LIVER DIRECTED THERAPY IN UVEAL MELANOMA- THE SOUTHAMPTON EXPERIENCE
|
|
- Jeffrey Wells
- 6 years ago
- Views:
Transcription
1 LIVER DIRECTED THERAPY IN UVEAL MELANOMA- THE SOUTHAMPTON EXPERIENCE DR IOANNIS KARYDIS ASSOCIATE PROFESSOR IN MEDICAL ONCOLOGY UNIVERSITY OF SOUTHAMPTON AND SOUTHAMPTON UNIVERSITY HOSPITAL
2 UVEAL MELANOMA BACKGROUND Incidence 2-8/million in Europe new cases / year in UK 50% will develop metastatic disease within 15 years Historic data: Median expected survival 4-6 months At 1 year post diagnosis of metastasis only 10-15% still alive without treatment
3 UVEAL MELANOMA AN ORPHAN DISEASE No molecular targeted treatments available Chemo-resistant (ORR<10 % even with combination regimes) Immunotherapies unproven
4 TARGETING THE LIVER 85-95% will develop liver metastases In >~ 50% liver is the only site of metastatic disease Less than 5-10% qualify for surgical resection Imaging often underestimates extent of disease Uncontrolled liver disease often behaves aggressively Immunotherapeutics less likely to work
5 LIVER DIRECTED THERAPIES Chemo- / Immuno- / Radioembolisation Ablation modalities Hepatic Perfusion
6 UVEAL MELANOMA IN SOUTHAMPTON high risk UM patients a year referred for follow-up post treatment of primary tumour Direct referrals from UK and abroad for management of metastatic disease Ocular Melanoma Multidisciplinary team Interventional radiologists Medical Oncologists Hepatobiliary surgeons Perfusionists Anaestetists Nurse specialists
7 INTEGRATING LIVER DIRECTED AND SYSTEMIC MANAGEMENT Early diagnosis of metastatic disease Serial imaging 6 - monthly liver MRI Liver directed management Surgery Melphalan PHP / TACE SIRTS Systemic treatment Ipilimumab Anti PD-1 agents Clinical Trials
8 PERCUTANEOUS HEPATIC PERFUSION ( PHP ) Chemofiltration circuit Hepatic vein & IVC Isolation Hepatic Artery cannulation
9 WORK-UP FOR MELPHALAN PHP Accurate Staging Clinical Assessment Management plan MRI liver, whole body CT CPET testing OM MDT Staging laparoscopy Oncology & Anaesthetic Review Final consultation with patient
10 THE SOUTHAMPTON EXPERIENCE 25 patients received 43 cycles (median 2, range 1-4) 2 treatments abandoned on day of procedure due to unsuitable anatomy on angiography Median length of stay: 4 days range 3-8, though only 3 episodes were longer than 5 days
11 HEPATIC RESPONSE ASSESSMENT Best hepatic response (by liver MRI): Overall Response Rate (CR+PR): 37 % Disease control rate (CR+PR+SD): 83 % Median liver Progression Free Survival : 242 days Best liver Response Complete Response Partial Response Stable Disease >3months Progressive Disease N (%) 1 (4%) 8 (33%) 11 (46%) 4 (17%)
12
13 OUTCOMES Median Survival : 511 days (17 months) 12/25 patients still alive after a median of 315 days (~10.5 months) 1 year survival rate ~ 65% Progression Free Survival Median overall PFS ~ 182 days (~6 mo) Median liver PFS ~ 242 days (~8 mo) In 9/21 (~42%) cases systemic progression preceded liver progression.
