Saturday, January 07, 2012
open access: As-Needed Morphine: Yes, but at What Dose and at What Interval?
..........Given the above-illustrated opinion conflicts, with a 10-fold variation in dose and a six-fold variation in timing interval, a search through published sources was conducted, mirroring a wide range of combinations regarding recommendations for both the PRN narcotic doses and the appropriate intervals at which they should be repeated in the event of continued pain. Data from 22 review articles and texts that review guidelines for the treatment of cancer pain, presented in Table 3, 1-22 provided a 20-fold variation in recommended narcotic doses (1% to 20% of daily doses) along with scattered opinions, or no direction, regarding appropriate dose intervals for potential repeat doses...............
.............Specific guidelines for prescribing opioids are needed to allow practitioners to feel comfortable in administering these medications. These guidelines must include how to determine the appropriate dose for breakthrough pain, and the appropriate and safe interval that will allow for rapid pain relief, but maintain patient safety. On completion of this project, the 2004 National Comprehensive Cancer Network guidelines for cancer pain were found.27 These guidelines come to similar conclusions that recommend the use of intravenous narcotic doses of 10% to 20% of the daily intravenous morphine equivalent and the use of repeat doses at 15-minute intervals, if pain is still present. The information from this project might be used to facilitate continuous-improvement projects at individual institutions. Such a project is in process locally. The incorporation of this new information regarding PRN narcotic use should better serve the needs of patients.
When a Decision Must Be Made: Role of Computer Modeling in Clinical Cancer Research
Every day, multidisciplinary oncology teams make dozens of treatment decisions that may have a tremendous impact on a patient's survival and quality of life. Made with the best of intentions, these decisions are informed by basic science and clinical research findings, clinical experience, and health policy. All too often, results from the gold standard of clinical trial research, a randomized controlled trial (RCT), that fit the specific details of the patient's situation are not available to guide these decisions...........
open accerss: Exposure–response relationship of AMG 386 in combination with weekly paclitaxel in recurrent ovarian cancer and its implication for dose selection
Abstract
Purpose
Blogger's Note: stats removed for ease of reading (eg. CI):
Progression-free survival (the primary endpoint) in the phase 2 study was 7.2 months in the AMG 386 10 mg/kg QW dose group and 5.7 months in the 3 mg/kg group, compared with 4.6 months for placebo. Results from Tarone’s test and dose-exposure analyses suggested a dose–response effect for PFS across the three arms....
To characterize exposure–response relationships of AMG 386 in a phase 2 study in advanced ovarian cancer for the facilitation
of dose selection in future studies.
.....AMG 386 (previously referred to as 2xCon4) is an investigational peptide-Fc fusion protein that mediates antiangiogenic effects
by potently and selectively inhibiting the interaction of angiopoietin-1 and angiopoietin-2 with Tie2 [16].
Primary endpoint results from a phase 2 study of AMG 386 in combination
with weekly paclitaxel for the treatment of recurrent
ovarian cancer showed longer median progression-free
survival (PFS) for patients receiving AMG 386 at 10 and 3 mg/kg once
weekly (QW), compared with placebo (the data are
described in the primary analysis [17]). Additional dose-exposure analyses suggested a dose–response effect across treatment arms......
Blogger's Note: stats removed for ease of reading (eg. CI):
Progression-free survival (the primary endpoint) in the phase 2 study was 7.2 months in the AMG 386 10 mg/kg QW dose group and 5.7 months in the 3 mg/kg group, compared with 4.6 months for placebo. Results from Tarone’s test and dose-exposure analyses suggested a dose–response effect for PFS across the three arms....
not yet recruiting: Integrated Molecular Profiling in Advanced Cancers Trial - breast, non-small cell lung, colorectal, ovarian, phase 1 (patients) - Full Text View - ClinicalTrials.gov UHN (Toronto)
Advanced cancer
Purpose
Advanced breast, non-small cell lung, colorectal and ovarian cancers; as well as patients who are phase I trial candidates
Substantial progress has been made in the treatment of cancer
through the use of targeted therapies, but what works for one patient
might not work for another patient. Certain drugs are now being
developed that target specific molecules in the body that are believed
to be part of the disease.
Biomarkers are specific characteristics of the cancer
that may help provide prognostic information (i.e. how well patients
will be regardless of the treatments given) or help predict sensitivity
or resistance to a specific treatment.
The study will collect archival tumor samples (previously collected biopsy or surgical tumor samples) to provide biomarker data about a patient's cancer,
in order to help their physicians to identify which clinical trials of
molecularly targeted therapies may be most appropriate for the patient
in the future.
Integrated Molecular Profiling in Advanced Cancers Trial (IMPACT)
This study is not yet open for participant recruitment.
Verified on January 2012 by University Health Network, Toronto
First Received on January 4, 2012.
Last Updated on January 5, 2012
History of Changes
| Sponsor: | University Health Network, Toronto |
|---|---|
| Collaborator: | Princess Margaret Hospital, Canada |
| Information provided by (Responsible Party): | University Health Network, Toronto |
| ClinicalTrials.gov Identifier: | NCT01505400 |
Prognostic significance of L1CAM in (serous) ovarian cancer and its role in constitutive NF-κB activation
Conclusions:
L1CAM expression contributes to the invasive and metastatic phenotype of serous ovarian carcinoma. L1CAM expression and shedding in the tumor microenvironment could contribute to enhanced invasion and tumor progression through increased IL-1β production and NF-κB activation.
open access: Development and validation of a prediction index for hand-foot skin reaction in cancer patients receiving sorafenib
Background: This study describes a repeated measures prediction index to identify patients at high risk of ≥ grade 2 hand-foot skin reaction (HFSR) before each week of sorafenib therapy.
Results: Pretreatment white blood cell count, female gender, good performance status, presence of lung and liver metastases and number of affected organs were predictors for ≥ grade 2 HFSR.
U.S. - Planned Cooperative Group Merger Is Generating Concern - NCI clinical trials - gynecologic oncologists, funding, more common cancers, GOG....
A proposed overhaul of the National Cancer Institute’s clinical trials system has created anxiety among gynecologic researchers who fear projects in women’s cancer will be diminished in a scramble for funding with more common malignancies.......
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