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Maria E Cabanillas - One of the best experts on this subject based on the ideXlab platform.
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efficacy and tolerability of vemurafenib in patients with brafv600e positive papillary thyroid Cancer m d anderson Cancer Center off label experience
The Journal of Clinical Endocrinology and Metabolism, 2015Co-Authors: Ramona Dadu, Naifa L Busaidy, Steven G Waguespack, Camilo Jimenez, Anita K Ying, Mouhammed Amir Habra, Komal Shah, Roland L Bassett, Steven I Sherman, Maria E CabanillasAbstract:Context: Vemurafenib, a selective BRAF inhibitor, appears to have promising clinical activity in patients with papillary thyroid Cancer (PTC) harboring the BRAFV600E mutation. Objective: To determine the efficacy and safety of vemurafenib when used outside of a clinical trial. Design: A retrospective review at MD Anderson Cancer Center. Methods: The best responses were evaluated using RECIST v1.1. A single radiologist reviewed all images. Adverse events (AEs) were evaluated using CTCAE v.4.0. Results: We identified 17 patients with advanced PTC harboring the BRAFV600E mutation who were treated with vemurafenib outside of a clinical trial. Median age at diagnosis was 63 years, and 53% were male. At vemurafenib start, 3 (18%) patients had disease confined to the neck, and 14 (72%) had distant metastases. Tyrosine kinase inhibitors had been previously administered to 4 (24%) patients. Two (12%) patients discontinued vemurafenib because of AEs before restaging. Best response: partial response (PR) in 7/15 (47...
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cushing syndrome secondary to ectopic adrenocorticotropic hormone secretion the university of texas md anderson Cancer Center experience
Cancer, 2011Co-Authors: Shamim Ejaz, Rena Vassilopoulousellin, Naifa L Busaidy, Steven G Waguespack, Camilo Jimenez, Anita K Ying, Maria E Cabanillas, Maher Abbara, Mouhammed Amir HabraAbstract:Background: Cushing syndrome (CS) secondary to ectopic adrenocorticotropic hormone (ACTH) secretion (EAS) has been described in association with a variety of tumors. The current experience with this syndrome was based on a few case series and individual case reports. Limited data were available about the tumors associated with CS-EAS in a Cancer Center setting. In this report, the authors have described their experience with CS-EAS at The University of Texas MD Anderson Cancer Center to further enhance the current understanding and management of this syndrome. Methods: This was a retrospective review of 43 patients with CS-EAS who were diagnosed between 1979 and 2009 at The University of Texas MD Anderson Cancer Center. Results: Different neuroendocrine tumors were associated with CS-EAS. Twenty-one patients (48.9%) had tumors located in the chest cavity, with bronchial carcinoid and small cell lung Cancer representing the 2 most common causes. The ACTH source remained occult in 4 patients (9.3%) despite extensive workup. Clinical presentation varied, and the classic features of CS were not evident in some patients. Death occurred in 27 patients (62.8%), and the median overall survival was 32.2 months. Major morbidities included new-onset or worsening hyperglycemia (77%), symptomatic venous thromboembolism (14%), and infections (23%). Conclusions: In patients with CS-EAS who attended a comprehensive Cancer Center, tumors originating in the chest cavity were the leading tumors associated with this syndrome. The authors suspect that CS-EAS is under reported because of the atypical presentation in some patients. Thus, they suggest careful evaluation of patients with neuroendocrine tumors to avoid missing coexisting CS-EAS.
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cushing syndrome secondary to ectopic adrenocorticotropic hormone secretion the university of texas md anderson Cancer Center experience
Cancer, 2011Co-Authors: Shamim Ejaz, Rena Vassilopoulousellin, Naifa L Busaidy, Steven G Waguespack, Camilo Jimenez, Anita K Ying, Maria E Cabanillas, Maher Abbara, Mouhammed Amir HabraAbstract:BACKGROUND: Cushing syndrome (CS) secondary to ectopic adrenocorticotropic hormone (ACTH) secretion (EAS) has been described in association with a variety of tumors. The current experience with this syndrome was based on a few case series and individual case reports. Limited data were available about the tumors associated with CS-EAS in a Cancer Center setting. In this report, the authors have described their experience with CS-EAS at The University of Texas MD Anderson Cancer Center to further enhance the current understanding and management of this syndrome. METHODS: This was a retrospective review of 43 patients with CS-EAS who were diagnosed between 1979 and 2009 at The University of Texas MD Anderson Cancer Center. RESULTS: Different neuroendocrine tumors were associated with CS-EAS. Twenty-one patients (48.9%) had tumors located in the chest cavity, with bronchial carcinoid and small cell lung Cancer representing the 2 most common causes. The ACTH source remained occult in 4 patients (9.3%) despite extensive workup. Clinical presentation varied, and the classic features of CS were not evident in some patients. Death occurred in 27 patients (62.8%), and the median overall survival was 32.2 months. Major morbidities included new-onset or worsening hyperglycemia (77%), symptomatic venous thromboembolism (14%), and infections (23%). CONCLUSIONS: In patients with CS-EAS who attended a comprehensive Cancer Center, tumors originating in the chest cavity were the leading tumors associated with this syndrome. The authors suspect that CS-EAS is under reported because of the atypical presentation in some patients. Thus, they suggest careful evaluation of patients with neuroendocrine tumors to avoid missing coexisting CS-EAS. Cancer 2011;. © 2011 American Cancer Society.
