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2. Effectiveness of adjuvant trastuzumab in daily clinical practiceErika Matos, Branko Zakotnik, Cvetka Grašič-Kuhar, 2014, original scientific article Abstract: Background. Human epidermal growth factor receptor 2 (HER2) positive breast cancer is an entity with aggressive behaviour. One year of adjuvant trastuzumab significantly improves the disease free survival in the range of 40-50% and reduces the risk of dying from HER2 positive breast cancer by one third. Adjuvant treatment with trastuzumab became available in Slovenia in 2005 and the aim of this study is to explore, if the exceptional results reported in adjuvant clinical trials are achieved also in daily clinical practice. Patients and methods. An analysis of tumour and patient characteristics, type of treatment and outcome (relapse free and overall survival) of 313 patients (median age 52 years) treated at the Institute of Oncology Ljubljana in years 2005-2009 was performed. Results. Median follow-up was 4.4 years. Sixty-one patients relapsed and 24 died. Three and four years relapse free survival was 84.2% and 80.8% and the overall survival was 94.4% and 92.5%, respectively. Independent prognostic factors for relapse were tumour grade (HR 2.10; 95% CI 1.07-4.14; p = 0.031) and nodal stage (HR 1.35; 1.16-1.56; p < 0.0001) and for the overall survival nodal stage only (HR 1.36; 1.05-1.78; p = 0.021). Conclusions. The outcome in patients with adjuvant trastuzumab in daily clinical practice, treated by medical oncologists, is comparable to results obtained in international adjuvant studies.
Keywords: breast cancer, trastuzumab, adjuvant, clinical practice
Published in DiRROS: 11.04.2024; Views: 97; Downloads: 15
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4. Triple negative breast cancer : prognostic factors and survivalTanja Ovčariček, Snježana Frković-Grazio, Erika Matos, Barbara Možina, Simona Borštnar, 2011, original scientific article Abstract: Background. Triple negative breast cancer (TNBC) is defined by a lack of expression of both estrogen (ER) and progesteron(PgR) receptors as well as human epidermal growth factor receptor 2 (HER2). Our retrospective analysis addressed prognostic factors for short- and long-term outcomes of patients (pts) with TNBC pts treated in routine clinical practice. Patient and methods.Our retrospective study included 269 TNBC treated at Institute of Oncology Ljubljana between March 2000 and December 2006. The collected data included patientsć, tumoursć and treatmentsć characteristics. The survival analyses were performed using the Kaplan-Meier method. The Cox proportional hazard model was used in the multivariate analysis. Results. The median age ofour patients was 55.3 yrs (23-88.5) and the median follow-up was 5.9 yrs (0.3-9.6). Six (2%) pts experienced local only, 79 (92%) pts distal recurrenceand 66 (24%) died. The predominant localisation of the first relapsewas in visceral organs (70.4%). The 5-year disease-free survival (DFS) for the entire group was 68.2% and the 5-year overall survival (OS) was 74.5%.We found a pattern of high recurrence rate in the first 3 years following the diagnosis and a clear decline in recurrence rate over the next 3years. In the univariate analysis age, nodal status, size and lymphovascular invasion (LVI) were found to have a significant impact on DFS as well as on OS. In the multivariate analysis only age (HR=1.79; 95%CI=1.14-2.82; p=0.012) and nodal status (HR=2.71; 95%CI=1.64-4.46; p<0.001) retained their independent prognostic value for DFS and for OS only the nodal status (HR=2.96; 95%CI=1.51-5.82; p=0.002). (Abstract truncated at 2000 characters)
Published in DiRROS: 19.03.2024; Views: 92; Downloads: 30
