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Mitomycin C and capecitabine: An additional option as an advanced line therapy in patients with metastatic colorectal cancer

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World Journal of Gastrointestinal Oncology 2023年第11期15卷 1913-1924页

作者： Gil Mullin Michal Sternschuss Yosef Landman aaron sulkes Baruch Brenner Faculty of Medicine Tel-Aviv UniversityTel Aviv 6997801Israel Institute of Oncology Davidoff Cancer CenterBeilinson CampusPetah-Tikva 4941492Israel

BACKGROUND In recent years survival of patients with metastatic colorectal cancer(mCRC),though still limited,has improved significantly;clearly,when the disease becomes refractory to standard regimens,additional treatment options are *** have shown that mitomycin C(MMC),an antitumor antibiotic,and capecitabine,a precursor of 5-fluorouracil,may act synergistically in *** efficacy of MMC/capecitabine has been demonstrated in the first-line setting,but only a few small studies have tested it in the advanced-line setting,with contradictory *** a median of 2 MMC/capecitabine cycles(range 0.5-9.0).Thirty-four patients(28.6%)experienced grade≥3 toxicity,including 2(1.7%)with grade 4;there was no drug-related *** objective response rate was 0.8%,and the disease control rate,24.4%.Median progression-free survival(PFS)was 2.1 mo(range 0.2-20.3),and median overall survival,4.8 mo(range 0.2-27.5).The 6-month overall survival rate was 44%;8.7%of patients remained *** associated with longer PFS were lower gamma-glutamyl transferase level(P=0.030)and primary tumor location in the left colon(P=0.017).Factors associated with longer overall survival were lower gamma-glutamyl transferase level(P=0.022),left-colon tumor location(P=0.044),low-to-moderate histological grade(P=0.012),Eastern Cooperative Oncology Group performance status 0-1(P=0.036),and normal bilirubin level(P=0.047).CONCLUSION MMC/capecitabine is an active,available,and relatively safe regimen for use beyond standard lines of therapy in *** clinical and laboratory parameters can identify patients more likely to benefit.

关键词： Colorectal cancer Metastatic cancer Chemotherapy Mitomycin C/Capecitabine Advanced line treatment

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Octogenarian patients with colorectal cancer: Characterizing an emerging clinical entity

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World Journal of Gastroenterology 2017年第8期23卷 1387-1396页

作者： Hadar Goldvaser Noa Katz Shroitman Irit Ben-Aharon Ofer Purim Yulia Kundel Daniel Shepshelovich Tzippy Shochat aaron sulkes Baruch Brenner Institute of Oncology Davidoff Cancer CenterBeilinson HospitalRabin Medical Center Sackler Faculty of Medicine Tel Aviv University Division of Medical Oncology and Hematology Princess Margaret Cancer Centre and the Department of MedicineUniversity of Toronto Department of Medicine A Beilinson HospitalRabin Medical Center Statistical Consulting Unit Beilinson HospitalRabin Medical Center

To characterize colorectal cancer (CRC) in octogenarians as compared with younger *** single-center, retrospective cohort study which included patients diagnosed with CRC at the age of 80 years or older between 2008-2013. A control group included consecutive patients younger than 80 years diagnosed with CRC during the same period. Clinicopathological characteristics, treatment and outcome were compared between the groups. Fisher’s exact test was used for dichotomous variables and χ2 was used for variables with more than two categories. Overall survival was assessed by Kaplan-Meier survival analysis, with the log-rank test. Cancer specific survival (CSS) and disease-free survival were assessed by the Cox proportional hazards model, with the Fine and Gray correction for non-cancer death as a competing *** study included 350 patients, 175 patients in each group. Median follow-up was 40.2 mo (range 1.8-97.5). Several significant differences were noted. Octogenarians had a higher proportion of Ashkenazi ethnicity (64.8% vs 47.9%, P < 0.001), a higher rate of personal history of other malignancies (22.4% vs 13.7%, P = 0.035) and lower rates of family history of any cancer (36.6% vs 64.6%, P < 0.001) and family history of CRC (14.4% vs 27.3%, P = 0.006). CRC diagnosis by screening was less frequent in octogenarians (5.7% vs 20%, P < 0.001) and presentation with performance status (PS) of 0-1 was less common in octogenarians (71% vs 93.9%, P < 0.001). Octogenarians were more likely to have tumors located in the right colon (45.7% vs 34.3%, P = 0.029) and had a lower prevalence of well differentiated histology (10.4% vs 19.3%, P = 0.025). They received less treatment and treatment was less aggressive, both in patients with metastatic and non-metastatic disease, regardless of PS. Their 5-year CSS was worse (63.4% vs 77.6%, P = 0.009), both for metastatic (21% vs 43%, P = 0.03) and for non-metastatic disease (76% vs 88%, P = 0.028).CONCLUSI

关键词： Colon Rectum Elderly Octogenarian Age

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Cisplatin-Induced Posterior Reversible Encephalopathy Syndrome—Brief Report and Review of the Literature

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Journal of Behavioral and Brain Science 2012年第1期2卷 97-101页

作者： Limor Amit Irit Ben-Aharon Thomas Tichler Edna Inbar aaron sulkes Salomon M. Stemmer Department of Radiology Rabin Medical Center Beilinson Campus Petah-Tiqva Israel Institute of Oncology Davidoff Center Rabin Medical Center Beilinson Campus Petah-Tiqva Israel The Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel

Cisplatin is one of the most broadly used chemotherapeutic agents. Several central nervous system toxicities have been attributed to this agent, among which is a rare clinicoradiological condition referred to as posterior reversible leukoen-cephalopathy syndrome (PRES) or reversible posterior leukoencephalopathy syndrome (RPLS). PRES is characterized by subacute onset of headache, visual disturbances, confusion, seizures and rarely, coma. This usually reversible syn-drome was associated in the past mainly with hypertension. Several reports have associated the syndrome with several immunosuppressive and chemotherapeutic agents suggesting a disruption of the blood brain barrier due to direct damage to the endothelium and vasogenic edema. This syndrome is readily diagnosed with Computed Tomography (CT) or Magnetic resonance imaging (MRI) studies and quick withdrawal of the causative agent in conjunction with supportive care including rapid hypertension control and reduction of elevated intracranial pressure when needed, usually reverse the neurological symptoms with minimal or even no sequela within several days. In this brief report and review of the literature we describe two cases of PRES in two female patients that occurred a few days after receiving Cisplatin-based chemotherapy. We discuss the clinical presentation, diagnosis and treatment of this syndrome by reviewing the literature. The escalating number of clinical reports of PRES merit further studies of the mechanism of toxicity, appropriate treatment and awareness of physicians to this life threatening

关键词： PRES RPLS Encephalopathy Cisplatin Hypertension

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