Podcasts about carcinomatosis

¿Qué Es La Carcinomatosis? | Episodio #321 | Dr. Franco Krakaur | Cirujano Oncólogo

Carcinomatosis Adquiere mi nuevo libro ""Bendito Cáncer"" en el siguiente enlace: www.medicooncologo.com/libro-bendito-cancer Sígueme en mis redes sociales: Instagram: instagram.com/drfrancokrakaur Facebook: facebook.com/drfrancokrakaur Canal de YouTube: bit.ly/3hF5lsk TikTok: tiktok.com/@dr.francokrakaur Spotify Podcast: spoti.fi/3bOm0Jd Sitio web. www.medicooncologo.com WhatsApp: wa.link/l9olpa (+52 55 3471 0500) Blog: www.medicooncologo.com/blog Libro ""Bendito Cáncer"" medicooncologo.com/libro-bendito-cancer Holisticare Organics: holisticare.shop"

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez, is joined by Dr. Jorge Hoegl to discuss peritoneal carcinomatosis after minimally invasive surgery in cervical cancer. Dr. Jorge Hoegl is an early career gynecologic oncologist at the Department of Obstetrics and Gynecology at the General Hospital of the East “Dr. Domingo Luciani” in Caracas, Venezuela. Highlights: -Peritoneal carcinomatosis represented more than 15% of all recurrences, with a recurrence rate of 22.2% in minimally invasive surgery compared to 8.8%. -Peritoneal carcinomatosis has been frequently grouped within distant recurrences and perhaps this made it not such a notorious fact. -Peritoneal carcinomatosis does not appear to be an unusual recurrence pattern associated with cervical cancer and it should be reported separately.

In a subset of patients with metastatic colorectal cancer (mCRC), the peritoneum is the predominant site of dissemination. While cure can be achieved by cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), this procedure is associated with long-term morbidity and high relapse rates. In this episode of ModPath CHAT, Drs. Siesing and Jirstrom from Lund University in Sweden discuss their recent study in Modern Pathology on the topic. Multi-region immunohistochemical profiling and deep targeted DNA-sequencing was performed on 7 mCRC patients with peritoneal carcinomatosis (PC). SATB2 was lacking in the majority of cases, and a conspicuous intra-patient heterogeneity was denoted for expression of (RBM3). Mutations in key CRC driver genes, i.e., KRAS, APC and TP53, were homogenously distributed across all samples. The authors conclude that their findings should trigger additional studies addressing the potential distinctiveness of mCRC with PC, which might pave the way for improved personalized treatment of these patients. See acast.com/privacy for privacy and opt-out information.

Vadim Gushchin, MD, Brian Badgwell, MD, and Jeremy Davis, MD discuss the role and timing of preoperative treatments before cytoreduction and HIPEC for gastric cancer. The panelists offer useful tips on surgical management of gastric cancer patients with peritoneal carcinomatoses, such as how to decide on the extent of the surgery, whether patients with CDH1 mutation should be treated differently, and others.

In this episode of SurgOnc Today™, Brian Badgwell, MD, Farshid Dayyani MD, PhD, and Maheswari Senthil, MD, discuss the management of gastric cancer peritoneal carcinomatosis. Evaluation of response to systemic treatment, use of intraperitoneal chemotherapy and nuances of patient selection for Cytoreductive surgery are discussed.

