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Monoclonal Antibody-Mediated Chemotherapy

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21. TLR9 Agonist SD-101, Ipilimumab, and Radiation Therapy in Treating Patients With Low-Grade Recurrent B-cell Lymphoma

with the treatment schedule Ability to understand and the willingness to sign a written informed consent document Exclusion Criteria Pre-existing autoimmune or antibody mediated disease including systemic lupus erythematosus, rheumatoid arthritis, multiple sclerosis, Sjogren's syndrome, autoimmune thrombocytopenia, Addison's disease, but excluding the presence of auto-antibodies without clinical autoimmune disease History of inflammatory bowel disease (eg, Crohn's disease or ulcerative colitis), celiac disease (...) -associated Lymphoid Tissue Nodal Marginal Zone B-cell Lymphoma Recurrent Grade 1 Follicular Lymphoma Recurrent Grade 2 Follicular Lymphoma Recurrent Marginal Zone Lymphoma Recurrent Small Lymphocytic Lymphoma Splenic Marginal Zone Lymphoma Biological: Ipilimumab Drug: SD-101 Radiation: Radiation therapy Phase 1 Phase 2 Detailed Description: Monoclonal antibodies, such as ipilimumab, may block cancer growth in different ways by targeting certain cells. Biological therapies, such as TLR9 agonist SD-101

2014 Clinical Trials

22. Cancer Associated and Related Autoimmune Retinopathies (Overview)

. Anecdotal reports describe improvement in both CAR and MAR with high-dose intravenous methylprednisolone, plasmapheresis combined with steroids, or intravenous immunoglobulin (IVIG); however, the treatment results are largely disappointing. [ , ] Espandar et al described a beneficial response in a patient with CAR treated with alemtuzumab, a monoclonal antibody that is used for the treatment of various B-cell mediated disorders. [ ] Calcium antagonists aimed at blocking antibody-mediated apoptosis were (...) disease as the cause of the vision loss should include contrast-enhanced MRI of the head and orbits and lumbar puncture for cytologic examination. Some chemotherapeutic agents, such as vincristine and carmustine (BCNU), can cause optic neuropathy. Patients who have received cranial radiation are also at risk for vision loss, which is usually identifiable on MRI. Vision loss in patients with metastatic disease may be due to infiltration of malignant cells around the optic nerve. Diffuse melanocytic

2014 eMedicine.com

23. Cancer Associated and Related Autoimmune Retinopathies (Treatment)

. Anecdotal reports describe improvement in both CAR and MAR with high-dose intravenous methylprednisolone, plasmapheresis combined with steroids, or intravenous immunoglobulin (IVIG); however, the treatment results are largely disappointing. [ , ] Espandar et al described a beneficial response in a patient with CAR treated with alemtuzumab, a monoclonal antibody that is used for the treatment of various B-cell mediated disorders. [ ] Calcium antagonists aimed at blocking antibody-mediated apoptosis were (...) disease as the cause of the vision loss should include contrast-enhanced MRI of the head and orbits and lumbar puncture for cytologic examination. Some chemotherapeutic agents, such as vincristine and carmustine (BCNU), can cause optic neuropathy. Patients who have received cranial radiation are also at risk for vision loss, which is usually identifiable on MRI. Vision loss in patients with metastatic disease may be due to infiltration of malignant cells around the optic nerve. Diffuse melanocytic

2014 eMedicine.com

24. Cancer Associated and Related Autoimmune Retinopathies (Follow-up)

. Anecdotal reports describe improvement in both CAR and MAR with high-dose intravenous methylprednisolone, plasmapheresis combined with steroids, or intravenous immunoglobulin (IVIG); however, the treatment results are largely disappointing. [ , ] Espandar et al described a beneficial response in a patient with CAR treated with alemtuzumab, a monoclonal antibody that is used for the treatment of various B-cell mediated disorders. [ ] Calcium antagonists aimed at blocking antibody-mediated apoptosis were (...) disease as the cause of the vision loss should include contrast-enhanced MRI of the head and orbits and lumbar puncture for cytologic examination. Some chemotherapeutic agents, such as vincristine and carmustine (BCNU), can cause optic neuropathy. Patients who have received cranial radiation are also at risk for vision loss, which is usually identifiable on MRI. Vision loss in patients with metastatic disease may be due to infiltration of malignant cells around the optic nerve. Diffuse melanocytic

