N. Janmunee, A. Tangkananan, P. Thongkhao, J. Hanprasertpong
{"title":"Late recurrence of locally advanced cervical cancer treated with concurrent chemoradiotherapy","authors":"N. Janmunee, A. Tangkananan, P. Thongkhao, J. Hanprasertpong","doi":"10.5603/ocp.2022.0039","DOIUrl":"https://doi.org/10.5603/ocp.2022.0039","url":null,"abstract":"","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2022-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75961874","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}
Pancreatic cancer is one of common malignant neoplasms. It is characterised by poor prognosis and high mortality, which is mainly due to detection in advanced stage. The review presents the epidemiological and clinical characteristics of pancreatic cancer as well as current strategies of systemic treatment of advanced disease, including firstand second-line chemotherapy as well as molecularly targeted therapies and immunotherapy.
{"title":"Advanced pancreatic cancer: diagnosis and systemic treatment evolution over the last decades","authors":"Ireneusz Raczyński, J. Didkowska, B. Radecka","doi":"10.5603/ocp.2022.0030","DOIUrl":"https://doi.org/10.5603/ocp.2022.0030","url":null,"abstract":"Pancreatic cancer is one of common malignant neoplasms. It is characterised by poor prognosis and high mortality, which is mainly due to detection in advanced stage. The review presents the epidemiological and clinical characteristics of pancreatic cancer as well as current strategies of systemic treatment of advanced disease, including firstand second-line chemotherapy as well as molecularly targeted therapies and immunotherapy.","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73562355","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}
B. Radecka, Justyna Czech, Agnieszka Siedlaczek, M. Maczkiewicz, A. Jagiełło-Gruszfeld, R. Duchnowska
{"title":"Chemotherapy compliance in elderly patients with solid tumors: a real-world clinical practice data","authors":"B. Radecka, Justyna Czech, Agnieszka Siedlaczek, M. Maczkiewicz, A. Jagiełło-Gruszfeld, R. Duchnowska","doi":"10.5603/ocp.2022.0009","DOIUrl":"https://doi.org/10.5603/ocp.2022.0009","url":null,"abstract":"","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2022-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77175284","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}
M. Mansoorian, Seyyed Amir Yasin Ahmadi, Shahriar Sabouri
{"title":"IgG4-related disease presenting with cholangitis mimicking cholangiocarcinoma: a case report with a literature review","authors":"M. Mansoorian, Seyyed Amir Yasin Ahmadi, Shahriar Sabouri","doi":"10.5603/ocp.2022.0038","DOIUrl":"https://doi.org/10.5603/ocp.2022.0038","url":null,"abstract":"","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2022-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82757215","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}
J. Agboola, O. Ayosanmi, Oluwatobi Mogbojuri, Maureen P. Bezold
Objectives. The study aims to reveal the trend of mammogram uptake in seventeen rural counties in Illinois to understand how the COVID-19 pandemic influenced breast cancer screening in the area. Material and methods. Aggregated data on mammography screening for West Central Illinois was provided by the Illinois Hospital Association. Data for 2018 and 2019 was used to determine the typical monthly and an- nual screenings for the two years before the onset of COVID-19. Then, the two years' data was compared to the 2020 data. The monthly mean values for the aggregated 2018 and 2019 data were generated as the base "year" to compare with the monthly value for 2020. Paired t-test analysis was used to find if there were any statistically significant differences between the years and between the base year and 2020. Results. January 2020 revealed an uptick to 2921, which is more than the uptake for January 2018 (2700) and January 2019 (2488), and 13% greater than the mean value of 2594 for the previous two years. This was followed by a gradual decrease in uptake in February 2020 by 4% compared to previous years at a mean of 2518 and a further decline in March (44%), with a drastic fall (98%) by April 2020 at 56 screening mammograms in all 17 counties. The lowest uptake in any three months occurred from March through May 2020. Compared to previous years, an increase in uptake was noted across the region in 2020 June (8%) and July (4%) after the pandemic restrictions were relaxed. Overall, the total uptake in 2020 was 15% less than the average annual uptake for 2018-2019 with a deficit of 5537. There was no statistically significant difference in mammogram uptake across the three years. Conclusions. The findings reveal that there was a significant reduction in uptake during the pandemic restriction period. However, increased uptake during the rest of the year effectively mitigated this reduction to such an extent that there was no statistically significant downturn compared to each of the previous two years. A rising trend in total annual uptake noted in preceding years could have continued without the COVID-19 event.
