J. Feliu Batlle

Employment in a cohort of breast cancer patients

BACKGROUND Breast cancer survivors can have problems in returning to work. However, the importance of work to cancer survivors has until recently received little attention. AIMS To investigate employment- and work-related disability in a cohort of breast cancer patients to identify possible discrimination and other obstacles to remaining in work. METHODS Questionnaire study of breast cancer patients employed at diagnosis and where diagnosis had been confirmed at least 6 months before the interview. Participants completed a questionnaire concerning cancer-related symptoms and work-related factors and clinical details were obtained from their medical records. RESULTS The study included 96 consecutive patients with breast cancer aged between 18 and 65 years. In total, 80% of patients were unable to work after diagnosis, but 56% returned to work at the end of treatment. The sequelae of the disease or its treatment and the stage of disease were independently associated with the ability to work after the end of treatment. Only one patient did not tell his/her employers and coworkers about his/her disease. In total, 29% noticed changes in their relation with co-workers and managers, usually in the sense that they tried to be helpful. None reported job discrimination. CONCLUSION Breast cancer survivors in this study encountered some problems in returning to work, mainly linked to the sequelae of their disease and its treatment rather than to discrimination by employers or colleagues.

Irinotecan-cetuximab-bevacizumab as a salvage treatment in heavily pretreated metastatic colorectal cancer patients: a retrospective observational study.

Background: The objective was to evaluate the efficacy of irinotecan-cetuximab-bevacizumab in combination as a salvage treatment for heavily pretreated metastatic colorectal cancer patients. Methods: A total of 39 patients resistant to both oxaliplatin and irinotecan were included in this retrospective study. Treatment consisted of irinotecan 180/m2 every 14 days, weekly cetuximab standard dose and bevacizumab 5 mg/kg every 14 days. Results: Partial response was observed in 8 patients (20%), stable disease in 24 (61%) and progressive disease in 7 (18%). Overall response rate in KRAS wild type was 6/22 (27%) and in mutated KRAS it was 2/15 (13%). Median time to progression was 8 months (6.4–9.4) and median overall survival 12 months (10.1–13.8). Overall, grade 3–4 adverse events were observed in 24 patients (62%). Conclusions: This regimen is active and moderately well tolerated in heavily pretreated advanced colorectal patients. However, caution is advisable when interpreting these results, because they run against the findings of two large phase III trials.

Cáncer de pulmón (II). Tratamiento médico

PUNTOS CLAVE Tratamiento quirurgico. Dentro del cancer de pulmon, la variante de celula no pequena supone el 80% de casos * La cirugia es el tratamiento de eleccion de los casos de cancer de pulmon no microcitico que son resecables. Tratamiento medico. El tratamiento medico del cancer de pulmon no microcitico puede conseguir un beneficio en la mayoria de los pacientes. Tratamiento adyuvante. La quimioterapia adyuvante, basada en un esquema de cisplatino incrementa la supervivencia conseguida con la cirugia. Tratamiento neoadyuvante. El tratamiento neoadyuvante puede rescatar enfermos en estadio IIIA para la cirugia. Extension locorregional. En situacion de afectacion locorregional (estadio IIIB), la combinacion de quimioterapia y radioterapia, a ser posible concomitante, es la opcion terapeutica de eleccion. Enfermedad avanzada. La quimioterapia ha demostrado un beneficio clinico frente al mejor tratamiento de soporte, tanto en supervivencia como en reduccion de los sintomas relacionados. Terapia biologica. Las nuevas terapias dirigidas, como cetuximab y hevacizumab, ofrecen resultados muy interesantes. En caso de cetuximab, un subgrupo de pacientes con un perfil muy concreto, ya que se trata predominantemente de mujeres, con la variante de adenocarcinoma bronquioloalveolar, no fumadoras. En lo que respecta a Avastin, los resultados de este anticuerpo contra el VEGF son muy prometedores, ya que ha aumentado la supervivencia en combinacion con quimioterapia. --------------------------------------------------------------------------------