Mouhammed Amir Habra - One of the best experts on this subject based on the ideXlab platform.
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efficacy and tolerability of vemurafenib in patients with brafv600e positive papillary thyroid Cancer m d anderson Cancer Center off label experience
The Journal of Clinical Endocrinology and Metabolism, 2015Co-Authors: Ramona Dadu, Naifa L Busaidy, Steven G Waguespack, Camilo Jimenez, Anita K Ying, Mouhammed Amir Habra, Komal Shah, Roland L Bassett, Steven I Sherman, Maria E CabanillasAbstract:Context: Vemurafenib, a selective BRAF inhibitor, appears to have promising clinical activity in patients with papillary thyroid Cancer (PTC) harboring the BRAFV600E mutation. Objective: To determine the efficacy and safety of vemurafenib when used outside of a clinical trial. Design: A retrospective review at MD Anderson Cancer Center. Methods: The best responses were evaluated using RECIST v1.1. A single radiologist reviewed all images. Adverse events (AEs) were evaluated using CTCAE v.4.0. Results: We identified 17 patients with advanced PTC harboring the BRAFV600E mutation who were treated with vemurafenib outside of a clinical trial. Median age at diagnosis was 63 years, and 53% were male. At vemurafenib start, 3 (18%) patients had disease confined to the neck, and 14 (72%) had distant metastases. Tyrosine kinase inhibitors had been previously administered to 4 (24%) patients. Two (12%) patients discontinued vemurafenib because of AEs before restaging. Best response: partial response (PR) in 7/15 (47...
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cushing syndrome secondary to ectopic adrenocorticotropic hormone secretion the university of texas md anderson Cancer Center experience
Cancer, 2011Co-Authors: Shamim Ejaz, Rena Vassilopoulousellin, Naifa L Busaidy, Steven G Waguespack, Camilo Jimenez, Anita K Ying, Maria E Cabanillas, Maher Abbara, Mouhammed Amir HabraAbstract:Background: Cushing syndrome (CS) secondary to ectopic adrenocorticotropic hormone (ACTH) secretion (EAS) has been described in association with a variety of tumors. The current experience with this syndrome was based on a few case series and individual case reports. Limited data were available about the tumors associated with CS-EAS in a Cancer Center setting. In this report, the authors have described their experience with CS-EAS at The University of Texas MD Anderson Cancer Center to further enhance the current understanding and management of this syndrome. Methods: This was a retrospective review of 43 patients with CS-EAS who were diagnosed between 1979 and 2009 at The University of Texas MD Anderson Cancer Center. Results: Different neuroendocrine tumors were associated with CS-EAS. Twenty-one patients (48.9%) had tumors located in the chest cavity, with bronchial carcinoid and small cell lung Cancer representing the 2 most common causes. The ACTH source remained occult in 4 patients (9.3%) despite extensive workup. Clinical presentation varied, and the classic features of CS were not evident in some patients. Death occurred in 27 patients (62.8%), and the median overall survival was 32.2 months. Major morbidities included new-onset or worsening hyperglycemia (77%), symptomatic venous thromboembolism (14%), and infections (23%). Conclusions: In patients with CS-EAS who attended a comprehensive Cancer Center, tumors originating in the chest cavity were the leading tumors associated with this syndrome. The authors suspect that CS-EAS is under reported because of the atypical presentation in some patients. Thus, they suggest careful evaluation of patients with neuroendocrine tumors to avoid missing coexisting CS-EAS.
