M Aapro

..2% of patients) but thromboembolic-related mortality was identical in both groups (1.1%). Epoetin beta provided a slight beneficial effect on tumour progression and did not impact on early survival or thromboembolic-related mortality...

..Evidence from multiple low level studies derived from audit data and clinical practice suggests that some patients receive suboptimal daily G-CSFs; the use of pegfilgrastim may avoid this problem...

..The new agents offer major advances in several cancer types and a better use of chem(radio)therapy offers it in other cancers...

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..Despite the evidence of benefit of chemotherapy in TNBC in older women, there is still a tendency for geriatric patients to receive less adjuvant chemotherapy than their younger counterparts...

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..at recommended doses, i.v. iron is well tolerated, particularly compared with oral iron, but caution should be used in some specific situations...

..Further advances are being investigated, with promising data reported from phase III trials...

..Our objective was to evaluate the effect of guideline-consistent CINV prophylaxis (GCCP) on patient outcomes...

..v. iron with or without concomitant erythropoiesis-stimulating agents (ESAs)...

..In conclusion, all cancer patients, not only those receiving potentially nephrotoxic agents, require renal monitoring...

..Finally prescribers will want to check that the lower cost of biosimilars will allow them to adhere to international guidelines. This should benefit patients and the community...

..Oral chemotherapy is one of the options for the treatment of endocrine non-responsive metastatic breast cancer...

..This review summarizes the available data for bisphosphonate benefits in both the adjuvant and metastatic settings in the context of evolving clinical practice...

..Although the addition of bevacizumab significantly improves the efficacy of chemotherapy for advanced breast cancer, regulatory concerns still exist with regard to the magnitude of the benefits and the overall safety profile...

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..The HPV vaccine--now approved for prevention of cervical cancer--might have a role in preventing oral cancers and a review of 45 studies showed that oral contraceptives reduce the risk of ovarian cancer...

..The results of this meta-analysis indicate that when used within current EORTC treatment guidelines, epoetin-beta has no negative impact on survival, tumour progression or TEEs-related mortality...

..A sustained hemoglobin level of about 12 g/dl should be the target for treatment with ESAs. ESAs should be used according to the EORTC guidelines and within label with carefully considered exceptions...

..One may hope that the near future will deliver on this, leading to an increased treatment effectiveness and decreased exposure to unjustified toxicity...

..The Breast Cancer-Anemia and the Value of Erythropoietin (BRAVE) study evaluated whether epoetin beta would improve survival in patients with metastatic breast cancer (MBC)...

..Increased patient involvement with treatment decisions will likely encourage patient compliance and thereby maximize clinical benefit from bisphosphonate therapy...

..BP are well established as supportive therapy to reduce the frequency and severity of skeletal complications in patients with bone metastases from different cancers...

..To address this issue, the Anaemia Cancer Treatment (A.C.T.) study was initiated. The background to the development of the A.C.T. study and study methodology are described...

..These data suggest that antithrombotic therapy may have the potential to reduce the risk of TVEs under epoetin therapy. These findings are hypothesis-generating and need to be confirmed in a prospective, randomised study...

..Pegfilgrastim provided effective PP in elderly patients, a population who may be vulnerable to chemotherapy-related FN and for whom current practice may not provide adequate protection...

..Bevacizumab-based combinations increase the activity and also toxicity of taxane chemotherapy, and are not a preferred option...

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..The incidence of this event can be reduced with careful oral hygiene. A positive benefit-risk ratio for bisphosphonates has been established, and ongoing clinical trials will determine whether individualized therapy is possible...

..Compliance with long-term therapy, strategies to improve adherence, and considerations in elderly patients with hormone-responsive breast cancer are also discussed...

..Therefore, the concern of negative interactions remains largely theoretical but needs to be verified with new agents extensively metabolized through the 3A4 pathway...

..These studies should also incorporate prospective evaluation of risk stratification for neutropenia and its complications...

..We evaluated the possibility to reduce the total dose of corticosteroids when palonosetron, a long-acting second-generation 5-hydroxytryptamine-3 (5-HT(3)) receptor antagonist, is used...

