References of "Jerusalem, Guy"
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See detailAn open-label expanded access study of lapatinib and capecitabine in patients with HER2-overexpressing locally advanced or metastatic breast cancer.
Capri, G.; Chang, J.; Chen, S. C. et al

in Annals of Oncology (2010), 21(3), 474-80

BACKGROUND: The Lapatinib Expanded Access Program (LEAP) was designed to provide access to lapatinib plus capecitabine for HER2-positive metastatic breast cancer patients who previously received an ... [more ▼]

BACKGROUND: The Lapatinib Expanded Access Program (LEAP) was designed to provide access to lapatinib plus capecitabine for HER2-positive metastatic breast cancer patients who previously received an anthracycline, a taxane, and a trastuzumab and had no other treatment options. PATIENTS AND METHODS: LEAP opened globally and enrollment continued until lapatinib received regulatory approval in each participating country. Patients were assessed for progression-free survival (PFS) and overall survival (OS) and monitored for serious adverse events (SAEs). RESULTS: As of 30 September 2008, 4283 patients from 45 countries enrolled in LEAP. The median treatment duration was 24.7 weeks. The most common drug-related SAEs were diarrhea (9.7%), vomiting (4.3%), and nausea (2.4%) and were mainly grade 3 or higher. The incidences of special interest SAEs were decreased left ventricle ejection fraction (0.5%), interstitial lung disease/pneumonitis (0.2%), and serious hepatobiliary events (0.4%). This safety profile is consistent with the overall lapatinib program. The median PFS and OS were 21.1 [95% confidence interval (CI) = 20.1-22.3] and 39.6 (95% CI = 37.7-40.7) weeks, respectively (n = 4006). Subgroup analysis showed longer PFS and OS in patients who had not received prior capecitabine. CONCLUSIONS: These results demonstrate the safety and efficacy of lapatinib in a broader patient population compared with a clinical trial. [less ▲]

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See detailLe medicament du mois. Everolimus (RAD001/Afinitor) dans le traitement du cancer du rein métastatique.
Gennigens, Christine ULg; Sautois, Brieuc ULg; Jerusalem, Guy ULg

in Revue Médicale de Liège (2010), 65(4), 212-6

Renal cell carcinoma accounts for 3% of all malignant tumours. Until a few years ago, immunotherapy (interferon and/or interleukin-2) was the only approved option in the metastatic setting. Better ... [more ▼]

Renal cell carcinoma accounts for 3% of all malignant tumours. Until a few years ago, immunotherapy (interferon and/or interleukin-2) was the only approved option in the metastatic setting. Better knowledge of renal cell cancer biology drew attention on the fundamental role of angiogenesis. Several strategies targeting angiogenesis have been developed including VEGF ("Vascular Endothelial Growth Factor") and VEGFR inhibitors. They are now the usual treatment in first line. Until recently, no standard treatment was available after failure under or after these inhibitors. Everolimus (Afinitor), a mTOR ("mammalian Target Of Rapamycin") inhibitor, has just been validated and reimbursed in this setting. In this paper, we will review the mechanism of action and the clinical results of everolimus. [less ▲]

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See detailResults of the CONFIRM phase III trial comparing fulvestrant 250 mg with fulvestrant 500 mg in postmenopausal women with estrogen receptor-positive advanced breast cancer.
Di Leo, Angelo; Jerusalem, Guy ULg; Petruzelka, Lubos et al

in Journal of Clinical Oncology (2010), 28(30), 4594-600

PURPOSE: We compared fulvestrant 500 mg regimen with the approved dose of fulvestrant 250 mg per month for treatment of postmenopausal women with estrogen receptor-positive advanced breast cancer who ... [more ▼]