Researchers are conducting the first U.S. trial of pressurized intraperitoneal aerosolized chemotherapy (PIPAC) for the treatment of peritoneal carcinomatosis in patients with gynecologic or gastrointestinal cancers. Coprincipal investigator Thanh H. Dellinger, MD, of City of Hope in Duarte, Calif., describes this trial and the PIPAC procedure to host David H. Henry, MD, in this episode. To start, the pair discuss a patient who might be eligible for PIPAC – one with stage 3 ovarian cancer. General approach to stage 3 ovarian cancer Therapy typically includes a combination of surgery and chemotherapy. The order in which chemotherapy is given, either pre- or postoperatively, depends on performance status and whether patients have extra-abdominal disease or parenchymal liver disease. Operative approaches, including debulking surgery, are pursued if believed to be optimal, meaning all gross residual disease can be resected. If all residual disease cannot be resected, patients are offered neoadjuvant chemotherapy, typically for three to four cycles before an interval debulking surgery, followed by postoperative adjuvant chemotherapy. Intraperitoneal chemotherapy Intraperitoneal (IP) chemotherapy is used to treat peritoneal surface malignancies. The peritoneum is a separate organ that is difficult to treat adequately with intravenous chemotherapy alone. Giving IP chemotherapy in combination with intravenous chemotherapy may be more effective than intravenous chemotherapy alone (N Engl J Med. 2006; 354:34-43; https://bit.ly/3g3lngx). However, there are many challenges in delivering IP chemotherapy, including increased side effects of abdominal pain and IP catheter failure. Recent clinical trials have shown that, with the addition of bevacizumab, the survival benefit with IP chemotherapy may not be as significant as prior trials suggested (J Clin Oncol. 2019 Jun 1;37[16]:1380-90; https://bit.ly/2VAmRVW). In general, IP chemotherapy has not been embraced by the medical oncology community as much other types of chemotherapies, Dr. Dellinger said. What is PIPAC? PIPAC is a novel therapy discovered by a German surgical oncologist, Marc A. Reymond, MD, from University of Tuebingen (Germany). PIPAC delivers chemotherapy at a reduced dose directly into the intraperitoneal cavity but in a pressurized and aerosolized form. PIPAC is done at the time of the diagnostic laparoscopy and requires a nebulizer for aerosolization of the chemotherapy as well as a high-pressure injector. This approach allows for the chemotherapy to be pushed deeper into tissues, compared with hyperthermic intraoperative peritoneal chemotherapy (HIPEC). With HIPAC, tissue penetration is typically 1 mm or less. With PIPAC, there is deeper penetration and better distribution of chemotherapy throughout the entire intraperitoneal cavity. With PIPAC, chemotherapeutic agents are given at a lower dose than is typically administered with IP or intravenous chemotherapy, which helps in reducing the toxicity. PIPAC is given every 6 weeks for three cycles, requiring three laparoscopic procedures. These laparoscopic procedures allow for the opportunity to obtain peritoneal tumor biopsies before and after to investigate the natural course of these tumors and their microenvironment. Toxicity of PIPAC PIPAC has been done in more than 800 patients with gastrointestinal and gynecologic cancers in Europe and Asia. Severe adverse events  have been minimal, with about 12%-15% grade 3/4 SAEs and very rare grade 5 SAEs. The most common side effect is typically abdominal pain, attributed to the IP administration in conjunction with the laparoscopic surgery. Renal toxicity is a concern with intravenous cisplatin use, but this has not yet been seen with PIPAC. With PIPAC, cisplatin is given at 10.1 mg/m2 and doxorubicin is given at 2.1 mg/m2, doses that are much lower than the typical doses for these drugs. PIPAC in clinical trials PIPAC clinical trials have moved into phase 2 in Europe for ovarian cancer, with a publication demonstrating an objective response rate of over 60% in platinum-resistant ovarian cancer (Gynecol Oncol. 2015 May;137[2]:223-8; https://bit.ly/2KY701r). A phase 3 trial of PIPAC was planned but was stalled because of the COVID-19 pandemic. Because of the need for Food and Drug Administration approval, researchers have just launched the first phase 1 trial of PIPAC in the United States. Phase 1 trial of PIPAC City of Hope is working with affiliates at Mayo Clinic in Jacksonville, Fla.; Northwell Health in New York; and the National Institutes of Health to enroll eligible candidates for a phase 1 trial (NCT04329494; https://bit.ly/3qs8H7U). Eligible candidates include those with gastric, uterine, colorectal, appendiceal, and ovarian cancer with evidence of peritoneal carcinomatosis who have failed at least one line of therapy. PIPAC is an outpatient procedure, but given the trial and need for monitoring, patients typically leave the hospital the following day after blood samples are obtained for the study. City of Hope has recruited seven patients since activating their study in August 2020, with a goal of enrolling 16 patients by spring 2021. Future directions Peritoneal tumor biopsies obtained during the laparoscopic procedures are being used to study the microenvironment of these cancers. In eventual phase 2 clinical trials, the researchers may include immune checkpoint inhibitors. Biomarker analyses are underway, looking at expression of PD-1 and tumor-infiltrating lymphocytes. The researchers are also studying the role of genomic sequencing and DNA repair. Disclosures: Dr. Dellinger and Dr. Henry have no financial disclosures relevant to this episode. Show notes by Sheila De Young, DO, resident at Pennsylvania Hospital, Philadelphia. *  *  * For more MDedge Podcasts, go to mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgehemonc David Henry on Twitter: @davidhenrymd