..Epoetin-beta is used to treat patients with cancer undergoing chemotherapy to alleviate the symptoms of anaemia, reduce the risk of blood transfusions and improve quality of life (QoL)...

..However, based on the currently available data and meta-analysis, the use of ESAs has to be carefully balanced against any possible risk for higher mortality...

..One may hope that the near future will deliver on this, leading to an increased treatment effectiveness and decreased exposure to unjustified toxicity...

..The evidence on which these conclusions are based is reviewed in this article...

..The findings of such studies are expected to lead to a greater understanding of the optimal use of epoetins in cancer-related anaemia...

..Selection of an appropriate 5-HT(3)-receptor antagonist should be based on proven efficacy and safety, as well as on the individual characteristics of the patient...

..Data also suggest that its safety profile and minimal potential for drug-drug interactions would make it an antiemetic agent of choice for elderly cancer patients...

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..This review is summarizing results of the most important trials, while trying to present data in a context useful to the clinician...

..The PubMed search engine was used to search for relevant literature (up to December 2004) and relevant international congress materials collected during 2003 and 2004...

..However, due to financial considerations, these agents often are used at lower doses than recommended...

..e., T-score < or =-2.0). These studies will provide important insight into the management of CTIBL...

..Possible reasons for the disparity, and the resulting clinical consequences, are also considered...

..Based on its safety profile, antiemetic control, and convenient dosing, palonosetron can be recommended for use in elderly patients with cancer receiving emetogenic chemotherapy...

..This review summarizes results of some of the most important randomized clinical trials, but does not attempt to solve the cost-benefit question...

..Forthcoming results from all these trials should determine whether ZA could be used to improve bone heath in women undergoing adjuvant therapy with AAAs for breast cancer...

..Finally, studies have shown that filgrastim, lenograstim and pegfilgrastim have clinical efficacy and we recommend the use of any of these agents to prevent FN and FN-related complications, where indicated...

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..However, when treatment is being given with curative intent, care should be taken to ensure reduced cardiotoxicity is not achieved at the expense of efficacy...

..On this basis, granisetron should be considered the first-choice antiemetic for patients at increased risk of cardiac complications...

..Vinorelbine has also demonstrated useful activity in the treatment of a wide range of other malignancies including prostatic carcinoma, multiple myeloma, cancer of the ovary, cervix and head and neck and malignant lymphomas...

..As in other disease settings, it may be possible to devise nonanthracycline-containing neoadjuvant regimens which are at least as effective as those in current use...

..We designed a study to evaluate the efficacy of a setron (granisetron) in the delayed phase, compared with metoclopramide, each combined with a corticosteroid...

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..Therefore, no role has been demonstrated in our cohort for the use of fotemustine, a nitrosourea, in pretreated ovarian cancer...

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..Here, the most recent developments in the antiemetic therapy, including new antiemetic drugs and the latest guidelines for antiemetic prophylaxis, are reviewed...

..A special focus is dedicated to neutropenia and the use of CSFs in the treatment of the three "big killers" among the solid tumours: breast cancer, lung cancer and colorectal cancer...

..In conclusion, no level I or II evidence-based guidelines can be given, as few adequate studies have been performed in this area, which therefore remains poorly documented...

..CONCLUSIONS: Anemic geriatric patients receiving EPO for CRA responded comparably to younger patients <65 years and should be treated similarly...

..Although this document alone may not solve all the challenges with appropriate antiemetic management, it will hopefully prove to be a step in the right direction...

..The efficacy and safety of darbepoetin alpha (DA) for treating patients with active cancer and anemia not receiving or planning to receive cytotoxic chemotherapy or myelosuppressive radiotherapy was evaluated...

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..These findings are noteworthy, since a growing body of clinical evidence indicates that the treatment of anemia can significantly improve patients' quality of life and may also improve the clinical outcome...

..It is therefore important to share and build on experiences, through research and discussion, to maximise the healthcare professional's ability to offer the best standard of care to patients...

..Use of bisphosphonate therapy should be carefully planned in patients with metastatic bone disease who have risk factors for ONJ, and appropriate preventive measures taken to avoid the development of this condition...

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..The theoretical and practical aspects of teleoncology and its current as well as future role in a multidisciplinary approach to cancer patients are discussed...