14 COMPARATOR: PHASE III TRIAL Hepatic median PFS: Overall median PFS: Median OS: 242 vs 245 days 182 vs 186 days 511 vs 301 days From: Hughes et al, Ann Surg Onc Apr 2016, Vol 23, Issue 4, pp Results of a Randomized Controlled Multicenter Phase III Trial of Percutaneous Hepatic Perfusion Compared with Best Available Care for Patients with Melanoma Liver Metastases
15 WHAT ABOUT SIDE EFFECTS? Adverse Events UHS Phase III trial G3-4 Neutropenia 7/25 (28%) 60/70 (86%) Febrile neutropenia 2/25 (8%) 12/70 (17%) G3-4 Anaemia 10/25 (40%) 44/70 (63%) G3-4 Thrombocytopenia 7/25 (28%) 56/80 (80%) Cardiac arrhythmias 2/25 (8%) 4/70 (6%) Troponin rise 1/25 (4%) 6/70 (9%)
16 SEVERE NON-HAEMATOLOGICAL TOXICITIES No treatment related fatalities Immediate toxicities: Cardiovascular : 3/25 1 case of pulmonary oedema 2 cases of cardiac arrhythmias Vascular access complication : 2/25 1 case of intraabdominal haemorrhage 1 case of IVC thrombus (with subsequent PE) Late toxicities Thromboembolic (4/25) 3 cases of PE, 1 DVT diagnosed within 3 months of procedure 1 case of G3 fatigue
17 NON-HAEMATOLOGICAL MILD-MODERATE TOXICITIES Mild abnormalities in liver function tests common (32%) but resolve rapidly Other notable mild toxicities include: Nausea / Vomiting ( 12% & 8% respectively) Epigastric discomfort (12%) Constipation (8%) Mucositis/ Alopecia (4%)
18 HAEMATOLOGICAL TOXICITIES Immediate haematological toxicities common but easily manageable: Grade Anaemia 4 (16%) 10 (40%) 10 (40%) 0 Thrombocytopenia 5 (20%) 11 (44%) 3 (12%) 4 (16%) Neutropenia 0 1(4%) 2 (8%) 5 (20%) 2 episodes of neutropenic sepsis were documented Platelet and blood transfusions were needed in 19 (76%) and 13 (52%) respectively, typically in the peri/immediate post-procedure setting There was 1 case of systemic coagulopathy (DIC) requiring extensive coagulation factor support
19 PROS/CONS OF M-PHP PROS: High hepatic disease control rates Generally well tolerated in appropriately selected patients CONS Risk of potentially life threatening complications Technically demanding & expensive BIG ISSUE Lack of concrete evidence of survival benefit/ superiority versus alternatives
20 FOCUS TRIAL WHY? Phase 3 trial allowed crossover -> survival benefit diluted, not statistically significant In the absence of evidence from randomised clinical trials NHS funding extremely unlikely Since then technique has improved New Immunotherapies have also arrived! <-> less effective in patients with uncontrolled liver disease * Is M-PHP superior to current alternatives? *
21 Randomised: Melphalan PHP vs alternative Standard of Care (TACE/immunotherapy/chemotherapy) Inclusion criteria Histologically proven & measurable liver metastatic disease No previous intra-arterial hepatic therapy No contraindication to Melphalan PHP
22 MELPHALAN CHEMOPERFUSION A TECHNIQUE AT CROSSROADS Appropriate patient selection and optimised perioperative management have resulted in improved side-effect profile Role in a rapidly developing field of alternative potentially complementary treatment approaches remains to be determined
23 SOUTHAMPTON PHP EXPERIENCE SUMMARY Melphalan PHP can be delivered safely by an experienced multidisciplinary team in the UHS Can provide significant benefits in a carefully selected group of patients as part of a multidisciplinary approach Further research is needed to establish its place in the context of new systemic and especially immunotherapeutic treatment Randomised Phase III study now open for recruitment!
Clinical Commissioning Policy Proposition:
Clinical Commissioning Policy Proposition: Chemosaturation for liver metastases from ocular melanomas Reference: NHS England A02X05/01 Information Reader Box (IRB) to be inserted on inside front cover
More informationDelcath Investor Presentation (OTCQB: DCTH)
Delcath Investor Presentation (OTCQB: DCTH) December 2018 1 DELCATH SYSTEMS, INC Forward-looking Statements This presentation contains forward-looking statements, within the meaning of the federal securities
More informationDelcath Investor Presentation (OTCQB: DCTH)
Delcath Investor Presentation (OTCQB: DCTH) June 2018 1 DELCATH SYSTEMS, INC Forward-looking Statements This presentation contains forward-looking statements, within the meaning of the federal securities
More informationDelcath Investor Presentation (OTCQB: DCTH)
Delcath Investor Presentation (OTCQB: DCTH) March 2018 1 DELCATH SYSTEMS, INC Forward-looking Statements This presentation contains forward-looking statements, within the meaning of the federal securities
More informationRare melanoma: Are the options improving? Dr Neil Steven Consultant in Medical Oncology University Hospital Birmingham University of Birmingham
Rare melanoma: Are the options improving? Dr Neil Steven Consultant in Medical Oncology University Hospital Birmingham University of Birmingham Classifying melanoma Melanoma (site of origin, thickness,
More informationJose Ramos. Role of Surgery in isolated hepatic metastasis from breast carcinoma, melanoma or sarcoma
Role of Surgery in isolated hepatic metastasis from breast carcinoma, melanoma or sarcoma Jose Ramos University of the Witwatersrand Donald Gordon Medical Centre Evolution of liver resection Better understanding
