A mathematical model for the primary tumor of mcrc
|
|
- Jonas Walters
- 6 years ago
- Views:
Transcription
1 A mathematical model for the primary tumor of mcrc Marta Leocata Joint work with F.Flandoli, C. Ricci, M.C. Polito, V. De Mattei December 2, 2016 University of Pisa
2 Plan of the talk General Project; A mathematical model for mcrc before treatment; A mathematical model for mcrc during treatment; Monte Carlo simulation. 1
3 General Project
4 General Project
5 General Project Age Sex Number of lesions Albumina K-RAS B-RAF.
6 General Project FOLFOXIRI Age Sex Number of lesions Albumina K-RAS B-RAF PFS OS TTP. 5-FU 5-FU+BV 2
7 State of the art of the project
8 Main idea Age Sex Number of lesions Albumina K-RAS B-RAF TTP.
9 Main idea Age Sex Number of lesions Albumina K-RAS B-RAF. λ µ η C hypo V. 5-FU 5-FU+BV TTP
10 Main idea Age Sex Number of lesions Albumina K-RAS B-RAF.? λ µ η C hypo V. 5-FU 5-FU+BV TTP 3
11 A mathematical model for mcrc
12 A mathematical model for mcrc The model is characterized by the following quantities: N t = N hyp t + N norm t = number of cancerous cells; - Nt norm = number of cancerous normoxic cells; - Nt hyp = number of cancerous hypoxic cells; 4
13 A mathematical model for mcrc The model is characterized by the following quantities: N t = N hyp t + N norm t = number of cancerous cells; - Nt norm = number of cancerous normoxic cells; - Nt hyp = number of cancerous hypoxic cells; V t = intensity of VEGF field; A t = level of vascularization due to Angiogenesis. 4
14 Equation for N t We approximate the cancerous mass as a sphere: η thickness of proliferating boundary Hypoxic cells Remark: η = the thickness of proliferating boundary in term of cells.
15 Equation for N t We approximate the cancerous mass as a sphere: Angiogenesis η thickness of proliferating boundary Hypoxic cells Remark: η = the thickness of proliferating boundary in term of cells. 5
16 Equation for N t By this approximation we imagine that: d dt N t = λnt norm µn t 6
17 Equation for N t By this approximation we imagine that: d dt N t = λnt norm µn t ( ) 3 1 = λn t N 1/3 t /2η }{{} boundary term 6
18 Equation for N t By this approximation we imagine that: d dt N t = λnt norm µn t ( ) 3 1 = λn t N 1/3 t /2η }{{} boundary term ) 3 1 λa t N t (1 1 + N 1/3 t /2η }{{} Angiogenesis term + 6
19 Equation for N t By this approximation we imagine that: d dt N t = λnt norm µn t ( ) 3 1 = λn t N 1/3 + t /2η }{{} boundary term ) 3 1 λa t N t (1 1 + N 1/3 t /2η }{{} Angiogenesis term µn t }{{} death term 6
20 Equation for N t By this approximation we imagine that: d dt N t = λnt norm µn t ( ) 3 1 = λn t N 1/3 + t /2η }{{} boundary term ) 3 1 λa t N t (1 1 + N 1/3 t /2η }{{} Angiogenesis term µn t }{{} death term and N hypo t = N t N norm t = (1 A t ) N t ( N 1/3 t /2η ) 3 6
21 Equation for A t A t = space average of vascularization due to Angiogenesis. 7
22 Equation for A t A t = space average of vascularization due to Angiogenesis. d dt A t = C V A (V t V thrsld )(A t + A pre )(1 A t )1 Vt>V }{{ thrsld } growth term 7
23 Equation for A t A t = space average of vascularization due to Angiogenesis. d dt A t = C V A (V t V thrsld )(A t + A pre )(1 A t )1 Vt>V }{{ thrsld } 2A 10 t 1 Vt V }{{ thrsld } decresing term growth term 7
24 Equation for VEGF V t = space average of VEGF field. 8
25 Equation for VEGF V t = space average of VEGF field. d dt V t = ( C hypo V (N hypo t N t ) 2/3 }{{} growth term ) C A,V A t V t (1 V t ) }{{} Absorption term 8
26 Equation for VEGF: 2/3 formula
27 Equation for VEGF: 2/3 formula Pre-Angiogenesis: η
28 Equation for VEGF: 2/3 formula Pre-Angiogenesis: We imagine the sphere of Hypoxic η cells as a sphere uniformly charged of radius R η. 9
29 Equation for VEGF: 2/3 formula It induces a field : E(r) = with potential on the boundary C(R η)3 r 2 V (R) = C(R η) 2 VEGF work needed to move blood vessels from infinite distance to the sphere of hypoxic cells. V t = C(R t η) 2 C(N hypo t ) 2/3 10
30 Parameters of the free model Parameters Meaning λ growth rate due to cell proliferation µ decay rate due to cell loss η thickness of proliferating boundary C hypo V C A,V C V A VEGF production rate from hypoxic cells absorption rate of VEGF from vasculature reaction rate of angiogenesis to VEGF 11
31 Discussion on Parameters of the free model: η 12
32 Discussion on Parameters of the free model: η Reasonable values for η? 12
33 Discussion on Parameters of the free model: η Reasonable values for η? Tumors of radius 1mm are usually avascular; Proportion of proliferating boundary with respect to the total (α) is not small. 12
34 Discussion on Parameters of the free model: η Reasonable values for η? Tumors of radius 1mm are usually avascular; Proportion of proliferating boundary with respect to the total (α) is not small. η = 103 (1 (1 α) 1/3 ) 12 Through Spherical Approximation 12
35 Discussion on Parameters of the free model: η Reasonable values for η are around
36 Discussion on Parameters of the free model: (λ, µ) 14
37 Discussion on Parameters of the free model: (λ, µ) Average of DT=
38 Discussion on Parameters of the free model Parameters Value λ 0.05 µ η 15 C hypo V 0.08 C A,V 0.01 C V A A pre 0.2 V thrshld
39 Simulation without therapy 16
40 Simulation without therapy. Comments Diamonds denote the range where angiogenesis is expected to start and the red star is that initial time; The second red star is when 10 9 cells are reached which should be close to 8 years; At the beginning Boundary term N t ; If N 1/3 t /η >> 1 Boundary term N 2/3 t ; If N t is large and there is Angiogenesis Exponential regime. 17
41 A mathematical model for mcrc during treatment
42 Treatment Following 1 we investigate the case of first line therapy based on 5-Fluoracile (5-FU) with or without Bevacizumab (BV). 8 weeks 8 weeks 12 cycles of 5-FU(+BV) 1 F. F. Kabbinavar et al., Addition of Bevacizumab to Bolus Fluorouracil and Leucovorin in First-Line Metastatic Colorectal Cancer: Results of a Randomized Phase II Trial, J. Clinical Oncology 23 (2005), n. 16,
43 Drug resistance due to mutations We introduce new quantities: 19
