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Expert Review of Anticancer Therapy

Ho-Jae Lee, Young-Min Han, Jeong Min An, Eun A Kang, Yong Jin Park, Ji-Young Cha, Ki Baik Hahm
Although inflammation is defensive and healing process that maintains organ homeostasis, unresolved inflammation can lead to diseases. Polyunsaturated fatty acids (PUFAs), especially n-6 PUFAs abundant in Western diet, are precursors of pro-inflammatory mediators, whereas n-3 PUFAs possess anti-inflammatory properties. Therefore, interest in the cancer-preventive effect of n-3 PUFAs is increasing. Areas covered: We have observed significant reductions of gastrointestinal (GI) tumorigenesis in the Fat-1 transgenic mouse as evidenced that the decrease in Helicobacter pylori-infected gastric tumorigenesis, colon, biliary and pancreatic cancer was seen in Fat-1 mice producing n-3 PUFAs...
September 17, 2018: Expert Review of Anticancer Therapy
Robin L Jones, Axel Le Cesne, Tony Ibrahim, Xavier Garcia Del Muro, Franka Menge
Health-related quality of life (HRQoL) is a patient-reported outcome that addresses patients' perceptions of symptoms across physical, emotional, cognitive and social domains. As HRQoL is currently rarely measured outside clinical trials in oncology, it must be inferred from patients' everyday performance during treatment. To gain insight into the HRQoL of advanced STS patients receiving palliative treatment in clinical practice, three case studies of patients treated with trabectedin are examined. Areas covered: The patient in Case 1 has maintained complete remission for more than 8 years after receiving 9 cycles of second-line trabectedin followed by secondary surgery for recurrent myxoid liposarcoma, and was able to resume normal activities during trabectedin treatment...
September 17, 2018: Expert Review of Anticancer Therapy
Andrea Spallanzani, Giulia Orsi, Kalliopi Andrikou, Fabio Gelsomino, Margherita Rimini, Laura Riggi, Stefano Cascinu
Since 2007 Sorafenib has represented the only approved drug for first-line treatment of advanced hepatocellular carcinoma (HCC). Lenvatinib, an orally active inhibitor of multiple receptor tyrosine kinases (VEGFR 1-3, FGFR 1-4, PDGFRa, RET and KIT), showed preclinical and clinical activity in the treatment of solid tumours, including HCC. Areas covered: In this review we summarize the current therapeutic paradigm for the systemic treatment of advanced HCC, focusing on Lenvatinib pre-clinical and clinical development...
September 15, 2018: Expert Review of Anticancer Therapy
Michael J Nathenson, Anthony P Conley
Uterine adenosarcoma is a rare tumor with both epithelial and stromal components. Standard treatment is total abdominal hysterectomy and bilateral salpingo-oophorectomy. There is no defined role for adjuvant or neoadjuvant chemotherapy or radiation. There is a misconception that this is an indolent, low-grade sarcoma. In fact, at least 50% of patients will develop disease recurrence. Establishing prognostic factors is of paramount importance. Areas covered: This article reviews the current literature regarding adenosarcoma prognostic factors from case reports, case series, and retrospective series...
September 11, 2018: Expert Review of Anticancer Therapy
Ronan J Kelly
BRAFV600E mutations occur in 1-2% of lung adenocarcinomas and act as oncogenic drivers via the mitogen-activated protein kinase (MAPK) pathway. These mutations are mutually exclusive from the more common, epidermal growth factor receptor mutations or anaplastic lymphoma kinase rearrangements and have been associated with poor outcomes and a lower response to platinum-based chemotherapy. Areas covered: Dabrafenib is a potent adenosine-triphosphate-competitive inhibitor of BRAF kinase and is selective for the BRAFV600E mutation in kinase panel screening, cell lines, and xenografts...
September 10, 2018: Expert Review of Anticancer Therapy
Paweł Krawczyk, Renata Duchnowska, Marcin Nicoś, Dariusz Kowalski, Kamila Wojas-Krawczyk
There are no effective central nervous system (CNS) metastases prevention methods in lung cancer patients. Prophylactic cranial irradiation has a limited effectiveness and relatively high toxicity. Systemic chemotherapy is not relevant in reducing the risk of CNS in lung cancer patients. The understanding of molecular background of brain metastases in non-small cell lung cancer patients could contribute to the development of personalized treatments for such patients. Areas covered: This article summarizes the latest clinical trials concerning the use of radiotherapy, chemotherapy, molecularly targeted therapies and immunotherapy in lung cancer patients, with particular consideration of brain lung cancer metastasis prevention...
