Dr. William Tew of Memorial Sloan Kettering Cancer Center discusses how to manage side effects of targeted therapies for ovarian cancer. Dr. Tew also discusses the severity of your side effects, communicating them to your doctor, and the latest information on symptom-tracking tools.
Triple Negative Breast Cancer and Women of Color (Slide 1)bkling
In this webinar, Dr. Onyinye D. Balogun and Dr. Lisa Newman of Weill Cornell Medicine-New York Presbyterian Hospital Network discuss all aspects of triple negative breast cancer and its impact on women of color in recognition of Black History Month.
SHARE: Metastatic Breast Cancer: Cutting-Edge Research from National Cancer w...bkling
Patricia Steeg, PhD, Chief of Women's Cancers Section at the Center for Cancer Research at NCI, will present her novel research relating to metastatic breast cancer, including the development of experimental models of brain metastasis. Join SHARE and Dr. Steeg for this nformative webinar.
SHARE Webinar: Latest Research on Metastatic Breast Cancer from SABCS 2015bkling
Dr. Tiffany Traina, medical oncologist at Memorial Sloan-Kettering Cancer Center, presents the latest research on metastatic breast cancer reported at the San Antonio Breast Cancer Symposium in December 2015.
Triple Negative Breast Cancer and Women of Color (Slide 2)bkling
In this webinar, Dr. Onyinye D. Balogun and Dr. Lisa Newman of Weill Cornell Medicine-New York Presbyterian Hospital Network discuss all aspects of triple negative breast cancer and its impact on women of color in recognition of Black History Month
Triple Negative Breast Cancer and Women of Color (Slide 1)bkling
In this webinar, Dr. Onyinye D. Balogun and Dr. Lisa Newman of Weill Cornell Medicine-New York Presbyterian Hospital Network discuss all aspects of triple negative breast cancer and its impact on women of color in recognition of Black History Month.
SHARE: Metastatic Breast Cancer: Cutting-Edge Research from National Cancer w...bkling
Patricia Steeg, PhD, Chief of Women's Cancers Section at the Center for Cancer Research at NCI, will present her novel research relating to metastatic breast cancer, including the development of experimental models of brain metastasis. Join SHARE and Dr. Steeg for this nformative webinar.
SHARE Webinar: Latest Research on Metastatic Breast Cancer from SABCS 2015bkling
Dr. Tiffany Traina, medical oncologist at Memorial Sloan-Kettering Cancer Center, presents the latest research on metastatic breast cancer reported at the San Antonio Breast Cancer Symposium in December 2015.
Triple Negative Breast Cancer and Women of Color (Slide 2)bkling
In this webinar, Dr. Onyinye D. Balogun and Dr. Lisa Newman of Weill Cornell Medicine-New York Presbyterian Hospital Network discuss all aspects of triple negative breast cancer and its impact on women of color in recognition of Black History Month
Describes the emerging resistance of epithelial cancer of the ovary to current therapies and the role of PARP inhibitors in the management in view of the recent drug approvals.
Audio and slides for this presentation are available on YouTube: http://youtu.be/6W_xoH4s-Yk
Dr. Patrick Wen, of Dana-Farber Cancer Institute's Center for Neuro-Oncology, discusses current clinical trial options for brain tumor patients and some of the new therapies available in neuro-oncology. This presentation was originally given at Dana-Farber Cancer Institute on Dec. 4, 2013.
What's the latest in breast cancer treatment and research? Erica Mayer, MD, MPH, a medical oncologist in the Susan F. Smith Center for Women's Cancers, shares the latest breast cancer news.
This presentation was originally given on Oct. 16, 2015, at the annual Young Women with Breast Cancer Forum, hosted by the Program for Young Women with Breast Cancer in the Susan F. Smith Center for Women's Cancers at Dana-Farber Cancer Institute, in Boston, Mass.
Learn more: http://www.susanfsmith.org
Cancer is a leading cause of death in developed countries. In this webcast Dr. Andreas Scherer will explain how personalized medicine can transform our approach to fighting this disease. He will also discuss current roadblocks and diagnostic challenges, and the pivotal role of Next Gen Sequencing to overcome these challenges.
The webcast will inform about best practices to design and implement a cancer testing pipeline: from sample preparation, to sequencing, to secondary and tertiary analysis of sequencing data. The goal is to rapidly identify clinically actionable data that allows an oncologist to quickly determine the best available treatment options.
The webcast will include demonstrations of the Golden Helix VarSeq software in the context of analyzing cancer gene panels and somatic mutations.
Elizabeth Swisher, MD, gives an update on the research being performed by the Stand Up to Cancer Ovarian Cancer Dream Team, supported by the National Ovarian Cancer Coalition (NOCC), OCRF, and OCNA.
Report Back from SGO: What's the Latest in Ovarian Cancer?bkling
Dr. Joyce F. Liu, Director of Clinical Research for Gynecologic Oncology at Dana-Farber Cancer Institute, provides a comprehensive update from the Society of Gynecologic Oncology (SGO) Annual Meeting on Women’s Cancer.