PURPOSE: We compared fulvestrant 500 mg regimen with the approved dose of fulvestrant 250 mg per month for treatment of postmenopausal women with estrogen receptor-positive advanced breast cancer who experienced progression after prior endocrine therapy. PATIENTS AND METHODS: Comparison of Faslodex in Recurrent or Metastatic Breast Cancer (CONFIRM) is a double-blind, parallel-group, multicenter, phase III study. Patients were randomly assigned to fulvestrant 500 mg (500 mg intramuscularly [IM] on day 0, then 500 mg IM on days 14 and 28 and every 28 days thereafter) or 250 mg every 28 days. Primary end point was progression-free survival (PFS). Secondary end points included objective response rate, clinical benefit rate (CBR), duration of clinical benefit (DoCB), overall survival (OS), and quality of life (QOL). RESULTS: PFS was significantly longer for fulvestrant 500 mg (n = 362) than 250 mg (n = 374) (hazard ratio [HR] = 0.80; 95% CI, 0.68 to 0.94; P = .006), corresponding to a 20% reduction in risk of progression. Objective response rate was similar for fulvestrant 500 mg and 250 mg (9.1% v 10.2%, respectively). CBR was 45.6% for fulvestrant 500 mg and 39.6% for fulvestrant 250 mg. DoCB and OS were 16.6 and 25.1 months, respectively, for the 500-mg group, whereas DoCB and OS were 13.9 and 22.8 months, respectively, in the 250-mg group. Fulvestrant 500 mg was well tolerated with no dose-dependent adverse events. QOL was similar for both arms. CONCLUSION: Fulvestrant 500 mg was associated with a statistically significant increase in PFS and not associated with increased toxicity, corresponding to a clinically meaningful improvement in benefit versus risk compared with fulvestrant 250 mg. [less ▲]

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See detailBenefit of the sequential administration of Docetaxel after standard FEC regimen for node-positive breast cancer : long-term follow-up results of the FNCLCC-PACS 01 trial
Coudert, Bruno; Campone, Mario; Spielmann, Marc et al

in Cancer Research (2009, December 15), 69

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See detailANTICORPS MONOCLONAUX ET CANCER DU SEIN: Actualités thérapeutiques
Collignon, Joëlle ULg; Gennigens, Christine ULg; Rorive, Andrée ULg et al

in Revue Médicale de Liège (2009), 64(5-6), 279-83

About 9,500 new breast cancers are diagnosed in Belgium every year. Improvement of our knowledge of altered molecular events leading to the proliferation of tumor cells has resulted in the development of ... [more ▼]

About 9,500 new breast cancers are diagnosed in Belgium every year. Improvement of our knowledge of altered molecular events leading to the proliferation of tumor cells has resulted in the development of targeted therapies in subgroups of cancers. One of the first validation of targeted therapy is the anti-HER-2 monoclonal antibody trastuzumab (Herceptin) in patients with overexpression of human epidermal growth factor receptor type 2 (HER2) occurring in 20 to 25% of invasive breast carcinoma. Trastuzumab binds the extracellular juxtamembrane domain and is only active in tumor with HER2 gene amplification detected by fluorescence in situ hybridization (FISH). The results from randomized trials have rapidly lead to the approvement of the drug in the metastatic and then in the adjuvant setting. Another targeted therapy, also approved in the treatment of breast cancer, is the monoclonal antibody bevacizumab with an anti-VEGF (Vascular Endothelial Growth Factor) activity. We will review the benefit of these targeted therapies in breast cancer and their role in the treatment of breast cancer. [less ▲]

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See detailTumor Margin after conservative breast cancer surgery for early disease: an issue or not ?
Coucke, Philippe ULg; Vavassis, Peter; Vanderick, JEAN ULg et al

in Belgian Journal of Medical Oncology [=BJMO] (2009), 3(3), 93-100

Summary is standard of care. However, the question is Conservative breast surgery (CBS), i.e. tumorec- whether this approach is able to consolidate local tomy (TUM), has replaced more radical surgical ... [more ▼]

Summary is standard of care. However, the question is Conservative breast surgery (CBS), i.e. tumorec- whether this approach is able to consolidate local tomy (TUM), has replaced more radical surgical control irrespective of the extent of the surgical approaches such as mastectomy (MAST) and margin. No consensus exists in the literature con-quadrantectomy (QUAD). The aim of surgeons is cerning what should be considered as a minimal to avoid recurrence and still obtain a good cos-and hence a safe margin. This review will summetic result. After CBS for early disease, adjuvant marize the published data in order to try to define radiation consisting of whole breast irradiation a pragmatic treatment approach. followed by a boost dose on the surgical bed is standard of care. However, the question is whether this approach is able to consolidate local control irrespective of the extent of the surgical margin. No consensus exists in the literature concerning what should be considered as a minimal and hence a safe margin. This review will summarize the published data in order to try to define a pragmatic treatment approach. [less ▲]