{"title":"Uptake of screening mammogram in West Central Illinois during the COVID-19 pandemic: lessons learned","authors":"J. Agboola, O. Ayosanmi, Oluwatobi Mogbojuri, Maureen P. Bezold","doi":"10.5603/ocp.2022.0024","DOIUrl":"https://doi.org/10.5603/ocp.2022.0024","url":null,"abstract":"Objectives. The study aims to reveal the trend of mammogram uptake in seventeen rural counties in Illinois to understand how the COVID-19 pandemic influenced breast cancer screening in the area. Material and methods. Aggregated data on mammography screening for West Central Illinois was provided by the Illinois Hospital Association. Data for 2018 and 2019 was used to determine the typical monthly and an- nual screenings for the two years before the onset of COVID-19. Then, the two years' data was compared to the 2020 data. The monthly mean values for the aggregated 2018 and 2019 data were generated as the base \"year\" to compare with the monthly value for 2020. Paired t-test analysis was used to find if there were any statistically significant differences between the years and between the base year and 2020. Results. January 2020 revealed an uptick to 2921, which is more than the uptake for January 2018 (2700) and January 2019 (2488), and 13% greater than the mean value of 2594 for the previous two years. This was followed by a gradual decrease in uptake in February 2020 by 4% compared to previous years at a mean of 2518 and a further decline in March (44%), with a drastic fall (98%) by April 2020 at 56 screening mammograms in all 17 counties. The lowest uptake in any three months occurred from March through May 2020. Compared to previous years, an increase in uptake was noted across the region in 2020 June (8%) and July (4%) after the pandemic restrictions were relaxed. Overall, the total uptake in 2020 was 15% less than the average annual uptake for 2018-2019 with a deficit of 5537. There was no statistically significant difference in mammogram uptake across the three years. Conclusions. The findings reveal that there was a significant reduction in uptake during the pandemic restriction period. However, increased uptake during the rest of the year effectively mitigated this reduction to such an extent that there was no statistically significant downturn compared to each of the previous two years. A rising trend in total annual uptake noted in preceding years could have continued without the COVID-19 event.","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88756460","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}
Bladder carcinoma in situ (CIS) is a potentially invasive tumor whose early detection is a key step to ensuring the preservation of the bladder, reducing mortality, and improving the quality of patients’ life. The early diagnosis of bladder cancer requires a sensitive technique that can detect the lesion to determine its stage and grade. ALA induced-PpIX makes it possible to detect tumors with 90% sensitivity. ALA hexyl ester (hALA) increases the sensitivity to 95%. Macroscopic techniques require a histological biopsy to define the tumor invasiveness. Imaging with Fibered Optic Confocal Fluorescence Microscopy allows the optical sectioning of examined tissues providing images with subcellular resolution after labeling with adequate fluorescent dye chosen based on the sensitivity of the used device. Available fluorescent agents are compatible with used devices; however, their toxicity and mutagenesis studies are unsatisfactory. During imaging, an optical fiber is introduced into the bladder via the urethra and placed in contact with the bladder wall. The distinction between the different types of epithelial cells is based on the cell size, morphology, and signal intensity. Although not fully adopted for clinical application, the FOCM represents a real asset that reduces invasiveness and complements the fluorescence-based endoscopy.
