The lancet oncology
-
The lancet oncology · Nov 2013
Randomized Controlled TrialResumption of imatinib to control metastatic or unresectable gastrointestinal stromal tumours after failure of imatinib and sunitinib (RIGHT): a randomised, placebo-controlled, phase 3 trial.
Few treatment options remain for patients with metastatic or unresectable gastrointestinal stromal tumours (GIST) after objective progression on approved tyrosine-kinase inhibitors. We aimed to assess efficacy of imatinib rechallenge in these patients. ⋯ In patients with GIST that is refractory to treatment with all standard tyrosine-kinase inhibitors, the disease continues to harbour many clones that are sensitive to kinase inhibitors. Continued kinase suppression might slow, although not halt, disease progression.
-
The lancet oncology · Nov 2013
Randomized Controlled Trial Multicenter Study Comparative StudyTwo schedules of etirinotecan pegol (NKTR-102) in patients with previously treated metastatic breast cancer: a randomised phase 2 study.
New therapeutic options are needed for patients with heavily pretreated breast cancer. Etirinotecan pegol is a long-acting topoisomerase-I inhibitor designed to provide prolonged tumour-cell exposure to SN38, the active metabolite. We aimed to assess the efficacy and safety of two etirinotecan pegol dosing schedules in patients with previously treated metastatic breast cancer to determine an optimum dosing schedule for phase 3 trials. ⋯ On the basis of the overall clinical data, pharmacokinetics, and tolerability profile, etirinotecan pegol 145 mg/m(2) every 21 days has been selected for a phase 3 trial against treatment of physician's choice in patients with advanced breast cancer.
-
The lancet oncology · Nov 2013
Review Practice GuidelineManagement of sarcoma in the Asia-Pacific region: resource-stratified guidelines.
Sarcomas are a rare and diverse set of cancers that disproportionately affect young people. The best possible outcome depends on access to highly specialised, multidisciplinary care. ⋯ This Review proposes an evidence-based, consensus recommendation for optimum management of bone and soft-tissue sarcoma across the Asia-Pacific region, taking into account variation in health-care resources, stratified according to the Breast Health Global Initiative resource levels. A web-based survey of 89 clinicians involved in the care of patients with sarcoma from 18 Asia-Pacific countries generated the recommendations for diagnosis, staging, and management, including supportive and palliative care, and research.
-
The lancet oncology · Nov 2013
Multicenter StudyRecurrence patterns across medulloblastoma subgroups: an integrated clinical and molecular analysis.
Recurrent medulloblastoma is a therapeutic challenge because it is almost always fatal. Studies have confirmed that medulloblastoma consists of at least four distinct subgroups. We sought to delineate subgroup-specific differences in medulloblastoma recurrence patterns. ⋯ Medulloblastoma does not change subgroup at the time of recurrence, reinforcing the stability of the four main medulloblastoma subgroups. Significant differences in the location and timing of recurrence across medulloblastoma subgroups have potential treatment ramifications. Specifically, intensified local (posterior fossa) therapy should be tested in the initial treatment of patients with SHH tumours. Refinement of therapy for patients with group 3 or group 4 tumours should focus on metastases.
-
The lancet oncology · Nov 2013
Comparative StudyEconomic burden of cancer across the European Union: a population-based cost analysis.
In 2008, 2·45 million people were diagnosed with cancer and 1·23 million died because of cancer in the 27 countries of the European Union (EU). We aimed to estimate the economic burden of cancer in the EU. ⋯ Our results show wide differences between countries, the reasons for which need further investigation. These data contribute to public health and policy intelligence, which is required to deliver affordable cancer care systems and inform effective public research funds allocation.