Menée à partir des données des registres américains des cancers portant sur des patients atteints d'un cancer du poumon de stade III et bénéficiant du système d'assurance Medicare (âge > 65 ans), cette étude analyse sur la période 2002-2009 l'évolution de l'utilisation de la radiothérapie avec modulation d'intensité, puis évalue, du point de vue de la survie globale, son efficacité par rapport à la radiothérapie conformationnelle 3D

Comparative Effectiveness of Intensity-Modulated Versus 3D Conformal Radiation Therapy Among Medicare Patients with Stage III Lung Cancer

Chen, Aileen B. ; Li, Ling ; Cronin, Angel ; Schrag, Deborah

Introduction : The clinical benefit of intensity-modulated radiation therapy (IMRT) compared to 3D conformal radiation (3D-RT) has not been well established for locally advanced non-small-cell lung cancer (NSCLC). Methods : Using SEER-Medicare, we identified Medicare beneficiaries diagnosed with stage III NSCLC who received potentially curative (>= 25 fractions) thoracic IMRT or 3D-RT from 2002-2009. Overall survival and number of hospital days within 90 days of radiation were analyzed using [...]

A partir d'une revue systématique de la littérature publiée entre 1946 et 2014 (7 études), cette étude analyse l'utilisation, l'efficacité, du point de vue de la progression biochimique ou clinique de la maladie, et les complications des traitements chirurgicaux et de la radiothérapie pour traiter des métastases chez les patients atteints d'un cancer de la prostate récidivant

Metastasis-directed Therapy of Regional and Distant Recurrences After Curative Treatment of Prostate Cancer: A Systematic Review of the Literature

Ost, Piet ; Bossi, Alberto ; Decaestecker, Karel ; De Meerleer, Gert ; Giannarini, Gianluca ; Karnes, R. Jeffrey ; Roach Iii, Mack ; Briganti, Alberto

Context : The introduction of novel imaging modalities has increased the detection of oligometastatic prostate cancer (PCa) recurrence, potentially justifying the use of a metastasis-directed therapy (MDT) with surgery or radiotherapy (RT) rather than a systemic approach. Objective : To perform a systematic review of MDT for oligometastatic PCa recurrence. Evidence acquisition : This systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-analysis [...]

Cet article passe en revue les avancées récentes et les controverses concernant la radiothérapie dans le traitement d'un cancer de la prostate

Progress and controversies : Radiation therapy for prostate cancer

Martin, Neil E. ; D'Amico, Anthony V.

Radiation therapy remains a standard treatment option for men with localized prostate cancer. Alone or in combination with androgen-deprivation therapy, it represents a curative treatment and has been shown to prolong survival in selected populations. In this article, the authors review recent advances in prostate radiation—treatment techniques, photon versus proton radiation, modification of treatment fractionation, and brachytherapy—all focusing on disease control and the impact on morbidity. [...]

A partir d'une revue systématique de la littérature publiée entre 1990 et 2014 (6 essais), cette étude évalue l'efficacité, du point de vue du contrôle biochimique à 5 ans, et la toxicité d'une radiothérapie hypofractionnée pour traiter un cancer primitif de la prostate

A Systematic Review of Hypofractionation for Primary Management of Prostate Cancer

Koontz, Bridget F. ; Bossi, Alberto ; Cozzarini, Cesare ; Wiegel, Thomas ; D’Amico, Anthony

Context : Technological advances in radiation therapy delivery have permitted the use of high-dose-per-fraction radiation therapy (RT) for early-stage prostate cancer (PCa). Level 1 evidence supporting the safety and efficacy of hypofractionated RT is evolving as this modality becomes more widely utilized and refined. Objective : To perform a systematic review of the current evidence on the safety and efficacy of hypofractionated RT for early-stage PCa and to provide in-context recommendations [...]