44 Drug resistance due to mutations We introduce new quantities: Nt R,norm Nt R,hypo Nt R = Nt R,norm resistant cells; = number of hypoxic 5-FU drug resistant cells; = number of normoxic 5-FU drug resistant cells; + N R,hypo t = total number of 5-FU drug 19
45 Drug resistance due to mutations We introduce new quantities: Nt R,norm Nt R,hypo Nt R = Nt R,norm resistant cells; = number of hypoxic 5-FU drug resistant cells; = number of normoxic 5-FU drug resistant cells; + N R,hypo t So we have two subpopulation: = total number of 5-FU drug N R t N S t = Nt R,norm = Nt S,norm + N R,hypo t + N S,hypo t 19
46 Drug resistance due to mutations We introduce new quantities: Nt R,norm Nt R,hypo Nt R = Nt R,norm resistant cells; = number of hypoxic 5-FU drug resistant cells; = number of normoxic 5-FU drug resistant cells; + N R,hypo t So we have two subpopulation: = total number of 5-FU drug N R t N S t = Nt R,norm = Nt S,norm + N R,hypo t + N S,hypo t How do we describe the growth of the two subpopulations? 19
47 Drug resistance due to mutations: growth of the two subpopulations Before treatment: 20
48 Drug resistance due to mutations: growth of the two subpopulations Before treatment: In red: 5-FU resistant cells
49 Drug resistance due to mutations: growth of the two subpopulations Before treatment: We conjecture that the fictitious proliferating boundary of 5-FU drug resistant is thinner than the case of sensitive cells In red: 5-FU resistant cells
50 Drug resistance due to mutations: growth of the two subpopulations Before treatment: We conjecture that the fictitious proliferating boundary of 5-FU drug resistant is thinner than the case of sensitive cells In red: 5-FU resistant cells η R < η S 20
51 Drug resistance due to mutations: growth of the two subpopulations After treatment: 21
52 Drug resistance due to mutations: growth of the two subpopulations After treatment: The approximation as two separate sphere becames reasonable
53 Drug resistance due to mutations: growth of the two subpopulations After treatment: The approximation as two separate sphere becames reasonable η R = η S 21
54 Drug resistance due to mutations: transition of species Let p = the probability of mutation. In the infinitesimal interval [t, t + t] the number of proliferating cells is λnt S,norm t Thus the average number of mutated descendants is: pλnt S,norm t 22
55 Drug resistance due to mutations: Equation for N R t and N S t d dt NS t = λnt S,norm µ Nt S 23
56 Drug resistance due to mutations: Equation for N R t and N S t d dt NS t = λn t S,norm µ Nt S pλn t S,norm }{{} change of species term 23
57 Drug resistance due to mutations: Equation for N R t and N S t d dt NS t = λn t S,norm µ Nt S pλn t S,norm }{{} change of species term d dt NR t = λnt R,norm µ Nt R 23
58 Drug resistance due to mutations: Equation for N R t and N S t d dt NS t = λn t S,norm µ Nt S pλn t S,norm }{{} change of species term d dt NR t = λn t R,norm µ Nt R +pλn t S,norm }{{} change of species term 23
59 Drug resistance due to mutations: Equation for N R t and N S t d dt NS t = λn t S,norm µ Nt S pλn t S,norm }{{} change of species term d dt NR t = λn t R,norm µ Nt R +pλn t S,norm }{{} change of species term Then d dt N t = λp t Nt norm µn t where ( N S N t = t N R t ), N norm t = ( N S,norm) [ t Nt R,norm, P = 1 p p 0 1 ] 23
60 Action of 5-FU 5-FU acts as a control on our system. 24
61 Action of 5-FU 5-FU acts as a control on our system. It simply acts on N S t : d dt NS t = λn S,norm t (1 ut FU ) }{{} control term µn S t 24
62 Action of 5-FU 5-FU acts as a control on our system. It simply acts on N S t : d dt NS t = λn S,norm t (1 ut FU ) }{{} control term µn S t G 0 M G 1 S 5-FU acts on S G 2 where ut FU plasma describes concentration of 5-Fu in tissues, NOT in 24
63 Action of 5-FU: u FU t In every period of N0 5-FU therapy u FU t = 0. 25
64 Action of 5-FU: u FU t In every period of N0 5-FU therapy u FU t = 0. Administration of 5-FU
65 Action of 5-FU: u FU t In every period of N0 5-FU therapy u FU t = 0. Administration of 5-FU concentration during a single week? (1 + C FU ) exp( log(1+c FU) N FU t) where C FU = intensity of cell kill with respect cell proliferation; N FU = days of action of 5-FU. 25
66 Action of 5-FU: Plot of 1 u FU t
67 Action of 5-FU: Plot of 1 u FU t λ(1 u FU 0 ) = λc FU
68 Action of 5-FU: Plot of 1 u FU t λ(1 u FU 0 ) = λc FU (1 u FU N FU ) = 0 26
69 Action of Bevacizumab Bevacizumab acts as a control on our system. It acts on VEGF: ) d (N dt V t t = (C hypo 2/3 hypo V C V AA t N t ) C beva V ut beva V }{{} t (1 V t ) Control term 27
70 Action of Bevacizumab: u BV t In every period of No BEVA therapy u BV t = 0. 28
71 Action of Bevacizumab: u BV t In every period of No BEVA therapy u BV t = 0. where Administration of Bevacizumab concentration during two weeks? exp( log(2) N BV t) N BV = half life of Bevacizumab. 28
72 Action of Bevacizumab: Plot of u BV t 29
73 Action of Bevacizumab: Plot of u BV t u BV N BV = 1/2 29
74 Plot of VEGF and A t with therapy How do VEGF and A t react to therapy? Figure 1: On the right: plot of A t. On the left: plot of V t. 30
75 Parameters of the model with therapy Parameters Meaning Value η sens thickness of p.b. of sensitive cells 15 η res thickness of p.b. of resistant cells η sens /1.2 p probability of mutation 10 5 N start number of cells when therapy starts N FU number of days of action of 5-FU 6 C FU intensity of 5-FU action 20 N beva number of days of action of Bevacizumab 12 C beva V inhibition rate of bevacizumab on VEGF 1 31
76 Simulation with therapy (5-FU+ Bevacizumab) Figure 2: In green: resistant cells (N R t ). In blue: total cells (N S t + N R t ). 32
77 Computation of TTP How to evaluate differences between the two therapies? 33
78 Computation of TTP How to evaluate differences between the two therapies? s = Time of minimum volume. 33
79 Computation of TTP How to evaluate differences between the two therapies? s = Time of minimum volume. Clinical measuraments: in terms of diameter [D t > D s + 0.2D s ] Measuraments in our model: in terms of cells [?] 33
