View clinical trials related to Cancer.
Filter by:Proton therapy is a limited medical resource that is more expensive than conventional x-ray therapy. To correctly measure the success of proton therapy in treating different conditions, it is important to check a patient's health status after their treatment is finished. Checking on the progress of patients over many years (called long-term follow-up) is needed because the long-term effects of proton therapy are not well known.
The investigators have developed a mobile application (for use on smart phones) to help cancer patients better manage cancer pain. This study is a randomized controlled trial to evaluate the effect of this mobile-based intervention. The investigators' hypothesis is that subjects randomized to the intervention group will have a reduction in pain and pain-related hospitalizations.
Background Denmark has a lower survival of cancer compared to most European countries. Fast track pathways for organ specific cancers were established in the years 2008-2010. In 2011 further a fast track pathway for non-specific serious symptoms. Cancer in general practice is a low prevalence condition. Each general practitioner (GP) will see 8-10 new cancer patients per year. The investigators know that cancer patients have an increased use of general practice prior to diagnosis and that 25% of them wait for more than 20 days in general practice for referral according to the GPs. The latest Danish Cancer Plan therefore includes a CME as a key strategy to lower the GP threshold to refer patients to cancer fast track pathways. The aim of this study was to investigate the effect of this CME in early cancer diagnosis. This is measured by changes in GP knowledge, attitude and risk assessment. GP referral behavior assessed by primary care interval and use of fast track referrals. GP´s cancer hit rate, cancer patients´ tumor stage at treatment and 1 year survival. Methods/Design The study is conducted as a stepped wedge controlled design based on a quasi-cluster randomization. In august 2012 an invitation to participate in the present study were sent to 859 general Practitioners (GPs) from the Central Denmark Region. GPs completed a form for each patient they referred to a fast-track diagnostic pathway for cancer within an 8-month period. Every other week, we received data from a regional database. We reminded the referring GP-practice about non included patients. The collected data will be linked to registries. The CME-intervention The CME-course was a 3-hour meeting after work. Guided by the available evidence from the literature following the investigators ensured a multifaceted interactive teaching method including case-based education. The content included by other topics positive predictive values, false reassurance from negative testing and other pit-false. Statistical analyses The outcomes will be analyzed in a generalized linear random-effects model with random effect of GPs. Based on data it will be assessed whether further modeling of inter correlation within practices and within clusters is required, and whether the intervention effects are assumed equal for all GPs, or in random interaction with them. Analyses will be performed both in the full GP-population ("intention to intervening ") and in the 3 subgroups of GPs.
In mouse models and in patients, expression of the chemokine receptor CXCR4 on various cancers has been correlated with aggressive biological behavior, including increased rates and certain sites of metastasis, and decreased survival. Plerixafor (Mozobil ; Genzyme; Cambridge, MA) has been identified as a specific inhibitor of CXCR4, and it is currently approved by the Food and Drug Administration as a stem-cell mobilizing agent in combination with granulocyte colony-stimulating factor in the treatment of non-Hodgkin's lymphoma and multiple myeloma. Our group has recently shown that plerixafor can be labeled with the positron-emitting radionuclide copper-64((64)Cu) to form (64)Cu-plerixafor, which can be used to visualize CXCR4-positive tumor xenografts in mice using small-animal positron emission tomography (PET). Determining CXCR4 expression in tumors using (64)Cu-plerixafor and PET/computerized tomography (CT) scanning could be useful in predicting tumor behavior and responses to current and experimental therapies, including therapies targeting CXCR4, which could lead to more effective personalized cancer treatments. This study s primary objective is to evaluate (64)Cu-plerixafor as an imaging agent for quantifying CXCR4 expression in subjects (greater than or equal to 18 years of age) with cancer; at least 1 detectable solid tumor of greater than or equal to 2 cm in diameter found outside of the lymph nodes, bone marrow, liver, gallbladder, kidney, bladder, and brain; and preexisting biopsies of the tumors obtained since the first detection of the current occurrence/recurrence of disease. The secondary objectives are to correlate (64)Cu-plerixafor standardized uptake value in the target lesion with the level of CXCR4 expression detected via immunohistochemistry and to calculate human dosimetry for (64)Cu-plerixafor. Preexisting tumor biopsies from less than or equal to 75 subjects recruited from the National Cancer Institute and the Georgetown University Hospital will be evaluated for CXCR4 expression via immunohistochemistry. Subjects who meet the eligibility criteria will continue onto the study. Five subjects with CXCR4-positive tumor biopsies will be administered an initial intravenous infusion of (64)Cu-plerixafor (8 +/-0.8 mCi ; 0.48+/- 0.048 rem; not to exceed 5 microg of (64)Cu -plerixafor) over 2 minutes. They will then undergo an initial low-dose transmission CT scan followed by 3 consecutive torso PET scans as soon as practical after the infusion, and 2 additional PET/CT scans at 4 hours +/- 1 hour and 24 hours +/- 2 hours post-infusion. Human dosimetry will be calculated based on these results, and a maximum dose will be used, not to exceed the calculated limit of a total effective dose of 5 rem, or the radiation exposure limit for each organ. The remaining subjects with CXCR4-positive (n=15) and CXCR4-negative (n=5) tumor biopsies will be administered 64Cu-plerixafor at the same, or a newly calculated dose, and will undergo 1 PET/CT scan between 1 and 4 hours post-infusion, depending on the dosimetry results. All subjects will undergo one comprehensive final study visit between study days 19 and 23 (11-17 days after injection with (64)Cu -plerixafor). Additionally, blood will be collected 2 more times between study days 13-16 and study days 26-30 to measure blood cell counts.
