References of "Aapro, Matti S"
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See detailManagement of Aromatase Inhibitor-Associated Bone Loss (AIBL) in postmenopausal women with hormone sensitive breast cancer: Joint position statement of the IOF, CABS, ECTS, IEG, ESCEO, IMS and SIOG.
HADJI, P.; Aapro, Matti S.; BODY, J.J. et al

in Journal of Bone Oncology (2017), 23(7), 1-12

Background: Several guidelines have been reported for bone-directed treatment in women with early breast cancer (EBC) for averting fractures, particularly during aromatase inhibitor (AI) therapy. Recently ... [more ▼]

Background: Several guidelines have been reported for bone-directed treatment in women with early breast cancer (EBC) for averting fractures, particularly during aromatase inhibitor (AI) therapy. Recently, a number of studies on additional fracture related risk factors, new treatment options as well as real world studies demonstrating a much higher fracture rate than suggested by randomized clinical controlled trials (RCTs). Therefore, this updated algorithm was developed to better assess fracture risk and direct treatment as a position statement of several interdisciplinary cancer and bone societies involved in the management of AI-associated bone loss (AIBL). Patients and methods: A systematic literature review identified recent advances in the management of AIBL. Results with individual agents were assessed based on trial design, size, follow-up, and safety. Results: Several fracture related risk factors in patients with EBC were identified. Although, the FRAX algorithm includes fracture risk factors (RF) in addition to BMD, it does not seem to adequately address the effects of AIBL. Several antiresorptive agents can prevent and treat AIBL. However, concerns regarding compliance and longterm safety remain. Overall, the evidence for fracture prevention is strongest for denosumab 60 mg s.c. every 6 months. Additionally, recent studies as well as an individual patient data meta-analysis of all available randomized trial data support additional anticancer benefits from adjuvant bisphosphonate treatment in postmenopausal women with a 34% relative risk reduction in bone metastasis and 17% relative risk decrease in breast cancer mortality that needs to be taken into account when advising on management of AIBL. Conclusions: In all patients initiating AI treatment, fracture risk should be assessed and recommendation with regard to exercise and calcium/vitamin D supplementation given. Bone-directed therapy should be given to all patients with a T-score<−2.0 or with a T-score of<–1.5 SD with one additional RF, or with ≥2 risk factors (without BMD) for the duration of AI treatment. Patients with T-score>−1.5 SD and no risk factors should be managed based on BMD loss during the first year and the local guidelines for postmenopausal osteoporosis. Compliance should be regularly assessed as well as BMD on treatment after 12 - 24 months. Furthermore, because of the decreased incidence of bone recurrence and breast cancer specific mortality, adjuvant bisphosphonates are recommended for all postmenopausal women at significant risk of disease recurrence. [less ▲]

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See detailEpidemiological and nonclinical studies investigating effects of iron in carcinogenesis-A critical review
Beguin, Yves ULiege; Aapro, Matti S.; Ludwig, Heinrich P. et al

in Critical Reviews in Oncology/Hematology (2014), 89

The efficacy and tolerability of intravenous (i.v.) iron in managing cancer-related anemia and iron deficiency has been clinically evaluated and reviewed recently. However, long-term data in cancer ... [more ▼]

The efficacy and tolerability of intravenous (i.v.) iron in managing cancer-related anemia and iron deficiency has been clinically evaluated and reviewed recently. However, long-term data in cancer patients are not available; yet, long-term i.v. iron treatment in hemodialysis patients is not associated with increased cancer risk. This review summarizes epidemiological and nonclinical data on the role of iron in carcinogenesis. In humans, epidemiological data suggest correlations between certain cancers and increased iron exposure or iron overload. Nonclinical models that investigated whether iron can enhance carcinogenesis provide only limited evidence relevant for cancer patients since they were typically based on high iron doses as well as injection routes and iron formulations which are not used in the clinical setting. Nevertheless, in the absence of long-term outcome data from prospectively defined trials in i.v. iron-treated cancer patients, iron supplementation should be limited to periods of concomitant anti-tumor treatment. [less ▲]

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See detailA European patient record study on diagnosis and treatment of chemotherapy-induced anaemia
Ludwig, Heinz P.; Aapro, Matti S.; Bokemeyer, Carsten et al

in Supportive Care in Cancer (2014), 22

Purpose – Patients with cancer frequently experience chemotherapy‐induced anaemia (CIA) and iron deficiency (ID). Erythropoiesis‐stimulating agents (ESA), iron supplementation and blood transfusions are ... [more ▼]