80 Computation of TTP How to evaluate differences between the two therapies? s = Time of minimum volume. Clinical measuraments: in terms of diameter [D t > D s + 0.2D s ] Measuraments in our model: in terms of cells [?] D t > D s + 0.2D s V t > (1, 2) 3 V s N t 1.7 N s n t := N t N s N s
81 Computation of TTP 12 cycles of therapy T 0 Computation of N Computation of N 1. We compute N k at times T 0 + k 8. Where T 0 = time when therapy starts; 2. N k0 = inf k {N k }; 3. We compute n k = N k N k0 N k0 for k > k 0 ; 4. We compute the first k 1 such that n k
82 Computation of TTP 12 cycles of therapy T 0 Computation of N Computation of N 1. We compute N k at times T 0 + k 8. Where T 0 = time when therapy starts; 2. N k0 = inf k {N k }; 3. We compute n k = N k N k0 N k0 for k > k 0 ; 4. We compute the first k 1 such that n k1 0.7 TTP 34
83 Simulation with Therapy Figure 3: Simulation with Therapy= 5-FU. TTP=
84 Simulation with Therapy Figure 4: Simulation with Therapy= 5-FU+BEVA TTP=9.3 36
85 Monte Carlo Simulations
86 Monte Carlo Simulations GOAL: We want to evaluate the model 37
87 Monte Carlo Simulations GOAL: We want to evaluate the model Compute Kaplan-Meier curves. 37
88 Monte Carlo Simulations GOAL: We want to evaluate the model Compute Kaplan-Meier curves. We randomize some of the coefficients: 37
89 Monte Carlo Simulations GOAL: We want to evaluate the model Compute Kaplan-Meier curves. We randomize some of the coefficients: Parameters Value or distribution η res η sens /unif[1, 2] p N start 10 unif[4,6] 2 10 unif[8,11] N FU unif[1, 7] C FU unif[5, 25] N beva unif[1, 14] C beva V unif[0, 5] 37
90 Monte Carlo Simulations GOAL: We want to evaluate the model Compute Kaplan-Meier curves. We randomize some of the coefficients: Parameters Value or distribution η res η sens /unif[1, 2] p N start 10 unif[4,6] 2 10 unif[8,11] N FU unif[1, 7] C FU unif[5, 25] N beva unif[1, 14] C beva V unif[0, 5] 37
91 Monte Carlo Simulation: Kaplan-Meier curves 38
92 Monte Carlo Simulation: Kaplan-Meier curves Remark:The result is in agreement with trial of Kabbinavar et al., restricted to patients with one metastatic disease site. 38
93 Link with prognostic factors Prognostic factors? Parameters of our model 39
94 Link with prognostic factors Prognostic factors Three factors:? Parameters of our model 39
95 Link with prognostic factors Prognostic factors Three factors:? Parameters of our model Age; Prior Adjuvant chemotherapy; Baseline albumin. 39
96 Link with prognostic factors: Age We conjecture: Age λ µ 40
97 Link with prognostic factors: Age We conjecture: Age λ µ Table 1: Change of values for some class of younger patients. Parameters Value or distribution λ 0.08 µ 0.02 Median TTP (5-FU) = 5.6. Median TTP (5-FU+BEVA) =
98 Link with prognostic factors: Prior adjuvant chemotherapy (PAC) We conjecture: PAC N start 41
99 Link with prognostic factors: Prior adjuvant chemotherapy (PAC) We conjecture: PAC N start Table 2: Change of distribution for a class of patient who received a prior adjuvant chemotherapy. Parameters N start Value or distribution 10 unif[8,9] Median TTP (5-FU) = 9.3. Median TTP (5-FU+BEVA) =
100 Link with prognostic factors: Baseline Albumina We conjecture: Albumina N FU C FU N bevat C beva V 42
101 Link with prognostic factors: Baseline Albumina We conjecture: Albumina N FU C FU N bevat C beva V Table 3: Change of distribution for a class of patient with b.a. 3.5 g/dl. Median TTP (5-FU) = 7.5. Median TTP (5-FU+BEVA) = 7.5. Parameters Value or distribution N FU unif[1, 4] C FU unif[5, 20] N beva unif[1, 7] C beva V unif[0, 1] 42
102 Next step FOLFOXIRI Age Sex Number of lesions Albumina K-RAS B-RAF. λ µ η C hypo V. 5-FU 5-FU+BV PFS OS TTP
103 Next step FOLFOXIRI Modelize: 1.Metastasis 2.Multidrug resistance Age Sex Number of lesions Albumina K-RAS B-RAF. λ µ η C hypo V. 5-FU 5-FU+BV PFS OS TTP 43
104 Thank you for your attention! 44
Mathematics Meets Oncology
.. Mathematics Meets Oncology Mathematical Oncology Philippe B. Laval Kennesaw State University November 12, 2011 Philippe B. Laval (Kennesaw State University)Mathematics Meets Oncology November 12, 2011
More informationManagement Of Patients With Metastatic Colorectal Cancer in Lebanese Hospitals and Associated Direct Cost: A Multicenter Cohort Study
Management Of Patients With Metastatic Colorectal Cancer in Lebanese Hospitals and Associated Direct Cost: A Multicenter Cohort Study Henaine AM; Chahine G; Massoud M; Salameh P; Awada S; Lahoud N; El
More informationSUMMARY OF THE SIRFLOX RESULTS
SUMMARY OF THE SIRFLOX RESULTS The SIRFLOX study results on the combination of SIR-Spheres Y-90 resin microspheres with first-line chemotherapy were published in Journal of Oncology in early 2016. 1 There
More informationIs it possible to cure patients with liver metastases? Taghizadeh Ali MD Oncologist, MUMS
Is it possible to cure patients with liver metastases? Taghizadeh Ali MD Oncologist, MUMS Survival Rates of by Stage of Adenocarcinoma of the Colon Liver Resection New Perspective Colorectal cancer liver
More informationSupplementary Online Content
Supplementary Online Content Venook AP, Niedzwiecki D, Lenz H-J, et al. Effect of first-line chemotherapy combined with cetuximab or bevacizumab on overall survival in patients with KRAS wild-type advanced
More informationCost-effectiveness of Cetuximab and Panitumumab in First-line Treatment for Patients with KRAS Wild-Type Metastatic Colorectal Cancer in Ontario
Cost-effectiveness of Cetuximab and Panitumumab in First-line Treatment for Patients with KRAS Wild-Type Metastatic Colorectal Cancer in Ontario Emmanuel Ewara, Dr. Greg Zaric, Dr. Stephen Welch, Dr. Sisira
More informationMEETING SUMMARY ESMO 2018, Munich, Germany. Dr. Jenny Seligmann University of Leeds, UK HIGHLIGHTS ON COLORECTAL CANCER
MEETING SUMMARY ESMO 2018, Munich, Germany Dr. Jenny Seligmann University of Leeds, UK HIGHLIGHTS ON COLORECTAL CANCER DISCLAIMER Please note: The views expressed within this presentation are the personal
More informationCetuximab with Chemotherapy as Treatment for Stage III Colon or Metastatic Colorectal Cancer