Triple-Negative Breast Cancer: 2018 Status UpdateZeena Nackerdien
Up to 20% of all invasive female breast cancer diagnoses are defined by the clinically significant absence of three hormone receptors i.e., ER, PR and HER2. This group of highly heterogeneous tumors exhibit aggressive growth patterns and are known as TNBCs. Although most TNBCs are ductal carcinomas (no special types), the identification of specific histologic/molecular subtypes potentially open up further modes of treatment for a disease that has thus far mainly been treated with cytotoxic chemotherapies. Biologic features in tumor subsets that carry such implications include BRCA pathway inhibition, increased tumor infiltrating lymphocytes (TILs), detection of other biomarkers paving the way for immunotherapies such as elevated PD-L1 expression and AR expression. Here, is some of the relevant information about TNBCs.
Disclaimer: This deck is meant to provide a springboard to interested readers who wish to look for materials to discuss with a doctor and is not a substitute for expert advice. Information was culled from the Internet and sources cited in the deck.
Immunotherapy for Metastatic Triple Negative Breast Cancerbkling
Sylvia Adams, MD, medical oncologist, and associate professor at the NYU School of Medicine, discusses the latest research including the role of immunology in the treatment of triple negative metastatic breast cancer. This webinar was hosted on October 19, 2016.
In this session, H. Kim Lyerly, MD, FACS, Director of the Center of Applied Therapeutics at Duke University, discussed research in tumor dormancy in breast cancer. Topics included the role of disseminated tumor cells, the bone marrow, and the potential for immune responses to control or prevent recurrences. Q&A period followed
Strategies for Managing Recurrent Ovarian Cancerbkling
When ovarian cancer returns, it's not uncommon to experience a range of emotions and feel overwhelmed. But it's important to remember that recurrent ovarian cancer can often be successfully treated. Dr. Shannon N. Westin, gynecologic oncologist and clinical investigator at MD Anderson Cancer Center, goes over the latest treatment options for recurrent disease.
Metastatic Breast Cancer Awareness Day: Special Event Webinarbkling
These slides accompany a conversation about living with metastatic breast cancer. Listen to the recording here: http://bit.ly/MBCTalk
Women with Stage IV disease talked about making treatment decisions, handling fear and anxiety, and living life as fully as possible.
The family center disability webinar for share sept 2017bkling
Caroline L. Bersak, Esq., from The Family Center's Legal Wellness Institute, explores your options for disability insurance. Learn about Social Security Disability Insurance, Supplemental Security Income, and special rules and processes for people with metastatic breast cancer.
Describes the emerging resistance of epithelial cancer of the ovary to current therapies and the role of PARP inhibitors in the management in view of the recent drug approvals.
Audio and slides for this presentation are available on YouTube: http://youtu.be/6W_xoH4s-Yk
Dr. Patrick Wen, of Dana-Farber Cancer Institute's Center for Neuro-Oncology, discusses current clinical trial options for brain tumor patients and some of the new therapies available in neuro-oncology. This presentation was originally given at Dana-Farber Cancer Institute on Dec. 4, 2013.
What's the latest in breast cancer treatment and research? Erica Mayer, MD, MPH, a medical oncologist in the Susan F. Smith Center for Women's Cancers, shares the latest breast cancer news.
This presentation was originally given on Oct. 16, 2015, at the annual Young Women with Breast Cancer Forum, hosted by the Program for Young Women with Breast Cancer in the Susan F. Smith Center for Women's Cancers at Dana-Farber Cancer Institute, in Boston, Mass.
Learn more: http://www.susanfsmith.org
Cancer is a leading cause of death in developed countries. In this webcast Dr. Andreas Scherer will explain how personalized medicine can transform our approach to fighting this disease. He will also discuss current roadblocks and diagnostic challenges, and the pivotal role of Next Gen Sequencing to overcome these challenges.
The webcast will inform about best practices to design and implement a cancer testing pipeline: from sample preparation, to sequencing, to secondary and tertiary analysis of sequencing data. The goal is to rapidly identify clinically actionable data that allows an oncologist to quickly determine the best available treatment options.
The webcast will include demonstrations of the Golden Helix VarSeq software in the context of analyzing cancer gene panels and somatic mutations.
Elizabeth Swisher, MD, gives an update on the research being performed by the Stand Up to Cancer Ovarian Cancer Dream Team, supported by the National Ovarian Cancer Coalition (NOCC), OCRF, and OCNA.
Report Back from SGO: What's the Latest in Ovarian Cancer?bkling
Dr. Joyce F. Liu, Director of Clinical Research for Gynecologic Oncology at Dana-Farber Cancer Institute, provides a comprehensive update from the Society of Gynecologic Oncology (SGO) Annual Meeting on Women’s Cancer.
Triple-Negative Breast Cancer: 2018 Status UpdateZeena Nackerdien
Up to 20% of all invasive female breast cancer diagnoses are defined by the clinically significant absence of three hormone receptors i.e., ER, PR and HER2. This group of highly heterogeneous tumors exhibit aggressive growth patterns and are known as TNBCs. Although most TNBCs are ductal carcinomas (no special types), the identification of specific histologic/molecular subtypes potentially open up further modes of treatment for a disease that has thus far mainly been treated with cytotoxic chemotherapies. Biologic features in tumor subsets that carry such implications include BRCA pathway inhibition, increased tumor infiltrating lymphocytes (TILs), detection of other biomarkers paving the way for immunotherapies such as elevated PD-L1 expression and AR expression. Here, is some of the relevant information about TNBCs.