Menée sur 1 107 patients atteints d'un cancer de la prostate de stade pN1 traité entre 1988 et 2010 par prostatectomie radicale avec curage ganglionnaire pelvien étendu, cette étude évalue, du point de vue de la survie, l'intérêt d'ajouter une radiothérapie adjuvante à un traitement hormonal adjuvant

Impact of Adjuvant Radiotherapy on Survival of Patients With Node-Positive Prostate Cancer

Abdollah, Firas ; Karnes, R. Jeffrey ; Suardi, Nazareno ; Cozzarini, Cesare ; Gandaglia, Giorgio ; Fossati, Nicola ; Vizziello, Damiano ; Sun, Maxine ; Karakiewicz, Pierre I. ; Menon, Mani ; Montorsi, Francesco ; Briganti, Alberto

Purpose : The role of adjuvant radiotherapy (aRT) in treating patients with pN1 prostate cancer is controversial. We tested the hypothesis that the impact of aRT on cancer-specific mortality (CSM) in these individuals is related to tumor characteristics. Methods : We evaluated 1,107 patients with pN1 prostate cancer treated with radical prostatectomy and anatomically extended pelvic lymph node dissection between 1988 and 2010 at two tertiary care centers. All patients received adjuvant hormonal [...]

Menée sur des lignées cellulaires et trois patients atteints d'une tumeur stromale gastro-intestinale réfractaire à l'imatinib, au sunitinib et au regorafenib, cette étude évalue l'activité antitumorale du ponatinib

Ponatinib inhibits polyclonal drug-resistant KIT oncoproteins and shows therapeutic potential in heavily pretreated gastrointestinal stromal tumor (GIST) patients

Garner, Andrew P ; Gozgit, Joseph M. ; Anjum, Rana ; Vodala, Sadanand ; Schrock, Alexa ; Zhou, Tianjun ; Serrano, Cesar ; Eilers, Grant ; Zhu, Meijun ; Ketzer, Julia ; Wardwell, Scott ; Ning, Yaoyu ; Song, Youngchul ; Kohlmann, Anna ; Wang, Frank ; Clackson, Tim ; Heinrich, Michael C ; Fletcher, Jonathan A ; Bauer, Sebastian ; Rivera, Victor M

Purpose: KIT is the major oncogenic driver of gastrointestinal stromal tumors (GISTs). Imatinib, sunitinib and regorafenib are approved therapies; however, efficacy is often limited by the acquisition of polyclonal secondary resistance mutations in KIT, with those located in the activation (A) loop (exons 17/18) being particularly problematic. Here we explored the KIT inhibitory activity of ponatinib in preclinical models and describe initial characterization of its activity in GIST patients. [...]

Menée à l'aide de modèles murins de cancer du sein, cette étude met en évidence le rôle joué par l'hétérogénéité du micro-environnement tumoral dans l'efficacité clinique de nanoparticules chargées en doxorubicine

Effects of Tumor Microenvironment Heterogeneity on Nanoparticle Disposition and Efficacy in Breast Cancer Tumor Models

Song, Gina ; Darr, David ; Santos, Charlene M ; Ross, Mark ; Valdivia, Alain ; Jordan, Jamie ; Midkiff, Bentley R ; Cohen, Stephanie M ; Feinberg, Nana N ; Miller, Christopher Ryan ; Tarrant, Teresa K ; Rogers, Arlin B ; Dudley, Andrew C ; Perou, Charles M. ; Zamboni, William C

Purpose: Tumor cells are surrounded by a complex microenvironment. The purpose of our study was to evaluate the role of heterogeneity of the tumor microenvironment in the variability of nanoparticle (NP) delivery and efficacy. Experimental Design: C3(1)-T-Antigen genetically engineered mouse model (C3-TAg) and T11/TP53Null orthotopic syngeneic murine transplant model (T11) representing human breast tumor subtypes basal-like and claudin-low, respectively, were evaluated. For the pharmacokinetic [...]

Menée sur des lignées cellulaires de cancer du sein triplement négatif et de cancer de l'estomac, puis à l'aide d'un modèle murin, cette étude évalue l'activité antitumorale d'une immunotoxine recombinante ciblée sur la mésothéline (RG7787)

Efficacy of RG7787, a Next Generation Mesothelin-targeted Immunotoxin, Against Triple-negative Breast and Gastric Cancers

Alewine, Christine ; Xiang, Laiman ; Yamori, Takao ; Niederfellner, Gerhard ; Bosslet, Klaus ; Pastan, Ira

The RG7787 mesothelin-targeted recombinant immunotoxin (RIT) consists of an antibody fragment targeting mesothelin (MSLN) fused to a 24-kD fragment of Pseudomonas exotoxin A for cell killing. Compared to prior RITs, RG7787 has improved properties for clinical development including decreased non-specific toxicity and immunogenicity and resistance to degradation by lysosomal proteases. MSLN is a cell surface glycoprotein highly expressed by many solid tumor malignancies. New reports have [...]

