Hasil Pencarian  ::  Simpan CSV :: Kembali

"In the past 10 years, recent development of targeted therapy in metastatic renal cell carcinoma (mRCC) has provided a new hope and significantly enhanced the prognosis of the disease. Three class of targeted therapy were developed, including multi-targeted tyrosine kinase inhibitors (TKI), the mammalian target of rapamycin (mTOR) complex-1 kinase inhibitors, and the humanized antivascular endothelial growth factor (VEGF) monoclonal antibody. Hence, the objective of this article was to critically examine the current evidence of targeted therapy treatment for patients with mRCC. In the majority of trials evaluating targeted therapy, patients were stratified according to Memorial Sloan Kattering Cancer Center (MSKCC) risk model and the recommendation of targeted treatment based on risk features. In first-line setting (no previous treatment), sunitinib, pazopanib, or bevacizumab plus IFN-α were recommended as treatment options for patient with favorable- or intermediate- risk features and clear cell histology. Patients who progressed after previous cytokine therapy would have sorafenib or axitinib as treatment options. Clear-cell mRCC with favorable- or intermediate- risk features and failure with first-line TKI therapy might be treated with sorafenib, everolimus, temsirolimus or axitinib. However, the current evidence did not show the best treatment sequencing after first-line TKI failure. In patients with poor-risk clear-cell and non-clear cell mRCC, temsirolimus was the treatment option supported by phase III clinical trial. In addition, several new drugs, nowadays, are still being investigated and waiting for the result of phase II or III clinical trial, and this might change the standard therapy for mRCC in the future.

---

ada sepuluh tahun terakhir, perkembangan terapi target pada karsinoma sel renal bermetastasis menjadi harapan baru dan mampu meningkatkan prognosis penyakit tersebut. Terdapat tiga terapi target yang telah dikembangkan termasuk multi-targeted tyrosine kinase inhibitors (TKI), penghambat mammalian target of rapamycin (mTOR) complex-1 kinase, dan antibodi monoklonal humanized antivascular endothelial growth factor (VEGF). Tujuan artikel ini secara kritis menelaah studi terkini terapi target untuk tatalaksana pasien tersebut. Pada sebagian besar uji klinis yang mengevaluasi terapi target, pasien distratifikasi berdasakan model yang dikembangkan oleh Memorial Sloan Kattering Cancer Center (MSKCC) dan rekomendasi terapi berdasarkan tingkat resiko pasien. Terapi target lini pertama (belum pernah mendapatkan terapi sistemik sebelumnya), sunitinib, pazopanib, atau bevacizumab ditambah IFN-α merupakan pilihan terapi dengan tingkat resiko menguntugkan dan sedang serta gambaran histologi sel jernih. Pasien yang mengalami progresifitas pasca terapi sitokin, sorafenib atau axitinib adalah pilihan yang direkomendasikan. Karsinoma sel ginjal bermetastasis tipe sel jernih dengan tingkat resiko menguntungkan dan sedang yang gagal pada terapi target lini pertama dapat ditatalaksana dengan sorafenib, everolimus, temsirolimus atau axitinib. Akan tetapi, studi saat ini menunjukkan tidak ada pilihan terapi sekuensial terbaik pasca kegagalan terapi lini pertama. Pasien dengan tingkat risiko buruk dan gambaran histologi bukan sel jernih, temsirolimus merupakan terapi target yang didukung oleh uji klinis fase III. Saat ini, beberapa obat baru masih dalam tahap uji klinis fase II dan III dan hasil uji klinis tersebut mungkin dapat mengubah terapi standar pasien karsinoma sel ginjal bermetastasis di masa yang akan datang."

"ABSTRAKPersaingan dalam bisnis pembayaran digital di skala internasional maupun lokal akan semakin tinggi intensitasnya. Dalam menghadapi kondisi persaingan seperti ini, perusahaan pembayaran digital dituntut untuk senantiasa mengembangkan sumber keunggulan bersaingnya melalui penetapan strategi bisnis digital dan pengembangan model bisnis digital yang mampu menjamin terciptanya nilai unggul bagi konsumen dan pada akhirnya dapat memberikan nilai kepada pemilik perusahaan."