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See detailTrastuzumab treatment of early stage breast cancer is cost-effective from the perspective of the Belgian health care authorities.
Van Vlaenderen, I.; Canon, J. L.; Cocquyt, V. et al

in Acta Clinica Belgica (2009), 64(2), 100-12

Trastuzumab (Herceptin, Roche) is a recombinant, humanized monoclonal antibody directed against the neu-HER2 protein, since May 2002 reimbursed in Belgium for the treatment of metastatic HER2+ breast ... [more ▼]

Trastuzumab (Herceptin, Roche) is a recombinant, humanized monoclonal antibody directed against the neu-HER2 protein, since May 2002 reimbursed in Belgium for the treatment of metastatic HER2+ breast cancer and since June 2007 also in adjuvant therapy of HER2+ early stage breast cancer. The purpose of this study was to estimate the cost-effectiveness from the Belgian health care payer perspective of reimbursing trastuzumab in the Latter indication. A Markov state transition model was designed to adequately capture the natural history and course of disease for early stage breast cancer patients, and to simulate cost and disease progression over a life time perspective. The model estimates differences in outcomes for patients treated with adjuvant trastuzumab during 1 year compared to current therapy, and captures cost consequences and health benefits of trastuzumab treatment. Health benefits were expressed in terms of quality-adjusted life years gained, and future benefits were discounted at 1.5%. Costs were calculated from the perspective of the Belgian authorities' health care budget, and future costs were discounted at 3%. Where relevant, the costs per Markov state were obtained from the IMS Hospital Disease database. Additionally, an expert opinion analysis on resource use during the follow-up of treated early breast cancer patients provided the cost estimates for states with minor or without hospital costs. The incremental cost-effectiveness ratio based on a life time simulation was estimated at Euro 10,315 per quality-adjusted life year gained. It can be concluded that trastuzumab treatment of HER2+ early stage breast cancer patients is cost-effective from the perspective of the Belgian health care authorities. [less ▲]

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See detailAngiosarcome sur lymphoedeme chronique: un cas de syndrome de Stewart-Treves.
Gonne, E.; Collignon, Joëlle ULg; Kurth, William ULg et al

in Revue Médicale de Liège (2009), 64(7-8), 409-13

The Stewart-Treves Syndrome is defined as an angiosarcoma (very aggressive malignant tumor originating from endothelial cells) appearing in a specific clinical setting. This tumor develops in patients ... [more ▼]

The Stewart-Treves Syndrome is defined as an angiosarcoma (very aggressive malignant tumor originating from endothelial cells) appearing in a specific clinical setting. This tumor develops in patients suffering from chronic lymphedema of the upper limb following mastectomy and axillary lymph node dissection for breast cancer. The diagnosis relies on medical history, clinical examination and a histological assesment (biopsy or resection). This syndrome represents a rare clinical entity. Unfortunately, the prognosis is poor. A large surgical resection is the treatment of choice if the patient is a candidate for a surgical resection with a curative intent Radiotherapy is sometimes used as a palliative local treatment. Chemotherapy is only used in more advanced cases, not curable by surgery alone. [less ▲]

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See detailAnticorps monoclonaux a usage therapeutique en hemato-oncologie. Generalites.
Gennigens, Christine ULg; Collignon, Joëlle ULg; Jerusalem, Guy ULg et al

in Revue Médicale de Liège (2009), 64(5-6), 264-7

For many years, chemotherapy, hormonotherapy and immunotherapy were the mainstay of cancer treatment. Recent advances in our knowledge of cell biology and particularly of cancer cell transformation ... [more ▼]

