• 제목/요약/키워드: second line therapy

검색결과 110건 처리시간 0.024초

Oxaliplatin, 5-Fluorouracil and Leucovorin (FOLFOX-4) as First Line Chemotherapy in Elderly Patients with Advanced Gastric Cancer

  • Haghighi, Shirin;Kasbkar, Hadi;Esmaeilpour, Keihan;Yasaei, Mehrdad
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권7호
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    • pp.3277-3280
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    • 2016
  • Background: Gastric cancer is considered the fourth most common cancer and second most common cause of cancer-related mortalities worldwide. Gastric cancer develops more frequently among elderly. The oxaliplatin/5FU/leucovorin (FOLFOX) regimen has shown a notable activity against gastric cancer. Aim: To evaluate the responses and complications of FOLFOX-4 regimen as first line chemotherapy in elderly patients with advanced gastric cancer. Materials and Methods: From October 2014 to November 2015, a total of 21 patients with metastatic or local AGC (advanced gastric cancer) were analyzed. All patients were administered a FOLFOX-4 regimen consisting of a 2h infusion of oxaliplatin $85mg/m^2$ (day 1), continuous infusion of $1000mg/m^2$ 5-Fu in 24h., and leucovorin $200mg/m^2$ in 2h infusion as a first-line chemotherapy. Results: A total of 18 patients were assessable for efficacy and toxicity. One of 18 patients achieved a complete response, and 12 had partial responses, giving an overall response rate of 72.6%. Three (16%) patients demonstrated stable disease and 2 (12%) progression. The median progression free survival was 7.3 months, and the median overall survival was 11.9 months. One patient had grade 3 neuropathy. No other grade 3 or 4 NCI-CTC were seen. Conclusions: The FOLFOX-4 regimen used in our study was both active and acceptable for AGC in elderly patients as neoadjuvant and main therapy.

중등학교 조리실습에 대한 현황과 효율화방안 (The Present Situtation and Efficient Way of Cooking Practice in the Middle and High School)

  • 김정미;주정숙
    • 한국가정과교육학회지
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    • 제1권1호
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    • pp.53-62
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    • 1989
  • Cooking practice is keenly related to not only the betterment of family health but to the improvement of dietary life. Cooking is a kind of practical skill and one is skill in it by repeated practice. The aim of cooking practice in school is to fix cooking method practically and scientifically, to acquire cooking skill. To achieve this aim there are many unrecognized or unsolved problems in the first-line schools. The problems and efficient ways of cooking practice in the middle and high school are as follows; 1. The aim of cooking practice: It should be first of all remembered that the practice is so practical that the knowledge and skill of cooking should be related to the future domestic life. Second, the practice should be able to serve the communal and national life by scientifying and improving life. 2. The content of the practice: First, it should be so arranged step by step that the content of each year should not be repeated. Second, the ratio of Korean cooking practice should be increased and the material of the practice should be chosen in consideration of the peculiarity of the community, seasons and economical problems so that it may be applied to the very day life. Third, to improve dietary life, the practice should be a way of the simplification of dietary life, of the nutritional efficiency. Forth, for the betterment of physical condition of the family the practice should involve balanced dietary plans and dietary therapy. 3. Teaching method: First, the practice should be scientific and comprehensive in consideration of not only cooking skills but also knowledge of nutrition. Second, micro-class system should be adopted, and practice labor should be allotted each student to develop cooperative attitude and the sense of responsibility. Third, in addition to the practice conducted in a body, comparative cooking, applicable cooking and experimental ability and the content of the text. Fourth, teachers should let the students examine and find problems by bringing them to a focus on the basis of theory. 4. Administration method: First, the practice schedule should be planned that a class has practices at least more than twice a semester. Second, two hours of class should be continued without cessation after beforehand survey and theory study. Third, facilities and utensils for practice should be enlarged. That is, cooking practice rooms, tools, utensils should be prepared. Fourth, enough cost of practice should be secured. The above mentioned points show the present situation and problems with which cooking practice teaching is confronted. In order to normalize cooking practice teaching, the first-line schools should give the above mentioned problems their careful consideration and improve the present situation so that efficient, creative, practical cooking practice will be possible.