Cetuximab with Chemotherapy as Treatment for Stage III Colon or Metastatic Colorectal Cancer Cetuximab with Chemotherapy (CT) as First-Line Treatment for Metastatic Colorectal Cancer (mcrc): Analysis of
More informationBevacizumab is currently licensed for the following indication relevant for this NICE review:
Roche Executive Summary Context Bevacizumab (Avastin) is a humanized (93% human) murine monoclonal antibody which binds to and neutralizes VEGF, a powerful pro-angiogenic glycoprotein produced by both
More informationWinship Cancer Institute of Emory University Neoadjuvant Systemic Therapy in Metastatic Renal Cell Carcinoma Patients
Winship Cancer Institute of Emory University Neoadjuvant Systemic Therapy in Metastatic Renal Cell Carcinoma Patients Bradley Carthon, MD, PhD Assistant Professor, Genitourinary Medical Oncology Winship
More informationADVANCED COLORECTAL CANCER: UNRESECTABLE OR BORDERLINE RESECTABLE (GROUP 1) CHEMOTHERAPY +/- TARGETED AGENTS. Andrés Cervantes. Professor of Medicine
ADVANCED COLORECTAL CANCER: UNRESECTABLE OR BORDERLINE RESECTABLE (GROUP 1) CHEMOTHERAPY +/- TARGETED AGENTS Andrés Cervantes Professor of Medicine 1995 One option Advances in the treatment of mcrc 2000
More informationTargeted Therapies in Metastatic Colorectal Cancer: An Update
Targeted Therapies in Metastatic Colorectal Cancer: An Update ASCO 2007: Targeted Therapies in Metastatic Colorectal Cancer: An Update Bevacizumab is effective in combination with XELOX or FOLFOX-4 Bevacizumab
More informationDoes it matter which chemotherapy regimen you partner with the biologic agents?
Does it matter which chemotherapy regimen you partner with the biologic agents? Yes, it does matter! Axel Grothey Disclosures Research Funding to MAYO Clinic Genentech Bayer Eisai Pfizer Imclone Potential
More informationTherapeutic Options for Patients with BRAF-mutant Metastatic Colorectal Cancer
Therapeutic Options for Patients with BRAF-mutant Metastatic Colorectal Cancer Axel Grothey, M.D., Professor of Oncology, Clinical and Translational Science Division of Medical Oncology Mayo Clinic, Rochester,
More informationADVANCES IN COLON CANCER
ADVANCES IN COLON CANCER Peter T. Silberstein, M.D., FACP Professor, Creighton University Chief Hematology/Oncology UNIVERSAL SCREENING FOR LYNCH SYNDROME OF ALL PATIENTS WITH COLON CANCER ADOPTED BY CHI
More informationCOLON CANCER PERITONEAL CARCINOMATOSIS TREATMENT Prof. Annibale Donini
UNIVERSITY OF PERUGIA Department of General and Emergency Surgery Chief: Prof. Annibale Donini COLON CANCER PERITONEAL CARCINOMATOSIS TREATMENT Prof. Annibale Donini COLON CANCER IS A HIGHLY FREQUENT NEOPLASIA
More informationCancer Cell Research 14 (2017)
Available at http:// www.cancercellresearch.org ISSN 2161-2609 Efficacy and safety of bevacizumab for patients with advanced non-small cell lung cancer Ping Xu, Hongmei Li*, Xiaoyan Zhang Department of
More information+ Radioembolization for ColoRectal Cancer Metastatic to the Liver
+ Radioembolization for ColoRectal Cancer Metastatic to the Liver Oct 4 th 2017 Alain Hendlisz, Institut Jules Bordet 1 st International Course on THERANOSTICS & MOLECULAR RADIOTHERAPY Indication and Rationale
More informationMathematical modelling of spatio-temporal glioma evolution
Papadogiorgaki et al. Theoretical Biology and Medical Modelling 213, 1:47 RESEARCH Open Access Mathematical modelling of spatio-temporal glioma evolution Maria Papadogiorgaki 1*, Panagiotis Koliou 2, Xenofon
More informationState of the Art: Colorectal Cancer Liver Metastasis Dr. Iain Tan
State of the Art: Colorectal Cancer Liver Metastasis Dr. Iain Tan Consultant GI Medical Oncologist National Cancer Centre Singapore Clinician Scientist, Genome Institute of Singapore OS (%) Overall survival
More informationOncologist. The. Gastrointestinal Cancer
The Oncologist Gastrointestinal Cancer The Clinical Benefit of Bevacizumab in Metastatic Colorectal Cancer Is Independent of K-ras Mutation Status: Analysis of a Phase III Study of Bevacizumab with Chemotherapy
More informationStatistical Methods for the Evaluation of Treatment Effectiveness in the Presence of Competing Risks
Statistical Methods for the Evaluation of Treatment Effectiveness in the Presence of Competing Risks Ravi Varadhan Assistant Professor (On Behalf of the Johns Hopkins DEcIDE Center) Center on Aging and
More informationStergios Moschos, MD
Stergios Moschos, MD Clinical Associate Professor of Medicine Department of Medicine Division of Hematology/Oncology University of North Carolina at Chapel Hill Solid Tumor with one of the Highest Mutation
More informationChemotherapy of colon cancers
Chemotherapy of colon cancers Stage distribution Stage I : 15% T 1,2 NO Stage IV: 20 25% M+ Stage II : 20 30% T3,4 NO Stage III N+: 30 40% clinical stages I, II, or III colon cancer are at risk for having
More informationStatistical Challenges in Immunotherapy: Non Proportional Hazard Model. BBS / PSI CIT event 15-June-2017, Basel Claude BERGE, Roche
Statistical Challenges in Immunotherapy: Non Proportional Hazard Model BBS / PSI CIT event 15-June-2017, Basel Claude BERGE, Roche 1 Statistical Challenges Biomarker Efficacy Endpoint Study Design & Analysis
More informationColorectal Cancer: Lumping or Splitting? Jimmy J. Hwang, MD FACP Levine Cancer Institute Carolinas HealthCare System Charlotte, NC
Colorectal Cancer: Lumping or Splitting? Jimmy J. Hwang, MD FACP Levine Cancer Institute Carolinas HealthCare System Charlotte, NC 2 Epidemiology Colorectal Cancer is the 2 nd Leading Cause of Cancer-related
More informationModeling of the Impact of Blood Vessel Flow on the Temperature Distribution during Focused Ultrasound Treatments
Presented at the COMSOL Conference 2010 Boston Modeling of the Impact of Blood Vessel Flow on the Temperature Distribution during Focused Ultrasound Treatments Elisabetta Sassaroli, King C. P. Li, Brian
More informationMathematics and Physics of Cancer: Questions. Robijn Bruinsma, UCLA KITP Colloquium May 6, ) Cancer statistics and the multi-stage model.