Norris Cotton Cancer Center Grand Rounds presented on June 12, 2018 Paula K. Rauschkolb, DO Assistant Professor of Medicine, Geisel School of Medicine, Dartmouth

GRACE is happy to present the 8th in our series ASCO 2016 Lung Cancer Roundtable, Highlights and New Approaches in Lung Cancer.  Featuring Jack West, MD, Janet Freeman-Daily, Everett Vokes, MD, and Suresh Ramalingam, MD, this roundtable discussion, moderated by Dr. West, highlights the newest and most intriguing discussions from ASCO 2016. Drs. West, Vokes and Ramalingam, along with patient advocate Janet Freeman-Daily, discuss new trials of targeting therapies used to treat leptomeningeal carcinomatosis.

GRACE is happy to present the 8th in our series ASCO 2016 Lung Cancer Roundtable, Highlights and New Approaches in Lung Cancer.  Featuring Jack West, MD, Janet Freeman-Daily, Everett Vokes, MD, and Suresh Ramalingam, MD, this roundtable discussion, moderated by Dr. West, highlights the newest and most intriguing discussions from ASCO 2016. Drs. West, Vokes and Ramalingam, along with patient advocate Janet Freeman-Daily, discuss new trials of targeting therapies used to treat leptomeningeal carcinomatosis.

GRACE is happy to present the 8th in our series ASCO 2016 Lung Cancer Roundtable, Highlights and New Approaches in Lung Cancer.  Featuring Jack West, MD, Janet Freeman-Daily, Everett Vokes, MD, and Suresh Ramalingam, MD, this roundtable discussion, moderated by Dr. West, highlights the newest and most intriguing discussions from ASCO 2016. Drs. West, Vokes and Ramalingam, along with patient advocate Janet Freeman-Daily, discuss new trials of targeting therapies used to treat leptomeningeal carcinomatosis.

Dr. Taofeek Owonikoko reviews why we often see brain metastases develop as a first or only site of progression in patients with NSCLC and a driver mutation.

Dr. Taofeek Owonikoko reviews why we often see brain metastases develop as a first or only site of progression in patients with NSCLC and a driver mutation.

Dr. Taofeek Owonikoko reviews why we often see brain metastases develop as a first or only site of progression in patients with NSCLC and a driver mutation.

Leptomeningeal carcinomatosis is cancer that has spread to the coating of the brain and spinal cord. In the past, prognosis has been bad. But now doctors are learning of effective treatments to deal with this issue.

Leptomeningeal carcinomatosis is cancer that has spread to the coating of the brain and spinal cord. In the past, prognosis has been bad. But now doctors are learning of effective treatments to deal with this issue.

Leptomeningeal carcinomatosis is cancer that has spread to the coating of the brain and spinal cord. In the past, prognosis has been bad. But now doctors are learning of effective treatments to deal with this issue.

Linfadenectomía y Carcinomatosis en el Cáncer Gástrico. Asignatura: Neoplasias del Tracto Digestivo. Máster Universitario en Investigación Clínica y Quirúrgica. Profesor: Francisco Javier Lacueva Gómez. Dpto. de Patología y Cirugía. Área de Cirugía. Proyecto PLE 2013. Universidad Miguel Hernández de Elche. Se realiza una revisión de los estudios con mayor nivel de evidencia de las complicaciones de la linfadenectomía en el carcinoma gástrico así como de los beneficios en términos de supervivencia. Se establecen sus indicaciones actuales y sus límites. Adicionalmente, se revisa el diagnóstico y el estado actual del tratamiento de la carcinomatosis peritoneal en estos tumores.

