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Since the identification of anaplastic lymphoma kinase (ALK) gene rearrangements in non-small cell lung cancer (NSCLC) in 2005, the treatment of ALK-rearranged NSCLC(ALK+NSCLC) has evolved at a rapid pace. Thismolecularly distinct subset of NSCLC has uniquely important biology, clinicopathologic features and mechanisms of drug resistance which impact on the choice of treatment for a patient with this disease. There are multiple ALK tyrosine kinase inhibitors now available in clinical practice with efficacy data continuing to emerge and guide the optimal treatment algorithm. A detailed search of medical databases and clinical trial registrieswas conducted to capture all relevant articles on this topic enabling an updated detailed overview of the landscape of management of ALK-rearranged NSCLC. [ABSTRACT FROM AUTHOR]

We present three patients with lung nodules with an antecedent history of primary cutaneous melanoma or metastasis of melanoma to extrathoracic lymph nodes. Based on radiological findings, it was suspected that these patients had metastatic disease. Subsequent investigations confirmed the cause of the nodules was non-tuberculous mycobacterial infection. We discuss the similarities in symptoms and radiological features between atypical mycobacterial infections and metastatic disease and why a biopsy is important prior to planning a patient's treatment. [ABSTRACT FROM AUTHOR]

Gefitinib is an oral, selective epidermal growth factor receptor (EGFR) inhibitor that has activity in non-small cell lung cancer (NSCLC).To evaluate the tolerability, safety-profile and response of single agent gefitinib in patients with advanced stage NSCLC.Twenty-seven patients of good performance status with stage IIIB or IV NSCLC were entered on the study at the Sydney Cancer Centre. Gefitinib was prescribed at an oral dose of 250 mg daily, as a continuous dose. Radiological evaluation of indicator lesions occurred at baseline and were repeated every 2–3 months until disease progression. Toxicity was graded using standard measures at baseline and at every month.The response rate was 17% in the patients eligible for evaluation. Symptom improvement was observed in 75% of patients. No patients withdrew because of adverse events. Toxicity was observed in 15 patients and consisted mainly of rash (59%), which was usually mild in severity.Gefitinib is active in NSCLC. It is well tolerated with minimal side-effects. Symptomatic improvement was found in the majority of patients treated with gefitinib. There may be a role for gefitinib in the palliation of symptoms in patients with advanced NSCLC. (Intern Med J 2005; 35: 77–82) [ABSTRACT FROM AUTHOR]

Expression of epidermal growth factor receptor in head and neck cancers correlates with clinical progression: a multicentre immunohistochemical study in the Asia–Pacific region Aims: With ongoing efforts to target the epidermal growth factor receptor (EGFR)-mediated tumour growth in the treatment of selected human malignancies, there is a need to determine the expression levels of EGFR and to evaluate its prognostic value in various malignancies in the Asia–Pacific region. Methods and results : A total of 172 patients with head and neck squamous cell carcinomas from Australia, Hong Kong, Singapore, and Taiwan were selected for EGFR detection. Immunohistochemical staining was performed to evaluate EGFR expression. EGFR expression was present in 88.4% (152/172) of all cases tested. Specifically, EGFR expression was found in 91.3% (42/46), 84.6% (22/26), 84.1% (37/44), 96.0% (24/25), and 87.1% (27/31) cases of head and neck squamous cell carcinomas from the oral cavity, oropharynx, nasopharynx, hypopharynx, and larynx, respectively. The results demonstrate a stronger EGFR expression in T4 tumours ( P =0.017) and later clinical stages ( P =0.016). No significant correlation was seen with risk factors, primary tumour site and ethnicity. Conclusions: The majority of head and neck squamous cell carcinomas express EGFR, indicating the importance of studying the efficacy of anti-cancer therapy through this pathway. The results also show similar rates of receptor expression in head and neck squamous cell carcinoma patients from our region compared with other parts of the world. [ABSTRACT FROM AUTHOR]

Aims: This paper assesses the impact of different models of early intervention (EI) service provision on functional recovery and inpatient hospital admission. The study compares the outcome of a comprehensive EI team with a partial model (community mental health team (CMHT) plus specialist support) and traditional care (generic CMHT) over a 10-year period., Methods: The design is in comparison with historical control. The study compares the functional recovery outcomes of three cohorts from the same geographical area over the period 1998-2007. The primary outcomes were partial and full functional recovery defined with respect to readily identifiable UK benefit system thresholds and psychiatric inpatient admission days at 1 and 2 years post-referral., Results: Only 15% of individuals made a full or partial functional recovery at 2 years under the care of a traditional generic CMHT in 1998. In 2007, 52% of the cases were making a full or partial functional recovery under the care of the comprehensive EI team. A large reduction in inpatient admissions was associated with the EI strategy., Conclusions: The implementation of comprehensive EI teams can have a major impact in improving functional recovery outcomes in psychosis and reducing inpatient admissions. Partial implementation using limited funding of specialist workers in collaboration with traditional care appeared to have a more limited effect on these recovery dimensions. The implementation of targeted EI in psychosis strategies can result in substantive functional benefits., (© 2009 The Authors. Journal compilation © 2009 Blackwell Publishing Asia Pty Ltd.)

This study reports the results of a phase II trial of carboplatin 100 mg/m2 combined with etoposide 120 mg/m2 each given for 3 consecutive days every 28 days in women with recurrent or metastatic carcinoma of the cervix. Seventeen eligible patients were treated between August, 1990 and May, 1993. In the 16 evaluable patients, there were 2 complete responses, and no partial responses with an overall objective response rate of 12.5% (95% confidence interval 1.6%-38%). The main toxicities of this regimen related to myelosuppression and emesis. The combination of carboplatin and etoposide did not achieve either a better response rate or a substantially improved toxicity profile than is seen with single agent cisplatin.