The Experts below are selected from a list of 139527 Experts worldwide ranked by ideXlab platform
Paul Russo - One of the best experts on this subject based on the ideXlab platform.
-
Systemic Therapy FOR RENAL CELL CARCINOMA
The Journal of urology, 2000Co-Authors: Robert J. Motzer, Paul RussoAbstract:Purpose: We review the status of Systemic Therapy for patients with advanced renal cell carcinoma.Materials and Methods: A literature search was performed on MEDLINE and CANCERLIT to identify results of Systemic Therapy for patients with renal cell carcinoma published from January 1990 through December 1998. Treatment results of chemoTherapy agents, immunoTherapy, combination programs and adjuvant Therapy were reviewed.Results: No chemoTherapy agent has produced response rates that justify its use as a single agent. Interferon-α and interleukin (IL)-2 demonstrated low response rates ranging from 10% to 20%. The results of 2 randomized trials suggest that treatment with interferon-α compared to vinblastine or medroxyprogesterone achieves a small improvement in survival. Response rates in patients treated with low dose IL-2 are similar to those achieved with a high dose bolus schedule but whether the responses are as durable is being addressed in an ongoing randomized trial. A randomized trial of interferon...
Daniel J. George - One of the best experts on this subject based on the ideXlab platform.
-
Deferred Systemic Therapy in patients with metastatic renal cell carcinoma.
Clinical genitourinary cancer, 2014Co-Authors: Aaron P. Mitchell, Bradford R. Hirsch, Michael R. Harrison, Amy P. Abernethy, Daniel J. GeorgeAbstract:Abstract Background With the advent of small-molecule “targeted” therapies, the prevailing treatment paradigm for metastatic renal cell carcinoma (mRCC) is that all patients who are able to tolerate Systemic Therapy should receive it. However, oncologists often defer the initiation of Systemic Therapy for patients with mRCC. The outcomes of and clinical reasoning behind the initial management of patients with mRCC without Systemic Therapy have not been well described. Methods We conducted a retrospective cohort study of all patients with mRCC treated within the Duke University Health System and diagnosed from January 1, 2007, to January 1, 2011. We defined our cohort as patients who did not receive Systemic Therapy during the first year after mRCC diagnosis. The clinical rationale for the lack of immediate treatment was ascertained by manual chart review. Results A total of 60 of 268 patients (22%) with mRCC managed without initial Systemic Therapy were included in our study. The median age was 61.2 years, the median duration from diagnosis of localized RCC to development of mRCC was 41.9 months, and 91% of patients had Eastern Cooperative Oncology Group functional status of ≤ 1. Of the patients, 60% were managed with surgical metastasectomy alone, 12% received multiple local treatment modalities, 13% received active surveillance, 7% were managed supportively, and 8% were categorized as “other.” Conclusions The majority of patients in our cohort had favorable disease characteristics and experienced favorable outcomes with surgery alone. Our results suggest that this population could represent 20% of patients with mRCC in tertiary care settings. Prospective data are needed to evaluate deferred Systemic Therapy as a management strategy.
Robert J. Motzer - One of the best experts on this subject based on the ideXlab platform.
-
Systemic Therapy FOR RENAL CELL CARCINOMA
The Journal of urology, 2000Co-Authors: Robert J. Motzer, Paul RussoAbstract:Purpose: We review the status of Systemic Therapy for patients with advanced renal cell carcinoma.Materials and Methods: A literature search was performed on MEDLINE and CANCERLIT to identify results of Systemic Therapy for patients with renal cell carcinoma published from January 1990 through December 1998. Treatment results of chemoTherapy agents, immunoTherapy, combination programs and adjuvant Therapy were reviewed.Results: No chemoTherapy agent has produced response rates that justify its use as a single agent. Interferon-α and interleukin (IL)-2 demonstrated low response rates ranging from 10% to 20%. The results of 2 randomized trials suggest that treatment with interferon-α compared to vinblastine or medroxyprogesterone achieves a small improvement in survival. Response rates in patients treated with low dose IL-2 are similar to those achieved with a high dose bolus schedule but whether the responses are as durable is being addressed in an ongoing randomized trial. A randomized trial of interferon...
Aaron P. Mitchell - One of the best experts on this subject based on the ideXlab platform.
-
Deferred Systemic Therapy in patients with metastatic renal cell carcinoma.
Clinical genitourinary cancer, 2014Co-Authors: Aaron P. Mitchell, Bradford R. Hirsch, Michael R. Harrison, Amy P. Abernethy, Daniel J. GeorgeAbstract:Abstract Background With the advent of small-molecule “targeted” therapies, the prevailing treatment paradigm for metastatic renal cell carcinoma (mRCC) is that all patients who are able to tolerate Systemic Therapy should receive it. However, oncologists often defer the initiation of Systemic Therapy for patients with mRCC. The outcomes of and clinical reasoning behind the initial management of patients with mRCC without Systemic Therapy have not been well described. Methods We conducted a retrospective cohort study of all patients with mRCC treated within the Duke University Health System and diagnosed from January 1, 2007, to January 1, 2011. We defined our cohort as patients who did not receive Systemic Therapy during the first year after mRCC diagnosis. The clinical rationale for the lack of immediate treatment was ascertained by manual chart review. Results A total of 60 of 268 patients (22%) with mRCC managed without initial Systemic Therapy were included in our study. The median age was 61.2 years, the median duration from diagnosis of localized RCC to development of mRCC was 41.9 months, and 91% of patients had Eastern Cooperative Oncology Group functional status of ≤ 1. Of the patients, 60% were managed with surgical metastasectomy alone, 12% received multiple local treatment modalities, 13% received active surveillance, 7% were managed supportively, and 8% were categorized as “other.” Conclusions The majority of patients in our cohort had favorable disease characteristics and experienced favorable outcomes with surgery alone. Our results suggest that this population could represent 20% of patients with mRCC in tertiary care settings. Prospective data are needed to evaluate deferred Systemic Therapy as a management strategy.
Marshall S. Baker - One of the best experts on this subject based on the ideXlab platform.
-
Clinically resectable acinar cell carcinoma of the pancreas: Is there a benefit to adjuvant Systemic Therapy?
American journal of surgery, 2019Co-Authors: Dhruv J. Patel, Waseem Lutfi, Patrick Sweigert, Emanuel Eguia, Gerard Abood, Lawrence M. Knab, Paul C. Kuo, Marshall S. BakerAbstract:Abstract Background Prior studies of adjuvant Systemic Therapy in pancreatic acinar cell carcinoma have been underpowered. Methods We queried the National Cancer Data Base to identify patients presenting with resectable (clinical stage I and II) acinar cell carcinoma between 2004 and 2015. Multivariable Cox Regression was used to evaluate the association between overall survival and Systemic Therapy. Results 298 patients met inclusion criteria: 38 received no treatment; 60 received Systemic Therapy alone; 84 received surgical resection alone; 116 underwent resection followed by adjuvant Systemic Therapy. On univariate analysis, resection was associated with a survival benefit compared to no treatment and Systemic Therapy alone (3-year overall survival: 57% vs. 26%, p Conclusions Adjuvant Therapy is associated with a significant survival benefit in patients with resectable acinar cell carcinoma.