More informationStandard care plan for 1 st line palliative chemotherapy in advanced non small cell lung cancer References
CHEMOTHERAPY CARE PLAN Document Title: Document Type: Subject: Approved by: Currency: Carboplatin & Gemcitabine combination chemotherapy (Lung cancer) Clinical Guideline Standard Care Plan 2 Years Review
More informationChemosaturation: Indication, Technique and Outcome
Chemosaturation: Indication, Technique and Outcome Thomas J Vogl, S Koch, B Gebauer, W Willinek, C Engelke, R Bruening, F Wacker, A Enk I D I R: Institute of Diagnostic and Interventional Radiology Goethe
More informationStaging & Current treatment of HCC
Staging & Current treatment of HCC Dr.: Adel El Badrawy Badrawy; ; M.D. Staging & Current ttt of HCC Early stage HCC is typically silent. HCC is often advanced at first manifestation. The selective ttt
More informationStandard care plan for Carboplatin and Etoposide Chemotherapy References
CHEMOTHERAPY CARE PLAN Document Title: Document Type: Subject: Approved by: Currency: Carboplatin/Etoposide Chemotherapy Clinical Guideline Standard Care Plan 2 Years Review date: Author(s): Standard care
More informationC.W. Nutting & J.S. Zager on behalf of the DCTH P3 Investigators
Chemosaturation Therapy with Percutaneous Hepatic Perfusions of Melphalan Versus Standard of Care in Patients with Hepatic Metastases from Melanoma: A Randomized Multicenter Phase 3 Study C.W. Nutting
More informationSurveillance following treatment of primary ocular melanoma
Surveillance following treatment of primary ocular melanoma Introduction 50% of UM patients relapse with predominantly liver metastases Risk of metastatic disease can be predicted relatively accurately
More informationCisplatin and Gemcitabine Bladder Cancer: Full and split dose
Systemic Anti Cancer Treatment Protocol Cisplatin and Gemcitabine Bladder Cancer: Full and split dose PROCTOCOL REF: MPHAUROCIG (Version No: 1.0) Approved for use in: Neoadjuvant and palliative indications
More informationManagement of Colorectal Liver Metastases
Management of Colorectal Liver Metastases MM Bernon, JEJ Krige HPB Surgical Unit, Groote Schuur Hospital Department of Surgery, University of Cape Town 50% of patients with colorectal cancer develop liver
More informationDelcath Investor Presentation (NASDAQ: DCTH)
Delcath Investor Presentation (NASDAQ: DCTH) February 2017 1 DELCATH SYSTEMS, INC Forward-looking Statements This presentation contains forward-looking statements, within the meaning of the federal securities
More informationManagement of Stage IV Colorectal Cancer: Expanding the Horizon
Management of Stage IV Colorectal Cancer: Expanding the Horizon May Tee, MD, MPH and Jan Franko, MD, PhD MercyOne Surgical Group (Mercy Surgical Affiliates) GI Oncology Conference 2019 March 1, 2019 Disclosures
More informationBladder Cancer Guidelines
Bladder Cancer Guidelines Agreed by Urology CSG: October 2011 Review Date: September 2013 Bladder Cancer 1. Referral Guidelines The following patients should be considered as potentially having bladder
More informationSAFETY CONSIDERATIONS WITH YONDELIS (trabectedin)
SAFETY CONSIDERATIONS WITH YONDELIS (trabectedin) Please see Important Safety Information on pages 14 and 15 and accompanying full Prescribing Information. YONDELIS (trabectedin) STUDY DESIGN INDICATION
More informationPEMBROLIZUMAB (KEYTRUDA ) for the treatment of advanced melanoma or previously treated NSCLC
DRUG ADMINISTRATION SCHEDULE Day Drug Dose Route Diluent Rate Day 1 Pembrolizumab 2mg/kg IV Infusion 100mL 0.9% Sodium Chloride* Or 100mL 5% Glucose* *Final concentration must be between 1 to 10mg/mL Over
More informationInvestor Presentation (NASDAQ: DCTH)
Investor Presentation (NASDAQ: DCTH) June 2015 1 DELCATH SYSTEMS, INC Forward-looking Statements This presentation contains forward-looking statements, within the meaning of the federal securities laws,
More informationContents. Contributors. Reviewers. Acknowledgements I CARDIOVASCULAR COMPLICATIONS
Contributors Reviewers Acknowledgements Preface xii xvi xvii xviii I CARDIOVASCULAR COMPLICATIONS 1 Cardiac Complications of Cancer and Anticancer Treatment 3 Introduction 3 Malignant Pericardial Effusion
More informationThe Surgical Management of Colorectal Metastases
11th July 2017 Bowel Cancer UK The Surgical Management of Colorectal Metastases Ben Cresswell MD(Res) FRCS Consultant HPB Surgeon The Basingstoke Hepatobiliary Unit United Kingdom Surgical Management of
More informationTargeted Therapies in Melanoma
Mutations and Targets Targeted Therapies in Melanoma ckit NRAS
More informationCarboplatin and Gemcitabine
Systemic Anti Cancer Treatment Protocol Carboplatin and Gemcitabine PROTOCOL REF: MPHACAGELU (Version No: 1.0) Approved for use in: Advanced non-small cell lung cancer Performance status: 0 to 2 Re-challenge
More informationNATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE SCOPE
NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE 1 Guideline title SCOPE Malignant melanoma: assessment and management of malignant melanoma 1.1 Short title Malignant Melanoma 2 The remit The Department
More informationThis clinical study synopsis is provided in line with Boehringer Ingelheim s Policy on Transparency and Publication of Clinical Study Data.
