Breast cancer is the most common cancer among women in Poland and worldwide, second only to lung cancer in terms of mortality. Germline mutations account for approximately 5–10% of all breast cancer cases, with mutations in the BRCA1/2 genes being the most frequently identified. The presence of pathogenic variants in the BRCA1/2 genes is associated with a more than 60% risk of developing breast cancer, a 40–60% risk of ovarian cancer in women with a BRCA1 mutation, and a 13–30% risk in women with a BRCA2 variant. Breast cancer is often diagnosed at a younger age in BRCA1/2 mutation carriers. The prevalence and increased accessibility of genetic testing, especially next-generation sequencing, lead to a higher number of diagnosed individuals and healthy family members. Identifying a pathogenic variant in the BRCA1/2 genes, analyzing a family history, and genetic counseling enables the development of individual recommendations for further management. This article aims to present the diagnostic and therapeutic approach in breast cancer patients with a pathogenic variant in the BRCA1/2 genes.
{"title":"Diagnosis and treatment of patients with breast cancer and mutation in the BRCA1/2 genes","authors":"Joanna Kufel-Grabowska, Bartosz Wasąg","doi":"10.5603/ocp.2023.0035","DOIUrl":"https://doi.org/10.5603/ocp.2023.0035","url":null,"abstract":"Breast cancer is the most common cancer among women in Poland and worldwide, second only to lung cancer in terms of mortality. Germline mutations account for approximately 5–10% of all breast cancer cases, with mutations in the BRCA1/2 genes being the most frequently identified. The presence of pathogenic variants in the BRCA1/2 genes is associated with a more than 60% risk of developing breast cancer, a 40–60% risk of ovarian cancer in women with a BRCA1 mutation, and a 13–30% risk in women with a BRCA2 variant. Breast cancer is often diagnosed at a younger age in BRCA1/2 mutation carriers. The prevalence and increased accessibility of genetic testing, especially next-generation sequencing, lead to a higher number of diagnosed individuals and healthy family members. Identifying a pathogenic variant in the BRCA1/2 genes, analyzing a family history, and genetic counseling enables the development of individual recommendations for further management. This article aims to present the diagnostic and therapeutic approach in breast cancer patients with a pathogenic variant in the BRCA1/2 genes.","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135167506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emilia Babula, Aleksandra Sikora, Paweł Sobczuk, Piotr Rutkowski
Gastrointestinal stromal tumors (GISTs) are relatively rare in the population (0.4 to 2 cases per 100 000 per year) and account for approximately 1–2% of gastrointestinal cancers. According to the latest 2020 World Health Organization (WHO) classification of sarcomas, all GISTs are malignant, regardless of their size or mitotic index. In the systemic treatment of GIST, KIT tyrosine kinase receptor and platelet-derived growth factor receptor (PDGFRA) inhibitors, such as imatinib, sunitinib, or regorafenib, are used. The effectiveness of imatinib is significantly reduced in the case of secondary mutations in the KIT gene. The latest drug from the group of KIT inhibitors, ripretinib, was the first to show efficacy against most mutations associated with resistance, as well as in wild-type GIST, in which mutations in KIT and PDGFRA are not found. Analysis of the INVICTUS study showed a beneficial effect of ripretinib at the recommended dose of 150 mg/day on progression-free survival (PFS) in patients with advanced or metastatic GIST previously treated with at least three other inhibitors. However, the preliminary results of the phase III INTRIGUE study did not show an improvement in PFS in patients receiving ripretinib compared to sunitinib in the second-line therapy of GIST patients. Ripretinib has a favorable and acceptable safety profile and is recommended for treating patients with advanced GIST in the fourth line of treatment. In this article, we summarize the most essential data on the efficacy and safety of ripretinib in treating GIST patients and the recommendations for its use.
