Qualification: 
MD, DM, MBBS
pavithrank@aims.amrita.edu

Qualification : MD (Internal Medicine), DM (Medical Oncology), FRCP (London)

Dr. K. Pavithran currently serves as Professor and Head of the Department of Medical Oncology and Hematology at Amrita Institute of Medical Sciences. He took his MD in Internal Medicine from Calicut Medical College and DM in Medical Oncology from Kidwai Memorial Institute of Oncology, Bangalore. He is a Fellow of the Royal College of Physicians, London. He had his training in hematology from the Royal Hallamshire Hospital, Sheffield, United Kingdom and gained experience in bone-marrow transplantation from Fred Hutchinson Cancer Centre, Seattle, USA.

Dr. Pavithran is a member of many national (ISHTM, ISMPO, ISO, API, IMA, Indian Association of Cancer Research, ICON) and international organizations (American Society of Medical Oncology, European Society of Medical Oncology, International Medical Sciences Academy, International Association for the Study of Lung Cancer (IASLC).

He has presented many papers and delivered many lectures at various national and international conferences He has participated in more than 35 clinical trials.

He is also the reviewer for Biomed Central Journals (www.biomedcentral.com), American Journal of Clinical Oncology, Supportive Oncology, Indian Journal of Cancer, Journal of Cancer Research and Experimental Oncology, Indian Journal of Medical & Pediatric Oncology, Journal of Association of Physicians of India, Indian Journal of Dermatology & Venereology, Indian Journal of Medical Sciences and Indian Journal of Hematology and Transfusion Medicine. He also serves in the editorial board of many national and international journals.

Achievements

He has been awarded Fellowship by the World Federation of Haemophilia in 1993 and Indian College of Physicians in 2003. He is also a Fellow of International Medical Sciences Academy and a Fellow of the Royal College of Physicians, London.

He has to his credit numerous publications (80 papers in International Journals and 98 in National Journals). He has edited two books on cancer (Essentials of Clinical Oncology and A Companion to Essentials of Clinical Oncology) and has contributed more than 40 chapters in various books

Publications

Publication Type: Journal Article

Year of Publication Title

2020

Dr. Pavithran K., B, K., RV, R., and DK, V., “Impact of St. Gallen Surrogate Classification for Intrinsic Breast Cancer Sub-types on Disease Features, Recurrence, and Survival in South Indian Patients”, Indian J Cancer, vol. 57, no. 1, pp. 49-54, 2020.[Abstract]


Background: Breast cancer is a heterogeneous group of disease, and recently, intrinsic sub-typing on the basis of gene expression profiling is found to be a predictor of breast cancer clinical course. The St. Gallen has released surrogate classification for breast cancer sub-types depending on immunohistochemistry (IHC) markers.
Aim: The aim of our study was to analyze the distribution of sub-types using IHC surrogate markers in our patient population and to assess the clinico-pathological factors in different sub-types.
Materials and Methods:A total of 635 non-metastatic patients who underwent radical intend treatment from January 2011 to December 2013 were included for this retrospective analysis. A statistical analysis was done by Windows SPSS version 20. The Chi-square test was used to examine the correlations of these sub-types with clinico-pathological parameters. The Kaplan-Meier method estimates were used for survival analysis.
Results: The median follow-up was 42.77 months (5 months to 112 months). Luminal B was the predominant group. Disease free survival (DFS) at 5 years was 95% in luminal A, 78% in luminal B HER-2 negative, 80% in luminal B HER-2 positive, 72% in triple negative, and 79% in HER-2/neu non-luminal. Tumor size, Ki67, T stage, N stage, and grade were significantly associated with DFS in all biological type with a P value of less than 0.05.
Conclusion: Surrogate classification was successfully applied in our patient cohort. Luminal B and triple negative sub-groups were more prevalent in our patients, and this finding is at variance with published international data. Biological sub-type also emerged as an important predictor of survival.

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2020

Dr. Pavithran K., RN, I., S, A., and P, P., “Immunohistochemical Markers of Tumor Microenvironment as Prognostic Predictors in Diffuse Large B-Cell Lymphoma: Study from an Oncology Centre in South India”, Asian J Oncology, 2020.[Abstract]


Diffuse large B-cell lymphoma (DLBCL) accounts for 60% of lymphomas in India. Although the survival of DLBCL patients has improved following the addition of rituximab, a subset of patients do not respond well to therapy. Among the several factors responsible for this varied response, tumor microenvironment is considered to be crucial. This study is a search for such prognostic markers in the tumor microenvironment.

