No abstract

PET/CT upstages 17% of cases and detects occult splenic involvement. This may have potential therapeutic and prognostic implications. SUV >10 may predict for an aggressive histology. Except for indolent B-NHL, our data show that PET scans have a good overall NPV in excluding lymphomatous bone marrow involvement. This is particularly true of early-stage HL, suggesting that BMB may be safely omitted in this group.

The weekly regimen of Genexol-PM was well tolerated and responses were observed in patients with refractory tumors, including patients who had failed taxane-based chemotherapy previously.

Human papillomavirus (HPV) is the etiologic risk factor for cervical cancer. Some studies have suggested an association with a subset of lung tumors, but the etiologic link has not been firmly established. We performed an international pooled analysis of cross-sectional studies (27 datasets, n = 3249 patients) to evaluate HPV DNA prevalence in lung cancer and to investigate viral presence according to clinical and demographic characteristics. HPV16/18 were the most commonly detected, but with substantial variation in viral prevalence between geographic regions. The highest prevalence of HPV16/18 was observed in South and Central America, followed by Asia, North America and Europe (adjusted prevalence rates = 22, 5, 4 and 3%, respectively). Higher HPV16 prevalence was noted in each geographic region compared with HPV18, except in North America. HPV16/18-positive lung cancer was less likely observed among White race (adjusted odds ratio [OR] = 0.33, 95% confidence interval [CI] = 0.12-0.90), whereas no associations were observed with gender, smoking history, age, histology or stage. Comparisons between tumor and normal lung tissue show that HPV was more likely to be present in lung cancer rather than normal lung tissues (OR = 3.86, 95% CI = 2.87-5.19). Among a subset of patients with HPV16-positive tumors, integration was primarily among female patients (93%, 13/14), while the physical status in male cases (N = 14) was inconsistent. Our findings confirm that HPV DNA is present in a small fraction of lung tumors, with large geographic variations. Further comprehensive analysis is needed to assess whether this association reflects a causal relationship.

Most of our patients adhered to their antiemetics and tolerated AC chemotherapy reasonably well, without vomiting; yet nausea persisted. To improve CINV control, clinicians must actively communicate with patients to facilitate accurate assessment of risk factors and CINV response and to encourage adherence to delayed antiemetics.

Rituximab (Mabthera) is currently approved for the treatment of multiple subtypes of CD20-expressing, B-cell, non-Hodgkin's lymphoma. This study aimed to investigate whether rapid infusion of rituximab over 90 min is feasible without compromising patient's safety, and to reduce resource utilization at a cancer center. This is a prospective and open label study. Lymphoma patients who have received one cycle of rituximab without experiencing grade 3 or 4 infusional reaction were eligible for the rapid infusion of rituximab. Rapid infusion rituximab is infused over 90 min, with 20% of the dose given over the first 30 min and the remaining 80% over 60 min. A total of 79 patients were recruited for this study with a total of 269 infusions administered. Sixty-nine patients (87.3%) received rituximab in combination with chemotherapy. Average number of rituximab infusions administered to patients was 3.4 cycles. Rapid rituximab infusion schedule was well tolerated without any grade 3/4 infusion-related adverse events observed. An average amount of time saved per patient was 10.2 h. Rapid infusion rituximab over 90 min was well tolerated by patients, and shortened infusions have resulted in substantial reduction of resource utilization.

Patients with N(0) disease and RLN appear to share a similar prognosis to patients with N(1) disease.

The problem of choosing a sample size for a clinical trial is a very common one. In some settings, such as rare diseases or other small populations, the large sample sizes usually associated with the standard frequentist approach may be infeasible, suggesting that the sample size chosen should reflect the size of the population under consideration. Incorporation of the population size is possible in a decision‐theoretic approach either explicitly by assuming that the population size is fixed and known, or implicitly through geometric discounting of the gain from future patients reflecting the expected population size. This paper develops such approaches. Building on previous work, an asymptotic expression is derived for the sample size for single and two‐arm clinical trials in the general case of a clinical trial with a primary endpoint with a distribution of one parameter exponential family form that optimizes a utility function that quantifies the cost and gain per patient as a continuous function of this parameter. It is shown that as the size of the population, N, or expected size, N∗ in the case of geometric discounting, becomes large, the optimal trial size is O(N1/2) or O(N∗1/2). The sample size obtained from the asymptotic expression is also compared with the exact optimal sample size in examples with responses with Bernoulli and Poisson distributions, showing that the asymptotic approximations can also be reasonable in relatively small sample sizes.