Disclaimer: This deck is meant to provide a springboard to interested readers who wish to look for materials to discuss with a doctor and is not a substitute for expert advice. Information was culled from the Internet and sources cited in the deck.
Immunotherapy for Metastatic Triple Negative Breast Cancerbkling
Sylvia Adams, MD, medical oncologist, and associate professor at the NYU School of Medicine, discusses the latest research including the role of immunology in the treatment of triple negative metastatic breast cancer. This webinar was hosted on October 19, 2016.
In this session, H. Kim Lyerly, MD, FACS, Director of the Center of Applied Therapeutics at Duke University, discussed research in tumor dormancy in breast cancer. Topics included the role of disseminated tumor cells, the bone marrow, and the potential for immune responses to control or prevent recurrences. Q&A period followed
Strategies for Managing Recurrent Ovarian Cancerbkling
When ovarian cancer returns, it's not uncommon to experience a range of emotions and feel overwhelmed. But it's important to remember that recurrent ovarian cancer can often be successfully treated. Dr. Shannon N. Westin, gynecologic oncologist and clinical investigator at MD Anderson Cancer Center, goes over the latest treatment options for recurrent disease.
Metastatic Breast Cancer Awareness Day: Special Event Webinarbkling
These slides accompany a conversation about living with metastatic breast cancer. Listen to the recording here: http://bit.ly/MBCTalk
Women with Stage IV disease talked about making treatment decisions, handling fear and anxiety, and living life as fully as possible.
The family center disability webinar for share sept 2017bkling
Caroline L. Bersak, Esq., from The Family Center's Legal Wellness Institute, explores your options for disability insurance. Learn about Social Security Disability Insurance, Supplemental Security Income, and special rules and processes for people with metastatic breast cancer.
Following diagnosis and treatment for breast cancer, many women experience changes in their sexuality. In this webinar, Madeleine M. Castellanos, MD, a psychiatrist specializing in sex therapy and sexual medicine, addresses the physical, psychological, and relationship issues that often emerge and explores strategies to find happiness and fulfillment.
Difficult Conversations: Bridging the Communication Gap with your Oncologistbkling
Lidia Schapira, MD, Director of the Cancer Survivorship Program at Stanford University, shares her expertise to help you get the most out of your communication with your oncologist. Learn strategies to optimize your meetings with your health care team.
Report Back from ASCO on Metastatic Breast Cancerbkling
Dr. Anne Moore, Medical Director of the Weill Cornell Breast Center, shares her experiences from the American Society of Clinical Oncology's June 2017 Conference. She also updates us on the latest research from the conference as it relates to metastatic breast cancer.
Invasive Lobular Carcinoma — Highlights from the First Ever ILC Symposium bkling
Steffi Osterreich, PhD, and Rachel Jankowitz, MD, of University of Pittsburgh Cancer Institute, join Heather Hillier, breast advocate and co-chair of the first international ILC Symposium, in offering an overview of Invasive Lobular Carcinoma and highlights from the conference, which took place in Pittsburgh in September 2016. The program was presented in collaboration with MBCN.
H. Kim Lyerly, M.D., FACS, discusses research in tumor dormancy in breast cancer, including the role of disseminated tumor cells, bone marrow, and the potential for immune responses to control or prevent recurrences. Dr. Lyerly is Director of the Center of Applied Therapeutics at Duke University.
SHARE Presentation: New Developments in the Medical Treatment of Breast Cance...bkling
Dr. Cliff Hudis on the latest information on new breast cancer treatments. Dr. Hudis is Chief of Breast Cancer Medicine Service at Memorial Sloan-Kettering Cancer Center.
Strategies for Long-term Management of Recurrent Ovarian Cancerbkling
A panel of doctors and patients will discuss decision-making in the recurrent setting of ovarian cancer, including how to understand and consider options like chemotherapy, surgery, and clinical trials. Panelists include Dr. Jason Wright and Dr. June Hou from Columbia University College of Physicians and Surgeons, survivor/research advocate Annie Ellis, and others living with recurrence.
Dr. Stephanie Blank and Dr. Melissa Frey update us on the latest developments in ovarian cancer research and treatment from the annual conference of the Society of Gynecologic Oncology. Dr. Blank is a gynecologic oncologist at Perlmutter Cancer Center at NYU Langone Medical Center and an associate professor at NYU School of Medicine. Dr. Frey is a Gynecological Oncology Fellow at NYU Langone Medical Center.
Clinical Trials for Metastatic Breast Cancerbkling
Courtney Hudson, CEO and Co-Founder of EmergingMed, explains the latest clinical trials for metastatic breast cancer and how to find them. Learn how to identify appropriate clinical trials, determine eligibility and "must ask" questions for the researchers, find strategies to determine your best options, and figure out which questions to ask when making your decisions.
