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Objective We reported the alveolar bone histology prior to dental extractions in cancer patients, who received bone‐targeting agents (BTA). Subjects and Methods Fifty‐four patients were included. Patients underwent extractions, and bone biopsies were taken. Results Extractions were performed due to pain, swelling, purulence, fistula, and numbness, not responding to treatment, in 40 patients (group A); extractions due to asymptomatic, non‐restorable teeth, were performed in 14 patients (group B). Complete alveolar jaw bone histological necrosis was observed in 28 of 40 (70%) patients of group A and none of group B (p < .001). The development of clinical osteonecrosis (MRON) was assessed in 44 patients; 10 patients, who were also treated with Low Level Laser Treatments‐LLLT, were excluded from this analysis, as the alternative therapies were a confounding factor. Twelve patients, with alveolar bone histological necrosis prior to extraction, developed medication‐related osteonecrosis of the jaw (MRONJ) compared with two patients with vital or mixed vital/non‐vital bone (p < .0007). BTAs >1 year and concurrent targeted therapy were also significantly associated with MRONJ (p = .016 and p = .050). Conclusion Pain, swelling, purulence, fistula, and numbness were significantly associated with complete bone histological necrosis prior to extractions and increased MRONJ development. Research is justified to explore whether histological necrosis represents an early stage of osteonecrosis.

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Background/Aim: Subcutaneous (s.c.) trastuzumab was introduced in the (neo)adjuvant setting, based on the non-inferiority results and patient preference. In the advanced setting, preliminary safety data have only been reported. We conducted an observational study of s.c. trastuzumab in combination with i.v. pertuzumab and docetaxel in the firstline setting of human epidermal growth factor receptor 2 (HER2)-positive advanced breast cancer. Patients and Methods: In this single-institution study, patients received 600 mg s.c. trastuzumab in combination with 840 mg pertuzumab for the first cycle and 420 mg for the following cycles, and 75-100 mg/m 2 docetaxel, followed by maintenance with s.c. trastuzumab and pertuzumab until disease progression or unacceptable toxicity. Endpoints were efficacy and safety. Results: Forty patients were enrolled. The median number of cycles with docetaxel was six, while the median number of maintenance cycles was 21. With a median follow-up of 37 months, median progression-free survival and overall survival were 24 and 35 months. Conclusion: Subcutaneous trastuzumab in combination with pertuzumab and docetaxel is well tolerated and effective in HER2-positive advanced breast cancer.Breast cancer is the most common cancer and the second leading cause of cancer-related death among women worldwide. It is recognized as a heterogeneous disease. Human epidermal growth factor receptor 2 (HER2) overexpression in breast cancer is related to a more aggressive subtype. The addition of pertuzumab to trastuzumab and docetaxel significantly improved the median overall survival (OS) for patients with HER2-positive metastatic breast cancer (MBC). Thus, the combination of intravenous (i.v.) trastuzumab, pertuzumab and docetaxel is considered to be the standard first-line treatment in this setting (1, 2). Subcutaneous (s.c.) trastuzumab was first introduced in the (neo)adjuvant setting based on the results of the HannaH study reporting comparable safety and noninferiority (3, 4), as well as the PrefHer study pointing out patient preference for s.c. trastuzumab versus i.v. administration (5). This transition led to time and cost reductions (6). Based on that, we adopted a combination of s.c. trastuzumab, pertuzumab and docetaxel in patients with HER2-positive MBC. We present the results of our observational study. Patients and MethodsStudy design. This study was a retrospective single-arm analysis of fixed-dose s.c. trastuzumab combined with pertuzumab and docetaxel as first-line treatment in HER2-positive advanced breast cancer (metastatic or locally advanced). The data collected derived from a single center, the Saint-Savvas Anticancer Hospital, Athens, Greece. The primary endpoint of the study was to assess the efficacy of the combination by means of progression-free survival (PFS). Secondary endpoints were: i) Safety profile as determined by National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI-CTCAE) v. 4.03 (7) and ii) overall survival (OS). All patients gave their written in...

Uridine glucuronosyltransferase (UGT) gene polymorphisms have been linked to irinotecan toxicity. Our purpose was to study the association between UGT1A1*28, UGT1A7*2, and UGT1A7*3 polymorphisms and irinotecan toxicity in Greek patients receiving low-dose weekly irinotecan. Blood samples were collected for 46 patients. DNA was extracted and UGT1A1 promoter and UGT1A7 exon 1 genotyping was carried out. Laboratory tests and physical examination were performed on regular basis for the assessment of toxicity. UGT1A1*28 was significantly correlated with both haematologic and non-haematologic toxicity. Moreover, patients carrying UGT1A7 polymorphisms had significant incidence of toxicity. To conclude, UGT polymorphisms play a role in the toxicity of irinotecan, even if the drug is administered in low doses. The genotyping test may be a useful tool for the management of patients who are going to receive irinotecan.