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Expert Review of Anticancer Therapy

Stephen B Edge, Gabriel N Hortobagyi, Armando E Giuliano
Cancer staging has historically been based solely on the anatomic extent of the tumor (T), spread to lymph nodes (N), and presence of distant metastases (M). More recently biologic factors have been added to modify TNM stage groups to provide more accurate prognosis for patients. Areas covered: The American Joint Committee on Cancer (AJCC) updated breast cancer staging in 2016 to include T, N, M, tumor grade and expression of estrogen and progesterone receptors and HER2. Addition of these factors changed the stage group for a large fraction of cases compared to prior TNM stage groupings...
February 13, 2019: Expert Review of Anticancer Therapy
Elise F Nassif, Alexandre Arsène-Henry, Youlia M Kirova
Thirty per cent of cancer patients develop brain metastases, with multiple combination or sequential treatment modalities available, to treat systemic or central nervous system (CNS) disease. Most patients experience toxicities as a result of these treatments, of which cognitive impairment is one of the adverse events most commonly reported, causing major impairment of the patient's quality of life. Areas covered: This article reviews the role of cancer treatments in cognitive decline of patients with brain metastases: surgery, radiotherapy, chemotherapy, targeted therapies, immunotherapies and hormone therapy...
February 12, 2019: Expert Review of Anticancer Therapy
Cesar E Ochoa, Richard W Joseph
No abstract text is available yet for this article.
January 28, 2019: Expert Review of Anticancer Therapy
Amro Elshoury, Amanda Przespolewski, Jeffrey Baron, Eunice S Wang
Mutations of the FLT3 gene are among most common genetic abnormalities occurring in acute myeloid leukemia (AML) and are associated with dismal prognosis. Tremendous effort has been devoted to developing clinically effective FLT3 inhibitors. First generation inhibitors consisted of multi-kinase inhibitors (sorafenib, lestaurtinib, midostaurin), which blocked FLT3 as well as multiple other kinase receptors. The failure of these agents to induce durable responses led to the development of second generation FLT3 tyrosine kinase inhibitors (quizartinib, crenolinib, gilteritinib) exhibiting high potency and specificity for mutant FLT3 kinases and sustained in vivo FLT3 inhibition...
January 25, 2019: Expert Review of Anticancer Therapy
Costanza Canino, Lorenzo Perrone, Eugenia Bosco, Giuseppe Saltalamacchia, Alessandra Mosca, Mimma Rizzo, Camillo Porta
Renal cell carcinoma (RCC), and particularly its clear cell histological subtype, is commonly characterized by genetic alterations in the Von Hippel Lindau (VHL) tumor suppressor gene, leading to a typically exasperated angiogenesis. However, other biological and genetic peculiarities contribute to differentiate this malignancy from other solid tumors, including its immunogenicity. Areas covered: This review focuses on the present and future role of antiangiogenic drugs, administered either alone (as it has been in the past few years), or in combination with other agents (e...
January 24, 2019: Expert Review of Anticancer Therapy
Jarred P Reed, Edwin M Posadas, Robert A Figlin
Renal cell carcinoma (RCC) is among the most commonly diagnosed solid malignancies, but until recently there were few systemic treatment options for advanced disease. Since 2005, the treatment landscape has been transformed by the development of several novel systemic therapies. In particular, tyrosine kinase inhibitors (TKIs) targeting the vascular endothelial growth factor (VEGF) pathway have been instrumental in improving outcomes in patients with metastatic disease. Areas covered: The armamentarium of TKIs available for the treatment of RCC has expanded in recent years...
January 22, 2019: Expert Review of Anticancer Therapy
Brittney H Cotta, Margaret F Meagher, Aaron Bradshaw, Stephen T Ryan, Gerant Rivera-Sanfeliz, Ithaar H Derweesh
Percutaneous renal mass biopsy has evolved over the last decade with improvements on previous pitfalls including low tissue yield, high non-diagnostic rates, and complications. As understanding of tumor biology and natural history of renal cortical neoplasms has improved, percutaneous renal mass biopsy is poised to have an expanding role in an area characterized by individualized management and refined risk stratification. Areas covered: This review summarizes the evolution of renal mass biopsy to its current state with respect to outcomes, indications, and clinical guidelines...
