RESUMEN
Background: This study was undertaken to document the pattern of expression of estrogen (ER), progesterone (PR) and human epidermal growth factor receptor-2 (HER2) and the usage of HER2-targeted therapy in a large tertiary care hospital in India in the year 2008. Materials and Methods: The histopathology reports of all breast cancer patients registered in the hospital in 2008 were extracted from the electronic medical record system. All the cases were immunohistochemically evaluated for estrogen and progesterone receptor status (ER and PR), and c-erbB-2 protein (HER2) expression using standard immunoperoxidase method. The use of HER2-targeted therapies was evaluated by extracting relevant information from the database of the hospital pharmacy and case charts of patients enrolled in ongoing approved trials. Results: A total of 2001 new patients of invasive breast cancers with available pathology reports were registered in the hospital in the year 2008. ER and/or PR expression was positive in tumors of 1025 (51.2%) patients. HER2 3+ expression by immunohistochemistry (IHC) was found in 335 (16.7%) and HER2 2+ in 163 (8.1%). The triple negative phenotype was found in 596 (29.8%) patients. An estimated 441 patients were eligible to receive HER2-targeted therapy based on their HER2 status. Of these 38 (8.6%) patients received some form of HER2-targeted therapy; 20 patients (4.5%) as part of ongoing clinical trials and 18 (4.1%) as part of routine care. Conclusions: The overwhelming majority of patients eligible for HER2-targeted therapy in our institution are unable to receive it because of financial constraints and limited access to health insurance. There is a higher fraction of patients with the triple negative phenotype compared to the Western population.
Asunto(s)
Adulto , Anciano , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/economía , Neoplasias de la Mama/metabolismo , Neoplasias de la Mama/patología , Costo de Enfermedad , Registros Electrónicos de Salud , Estrógenos/metabolismo , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Inmunohistoquímica , India , Persona de Mediana Edad , Terapia Molecular Dirigida , Progesterona/metabolismo , Receptor ErbB-2/metabolismo , Estudios Retrospectivos , Centros de Atención Terciaria , Biomarcadores de Tumor/metabolismoRESUMEN
Central nervous system (CNS) are rare neoplasms with considerable heterogeneity and variation. The most common primary lesions of CNS are gliomas. A majority of the data about the demography and management of gliomas has emerged from the west. However, there may be considerable variation in the presentation, behavior, and response to treatment between patients in the western world and the Asian population. This article discusses gliomas with special reference to data from oncology centers in India.
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Antineoplásicos/uso terapéutico , Neoplasias del Sistema Nervioso Central/epidemiología , Neoplasias del Sistema Nervioso Central/genética , Neoplasias del Sistema Nervioso Central/terapia , Glioma/epidemiología , Glioma/genética , Glioma/terapia , Humanos , India/epidemiología , Calidad de Vida , Radiocirugia , RadioterapiaRESUMEN
Extracranial spread of recurrent meningiomas involving the middle ear is rare. We present the case of a 59-year-old woman with headache and swelling of scalp over the right temporal region. MRI revealed a lesion in the right temporal lobe suggestive of meningioma. She underwent complete surgical excision of the lesion followed by post-operative radiotherapy. After 1 year, she presented with right-sided otalgia and a middle-ear mass extruding into the external auditory canal. She was re-operated and histopathology was anaplastic meningioma. We are discussing this unusual pattern of recurrence in our patient with a review of literature.
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Sordera/etiología , Conducto Auditivo Externo/patología , Neoplasias del Oído/secundario , Femenino , Humanos , Neoplasias Meníngeas/patología , Meningioma/patología , Persona de Mediana Edad , Recurrencia Local de Neoplasia/cirugía , Factores de Riesgo , Lóbulo Temporal/patologíaAsunto(s)
Adulto , Acatisia Inducida por Medicamentos , Antiácidos/efectos adversos , Antieméticos/efectos adversos , Antagonistas de Dopamina , Úlcera Duodenal/tratamiento farmacológico , Discinesia Inducida por Medicamentos/etiología , Distonía/inducido químicamente , Femenino , Antagonistas de los Receptores H2 de la Histamina/efectos adversos , Humanos , Receptores Dopaminérgicos/efectos de los fármacos , Factores de TiempoRESUMEN
A young female with pure red cell aplasia with brisk response to prednisolone therapy is described. The patient has remained in remission on a small dose of prednisolone for 10 months.