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Hematology/oncology Clinics of North America

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https://www.readbyqxmd.com/read/30390771/ovarian-cancer
#1
EDITORIAL
Ursula A Matulonis
No abstract text is available yet for this article.
December 2018: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/30390770/targeting-dna-damage-response-and-repair-as-a-therapeutic-strategy-for-ovarian-cancer
#2
REVIEW
Panagiotis A Konstantinopoulos, Ursula A Matulonis
Large-scale genomic studies have demonstrated that ovarian cancer is characterized by frequent genetic and epigenetic alterations of gene members of the homologous recombination repair pathway. Homologous recombination repair deficiency induces genomic instability and hyperdependence on alternative DNA repair mechanisms, and is associated with enhanced sensitivity to double-strand break-inducing agents such as platinum analogues and poly(adenosine diphosphate)-ribose polymerase inhibitors. The authors review the DNA repair pathway alterations that are present in ovarian cancer, and discuss current and emerging therapeutic approaches that target the DNA damage response and repair focusing on chemotherapy and poly(adenosine diphosphate)-ribose polymerase inhibitors...
December 2018: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/30390769/mechanisms-of-drug-resistance-in-high-grade-serous-ovarian-cancer
#3
REVIEW
Alison E Freimund, Jessica A Beach, Elizabeth L Christie, David D L Bowtell
Resistance in ovarian cancer is driven by a range of mechanisms, some of which are therapy specific whereas others confer multidrug resistance. This review outlines our current understanding of the heterogeneous mechanisms of both primary and acquired drug resistance in high-grade serous ovarian cancer with a focus on the most common therapeutics, including platinum and taxanes. Current therapeutic strategies for overcoming resistance, including the use of non-P- glycoprotein substrate therapies, are outlined, with an emphasis on the importance of developing resistance biomarkers to guide future therapy approaches and improve patient outcomes...
December 2018: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/30390768/management-and-treatment-of-recurrent-epithelial-ovarian-cancer
#4
REVIEW
Shannon Armbruster, Robert L Coleman, Jose Alejandro Rauh-Hain
Most women with advanced epithelial ovarian cancer will experience many episodes of recurrent disease with progressively shorter disease-free intervals. For women whose disease continues to respond to platinum-based drugs, the disease can often be controlled for 5 years or more. Enormous progress has been made in the management of this disease, and new targeted treatments such as antiangiogenic drugs, poly(adenosine diphosphate-ribose) polymerase inhibitors, and immune checkpoint inhibitors offer potential for improved survival...
December 2018: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/30390767/diagnosis-and-treatment-of-ovarian-cancer
#5
REVIEW
Brian Orr, Robert P Edwards
Epithelial ovarian cancer classically presents with vague persistent gastrointestinal, urologic, or nonacute abdominal/pelvic symptoms (bloating, early satiety, discomfort). Ultimately, a pelvic examination or imaging identifies an adnexal mass typically with accompanied advanced peritoneal dissemination. Management involves aggressive cytoreductive surgery in combination with platinum and taxane chemotherapy. Over the last 20 years, optimal resection and mode and timing of chemotherapy have evolved. The authors review the initial diagnosis and management and present the available data and recommendations to guide the decision tree of when to use neoadjuvant, intraperitoneal, HIPEC, dose-dense, and maintenance chemotherapy in the front-line treatment of epithelial ovarian cancer...
December 2018: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/30390766/pathogenesis-genetics-and-genomics-of-non-high-grade-serous-ovarian-cancers
#6
REVIEW
Narthana Ilenkovan, Charlie Gourley
The 5 main non-high grade serous epithelial ovarian cancers (clear cell, low grade endometrioid, low grade serous, mucinous, and carcinosarcoma) are discrete in terms of their pathogenesis, molecular biology, and treatment sensitivity. This article reviews the current understanding of their pathogenesis and molecular biology, highlighting areas of uncertainty where future research efforts should be focused.
December 2018: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/30390765/frontiers-in-the-pathology-and-pathogenesis-of-ovarian-cancer-cancer-precursors-and-precursor-escape
#7
REVIEW
Thing Rinda Soong, Daniela M Dinulescu, Wa Xian, Christopher P Crum
This article summarizes the pathogenesis of ovarian carcinoma, focusing on the paradox of high-grade serous carcinogenesis. The fallopian tube is the prime site of origin in early serous cancers. Because a subset of serous cancers is associated with early serous proliferations absent intramucosal carcinomas, "precursor escape" is emerging, whereby some advanced cancers trace their roots to early serous proliferations. This has parallels in the endometriosis model and opens up a novel mechanism by which advanced malignancy could emerge without an obvious tubal carcinoma...
