AIM:To evaluate the current role of sorafenib,an oral multikinase inhibitor in the treatment of breast cancer.METHODS:An extensive search of the literature until March 2016 was carried out in Medline and clinicaltrial...AIM:To evaluate the current role of sorafenib,an oral multikinase inhibitor in the treatment of breast cancer.METHODS:An extensive search of the literature until March 2016 was carried out in Medline and clinicaltrials.gov,by using the search terms "sorafenib" and "breast cancer".Papers found were checked for further relevant publications.Overall,21 relevant studies were found,18 in advanced breast cancer(16 in stage Ⅳ and two in stages Ⅲ-Ⅳ) and three in early breast cancer.RESULTS:Among studies in advanced breast cancer,there were two trials with sorafenib as monotherapy,four trials of sorafenib in combination with taxanes,two in combination with capecitabine,one with gemcitabine and/or capecitabine,one with vinorelbine,one with bevacizumab,one with pemetrexed and one with ixabepilone,three trials of sorafenib in combination with endocrine therapy and two trials in women with brain metastases undergoing whole brain radiotherapy.In addition,there was one trial of sorafenib added to standard chemotherapy in the adjuvant setting,and two trials in the neoadjuvant setting.In general,sorafenib was well tolerated in breast cancer patients,though its dosage had to be adjusted in some trials,and discontinuation rates were high,particularly for the combination of sorafenib with anastrozole.Sorafenib monotherapy and combinations with taxanes,bevacizumab and ixabepilone showed inadequate efficacy,while efficacy results from combinations with gemcitabine and/or capecitabine and possibly tamoxifen were more promising.CONCLUSION:At present,sorafenib should not be used for the treatment of breast cancer outside of clinical trials and more clinical data are needed in order to support its standard use in breast cancer therapy.展开更多
Intrahepatic cholangiocarcinoma(iCCA)is a subgroup of cholangiocarcinoma that accounts for about 10%-20%of the total cases.Infection with hepatitis B virus(HBV)is one of the most important predisposing factors leading...Intrahepatic cholangiocarcinoma(iCCA)is a subgroup of cholangiocarcinoma that accounts for about 10%-20%of the total cases.Infection with hepatitis B virus(HBV)is one of the most important predisposing factors leading to the formation of iCCA.It has been recently estimated based on abundant epidemiological data that the association between HBV infection and iCCA is strong with an odds ratio of about 4.5.The HBV-associated mechanisms that lead to iCCA are under intense investigation.The diagnosis of iCCA in the context of chronic liver disease is challenging and often requires histological confirmation to distinguish from hepatocellular carcinoma.It is currently unclear whether antiviral treatment for HBV can decrease the incidence of iCCA.In terms of management,surgical resection remains the mainstay of treatment.There is a need for effective treatment modalities beyond resection in both first-and second-line treatment.In this review,we summarize the epidemiological evidence that links the two entities,discuss the pathogenesis of HBV-associated iCCA,and present the available data on the diagnosis and management of this cancer.展开更多
文摘AIM:To evaluate the current role of sorafenib,an oral multikinase inhibitor in the treatment of breast cancer.METHODS:An extensive search of the literature until March 2016 was carried out in Medline and clinicaltrials.gov,by using the search terms "sorafenib" and "breast cancer".Papers found were checked for further relevant publications.Overall,21 relevant studies were found,18 in advanced breast cancer(16 in stage Ⅳ and two in stages Ⅲ-Ⅳ) and three in early breast cancer.RESULTS:Among studies in advanced breast cancer,there were two trials with sorafenib as monotherapy,four trials of sorafenib in combination with taxanes,two in combination with capecitabine,one with gemcitabine and/or capecitabine,one with vinorelbine,one with bevacizumab,one with pemetrexed and one with ixabepilone,three trials of sorafenib in combination with endocrine therapy and two trials in women with brain metastases undergoing whole brain radiotherapy.In addition,there was one trial of sorafenib added to standard chemotherapy in the adjuvant setting,and two trials in the neoadjuvant setting.In general,sorafenib was well tolerated in breast cancer patients,though its dosage had to be adjusted in some trials,and discontinuation rates were high,particularly for the combination of sorafenib with anastrozole.Sorafenib monotherapy and combinations with taxanes,bevacizumab and ixabepilone showed inadequate efficacy,while efficacy results from combinations with gemcitabine and/or capecitabine and possibly tamoxifen were more promising.CONCLUSION:At present,sorafenib should not be used for the treatment of breast cancer outside of clinical trials and more clinical data are needed in order to support its standard use in breast cancer therapy.
文摘Intrahepatic cholangiocarcinoma(iCCA)is a subgroup of cholangiocarcinoma that accounts for about 10%-20%of the total cases.Infection with hepatitis B virus(HBV)is one of the most important predisposing factors leading to the formation of iCCA.It has been recently estimated based on abundant epidemiological data that the association between HBV infection and iCCA is strong with an odds ratio of about 4.5.The HBV-associated mechanisms that lead to iCCA are under intense investigation.The diagnosis of iCCA in the context of chronic liver disease is challenging and often requires histological confirmation to distinguish from hepatocellular carcinoma.It is currently unclear whether antiviral treatment for HBV can decrease the incidence of iCCA.In terms of management,surgical resection remains the mainstay of treatment.There is a need for effective treatment modalities beyond resection in both first-and second-line treatment.In this review,we summarize the epidemiological evidence that links the two entities,discuss the pathogenesis of HBV-associated iCCA,and present the available data on the diagnosis and management of this cancer.
