http://hdl.handle.net/10027/7424 Thu, 23 May 2013 21:05:05 GMT 2013-05-23T21:05:05Z http://hdl.handle.net/10027/8404 Long-term follow-up of HLA-A2+ patients with high-risk, hormone-sensitive prostate cancer vaccinated with the prostate specific antigen peptide homologue, PSA146-154 Perambakam, Supriya; Xie, Hui; Edassery, Seby; Peace, David J. Twenty eight HLA-A2+ patients with high-risk, locally advanced or metastatic, hormone-sensitive prostate cancer were immunized with a peptide homologue of prostate specific antigen, PSA146-154, between July 2002 to September 2004 and monitored for clinical and immune responses. Fifty percent of the patients developed strong PSA146-154-peptide specific delayed type hypersensitivity skin responses, tetramer and/or IFN-γ responses within one year. Thirteen patients had stable or declining serum levels of PSA one year post-vaccination. A decreased risk of biochemical progression was observed in patients who developed augmented tetramer responses at six months compared to pre-vaccination levels (p=0.02). Thirteen patients have died while 15 patients remain alive with a mean overall survival of 60 months (95% CI, 51 to 68 months) per Kaplan-Meier analysis. A trend towards greater overall survival was detected in men with high-risk, hormone-sensitive CaP who developed specific T-cell immunity following vaccination with PSA146-154 peptide. Copyright © 2010 Supriya Perambakam et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. doi 10.1155/2010/473453 Fri, 01 Jan 2010 06:00:00 GMT http://hdl.handle.net/10027/8404 2010-01-01T06:00:00Z http://hdl.handle.net/10027/7594 Outcome after reduced chemotherapy for intermediate-risk neuroblastoma Baker, David L.; Schmidt, Mary L.; Cohn, Susan L.; Maris, John M.; London, Wendy B.; Buxton, Allen; Stram, Daniel; Castleberry, Robert P.; Shimada, Hiroyuki; Sandler, Anthony; Shamberger, Robert C.; Look, Thomas; Reynolds, Patrick; Seeger, Robert C.; Matthay, Katherine Background The survival rate among patients with intermediate-risk neuroblastoma who receivedose-intensive chemotherapy is excellent, but the survival rate among patients whoreceive reduced doses of chemotherapy for shorter periods of time is not known.MethodsWe conducted a prospective, phase 3, nonrandomized trial to determine whether a 3-year estimated overall survival of more than 90% could be maintained with reductions in the duration of therapy and drug doses, using a tumor biology−based therapy assignment. Eligible patients had newly diagnosed, intermediate-risk neuroblastoma without MYCN amplification; these patients included infants (<365 days of age) who had stage 3 or 4 disease, children (≥365 days of age) who had stage 3 tumors with favorable histopathological features, and infants who had stage 4S disease with a diploid DNA index or unfavorable histopathological features. Patients who had disease with favorable histopathological features and hyperdiploidy were assigned to four cycles of chemotherapy, and those with an incomplete response or either unfavorable feature were assigned to eight cycles. Results Between 1997 and 2005, a total of 479 eligible patients were enrolled in this trial (270 patients with stage 3 disease, 178 with stage 4 disease, and 31 with stage 4S disease). A total of 323 patients had tumors with favorable biologic features, and 141 had tumors with unfavorable biologic features. Ploidy, but not histopathological features, was significantly predictive of the outcome. Severe adverse events without disease progression occurred in 10 patients (2.1%), including secondary leukemia (in 3 patients), death from infection (in 3 patients), and death at surgery (in 4 patients). The 3-year estimate (±SE) of overall survival for the entire group was 96±1%, with an overall survival rate of 98±1% among patients who had tumors with favorable biologic features and 93±2% among patients who had tumors with unfavorable biologic features. Conclusions A very high rate of survival among patients with intermediate-risk neuroblastoma was achieved with a biologically based treatment assignment involving a substantially reduced duration of chemotherapy and reduced doses of chemotherapeutic agents as compared with the regimens used in earlier trials. These data provide support for further reduction in chemotherapy with more refined risk stratification. Post print version of article may differ from published version. The definitive version is available through Massachusetts Medical Society at http://www.nejm.org/doi/full/10.1056/NEJMoa1001527#t=article. Thu, 30 Sep 2010 05:00:00 GMT http://hdl.handle.net/10027/7594 2010-09-30T05:00:00Z