2014 eMedicine.com

25. Cancer Associated and Related Autoimmune Retinopathies (Diagnosis)

. Anecdotal reports describe improvement in both CAR and MAR with high-dose intravenous methylprednisolone, plasmapheresis combined with steroids, or intravenous immunoglobulin (IVIG); however, the treatment results are largely disappointing. [ , ] Espandar et al described a beneficial response in a patient with CAR treated with alemtuzumab, a monoclonal antibody that is used for the treatment of various B-cell mediated disorders. [ ] Calcium antagonists aimed at blocking antibody-mediated apoptosis were (...) disease as the cause of the vision loss should include contrast-enhanced MRI of the head and orbits and lumbar puncture for cytologic examination. Some chemotherapeutic agents, such as vincristine and carmustine (BCNU), can cause optic neuropathy. Patients who have received cranial radiation are also at risk for vision loss, which is usually identifiable on MRI. Vision loss in patients with metastatic disease may be due to infiltration of malignant cells around the optic nerve. Diffuse melanocytic

2014 eMedicine.com

26. Lung Transplantation (Follow-up)

that may complicate surgery if untreated Blood typing and screening - To match the donor and recipient Renal disease battery - To detect adverse effects of calcineurin inhibitors and certain antimicrobial agents Liver function tests and/or hepatitis battery - To assess for contraindications (ie, abnormal results) to lung transplantation Preformed reactive antibody panel - To assess the risk of development of antibody-mediated rejection Lipid profile - To detect adverse effects of certain (...) -center prospective trial, RATG did decrease the incidence of acute rejection. No study has documented that any of these agents have a beneficial impact on the incidence of BO. Potential adverse effects include the following: Cytokine release syndrome (ie, chills, fever, vomiting, diarrhea, headache) Increased incidence of infection Increased risk of ( ) Leukopenia Alemtuzumab (Campath), a newer monoclonal antibody, binds to the CD52 surface antigen and has been used in adult lung transplant

2014 eMedicine Pediatrics

27. Lung Transplantation (Overview)

that may complicate surgery if untreated Blood typing and screening - To match the donor and recipient Renal disease battery - To detect adverse effects of calcineurin inhibitors and certain antimicrobial agents Liver function tests and/or hepatitis battery - To assess for contraindications (ie, abnormal results) to lung transplantation Preformed reactive antibody panel - To assess the risk of development of antibody-mediated rejection Lipid profile - To detect adverse effects of certain (...) -center prospective trial, RATG did decrease the incidence of acute rejection. No study has documented that any of these agents have a beneficial impact on the incidence of BO. Potential adverse effects include the following: Cytokine release syndrome (ie, chills, fever, vomiting, diarrhea, headache) Increased incidence of infection Increased risk of ( ) Leukopenia Alemtuzumab (Campath), a newer monoclonal antibody, binds to the CD52 surface antigen and has been used in adult lung transplant

2014 eMedicine Pediatrics

28. Lung Transplantation (Treatment)

that may complicate surgery if untreated Blood typing and screening - To match the donor and recipient Renal disease battery - To detect adverse effects of calcineurin inhibitors and certain antimicrobial agents Liver function tests and/or hepatitis battery - To assess for contraindications (ie, abnormal results) to lung transplantation Preformed reactive antibody panel - To assess the risk of development of antibody-mediated rejection Lipid profile - To detect adverse effects of certain (...) -center prospective trial, RATG did decrease the incidence of acute rejection. No study has documented that any of these agents have a beneficial impact on the incidence of BO. Potential adverse effects include the following: Cytokine release syndrome (ie, chills, fever, vomiting, diarrhea, headache) Increased incidence of infection Increased risk of ( ) Leukopenia Alemtuzumab (Campath), a newer monoclonal antibody, binds to the CD52 surface antigen and has been used in adult lung transplant