For many years, chemotherapy, hormonotherapy and immunotherapy were the mainstay of cancer treatment. Recent advances in our knowledge of cell biology and particularly of cancer cell transformation, growth and metastasis have led to the identification of specific pathways playing a role in the pathophysiology of cancer. New drugs specifically developed to control these targets are collectively named "targeted therapies". Two types of targeted therapies are available: kinase (mainly tyrosine kinase) inhibitors (suffix -nib) are small molecules binding directly to the intracellular kinase domain and acting as competitive inhibitor of ATP binding and monoclonal antibodies (suffix -mab) directed towards specific cell surface receptors or their ligands to prevent receptor activation. This paper will only review monoclonal antibodies (mabs). Thirty years after their discovery mAbs have become efficient therapeutic tools. Progress in molecular engineering as well as improved knowledge of cell signalling pathways together with a better selection of the targets turned them into valuable treatments. Several mAbs are currently licensed for the treatment of hematological or solid malignancies and many others are expected in the near future. [less ▲]

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See detailLe cas clinique du mois. Reaction de rappel d'irradiation induite par l'administration de cyclophosphamide.
Mievis, Carole ULg; Jansen, Nicolas ULg; Schleich, FLorence ULg et al

in Revue Médicale de Liège (2009), 64(4), 179-81

Radiation recall dermatitis is an inflammatory skin reaction occurring in a previously irradiated field following the delivery of a promoting agent. It has been described after a number of antineoplastic ... [more ▼]

Radiation recall dermatitis is an inflammatory skin reaction occurring in a previously irradiated field following the delivery of a promoting agent. It has been described after a number of antineoplastic agents such as gemcitabine, taxanes, anthracyclines. We report the case of a 50-year-old man with metastatic prostate cancer who developed two consecutive radiation recall dermatitis episodes triggered by oral cyclophosphamide. They occurred 4 to 5 weeks after palliative radiotherapy on bone metastasis. Spontaneous resolution was observed within 6 weeks after discontinuation of cyclophosphamide and with local supportive care. To our knowledge this is the first reported case of radiation recall dermatitis after oral cyclophosphamide. [less ▲]

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See detailNuclear medicine imaging
Jerusalem, Guy ULg; Withofs, Nadia ULg

in Schmoll, Hans-Joachim; Van't Veer, Laura; Vermorken, Jan (Eds.) et al ESMO Handbook of Cancer Diagnosis and Treatment Evaluation (2009)

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See detailCarninome intracanalaire (in situ) du sein : pouvons-nous raisonnablement éviter la radiothérapie pour certaines patientes opérées ?
Coucke, Philippe ULg; Barthelemy, Nicole ULg; Jansen, Nicolas ULg et al

in Revue Médicale de Liège (2008), 63(2), 75-81

Dans le cadre de la prise en charge multidisciplinaire du carcinome intracanalaire du sein (carcinome intra-canalaire in situ = DCIS = Ductal Carcinoma In Situ), on évoque souvent la possibilité de ... [more ▼]

Dans le cadre de la prise en charge multidisciplinaire du carcinome intracanalaire du sein (carcinome intra-canalaire in situ = DCIS = Ductal Carcinoma In Situ), on évoque souvent la possibilité de renoncer à la radiothérapie complémentaire après un geste de chirurgie conservatrice. S’il est vrai que la radiothérapie, dans ce contexte, n’apporte pas de bénéfice en survie, il n’en reste pas moins qu’on observe à long terme un effet bénéfique en contrôle local. Il existe un effet significativement marqué sur le taux de rechute de type DCIS et de type invasif dans les différentes études randomisées destinées à éclaircir la problématique du rôle de la radiothérapie. La question est de savoir si on peut distinguer un sous-groupe de patientes pour qui le contrôle local n’est pas modifié par l’adjonction d’une radiothérapie adjuvante. Pour l’instant, nous ne sommes pas à même de définir ce sous-groupe, car les critères de sélection n’ont pas été mis à l’épreuve dans le cadre d’un essai randomisé. Faute de ces données, il nous semble plus adéquat de proposer jusqu’à preuve du contraire, une radiothérapie aux patientes opérées, même si l’intervention est a priori radicale, mais conservatrice, et même si les facteurs pronostiques semblent plutôt favorables. Cependant, la radiothérapie n’est pas indiquée après une mastectomie. [less ▲]