December 2018: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/30390764/early-detection-of-ovarian-cancer
#8
REVIEW
Kevin M Elias, Jing Guo, Robert C Bast
Early detection of ovarian cancer could reduce mortality by 10% to 30%. Effective screening requires high sensitivity (>75%) and extremely high specificity (99.7%). Clinical trials suggest the best specificity is achieved with 2-stage strategies in which increasing serum CA125 level triggers transvaginal sonography to detect a malignant pelvic mass, although evidence for such approaches improving overall survival has been limited. Screening may be improved by combining CA125 with novel biomarkers, such as autoantibodies, circulating tumor DNA, or microRNAs...
December 2018: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/30390763/risk-factors-for-ovarian-carcinoma
#9
REVIEW
Adrianne R Mallen, Mary K Townsend, Shelley S Tworoger
Ovarian cancer is the leading gynecologic killer of women in the United States. At diagnosis, most women present with advanced-stage disease. There are currently no effective screening strategies for average-risk women, thus understanding disease development and progression is important for developing risk-reduction strategies and identifying high-risk populations who can benefit from preventive surgery. Cancer epidemiology has greatly contributed to the understanding of this complex, heterogeneous disease by identifying various factors that may modify disease development...
December 2018: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/30390762/palliative-care-and-symptom-management-for-women-with-advanced-ovarian-cancer
#10
REVIEW
Devin Miller, Nicole Nevadunsky
The purpose of this article is to review data supporting the benefit of palliative care, specifically for women with advanced ovarian cancer. Authors discuss barriers to implementation of palliative care, including confusion with hospice and challenges of prognostication. Generalist-level palliative techniques for treatment of pain, shortness of breath, bowel obstruction, and ascites are described. A description of physician-assisted suicide in legalized states is provided. Resources for physicians regarding communication and end-of-life decision making support for patients and their families...
December 2018: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/30390761/living-through-ovarian-cancer-treatment-acute-and-long-term-toxicities-of-chemotherapy-for-advanced-stage-disease
#11
REVIEW
Allison Gockley, Alexi Wright
Toxicities during chemotherapy for patients with ovarian cancer who present with advanced-stage disease are frequent and diverse. This review aims to describe common toxicities and management strategies for classic cytotoxic treatments and to briefly discuss the current understanding of toxicities associated with targeted therapies.
December 2018: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/30390760/antibody-drug-conjugates-in-the-treatment-of-epithelial-ovarian-cancer
#12
REVIEW
Debra L Richardson, Shelly M Seward, Kathleen N Moore
Antibody drug conjugates are novel mechanisms for delivering chemotherapy. They vary based on the targeted antigen, conjugated cytotoxic, and the type of linker used. These differences determine what cells are targeted. There are 2 antibody drug conjugates approved for use in cancer. For epithelial ovarian cancer, more than 15 antibody drug conjugates are under study. Using antibody drug conjugates in epithelial ovarian cancer makes sense. This review discusses promising trial results demonstrating efficacy...
December 2018: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/30390759/targeting-angiogenesis-taming-the-medusa-of-ovarian-cancer
#13
REVIEW
Neesha C Dhani, Amit M Oza
Epithelial ovarian cancer remains the most lethal gynecologic cancers with a 5-year survival rate of less than 50%. Cytotoxic combinations are associated with incremental toxicity, leading to interest in evaluating cytotoxic/biologic combinations with improved therapeutic ratios. Angiogenesis is critical to the normal physiology of the gynecologic tract and a novel drug target. Current data suggests antiangiogenics should be considered a critical component of epithelial ovarian cancer treatment. Given the serious adverse event of gastrointestinal perforation/fistula in advanced disease, priority should be given to front-line treatment...
