1,721,280 research outputs found
Cost-effectiveness and sustainability of breast cancer screening and new anti-cancer drugs
No full textIn our first lesson together we used to ask to our students "what is the price of a life?". The answer was always "there is no price of a life". Although nice, it’s not true; unfortunately, the only costless man is a dead one. In the last few years there has been a heated debate about cost and benefit in oncology, focused in particular on breast cancer screening and the availability and affordability of new drugs. In our opinion, an affordable, ethically and politically correctbudget for healthcare is government issued as part of a social healthcare system. In this context, all governments should declare how much is affordable in relationship with the economic situation of the country and decide what drugs and treatments can be provided for free (as part of a life-long system of national taxation) and which canno
Pertuzumab therapy for HER2-positive metastatic gastric or gastro-oesophageal junction cancer
No full textIn The Lancet Oncology, Josep Tabernero and colleagues 1 report the final analysis of the JACOB trial, which tested the efficacy and safety of pertuzumab (a monoclonal antibody targeting HER2 receptors) combined with
trastuzumab and chemotherapy in previously untreated patients with HER2-positive metastatic gastric or gastrooesophageal junction cancer. JACOB was the first trial to investigate a dual HER2 blockade in metastatic gastric
cancer; unfortunately, no significant improvement in overall survival was observed in the group treated with the dual-HER2 targeted combination
Is there a place for bevacizumab in patients with extensive-stage small cell lung cancer?
No full textIt was estimated that small cell lung cancer (SCLC) accounts for about one Sixth of all lung cancer cases. Patients with SCLC are usually diagnosed in advanced stage of disease. Unfortunately at this stage, prognosis is very poor. Bevacizumab is a monoclonal antibody against VEGF, which inhibits the angiogenesis in malignant tumors. Although Bevacizumab has been approved for firstline use in advanced non-SCLC, the first report has been available for its use in SCLC. In this review, we summarized all available data on the use of Bev in SCLC patients. Finally, future directions are discusse
Is the Gleason score the driver for the treatment decision-making of patients with castration-resistant prostate cancer in the new era of the anti-androgenic therapies?
No full textFizazi et al. [1] showed the initial diagnostic Gleason score in patients with metastatic castration-resistant prostate cancer (mCRPC) should not be considered in the medical decision oriented to abiraterone. Based on these findings, we believe it would be important to extend the analyses carried out by Fizazi et al. to all novel anti-androgenic therapies with a pooled analysis of available trials from the literature. The studies were identified, according to the following inclusion criteria: (i) patients with mCRPC; (ii) a novel anti-androgenic therapy including the selective 17,20-lyase inhibitor orteronel; (iii) the presence of a control arm for comparison ( placebo or not); and (iv) the presence of data on overall survival (OS) and progression-free survival (PFS) according to the Gleason score. The following
exclusion criteria were used: (i) insufficient data were available to estimate the outcomes; (ii) animal studies; (iii) the size of each arm was<10 participants; and (iv) non-randomized studies. The summary estimates were generated using a fixedeffect model (Mantel–Haenszel method) or a random-effect model (DerSimonian–Laird method) depending on the absence or presence of heterogeneity (I2). Seven studies were included in the analysis (Table 1), Gleason score of 8 was the cut-off for the analysis. ELM-PC 4, ELM-PC 5, COU-AA-301, COU-AA-302 and PREVAIL trials reported data on hazard ratio (HR) of OS (Table 1) according to the initial Gleason score. The AFFIRM trial was excluded because it does not report data on PFS and OS according to the Gleason score. In regard to OS, a total of 6187 cases were included; 2982 cases (1654 in the experimental and 1328 in the control arm) had Gleason score <8, while 3205 cases (1797 in the experimental and 1408 in the control arm) had Gleason score ≥8 (Table 1). The analysis according to the Gleason score revealed novel anti-androgenic therapies significantly improved OS with similar extent in patients with Gleason score <8 [HR = 0.82, 95% confidence interval (CI) 0.73–0.91; P = 0.0004] compared with performance Gleason score ≥8 (HR = 0.81, 95% CI 0.73– 0.90; P < 0.00001] (Figure 1A). The fixed-effects model was used for the analysis due to the moderate heterogeneity (I2 = 46%) between the trials
Biological therapies for metastatic breast cancer: Antiangiogenesis
No full textBiological therapies for metastatic breast cancer: Antiangiogenesi
Expanding treatment options for metastatic gastric cancer
No full textExpanding treatment options for metastatic gastric cance
Re: Johann S. de Bono, Matthew R. Smith, Fred Saad, et al. Subsequent Chemotherapy and Treatment Patterns After Abiraterone Acetate in Patients with Metastatic Castration-resistant Prostate Cancer: Post Hoc Analysis of COU-AA-302. Eur Urol. In press. http://dx.doi.org/10.1016/j.eururo.2016.06.033
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Therapeutic resistance and optimal drug sequencing in HER2-positive metastatic breast cancer: unmet needs and future perspectives
Full text linkIn the last couple of decades substantial therapeutic improvements deeply influenced the treatment of HER2-positive metastatic breast cancer. The most impactful advancements were obtained especially in the first-line setting, with the trastuzumab/pertuzumab anti-HER2 double blockade, and in the second line, with the advent of the potent antibody-drug conjugate trastuzumab deruxtecan. Nevertheless, a careful observation of the patterns of early-progression and long-term effects on overall survival of the most novel agents and combinations, highlights the challenges represented by the emergence of therapeutic resistance and optimal drug sequencing. The integration of sequence studies, tumor-related biomarker development/implementation and understanding of primary mechanisms of resistance to novel anti-HER2 agents, will be the way to move forward to effectively tackle these novel unmet needs
Re: Karim Fizazi, Kim N. Chi, Johann S. de Bono, et al. Low Incidence of Corticosteroid-associated Adverse Events on Long-term Exposure to Low-dose Prednisone Given with Abiraterone Acetate to Patients with Metastatic Castration-resistant Prostate Cancer. Eur Urol. In press. http://dx.doi.org/10.1016/j.eururo.2016.02.035: Corticosteroid-associated Adverse Events in Elderly Patients
No full textLow Incidence of Corticosteroid-associated Adverse Events on Long-term Exposure to Low-dose Prednisone Given with Abiraterone Acetate to Patients with Metastatic Castration-resistant Prostate Cance
Neoadjuvant treatment of HER2 and hormone-receptor positive breast cancer - Moving beyond pathological complete response
No full textPathologic complete response (pCR) was noted to be prognostic in all but hormone receptor-positive (HR) breast cancer cases even when HER2 is overexpressed. Evocative data suggest that HER2-positive breast cancer patients are a heterogeneous population and a subset of HER2-positive and HR-positive tumors biologically behave more like HER2-negative. Identification and targeted monitoring of these patients is crucial to consolidate data aiming to optimize combination treatment with new agents, thereby avoiding overtreatment with chemotherapy. The questions surrounding HER2-positive and HR-positive breast cancer patients treatment as well as the potential direction towards development of surrogate markers alternative to pCR are discusse
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