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3.
Cureus ; 10(7): e2982, 2018 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-30237943

RESUMO

Thymic carcinomas are the most aggressive histological subtype of thymic tumors with limited data to guide correct management. No standard treatments are available for patients with advanced thymic carcinoma after progressing while on platinum-based chemotherapy. We present a case of a patient with metastatic thymic carcinoma with an unusual response and favorable evolution after receiving treatment with sunitinib, obtaining a progression-free survival of 23 months, much higher than reported to date. We review the literature on the efficacy of sunitinib in metastatic thymic carcinoma after progression to first-line treatment with platinum combinations.

4.
Med. clín (Ed. impr.) ; 151(5): 198-206, sept. 2018. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-173884

RESUMO

Durante medio siglo los antagonistas de la vitamina K han sido la única opción disponible para la terapia anticoagulante oral. En los últimos años se han desarrollado anticoagulantes orales directos: un inhibidor directo de la trombina (dabigatrán etexilato) y 3 inhibidores directos del factor X activado (rivaroxabán, apixabán y edoxabán). Todos ellos han demostrado un beneficio-riesgo favorable, comparables en eficacia y seguridad a los anticoagulantes tradicionales antagonistas de la vitamina K, en la prevención del ictus y la embolia sistémica en pacientes con fibrilación auricular no valvular, la profilaxis y el tratamiento del tromboembolismo venoso y el síndrome coronario agudo. En 2008 la Agencia Europea del Medicamento aprobó el primer anticoagulante oral directo, dabigatrán. Posteriormente, rivaroxabán, apixabán y edoxabán fueron autorizados. En este artículo se revisa la experiencia acumulada con cada uno de estos fármacos


Vitamin K antagonists were the only choice for chronic oral anticoagulation for more than half a century. Over the past few years, direct oral anticoagulants have emerged, including one direct thrombin inhibitor (dabigatran etexilate) and three factor Xa inhibitors (apixaban, edoxaban and rivaroxaban). In randomised controlled trials comparing direct oral anticoagulants with traditional vitamin K antagonists, the direct oral anticoagulants all showed a favourable benefit-risk balance in their safety and efficacy profile, in prevention of thromboembolic events in patients with atrial fibrillation and in the prevention and treatment of venous thromboembolism and acute coronary syndrome. In 2008, dabigatran was the first direct oral anticoagulant approved by the European Medicine Agency. Subsequently, rivaroxaban, apixaban and edoxaban were also authorised. This article reviews the evidence related to the use of these drugs


Assuntos
Humanos , Dabigatrana/uso terapêutico , Rivaroxabana/uso terapêutico , Inibidores do Fator Xa/uso terapêutico , Tromboembolia Venosa , Anticoagulantes/uso terapêutico , Administração Oral , Vitamina K/antagonistas & inibidores , Doenças Cardiovasculares
5.
Med Clin (Barc) ; 151(5): 198-206, 2018 09 14.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-29295790

RESUMO

Vitamin K antagonists were the only choice for chronic oral anticoagulation for more than half a century. Over the past few years, direct oral anticoagulants have emerged, including one direct thrombin inhibitor (dabigatran etexilate) and three factor Xa inhibitors (apixaban, edoxaban and rivaroxaban). In randomised controlled trials comparing direct oral anticoagulants with traditional vitamin K antagonists, the direct oral anticoagulants all showed a favourable benefit-risk balance in their safety and efficacy profile, in prevention of thromboembolic events in patients with atrial fibrillation and in the prevention and treatment of venous thromboembolism and acute coronary syndrome. In 2008, dabigatran was the first direct oral anticoagulant approved by the European Medicine Agency. Subsequently, rivaroxaban, apixaban and edoxaban were also authorised. This article reviews the evidence related to the use of these drugs.


Assuntos
Antitrombinas/uso terapêutico , Acidente Vascular Cerebral/prevenção & controle , Síndrome Coronariana Aguda/prevenção & controle , Administração Oral , Anticoagulantes/administração & dosagem , Anticoagulantes/efeitos adversos , Anticoagulantes/uso terapêutico , Antitrombinas/administração & dosagem , Antitrombinas/efeitos adversos , Fibrilação Atrial/complicações , Ensaios Clínicos como Assunto , Dabigatrana/administração & dosagem , Dabigatrana/uso terapêutico , Inibidores do Fator Xa/administração & dosagem , Inibidores do Fator Xa/uso terapêutico , Hemorragia/induzido quimicamente , Hemorragia/terapia , Humanos , Complicações Pós-Operatórias/prevenção & controle , Pirazóis/administração & dosagem , Pirazóis/uso terapêutico , Piridinas/administração & dosagem , Piridinas/uso terapêutico , Piridonas/administração & dosagem , Piridonas/uso terapêutico , Rivaroxabana/administração & dosagem , Rivaroxabana/uso terapêutico , Prevenção Secundária , Tiazóis/administração & dosagem , Tiazóis/uso terapêutico , Tromboembolia Venosa/prevenção & controle , Suspensão de Tratamento
6.
Medwave ; 17(6): e7007, 2017 Jul 31.
Artigo em Espanhol | MEDLINE | ID: mdl-28777782

RESUMO

There are no approved therapeutic regimes for adrenal carcinoma following progression to a first line of chemotherapy/mitotane although a high percentage of patients are candidates to receive them. In the present article we review the possible therapeutic alternatives after the progression to a first line of treatment in patients with adrenal carcinoma and we report a case in which a prolonged overall survival is achieved, much higher than expected, probably in relation to the multidisciplinary management of the case and the use of most of the therapeutic arsenal available.


Assuntos
Neoplasias do Córtex Suprarrenal/tratamento farmacológico , Carcinoma Adrenocortical/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias do Córtex Suprarrenal/patologia , Carcinoma Adrenocortical/patologia , Adulto , Humanos , Masculino , Mitotano/administração & dosagem , Cuidados Paliativos/métodos , Equipe de Assistência ao Paciente/organização & administração , Taxa de Sobrevida
9.
World J Oncol ; 6(6): 485-490, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28983351

RESUMO

Adrenocortical carcinoma (ACC) is a rare and heterogeneous malignancy, with an incidence of approximately 0.72 per million cases per year leading to 0.2% of all cancer deaths in the United States. Metastatic ACC has a dismal prognosis with an overall survival of less than 1 year. We present a case of a 37-year-old man with metastatic ACC with unusual good prognosis and review the therapeutic options in the literature.

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