abcd Clinical Study for Public Disclosure This clinical study synopsis is provided in line with s Policy on Transparency and Publication of Clinical Study Data. The synopsis which is part of the clinical
More informationState of the art management of Colorectal Liver Metastasis: an interplay of Chemotherapy and Surgical options
State of the art management of Colorectal Liver Metastasis: an interplay of Chemotherapy and Surgical options Ioannis S. Hatzaras, MD, MPH, FACS Assistant Professor of Surgery Division of Surgical Oncology
More informationCarboplatin / Gemcitabine Gynaecological Cancer
Systemic Anti Cancer Treatment Protocol Carboplatin / Gemcitabine Gynaecological Cancer PROCTOCOL REF: MPHAGYNCAG (Version No: 1.0) Approved for use in: Recurrent/metastatic endometrial carcinoma Previously
More informationInvestor Presentation (NASDAQ: DCTH)
Investor Presentation (NASDAQ: DCTH) April 2015 1 DELCATH SYSTEMS, INC Forward-looking Statements This presentation contains forward-looking statements, within the meaning of the federal securities laws,
More informationSurgical Management of Pancreatic Cancer
I Congresso de Oncologia D Or July 5-6, 2013 Surgical Management of Pancreatic Cancer Michael A. Choti, MD, MBA, FACS Department of Surgery Johns Hopkins University School of Medicine, Baltimore, MD Estimated
More informationNab-Paclitaxel (Abraxane) and Gemcitabine For Pancreatic Adenocarcinoma Cumbria, Northumberland, Tyne & Wear Area Team
DRUG ADMINISTRATION SCHEDULE Day Drug Dose Route Diluent & Rate 1 8 15 Sodium Chloride 0.9% 100ml Infusion Fast Running Dexamethasone 8mg Oral Ondansetron 8mg Oral/ IV Chlorphenamine 10mg Intravenous Slow
More informationClinical Activity Lung Cancer. Andrea Camerini Ospedale Versilia
Clinical Activity Lung Cancer Andrea Camerini Ospedale Versilia The three main objectives in advanced NSCLC 1. In advanced/metastatic cancer, palliation is often the primary treatment goal 2. Potential
More informationFIRST RESULTS OF NEW DATA OF ABRAXANE IN COMBINATION WITH ATEZOLIZUMAB PRESENTED AT ESMO 2018
FIRST RESULTS OF NEW DATA OF ABRAXANE IN COMBINATION WITH ATEZOLIZUMAB PRESENTED AT ESMO 2018 IMpassion130 reports first positive Phase III study results for a chemotherapy/immunotherapy (ABRAXANE plus
More informationStudy No: Title: Rationale: Phase: Study Period: Study Design: Centres: Indication: Treatment: Objectives: Primary Outcome/Efficacy Variable:
The study listed may include approved and non-approved uses, formulations or treatment regimens. The results reported in any single study may not reflect the overall results obtained on studies of a product.
More informationSurgical management of HCC. Evangelos Prassas Hepatobiliary and Pancreatic Surgery / Liver Transplantation Kings College Hospital / London
Surgical management of HCC Evangelos Prassas Hepatobiliary and Pancreatic Surgery / Liver Transplantation Kings College Hospital / London Global distribution of HCC and staging systems WEST 1. Italy (Milan,
More informationSIR-Spheres: Des essais cliniques à la pratique courante
SIR-Spheres: Des essais cliniques à la pratique courante Un focus sur le traitement du mcrc en échappement thérapeutique Dr. Michaël Vouche, MD. PhD. Université Libre de Bruxelles Institut Jules Bordet
More informationHepatocellular Carcinoma HCC Updated November 2015 by: Dr. Mohammed Alghamdi (Medical Oncology Fellow, University of Calgary)
Hepatocellular Carcinoma HCC Updated November 2015 by: Dr. Mohammed Alghamdi (Medical Oncology Fellow, University of Calgary) Staff Reviewers: Dr. Yoo Joung Ko (Medical Oncologist, Sunnybrook Odette Cancer
More informationCPAG Summary Report for Clinical Panel 1608 Bendamustine for relapsed multiple myeloma
MANAGEMENT IN CONFIDENCE CPAG Summary Report for Clinical Panel 1608 Bendamustine for relapsed multiple myeloma The Benefits of the Proposition (Grade of Evidence to be left blank) No Outcome measures
More informationTRANSEARTERIAL CHEMO- EMBOLIZATION FOR HEPATIC METASTASES FROM NEURO-ENDOCINE NEOPLASIA AND HEPATOMA DR SAMIA AHMAD
UNIVERSITY OF PRETORIA STEVE BIKO ACADEMIC HOSPITAL SOUTH AFRICA TRANSEARTERIAL CHEMO- EMBOLIZATION FOR HEPATIC METASTASES FROM NEURO-ENDOCINE NEOPLASIA AND HEPATOMA DR SAMIA AHMAD 1 INTRODUCTION Hepatic
More informationSurgical Metabolism Section, Surgery Branch, NCI, Bethesda, MD Division of Surgical Oncology, University of Maryland, Baltimore, MD
High Dose Intra-Arterial Melphalan Delivered via Percutaneous Hepatic Perfusion (PHP) for Patients with Unresectable Hepatic Metastases from Primary Neuroendocrine Tumors. James F. Pingpank, Richard E.
