Phase II Study of Vinorelbine in Patients With Malignant Pleural Mesothelioma
By Jeremy P. C. Steele, Jonathan Shamash, Marie T. Evans, Nicole H. Gower, Marc D. Tischkowitz, Robin M. Rudd
From the Department of Medical Oncology, St Bartholomew’s Hospital, and the London Lung Cancer Group, London, United Kingdom.
Address reprint requests to Jeremy P.C. Steele, MD, MRCP, Department of Medical Oncology, St Bartholomew’s Hospital, West Smithfield, London EC1A 7BE, United Kingdom; email j.p.steele@ mds.qmw.ac.uk.
PURPOSE: To evaluate the response rate and impact on quality of life of vinorelbine given as cycles of 30 mg/m2 weekly for 6 weeks to patients with malignant pleural mesothelioma.
PATIENTS AND METHODS: Twenty-nine patients with histologically proven malignant pleural mesothelioma were enrolled (26 male patients and three female patients; median age, 58 years [range, 29 to 77 years]). Seventeen patients had epithelioid tumors, two had sarcomatoid tumors, and 10 had biphasic tumors. The International Mesothelioma Interest Group staging system was used: one patient had stage Ib disease, 10 had stage II disease, eight had stage III disease, and 10 had stage IV disease. Patients were treated with weekly injections of vinorelbine 30 mg/m2. A cycle consisted of six weekly injections. The new guidelines to evaluate the response to treatment in solid tumors were used. Responses were measured by spiral computed tomography scan.
RESULTS: All twenty-nine patients had measurable disease and were assessed for response. There were seven partial responses (24% [95% confidence interval, 10% to 44%]), 16 patients had stable disease (55%), and six patients had disease progression on therapy (21%). The median number of vinorelbine injections was 12 (range, 2 to 30). Quality-of-life analyses showed a benefit for vinorelbine therapy.
CONCLUSION: Vinorelbine shows promise in the palliation of patients with malignant pleural mesothelioma. The relatively low toxicity of the drug suggests that trials of vinorelbine in combination with other agents should be feasible.
The authors acknowledge the support of Pierre-Fabre Oncology for subsidized drug costs.
Welcome to San Diego. Did you know that there are not many cities in the United States of America that can be compared to San Diego in terms of healthy living conditions? This is of course because San Diego enjoys great weather for most of the year, which in turn encourages people to spend more time outdoors in the clean, fresh air. Fortunately for the residents of this fine city, the region is located in close proximity to mountains, desserts, lakes, and many other natural resources, which when combined, help to keep the air in San Diego clean and fresh.
So, with that said, is there really a need for mesothelioma lawyers San Diego? Unfortunate as it may be, the simple answer is yes. In stark contrast to being such a healthy city to live in, San Diego has the misfortune of having one of the highest rates of mesothelioma in the country, and of course, mesothelioma is not only an extremely debilitating disease, but it's also fatal. With that in mind, mesothelioma lawyers San Diego are there for those who have been unfortunate enough to have been diagnosed with this dreadful illness. Let's go ahead and take a look at the various stages a person goes through with the disease.
Initial Exposure
First and foremost, no one single cause has been proven to trigger the condition. However, it has been noted that everyone who suffers from this debilitating disease has something in common, in that they have all been exposed to asbestos at some point in their lives. Asbestos has in the past been used in numerous applications such as for insulation purposes for example. In fact, asbestos was widely used in the ship building industry and also in the building industry because of its excellent fire retardant properties.