September 8, 2018: Expert Review of Anticancer Therapy
Lital Keinan-Boker
No abstract text is available yet for this article.
September 7, 2018: Expert Review of Anticancer Therapy
Rosaria Condorelli, Ines Vaz Luis
Recent improvements in the survival of hormone-responsive breast cancer are strongly associated with therapeutic advances, particularly with the uptake of adjuvant endocrine therapy. Nevertheless, endocrine therapy is also linked with adverse effects that impact quality of life, social function and adherence to treatment. Areas covered: This review examines the spectrum and consequences of adverse effects of tamoxifen and aromatase inhibitors, and the pharmacological and non-pharmacological approaches to mitigate some of the most frequent and disturbing side effects of endocrine therapy (including vasomotor, musculoskeletal and vulvo-vaginal symptoms)...
September 6, 2018: Expert Review of Anticancer Therapy
Lei Huang, Tuan-Jie Li
Minimally-invasive surgery is gaining increasing popularity for the management of gastric cancer (GC). Areas covered: The authors hereby comprehensively and systematically reviewed the randomized and/or prospective evidence on laparoscopic gastrectomy (LG) for GC. For early GC located in the distal stomach, various randomized trials have demonstrated the superiority/non-inferiority of LG especially in reducing surgical trauma and enhancing postoperative recovery without compromising surgical safety and oncologic efficacy...
September 6, 2018: Expert Review of Anticancer Therapy
Annalisa Guida, Bernard Escudier, Laurence Albiges
Bone metastases (BMs) are common and cause morbidity in cancer patients. This review focuses on evidence in BMs from metastatic renal cell carcinoma (mRCC) management and discusses current evidence on the role of systemic treatments in BMs management, bone-targeting agents' benefits in skeletal-related events prevention and local therapeutic approaches to BM in mRCC. Areas covered: A comprehensive review of literature concerning incidence, prognosis, and therapeutic approaches of BMs was performed, focusing on the latest emerging evidence in management of BMs from mRCC...
September 5, 2018: Expert Review of Anticancer Therapy
Paul Lesueur, Isabelle Martel-Laffay, Alexandre Escande, Manon Kissel, Chrystel Locher, Radj Gervais, Roland Schott, Alain Vergnenegre, Christos Chouaid
Cisplatin-based chemotherapy administered concomitantly to thoracic radiotherapy is the treatment recommended by the European guidelines for fit patients with unresectable stage III non-small cell lung cancer (NSCLC). Cisplatin may be combined with etoposide, vinorelbine or other vinca alkaloids, which act also as radiation sensitizers. Initially administered intravenously, vinorelbine is also available as oral formulation and is the only orally available microtubule-targeting agent. In addition, the oral formulation avoids the risk of extravasation and phlebitis...
September 1, 2018: Expert Review of Anticancer Therapy
Soraya Puglisi, Paola Perotti, Deborah Cosentini, Elisa Roca, Vittoria Basile, Alfredo Berruti, Massimo Terzolo
Adrenocortical carcinoma (ACC) is a rare tumor characterized by poor prognosis in most cases. Moreover, in most cases ACC produces an excess of adrenal steroid hormones with relevant clinical consequences. Areas covered: After an extensive literature search, this narrative review addresses diagnostic management, including hormonal, radiological and pathological assessment, and treatment, which should be directed toward both cancer and hormone related problems. While surgery is the first option in ACC without evidence of metastatic disease, and the only possibility of cure, the therapeutic management of metastatic patients is centered on systemic therapy including mitotane alone or in combination with chemotherapy...
August 21, 2018: Expert Review of Anticancer Therapy
Imane El Dika, David H Ilson
Gastrointestinal (GI) cancers altogether represent the most common cancer type. HER2 is found to be present in nearly all histologic types of GI cancers in variable degrees of expression. Over the last decade, substantial advances have been made in targeting HER2-positive cancers. Areas covered: The present review summarizes the current progress and future directions for HER2 targeted therapies in GI cancers, including esophagogastric, pancreaticobiliary, and colon cancers. To date trastuzumab is the only anti-HER2 therapy approved for metastatic esophagogastric adenocarcinoma...
