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Current Treatment Options in Oncology

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https://www.readbyqxmd.com/read/27822685/sequencing-treatment-for-castration-resistant-prostate-cancer
#1
REVIEW
Catherine E Handy, Emmanuel S Antonarakis
Prostate cancer is the most common non-cutaneous cancer diagnosed in men and the second leading cause of male cancer deaths in the USA. While most cases are diagnosed in early stages, some will present as or progress to metastatic disease and eventually castration-resistant prostate cancer (mCRPC) which has a mortality rate exceeding 50 %. There are currently six approved systemic life-prolonging therapies for use in mCRPC, yet little data to guide sequencing. Clinical factors, including the presence or absence of symptoms and the presence or absence of visceral metastases, should help determine the best therapeutic choice at each treatment node...
December 2016: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/27817056/erratum-to-cutaneous-complications-of-targeted-melanoma-therapy
#2
Emily de Golian, Bernice Y Kwong, Susan M Swetter, Silvina B Pugliese
No abstract text is available yet for this article.
December 2016: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/27787754/oligometastatic-prostate-cancer
#3
REVIEW
Daniel J Stevens, Prasanna Sooriakumaran
The mainstay of treatment for men with three or fewer non-castrate metastatic lesions outside of the prostate remains morbid palliative androgen deprivation therapy. We believe there is now a significant body of retrospective literature to suggest a survival benefit if these men have radical treatment to their primary tumour alongside 'metastasis-directed therapy' to the metastatic deposits. However, this regimen should be reserved to high-volume centres with quality assurance programmes and excellent outcomes...
December 2016: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/27766547/drug-combinations-as-the-new-standard-for-melanoma-treatment
#4
Marta Polkowska, Edyta Czepielewska, Małgorzata Kozłowska-Wojciechowska
Advanced melanoma is related to a very grim prognosis and fast progression. Until recently, there has been no indicated treatment that would affect the disease's outcome. However, the progress in immunotherapy and molecular therapy has significantly changed the unfavourable prognosis of melanoma progression and its short survival rate. Both approaches have improved patients' outcomes and provided renewed hope for successful treatment. Moreover, in order to further enhance patients' outcomes and to avoid mechanisms of tumour resistance, investigators attempted a combined approach...
December 2016: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/27766546/management-of-skin-cancer-in-the-high-risk-patient
#5
James W Behan, Adam Sutton, Ashley Wysong
Skin cancer is the most common of human cancers and outnumbers all other types of cancer combined in the USA by over threefold. The majority of non-melanoma skin cancers are easily treated with surgery or locally destructive techniques performed under local anesthesia in the cost-effective outpatient setting. However, there is a subset of "high-risk" cases that prove challenging in terms of morbidity, mortality, adjuvant treatment required, as well as overall cost to the health care system. In our opinion, the term "high risk" when applied to skin cancer can mean one of three things: a high-risk tumor with aggressive histologic and/or clinical features with an elevated risk for local recurrence or regional/distant metastasis, a high-risk patient with the ongoing development of multiple skin cancers, and a high-risk patient based on immunosuppression...
December 2016: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/27766545/from-2000-to-2016-which-second-line-treatment-in-advanced-non-small-cell-lung-cancer
#6
Ettore D'Argento, Sabrina Rossi, Giovanni Schinzari, Antonia Strippoli, Michele Basso, Alessandra Cassano, Carlo Barone
New treatments-as immunotherapies and new antiangiogenic agents-are now available in second-line setting for patients affected by EGFR wild-type and ALK-negative non-small-cell lung cancer (NSCLC). Nintedanib, ramucirumab, nivolumab and pembrolizumab have to be included in the therapeutic sequences for patients affected by NSCLC, but no clear selection criteria are to date offered, except for patients with PD-L1 expression ≥50 %. Performance status, smoking habits and comorbidities should be considered as clinical criteria in order to select the appropriate treatment, but also tumour characteristics as histotype, platinum resistance and rapid progression after a first-line therapy should be taken into account...
December 2016: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/27658789/genomic-profiling-of-biliary-tract-cancers-and-implications-for-clinical-practice
#7
Apurva Jain, Lawrence N Kwong, Milind Javle
Biliary tract cancers are relatively uncommon, have an aggressive disease course and a dismal clinical outcome. Until recently, there have been very few clinical advances in the management of these patients and gemcitabine-based chemotherapy has been the only widely accepted systemic therapy. The advent of next generation sequencing technologies can potentially change the treatment paradigm of this disease. Targeted therapy directed against actionable mutations and identification of molecular subsets with distinct prognostic significance is now feasible in clinical practice...