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알러지 비염 환자 22례에 대한 임상적 고찰 (Clinical Study in 22 Cases of Patients for Suffering Allergic Rhinitis)

  • 송재진;김동희;박양춘;김철중
    • 동의생리병리학회지
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    • 제16권2호
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    • pp.397-402
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    • 2002
  • Clinical studies were done treated with aroma therapy in 22cases of patients for suffering allergic rhinitis. who were treated at Dept of Oriental respiratory internal medicine in the Hospital of Taejeon University from January 2001 to May 2001. The results were as follows. 1. In distribution of sex & age. 45.5% of them were man, and 54.5% of them were woman. Of those who were attached, 2. In distribution of occupation, 59% of them were student, 18% of them were housewife, 18% of them were white color, 9% Of them were blue color. 3. In distribution of the period of the clinical history, under six months was 32%, under 1 year was 9%, under 3 years was 27%, over 3 years was 32%. 4. In distribution of the seasonal contributing factor, most of them were perenial allergic rhinitis, others generally started in spring or winter. 5. In distribution of past history, 59% of them are none, 18% of them are asthma, 18% of them are atopic dermatitis, 5% of them are allergic dermatitis. 6. In distribution of family history, 46% of them are none, 27% of them are sibling line, 18% of them are paternal line, 9% of them are maternal line. 7. In distribution of symptom, the ratio of sneezing was 90%, nasal discharge was 81 %, nasal obstruction was 46%, pruritus was 41 %, headache was 31%, asthma was 22%, digestion disorder was 18%, tears was 9%, nosebreeding was 5%. 8. In distribution of diagnosis in descending order, wind-cold evil was 5%, spleen-lung energy asthnia was 31 %, lung-kidney asthnia was 64%. 9. In distribution of Herb medicine treatment, Tonggyu-tang was the most, the second was hyunggaiyunyo-tang. 10 In emotional change of patients aroma-therapy, only 14% of them felt good. 11. The total remedial value of the 22 patients was revealed 32.9%. 12. In proportion to grow older, the remedial value were decreased. 13. In proportion to the period of the clinical history was longer, the remedial value were decreased.

Early or Late Gefitinib, Which is Better for Survival? - Retrospective Analysis of 228 Korean Patients with Advanced or Metastatic NSCLC

  • Kim, Dong-Gun;Kim, Min-Kyoung;Bae, Sung-Hwa;Koh, Sung-Ae;Park, Sung-Woo;Kim, Hyun-Je;Kim, Myung-Jin;Jang, Hyo-Jin;Lee, Kyung-Hee;Lee, Kwan-Ho;Chung, Jin-Hong;Shin, Kyung-Chul;Ryoo, Hun-Mo;Hyun, Myung-Soo
    • Journal of Yeungnam Medical Science
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    • 제28권1호
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    • pp.31-44
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    • 2011
  • Background: The optimal timing of treatment with EGFR-tyrosine kinase inhibitors (EGFR-TKI) in NSCLC patients has not yet been determined. Methods: We separated 228 patients with advanced /metastatic NSCLC treated with gefitinib into an early gefitinib group (patients who received gefitinib as first- or second-line treatment) and a delayed gefitinib group (patients who received gefitinib as third or fourth-line treatment) and attempted to determine whether the timing of gefitinib treatment affected clinical outcomes. Results: Median overall survival (OS), progression free survival (PFS), and median OS from first-line treatment of advanced/metastatic disease (OSt) for 111 patients in the early gefitinib group were 6.2 months, 3.3 months, and 11.6 months. However, median OS, PFS, and OSt for 84 patients in the delayed gefitinib group were 7.8 months, 2.3 months, and 22.7 months. No differences in OS and PFS were observed between the 2 groups. However, OSt was significantly longer in the delayed gefitnib group. Timing of gefitinib therapy was one of the independent predictors of OSt. Hb ${\geq}$ 10 g/dl, and having never smoked, and ECOG performance status ${\leq}1$ were independent predictors of better PFS. Conclusion:Deferral of gefitinib therapy in patientswith advanced ormetastatic NSCLC may be preferable if they are able to tolerate chemotherapy.

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침습성 아스페르길루스증의 치료 목적으로 voriconazole을 단독으로 투여받는 폐이식 환자에서 voriconazole 약물혈중농도 모니터링의 유효성 검증 (Validation of Voriconazole Therapeutic Drug Monitoring in Lung Transplant Recipients Receiving Voriconazole alone for Treatment of Invasive Aspergillosis)

