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Current Treatment Options in Oncology

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https://read.qxmd.com/read/30741372/updates-on-minimally-invasive-surgery-in-non-small-cell-lung-cancer
#1
REVIEW
Norihiko Ikeda
Video-assisted thoracic surgery (VATS) has become widely used since the 1990s and has become a standard treatment approach mainly for early-stage non-small cell lung cancer. The few randomized controlled trials providing evidence of the effectiveness of VATS lobectomy at present are supported by a large number of propensity-matched studies, several high-quality meta-analyses, and outcome studies. These studies provide comprehensive data demonstrating the lower morbidity, shorter chest tube duration, and shorter hospital stay of VATS than thoracotomy during the postoperative course...
February 11, 2019: Current Treatment Options in Oncology
https://read.qxmd.com/read/30741367/prognostic-significance-of-complex-karyotypes-in-acute-myeloid-leukemia
#2
REVIEW
Yahya Daneshbod, Leila Kohan, Vahideh Taghadosi, Olga K Weinberg, Daniel A Arber
Acute myeloid leukemia (AML) patients with a complex karyotype (CK-AML) show at least 3 unrelated clonal cytogenetic abnormalities with notoriously poor outcome. Such cases fall into either AML with myelodysplasia-related changes or therapy-related AML in the current World Health Organization classification of AML. Allogeneic stem cell transplantation is one of the only treatment modalities that can provide a long-term survival benefit and is recommended as a consolidative treatment in patients who are able to achieve complete remission...
February 11, 2019: Current Treatment Options in Oncology
https://read.qxmd.com/read/30741358/treatment-approaches-for-cisplatin-ineligible-patients-with-invasive-bladder-cancer
#3
REVIEW
David J Einstein, Guru Sonpavde
Cisplatin has been established as an important agent in the neoadjuvant setting prior to radical cystectomy (RC) surgery for muscle-invasive urothelial cancer (MIUC) as well as in the unresectable or metastatic urothelial carcinoma (mUC) setting. Unfortunately, many patients in practice are felt to be "cisplatin-ineligible." Thus, it is vital that we develop treatment approaches and novel therapeutics for this population. We evaluate therapeutic alternatives to cisplatin-based treatment. For patients undergoing RC, there is no recommended alternative to neoadjuvant cisplatin-based combination therapy, and upfront RC or clinical trials are preferable...
February 11, 2019: Current Treatment Options in Oncology
https://read.qxmd.com/read/30741356/innovating-cancer-care-delivery-the-example-of-the-4r-oncology-model-for-colorectal-cancer-patients
#4
REVIEW
Julia Trosman, Christine Weldon, Sheetal Kircher, William Gradishar, Al Benson
Care delivery innovation is necessary to address the growing complexity of cancer care across specialties and integrate new diagnostics, treatments, and services into care delivery. Informed by Cancer Care Delivery Research (CCDR), multilevel intervention research, and other disciplines, this article describes the 4-step cancer care delivery innovation cycle. The cycle guides collaborative efforts of cancer clinicians, researchers, patients, and other stakeholders to systematically define care delivery problems and formulate, test, and implement care innovations to effectively address problems...
February 11, 2019: Current Treatment Options in Oncology
https://read.qxmd.com/read/30741354/management-of-nonmetastatic-castration-resistant-prostate-cancer-recent-advances-and-future-direction
#5
REVIEW
John Esther, Benjamin L Maughan, Neysi Anderson, Neeraj Agarwal, Andrew W Hahn
Nonmetastatic castration-resistant prostate cancer (nmCRPC) comprises a relatively narrow niche of advanced prostate cancer, but the treatment landscape for men with nmCRPC has drastically changed over the past year. Prior to the SPARTAN and PROSPER trials, men with nmCRPC were commonly treated with first-generation androgen receptor antagonists, such as bicalutamide or flutamide, or with estrogens or ketoconazole, none of which were associated with any proven survival benefit. The SPARTAN trial evaluated apalutamide versus placebo for men with nmCRPC and found that apalutamide significantly improved metastasis-free survival (MFS), the primary endpoint of this trial...