"Illegal Immigrant is a common problem between Indonesia and Australia. However, in handling the problem in sea border, Indonesia take a humanitarian approach while Australia take security approach through Operation Sovereign Border that had resulted to diplomatic confrontation. Therefore, this study focus on analyzing synergy of the two countries in dealing with illegal immigrant in sea border area. This study uses national security, migration as security issue to analyze national interest. Cooperative security, defense diplomacy, synergy concept and naval diplomacy theory to analyze defense diplomacy implementation as a whole. The approach of this study is qualitative method through data collection processed by software NVivo which are beneficial for coding, triangulation, and finding relations among interviewees while Soft System Methodology used as data analysis technique consist of seven steps that are very comprehensive in explaining the whole study. The results of this study showed the two countries have not synergized yet. Indonesia and Australia have common non-traditional security interests and different traditional security interests because Indonesia has a territorial importance base opposed to Australian immigration interests. Indonesia and Australia have been doing bilateral defense diplomacy through 2 + 2 Dialogue, Defense Ministers Meeting and Navy to Navy Talk but have not produced a concrete solution, therefore sharing responsibility and Confidence Building Measures have not been achieved. Thus, naval diplomacy is required to support defense diplomacy through coordinated patrols that Standard Operating Procedure and Standard Exercise Procedure must be formulated in order to achieve interests of both countries."

"ABSTRAKPengetahuan menjadi aspek penting dalam memulai suatu bisnis konfeksi. Proses sosialisasi dan internalisasi hal yang utama bagi pemilik konfeksi untuk mendapatkan pengetahuan serta pengalaman segala aspek bisnisnya. Pengalaman mempunyai kontribusi besar dalam proses sosialisasi. Hasil dari pengetahuan tersebut akan membentuk sebuah model yang berbeda dan strategi-strategi bisnis untuk mengembangkan usahanya. “Kampung Konfeksi” terdapat konfeksi yang berasal dari Jawa dan Batak. Mereka mempunyai strategi, aturan main, dan nilai-nilai yang berbeda. Penelitian ini adalah pendekatan kualitatif yang dilakukan dengan pengamatan terlibat serta wawancara mendalam.

---

ABSTRACTBusiness knowledge has become important aspect for starting a convection business. Process socialization and internalization are the main aspects for the owner of convection to gain knowledge and experience of all aspects of its business. Business experience has a major contribution in the process of socialization. Results of such knowledge will form various models and business strategies to expand its business. "Kampung Convection" is center of small garment business which is done by Javanese and Bataknese entrepreneurs. They have different strategies, rules and cultural values in doing there business. This study was carried out based on qualitative research methods and also applying techniques of depth interviews and participant observation."

"Doxorubicin dan docetaxel masing-masing dikenal sebagai obat sitotoksik yang aktif untuk pengobatan kanker payudara metastatik (KPM). Kombinasi keduanya juga telah memperlihatkan derajat aktivitas yang tinggi sebagai kemoterapi lini kedua untuk KPM. Penelitian ini bertujuan untuk mengevaluasi keampuhan dan keamanan kombinasi docetaxel-doxorubisin sebagai kemoterapi lini pertama untuk penderita KPM di Indonesia. Sebanyak 26 pasien wanita berusia 31-65 tahun dengan KPM diikutsertakan dalam studi. Pasien belum pernah mendapat taxane atau doxorubicin kumulatif sebesar 250 mg/m2 serta tidak menderita penyakit jantung. Terapi terdiri dari doxoubicin 50 mg/m2 sebagai bolus intravena (IV) diikuti satu jam kemudian oleh docetaxel 60 mg/m2 dengan infus IV selama 1 jam, setiap 3 minggu untuk 6 siklus. Premedikasi dengan kortikosteroid oral diberikan sehari sebelum kemoterapi sampai hari kedua setiap siklus. Fraksi ejeksi ventrikel kiri direkam di awal studi dan setelah siklus ke-6. Di akhir studi, secara total telah diberikan 156 siklus kemoterapi. Lima dan 11 orang pasien mengalami respons komplit (RK) dan parsial (RP), berturut-turut, yang menjadikan respons keseluruhan terbaik sebesar 61,54%. Tiga orang pasien dengan metastatis hepar luas tampak hilang sama sekali setelah 6 siklus. Toksisitas derajat 3-4 tersering adalah leukopenia (80,77%) dan febrile neutropenia (5,77%). Leukopenia biasanya singkat, dan terutama terjadi pada siklus pertama dan kedua serta tidak membutuhkan penurunan dosis. Tidak ada pasien yang mengalami gagal jantung. Terdapat satu kematian akibat penyakit yang progresif setelah 6 siklus. Kombinasi doxorubicin 50 mg/m2 dan docetaxel 60 mg/m2 tampak aktif sebagai kemoterapi lini pertama pada KPM, khususnya pada pasien dengan metastatis hepar, dengan profil toksisitas yang dapat ditatalaksana. (Med J Indones 2004; 14: 20-5)

