Seminars in oncology最新文献

{"title":"Efficacy of metformin drug in preventing metabolic syndrome associated with androgen deprivation therapy (ADT) in prostate cancer patients: A systematic review and meta-analysis","authors":"Ibrahim Abdelnasar Yakout ,&nbsp;Mohamed Mustafa Gallab ,&nbsp;Daie AbdelRahman Mohamed ,&nbsp;Hiba Hamdar ,&nbsp;Sara I． Ibrahim ,&nbsp;Adham Mohamed ,&nbsp;Abdelrahman Abdelshafi ,&nbsp;Mohamed Abd-ElGawad","doi":"10.1053/j.seminoncol.2024.10.001","DOIUrl":"10.1053/j.seminoncol.2024.10.001","url":null,"abstract":"<div><h3>Background</h3><div>Prostate cancer patients undergoing long-term (Androgen deprivation therapy) ADT will tend to have metabolic changes. Metabolic syndrome represents the accumulation of several medical conditions that significantly increase the risk of developing severe diseases like cardiovascular disorders, insulin resistance, and hyperglycemia. We are conducting this systematic review and meta-analysis to fill up the gap and to resolve the debate regarding the effectiveness of metformin in reducing metabolic syndrome associated with ADT in prostate cancer patients.</div></div><div><h3>Methods</h3><div>We conducted the systematic review and meta-analysis according to the Handbook of Cochrane Systematic Review of Intervention and the PRISMA guidelines. We conducted the search process using the following databases: the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Scopus, and Web of Science. We selected the articles that fit within the following criteria, Randomized Controlled Trials (RCTs) and Cohort studies which evaluate the efficacy of metformin in reducing metabolic syndromes for prostate cancer patients undergoing androgen deprivation therapy (ADT). The efficacy of metformin in metabolic syndrome that resulted from using androgen deprivation therapy for prostate cancer patients was evaluated by the changes from baseline in Body Mass Index (BMI), waist circumference by cm, glycated hemoglobin (HbA1c), and blood pressure both systolic and diastolic. Revman software Version 5.4.1 was used to perform all statistical analyses.</div></div><div><h3>Results</h3><div>Our search retrieved 781 records. Seven records were included in our study: 5 published randomized control clinical trials and 2 cohort studies and only 6 studies were included in the meta-analysis. For BMI the pooled effect estimates of 3 studies favored Metformin over placebo, but this is not a significant difference (MD = -0.9, <em>P</em> = 0.05), for systolic pressure the pooled effect estimates of 3 studies favored Metformin over placebo, but this is not a significantly different placebo (MD = -3.18, <em>P</em> = 0.22), for HBA1c the pooled effect estimates of 3 studies showed that no significant difference between placebo and metformin (MD = -0.01, <em>P</em> = 0.86)002E</div></div><div><h3>Conclusion</h3><div>Despite the promising direction in some parameters, our findings underscore the need for further research to establish a clearer understanding of metformin's role in mitigating metabolic changes in prostate cancer patients undergoing ADT.</div></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"51 5","pages":"Pages 163-174"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep Myometrial Infiltration leads to a measurable Inflammatory Response in Endometrial Cancer. A Prospective Observational Study","authors":"Carlo Ronsini ,&nbsp;Irene Iavarone ,&nbsp;Eleonora Braca ,&nbsp;Maria Giovanna Vastarella ,&nbsp;Luigi Della Corte ,&nbsp;Clorinda Vitale ,&nbsp;Giada Andreoli ,&nbsp;Elvira La Mantia ,&nbsp;Luigi Cobellis ,&nbsp;Pasquale de Franciscis","doi":"10.1053/j.seminoncol.2024.10.002","DOIUrl":"10.1053/j.seminoncol.2024.10.002","url":null,"abstract":"<div><h3>Backgrounds</h3><div>This study aims to evaluate the correlation between inflammation indices, such as neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), platelet-lymphocyte ratio (PLR) and deep myometrial infiltration (≥50%) prospectively in patients with endometrial carcinoma, providing insights into the interaction between these parameters</div></div><div><h3>Material and Methods</h3><div>A prospective observational cohort study was conducted at AOU Vanvitelli in Naples, Italy, from August 2023 to March 2024. Data from 161 patients undergoing surgery for endometrial cancer, including preoperative blood counts and histopathological information, were collected. Statistical analyses were performed using R software.