More informationSupplementary Online Content
Supplementary Online Content Chawla SP, Papai Z, Mukhametshina G, et al. First-line aldoxorubicin vs doxorubicin in metastatic or locally advanced unresectable soft-tissue sarcoma: a phase 2b randomized
More informationCarfilzomib and Dexamethasone (CarDex)
Carfilzomib and Dexamethasone (CarDex) Indication Relapsed multiple myeloma for patients who have had only one previous line of therapy (that did not include bortezomib). (NICE TA457) ICD-10 codes Codes
More informationCisplatin and Gemcitabine (bladder)
Cisplatin and Gemcitabine (bladder) Indication Palliative therapy for locally advanced or metastatic bladder cancer in patients with good renal function. Palliative therapy for urothelial transitional
More informationNursing s Role in the Management of New Oral Chemotherapy Agents
Nursing s Role in the Management of New Oral Chemotherapy Agents Mechelle Barrick BSN, RN, OCN, CCRP Clinical Research Nurse Coordinator Greater Baltimore Medical Center mbarrick@gbmc.org THE NURSES ROLE
More informationGamma Knife Radiosurgery A tool for treating intracranial conditions. CNSA Annual Congress 2016 Radiation Oncology Pre-congress Workshop
Gamma Knife Radiosurgery A tool for treating intracranial conditions CNSA Annual Congress 2016 Radiation Oncology Pre-congress Workshop ANGELA McBEAN Gamma Knife CNC State-wide Care Coordinator Gamma Knife
More informationRadiotherapy for Rectal Cancer. Kevin Palumbo Adelaide Radiotherapy Centre
Radiotherapy for Rectal Cancer Kevin Palumbo Adelaide Radiotherapy Centre Overview CRC are common (3 rd commonest cancer) rectal Ca approx 25-30% of all CRC. Presentation PR bleeding: beware attributing
More informationBCCA Protocol Summary for Curative Combined Modality Therapy for Carcinoma of the Anal Canal Using Mitomycin, Capecitabine and Radiation Therapy
BCCA Protocol Summary for Curative Combined Modality Therapy for Carcinoma of the Anal Canal Using Mitomycin, and Radiation Therapy Protocol Code: Tumour Group: Contact Physician: GICART Gastrointestinal
More informationSingle Technology Appraisal (STA) Nivolumab for adjuvant treatment of resected stage III and IV melanoma
Single Technology Appraisal (STA) Nivolumab for adjuvant treatment of resected stage III and IV Response to consultee and commentator comments on the draft remit and draft scope (pre-referral) Comment:
More informationThe Management of Advanced Stage Hepatocellular Carcinoma
The Management of Advanced Stage Hepatocellular Carcinoma Pierce K.H Chow MD PhD Professor, Duke-NUS Graduate Medical School Singapore Senior Consultant Surgeon, National Cancer Center Singapore Senior
More informationHepatocellular Carcinoma. Markus Heim Basel
Hepatocellular Carcinoma Markus Heim Basel Outline 1. Epidemiology 2. Surveillance 3. (Diagnosis) 4. Staging 5. Treatment Epidemiology of HCC Worldwide, liver cancer is the sixth most common cancer (749
More informationMULTIDISCIPLINARY GENITOURINARY ONCOLOGY COURSE
MULTIDISCIPLINARY GENITOURINARY ONCOLOGY COURSE Case 2 Testicular Cancer Nuno Sineiro Vau Medical Oncologist Champalimaud Foundation, Lisbon October 2017 Male, 36 year-old, sales manager. Past medical
More informationCISPLATIN Chemo-radiation regimen Gynaecological Cancer
Systemic Anti Cancer Treatment Protocol CISPLATIN Chemo-radiation regimen Gynaecological Cancer PROCTOCOL REF: MPHAGYNCIX (Version No: 1.0) Approved for use in: Locally advanced cervical cancer (adjuvant/curative)
More informationPercutaneous Radiofrequency Ablation of Lung Malignant Tumours: Survival, disease progression and complication rates
Percutaneous Radiofrequency Ablation of Lung Malignant Tumours: Survival, disease progression and complication rates Poster No.: C-2576 Congress: ECR 2012 Type: Authors: Keywords: DOI: Scientific Exhibit
More informationMetronomic chemotherapy for breast cancer
Metronomic chemotherapy for breast cancer M. Colleoni International Breast Cancer Study Group (IBCSG), Division of Medical Senology, European Institute of Oncology Metronomic Scheduling and Inhibition
More informationMetastasectomy for Melanoma What s the Evidence and When Do We Stop?
