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Expert Review of Anticancer Therapy

Timothy J Price, Monica Tang, Peter Gibbs, Daniel G Haller, Marc Peeters, Dirk Arnold, Eva Segelov, Amitesh Roy, Niall Tebbutt, Nick Pavlakis, Chris Karapetis, Matthew Burge, Jeremy Shapiro
Outcomes in metastatic colorectal cancer are improving, with better understanding and use of targeted therapies. Areas covered: A review of the literature and recent conference presentations was undertaken on the topic of systemic treatment of metastatic colorectal cancer. This article reviews the current evidence for targeted therapies in advanced colorectal cancer, including up-to-date data regarding anti-EGFR and anti-VEGF agents, the relevance of primary tumour location and novel subgroups such as BRAF mutated, HER2 amplified and mismatch-repair deficient cancers...
July 18, 2018: Expert Review of Anticancer Therapy
Guillaume Ploussard, Alexandre de la Taille
The prostate cancer antigen 3 (PCA3) score has been the first urine assay to obtain the Food and Drug Administration approval for guiding decisions regarding additional biopsies. Different aspects of this urinary assay (diagnostic performance, prognostic value, cost/benefit balance, integration with other molecular and imaging modalities) have now been well evaluated. Areas covered: This expert review will summarize current achievements and future perspectives provided by this urine biomarker. Expert commentary: The clinical benefit of the PCA3 score, in addition to the other established factors has been demonstrated before regarding biopsy decision-making in men with persistent risk of prostate cancer...
July 17, 2018: Expert Review of Anticancer Therapy
Alessandro Pulsoni, Luca Vincenzo Cappelli, Laura Ballotta, Martina Canichella, Alessandra Serrao, Giorgia Annechini, Gianna Maria D'Elia, Robin Foà
Recent advances in prognostication as well as management of Follicular Lymphoma (FL) are moving to personalized approach. Areas covered: Prognostic scores as well as consolidated and innovative therapeutic approaches are evaluated according to the various presentation modalities. For asymptomatic, low-tumor burden FL, a 'watch and wait' policy is currently the first-choice approach, although possible alternatives are discussed. Early stage FL may be treated with local radiotherapy although the role of minimal residual disease in possible additional agents should be determined...
July 16, 2018: Expert Review of Anticancer Therapy
Pol Specenier, Jan B Vermorken
The majority of patients with locally advanced head and neck squamous cell carcinoma (HNSCC) will recur. The treatment of patients with recurrent/metastatic (R/M) HNSCC) is rapidly evolving. Areas covered: This article will comprehensively review the current systemic treatment of R/M HNSCC. Expert Commentary: For the time being, the EXTREME regimen (cetuximab in combination with platinum and 5-fluorouracil) still remains standard of care in previously untreated R/M HNSCC patients who are candidates for combination chemotherapy...
July 12, 2018: Expert Review of Anticancer Therapy
Li Li, Henry Mok, Pavan Jhaveri, Mark D Bonnen, Andrew G Sikora, N Tony Eissa, Ritsuko U Komaki, Yohannes T Ghebre
Chemotherapy and radiation therapy are two mainstream strategies applied in the treatment of cancer that is not operable. Patients with hematological or solid tumor malignancies substantially benefit from chemotherapeutic drugs and/or ionizing radiation delivered to the site of malignancy. However, considerable adverse effects, including lung inflammation and fibrosis, are associated with the use of these treatment modalities. Areas covered: As we move towards the era of precision health, we are compelled to understand the molecular basis of chemoradiation-induced pathological lung remodeling and to develop effective treatment strategies that mitigate the development of chronic lung disease (i...
July 11, 2018: Expert Review of Anticancer Therapy
Hélène Babey, Gilles Quéré, Renaud Descourt, Ronan Le Calloch, Luca Lanfranco, Jean-Baptiste Nousbaum, Divi Cornec, Alice Tison, Christos Chouaid
Because of their efficacy against numerous cancers, immune-checkpoint inhibitors (ICIs), anti-cytotoxic T-lymphocyte antigen-4 (CTLA4) and anti-programmed cell-death (PD-1) monoclonal antibodies, are being used ever more often in oncology. However, some patients were excluded from clinical trials because of their comorbidities, despite their potentially higher cancer frequencies, as is the case for immunocompromised patients. Areas covered: We analyzed reported preclinical and clinical information and evaluated the risk/benefit ratio for 4 immunocompromised populations: people living with human immunodeficiency virus (PLHs), solid-organ-transplant recipients, recipients of hematopoietic stem-cell allografts and patients with autoimmune diseases...