{"title":"Superficial bladder cancer diagnosis — the deliberate choice between fluorescent diagnosis and optical biopsy","authors":"Sami El Khatib","doi":"10.5603/ocp.2022.0027","DOIUrl":"https://doi.org/10.5603/ocp.2022.0027","url":null,"abstract":"Bladder carcinoma in situ (CIS) is a potentially invasive tumor whose early detection is a key step to ensuring the preservation of the bladder, reducing mortality, and improving the quality of patients’ life. The early diagnosis of bladder cancer requires a sensitive technique that can detect the lesion to determine its stage and grade. ALA induced-PpIX makes it possible to detect tumors with 90% sensitivity. ALA hexyl ester (hALA) increases the sensitivity to 95%. Macroscopic techniques require a histological biopsy to define the tumor invasiveness. Imaging with Fibered Optic Confocal Fluorescence Microscopy allows the optical sectioning of examined tissues providing images with subcellular resolution after labeling with adequate fluorescent dye chosen based on the sensitivity of the used device. Available fluorescent agents are compatible with used devices; however, their toxicity and mutagenesis studies are unsatisfactory. During imaging, an optical fiber is introduced into the bladder via the urethra and placed in contact with the bladder wall. The distinction between the different types of epithelial cells is based on the cell size, morphology, and signal intensity. Although not fully adopted for clinical application, the FOCM represents a real asset that reduces invasiveness and complements the fluorescence-based endoscopy.","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86768878","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}
Łukasz Dudziński, Marcin Glinka, M. Panczyk, M. Kryska, T. Kubiak
Introduction. Functioning of the medical rescue team one year before the pandemic was compared to the two years of the pandemic outbreak in relation to specific intervention groups. Our observation focused on patients with oncological diseases.Material and methods. The analysis was carried out in a county (powiat) in the Lubelskie Voivodeship (Province). The study included a 3-year retrospective analysis from March 2019 to the end of February 2022. The material consisted of departure order flow sheets and ambulance flow sheet records.Results. In the 3-year period, 560 events met the criteria for inclusion in the analysis: 195 (period I), 165 (period II), and 200 (period III). By eliminating interventions that were repeated calls to the same patient, the population under study consisted of 510 people: 215 men and 295 women.Conclusions. The COVID-19 pandemic did not have a significant impact on the number of MRT interventions among cancer patients, nor on the mean intervention time in patients diagnosed with ICD-10 CXX and DXX. EMSs participate in oncological calls only for symptomatic treatment (pain, dyspnea, diarrhea) and cannot stop or cure initial medical conditions.
{"title":"Epidemiology of neoplasms in the practice of Medical Rescue Teams in the northern part of the Lubelskie Voivodeship during the SARS-CoV-2-pandemic — a three-year observation","authors":"Łukasz Dudziński, Marcin Glinka, M. Panczyk, M. Kryska, T. Kubiak","doi":"10.5603/ocp.2022.0025","DOIUrl":"https://doi.org/10.5603/ocp.2022.0025","url":null,"abstract":"Introduction. Functioning of the medical rescue team one year before the pandemic was compared to the two years of the pandemic outbreak in relation to specific intervention groups. Our observation focused on patients with oncological diseases.Material and methods. The analysis was carried out in a county (powiat) in the Lubelskie Voivodeship (Province). The study included a 3-year retrospective analysis from March 2019 to the end of February 2022. The material consisted of departure order flow sheets and ambulance flow sheet records.Results. In the 3-year period, 560 events met the criteria for inclusion in the analysis: 195 (period I), 165 (period II), and 200 (period III). By eliminating interventions that were repeated calls to the same patient, the population under study consisted of 510 people: 215 men and 295 women.Conclusions. The COVID-19 pandemic did not have a significant impact on the number of MRT interventions among cancer patients, nor on the mean intervention time in patients diagnosed with ICD-10 CXX and DXX. EMSs participate in oncological calls only for symptomatic treatment (pain, dyspnea, diarrhea) and cannot stop or cure initial medical conditions.","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88445136","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}
Introduction. This study conducted among medical students from different countries aimed to compare their knowledge of palliative care, euthanasia, and assisted suicide, their attitudes toward euthanasia practice, law, and its legalization, as well as motives behind their ethical choices. Material and methods. The 18-item questionnaire survey was conducted among medical students. Question-naires were voluntary and anonymous and they were completed within 30 minutes after completion of obligatory 30-hour palliative medicine courses. During theoretical seminars and practical classes, students were provided with basic knowledge on symptom management, and psychological, social, and spiritual support. An ethical approach was presented, in which both euthanasia and assisted suicide were not acceptable. Results. A total of 659 students participated. There were 486 (73.75%) students from Poland and 173 (26.25%) foreign students from Taiwan 54 (8.19%), USA 48 (7.28%), Norway 32 (4.86%), Canada 27 (4.10%), Germany 5 (0.76%), Great Britain 4 (0.61%), and Sweden 3 (0.45%). Students from Poland and other countries did not differ in terms of knowledge of palliative care, but differences emerged regarding knowledge of euthanasia and assisted suicide. Respondents from different countries differed in their responses to all questions regarding legal aspects and euthanasia. The only exception was assisted suicide where no difference was found. Conclusions. A significant percentage of students were unable to provide definitions of palliative care, euthanasia, or assisted suicide. The results suggest differences in the attitudes toward euthanasia between students originating from different continents. Culture, religious affiliation, and gender might be factors influencing these results.
