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Current Oncology Reports

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https://www.readbyqxmd.com/read/27822695/the-treatment-of-melanoma-brain-metastases
#1
REVIEW
Nour Kibbi, Harriet Kluger
Melanoma is the malignancy with the highest rate of dissemination to the central nervous system once it metastasizes. Until recently, the prognosis of patients with melanoma brain metastases (MBM) was poor. In recent years, however, the prognosis has improved due to high-resolution imaging that facilitates early detection of small asymptomatic brain metastases and early intervention with local modalities such as stereotactic radiosurgery. More recently, a number of systemic therapies have been approved by the Food and Drug Administration for metastatic melanoma, resulting in improved survival for many MBM patients...
December 2016: Current Oncology Reports
https://www.readbyqxmd.com/read/27812861/metastatic-bladder-cancer-second-line-treatment-and-recommendations-of-the-genitourinary-tumor-division-of-the-galician-oncologic-society-sog-gu
#2
REVIEW
Jorge García, Lucia Santomé, Urbano Anido, Ovidio Fernández-Calvo, Javier Afonso-Afonso, Martín Lázaro, Ana Medina, Sergio Vázquez Estévez
Once metastatic bladder cancer has progressed to first-line treatment, the number of therapeutic options is scarce. Among chemotherapeutic agents showing activity in phase II trials, including taxanes, vinflunine (VFL) is the only one shown to increase overall survival in a phase III trial. In addition to its efficacy, VFL is safe in special population groups. Despite this, the prognosis for these patients remains poor, and more effective therapies need to be developed. Agents acting on new therapeutic targets as well as biomarkers to aid matching patients to specific treatments are currently under evaluation...
December 2016: Current Oncology Reports
https://www.readbyqxmd.com/read/27812860/opioids-and-chronic-pain-where-is-the-balance
#3
REVIEW
Mellar P Davis, Zankhana Mehta
Chronic opioid therapy (defined as greater than 3 months on opioids) is a common practice for those with non-cancer pain, cancer survivors with treatment-related pain, and individuals with cancer undergoing disease-modifying therapy with a survival that can be for a year or more. Recent studies have found unique long-term toxicities with opioids which reduce the utility of opioid therapy in chronic pain. The risk of addiction, depression, central hypogonadism, sleep-disordered breathing, impaired wound healing, infections, cognitive impairment, falls, non-vertebral fractures, and mortality are increased in populations on long-term opioids...
December 2016: Current Oncology Reports
https://www.readbyqxmd.com/read/27812859/palliative-care-of-cancer-in-the-older-patient
#4
REVIEW
Lodovico Balducci, Dawn Dolan
The scope of palliative care includes goal setting, symptom management, and care of the care giver. Palliative care is essential for patient-centered care of the older cancer patients. The diversity of this population in terms of life expectancy, treatment tolerance, function, disability, and social support mandates personalized treatment plans. The assessment of physiologic age is currently based on a comprehensive geriatric assessment (CGA). A number of biologic markers of aging including the inflammatory index, the genomic clock, the expression of p16INKa4, and the circulating levels of vitamin D may complement the CGA and fine-tune the determination of physiologic age...
December 2016: Current Oncology Reports
https://www.readbyqxmd.com/read/27807821/age-related-disparity-breast-cancer-in-the-elderly
#5
REVIEW
Rahul Gosain, YaoYao Pollock, Dharamvir Jain
Aging poses an unique opportunity to study cancer biology and treatment in older adults. Breast cancer is often studied in young women; however, much investigation remains to be done on breast cancer in our expanding elderly population. Diagnostic and management strategies applicable to younger patients cannot be empirically used to manage older breast cancer patients. Lack of evidence-based data continues to be the major impediment toward delivery of personalized cancer care to elderly breast cancer patients...
November 2016: Current Oncology Reports
https://www.readbyqxmd.com/read/27718181/uterine-adenosarcoma-a-review
#6
Michael J Nathenson, Vinod Ravi, Nicole Fleming, Wei-Lien Wang, Anthony Conley
Adenosarcomas are rare malignancies of the female genital tract, accounting for approximately 5 % of uterine sarcomas. Occasionally, adenosarcoma occurs in the ovaries or in extra-uterine tissue, which may be related to endometriosis. These tumors are characterized by benign epithelial elements and a malignant mesenchymal component. Pathologic diagnosis is dependent on the identification of the characteristic morphologic features. The most common immunohistochemical markers for adenosarcoma are CD10 and WT1, but these are not specific...
November 2016: Current Oncology Reports
https://www.readbyqxmd.com/read/27613168/optimal-use-of-braf-targeting-therapy-in-the-immunotherapy-era
#7
REVIEW
Kevin Wood, Jason J Luke
PURPOSE OF REVIEW: The therapeutic landscape for metastatic melanoma has been revolutionized in recent years. This review will discuss existing evidence for therapeutic approaches for BRAF-mutated metastatic melanoma. RECENT FINDINGS: Clinical trials involving combined BRAF/MEK inhibition with either vemurafenib plus cobimetinib or dabrafenib plus trametinib have shown improved overall survival compared to monotherapy with BRAF inhibitors alone. In a subset of patients with good prognostic factors, long-term clinical benefit has been noted...
