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1.
Curr Treat Options Oncol ; 24(8): 965-987, 2023 08.
Article in English | MEDLINE | ID: mdl-37212934

ABSTRACT

OPINION STATEMENT: One of the great challenges in digestive oncology is choosing the optimal therapy for RAS-mutated metastatic colorectal cancer (mCRC). Even though the RAS genes and accompanying pathway were identified decades ago and extensive knowledge exists on their role in carcinogenesis, it has proven challenging to translate these insights into new therapies and clinical benefit for patients. However, recently, new drugs targeting this pathway (for example, KRASG12C inhibitors) have shown promising results in clinical trials, as monotherapy or in combination regimens. Although resistance remains an important issue, more knowledge on adaptive resistance and feedback loops in the RAS-pathway has led to strategical combination regimens to overcome this problem. In the past year, many encouraging results have been published or presented at conferences. Even though some of the data is still preliminary, these studies may bring practice-changing results and can lead to a clinical benefit for patients over the coming years. Because of these recent developments, the treatment of RAS-mutated mCRC has become a topic of great interest. Therefore, in this review, we will summarize the standard of care and discuss the most important emerging therapies for this patient population.


Subject(s)
Colonic Neoplasms , Colorectal Neoplasms , Rectal Neoplasms , Humans , Colorectal Neoplasms/drug therapy , Colorectal Neoplasms/genetics , Colorectal Neoplasms/pathology , Antibodies, Monoclonal/therapeutic use , Mutation , ErbB Receptors/genetics , Colonic Neoplasms/drug therapy , Proto-Oncogene Proteins p21(ras)/genetics
2.
Sleep Med ; 16(11): 1409-1412, 2015 Nov.
Article in English | MEDLINE | ID: mdl-26498244

ABSTRACT

BACKGROUND AND AIM: Obesity is a known risk factor for the development of obstructive sleep apnea (OSA) in children. Early screening is essential because of the possible complications associated with OSA. At present, the gold standard for diagnosing OSA is polysomnography, which however has multiple limitations. The aim of this study is to examine the role of nocturnal oximetry as a screening tool for OSA in obese children and adolescents. MATERIALS AND METHODS: This retrospective study included obese children who underwent a polysomnography at the Antwerp University Hospital between November 2010 and May 2014. Their oximetries were scored manually, blinded for the polysomnography results, according to Brouilette et al. OSA was defined as an obstructive apnea-hypopnea index (oAHI) ≥ 2 on polysomnography. RESULTS: This study included 130 obese patients (38% boys, mean age 12 years). Polysomnography results determined 44 patients (34%) with a diagnosis of OSA. Oximetry results classified 16 patients as positive, 43 as negative, and 71 as inconclusive. Further analysis of the positive and negative oximetry results showed a sensitivity and specificity of 58% and 88%, respectively, with a negative and positive predictive value of 81% and 69%, respectively. A second analysis, using the oxygen desaturation index, showed inferior results in comparison to the score attained by Brouillette (sensitivity 57%, specificity 73%). CONCLUSIONS: These results suggest that oximetry alone is insufficient as a screening tool for OSA in obese children. Other screening methods need to be explored in the future.


Subject(s)
Obesity/complications , Oximetry/methods , Sleep Apnea, Obstructive/diagnosis , Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Polysomnography/methods , Retrospective Studies , Sensitivity and Specificity , Sleep Apnea, Obstructive/complications , Surveys and Questionnaires
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