Chemotherapy disease progression

The response to chemotherapy may be referred to as complete response, partial response, stable disease, or disease progression. 

The major initial treatment modality for advanced prostate cancer is androgen ablation (e.g., orchiectomy or luteinizing hormone-releasing hormone [LHRH] agonists with or without antiandrogens). After disease progression, secondary hormonal manipulations, cytotoxic chemotherapy, and supportive care are used. 

When CNS involvement occurs, the poor penetration of suramin and pentamidine into the CSF requires alternative forms of chemotherapy, such as melarsoprol in combination with suramin. In treating Onchocerca volvulus infections, suramin kills adult worms and is an alternative to ivermectin. Suramin is used after initial treatment with diethylcarbamazine, which is used to kill the microfilariae. It produces favorable results in pemphigus and prolongs the time to disease progression in hormone-refractory prostate cancer. 

E. Therapeutic response According to the product label, studies have shown that Rofewn-A can normalize serum transaminases, improve Uver histology, and reduce viral load in patients with chronic hepatitis C virus (HCV) infection. Other studies have shown that Roferon-A can produce clinically meaningful tumor regression or disease stabilization in patients with hairy-cell leukemia or in patients with AIDS-related Kaposi s sarcoma. In Ph-positive CML, Roferon-A supplemented with intermittent chemotherapy has been shown to prolong overall survival and to delay disease progression compared to patients treated with chemotherapy alone. In addition Roferon-A has been shown to produce sustained complete cytogenetic responses in a small subset of patients with CML in chronic phase. 

Chemotherapy repeated every three weeks for up to six cycles - trastuzumab continued until disease progression.) Comment on the appropriateness of this... 

Chemotherapy repeated every three weeks for up to six cycles - trastuzumab continued until disease progression.) Comment on the appropriateness of this chemotherapy regimen as a treatment option. Are the doses appropriate for Mrs CR and if not, what would you advise the clinician to do How are these drugs administered What acute patient monitoring would you advise Mrs CR s nurse to undertake during and just after administration of trastuzumab ... 

Because SCLC has the propensity to disseminate early on in the disease, surgery is not usually indicated. SCLC is radiosensitive, and radiotherapy is used in combination with chemotherapy in patients with limited disease. Prophylactic cranial irradiation is used in select patients to reduce the risk of CNS metastases. Combination chemotherapy will prolong the survival of most patients with SCLC. Patients with limited disease are more likely to have a complete response to chemotherapy and longer survival than those who have extensive disease at the time of diagnosis. The most widely used chemotherapy regimens for SCLC include cisplatin or carboplatin plus etoposide. Despite very high response rates to chemotherapy, most patients with SCLC eventually have disease progression and die from this disease. 

Systemic chemotherapy represents the mainstay of therapy for patients whose disease progresses following initial treatment for metastatic disease. Figure 127-7 depicts an algorithm for treatment of refractory metastatic disease. Treatment options are based on type of and response to prior treatments, the site and extent of disease, and patient factors and treatment preferences. 

Answer E. HAART in the management of HIV infection is reported in many but not all patients to decrease viral load, increase CD4 cells, slow disease progression, and reduce opportunistic infections. However, in terms of the chemotherapy of AIDS, the word cure has little meaning. Discontinuance of HAART, after suppression of viral RNA copies below the sensitivity of the best current methods of analysis, is followed by the reemergence of detectable viral RNA in the blood within a few months. 

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