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cushing syndrome secondary to ectopic adrenocorticotropic hormone secretion the university of texas md anderson Cancer Center experience
Cancer, 2011Co-Authors: Shamim Ejaz, Rena Vassilopoulousellin, Naifa L Busaidy, Steven G Waguespack, Camilo Jimenez, Anita K Ying, Maria E Cabanillas, Maher Abbara, Mouhammed Amir HabraAbstract:BACKGROUND: Cushing syndrome (CS) secondary to ectopic adrenocorticotropic hormone (ACTH) secretion (EAS) has been described in association with a variety of tumors. The current experience with this syndrome was based on a few case series and individual case reports. Limited data were available about the tumors associated with CS-EAS in a Cancer Center setting. In this report, the authors have described their experience with CS-EAS at The University of Texas MD Anderson Cancer Center to further enhance the current understanding and management of this syndrome. METHODS: This was a retrospective review of 43 patients with CS-EAS who were diagnosed between 1979 and 2009 at The University of Texas MD Anderson Cancer Center. RESULTS: Different neuroendocrine tumors were associated with CS-EAS. Twenty-one patients (48.9%) had tumors located in the chest cavity, with bronchial carcinoid and small cell lung Cancer representing the 2 most common causes. The ACTH source remained occult in 4 patients (9.3%) despite extensive workup. Clinical presentation varied, and the classic features of CS were not evident in some patients. Death occurred in 27 patients (62.8%), and the median overall survival was 32.2 months. Major morbidities included new-onset or worsening hyperglycemia (77%), symptomatic venous thromboembolism (14%), and infections (23%). CONCLUSIONS: In patients with CS-EAS who attended a comprehensive Cancer Center, tumors originating in the chest cavity were the leading tumors associated with this syndrome. The authors suspect that CS-EAS is under reported because of the atypical presentation in some patients. Thus, they suggest careful evaluation of patients with neuroendocrine tumors to avoid missing coexisting CS-EAS. Cancer 2011;. © 2011 American Cancer Society.
Lina Asmar - One of the best experts on this subject based on the ideXlab platform.
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combined modality treatment of inflammatory breast carcinoma twenty years of experience at m d anderson Cancer Center
Annual Meeting of the American Society of Clinical Oncology, 1997Co-Authors: Naoto T Ueno, Aman U Buzdar, S E Singletary, Frederick C Ames, Marsha D Mcneese, F A Holmes, Richard L Theriault, Eric A Strom, Barbara Wasaff, Lina AsmarAbstract:Purpose: To review the 20 years of experience at M. D. Anderson Cancer Center with a combined-modality approach against inflammatory breast carcinoma. Patients and methods: A total of 178 patients with inflammatory breast carcinoma were treated in the past 20 years at M. D. Anderson Cancer Center by a combined-modality approach under four different protocols. Each protocol included induction chemotherapy, then local therapy (radiotherapy or mastectomy). then adjuvant chemotherapy, and, if mastectomy was performed, adjuvant radiotherapy. Chemotherapy consisted of 5-fluorouracil, doxorubicin, and cyclophosphamide (FAC) with or without vincristine and prednisone (VP). In protocol D, patients received an alternate adjuvant chemotherapy regimen, methotrexate and vinblastine (MV), if they did not have a complete response (CR) to induction chemotherapy.
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combined modality treatment of inflammatory breast carcinoma twenty years of experience at m d anderson Cancer Center
Cancer Chemotherapy and Pharmacology, 1997Co-Authors: Naoto T Ueno, Aman U Buzdar, S E Singletary, Frederick C Ames, Marsha D Mcneese, F A Holmes, Richard L Theriault, Eric A Strom, Barbara Wasaff, Lina AsmarAbstract:Purpose: To review the 20 years of experience at M. D. Anderson Cancer Center with a combined-modality approach against inflammatory breast carcinoma. Patients and methods: A total of 178 patients with inflammatory breast carcinoma were treated in the past 20 years at M. D. Anderson Cancer Center by a combined-modality approach under four different protocols. Each protocol included induction chemotherapy, then local therapy (radiotherapy or mastectomy), then adjuvant chemotherapy, and, if mastectomy was performed, adjuvant radiotherapy. Chemotherapy consisted of 5-fluorouracil, doxorubicin, and cyclophosphamide (FAC) with or without vincristine and prednisone (VP). In protocol D, patients received an alternate adjuvant chemotherapy regimen, methotrexate and vinblastine (MV), if they did not have a complete response (CR) to induction chemotherapy. Results: The median follow-up of live patients in group A was 215 months, in group B 186 months, in group C 116 months, and in group D 45 months. An estimated 28% of patients were currently free of disease beyond 15 years. At the time of analysis, 50 patients were alive without any evidence of disease. A further 12 patients died of intercurrent illness, and 15 patients were followed beyond 10 years without recurrence of disease. Among initial recurrence, 20% of patients had local failure, 39% systemic failure, and 9% CNS recurrence. Initial response to induction chemotherapy was an important prognostic factor. Disease-free survival (DFS) at 15 years was 44% in patients who had a CR to induction chemotherapy, 31% in those who had a partial response (PR), and 7% in those who had less than a PR. There was no improvement in overall survival (OS) or DFS among patients who underwent alternate chemotherapy (MV) compared with those who did not. Using surgery and radiotherapy as opposed to radiotherapy alone as local therapy did not have an impact on the DFS or OS rate. Conclusion: These long-term follow-up data show that with a combined-modality approach a significant fraction of patients (28%) remained free of disease beyond 15 years. In contrast, single-modality treatments yielded a DFS of less than 5%. Thus, using combined-modality treatment (chemotherapy, then mastectomy, then chemotherapy and radiotherapy) is recommended as a standard of care for inflammatory breast carcinoma.