November 2016: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/27645330/cutaneous-complications-of-targeted-melanoma-therapy
#8
REVIEW
Emily de Golian, Bernice Y Kwong, Susan M Swetter, Silvina B Pugliese
The landscape of advanced and metastatic melanoma therapy has shifted dramatically in recent years. Since 2011, eight drugs (ipilimumab, vemurafenib, dabrafenib, trametinib, cometinib, pembrolizumab, nivolumab, and talimogene laherparepvec) have received FDA approval for the treatment of advanced or metastatic melanoma, including combination regimens of both small molecule kinase and immune checkpoint inhibitors. These therapies have revolutionized the management of unresectable regional nodal and distant melanoma, providing hope of extended survival to patients...
November 2016: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/27627999/percutaneous-minimally-invasive-techniques-in-the-treatment-of-spinal-metastases
#9
REVIEW
Mara Bozza Stephenson, Bryan Glaenzer, Angelo Malamis
Spinal metastases are a common and morbid condition in America. Of the 1.6 million new cases of cancer estimated to be diagnosed in the USA in 2015, approximately 5-10 % will develop spinal metastases. This number is expected to increase as the life expectancy of cancer patients increases. Patients with osteolytic spinal metastases experience severe and often debilitating pain, which significantly reduces quality of life. Due to the morbidity of open surgery, particularly in oncologic patients, the treatment paradigm has shifted towards minimally invasive therapy...
November 2016: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/27544507/antibody-drug-conjugates-adcs-changing-the-treatment-landscape-of-lymphoma
#10
REVIEW
Deepa Jagadeesh, Mitchell R Smith
While strides advancing cancer treatment have made it possible to cure some malignancies, the effort to strike an intricate balance between attaining higher efficacy and lower toxicity has been difficult to accomplish, especially with conventional chemotherapy agents. Introduction of antibody drug conjugates (ADCs) has brought us a step closer to this goal and made it possible to target the cancer cells and to minimize effects on normal tissue. Continued efforts have led to approval of two ADCs for cancer therapy, while many others are in various stages of clinical development...
October 2016: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/27523606/adjuvant-therapy-of-resected-non-small-cell-lung-cancer-can-we-move-forward
#11
REVIEW
Lucio Buffoni, Tiziana Vavalà, Silvia Novello
Twenty years ago, an individual patient data meta-analysis of eight cisplatin-based adjuvant chemotherapy (AC) studies in completely resected early stage non-small cell lung cancer (NSCLC) demonstrated a 13 % reduction of the risk of death favoring chemotherapy that was of borderline statistical significance (p = 0.08). This marginal benefit boosted a new generation of randomized trials to evaluate the role of modern platinum-based regimens in resectable stages of NSCLC and, although individual studies generated conflicting results, overall they contributed to confirm the role of AC which is now recommended for completely resected stage II and III NSCLC, mostly 4 cycles, while subset analyses suggested a benefit in patients with large IB tumors...
October 2016: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/27520784/the-benefit-of-a-multidisciplinary-approach-to-the-patient-treated-with-chemo-radiation-for-head-and-neck-cancer
#12
REVIEW
Paolo Bossi, Salvatore Alfieri
In the past two decades, multidisciplinary care has emerged as new way to manage cancer given the need to gather together specific areas of expertise and to discuss the variety of treatment approaches available for each patient. Of all the cancer subtypes, head and neck cancer might be considered one of the most valid areas, from an oncological point of view, for a multidisciplinary approach to be applied. Head and Neck Cancer is a complex disease area due to its varied histology and subsites, its numerous feasible treatments, its multiple typical comorbidities, and its treatment-induced toxicities whose management requires the simultaneous involvement of several professionals as part of the same health care team...
October 2016: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/27515170/sequencing-of-new-and-old-therapies-for-metastatic-melanoma
#13
REVIEW
Megan Ratterman, Sigrun Hallmeyer, Jon Richards
Identification of BRAF driver mutations and agents that block their activity combined with development of immune checkpoint inhibitor therapies have dramatically changed survival and quality of life for patients with metastatic melanoma. Approximately half of patients with metastatic melanoma do not harbor mutations in the BRAF gene and therefore cannot benefit from currently available agents that target this mutation. Additionally, few patients with metastatic melanoma achieve durable disease control with these targeted therapies alone...
October 2016: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/27501915/the-role-of-molecular-diagnostics-in-the-management-of-patients-with-gliomas
#14
REVIEW
Hans-Georg Wirsching, Michael Weller
The revised World Health Organization (WHO) classification of tumors of the central nervous system of 2016 combines biology-driven molecular marker diagnostics with classical histological cancer diagnosis. Reclassification of gliomas by molecular similarity beyond histological boundaries improves outcome prediction and will increasingly guide treatment decisions. This change in paradigms implies more personalized and eventually more efficient therapeutic approaches, but the era of molecular targeted therapies for gliomas is yet at its onset...