Menée in vitro et in vivo, cette étude suggère l'intérêt d'une stratégie thérapeutique visant à activer la signalisation TLR8 pour améliorer l'efficacité d'une immunothérapie

TLR8 signaling enhances tumor immunity by preventing tumor-induced T-cell senescence

Ye, Jian ; Ma, Chunling ; Hsueh, Eddy C. ; Dou, Jie ; Mo, Wei ; Liu, Shuai ; Han, Bing ; Huang, Yi ; Zhang, Yanping ; Varvares, Mark A. ; Hoft, Daniel F. ; Peng, Guangyong

Accumulating evidence suggests the immunosuppressive microenvironments created by malignant tumors represent a major obstacle for effective anti-tumor immunity. A better understanding of the suppressive mechanisms mediated by tumor microenvironments and the development of strategies to reverse the immune suppression are major challenges for the success of tumor immunotherapy. Here, we report that human tumor cells can induce senescence in naïve/effector T cells, exhibiting potent suppressive [...]

Menée sur une cohorte de 40 patients atteints d'un mélanome traité à l'aide d'un anticorps anti-CTLA-4 (ipilimumab), cette étude suggère que l'efficacité du traitement réside dans l'induction de nouvelles réponses des lymphocytes T

Anti–CTLA-4 therapy broadens the melanoma-reactive CD8+ T cell response

Kvistborg, Pia ; Philips, Daisy ; Kelderman, Sander ; Hageman, Lois ; Ottensmeier, Christian ; Joseph-Pietras, Deborah ; Welters, Marij J. P. ; van der Burg, Sjoerd ; Kapiteijn, Ellen ; Michielin, Olivier ; Romano, Emanuela ; Linnemann, Carsten ; Speiser, Daniel ; Blank, Christian ; Haanen, John B. ; Schumacher, Ton N.

Anti–CTLA-4 treatment improves the survival of patients with advanced-stage melanoma. However, although the anti–CTLA-4 antibody ipilimumab is now an approved treatment for patients with metastatic disease, it remains unknown by which mechanism it boosts tumor-specific T cell activity. In particular, it is unclear whether treatment amplifies previously induced T cell responses or whether it induces new tumor-specific T cell reactivities. Using a combination ultraviolet (UV)–induced peptide [...]

Mené sur 38 patients atteints d'une tumeur solide métastatique, cet essai de phase I évalue la doxe maximale tolérée et l'activité clinique d'un composé appelé CH5132799, un inhibiteur de PI3K

First-in-Human study of CH5132799, an Oral Class I PI3K Inhibitor, Studying Toxicity, Pharmacokinetics and Pharmacodynamics, in Patients with Metastatic Cancer

Blagden, Sarah ; Omlin, Aurelius ; Josephs, Debra H ; Stavraka, Chara ; Zivi, Andrea ; Pinato, David J ; Anthoney, David A ; Decordova, Shaun ; Swales, Karen ; Riisnaes, Ruth ; Pope, Lorna ; Noguchi, Kohei ; Shiokawa, Rie ; Inatani, Michiyasu ; Prince, Jenny ; Jones, Keith ; Twelves, Chris J ; Spicer, James F. ; Banerji, Udai

Purpose: This Phase I dose-escalation study investigated the maximum tolerated dose (MTD), dose-limiting toxicities (DLTs), safety, pharmacokinetics (PK), pharmacodynamics (PD) and preliminary clinical activity of CH5132799. Patients and Methods: Patients with metastatic solid tumors were eligible for the study. CH5132799 was administered orally once daily (QD) or twice daily (BID) in 28-day cycles. Results: Thirty-eight patients with solid tumors received CH5132799 at 2-96 mg QD or 48-72 mg [...]