Mathematics and Physics of Cancer: Questions Robijn Bruinsma, UCLA KITP Colloquium May 6, 2009 1) Cancer statistics and the multi-stage model. 2) Cancer microevolution and clonal expansion. 3) Metastasis:
More informationPlasma ctdna RAS/RAF mutations analysis for monitoring overall survival (OS) and heterogeneity in metastatic colorectal cancer patients (mcrc)
Plasma ctdna RAS/RAF mutations analysis for monitoring overall survival (OS) and heterogeneity in metastatic colorectal cancer patients (mcrc) Authors: Andrea Petricca Mancuso, Veronica Varchetta, Fabrizio
More informationJonathan Dickinson, LCL Xeloda
Xeloda A blockbuster in the making Jonathan Dickinson, LCL Xeloda Xeloda unique tumor-activated mechanism Delivering more cancer-killing agent straight into cancer Highly effective comparable efficacy
More informationReal-world observational data in costeffectiveness analyses: Herceptin as a case study
Real-world observational data in costeffectiveness analyses: Herceptin as a case study DR BONNY PARKINSON, PROFESSOR ROSALIE VINEY, ASSOCIATE PROFESSOR STEPHEN GOODALL AND PROFESSOR MARION HAAS ISPOR AUSTRALIA
More informationTWISTED SURVIVAL: IDENTIFYING SURROGATE ENDPOINTS FOR MORTALITY USING QTWIST AND CONDITIONAL DISEASE FREE SURVIVAL. Beth A.
TWISTED SURVIVAL: IDENTIFYING SURROGATE ENDPOINTS FOR MORTALITY USING QTWIST AND CONDITIONAL DISEASE FREE SURVIVAL by Beth A. Zamboni BS Statistics, University of Pittsburgh, 1997 MS Biostatistics, Harvard
More informationSergio Bracarda MD. Head, Medical Oncology Department of Oncology AUSL-8 Istituto Toscano Tumori (ITT) San Donato Hospital Arezzo, Italy
Sergio Bracarda MD Head, Medical Oncology Department of Oncology AUSL-8 Istituto Toscano Tumori (ITT) San Donato Hospital Arezzo, Italy Ninth European International Kidney Cancer Symposium Dublin 25-26
More informationCase Studies in Bayesian Augmented Control Design. Nathan Enas Ji Lin Eli Lilly and Company
Case Studies in Bayesian Augmented Control Design Nathan Enas Ji Lin Eli Lilly and Company Outline Drivers for innovation in Phase II designs Case Study #1 Pancreatic cancer Study design Analysis Learning
More informationFIRST LINE 5-FU-BASED CHEMOTHERAPY WITH/ WITHOUT BEVACIZUMAB FOR METASTATIC COLORECTAL CANCER: ONE CENTER EXPERIENCE RESULTS
PROCEEDINGS FIRST LINE 5-FU-BASED CHEMOTHERAPY WITH/ WITHOUT BEVACIZUMAB FOR METASTATIC COLORECTAL CANCER: ONE CENTER EXPERIENCE RESULTS Assia Konsoulova, Ivan Donev, Nikolay Conev, Sonya Draganova, Trifon
More informationWhen You Look Matters: The Effect of Assessment Schedule on Progression-Free Survival
COMMENTARY When You Look Matters: The Effect of Assessment Schedule on Progression-Free Survival Katherine S. Panageas, Leah Ben-Porat, Maura N. Dickler, Paul B. Chapman, Deborah Schrag Progression-free
More informationTumors in the Randomized German AIO study KRK-0306
FOLFIRI plus Cetuximab versus FOLFIRI plus Bevacizumab as First- Line Treatment for Patients with Metastatic Colorectal Cancer (mcrc): Analysis of Patients with KRAS-Mutated Tumors in the Randomized German
More information4. Aflibercept showed significant improvement in overall survival (OS), the primary
Cost effectiveness of aflibercept (Zaltrap ) in combination with FOLFIRI in the treatment of adult patients with metastatic colorectal cancer (mcrc) that is resistant to or has progressed after an oxaliplatin
More informationConflicts of Interest GI Malignancies: An Update on Current Treatment Options
Conflicts of Interest GI Malignancies: An Update on Current Treatment Options Nothing to disclose Trevor McKibbin, PharmD, MS, BCOP Clinical Specialist, Hematology/Oncology Winship Cancer Institute of
More informationMathematical Modeling of Therapy-induced Cancer Drug Resistance: Connecting Cancer Mechanisms to Population Survival Rates
Supplementary Information Mathematical Modeling of herapy-induced Cancer Drug Resistance: Connecting Cancer Mechanisms to Population Survival Rates Xiaoqiang Sun 1,2 *, Jiguang Bao 3, Yongzhao Shao 4,5
More informationNICE Single Technology Appraisal of cetuximab for the treatment of recurrent and /or metastatic squamous cell carcinoma of the head and neck
NICE Single Technology Appraisal of cetuximab for the treatment of recurrent and /or metastatic squamous cell carcinoma of the head and neck Introduction Merck Serono appreciates the opportunity to comment
More informationCancer Treatment Using Multiple Chemotheraputic Agents Subject to Drug Resistance
Cancer Treatment Using Multiple Chemotheraputic Agents Subject to Drug Resistance J. J. Westman Department of Mathematics University of California Box 951555 Los Angeles, CA 90095-1555 B. R. Fabijonas
More informationNATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE. Technology Appraisals. Patient Access Scheme Submission Template
NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE Technology Appraisals Patient Access Scheme Submission Template Bevacizumab in combination with fluoropyrimidine-based chemotherapy for the first-line
More informationTHE ROLE OF PREDICTIVE AND PROGNOSTIC MARKERS IN COLORECTAL CANCER
THE ROLE OF PREDICTIVE AND PROGNOSTIC MARKERS IN COLORECTAL CANCER Cathy Eng, M.D., F.A.C.P. Associate Professor Associate Medical Director, Colorectal Center Dept of GI Medical Oncology November 5, 2010
More informationSimulating the Tumor Growth with Cellular Automata Models
Simulating the Tumor Growth with Cellular Automata Models S. Zouhri Université Hassan II- Mohammédia, Faculté des Sciences Ben M'sik Département de Mathématiques, B.7955, Sidi Othmane, Casablanca, Maroc
More informationSpreading of Epidemic Based on Human and Animal Mobility Pattern