February 11, 2019: Current Treatment Options in Oncology
https://read.qxmd.com/read/30741353/palliative-cancer-care-in-the-outpatient-setting-which-model-works-best
#6
REVIEW
David Hui
Multiple randomized controlled trials have underscored the importance of timely referral to palliative care for patients with advanced cancer. Outpatient palliative care can facilitate timely referral and is increasingly available in many cancer centers. The key question is which model of outpatient palliative care is optimal. There are currently many variations for how palliative care is delivered in the outpatient setting, including (1) Interdisciplinary Specialist Palliative Care in Stand-Alone Clinics, (2) Physician-Only Specialist Palliative Care in Stand-Alone Clinics, (3) Nurse-Led Specialist Palliative Care in Stand-Alone Clinics, (4) Nurse-Led Specialist Palliative Care Telephone-Based Interventions, (5) Embedded Specialist Palliative Care with Variable Team Makeup, and (6) Advanced Practice Providers-Based Enhanced Primary Palliative Care...
February 11, 2019: Current Treatment Options in Oncology
https://read.qxmd.com/read/30741348/diagnosis-and-management-of-basal-cell-carcinoma
#7
REVIEW
Keiji Tanese
Basal cell carcinomas (BCCs) are common skin cancers that tend to appear on sun-exposed skin. Pathobiologically, activation of the Hedgehog signaling pathway characterizes the majority of cases. In general, BCCs are slow-growing and rarely metastasize. Nevertheless, they are locally invasive and can be destructive. While typical cases are diagnosed based on clinical findings, the clinicopathological manifestations are varied. Consequently, skin biopsy is essential to confirm the diagnosis and evaluate the risk of recurrence...
February 11, 2019: Current Treatment Options in Oncology
https://read.qxmd.com/read/30739214/guidelines-for-treatment-and-monitoring-of-adult-survivors-of-pediatric-brain-tumors
#8
REVIEW
Anna J Janss, Claire Mazewski, Briana Patterson
Pathologies of pediatric brain tumors are more varied than those diagnosed in adults and survival outcomes more optimistic. Therapies for pediatric brain tumors are also diverse and treatment options are expanding. The growing number of adult survivors of childhood brain tumors is quite diverse. Medical management of these adults requires understanding the tumor diagnosis and location, the modalities used to treat the tumor, the age of the survivor at the time of diagnosis and treatment, any complications of treatment, and, most importantly, the baseline medical condition and neurological function of each adult survivor...
February 9, 2019: Current Treatment Options in Oncology
https://read.qxmd.com/read/30715612/blastic-plasmacytoid-dendritic-cell-neoplasm
#9
REVIEW
Daniel Kerr, Ling Zhang, Lubomir Sokol
While there is a high initial response rate with standard chemotherapeutic regimens for blastic plasmacytoid dendritic cell neoplasm (BPDCN), the responses are typically not durable and this remains a very aggressive disease with generally poor outcomes. For this reason, the standard approach for eligible patients has been high-dose induction chemotherapy preferably with acute lymphoblastic leukemia (ALL)-based regimens followed by consolidation with allogeneic hematopoietic stem cell transplantation (alloHSCT)...
February 4, 2019: Current Treatment Options in Oncology
https://read.qxmd.com/read/30684093/the-optimal-duration-of-adjuvant-therapy-for-stage-iii-colon-cancer-the-european-perspective
#10
REVIEW
Giacomo Bregni, Sara Elena Rebuzzi, Alberto Sobrero
The International Duration Evaluation of Adjuvant Therapy (IDEA) collaboration was created to pool data from different studies worldwide in order to assess whether a shorter duration of adjuvant treatment in colon cancer could maintain the expected benefit while reducing toxicity. The results of the IDEA trials were clinically relevant. They confirmed a two- to sixfold reduction in neurotoxicity for the shorter duration across trials. Overall, the 3-year disease-free survival was very similar: only 0.9% lower for the 3 months group...