Dimitrios P Kontoyiannis - One of the best experts on this subject based on the ideXlab platform.
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phaeohyphomycosis in a tertiary care Cancer Center
Clinical Infectious Diseases, 2009Co-Authors: Ronen Benami, Russell E Lewis, Issam I Raad, Dimitrios P KontoyiannisAbstract:Background. Phaeohyphomycosis is a rare opportunistic fungal infection. To assess the range of clinical presentations and outcomes of phaeohyphomycosis in patients with Cancer, we reviewed cases diagnosed at the M. D. Anderson Cancer Center (Houston, TX). Methods. We searched the microbiology laboratory records for dematiaceous molds that had been isolated during the period from January 1989 through March 2008. Demographic and clinical data were abstracted from patients' medical records. Invasive phaeohyphomycosis was defined according to the criteria of the European Organization for Research and Treatment of Cancer Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycosis Study Group for proven or probable invasive fungal disease. Archived dematiaceous mold isolates were tested for antifungal drug susceptibility. Results. Of 348 isolates of dematiaceous fungi recovered, only 39 isolates (11%), recovered from 39 patients, were associated with proven or probable invasive fungal disease (33 proven and 6 probable). The incidence rate of phaeohyphomycosis increased from 1.0 to 3.1 cases per 100,000 patient-days during the study period (P = .006). Of these 39 patients, 14 (36%) had a breakthrough infection while receiving prophylactic or empirical antifungal therapy. Sites of infection were the lungs (15 [38%] of 39 patients), skin (15 [38%]), sinuses (14 [36%]), and bloodstream (7 [18%]). Thirteen patients (33%) had a disseminated infection. Values of the serum galactomannan index were measured for 11 (28%) of 39 patients. The galactomannan index value was elevated (>0.5) in 5 (45%) of these 11 patients. The mortality rate at 12 weeks was 33%. Cox regression analysis revealed a significantly higher risk of death for patients with disseminated infection (hazard ratio, 5.7; P =.03) and a lower risk for patients who recovered from neutropenia within 30 days (hazard ratio, 0.2; P =.04). Isolates were frequently not susceptible to voriconazole and caspofungin. Conclusions. Although rare, dematiaceous molds are increasingly encountered in immunosuppressed patients with Cancer. The propensity of these fungi for dissemination and for resistance to antifungal drugs presents management challenges.
Camilo Jimenez - One of the best experts on this subject based on the ideXlab platform.
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efficacy and tolerability of vemurafenib in patients with brafv600e positive papillary thyroid Cancer m d anderson Cancer Center off label experience
The Journal of Clinical Endocrinology and Metabolism, 2015Co-Authors: Ramona Dadu, Naifa L Busaidy, Steven G Waguespack, Camilo Jimenez, Anita K Ying, Mouhammed Amir Habra, Komal Shah, Roland L Bassett, Steven I Sherman, Maria E CabanillasAbstract:Context: Vemurafenib, a selective BRAF inhibitor, appears to have promising clinical activity in patients with papillary thyroid Cancer (PTC) harboring the BRAFV600E mutation. Objective: To determine the efficacy and safety of vemurafenib when used outside of a clinical trial. Design: A retrospective review at MD Anderson Cancer Center. Methods: The best responses were evaluated using RECIST v1.1. A single radiologist reviewed all images. Adverse events (AEs) were evaluated using CTCAE v.4.0. Results: We identified 17 patients with advanced PTC harboring the BRAFV600E mutation who were treated with vemurafenib outside of a clinical trial. Median age at diagnosis was 63 years, and 53% were male. At vemurafenib start, 3 (18%) patients had disease confined to the neck, and 14 (72%) had distant metastases. Tyrosine kinase inhibitors had been previously administered to 4 (24%) patients. Two (12%) patients discontinued vemurafenib because of AEs before restaging. Best response: partial response (PR) in 7/15 (47...
