Strikingly high activity of metronomic chemotherapy in a patient with locally advanced, life-threatening cutaneous squamous-cell cancer — case report and discussion of the literature

The current treatment of choice in patients with advanced or metastatic squamous-cell carcinoma (SCC) of the skin is immunotherapy based on anti-PD1/L1 antibodies. For many years, there has been a consensus, that SCC of the skin is a chemorefractory neoplasm. However, despite a recent approval of checkpoint inhibitors for the treatment of cutaneous SCC, their extremely high cost makes them unavailable for many patients worldwide, and additionally, in many patients, their use may be contraindicated by patients’ clinical conditions. This article provides strong arguments that optimized and well-matched chemotherapy still represents an active treatment option even in the era of novel therapies

Preoperative treatment of HER2-positive breast cancer

xPreoperative chemotherapy is more and more frequently used in the treatment of localized and locally-advanced breast cancer. This approach not only creates optimal conditions for organ-sparing surgery but also provides us with valuable information on the biology and chemosensitivity of cancer. This data is then crucial for the choice of systemic adjuvant therapy. The availability of two anti-HER2 targeted agents (pertuzumab and trastuzumab) for the neoadjuvant treatment of breast cancer significantly improves the efficacy of this approach. Significantly increased percentage of patients experiencing complete pathological response correlates with improved outcomes. This article is aimed at summarizing current knowledge regarding the role of pertuzumab in neoadjuvant treatment of HER2-positive breast cancer and comprises essential guidelines for the optimal use of currently reimbursed therapies in this disease

Leczenie systemowe wczesnego raka piersi na podstawie wytycznych St. Gallen 2013

2013 St. Gallen International Expert Consensus has modified some issues on the treatment strategy of early breast cancer. The clinico-pathological differentiation of Luminal A and B tumors is now based not only on Ki67 expression (high proliferation threshold increased to ≥ 20%), but also on the level of PgR expression (≥ 20% requiredfor Luminal A). Based on recent results of ATLAS and aTTom trials, prolonged (up to 10 years) hormonal therapy with tamoxifen has been included in St. Gallen recommendations. For the first time the obesity has been commentedas a potential, negative predictive factor for aromatase inhibitors activity in premenopausal patients.Tegoroczne międzynarodowe wytyczne St. Gallen doprecyzowały kilka zagadnień dotyczących strategii leczenia systemowego wczesnego raka piersi. Uściślono definicje podtypów kliniczno-patologicznych raka piersi w zakresie podtypu luminalnego A i B. Po raz pierwszy pojawiły się wyraźne rekomendacje dotyczące stosowania wielogenowych testów oceny ryzyka w podejmowaniu decyzji terapeutycznych. Na podstawie wyników badań ATLAS i aTTom eksperci opowiedzieli się za zasadnością stosowania przedłużonej (do 10 lat) hormonoterapii uzupełniającej tamoksyfenem przynajmniej u części chorych. Po raz pierwszy zwrócono uwagę na ryzyko mniejszej efektywności hormonoterapii opartej na inhibitorach aromatazy u otyłych chorych przed menopauzą