Spreading of Epidemic Based on Human and Animal Mobility Pattern Yanqing Hu, Dan Luo, Xiaoke Xu, Zhangang Han, Zengru Di Department of Systems Science, Beijing Normal University 2009-12-22 Background &
More informationpatients in the era of
Communicating with cancer patients in the era of personalized medicine September 9 th, 2017 Gerald Prager, M.D. Comprehensive Cancer Center Vienna Medical University of Vienna, Austria Gerald Prager, M.D.
More informationColorectal Cancer Therapy and Associated Toxicity
Colorectal Cancer Therapy and Associated Toxicity Mountain States Cancer Conference November 6, 2010 Colin D. Weekes, M.D., Ph.D Assistant Professor University of Colorado GI Cancers Are Common 2009 Estimated
More informationThe efficacy of bevacizumab in Chinese patients with metastatic colorectal cancer and its effect in different line setting*
Chinese-German J Clin Oncol DOI 10.1007/s10330-014-1295-2 April 2014, Vol. 13, No. 4, P169 P173 The efficacy of bevacizumab in Chinese patients with metastatic colorectal cancer and its effect in different
More informationIndividual- and trial-level surrogacy in colorectal cancer
Stat Methods Med Res OnlineFirst, published on February 19, 2008 as doi:10.1177/0962280207081864 SMM081864 2008/2/5 page 1 Statistical Methods in Medical Research 2008; 1 9 Individual- and trial-level
More informationBevacizumab for Recurrent Glioblastoma Multiforme: A Meta-Analysis
403 Multiforme: A Meta-Analysis Eric T. Wong, MD a ; Shiva Gautam, PhD b ; Christopher Malchow a ; Melody Lun c ; Edward Pan, MD d ; and Steven Brem, MD d ; Boston, Massachusetts, and Tampa, Florida Key
More informationXXV Corso Nazionale TSLB: evoluzione o ri(e)voluzione?
XXV Corso Nazionale TSLB: evoluzione o ri(e)voluzione? Marcatori predittivi di efficacia nel carcinoma del colon: DESTRO verso SINISTRO conta? Dott. Matteo Clavarezza S.C. Oncologia Medica RAS metastatic
More informationCurrent standard in treatment of peritoneal carcinomotisis. Data behind the HIPEC trials
Current standard in treatment of peritoneal carcinomotisis Data behind the HIPEC trials Overview Peritoneal carcinomatosis STANDARD treatment HIPEC Results of treatment Counter side of treatment Peritoneal
More informationA retrospective analysis of the safety and efficacy of apatinib in treating advanced metastatic colorectal cancer
Oncology and Translational Medicine DOI 10.1007/s10330-017-0235-5 October 2017, Vol. 3, No. 5, P210 P216 ORIGINAL ARTICLE A retrospective analysis of the safety and efficacy of apatinib in treating advanced
More informationNew paradigms for treating metastatic melanoma
New paradigms for treating metastatic melanoma Paul B. Chapman, MD Melanoma Clinical Director Melanoma and Immunotherapeutics Service Memorial Sloan Kettering Cancer Center, New York 20 th Century Overall
More informationVirtual Melanoma: When, Where and How Much to Cut Yang Kuang, Arizona State University
Virtual Melanoma: When, Where and How Much to Cut Yang Kuang, Arizona State University Based on: Eikenberry S, Thalhauser C, Kuang Y. PLoS Comput Biol. 2009, 5:e1000362. Mathematical Modeling of Melanoma
More informationA Single-Center Phase 2 Trial. Bevacizumab is a humanized immunoglobulin G1 murine antibody directed against all isoforms of
Bevacizumab in Association With de Gramont 5-Fluorouracil/Folinic Acid in Patients With Oxaliplatin-, Irinotecan-, and Cetuximab-Refractory Colorectal Cancer A Single-Center Phase 2 Trial Bruno Vincenzi,
More informationAshita Waterston Beatson West of Scotland Cancer Centre
Ashita Waterston Beatson West of Scotland Cancer Centre Aim of treatment Scheduling and choice of treatments are dictated by aim: Down staging for resectability: upfront intensive Prolong survival: combination
More informationSome alternatives for Inhomogeneous Poisson Point Processes for presence only data
Some alternatives for Inhomogeneous Poisson Point Processes for presence only data Hassan Doosti Macquarie University hassan.doosti@mq.edu.au July 6, 2017 Hassan Doosti (MQU) Inhomogeneous Spatial Point
More informationDynamique des populations et résistance aux traitements : modèles mathématiques
Dynamique des populations et résistance aux traitements : modèles mathématiques Alexander Lorz 1 R. Chisholm, J. Clairambault, A. Escargueil, M.E. Hochberg, T. Lorenzi, P. Markowich, B. Perthame, E. Trélat
More information1.4 - Linear Regression and MS Excel
1.4 - Linear Regression and MS Excel Regression is an analytic technique for determining the relationship between a dependent variable and an independent variable. When the two variables have a linear
More informationPatient Model for Colon and Colorectal Cancer Care Trajectory Simulation
Research Article imedpub Journals www.imedpub.com Health Science Journal DOI: 10.21767/1791-809X.1000536 Patient Model for Colon and Colorectal Cancer Care Trajectory Simulation Quentin Gilli, Karam Mustapha
More informationCase Report Management of a Patient with Metastatic Colorectal Cancer and Liver Metastases
Case Reports in Oncological Medicine, Article ID 790192, 4 pages http://dx.doi.org/10.1155/2014/790192 Case Report Management of a Patient with Metastatic Colorectal Cancer and Liver Metastases Muhammad
More informationTobias Engel Ayer Botrel 1,2*, Luciana Gontijo de Oliveira Clark 1, Luciano Paladini 1 and Otávio Augusto C. Clark 1
Botrel et al. BMC Cancer (2016) 16:677 DOI 10.1186/s12885-016-2734-y RESEARCH ARTICLE Open Access Efficacy and safety of bevacizumab plus chemotherapy compared to chemotherapy alone in previously untreated
More informationAndrogen Receptor Expression in Renal Cell Carcinoma: A New Actionable Target?