Metastasectomy for Melanoma What s the Evidence and When Do We Stop? Vernon K. Sondak, M D Chair, Moffitt Cancer Center Tampa, Florida Focus on Melanoma London, UK October 15, 2013 Disclosures Dr. Sondak
More informationFAST TRACK MANAGEMENT OF PANCREATIC CANCER
FAST TRACK MANAGEMENT OF PANCREATIC CANCER Jawad Ahmad Consultant Hepatobiliary Surgeon University Hospital Coventry and Warwickshire NHS Trust Part 1. Fast Track Surgery for Pancreatic Cancer Part 2.
More informationBreast Pathway Group Bevacizumab & Paclitaxel in Advanced Breast Cancer
Breast Pathway Group Bevacizumab & Paclitaxel in Advanced Breast Cancer Indication: First-line or second-line treatment of triple negative advanced breast cancer National Cancer Drug Fund criteria: Advanced
More informationClinical Aspects of SBRT in Abdominal Regions Brian D. Kavanagh, MD, MPH University of Colorado Department of Radiation Oncology
Clinical Aspects of SBRT in Abdominal Regions Brian D. Kavanagh, MD, MPH University of Colorado Department of Radiation Oncology Abdominal SBRT: Clinical Aspects Rationales for liver and pancreas SBRT
More informationManchester Cancer Colorectal Pathway Board: Guidelines for management of colorectal hepatic metastases
Manchester Cancer Colorectal Pathway Board: Guidelines for management of colorectal hepatic metastases Date: April 2015 Date for review: April 2018 1. Principles The recognised specialist HPB MDT for Greater
More informationOptimising Perioperative Pain Management And Surgical Outcomes
Optimising Perioperative Pain Management And Surgical Outcomes Dr Chew Ghee Kheng MBBS FRCOG MD FAMS Senior Consultant Gynaecologist Subspecialist in Gynaecology Oncology Surgery Singapore General Hospital
More informationSelection Criteria and Insertion of SIRT into HCC Treatment Guidelines
Selection Criteria and Insertion of SIRT into HCC Treatment Guidelines 2 nd Asia Pacific Symposium on Liver- Directed Y-90 Microspheres Therapy 1st November 2014, Singapore Pierce Chow FRCSE PhD SIRT in
More informationAlliance A Symptomatic brain radionecrosis after receiving radiosurgery for
RANDOMIZED PHASE II STUDY: CORTICOSTEROIDS + BEVACIZUMAB VS. CORTICOSTEROIDS + PLACEBO (BEST) FOR RADIONECROSIS AFTER RADIOSURGERY FOR BRAIN METASTASES Pre-registration Eligibility Criteria Required Initial
More informationPANCREATIC CANCER GUIDELINES
PANCREATIC CANCER GUIDELINES North-East London Cancer Network & Barts and the London HPB Centre PROTOCOL FOR MANAGEMENT OF PANCREATIC CANCER (SEPTEMBER 2010) I. PRE-REFERRAL GUIDELINES Screening 1. Offer
More informationColorectal Liver Metastases Metachronous
Colorectal Liver Metastases Metachronous Professor Rowan Parks Professor of Surgical Sciences University of Edinburgh No disclosures Natural History of Unresected Untreated Colorectal Metastases Year N
More informationEdith A. Perez, Ahmad Awada, Joyce O Shaughnessy, Hope Rugo, Chris Twelves, Seock-Ah Im, Carol Zhao, Ute Hoch, Alison L. Hannah, Javier Cortes
BEACON: A Phase 3 Open-label, Randomized, Multicenter Study of Etirinotecan Pegol (EP) versus Treatment of Physician s Choice (TPC) in Patients With Locally Recurrent or Metastatic Breast Cancer Previously
More informationColon Cancer Liver Metastases: Liver-Directed Therapy
Colon Cancer Liver Metastases: Liver-Directed Therapy Shishir K. Maithel, MD FACS Assistant Professor of Surgery Division of Surgical Oncology Winship Cancer Institute Emory University August 10, 2014
More informationWest of Scotland Cancer Network Chemotherapy Protocol
West of Scotland Cancer Network Chemotherapy Protocol DOCETAXEL/TRASTUZUMAB (BRWOS-005/1) Indication Docetaxel in combination with is indicated for the treatment of patients with HER2 overexpressing locally
More informationScottish Medicines Consortium
Scottish Medicines Consortium lenalidomide, 5mg,10mg,15mg and 25mg capsules (Revlimid) No. (441/08) Celgene Europe Limited 04 April 2008 The Scottish Medicines Consortium has completed its assessment of
More informationCABAZITAXEL Prostate Cancer
Systemic Anti-Cancer Treatment Protocol CABAZITAXEL Prostate Cancer PROCTOCOL REF: MPHACABAZ (Version No: 1.0) Approved for use in: Cabazitaxel in combination with prednisolone is a treatment option for
More informationLenvatinib and sorafenib for treating differentiated thyroid cancer after radioactive iodine [ID1059]
Contains AIC Lenvatinib and sorafenib for treating differentiated thyroid cancer after radioactive iodine [ID1059] Multiple Technology Appraisal Background and Clinical Effectiveness Lead team: Femi Oyebode