December 2018: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/30390758/emerging-role-and-future-directions-of-immunotherapy-in-advanced-ovarian-cancer
#14
REVIEW
Thinle Chodon, Amit A Lugade, Sebastiano Battaglia, Kunle Odunsi
Clinical progress in cancer immunotherapy has been slow; however, within the last 5 years, breakthrough successes have brought immunotherapy to the forefront in cancer therapy. Promising results have been observed in solid tumors and hematologic malignancies. Most treatment modalities have shown limited efficacy as monotherapy. The complex nature of cancer and the immunosuppressive microenvironment emphasizes the need to personalize immunotherapy by manipulating the patient's own immune system. For successful and long-lasting cure of cancer, a multimodal approach is essential, combining antitumor cell therapy with manipulation of multiple pathways in the tumor microenvironment to ameliorate tumor-induced immunosuppression...
December 2018: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/30390757/treatment-of-rare-epithelial-ovarian-tumors
#15
REVIEW
Lauren P Cobb, David M Gershenson
Traditionally, the management of epithelial ovarian cancer has been approached using a one-size-fits-all mentality. This strategy does not acknowledge the differences in epidemiology and clinical behavior of many of the histologic and molecular subgroups of ovarian cancer, specifically the rare histologies. While cytoreductive surgery followed by adjuvant platinum and taxane-based chemotherapy is the mainstay of primary treatment of epithelial ovarian cancer as a group, further investigation of novel therapeutics is critical for improving outcomes of these rare histologies...
December 2018: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/30190026/waldenstr%C3%A3-m-macroglobulinemia-lessons-learned-from-basic-and-clinical-research
#16
EDITORIAL
Jorge J Castillo, Efstathios Kastritis, Steven P Treon
No abstract text is available yet for this article.
October 2018: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/30190025/novel-approaches-in-waldenstr%C3%A3-m-macroglobulinemia
#17
REVIEW
Michael A Spinner, Gaurav Varma, Ranjana H Advani
Recent advances in the understanding of Waldenström macroglobulinemia (WM) biology have paved the way for development of a plethora of novel therapeutic strategies. The success of ibrutinib in WM has shifted treatment paradigms away from conventional chemoimmunotherapy approaches. Recognition of high-risk genomic subgroups as well as mechanisms of acquired resistance to ibrutinib have led to targeting of additional pathways. In this article, the authors review ongoing and emerging trials of novel therapies in WM that target the B-cell receptor pathway beyond ibrutinib, toll-like receptor pathway, chemokine signaling, apoptotic pathway, chromatin remodeling, protein transport, the immune microenvironment, and CD19-directed immunotherapy...
October 2018: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/30190024/high-dose-therapy-and-hematopoietic-stem-cell-transplantation-in-waldenstr%C3%A3-m-macroglobulinemia
#18
REVIEW
Charalampia Kyriakou
Waldenström macroglobulinemia (WM) is an indolent low-grade non-Hodgkin lymphoma characterized by bone marrow infiltration by lymphoplasmacytic cells and associated clonal IgM paraproteinemia. Recent insights into the biology and genomic characteristics of WM have provided a further platform for more targeted therapies. Despite the high response rates and better depth and duration of responses, the disease remains incurable. This review focuses on use of the high-dose therapy with either autologous or allogeneic hematopoietic stem cell transplantation...
October 2018: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/30190023/first-generation-and-second-generation-bruton-tyrosine-kinase-inhibitors-in-waldenstr%C3%A3-m-macroglobulinemia
#19
REVIEW
Kimon V Argyropoulos, M Lia
Waldenström macroglobulinemia (WM) is an indolent B-cell lymphoma that is heavily dependent on Bruton tyrosine kinase (BTK) hyperactivation. Ibrutinib is a first-generation BTK inhibitor that has shown high activity and durable responses in patients with relapsed/refractory WM. Newer and more selective BTK inhibitors are currently being tested in several clinical trials and are expected to address the toxicity and the acquired resistance observed in patients receiving ibrutinib. Updates on ibrutinib and second-generation BTK inhibitors are summarized in this review...
October 2018: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/30190022/monoclonal-antibodies-for-waldenstr%C3%A3-m-macroglobulinemia
#20
REVIEW
Andres Dominguez, Efstathios Kastritis, Jorge J Castillo
For the last 2 decades, anti-CD20 monoclonal antibodies have revolutionized the treatment of patients with B-cell lymphomas. These agents have shown efficacy when used as single agents and also have improved response and survival rates when added to chemotherapy. Monoclonal antibodies are safe and effective as well in patients with Waldenström macroglobulinemia (WM). The purpose of this article is to review the mechanism of action of monoclonal antibodies and to discuss current clinical data supporting their use in patients with WM...
October 2018: Hematology/oncology Clinics of North America
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