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donderdag 9 november 2017

The Lancet: [Articles] Incomplete excision of cervical precancer as a predictor of treatment failure: a systematic re...

[Articles] Incomplete excision of cervical precancer as a predictor of treatment failure: a systematic review and meta-analysis
The risk of residual or recurrent CIN2+ is significantly greater with involved margins on excisional treatment; however, high-risk HPV post-treatment predicts treatment failure more accurately than margin status.
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[Comment] Questioning the value of margin status in treated cervical precancer
Cervical carcinoma is the third most common cancer in women worldwide, with more than 500 000 diagnoses and 250 000 deaths annually.1 Persistent infection with human papillomavirus (HPV) can lead to high-grade neoplastic changes (cervical intraepithelial neoplasia [CIN]) that, if untreated, can progress to invasive disease within 10–15 years.2 Knowledge of cervical cancer pathogenesis and the natural history of its precursor lesion (CIN grade 3 [CIN3]) together with a suitable test (the Papanicolaou smear) and excisional treatments, has led to the implementation of successful screening programmes in many countries.
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[News] Gut microbiome and immunotherapy response
A new study by Vancheswaran Gopalakrishnan (MD Anderson Cancer Center, Houston, TX, USA) and colleagues has found that the composition of the gut microbiome affects the way patients with advanced melanoma respond to anti-PD-1 immunotherapy.
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[Articles] Health-related quality-of-life results for pembrolizumab versus chemotherapy in advanced, PD-L1-positive NSCLC (KEYNOTE-024): a multicentre, international, randomised, open-label phase 3 trial
Pembrolizumab improves or maintains health-related QOL compared with that for chemotherapy, and might represent a new first-line standard of care for PD-L1-expressing, advanced NSCLC.
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[Comment] Quality of life: an important element of treatment value
In the era of platinum-based chemotherapy, attempts to improve the quality of life (QOL) of patients with advanced non-small-cell lung cancer (NSCLC) using a less toxic treatment than the existing standard therapy were often disappointing. In a randomised trial1 comparing cisplatin-based treatment to a so-called platinum-free combination chemotherapy, the goal of improving QOL was not met. The lesson learned was that in patients with a disease often associated with serious symptoms, reduction of treatment-related toxicity is not enough to improve global QOL, and more effective control of disease is needed to achieve a positive QOL balance.
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