More informationMabThera. SC. The wait is over. MabThera delivered in just 5 minutes. SC= subcutaneous injection
MabThera SC. The wait is over. MabThera delivered in just 5 minutes Abbreviated Prescribing Information MabThera 1400 mg solution for subcutaneous (SC) injection (Rituximab) Indications: Indicated in adults
More informationReference: NHS England: 16022/P
Clinical Commissioning Policy: The use of Stereotactic Ablative Radiotherapy (SABR) as a treatment option for patients with Hepatocellular carcinoma or Cholangiocarcinoma Reference: NHS England: 16022/P
More informationCombining Lurbinectedin and Doxorubicin The UCLH Experience in Small Cell Lung Cancer
Combining Lurbinectedin and Doxorubicin The UCLH Experience in Small Cell Lung Cancer Dr Martin Forster MD PhD Clinical Senior Lecturer in Experimental Cancer Medicine Consultant in Medical Oncology UCL
More informationtrabectedin, 0.25 and 1mg powder for concentrate for solution for infusion (Yondelis ) SMC No. (452/08) Pharma Mar S.A. Sociedad Unipersonal
trabectedin, 0.25 and 1mg powder for concentrate for solution for infusion (Yondelis ) SMC No. (452/08) Pharma Mar S.A. Sociedad Unipersonal 08 October 2010 The Scottish Medicines Consortium (SMC) has
More informationLIVER DIRECTED THERAPIES FOR PATIENTS WITH UNRESECTABLE METASTASES
LIVER DIRECTED THERAPIES FOR PATIENTS WITH UNRESECTABLE COLORECTAL CANCER LIVER METASTASES Jaime R. Merchan, MD, MMSc Associate Professor of Medicine Division of Hematology-Oncology University of Miami
More informationTransarterial Chemoembolization (TACE)
Transarterial Chemoembolization (TACE) Princess Margaret Know what to expect Read this booklet to learn: What TACE is...1 How TACE works...2 The benefits of TACE...3 The risks and side effects of TACE...3
More informationHEPATIC METASTASES. We can state 3 types of metastases depending on their treatment options:
HEPATIC METASTASES 1. Definition Metastasis means the spread of cancer. Cancerous cells can separate from the primary tumor and enter the bloodstream or the lymphatic system (the one that produces, stores,
More informationVolume 14, Issue 4, Oncology special
Volume 14, Issue 4, 2012 - Oncology special The growing role of interventional oncology within multidisciplinary cancer care Interventional radiology (IR) is already well established within the field of
More informationRadiation Therapy for Liver Malignancies
Outline Radiation Therapy for Liver Malignancies Albert J. Chang, M.D., Ph.D. Department of Radiation Oncology, UCSF March 23, 2014 Rationale for developing liver directed therapies Liver directed therapies
More informationRole of SIRT Beyond First Line Therapy in Colorectal Cancer. Dr Toh Han Chong Division of Medical Oncology National Cancer Centre Singapore
Role of SIRT Beyond First Line Therapy in Colorectal Cancer Dr Toh Han Chong Division of Medical Oncology National Cancer Centre Singapore MILESTONES IN THE TREATMENT OF COLON CANCER SIR-Spheres microspheres
More informationOncology General Principles L A U R I E S I M A R D B R E A S T S U R G I C A L O N C O L O G Y F E L L O W D E C E M B E R
Oncology General Principles L A U R I E S I M A R D B R E A S T S U R G I C A L O N C O L O G Y F E L L O W D E C E M B E R 2 0 1 2 Objectives Discuss Diagnostic and staging strategies in oncology Know
More informationPeptide Receptor Radiation Therapy (PRRT) in Patients with Neuroendocrine Tumors: The Edmonton Experience
Peptide Receptor Radiation Therapy (PRRT) in Patients with Neuroendocrine Tumors: The Edmonton Experience Sandy McEwan, M.B. F.R.C.P.C Chair, Department of Oncology University of Alberta Disclosures I
More informationShock and Resuscitation: Part II. Patrick M Reilly MD FACS Professor of Surgery
Shock and Resuscitation: Part II Patrick M Reilly MD FACS Professor of Surgery Trauma Patient 1823 / 18 Police Dropoff Torso GSW Lower Midline / Right Buttock Shock This Monday Trauma Patient 1823 / 18
More informationReference: NHS England 1602
Clinical Commissioning Policy Proposition: Clofarabine for refractory or relapsed acute myeloid leukaemia (AML) as a bridge to stem cell transplantation Reference: NHS England 1602 First published: TBC
More informationSunitinib (renal) ICD-10 codes Codes with a prefix C64
Sunitinib (renal) Indication First line treatment of patients with advanced and/or metastatic renal cell carcinoma who are suitable for immunotherapy and have an Eastern Cooperative Oncology Group (ECOG)
