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vrijdag 23 juni 2017

The Lancet: [News] Alectinib surpasses crizotinib for untreated -positive NSCLC

[News] Alectinib surpasses crizotinib for untreated -positive NSCLC
Alectinib was more effective and less toxic than crizotinib in patients with treatment-naive non-small-cell lung cancer (NSCLC) harbouring rearranged ALK, according to results from the ALEX trial.
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[Articles] Concurrent once-daily versus twice-daily chemoradiotherapy in patients with limited-stage small-cell lung cancer (CONVERT): an open-label, phase 3, randomised, superiority trial
Survival outcomes did not differ between twice-daily and once-daily concurrent chemoradiotherapy in patients with limited-stage small-cell lung cancer, and toxicity was similar and lower than expected with both regimens. Since the trial was designed to show superiority of once-daily radiotherapy and was not powered to show equivalence, the implication is that twice-daily radiotherapy should continue to be considered the standard of care in this setting.
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[Comment] Which fractionation of radiotherapy is best for limited-stage small-cell lung cancer?
The role of radiotherapy in the treatment of small-cell lung cancer has been established through a series of clinical trials and meta-analyses during the past 20 years, which showed that local radiotherapy in addition to chemotherapy1 and whole-brain radiotherapy2 can improve patient prognosis. Moreover, use of radiotherapy with concurrent chemotherapy3 in the early stages of disease has been shown to further improve treatment outcomes. Results from the Intergroup 0096 trial4 showed that a radiotherapy dose of 45 Gy given twice daily led to improved prognosis when compared with once-daily fractionation regimens employing the same total radiotherapy dose.
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[Articles] Selective inhibition of FLT3 by gilteritinib in relapsed or refractory acute myeloid leukaemia: a multicentre, first-in-human, open-label, phase 1–2 study
Gilteritinib had a favourable safety profile and showed consistent FLT3 inhibition in patients with relapsed or refractory acute myeloid leukaemia. These findings confirm that FLT3 is a high-value target for treatment of relapsed or refractory acute myeloid leukaemia; based on activity data, gilteritinib at 120 mg/day is being tested in phase 3 trials.
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[News] Atezolizumab in advanced non-small-cell lung cancer
In patients with PD-L1-positive non-small-cell lung cancer (NSCLC), the PD-L1 inhibitor atezolizumab can improve the proportion of patients achieving an objective response (ORR) compared with historical controls, according to the results of a new study.
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