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PDF iconimmunohistochemical-markerstumor-microenvironment-as-prognostic-predictors.pdf

2020

Dr. Pavithran K., E, D., R, K., L, R., S, R., and A, P., “Pemetrexed-Associated Hyperpigemented Skin Rash”, Am J Ther 2020 , 2020.

2020

Dr. Pavithran K., A, B., V, T., B, S., P, M., D, A., G, S., and A, D., “Primary Tumor Location as a Prognostic and Predictive Marker in Metastatic Colorectal Cancer (mCRC)”, Front Oncol. 2020, 2020.[Abstract]


Clinico-pathological differences between adenocarcinoma in the right and left colo-rectum play a role in determining the prognosis and response to treatment. Studies suggest that primary tumor location is more relevant as the disease progresses and reflects a possible difference in biology and response to therapy. This review aims to explore the clinico-pathological features of right and left colo-rectum and the impact of primary tumor location on prognosis of CRC as well as discuss the available clinical data on tumor sidedness in metastatic colorectal cancer. In so far as the clinical data of tumor sidedness is concerned, very few reviews have discussed the clinical implications of sidedness in heavily pre-treated metastatic colorectal cancer (second and subsequent lines of therapy in metastatic disease). This review aims to fill the current gap in this setting.

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PDF iconprimary-tumor-location-prognostic-and-predictive-marker-in-metastatic-colorectal-cancer.pdf

2020

Dr. Pavithran K., GR, D., H, J., NV, S., R, A., A, N., and T, K., “Primary Neuroendocrine Carcinoma of the Larynx: A Case Report”, Indian Journal of Otolaryngology and Head & Neck Surgery, 2020.[Abstract]


Neuroendocrine tumours can originate from any part of the body. The most common site in the head and neck is the larynx, accounts for less than 0.6%. The neuroendocrine carcinomas (NECs) of the larynx are rare tumours with high incidence of widespread metastases and poor prognosis. Here we report a 50-year-old male with localised primary moderately differentiated NEC of the larynx. He was treated with surgery followed by adjuvant chemotherapy and concurrent chemoradiation. He is free of his disease and is doing well.

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PDF iconprimary-neuroendocrine-carcinoma-larynx.pdf

2020

Dr. Pavithran K., ,, F, N., and A, R., “Isolated Splenic Metastasis from Ovarian Carcinoma”, Indian J Gynecol Oncolog 2020, vol. 18, 2020.[Abstract]


Isolated Splenic metastasis from ovarian cancer rarely occurs with only very few cases recorded in the literature. It can occur as a synchronous metastasis or as late as 20 years post-primary debulking surgery.

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PDF iconisolated-splenic-metastasis-from-ovarian-carcinoma-full-01.pdf

2020

A. Hemakumar and Dr. Pavithran K., “Imatinib-induced Haematuria Necessitating Drug Discontinuation”, Journal of Onco-Nephrology, pp. 1-3, 2020.[Abstract]


Gastrointestinal stromal tumours are rare neoplasms of the gastrointestinal tract that are mesenchymal in origin. The introduction of tyrosine kinase inhibitors resulted in significant improvement in survival of patients with gastrointestinal stromal tumour even in advanced disease conditions. A 43-year-old adult male who is a known case of gastrointestinal stromal tumour of the stomach, on adjuvant therapy with imatinib, presented with a history of gross haematuria of several episodes as well as persistent microhaematuria and was evaluated for the same. He was investigated for all possible causes, but all were negative. The patient was advised to withhold imatinib. Haematuria resolved 1 month after stopping imatinib. Then it was rechallenged. He had recurrence of symptoms, so it was discontinued. In view of the temporal relation of haematuria and administration of imatinib, a diagnosis of imatinib-induced haematuria was made.

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PDF iconImatinib-induced-haematuria-necessitating-drug-discontinuation.pdf

2020

T. Sachu, Aneesh, P., Dr. Umadevi P., and Dr. Pavithran K., “Therapeutic Drug Monitoring of Sorafenib in Hepatocellular Carcinoma Patients”, Therapeutic drug monitoring, vol. 42, no. 2, pp. 345-347, 2020.

