Clinical Significance

Abstract

Kitchener HC et al. Recurrent borderline tumors after conservative treatment management in women wishing to retain their fertility. Sukpan K et al. Mucinous tumor of low malignant potential ('borderline' or 'atypical proliferative' tumor) of the ovary: a study of 171 cases with the assessment of intraepithelial carcinoma and microinvasion. Ribassin-Majed L et al. Influence of histological subtypes on the risk of an invasive recurrence in a large series of stage I borderline ovarian tumor including 191 conservative treatments. Pathologic findings in eight cases of ovarian serous borderline tumors, three with foci of serous carcinoma, that preceded death or morbidity from invasive carcinoma. L et al. Age-dependent differences in borderline ovarian tumours (BOT) regarding clinical characteristics and outcome: results from a subanalysis of the Arbeitsgemeinschaft Gynaekologische Onkologie (AGO) ROBOT Study. Netupitant and palonosetron (NEPA): a winning team in the race for the optimal treatment of chemotherapy-induced nausea and vomiting? During the lifetime of many of healthcare professionals reading this article, the way in which chemotherapy induced nausea and vomiting (CINV) is approached and treated has transformed. The three papers reporting phase 2 and 3 dose-finding [1], efficacy and safety [1–3] studies of an oral fixed-dose combination (netupitant and palonosetron, NEPA) of a tachykinin NK 1 receptor [substance P (SP)] antagonist (NK 1 RA, netupitant, 300 mg) and a 5-hydroxytryptamine 3 receptor antagonist [5-HT 3 RA, palonosetron (PALO), 0.5 mg] are the latest clinical developments in the search for optimal anti-emetic therapy. This shift in approach to CINV is multifactorial: (i) a change in the attitude of healthcare professionals to nausea and vomiting, now viewed as something to be treated rather than tolerated by the patient; (ii) identification of risk factors initially: age, sex, alcohol consumption and emetic history, but screening for polymorphisms that may influence efficacy of 5-HT 3 RA (e.g. ABCB1, [4]) could be included; (iii) anti-emetic guidelines [5]; (iv) the introduction of the highly emetic cisplatin in the 1980s stimulated research into anti-emetics [6, 7]; (v) the recognition of anticipatory, acute and delayed phases of CINV [8] and insights into their differing mechanisms and pharmacology [9–11]; (vi) a shift in the way that identification of novel anti-emetics was approached by using models such as the ferret in which emesis was induced by cisplatin and which led to identification of the involvement of 5-The papers make three advances of note: (i) a single oral dose of NEPA on day 1 …