Antiangiogenic therapy in ovarian cancer – for whom and when?

Tumor angiogenesis appears to be an important process in epithelial ovarian cancer development. Bevacizumab is a monoclonal antibody that can neutralize vascular endothelial growth factor, a promoter of the initiation phase of angiogenesis. First-line chemotherapy in combination with bevacizumab followed by maintenance bevacizumab demonstrated efficacy over chemotherapy alone in two phase III trials (Gynecologic Oncology Group, GOG 218 and ICON7); however, absolute progression-free survival benefit remains modest, with no demonstrated impact on overall survival. The addition of molecularly targeted agents to the treatment of women with recurrent and platinum-sensitive disease has been recently reported in the OCEANS study, which evaluated the benefit of adding bevacizumab to carboplatin and gemcitabine in women with platinum-sensitive recurrent disease. Bevacizumab-based therapy also extended progressionfree survival from 8 to 12 months. However, overall survival was not different between the two arms. In the Gynecologic Oncology Group 213 (GOG 213) trial, women with platinum-sensitive recurrent epithelial ovarian cancer were randomly assigned to medical treatment (carboplatin plus paclitaxel with or without bevacizumab). A significant improvement in progression-free survival (14 versus 10 months, respectively) was observed. A trend towards a significant improvement in overall survival, which was not statistically significant, was reported. In November 14, 2014, based on AURELIA findings, the Food and Drug Administration approved bevacizumab in combination with paclitaxel, pegylated liposomal doxorubicin, or topotecan, for the treatment of patients with platinum-resistant recurrent epithelial ovarian cancer. Ovarian cancer is a primary cancer against which these new agents are being tested. This review will describe the role of angiogenesis inhibitors in epithelial ovarian cancer

Safra kesesinin intravasküler diffüz büyük hücreli lenfoması

Intravascular large B-cell lymphoma (IVLBCL) is a rare type of extranodal B-cell lymphoma characterized by the growth of lymphoma cells within the lumina of small vessels. Two major patterns of clinical presentation have been recognized: the first is in European countries, with brain and skin involvement, and the second in Asian countries, where patients typically present with multiorgan failure, hepatosplenomegaly, pancytopenia, and hemophagocytic syndrome [1,2,3,4,5]. Primary IVLBCL of the gallbladder is exceedingly rare

Terapia antyangiogenna w raku jajnika – dla kogo ikiedy?

Tumor angiogenesis appears to be an important process in epithelial ovarian cancer development. Bevacizumab is a monoclonal antibody that can neutralize vascular endothelial growth factor, a promoter of the initiation phase of angiogenesis. First-line chemotherapy in combination with bevacizumab followed by maintenance bevacizumab demonstrated efficacy over chemotherapy alone in two phase III trials (Gynecologic Oncology Group, GOG 218 and ICON7); however, absolute progression-free survival benefit remains modest, with no demonstrated impact on overall survival. The addition of molecularly targeted agents to the treatment of women with recurrent and platinum-sensitive disease has been recently reported in the OCEANS study, which evaluated the benefit of adding bevacizumab to carboplatin and gemcitabine in women with platinum-sensitive recurrent disease. Bevacizumab-based therapy also extended progressionfree survival from 8 to 12 months. However, overall survival was not different between the two arms. In the Gynecologic Oncology Group 213 (GOG 213) trial, women with platinum-sensitive recurrent epithelial ovarian cancer were randomly assigned to medical treatment (carboplatin plus paclitaxel with or without bevacizumab). A significant improvement in progression-free survival (14 versus 10 months, respectively) was observed. A trend towards a significant improvement in overall survival, which was not statistically significant, was reported. In November 14, 2014, based on AURELIA findings, the Food and Drug Administration approved bevacizumab in combination with paclitaxel, pegylated liposomal doxorubicin, or topotecan, for the treatment of patients with platinum-resistant recurrent epithelial ovarian cancer. Ovarian cancer is a primary cancer against which these new agents are being tested. This review will describe the role of angiogenesis inhibitors in epithelial ovarian cancer.Angiogeneza nowotworowa wydaje się istotnym procesem w rozwoju raka jajnika. Bewacyzumab jest przeciwciałem monoklonalnym zdolnym do neutralizacji naczyniowo-śródbłonkowego czynnika wzrostu, promotora początkowej fazy angiogenezy. W dwóch badaniach klinicznych III fazy (Gynecologic Oncology Group – GOG 218 oraz ICON7) wykazano skuteczność chemioterapii pierwszego rzutu w skojarzeniu z bewacyzumabem i następowym leczeniem podtrzymującym bewacyzumabem w porównaniu z samą chemioterapią, jednak bezwzględne korzyści czasu wolnego bez progresji pozostają niewielkie, bez wpływu na przeżycie całkowite. W  badaniu OCEANS oceniono korzyści wynikające z  włączenia bewacyzumabu do terapii karboplatyną i gemcytabiną u kobiet z nawrotowym rakiem jajnika wrażliwym na platynę. Leczenie oparte na bewacyzumabie wydłużyło czas przeżycia bez progresji choroby z 8 do 12 miesięcy. Nie stwierdzono różnicy w odniesieniu do przeżycia całkowitego między dwiema grupami pacjentek. W badaniu klinicznym GOG 213 (Gynecologic Oncology Group 213) kobietom z nawrotowym rakiem jajnika wrażliwym na platynę losowo przypisywano rodzaj leczenia (karboplatynę plus paklitaksel z lub bez bewacyzumabu). Zaobserwowano istotną poprawę w zakresie przeżycia bez progresji choroby (odpowiednio 14 i 10 miesięcy). Odnotowano tendencję do poprawy w zakresie przeżycia ogólnego, jednak bez istotności statystycznej. W oparciu o wyniki badania AURELIA 14 listopada 2014 roku Agencja Żywności i Leków zatwierdziła bewacizumab w skojarzeniu z paklitakselem, pegylowaną liposomalną doksorubicyną lub topotekanem w leczeniu chorych z wrażliwym na platynę nawrotowym rakiem jajnika. Rak jajnika jest pierwszym nowotworem, wobec którego badane są te leki. W niniejszej pracy opisano rolę inhibitorów angiogenezy w nabłonkowym raku jajnika

