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Efficacy of Nilotinib versus Imatinib in Philadelphia Positive Patients with Chronic Myeloid Leukemia in Early Chronic Phase Who Have a Warning Molecular Response to Imatinib

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Journal of Cancer Therapy 2018年第11期9卷 883-897页

作者： amen hamdy zaky aly Ahmed EL Sayed Mohammed Khalifa Esraa Abdallah Abdelkariem Gadallah Department of Medical Oncology South Egypt Cancer Institute Assuit University Assiut Egypt Department of Clinical Oncology Faculty of Medicine Sohag University Sohag Egypt Department of Medical Oncology Sohag Cancer Center Sohag Egypt

Background and Objectives: Chronic myeloid leukemia (CML) accounts for approximately 15% of newly diagnosed cases of leukemia in adults. In this study, the efficacy of nilotinib at 400 mg BID is compared with imatinib at 400 mg BID in CML patients with suboptimal molecular response after at least 12 months of daily dose 400 mg of imatinib therapy. Patients and Methods: This study included a total number of 50 patients, divided into two groups (25 patients each). The first group (Group I): Patients received imatinib at 400 mg BID, second group (Group II): Patients had a suboptimal molecular response to imatinib and received nilotinib at 400 mg BID in early chronic phase. During the two years period of data collection, the primary end included median survival. The secondary end included response rate, type of response, duration of response and progression free survival. Also side effects were recorded. Patients were followed up every month by complete and differential blood counts, liver function test, renal function test and (PCR) every three months for two year. Results: Nilotinib group had significantly higher frequency of major molecular response (MMR) where 23 (92%) patients achieved it while only 16 (64%) patients in Imatinib group achieved MMR (P = 0.01). Nilotinib had better toxicities profile than Imatinib. Conclusion: Both Nilotinib and high dose Imatinib achieved response in CML patients with suboptimal response with rapid and deeper molecular response, better survival outcomes and less side effects in nilotinib.

关键词： Nilotinib Imatinib Philadelphia Positive Chronic Myeloid Leukemia Patients Warning Molecular Response

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Oral Vinorelbine as Switch Maintenance Therapy versus Best Supportive Care in Patients with Advanced Adenocarcinoma Non-Small Cell Lung Cancer EGFR Wild Type

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Journal of Cancer Therapy 2019年第12期10卷 908-914页

作者： amen hamdy zaky Ahmed Refaat Abd Elzaher Ola Nabih Medical Oncology Department South Egypt Cancer Institute Assuit University Assuit Egypt Clinical Oncology Department Faculty of Medicine Assuit University Assuit Egypt

Background: This study was performed to evaluate the efficacy and safety of switch maintenance therapy with oral vinorelbine in advanced non-small cell lung cancer (NSCLC) with adenocarcinoma limited to epidermal growth factor receptor (EGFR) wild type. Materials and Methods: In this single randomized trial, patients with advanced stage (IIIB and IV) NSCLC with adenocarcinoma EGFR wild-type status, treated with 6 cycles of platinum based chemotherapy. Patients did not show progression after first-line chemotherapy were randomly assigned to receive switch maintenance with vinorelbine (80 mg/m2, day 1, 8) (group I) or the best supportive care until disease progression (group II). Results: The median progression free survival (PFS) was 9.7 months for group I versus 5.7 months for group II with statistically significant difference between both groups [HR = 1.15;95% CI 1.19 to 1.49;P value = 0.002], while the median overall survival (OS) was 13.2 months for group I versus 11.9 months for group II with no statistically significant differences between both groups [HR = 1.24;95% CI 1.05 to 1.46;P value = 0. 3]. The patients who received oral vinorelbine had tolerable toxicity profile. Conclusion: Switch maintenance therapy with oral vinorelbine, though improve PFS, did not improve OS in patients with NSCLC with adenocarcinoma EGFR wild type.

关键词： Lung Cancer Maintenance Chemotherapy Vinorelbine EGFR-Wild Type

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Feasibility of Upfront Debulking Surgery versus Neoadjuvant Chemotherapy Followed by Interval Debulking Surgery for Advanced Ovarian Cancer

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Journal of Cancer Therapy 2018年第2期9卷 145-155页

作者： amen hamdy zaky Adel Gabr Doaa Wadie Maximous Ahmed A. S. Salem Amr Farouk Mourad Haisam Atta Marwa Ismail Medical Oncology Department South Egypt Cancer Institute Assiut University Assiut Egypt Surgical Oncology Department South Egypt Cancer Institute Assiut University Assiut Egypt Radiadiagnosis Department South Egypt Cancer Institute Assiut University Assiut Egypt Clinical Oncology Department Faculty of Medicine Assiut University Assiut Egypt

Background: Inappropriately ovarian cancer cannot be detected until an advanced stage. Radical debulking surgery is considered the cornerstone in the management of advanced ovarian cancer pointing to complete tumor resolution. Unless optimal debulking cannot be achieved, these patients gain little benefit from surgery. Neoadjuvant chemotherapy (NACT) has been recommended as a novel therapeutic modality to a diversity of malignant tumors when the disease is not willing to optimal surgical resection at the time of diagnosis or the patient who unfit for aggressive debulking surgery. The purpose of this study is to compare survival in the patient with advanced ovarian cancer (stage III/IV) underwent primary debulking surgery followed by adjuvant chemotherapy (PDS-ACTR) to those who received neoadjuvant chemotherapy followed by interval debulking surgery (NACT-IDS). Results: Neoadjuvant chemotherapy (NACT-IDS) showed significant complete cytoreduction and decreased in surgical morbidity in comparison to primary debulking surgery (PDS-ACTR). NACT-IDS showed significant improvement in progression-free survival (P-value 0.002) and overall survival (P-value 0.03) in comparison to PDS-ACTR. Response to NACT and residual volume were the two independent prognostic factors for overall survival. Conclusion: NACT-IDS for advanced ovarian cancer (III/IV) resulted in higher frequency of complete resection with no residual tumor, less post-operative surgical morbidity and significant increase progression-free survival and overall survival. Both responses to NACT and residual tumor volume were the two independent prognostic factors for survival in ovarian cancer.

关键词： Advanced Ovarian Cancer Debulking Surgery Neoadjuvant Chemotherapy

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