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woensdag 28 februari 2018

The Lancet: [Articles] Adjuvant anastrozole versus exemestane versus letrozole, upfront or after 2 years of tamoxifen...

[Articles] Adjuvant anastrozole versus exemestane versus letrozole, upfront or after 2 years of tamoxifen, in endocrine-sensitive breast cancer (FATA-GIM3): a randomised, phase 3 trial
5 years of treatment with aromatase inhibitors was not superior to 2 years of tamoxifen followed by 3 years of aromatase inhibitors. None of the three aromatase inhibitors was superior to the others in terms of efficacy. Therefore, patient preference, tolerability, and financial constraints should be considered when deciding the optimal treatment approach in this setting.
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[Articles] Addition of the PARP inhibitor veliparib plus carboplatin or carboplatin alone to standard neoadjuvant chemotherapy in triple-negative breast cancer (BrighTNess): a randomised, phase 3 trial
Although the addition of veliparib and carboplatin to paclitaxel followed by doxorubicin and cyclophosphamide improved the proportion of patients with triple-negative breast cancer who achieved a pathological complete response, the addition of veliparib to carboplatin and paclitaxel did not. Increased toxicities with the addition of carboplatin (with or without veliparib) to paclitaxel were manageable and did not substantially affect treatment delivery of paclitaxel followed by doxorubicin and cyclophosphamide.
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[Comment] Addition of platinum salts to neoadjuvant chemotherapy in triple-negative breast cancer: a new standard of care?
The St Gallen Consensus Conference panel strongly endorsed the preference for neoadjuvant therapy in stage II and III triple-negative breast cancer.1 In The Lancet Oncology, Sibylle Loibl and colleagues report the results of the randomised, double-blind, phase 3, BrighTNess trial.2 The study assessed the addition of the poly(ADP-ribose) polymerase (PARP) inhibitor veliparib plus carboplatin, or carboplatin alone, to a standard neoadjuvant chemotherapy regimen (weekly paclitaxel followed by doxorubicin and cyclophosphamide) in patients with triple-negative breast cancer, and showed that the proportion of patients who achieved a pathological complete response significantly improved in the veliparib plus carboplatin plus paclitaxel group compared with the paclitaxel-based chemotherapy alone group (168 [53%] of 316 patients vs 49 [31%] of 158 patients, p=0·001), confirming the results of the previous, phase 2, I-SPY 2 trial.
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[Articles] Concurrent chemoradiotherapy with nedaplatin versus cisplatin in stage II–IVB nasopharyngeal carcinoma: an open-label, non-inferiority, randomised phase 3 trial
Our findings show that nedaplatin-based concurrent chemoradiotherapy represents an alternative doublet treatment strategy to cisplatin-based concurrent chemoradiotherapy for patients with locoregional, advanced nasopharyngeal carcinoma. Further investigations are needed to explore the potential use of this treatment as induction or adjuvant chemotherapy or in combination with other agents.
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[Comment] Nedaplatin in nasopharyngeal cancer: the rebirth of platinum salts?
During the past 20 years, three major advances have helped to substantially improve the prognosis of patients with nasopharyngeal carcinoma. First, the use of cisplatin-based concurrent chemoradiation,1 alone2 or with adjuvant3,4 or induction5,6 chemotherapy, has led to improved survival and disease control. Second, the advent of intensity-modulated radiotherapy has allowed treatment volumes to be adapted to the local and regional extension of disease, especially for patients with a posterior extension close to neurological structures, along with better protection of adjacent normal tissues.
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