More informationNivolumab and Ipilimumab
Nivolumab and Ipilimumab Indication Advanced (unresectable or metastatic) melanoma. (NICE TA400) ICD-10 codes Codes prefixed with C43 Regimen details Cycles 1-4 Nivolumab and Ipilimumab every 3 weeks Day
More informationImmunotherapies in melanoma: regulatory perspective. Jorge Camarero (AEMPS)
Immunotherapies in melanoma: regulatory perspective Jorge Camarero (AEMPS) Challenges for the approval of anti-cancer immunotherapeutic drugs EMA-CDDF joint meeting, London 4-5 February 2016 disclaimers
More informationThis is a controlled document and therefore must not be changed
AZACITIDINE NICE TA218 Treatment of adults not eligible for haematopoietic stem cell transplantation who have: Intermediate-2 and high-risk MDS according to the International Prognostic Scoring System
More informationStrategies for the Treatment of Elderly DLBCL Patients, New Combination Therapy in NHL, and Maintenance Rituximab Therapy in FL
New Evidence reports on presentations given at ASH 2009 Strategies for the Treatment of Elderly DLBCL Patients, New Combination Therapy in NHL, and Maintenance Rituximab Therapy in FL From ASH 2009: Non-Hodgkin
More informationA) PUBLIC HEALTH B) PRESENTATION & DIAGNOSIS
Hepatocellular Carcinoma HCC Updated November 2015 by: Dr. Mohammed Alghamdi (Medical Oncology Fellow, University of Calgary), April 2017 by Dr. Jenny Ko (Medical Oncologist, Abbotsford Centre, BC Cancer
More informationFDA Approves ABRAXANE for the First-Line Treatment of Advanced Non-Small Cell Lung Cancer
October 12, 2012 FDA Approves ABRAXANE for the First-Line Treatment of Advanced Non-Small Cell Lung Cancer Approval Based on Significantly Improved Overall Response Rates in all Patients Regardless of
More informationDALLA CAPECITABINA AL TAS 102
DALLA CAPECITABINA AL TAS 102 Milano 29 settembre 2016 LE PROSPETTIVE NELLA RICERCA Armando Santoro Humanitas Cancer Center THE 1,2.AND 3 LINE CHEMOTHERAPY IN CRC M BEVACIZUMAB AFLIBERCET RAS wt RAS mu
More informationThis clinical study synopsis is provided in line with Boehringer Ingelheim s Policy on Transparency and Publication of Clinical Study Data.
abcd Clinical Study Synopsis for Public Disclosure This clinical study synopsis is provided in line with s Policy on Transparency and Publication of Clinical Study Data. The synopsis which is part of the
More informationApril 7, Introduction
April 7, 2017 ICD-10 Coordination and Maintenance Committee Department of Health and Human Services Centers for Medicare & Medicaid Services 7500 Security Boulevard Baltimore, MD 21244-1850 ICDProcedureCodeRequest@cms.hhs.gov
More informationNeodjuvant chemotherapy
Neodjuvant chemotherapy Dr Robert Huddart Senior Lecturer and Honorary Consultant in Clinical Oncology Royal Marsden Hospital and Institute of Cancer Research Why consider neo-adjuvant chemotherapy? Loco-regional
More informationPRODUCT MONOGRAPH. Trametinib Tablets. 0.5 mg and 2 mg. ATC Code: L01XE23 Protein Kinase Inhibitor
PRODUCT MONOGRAPH Pr MEKINIST Trametinib Tablets 0.5 mg and 2 mg ATC Code: L01XE23 Protein Kinase Inhibitor Novartis Pharmaceuticals Canada Inc. Date of Revision: 385 Bouchard Blvd. September 21, 2018
More informationATEZOLIZUMAB (TECENTRIQ )
DRUG ADMINISTRATION SCHEDULE Day Drug Daily Dose Route Diluent Rate Day 1 Atezolizumab 1200 mg IV Infusion 250mL 0.9% Sodium Chloride Over 60 minutes* *The initial dose of atezolizumab must be administered
More informationAACR 2018 Investor Meeting
AACR 218 Investor Meeting April 16, 218 1 Forward-Looking Information This presentation contains statements about the Company s future plans and prospects that constitute forward-looking statements for
More informationLung cancer Surgery. 17 TH ESO-ESMO MASTERCLASS IN CLINICAL ONCOLOGY March, 2017 Berlin, Germany
17 TH ESO-ESMO MASTERCLASS IN CLINICAL ONCOLOGY 24-29 March, 2017 Berlin, Germany Lung cancer Surgery Sven Hillinger MD, Thoracic Surgery, University Hospital Zurich Case 1 59 y, female, 40 py, incidental
More informationThe next wave of successful drug therapy strategies in HER2-positive breast cancer. Hans Wildiers University Hospitals Leuven Belgium
The next wave of successful drug therapy strategies in HER2-positive breast cancer Hans Wildiers University Hospitals Leuven Belgium Trastuzumab in 1st Line significantly improved the prognosis of HER2-positive
More information