Mené sur 71 patients atteints d'une tumeur solide de stade avancé, cet essai de phase I évalue la toxicité et l'activité clinique d'un composé appelé MK-2206, un inhibiteur d'AKT, administré selon deux modalités différentes

Interrogating two schedules of the AKT inhibitor MK-2206 in patients with advanced solid tumors incorporating novel pharmacodynamic and functional imaging biomarkers

Yap, Timothy A. ; Yan, Li ; Patnaik, Amita ; Tunariu, Nina ; Biondo, Andrea ; Fearen, Ivy ; Papadopoulos, Kyriakos ; Olmos, David ; Baird, Richard D. ; Delgado, Liliana M. ; Tetteh, Ernestina ; Beckman, Robert A ; Lupinacci, Lisa ; Riisnaes, Ruth ; Decordova, Shaun ; Heaton, Simon P. ; Swales, Karen ; Desouza, Nandita M. ; Leach, Martin O. ; Garrett, Michelle D ; Sullivan, Daniel M ; de Bono, Johann S. ; Tolcher, Anthony

Purpose: Multiple cancers harbor genetic aberrations that impact AKT signaling. MK-2206 is a potent pan-AKT inhibitor with a maximum tolerated dose (MTD) previously established at 60mg on alternate days (QOD). Due to a long half-life (60-80h), a weekly (QW) MK-2206 schedule was pursued to compare intermittent QW and continuous QOD dosing. Experimental Design: Patients with advanced cancers were enrolled onto a QW dose-escalation phase I study to investigate the safety and [...]

Mené sur 347 patients atteints d'une leucémie promyélocytaire aiguë, cet essai compare l'efficacité, du point de vue de la survie sans récidive à 4 ans, de l'acide tout-trans-rétinoïque (ATRA) et du tamibarotène en traitement d'entretien

Tamibarotene As Maintenance Therapy for Acute Promyelocytic Leukemia: Results From a Randomized Controlled Trial

Shinagawa, Katsuji ; Yanada, Masamitsu ; Sakura, Toru ; Ueda, Yasunori ; Sawa, Masashi ; Miyatake, Junichi ; Dobashi, Nobuaki ; Kojima, Minoru ; Hatta, Yoshihiro ; Emi, Nobuhiko ; Tamaki, Shigehisa ; Gomyo, Hiroshi ; Yamazaki, Etsuko ; Fujimaki, Katsumichi ; Asou, Norio ; Matsuo, Keitaro ; Ohtake, Shigeki ; Miyazaki, Yasushi ; Ohnishi, Kazunori ; Kobayashi, Yukio ; Naoe, Tomoki

Purpose : The introduction of all-trans-retinoic acid (ATRA) has significantly improved outcomes for acute promyelocytic leukemia (APL), although a subset of patients still suffer relapse. The purpose of this study was to evaluate the role of maintenance therapy with the synthetic retinoid tamibarotene in APL. Patients and Methods : Patients with newly diagnosed APL in molecular remission at the end of consolidation therapy were randomly assigned to receive ATRA or tamibarotene, both orally, [...]

A partir de 3 011 électrocardiogrammes pratiqués sur 113 patients atteints d'une leucémie myéloïde aiguë ou d'un syndrome myélodysplasique, cette étude évalue la prévalence d'une arythmie cardiaque (prolongation de l'intervalle QT) associée à un traitement à l'aide de trioxyde d'arsenic

Prevalence, Management, and Clinical Consequences of QT Interval Prolongation During Treatment With Arsenic Trioxide

Roboz, Gail J. ; Ritchie, Ellen K. ; Carlin, Rebecca F. ; Samuel, Michael ; Gale, Leanne ; Provenzano-Gober, Juliette L. ; Curcio, Tania J. ; Feldman, Eric J. ; Kligfield, Paul D.

Purpose : Arsenic trioxide (ATO) is a highly effective agent for the treatment of acute promyelocytic leukemia (APL). QT interval prolongation is common with ATO and can pose a barrier to effective administration. The objective of this study was to characterize the prevalence, management, and clinical consequences of QT prolongation in a large cohort of patients treated with ATO. Patients and Methods : We analyzed 3,011 electrocardiograms from 113 patients with non-APL acute myeloid leukemia [...]

Mené sur 89 patients atteints d'un mésothéliome pleural malin non résécable, cet essai de phase II évalue l'efficacité, du point de vue de la survie sans progression à 6 mois, et la toxicité de l'amatuximab en combinaison avec du pemetrexed et du cisplatine

Phase II clinical trial of amatuximab, a chimeric anti-mesothelin antibody with pemetrexed and cisplatin in advanced unresectable pleural mesothelioma

Hassan, Raffit ; Kindler, Hedy L. ; Jahan, Thierry ; Bazhenova, Lyudmila ; Reck, Martin ; Thomas, Anish ; Pastan, Ira ; Parno, Jeff ; O'Shannessy, Daniel J. ; Fatato, Penny ; Maltzman, Julia D. ; Wallin, Bruce A

Purpose:Amatuximab is a chimeric monoclonal antibody to mesothelin, a cell surface glycoprotein highly expressed in malignant pleural mesothelioma (MPM). Based on its synergy with chemotherapy in pre-clinical studies, we evaluated the antitumor activity of amatuximab plus pemetrexed and cisplatin in patients with unresectable MPM. Experimental Design:In a single-arm phase II study, amatuximab 5 mg/kg was administered on days 1 and 8 with pemetrexed, 500 mg/m2 and cisplatin, 75 mg/m2 on day 1 of [...]

