[Show abstract][Hide abstract] ABSTRACT: More than one thousand patients die due to cutaneous melanoma in Poland every year. Apart from high mortality constantly growing incidence with doubling rate in 10 years is also the great concern. Other problems include limited treatment modalities and unsatisfactory results of systemic therapy in advanced melanoma. Activation of antitumor immune response through blockade of CTLA-4 molecule expressed on T cells seems to be a promising treatment for melanoma. Randomized clinical trials showed that administration of anti-CTLA-4 antibodies statistically significantly prolongs overall survival of melanoma patients after failure of previous systemic therapy. Although clinical benefit is limited to minority of pa- tients, this led to the market approval of this drug in US and Europe. Since kinetics of clinical response to ipilimumab is different from standard chemotherapy employment of the immune-related response criteria (modified RECIST criteria) is recommended for evaluation of objective responses to the therapy. The risk of immune related adverse events necessitates careful patient selection and incisive observation during and after ipilimumab treatment. Prompt application of appropriate immunosuppressive and supportive therapy might enable to avoid uncontrolled activation of autoreactive immune response.
[Show abstract][Hide abstract] ABSTRACT: The antiestrogen tamoxifen may have partial estrogen-like effects on the postmenopausal uterus. Aromatase inhibitors (AIs) are increasingly used after initial tamoxifen in the adjuvant treatment of postmenopausal early breast cancer due to their mechanism of action: a potential benefit being a reduction of uterine abnormalities caused by tamoxifen.
Sonographic uterine effects of the steroidal AI exemestane were studied in 219 women participating in the Intergroup Exemestane Study: a large trial in postmenopausal women with estrogen receptor-positive (or unknown) early breast cancer, disease free after 2-3 years of tamoxifen, randomly assigned to continue tamoxifen or switch to exemestane to complete 5 years adjuvant treatment. The primary end point was the proportion of patients with abnormal (> or =5 mm) endometrial thickness (ET) on transvaginal ultrasound 24 months after randomisation.
The analysis included 183 patients. Two years after randomisation, the proportion of patients with abnormal ET was significantly lower in the exemestane compared with tamoxifen arm (36% versus 62%, respectively; P = 0.004). This difference emerged within 6 months of switching treatment (43.5% versus 65.2%, respectively; P = 0.01) and disappeared within 12 months of treatment completion (30.8% versus 34.7%, respectively; P = 0.67).
Switching from tamoxifen to exemestane significantly reverses endometrial thickening associated with continued tamoxifen.
Full-text · Article · Aug 2009 · Annals of Oncology
[Show abstract][Hide abstract] ABSTRACT: Lung cancer is in Poland the most common malignancy. Non-small cell lung cancer (NSCLC) accounts for approximately 80% of all lung tumors. In the multidisciplinary treatment of non-small cell lung cancer patients the role of chemotherapy and, most recently, molecular targeted therapy is increasing. In 2005 we published recommendations for systemic treatment of non-small cell lung cancer and mesothelioma. As many new studies have been published since, it was necessary to update this document. We present here a consensus statement on this topic, prepared by a panel of experts in oncology, thoracic surgery, pathology and pneumonology.
No preview · Article · Feb 2008 · Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc
[Show abstract][Hide abstract] ABSTRACT: Small-cell lung cancer is characterized by an aggressive clinical course with high tendency for early dissemination. At presentation, patients are usually symptomatic and with hilar or mediastinal mass at radiography. Staging should be focused on identifying any evidence of distant spread. Chemotherapy including cisplatin and etoposide is a cornerstone of treatment for all patients. Limited-stage disease should be managed by chemotherapy combined with concurrent chest irradiation. All patients who achieve complete response should be considered for elective cranial irradiation. Surgical treatment may be used in highly selected patients with TNM stage I disease, and surgery should always be combined with chemotherapy. Extensive-stage disease should be managed by multi-agent chemotherapy alone. Long-term survivors should undergo careful monitoring for development of a second primary tumour.
No preview · Article · Feb 2007 · Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to perform a retrospective analysis the prognostic factors of the risk of treatment failure in breast cancer patients treated with primary modified radical mastectomy at one institution. The study group included 684 patients treated between 1990 and 1997. During the follow-up period recurrence was observed in 194 patients (28%). The analysis was based on the site of first recurrence. The basic categories of the first site of relapse were defined as loco-regional and distant. The latter site was subdivided into three sub-groups: soft tissue, bone and viscera metastases according to the rule of dominant site of disease. In 141 patients relapse was confined to one site, and 53 patients it was observed at two or more sites. Isolated local and/or regional relapse occurred in 65 patients, soft tissue metastases as the dominant site in 49 cases, bone metastases in 54 cases and visceral metastases in 92 cases.. Primary tumor stage, number of involved lymph nodes, fat tissue involvement and presence of vessel invasion differed significantly between the groups with and without relapse. Actuarial survival probability at 5 years was 77% and disease free survival probability - 68%. The cumulated risk of local and/or regional relapse at 5 years and 10 years was 9% and 13%, respectively. The respective rates for soft tissue metastases were 7% and 10%, for bones 8% and 18% and for the viscera - 14% and 18%. At each of the analyzed sites the occurrence of relapse was significantly influenced by the number of involved lymph nodes. Bone metastases were more frequent in ductal cancer, and the risk of visceral metastases was associated with primary tumor stage. The results of this analysis suggest that the number of involved axillary lymph nodes is the strongest clinical factor which allows to predict the risk of treatment failure in breast cancer.