Precision Oncology: Combining Orthotopic-PDX Models and MRI, Moving Research ...Scintica Instrumentation
Certis Oncology Solutions is a precision oncology and translational science company. It works directly with cancer patients and their oncologists to help determine the best therapies for individuals, and also partners with pharmaceutical companies to help develop the next generation of anticancer therapies. Certis’s approach to studying drug efficacy is rooted in orthotopic patient-derived xenograft (O-PDX) models. Because tumors are internal to the animal, they usually cannot be measured by calipers. Certis overcomes this challenge by using magnetic resonance imaging (MRI), employing the Aspect M3 Compact MRI to generate high-resolution 3D anatomical images to monitor anti-cancer therapies in real-time.
Topics that were discussed in this webinar :
- Overview of precision oncology and testing platforms
- Comparison on subcutaneous and orthotopic in vivo models
- Imaging modalities for pre-clinical in vivo studies
- Applications of MRI in precision oncology and preclinical in vivo pharmacology studies
Chair and Presenter, Prof Eric Van Cutsem, MD, PhD, and Scott Kopetz, MD, PhD, prepared useful Practice Aids pertaining to colorectal cancer for this CME/MOC/NCPD activity titled “Putting a Personalized Colorectal Cancer Treatment Algorithm Into Practice: Navigating Practicalities in the Era of Molecularly Defined Care.” For the full presentation, downloadable Practice Aids, and complete CME/MOC/NCPD information, and to apply for credit, please visit us at https://bit.ly/3aSSAtm. CME/MOC/NCPD credit will be available until November 13, 2022.
Dr. Paul Sabbatini: Recurrent Ovarian Cancer: Now What? (SHARE Program)bkling
On May 22, 2013, SHARE presented "Recurrent Ovarian Cancer: Now What?" The program featured Dr. Ginger Gardner and Dr. Paul Sabbatini of Memorial Sloan-Kettering Cancer Center discussing treatment strategies, as well as new approaches and agents, for managing an ovarian cancer recurrence. Listen to the audio here http://www.sharecancersupport.org/sabbatini.
The information in this presentation is not intended to be a substitute for professional medical advice, diagnosis or treatment.
Precision Oncology: Combining Orthotopic-PDX Models and MRI, Moving Research ...Scintica Instrumentation
Certis Oncology Solutions is a precision oncology and translational science company. It works directly with cancer patients and their oncologists to help determine the best therapies for individuals, and also partners with pharmaceutical companies to help develop the next generation of anticancer therapies. Certis’s approach to studying drug efficacy is rooted in orthotopic patient-derived xenograft (O-PDX) models. Because tumors are internal to the animal, they usually cannot be measured by calipers. Certis overcomes this challenge by using magnetic resonance imaging (MRI), employing the Aspect M3 Compact MRI to generate high-resolution 3D anatomical images to monitor anti-cancer therapies in real-time.
Topics that were discussed in this webinar :
- Overview of precision oncology and testing platforms
- Comparison on subcutaneous and orthotopic in vivo models
- Imaging modalities for pre-clinical in vivo studies
- Applications of MRI in precision oncology and preclinical in vivo pharmacology studies
Chair and Presenter, Prof Eric Van Cutsem, MD, PhD, and Scott Kopetz, MD, PhD, prepared useful Practice Aids pertaining to colorectal cancer for this CME/MOC/NCPD activity titled “Putting a Personalized Colorectal Cancer Treatment Algorithm Into Practice: Navigating Practicalities in the Era of Molecularly Defined Care.” For the full presentation, downloadable Practice Aids, and complete CME/MOC/NCPD information, and to apply for credit, please visit us at https://bit.ly/3aSSAtm. CME/MOC/NCPD credit will be available until November 13, 2022.
Dr. Paul Sabbatini: Recurrent Ovarian Cancer: Now What? (SHARE Program)bkling
On May 22, 2013, SHARE presented "Recurrent Ovarian Cancer: Now What?" The program featured Dr. Ginger Gardner and Dr. Paul Sabbatini of Memorial Sloan-Kettering Cancer Center discussing treatment strategies, as well as new approaches and agents, for managing an ovarian cancer recurrence. Listen to the audio here http://www.sharecancersupport.org/sabbatini.
The information in this presentation is not intended to be a substitute for professional medical advice, diagnosis or treatment.
This is a powerpoint on Bladder Cancer. Sources are on the last slide of the powepoint! No copy right intended! Enjoy! I hope you learn a lot and I hope you live your life Bladder Cancer free! Also the red words are what I would say during the presentation, basically extra details! So keep that in mind!
-Shelby
Presentación realizada por el Dr. Julio Lambea Sorrosal del
Servicio de Oncología Médica Clínico Lozano Blesa de Zaragoza, en el marco de la I Jornada de actualización e innovación en Oncología que tuvo lugar en el CIBA en enero de 2015.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the 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 lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
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. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
1. Bladder Cancer Guidelines
A Brief Review
Waleed A. Hassen M.D.
