21 research outputs found
Triple negative breast cancer: new perspectives for targeted therapies
Breast cancer is a heterogeneous disease, encompassing a large number of entities showing different morphological features and having clinical behaviors. It has became apparent that this diversity may be justified by distinct patterns of genetic, epigenetic, and transcriptomic aberrations. The identification of gene-expression microarray-based characteristics has led to the identification of at least five breast cancer subgroups: luminal A, luminal B, normal breast-like, human epidermal growth factor receptor 2, and basal-like. Triple-negative breast cancer is a complex disease diagnosed by immunohistochemistry, and it is characterized by malignant cells not expressing estrogen receptors or progesterone receptors at all, and human epidermal growth factor receptor 2. Along with this knowledge, recent data show that triple-negative breast cancer has specific molecular features that could be possible targets for new biological targeted drugs. The aim of this article is to explore the use of new drugs in this particular setting, which is still associated with poor prognosis and high risk of distant recurrence and death
Primary prophylaxis of neutropenia in women affected by breast cancer undergoing adjuvant chemotherapy with fec 100+/- docetaxel. Comparison of efficacy and tolerability between lenograstim and pegfilgrastim
Objectives: evaluate safety and toxicity of a single injection of pegfilgrastim compared
to daily administration of lenograstim in breast cancer patient undergoing adjuvant
chemotherapy
ESMO management and treatment adapted recommendations in the COVID-19 era: gynaecological malignancies
The rapid spread of severe acute respiratory syndrome
coronavirus 2 infection and its related disease (COVID-19)
has required an immediate and coordinate healthcare
response to face the worldwide emergency and define
strategies to maintain the continuum of care for the
non-COVID-19 diseases while protecting patients and
healthcare providers. The dimension of the COVID-19
pandemic poses an unprecedented risk especially for the
more vulnerable populations. To manage patients with
cancer adequately, maintaining the highest quality of
care, a definition of value-based priorities is necessary
to define which interventions can be safely postponed
without affecting patients’ outcome. The European
Society for Medical Oncology (ESMO) has endorsed a
tiered approach across three different levels of priority
(high, medium, low) incorporating information on the
value-based prioritisation and clinical cogency of the
interventions that can be applied for different disease
sites. Patients with gynaecological cancer are at particular
risk of COVID-19 complications because of their age and
prevalence of comorbidities. The definition of priority
level should be based on tumour stage and histology,
cancer-related symptoms or complications, aim (curative
vs palliative) and magnitude of benefit of the oncological
intervention, patients’ general condition and preferences.
The decision-making process always needs to consider
the disease-specific national and international guidelines
and the local healthcare system and social resources,
and a changing situation in relation to COVID-19 infection.
These recommendations aim to provide guidance for the
definition of deferrable and undeferrable interventions
during the COVID-19 pandemic for ovarian, endometrial
and cervical cancers within the context of the ESMO
Clinical Practice Guidelines
Breast cancer during pregnancy
Viene descritta la gestione della paziente a cui viene diagnosticato un carcinoma della mammella in gravidanza, spiegando quali accertamenti diagnostici sono possibili, senza danno per la madre o per il feto e la terapia che può essere effettuata nelle diverse fasi della gravidanza
Bevacizumab in ovarian cancer: a critical review of phase III studies
Bevacizumab (BV) is a humanized monoclonal antibody targeting vascular endothelial growth factor and it is the first molecular-targeted agent to be used for the treatment of ovarian cancer (OC). Randomized Phase III trials evaluated the combination of BV plus standard chemotherapy for first-line treatment of advanced OC and for platinum-sensitive and platinum-resistant recurrent OC. These trials reported a statistically significant improvement in progression-free survival but not in overall survival. Furthermore, BV effectively improved the quality of life with regard to abdominal symptoms in recurrent OC patients. Bevacizumab is associated with adverse events such as hypertension, bleeding, thromboembolism, proteinuria, delayed wound healing, and gastrointestinal events. However, most of these events can be adequately managed. This review describes the latest evidence for BV treatment of OC and selection of patients for personalized treatment
Critical appraisal of bevacizumab in the treatment of metastatic colorectal cancer
Colorectal cancer is one of the most common cancers worldwide. The prognosis of patients with metastatic colorectal cancer in recent years has increased from 5 months with best supportive care to nearly 2 years with chemotherapy combined with bevacizumab, an antivascular endothelial growth factor monoclonal antibody. New prognostic and predictive biomarkers have been identified to guide chemotherapy in metastatic colorectal cancer, such as KRAS and BRAF oncogenes. However, the status of these oncogenes does not affect the efficacy of bevacizumab, and biomarkers predicting response to treatment with bevacizumab are still lacking. Addition of bevacizumab to regimens based on fluoropyrimidines or irinotecan has been shown to improve overall survival in treatment-naive patients with metastatic colorectal cancer. Similarly, a significant increase in overall survival rate is achieved by adding bevacizumab to fluoropyrimidines and oxaliplatin in patients with disease progression. Bevacizumab has been found to be effective even when used as third-line therapy and later. In addition, cohort studies have shown that bevacizumab improves survival significantly despite disease progression. Finally, bevacizumab therapy in the neoadjuvant setting for the treatment of liver metastasis is well tolerated, safe, and effective
Plerixafor and autologous stem cell transplantation: Impressive result in a chemoresistant testicular cancer patient treated with high-dose chemotherapy
Plerixafor, a CXCR4 antagonist, induces the rapid release of hematopoietic progenitor stem cells from the bone marrow into peripheral blood; it is approved for autologous hematopoietic progenitor stem cell mobilization in multiple myeloma and non-Hodgkin's lymphoma patients. We report the case of a 34-year-old patient with metastatic testicular embryonal carcinoma who was extensively and in vain pretreated with chemotherapy and failed to mobilize an adequate number of hematopoietic progenitor stem cells following high-dose chemotherapy, with the support of granulocyte colony-stimulating factors. After a cycle of high-dose cyclophosphamide associated with granulocyte colony-stimulating factors, plerixafor was administered to the patient, with the clinical evidence of an increase in hematopoietic progenitor stem cells in the peripheral blood. The patient achieved a complete engraftment following two cycles of high-dose chemotherapy (paclitaxel, ifosfamide, carboplatin, etoposide), with the support of hematopoietic progenitor stem cells; the patient showed discrete tolerability to the treatment. At biochemical control, the -human chorionic gonadotropin value decreased from 86 to less than 1.2 mUI/ml and total body PET-CT scan showed a complete response to chemotherapy. According to this experience, we believe that in patients with advanced germ cell cancer, it is essential to explore the possibility of the use of high-dose chemotherapy to induce a stable and permanent response; in this context, plerixafor, with the support of granulocyte colony-stimulating factors, may be an innovative option for satisfactory mobilization during high-dose chemotherapy protocols. (C) 2013 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins