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":"24 1","pages":"0"},"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":"1 1","pages":"0"},"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":"61 1","pages":"0"},"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":"52 1","pages":"0"},"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":"42 1","pages":"0"},"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}
Teodoro J. Oscanoa, Edwin Cieza-Macedo, Xavier Vidal, Roman Romero-Ortuno
Introduction. The need for comprehensive geriatric assessment (CGA) in older adults with cancer is increasing, which makes it necessary to have a screening instrument to identify those who would benefit from this evaluation. This study aimed to investigate diagnostic performance of the Timed Up and Go test (TUG) for identifying vulnerable or frail older adults with cancer who might benefit from CGA. Material and methods. This observational and retrospective study took place at the geriatric center of Almenara Hospital in Lima, Peru. We extracted CGA reports from electronic medical records of outpatients and inpatients aged 60 years and older with cancer, who were evaluated between November 2022 and July 2023. Patients were classified based on SIOG-2 (International Society of Geriatric Oncology) criteria as fit, vulnerable, or frail, based on scales including Activities of Daily Living (ADL), Instrumental ADL, Mini-Nutritional Assessment (MNA), Mini-Mental State Exam (MMSE), Geriatric Depression Scale, and Cumulative Illness Rating Scale-Geriatrics (CIRS-G). For the study, two groups were formed: fit patients and non-fit patients (vulnerable plus frail). We estimated sensitivity, specificity, and positive predictive values of the TUG test. The accuracy of the TUG test was analyzed using the area under the receiver operating characteristic curve (AUC). Results. Among the 283 included patients, 154 were men (54.4%) and 129 women (45.6%), and the mean age was 76.8 ± 15.8 years. The most common neoplasms were colorectal (19.4%), stomach (15.2%), prostate (9.9%), and bile duct cancers (8.1%). The percentage of fit and non-fit patients was 21.9% and 78.1%, respectively. When the TUG test was equal to or greater than 15.5 seconds, sensitivity, specificity, positive predictive value, and AUC were 68.5% (95% CI 61.9–74.5), 88.5% (77.8–95.3), 95.6% (91.1–98.2), and 84.8% (0.80–0.90), respectively. Conclusions. A TUG test result equal to or greater than 15.5 seconds demonstrated good screening properties for identifying older cancer patients who were vulnerable or frail and could benefit from CGA.
介绍。对患有癌症的老年人进行综合老年评估(CGA)的需求正在增加，这使得有必要有一种筛查工具来确定那些将从这种评估中受益的人。本研究旨在探讨time Up and Go测试(TUG)的诊断性能，以识别可能受益于CGA的脆弱或虚弱的老年癌症患者。材料和方法。这项观察性和回顾性研究在秘鲁利马Almenara医院的老年中心进行。我们从2022年11月至2023年7月期间评估的60岁及以上癌症门诊和住院患者的电子病历中提取了CGA报告。根据SIOG-2(国际老年肿瘤学会)标准，根据日常生活活动(ADL)、工具ADL、迷你营养评估(MNA)、迷你精神状态检查(MMSE)、老年抑郁量表和累积疾病评定量表-老年病学(CIRS-G)等量表，将患者分为健康、易受伤害或虚弱。在这项研究中，分为两组:健康患者和非健康患者(脆弱加虚弱)。我们估计了TUG试验的敏感性、特异性和阳性预测值。利用接收机工作特性曲线下面积(AUC)对TUG试验的精度进行了分析。结果。283例患者中，男性154例(54.4%)，女性129例(45.6%)，平均年龄76.8±15.8岁。最常见的肿瘤是结直肠癌(19.4%)、胃癌(15.2%)、前列腺癌(9.9%)和胆管癌(8.1%)。适合和不适合患者的比例分别为21.9%和78.1%。当TUG试验≥15.5秒时，灵敏度、特异度、阳性预测值和AUC分别为68.5% (95% CI 61.9 ~ 74.5)、88.5% (95% CI 77.8 ~ 95.3)、95.6% (95% CI 91.1 ~ 98.2)和84.8%(0.80 ~ 0.90)。结论。TUG测试结果等于或大于15.5秒，显示出良好的筛选特性，可以识别易受伤害或虚弱的老年癌症患者，并可能从CGA中受益。
{"title":"Evaluation of the Timed Up and Go test for screening vulnerability and frailty in older cancer patients","authors":"Teodoro J. Oscanoa, Edwin Cieza-Macedo, Xavier Vidal, Roman Romero-Ortuno","doi":"10.5603/ocp.96855","DOIUrl":"https://doi.org/10.5603/ocp.96855","url":null,"abstract":"Introduction. The need for comprehensive geriatric assessment (CGA) in older adults with cancer is increasing, which makes it necessary to have a screening instrument to identify those who would benefit from this evaluation. This study aimed to investigate diagnostic performance of the Timed Up and Go test (TUG) for identifying vulnerable or frail older adults with cancer who might benefit from CGA. Material and methods. This observational and retrospective study took place at the geriatric center of Almenara Hospital in Lima, Peru. We extracted CGA reports from electronic medical records of outpatients and inpatients aged 60 years and older with cancer, who were evaluated between November 2022 and July 2023. Patients were classified based on SIOG-2 (International Society of Geriatric Oncology) criteria as fit, vulnerable, or frail, based on scales including Activities of Daily Living (ADL), Instrumental ADL, Mini-Nutritional Assessment (MNA), Mini-Mental State Exam (MMSE), Geriatric Depression Scale, and Cumulative Illness Rating Scale-Geriatrics (CIRS-G). For the study, two groups were formed: fit patients and non-fit patients (vulnerable plus frail). We estimated sensitivity, specificity, and positive predictive values of the TUG test. The accuracy of the TUG test was analyzed using the area under the receiver operating characteristic curve (AUC). Results. Among the 283 included patients, 154 were men (54.4%) and 129 women (45.6%), and the mean age was 76.8 ± 15.8 years. The most common neoplasms were colorectal (19.4%), stomach (15.2%), prostate (9.9%), and bile duct cancers (8.1%). The percentage of fit and non-fit patients was 21.9% and 78.1%, respectively. When the TUG test was equal to or greater than 15.5 seconds, sensitivity, specificity, positive predictive value, and AUC were 68.5% (95% CI 61.9–74.5), 88.5% (77.8–95.3), 95.6% (91.1–98.2), and 84.8% (0.80–0.90), respectively. Conclusions. A TUG test result equal to or greater than 15.5 seconds demonstrated good screening properties for identifying older cancer patients who were vulnerable or frail and could benefit from CGA.","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135199941","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}
Advanced squamous-cell lung carcinoma remains a disease with an unfavorable prognosis. Until recently, chemotherapy was used in systemic treatment, and its effectiveness was limited. Implementation of immune check-point inhibitors allowed for an improvement in treatment results. The KEYNOTE-407 study included patients with squamous-cell lung cancer who received 4 immunochemotherapy cycles followed by maintenance treatment with pembrolizumab. Median overall survival of 17.2 months versus 11.6 months for chemotherapy was obtained (risk of death reduction by 29%) while the percentage of patients remaining in follow-up was 18%. Analysis of patients with good performance status treated in clinical practice confirms the results from the registration study and emphasizes the importance of taking into consideration clinical factors while qualifying patients for treatment.
{"title":"Pembrolizumab in combination with chemotherapy in patients with advanced squamous cell lung cancer — clinical trials and real-world data","authors":"Magdalena Knetki-Wróblewska, Dariusz M. Kowalski","doi":"10.5603/ocp.2023.0047","DOIUrl":"https://doi.org/10.5603/ocp.2023.0047","url":null,"abstract":"Advanced squamous-cell lung carcinoma remains a disease with an unfavorable prognosis. Until recently, chemotherapy was used in systemic treatment, and its effectiveness was limited. Implementation of immune check-point inhibitors allowed for an improvement in treatment results. The KEYNOTE-407 study included patients with squamous-cell lung cancer who received 4 immunochemotherapy cycles followed by maintenance treatment with pembrolizumab. Median overall survival of 17.2 months versus 11.6 months for chemotherapy was obtained (risk of death reduction by 29%) while the percentage of patients remaining in follow-up was 18%. Analysis of patients with good performance status treated in clinical practice confirms the results from the registration study and emphasizes the importance of taking into consideration clinical factors while qualifying patients for treatment.","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136099459","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}
Heba Mohamed El-Zawahry, Ayman Abd Al-Samie Gaber, Amany Abd-Elhameed Abou-Bakr, Marwa Nabil Abd-Elhafez, Ahmed Mohamed El-Debawy
Introduction. This study aims to investigate the efficacy and tolerability of the vinorelbine-based combination chemotherapy with either cisplatin or capecitabine in metastatic triple-negative breast cancer (mTNBC) pretreated with anthracycline and taxane. Material and methods. This is an open-labeled randomized prospective single-institute study, that included all patients who received chemotherapy for mTNBC in the period between 1st of July 2016 and 30th of June 2017 and were pretreated with anthracycline and taxane. Patients were randomized to either vinorelbine 25 mg/m2 I.V on days 1 and 8 plus oral capecitabine 1000 mg/m2 twice daily, on days 1–14 (NX); or vinorelbine 25 mg/m2 I.V on days 1 and 8 plus cisplatin 75 mg/m2 (NP), every 21 days. The primary endpoint was time to progression (TTP), whereas the secondary endpoints were objective response rate (ORR), safety, and overall survival (OS). Results. Median TTP was 9.9 months with NP vs. 8 months with NX, (p = 0.22). ORR was 40% with NP vs . 36% with NX, (p = 0.77). Median OS was 13 months with NP vs . 13.2 months with NX (p = 0.599). Both regimens demonstrated similar rates of grade ≥ 3 vomiting and neutropenia. A higher incidence of thrombocytopenia, tinnitus, and kidney function alteration were reported with NP. A higher incidence of anorexia, diarrhea, mucositis, and hand-foot syndrome were reported with NX. Conclusions. Vinorelbine-based combination chemotherapy regimens with either cisplatin or capecitabine are active in the treatment of mTNBC pretreated with anthracycline and taxane with manageable toxicity profiles. Both regimens have comparable TTP, ORR, OS, and safety profiles.
{"title":"Vinorelbine plus platinum compared to vinorelbine plus capecitabine in treatment of patients with metastatic triple negative breast cancer previously treated with anthracycline and taxane: a prospective randomized study","authors":"Heba Mohamed El-Zawahry, Ayman Abd Al-Samie Gaber, Amany Abd-Elhameed Abou-Bakr, Marwa Nabil Abd-Elhafez, Ahmed Mohamed El-Debawy","doi":"10.5603/ocp.96278","DOIUrl":"https://doi.org/10.5603/ocp.96278","url":null,"abstract":"Introduction. This study aims to investigate the efficacy and tolerability of the vinorelbine-based combination chemotherapy with either cisplatin or capecitabine in metastatic triple-negative breast cancer (mTNBC) pretreated with anthracycline and taxane. Material and methods. This is an open-labeled randomized prospective single-institute study, that included all patients who received chemotherapy for mTNBC in the period between 1st of July 2016 and 30th of June 2017 and were pretreated with anthracycline and taxane. Patients were randomized to either vinorelbine 25 mg/m2 I.V on days 1 and 8 plus oral capecitabine 1000 mg/m2 twice daily, on days 1–14 (NX); or vinorelbine 25 mg/m2 I.V on days 1 and 8 plus cisplatin 75 mg/m2 (NP), every 21 days. The primary endpoint was time to progression (TTP), whereas the secondary endpoints were objective response rate (ORR), safety, and overall survival (OS). Results. Median TTP was 9.9 months with NP vs. 8 months with NX, (p = 0.22). ORR was 40% with NP vs . 36% with NX, (p = 0.77). Median OS was 13 months with NP vs . 13.2 months with NX (p = 0.599). Both regimens demonstrated similar rates of grade ≥ 3 vomiting and neutropenia. A higher incidence of thrombocytopenia, tinnitus, and kidney function alteration were reported with NP. A higher incidence of anorexia, diarrhea, mucositis, and hand-foot syndrome were reported with NX. Conclusions. Vinorelbine-based combination chemotherapy regimens with either cisplatin or capecitabine are active in the treatment of mTNBC pretreated with anthracycline and taxane with manageable toxicity profiles. Both regimens have comparable TTP, ORR, OS, and safety profiles.","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":"226 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135256800","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}
Imbalances of serum potassium levels are common complications in patients receiving systemic antineoplastic therapy. These conditions can provoke further complications such as cardiac arrhythmia and paralysis due to the significant role of potassium in muscle physiology. Many cytotoxic drugs and novel targeted therapy agents have been found to induce hypokalemia and occasionally hyperkalemia. Therefore, they should be administered carefully and a broad understanding of the topic is necessary for medical oncologists. To this end, the present narrative review explores the pathophysiology of potassium disorders induced by systemic therapy and points out some therapeutic strategies for reversing them.
{"title":"Potassium imbalances induced by systemic cancer therapy: pathophysiology and potential therapeutic strategies","authors":"Datis Kalali","doi":"10.5603/ocp.96314","DOIUrl":"https://doi.org/10.5603/ocp.96314","url":null,"abstract":"Imbalances of serum potassium levels are common complications in patients receiving systemic antineoplastic therapy. These conditions can provoke further complications such as cardiac arrhythmia and paralysis due to the significant role of potassium in muscle physiology. Many cytotoxic drugs and novel targeted therapy agents have been found to induce hypokalemia and occasionally hyperkalemia. Therefore, they should be administered carefully and a broad understanding of the topic is necessary for medical oncologists. To this end, the present narrative review explores the pathophysiology of potassium disorders induced by systemic therapy and points out some therapeutic strategies for reversing them.","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":"89 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135256799","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}
Maria Rozpłoch-Sapa, Patrycja Mrowczyk, Łukasz Kwinta, Mateusz Łobacz, Paweł M. Potocki
Introduction. Ovarian cancer (OC) is the leading cause of cancer death worldwide. In Poland, it is the fourth leading cause of death from neoplasms in women. OC is a heterogeneous disease with low-grade cases characterized by a better prognosis, but poor chemosensitivity. Metronomic chemotherapy (MC) may be a beneficial approach. Case presentation. We present a patient with low-grade serous ovarian cancer (LGSOC) with long-term disease control achieved with MC despite being resistant to standard-dose chemotherapy with paclitaxel and carboplatin. Overall survival (OS) of the patient was 65 months. MC was administered most of the time. The patient was treated with two metronomic regimens: topotecan plus cyclophosphamide and vinorelbine plus methotrexate, both in combination with hormone therapy. The cancer was found to harbor the BRAF V600E mutation (v-raf murine sarcoma viral oncogene homolog B1, a valine-to-glutamic acid substitution at position 600), but that did not impact the treatment. Conclusions. LGSOC has distinct features from high-grade serous ovarian cancer (HGSOC). MC may be a valuable option in LGSOC despite being understudied. The BRAF V600E mutation occurs in 2–33% of low-grade serous ovarian tumors. It is a more common finding in LGSOC than in HGSOC. BRAF inhibition in OC may be a new therapeutic option. Some BRAF inhibitors have already been registered for solid tumors with this mutation.
{"title":"Low-grade serous ovarian cancer with BRAFV600E mutation treated with metronomic chemotherapy — a case report and literature review","authors":"Maria Rozpłoch-Sapa, Patrycja Mrowczyk, Łukasz Kwinta, Mateusz Łobacz, Paweł M. Potocki","doi":"10.5603/ocp.96964","DOIUrl":"https://doi.org/10.5603/ocp.96964","url":null,"abstract":"Introduction. Ovarian cancer (OC) is the leading cause of cancer death worldwide. In Poland, it is the fourth leading cause of death from neoplasms in women. OC is a heterogeneous disease with low-grade cases characterized by a better prognosis, but poor chemosensitivity. Metronomic chemotherapy (MC) may be a beneficial approach. Case presentation. We present a patient with low-grade serous ovarian cancer (LGSOC) with long-term disease control achieved with MC despite being resistant to standard-dose chemotherapy with paclitaxel and carboplatin. Overall survival (OS) of the patient was 65 months. MC was administered most of the time. The patient was treated with two metronomic regimens: topotecan plus cyclophosphamide and vinorelbine plus methotrexate, both in combination with hormone therapy. The cancer was found to harbor the BRAF V600E mutation (v-raf murine sarcoma viral oncogene homolog B1, a valine-to-glutamic acid substitution at position 600), but that did not impact the treatment. Conclusions. LGSOC has distinct features from high-grade serous ovarian cancer (HGSOC). MC may be a valuable option in LGSOC despite being understudied. The BRAF V600E mutation occurs in 2–33% of low-grade serous ovarian tumors. It is a more common finding in LGSOC than in HGSOC. BRAF inhibition in OC may be a new therapeutic option. Some BRAF inhibitors have already been registered for solid tumors with this mutation.","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136363712","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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