</div></div><div><h3>Results</h3><div>After logistic regression, NLR and MLR showed a statistically significant association with deep myometrial infiltration (NLR log(OR) 0.15, <em>P</em> = .040; MLR log(OR) 0.30, <em>P</em> = .008). However, after multivariate logistic regression which included other risk factors such as grading, histotype, and MSI only NLR retained statistical significance, (Log(Or) 0.18, <em>P</em> = .031).</div></div><div><h3>Conclusion</h3><div>Our results demonstrate noticeable changes in inflammation indices associated with deep myometrial infiltration in endometrial carcinoma. Moreover, a correlation between NLR and deep myometrial infiltration exists regardless of microsatellite instability, histotype, and grading.</div></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"51 5","pages":"Pages 149-153"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatitis B Virus Reactivation in Cancer Patients Receiving Chemotherapy—A Systematic Review and Meta-Analysis","authors":"Natee Deepan ,&nbsp;Soe Thiha Maung ,&nbsp;Pakanat Decharatanachart ,&nbsp;Roongruedee Chaiteerakij","doi":"10.1053/j.seminoncol.2024.08.001","DOIUrl":"10.1053/j.seminoncol.2024.08.001","url":null,"abstract":"<div><div>Hepatitis B virus (HBV) reactivation is a critical concern for patients with a diagnosis of cancer receiving chemotherapy worldwide. Our aim was to assess the rate of HBV reactivation during chemotherapy globally. We systematically reviewed PubMed, Embase, Scopus, and Google Scholar databases for chemotherapy-related HBV reactivation studies from inception until July 2023. A random-effects model was used to estimate the pooled reactivation rate. Total 86 studies involving 21,297 patients were included, comprising 62 and 24 studies from Eastern and Western regions. Pooled results indicated a 9% reactivation rate (95%CI: 7%–13%, <em>I²</em> = 95%). Reactivation rates were 10% (95%CI: 7%–14%, <em>I²</em> = 92%) for hematological malignancies and 5% (95%CI: 3%–9%, <em>I²</em> = 94%) for solid tumors. Presence of HBV DNA, HBeAg, and HBsAg were correlated with reactivation rates of 29% (95%CI: 10%–60%, <em>I²</em> = 91%), 23% (95%CI: 14%–36%, <em>I²</em> = 78%), and 15% (95%CI: 11%–20%, <em>I²</em> = 90%), respectively. For patients with positive anti-HBe Ab, anti-HBc, and anti-HBs Ab serology, pooled reactivation rates were 7% (95%CI: 3%–14%, <em>I²</em> = 81%), 4% (95%CI: 3%–7%, <em>I²</em> = 85%), and 3% (95%CI: 2%–6%, <em>I²</em> = 80%), respectively. With antiviral prophylaxis, reactivation rates were 1% (95%CI: 0%–17%, <em>I²</em> = 59%), 1% (95%CI: 0%–5%, <em>I²</em> = 0%), 4% (95%CI: 2%–9%, <em>I²</em> = 85%), and 6% (95%CI: 3%–12%, <em>I²</em> = 32%) for patients receiving tenofovir, entecavir, lamivudine, and telbivudine, respectively. Patients with a diagnosis of cancer undergoing chemotherapy face increased risk of HBV reactivation. This analysis raises public awareness and serves as a resource for future clinical trials.</div></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"51 5","pages":"Pages 123-134"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deciphering the US Regulatory Framework: Comparison Between Oncology Biosimilars and Reference Biologics","authors":"Ankita Tandulje ,&nbsp;Priya Varpe ,&nbsp;Purva Chaugule ,&nbsp;Rajeev Singh Raghuvanshi ,&nbsp;Saurabh Srivastava","doi":"10.1053/j.seminoncol.2024.08.002","DOIUrl":"10.1053/j.seminoncol.2024.08.002","url":null,"abstract":"<div><div>Biological oncology agents are vital in cancer care, but their exorbitant expenses present obstacles for patients, families, healthcare professionals, and insurance providers. The advent of biosimilars represents a transformative solution, offering more affordable alternatives after the expiration of biologics patents. Biosimilar agents, similar to biological agents in structure, function, safety, and immunogenicity, enhance healthcare accessibility, improve outcomes, and reduce costs. Thus, the safety of biosimilars in clinical settings is of utmost importance. This review provides a detailed overview of the United States (US) regulatory framework for biosimilars along with a comparative analysis of Food and Drug Administration (FDA) approved biosimilar products. The FDA's “Biosimilar product information” database and “FDA's Purple Book” database were used to retrieve data on approved biosimilars and reference biologicals respectively. The study compares biosimilars and their reference products, examining their physiological action, pharmacokinetics, indications, adverse reactions, and immunogenicity test results and concludes that biosimilars do not have significant variations from their reference biologic products. This analysis will offer critical insights for medical practitioners, clinicians, and patients. It empowers stakeholders to make informed decisions, assessing whether biosimilars offer an equivalent level of safety compared to their reference products. Biosimilars are endorsed as credible substitutes for originator biologics, improving accessibility and affordability in cancer care, and benefiting patients and healthcare systems.