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See detailPET/CT for assessing bone involvement in prostate and breast cancer.
WITHOFS, Nadia ULg; GRAYET, Benjamin ULg; TANCREDI, T. et al

in Journal of Nuclear Medicine (The) (2008), 49(SUPPL), 21

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See detailTomographie à émission de positons et lymphomes
Hustinx, Roland ULg; Jerusalem, Guy ULg; De Prijck, Bernard ULg

in Médecine Nucléaire : Imagerie Fonctionnelle et Métabolique (2008), 32

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See detailCarcinome intracanalaire (in situ) du sein : pouvons-nous raisonnablement éviter les radiothérapie pour certaines patientes opérées?
Coucke, Philippe ULg; Barthelemy, Nicole ULg; Jansen, Nicolas ULg et al

in Revue Médicale de Liège (2008), 63 (2)

Dans le cadre de la prise en charge multidisciplinaire du carcinome intracanalaire du sein (carcinome intra-canalaire in situ = DCIS = Ductal Carcinoma In Situ), on évoque souvent la possibilité de ... [more ▼]

Dans le cadre de la prise en charge multidisciplinaire du carcinome intracanalaire du sein (carcinome intra-canalaire in situ = DCIS = Ductal Carcinoma In Situ), on évoque souvent la possibilité de renoncer à la radiothérapie complémentaire après un geste de chirurgie conservatrice. S’il est vrai que la radiothérapie, dans ce contexte, n’apporte pas de bénéfice en survie, il n’en reste pas moins qu’on observe à long terme un effet bénéfique en contrôle local. Il existe un effet significativement marqué sur le taux de rechute de type DCIS et de type invasif dans les différentes études randomisées destinées à éclaircir la problématique du rôle de la radiothérapie. La question est de savoir si on peut distinguer un sous-groupe de patientes pour qui le contrôle local n’est pas modifié par l’adjonction d’une radiothérapie adjuvante. Pour l’instant, nous ne sommes pas à même de définir ce sous-groupe, car les critères de sélection n’ont pas été mis à l’épreuve dans le cadre d’un essai randomisé. Faute de ces données, il nous semble plus adéquat de proposer jusqu’à preuve du contraire, une radiothérapie aux patientes opérées, même si l’intervention est a priori radicale, mais conservatrice, et même si les facteurs pronostiques semblent plutôt favorables. Cependant, la radiothérapie n’est pas indiquée après une mastectomie. [less ▲]

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See detailActualités thérapeutiques en oncologie sénologique: place actuelle et perspectives des traitements cibles
Jerusalem, Guy ULg; Rorive, Andrée ULg; Gennigens, Christine ULg et al

in Revue Médicale de Liège (2007), 62 Spec No

The introduction of targeted therapies has largely modified the treatment strategies in oncology. Two targets are currently used for defining the systemic treatment of breast cancer: hormone receptors and ... [more ▼]

The introduction of targeted therapies has largely modified the treatment strategies in oncology. Two targets are currently used for defining the systemic treatment of breast cancer: hormone receptors and HER2 overexpression. Trastuzumab, a monoclonal antibody, is the only registered antiHER2 treatment in Belgium. The association of trastuzumab with chemotherapy is now the recommended adjuvant treatment for early breast cancer overexpressing HER2. Other antiHER2 medications are available and some will probably be registered soon. Angiogenesis is another potential target for improving the treatment results. The CHU Liege, as a reference center for the systemic treatment of solid tumors, participates in many international trials in order to validate these new approaches. The highest quality of care is required to be in compliance with the conduct of these clinical trials. Another benefit for the patient is the easy access to last generation medical treatments, generally not accessible in our health care system in Belgium outside of clinical trials. [less ▲]

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See detailTomographie a emission de positons: un premier bilan.
Jerusalem, Guy ULg; Withofs, Nadia ULg; Rorive, Andrée ULg et al

in Revue du Praticien (La) (2007), 57(17), 1864-70

Positron emission tomography (PET) has been widely used for several years for staging and response evaluation in oncology. It is time to critically review its role in routine patient care. [18F]-labelled ... [more ▼]