Purpose – Patients with cancer frequently experience chemotherapy‐induced anaemia (CIA) and iron deficiency (ID). Erythropoiesis‐stimulating agents (ESA), iron supplementation and blood transfusions are available therapies. This study evaluated routine practice in CIA management. Methods – Medical oncologists and/or haematologists from nine European countries (n=375) were surveyed on their last five cancer patients treated for CIA (n=1730). Information was collected on tests performed at diagnosis of anaemia, levels of haemoglobin (Hb), serum ferritin and transferrin saturation (TSAT), and applied anaemia therapies. Results – Diagnostic tests and therapies for CIA varied across Europe. Anaemia and iron status were mainly assessed by Hb (94%) and ferritin (48%) measurements. TSAT was only tested in 14%. At anaemia diagnosis, 74% of patients had Hb ≤10g/dL, including 15% with severe (Hb <8g/dL) anaemia. Low iron levels (ferritin ≤100ng/mL) were detected in 42% of evaluated patients. ESA was the most commonly used treatment (63%) and 30% of ESA‐treated patients also received iron supplementation. Most iron‐treated patients (74%) received an oral iron; intravenous iron was administered to 26%. 52% of patients received transfusions and in 76% of these, transfusions formed part of a regular anaemia treatment regimen. Management practices were similar in 2009 and 2011. Conclusion – Management of anaemia and iron status in patients treated for CIA varies substantially across Europe. Iron status is only assessed in half of the patients. In contrast to clinical evidence, iron treatment is underutilised and mainly based on oral iron supplementation. Implementation of guidelines needs to be increased, particularly the minimisation of blood transfusions. [less ▲]

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See detailAnaemia and cancer : oral or intravenous iron ?
Aapro, Matti S.; Österborg, Anders; Gascon, Pere et al

in Therapeutics (2012)

Anaemia and absolute or functional iron deficiency (ID) are common issues among cancer patients, with the prevalence of ID ranging from 32% to 60%. Most randomised clinical trials have shown superior ... [more ▼]

Anaemia and absolute or functional iron deficiency (ID) are common issues among cancer patients, with the prevalence of ID ranging from 32% to 60%. Most randomised clinical trials have shown superior efficacy of IV iron over oral or no iron supplementation in anaemic cancer patients receiving erythropoiesis-stimulating agents. Intravenous iron supplementation reduced blood transfusions, increased haemoglobin, and improved quality of life. At recommended doses, IV iron is well tolerated, and allergic reactions are exceedingly rare with modern formulations. Oral iron is often poorly tolerated and this can lead to compliance issues. [less ▲]

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See detailPrevalence and management of cancer-related anaemia, iron deficiency and the specific role of intravenous iron
Aapro, Matti S.; Osterborg, Anders C.; Gascon, Pere et al

in Annals of Oncology (2012), 23

Background: Chronic diseases reduce the availability of iron for effective erythropoiesis. This review summarises clinical consequences of iron deficiency (ID) and anaemia in cancer patients, mechanisms ... [more ▼]

Background: Chronic diseases reduce the availability of iron for effective erythropoiesis. This review summarises clinical consequences of iron deficiency (ID) and anaemia in cancer patients, mechanisms how impaired iron homeostasis affects diagnosis and treatment of ID, and data from clinical trials evaluating i.v. iron with or without concomitant erythropoiesis-stimulating agents (ESAs). Design: Clinical trial reports were identified in PubMed and abstracts at relevant major congresses. Results: Reported prevalence of ID in cancer patients ranges from 32 to 60% and most iron-deficient patients are also anaemic. Randomised clinical trials have shown superior efficacy of i.v. iron over oral or no iron in reducing blood transfusions, increasing haemoglobin, and improving quality of life in ESA-treated anaemic cancer patients. Furthermore, i.v. iron without additional ESA should be evaluated as potential treatment in patients with chemotherapyinduced anaemia. At recommended doses, i.v. iron is well tolerated, particularly compared with oral iron. No serious drug-related adverse effects were seen during long-term use in renal disease and no effect on tumour growth has been observed in trials with anaemic cancer patients. Conclusions: Reliable diagnosis and treatment of ID are recommended key steps in modern cancer patient management to minimise impact on quality of life and performance status. [less ▲]

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See detailToo low iron doses and too many dropouts in negative iron trial
Aapro, Matti S.; Beguin, Yves ULiege; Birgegard, G. et al

in Journal of Clinical Oncology (2011)

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