ABSTRACT
Lung cancer (LC) is associated with ageing, with the average age of affected individuals being approximately 70 years. However, despite a higher incidence and prevalence among older people, the older adult population is underrepresented in clinical trials. For LC with Epidermal Growth Factor Receptor (EGFR) mutations, there is no clear association of this mutation with age. Geriatric assessments (GAs) and a multidisciplinary approach are essential for defining the optimal treatment. In this consensus, a group of experts selected from the Oncogeriatrics Section of the Spanish Society of Medical Oncology (Sección de Oncogeriatría de la Sociedad Española de Oncología MédicaSEOM), the Spanish Lung Cancer Group (Grupo Español de Cáncer de PulmónGECP) and the Association for Research on Lung Cancer in Women (Asociación para la Investigación del Cáncer de Pulmón en MujeresICAPEM) evaluate the scientific evidence currently available and propose a series of recommendations to optimize the management of older adult patients with advanced LC with EGFR mutations (AU)
Subject(s)
Humans , Male , Female , Aged , Carcinoma, Non-Small-Cell Lung/drug therapy , Carcinoma, Non-Small-Cell Lung/genetics , Lung Neoplasms/drug therapy , Lung Neoplasms/genetics , Consensus , Receptor, ErbB-2/geneticsABSTRACT
Oligometastatic disease (OMD) defines a status of cancer that is intermediate between localized and widely spread metastatic disease, and can be treated with curative intent. While imaging diagnostic tools have considerably improved in recent years, unidentified micrometastases can still escape from current detection techniques allowing disease to progress. The variety of OMD scenarios are mainly defined by the number of metastases, the biological and molecular tumour profiles, and the timing of the development of metastases. Increasing knowledge has contributed to the earlier and improved detection of OMD, underlining the importance of an early disease control. Based on increasing detection rates of OMD in the current real clinical practice and the lack of standardized evidence-based guidelines to treat this cancer status, a board of experts from the Spanish Societies of Radiation Oncology (SEOR) and Medical Oncology (SEOM) organized a series of sessions to update the current state-of-the-art on OMD from a multidisciplinary perspective, and to discuss how results from clinical studies may translate into promising treatment options. This experts review series summarizes what is known and what it is pending clarification in the context of OMD in the scenarios of Non-Small Cell Lung Cancer and Breast Cancer (Part I), and Prostate Cancer and Colorectal Cancer (Part II), aiming to offer specialists a pragmatic framework that might contribute to the improved management of patients (AU)
Subject(s)
Humans , Male , Colorectal Neoplasms/radiotherapy , Prostatic Neoplasms/radiotherapy , Colorectal Neoplasms/surgery , Prostatic Neoplasms/surgery , Radiosurgery/methods , Colorectal Neoplasms/pathology , Prostatic Neoplasms/pathologyABSTRACT
Objetivo: La comparación indirecta ajustada con emparejamiento es unametodología desarrollada para la evaluación de nuevos tratamientos frente asus alternativas cuando no se dispone de comparación directa mediante unensayo clínico aleatorizado y controlado. Estas comparaciones son de especial interés en el área de la hematooncología, en la que la incertidumbre en latoma de decisiones sobre la inclusión de nuevos fármacos se ve frecuentementeacentuada tanto por la gravedad de la enfermedad como por el elevadocoste del tratamiento. El objetivo de este artículo es describir cómo la metodología de comparación indirecta ajustada con emparejamiento ha sido empleadahasta la fecha en la evaluación de fármacos hematooncológicos por parte deagencias internacionales.Método: Para la obtención de los datos del análisis se ha realizado una búsqueda exhaustiva en las páginas web de las agencias nacionales europeasentre enero de 2015 y octubre de 2019 que mostraran información públicadel proceso evaluativo. Se revisaron las evaluaciones de estas agencias paraobtener un listado de fármacos oncohematológicos para los que constara lapresentación de documentación de una comparación indirecta ajustada con emparejamiento. Para este listado de fármacos se analizó para cada agenciaseleccionada el papel que dicha comparación tuvo en la evaluación.Resultados: Se han encontrado 13 tratamientos para patologías hematooncológicas en las que el laboratorio había presentado comparaciones conmetodología de comparación indirecta ajustada con emparejamiento en sudocumentación, principalmente a partir del primer semestre de 2018. (AU)