{"title":"Ripretinib in the treatment of patients with advanced gastrointestinal stromal tumors (GIST)","authors":"Emilia Babula, Aleksandra Sikora, Paweł Sobczuk, Piotr Rutkowski","doi":"10.5603/ocp.96771","DOIUrl":"https://doi.org/10.5603/ocp.96771","url":null,"abstract":"Gastrointestinal stromal tumors (GISTs) are relatively rare in the population (0.4 to 2 cases per 100 000 per year) and account for approximately 1–2% of gastrointestinal cancers. According to the latest 2020 World Health Organization (WHO) classification of sarcomas, all GISTs are malignant, regardless of their size or mitotic index. In the systemic treatment of GIST, KIT tyrosine kinase receptor and platelet-derived growth factor receptor (PDGFRA) inhibitors, such as imatinib, sunitinib, or regorafenib, are used. The effectiveness of imatinib is significantly reduced in the case of secondary mutations in the KIT gene. The latest drug from the group of KIT inhibitors, ripretinib, was the first to show efficacy against most mutations associated with resistance, as well as in wild-type GIST, in which mutations in KIT and PDGFRA are not found. Analysis of the INVICTUS study showed a beneficial effect of ripretinib at the recommended dose of 150 mg/day on progression-free survival (PFS) in patients with advanced or metastatic GIST previously treated with at least three other inhibitors. However, the preliminary results of the phase III INTRIGUE study did not show an improvement in PFS in patients receiving ripretinib compared to sunitinib in the second-line therapy of GIST patients. Ripretinib has a favorable and acceptable safety profile and is recommended for treating patients with advanced GIST in the fourth line of treatment. In this article, we summarize the most essential data on the efficacy and safety of ripretinib in treating GIST patients and the recommendations for its use.","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135665842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Wojciech Leppert, Jerzy Wordliczek, Małgorzata Malec-Milewska, Mahdalena Kocot-Kępska, Jarosław Woroń, Renata Zajączkowska, Jan Dobrogowski, Maciej Krzakowski, Małgorzata Krajnik
In order to elaborate diagnostic and therapeutic recommendations regarding the management of cancer patients with pain, a narrative review of the literature in PubMed and Cochrane database was conducted for the period of 2000–2022. An Expert Group of three scientific associations: Polish Association of Palliative Care, Polish Association for the Study of Pain, and Polish Association of Clinical Oncology was appointed, which made a literature review and formulated guidelines with strength of recommendations and quality of evidence. To achieve optimal effect of pain treatment cancer patients require complex clinical assessment of pain with detailed recognition of pathophysiology, intensity and time frame (baseline and breakthrough — episodic) of pain. Pain evaluation should encompass other symptoms, comorbidities, disturbances in psychological, social, and spiritual dimensions, which may induce patients’ suffering and total pain appearance. An important role plays anticancer local and systemic treatment, which may induce or exacerbate pain induced by cancer or comorbidities. A standard approach in patients with chronic pain in the course of cancer and other diseases is based on World Health Organization (WHO) analgesic ladder algorithm, which is supplemented with non-pharmacological management. It is recommended an individual approach in pain treatment depending on clinical situation of a concrete patient. Efforts should be made to effectively manage other symptoms, which accompany cancer. An introduction of specific treatment taking into account given pathophysiology, time frame and intensity of pain increase effectiveness and significantly shorten time necessary to achieve effective analgesia, and moreover contribute to decrease intensity and frequency of adverse effects of analgesics used.
{"title":"Diagnostic and therapeutic management of cancer patients with pain: recommendations of the Expert Group of the Polish Association for Palliative Care, Polish Association for the Study of Pain, and Polish Association of Clinical Oncology","authors":"Wojciech Leppert, Jerzy Wordliczek, Małgorzata Malec-Milewska, Mahdalena Kocot-Kępska, Jarosław Woroń, Renata Zajączkowska, Jan Dobrogowski, Maciej Krzakowski, Małgorzata Krajnik","doi":"10.5603/ocp.2023.0029","DOIUrl":"https://doi.org/10.5603/ocp.2023.0029","url":null,"abstract":"In order to elaborate diagnostic and therapeutic recommendations regarding the management of cancer patients with pain, a narrative review of the literature in PubMed and Cochrane database was conducted for the period of 2000–2022. An Expert Group of three scientific associations: Polish Association of Palliative Care, Polish Association for the Study of Pain, and Polish Association of Clinical Oncology was appointed, which made a literature review and formulated guidelines with strength of recommendations and quality of evidence. To achieve optimal effect of pain treatment cancer patients require complex clinical assessment of pain with detailed recognition of pathophysiology, intensity and time frame (baseline and breakthrough — episodic) of pain. Pain evaluation should encompass other symptoms, comorbidities, disturbances in psychological, social, and spiritual dimensions, which may induce patients’ suffering and total pain appearance. An important role plays anticancer local and systemic treatment, which