Unfortunately, it has not yet been established to what extent a person needs to be exposed to asbestos before developing mesothelioma. In fact, nobody can say for sure how long you need to be exposed to asbestos in order to even be considered as being at risk. Because of this lack of knowledge regarding asbestos, people are generally advised to avoid it altogether, rather than put themselves at risk ofdeveloping such a crippling disease. Development of Mesothelioma
In layman's terms, once the condition has begun developing, it is almost as if the body begins attacking itself. What we do know is that when asbestos fibers are inhaled by an individual they tend to become embedded in the lungs, or at least in the protective tissue which surrounds the lungs. As part of the body's natural defense mechanism, it tries to rid itself of thesefibers but unfortunately it's not able to do so. At this point mucous membranes will begin forming around the fibers, and of course this means that the fibers end up getting locked even more securely into position. As these masses of mucous membranes or tumors continue to grow, so to do they begin to spread. Simply put, when the condition is at this stage, the person concerned could be considered to be suffering from a deadly form of cancer. In a Nutshell
There is no cure for mesothelioma, and it's estimated that there are more than 2,500 Americans dying every year because of the disease. Alarmingly enough, once you have been diagnosed with the disease, death usually occurs within two years. Conclusion
If you have been diagnosed with the disease, or if you know someone who has, then mesothelioma lawyers San Diego are there to help. After all, there's not much chance that you yourself were responsible for inhaling asbestos fibers, and contrary to what you may believe, employers have an obligation to provide their employees with a safe working environment. If they have failed you, then you may be entitled to compensation.
Pennsylvania Mesothelioma lawyers assist sufferers of Mesothelioma cancer in the Keystone State. They have helped many families that have been victimized by mesothelioma cancer and other asbestos related cancers. They have witnessed the terrible toll of these illnesses firsthand.
Asbestos Causes Mesothelioma Cancer
Asbestos is a harmful substance which was used in many products in the pass. When small asbestos particles are introduced into the human body through inhaling or ingesting, they trigger deadly diseases likemesothelioma cancer. Of the illnesses caused by asbestos exposure, mesothelioma cancer is the most deadly. It manifests itself in the thin membrane that lines the lungs, abdomen, or heart. Mesothelioma usually develops 20 to 40 years after the victim has been exposed to asbestos.
Pennsylvania Mesothelioma Lawyers Are Dedicated To Assisting Victims
Many Pennsylvania Mesothelioma lawyers are dedicated to helping their clients get compensation and medical treatment they deserve. Those who have or know someone that hasmesothelioma cancer should know that they can assist you. Over many years, Pennsylvania Mesothelioma lawyers have represented countless citizens all over the state including all the major cities and small towns.
Pennsylvania Mesothelioma Lawyers Resources and Experience
Law firms in Pennsylvania have the resources and experience needed to help individuals and families face the largest corporation in this difficult area of law. These law firms have help people get billions of dollars in settlement and compensation. Many families that have dealt with mesothelioma have been helped.
Pennsylvania Mesothelioma Lawyers Understand Pennsylvania Law
Pennsylvania citizens should understand that this state has laws which set it apart from other states that could affect someone ability to make a claim. An example of this is Pennsylvania’s statute of limitation legislation which puts a limit of the time frame thatmesothelioma cancer sufferer and their family members can file a suit.
Pennsylvania Mesothelioma Lawyers Help Victims
Pennsylvania mesothelioma lawyers are prepared to assist victims comprehend the issues related to filing a mesothelioma lawsuit and steer the victims through the maze like court system.
Contact Pennsylvania Mesothelioma Lawyers for Mesothelioma Lawsuits
These law firms pursue mesothelioma and asbestos lawsuit cases in the state of Pennsylvania. Those who have been or have dear ones that have been exposed to asbestos and have symptoms of mesothelioma or lung cancer should contact aPennsylvania mesothelioma lawyer. Many offer free, no obligation consultation. Many also handle cases on a contingency basis. So if you are in need call t
One significant advantage of a structured settlement is tax avoidance. With appropriate set-up, a structured settlement may significantly reduce the plaintiff's tax obligations as a result of the settlement, and may in some cases be tax-free.
A structured settlement can protect a plaintiff from having settlement funds dissipated, when they are necessary to pay for future care or needs. Sometimes astructured settlement can help protect a plaintiff from himself - some people simply aren't good with money, or can't say no to relatives who want to "share the wealth", and even a large settlement can be rapidly exhausted. Minors may benefit from a structured settlement as well, such as a settlement which provides for certain costs during their youth, an additional disbursement to pay for college or other educational expenses, and then one or more disbursements in adulthood. An injured person who has long-term special needs maybenefit from having periodic lump sums with which to purchase medical equipment or modified vehicles.