2014 eMedicine Pediatrics

30. Lung Transplantation (Diagnosis)

that may complicate surgery if untreated Blood typing and screening - To match the donor and recipient Renal disease battery - To detect adverse effects of calcineurin inhibitors and certain antimicrobial agents Liver function tests and/or hepatitis battery - To assess for contraindications (ie, abnormal results) to lung transplantation Preformed reactive antibody panel - To assess the risk of development of antibody-mediated rejection Lipid profile - To detect adverse effects of certain (...) -center prospective trial, RATG did decrease the incidence of acute rejection. No study has documented that any of these agents have a beneficial impact on the incidence of BO. Potential adverse effects include the following: Cytokine release syndrome (ie, chills, fever, vomiting, diarrhea, headache) Increased incidence of infection Increased risk of ( ) Leukopenia Alemtuzumab (Campath), a newer monoclonal antibody, binds to the CD52 surface antigen and has been used in adult lung transplant

2014 eMedicine Pediatrics

31. Liver Transplantation (Treatment)

jaundice and allograft dysfunction. The ducts suffer direct immunological injury and ischemia from the obliterative arteriopathy caused by antibody-mediated intimal damage of hepatic arterioles. In the late phase of chronic rejection, diffuse hepatic fibrosis occurs. Allograft function deteriorates, marked by cholestasis and, ultimately, loss of synthetic function and portal hypertension. Heavy immunosuppression with tacrolimus, mycophenolate mofetil, and/or sirolimus may reverse chronic rejection

2014 eMedicine Surgery

32. Intestinal and Multivisceral Transplantation (Treatment)

on macrophages, suppress inducer T and B cells, and augment suppressor T cells. The administration of immune globulins may increase CSF IgG levels by 10%. Immunoglobulins may be used in the setting of rotavirus infection and occasionally in the setting of antibody-mediated rejection. CMV hyperimmune globulin (CytoGam) is used to prevent CMV disease in immunosuppressed recipients of organ transplants. In both adults and children, the dose is 150 mg/kg IV postoperative day 3, then 100 mg/kg qwk IV for 4 wk (...) 0.3 mg/kg/d PO qd. Basiliximab (Simulect) is a chimeric monoclonal antibody that specifically binds to and blocks the interleukin-2 (IL-2) receptor on the surface of activated T cells. Adults dosing depends on body weight. Adults < 20 kg are given 10 mg on days 0 and 4; adults >20 kg are given 20 mg on days 0 and 4. The dosage is not established for children < 2 years. Children aged 2-15 years are given 12 mg/m 2 IV, not to exceed 20 mg. The dosage in children >15 years is the same

2014 eMedicine Surgery

36. Liver Transplantation (Follow-up)

jaundice and allograft dysfunction. The ducts suffer direct immunological injury and ischemia from the obliterative arteriopathy caused by antibody-mediated intimal damage of hepatic arterioles. In the late phase of chronic rejection, diffuse hepatic fibrosis occurs. Allograft function deteriorates, marked by cholestasis and, ultimately, loss of synthetic function and portal hypertension. Heavy immunosuppression with tacrolimus, mycophenolate mofetil, and/or sirolimus may reverse chronic rejection

