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Hematology/oncology Clinics of North America

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https://www.readbyqxmd.com/read/27912837/evolving-treatment-options-for-lung-cancer
#1
EDITORIAL
Daniel Morgensztern, Roy S Herbst
No abstract text is available yet for this article.
February 2017: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/27912836/epidermal-growth-factor-receptor-mutated-advanced-non-small-cell-lung-cancer-a-changing-treatment-paradigm
#2
REVIEW
Suchita Pakkala, Suresh S Ramalingam
Activating mutations in the epidermal growth factor receptor (EGFR) are present in approximately 15% of US patients with lung adenocarcinoma. EGFR tyrosine kinase inhibitors are associated with high response rate and progression-free survival for patients with non-small cell lung cancer with this genotype. Gefitinib, erlotinib, and afatinib are the EGFR tyrosine kinase inhibitors that are presently in clinical use. Understanding resistance mechanisms has led to the identification of a secondary mutational target, T790M, in more than half of patients, for which osimertinib has been approved...
February 2017: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/27912835/second-line-chemotherapy-and-beyond-for-non-small-cell-lung-cancer
#3
REVIEW
Greg Durm, Nasser Hanna
The landscape for the second- and third-line treatment of advanced non-small cell lung cancer has changed dramatically over the last two decades. Immunotherapeutic agents have become a preferred choice following progression on platinum-based first-line chemotherapy. However, there remains a role for cytotoxic chemotherapy and pemetrexed and docetaxel (with or without ramucirumab) are approved for single-agent use in the second-line setting. With the discovery of new genetic alterations and the development of novel targeted drugs, the treatment of advanced non-small cell lung cancer following progression on first-line therapy continues to become more complicated as new treatment algorithms evolve...
February 2017: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/27912834/first-line-systemic-therapy-for-non-small-cell-lung-cancer
#4
REVIEW
Rebecca S Heist
Major advances in the treatment of metastatic non-small cell lung cancer have led to significant incremental improvements in patient outcomes. Platinum-based combination therapy remains the cornerstone of first-line therapy. The addition of biologic agents, such as bevacizumab or necitumumab, in selected populations has shown benefit over chemotherapy alone. The advent of maintenance therapy has also improved overall survival outcomes in selected populations of patients. Ongoing studies will further refine optimal treatment in the first-line setting and further advance first-line treatment options...
February 2017: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/27912833/treatment-of-locally-advanced-non-small-cell-lung-cancer
#5
REVIEW
Kit Tam, Megan Daly, Karen Kelly
Locally advanced non-small cell lung cancer is a heterogeneous disease with typically poor outcomes. Select patients may benefit from the integration of surgery, whereas patients with bulky, multistation, or contralateral (N3) mediastinal involvement are managed with definitive chemoradiation. Attempts to improve outcomes through induction, consolidation, or maintenance chemotherapy or radiation dose escalation have not demonstrated a survival benefit. Current research efforts focus on the integration of novel systemic agents that exploit tumor-specific driver mutations, augment antitumor immune response, or enhance radiation sensitivity...
February 2017: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/27912832/neoadjuvant-and-adjuvant-therapy-for-non-small-cell-lung-cancer
#6
REVIEW
Jody C Chuang, Ying Liang, Heather A Wakelee
The use of 4 cycles of cisplatin-based adjuvant chemotherapy is now the standard of care for patients with resected stage II and IIIA non-small cell lung cancer. Neoadjuvant chemotherapy lacks the same level of data as adjuvant treatment, but meta-analyses of this approach support its use. Selection of patients who are most likely to benefit from chemotherapy remain elusive. Ongoing adjuvant trials are exploring biomarkers, molecularly targeted agents, postoperative radiation therapy, and immunotherapy.
February 2017: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/27912831/systemic-treatment-of-brain-metastases
#7
REVIEW
Saiama N Waqar, Daniel Morgensztern, Ramaswamy Govindan
Lung cancer continues to be the leading cause of cancer-related mortality in the United States. Brain metastases are a significant problem in patients with lung cancer and have conventionally been treated with whole-brain radiation. This article reviews the data for systemic chemotherapy to treat brain metastasis from lung cancer and examines the activity of small molecule tyrosine kinase inhibitors for the targeted therapy for brain metastases from EGFR-mutant and ALK-rearranged non-small cell lung cancer...
