RESUMO
BACKGROUND: Treatment outcomes have improved in lymphoid malignancies but relapse remains inevitable for most patients. Everolimus and lenalidomide have shown clinical activity as single agents in patients with relapsed and refractory Hodgkin and non-Hodgkin lymphomas. PATIENTS AND METHODS: The present phase I/II trial for patients with relapsed and refractory lymphoid malignancy opened at Mayo Clinic from January 2011 to May 2013. The trial used a standard cohort 3 + 3 design to determine the maximum tolerated dose for the combination. Stem cell transplantation had failed in 27 of the patients (49%), 63% had stage IV disease, and ≥ 3 previous therapies had failed in 78%. RESULTS: Of the 58 patients, enrolled, 55 were evaluable for analysis. The maximum tolerated dose was 5 mg/d for everolimus plus 10 mg/d for 21 days for lenalidomide. The most common grade ≥ 3 toxicities were hematologic and included neutropenia (56%), leukopenia (38%), and thrombocytopenia (33%). Seven patients discontinued the study because of adverse events. One patient died of disease progression. The overall response rate was 27% (15 of 55), with 38% (21 of 55) having stable disease. CONCLUSION: The present phase I/II trial of everolimus and lenalidomide for R/R lymphoma has shown the combination to be tolerable, with neutropenia as the main dose-limiting toxicity. Encouraging responses were seen in this heavily pretreated group, and the patients with a response had meaningful duration of response.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Resistencia a Medicamentos Antineoplásicos/efeitos dos fármacos , Linfoma/tratamento farmacológico , Alvo Mecanístico do Complexo 1 de Rapamicina/antagonistas & inibidores , Recidiva Local de Neoplasia/tratamento farmacológico , Terapia de Salvação , Adulto , Idoso , Idoso de 80 Anos ou mais , Everolimo/administração & dosagem , Feminino , Seguimentos , Humanos , Lenalidomida/administração & dosagem , Linfoma/patologia , Masculino , Dose Máxima Tolerável , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Taxa de Sobrevida , Resultado do Tratamento , Adulto JovemRESUMO
Se presenta la segunda parte del resultado de la sistematización "Saber Práctico del Proyecto Pedagógico de las Escuelas de Básica Primaria Malta y Pilsen 1996-1997" , analizando el sentido que guió la acción pedagógicay sus componentes, relación maestro-alumno, método, organización de la clase, estrategias de motivación, evaluación; tomando como eje transversal de reflexión el manejo que hace el practicante docente de la autoridad en la orientación de la clase; teniendo en cuenta especialmente las influencias internas y externas que motivaron cambios significativos en la acción pedagógica. La sistematización se realizó con el fin de comprender y comunicar la experiencia a los estudiantes que inician su práctica docente y puedan vivir este mismo proceso en el manejo de la autoridad en el aula.
It's presented the second port of the systematization result: Practice knowledge of Pedagogic Project on Malta and Pilsen elemental sch ools 1996-1997 analyzing the way that guided pedagogic action and its corn ponents- teacher-pupil relation, method, arranging, of the class, motivatiori strategies, and evaluatioritaking as transversal guide of reflection the management that teaching practican does with the authority in leading the class, taking into account the internat and externa! influences that motivatedthe meaningful changes in pedagogical action . Systematization was did it in order to understand and to cornrnunicate this experiences to the students who start their practice and live this process on the authority rnanagement in the classroom.