</div></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"51 5","pages":"Pages 135-141"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of neoadjuvant pembrolizumab in advanced melanoma","authors":"Maheen Amir MBBS, MS,&nbsp;Zoha Ali Khan MBBS, MS,&nbsp;Ayza Asad MBBS,&nbsp;Taha Gul Shaikh MBBS","doi":"10.1053/j.seminoncol.2024.09.001","DOIUrl":"10.1053/j.seminoncol.2024.09.001","url":null,"abstract":"<div><div>Melanoma, a malignancy originating from melanocytes, poses a significant global health challenge, with approximately 325,000 cases and 57,000 deaths annually. Advanced melanoma (AM), categorized as stage III and IV, presents considerable treatment challenges due to its complex mutational landscape. Traditional treatment options have included checkpoint inhibitors and BRAF inhibitors, with pembrolizumab emerging as a promising agent. Approved by the FDA and EMA for various stages of melanoma, pembrolizumab is a humanized monoclonal antibody that blocks the PD-1/PD-L1 interaction, thereby enhancing immune system-mediated tumor eradication.</div><div>This abstract discusses a recent phase 2 clinical trial evaluating the efficacy of neoadjuvant (presurgery) versus adjuvant (postsurgery) pembrolizumab treatment in resectable stage III or IV melanoma. The study, involving 313 patients across 90 US hospitals, found that neoadjuvant-adjuvant pembrolizumab significantly improved event-free survival (72%) compared to adjuvant-only treatment (49%) after 2 years. Treatment-related adverse events were consistent with known profiles, including fatigue, nausea, and diarrhea, without new severe adverse effects. No increase in surgery-related complications was observed with neoadjuvant treatment.</div><div>These findings suggest that neoadjuvant pembrolizumab offers substantial benefits over adjuvant-only treatment, although further research is warranted. Future studies should focus on larger cohorts, diverse demographics, and extended follow-up to validate these results and potentially integrate neoadjuvant pembrolizumab into standard treatment protocols for advanced melanoma.</div></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"51 5","pages":"Pages 161-162"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of PSA responses and changes in the rate of tumor growth (g-rate) with immune checkpoint inhibitors in US Veterans with prostate cancer","authors":"","doi":"10.1053/j.seminoncol.2024.04.002","DOIUrl":"10.1053/j.seminoncol.2024.04.002","url":null,"abstract":"<div><p><span><span><span>We examined data from US Veterans with prostate cancer<span> (PC) to assess disease response to immune checkpoint inhibitors (ICI) as </span></span>monotherapy<span> or combined with abiraterone or </span></span>enzalutamide to assess ICI efficacy in the real-world. We queried the VA corporate data warehouse (CDW) to identify Veterans with a diagnosis of PC who received ICI for any malignancy and had ≥1 PSA measurement while receiving ICI. To evaluate ICI monotherapy, we restricted analysis to Veterans who had not received LHRH agonists/antagonists, PC-directed medical therapy, or radiation/extirpative surgery of the bladder/prostate within and preceding the duration of ICI administration. For ICI combination analysis, we identified Veterans who received abiraterone or enzalutamide for PC while on ICI. We calculated rates of tumor (PSA) growth (</span><strong><em>g</em></strong>-rates), comparing them to a 1:2 matched reference cohort. We identified 787 Veterans with PC and ≥1 PSA measurement while receiving an ICI. Median duration of ICI therapy was 155 days. 223 Veterans received ICI monotherapy, with only 17(8%) having a reduction in PSA (median decline = 43%). 