November 2016: Current Oncology Reports
https://www.readbyqxmd.com/read/27613167/the-wide-experience-of-the-sequential-therapy-for-patients-with-metastatic-renal-cell-carcinoma
#8
REVIEW
Julio Lambea, Urbano Anido, Olatz Etxániz, Luis Flores, Álvaro Montesa, Juan Manuel Sepúlveda, Emilio Esteban
Sequential targeted therapies are the standard of care for patients with metastatic renal cell carcinoma (mRCC). Several drugs are available for patients whose disease progresses while they receive initial tyrosine kinase inhibitor (TKI) therapy; these include nivolumab (an inhibitor of PD-1 receptor), everolimus (an inhibitor of the mechanistic target of rapamycin) or additional TKIs. Until now, there has been no clinical evidence to support the use of one strategy versus another, so investigators and physicians rely on experience, judgement and findings from molecular analyses to select the appropriate treatment...
November 2016: Current Oncology Reports
https://www.readbyqxmd.com/read/27613166/incorporating-geriatric-medicine-providers-into-the-care-of-the-older-adult-with-cancer
#9
REVIEW
Allison Magnuson, Beverly Canin, G J van Londen, Beatrice Edwards, Pamela Bakalarski, Ira Parker
A significant proportion of cancer patients and survivors are age 65 and over. Older adults with cancer often have more complex medical and social needs than their younger counterparts. Geriatric medicine providers (GMPs) such as geriatricians, geriatric-trained advanced practice providers, and geriatric certified registered nurses have expertise in caring for older adults, managing complex medical situations, and optimizing function and independence for this population. GMPs are not routinely incorporated into cancer care for older adults; however, their particular skill set may add benefit at many points along the cancer care continuum...
November 2016: Current Oncology Reports
https://www.readbyqxmd.com/read/27586378/advanced-vulvar-cancers-what-are-the-best-options-for-treatment
#10
REVIEW
Alejandro Soderini, Alejandro Aragona, Nicholas Reed
The treatment of patients with vulvar cancer remains challenging for gynecologic oncologists. Up to 30 % of the cases are diagnosed in a clinical condition of irresectability, and some kind of strategy has to be taken into account beyond surgery. In this regard, a common and standard definition is critical to maximize oncological results and minimize complications after treatments. Each patient treatment must be tailored individually according to their clinical and biological features and to the setting in which they are dealing with...
October 2016: Current Oncology Reports
https://www.readbyqxmd.com/read/27586377/treatment-of-metastatic-prostate-cancer-in-older-adults
#11
REVIEW
Kah Poh Loh, Supriya G Mohile, Elizabeth Kessler, Chunkit Fung
The aging of the population, along with rising life expectancy, means that increasing numbers of older men will be diagnosed with prostate cancer, and a large proportion of these men will present with metastatic disease. In this paper, we discuss recent advances in prostate cancer treatment. In particular, we review management approaches for older patients with metastatic prostate cancer based on the decision tree developed by the International Society of Geriatric Oncology, which categorized older men as "fit," "vulnerable," and "frail" according to comprehensive geriatric assessment...
October 2016: Current Oncology Reports
https://www.readbyqxmd.com/read/27541923/clinical-implications-of-sarcopenic-obesity-in-cancer
#12
REVIEW
Isabella P Carneiro, Vera C Mazurak, Carla M Prado
Sarcopenia has been associated with several negative clinical outcomes in cancer. However, the consequences of sarcopenic obesity, a condition of combined sarcopenia and obesity burden, have been less extensively investigated. The aim of this paper was to review the current evidence on the prevalence and clinical implications of sarcopenic obesity in cancer. A total of 14 studies linking sarcopenic obesity to a clinical outcome in cancer were included. There is considerable inconsistency in methods used to evaluate body composition as well as in the criteria used to define sarcopenic obesity, which limits comparison among studies...
October 2016: Current Oncology Reports
https://www.readbyqxmd.com/read/27525737/capturing-and-incorporating-patient-reported-outcomes-into-clinical-trials-practical-considerations-for-clinicians
#13
REVIEW
Juliana Perez Botero, Gita Thanarajasingam, Rahma Warsame
Patient centeredness as the focus of healthcare delivery requires the incorporation of patient-reported outcomes into clinical trials. Clearly defining measurable outcomes as well as selecting the most appropriate validated collection tool to use is imperative for success. Creating and validating one's own instrument is also possible, albeit more cumbersome. Meticulous data collection to avoid missing data is key, as is limiting the number of data collection points to prevent survey fatigue and using electronic systems to facilitate data gathering and analysis...
