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Assessment of maintenance oral Etoposide following induction chemotherapy with gemcitabine and cisplating in chemonaive extensive small cell lung cancer

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The Chinese-German Journal of Clinical Oncology 2010年第10期9卷 569-573页

作者： lobna r ezz elarab Manal M Abdel Wahab Menha Swellam Zakaria Mostafa radiation Oncology&Nuclear Medicine Faculty of MedicineAin Shams University Biochemistry Department Genetic Engineering and Biotechnology Research DivisionNational Research Center Abbasia Chest Hospital

Objective： The aim of our study was to evaluate the response and tolerability to treatment when using gemcitabine-cisplatin combination （GC）, followed by maintenance therapy of oral etoposide for non-progressive patients in trial to improve progression free survival and overall survival. Methods： Thirty nine patients with extensive small cell lung cancer （SCLC） and ECOG ≤ 2 received 4 cycles of chemotherapy consisting of gemcitabine 1000 mg/m^2 （day 1 and 8） cisplating 75 mgim2 （day 1） every three weeks. Twenty seven non-progressive patients after 4 cycles of chemotherapy were randomized either to receive oral etoposide 50 mg/m^2 for consecutive 15 days every 3 weeks vs no therapy for three months or progression. results： Thirty nine eligible patients treated with GC, 27 non progressive patients were subsequently randomized to oral etoposide or observation. Median follow-up was 18 months. The overall response rate to GC was 59% and toxicity to oral etoposide was mild. There was improvement in median progression-free survival （PFS） favoring the maintenance arm of 10.5 months vs 7 months （P 〈 0.05）. Median overall survival （OS） had improved towards the maintenance arm （13 vs 11.5 months）. One year survival （60% vs 24%）, 18 months survival （20% vs 5%） favoring the maintenance. Multivariate analysis revealed that age, performance status, maintenance therapy, and response to treatment were independent prognostic factors for OS. Age, maintenance therapy, and response to treatment were highly significant factors for PFS. Conclusion： Gemcitabine-cisplatin is an effective and tolerable regiment for extensive disease of SCLC. The addition of 3 months of oral etoposide in non progressing patients was associated with a significant improvement of PFS and longer OS.

关键词： gemcitabine cisplatin small cell lung cancer

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维普期刊数据库

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Skeletal events of Anastrozole versus Tamoxifen on bone mineral density and bone biomarker osteocalcin in postmenopausal women with early breast cancer

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The Chinese-German Journal of Clinical Oncology 2010年第10期9卷 574-578页

作者： lobna r ezz elarab Menha Swellam Manal M Abdel Wahab Karima M Maher radiation Oncology & Nuclear Medicine Faculty of MedicineAin Shams University Biochemistry Department Genetic Engineering and Biotechnology Research DivisionNational Research Center radiology Department Faculty of MedicineAin Shams University

Objective： Postmenopausal women with breast cancer are at increased risk of bone loss because of age related estrogen deficiency face which accelerated with the use of aromatase inhibitors （AIs）. We aimed to study the effect on bone mineral density （BMD） and bone formation biomarker osteocalcin level in postmenopausal breast cancer patients, for the first three years of adjuvant hormonal treatment of both groups Tamoxifen versus Anastrozol. Methods： One-hundered postmenopausal breast cancers were prospectively randomized to receive either Tamoxifen 20 rag/day （n = 50） or Anastrozole 10 mg （n = 50）. Both BMD and osteocalcin were assessed initially before treatment and then at regular intervals for both groups. results： Use of Tamoxifen was associated with significant annual decrease in osteocalcin （P = 0.001）, whereas Anastrozole group had gradual increase of the annual levels （P 〈 0.01）. BMD decreased significantly in Anastrozole versus Tamoxifen groups （2.6% vs. 0.4%, P 〈 0.001）. Osteoporosis T 〈 -2.5 was reported significantly higher in Anastrozole group （P 〈 0.01）. Women with initial osteopenia in Anastrozole group showed significant decrease in BMD （P 〈 0.05）. The addition of bisphosphonate for patients with early osteoporosis markedly improved both osteocalcin level and BMD. Conclusion： Tamoxifen preserves BMD in postmenopausal breast cancer patients, whereas Anastrozole accelerates age associated fall in BMD especially in the first year of therapy, moreover, the addition of bisphosphonate can help to decrease the skeletal related events associated with treatment to ensure better quality of life with treatment.