January 26, 2019: Current Treatment Options in Oncology
https://read.qxmd.com/read/30675668/targeted-therapy-and-immunotherapy-for-melanoma-in-japan
#11
REVIEW
Kenjiro Namikawa, Naoya Yamazaki
Melanoma has several clinically and pathologically distinguishable subtypes, which also differ genetically. Mutation patterns vary among different melanoma subtypes, and efficacy of immune-checkpoint inhibitors differs depending on the subtype of melanoma. In spite of the recent revolution of systemic therapies for advanced melanoma, access to innovative agents is still restricted in many countries. This review article aimed to describe the epidemiology and current status of systemic therapies for melanoma in Japan, where melanoma is rare, but access to innovative agents is available...
January 24, 2019: Current Treatment Options in Oncology
https://read.qxmd.com/read/30675651/first-line-therapy-for-metastatic-soft-tissue-sarcoma
#12
REVIEW
Megan Meyer, Mahesh Seetharam
Soft tissue sarcomas are rare cancers with an expected incidence of about 14,000 new cases in 2018, and account for less than 1% of all cancers. It includes in excess of 75 heterogeneous subtypes with varying biology, molecular aberrations, and variable response to treatment. Because of the rarity of these tumors and the many different subtypes, there is no large-scale data to guide treatment, and hence the need for a multidisciplinary individualized approach to treatment, preferably at a high-volume tertiary referral center...
January 24, 2019: Current Treatment Options in Oncology
https://read.qxmd.com/read/30675650/new-concepts-of-treatment-for-patients-with-myelofibrosis
#13
REVIEW
Prithviraj Bose, Mansour Alfayez, Srdan Verstovsek
Seven years after the approval of the Janus kinase 1/2 (JAK1/2) inhibitor ruxolitinib, it remains the only drug licensed for the treatment of myelofibrosis. Patients who discontinue ruxolitinib have a dismal outcome, and this is, therefore, an area of significant unmet need. Given the central role that JAK-signal transducer and activator of transcription (STAT) activation plays in disease pathogenesis, there have been many other JAK inhibitors tested, but most have been abandoned, for a variety of reasons. The JAK2-selective inhibitor fedratinib has recently been resurrected, and there has been a resurgence of interest in the failed JAK1/2 inhibitor momelotinib, which possibly improves anemia...
January 24, 2019: Current Treatment Options in Oncology
https://read.qxmd.com/read/30675645/treatment-of-philadelphia-chromosome-positive-acute-lymphoblastic-leukemia
#14
REVIEW
Iman Abou Dalle, Elias Jabbour, Nicholas J Short, Farhad Ravandi
With the introduction of tyrosine kinase inhibitors (TKIs) in the management of Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL), the prognosis of patients has improved dramatically. Currently, the standard of care in the frontline setting for fit patients is TKI in combination with chemotherapy. Age-adjusted chemotherapy or corticosteroids alone have been used with TKIs in elderly patients with comorbidities with modest long-term benefit. The primary goal of treatment is the achievement of early deep molecular remission as the achievement of complete molecular remission (CMR) at 3 months has been demonstrated to be predictive of higher long-term survival...
January 24, 2019: Current Treatment Options in Oncology
https://read.qxmd.com/read/30635733/therapeutic-intensification-and-induction-chemotherapy-for-high-risk-locally-advanced-squamous-cell-carcinoma
#15
REVIEW
Maria Grazia Ghi, Adriano Paccagnella
The treatment of HNSCC has rapidly evolved over the past 30 years and multidisciplinary management is required, especially for locally advanced disease (LAHNSCC). Concomitant chemoradiation (cCRT) is the standard of care and cetuximab/RT (CET/RT) is an alternative treatment option, especially for patients unfit for concurrent cisplatin. Several intensification strategies have been explored to improve the outcome of the concomitant treatment. The combination of cisplatin plus cetuximab concurrent to RT failed to improve overall survival (OS) in two phase III trials...