February 2017: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/27912830/advances-in-small-cell-lung-cancer
#8
REVIEW
Gregory P Kalemkerian, Bryan J Schneider
Small cell lung cancer (SCLC) is an aggressive neuroendocrine tumor characterized by early metastatic spread and responsiveness to initial therapy. The incidence of SCLC has been declining in the United States in parallel with the decreasing prevalence of cigarette smoking. Limited stage disease is potentially curable with chemoradiotherapy followed by cranial irradiation. Extensive stage disease is incurable, but systemic chemotherapy can improve quality of life and prolong survival. Nearly all patients relapse with chemoresistant disease...
February 2017: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/27912829/immunotherapy-in-lung-cancer
#9
REVIEW
Lingling Du, Roy S Herbst, Daniel Morgensztern
The treatment of patients with good performance status and advanced stage non-small cell lung cancer has been based on the use of first-line platinum-based doublet and second-line docetaxel. Immunotherapy represents a new therapeutic approach with the potential for prolonged benefit. Although the vaccines studied have not shown benefit in patients with non-small cell lung cancer, immune checkpoint inhibitors against the PD-1/PD-L1 axis showed increased overall survival compared with docetaxel in randomized clinical trials, which led to the approval of nivolumab and pembrolizumab...
February 2017: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/27912828/lung-cancer-biomarkers
#10
REVIEW
Pamela Villalobos, Ignacio I Wistuba
The molecular characterization of lung cancer has changed the classification and treatment of these tumors, becoming an essential component of pathologic diagnosis and oncologic therapy decisions. Through the recognition of novel biomarkers, such as epidermal growth factor receptor mutations and anaplastic lymphoma kinase translocations, it is possible to identify subsets of patients who benefit from targeted molecular therapies. The success of targeted anticancer therapies and new immunotherapy approaches has created a new paradigm of personalized therapy and has led to accelerated development of new drugs for lung cancer treatment...
February 2017: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/27912827/new-targets-in-non-small-cell-lung-cancer
#11
REVIEW
Soo J Park, Soham More, Ayesha Murtuza, Brian D Woodward, Hatim Husain
With the implementation of genomic technologies into clinical practice, we have examples of the predictive benefit of targeted therapy for oncogene-addicted cancer and identified molecular dependencies in non-small cell lung cancer. The clinical success of tyrosine kinase inhibitors against epidermal growth factor receptor and anaplastic lymphoma kinase activation has shifted treatment emphasize the separation of subsets of lung cancer and genotype-directed therapy. Advances have validated oncogenic driver genes and led to the development of targeted agents...
February 2017: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/27912826/diagnosis-and-treatment-of-anaplastic-lymphoma-kinase-positive-non-small-cell-lung-cancer
#12
REVIEW
Kathryn C Arbour, Gregory J Riely
Anaplastic lymphoma kinase (ALK) gene rearrangements occur in a small portion of patients with non-small cell lung cancer (NSCLC). These gene rearrangements lead to constitutive activation of the ALK kinase and subsequent ALK-driven tumor formation. Patients with tumors harboring such rearrangements are highly sensitive to ALK inhibitors, such as crizotinib, ceritinib, and alectinib. Resistance to these kinase inhibitors occurs through several mechanisms, resulting in ongoing clinical challenges. This review summarizes the biology of ALK-positive lung cancer, methods for diagnosing ALK-positive NSCLC, current FDA-approved ALK inhibitors, mechanisms of resistance to ALK inhibition, and potential strategies to combat resistance...
February 2017: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/27912825/next-generation-sequencing-of-lung-cancers-lessons-learned-and-future-directions
#13
REVIEW
Siddhartha Devarakonda, Ashiq Masood, Ramaswamy Govindan
Targeted therapies and immune checkpoint inhibitors have significantly improved outcomes in a sizable fraction of patients with metastatic non-small cell lung cancer. Nevertheless, a majority of patients with lung cancer continue to have poor outcomes. The ability to comprehensively characterize the genomic alterations in various subtypes of lung cancer has the potential to transform cancer care by facilitating the identification of novel treatment strategies. The objective of this review is to summarize key findings from recent studies that have sequenced a large number of lung cancer samples and discuss the diagnostic, prognostic, and therapeutic relevance of these findings...
