You are here
Toxicity and quality of life after adjuvant chemoradiotherapy versus radiotherapy alone for women with high-risk endometrial cancer (PORTEC-3): an open-label, multicentre, randomised, phase 3 trial
Stephanie M de Boer, Melanie E Powell, Linda Mileshkin, Dionyssios Katsaros, Paul Bessette, Christine Haie-Meder, Petronella B Ottevanger, Jonathan A Ledermann, Pearly Khaw, Alessandro Colombo, Anthony Fyles, Marie-Helene Baron, Henry C Kitchener, et al.The Lancet Oncology, Volume 17, Issue 8, August 2016, Pages 1114 - 1126
Presentation by Dr. Laurent Zelek at the TAO Congress on 19/20 November 2015Treatment-induced toxicities represent a major problem in cancer therapy. Toxicities which cannot be managed by curative treatment or supportive care...
Presentation by William Boisseau at the TAO Congress on 19/20 November 2015The patient is a 27-year-old woman who has renal carcinoma with translocation TFEB. The TAP CT scan reveals metastases in...
Consequences of immune activation: management of common immune-related adverse events in check point inhibition
Presentation by Dr. Jeffrey Crawford at the TAO Congress on 19/20 November 2015In his presentation, Dr. Jeffrey Crawford reviews immune-related adverse events, which arise from immunologic enhancement, are inflammatory in nature and...
Self-management support intervention to control cancer pain in the outpatient setting: A randomized controlled trial study protocol
Hochstenbach, L.M.J., Courtens, A.M., Zwakhalen, S.M.G. , Kleef, M., de Witte, L.P.BMC Cancer, Volume 15, Issue 1, May 19, 2015, Article number 416
Assessment of pain, acceptance of illness, adjustment to life with cancer and coping strategies in breast cancer patients
Czerw, A., Religioni, U., Deptała, A.Breast Cancer, Epub ahead of print 2015 Jun 2, Article in Press,
Quality of cancer pain management: an update of a systematic review of undertreatments of patients with cancer
Greco MT, Roberto A, Corli O, Deandrea S, Bandieri E, Cavuto S, Apolone G.J Clin Oncol 2014; 32: 4149-54
Editors‘ comment: Dr. Carla Ripamonti
The American Pain Society defined pain as the 5th vital sign. Unfortunately the undertreatment of pain in oncologic setting is reported in many studies. The Pain Management Index (PMI) by Cleeland is defined as “an index that substracts the patient’s rating of pain from the rating of the strongest analgesic agent” and a negative score defines the undertreatment of pain.
A systematic review covering 26 studies from 1994 until 2007 and published in 2008, assessing the adequacy of pharmacologic pain therapy, reported the rate of potentially undertreated patient cases from 8% to 82% with a mean of 43.4%. The authors updated the systematic review of 2008 with a new set of 20 articles published from 2007 to 2013. According to the PMI, the undertreatment of pain decreased of about 25% (from 43.4 to 31.8%). Articles published more recently showed a tendency toward a lower prevalence of undertreatment. Non-specific settings of care and lower economic level were the only variables with an important significant association with PMI scores.
However, approximately one third of patients still do not receive pain medication according to their pain intensity.
Fallon MT, Storey DJ, Krishan A, Weir CJ, Mitchell R, Fleetwood-Walker SM, Scott AC, Colvin LASupport Care Cancer DOI 10.1007/s00520-015-2642-8, published online 15 February 2015
Editors‘ comment: Dr. Carla Ripamonti
Chemotherapy-induced peripheral neuropathy (CIPN) affects up to 96% of patients who receive potentially neurotoxic chemotherapy resulting in dose reduction or drug discontinuation for up to 50%. The use of adjuvant drugs such as antidepressants and anticonvulsants ± opioids is often not effective in relieving pain and can cause unpleasant adverse effects. A potential novel therapeutic approach has arisen as a result of basic science findings from the translational research Group at the University of Edinburgh. It demonstrated that endogenous neural circuitry underlying cooling-induced analgesia may represent a novel target for intervention. The researchers identified how the activation of the transient receptor potential melastatin (TRPM) 8 ion channel (a molecular receptor for cooling present in sensory nerves active in neuropathic pain) by topical agents such as topical menthol produced significant analgesia. In a proof-of-concept study 82% of patients with CIPN treated with topical 1% menthol cream twice daily had an improvement in total BFI scores (p<0.001), in mood (p=0.0004), catastrophising (p=0.001), walking ability (p=0.008) and sensation (p<0.01). The discovery of the TRP channels has provided an opportunity for the development of analgesics potentially more specific for certain pain syndrome and with a better side-effect profile than other interventions.
Management of Targeted Therapies: adverse events with immune checkpoint inhibitors – how to manage patients in clinical practice?
By Stéphane Champiat, recorded at TAO (Transatlantic Oncology meeting), Nov 20-21, 2014, ParisCancer immunotherapy targets the immune system, leading to a novel spectrum of adverse events – the so-called immune-related adverse events...