  • 손유정;이경아;조주희;김재송;손은선;박무석
    • 한국임상약학회지
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    • 제29권2호
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    • pp.89-100
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    • 2019
  • Background: Invasive aspergillosis (IA) is associated with high morbidity and mortality, particularly among immunocompromised patients, such as lung transplant recipients. Voriconazole, the first-line therapy for IA, shows a non-linear pharmacokinetic profile and has a narrow therapeutic range. Careful and appropriate administration is necessary, primarily because it is used for critically ill patients; however, the clinical usefulness of therapeutic drug monitoring (TDM) has not been sufficiently verified. Therefore, in this study, we validated the safety and efficacy of voriconazole TDM in lung transplant recipients receiving only voriconazole for IA treatment. Methods: The electronic medical records of lung transplant recipients (${\geq}19$ years of age) administered only voriconazole for > 7 days for treatment of IA from June 1, 2013 to May 31, 2018 were analyzed retrospectively. Results: Among the 54 patients, 27 each were allocated to TDM and non-TDM groups, respectively. There were no significant differences in patient characteristics between the two groups except for ICU-hospitalization status. Of the TDM group patients, 81.5% needed adjustment of voriconazole dosage because the levels were out of target range. Comparison of two groups showed that treatment response was higher throughout treatment and switching rates of second-line agents were significantly lower in the TDM group, but it was insufficient to confirm safety improvements through voriconazole TDM. Conclusions: Considering that the treatment response tended to be higher and the rates of switching to second-line antifungal agents were lower in the TDM group, voriconazole TDM may increase the therapeutic effect on IA in lung transplant patients.

Efficacy of Exemestane After Nonsteroidal Aromatase inhibitor Use in Metastatic Breast Cancer Patients

  • Kim, Sun-Hye;Park, In-Hae;Lee, Hye-Won;Lee, Keun-Seok;Nam, Byung-Ho;Ro, Jung-Sil
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권3호
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    • pp.979-983
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    • 2012
  • Background : Previous studies have suggested a lack of complete cross-resistance between steroidal (exemestane) and non-steroidal aromatase inhibitors (nSAI). Methods : Eighty-eight metastatic breast cancer (MBC) patients who received 25 mg of exemestane orally once a day at the National Cancer Center, Korea, between 2003 and 2009, were reviewed retrospectively. All patients had received nSAI for metastatic disease prior to exemestane therapy. Results : The median age was 52 years (range, 33-79), and 13 (14.8%) patients were premenopausal who concomitantly received GnRH agonist. Exemestane was given as a second- (80.7%) or third-line (19.3%) hormone therapy. The clinical benefit (CB) rate (complete response + partial response + stable disease ${\geq}$ 24 weeks) was 30.7%, with a median CB duration of 10.0 months (range, 6.3-78.7). The median progression-free survival (PFS) was 3.0 months (95% confidence interval [CI], 1.99-4.01) and the overall survival (OS) 21.5 months (95% CI, 17.96-25.04), with a median followup of 50.3 months. Patients who achieved CB had longer OS than those patients who did not (29.6 vs 17.9 months; P=0.002). On univariate analysis of predictive factors, patients who had achieved CB from previous nSAI tended to show lower CB rate (24.6% vs 44.4%, respectively; P=0.063) and shorter PFS (2.8 vs 4.8 months, respectively; p=0.233) than patients who had not. Achieving CB from previous nSAI became independent predictive factor for CBR to exemestane on multivariable analysis (Odds ratio = 2.852, P = 0.040). Conclusions : Exemestane after nSAI failure was effective in prolonging CB duration. The drug's efficacy seemed to be inferior in patients who had benefit from previous nSAI use.

전이성 췌장암의 치료 (Treatment for Metastatic Pancreatic Cancer)

  • 이보영;우상명
    • Journal of Digestive Cancer Research
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    • 제6권2호
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    • pp.64-68
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    • 2018
  • Pancreatic ductal adenocarcinoma is a dismal prognosis and 5th leading cause of cancer related death in Korea. A large proportion of patients are diagnosed at advanced or metastatic stage. Therefore systemic chemotherapy has become the mainstay of treatment for pancreatic cancer. For most patients advanced or metastatic pancreatic cancer that has a good Eastern Cooperative Oncology Group performance status (ECOG PS) 0 or 1, we can recommend for FOLFIRINOX (leucovorin, 5-fluorouracil [5-FU], irinotecan and oxaliplatin) and gemcitabine plus nanoparticle albumin-bound paclitaxel (nab-paclitaxel). Currently, steps towards improved therapeutic efficacy of palliative chemotherapy have been made by introducing these regimens. For patients with an ECOG PS of 2, gemcitabine monotherapy or S1 alone is recommended. The second-line therapy for patients initially treated with gemcitabine-based chemotherapy includes provide FOLFOX (leucovorin, 5-FU, and oxaliplatin), capecitabine plus oxaliplatin, and 5-FU plus liposomal irinotecan. The gemcitabine-based chemotherapy is a reasonable choice for patients treated with FOLFIRINOX. Currently, studies on selecting patients for biomarkers related to molecular biologic features of tumors are underway for the realization of precise medicine, and the development and verification of preclinical models for the development of new therapeutic agents are being carried out continuously.

