib.* Other malignancy within the last 5 years except: adequately treated non-melanoma skin cancer, curatively treated in situ cancer of the cervix, ductal carcinoma in situ (DCIS), Stage 1, grade 1 endometrial carcinoma, or other solid tumours including lymphomas (without bone marrow involvement) curatively treated with no evidence of disease for ≥5 years. Patients with a history of localised triple negative breast cancer may be eligible, provided they completed their adjuvant chemotherapy more than three years prior to registration, and that the patient remains free of recurrent or metastatic disease.* Resting ECG with QTc > 470 msec on 2 or more time points within a 24 hour period or family history of long QT syndrome* Patients receiving any systemic chemotherapy or radiotherapy (except for palliative reasons) within 3 weeks prior to study treatment* Concomitant use of known strong CYP3A inhibitors (eg. itraconazole, telithromycin, clarithromycin, protease inhibitors boosted with ritonavir or cobicistat, indinavir, saquinavir, nelfinavir, boceprevir, telaprevir) or moderate CYP3A inhibitors (eg. ciprofloxacin, erythromycin, diltiazem, fluconazole, verapamil). The required washout period prior to starting olaparib is 2 weeks.* Concomitant use of known strong (eg. phenobarbital, enzalutamide, phenytoin, rifampicin, rifabutin, rifapentine, carbamazepine, nevirapine and St John's Wort ) or moderate CYP3A inducers (eg. bosentan, efavirenz, modafinil). The required washout period prior to starting olaparib is 5 weeks for enzalutamide or phenobarbital and 3 weeks for other agents.* Persistent toxicities (>Common Terminology Criteria for Adverse Event (CTCAE) grade 2) caused by previous cancer therapy, excluding alopecia.* Patients with myelodysplastic syndrome/acute myeloid leukaemia or with features suggestive of MDS/AML.* Major surgery within 2 weeks of starting study treatment and patients must have recovered from any effects of any major surgery.* Patients considered a poor medical risk due to a serious, uncontrolled medical disorder, non-malignant systemic disease or active, uncontrolled infection. Examples include, but are not limited to, uncontrolled ventricular arrhythmia, recent (within 3 months) myocardial infarction, uncontrolled major seizure disorder, unstable spinal cord compression, superior vena cava syndrome, extensive interstitial bilateral lung disease on High Resolution Computed Tomography (HRCT) scan or any psychiatric disorder that prohibits obtaining informed consent.* Patients unable to swallow orally administered medication and patients with gastrointestinal disorders likely to interfere with absorption of the study medication.* Breast feeding women.* Immunocompromised patients, e.g., patients who are known to be serologically positive for human immunodeficiency virus (HIV).* Patients with a known hypersensitivity to olaparib or any of the excipients of the product.* Patients with known active hepatitis (i.e. Hepatitis B or C) due to risk of transmitting the infection through blood or other body fluids* Previous allogenic bone marrow transplant or double umbilical cord blood transplantation (dUCBT)* Whole blood transfusions in the last 120 days prior to entry to the study (packed red blood cells and platelet transfusions are acceptable, for timing refer to inclusion criteria no.8)
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Study Objectives The primary purpose of this study is to identify the maximum tolerated dose(s) (MTD) of neratinib in combination with temsirolimus in subjects with solid tumors. This study will also include a preliminary evaluation of efficacy, and assessment of pharmacokinetic (PK) parameters of the combination. Conditions: Neoplasms, Malignant Carcinoma Intervention / Treatment: DRUG: Neratinib, DRUG: Temsirolimus
Inclusion Criteria: * Pathologic diagnosis of advanced or metastatic solid tumor. * Measurable disease per Response Criteria in Solid Tumors (RECIST criteria). * Incurable cancer, with disease progression following at least 1 conventional or standard therapy for locally advanced or metastatic disease. * Negative pregnancy test for women of child bearing potential. Exclusion Criteria: * Chronic treatment with corticosteroids. * Primary central nervous system (CNS) tumors and active metastases. * Presence of clinically significant or uncontrolled cardiac disease. * Significant chronic or recent acute gastrointestinal disorder with diarrhea as a major symptom. * Symptomatic or prior history of non-infectious interstitial pneumonitis.