2019

P. Thomas, Vincent, B., George, C., Joshua, J. Mariam, Dr. Pavithran K., and Meenu Vijayan, “A comparative study on erlotinib & gefitinib therapy in non-small cell lung carcinoma patients”, Indian J Med Res, vol. 150, no. 1, pp. 67-72, 2019.[Abstract]


Background & objectives: Tyrosine kinase inhibitors (TKIs) targeting the epidermal growth factor receptor (EGFR) have been evaluated in patients with advanced non-small cell lung cancer (NSCLC). Erlotinib and gefitinib are the first-generation EGFR-TKIs for patients with NSCLC. However, there is a paucity of studies comparing the effectiveness of these two drugs. Hence, this study was aimed to compare the effectiveness and safety of erlotinib and gefitinib in NSCLC patients.
Methods:This study included 71 NSCLC patients who received EGFR-TKIs between 2013 and 2016. Adverse drug reaction of both erlotinib (n=37) and gefitinib (n=34) was determined and graded according to Common Terminology Criteria for Adverse Events grading system. Effectiveness was measured using response evaluation criteria in solid tumours and progression-free survival (PFS). Pharmacoeconomic analysis was performed by cost-effective analysis.
Results: When comparing safety profile, both the drugs had similar adverse events except for dermal side effects such as acneiform eruption (51.4%), rash (54.05%) and mucositis (59.5%) for erlotinib and 20.6, 26.5 and 29.4 per cent for gefitinib, respectively. The PFS of the two drugs was compared to differentiate the effectiveness of erlotinib and gefitinib. There was no significant difference between the effectiveness of the two drugs. The pharmacoeconomic analysis showed that gefitinib was more cost-effective than erlotinib.

Interpretation & conclusions:This study showed that erlotinib and gefitinib had similar effectiveness but gefitinib had a better safety profile compared to erlotinib. Therefore, gefitinib could be considered a better option for NSCLC patients compared to erlotinib. However, further studies need to be done with a large sample to confirm these findings.

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2019

S. K. Mathew, Thomas, A., R, R. P., Sivadas, A., and Dr. Pavithran K., “Clinical Evidence of Regorifenib in Metastatic Colorectal Cancer: A Case Report”, Research Journal of Pharmacy and Technology, vol. 12, no. 2, 2019.[Abstract]


Regorafenib{first small-molecule multikinase inhibitor 3}is used for patients who had earlier treatment with multiple regimens for metastatic colorectal cancer. Here we address a female patient who is 45 year old who had stage III disease with carcinoma recto sigmoid and hemicolectomy. From November 2012 to May 2¬013, patient had 12 cycles of FOLFOX regimen as adjuvant chemotherapy and it got relapsed after 7 months , later on, 6 cycles of Irinotecan 6 5FU/LV/Avastin as a second line agent was administered. From December 2013– May 2014, she had a 6 months of PFS. On her next follow up, she showed relapse of the disease in USG abdomen and PET scan and hence initiated on regorifinib with a dose of 160 mg once daily as the third line therapy. On development of jaundice and hand foot syndrome after 2 weeks of treatment, the dose was reduced to 80mg 2 tablets/day. As she was tolerating well with the decreased dose and showed good clinical response, she was advised for regular follow up. After 22 months of revaluation, it was observed that rising CEA and CT scan showed progressive disease, hence the treatment was changed to capecitabine. Even after 50 months from the diagnosis of disease, she is still continuing in good performance status 5. The patients survival period were less than 6 months only, before the availability of these newer targeted and chemotherapuetic agents. We emphasize the fact that Regorafenib plays an significant role in the treatment of refractory metastatic colorectal cancer patients as a third line agent with meaningful improvement in the survival and minimum side effects. More »»

2019

D. S. Raju, Sugunan, A., Dr. Pavithran K., Arun Philip, and Remya Reghu, “Chemoport-related Fungemia Caused by Trichosporon asahii.”, J Pediatr Hematol Oncol, 2019.[Abstract]


Trichosporon asahii is a rare opportunistic fungal pathogen that causes fatal systemic infection in immunocompromised patients. Neutropenia developing due to malignancies is an important risk factor for fungal infection. Invasive infections due to T. asahii can be divided into disseminated and localized forms. The disseminated form is more common and usually occurs in neutropenic patients. The patient typically has an acute febrile illness that progresses rapidly to multiorgan failure. Here, we are presenting a case of fungal sepsis by invasive T. asahii in a 1-year-old child with Wilms Tumor. To the best of our knowledge, this is the first time that fungal sepsis due to T. asahii has been reported in a Wilms tumor patient. The incidence of rare invasive fungal infections is increasing in immunocompromised patients in whom management becomes difficult due to their heterogenous antifungal susceptibility pattern and intrinsic resistance to the standard antifungal agents that are routinely given. The patient was admitted with high spiking fever, and his laboratory investigations suggested neutropenia. T. asahii was isolated from the blood culture, for which he was started on inj. voriconozole. After 14 days of treatment, the fungus was cleared out from the patient's blood.