Chairman of Urology
Tawam Hospital
Assistant Professor
Johns Hopkins Medical Institutions
3. Understanding Pathology
WHO/ISUP 1998 Consensus WHO 2004
• Papilloma
• Papillary urothelial neoplasm of low
malignant potential (PUNLMP)
• Urothelial Carcinoma low-grade
• Urothelial Carcinoma high grade *
– Previously classified grade 2 now high grade
4. Understanding Pathology
Recurrence vs Progression
Pathology 5 yr Recurrence Prob. Muscle
Invasion
Ta, Low grade 50% Minimal
Ta, high grade 60% Moderate
T1, low grade 50% Moderate
(rare)
T1, high grade 50-70% Moderate-High
Tis 50-90% High
5. Understanding Pathology
Pathologic Reporting
• Pathology report must comment:
– Histologic grade
– The presence of muscularispropria, and degree
of involvement
– Presence or absence of LVI
– Presence or absence of CIS
9. Staging
• Suspect Muscle Invasive Disease
– CBC, Chemistry including AlkPhos
– CXR or CT Chest
– Upper tract imaging
– CT or MRI
– Bone Scan if Alk. Phos elevated or symptoms
10. Transurethral Resection
• Goals of TUR:
– Complete resection of all visible tumor when
possible
– Adequate mapping of bladder if needed
– Adequate staging by ensuring presence of
muscle
11. Management
• cTa (low grade)
– Complete resection
– Observation vs single dose intravesical
chemotherapy*
12. Management
• cTa (high grade)
– Complete resection
– Re-resection if no muscle in specimen*
– Induction Immunotherapy
– Chemotherapy only if unable to tolerate BCG
13. Management
• cT1 (high grade)
– Complete resection
– Strongly advise re-resection
– Consider early cystectomy especially if re-
resection shows higher stage or volume disease
– Induction BCG otherwise
– Chemotherapy only if unable to tolerate BCG
14. Restaging TURBT
• 150 cases who underwent re-staging
TURBT
• Residual disease found in 76% Patients
• Upstaging to muscle invasive disease in 30% of
patients who initially had superficial disease
• Results are similar when same surgeon
performs resection
15. Management
• cTis
– Induction Immunotherapy
– If response consider maintenance BCG
• (x 3 years)
– Recurrent or persistent CIS, consider
cystectomy after no more then 2 courses of
BCG
17. 2nd Course of BCG
Salvage up to 50% on
non-responders
# courses Progression %
Rate Developing
Risk of progression and Mets
Mets increases as the # 1 7% 5%
courses of BCG
increases
2 11% 14%
3 30% 50%
Catalona et al., J Urol, 137: 220-4, 1987
18. Management
• cT2
– Radical Cystectomy remains treatment of
choice
– If positive nodes on CT- Biopsy
– Partial cystectomy in SELECTED pts:
• Solitary lesion (small)
• Amenable location to resection with margin
• No CIS
• Lymphadenectomy should always accompany
24. Management
– cT2
• Radiation concomitant with chemo therapy
– No hydronephrosis
– Repeat TUR and boost to 65Gy if negative
– Simulate/treat patient with empty bladder
– High recurrence rate
• Radiation alone in patients with extensive co-
morbidities
27. DSS 1.66 in favor of chemo (p=.002, Overall Survival 1.33 in favor of chemo p
28. Adjuvant Trials
Series Chemo N Survival
Richards 5FU/Dox 129 No
Freiha CMV 55 No
Studer Cisplatin 77 No
Stockle MVAC 49 Yes
Skinner CAP 91 Yes
29. Neoadjuvant Chemotherapy plus Cystectomy and PLND
Survival and Local Relapse analysis (N = 307)
Dotan el al, ASCO 2005
Treatment 5 year Survival Freedom from local
relapse
Neoadjuvant MVAC + >10 nodes 81% 91%
Surgery alone >10 nodes 64% 90%
Neoadjuvant MVAC <10 nodes 55% 73%
Surgery alone < 10 nodes 39% 66%
No cystectomy 11% 12%
30. Management
– Metastatic Disease
• Gemcitabine/Cisplatin preferred
– Equivalent efficacy to MVAC
• 3 drug regimens have not been shown to be more
efficacious
• Carboplatin is NOT a substitute for Cisplatin
– Consider split dose cisplatin for borderline renal function
• Consider Carboplatin or Taxane-based regimens for
patients not candidates for Cisplatin
31. Management
– Bladder cancer is a lifelong disease
– Attention to published surveillance protocols
– Attempt multi-disciplinary care whenever
possible
– Do not forget about upper tracts