In some situations, it will be better for a severely disabled plaintiff to set up a special needs trust, rather than entering into a lump sum orstructured settlement . Any plaintiff who is receiving, or expects to receive, Medicaid or other public assistance, or the guardian or conservator entering into a settlement on behalf of a disabled ward, should consult with a disabilities financial planner about their situation before choosing any particular settlement option or structure.
Potential Disadvantages of Structured Settlements
Some people who enter into structured settlements feel trapped by the periodic payments. They may wish to purchase a new home, or other expensive item, yet be unable to muster the resources because they can't borrow against future payments under their settlement.
Some people will do better by accepting a lump sum settlement, and investing it themselves. Many standard investments will give a greater long-term return than the annuities used in structured settlements.
Selling a Structured Settlement
If you have a structured settlement, you may have been approached by a company interested in purchasing your settlement, or may be curious about selling your settlement in return for a lump sum buyout. About two thirds of states have enacted laws which restict the sale ofstructured settlements, and tax-free structured settlements are also subject to federal restrictions on their sale to a third party. Also, some insurancecompanies will not assign or transfer annuities to third parties, to discourage the sale of structured settlements. As a consequence, depending upon where you live and the terms of your annuities, it may not be possible for you to sell your settlement.
Keep in mind that companies which buy structured settlements intend to profit from their purchase, and sometimes their offers may seem quite low. You may benefit from approaching more than one company in relation to the sale of your settlement, to make sure that you obtain the highest payoff. You also want to be sure that the company which wants to buy your settlement is established, well-funded, and reputable - you don't want a fly-by-night outfit to obtain the rights to yourannuities but to disappear or go bankrupt before paying you the buyout money. You may have to go to court to get a judge to approve the buyout. It is usually a good idea to consult with a lawyer before entering into an agreement to sell your settlement.
Any person entering into a structured settlement should be on guard for potential exploitation in relation to the settlement:
Excessive Commissions - Annuities can be highly profitable for insurance companies, and they often carry very large commissions. It is important to ensure that the commissions charged in setting up a structured settlement don't consume an inappropriate percentage of its principal.
Overstated Value - Sometimes, after negotiating a particular settlement figure, the defense will overstate the value of a structured settlement. As a result the plaintiff, in accepting the settlement, in fact obtains a significantly lower dollar value than was agreed upon. Some defendants have nominally paid the full amount of the settlement, knowing that they would later obtain significant rebates from the annuity companies they used. Plaintiffs should consider compariing the fees and commissions charged for similar settlement packages by a variety ofinsurance companies , to make sure that they are in fact getting full value. A plaintiff may wish to make it a condition of the settlement that the defendant will actually pay the full value of the settlement in setting up thestructured settlement, and that any rebates received by the defendant for annuities included in the settlement be payable to the plaintiff.
Self-Dealing - There have been cases where the plaintiff's lawyer is also in the insurance business, and sets up a structured settlement on behalf of a client without disclosing that the attorney is purchasing the annuities from his own business, or is pocketing a large commission on the annuities. Similarly, there have been situations where the plaintiff's attorney has referred the client to a particular financial planner to set up astructured settlement , without disclosing that the financial planner will be paying the attorney a referral fee in relation to the client's account. Make sure that you know what financial interest, if any, your lawyer has in relation to any financial services sold or recommended by the lawyer.
Life Expectancy - It is unfortunate, but many people who receive large personal injury or workers' compensation settlements will have a shortened life expectancy as a result of their injuries. It is important to consider life expectancy in association with anystructured settlement, and to consider whether it is appropriate to enter into an annuity where payments will cease upon death. Sometimes it will make sense to insist upon an annuity that pays a minimum number of payments, or one that will pay a balance into the plaintiff's estate, such that the value of the settlement is not lost to aninsurance company upon the plaintiff's untimely death.