July 11, 2018: Expert Review of Anticancer Therapy
Jacob J Mandel, Michael Youssef, Ethan Ludmir, Shlomit Yust-Katz, Akash Patel, John F de Groot
Several recent phase III studies have attempted to improve the dismal survival seen in glioblastoma patients, with disappointing results despite prior promising phase II data. Areas covered: A literature review of prior phase II and phase III studied in glioblastoma was performed to help identify possible areas of concern. Numerous issues in previous phase II trials for glioblastoma were found that may have contributed to these discouraging outcomes and discordant results. Expert Commentary: These concerns include the improper selection of therapeutics warranting investigation in a phase III trial, suboptimal design of phase II studies (often lacking a control arm), absence of molecular data, the use of imaging criteria as a surrogate endpoint, and a lack of pharmacodynamic testing...
July 4, 2018: Expert Review of Anticancer Therapy
Lingaku Lee, Tetsuhide Ito, Robert T Jensen
Recently there have been a number of advances in imaging pancreatic neuroendocrine tumors (panNETs), as well as other neuroendocrine tumors (NETs), which have had a profound effect on the management and treatment of these patients, but in some cases are also associated with controversies. Areas covered: These advances are the result of numerous studies attempting to better define the roles of both cross-sectional imaging, endoscopic ultrasound, with or without fine needle aspiration, and molecular imaging in both sporadic and inherited panNET syndromes; the increased attempt to develop imaging parameters that correlate with tumor classification or have prognostic value; the rapidly increasing use of molecular imaging in these tumors and the attempt to develop imaging parameters that correlate with treatment/outcome results...
July 4, 2018: Expert Review of Anticancer Therapy
Marco Salvini, Mattia D'Agostino, Francesca Bonello, Mario Boccadoro, Sara Bringhen
In the majority of cases, multiple myeloma is a disease occurring in elderly patients. In the last decades, a major improvement in myeloma patients' outcome has been achieved with the introduction of several new drugs. However, this positive outcome was less likely to occur in elderly patients. Areas covered: An overall increase of myeloma cases in elderly patients is expected in the next years. This patient population is highly heterogeneous in terms of physiological functions and ability to resist stressing conditions such as myeloma and its treatment...
July 4, 2018: Expert Review of Anticancer Therapy
Elizabeth V Connor, Peter G Rose
Endometrial cancer is the most common gynecologic malignancy in the developed world, and its incidence is increasing. Mortality from this cancer has not improved in recent decades and is primarily driven by high-grade carcinomas that are more likely to present at an advanced stage and ultimately are more likely to recur. The prognosis for recurrent endometrial cancer is poor, especially for the 50% of these women that present with extrapelvic disease recurrence. As a standard of care, recurrent disease has been treated with platinum-based chemotherapy; however, new therapies are emerging as we identify drivers of proliferation and metastasis at the cellular and molecular levels...
July 4, 2018: Expert Review of Anticancer Therapy
Marina E Cazzaniga, Elisabetta Munzone, Emilia Montagna, Giovanni Pappagallo
BACKGROUND: The aim of this study was to record the opinions of Italian oncologists about the use of oral vinorelbine administered metronomically in patients with advanced breast cancer. METHODS: A series of meetings were held throughout Italy, and participants were asked how much they agreed with each of the several statements. RESULTS: The majority of oncologists agreed that the concept of the minimum biologically effective dose should be used for drugs administered metronomically...
July 4, 2018: Expert Review of Anticancer Therapy
Paul G Richardson, Jacob Laubach, Sara Gandolfi, Thierry Facon, Katja Weisel, Peter O'Gorman
In multiple myeloma (MM), maintenance therapy is a longer, less intensive treatment course than initial therapy that is administered postinduction to delay disease progression. Maintenance and continuous therapy have been shown to suppress minimal residual disease and deepen and prolong responses, with the goal of improving progression-free survival and overall survival. Areas covered: In this review, we have summarized current clinical trial data on maintenance and continuous therapy in newly diagnosed MM and relapsed/refractory MM (RRMM), focusing on lenalidomide and bortezomib...
