No abstract

Sipuleucel-T is an immunotherapy indicated for the treatment of metastatic prostate cancer. It offers a new mechanism to treat prostate cancer without the side effects of hormone therapies and chemotherapies. In previous studies sipuleucel-T did not delay disease progression, but demonstrated an overall survival benefit compared to placebo. While clinical trials have evaluated the effects of sipuleucel-T on overall survival and progression, more studies are needed to evaluate its effectiveness and role in the management of prostate cancer. The objective of this study is to identify the incidence and possible predictors for disease progression in patients receiving sipuleucel-T. A retrospective review of patients who received sipuleucel-T between 1 September 2010 and 11 October 2011 was conducted (n = 36). Patients who changed therapy or died within 120 days were classified as experiencing rapid progression. Potential predictors of rapid progression were examined using logistic regression. Seven patients met criteria for rapid progression. Progression occurred in 72.2% of all patients. The median days to progression was 158. No significant predictors of rapid progression were identified. Currently no predictors have been found to be associated with rapid progression in prostate cancer patients on sipuleucel-T.

No abstract

In order to expose malignant cells to high concentrations of cytotoxic chemotherapeutic agents, drugs can be instilled directly into the peritoneal cavity of patients with ovarian carcinomas through a Tenckhoff catheter. The peritoneal dialysate removed during such therapy can be examined cytologically for the presence of carcinoma cells. The cytologic specimens from Tenckhoff catheters from 40 consecutive patients with primary ovarian (39) and tubal (1) cancer who received intraperitoneal chemotherapy have been reviewed retrospectively. A total of 237 specimens yielded 78 (33%) positive, 138 (58%) negative, and 21 (9%) inconclusive or suspicious fluids. The major diagnostic problem was the marked mesothelial atypia, which may be related to the high concentrations of cytotoxic agents intimately in contact with the peritoneum. Of the 15 patients who had tissue examined after placement of the catheter (mean interval, 5 months), results agreed with those of the catheter cytologic specimens in ten patients. The catheter cytologic specimen was never positive when histology was negative. Of the 36 patients with evaluable follow-up (mean, 19 months), agreement between the clinical course and the catheter cytologic results was found in 27 patients (75%). Again, interpretation of the catheter specimens was never positive in the face of a benign clinical course. Thus, evaluation of catheter specimens by cytologic examination has a diagnostic sensitivity and specificity of 59% and 100%, respectively. Tenckhoff catheter cytology has proven to be a rather valuable tool to monitor persistent or recurrent intraperitoneal ovarian carcinoma.