January 18, 2019: Expert Review of Anticancer Therapy
Marcello Maida, Gaetano Morreale, Emanuele Sinagra, Gianluca Ianiro, Vito Margherita, Alfonso Cirrone Cipolla, Salvatore Camilleri
Colorectal cancer (CRC) is a major healthcare problem all over the world and CRC screening is effective in reducing mortality and increasing the 5-year survival. Colonoscopy has a central role in CRC screening. It can be performed as a primary screening test, as a recall policy after a positive result of another screening test, and for surveillance. Since effectiveness of endoscopic screening depends on adequate detection and removal of colonic polyps, consistent quality measures, which are useful in enhancing the diagnostic yield of examination, are essential...
January 7, 2019: Expert Review of Anticancer Therapy
Lizza E L Hendriks, Jessica Menis, Martin Reck
Small cell lung cancer (SCLC) is a tumor with a poor prognosis, often diagnosed in an advanced stage. Despite aggressive treatment of early and locally advanced disease, SCLC often relapses. First line chemotherapy provides good response rates in advanced disease, but progression free and overall survival are limited. New drugs such as some targeted therapies and immune therapies are promising in SCLC. Areas covered: In this review, we discuss the preclinical rationale and trial data for targeted therapies and immune therapies in SCLC, with a specific focus on clinical trials...
December 28, 2018: Expert Review of Anticancer Therapy
Michael S Xu, Jennifer Li, Sam M Wiseman
Gross extrathyroidal extension of thyroid cancer is an indicator of a worse cancer prognosis and may lead to major vessel invasion (MVI) that represents an uncommon and highly morbid manifestation of disease progression. Areas covered: This review aims to evaluate the current literature reporting on thyroid cancer that exhibits MVI, with a focus on relevant patient and pathological characteristics, diagnostic evaluation, and management, of this uncommon but challenging thyroid cancer presentation. Expert commentary: Vascular invasion by thyroid cancer is uncommon and has a poor prognosis with high associated perioperative morbidity and mortality...
December 24, 2018: Expert Review of Anticancer Therapy
Yuka Kozuma, Gouji Toyokawa, Takashi Seto
Anaplastic lymphoma kinase (ALK) is one of the most attractive molecular targets for the treatment of patients with non-small-cell lung cancer. Treatment with ALK inhibitors is recognized as the standard-of-care for patients with ALK gene rearrangements, but it is important to appropriately select patients who will benefit from such treatment. Areas covered: In this article, we review the evidence regarding ALK testing. Immunohistochemistry (IHC), fluorescence in situ hybridization (FISH), and reverse transcription polymerase chain reaction (RT-PCR) are the representative methods for detecting ALK gene fusions...
December 21, 2018: Expert Review of Anticancer Therapy
Bernard Escudier, Francis Worden, Masatoshi Kudo
In 2005, sorafenib was the first targeted therapy approved for advanced renal cell carcinoma (RCC), transforming treatment. In hepatocellular carcinoma (HCC), for more than a decade, sorafenib remained the only approved systemic therapy to have demonstrated a survival benefit in first-line unresectable HCC. In 2013, sorafenib was the first targeted agent approved for patients with differentiated thyroid cancer (DTC) refractory to radioactive iodine treatment. Areas covered: This review discusses the development, advances, and challenges associated with sorafenib use in RCC, HCC, and DTC over the past decade...
December 21, 2018: Expert Review of Anticancer Therapy
Barouyr Baroudjian, Dimitri Arangalage, Stefania Cuzzubbo, Baptiste Hervier, Celeste Lebbé, Gwenael Lorillon, Abdellatif Tazi, Gerard Zalcman, Mohamed Bouattour, Frederic Lioté, J F Gautier, Solenn Brosseau, Nelson Lourenco, Julie Delyon
Immune checkpoint inhibitors (ICI) are now a standard of care in the treatment of many cancers leading to durable responses in patients with metastatic disease. These agents are generally well tolerated but can lead to the appearance of the newly called immune-related adverse events (irAEs). As any organ may be affected, clinicians should be aware of the broad range of clinical manifestations and symptoms and keep in mind that toxicities may occur late, at any point along a patient's treatment course. Although the most common irAEs are rarely severe, some of them may be associated with great morbidity and even become life-threatening...
December 20, 2018: Expert Review of Anticancer Therapy
Arnaud Jeanson, Arnaud Boyer, Laurent Greillier, Pascale Tomasini, Fabrice Barlesi
Mitogen-activated protein kinase (MAPK) pathway is known to be involved in the tumorigenesis of cancer cells including non-small cell lung cancer (NSCLC) and kinases involved in this pathway are frequently mutated. The development of new targeted therapies in cancer has led to the evaluation of MEK-inhibitors. Areas covered: This article reviews different studies using trametinib alone, in combination with other targeted therapies or associated with other non-targeted therapies in NSCLC, with a focus on KRAS mutant and BRAF mutant NSCLC...
