• Title/Summary/Keyword: Systemic therapy

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Impressive effect of cisplatin monotherapy on a patient with heavily pretreated triple-negative breast cancer with poor performance

  • Baek, Dong Won;Park, Ji-Young;Lee, Soo Jung;Chae, Yee Soo
    • Journal of Yeungnam Medical Science
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    • v.37 no.3
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    • pp.230-235
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    • 2020
  • Systemic therapy for metastatic triple-negative breast cancer (TNBC) still remains challenging because there are no targeted agents or endocrine therapies currently available. The present case report documents the successful use of cisplatin monotherapy to manage a heavily pretreated TNBC patient showing poor response to therapy. The patient was a 51-year-old woman who had already undergone several lines of systemic chemotherapy for widespread TNBC. Although the mutation analysis performed on DNA isolated from blood cells and progressed lesion samples confirmed the tumor to be germline BRCA wild-type, cisplatin monotherapy was administered based on the increasing evidence of safety and efficacy of platinum for breast cancer. After three cycles of cisplatin treatment, the patient's metastatic lesions dramatically improved without any major toxicity, and she completed 17 cycles with good response. This case study indicates that patients with heavily pretreated TNBC can potentially achieve a good response to cisplatin monotherapy.

Current Drugs and Drug Targets in Non-Small Cell Lung Cancer: Limitations and Opportunities

  • Daga, Aditi;Ansari, Afzal;Patel, Shanaya;Mirza, Sheefa;Rawal, Rakesh;Umrania, Valentina
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.10
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    • pp.4147-4156
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    • 2015
  • Lung cancer is a serious health problem and leading cause of death worldwide due to its high incidence and mortality. More than 80% of lung cancers feature a non-small cell histology. Over few decades, systemic chemotherapy and surgery are the only treatment options in this type of tumor but due to their limited efficacy and overall poor survival of patients, there is an urge to develop newer therapeutic strategies which circumvent the problems. Enhanced knowledge of translational science and molecular biology have revealed that lung tumors carry diverse driver gene mutations and adopt different intracellular pathways leading to carcinogenesis. Hence, the development of targeted agents against molecular subgroups harboring critical mutations is an attractive approach for therapeutic treatment. Targeted therapies are clearly more preferred nowadays over systemic therapies because they target tumor specific molecules resulting with enhanced activity and reduced toxicity to normal tissues. Thus, this review encompasses comprehensive updates on targeted therapies for the driver mutations in non-small cell lung cancer (NSCLC) and the potential challenges of acquired drug resistance faced i n the field of targeted therapy along with the imminent newer treatment modalities against lung cancer.

Irinotecan as a Palliative Therapy for Metastatic Breast Cancer Patients after Previous Chemotherapy

  • Lan, Hai;Li, Yan;Lin, Cong-Yao
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.24
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    • pp.10745-10748
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    • 2015
  • Background: This analysis was conducted to evaluate the efficacy and safety of irinotecan based chemotherapy for treatment of patients with metastatic breast cancer (MBC) who experienced disease progression after one to three chemotherapy regimens, including at least one anthracycline- or taxane-based. Methods: Clinical studies were identified using a predefined search strategy. Pooled response rates (RR) to treatment were calculated. Results: As irinotecan based regimens, 5 clinical studies which including 217 patients with refractory MBC were considered eligible for inclusion, with irinotecan, cisplatin, capecitabine, or TS-1. Systemic analysis suggested that, in all patients, pooled RR was 48.8% (106/217) with irinotecan based regimens. Thrombocytopenia and leukocytopenia were the main side effects. No grade III or IV renal or liver toxicity was observed. No treatment related deaths occurred. Conclusion: This systemic analysis suggests that irinotecan based regimens are beneficial and safe for treating patients with MBC after other chemotherapy.

Case of Multiple Systemic Atrophy Treated with Korean Medical Treatment and Rehabilitation Therapy (재활치료와 한방치료를 병행한 다발성 뇌신경계 위축증 1례)

  • Park, Jang-Kyung;Maeng, Yu-Sook;Lee, Seung-Bok;Kim, Dong-Il
    • The Journal of Korean Medicine
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    • v.32 no.2
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    • pp.118-125
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    • 2011
  • Multiple system atrophy (MSA) is an idiopathic and progressive neurodegenerative disorder. Up to now, treatment of MSA patients had not been reported in Oriental medicine and only rarely reported in Western medicine. We experienced a 75-year-old female diagnosed with MSA and had quadriparesis with dysphagia. She was admitted to the hospital and received herbal medication, acupuncture, moxibustion and rehabilitation therapy. After 2 months, her motor power and swallowing function on video fluoroscopic swallowing test significantly improved. This report shows that Oriental medicine may play a role in the treatment of MSA, and further study is merited.