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Study Objectives This study evaluates disparities and barriers in cancer care delivery and outcomes in women of color by identifying socioeconomic variables that may be related to the inequity. Social determinants of health, or the conditions in which people live, work, and play, have a profound effect on health outcomes. This research is being done to understand whether social determinants of health factors like employment, household income, and home ownership affect access to care services and outcomes for patients with metastatic breast cancer who receive their cancer treatment at Sidney Kimmel Cancer Center at Jefferson Health. Conditions: Anatomic Stage IV Breast Cancer AJCC v8, Metastatic Breast Carcinoma Intervention / Treatment:
Inclusion Criteria: * Female * Aged 18 and older * English-speaking * Diagnosed with metastatic breast cancer within 24 months of study enrollment * Receiving treatment at the SKCC in Center City, New Jersey, or Methodist Hospital * Provide signed and dated informed consent form * Willing to comply with all study procedures and be available for the duration of the study Exclusion Criteria: * Male breast cancer patients * Women with breast cancer that is not metastatic * Women who discontinue treatment for their metastatic disease at SKCC
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Study Objectives To investigate the sensitivity of the \[18F\]fluoroethylcholine (FEC) Positron-Emission-Tomography/ Magnetic Resonance Imaging (PET/MRI) method in tumour detection and location (side assignment, encapsulation, invasion of the seminal vesicle) and detection of affected lymph nodes, and to compare these with presently used detection procedures (needle biopsy, digital rectal examination, transrectal ultrasound, and pre-therapeutic assessment), with a view to finding out whether the \[18F\]fluoroethylcholine PET/MRI method is comparable to, or superior to, the established method. Postoperative histology served as the standard of reference. Conditions: Prostate Cancer Intervention / Treatment: OTHER: 18F-Ethylcholine Positron Emission Tomography (FEC-PET), OTHER: Endorectal Magnetic Resonance Imaging (1.5Tesla) (eMRI)
Inclusion Criteria: * Histologically diagnosed prostate cancer (needle biopsy) * Radical prostatectomy as primary treatment * No nutrition within 12 hours before Positron-Emission-Tomography (PET) * No food containing choline within 24 hous before PET * Age > 50 years Exclusion Criteria: * Total endo-prothesis of the hip region * Clinical or chemical detection of an acute infection * Missing patient agreement * Secondary cancer * Surgical treatment within 3 month before PET * Claustrophobia * Medical drugs with choline * Severe liver damage * Cardiac infarction * Bradycardia (pulse rate < 55/min) * Allergic reaction against Neurotropan * Bronchial asthma * Cardiac pacemaker * Small metal implants (e.g., clips, cochlea-implants, etc.)
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Study Objectives Patients with Myeloma or CLL with severe secondary hypogammaglobinemia and recurrent infections will be included in this study; for whom an IgSC treatment was prescribed. The IgSC prescription will be the decision of the treating physician. Patient care and follow up will be performed according to the current clinical practice and the recommendations of HAS. Conditions: Secondary Immune Deficiency Intervention / Treatment: DRUG: Gammanorm, DRUG: Other Subcutaneous Immunoglobulins
Inclusion Criteria: * Adult male or female (≥18 years old), Myeloma or Chronic Lymphocytic Leukemia patients with secondary hypogammaglobinemia and recurring infections.* Patients with indication for IgSC treatment but who have not started the treatment yet. Prior IgSC or IgIV treatment 6 months before inclusion is accepted (with a washout period of 6 months minimum).* Patient having received all the necessary information about the study and signed an informed consent document. Exclusion Criteria: * Patient having initiated an IgSC treatment.* Patient having received IgSC or IgIV treatment within 6 months prior to inclusion.* Incapacity/Inability to attend the follow-up visits.* Patient refusing to participate in the study.* HIV positive patients.* Incapacity to understand the study objective and process, to agree or to give informed consent to participate in the study.* Pregnant or breast-feeding women
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