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2019

A. Asok, Sreekumar, S., Radhika,, Cc, A., Dr. Umadevi P., and Dr. Pavithran K., “Effectiveness of zolpidem and sleep hygiene counseling in the treatment of insomnia in solid tumor patients.”, J Oncol Pharm Pract, vol. 25, no. 7, pp. 1608-1612, 2019.[Abstract]


Objective: To study the effectiveness of zolpidem and sleep hygiene counseling in managing insomnia in solid tumor patients.
Methods: Cancer patients with a Pittsburgh Sleep Quality Index score ≥ 5 were grouped into two. Both groups received treatment for insomnia in the form of either zolpidem 5 mg for 7 days or sleep hygiene counseling.
Result: At baseline, zolpidem and counseling group had a mean Pittsburgh Sleep Quality Index score of 14.82 ± 2.61 and 11.67 ± 3.32, respectively. The difference in mean Pittsburgh Sleep Quality Index score was found to be 4.03 in patients using zolpidem and 1.5 in counseled patients (p = 0.003). The components of Pittsburgh Sleep Quality Index namely difficulty falling asleep within 30 min (sleep latency), overall sleep quality, trouble staying awake during daytime and trouble staying motivated to get things done showed statistically significant improvement after treatment with zolpidem. Following sleep hygiene counseling, the proportion of patients with sleep latency > 30 min reduced considerably. Waking up to use the bathroom was the most common problem reported by approximately 94% patients in both groups before treatment which remained the most prevalent problem even after treatment. Night or early morning awakenings seemed to decrease significantly in patients taking zolpidem (p = 0.039) while it did not show any improvement with counseling. Counseling seemed to get patients to sleep within 30 min.
Conclusion: Patients on zolpidem showed a reduction in their Pittsburgh Sleep Quality Index scores thereby suggesting it as a treatment for insomnia in solid tumor patients. Sleep hygiene counseling, though not as effective as zolpidem, made a slight difference in the overall sleep.

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2011

Chitra P., M., D. Jeyagowri, and Dr. Pavithran K., “Standards Practice and Safe Handling of Chemotherapy Drugs”, Prisms Nursing Practice, vol. 6, no. 3, 2011.

2010

Chitra P., M., D. Jeyagowri, and Dr. Pavithran K., “Foot Massage - A Nursing Practice”, Prisms Nursing Practice, vol. 5, no. 1, 2010.

2008

Chitra P., M., D. Jeyagowri, and Dr. Pavithran K., “Nursing Intervention in Laughter Therapy”, Nightingale Nursing Times, vol. 4, no. 8, 2008.

2008

Chitra P., M., D. Jeyagowri, and Dr. Pavithran K., “Complementary medicine and alternative therapies”, Indian Journal of Holistic Nursing, vol. 4, no. 2, 2008.

Clinical Trials – Ongoing

  • A Phase II Randomized, Multi-Center, Double-Blind, Global Study to Determine the Efficacy and Safety of Durvalumab plus Olaparib Combination Therapy Compared with Durvalumab Monotherapy as Maintenance Therapy in Patients whose Disease has not Progressed Following Standard of Care Platinum-Based Chemotherapy with Durvalumab in First-Line Stage IV Non-Small Cell Lung Cancer (ORION)
  • A global, multicenter, three arms, open-label randomized study to evaluate the efficacy and safety of Nanosomal Docetaxel Lipid Suspension compared to Taxotere® (Docetaxel Injection Concentrate) in triple-negative breast cancer patients with locally advanced or metastatic breast cancer after failure to prior chemotherapy
  • A Prospective, Randomized, Multicentre, Comparative, open-label, Parallel study to evaluate the Efficacy, Safety and Pharmacokinetics of Test-Trastuzumab Emtansine (ZRC-3256; Cadila Healthcare Ltd) and Reference-Trastuzumab Emtansine (Kadcyla®, a product of Roche) in HER2- Positive Metastatic Breast Cancer Patients.
  • Reditux™ Registry to Compare Effectiveness, Safety, and Resource Utilization of Reditux™ v-s. the Reference Medicinal Product to Treat Diffuse Large B-Cell Lymphoma and Chronic Lymphocytic Leukaemia in Routine Clinical Practice.