Androgen Receptor Expression in Renal Cell Carcinoma: A New Actionable Target? New Frontiers in Urologic Oncology Juan Chipollini, MD Clinical Fellow Department of Genitourinary Oncology Moffitt Cancer
More informationJY Douillard MD, PhD Professor of Medical Oncology
Colorectal Cancer ESMO Preceptorship Program Prague May 22-23rd 2014 Review of the ESMO Consensus Conference on metastatic colo-rectal cancer Basic strategy and groups (RASwt/mut, BRAF mut) JY Douillard
More informationLimiting the Development of Anti-Cancer Drug Resistance in a Spatial Model of Micrometastases
Limiting the Development of Anti-Cancer Drug Resistance in a Spatial Model of Micrometastases arxiv:1601.03412v2 [q-bio.to] 2 Mar 2016 September 1, 2018 Ami B. Shah Department of Biology The College of
More informationMedical Therapy of Colorectal Cancer in the Biomarker Era
Medical Therapy of Colorectal Cancer in the Biomarker Era Axel Grothey Professor of Oncology Mayo Clinic College of Medicine Rochester, Minnesota Disclosures Consulting activities (honoraria went to the
More informationResearch Article A Mathematical Model of Tumor Volume Changes during Radiotherapy
The Scientific World Journal Volume 203, Article ID 8070, 5 pages http://dx.doi.org/0.55/203/8070 Research Article A Mathematical Model of Tumor Volume Changes during Radiotherapy Ping Wang and Yuanming
More informationtrial update clinical
clinical trial update by John W. Mucenski, BS, PharmD, Director of Pharmacy Operations, UMPC Cancer Centers In order to provide the most up-to-date and efficacious care to their patients, oncologists must
More informationWhat to do after 1 st line failure?
ESMO Preceptorship Programme Colorectal Cancer Singapore 20-22 nd 2016 JY Douillard MD PhD ESMO CMO What to do after 1 st line failure? mcrc: How to maximize survival? Improving 1st line therapy efficacy
More informationChemotherapy re-challenge response rate in metastatic colorectal cancer
Original Article Chemotherapy re-challenge response rate in metastatic colorectal cancer Alexandra E. Chambers 1, Jacob Frick 1, Natalee Tanner 1, Richard Gerkin 2, Madappa Kundranda 3, Tomislav Dragovich
More informationCommon disease 175,000 new cases/year 44,000 deaths/year Less than 10% with newly diagnosed at presentation have stage IV disease Chronic disease,
Chemotherapy for Metastatic Breast Cancer: Recent Results HARMESH R. NAIK, MD. Karmanos Cancer Institute and St. Mary Hospital Metastatic breast cancer (MBC) Common disease 175,000 new cases/year 44,000
More informationPrognostic significance of K-Ras mutation rate in metastatic colorectal cancer patients. Bruno Vincenzi Università Campus Bio-Medico di Roma
Prognostic significance of K-Ras mutation rate in metastatic colorectal cancer patients Bruno Vincenzi Università Campus Bio-Medico di Roma Colorectal cancer 3 rd most common cancer worldwide Approximately
More informationRAS and BRAF in metastatic colorectal cancer management
Review Article RAS and BRAF in metastatic colorectal cancer management Jun Gong 1, May Cho 1, Marwan Fakih 2 1 Department of Medical Oncology, City of Hope National Medical Center, Duarte, CA, USA; 2 Medical
More informationPharmacokinetics Overview
Pharmacokinetics Overview Disclaimer: This handout and the associated lectures are intended as a very superficial overview of pharmacokinetics. Summary of Important Terms and Concepts - Absorption, peak
More informationModeling Multi-Mutation And Drug Resistance: A Case of Immune-Suppression
Global Journal of Pure and Applied Mathematics. ISSN 0973-1768 Volume 14, Number 6 (2018), pp. 787-807 Research India Publications http://www.ripublication.com/gjpam.htm Modeling Multi-Mutation And Drug
More informationNovel Molecular Molecular Therapies In Hepatocarcinoma Prof Eric
Novel Molecular Therapies In Hepatocarcinoma Prof. Eric Raymond Department of Médical Oncology Hôpital Beaujon, Clichy Université Paris 7 Denis Diderot INSERM-U728 eric.raymond@bjn.aphp.fr HCC is a highly
More information2/20/14& Medical Management of Colon and Rectal Cancer: An Overview. Outline / Learning Objectives. How common is colon cancer?