A diagnosis of DCIS often brings mixed messages. Is this a real breast cancer? What is the meaning of Stage 0? If this is not life threatening, why are the treatments similar to those recommended for an invasive cancer? Deborah Collyar, founder of Patient Advocates in Research, helps us interpret the new findings that will aid you in navigating this diagnosis.
Dr. Maurie Markman, President of Science and Medicine at Cancer Treatment Centers of America, shares his expertise on the latest developments in immunotherapy for ovarian cancer.
Facing Forward: When Cancer Changes the Road Aheadbkling
A breast or ovarian cancer diagnosis brings unimaginable changes to a woman's life. Join us for a webinar as Julie Larson, LCSW, helps you reflect upon the psychological impact of this diagnosis. Learn how to develop strategies to face the challenges and emotions of your new normal.
New Developments in Breast Reconstruction Surgerybkling
Deborah Axelrod, MD, of NYU Langone Perlmutter Cancer Center, and Rachel Bluebond-Langner, MD, of NYU Langone Medical Center discuss the latest research in autologous breast reconstruction, fat injection, pre-pectoral implants, and oncoplastic surgery.
Disclaimer: Graphic medical imagery.
Clinical Trials for Ovarian Cancer: Fact vs. Fictionbkling
Courtney Hudson, CEO & Co-Founder of EmergingMed, explains the basics of clinical trials and the process of developing new treatments in the emerging age of personalized medicine and immunotherapy. Lean how to identify appropriate clinical trials, find strategies to determine your best options, and figure out which questions to ask when making your decisions. Watch the accompanying webinar: https://vimeo.com/203510985
Finding a Clinical Trial That's Right for Youbkling
Elly Cohen, PhD, Program Director of BreastCancerTrials.org, works closely with breast cancer organizations that promote patient awareness of clinical trials as a routine option for care. In this webinar, Elly walked listeners through the steps involved in finding clinical trials that are specific to their diagnosis.
Personalized medicine involves the prescription of specific therapeutics best suited for an individual based on their genetic or proteomic profile. This talk discusses current approaches in drug discovery/development, the role of genetics in drug metabolism, and lawful/ethical issues surrounding the deployment of new health technology. I highlight some bioinformatic roles in the drug discovery process, and discuss the use of semantic web technologies for data integration and knowledge discovery..
Richard Carvajal, MD presents Targeted Therapy for Uveal Melanoma and the Uveal Melanoma Clinical Research Landscape at the 2017 CURE OM Patient & Caregiver Symposium.
El futuro del tratamiento del cáncer renal metastásico: inmunoterapia y terap...Mauricio Lema
Ponencia en el primer simposio de la Asociación Colombiana de Hematología y Oncología (ACHO) de cáncer genitourinario, Bogotá, septiembre 23 y 24 de 2016.
Richard S. Finn, MD, Anthony El-Khoueiry, MD, and Josep M. Llovet, MD, PhD, prepared useful practice aids pertaining to hepatocellular carcinoma for this CME activity titled "Breaking the Paradox: Expanding Options and New Questions in HCC Management: Mapping the Pathways to Better Patient Outcomes." For the full presentation, monograph, complete CME information, and to apply for credit, please visit us at http://bit.ly/2HU6L5K. CME credit will be available until February 14, 2020.
This is a briefing on the PD-1 and PD-L1 targeted agents. This briefing provides a summary of the agents in clinical development for the treatment of cancer. The briefing specifically focusses on the clinical and commercial development of nivolumab which includes a product profile, clinical development program and timeline, SWOT, potential issues, strategy, etc. More details on the products contained in this briefing can be obtained upon special request.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Let's Talk About It: Ovarian Cancer (The Emotional Toll of Treatment Decision...bkling
Making treatment decisions is stressful. The work of understanding complex medical information, crafting questions for your medical team, and trusting oneself is hard. We break down this intense time in ways that might feel more manageable and help you regain a sense of calm as you work hard to care for yourself at each turn in the road. Let’s talk about it.
Report Back from SGO: What’s the Latest in Ovarian Cancer?bkling
Are you curious about what’s new in ovarian cancer research or unsure what the findings mean? Join Dr. Elena Pereira, a gynecologic oncologist at Lenox Hill Hospital, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Pereira will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Part I - Anticipatory Grief: Experiencing grief before the loss has happenedbkling
Anticipatory grief is the emotional experience when there is an impending loss that will occur. Often, people associate loss and grief with death, this is just one area in which grief and loss can occur. Anticipatory grief is often a slower grieving process marked by intermittent, small or large losses. In the world of cancer, anticipatory grief may show up in a variety of ways, such as before a major surgery, losing hair from chemotherapy treatment or caring for a loved one with advanced cancer.
Learn about anticipatory grief and ways to cope with it. We will also explore methods to heal from this challenging experience.
See it and Catch it! Recognizing the Thought Traps that Negatively Impact How...bkling
A cancer diagnosis is stressful. Feelings of worry, fear, self-doubt, sadness, and loneliness are normal but can feel exhausting and consuming at times. Cultivating a habit of thought-watching and learning to recognize thought traps that might be contributing to our discomfort can help us respond and care for ourselves in helpful ways. Learn more about the connection between what we think and how we feel and what you can do about it that might impact how you feel today. Let’s talk about it.