---

Doxorubicin and docetaxel as a single agent are known as active cytotoxic agents for the treatment of metastatic breast cancer (MBC). Their combination has also shown to be highly active as a second-line chemotherapy of MBC. This study was design to evaluate the efficacy and safety of docetaxel-doxorubicin combination as first line chemotherapy of MBC patients in Indonesia. Twenty-six female patients between 31-65 years old with advanced or MBC was enrolled. No prior taxane or cumulative doxorubicin of 250 mg/m2 was allowed and patients should not have a heart disease. Treatment consisted of doxorubicin 50 mg/m2 as intravenous (IV) bolus followed one hour later by docetaxel 60 mg/m2 by IV infusion over 1 hour every 3 weeks for 6 cycles. Premedication with oral corticosteroid was administered a day prior to chemotherapy until the second day of each cycle. Left ventricular ejection fraction was recorded at baseline and after the 6th cycle. At the end of study, a total of 156 cycles of chemotherapy have been delivered. Five and 11 patients had a complete response (CR) and partial response (PR), respectively, which accounted for a 61.54% best overall response. Three patients with extensive liver metastases showed complete disappearance after 6 cycles. Most frequent grade 3-4 toxicities were leukopenia (80.77%) and febrile neutropenia (5.77%). Leukopenia was usually short in duration, occurred mainly during the first and second cycle and did not require dose reduction. No patient developed heart failure. There was one death due to progressive disease after 6 cycles. Combination of doxorubicin 50 mg/m2 and docetaxel 60 mg/m2 was sufficiently active as first-line chemotherapy of MBC, especially in patients with liver metastases, with a manageable toxicity profile. (Med J Indones 2004; 14: 20-5)"

"Aim: to learn the role of docetaxel in non-castrate resistant prostate cancer patient. Methods: literature search was conducted to find relevant study comparing the combination of docetaxel and androgen deprivation therapy (ADT) to ADT alone in non-castrate resistant prostate cancer using PubMed, Cohrane Library, Proquest, EBSCO, and Scopus database. Quality assessment of studies was done using Bond University Rapid Critical Appraisal of a Systematic Review. Results: we found 494 studies from literature search, but only two studies were included in final selection. Based on validity assessment, we chose one study to be discussed further. This study showed that combination of docetaxel and ADT is better than ADT alone in regards of overall survival (HR 0.64; 95% CI 0.55, 0.75; p<0.0001; NNT=3), biochemical progression free survival (HR 0.63; 95% CI 0.57, 0.69; p<0.0001; NNT=2) and clinical progression free survival (HR 0.73; 95% CI 0.64, 0.84; p<0.0001; NNT=2). Benefit of docetaxel and ADT combination was especially seen in high volume disease (HR 0.67; 95% CI 0.54, 0.83; p=0.0003; NNT=3). Conclusion: addition of docetaxel into ADT has beneficial effects in terms of overall survival and progression free survival in patients with non-castrate resistant metastatic prostate cancer.

---

Tujuan: untuk mengetahui peran docetaxel pada pasien kanker prostat metastasis non-castrate resistant.

Metode: penelusuran literature dilakukan untuk mencari studi mengenai perbandingan antara kombinasi docetaxel dan terapi deprivasi androgen (ADT) dengan ADT pada pasien kanker prostat metastasis non-castrated resistant. Penelusuran dilakukan dengan menggunakan PubMed, Cohrane Library, Proquest, EBSCO, and Scopus. Penilaian kualitas literature dilakukan dengan menggunakan Bond University Rapid Critical Appraisal of a Systematic Review.