October 2016: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/27476159/long-term-effect-of-cranial-radiotherapy-on-pituitary-hypothalamus-area-in-childhood-acute-lymphoblastic-leukemia-survivors
#15
REVIEW
Cecilia Follin, Eva Marie Erfurth
Survival rates of childhood cancer have improved markedly, and today more than 80 % of those diagnosed with a pediatric malignancy will become 5-year survivors. Nevertheless, survivors exposed to cranial radiotherapy (CRT) are at particularly high risk for long-term morbidity, such as endocrine insufficiencies, metabolic complications, and cardiovascular morbidity. Deficiencies of one or more anterior pituitary hormones have been described following therapeutic CRT for primary brain tumors, nasopharyngeal tumors, and following prophylactic CRT for childhood acute lymphoblastic leukemia (ALL)...
September 2016: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/27461038/relapsed-glioblastoma-treatment-strategies-for-initial-and-subsequent-recurrences
#16
REVIEW
Alicia Tosoni, Enrico Franceschi, Rosalba Poggi, Alba A Brandes
At the time of glioblastoma (GBM) recurrence, a sharp analysis of prognostic factors, disease characteristics, response to adjuvant treatment, and clinical conditions should be performed. A prognostic assessment could allow a careful selection between patients that could be proposed to intensified approaches or palliative setting. Participation in clinical trials aims to improve outcome, and should be encouraged due to dismal prognosis of GBM patients after recurrence. Reoperation should be proposed if the tumor is amenable to a complete resection and if prognostic factors suggest that patient could benefit from a second surgery...
September 2016: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/27461037/the-promise-of-molecularly-targeted-and-immunotherapy-for-advanced-melanoma
#17
REVIEW
Kim Margolin
Advanced melanoma, rarely diagnosed at the time of primary melanoma excision but most often occurring later via lymphatic or hematogenous dissemination, is the cause of death for approximately 10,000 people in the USA each year, with the rate of incidence and death increasing yearly. Its causes are multifactorial and depend in large part on solar ultraviolet damage to DNA as well as underlying genetic predisposition. Cutaneous melanoma is the most common, but other subsets of importance are mucosal and uveal primaries, with different biology and treatment considerations...
September 2016: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/27461036/circulating-tumor-dna-to-monitor-therapy-for-aggressive-b-cell-lymphomas
#18
REVIEW
Mary Kwok, S Peter Wu, Clifton Mo, Thomas Summers, Mark Roschewski
The goal of therapy for aggressive B-cell lymphomas such as diffuse large B-cell lymphoma (DLBCL) and Burkitt lymphoma (BL) is to achieve cure. Combination chemotherapy with rituximab cures most patients, but those with recurrent disease have a poor prognosis. Medical imaging scans such as computed tomography (CT) and positron emission tomography (PET) are the principal methods to assess response and monitor for disease relapse after therapy but are fundamentally limited by risks of radiation, cost, and a lack of tumor specificity...
September 2016: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/27447703/controversies-in-the-therapy-of-brain-metastases-shifting-paradigms-in-an-era-of-effective-systemic-therapy-and-longer-term-survivorship
#19
REVIEW
Colette J Shen, Michael Lim, Lawrence R Kleinberg
With the development of therapies that improve extracranial disease control and increase long-term survival of patients with metastatic cancer, effective treatment of brain metastases while minimizing toxicities is becoming increasingly important. An expanding arsenal that includes surgical resection, whole brain radiation therapy, radiosurgery, and targeted systemic therapy provides multiple treatment options. However, significant controversies still exist surrounding appropriate use of each modality in various clinical scenarios and patient populations in the context of cancer care strategies that control systemic disease for increasingly longer periods of time...
September 2016: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/27423794/limited-stage-aggressive-non-hodgkin-lymphoma-what-is-optimal-therapy
#20
REVIEW
Abhijeet Kumar, Srinath Sundararajan, Soham Puvvada, Daniel O Persky
The seminal SWOG trial S8736 trial established the success of a short course of chemotherapy followed by involved field radiation in treating limited stage aggressive NHL lymphoma. Addition of rituximab offered a surprisingly modest improvement in this disease subset. Radioimmunotherapy could hold a slight advantage over rituximab, but that should be investigated in a randomized trial setting. The role of radiation therapy continues to be widely debated, with interpretation complicated by different trial populations, methods of assessing risk, as well as by differences in timing and dose of radiation...
September 2016: Current Treatment Options in Oncology
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