Systemic Review on Forest Healing Journals (산림 치유 관련 논문에 관한 체계적 고찰)

  • Sun, Seung-Ho;Lee, Seon-Goo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.24 no.4
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    • pp.566-570
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    • 2010
  • This review was conducted to investigate clinical trial trend, clinical effect, and study methods of forest healing. Literature search was performed using the search engines of eight electronic databases from inception to march 2010 without language limitation. The search terms were "forest healing", "forest experience", "forest therapy", "forest treatment", "clinical trial", and "clinical study". Inclusion criteria were randomized controlled trials (RCTs) among all kinds of study searched about forest healing. Selection literature and data extraction was performed by authors(SH Sun and SG Lee) independently. Total three studies were selected finally. The methodological quality in all study was low because of poor reporting. Study indications were metal health, depression, self-esteem, and stress. The scale of studies was very small, which was the level of pilot study. There were no description for obtaining informed consent and being reviewed by Institutional Review Board (IRB), and could be any problems for statistical method in any studies. It is difficult to accept the fact that each studies had the significant effect for study indications in the results of studies. It is concluded that the evidence that health healing have a significant effect is insufficient. Further systematic and methodological study and well-designed clinical trial will be needed.

Inhibitory Effect of Immediate-Type Hypersensitivity of Syzygium aromaticum extract by Anal Therapy (肛腸療法에 의한 丁香의 卽刻型 過敏反應 抑制效果)

  • Bae, Seong-hyeok;Moon, goo;Won, Jin-hee
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.13 no.1
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    • pp.141-156
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    • 2000
  • Cloves are the dried flower buds of Syzygium aromaticum (L.) Mere et Perry (Myrtaceae). They have been successfully used for the management of various allergic disorders by oral administration in Korea. In this study, the author investigated the effect of an aqueous extract of Syzygium aromaticum on immediate-type hypersensitivity by anal administration. Anal administration of Syzygium aromaticum showed a marked inhibition rate in systemic hypersensitivity with a dose of 1 mg/kg 1 hr before intraperitoneal injection of compound 48/80. Anal administration of Syzygium aromaticum significantly reduced plasma histamine contents induced by compound 48/80. Anal administration of Syzygium aromaticum (1 mg/kg) also inhibited to $61.4\%$ (P<0.01) local a1lergic reaction activated by anti-dinitrophenyl (DNP) IgE. In addition, Syzygium aromaticum dose-dependently inhibited the histamine release from the peritoneal mast cells by compound 48/80 or anti-DNP IgE. When Syzygium aromaticum was added, the level of cAMP in peritoneal mast cells transiently and significantly increased about 47-fold at 10 second compared with that of basal cells. These results provide evidence that anal therapy of Syzygium aromaticum may be beneficial in the treatment of systemic and local immediate-type hypersensitivity by inhibition of histamine release from mast cells in vivo and in vitro.

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A Case of Paradoxical Flare of Pustular Psoriasis after Ustekinumab Therapy (Ustekinumab 치료 후 발생한 고름물집건선의 Paradoxical Flare 1예)

  • Kang, In-Hye;Shin, Min Kyung;Lee, Mu-Hyoung;Jeong, Ki-Heon
    • Korean journal of dermatology
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    • v.56 no.9
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    • pp.548-551
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    • 2018
  • Biologics are the most advanced treatment for psoriasis. Ustekinumab, one of the biologics for psoriasis, is a human monoclonal antibody that binds to the p40 subunit of interleukin-12 and interleukin-23. A 41-year-old woman with a 17-year history of plaque psoriasis and psoriatic arthritis presented with worsening lesions. The patient had previously been treated with a number of topical and systemic medications and narrow band ultraviolet B. However, none of the treatments consistently controlled her disease. Thus, treatment with ustekinumab 45 mg via subcutaneous injection was initiated. Approximately 7 days after the first treatment, she experienced a flare with generalized pustules in her whole body. The condition was controlled with systemic steroid treatment. The patient was subsequently treated with adalimumab, and improvement in her plaque and pustular lesions was noted. Herein, we report a case of psoriasis that flared up after ustekinumab therapy, which was accompanied by a morphological change from plaque to pustular lesions.