Hasil: kami menemukan 494 studi dari penelurusan literature, namun hanya 2 studi yang sesuai dengan kriteria seleksi. Berdasarkan analisis validitas, kami memilih satu studi untuk dapat dibahas secara lebih lanjut. Studi ini menunjukkan bahwa kombinasi docetaxel dan ADT lebih baik dari ADT dalam angka kesintasan secara umum (HR 0,64; 95% CI 0,55 0.75; p<0,0001; NNT=3), angka kesintasan bebas progresi biokimia (HR 0,63; 95% CI 0,57, 0,69; p<0,0001; NNT=2), dan angka bebas progresi klinis (HR 0,73; 95% CI 0,64, 0,84; p<0,0001; NNT=2). Keuntungan dari kombinasi docetaxel dan ADT terutama terlihat pada kanker prostat dengan volume tinggi (HR 0,67; 95% CI 0,54, 0,83; p=0,0003; NNT=3).

Kesimpulan: penambahan docetaxel pada ADT memiliki efek yang menguntungkan dalam angka kesintasan secara umum dan angka bebas progresi pada kanker prostat metastasis non-castrated resistant."

"Tujuan: untuk menganalisis penanda biologi CXCR4, IL11-RA, TFF1 dan MLF1P, klinikopatologi dan profil ekspresi genetik mRNA sebagai penanda peningkatan kejadian metastasis tulang pada pasien kanker payudara stadium lanjut.Metode: studi ini merupakan penelitian potong lintang. Analisis dilakukan pada total 92 pasien kanker payudara, terdiri atas 46 pasien metastasis tulang dan 46 pasien dengan metastasis nontulang. Analisis imunohistokimia dan microarray, dilakukan pada 81 sampel formalin fixed paraffin embedded (FFPE) dari 81 pasien yang didapat. Data dikumpulkan melalui rekam medis, pemeriksaan imunohistokimia (IHK), dan microarray dengan nanoString nCounterTM.Hasil: artikel ini merupakan bagian satu dari dua tahap pelaporan hasil penelitian. Pada tahap satu diperoleh hasil analisis IHK, IL11-RA dengan cut-off ≥103,5 menunjukkan peningkatan kejadian metastasis tulang, dengan OR 3,803 (95 % interval kepercayaan [IK], 1,375-10,581), p=0,010, dan MLF1P dengan cut-off ≥83,0 menunjukkan peningkatan kejadian metastasis tulang, dengan OR 2,784 (95% IK, 1,009-7,681), p=0,048. Status ER+ menunjukkan peningkatan kejadian metastasis tulang, dengan OR 7,640 (95 % IK, 2,599-22,459), p<0,000. AUC gabungan IL-11RA, MLF1P dan ER+, mempunyai ketepatan hampir 80% (meningkat dibandingkan AUC masing-masing secara terpisah), untuk membedakan dan menjelaskan kejadian metastasis tulang, pada kanker payudara stadium lanjut.Kesimpulan: IL11-RA, MLF1P dan ER+, merupakan determinan peningkatan kejadian metastasis tulang pasien kanker payudara stadium lanjut.

---

Aim: to analyze expression of biomarkers CXCR4, IL11-RA, TFF1 and MLF1P, and clinico pathology in advanced breast cancer patients with bone metastatic.

Methods: this is a cross-sectional study. Analysis was done against a total of 92 breast cancer patients, including 46 bone metastatic patients and 46 non-bone metastatic patients. Immunohistochemistry and microarray analysis was performed in 81 formalin fixed paraffin embedded (FFPE) samples from 81 patients were used. Data were collected through medical records, immunohistochemistry (IHC), and microarray with nanoString nCounterTM.

Results: this article is part one of a two stage reporting research results. In part one we got the results of the IHC analysis, IL11-RA with cut-off ≥103.5 showed OR 3.803 (95 % confidence interval [CI], 1.375-10.581), p=0.010, MLF1P with cut-off ≥83.0 OR 2.784 (95% CI, 1.009-7.681), p=0.048, and ER+ OR 7.640 (95 % CI, 2.599-22.459), p<0.000, were associated with bone metastastic incidences in advanced breast cancer, and were statistically significantly different. A combination of IL-11RA, MLF1P and ER+, showed an accuracy of approaching 80% to discriminate between bone metastatic and non bone metastatic in advanced breast cancer patients.

Conclusion: IL11-RA, MLF1P, and ER+ were the determinants that were associated with increasing bone metastasis incidence."