Background BEECH investigated the efficacy of capivasertib (AZD5363), an oral inhibitor of AKT isoforms 1–3, in combination with the first-line weekly paclitaxel for advanced or metastatic estrogen receptor-positive (ER+)/human epidermal growth factor receptor 2-negative (HER2−) breast cancer, and in a phosphoinositide 3-kinase, catalytic, alpha polypeptide mutation sub-population ( PIK3CA +). Patients and methods BEECH consisted of an open-label, phase Ib safety run-in (part A) in 38 patients with advanced breast cancer, and a randomised, placebo-controlled, double-blind, phase II expansion (part B) in 110 women with ER+/HER2− metastatic breast cancer. In part A, patients received paclitaxel 90 mg/m 2 (days 1, 8 and 15 of a 28-day cycle) with capivasertib taken twice daily (b.i.d.) at two intermittent ascending dosing schedules. In part B, patients were randomly assigned, stratified by PIK3CA mutation status, to receive paclitaxel with either capivasertib or placebo. The primary end point for part A was safety to recommend a dose and schedule for part B; primary end points for part B were progression-free survival (PFS) in the overall and PIK3CA + sub-population. Results Capivasertib was well tolerated, with a 400 mg b.i.d. 4 days on/3 days off treatment schedule selected in part A. In part B, median PFS in the overall population was 10.9 months with capivasertib versus 8.4 months with placebo [hazard ratio (HR) 0.80; P = 0.308]. In the PIK3CA + sub-population, median PFS was 10.9 months with capivasertib versus 10.8 months with placebo (HR 1.11; P = 0.760). Based on the Common Terminology Criteria for Adverse Event v4.0, the most common grade ≥3 adverse events in the capivasertib group were diarrhoea, hyperglycaemia, neutropoenia and maculopapular rash. Dose intensity of paclitaxel was similar in both groups. Conclusions Capivasertib had no apparent impact on the tolerability and dose intensity of paclitaxel. Adding capivasertib to weekly paclitaxel did not prolong PFS in the overall population or PIK3CA+ sub-population of ER+/HER2− advanced/metastatic breast cancer patients. ClinicalTrials.gov: NCT01625286.

PURPOSE To develop recommendations involving targeted therapies for patients with advanced gastroesophageal cancer. METHODS The American Society of Clinical Oncology convened an Expert Panel to conduct a systematic review of relevant studies and develop recommendations for clinical practice. RESULTS Eighteen randomized controlled trials met the inclusion criteria for the systematic review. RECOMMENDATIONS For human epidermal growth factor receptor 2 (HER2)–negative patients with gastric adenocarcinoma (AC) and programmed death-ligand 1 (PD-L1) combined positive score (CPS) ≥ 5, first-line therapy with nivolumab and chemotherapy (CT) is recommended. For HER2-negative patients with esophageal or gastroesophageal junction (GEJ) AC and PD-L1 CPS ≥ 5, first-line therapy with nivolumab and CT is recommended. First-line therapy with pembrolizumab and CT is recommended for HER2-negative patients with esophageal or GEJ AC and PD-L1 CPS ≥ 10. For patients with esophageal squamous cell carcinoma and PD-L1 tumor proportion score ≥ 1%, nivolumab plus CT, or nivolumab plus ipilimumab is recommended; for patients with esophageal squamous cell carcinoma and PD-L1 CPS ≥ 10, pembrolizumab plus CT is recommended. For patients with HER2-positive gastric or GEJ previously untreated, unresectable or metastatic AC, trastuzumab plus pembrolizumab is recommended, in combination with CT. For patients with advanced gastroesophageal or GEJ AC whose disease has progressed after first-line therapy, ramucirumab plus paclitaxel is recommended. For HER2-positive patients with gastric or GEJ AC who have progressed after first-line therapy, trastuzumab deruxtecan is recommended. In all cases, participation in a clinical trial is recommended as it is the panel's expectation that targeted treatment options for gastroesophageal cancer will continue to evolve. Additional information is available at www.asco.org/gastrointestinal-cancer-guidelines .

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Factores de riesgo para cáncer de prostata: Estudio caso control.Risk for prostate cancer. A case control study. Efraín Alarcon RESUMENEl presente es un estudio multicéntrico retrospectivo tipo caso-control para conocer los factores de riesgo del cáncer de próstata (Cap). Se compararon 327 casos de Cap con 303 controles (Adenoma de próstata) mediante el diseño de una ficha. Consignándose variables demográficas, hábitos nocivos, antecedentes de cáncer familiar, enfermedades previas y tipo histológico. Para evaluar estas variables dividimos ambos grupos por edad (>70 y <70 años): el Odds Ratio (OR) para el Cap fue significativamente elevado cuando tenían antecedente de cáncer familiar (en forma global) en el grupo joven (OR=3.4, IC95%: 1.7-6-7) o cuando fumaban mas de 10 cig/día para el grupo mayor (OR= 3.7, IC95%: 1.6-8.3). La asociación fue negativa cuando tenían el antecedente de enfermedades venéreas en el grupo joven (OR=0.4, IC95%: 0.2-1.0) o una ingesta de licor mayor de 1 vez/mes en el mismo grupo (OR=0.4, IC95%: 0.2-0.9); sin embargo estas dos últimas asociaciones no parecen espúreas. Para el resto de variables no encontramos asociación con el Cap. (Rev Med Hered 1994; 5;161-168) PALABRAS CLAVE: Cáncer de próstata, cáncer, próstata. SUMMARYThe present is a multicentri case -control study for 1985-1989 years know risk factors for prostate cancer (Pca). We compared 327 casis with 303 controls (prostate adenoma). We design a index card to harvest demographics variables, noxius habits, family history of cancer, previous disease, frequent use drugs and histologic information. To evaluate this variables we divided both groups for age (<70 and >70 years) the Odd Ratio (OR) for Pca was significant with family history of cancer in younger group (OR= 3.4; 95% CI: 1.7-6.7) and between who smoking more than 10 cig/day in mayor group (OR=3.7; 95% CI: 1.6-8.3). Exist negative association with history of veneral disease in younger group (OR=0.4; 95% CI: 0.2-1.0) and with drink licor more than one times/month for the same group (OR=0.4; 95% ci: 0.2-0.9); this lats appears to be espureal association. We didn´t find any other association for the other variables. (Rev Med Hered 1994; 5; 161-168).