Prostate cancer is the second most common cancer in men;therefore,the development of adequate programs of prevention is essential to achieve an early detection of the disease and to reduce the mortality.Over the years...Prostate cancer is the second most common cancer in men;therefore,the development of adequate programs of prevention is essential to achieve an early detection of the disease and to reduce the mortality.Over the years,many screening studies were conducted,but their results were conflicting.They did not report a significant reduction of cancer mortality with a high rate of overdiagnosis and overtreatment.We analyzed the main risk factors for prostate cancer,especially genetic ones,not only leading to relevant changes in the treatment of metastatic disease but also being able to guide the management of the screening.Updated data of the main screening programs were reported.Although prostate-specific antigen(PSA)resulted to be the most commonly used serum marker for diagnosis of prostate cancer,it has to be integrated with imaging tools such as magnetic resonance that also support the decision of performing a targeted biopsy.The international guidelines on screening and detection of prostate cancer are presented.They state that the individual screening should not be proposed to all men just based on age,but it should also consider comorbidities,life expectancy,individual’s preferences,and risk factors.The planning of an individual screening program should always be guided by a risk-adapted approach:the starting age of screening should be anticipated in men at higher risk,as those with African descent,germline breast cancer susceptibility gene(BRCA)mutations,and strong family history.In the future,clinical studies should include new laboratory and imaging biomarkers to better customize the screening.展开更多
BACKGROUND Non-clear cell(ncc)metastatic renal-cell carcinoma(RCC)has dismal results with standard systemic therapies and a generally worse prognosis when compared to its clear-cell counterpart.New systemic combinatio...BACKGROUND Non-clear cell(ncc)metastatic renal-cell carcinoma(RCC)has dismal results with standard systemic therapies and a generally worse prognosis when compared to its clear-cell counterpart.New systemic combination therapies have emerged for metastatic RCC(mRCC),but the pivotal phase III trials excluded patients with nccRCC,which constitute about 30%of metastatic RCC cases.AIM To provide a piece of real-life evidence on the use of pazopanib in this patient subgroup.METHODS The present study is a multicenter retrospective observational analysis aiming to assess the activity,efficacy,and safety of pazopanib as first-line therapy for advanced nccRCC patients treated in a real-life setting.RESULTS Overall,48 patients were included.At the median follow-up of 40.6 mo,the objective response rate was 27.1%,the disease control rate was 83.3%,and the median progression-free survival and overall survival were 12.3(95%confidence interval[CI]:3.6-20.9)and 27.7(95%CI:18.2-37.1)mo,respectively.Grade 3 adverse events occurred in 20%of patients,and no grade 4 or 5 toxicities were found.CONCLUSION Pazopanib should be considered as a good first-line option for metastatic RCC with variant histology.展开更多
文摘Prostate cancer is the second most common cancer in men;therefore,the development of adequate programs of prevention is essential to achieve an early detection of the disease and to reduce the mortality.Over the years,many screening studies were conducted,but their results were conflicting.They did not report a significant reduction of cancer mortality with a high rate of overdiagnosis and overtreatment.We analyzed the main risk factors for prostate cancer,especially genetic ones,not only leading to relevant changes in the treatment of metastatic disease but also being able to guide the management of the screening.Updated data of the main screening programs were reported.Although prostate-specific antigen(PSA)resulted to be the most commonly used serum marker for diagnosis of prostate cancer,it has to be integrated with imaging tools such as magnetic resonance that also support the decision of performing a targeted biopsy.The international guidelines on screening and detection of prostate cancer are presented.They state that the individual screening should not be proposed to all men just based on age,but it should also consider comorbidities,life expectancy,individual’s preferences,and risk factors.The planning of an individual screening program should always be guided by a risk-adapted approach:the starting age of screening should be anticipated in men at higher risk,as those with African descent,germline breast cancer susceptibility gene(BRCA)mutations,and strong family history.In the future,clinical studies should include new laboratory and imaging biomarkers to better customize the screening.
文摘BACKGROUND Non-clear cell(ncc)metastatic renal-cell carcinoma(RCC)has dismal results with standard systemic therapies and a generally worse prognosis when compared to its clear-cell counterpart.New systemic combination therapies have emerged for metastatic RCC(mRCC),but the pivotal phase III trials excluded patients with nccRCC,which constitute about 30%of metastatic RCC cases.AIM To provide a piece of real-life evidence on the use of pazopanib in this patient subgroup.METHODS The present study is a multicenter retrospective observational analysis aiming to assess the activity,efficacy,and safety of pazopanib as first-line therapy for advanced nccRCC patients treated in a real-life setting.RESULTS Overall,48 patients were included.At the median follow-up of 40.6 mo,the objective response rate was 27.1%,the disease control rate was 83.3%,and the median progression-free survival and overall survival were 12.3(95%confidence interval[CI]:3.6-20.9)and 27.7(95%CI:18.2-37.1)mo,respectively.Grade 3 adverse events occurred in 20%of patients,and no grade 4 or 5 toxicities were found.CONCLUSION Pazopanib should be considered as a good first-line option for metastatic RCC with variant histology.
