© 2007 European Society for Medical Oncology
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Risk of relapse and mortality after 5 years of tamoxifen |
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 Top Risk of relapse and... EGFR and KRAS mutations...Bortezomib for mantle cell...Twice-daily pain monitoring as...Quote |
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Over half of the 15-year relapses and mortality from breast cancer occur beyond five years from diagnosis. Currently more than five years of tamoxifen is not recommended following the results from NSABP B-14 and other trials which have suggested that the agonist activity of tamoxifen becomes dominant with time and may promote tumor growth. Consequently, individualized estimates of the risk of relapse and death after 5 years of tamoxifen could improve decisions regarding extended hormonal therapy. In this issue, Kennecke et al. report the results of a study that aimed to assess the risk of a breast cancer event and mortality during years 6 to 10 after diagnosis in postmenopausal women with early-stage breast cancer who were event free after five years of tamoxifen in a large, population-based cohort. These authors report that standard pathologic factors of risk continue to be prognostic during the second five years after tamoxifen with initial tumor stage and biology continuing to influence events even 10 years after diagnosis and therapy with tamoxifen.
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EGFR and KRAS mutations as criteria for treatment with TKIs |
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TopRisk of relapse and...EGFR and KRAS mutations...Bortezomib for mantle cell...Twice-daily pain monitoring as...Quote |
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Mutations of the tyrosine kinase domain of the epidermal growth factor receptor (EGFR) have recently been discovered in patients with non-small-cell lung cancer (NSCLC). In addition, EGFR mutations have been more frequently detected in NSCLC patients with specific characteristics such as a non-smoking status, adenocarcinoma and in particular bronchioloalveolar carcinoma (BAC), female gender and Asiatic origin. The presence of EGFR mutations is closely associated with a favorable response to treatment with tyrosine kinase inhibitors (TKIs). By contrast, the presence of KRAS mutations is associated with unresponsiveness to EGFR inhibitors. In this issue, van Zandwijk et al. report the results of both retrospective and prospective studies of EGFR and KRAS mutation status and response on EGFR TKIs in patients with NSCLC. These authors confirm the role of EGFR and KRAS mutations in predicting response/non-response to TKIs and suggest that exon 19 deletions are associated with the best responses.
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Bortezomib for mantle cell lymphoma |
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TopRisk of relapse and...EGFR and KRAS mutations...Bortezomib for mantle cell...Twice-daily pain monitoring as...Quote |
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Mantle cell lymphoma represents some 6% of cases of non-Hodgkin's lymphoma and is currently considered incurable, with a median survival of 3-4 years. In vitro inhibition of NF-
B by the proteasome inhibitor bortezomib leads to cell cycle arrest and apoptosis in mantle cell lymphoma cells, and a phase I trial of bortezomib in patients with refractory hematologic malignancies objective responses were identified in patients with myeloma as well as mantle cell and follicular lymphomas. Positive phase II studies of bortezomib in myeloma have followed. In this issue, Belch et al. report the results of a phase II trial that aimed to evaluate the activity and toxic effects of bortezomib in patients with mantle cell lymphoma. These authors conclude that single agent bortezomib, at a dose of 1.3 mg/m2 given twice weekly every 21 days is active when treating patients with mantle cell lymphoma. The suggest that while cumulative neuromuscular toxicities limit therapy duration and issues related to fluid retention require further evaluation, continued study of this drug in combination regimens is warranted. |
Twice-daily pain monitoring as standard clinical practice |
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TopRisk of relapse and...EGFR and KRAS mutations...Bortezomib for mantle cell...Twice-daily pain monitoring as...Quote |
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Cancer is the most frequent cause of chronic pain and despite increased attention to the use of analgesics in cancer-patient care, these patients are still a long way from receiving satisfactory pain control. Guidelines for the treatment of cancer pain consider a careful assessment of pain intensity to be the basic condition allowing optimal analgesic treatment. However, most reported studies of pain intensity monitoring have been limited to the palliative care setting or patients with advanced disease. In this issue, Martoni et al. describe their experiences exploring the use of pain intensity monitoring in everyday clinical practice at a medical oncology inpatient unit. These authors consider the "Pain-free Hospital" programme, which included a training course for nurses and the recording every 12 hours of a visual analog scale (VAS) pain intensity rating in all the patients admitted independent of disease stage. They conclude that systematic twice-daily pain intensity monitoring using VAS at a medical oncology inpatient ward is feasible in routine clinical practice with good patient compliance. They now propose to prospectively evaluate the reliability of systematic pain intensity monitoring in driving the analgesic therapy prescription.
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TopRisk of relapse and...EGFR and KRAS mutations...Bortezomib for mantle cell...Twice-daily pain monitoring as...Quote |
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"I don't mind giving a reasonable amount, but a pint...why that's very nearly an armful."
Tony Hancock as The Blood Donor, written by Ray Galton and Alan Simpson
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Related articles in Ann Oncol:
- Late risk of relapse and mortality among postmenopausal women with estrogen responsive early breast cancer after 5 years of tamoxifen
- HF Kennecke, IA Olivotto, C Speers, B Norris, SK Chia, C Bryce, and KA Gelmon
Ann Oncol 2007 18: 45-51.[Abstract] [FREE Full Text] - EGFR and KRAS mutations as criteria for treatment with tyrosine kinase inhibitors: retro- and prospective observations in non-small-cell lung cancer
- N van Zandwijk, A Mathy, L Boerrigter, H Ruijter, I Tielen, D de Jong, P Baas, S Burgers, and P Nederlof
Ann Oncol 2007 18: 99-103.[Abstract] [FREE Full Text] - A phase II study of bortezomib in mantle cell lymphoma: the National Cancer Institute of Canada Clinical Trials Group trial IND.150
- A Belch, CT Kouroukis, M Crump, L Sehn, RD Gascoyne, R Klasa, J Powers, J Wright, and EA Eisenhauer
Ann Oncol 2007 18: 116-121.[Abstract] [FREE Full Text] - Twice-daily pain monitoring as standard clinical practice for inpatients at a medical oncology unit: a descriptive study
- AA Martoni, C Degli Esposti, A Cricca, G Rocchi, and S Giaquinta
Ann Oncol 2007 18: 158-162.[Abstract] [FREE Full Text]
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