Objective: Matching-Adjusted Indirect Comparison is a methodologythat has been developed to assess new treatments vs alternatives whena direct comparison is not available through a randomized controlledtrial. These comparisons are of particular interest in the areas of oncology and hematology where uncertainty in decision-making on the inclusion of new drugs is frequently accentuated by both the severity of thedisease and the high cost of treatment. The objective of this study wasto describe how Matching-Adjusted Indirect Comparison methodologyhas been used to date in the assessment of hematological cancer drugsby international agencies.Method: Between January 2015 and October 2019, an exhaustivesearch was conducted of the websites of European National Agencies that provided public information on the assessment process. Theassessments provided by these agencies were reviewed to obtain a listof hematological cancer drugs for which the presentation of a MatchedAdjusted Indirect Comparison was recorded. For this list of drugs, the role of the comparison in the assessment process was analyzed for eachselected agency.Results: Thirteen hematological and oncological treatments were foundin which the pharmaceutical marketing authorization holder had presentedMatching-Adjusted Indirect Comparisons: most of this information referredto the first half of 2018. Acceptance of this methodology diverges amongagencies, ranging from 50% in the case of the British National Institutefor Health and Clinical Excellence, to 40% in the case of French NationalAuthority for Health, to not having been taken into account in any of the3 cases assessed by the German Institute for Quality and Efficiency inHealth Care. The main cause of non-acceptance was matching-relatedproblems.Conclusions: Matching- Adjusted Indirect Comparison methodology isa tool that is being utilized in the decision-making process for assessingnew hematological cancer treatments. (AU)
Subject(s)
Humans , Medical Care , Pharmaceutical Preparations , Therapeutics , Leukemia, MyeloidABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Pleural Neoplasms/diagnostic imaging , Biopsy , Thigh/pathology , Neoplasm Metastasis/diagnostic imaging , Thoracoscopy/methods , Muscular Diseases/diagnostic imaging , Muscular Diseases/pathology , Musculoskeletal Pain/etiology , Musculoskeletal Pain/pathology , Musculoskeletal System/pathologyABSTRACT
No disponible
Subject(s)
Humans , Female , Adult , Sarcoma/diagnosis , Sarcoma , Sarcoma/therapy , Lung Neoplasms/complications , Lung Neoplasms/diagnosis , Lung Neoplasms/radiotherapyABSTRACT
No disponible
Subject(s)
Aged , Female , Humans , Adenocarcinoma/diagnosis , Adenocarcinoma/pathology , Lung Neoplasms/diagnosis , Lung Neoplasms/pathology , Solitary Pulmonary Nodule/pathology , ErbB Receptors/genetics , ErbB Receptors/antagonists & inhibitors , Genes, erbB-1 , Mutation , BiopsyABSTRACT
No disponible
Subject(s)
Female , Humans , Middle Aged , Solitary Fibrous Tumor, Pleural/diagnosis , Pleural Neoplasms/diagnosis , Chest Pain/etiology , Diagnosis, DifferentialABSTRACT
Bevacizumab has been shown to be effective combined with chemotherapy for first-line treatment of advanced colorectal cancer, but little information is available about its efficacy and safety in patients who may be candidates for surgery at any time during the disease. The case history of a female patient with colorectal cancer, undergoing surgery for liver metastases and bilateral surgery for lung metastases at different time-points during her disease, is reported. Perioperative bevacizumab administration caused no complications either associated with surgery, in the early postoperative period, or in the subsequent months.
ABSTRACT
Cada año se diagnostican en España 18.000 nuevos casos de cáncer de pulmón (CP). Aproximadamente el 80-90% de los casos se relacionan con el consumo de tabaco. El humo del tabaco contiene más de 300 sustancias químicas, de las que más de 40 son potenciales carcinógenos. En la última década, tanto en España como en Europa, se ha observado una preocupante tendencia al aumento de la prevalencia de mujeres fumadoras. El abandono del hábito tabáquico reduce sustancialmente el riesgo de desarrollar un CP, que, no obstante, no iguala al de los individuos que nunca han fumado. Por otra parte, la exposición ambiental al tabaco también ha demostrado ser causa de un aumento del riesgo de desarrollar CP. Este trabajo ofrece una revisión actualizada sobre los principales factores etiológicos del CP, el riesgo asociado al consumo de tabaco y a su exposición ambiental, los factores genéticos asociados y la exposición medioambiental a sustancias como el arsénico, el asbesto o los hidrocarburos aromáticos policíclicos
Every year, in Spain 18,000 new cases of lung cancer (LC) are diagnosed. Approximately, 80-90% LC in men and women are directly attributable to tobacco abuse. Cigarette smoke contains over 300 chemicals, 40 of which are known to be potent carcinogens. In the last decade, as in Spain, prevalence of smoking in women has generally increased in the European Union. LC risk can be substantially reduced after smoking cessation, yet never reaches baseline. On the other hand, environmental tobacco smoke exposure (passive smoking) in nonsmokers appears to have a significantly increased risk of LC. An updated of etiology factors of LC, risk related to duration as well as intensity of smoking, relationship between environmental tobacco smoke exposure and LC risk, genetic predisposition and a variety of occupational and environmental exposures implicated as potential risk factors for the development of LC will be reviewed here