January 11, 2019: Current Treatment Options in Oncology
https://read.qxmd.com/read/30635732/systemic-therapy-for-advanced-hepatocellular-carcinoma-in-an-evolving-landscape
#16
REVIEW
Kabir Mody, Ghassan K Abou-Alfa
Globally, hepatocellular carcinoma (HCC) is a leading cause of cancer-related death and a malignancy with rising incidence. After sorafenib remaining the one and only FDA-approved therapy for the disease for many years, the past 2 years has seen the landscape of available treatments change dramatically. Multiple multi-targeted tyrosine kinases (TKIs) have demonstrated success and garnered FDA approval both in the first- (lenvatinib) and second-line (regorafenib) settings. Now, various questions regarding the sequencing of these therapies remain for investigation...
January 11, 2019: Current Treatment Options in Oncology
https://read.qxmd.com/read/30554335/immunotherapy-advances-in-urothelial-carcinoma
#17
REVIEW
Rohit K Jain, Travis Snyders, Lakshminarayanan Nandgoapal, Rohan Garje, Yousef Zakharia, Shilpa Gupta
Checkpoint inhibitors have monumentally transformed the treatment of metastatic urothelial carcinoma. While the efficacy and safety of the different agents are similar in platinum-refractory metastatic urothelial carcinoma, pembrolizumab is the only agent that was superior to chemotherapy in a randomized phase III trial. Pembrolizumab and atezolizumab are also approved as first-line therapies in cisplatin-ineligible metastatic urothelial carcinoma. Several immunotherapy trials are ongoing in non-metastatic setting to maximize responses upfront...
December 15, 2018: Current Treatment Options in Oncology
https://read.qxmd.com/read/30523434/is-there-value-in-molecular-profiling-of-soft-tissue-sarcoma
#18
REVIEW
Antoine Italiano
Soft-tissue sarcomas represent a heterogeneous group of diseases accounting for up to 1% of cancer in adults and 15% of cancer in children. Introduction of next-generation sequencing (NGS) technologies has allowed to gain additional insight into the genetic diversity and complexity of sarcomas, including the potential therapeutic implications of some genetic alterations.Two large studies have investigated the role of targeted NGS to identify actionable mutations in patients with soft-tissue sarcomas. In these two studies, actionable alterations were identified in up to 50% of patients...
December 7, 2018: Current Treatment Options in Oncology
https://read.qxmd.com/read/30483908/capecitabine-versus-continuous-infusion-fluorouracil-for-the-treatment-of-advanced-or-metastatic-colorectal-cancer-a-meta-analysis
#19
REVIEW
Zehua Wu, Yanhong Deng
Nowadays, systemic chemotherapy with intravenous (IV) 5-fluorouracil (5-FU) remains the most commonly prescribed treatment for metastatic colorectal cancers (CRC), in combination with other cytotoxic drugs. 5-FU can be administered through a bolus injection or continuous infusion (cIV), with the latter becoming the preferred administration method and standard of care in recent years. Oral fluoropyrimidines were developed to overcome challenges associated with the IV administration of 5-FU, among which capecitabine has become the most widely used one...
November 27, 2018: Current Treatment Options in Oncology
https://read.qxmd.com/read/30483900/proton-therapy-in-non-small-cell-lung-cancer
#20
REVIEW
Shane Mesko, Daniel Gomez
Non-small cell lung cancer (NSCLC) accounts for 85% of new lung cancer cases and has 5-year survival rates ranging from 92% in early-stage disease to as low as 13% in locally advanced cases. Radiation therapy is a key component in the treatment repertoire for NSCLC, where it is currently used alone or in combinations with chemotherapy and surgery. Despite the broad use of modern photon radiation techniques, as many as 25% of patients experience isolated locoregional recurrences, and toxicity has been proven to be a limiting factor in many cases...
November 27, 2018: Current Treatment Options in Oncology
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