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vrijdag 10 februari 2017

The Lancet: [Reportage] Cancer care on Palm Island, Australia

[Reportage] Cancer care on Palm Island, Australia
With a troubled historical past and a large section of the community unemployed, cancer care on Palm Island, Australia, is in urgent need of attention. Georgina Kenyon discusses the state of cancer care on the island, the most pressing issues, and promising interventions being implemented.
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[Comment] Short-course radiotherapy with delayed surgery for rectal cancer: a third option
Rectal cancers can be divided into three groups according to risk of recurrence: early, intermediate, and locally advanced. For intermediate-risk tumours (mostly cT3 without threatened or involved mesorectal fascia) either short-course radiotherapy (5 × 5 Gy) with immediate surgery or chemoradiation (45–50·4 Gy at 1·8–2 Gy per fraction with fluoropyrimidine) with delayed surgery is recommended. Two randomised trials compared these two schedules and showed no difference in postoperative morbidity, oncological outcomes, or late toxicity; a lower frequency of early radiation-induced complications was noted after short-course radiotherapy with immediate surgery compared with chemoradiation.
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[News] Azathioprine associated with myeloid neoplasm risk
Exposure to azathioprine, an immunosuppressant, is associated with increased risk for myeloid neoplasm in patients with primary autoimmune disease, according to a retrospective study by Natalie Ertz-Archambault and colleagues (Mayo Clinic, Phoenix, AZ, USA). The investigators examined the records of 40 011 patients who visited two US medical centres between 2004 and 2014. The patients were all diagnosed with one of 27 autoimmune diseases. The researchers confirmed 86 patients as having therapy-associated myeloid neoplasm.
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[Articles] Utidelone plus capecitabine versus capecitabine alone for heavily pretreated metastatic breast cancer refractory to anthracyclines and taxanes: a multicentre, open-label, superiority, phase 3, randomised controlled trial
Despite disease progression with previous chemotherapies, utidelone plus capecitabine was more efficacious compared with capecitabine alone for the outcome of progression-free survival, with mild toxicity except for peripheral sensory neuropathy, which was manageable. The findings from this study support the use of utidelone plus capecitabine as an effective option for patients with metastatic breast cancer.
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[Comment] Classic cytotoxic drugs: a narrow path for regulatory approval
Several classic cytotoxic drugs have shown encouraging activity in the treatment of metastatic breast cancer.1–3 However, only a few have received an overwhelming welcome from regulatory authorities and succeeded in obtaining widespread regulatory approval for routine use. For example eribulin was approved for treatment of metastatic breast cancer in several countries including Japan, USA, and Europe, based on data that showed longer overall survival in patients treated with eribulin compared with patients treated with physician's choice of treatment.
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