Presse Med
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Review
[Recent advances in targeted therapies in the treatment of HER2-positive metastatic breast cancer].
Metastatic breast cancer (MBC) is an incurable disease. The goal of treatment is mainly palliative to improve quality of life by the control of disease (in terms of disease free survival [DFS]) as long as possible, and to treat symptoms with fewer side effects. The gene c-erb B2 or neu or HER2 is amplified in 20-25% of breast cancers. ⋯ After disease progression with trastuzumab-based therapy, rechallenging Trastuzumab in combination with chemotherapy is a reasonable option. After a second progression with trastuzumab, a combination based on lapatinib plus Capecitabine (or other chemotherapy if Capecitabine was previously used) should be proposed; the combination based on lapatinib and trastuzumab is reasonable. Inclusion in clinical trials must continue to improve outcomes for our patients.
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Mephedrone is a synthetic psychostimulant derived from cathinone belonging to the family of phenylethylamines. Sold on the Internet, it has recently emerged in France in recreational settings, and is mostly consumed by young people from the gay community and festive environment. ⋯ Its legal aspect, ease of getting it on the Internet and cheap price coupled and an alternative-seeking to other psychostimulants make mephedrone a prime target for these populations and a source of abuse, with psychiatric and somatic complications. There is no curative pharmacological treatment approved by health authorities.
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Increasing rituximab prescription for ANCA-associated necrotizing vasculitides justifies the publication of recommendations for clinicians. Rituximab is approved in the United States to induce and maintain remission. ⋯ However, governmental agencies' approvals cannot replace clinical practice guidelines. Herein, the French Vasculitis Study Group Recommendations Committee, comprised of physicians with extensive experience in the treatment of vasculitides, presents its consensus guidelines based on literature analysis, the results of prospective therapeutic trials and personal experience.