This is a dose-escalation, Phase I/II, open-label, three-part study. Part 1 is designed to determine the recommended dose and schedule for the orally administered MEK inhibitor trametinib, given together with the CDK4/6 inhibitor palbociclib in subjects with solid tumors. Multiple dose levels of each inhibitor will be tested to determine the recommended dose and schedule. Part 2 will evaluate the effect of the combination on tumor biomarkers safety, and anti-cancer activity in subjects with cutaneous melanoma that do not have a change at BRAFV600. Approximately 100-200 subjects will be enrolled. All subjects will receive trametinib and/or palbociclib until disease progression, death, consent withdrawal or unacceptable adverse event (AE). Data was only collected and analyzed for the Phase I component of the study, the Phase II component of the study was terminated without data collection
Study is designed to determine the maximum tolerated dose (MTD) of SNX-5422 when given in combination with everolimus.
This study aimed to evaluate the subsequent cancer risks, including gynecological cancers and malignancies at other sites, after the detection of screening positives and the diagnosis for primary cervical cancer.
Cancer is the second cause of over-one-year-old children mortality after accident. Survival rate is more than 70%, but in some cases, curative treatments are not sufficient and palliative support is implemented for those children in end of life. Pediatric guidelines about the place of end-of-life care are varied. On European scale, home is recommended (IMPaCCT study, 2007). In France, the 2008-2012 palliative care development program recommended home or initial hospital care unit. This program also supports implementation of mobile team rather than specific hospital units. In Brittany, a pattern of regional palliative care resource team has been implemented since 2005. In oncology, further to the guidelines, end-of-life place of care is often discussed several times for each case. Sometimes occur a lot of returns between home and hospital, psychological difficulties, and difficulties to offer adapted care conditions. Finally, less than 30% of children in palliative care decease at home. The primary objective is to identify main determinants of the place of palliative care in pediatric oncology. The secondary objective is to clarify the factors of change comparing to the initial planned place. Intervention : Questionnaire completed by the parents Interview with the parents and the psychologist (University Rennes 2) Number of subjects is : Parents of 68 to 93 children who died from cancer after a palliative phase, that means 136 to 186 parents. Expected results and perspectives : Using both quantitative and qualitative methods, expected results are the followings: - Identification of the objective and subjective factors, which influenced the decision of the place of care. - Determination of the factors of change comparing to the initial planned place. Once identified, main factors could be the ones to pay attention to in order to help for initial decision, better anticipation of change of place and better guidance of palliative care organization wherever, at home or in hospital. Results would be new information for research on palliative care for children but also for adults. Finally, this work is part of an improving approach of palliative care, related to the development of open-care hospital networks. We can expect some public health impacts with new arguments to help for complementary recommendations.
The purpose of this research study is to examine the pharmacokinetics (the process by which a drug is absorbed, distributed, metabolized, and eliminated by the body) of micafungin when it is given at 5mg/kg dose to immunocompromised children as anti-fungal prophylaxis. These children are at high risk for developing invasive fungal disease due to their compromised immunity and associated variable degree and duration of neutropenia. Currently, children who receive micafungin are given daily or alternate day dosing. The investigators will give a ONE TIME dose of micafungin and draw PK levels up to 96 hours post-infusion. The investigators goal is to obtain comparable micafungin drug concentrations at the end of 96 hours (4 days) as compared to lower dose at every 24 hour dosing. The investigators dosing proposal is likely to be effective prophylaxis for immunocompromised patients and would broaden its applicability to larger populations.
This a first-in-human study of an antibody blocking the function of the oncogene c-met in patients with cancer.