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Crizotinib for ALK-rearranged Non-Small Cell Lung Cancer: A new targeted therapy for a new target.

Crizotinib for ALK-rearranged Non-Small Cell Lung Cancer: A new targeted therapy for a new target.

Clin Cancer Res. 2012 Apr 30;

Authors: Gandhi L, Janne PA

Abstract
Crizotinib (PF02341066, Xalkori, Pfizer) was recently approved by the Food and Drug Administration for treatment of ALK-positive non-small cell lung cancer (NSCLC) as defined by a jointly approved diagnostic test using a break-apart fluorescence in-situ hybridization (FISH) assay. The approval was made on dramatic response rates in ALK-positive NSCLC patients of 54-61% in phase I and II trials. Overall disease control rates on these trials to date are close to 90%. Progression-free survival approaches 10 months. This review focuses on the ALK inhibitory activity of crizotinib in preclinical and clinical trials that led to approval as well as the diagnostic methodologies to classify patients with ALK-positive NSCLC. Although these patients represent a small subset of all NSCLC, the rapid time course from identification of this unique target to an approved targeted therapy with striking benefit serves as a paradigm for the development of targeted therapeutics in an era of personalized medicine.

PMID: 22547770 [PubMed - as supplied by publisher]

Chest Ultrasound in Practice: a review of utility in the clinical setting

Clinician‐performed chest ultrasound is rapidly entering clinical practice in the fields of intensive care, respiratory medicine and acute medicine. Ultrasound is clearly useful in the diagnosis and characterization of pleural diseases. It is also critical in improving the safety of pleural interventions. More recently, attention has also focused on the use of lung ultrasound. While the normal aerated lung is not well imaged by ultrasound, lung pathology reaching the pleura often provides an ‘acoustic window’ for a number of lung conditions.

Lung ultrasound is useful to diagnose pneumothorax, interstitial and alveolar lung abnormalities, and pleurally‐based lung masses. There is some evidence that integrating routine chest ultrasound into clinical practice has benefit in t...

Respiratory monitoring in the ICU: a consensus of 16

Monitoring plays an important role in the current management of patients with acute respiratory failure, but sometimes lacks definition regarding which "signals" and "derived variables" should be prioritized as well as specifics related to timing (continuous vs. intermittent) and modality (static vs. dynamic).

Many new techniques of respiratory monitoring have been made available recently for clinical use, but their place is not yet always well defined. Appropriate use of available monitoring techniques and correct interpretation of the data provided can help improve our understanding of the disease processes involved and the effects of clinical interventions.

In this consensus paper, we provide an overview of the important parameters that can and should be monitored in the critically ill ...

Is the Incidence of Heparin-Induced Thrombocytopenia Affected by the Increased Use of Heparin for the Prevention of Deep Venous Thrombosis?

CONCLUSIONS:We conclude that concerns for HIT should not be a limiting factor for the systematic implementation of heparin-based VTE prophylaxis.

The Relationship Between Lung Inflammation and Cardiovascular Disease.

Acute and chronic lung inflammation is an under-recognized risk factor for cardiovascular disease. Yet, there are compelling epidemiological data to indicate that airway exposures to cigarette smoke, air pollution particles, and viral and bacterial pathogens are strongly related to acute ischemic events. Over the past 10 years, there have been important human and animal studies that have provided experimental evidence to support a causal link.

In this article, we review the epidemiological data for the relationship between lung inflammation and cardiovascular disease and provide plausible mechanistic pathways by which acute and chronic inflammation contributes to the development of acute cardiovascular syndromes.

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