December 4, 2018: Expert Review of Anticancer Therapy
Carlos Martínez-Pérez, Arran K Turnbull, J Michael Dixon
In breast cancer, estrogen receptor (ER) and human epidermal growth factor receptor 2 (HER2) are essential biomarkers to predict response to endocrine and anti-HER2 therapies, respectively. In metastatic breast cancer, the use of these receptors and targeted therapies present additional challenges: temporal heterogeneity, together with limited sampling methodologies, hinders receptor status assessment, and the constant evolution of the disease invariably leads to resistance to treatment. Areas covered: This review summarizes the genomic abnormalities in ER and HER2, such as mutations, amplifications, translocations, and alternative splicing, emerging as novel biomarkers that provide an insight into underlying mechanisms of resistance and hold potential predictive value to inform treatment selection...
December 3, 2018: Expert Review of Anticancer Therapy
Iacopo Panarese, Gabriella Aquino, Andrea Ronchi, Francesco Longo, Marco Montella, Immacolata Cozzolino, Giuseppe Roccuzzo, Giuseppe Colella, Michele Caraglia, Renato Franco
Oral and oropharyngeal squamous cell carcinoma (OSCC and OPSCC) represents an increasing problem in the global public health. Indeed, squamous cell carcinoma is the most frequent malignancy in oral cavity and 1 of the 10 most common cancers worldwide. According to the most recent GLOBOCAN estimate in Europe between 2012 and 2015, there was an overall increasing incidence and mortality for oral cancer, mostly HPV-related in the oropharyngeal region with evidence of significant differences from the prognostic and therapeutic point of view...
February 2019: Expert Review of Anticancer Therapy
Tommy Buchanan, David Mutch
Although a relatively uncommon disease, the treatment of vulvar cancer has changed considerably over the years and has been under considerable focus due to its past overtreatment and apparent increase in incidence. The purpose of this review is to describe the recommended management of the most commonly encountered vulvar carcinomas based on the most recent available literature. Areas covered: The clinical environment of squamous cell vulvar cancers are illustrated in order to describe the potential pitfalls and limitations of treatment...
January 2019: Expert Review of Anticancer Therapy
Stephanie M De Boer, Remi A Nout, Tjalling Bosse, Carien L Creutzberg
Although the majority of women with endometrial cancer have a favorable prognosis due to early symptoms, 15-20% have high-risk disease features and are at increased risk of recurrence. In order to improve prognosis for these patients, several trials have compared chemotherapy (CT), radiotherapy (RT) or the combination of CTRT. Areas covered: This review focuses on the current evidence on adjuvant treatment for women with high-risk endometrial cancer and future perspectives. Expert commentary: For stage I-II high-risk endometrial cancer, external beam radiotherapy ensured good local control and no significant benefit in progression-free or overall survival was found with the addition of chemotherapy in 2 recent randomized trials...
January 2019: Expert Review of Anticancer Therapy
Fabian Finkelmeier, Oliver Waidmann, Joerg Trojan
T-cell checkpoint inhibition as a cancer treatment approach has been the main breakthrough in cancer treatment during the last years. Since the approval of the first commercial CTLA-4 antibody ipilimumab in 2011 for the treatment of melanoma, research and drug development in this field has accelerated massively. In 2014, the US Food and Drug Administration (FDA) approved the first PD-1 targeting agent, namely pembrolizumab, shortly followed by nivolumab. Areas covered: Nivolumab is a fully human immunoglobulin G4 anti-PD-1 monoclonal antibody which is approved for multiple advanced malignancies, including melanoma, non-small cell lung cancer, renal cell cancer, Hodgkin's lymphoma, squamous head and neck cancer, and urothelial carcinoma...
December 2018: Expert Review of Anticancer Therapy
Omar Abdel-Rahman, Hani Oweira, Anwar Giryes
A systematic review was performed to explore the health-related quality of life (HRQoL) outcomes among cancer patients receiving PD-(L)1 inhibitors compared to those receiving traditional cytotoxic therapy. Areas covered: Citations from PubMed and the American Society of Clinical Oncology meeting library were examined. Cross-references from original studies and review articles were also reviewed. Eligible trials included randomized controlled trials of cancer patients treated with one of the PD-(L)1 inhibitors and reporting HRQoL outcomes...
December 2018: Expert Review of Anticancer Therapy
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