Gender medicine and oncology: report and consensus of an ESMO workshop.

Details

Serval ID
serval:BIB_C7C76EA90383
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Gender medicine and oncology: report and consensus of an ESMO workshop.
Journal
Annals of oncology
Author(s)
Wagner A.D., Oertelt-Prigione S., Adjei A., Buclin T., Cristina V., Csajka C., Coukos G., Dafni U., Dotto G.P., Ducreux M., Fellay J., Haanen J., Hocquelet A., Klinge I., Lemmens V., Letsch A., Mauer M., Moehler M., Peters S., Özdemir B.C.
ISSN
1569-8041 (Electronic)
ISSN-L
0923-7534
Publication state
Published
Issued date
01/12/2019
Peer-reviewed
Oui
Volume
30
Number
12
Pages
1914-1924
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
The importance of sex and gender as modulators of disease biology and treatment outcomes is well known in other disciplines of medicine, such as cardiology, but remains an undervalued issue in oncology. Considering the increasing evidence for their relevance, European Society for Medical Oncology decided to address this topic and organized a multidisciplinary workshop in Lausanne, Switzerland, on 30 November and 1 December 2018.
Twenty invited faculty members and 40 selected physicians/scientists participated. Relevant content was presented by faculty members on the basis of a literature review conducted by each speaker. Following a moderated consensus session, the final consensus statements are reported here.
Clinically relevant sex differences include tumour biology, immune system activity, body composition and drug disposition and effects. The main differences between male and female cells are sex chromosomes and the level of sexual hormones they are exposed to. They influence both local and systemic determinants of carcinogenesis. Their effect on carcinogenesis in non-reproductive organs is largely unknown. Recent evidence also suggests differences in tumour biology and molecular markers. Regarding body composition, the difference in metabolically active, fat-free body mass is one of the most prominent: in a man and a woman of equal weight and height, it accounts for 80% of the man's and 65% of the woman's body mass, and is not taken into account in body-surface area based dosing of chemotherapy.
Sex differences in cancer biology and treatment deserve more attention and systematic investigation. Interventional clinical trials evaluating sex-specific dosing regimens are necessary to improve the balance between efficacy and toxicity for drugs with significant pharmacokinetic differences. Especially in diseases or disease subgroups with significant differences in epidemiology or outcomes, men and women with non-sex-related cancers should be considered as biologically distinct groups of patients, for whom specific treatment approaches merit consideration.
Keywords
Body Composition, Decision Making, Female, Humans, Male, Medical Oncology/trends, Neoplasms/epidemiology, Neoplasms/genetics, Neoplasms/pathology, Neoplasms/therapy, Physicians, Sex Characteristics, Treatment Outcome, gender, gender medicine, oncology, pharmacology, sex
Pubmed
Web of science
Open Access
Yes
Create date
16/10/2019 19:01
Last modification date
12/08/2020 5:22
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