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5. Adjuvant treatment of breast cancer patients with trastuzumabErika Matos, Tanja Čufer, 2007, review article Abstract: Background. Trastuzumab is a monoclone antibody directed against HER2 receptors that are overexpressed in approximately 20% of breast cancer patients. The present paper presents five clinical trials in which trastuzumabwas applied in breast cancer patients in adjuvant setting. The results of all the trials consistently demonstrate a high efficacy of this target drug in the patients with HER2 positive tumours. So far, no formal guidelines for using trastuzumab in adjuvant setting for breast cancer have been approved. The reasons are many: (i) mean observation time in the studies done so far was considerably short; (ii) the drug was used according to different schedules, (iii) the overall time of treatment with trastuzumab was different in each trial, (iv) late side effects of treatment with trastuzumab are inadequately investigated, and (v) nobody can so far say for sure for which HER2 status patients therapy with trastuzumab is really beneficial. Conclusions. Trastuzumab is definitely very helpful in the treatment of the HER2-positive breast cancer patients that are hormone-independent and of anatomically larger tumours; but, what the absolute benefit of trastuzumab therapy in the treatment of small hormone-dependent tumours is remains a mystery. Incidentally, it must be borne in mind that cardiotoxicity, the well known side effect, may put particularly elderly patients at risk of death, thus beating any treatment advantages down. It has also not been yet resolved at what time it would be most appropriate to start with the therapy with trastuzumab, what would be the optimal duration of the therapy and whether trastuzumab is to be administered concurrently with chemotherapy or immediately after it? What is the optimal treatment duration, one or two yearsor only a few months? In addition there is still a question of optimal HER2 status determination and which HER2 status predicts for trastuzumab benefit. (Abstract truncated at 2000 characters)
Published in DiRROS: 22.02.2024; Views: 177; Downloads: 29
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8. Vloga zaviralcev imunskih kontrolnih točk pri zdravljenju raka neznanega izvoraErika Matos, Kaja Cankar, 2023, published scientific conference contribution Abstract: Rak neznanega izvora (RNI) je histološko potrjen rak, pri keterem anatomski izvor kljub izčrpni diagnostiki ostane nerazpoznan. Trenutno nimamo dokazov, da bi identifikacija tkivnega izvora RNI in usmerjeno zdravljenje izboljšalo preživetje bolnikov, v primerjavi z empiričnim zdravljenjem, je pa pomembno, da v skupini bolnikov z RNI identificiramo in ustrezno zdravimo tiste bolnike, ki jih uvrščano v prognostično ugodno skupino. Zaviralci imunskih kontrolnih točk (ZIKT) so učinkovita zdravila za zdravljenje malignih bolezni različnega izvora. V literaturi najdemo anekdotične opise učinkovitosti te skupine zdravil tudi pri bolnikih z rakom neznanega izvora (RNI). Rezultati edine do sedaj zaključene raziskave, ki je usmerjeno proučevala ZIKT pri bolnikih z RNI, NivoCUP, faza 2, kažejo na potencialno učinkovitost nivolumaba pri bolnikih z RNI. Objektivni odgovor je bil dosežen pri 21,4% bolnikov, med njimi tudi tistih z verjetno kemo-rezistentnimi tumorji, pri nekaterih bolnikih so bili odgovori na zdravljenje dolgotrajni. Rezultati sicer potrebujejo potrditev z obsežnejšo, randomizirano raziskavo. Pembrolizumab je trenutno edini ZIKT, ki ima s strani ameriške regulatorne organizacije (FDA) odobritev za agnostično zdravljenje v primeru dokazane okvare proteinov za popravljanje neujemanja oz. visoke mikrosatelitne nestabilnosti (MSI-H/MMRd) ali visokem tumorskem bremenu v DNK tumorske celice (TMB-H). Potrebujemo še dodatne prediktivne bio-markerje, s pomočjo katerih se bomo bolj zanseljivo odločali o optimalnem zdravljenju bolnikov z RNI.
Keywords: imunoterapija, onkologija, onkološko zdravljenje
Published in DiRROS: 16.02.2023; Views: 377; Downloads: 185
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