may induce or exacerbate pain induced by cancer or comorbidities. A standard approach in patients with chronic pain in the course of cancer and other diseases is based on World Health Organization (WHO) analgesic ladder algorithm, which is supplemented with non-pharmacological management. It is recommended an individual approach in pain treatment depending on clinical situation of a concrete patient. Efforts should be made to effectively manage other symptoms, which accompany cancer. An introduction of specific treatment taking into account given pathophysiology, time frame and intensity of pain increase effectiveness and significantly shorten time necessary to achieve effective analgesia, and moreover contribute to decrease intensity and frequency of adverse effects of analgesics used.","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135665846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Convolutional neural networks in auto-segmentation of nasopharyngeal carcinoma tumor — a systematic review and meta-analysis","authors":"Maryam Zamanian, Iraj Abedi","doi":"10.5603/ocp.2023.0040","DOIUrl":"https://doi.org/10.5603/ocp.2023.0040","url":null,"abstract":"","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136077640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yassir Benameur, Salah Nabih Oueriagli, Omar Ait Sahel, Abderrahim Doudouh
Lung cancer is currently one of the most common malignancies worldwide. Among all metastatic sites of this cancer, cardiac metastases are exceptional, and long-term prognosis in these patients is very poor. 18F-FDG PET/CT is a valuable imaging tool for initial staging and assessment of treatment response of various neoplasms. In the case of lung cancer, its role is clearly defined, and its effectiveness is superior to other diagnostic imaging methods. We present a rare 18F-FDG PET/CT image finding in a 71-year-old man with biopsy-proven lung squamous cell carcinoma, showing increased cardiac 18F-FDG uptake subsequently found to be compatible cardiac metastasis.
{"title":"Cardiac metastasis of lung cancer diagnosed by fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT)","authors":"Yassir Benameur, Salah Nabih Oueriagli, Omar Ait Sahel, Abderrahim Doudouh","doi":"10.5603/ocp.95808","DOIUrl":"https://doi.org/10.5603/ocp.95808","url":null,"abstract":"Lung cancer is currently one of the most common malignancies worldwide. Among all metastatic sites of this cancer, cardiac metastases are exceptional, and long-term prognosis in these patients is very poor. 18F-FDG PET/CT is a valuable imaging tool for initial staging and assessment of treatment response of various neoplasms. In the case of lung cancer, its role is clearly defined, and its effectiveness is superior to other diagnostic imaging methods. We present a rare 18F-FDG PET/CT image finding in a 71-year-old man with biopsy-proven lung squamous cell carcinoma, showing increased cardiac 18F-FDG uptake subsequently found to be compatible cardiac metastasis.","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136077807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Piotr Rutkowski, Dorota Kiprian, Tomasz Świtaj, Radosław Michalik, Mateusz Spałek, Katarzyna Kozak, Tomasz Mandat, Bożena Cybulska-Stopa, Monika Dudzisz-Śledź
{"title":"Management of melanoma central nervous system metastases","authors":"Piotr Rutkowski, Dorota Kiprian, Tomasz Świtaj, Radosław Michalik, Mateusz Spałek, Katarzyna Kozak, Tomasz Mandat, Bożena Cybulska-Stopa, Monika Dudzisz-Śledź","doi":"10.5603/ocp.2023.0042","DOIUrl":"https://doi.org/10.5603/ocp.2023.0042","url":null,"abstract":"","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136077808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michał Seweryn, Tomasz Banaś, Joanna Augustyńska, Agnieszka Leszczyńska, Paweł M. Potocki
Introduction. HER2-positive breast cancer represents 10–20% of all breast tumors. This study aimed to create a model-based cost-minimization analysis that compared non-drug related costs of different therapies used in the treatment of HER2-positive breast cancer in Poland: pertuzumab SC plus trastuzumab SC (Pert/TrasSC) vs. pertuzumab IV plus trastuzumab IV (PertIV + TrasIV) vs. pertuzumab IV plus trastuzumab SC (PertIV + TrasSC). Material and methods. The cost-minimization analysis was based on the results of a questionnaire addressed to leading oncology centers in Poland. The model was broken down into three categories of cost savings: reduced labor costs of nurses, pharmacists and non-drug related consumables, and from two categories of treatment time reduction: occupation of infusion chair and duration of hospital stay. Data on resources used and costs were collected in the first half of 2022. Results. Data were obtained from four oncology centers. The savings generated per patient from healthcare personnel’s work and from non-drug consumables for the Pert/TrasSC arm were 178 PLN compared to PertIV + TrasIV and 168 PLN compared to PertIV + TrasSC. Full adaptation of Pert/TrasSC was estimated to result in average 8-fold higher savings in healthcare personnel workload per patient and in a treatment capacity increase of 241 patients. Conclusions. Our model shows that Pert/TrasSC treatment is associated with significantly lower labor costs for nurses and pharmacists and lower costs of non-drug consumables compared to the other treatment options. Moreover, it reduced patients’ chair time due to shorter administration/observation time and released capacity in chemotherapy infusion sites.