12 (5%) had PSA declines &gt;30% (PSA30) which included 6 (3%) who had PSA reductions greater than 50% (PSA50). Median <strong><em>g</em></strong>-rates for ICI plus abiraterone (n = 20) or enzalutamide (n = 31) were 0.000689/d⁻¹ and 0.002819/d⁻¹, respectively, and were statistically insignificant compared to <strong><em>g</em></strong>-rates of matched cohorts receiving abiraterone (<strong><em>g</em></strong> = 0.000925/d⁻¹, <em>P</em> = 0.73) or enzalutamide (<strong><em>g</em></strong> = 0.001929/d⁻¹, <em>P</em><span> = 0.58) alone. Our data align with clinical trial data in PC, demonstrating limited benefit from ICI monotherapy and predicting no survival benefit from simultaneous abiraterone or enzalutamide with an ICI using </span><strong><em>g</em></strong>-rate.</p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"51 3","pages":"Pages 59-68"},"PeriodicalIF":3.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141029034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RENO Study: Clinical characteristics, treatment patterns and survival results in patients with metastatic renal cell carcinoma in Northern Spain","authors":"","doi":"10.1053/j.seminoncol.2024.02.002","DOIUrl":"10.1053/j.seminoncol.2024.02.002","url":null,"abstract":"<div><h3>Background</h3><p>The current available evidence on the management of metastatic renal cell cancer (mRCC) in real life is scarce in our environment. We present a summary of the existing real-world data and the results of an analysis describing the clinical characteristics, treatments, and health outcomes of patients with mRCC in northern Spain.</p></div><div><h3>Methods</h3><p>Retrospective observational study. Adult patients diagnosed with mRCC between Jan 2007 and Dec 2019 were included. Epidemiological, efficacy and toxicity data were collected. Median overall survival (OS) and progression-free survival (PFS) were determined using the Kaplan-Meier method.</p></div><div><h3>Results</h3><p>A total of 829 patients were included (median age at diagnosis:63 years;73% men). Median follow-up was 180 months. The preponderant histology was clear cell (85%). In 50% the initial diagnosis was advanced disease. The distribution according to IMDC prognosis was good (24%), intermediate (50%) and poor (26%). The most frequent metastatic locations were lung (68.3%) and lymph node (41.0%). Most patients (95%) received a first line (1L) systemic treatment, 60% were treated with a second line (2L) of therapy and 37% received third line (3L). A VEGFR-TKIs was the most common treatment (1L: 90%, <em>n =</em> 507; 2L: 49%, <em>n =</em> 233; 3L: 54%, <em>n =</em> 156) followed by mTOR inhibitors (1L: 2%, <em>n =</em> 4; 2L: 27%, <em>n =</em> 126; 3L: 23%, <em>n =</em> 68) and immunotherapy (1L: 3.7%, <em>n =</em> 25; 2L: 27%, <em>n =</em> 126). Median OS was 24.5 months in the general population. According to IMDC prognostic groups, OS was 52.5, 25.7 and 9 months respectively. From the start of the 1L, 2L, and 3L treatment, median PFS was: 1L: 7.8 (6.8–9.0); 2L: 4.9 (4.3–5.5); 3L: 4.3 (3.8–4.8) months. No unexpected toxicity was reported.</p></div><div><h3>Conclusions</h3><p>The Real-World Data on the management of mRCC in Northern Spain are comparable in epidemiology, efficacy, and safety to studies conducted in other areas of the world. The significant reduction in the number of patients receiving second and subsequent lines of therapy hampers the access to new therapies developed in this context.</p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"51 3","pages":"Pages 77-86"},"PeriodicalIF":3.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0093775424000058/pdfft?md5=bbf749368d6faba97ca571a2cd93dc91&pid=1-s2.0-S0093775424000058-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140592805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Invasive lobular breast cancer: Focus on prevention, genetics, diagnosis, and treatment","authors":"","doi":"10.1053/j.seminoncol.2024.05.001","DOIUrl":"10.1053/j.seminoncol.2024.05.001","url":null,"abstract":"<div><p><span><span><span><span>Invasive lobular cancer (ILC) is the most common of the breast cancer special types, accounting for up to 15% of all breast malignancies. The distinctive biological features of ILC include the loss of the </span>cell adhesion molecule E-cadherin, which drives the tumor's peculiar discohesive growth pattern, with cells arranged in single file and dispersed throughout the </span>stroma. Typically, such tumors originate in the lobules, are more commonly bilateral compared to invasive ductal cancer (IDC) and require a more accurate diagnostic examination through imaging. They are luminal in molecular subtype, and exhibit estrogen and </span>progesterone receptor positivity and </span>HER2<span> negativity, thus presenting a more unpredictable response to neoadjuvant therapies. There has been a significant increase in research focused on this distinctive breast cancer subtype, including studies on its pathology, its clinical and surgical management, and the high-resolution definition of its genomic profile, as well as the development of new therapeutic perspectives. This review will summarize the heterogeneous pattern of this unique disease, focusing on challenges in its comprehensive clinical management and on future insights and research objectives.