Menée sur 925 patientes atteintes d'un cancer du sein HER2+, cette étude rétrospective italienne évalue les bénéfices, en terme de taux de récidive à 3 ans, de survie sans récidive et de survie globale, de l'ajout du trastuzumab à une chimiothérapie adjuvante

Outcomes of HER2-positive early breast cancer patients in the pre-trastuzumab and trastuzumab eras: a real-world multicenter observational analysis. The RETROHER study

Vici, Patrizia ; Pizzuti, Laura ; Natoli, Clara ; Moscetti, Luca ; Mentuccia, Lucia ; Vaccaro, Angela ; Sergi, Domenico ; Di Lauro, Luigi ; Trenta, Patrizia ; Seminara, Patrizia ; Santini, Daniele ; Iezzi, Laura ; Tinari, Nicola ; Bertolini, Ilaria ; Sini, Valentina ; Mottolese, Marcella ; Giannarelli, Diana ; Giotta, Francesco ; Maugeri-Saccà, Marcello ; Barba, Maddalena ; Marchetti, Paolo ; Michelotti, Andrea ; Sperduti, Isabella ; Gamucci, Teresa

Addition of trastuzumab to adjuvant chemotherapy has dramatically reduced the risk of recurrence and has become the standard of care for human epidermal growth factor receptor 2 (HER2)-positive early breast cancer patients. Since most data on trastuzumab benefits come from clinical trials, conducted in selected patient populations, we performed a retrospective analysis of HER2-positive early breast cancer patients treated in the “pre-trastuzumab” and “trastuzumab” eras, with the aim to [...]

A partir d'une revue de la littérature (4 études), cette méta-analyse montre qu'une chirurgie cytoréductive en combinaison avec une chimiothérapie hyperthermique intrapéritonéale peut, par rapport à une chimiothérapie systémique seule, améliorer la survie des patients atteints d'un cancer colorectal avec métastases péritonéales

Cytoreductive surgery in combination with hyperthermic intraperitoneal chemotherapy improves survival in patients with colorectal peritoneal metastases compared with systemic chemotherapy alone

Mirnezami, R. ; Mehta, A. M. ; Chandrakumaran, K. ; Cecil, T. ; Moran, B. J. ; Carr, N. ; Verwaal, V. J. ; Mohamed, F. ; Mirnezami, A. H.

Background : Colorectal cancer peritoneal metastasis (CPM) confers an exceptionally poor prognosis, and traditional treatment involving systemic chemotherapy (SC) is largely ineffective. Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is increasingly advocated for selected patients with CPM; however, opinions are divided because of the perceived lack of evidence, high morbidity, mortality, and associated costs for this approach. As there is no clear [...]

Menée sur 30 patients atteints d'un neuroblastome à haut risque de récidive et ayant reçu une chimiothérapie d'induction puis subi une résection, cette étude évalue, du point de vue du taux de survie sans progression et du taux de survie globale à 5 ans, l'efficacité d'une radiothérapie ciblant la tumeur primitive et les sites métastatiques révélés par la méta-iodobenzylguanidine

Radiation Therapy to the Primary and Postinduction Chemotherapy MIBG-Avid Sites in High-Risk Neuroblastoma

Mazloom, Ali ; Louis, Chrystal U. ; Nuchtern, Jed ; Kim, Eugene ; Russell, Heidi ; Allen-Rhoades, Wendy ; Krance, Robert ; Paulino, Arnold C.

Purpose : Although it is generally accepted that consolidation therapy for neuroblastoma includes irradiation of the primary site and any remaining metaiodobenzylguanidine (MIBG)-avid metastatic sites, limited information has been published regarding the efficacy of this approach. Methods and Materials : Thirty patients with high-risk neuroblastoma were treated at 1 radiation therapy (RT) department after receiving 5 cycles of induction chemotherapy and resection. All patients had at least a [...]