July 3, 2018: Expert Review of Anticancer Therapy
Gaia Cristina Ghedini, Roberto Ronca, Marco Presta, Arianna Giacomini
Deregulation of the fibroblast growth factor (FGF)/FGF receptor (FGFR) network occurs frequently in tumors due to gene amplification, activating mutations, and oncogenic fusions. Thus, the development of FGF/FGFR-targeting therapies is the focus of several basic, preclinical, and clinical studies. Areas covered: This review will recapitulate the status of current FGF/FGFR-targeted drugs. Expert commentary: Non-selective FGF/FGFR inhibitors have been approved for cancer treatment but evidence highlights various complications affecting their use in the clinical practice...
July 2, 2018: Expert Review of Anticancer Therapy
Balamurugan A Vellayappan, Samuel T Chao, Matthew Foote, Matthias Guckenberger, Kristin J Redmond, Eric L Chang, Nina A Mayr, Arjun Sahgal, Simon S Lo
Owing to improvements in clinical care and systemic therapy, more patients are being diagnosed with, and living longer with, spinal metastases (SM). In parallel, tremendous technological progress has been made in the field of radiation oncology. Advances in both software and hardware are able to integrate three- (and four-) dimensional body imaging with spatially accurate treatment delivery methods. This is able to improve the efficacy, shorten the overall treatment schedule and potentially reduce treatment-related toxicity...
June 25, 2018: Expert Review of Anticancer Therapy
Ariel E Marciscano, James L Gulley, Howard L Kaufman
No abstract text is available yet for this article.
June 25, 2018: Expert Review of Anticancer Therapy
Emily Z Keung, Jeffrey E Gershenwald
The eighth edition of the American Joint Committee on Cancer (AJCC) melanoma staging system was implemented in the United States on January 1, 2018. Areas covered: This article provides an overview of important changes in the eighth edition AJCC staging system from the seventh edition based on analyses of a large international melanoma database. The clinical implications of these changes for melanoma treatment are also discussed. Expert commentary: A standardized and contemporary cancer staging system that facilitates accurate risk stratification is essential to guide patient treatment...
June 20, 2018: Expert Review of Anticancer Therapy
Kathleen G Essel, Kathleen N Moore
Niraparib, an orally available selective inhibitor of poly(adenosine diphosphate-ribose) polymerase (PARP) is the first PARP inhibitor approved for use in patients with ovarian cancer who do not harbor a germline or somatic mutation in the breast cancer gene (BRCA). Overall niraparib is well tolerated and its toxicities, primarily hematologic, are manageable especially with recently released initial dose modification guidelines based on weight and baseline platelet count. The role of niraparib as maintenance following front-line platinum-based chemotherapy as well as in the treatment of recurrent high grade serous ovarian cancer (HGSOC) is an active area of investigation...
June 17, 2018: Expert Review of Anticancer Therapy
Apar Gupta, Nisha Ohri, Bruce G Haffty
The standard treatment for early-stage breast cancer is breast conservation therapy, consisting of breast conserving surgery followed by adjuvant radiation treatment (RT). Conventionally-fractionated whole breast irradiation (CF-WBI) has been the standard RT regimen, but recently shorter courses of hypofractionated whole breast irradiation (HF-WBI) have been advocated for patient convenience and reduction in healthcare costs and resources. Areas covered: This review covers the major randomized European and Canadian trials comparing HF-WBI to CF-WBI with long-term follow-up, as well as additional recently closed randomized trials that further seek to define the applicability of HF-WBI in clinical practice...
June 14, 2018: Expert Review of Anticancer Therapy
Yuval Freifeld, Laura-Maria Krabbe, Timothy N Clinton, Solomon L Woldu, Vitaly Margulis
Many controversies exist regarding the appropriate management of patients with upper tract urothelial carcinoma (UTUC), including staging, surgical management, use of systemic therapy, and prevention of bladder recurrence. Due to the rarity of this condition, high-level evidence is often lacking and in many cases guidelines are extrapolated from existing evidence on urothelial bladder cancer. Areas covered: This review paper summarizes the evidence on proper diagnosis and staging, surgical techniques, prevention of bladder recurrences, the use of local or systemic treatments in both neoadjuvant and adjuvant settings as well as special consideration for hereditary UTUC...
June 8, 2018: Expert Review of Anticancer Therapy
Jason M Redman, Ravi A Madan
No abstract text is available yet for this article.
June 7, 2018: Expert Review of Anticancer Therapy
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