Safety and efficacy of transdermal fentanyl in patients with cancer pain: phase IV, Turkish oncology group trial

We have performed a prospective evaluation of the efficacy, safety and convenience of the transdermal therapeutic system - fentanyl (TTS-F) in Turkish cancer patients when it was newly available in Turkey. Ninety-nine patients with historically confirmed malignancy and pain entered the study; the mean age was 55.1 (16-58) years. The study duration was 28 days. Transdermal therapeutic system - fentanyl was used in opioid-naive or pre-treated patients. Most patients reported a decrease in pain severity. Use of rescue medication decreased from day 4 to day 28. The majority of patients rated patch convenience of use as excellent. A total of 22.2% of patients experienced adverse events that were either probably related or very likely to be related to the study drug. The majority of the adverse events mentioned were related to the digestive system. Eighteen serious adverse events were reported by 13 patients. Six events were doubtfully related, and 12 events were not related to the study drug. Four patients died during the trial. None of these deaths was attributed to the study drug. In conclusion, the trial showed that TTS-F is easily managed, effective and will help to enable the appropriate opioid administration to patients who are suffering from cancer pain in Turkey

Transforming growth factor beta (TGF-ß), mesenchymal-epithelial transition (MET) and breast cancer metastasis

© 2014 Optimal Clinical (Doctors. MD).Genetic and microenviromental factors model the tissue architecture. The advance of gene expression profiling and individual tumor characterizing analysis have enabled to identify the clinical significance of transforming growth factor beta (TGF-ß), epithelial-mesenchymal transition (EMT), and mesenchymal-epithelial transition (MET) signaling pathways for metastatic process. TGF-ß, a potent multifunctional (both physiologic and pathophysiologic) regulatory polypeptide, has been extensively studied in relation to malignancy. According to alterations in the composition of surrounding extracellular matrix (ECM), normal and cancer cells respond differently to TGF-ß/TGF-ß signaling pathways. The progressive research in understanding the mechanisms controlling epithelial plasticity (EMTMET) in the mammary gland can enable to identify targets for therapy and biomarkers for prognosis and prediction of treatment outcome for breast cancer patients. Therapeutic targets for TGF-ß and MET signaling pathways are in early phase clinical trials in several tumor types including mammary tumors. The review includes recent advances in these paradox pathways and their clinical implications for breast cancer