1,721,009 research outputs found
Oligometastatic adrenocortical carcinoma: definition and treatment
No full textPurpose of review: Oligometastatic adrenocortical carcinoma (ACC) represents a distinct clinical subset of metastatic disease characterized by a limited tumor burden and potentially indolent biology. This review summarizes current evidence on its definition and management strategies. Recent findings: Although mitotane and EDP-M chemotherapy remain the backbone of systemic therapy for advanced ACC, increasing evidence supports integrating local treatments - such as surgery, stereotactic body radiotherapy (SBRT), image-guided thermal ablation (IGT), and transarterial embolization (TACE/TARE) - in selected patients. Retrospective studies suggest that individuals with ≤5 metastases or lesions <3 cm, often classified as stage IVa, achieve higher disease control rates and prolonged survival when local and systemic therapies are combined. Decision-making should consider patient fitness, tumor biology (Ki-67 index, time to recurrence), and prior treatments within a multidisciplinary framework. Summary: If a definition of oligometastatic ACC is required, a reasonable one would include stage IVa disease or up to five metastases <3 cm. Management should rely on a multidisciplinary approach in referral centers, integrating systemic and local therapies to optimize survival and quality of life
Letter re: Impact of EDP-M on survival of patients with metastatic adrenocortical carcinoma: A population-based study
No full textAdjuvant denosumab for early breast cancer-Evidence and controversy
Full text linkThe efficacy of adjuvant denosumab in combination with hormonotherapy in breast cancer patients was investigated in two randomized trials, ABCSG-18 and D-Care, but the results were mixed with respect to the impact of this drug on disease-free survival. However, the ABCSG-18 study has achieved its primary goal: prevention of clinical fractures. Therefore, the protective role of Denosumab on bone fragility induced by estrogen deprivation, already demonstrated in post-menopausal women, has been validated in the breast cancer setting
Maintenance of androgen deprivation therapy or testosterone supplementation in the management of castration-resistant prostate cancer: that is the question
No full textPurpose Whether or not androgen receptor (AR) axis could still be targetable in castration resistant prostate cancer (CRPC) patients with disease progression to next generation hormonal agents (NGHAs) is a controversial issue. Results Serum testosterone in CRPC patients has a positive prognostic role and increasing testosterone levels after androgen deprivation therapy (ADT) withdrawal or testosterone supplementation, as part of a bipolar androgen therapy (BAT) strategy, has been shown to potentially restore sensitivity to previous lines of NGHAs. Conclusion These data suggest that maintenance of ADT in CRPC patients receiving further lines of treatment, as recommended by current international guidelines, could be questionable. Conversely, testosterone supplementation aimed to re-sensitize CRPC to further hormonal manipulation is a strategy worth to be explored in future clinical trials
The Evolving Treatment Landscape of Medullary Thyroid Cancer
Full text linkGenetic assessment is crucial to address the correct treatment for advanced medullary thyroid cancer (MTC). Multi tyrosine kinase inhibitors (mTKIs) cabozantinib and vandetanib are good first line options, even vandetanib prescription is currently limited to RET mutated patients. Selective RET inhibitors such as pralsetinib could be a preferred upfront treatment in case of RET mutated MTC presenting common or gatekeeper RET mutations (e.g. M918T; V804L/M). Selpercatinib, otherwise, can be prescribed as the second line after disease progression to mTKIs. The best option for subsequent lines is to consider inclusion in clinical trials or alternatively other mTKIs such as sunitinib, sorafenib, lenvatinib, or pazopanib could be evaluated. New perspectives include next-generation RET inhibitors able to overcome resistance mechanisms responsible for disease progression to standard mTKIs and RET inhibitors, and immunotherapy for MTC presenting with high tumor mutational burden
Letter to the editor from Berruti et al: "Cytoreductive Surgery of the Primary Tumor in Metastatic Adrenocortical Carcinoma: Impact on Patients' Survival"
No full text
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
The long and winding road to effective immunotherapy in patients with adrenocortical carcinoma
No full textVariations 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
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