February 2017: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/27888886/the-increasing-complexity-of-aggressive-b-cell-lymphoma
#14
EDITORIAL
Laurie H Sehn
No abstract text is available yet for this article.
December 2016: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/27888885/mantle-cell-lymphoma-is-it-time-for-a-new-treatment-paradigm
#15
REVIEW
Andre Goy
Mantle cell lymphoma is a relatively rare subtype of lymphoma with a great deal of heterogeneity, both clinically and biologically. Since its recognition as a separate entity in the early 1990s though, consistent efforts have led to a significant improvement of overall survival, from a median overall survival of 2.5 years initially to 5-7 years currently. This decades-long and stepwise progress, summarized in the article, definitely accelerated recently, shedding light on a changing paradigm.
December 2016: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/27888884/update-on-burkitt-lymphoma
#16
REVIEW
Kieron Dunleavy, Richard F Little, Wyndham H Wilson
Because of its rarity and high curability, progress in advancing therapeutics in Burkitt lymphoma (BL) has been difficult. Over recent years, several new mutations that cooperate with MYC have been identified, and this has paved the way for testing novel agents in the disease. One of the challenges of most standard approaches typically used is severe treatment-related toxicity that often leads to discontinuation of therapy. To that point, there has been recent success developing intermediate intensity approaches that are well tolerated in all patient groups and maintain high cure rates in a multicenter setting...
December 2016: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/27888883/transformed-lymphoma
#17
REVIEW
Mary Ann Anderson, Piers Blombery, John F Seymour
Transformed lymphoma is a complex syndrome that encompasses an array of different underlying low-grade lymphoproliferative conditions transforming into more aggressive disease as manifest by morphologic, clinical, and genetic features. Over the last decade, advances in chemoimmunotherapy have led to new options. Knowledge surrounding the genetic changes driving the process of transformation is leading to novel targeted therapies. This article focuses on the transformation of chronic lymphocytic leukemia and follicular lymphoma into diffuse large B-cell lymphoma...
December 2016: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/27888882/the-challenge-of-primary-central-nervous-system-lymphoma
#18
REVIEW
Julia Carnevale, James L Rubenstein
Primary central nervous system (CNS) lymphoma is a challenging subtypes of aggressive non-Hodgkin lymphoma. Emerging clinical data suggest that optimized outcomes are achieved with dose-intensive CNS-penetrant chemotherapy and avoiding whole brain radiotherapy. Anti-CD20 antibody-based immunotherapy as a component of high-dose methotrexate-based induction programs may contribute to improved outcomes. An accumulation of insights into the molecular and cellular basis of disease pathogenesis is providing a foundation for the generation of molecular tools to facilitate diagnosis as well as a roadmap for integration of targeted therapy within the developing therapeutic armamentarium for this challenging brain tumor...
December 2016: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/27888881/central-nervous-system-prophylaxis-for-aggressive-b-cell-lymphoma-who-what-and-when
#19
REVIEW
Norbert Schmitz, Maike Nickelsen, Kerry J Savage
Central nervous system (CNS) relapse of aggressive B-cell lymphoma is a rare but serious complication with poor survival. Different approaches have been used to define risks factors for CNS relapse and establish prophylactic measures. Although patients with low or intermediate risk of CNS relapse should not undergo special diagnostic or therapeutic measures, CNS MRI as well as cytology and flow cytometry of the cerebrospinal fluid are suggested for high-risk patients (and patients with testicular involvement) at diagnosis, and prophylactic high-dose methotrexate in patients without proven CNS involvement...
December 2016: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/27888880/optimizing-outcomes-in-primary-mediastinal-b-cell-lymphoma
#20
REVIEW
Pier Luigi Zinzani, Alessandro Broccoli
Primary mediastinal B-cell lymphoma is characterized by a high chance of cure, and cured patients have a long disease-free life-expectancy; however, prognosis is severe in the case of relapsed or refractory disease. The initial use of the most effective chemoimmunotherapy regimen is therefore crucial. Understanding who will benefit from postinduction radiotherapy is also of paramount importance; positron emission tomography may be a reliable guide for physicians in determining which patients will require consolidation...
December 2016: Hematology/oncology Clinics of North America
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