Clinical oncology : a journal of the Royal College of Radiologists
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Clin Oncol (R Coll Radiol) · Jan 2001
ReviewHow accurate are physicians' clinical predictions of survival and the available prognostic tools in estimating survival times in terminally ill cancer patients? A systematic review.
The purpose of this review was to examine the accuracy of physicians' clinical predictions of survival and the available prognostic tools in estimating survival times in terminally ill cancer patients. A MEDLINE search for English language articles published between 1966 and March 2000 was performed using the following keywords: forecasting/clinical prediction, prognosis/prognostic factors, survival and neoplasm metastasis. Searches in CancerLit, EMBASE, PubMed, the Cochrane Library and reference sections of articles were performed. ⋯ Performance status combined with clinical symptoms and the clinician's estimate helps to guide an accurate prediction, as reviewed in an Italian series. There is fair evidence to support using performance status, and clinical and biochemical parameters, in addition to clinicians' judgement to aid survival prediction. However, there is weak evidence to support that clinicians' estimates alone could be specifically employed for survival prediction.
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Trastuzumab (Herceptin) is the first monoclonal antibody to be approved for the treatment of a solid tumour and is directed against the c-erb-B2 receptor. c-erb-B2 is a member of the epidermal growth factor family and approximately 25% of breast cancers express such receptors, which appear to confer a poorer prognosis and may be an indicator of resistance to cytotoxic chemotherapy. This review assesses the mechanisms of action of trastuzumab, discusses the measurement of the HER-2/neu gene and its products, and describes the preclinical and clinical studies that have been instrumental to date in the emergence of trastuzumab in clinical practice.
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Clin Oncol (R Coll Radiol) · Jan 1999
Review Case ReportsOvarian carcinoma metastatic to the breast.
We report the case history of a patient with ovarian carcinoma and bilateral breast metastases. The presence of metastases to the breast from a primary ovarian carcinoma, diagnosed at initial presentation, is a rarity.