Advocating for Better Outcomes: Ovarian Cancer and Youbkling
Many parts of your life can affect your health and your cancer risk. Things like your race, ethnicity, where you live, and your finances matter. Even so, how can you get the health care you need and lower your cancer risk? What should you and your family do if you need to speak up?
Join this special talk about knowing your risk, ovarian cancer care, and ways we can speak up to improve our health. provided by two experts from Memorial Sloan Kettering Cancer Center (MSK) and SHARE.
Do you want to feel empowered and confident in preserving your independence and lowering your risk for injury? Learn how to reduce the risk of injury, how to fall safely, and maximize quality of life. Avoid common pitfalls and connect with others who share this concern!
Speakers: Ayden Jones, Falls Prevention Consultant and A Matter of Balance Master Trainer, and Janvier Hoist-Forrester, OTS.
Embracing Life's Balancing Act: Part 2 - Fall Action Planbkling
Do you want to feel empowered and confident in preserving your independence and lowering your risk for injury? Learn how to reduce the risk of injury, how to fall safely, and maximize quality of life. Avoid common pitfalls and connect with others who share this concern!
Speakers: Ayden Jones, Falls Prevention Consultant and A Matter of Balance Master Trainer, and Janvier Hoist-Forrester, OTS.
Let's Talk About It: Communication, Intimacy, and Sex… Oh My!bkling
Changes to your body are normal to experience related to a cancer diagnosis. But the grief and the learning to live with a changed body take time. But what if you share your body with someone else? What if finding pleasure and connection through intimacy feels like an overwhelming or insurmountable obstacle on your road to healing? Let's talk together about our personal experiences and questions surrounding this important topic of communication and intimacy.
Let's Talk About It: To Disclose or Not to Disclose?bkling
Sharing your cancer diagnosis with others can bring up a range of unexpected feelings and questions. Deciding who you tell, how much to share, and why are all important things to consider. The answer to these questions is personal and it varies not only between survivors but also in different settings and relationships in your life. We talk together about personal experiences and questions surrounding this important topic.
Report Back from SGO: What’s New in Uterine Cancer?.pptxbkling
Dr. Ebony Hoskins, gynecologic oncologist at MedStar Washington Hospital Center, provides a comprehensive update from the Society of Gynecologic Oncology (SGO) Annual Meeting on Women’s Cancer. Dr. Hoskins breaks down the research presented at the conference, discusses new developments, and addresses the most pressing questions.
Learn Tips for Managing Chemobrain or Mental Fogginessbkling
Chemobrain, or mental fogginess, is experienced by many patients during and after cancer treatment. But what are some strategies that help?Dennis Lin, OTD, OTR/L, Occupational Therapist at City of Hope National Medical Center, will provide tips on how you can manage chemobrain and support better engagement in your daily life.
Vaccines: Will they become a form of Secondary and Primary Breast Cancer Prev...bkling
Our guest speaker Lee Gravatt Wilke, MD, Senior Medical Director at the University of Wisconsin School of Medicine and Public Health, explains the current state of vaccine clinical trials in breast cancer followed by a review of the STEMVAC trial, design of the vaccine, and the current state of the accrual and next steps.
Let's Talk About It: Uterine Cancer (Advance Care Planning)bkling
Although it can be a difficult topic, advance care planning is very important for anyone facing a cancer diagnosis. The goal of advance care planning is to set up a plan to make sure you get the care you want in the future. It is critical to prepare for future decisions about your medical care with your family and support system. We discuss how to start and continue those important conversations. Learn about the differences between palliative care and hospice, when to bring up your wishes with your medical team, and how to prepare your family for navigating these decisions.
Moving Forward After Uterine Cancer Treatment: Surveillance Strategies, Testi...bkling
You’ve been treated for uterine cancer. Now what? With surveillance strategies varying from doctor to doctor, it can be hard to know which advice you should follow. Dr. Jennifer Mueller, Head of the Endometrial Cancer Section, Gynecologic Oncology Service at Memorial Sloan Kettering Cancer Center, delves into surveillance guidelines, which tests to consider, and how to keep an eye out for any symptoms which could indicate recurrence.
Understanding and Managing Chemo-Induced Peripheral Neuropathy (CIPN)bkling
Certain chemotherapy drugs can cause chemotherapy-induced peripheral neuropathy (CIPN), which is one of the most common side effects of treatment. Chemotherapy treatments cause peripheral neuropathy by damaging the nerves in the fingers, hands, arms, legs, and feet. This can lead to symptoms including pain, numbness, tingling, and difficulty with mobility, which can greatly impact one’s quality of life. Dr. Anasheh Halabi is an Assistant Clinical Professor in Neuromuscular Medicine at UCLA who specializes in neuropathies and is a leading specialist in caring for patients with neurotoxicities related to cancer drugs. She discusses chemotherapy-related neuropathies, expectations, and management. The perspective of a patient who has experienced CIPN will also be included in the program.
