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Prevention of osteonecrosis of the jaw in the treatment with bone modifying agents
01/2021 MUDr. Lucie Reifová
Bone metastases are the major cause of morbidity and sometime mortality of patients with malignant tumours. The cancer with metastases is an incurable disease, however bone metastases are well influenced by modern systemic treatment targeted to bone - bisphosphonates and denosumab - bone modifying agents (BMA). This treatment significantly improves the quality of life of patients with bone metastases and often prolongs their life. However, it is necessary to be able to handle these substances. It is very important to start treatment early, long-term treatment, cooperation with patient and prevention and management of side effects. Bisphosphonates and denosumab are also indicated in the treatment of osteoporosis, but at a much lower dose than in the treatment of bone metastases. BMA therapy related osteonecrosis of the jaw is very difficult to treat and often leads to interruption or termination of this therapy. It is extremely important to prevent this undesirable situation.
ENTIRE ARTICLE
Bone metastases are the major cause of morbidity and sometime mortality of patients with malignant tumours. The cancer with metastases is an incurable disease, however bone metastases are well influenced by modern systemic treatment targeted to bone - bisphosphonates and denosumab - bone modifying agents (BMA). This treatment significantly improves the quality of life of patients with bone metastases and often prolongs their life. However, it is necessary to be able to handle these substances. It is very important to start treatment early, long-term treatment, cooperation with patient and prevention and management of side effects. Bisphosphonates and denosumab are also indicated in the treatment of osteoporosis, but at a much lower dose than in the treatment of bone metastases. BMA therapy related osteonecrosis of the jaw is very difficult to treat and often leads to interruption or termination of this therapy. It is extremely important to prevent this undesirable situation.
News in the treatment of metastatic HER2 positive breast cancer
01/2021 MUDr. Lucie Reifová
Metastatic breast cancer is still an uncurable disease. The prognosis of patients with HER2-positive metastatic breast cancer before the implementation of trastuzumab was poor. This targeted treatment to receptors dramatically improved the fate of patients regarding overall survival and a decrease in difficulties. A number of effective drugs has been invented since trastuzumab was implemented as the standard treatment in the last century - pertuzumab, trastuzumab emtansin (T-DM1) and lapatinib. Despite this almost all patients will suffer progression of disease and it is necessary to develop new drugs and methods. This type of cancer metastasizes to the brain very often and new drugs seem to be effective in that situation.
ENTIRE ARTICLE
Metastatic breast cancer is still an uncurable disease. The prognosis of patients with HER2-positive metastatic breast cancer before the implementation of trastuzumab was poor. This targeted treatment to receptors dramatically improved the fate of patients regarding overall survival and a decrease in difficulties. A number of effective drugs has been invented since trastuzumab was implemented as the standard treatment in the last century - pertuzumab, trastuzumab emtansin (T-DM1) and lapatinib. Despite this almost all patients will suffer progression of disease and it is necessary to develop new drugs and methods. This type of cancer metastasizes to the brain very often and new drugs seem to be effective in that situation.
Neoadjuvant hormonal therapy possibilities in breast cancer
04/2019 MUDr. Lucie Reifová
Hormonal therapy is an integral part of a multidisciplinary approach to the treatment of breast cancer with positive estrogen and/or progesteron receptors. While neoadjuvant chemotherapy is well established as a part of therapeutic regimes based on outcomes of clinical trials even in operable tumors, neoadjuvant hormonotherapy is generally used only in the treatment of locally advanced tumors, particularly in elderly population. There are a number of clinical trials comparing the efficacy of aromatase inhibitors with tamoxifen in the neoadjuvant setting, but there is a lack of comparison studies of neoadjuvant and adjuvant hormonal therapies. In addition to the effectiveness of neoadjuvant hormonotherapy in primary inoperable tumors, this treatment also leads to a reduction of mastectomies compared to breast conservation surgery. It is necessary to specify the optimal length of neoadjuvant hormonotherapy.
ENTIRE ARTICLE
Hormonal therapy is an integral part of a multidisciplinary approach to the treatment of breast cancer with positive estrogen and/or progesteron receptors. While neoadjuvant chemotherapy is well established as a part of therapeutic regimes based on outcomes of clinical trials even in operable tumors, neoadjuvant hormonotherapy is generally used only in the treatment of locally advanced tumors, particularly in elderly population. There are a number of clinical trials comparing the efficacy of aromatase inhibitors with tamoxifen in the neoadjuvant setting, but there is a lack of comparison studies of neoadjuvant and adjuvant hormonal therapies. In addition to the effectiveness of neoadjuvant hormonotherapy in primary inoperable tumors, this treatment also leads to a reduction of mastectomies compared to breast conservation surgery. It is necessary to specify the optimal length of neoadjuvant hormonotherapy.