RESUMO
Colorectal cancer is one of the most frequent cancers in the world and between 50% and 60% of patients will develop colorectal liver metastases (CRLM) during the disease. There have been great improvements in the management of CRLM during the last decades. The combination of modern chemotherapeutic and biological systemic treatments with aggressive surgical resection strategies is currently the base for the treatment of patients considered unresectable until few years ago. Furthermore, several new treatments for the local control of CRLM have been developed and are now part of the arsenal of multidisciplinary teams for the treatment of these complex patients. The aim of this review was to summarize and update the management of CRLM, its controversies and relevant evidence.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Colorretais/patologia , Hepatectomia/métodos , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/terapia , Camptotecina/análogos & derivados , Camptotecina/uso terapêutico , Eletroporação/métodos , Fluoruracila/uso terapêutico , Artéria Hepática , Humanos , Infusões Intra-Arteriais , Leucovorina/uso terapêutico , Transplante de Fígado , Margens de Excisão , Micro-Ondas/uso terapêutico , Compostos Organoplatínicos/uso terapêutico , Prognóstico , Ablação por Radiofrequência , ReoperaçãoRESUMO
El cáncer de mama HER2 positivo supone aproximadamente un 15% de los tumores malignos de mama. La terapia anti-HER2, principalmente representada por trastuzumab, es el pilar del tratamiento de esta enfermedad. La prolongación en la supervivencia que han conseguido las nuevas terapias anti-HER2, y el tratamiento dilatado de estas pacientes en los estadios precoces de la enfermedad así como en la enfermedad avanzada, supone un importante reto a los recursos existentes, tanto con respecto al personal sanitario y el tiempo de los hospitales de día oncológicos, como en cuanto al tiempo dedicado por las pacientes para su tratamiento. El desarrollo de una formulación subcutánea ha supuesto una disminución significativa en la utilización de estos recursos y facilidad de uso. En esta revisión, presentamos el desarrollo de esta nueva formulación, así como los datos de eficacia y preferencia (AU)
HER2-positive breast cancer accounts for approximately 15% of all malignant breast tumors. HER2-targeted therapy, mainly trastuzumab, remains the cornerstone of treatment. The increase in survival achieved by the new anti-HER2 therapies, and the prolonged treatment of these patients, both in the early and advanced breast cancer setting, poses a major challenge to existing health resources. This challenge involves the health personnel, the time consumed by oncologic day hospitals, and the time investment required by patients. The development of the new trastuzumab subcutaneous formulation has improved optimization of health resources and has increased ease of use. In the present article, we review the development of the drug, as well as efficacy and preference data (AU)
Assuntos
Humanos , Feminino , Neoplasias da Mama/tratamento farmacológico , /análise , /isolamento & purificação , Infusões Subcutâneas/instrumentação , Infusões Subcutâneas/métodos , Infusões Subcutâneas , Fluoruracila/uso terapêutico , Prognóstico , Resultado do Tratamento , Avaliação de Eficácia-Efetividade de Intervenções , Administração Intravenosa/métodos , Administração IntravenosaRESUMO
A 69 year old man with idiopathic chronic kidney disease was diagnosed with relapsing EGFR negative, ALK positive lung adenocarcinoma, and treated with chemotherapy and antiangiogenic treatment, under which his renal insufficiency worsened. During second line crizotinib treatment, further worsening of the renal function was seen, with very clear correlation with crizotinib withdrawal and rechallenge. No further drug causes for the worsening blood creatinine values were detected.