Let's Talk About It: Sick and Tired of Being Sick and Tiredbkling
Cancer-related fatigue is one of the most challenging treatment-related side effects. Your level of cancer-related fatigue may vary from day to day or last for extended periods. Survivors experience fatigue related to cancer treatment, but fatigue can also be a side effect of the logistical, mental, and emotional toll cancer takes on someone. This mental and emotional fatigue can often be minimized and particularly challenging to cope with as a survivor. Learn how to address your fatigue in mindful ways so you can navigate the days ahead.
What’s New with PARP Inhibitors and Ovarian Cancer?bkling
PARP inhibitors have revolutionized ovarian cancer treatment, but recent updates to the FDA-approved indications have caused confusion and raised questions for patients. So what do these changes mean? Dr. Thomas Herzog, Deputy Director of the University of Cincinnati Cancer Center, discusses the current landscape of PARP inhibitors for ovarian cancer and what it means for you.
Caring for You: The Mental & Emotional Toll of Survivorshipbkling
A cancer diagnosis is stressful. From gathering information about treatment options to navigating relationships with loved ones, it is normal to feel overwhelmed and emotional. This session will provide concrete tools for sharpening self-awareness to better understand needs and gain strategies for coping with intense emotions like worry and fear.
Let's Talk About It: Ovarian Cancer (Shifting Focus: The Relationship with Yo...bkling
Cancer treatment can change the relationship you have with your body. Surgical scars, hair loss, changes in sensitivity, discomfort or pain, and ongoing side effects can be overwhelming and emotional to experience. Feelings of loss, disconnect, anger, and shame are normal to have but can be uncomfortable or complicated to navigate. Join us on Wednesday, February 14th as together we openly discuss the path forward to healing and reclaiming the important relationship with your body post-diagnosis.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Side Effects Management for the Ovarian Cancer Community
1. Targeted Therapies:
Side effects and management
William Tew, MD
Associate Attending
Clinical Director, Gynecologic Medical Oncology
Memorial Sloan Kettering Cancer Center, NY
8. Harnessing the Power of the Immune System
How does the immune system recognize tumor as non-self?
9. Kerkar SP , Restifo NP Cancer Res 2012;72:3125-3130
Tumors are not just composed of cancer cells
10. Immunotherapy toxicities: Diverse
• Cancer vaccines – injection site rxn and
constitutional symptoms
• Cytokines – induce capillary leak
• Adoptive cell therapy – cytopenias (prep chemo),
cytokine release syndrome and autoimmunity
• T-cell regulation via immunomodulatory Ab….
Weber et al, JCO 2015
11. Immunomodulatory antibodies that regulate T cell activity
Turning up The Activating Blocking the Inhibiting
Slides courtesy of Drs. Dmitriy Zamarin and Alex Snyder
13. Year Drug Target Disease Indication
2011 Ipilimumab CTLA-4 Melanoma
2014 Nivolumab,
pembrolizumab
PD-1 Melanoma
2015 Nivolumab,
pembrolizumab
PD-1 NSCLC
2015 Nivolumab PD-1 RCC
2015 Nivolumab+ipilimumab PD-1 + CTLA4 Melanoma
2015 Pembrolizumab PD-1 Head and Neck SqCC
2016 Nivolumab PD-1 Hodgkin lymphoma
2016 Atezolizumab PDL-1 Urothelial cancer
2017? Anti-PD-1 MMR-deficient cancers
Current FDA Approvals: Checkpoint Inhibitors
*as of 10/30/2016
Nivolumab (Opdivo, BMS); Pembrolizumab (Keytruda, Merck); Atezolizumab (Tecentriq, Roche);
Ipilimumab (Yervoy, BMS)
14. Checkpoint Inhibitors Toxicities
• Result from inappropriate recognition of normal tissues by T cells, leading
to autoimmune tissue destruction.
• Side effects are generally mild and infrequent, but when they do occur,
they can be serious and even life threatening if not identified and treated
in a timely manner. Early recognition and treatment is essential.
• Need to be distinguished from other causes, especially infectious causes
or underlying disease
• Toxicities can be long-lasting, even after therapy discontinuation. Some
toxicities appear after therapy discontinuation.
• Some toxicities are irreversible (i.e. hypothyroidism, adrenal
insufficiency) and require long-term monitoring
17. General guidelines:
• Low grade toxicities (grade 1-2): observe, hold drug, topical steroids
( Rash – topical hydrocortisone; Diarrhea – budesonide)
• Medium grade toxicities (grade 2-3): hold, oral systemic steroids
(prednisone, methylprednisolone), closer monitoring
• High grade toxicities (grade 3-4): admit, IV steroids
• Steroid-refractory toxicities: other immunosuppressant agents
(Mycophenolate Mofetil for liver toxicity; Infliximab for other toxicities)
18. Toxicity Guidelines (non-protocol)
• On-line safety tools
– https://www.opdivosafetytool.com
• Multidisciplinary expert panel guidelines
– “Management of Immunotherapy Side Effects”
– American Society of Clinical Oncology (ASCO) and the National
Comprehensive Cancer Network® (NCCN®) joint collaboration
20. Immune-related Adverse Events (irAE)
ProportionofAffectedPatients
Rash/pruritus
Pneumonitis
Myocarditis, rare neurologic syndromes*, cholangitis*,
vasculitis neuropathy*, atrophic exocrine pancreatic
insufficiency*, sclerodermoid reaction*, others…
Figure legend: Approximate proportion of patients affected by immune-related adverse events of any
grade upon treatment with single-agent PD-1 blockade.