关键词： Anastrozole Tamoxifen, bone mineral density (BMD) breast cancer osteocalcin

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Capecitabine plus cisplatin treatment in patients with advanced hepatocellular carcinoma

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The Chinese-German Journal of Clinical Oncology 2010年第12期9卷 718-723页

作者： Manal M Abdel Wahab lobna r ezz elarab Mohamed A ezz elarab radiation Oncology and Nuclear Medicine Department Faculty of MedicineAin Shams University National Hepatology and Tropical Medicine research Institute

Objective： Hepatocellular carcinoma （HCC） is the sixth most common cancer in the world and the third leading cause of cancer related death globally. Parentral treatment of Egyptian patients of bilharziasis contributed to the high incidence of viral hepatitis, and subsequently liver cirrhosis and HCC. CapecJtabJne plus cJsplatJn protocol was evaluated regarding the efficacy and safety in patients with advanced HCC as first line chemotherapy. Methods： One hundred patients with advanced HCC were randomized to receive either capecitabine （1000 mg/m2） twice daily for fourteen days plus intravenous cisplatin （60 mg/m2） on day one to be repeated every three weeks with a maximum of six cycles or placebo （phase III trial）. results： Baseline characteristics were comparable in both groups. According to Barcelona Clinic Liver Cancer Staging System, stage C was the most predominant （82% vs. 75%） in both groups. Median OS was 12 months versus 10 months in favor of the treated group （P value 〈 0.05）. Median TTP was significantly higher in the chemotherapy group （7 months vs. 4.5 months） as well as disease control rate （40% vs. 29%）, no patient had achieved complete response. Grade 3 toxicity was more pronounced in the treatment group, as regards vomiting and diarrhea （10% vs. 2%）, neurotoxicity （6% vs. 2%）, elevation of aminotransferase and bilirubin （9.8% vs. 4.9%）, hand and foot syndrome reaction was recorded only in chemotherapy group. Conclusion： Capecitabine plus cisplatin regimen showed modest antitumor activity with tolerable toxicity in patients with advanced HCC. Moreover, because of the significantly prolonged time to progression, we demand further attention to this convenient, outpatient, and economic profile based chemotherapy protocol.

关键词： capecitabine cisplatin hepatocellular carcinoma (HCC) bilharziasis liver cirrhosis

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BrCA1 and EGFr as prognostic biomarkers in triple negative metastatic breast cancer patients treated with cisplatin plus docetaxel

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The Chinese-German Journal of Clinical Oncology 2010年第12期9卷 700-707页

作者： lobna r ezz elarab Manal El Mahdy Khaled Abdel Karim Clinical Oncology Department Faculty of MedicineAin Shams University Pathology Department Faculty of MedicineAin Shams University

Objective： The triple negative （TN） metastatic breast cancer （MBC） patients are known to have worse prognosis, shorter progressive free survival （PFS）, and overall survival （OS）, that mandates using aggressive chemotherapy regimens. This phase II study aimed at investigating the efficacy and safety of using cisplatin and docetaxel in patients with triple negative metastatic breast cancer, and the possibility of using breast cancer susceptibility genel （BrCA1） expression as a predictive marker of chemotherapy response, and epidermal growth factor receptor （EGFr） as prognostic marker. Method： Between January 2006 and March 2009, 40 eligible patients with TN MBC were included in the study. We examined BrCA1 expression and EGFr protein in their specimens using immunohistochemistry. The patients were treated with cisplatin 75 mg/m2 and docetaxel 75 mg/m2 every 3 weeks, TN measurable MBC patients previously treated with anthracycline in their adjuvant or neo adjuvant settings were included in the study. results： The median age of the treated patients was 43.5 years. Nearly half of the patients had an ECOG performance status of 0 or 1, and about third of them had one metastatic site. These metastatic sites were predominantly visceral in 80% of the patients. Fifty-five percent of TNMBC stained positive for BrCA1 and sixty-five percent for EGFr. Positivity for both markers was significantly associated with grade III tumors （P = 0.004）, OS, and PFS （P = 0.001 and 0.009） respectively. Overall, the regimen was well tolerated as Gill vomiting and neurological side effects were observed in 20% of the patients. Other toxiciUes were generally mild and medically manageable; with no treatment mortality was recorded. The overall disease control rate （ODCr） was 60%; the median PFS was 8 months, with a median overall OS of 17.5 months; while the median OS among responders was 23 months （95% CI 21.35 to 25.32）. The patients with negative EGFr had a significantly better Or, PFS, and OS th

关键词： EGFr BrCA1 breast cancer metastatic triple negative cisplatin docetaxel

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