2014 eMedicine Surgery

37. Intestinal and Multivisceral Transplantation (Follow-up)

on macrophages, suppress inducer T and B cells, and augment suppressor T cells. The administration of immune globulins may increase CSF IgG levels by 10%. Immunoglobulins may be used in the setting of rotavirus infection and occasionally in the setting of antibody-mediated rejection. CMV hyperimmune globulin (CytoGam) is used to prevent CMV disease in immunosuppressed recipients of organ transplants. In both adults and children, the dose is 150 mg/kg IV postoperative day 3, then 100 mg/kg qwk IV for 4 wk (...) 0.3 mg/kg/d PO qd. Basiliximab (Simulect) is a chimeric monoclonal antibody that specifically binds to and blocks the interleukin-2 (IL-2) receptor on the surface of activated T cells. Adults dosing depends on body weight. Adults < 20 kg are given 10 mg on days 0 and 4; adults >20 kg are given 20 mg on days 0 and 4. The dosage is not established for children < 2 years. Children aged 2-15 years are given 12 mg/m 2 IV, not to exceed 20 mg. The dosage in children >15 years is the same

2014 eMedicine Surgery

38. In Situ Vaccine for Low-Grade Lymphoma: Combination of Intratumoral Flt3L and Poly-ICLC With Low-Dose Radiotherapy

-grade B-cell lymphomas are the most prevalent subtype amongst these and are considered incurable with standard therapies. Chemotherapy and monoclonal antibody therapy induce temporary remissions, though disease generally recurs, becomes progressively more resistant to therapy and ultimately therapy-resistant. Standard therapies prolong survival, though there is no standard of care regarding when to initiate therapy (versus observation) or the optimal sequence of different therapies. Novel therapies (...) . Life expectancy greater than 4 months. Able to comply with the treatment schedule. Ability to understand and the willingness to sign a written informed consent document. Exclusion Criteria: Pre-existing autoimmune or antibody -mediated disease including: systemic lupus, erythematosus, rheumatoid arthritis, multiple sclerosis, Sjogren's syndrome, autoimmune thrombocytopenia, history of uveitis. Patients with controlled thyroid disease, or the presence of auto-antibodies without clinical autoimmune

2013 Clinical Trials

39. Immunotherapeutics

articles, as well... Video Overview of Antibody-Mediated Immunity Antibody-mediated immunity involves the activation of B cells and secretion of antibodies when in contact with a pathogen. When exposed to the chemicals released by activated helper... SOCIAL MEDIA Add to Any Platform Loading Topic Resources Immunotherapeutic agents use or modify . Use of these agents is rapidly evolving; new classes, new agents, and new uses of current agents are certain to be developed. A number of different classes (...) of immunotherapeutic agents have been developed (see also table ): Monoclonal antibodies Fusion proteins Soluble cytokine receptors Recombinant cytokines Small-molecule mimetics Cellular therapies Table Some Immunotherapeutic Agents in Clinical Use Agent Effects Some Indications Monoclonal antibodies* Abciximab Antiglycoprotein IIb/IIIa receptor Prevention of cardiac ischemic complications in patients undergoing percutaneous coronary intervention or in some high-risk patients with Adalimumab Anti–TNF-alpha

2013 Merck Manual (19th Edition)

40. Approach to the Patient With Suspected Immunodeficiency

of epicutaneous immunotherapy with a peanut patch is associated with a statistically significant increase in the... Video Overview of Antibody-Mediated Immunity Antibody-mediated immunity involves the activation of B cells and secretion of antibodies when in contact with a pathogen. When exposed to the chemicals released by activated helper... SOCIAL MEDIA Add to Any Platform Loading Topic Resources Immunodeficiency typically manifests as recurrent infections. However, recurrent infections are more likely (...) (eg, cytotoxic chemotherapy, bone marrow ablation before transplantation, radiation therapy) Prolonged serious illness (particularly in critically ill, older, and/or hospitalized patients) Primary immunodeficiencies are classified by the main component of the immune system that is deficient, absent, or defective: Manifestations of immunodeficiency Immunodeficiency typically manifests as recurrent infections. However, more likely causes of recurrent infections in children are repeated exposures

2013 Merck Manual (19th Edition)

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