Endocrinopathies, arthralgia
20%
Diarrhea
Friedman and Snyder, Annals of Oncology, 2017
Rare Side Toxicities: Long Tail of irAE
21.
22. Results on ECG and Immune Effects in Cardiac Muscle after Treatment with Ipilimumab and Nivolumab
Johnson DB et al. N Engl J Med 2016;375:1749-1755
23. Immunotherapy in Older adults: FDA experience
Singh et al, FDA subset analysis of the safety of nivolumab in elderly patients with advanced cancers.
J Clin Oncol 34, 2016 (suppl; abstr 10010)
- irAE rates similar across age group.
- Look at other parameters (which do
increase with age)
- drug discontinuation
- intervention required
26. FDA approved PARP inhibitors
Treatment
Approval date Rx Indication Data
Olaparib 12/2014 400 mg BID
(50 mg CAPSULES)
Deleterious germline BRCA mut ≥3 more
priors
Study 42
Rucaparib 12/2016 600 mg BID
(200 mg, 300 mg
capsules)
Deleterious germline OR somatic BRCA
mutation &
≥2 more priors
Study 10, ARIEL2
Maintenance
Niraparib 3/2017 300 mg daily
(100 mg capsules)
Recurrent ovarian cancer &
complete or partial response to platinum
based chemotherapy
NOVA
Olaparib 8/2017 300mg BID
(150mg, 100mg
TABLETS)
Recurrent ovarian cancer &
complete or partial response to platinum
based chemotherapy
SOLO-2
Study 19
27. Each PARP inhibitor has DIFFERENT properties/indication…
PARP inhibitor CYP enzymes used for
metabolism
Drug Drug Interactions Effect on renal and hepatic uptake
transporters
Rucaparib1 CYP2D6 (predominant)
CYP1A2 and CYP3A4 (lesser
extent)
Reversibly inhibits
CYP1A2, CYP2C19,
CYP2C9, CYP3A
Induces CYP1A2
Inhibits MATE1 and MATE2-K
(potent), OCT1 (moderate)
Olaparib1 CYP3A4* Inhibits CYP3A4 and
induces CYP2B6
Inhibits OATP1B1, OCT1, OCT2,
OAT3, MATE1, MATE2K
Niraparib2 CYP3A4/5 and CYP1A2
CYP2D6 (lesser extent)
Amide hydrolysis is main
hepatic clearance
Can induce CYP1A2
(weak)
No interaction with the major
hepatic or renal uptake
transporters
1
FDA package inserts
2
niraparib IB
*Reduce dose if strong or
moderate CYP3A inhibitors
are co-administered
Slides courtesy of Dr. Ursula Matulonis
28. GI toxicities are common with all PARP inhibitors
Toxicities (%) Grade of Tox Olaparib 1
Rucaparib2
Niraparib3
Nausea All Grades 64 77 73.6
Grade 3 and 4 3 5 3.0
Constipation All 20.65
40 39.8
Grades 3 and 4 0 2 0.5
Vomiting All 43 46 34.3
Grades 3 and 4 4 4 1.9
Decreased appetite All 22 39 25.3
Grades 3 and 4 1 3 0.3
Abdominal pain All 43 32 22.6
Grades 3 and 4 8 3 1.1
Diarrhea All 31 34 19.1
Grades 3 and 4 1 2 0.3
Dyspepsia All 25 104
11.4
Grades 3 and 4 0 <1% 0
Dysgeusia All 215
39 10.1
Grades 3 and 4 0 0.3 0
1
FDA insert, 2
FDA insert, 3
NOVA NEJM 2016, 4
Swisher Lancet Onc 2016, 5
Ledermann Lancet Oncology 2014
29. Fatigue is common with all PARP inhibitors
Toxicities (%) Grade of Tox Olaparib 1
Rucaparib2
Niraparib3
Fatigue All Grades 66 77 59.4%
Grade 3 and 4 8 11 8.2%
Insomnia All NR 12% 24.3%
Grades 3 and 4 NR 0 0.3%
Headaches All Grades 255
174
25.9
Grades 3 and 4 0 04
0.3
1
FDA insert, 2
FDA insert, 3
NOVA NEJM 2016, 4
Swisher Lancet Onc 2016
5
30. Hematologic toxicities
Toxicities Grade of Tox Olaparib1
Rucaparib2
Niraparib3
Decrease in hemoglobin All Grades 90 67 50.1
Grade 3 and 4 15 23 25.3
Decrease in platelets All 30 39 61.3
Grades 3 and 4 3 6 33.8
Decrease in neutrophil
count
All 25 35 30.2
Grades 3 and 4 7 10 19.6
1
FDA package insert, 2
FDA package insert, 3
NOVA NEJM 2016
(% of pts)
31. Additional toxicities differ between agents
Toxicities Grade of Tox Olaparib1
Rucaparib2
Niraparib3
Increased Creatinine All 30 92% NR
Grades 3 and 4 2 1 NR
Elevated ALT All NR 74% NR
Grades 3 and 4 NR 13% NR
Elevated AST All NR 73% NR
Grades 3 and 4 NR 5% NR
Hypertension All NR NR 19.3%
Grades 3 and 4 NR NR 8.2%
Nasopharyngitis/URI All 26 104
11.2
Grades 3 and 4 0 04
0
Dyspnea All NR 21 19.3
Grades 3 and 4 NR 0.5 1.1
Palpitations All NR NR 10.4
Grades 3 and 4 NR NR 0
1
FDA insert, 2
FDA insert, 3
NOVA NEJM 2016, 4
Swisher Lancet Onc 2016
5
(% of pts)
32. Other side effects…
• Pneumonitis
reported in <1% of pts treated with olaparib
• AML/MDS (leukemia, pre-leukemia)
OLAP 0.8% (22/2618)1
Rucaparib 0.5% (2/377)2
Niraparib 1.4% (5/367)3
• Increase in cholesterol
Rucaparib2
: 40% all grades; 2% grade 3 and 4
• Rash/photosensitivity reaction
Rucaparib: 15%/10%
Olaparib: 25%/0
1
FDA insert, 2
FDA insert, 3
NOVA NEJM 2016,
41. Summary
• Targeted agents bring unique, yet often manageable side
effects.