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cushing syndrome secondary to ectopic adrenocorticotropic hormone secretion the university of texas md anderson Cancer Center experience
Cancer, 2011Co-Authors: Shamim Ejaz, Rena Vassilopoulousellin, Naifa L Busaidy, Steven G Waguespack, Camilo Jimenez, Anita K Ying, Maria E Cabanillas, Maher Abbara, Mouhammed Amir HabraAbstract:Background: Cushing syndrome (CS) secondary to ectopic adrenocorticotropic hormone (ACTH) secretion (EAS) has been described in association with a variety of tumors. The current experience with this syndrome was based on a few case series and individual case reports. Limited data were available about the tumors associated with CS-EAS in a Cancer Center setting. In this report, the authors have described their experience with CS-EAS at The University of Texas MD Anderson Cancer Center to further enhance the current understanding and management of this syndrome. Methods: This was a retrospective review of 43 patients with CS-EAS who were diagnosed between 1979 and 2009 at The University of Texas MD Anderson Cancer Center. Results: Different neuroendocrine tumors were associated with CS-EAS. Twenty-one patients (48.9%) had tumors located in the chest cavity, with bronchial carcinoid and small cell lung Cancer representing the 2 most common causes. The ACTH source remained occult in 4 patients (9.3%) despite extensive workup. Clinical presentation varied, and the classic features of CS were not evident in some patients. Death occurred in 27 patients (62.8%), and the median overall survival was 32.2 months. Major morbidities included new-onset or worsening hyperglycemia (77%), symptomatic venous thromboembolism (14%), and infections (23%). Conclusions: In patients with CS-EAS who attended a comprehensive Cancer Center, tumors originating in the chest cavity were the leading tumors associated with this syndrome. The authors suspect that CS-EAS is under reported because of the atypical presentation in some patients. Thus, they suggest careful evaluation of patients with neuroendocrine tumors to avoid missing coexisting CS-EAS.
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cushing syndrome secondary to ectopic adrenocorticotropic hormone secretion the university of texas md anderson Cancer Center experience
Cancer, 2011Co-Authors: Shamim Ejaz, Rena Vassilopoulousellin, Naifa L Busaidy, Steven G Waguespack, Camilo Jimenez, Anita K Ying, Maria E Cabanillas, Maher Abbara, Mouhammed Amir HabraAbstract:BACKGROUND: Cushing syndrome (CS) secondary to ectopic adrenocorticotropic hormone (ACTH) secretion (EAS) has been described in association with a variety of tumors. The current experience with this syndrome was based on a few case series and individual case reports. Limited data were available about the tumors associated with CS-EAS in a Cancer Center setting. In this report, the authors have described their experience with CS-EAS at The University of Texas MD Anderson Cancer Center to further enhance the current understanding and management of this syndrome. METHODS: This was a retrospective review of 43 patients with CS-EAS who were diagnosed between 1979 and 2009 at The University of Texas MD Anderson Cancer Center. RESULTS: Different neuroendocrine tumors were associated with CS-EAS. Twenty-one patients (48.9%) had tumors located in the chest cavity, with bronchial carcinoid and small cell lung Cancer representing the 2 most common causes. The ACTH source remained occult in 4 patients (9.3%) despite extensive workup. Clinical presentation varied, and the classic features of CS were not evident in some patients. Death occurred in 27 patients (62.8%), and the median overall survival was 32.2 months. Major morbidities included new-onset or worsening hyperglycemia (77%), symptomatic venous thromboembolism (14%), and infections (23%). CONCLUSIONS: In patients with CS-EAS who attended a comprehensive Cancer Center, tumors originating in the chest cavity were the leading tumors associated with this syndrome. The authors suspect that CS-EAS is under reported because of the atypical presentation in some patients. Thus, they suggest careful evaluation of patients with neuroendocrine tumors to avoid missing coexisting CS-EAS. Cancer 2011;. © 2011 American Cancer Society.