A partir de données portant sur 43 essais cliniques (35 419 patients, 12 types de cancer, 23 agents thérapeutiques), cette étude analyse les conséquences de l'utilisation de diverses valeurs-seuils pour déclarer qu'un critère de jugement (ici, la survie globale) est "cliniquement" significatif

Raising the bar for antineoplastic agents: how to choose threshold values for superiority trials in advanced solid tumors

Sobrero, Alberto F ; Pastorino, Alessandro ; Sargent, Daniel J. ; Bruzzi, Paolo

Purpose. To establish the concept of minimum clinically meaningful outcome (mCMO) of treatment in advanced solid tumors, to establish its threshold and evaluate how many superiority trials of new antineoplastic agents pass this threshold. Experimental design. We chose overall survival (OS) as the primary indicator of patient benefit. Four conceptually different types of treatment effect can be identified in OS curves: hazard ratio (HR), gains in median OS, proportional and absolute increases at [...]

Cet article passe en revue les défis posés par le choix d'un dosage optimal des médicaments en oncologie

Optimizing Dosing of Oncology Drugs

Minasian, L. ; Rosen, O. ; Auclair, D. ; Rahman, A. ; Pazdur, R. ; Schilsky, R. L.

The purpose of this article is to acknowledge the challenges in optimizing the dosing of oncology drugs and to propose potential approaches to address these challenges in order to optimize effectiveness, minimize toxicity, and promote adherence in patients. These approaches could provide better opportunities to understand the sources of variability in drug exposure and clinical outcomes during the development and premarketing evaluation of investigational new drugs.

A partir de données issues de l'essai clinique AXIS ayant comparé l'axitinib et le sorafenib pour le traitement d'un carcinome métastatique à cellules rénales, cette étude de simulation suggère que l'utilisation de la survie sans progression, en tant que critère de jugement se substituant à la survie globale, est délicate lorsque la durée et la variabilité de la période de survie après progression sont importantes

Interpreting overall survival results when progression-free survival benefits exist in today's oncology landscape: a metastatic renal cell carcinoma case study

Tang Y, ; Bycott P, ; Åkerborg Ö, ; Jönsson L, ; Negrier S, ; Chen C

Background: The debate surrounding the acceptance of progression-free survival (PFS) as an intermediate endpoint to overall survival (OS) has grown in recent years, due to the challenges in demonstrating an OS benefit within clinical trials today. PFS is generally a good predictor of OS for cases where survival post-progression (SPP) is short, and less so when SPP is long. SPP depends on multiple factors, including residual effect from experimental treatment and effect from crossover or other [...]

Cet article présente des recommandations pour la prise en charge des patientes atteintes d'un cancer du sein de stade avancé

ESO-ESMO 2nd international consensus guidelines for advanced breast cancer (ABC2)

Cardoso, F. ; Costa, A. ; Norton, L. ; Senkus, E. ; Aapro, M. ; André, F. ; Barrios, C. H. ; Bergh, J. ; Biganzoli, L. ; Blackwell, K. L. ; Cardoso, M. J. ; Cufer, T. ; El Saghir, N. ; Fallowfield, L. ; Fenech, D. ; Francis, P. ; Gelmon, K. ; Giordano, S. H. ; Gligorov, J. ; Goldhirsch, A. ; Harbeck, N. ; Houssami, N. ; Hudis, C. ; Kaufman, B. ; Krop, I. ; Kyriakides, S. ; Lin, U. N. ; Mayer, M. ; Merjaver, S. D. ; Nordström, E. B. ; Pagani, O. ; Partridge, A. ; Penault-Llorca, F. ; Piccart, M. J. ; Rugo, H. ; Sledge, G. ; Thomssen, C. ; van't Veer, L. ; Vorobiof, D. ; Vrieling, C. ; West, N. ; Xu, B. ; Winer, E.

Advanced breast cancer (ABC) is a treatable but still generally incurable disease. The goals of care are to optimize both length and quality of life. Due to continuous research, several advances have been made, particularly for the human epidermal growth factor receptor 2 (HER-2)-positive and for luminal-like subtypes. Notwithstanding these advances, median overall survival of patients with ABC is still only 2–3 years, although the range is wide [1–5], and survival may be longer for patients [...]