Positron emission tomography (PET) has been widely used for several years for staging and response evaluation in oncology. It is time to critically review its role in routine patient care. [18F]-labelled fluorodeoxyglucose ([18F]-FDG) remains the radiotracer of choice in most indications. Its high sensitivity, the half-life of 110 minutes and the easy production of this radiotracer explain its routine use although the specificity is not very good. Infectious or inflammatory processes can mimic tumours. Appropriate selection of patients studied in the recommended indications and interpretation of images by an experienced team having access to both clinical information and other diagnostic studies allows reducing the risk of false positives. Although PET is highly accurate, not all patients suffering from cancer need a PET study. Major improvements were also observed with conventional imaging techniques over the past 10 years. It is important to avoid long waiting lists because otherwise treatment delay may counterbalance the benefit of PET studies. [less ▲]

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See detailActualites therapeutiques en oncologie: l'essor des therapeutiques ciblees
Gennigens, Christine ULg; Sautois, Brieuc ULg; Rorive, Andrée ULg et al

in Revue Médicale de Liège (2007), 62(5-6, May-Jun), 391-8

Over the last decades, significant advances were make in basic research as concerns the malignant transformation of normal cells. As a result, new targets for treatment were identified. "Targeted ... [more ▼]

Over the last decades, significant advances were make in basic research as concerns the malignant transformation of normal cells. As a result, new targets for treatment were identified. "Targeted therapies" indicates that treatments are directed against specific molecular targets that play a major role in the activation of cell division and in the growth and dissemination of tumors. In particular, targeted therapies were developed against epithelial growth factor receptors and angiogenesis. We can expect specifise therapies against many other targets in the near future. Several drugs have obtained a marketing license. Predictive factors for tumor response and long term outcome should be developed for a better selection of the patient population who will benefit from these treatments. New imaging techniques are under development in order to assess the molecular response to these new approaches. [less ▲]

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See detailPhosphorylated HER-2 tyrosine kinase and Her-2/neu gene amplification as predictive factors of response to trastuzumab in patients with HER-2 overexpressing metastatic breast cancer (MBC).
Giuliani, Rosa; Durbecq, Virginie; Di Leo, Angelo et al

in European Journal of Cancer (2007), 43(4), 725-35

AIM: Trastuzumab (T), a humanised monoclonal antibody against HER-2, is active in HER-2-positive MBC patients. However, nearly 60% of the patients do not benefit from T, stressing the need for additional ... [more ▼]

AIM: Trastuzumab (T), a humanised monoclonal antibody against HER-2, is active in HER-2-positive MBC patients. However, nearly 60% of the patients do not benefit from T, stressing the need for additional predictive markers. The following markers could be implicated in response to T: (1) the magnitude of Her-2 gene amplification; (2) the co-expression of the other HER family receptors, possibly responsible for HER-2 trans-activation; (3) the activated status of HER-2; (4) the activated status of downstream effectors as mitogen-activated protein kinases (MAPKs), p38 and p27. METHODS: Medical files of patients with MBC treated with T either as a single agent or in combination with chemotherapy (CT) were reviewed. HER family members (EGFR, HER-2, HER-3, HER-4), the phosphorylated forms of EGFR (p-EGFR), HER-2 (p-HER-2) and of the downstream effectors were evaluated in the archival tumours. The correlation between clinical outcome and the expression of these markers was investigated. RESULTS: (1) Increasing values of Her-2 amplification were associated with a higher probability of achieving an objective response; (2) no statistical significant correlation between the expression of the HER family receptors was found; (3) p-HER-2 was predictive of response in patients treated with T+CT; (4) a statistically significant correlation between p-ERK 1/2, p-p38 and p-HER-2 emerged, pointing to the activated vertical pathway p-HER-2-->p-MAPKs. CONCLUSIONS: p-HER-2 and the magnitude of Her-2 amplification were predictive of response to T and their role deserves to be analysed in larger and more homogenous T-treated populations such as those from large phase III trials. [less ▲]

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See detailFDG-PET for the routine follow-up in NHL: First prospective evaluation
Jerusalem, Guy ULg; Silvestre, R.; Beguin, Yves ULg et al

in Journal of Clinical Oncology (2006, June 20), 24(18, Part 1 Suppl. S), 439

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