Câncer colorretal metastático: papel atual dos anticorpos monoclonais e a individualização de seu uso

INTRODUÇÃO: Apesar dos poucos casos de cura no câncer colorretal metastático, a última década foi marcada por avanços na disponibilidade de novos fármacos com mecanismos de ação distintos e aplicabilidade em várias linhas de tratamento. De fato, a sobrevida mediana de pacientes com câncer colorretal metastático praticamente dobrou ao longo dos últimos 10 anos, e parte dessa mudança se deve à introdução dos anticorpos monoclonais, capazes de reconhecer antígenos com importância patogênica em tumores. OBJETIVO: Apresentar revisão dos resultados obtidos com os anticorpos monoclonais usados em câncer colorretal. MÉTODOS: Revisão de 29 trabalhos publicados e obtidos nas fontes atuais de busca virtual. Foram revisados o papel do Bevacizumabe - anticorpo contra o VEGF; o Cetuximabe e Panitumumabe - anticorpos contra o EGFR e o oncogene K-Ras na resposta ao tratamento. CONCLUSÃO: Sugere-se ao final algoritmo de tratamento com anticorpos monoclonais

Autonomy Versus Shame: Body Perceptions Of Colostomized Patients In Southeastern Brazil

Background: This study discusses the psychosocial characteristics of colostomy users' feelings. Methods: Qualitative research with colostomized patients that constituted one of the objectives of the Rectal Cancer Assessment (ACRE) study of the National Cancer Institute José Alencar Gomes da Silva - INCA. Data interpretation had as the main supposition the understanding that interpretations about one’s body are characterized by speeches and representations. Results: The feeling of shame was frequent in the testimonials. The shame of the colostomized body and the desire to hide it are associated with the negative feelings attributed to the “out-of-standard” body and the feces, collective and individual feelings that can be used as a basis for comparison in body interpretation. Conclusion: The colostomized body is still seen as a taboo, which intensifies feelings of isolation, abnormality, and not belonging, making it even more difficult to adapt, promote mental health and develop autonomy. Keywords: Body, Colostomy, Health promotion, Colorectal cancer.&nbsp

Brazilian cohort results of the PRECONNECT study: safety and efficacy of trifluridine/tipiracil in metastatic colorectal cancer

PRECONNECT is a multicenter study demonstrating the efficacy and tolerability of trifluridine/tipiracil in adult patients with histologically confirmed adenocarcinoma of the colon or rectum and pretreated metastatic lesions. The current article describes the characteristics and outcomes of the Brazilian cohort of patients who underwent trifluridine/tipiracil therapy within PRECONNECT. Brazilian patients (n=55) received oral trifluridine/tipiracil 35mg/m2 twice daily on days 1-5 and 8-12 of each 28-day cycle. The primary endpoint was safety including time to ECOG (Eastern Cooperative Oncology Group) PS (performance status) deterioration, and the secondary endpoints included progression-free survival (PFS) and quality of life (QoL). Baseline characteristics showed only 34.5% of patients underwent ≥3 lines of treatment, 29.1% presented ≥3 metastatic sites and 52.7% showed an ECOG PS of 0. The disease control rate (DCR) was 32.0% and 28.6% in patients with one and two metastatic sites, respectively, the median PFS was 3.0 months (95%CI: 2.5-3.4), and the time to ECOG PS deterioration (≥2) was 5.4 months. Drug-related treatment-emergent adverse events (TEAE) were observed at least once in 87.3% of patients, and the most common (≥40% of patients) hematological TEAEs were neutropenia and anemia; there was no febrile neutropenia case. The shorter time to ECOG PS deterioration showed in the Brazilian subset of patients is likely due to late diagnosis setting compared to the global population, despite that trifluridine/tipiracil showed good DCR results, including patients with two metastatic sites. In conclusion, safety and efficacy results provide confidence in routine practice use and are in line with the PRECONNECT stud

Survival and prognostic factors in patients with Non-Small Cell Lung Cancer treated in private health care

INTRODUCTION: Outcomes data on Non-Small Cell Lung Cancer (NSCLC) are scarce with regard to the private health care in Brazil. The aim of this study was to describe the characteristics, treatments performed, and the survival of patients with NSCLC in a Brazilian private oncologic institution. METHODS: Medical charts from patients treated between 1998 and 2010 were reviewed, and data were transferred to a clinical research form. Long-term follow-up and survival estimates were enabled through active surveillance. RESULTS: Five hundred sixty-six patients were included, and median age was 65 years. Most patients were diagnosed in advanced stages (79.6% III/IV). The overall survival was 19.0 months (95%CI 16.2 - 21.8). The median survival was 99.7, 32.5, 20.2, and 13.3 months for stages I, II, III, and IV, respectively (p < 0.0001). Among patients receiving palliative chemotherapy, the median survival was 12.2 months (95%CI 10.0 - 14.4). CONCLUSIONS: The outcomes described are favorably similar to the current literature from developed countries. Besides the better access to health care in the private insurance scenario, most patients are still diagnosed in late stages