Using Multiple Insurance Companies - For larger settlements, it often makes sense to purchase annuities for a structured settlement from several different companies, dividing the settlement between those companies. This can provide you with protection in the event that a company that issued annuities for your settlement package goes into bankruptcy - even in the event that one of the companies defaults in part or in full on your settlement payments, you would still receive full payment from the other companies.
This is a very frequently asked question from developers. Nowadays, almost every one has a mobile phone. Applications for mobile phone users are very keen. Several technologies are available for developing mobile phone applications: SMS, WAP, mobile Java. Among the 3, SMS is the most widely supported technology by handsets. You can send and receive SMS on many old handset models. On the other hand, you can only find WAP and mobile Java on more recent handsets. SMS is the technology for you if you want to support the largest number of handsets.
There are 2 ways to send SMS from a PC:
1. Connect a mobile phone or GSM modem to a PC, and then program the PC to send AT commands to instruct the mobile phone or GSM modem to send SMS. You can also use some third-party software or libraries/SDKs.
2. Get access to an SMS center (SMSC) or SMS gateway through a leased line or the Internet, and send SMS using a specific protocol supported by the SMSC or SMS gateway.
The 1st Way: Send SMS from a PC Using Mobile Phone or GSM Modem
The first method is suitable when the SMS traffic is low. If you want to use a mobile phone, you should notice that some models cannot do such kind of application (See more here). A program is required to interact with the mobile phone/GSM modem to send text/binary SMS. You can write the program in any of the popular languages, such as Visual Basic, Visual C++, Java, etc. The program should make use of the AT commands. You can write the program yourself (this would be quite interesting) or you can use some free or commercial software/libraries/SDKs if you do not want to do AT-programming yourself. Some of these software/libraries/SDKs can act as a layer between your application and the physical layer, so that you can send SMS using the same set of APIs no matter you are sending SMS through a mobile phone/GSM modem, SMS gateway or SMSC, provided that the software/library/SDK supports a protocol used by the SMS gateway or SMSC.
The HyperTerminal program in MS Windows can also be used to send AT commands (See more here).
If you want to program yourself, you may want to visit the website of your handset’s manufacturer. You may find the documentation of the AT commands and other related guides there. If you are going to use a library, visit the library’s website for further information.
There is not much difference between using a mobile phone and using a GSM modem, although some mobile phone models have certain limitations. If you are serious about your application, a GSM modem is recommended (See more here). A mobile phone/GSM modem can be connected to your PC through the serial port, USB, infrared port, etc. Of course, a SIM card from a valid operator should be put in the mobile phone/GSM modem.
If you are not developing an SMS application and just want to send SMS from your PC, you can make use of some ready-to-use software. One such software is available from Microsoft. You can download it free of charge from the link http://www.microsoft.com/globaldev/tools/smsSender.mspx. Mobile manufacturers may also provide such kind of software for sending SMS. You may want to take a look at their website.
How can I know whether my mobile phone can be used to send/receive SMS with my PC?
First of all, your GSM phone must provide some way to connect to the PC, e.g. through a serial cable, an USB cable, infrared, or bluetooth. Secondly, your phone should be able to accept the extended AT commands. You can check the manual of your mobile phone for this information. You can also test your mobile phone with HyperTerminal (See more here).
If you are going to use a library, remember to check the list of supported mobile phones/GSM modems from the library’s website.
The 2nd Way: Send SMS from a PC through an SMS Center/SMS Gateway, Using the Internet or Leased Line
If you want to run an SMS business, the above method will definitely not be able to take the load. You should get access to an SMS center (SMSC) or SMS gateway. This can be further divided into 2 scenarios.
* Sign an agreement with a network operator to get access to its SMSC. Then use an SMS gateway software (e.g. Kannel) to send SMS. The network operator may only allow access to its SMSC through a leased line connection for security reasons.
