We bring you the latest news from the healthcare about the health care in the United Kingdom.

woensdag 6 juni 2018

The Lancet: [Comment] Abiraterone plus olaparib in prostate cancer: a new form of synthetic lethality?

[Comment] Abiraterone plus olaparib in prostate cancer: a new form of synthetic lethality?
The advent of poly(ADP-ribose) polymerase (PARP) inhibitors, which have been approved for the treatment of ovarian and breast cancers, represents an important advancement in the treatment of cancers harbouring DNA-repair deficiency mutations. The synthetic lethality hypothesis has been used to explain the mechanism underlying the activity of these drugs. This hypothesis postulates that pharmacological inhibition of PARP1 (involved in single-strand DNA damage repair via the base-excision repair pathway) in cancer cells that harbour biallelic inactivating mutations in homologous recombination genes, such as BRCA2, will result in accumulation of catastrophic DNA damage, resulting in tumour cell apoptosis.
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[Comment] The LILAC trial and the blooming of anticancer biosimilars
Complex biosimilars (ie, monoclonal antibodies) are entering the oncology market in Europe and the USA. These drugs present a unique opportunity for the health-care system to remain sustainable. In The Lancet Oncology, Gunter von Minckwitz and colleagues1 report the results of the LILAC trial, which provides evidence that the biosimilar ABP 980 (Amgen Inc, Thousand Oaks, CA, USA) is not inferior to trastuzumab, according to the US Food and Drug Administration and European Medicines Agency requirements.
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[Articles] Efficacy and safety of ABP 980 compared with reference trastuzumab in women with HER2-positive early breast cancer (LILAC study): a randomised, double-blind, phase 3 trial
Although the lower bounds of the 90% CIs for RR and risk difference showed non-inferiority, the upper bounds exceeded the predefined equivalence margins when based on local laboratory review of tumour samples, meaning that non-superiority was non-conclusive. In our sensitivity analyses based on central laboratory evaluation of tumour samples, estimates for the two drugs were contained within the predefined equivalence margins, indicating similar efficacy. ABP 980 and trastuzumab had similar safety outcomes in both the neoadjuvant and adjuvant phases of the study.
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[Articles] Oral arsenic plus retinoic acid versus intravenous arsenic plus retinoic acid for non-high-risk acute promyelocytic leukaemia: a non-inferiority, randomised phase 3 trial
Oral RIF plus ATRA is not inferior to intravenous arsenic trioxide plus ATRA for the treatment of patients with non-high-risk acute promyelocytic leukaemia. This study suggests that a completely oral, chemotherapy-free model might be an alternative to the standard intravenous treatment for patients with non-high-risk acute promyelocytic leukaemia.
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[Comment] Towards home-based treatment for acute promyelocytic leukaemia, with caution
Once considered as the most rapidly fatal leukaemia, acute promyelocytic leukaemia is nowadays curable in most cases, with survival rates exceeding 90–95%.1 A fortunate coincidence of empirical observations, advances in basic and translational research, and international collaboration, have in a matter of a few years revolutionised acute promyelocytic leukaemia therapy and dramatically improved patient outcomes.2 Crucial landmarks in this progress were the identification of the genetic disease hallmark, the PML-RARA oncoprotein, and the combination of all-trans retinoic acid (ATRA) and arsenic trioxide.
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