Medical Management of Colon and Rectal Cancer: An Overview Jonathan Grim, MD, PhD VA Puget Sound Health Care System Fred Hutchinson Cancer Research Center UW Medicine Outline / Learning Objectives Epidemiology
More informationAvastin (bevacizumab)
Avastin (bevacizumab) Policy Number: 5.02.502 Last Review: 04/2018 Origination: 03/2017 Next Review: 04/2019 Policy Blue Cross and Blue Shield of Kansas City (Blue KC) will provide coverage for Avastin
More informationThe Oncologist 2018;23:1271 e128 TRIAL INFORMATION LESSONS LEARNED ABSTRACT. Clinical Trial Results
Clinical Trial Results Single-Agent Regorafenib in Metastatic Colorectal Cancer Patients with Any RAS or BRAF Mutation Previously Treated with FOLFOXIRI plus Bevacizumab (PREVIUM Trial) PILAR GARCÍA-ALFONSO,
More informationMETASTATIC COLORECTAL CANCER: TUMOR MUTATIONAL ANALYSIS AND ITS IMPACT ON CHEMOTHERAPY SUMA SATTI, MD
METASTATIC COLORECTAL CANCER: TUMOR MUTATIONAL ANALYSIS AND ITS IMPACT ON CHEMOTHERAPY SUMA SATTI, MD INTRODUCTION Second leading cause of cancer related death in the United States. 136,830 cases in 2014
More informationINMUNOTERAPIA I. Dra. Virginia Calvo
INMUNOTERAPIA I Dra. Virginia Calvo LBA62. Health-related quality of life (HRQoL) for Pembrolizumab or placebo plus Carboplatin and Paclitaxel or nab-paclitaxel in patients with metastatic squamous NSCLC:
More informationSponsor / Company: Sanofi Drug substance(s): Docetaxel (Taxotere )
These results are supplied for informational purposes only. Prescribing decisions should be made based on the approved package insert in the country of prescription. Sponsor / Company: Sanofi Drug substance(s):
More informationFirst line treatment in metastatic colorectal cancer
First line treatment in metastatic colorectal cancer Claus-Henning Köhne University Clinic Onkology and Haematology North West German Cancer Center (NWTZ) A non authorised version of ESMO guidelines was
More informationINDICATION: COMPENDIA TRANSPARENCY TRACKING FORM
COMPENDIA TRANSPARENCY TRACKING FORM DRUG: Panitumumab INDICATION: Metastatic colorectal cancer, wild-type KRAS mutation, first-line therapy, in combination with infusional fluorouracil, leucovorin, and
More informationBevacizumab plus chemotherapy in elderly patients with previously untreated metastatic colorectal cancer: single center experience
226 research article Bevacizumab plus chemotherapy in elderly patients with previously untreated metastatic colorectal cancer: single center experience Janja Ocvirk 1,2, Maja Ebert Moltara 1,Tanja Mesti
More informationChemotherapy for resectable liver mets: Options and Issues. Herbert Hurwitz Duke University Medical Center Durham, North Carolina, USA
Chemotherapy for resectable liver mets: Options and Issues Herbert Hurwitz Duke University Medical Center Durham, North Carolina, USA Chemotherapy regimens in 1 st line mcrc Standard FOLFOX-Bev FOLFIRI-Bev
More informationNew Options in Metastatic Colorectal Cancer. Jeffrey A. Bubis, DO, FACOI, FACP Fleming Island Baptist South Palatka
New Options in Metastatic Colorectal Cancer Jeffrey A. Bubis, DO, FACOI, FACP Fleming Island Baptist South Palatka 4 th most frequently diagnosed CA in the US 2 nd leading cause of CA death in the US Incidence
More informationPublished Ahead of Print on September 5, 2008 as /theoncologist
The Oncologist Symptom Management and Supportive Care Health-Related Quality of Life Impact of Bevacizumab When Combined with Irinotecan, 5-Fluorouracil, and Leucovorin or 5-Fluorouracil and Leucovorin
More informationDr. Iain Tan. Senior Consultant GI Medical Oncologist National Cancer Centre Singapore
ESMO-ASIA 2017 Preceptorship (GI cancers) Session: Metastatic colorectal cancer, liver limited metastases Topic: Unresectable or borderline resectable : chemotherapy +/- targeted agents Dr. Iain Tan Senior
More informationStochastic modeling of carcinogenesis
Stochastic modeling of carcinogenesis Rafael Meza Department of Epidemiology University of Michigan SPH-II 5533 rmeza@umich.edu http://www.sph.umich.edu/faculty/rmeza.html Outline Multistage carcinogenesis
More informationMOLECULAR AND CLINICAL ONCOLOGY 4: , 2016
774 Elevated levels of plasma lactate dehydrogenase is an unfavorable prognostic factor in patients with epidermal growth factor receptor mutation positive non small cell lung cancer, receiving treatment
More informationHow to fight a silent killer: Lessons learned from Ovarian Cancer. Stephen A. Cannistra, M.D.
How to fight a silent killer: Lessons learned from Ovarian Cancer Stephen A. Cannistra, M.D. How to fight a silent killer: Lessons learned from Ovarian Cancer Ovarian cancer is not common but is highly
More informationOHTAC Recommendation. KRAS Testing for Anti-EGFR Therapy in Advanced Colorectal Cancer
OHTAC Recommendation KRAS Testing for Anti-EGFR Therapy in Advanced Colorectal Cancer Presented to the Ontario Health Technology Advisory Committee in August, 2010 December 2010 Issue Background In February
More informationWhat s New in Colon Cancer? Therapy over the last decade
What s New in Colon Cancer? 9/19/2014 Michael McNamara, MD Therapy over the last decade Cytotoxic chemotherapy - 5FU ( Mayo, Roswell, Infusional) - Xeloda (01 ) - Oxaliplatin (02 ) - Irinotecan (96 ) Anti-
More informationNivolumab: esperienze italiane nel carcinoma polmonare avanzato
NSCLC avanzato: quali novità nel 2018? Negrar, 30 Ottobre 2018 Nivolumab: esperienze italiane nel carcinoma polmonare avanzato Francesco Grossi UOC Oncologia Medica Fondazione IRCCS Ca Granda Ospedale
More informationModeling Imatinib-Treated Chronic Myeloid Leukemia
Modeling Imatinib-Treated Chronic Myeloid Leukemia Cara Peters cpeters3@math.umd.edu Advisor: Dr. Doron Levy dlevy@math.umd.edu Department of Mathematics Center for Scientific Computing and Mathematical
More informationXu et al. Journal of Hematology & Oncology (2017) 10:22 DOI /s
Xu et al. Journal of Hematology & Oncology (2017) 10:22 DOI 10.1186/s13045-016-0384-9 RESEARCH Open Access Safety and efficacy of fruquintinib in patients with previously treated metastatic colorectal
More informationEnhanced Recovery After Discharge: does it happen?
Enhanced Recovery After Discharge: does it happen? Nader K Francis ERAS-UK Southampton 14 th November 2014 BJS 2014 Functional / symptoms Length of hospital stay 37 Readmission 29 Pain 16 Fatigue 9 BJS
More information