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Late Occurrence of Multiple Bone Metastasis in Patient with Well Controlled Advanced Pancreatic Cancer

  • Min Cheol Kim;Da Eun Jeong;Joon Hyuk Choi;Tae Nyeun Kim
    • Journal of Digestive Cancer Research
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    • 제4권1호
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    • pp.39-42
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    • 2016
  • A 67-year-old male was admitted due to abdominal pain. Abdominal CT scan performed in a local clinic showed about 2 cm sized pancreatic tail mass with extensive liver and multiple regional lymph node metastasis. Histology of liver biopsy revealed poorly differentiated adenocarcinoma. He underwent chemotherapy with gemcitabine and erlotinib for 5 cycles followed by 8 cycles of second line chemotherapy with 5-fluorouracil and cisplatin. At 12 months after diagnosis, follow-up abdominal CT scan revealed marked reduction of tumor mass in the liver and pancreas with small residual tumor. After one month of last chemotherapy, he complained radiating pain along left leg. Blood chemistry revealed isolated elevation of alkaline phosphatase (ALP) and multiple bone metastasis were demonstrated in bone scan. Palliative radiation therapy to pelvic bone was performed for the relief of bone pain. The prognosis of advanced pancreatic cancer is extremely poor. We report late occurrence of multiple bone metastasis in a patient with well controlled advanced pancreatic cancer with chemotherapy.

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A Phase II Study on Continuous Infusional Paclitaxel and 5-Fu as First-line Chemotherapy for Patients with Advanced Esophageal Cancer

  • Gu, Ming;Li, Su-Yi;Huang, Xin-En;Lin, Yan;Cheng, Hong-Yan;Liu, Lin
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권11호
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    • pp.5587-5591
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    • 2012
  • Objective: This study was performed to evaluated the efficacy and safety of continuous infusional paclitaxel and 5-Fu as first-line chemotherapy in patients with advanced esophageal squamous cell cancer (ESCC). Methods: A total of 22 patients with advanced esophageal squamous cell cancer with no indications for surgery and radiation therapy, or recurrent patients were enrolled from October 2008 to November 2010. All were treated with PTX 20 $mg/m^2$ was administered through a 16 hours continuous intravenous infusion on days 1 to 3, 8 and 9. DDP 3.75 $mg/m^2$ was given on days 1 to 4 and 8 to 11, continuous infusional 5-FU over 24-hours on days 1 to 5 and 8 to 12 at a dose of 375 $mg/m^2$, and folacin 60 mg orally synchronized with 5-Fu. The treatment was repeated every 21 days for at least two cycles. Results: 22 cases of all enrolled patients could be evaluated for the effect of treatment: 2 cases were CR, 9 cases PR, 5 cases SD and 2 cases PD, giving an overall response rate of 68.2%(15/22). The median time to progression was 7.0 months. The adverse reactions related to chemotherapy were tolerable; the most common toxic effects were marrow depression, alopecia, and fatigue. Conclusion: Low-dose continuous infusional PTX over 16-hours and 5-fu over 24-hours is a promising regimen with good tolerability in treating patients with advanced esophageal squamous cell cancer.

MicroRNA-214 Regulates the Acquired Resistance to Gefitinib via the PTEN/AKT Pathway in EGFR-mutant Cell Lines

  • Wang, Yong-Sheng;Wang, Yin-Hua;Xia, Hong-Ping;Zhou, Song-Wen;Schmid-Bindert, Gerald;Zhou, Cai-Cun
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권1호
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    • pp.255-260
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    • 2012
  • Patients with non-small cell lung cancer (NSCLC) who have activating epidermal growth factor receptor (EGFR) mutations derive clinical benefit from treatment with EGFR-tyrosine kinase inhibitors ((EGFR-TKIs)-namely gefitinib and erlotinib. However, these patients eventually develop resistance to EGFR-TKIs. Despite the fact that this acquired resistance may be the result of a secondary mutation in the EGFR gene, such as T790M or amplification of the MET proto-oncogene, there are other mechanisms which need to be explored. MicroRNAs (miRs) are a class of small non-coding RNAs that play pivotal roles in tumorigenesis, tumor progression and chemo-resistance. In this study, we firstly successfully established a gefitinib resistant cell line-HCC827/GR, by exposing normal HCC827 cells (an NSCLC cell line with a 746E-750A in-frame deletion of EGFR gene) to increasing concentrations of gefitinib. Then, we found that miR-214 was significantly up-regulated in HCC827/GR. We also showed that miR-214 and PTEN were inversely expressed in HCC827/GR. Knockdown of miR-214 altered the expression of PTEN and p-AKT and re-sensitized HCC827/GR to gefitinib. Taken together, miR-214 may regulate the acquired resistance to gefitinib in HCC827 via PTEN/AKT signaling pathway. Suppression of miR-214 may thus reverse the acquired resistance to EGFR-TKIs therapy.