Publication date: Available online 30 June 2018
Source:Critical Reviews in Oncology/Hematology
Author(s): Xiao Li, Yuchan Mao, Qiwen Wu, Yuanyuan Liu, Qianqian Wu, Binghuan Wen
AimThe majority of epithelial ovarian cancer patients who achieve a full remission following first-line chemotherapy would finally develop recurrent disease. However, the optimal management of recurrent ovarian cancer (ROC) remains undefined. The preset meta-analysis aims to evaluate the role of novel targeted agents (TAs) in the treatment of ROC in terms of response, overall survival and toxicities.Materials and methodsEligible studies were identified using Medline, Pubmed, and meeting abstracts. Searches were last updated on April 30, 2018. Eligible randomized controlled studies reported survival, toxicities and/or response data for ROC patients receiving novel TAs were included. Primary outcomes of interest were objective response rate (ORR), overall survival (OS), progression free survival (PFS) and adverse events (AEs).ResultsA total of 6,606 patients from 16 studies were eligible for analysis. The pooled results showed that the addition of novel TAs to chemotherapy significantly improved ORR (RR 1.63, 95%CI: 1.33-2.00, p < 0.001), PFS (0.78, 95%CI: 0.68-0.89, p < 0.001) and OS (HR 0.92, 95%CI: 0.87-0.99, p = 0.016) in ROC patients when compared to controls. Similar results in terms of ORR (RR 2.23, p < 0.001), PFS (HR 0.65, p < 0.001), and OS (HR 0.89, p = 0.015) were observed in platinum-sensitive ROC who received TAs. While the addition of novel TAs to chemotherapy significantly improved ORR (RR 1.84, p = 0.002) in platinum-resistant or refractory ROC, it did not translate into PFS (HR 0.83, p = 0.067) and OS (HR 0.94, p = 0.19) benefits. Sub-group analysis according to specific targeted agents showed that combination angiogenesis inhibitors with chemotherapy significantly improved PFS (HR 0.67, p = 0.018), but not for OS (HR 0.93, p = 0.31). As for toxicities, the use of TAs in ROC significantly increased the risk of developing serious AEs (RR 1.27, 95%CI: 1.08-1.50, p = 0.005) and AEs leading to treatment discontinuation (RR 1.93, 95%CI: 1.31-2.84, p = 0.001), but not for fatal AEs (RR: 1.49, 95% CI: 0.89–2.48, p = 0.13). In addition, correlation analysis indicates that PFS (r=0.86, p < 0.001) and ORR (r=0.85, p < 0.001) was strongly correlated with OS for ROC patients received TAs.ConclusionCombination treatment with novel TAs and chemotherapy significantly improved ORR, PFS and OS in platinum-sensitive ROC with an increased risk of severe adverse events. Conversely, we detect no statistically significant survival benefit in platinum-resistant or refractory ROC received TAs. Further prospective randomized studies are needed to confirm our findings and investigate more efficient agents in platinum-resistant or refractory ROC.
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Cancer Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174
Σάββατο 30 Ιουνίου 2018
Addition of targeted agents to chemotherapy for persistent or recurrent ovarian cancer: a meta-analysis of randomized controlled trials
Agenesis of dorsal pancreas associated with pancreatic neuroendocrine tumor: a case report and review of the literature
Agenesis of the dorsal pancreas is very rare. Less than 70 cases have been reported to date. Some of these cases had an association with a tumor. The literature of agenesis of the dorsal pancreas and agenesis ...
https://ift.tt/2IDGrbe
HBV infection and extra-hepatic cancers in adolescents and 20s: A retrospective study in China
Source:Cancer Epidemiology, Volume 55
Author(s): Tingna Lu, Qing Yang, Mei Li, Jiqing Zhang, Jing Zou, Lu Huang, Jianhua Lin, Haosheng Jin, Jiman He
BackgroundThe mean age at cancer diagnosis is younger in hepatitis B virus (HBV) infected than non-infected patients. It remains unknown whether this association reflects an increase in the incidence rates of extra-hepatic cancers in adolescents and younger.MethodsWe examined 10 common extra-hepatic cancers (lung, breast, gastric, prostate, esophageal, rectal, cervical, nasopharyngeal, lymphatic, and urinary bladder) among patients diagnosed at three Chinese hospitals during 2007–2016. We compared the percentage distribution (frequencies at each age point are shown as a percentage of the total frequency) of HBsAg+ with HBsAgˉ patients, and calculated the standardized incidence ratio for each age group.ResultsA total of 60,323 patients were identified. The mean age at cancer diagnosis was 1.5–5.5 years younger in hepatitis B surface antigen (HBsAg) positive patients compared to HBsAgˉ patients (p ≤ 0.001). Lymphoma patients had the highest prevalence rate of HBV infection (20.7%). Among the pooled HBsAg+ cancer patients, 14.8% (1138/7666) were aged ≤39 years; by contrast, 9.7% (5122/52657) of HBsAgˉ cancer patients were in the same age range, giving an odds ratio of 1.6 [95%CI1.509–1.733)]. The observations were similar when each cancer was considered individually. The odds ratio was greater in pooled male patients aged ≤39 years [1.9(95%CI1.705–2.085)] compared with females [1.6(95%CI1.382–1.83)]. The ratio of the observed to the expected number of HBsAg+ patients aged 15–19, 20–24, and 25–29 years were 3.3, 4.8 and 2.0, respectively, higher than 1.2–1.7 observed for older age-groups.ConclusionHBV infection is a risk factor for diverse extra-hepatic cancers in adolescents and 20s.
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Axillary reverse mapping (ARM): where to go
Abstract
In the past decades, breast surgeons have changed the clinical practice in the surgical treatment of breast cancer, by performing sentinel lymph node biopsy (SLNB) instead of performing axillary lymph node dissection (ALND) in axillary lymph node clinically negative breast cancer patients. ALND can also be avoided in SLN-positive patients who meet the Z-0011 criteria. However, the postoperative complications of SLNB and ALND, such as the secondary upper extremity lymphedema, are common and need effective solutions to prevent as soon as possible. The axillary reverse mapping (ARM) technique has been developed to map and preserve arm lymphatic drainage during ALND and/or SLNB, thereby minimizing arm lymphedema. However, the success of ARM in reducing lymphedema has not been exactly determined. If ARM can be confirmed to be both effective and oncologically safe in preventing lymphedema, this technique should be recommended in the management of breast cancer treatment.
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