* Send SMS using an interface supported by the network operator, or an SMS gateway provider. SMS gateway providers are companies specialized in SMS sending services. Unlike ordinary mobile network operators, these SMS gateway providers do not provide mobile phone services.
The first scenario is suitable for big businesses and when the SMS traffic is huge. Signing an agreement with a network operator is not an inexpensive and easy solution. This is of course not suitable for small businesses or individual developers. We will concentrate on the second scenario for the rest of this article. For the first scenario, you have to contact the mobile network operator for the details.
Basically, in order to send SMS with the second scenario, you have to know what interface/protocol the network operator or SMS gateway provider supported. Common protocols supported by SMS gateways include HTTP/HTTPS, SMTP (the protocol used by email), FTP, XML, etc. The SMS gateway staff will also provide you the set of commands they use under a certain protocol.
If you are not a developer and you just want to send SMS with your PC, the solution is even simplier. Some SMS gateway providers (like Clickatell) will offer a software for sending SMS with your PC free of charge. You just pay for the cost of the SMS. The software normally contains features like phone book management, group management, bulk SMS to multiple recipients or groups, etc.
Many mobile network operators provide SMS gateway services (although some do not). Normally, if a mobile network operator provide SMS gateway services, you can find an overview about them on the mobile network operator’s website. However, you probably will not be able to find any information about the cost of the SMS gateway service, the protocols supported, the documentation of the commands to use under a certain protocol, etc, from its website. This is because network operators want to know about your SMS application’s nature, traffic requirement, etc, before offering a price to you. If that’s the case, you will then need to contact the network operator’s staff for further information.
A more convenient way is to use the service provided by SMS gateway providers. Information like cost of service, network coverage, protocols supported, documentation of the API used, can very often be found on the SMS gateway providers’ website.Many new SMS developers have the misconception that sending SMS through an SMS gateway are only for big businesses or for those who have a very large volume of SMS traffic, and that it is very difficult to use. Because of such misconception, they employ a mobile phone/GSM modem solution for their SMS application.
In fact, it is very easy to use the service of an SMS gateway provider if you choose a simple protocol like HTTP/HTTPS. The cost per SMS sent through an SMS gateway provider can be as low as US$ 0.055 (or even lower. It depends on which SMS gateway provider you choose and the number of SMS you purchased). There is no minimal purchase requirement for many SMS gateway providers. Hence, you can use the service of an SMS gateway provider even if your SMS traffic is not high.
To use such kind of SMS gateways, usually you will register for an account at the SMS gateway provider’s website and buy a number of credits on its website. Sending an SMS will cost 1 or more credits, depending on the country you send to. After buying credits, you can immediately send SMS through the provider’s SMS gateway to all over the world using protocols like HTTP/HTTPS, SMTP, FTP, XML, etc. Some SMS gateways are non-credit-based, which means the cost per SMS is the same for sending to all countries around the world.
Let me show you how easy it is to send an SMS message through an SMS gateway, using a simple protocol like HTTP. To send an SMS message “Hello” to phone number 12345678, you will give a http get/post request in your program, something like
where “myAccount” and “myPasswd” are the name and password of the account you opened at the SMS gateway provider’s website. If error occurs, a string “error” will be returned. Otherwise, a string “success” will be returned. If the delivery of the SMS is successful, credits will be deducted from your account “myAccount”.
This is very easy, right? You can always type the above http:// line in your web browser’s “Address” text box and press the ENTER key, and you will get the same result. Since the command is gateway-specific, the actual command to use and the return values will be somewhat different from the above example. You have to check the SMS gateway provider’s API documentation for details.
Many SMS gateway providers also provide 2-way SMS service. Detail pricing and network coverage information may be found on the SMS gateway providers’ website. You can compare different SMS gateway providers and choose the one that best suit your needs and budget. You can have a look at the article How to choose an SMS gateway provider?. A comparison of some SMS gateway providers can be found at here.
Original Source : http://www.developershome.com/sms/howToSendSMSFromPC.asp
