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woensdag 21 maart 2018

The Lancet: [Articles] Modified XELIRI (capecitabine plus irinotecan) versus FOLFIRI (leucovorin, fluorouracil, and i...

[Articles] Modified XELIRI (capecitabine plus irinotecan) versus FOLFIRI (leucovorin, fluorouracil, and irinotecan), both either with or without bevacizumab, as second-line therapy for metastatic colorectal cancer (AXEPT): a multicentre, open-label, randomised, non-inferiority, phase 3 trial
mXELIRI with or without bevacizumab is well tolerated and non-inferior to FOLFIRI with or without bevacizumab in terms of overall survival. mXELIRI could be an alternative to FOLFIRI as a standard second-line backbone treatment for metastatic colorectal cancer, at least for Asian patient populations.
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[Comment] Modified XELIRI (capecitabine plus irinotecan) for metastatic colorectal cancer
The treatment of metastatic colorectal cancer has changed substantially in the past two decades with the development of more effective chemotherapy protocols and molecular-based strategies. Despite these changes, intravenous fluorouracil chemotherapy remains an important component of treatment for metastatic colorectal cancer, generally combined with leucovorin plus oxaliplatin (FOLFOX) or leucovorin plus irinotecan (FOLFIRI). However, changes to the method of delivery with oral alternatives, such as capecitabine, are being developed to simplify drug delivery.
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[Articles] Predictive test for chemotherapy response in resectable gastric cancer: a multi-cohort, retrospective analysis
The single patient classifiers validated in this study provide clinically important prognostic information independent of standard risk-stratification methods and predicted chemotherapy response after surgery in two independent cohorts of patients with resectable, stage II–III gastric cancer. The single patient classifiers could complement TNM staging to optimise decision making in patients with resectable gastric cancer who are eligible for adjuvant chemotherapy after surgery. Further validation of these results in prospective studies is warranted.
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[Comment] Precision medicine in the adjuvant treatment of gastric cancer
Adjuvant chemotherapy is considered the standard of care after surgical resection in patients with stage IB–III gastric cancer in most Asian countries. The benefit of adjuvant chemotherapy after surgery over surgery alone in terms of overall and disease-free survival was confirmed in an individual-patient data meta-analysis1 of 3838 patients treated in 17 randomised controlled trials. After surgery with curative intent, patients with gastric cancer receive postoperative chemotherapy to eradicate undetectable micrometastatic disease.
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[Articles] Nilotinib in locally advanced pigmented villonodular synovitis: a multicentre, open-label, single-arm, phase 2 trial
More than 90% of patients with locally advanced unresectable progressive pigmented villonodular synovitis achieved disease control with 12 weeks of nilotinib treatment. These results indicate that CSF1R tyrosine kinase inhibitors have anti-tumour activity with manageable toxicity in patients with inoperable progressive pigmented villonodular synovitis. Randomised trials investigating the efficacy of nilotinib for patients with unresectable pigmented villonodular synovitis are warranted.
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