1,721,015 research outputs found
Evolving nonendocrine therapeutic options for metastatic breast cancer: how adjuvant chemotherapy influences treatment.
No full textPatients with metastatic breast cancer (MBC) represent a very heterogeneous population and several factors are important for therapeutic decision: patients' characteristics including age, comorbidities, performance status, tumor biological profile, site and extension of metastatic spread, previous adjuvant therapies, and disease-free interval. New cytotoxic agents, new endocrine agents, and targeted therapies are becoming the new mainstay of adjuvant treatment. The growing understanding of the biology of breast cancer cells has led to the identification of key molecular points that represent possible targets for target-specific agents. Trastuzumab, the monoclonal antibody against the HER2 receptor, represents the standard treatment of high-risk early-stage breast cancer overexpressing HER2. With increasing use of very active drugs in the adjuvant setting, there is a greater need for effective therapy at the time of relapse. In endocrine resistant disease, a treatment-free interval > 12 months after adjuvant chemotherapy has been shown to be an important factor for drug sensitivity. If the tumor has been exposed to an anthracycline and a taxane in adjuvant setting and the treatment-free interval is > 12 months, the rechallenge with the same agents might be an option. If the treatment-free interval is < 12 months, it is preferable to use a different agent. Capecitabine, gemcitabine, and vinorelbine have demonstrated substantial activity in MBC. Novel cytotoxic agents including epothilones and vinflunine are currently in clinical development for taxane-resistant disease. Lapatinib, a new target agent that simultaneously inhibits both HER2 and epidermal growth factor receptor tyrosine kinases has been shown to be active in trastuzumab-resistant MBC. Moreover, several new agents targeting HER2 are currently under clinical development. There are no data on rechallenge with trastuzumab in patients who had received this agent as adjuvant treatment and relapsed after a long treatment-free interval, and this issue is a new area of research
Controversies of chemotherapy for the treatment of metastatic breast cancer.
Full text linkMetastatic breast cancer (MBC) remains an incurable disease. The aims of treatment include tumour shrinkage, symptom control, delay of disease progression and prolongation of survival while maintaining an acceptable quality of life. In the last decade, a decline in mortality has been observed. Combination chemotherapy generally provides some survival advantage over single-agent chemotherapy. Taxanes and antimetabolites are among the most effective agents, providing a balance between efficacy and tolerability. Increasing numbers of patients are receiving adjuvant anthracycline and taxane therapy. In these patients, treatment options include cytotoxic agents not used in adjuvant treatment, re-challenge with anthracycline and taxanes, or new targeted agents such as pertuzumab, lapatinib or bevacizumab. Biology of the disease at cell level plays a major role in treatment choice. Key points in the intracellular signal transduction pathways relevant for cell proliferation, apoptosis and the angiogenesis/metastasis process, represent possible targets for new target-specific agents. Tailored therapies are a step forward in improving patients' prognosis
Measurement of reticulated platelets following high dose chemotherapy with peripheral blood progenitor cell support in patients with solid tumors
No full textEvaluation of thrombopoiesis kinetics by measurement of reticulated platelets and CD34+ cell subsets in patients with solid tumors following high dose chemotherapy and autologous peripheral blood progenitor cell support
No full textBackground and Objectives. The transplantation of mobilized peripheral progenitor cells has resulted in shortening of neutrophil and platelet engraftment times following high-dose chemotherapy. Since reticulated platelet percentage (RP%) has been established as a measure of bone marrow platelet production, we performed this type of analysis on the thrombopoietic compartment during transplant-related chemotherapy.
Design and Methods. Kinetics of thrombopoiesis of 19 patients with solid tumors undergoing a single or double autologous peripheral blood progenitor cell transplant was characterized by evaluating the level of RR The correlation between CD34(+) cell subsets and the time of highest percentage of RP was also evaluated.
Results. The percentage of RP increased from day +8 after single transplant reaching the peak (3.4%) at day +10. In the group of patients receiving double transplant, the peak RP value of observed after the second transplant is not significantly different from that observed after the first transplant (3 vs 3.7%). In a subgroup of patients both the number of CD34+ cells/Kg infused and the percentage of CD34(+)CD61(+) cell subsets correlated with the day of RP peak.
Interpretation and Conclusions. These results suggest that RP measurement is an early indicator of engraftment. Additionally, the observation that RP percentage is high at the time of platelet transfusion in 13 out of 20 cases of transfusions (the 7 cases with low RP value being transfused during the period of obligate thrombocytopenia) suggests that the evaluation of this parameter, together with the platelet count, can be used to monitor, the need for platelet transfusion
Frequenza ed effetti dell'infezione de SARS-CoV-2 in pazienti oncologici
No full textLe persone con cancro corrono un rischio maggiore di sviluppare complicanze da COVID-19, sia a
causa dell’infezione stessa che secondariamente a ritardi terapeutici. Inoltre, in letteratura non esistono linee
guida univoche sulla gestione del trattamento chemioterapico nei pazienti oncologici. Lo scopo di questo lavoro è
quello di analizzare l’esperienza del nostro Dipartimento per mostrare la gestione adottata per i trattamenti oncologici e le conseguenze dell’infezione osservate.
Nel periodo da giugno 2020 a marzo 2021 è stato eseguito un tampone molecolare di screening a tutti i pazienti
in trattamento oncologico presso il Dipartimento di Oncologia Medica di Grosseto prima dell’esecuzione di ogni
trattamento terapeutico. Da marzo 2021 è stato inoltre organizzato un percorso speciale per i pazienti COVID19 per cercare di ridurre i ritardi di trattamento e garantire la terapia oncologica.
Dei 160 pazienti in trattamento attivo inclusi nello studio, 24 (15%) sono risultati positivi al tampone molecolare per la ricerca di SARS-CoV-2. Di questi, 2 (8,33%) sono stati ricoverati presso il Dipartimento di Malattie
Infettive. Nessun paziente con COVID-19 è deceduto. Al fine di consentire la prosecuzione della terapia oncologica nei pazienti affetti da COVID-19, 4 (16,67%) dei pazienti risultati positivi al tampone molecolare sono stati
sottoposti a trattamento oncologico. Nessuno di loro ha sviluppato una maggiore tossicità dal trattamento per il
tumore.
I nostri risultati, sebbene con un campione limitato, non rilevano un aumento della mortalità o morbilità nei
pazienti oncologici, inoltre non vi è stato un aumento della mortalità nei pazienti COVID-19 che hanno ricevuto
terapia sistemica. Riteniamo che le informazioni fornite in questo studio potranno contribuire a una migliore
comprensione degli effetti del SARS-CoV-2 nei pazienti con cancro
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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