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T Van Gorp

Publications and source records attributed to T Van Gorp.

5 recordsLinked to original sources
PubMed2006

Metastatic breast cancer: sequencing hormonal therapy and positioning of fulvestrant.

Fulvestrant, a novel estrogen receptor (ER) antagonist with no agonist effects, binds, blocks, and degrades the ER, thereby downregulating cellular ER levels, which in turn leads to reduced expression of the progesterone receptor. Due to this specific working mechanism, fulvestrant is an important addition to the armamentarium of endocrine agents in advanced breast cancer (ABC). Fulvestrant has been shown to be equally effective as the third-generation aromatase inhibitor (AI) anastrozole in postmenopausal patients with hormone-sensitive ABC progressing prior to tamoxifen. In another randomized phase III trial, it was shown that fulvestrant had similar efficacy to tamoxifen in the first-line treatment of postmenopausal women with hormone receptor-positive ABC. When comparing the side effects of fulvestrant with tamoxifen and anastrozole, it was shown that fulvestrant is well tolerated compared with these agents and is associated with a lower incidence of joint disorders. Clinical benefit on fulvestrant treatment after AI therapy has been reported in a substantial number of patients (28-46%). On the other hand, it was also shown that sensitivity to further endocrine therapy is retained following progression on first-line or second-line fulvestrant (57% and 46% clinical benefit, respectively). In conclusion, fulvestrant provides us with an additional endocrine treatment option making it possible to prolong the time that patients with ABC can be treated with endocrine therapy.

Antineoplastic Agents, Hormonal↗
PubMed2006

Endometrial carcinosarcoma with osteoclast-like giant cells.

We encountered a case of endometrial cancer with a poorly differentiated epithelial component, accompanied by a compact proliferation of atypical spindle cells and osteoclast-like giant cells. Immunohistochemically, the epithelial component was EMA and prekeratin positive with vimentin-positive spindle cells, whereas the osteoclast-like giant cells were strongly immunoreactive for CD68. The description of osteoclast-like giant cells adds to the knowledge of endometrial carcinosarcoma tumor biology.

Biopsy, Needle↗
PubMed2006

The position of neoadjuvant chemotherapy within the treatment of ovarian cancer.

It is clear that primary debulking remains the standard of care within the treatment of advanced ovarian cancer (International Federation of Gynaecology and Obstetrics, FIGO, stage III and IV). Debulking surgery should be performed by a gynaecologic oncologist without any residual tumour load, or so called optimal debulking'. Over the last decades, interest in the use of neoadjuvant chemotherapy together with an interval debulking has increased. Open laparoscopy is probably the most valuable tool for evaluating the operability primarily or at the time of interval debulking surgery. Neoadjuvant therapy can be used for patients that are primarily suboptimally debulked due to an extensive tumor load. In this situation, based on the randomized EORTC-GCG trial, interval debulking by an experienced surgeon improves survival in some patients who did not undergo optimal primary debulking surgery. Based on the GOG 152 data, interval debulking surgery does not seem to be indicated in patients who underwent primarily a maximal surgical effort by a gynecological oncologist. Neoadjuvant chemotherapy can also be used as an alternative to primary debulking. In retrospective analyses neoadjuvant chemotherapy followed by interval debulking surgery does not seem to worsen prognosis compared to primary debulking surgery followed by chemotherapy. However, we will have to wait for the results of future randomized trials to know whether neoadjuvant chemotherapy followed by interval debulking surgery is a good alternative to primary debulking surgery in stage IIIc and IV patients.

Chemotherapy, Adjuvant↗
PubMedDate not supplied

Predicting the clinical behavior of ovarian cancer from gene expression profiles.

We investigated whether prognostic information is reflected in the expression patterns of ovarian carcinoma samples. RNA obtained from seven FIGO stage I without recurrence, seven platin-sensitive advanced-stage (III or IV), and six platin-resistant advanced-stage ovarian tumors was hybridized on a complementary DNA microarray with 21,372 spotted clones. The results revealed that a considerable number of genes exhibit nonaccidental differential expression between the different tumor classes. Principal component analysis reflected the differences between the three tumor classes and their order of transition. Using a leave-one-out approach together with least squares support vector machines, we obtained an estimated classification test accuracy of 100% for the distinction between stage I and advanced-stage disease and 76.92% for the distinction between platin-resistant versus platin-sensitive disease in FIGO stage III/IV. These results indicate that gene expression patterns could be useful in clinical management of ovarian cancer.

Adenocarcinoma↗