August 21, 2018: Expert Review of Anticancer Therapy
Bernard Escudier, Camillo Porta, Tim Eisen, Jonathan Belsey, Damilola Gibson, Jonathan Morgan, Robert Motzer
The efficacy of VEGF-targeting therapies in clinical trials led to their recommendation in clinical guidelines for use across the advanced or metastatic renal cell carcinoma (RCC) treatment landscape, however, tolerability (including off-target effects) has remained a challenge. Tivozanib is a selective inhibitor of all three VEGFRs, with limited off-target interaction, which demonstrates efficacy with improved tolerability relative to multikinase VEGFR-TKIs. Areas covered: Covered here is the clinical development of tivozanib in advanced RCC, including the pivotal Phase III, multicenter, open-label, randomized clinical study comparing tivozanib with sorafenib for the treatment of VEGF- and mTOR therapy-naïve advanced RCC patients...
August 21, 2018: Expert Review of Anticancer Therapy
Felix Hilpert, Andreas Du Bois
Patient-reported outcomes (PROs), including quality-of-life considerations, are increasingly becoming key factors in clinical decision making. Areas covered: This review provides an overview of the current status of PROs in guiding clinical trial design and clinical decision making in patients with ovarian cancer and previews the future potential of PROs in these settings. Expert commentary: In ovarian cancer, considerable discord exists between patients and physicians regarding perceived symptom burden. During maintenance therapy, it is important that the most appropriate PROs (i...
October 2018: Expert Review of Anticancer Therapy
Christian Marth
BACKGROUND: The challenges of managing relapsed ovarian cancer increase as more advanced lines of chemotherapy are achieved. METHODS: A case study is presented to illustrate the complexities of selecting treatment in a patient with platinum-sensitive relapsed ovarian cancer and exposure to two previous lines of platinum-based chemotherapy. RESULTS: In this clinical scenario, options include re-treatment with platinum-based chemotherapy or treatment with a nonplatinum single-agent or a nonplatinum combination...
October 2018: Expert Review of Anticancer Therapy
Andreas du Bois
No abstract text is available yet for this article.
October 2018: Expert Review of Anticancer Therapy
Isabelle Ray-Coquard
OBJECTIVE: In patients with recurrent ovarian cancer, there are certain situations where further surgery and/or next-line platinum-based chemotherapy is not feasible or is not the best option. Multidisciplinary teams have a key role in reviewing available options and selecting the most appropriate intervention. METHODS: A case study of relapsed ovarian cancer illustrates some of the factors that shape decision-making and shows the potential of a non-platinum-based regimen in the context of limited platinum sensitivity...
October 2018: Expert Review of Anticancer Therapy
Nicoletta Colombo
OBJECTIVES: Ovarian cancer patients with relapse 6-12 months after last platinum treatment, who have received bevacizumab consolidation and are not BRCA mutant, represent a considerable therapeutic challenge. METHODS: By means of illustrative case study, this review evaluates various treatment strategies for use at first relapse in an ovarian cancer patient with limited sensitivity to platinum. RESULTS: Clinical parameters predictive of complete resection in secondary cytoreductive surgery include an Eastern Cooperative Oncology Group performance status of 0, no residual disease after first surgery, and <500 mL of ascites...
October 2018: Expert Review of Anticancer Therapy
Allison Barz Leahy, Caitlin W Elgarten, Stephan A Grupp, Shannon L Maude, David T Teachey
Cure rates for pediatric and young adult patients with refractory or recurrently relapsed acute lymphoblastic leukemia (ALL) are dismal. Survival from time of relapse is typically measured in weeks to months, and standard chemotherapy and currently approved targeted therapy achieve remission in less than a third of affected patients. To date, the only definitive curative therapy has been allogeneic hematopoietic stem cell transplant (HSCT). Advances in immunotherapy, with the introduction of chimeric antigen receptor T-cell therapies and the development of tisagenlecleucel, have changed the landscape...
October 2018: Expert Review of Anticancer Therapy
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