</span></p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"51 3","pages":"Pages 106-122"},"PeriodicalIF":3.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141139259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated lung metastases from pancreatic ductal adenocarcinoma (PDAC): Diagnostic and therapeutic challenges of a different disease","authors":"","doi":"10.1053/j.seminoncol.2024.04.001","DOIUrl":"10.1053/j.seminoncol.2024.04.001","url":null,"abstract":"<div><p>Pancreatic ductal adenocarcinoma<span><span><span> (PDAC) has a dismal prognosis, mostly due to the high rate of distant dissemination. However, growing evidence shows that isolated lung recurrence or metastases (ILM) from PDAC are not only less common, but also correlated with a better prognosis. Lung-only recurrence after surgery occurs later in time and is associated with more favorable prognostic characteristics of the </span>primary tumor. Moreover, recent findings suggest that this specific site of metastases is characterized by an immunologically “hot” microenvironment and a more favorable molecular profile that could possibly justify its clinical behavior. Thus, ILM from PDAC emerge as a distinct entity, that might also benefit from a different therapeutic approach, possibly with the integration of surgery and de-intensified </span>chemotherapy regimens, especially in selected patients. In this review we delve into the current scientific evidence on the clinical and biological characteristics of isolated LM from PDAC, also focusing on concerns with their diagnostic process and the therapeutic options for the management of this subset of patients.</span></p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"51 3","pages":"Pages 69-76"},"PeriodicalIF":3.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141043410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world experience with CDK4-6 inhibition in the old and oldest old with a diagnosis of breast cancer","authors":"","doi":"10.1053/j.seminoncol.2024.01.003","DOIUrl":"10.1053/j.seminoncol.2024.01.003","url":null,"abstract":"<div><p><span><span><span>This study describes characteristics, toxicity and survival in old patients with HR+/HER2-breast cancer (BC) treated with CDK4/6 inhibitors. Retrospective observational study that included patients ≥ 75 years with HR+/HER2-BC treated with CDK4/6 inhibitors between 2017 and 2021. Patients’ general and cancer-related data were collected. Comprehensive Geriatric Assessment scales were gathered. </span>Adverse events<span><span> reported before each cycle were included. At the end of the follow-up period, mortality was retrospectively registered from medical records. All 19 patients (94.7% women, median age 77.9 ± 10.1) were at risk of </span>frailty (G8 ≤ 14) and malnutrition (MNA-SF ≤ 11). Most were independent (52.7% Lawton ≥ 6), had no </span></span>cognitive impairment<span><span> (89.5%, MMSE ≥ 24), poor physical performance (70%, SPPB &lt; 8; 62.5% TUG ≥ 12’’) and polypharmacy (72.2%). Almost half had stage IV disease (47.1%). Palbociclib+letrozole was the most frequently prescribed treatment (36.8%). All patients developed some toxicity (94.7% hematologic, 36.8% renal) but except one, grade ≤ 2. Over the 42-month follow-up period, 10 reported progression and 8 died. The </span>median survival time was 19.9 ± 3.4 months. Five months after starting treatment, the probability of survival was 73%. At 30 months, 53% of patients survived. We found a high risk of frailty and </span></span>drug toxicity in this small sample. Most patients presented hematologic toxicity but to a low degree. The probability of survival increases with treatment.</p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"51 3","pages":"Pages 95-105"},"PeriodicalIF":3.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139949520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}