October 2016: Current Oncology Reports
https://www.readbyqxmd.com/read/27492426/update-on-the-management-of-pancreatic-cancer-in-older-adults
#14
REVIEW
Shin Yin Lee, Moussa Sissoko, Kevan L Hartshorn
Pancreatic cancer is more common in older adults, who are underrepresented in clinical trials and frequently under treated. Chronological age alone should not deter clinicians from offering treatment to geriatric patients, as they are a heterogeneous population. Geriatric assessment, frailty assessment tools, and toxicity risk scores help clinicians select appropriate patients for therapy. For resectable disease, surgery can be safe but should be done at a high-volume center. Adjuvant therapy is important; though there remains controversy on the role of radiation, chemotherapy is well studied and efficacious...
October 2016: Current Oncology Reports
https://www.readbyqxmd.com/read/27484062/immune-checkpoint-blockade-a-new-era-for-non-small-cell-lung-cancer
#15
REVIEW
Raffaele Califano, Keith Kerr, Robert David Morgan, Giuseppe Lo Russo, Marina Garassino, Floriana Morgillo, Antonio Rossi
Despite better understanding of it's molecular biology, non-small cell lung cancer (NSCLC) remains a challenging disease to treat. Unfortunately, treatment options are still very limited and prognosis for advanced disease is poor. Immune surveillance plays a crucial role in a host's defence against tumour cells, and this is particular relevant for lung cancer due to it's high somatic mutational load, which increases the chances for the immune system to recognize cancer cells as 'non-self'. Novel immunotherapies are emerging as an effective treatment for this disease...
September 2016: Current Oncology Reports
https://www.readbyqxmd.com/read/27484061/exercise-promotion-in-geriatric-oncology
#16
REVIEW
Peggy S Burhenn, Ashley Leak Bryant, Karen M Mustian
Evidence of the benefits of exercise for people with cancer from diagnosis through survivorship is growing. However, most cancers occur in older adults and little exercise advice is available for making specific recommendations for older adults with cancer. Individualized exercise prescriptions are safe, feasible, and beneficial for the geriatric oncology population. Oncology providers must be equipped to discuss the short- and long-term benefits of exercise and assist older patients in obtaining appropriate exercise prescriptions...
September 2016: Current Oncology Reports
https://www.readbyqxmd.com/read/27475806/evolving-immunotherapy-approaches-for-renal-cell-carcinoma
#17
REVIEW
Susanna A Curtis, Justine V Cohen, Harriet M Kluger
Metastatic renal cell carcinoma (mRCC) continues to be associated with high rates of morbidity and mortality. Renal cell carcinoma (RCC) is typically resistant to cytotoxic chemotherapy, and while targeted therapies have activity and prolong progression-free and overall survival, responses are usually not durable. Modulating the immune system with cytokine therapy, vaccine therapy, cell therapy, and checkpoint inhibitors offers hope of prolonged survival. Standard and emerging immune therapy approaches and combinations of immune therapies and other modalities are reviewed...
September 2016: Current Oncology Reports
https://www.readbyqxmd.com/read/27475805/the-obesity-paradox-in-cancer-a-review
#18
REVIEW
Hannah Lennon, Matthew Sperrin, Ellena Badrick, Andrew G Renehan
There is a common perception that excess adiposity, commonly approximated by body mass index (BMI), is associated with reduced cancer survival. A number of studies have emerged challenging this by demonstrating that overweight and early obese states are associated with improved survival. This finding is termed the "obesity paradox" and is well recognized in the cardio-metabolic literature but less so in oncology. Here, we summarize the epidemiological findings related to the obesity paradox in cancer. Our review highlights that many observations of the obesity paradox in cancer reflect methodological mechanisms including the crudeness of BMI as an obesity measure, confounding, detection bias, reverse causality, and a specific form of the selection bias, known as collider bias...
September 2016: Current Oncology Reports
https://www.readbyqxmd.com/read/27475804/immunotherapy-as-a-potential-treatment-for-chordoma-a-review
#19
REVIEW
Shalin S Patel, Joseph H Schwab
Chordoma is a locally aggressive primary malignancy of the axial skeleton. The gold standard for treatment is en bloc resection, with some centers now advocating for the use of radiation to help mitigate the risk of recurrence. Local recurrence is common, and salvaging local failures is quite difficult. Chemotherapy has been ineffective and small molecule targeted therapy has had only marginal benefits in small subsets of patients with rare tumor phenotypes or refractory disease. Recent successes utilizing immunotherapy in a variety of cancers has led to a resurgence of interest in modifying the host immune system to develop new ways to treat tumors...
September 2016: Current Oncology Reports
https://www.readbyqxmd.com/read/27469263/determining-adequate-margins-in-head-and-neck-cancers-practice-and-continued-challenges
#20
REVIEW
Michelle D Williams
Margin assessment remains a critical component of oncologic care for head and neck cancer patients. As an integrated team, both surgeons and pathologists work together to assess margins in these complex patients. Differences in method of margin sampling can impact obtainable information and effect outcomes. Additionally, what distance is an "adequate or clear" margin for patient care continues to be debated. Ultimately, future studies and potentially secondary modalities to augment pathologic assessment of margin assessment (i...
September 2016: Current Oncology Reports
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