{"title":"Non-drug related costs of treatment with pertuzumab and trastuzumab in HER2-positive breast cancer patients in Poland","authors":"Michał Seweryn, Tomasz Banaś, Joanna Augustyńska, Agnieszka Leszczyńska, Paweł M. Potocki","doi":"10.5603/ocp.97426","DOIUrl":"https://doi.org/10.5603/ocp.97426","url":null,"abstract":"Introduction. HER2-positive breast cancer represents 10–20% of all breast tumors. This study aimed to create a model-based cost-minimization analysis that compared non-drug related costs of different therapies used in the treatment of HER2-positive breast cancer in Poland: pertuzumab SC plus trastuzumab SC (Pert/TrasSC) vs. pertuzumab IV plus trastuzumab IV (PertIV + TrasIV) vs. pertuzumab IV plus trastuzumab SC (PertIV + TrasSC). Material and methods. The cost-minimization analysis was based on the results of a questionnaire addressed to leading oncology centers in Poland. The model was broken down into three categories of cost savings: reduced labor costs of nurses, pharmacists and non-drug related consumables, and from two categories of treatment time reduction: occupation of infusion chair and duration of hospital stay. Data on resources used and costs were collected in the first half of 2022. Results. Data were obtained from four oncology centers. The savings generated per patient from healthcare personnel’s work and from non-drug consumables for the Pert/TrasSC arm were 178 PLN compared to PertIV + TrasIV and 168 PLN compared to PertIV + TrasSC. Full adaptation of Pert/TrasSC was estimated to result in average 8-fold higher savings in healthcare personnel workload per patient and in a treatment capacity increase of 241 patients. Conclusions. Our model shows that Pert/TrasSC treatment is associated with significantly lower labor costs for nurses and pharmacists and lower costs of non-drug consumables compared to the other treatment options. Moreover, it reduced patients’ chair time due to shorter administration/observation time and released capacity in chemotherapy infusion sites.","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136359724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Commentary on Encorafenib plus cetuximab in patients with BRAFV600E-mutated metastatic colorectal cancer — Polish multicenter experience","authors":"Barbara Radecka","doi":"10.5603/ocp.97067","DOIUrl":"https://doi.org/10.5603/ocp.97067","url":null,"abstract":"","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136359440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marek Gełej, Patryk Zając, Maria Dąbrowska, Anna Dejws-Wątróbowska, Bogumiła Galińska, Łukasz Galus, Agnieszka Gwóźdź-Cieślik, Katarzyna Hetman, Maciej Kawecki, Mateusz Malik, Joanna Streb, Katarzyna Wierzbicka, Piotr Wiosek, Barbara Radecka
Introduction. The BRAF mutation occurs in 8–12% of patients with colorectal cancer. This is associated with unfavorable prognosis — in metastatic disease, median survival does not exceed one year. Molecularly targeted treatment — encorafenib with cetuximab — is the standard of care in cases of chemotherapy failure. Material and methods. Medical data of 18 patients treated with encorafenib and cetuximab in 2021–2023 in 10 oncology centers in Poland were assessed. We analyzed clinical, pathomorphological, and molecular factors, as well as the effectiveness and safety of treatment. Results. The median age in the group was 63 years. Patients with metastases limited to one location predominated (78%). Treatment with encorafenib and cetuximab was used not only in the third (in 50% of patients) or fourth (in 28%) lines of treatment but also in the second (in 22%). The objective response rate was 29.4%, and the disease control rate was 76.4%. Due to the short follow-up period, median progression-free survival was not reached. Four patients (22%) had a response lasting over 12 months. Conclusions. This study confirmed the efficacy and safety of targeted treatment with encorafenib and cetuximab in patients with metastatic colorectal cancer with the BRAF V600E mutation.
