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vrijdag 3 februari 2017

The Lancet: [Comment] Adjuvant ipilimumab for stage III melanoma: the patient voice

[Comment] Adjuvant ipilimumab for stage III melanoma: the patient voice
The therapeutic landscape for the management of patients with resected high-risk malignant melanoma is evolving rapidly; however, it remains an important clinical challenge. Adjuvant interferon has significant toxicities and limited efficacy, and drugs currently under investigation, targeting PD-1, BRAF, MEK, and CTLA-4, have the potential to be more effective. EORTC 18071, a randomised, placebo-controlled, double-blind phase 3 trial of adjuvant ipilimumab (anti CTLA-4 immunotherapy) compared with placebo in patients with stage III melanoma, showed longer recurrence-free survival (hazard ratio [HR] 0·76; p=0·001), and overall survival (HR 0·72; p<0·001) for patients treated with ipilimumab compared with placebo.
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[Articles] Health-related quality of life with adjuvant ipilimumab versus placebo after complete resection of high-risk stage III melanoma (EORTC 18071): secondary outcomes of a multinational, randomised, double-blind, phase 3 trial
Despite increased toxicity, which led to treatment discontinuation for most patients during the induction phase of ipilimumab administration, overall HRQoL, as measured by the EORTC QLQ-C30, was similar between groups, as no clinically relevant differences (10 points or more) in global health status scores were observed during or after induction. Clinically relevant deterioration for some symptoms was observed at week 10, but after induction, no clinically relevant differences remained. Together with the primary analysis, results from this trial show that treatment with ipilimumab results in longer recurrence-free survival compared with that for treatment with placebo, with little impairment in HRQoL despite grade 3–4 investigator-reported adverse events.
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[News] Intermittent sunitinib for metastatic renal cell carcinoma
Intermittent treatment with sunitinib is feasible for patients with metastatic renal cell carcinoma and does not seem to compromise its activity, suggest findings from a phase 2 study.
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[News] Novel mutations in cervical cancer
A comprehensive genomic analysis of cervical cancer has revealed several novel gene mutations and amplifications.
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[Comment] Anti-angiogenesis: disappointment in localised oesophagogastric cancer
A decade ago, investigators from the UK Medical Research Council (MRC) showed in their landmark MAGIC trial that the addition of peri-operative chemotherapy to surgery improves survival for patients with resectable oesophagogastric adenocarcinoma compared with surgery alone.1 In The Lancet Oncology, the same investigators now report results from the randomised phase 2–3 ST03 trial showing that complementing the same peri-operative chemotherapy regimen (epirubicin, cisplatin, and capecitabine) with bevacizumab, an anti-angiogenic monoclonal antibody directed against VEGF, does not improve overall survival or any other relevant endpoint.
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