• Special attention to drug combinations and populations not
studied in prospective studies (elderly)
• With a FDA indication and broader use, very rare side effects
can be discovered.
Editor's Notes
How does the immune system recognize tumor as non-self?
Member of CD28 family involved in T cell regulation
Expressed by activated T cells, memory T cells and regulatory T cells
Down regulates T cell activity upon binding to PD-L1/L2
Tumor PD-L1 expression may correlate with negative prognosis potential mechanism of tumor self defense
Member of CD28 family involved in T cell regulation
Expressed by activated T cells, memory T cells and regulatory T cells
Down regulates T cell activity upon binding to PD-L1/L2
Tumor PD-L1 expression may correlate with negative prognosis potential mechanism of tumor self defense
Fatal autoimmune myocarditis with rhabdomyolysis and refractory arrhythmias developed in two patients treated with a combination of anti–CTLA-4 and anti–PD-1 blockers.
On histologic examination, a myocardial infiltrate suggested acute cardiac allograft rejection.
Figure 1 Results on ECG and Immune Effects in Cardiac Muscle after Treatment with Ipilimumab and Nivolumab in Patient 1. Patient 1 had rapid progression to complete heart block (as shown on electrocardiography [ECG] in Panel A), followed by ventricular tachycardia (Panel B). Autopsy revealed lymphocytic infiltration of the myocardium (shown in the intraventricular septum in Panel C; staining with hematoxylin and eosin). The inflammatory infiltrate included CD3-positive T lymphocytes (Panel D), many of which were positive for CD8 (Panel E). Only cardiac and skeletal muscle was affected; smooth muscle and other tissues were spared (Panel F, hematoxylin and eosin). The black arrow points to esophageal smooth muscle without immune infiltration, and the green arrow points to esophageal skeletal muscle, which is heavily infiltrated by immune cells.
Background: With recent FDA approvals of immune checkpoint inhibitors for the treatment of advanced cancer, an increasing number of elderly patients will be treated with immunotherapy. Nivolumab is an immune checkpoint inhibitor, currently approved for the treatment of advanced renal cell cancer, melanoma, and non-small cell lung cancer based on significant responses including benefit in overall survival. However, little is known about the safety of nivolumab in an elderly patient population. Methods: Eligible patients received at least one dose of nivolumab as a single agent while enrolled in a phase 3 registration trial for the treatment of advanced renal cell cancer (CA209025), melanoma (CA209066), or non-small lung cancer (CA209057 and CA209017). Adverse events which occurred up to 100 days after last dose of nivolumab based on standardized adverse event datasets submitted by the sponsor were included. Results: See table. Conclusions: Immune therapies can benefit patients across a wide range of tumors. Currently there is little known about the safety of nivolumab in elderly patients. This exploratory analysis suggests that nivolumab is well tolerated in the elderly population in terms of adverse events. These data should be validated in larger patient cohorts, with specifically targeted age ranges to reflect the aging cancer population. The inclusion of greater numbers of elderly patients in registration clinical trials will further inform clinicians on the safety of immune based therapies in the elderly.
Each drug is metabolized differently
Other drugs patients are taking may influence the PARP Inhibitor levels
Drug interactions can occur based on CYP inhibition or induction
Effect on renal transporter proteins MATE1 and MATE2-K can increase serum creatinine
Tumor angiogenesis is the proliferation of a network of blood vessels that penetrates into cancerous growths, supplying nutrients and oxygen and removing waste products. Tumor angiogenesis actually starts with cancerous tumor cells releasing molecules that send signals to surrounding normal host tissue. This signaling activates certain genes in the host tissue that, in turn, make proteins to encourage growth of new blood vessels.
Grade 3 or greater toxicity: black, chemotherapy plus bevacizumab; stripes, chemotherapy alone.