Annals of medicine
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The appropriate use of conventional or potential treatments for hepatocellular carcinoma requires that benefit can be shown. Therefore, the accurate assessment of response is both critical and essential. Demonstration of benefit observed will be determined by the criteria used. ⋯ In this review, the goals of assessing tumor response in clinical practice and in clinical trials are outlined. The varying patterns of response to different therapeutic modalities such as locoregional therapy and molecularly targeted therapy are reviewed, and an approach to the assessment of response based on clinical, biochemical, morphological, and functional criteria has been outlined. The implications of current and proposed approaches of assessing response for clinical practice or design of clinical trials are reviewed.
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The use of highly active antiretroviral therapy against human immunodeficiency virus (HIV) can lead to rare instances of treatment failure and the emergence of drug resistance. HIV drug-resistant strains are archived in cellular reservoirs, and this can exclude the future efficacy of drugs or drug classes against which resistance has emerged. In addition, drug-resistant viruses can be transmitted between individuals. ⋯ Of these, raltegravir, elvitegravir, and dolutegravir are the only integrase strand transfer inhibitors that have been approved for human therapy by the US Food and Drug Administration. Dolutegravir is unique in its ability to seemingly evade HIV drug resistance in treatment-naïve individuals. Here, we review the use of integrase strand transfer inhibitors in the management of HIV, focusing on HIV resistance.