Current Status of Systemic Therapy in Hepatocellular Carcinoma (진행성 간세포암종의 전신치료제)

  • Lee, Han Ah;Seo, Yeon Seok
    • Journal of Digestive Cancer Research
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    • v.8 no.1
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    • pp.65-70
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    • 2020
  • Although being one of the major causes of malignancy related death globally, hepatocellular carcinoma (HCC) has not received much attention in respect of novel drug development. Fortunately, several new drugs were found to be effective and tolerable in patients with advanced HCC from a number of phase 3 studies during the recent several years. Novel multi-targeted kinase inhibitors and immune checkpoint inhibitors were approved for clinical use, and combination strategies to maximize the potent of drugs demonstrated promising antitumor activity and safety with high response rate and improved safety profile. The increased number of available agents for HCC will contribute to change of treatment strategies and prognosis of patients with advanced HCC. Still, there is a many critical questions remain unanswered. Currently ongoing trials and future studies will provide better understanding of tumor biology and optimized criteria for patient selection and combination therapies.

Phenytoin Induced Erythema Multiforme after Cranial Radiation Therapy

  • Kazanci, Atilla;Tekkok, Ismail Hakki
    • Journal of Korean Neurosurgical Society
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    • v.58 no.2
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    • pp.163-166
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    • 2015
  • The prophylactic use of phenytoin during and after brain surgery and cranial irradiation is a common measure in brain tumor therapy. Phenytoin has been associated with variety of adverse skin reactions including urticaria, erythroderma, erythema multiforme (EM), Stevens-Johnson syndrome, and toxic epidermal necrolysis. EM associated with phenytoin and cranial radiation therapy (EMPACT) is a rare specific entity among patients with brain tumors receiving radiation therapy while on prophylactic anti-convulsive therapy. Herein we report a 41-year-old female patient with left temporal glial tumor who underwent surgery and then received whole brain radiation therapy and chemotherapy. After 24 days of continous prophylactic phenytoin therapy the patient developed minor skin reactions and 2 days later the patient returned with generalized erythamatous and itchy maculopapuler rash involving neck, chest, face, trunk, extremities. There was significant periorbital and perioral edema. Painful mucosal lesions consisting of oral and platal erosions also occurred and prevented oral intake significantly. Phenytoin was discontinued gradually. Systemic admistration of corticosteroids combined with topical usage of steroids for oral lesions resulted in complete resolution of eruptions in 3 weeks. All cutaneous lesions in patients with phenytoin usage with the radiotherapy must be evoluated with suspicion for EM.

CASE REPORT OF NECROTIZING FASCITIS ON THE CERVICOFACIAL AREA (경부에 발생한 의인성 괴사성 근막염의 증례)

  • Moon, Cheol;Lee, Dong-Keun;Sung, Gil-Hyun;Park, Kyung-Ok;Lee, Jae-Eun;Kwon, Hyuk-Do
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.1
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    • pp.104-111
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    • 1994
  • Necrotizing fascitis is a severe soft tissue infection characterized by extensive necrosis of superficial fascia, suppurative fascitis, vascular thrombosis, widespread undermining of surrounding tissues. Associated systemic problems are widespread undermining of surrounding tissues, Associated systemic problems are common, with chronic alcoholism and diabetes being most prominent. Most commonly this disease presents in the extremities, trunk, and perineum. Necrotizing fascitis of dental origing is rare and its fulminating clinical course is not well documented in the dental literature. The present report is a case of necrotizing fascitis following vital extirpation of the pulp in a patient with uncontrolled diabetes mellitus and liver cirrhosis. Originally throught to be caused by hemolytic streptococcus organism or stphylococcus aureus, advances in anaerobic culturing have shown it to be a synergistic bacterial infection involving aerobic and ovligate anaerobes. it is relatively rare in relatively rare in haea and neck regions. If it was not diagnosed and treated in early stages, necrotizing fascitis can be potentially fetal, with a mortality rate approaching 40%. It's treatment requires early recognition, prompt and aggressive surgical debriment and proper supportive cares, such as, antibiotic therapy, fluid resuscitation and correction of metabolic and electrolyte disorder, resolving of the underlying systemic disease. Recently, we experienced two cases of necrotizing fascitis in cervicofacial region, One patient was 60 years old male with uncontrolled Diabetes Mellitus and other patient was 48 years old with steroid therapy during 30 years. Local surgical wound healing was successful but, patients were died after admission, because of lung abscess, gastrointestinal bleeding, septic shock and respiration hold.

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