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2014 Publications/Research Dr. Steve Martinez

PubMed Detailed Protocol for Administration of Intralesional IL-2

Detailed protocol for administration of intralesional IL-2 for the treatment of Stage IIIc and IV M1a metastatic melanoma based on current NCCN guidelines.

Authors: Patel F1, Wilken R, Burrall B, Martinez S, Wells V, King B, Maverakis E.

Abstract

Melanoma claims approximately 9,000 lives in the United States annually [1]. Patients who present with satellite, in-transit, or distant cutaneous metastases have limited treatment options and the prognosis for patients with metastatic disease remains poor. Surgical excision remains the most common treatment modality for cutaneous metastases, but may not address concurrent subclinical in-transit metastases. Other palliative treatment options include Bacillus Calmette-Guérin (BCG) and isolated limb perfusion (ILP). Although intravenous IL-2 has been used for treatment of metastatic melanoma since 1998, intralesional IL-2 has only now been included in the most recent National Comprehensive Cancer Network (NCCN) guidelines after case series and phase I/II clinical trials have shown promising results against Stage IIIc and IV M1a melanoma. Intralesional IL-2 protocols have varied markedly from study to study and there are no consensus guidelines available to help direct treatment. Herein, we present a detailed protocol for the administration of intralesional IL-2 that has been successfully used at two different institutions for treatment of cutaneous melanoma metastases.

PMID: 25419744 [PubMed - in process]

PubMed Utilization and Impact of a Postmastectomy Radiation Boost

Pract Radiat Oncol. 2014;4(6):e269-78. doi: 10.1016/j.prro.2014.05.006. Epub 2014 Jul 11.

Utilization and impact of a postmastectomy radiation boost for invasive breast cancer.

Authors: Mayadev J1, Fish K2, Valicenti R3, West D2, Chen A4, Martinez S5, Phillips T6.

Abstract

PURPOSE:
Additional radiation following postmastectomy radiation (PMRT) has an undefined benefit. We investigate those likely to be selected for a chest wall boost (CWB) and its effect on breast cancer survival (BCS) and overall survival (OS).

METHODS AND MATERIALS:
A total of 4747 women diagnosed from 2005 to 2009 were treated with PMRT identified from the California Cancer Registry (CCR); 2686 (57%) received a CWB. Univariate and multivariate analyses compared those receiving and not receiving a CWB for BCS and OS.

RESULTS:
With a median follow-up of 43.6 months, patients likely to receive a CWB were stage III (P ≤ .001), grade 3/4 (P = .03), positive nodes (P = .04), HER 2+ (P =.02). CWB was not related to BCS in the univariate (hazard ratio [HR], 1.00; 95% confidence interval [CI], 0.82-1.21), multivariate (HR, 1.04; 95% CI, 0.86 -1.26) analyses, and was not related OS for the univariate (HR, 0.92; 95% CI, 0.78-1.10), multivariate (HR, 0.95; 95% CI, 0.80-1.13) analyses. However, in multivariate analysis, patients not receiving chemotherapy who had a CWB had better BCS (HR, 1.77; 95% CI, 1.11-2.83).

CONCLUSIONS:
The majority of patients were treated with a CWB. We found no difference in BCS or OS with the addition of a CWB.

PMID: 25407878 [PubMed - in process]