{"title":"Encorafenib plus cetuximab in patients with BRAFV600E-mutated metastatic colorectal cancer — Polish multicenter experience","authors":"Marek Gełej, Patryk Zając, Maria Dąbrowska, Anna Dejws-Wątróbowska, Bogumiła Galińska, Łukasz Galus, Agnieszka Gwóźdź-Cieślik, Katarzyna Hetman, Maciej Kawecki, Mateusz Malik, Joanna Streb, Katarzyna Wierzbicka, Piotr Wiosek, Barbara Radecka","doi":"10.5603/ocp.96898","DOIUrl":"https://doi.org/10.5603/ocp.96898","url":null,"abstract":"Introduction. The BRAF mutation occurs in 8–12% of patients with colorectal cancer. This is associated with unfavorable prognosis — in metastatic disease, median survival does not exceed one year. Molecularly targeted treatment — encorafenib with cetuximab — is the standard of care in cases of chemotherapy failure. Material and methods. Medical data of 18 patients treated with encorafenib and cetuximab in 2021–2023 in 10 oncology centers in Poland were assessed. We analyzed clinical, pathomorphological, and molecular factors, as well as the effectiveness and safety of treatment. Results. The median age in the group was 63 years. Patients with metastases limited to one location predominated (78%). Treatment with encorafenib and cetuximab was used not only in the third (in 50% of patients) or fourth (in 28%) lines of treatment but also in the second (in 22%). The objective response rate was 29.4%, and the disease control rate was 76.4%. Due to the short follow-up period, median progression-free survival was not reached. Four patients (22%) had a response lasting over 12 months. Conclusions. This study confirmed the efficacy and safety of targeted treatment with encorafenib and cetuximab in patients with metastatic colorectal cancer with the BRAF V600E mutation.","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136359439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
KRAS regulates several cellular processes, such as cell proliferation, cell cycle regulation, metabolic changes, cell survival, and cell differentiation. Abnormalities in the KRAS gene are found in approximately 30% of patients with non-small cell lung cancer, usually in patients diagnosed with nonsquamous cancer and more often in Caucasian patients, women, and smokers. The p.G12C variant is most frequently found in KRAS-positive patients. Sotorasib is the first drug approved for this population. The superiority of sotorasib over docetaxel after failure of immunochemotherapy was demonstrated in the CodeBreak 200 phase III study for the primary endpoint — median progression-free survival was 5.6 months [95% confidence interval (CI) 4.3–7.8] vs . 4.5 months (3.0–5.7); hazard ratio = 0.66 (95% CI 0.51–0.86; p = 0–0017), while the 12-month progression-free survival rate was 24.8% for sotorasib and 10.1% for docetaxel. Currently, sotorasib monotherapy, at an initial dose of 960 mg/day, is indicated for use in adults with advanced non-small cell lung cancer with the KRAS p.G12C mutation who have experienced disease progression after at least one previous line of systemic treatment. More randomized trials are needed to determine the optimal place of sotorasib in the systemic treatment sequence in this patient population.
{"title":"Sotorasib for non-small cell lung cancer — current options and perspectives","authors":"Magdalena Knetki-Wróblewska, Bartosz Wasąg","doi":"10.5603/ocp.97414","DOIUrl":"https://doi.org/10.5603/ocp.97414","url":null,"abstract":"KRAS regulates several cellular processes, such as cell proliferation, cell cycle regulation, metabolic changes, cell survival, and cell differentiation. Abnormalities in the KRAS gene are found in approximately 30% of patients with non-small cell lung cancer, usually in patients diagnosed with nonsquamous cancer and more often in Caucasian patients, women, and smokers. The p.G12C variant is most frequently found in KRAS-positive patients. Sotorasib is the first drug approved for this population. The superiority of sotorasib over docetaxel after failure of immunochemotherapy was demonstrated in the CodeBreak 200 phase III study for the primary endpoint — median progression-free survival was 5.6 months [95% confidence interval (CI) 4.3–7.8] vs . 4.5 months (3.0–5.7); hazard ratio = 0.66 (95% CI 0.51–0.86; p = 0–0017), while the 12-month progression-free survival rate was 24.8% for sotorasib and 10.1% for docetaxel. Currently, sotorasib monotherapy, at an initial dose of 960 mg/day, is indicated for use in adults with advanced non-small cell lung cancer with the KRAS p.G12C mutation who have experienced disease progression after at least one previous line of systemic treatment. More randomized trials are needed to determine the optimal place of sotorasib in the systemic treatment sequence in this patient population.","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135835280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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