Prostate cancer is the most common malignancy in male patients. The second‐generation taxanes, cabazitaxel, is a therapeutic option with an overall survival advantage for patients with metastatic castration‐resistant prostate cancer. This review explores specific aspects of cabazitaxel including the duration of treatment, the efficacy of lower dose and effect on the incidence of adverse effects, and optimal sequencing of cabazitaxel. A systematic search of data baselines “PubMed, Ovid Medline, Scopus, and Embase” was carried out using the keywords “cabazitaxel” and “metastatic prostate cancer.” The search was limited to clinical studies performed after October 2010 addressing duration of treatment, the efficacy of lower dose, adverse effects, the sequence of cabazitaxel in relation to other lines of therapy and use in chemotherapy naïve patients. The current evidence supports the utility and safety of cabazitaxel as either a second‐ or third‐line agent after docetaxel, or as an alternative to docetaxel in the chemotherapy‐naive setting. Extended duration of cabazitaxel beyond 10 cycles is feasible and does not appear to lead to cumulative toxicity. In conclusion, cabazitaxel can improve survival in castrate‐resistant prostate cancer with an acceptable risk of toxicity. Studies confirmed the efficacy of reduced dose and utility in patients without prior chemotherapy.
An elderly lady presented with a 2-year history of intermittent vaginal bleeding and later the development of a vulvovaginal mass. A core biopsy histology specimen from the mass and the left inguinal lymph node was suggestive of metastatic adenocarcinoma of breast origin. No breast lesion was detected on mammography, and axillary nodes were negative. The histopathologic features and the expression of GATA3, cytokeratin (CK)7, mammaglobin staining and estrogen and progesterone receptors led to a diagnosis of breast cancer originating from the ectopic mammary tissue in the vulva. Given the rarity of these lesions, and the lack of standard treatment guidelines, the management of the patient was extrapolated from the established breast cancer treatment guidelines. Radiotherapy and chemotherapy followed by hormone therapy with aromatase inhibitor were administered to this patient in the metastatic setting with good palliation.
Pulmonary hypertension is a rare vascular disease that can affect patients with or surviving malignancy resulting in significant morbidity and high mortality. Malignant diseases can lead to elevated pulmonary artery pressure through different mechanisms, either directly by structural obstruction of pulmonary vessels or indirectly through hypercoagulable state or treatment toxicity culminating in high pulmonary vascular resistance. The most common causes of cancer-related pulmonary hypertension are thromboembolic diseases, tumour emboli and treatment toxicity and less commonly intravascular tumours and malignant extrinsic compression. NOWOTWORY J Oncol 2017; 67, 4: 236-242
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