{"title":"Attitudes toward euthanasia among medical students from different countries","authors":"Maria Forycka, W. Leppert, M. Majkowicz","doi":"10.5603/ocp.2022.0031","DOIUrl":"https://doi.org/10.5603/ocp.2022.0031","url":null,"abstract":"Introduction. This study conducted among medical students from different countries aimed to compare their knowledge of palliative care, euthanasia, and assisted suicide, their attitudes toward euthanasia practice, law, and its legalization, as well as motives behind their ethical choices. Material and methods. The 18-item questionnaire survey was conducted among medical students. Question-naires were voluntary and anonymous and they were completed within 30 minutes after completion of obligatory 30-hour palliative medicine courses. During theoretical seminars and practical classes, students were provided with basic knowledge on symptom management, and psychological, social, and spiritual support. An ethical approach was presented, in which both euthanasia and assisted suicide were not acceptable. Results. A total of 659 students participated. There were 486 (73.75%) students from Poland and 173 (26.25%) foreign students from Taiwan 54 (8.19%), USA 48 (7.28%), Norway 32 (4.86%), Canada 27 (4.10%), Germany 5 (0.76%), Great Britain 4 (0.61%), and Sweden 3 (0.45%). Students from Poland and other countries did not differ in terms of knowledge of palliative care, but differences emerged regarding knowledge of euthanasia and assisted suicide. Respondents from different countries differed in their responses to all questions regarding legal aspects and euthanasia. The only exception was assisted suicide where no difference was found. Conclusions. A significant percentage of students were unable to provide definitions of palliative care, euthanasia, or assisted suicide. The results suggest differences in the attitudes toward euthanasia between students originating from different continents. Culture, religious affiliation, and gender might be factors influencing these results.","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2022-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88525509","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}
K. Pogoda, A. Jagiełło-Gruszfeld, A. Niwińska, Z. Nowecki
Treatment outcomes in patients with metastatic triple-negative breast cancer (TNBC) have not improved significantly for many years. Modern treatments, including immune therapy and poly ADP-ribose polymerase (PARP) inhibitors, are available for a select group of TNBC patients. In many cases, classic chemotherapy remains the treatment of choice, which produces unsatisfactory response rates. The poor prognosis of patients with metastatic TNBC justifies intensive research on new drugs for this group of patients, including attempts to use conjugates. This article discusses the reports on sacituzumab govitecan (SG), which is composed of a monoclonal antibody targeting trophoblast-cell surface antigen 2 (Trop-2) expressed on many TNBC cells and linked to a payload (SN-38), the active metabolite of irinotecan. The structure and mechanism of action of this conjugate are presented. The available results of clinical trials with SG in breast cancer patients are summarized, including the results of the ASCENT registration study, which showed a significant improvement in the median progression-free survival, as well as overall survival, compared to classic chemotherapy in patients previously treated with advanced TNBC. The most common side effects of the drug are discussed, indicating principles of primary and secondary prophy - laxis that allow for effective management of possible complications. Directions for further research in breast cancer patients on this very promising conjugate were also indicated.
