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Recent clinical trial results suggest that anti-angiogenic therapy may be effective against recurrent malignant glioma. Though these treatments prolong progression-free survival, the extent to which they prolong overall survival is unknown. We pooled data from 34 patients treated at a single institution on phase II clinical trials of bevacizumab and(More)
PURPOSE Increasing evidence has suggested that angiogenesis inhibition might potentiate the effects of radiotherapy and chemotherapy in patients with glioblastoma (GBM). In addition, epidermal growth factor receptor inhibition might be of therapeutic benefit, because the epidermal growth factor receptor is upregulated in GBM and contributes to radiation(More)
2069 Background: EGFR and VEGFR signaling have been implicated in the development and growth of GBM. Simultaneous inhibition of both pathways may be more effective than inhibiting a single pathway. In addition, angiogenesis inhibitors may enhance radiation sensitivity. Vandetanib is an inhibitor of VEGFR-2 and EGFR tyrosine kinase activities that has(More)
Bevacizumab is frequently used to treat patients with recurrent high-grade glioma (HGG), but responses are generally not durable. Panobinostat is a histone deacetylase inhibitor with anti-neoplastic and anti-angiogenic effects and may work synergistically with VEGF inhibitors. We performed a phase I study to evaluate the safety and tolerability of the(More)
2038 Background: Most GBM patients relapse within 1 year from diagnosis. Among patients who progress on standard temozolomide, the optimal therapy is unknown. Resistance to temozolomide is partially mediated by the DNA repair enzyme, O6-methylguanine-DNA methyltransferase (MGMT). Since MGMT may be depleted by prolonged temozolomide administration,(More)
Despite recognition that clinical decision support (CDS) can improve patient care, there has been poor penetration of this technology into healthcare settings. We used CDS to increase inpatient influenza vaccination during implementation of an electronic medical record, in which pharmacy and nursing transactions increasingly became electronic. Over three(More)
PURPOSE Vandetanib, a tyrosine kinase inhibitor of KDR (VEGFR2), EGFR, and RET, may enhance sensitivity to chemotherapy and radiation. We conducted a randomized, noncomparative, phase II study of radiation (RT) and temozolomide with or without vandetanib in patients with newly diagnosed glioblastoma (GBM). EXPERIMENTAL DESIGN We planned to randomize a(More)
Over three influenza seasons spanning four years we evaluated the effect of standing orders, reminders, and iterations of Clinical Decision Support (CDS) to increase influenza (flu) vaccination among inpatients. Using CDS, coverage increased over each season: (0%, 12%, 35%). However, success was realized only after integration of the electronic medication(More)
We compared strategies to increase the rate of influenza vaccination. A written standing-orders policy that enabled nurses to vaccinate patients was compared with augmentation of the standing-orders policy with either electronic opt-out orders for physicians or electronic reminders to nurses. Use of opt-out orders yielded the highest vaccination rate (12%(More)
2040 Background: Patients with recurrent or progressive meningiomas who have exhausted surgical and radiation options have limited remaining treatment choices. Somatostatin receptors are expressed in nearly 90% of meningiomas, and somatostatin inhibits meningioma growth in vitro. The somatostatin analog octreotide had promising results in a pilot clinical(More)