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woensdag 12 september 2018

The Lancet: [Comment] Pertuzumab therapy for HER2-positive metastatic gastric or gastro-oesophageal junction cancer

[Comment] Pertuzumab therapy for HER2-positive metastatic gastric or gastro-oesophageal junction cancer
In The Lancet Oncology, Josep Tabernero and colleagues1 report the final analysis of the JACOB trial, which tested the efficacy and safety of pertuzumab (a monoclonal antibody targeting HER2 receptors) combined with trastuzumab and chemotherapy in previously untreated patients with HER2-positive metastatic gastric or gastro-oesophageal junction cancer. JACOB was the first trial to investigate a dual HER2 blockade in metastatic gastric cancer; unfortunately, no significant improvement in overall survival was observed in the group treated with the dual-HER2 targeted combination.
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[Articles] The burden of cancers and their variations across the states of India: the Global Burden of Disease Study 1990–2016
The substantial heterogeneity in the state-level incidence rate and health loss trends of the different types of cancer in India over this 26-year period should be taken into account to strengthen infrastructure and human resources for cancer prevention and control at both the national and state levels. These efforts should focus on the ten cancers contributing the highest DALYs in India, including cancers of the stomach, lung, pharynx other than nasopharynx, colon and rectum, leukaemia, oesophageal, and brain and nervous system, in addition to breast, lip and oral cavity, and cervical cancer, which are currently the focus of screening and early detection programmes.
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[Comment] Cancer trends and disparities in India: data needs for providing equitable cancer care
India, with a population close to 1·3 billion, and growing, is epidemiologically interesting and challenging for health-care planners. Regarding cancer burden, the population demographics, health policies, health-data recording, access to health care, and affordability have all improved substantially during the period between 1990 and 2016, as reported by The India State-Level Disease Burden Initiative Cancer Collaborators in their Global Burden of Disease paper in The Lancet Oncology.1 In addition to the heterogeneity in cancer incidence and outcomes between states, significant differences exist within each state, most prominently between urban and rural populations.
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[Articles] Overall survival in patients with BRAF-mutant melanoma receiving encorafenib plus binimetinib versus vemurafenib or encorafenib (COLUMBUS): a multicentre, open-label, randomised, phase 3 trial
The combination of encorafenib plus binimetinib provided clinically meaningful efficacy with good tolerability as shown by improvements in both progression-free survival and overall survival compared with vemurafenib. These data suggest that the combination of encorafenib plus binimetinib is likely to become an important therapeutic option in patients with BRAFV600-mutant melanoma.
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[Comment] Encorafenib plus binimetinib: an embarrassment of riches
Treatment of advanced BRAF-mutant cutaneous melanoma has undergone several breakthroughs, not only in terms of new therapeutic strategies but also in the number of drugs available. The BRAF–MEK inhibitor combinations vemurafenib plus cobimetinib and dabrafenib plus trametinib have been shown to improve overall survival along with pembrolizumab and nivolumab in monotherapy and when combined with ipilimumab.1 Now, another treatment option can be added to the list: encorafenib plus binimetinib.
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