A Three Year Retrospective Analysis Of Anti-Tnf Treatment Outcomes In Rheumatoid Arthritis And Ankylosing Spondylitis Patients

AbstractBackground/Aims:To investigate the effectiveness and reliability of anti-TNF treatment in Ankylosing Spondylitis-Rheumatoid arthritis patients.Methods:180 patients (110 Rheumatoid arthritis (RA) patients diagnosed according to 1987 American Rheumatism Association criteria, 70 Ankylosing Spondylitis (AS) patients diagnosed according to Modified NewYork Criteria) admitted to the hospital for arthritis and related compliants who were followed up and treated with anti-TNF treatment in the department of Rheumatology&Immunology from 2009 to 2011. We enrolled 100 patients with RA (76 women, 24 men) and 60 patients with AS (16 women, 44 men) to the study, excluded 20 patients according to the exclusion criterias. The response of the patients to the anti-TNF treatment was evaluated by comparing the clinical parameters BASDAI, DAS28 and VAS score; and laboratory measurements of erytrocyte sedimentation rate, C-reactive protein levels of rheumatoid arthritis and ankylosing spondylitis before and six months after the treatment.Results:After the six months of anti Tnf treatment, BASDAI score for AS, DAS28 score for RA, VAS, ESR and CRP levels for both diseases showed a statistically significant improvement, moreover it was determined that demographic variations did not affect these values.Conclusions: Our results demonstrated that anti-TNF treatment is safe and effective treatment modality in patients with Ankylosing Spondylitis and Rheumatoid arthritis. These findings are short-term results of a study, and therefore future studies with larger patient series and long term follow-up are needed to look at outcomes of long term therapies

Managing Synchronous Liver Metastases in Colorectal Cancer.

The most common site of blood-borne metastases from colorectal cancers (CRC) is the liver. Resection of (liver) metastases is a part of standard treatment of metastatic colorectal cancer. Hepatic resection is the first-line treatment of liver metastases, with 5-year survival rates between 25 and 58%. The enhanced efficacy of systemic chemotherapeutic regimens has increased tumor response rates and improved the progression-free and overall survival of patients with these malignancies. In approximately 20% of patients with initially unresectable liver metastases, the metastases may become resectable after administration of neoadjuvant chemotherapy. Unresectable liver metastases can be managed with systemic therapy and/or a variety of liver-directed techniques such as radiofrequency ablation, hepatic artery infusion, or yttrium-90 radioembolization. Our examination of the literature led us to propose a new patient-oriented algorithm to guide clinicians' decisions on the best choice of upfront therapy for CRC and synchronous liver metastases. The need for multidisciplinary consensus has become especially important for metastatic CRC

A case of membranous glomerulopathy associated with lung cancer and review of the literature.

Membraneous nephropathy (MN) is the most commonly occurring nephrotic syndrome in adults as well as the most common paraneoplastic nephropathy associated with solid tumors, and it is mostly associated with gastrointestinal system and lung carcinomas. Accurate diagnosis is important as the treatment of paraneoplastic glomerulonephritis is very varied from that of idiopathic ones. In the current report, a case of a patient that was referred with proteinuria and edema and was diagnosed with lung cancer, and responded markedly to treatment of malignancy, with improvement of MN, is presented. Active cancer is present in all patients with paraneoplastic MN. In numerous patients, the paraneoplastic MN and cancer diagnoses are made within one year of each other. The treatment of paraneoplastic syndromes is usually associated with the treatment of primary malignancy. There are conflicting data on which treatment modality is more suitable. In conclusion, further studies are required in order to determine the actual incidence of cancer in patients with nephropathy, explain the physiopathological association between cancer and nephropathy and to determine the most suitable treatment approaches

Adjuvant chemotherapy for gastric cancer in elderly patients has same benefits as in younger patients.

The age-adjusted mortality rate due to gastric cancer was reported to increase with age. This study aims to investigate the results of adjuvant chemotherapy in patients aged 65 years or older comparing with younger patients and focusing on its impact on survival

Lobular breast cancer metastasis to uterus during adjuvant tamoxifen treatment: A case report and review of the literature.

Tamoxifen plays a critical role in the treatment of hormone receptor-positive breast cancer. Despite these great benefits against breast cancer, tamoxifen increases the risk of endometrial pathologies such as endometrial hyperplasia, polyp, and neoplasms because of agonistic effect on endometrial tissues. Therefore, gynecologic follow-up should be carried out during tamoxifen treatment. Uterine tumors are frequently detected as the result of presentation with abnormal uterine bleeding. In addition, genital tract's metastases from distant primary tumors can present with abnormal uterine bleeding. Therefore, it is important to determine whether the uterine mass is metastatic or primary because different treatment modalities are used for them. In this context, breast carcinomas are the most frequent metastatic tumors, particularly invasive lobular carcinoma. Here, we report an invasive lobular carcinoma case that presented with abnormal uterine bleeding while receiving tamoxifen therapy and has metastasize in the uterus