{"title":"Sacituzumab govitecan — a new therapy for patients with triple-negative breast cancer","authors":"K. Pogoda, A. Jagiełło-Gruszfeld, A. Niwińska, Z. Nowecki","doi":"10.5603/ocp.2022.0003","DOIUrl":"https://doi.org/10.5603/ocp.2022.0003","url":null,"abstract":"Treatment outcomes in patients with metastatic triple-negative breast cancer (TNBC) have not improved significantly for many years. Modern treatments, including immune therapy and poly ADP-ribose polymerase (PARP) inhibitors, are available for a select group of TNBC patients. In many cases, classic chemotherapy remains the treatment of choice, which produces unsatisfactory response rates. The poor prognosis of patients with metastatic TNBC justifies intensive research on new drugs for this group of patients, including attempts to use conjugates. This article discusses the reports on sacituzumab govitecan (SG), which is composed of a monoclonal antibody targeting trophoblast-cell surface antigen 2 (Trop-2) expressed on many TNBC cells and linked to a payload (SN-38), the active metabolite of irinotecan. The structure and mechanism of action of this conjugate are presented. The available results of clinical trials with SG in breast cancer patients are summarized, including the results of the ASCENT registration study, which showed a significant improvement in the median progression-free survival, as well as overall survival, compared to classic chemotherapy in patients previously treated with advanced TNBC. The most common side effects of the drug are discussed, indicating principles of primary and secondary prophy - laxis that allow for effective management of possible complications. Directions for further research in breast cancer patients on this very promising conjugate were also indicated.","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74594445","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}
Polychemotherapy combined with trastuzumab (T) or trastuzumab with pertuzumab (TP) is a standard preoperative systemic treatment in patients with HER2-positive breast cancer. In Poland T is reimbursed according to the Drug Prescription Program of Ministry of Health (MoH) for patients with primary breast tumors bigger than 1cm independently from nodal status, whereas TP is reimbursed for patients with tumors bigger than 2 cm with positive lymph node(s) or lack of hormonal receptors expression. The Drug Prescription Program does not indicate which polychemotherapy should be combined with anti-HER2 therapy. Therefore, one can choose between classical sequential treatment based on anthracycline and taxane combined with T or dual HER2 blockade (usually 4 × AC → 12 × paclitaxel/4 × docetaxel + T/TP), or docetaxel with carboplatin combined with trastuzumab (TCH) or with dual HER2 blockade (TCHP). According to the present guidelines of the National Comprehensive Cancer Network (NCCN), polychemotherapy without anthracycline is preferred, which is justified because of its lower toxicity, especially cardiotoxicity. Currently, a pathologically confirmed complete response (pCR) is usually the primary objective in clinical trials dedicated to preoperative systemic treatment in breast cancer. pCR became a surrogate of treatment effectiveness. That is why oncologists eagerly use polychemotherapy combined with dual HER2 blockade as preoperative treatment to increase the patient’s chance to achieve pCR, sometimes even when the patient’s risk of relapse is relatively small. The goal of this article is to review current evidence-based knowledge about the effectiveness and toxicity of polychemotherapy with or without anthracycline combined with trastuzumab or dual HER2 blockade used as preoperative treatment in HER2-positive breast cancer patients.
{"title":"The role of anthracycline and pertuzumab in preoperative treatment of HER2-positive breast cancer","authors":"S. Dębska-Szmich, P. Potemski","doi":"10.5603/ocp.2022.0012","DOIUrl":"https://doi.org/10.5603/ocp.2022.0012","url":null,"abstract":"Polychemotherapy combined with trastuzumab (T) or trastuzumab with pertuzumab (TP) is a standard preoperative systemic treatment in patients with HER2-positive breast cancer. In Poland T is reimbursed according to the Drug Prescription Program of Ministry of Health (MoH) for patients with primary breast tumors bigger than 1cm independently from nodal status, whereas TP is reimbursed for patients with tumors bigger than 2 cm with positive lymph node(s) or lack of hormonal receptors expression. The Drug Prescription Program does not indicate which polychemotherapy should be combined with anti-HER2 therapy. Therefore, one can choose between classical sequential treatment based on anthracycline and taxane combined with T or dual HER2 blockade (usually 4 × AC → 12 × paclitaxel/4 × docetaxel + T/TP), or docetaxel with carboplatin combined with trastuzumab (TCH) or with dual HER2 blockade (TCHP). According to the present guidelines of the National Comprehensive Cancer Network (NCCN), polychemotherapy without anthracycline is preferred, which is justified because of its lower toxicity, especially cardiotoxicity. Currently, a pathologically confirmed complete response (pCR) is usually the primary objective in clinical trials dedicated to preoperative systemic treatment in breast cancer. pCR became a surrogate of treatment effectiveness. That is why oncologists eagerly use polychemotherapy combined with dual HER2 blockade as preoperative treatment to increase the patient’s chance to achieve pCR, sometimes even when the patient’s risk of relapse is relatively small. The goal of this article is to review current evidence-based knowledge about the effectiveness and toxicity of polychemotherapy with or without anthracycline combined with trastuzumab or dual HER2 blockade used as preoperative treatment in HER2-positive breast cancer patients.","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80118615","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：