Question and answer session with Dr. Minesh Mehta, Professor of Radiation Oncology at Northwestern University, on topics related to treatments for brain metastases and related complications, especially in the setting of lung cancer.

Question and answer session with Dr. Minesh Mehta, Professor of Radiation Oncology at Northwestern University, on topics related to treatments for brain metastases and related complications, especially in the setting of lung cancer.

Background: Peritoneal carcinomatosis (PC) is common in gastrointestinal (GI) cancer and there is no effective standard treatment. We investigated the tolerability and maximum tolerated dose (MTD) of the trifunctional antibody catumaxomab in patients with PC. Methods: In this open-label, phase I/II clinical trial, patients with epithelial cell adhesion molecule (EpCAM)-positive PC from GI cancer received 4 sequential intraperitoneal catumaxomab infusions: day 0: 10 mu g; day 3: 10 or 20 mu g; day 7: 30, 50, or 100 mu g; and day 10: 50, 100, or 200 mu g. Dose escalation was guided by dose-limiting toxicities. Results: The MTD was 10, 20, 50, and 200 mu g on days 0, 3, 7, and 10, respectively. Catumaxomab had an acceptable safety profile: Most common treatment-related adverse events (at the MTD) were fever, vomiting, and abdominal pain. At final examination, 11/17 evaluable patients (65%) were progression free: 1 patient had a complete and 3 a partial response. Median overall survival from the time of diagnosis of PC was 502 days. Conclusions: Intraperitoneal catumaxomab is a promising option for the treatment of PC from GI cancer.

Peritoneal carcinomatosis (PC) from epithelial tumors is a fatal diagnosis without efficient treatment. Trifunctional antibodies (trAb) are novel therapeutic approaches leading to a concerted anti-tumor activity resulting in tumor cell destruction. In addition, preclinical data in mouse tumor models demonstrated the induction of long lasting tumor immunity after treatment with trAb. We describe the induction of anti-tumor specific T-lymphocytes after intraperitoneal administration of trAb in patients with PC. 9 patients with progressive PC from gastric (n = 6) and ovarian cancer (n = 2), and cancer of unknown primary (n = 1) received 3 escalating doses of trAb after surgery and/or ineffective chemotherapy. The trAb EpCAM x CD3 (10, 20, 40 mu g) or HER2/neu x CD3 (10, 40, 80 mu g)were applicated by intraperitoneal infusion. Four weeks after the last trAb application, all patients were restimulated by subdermal injection of trAb + autologous PBMC + irradiated autologous tumor cells. Immunological reactivity was tested by analyzing PBMC for specific tumor reactive CD4+/CD8+ T lymphocytes using an IFN-gamma secretion assay. In 5 of 9 patients, tumor reactive CD4+/CD8+T-lymphocytes increased significantly, indicating specific anti-tumor immunity. A clinical response (stable disease, partial regression) has been observed in 5 of 9 patients, with a mean time to progression of 3.6 months. Follow-up showed a mean survival of 11.8 months (median 8.0 months) after trAb therapy. TrAb are able to induce anti-tumor immunity after intraperitoneal application and restimulation. The induction of long-lasting anti-tumor immunity may provide an additional benefit of the intraperitoneal therapy with trAb and should be further elevated in larger clinical trials.

In neurology, paroxysmal syndromes are well-known, eg, as manifestations of multiple sclerosis. We report a patient with meningeal carcinomatosis, who presented with therapyrefractory nausea and vomiting. The clinical suspicion of a paroxysmal syndrome prompted a trial of carbamazepine, which resulted in complete cessation of the symptoms. In cancer patients with central nervous system (CNS) involvement and therapy-refractory symptoms with sudden onset, carbamazepine treatment should be considered.