Introduction by the Guest Editor.
PMID: 32496450 [PubMed - in process] (Source: Cancer Journal)
Source: Cancer Journal - May 1, 2020 Category: Cancer & Oncology Authors: Younes A Tags: Cancer J Source Type: research

Lymphoma Classification.
Abstract Twenty-five years after the Revised European American Classification of Lymphoid Neoplasms classification was published, its principle of an integrative approach to disease definition based on several parameters still prevails and has been adopted and expanded in the following World Health Organization classifications of tumors of the hematopoietic organs. The latest World Health Organization classification revised in 2017 comprises more than 80 entities of mature lymphoid neoplasms (B-cell, T-cell, and Hodgkin lymphomas), which are defined according to their morphology, immunophenotype, genetic lesions a...
Source: Cancer Journal - May 1, 2020 Category: Cancer & Oncology Authors: de Leval L, Jaffe ES Tags: Cancer J Source Type: research

Molecular Diagnostics of Non-Hodgkin Lymphoma.
Abstract Non-Hodgkin lymphoma encompasses a diverse group of B-cell and T-cell neoplasms. Current classification is based on clinical information, histologic assessment, immunophenotypic characteristics, and molecular alterations. A wide range of genetic alterations, including large chromosomal structural rearrangements, aneuploidies, point mutations, and copy number alterations, have been reported across all types of lymphomas. Many of these are now incorporated into the World Health Organization-defined criteria for the diagnostic evaluation of patients with lymphoid proliferations and, therefore, their accurate...
Source: Cancer Journal - May 1, 2020 Category: Cancer & Oncology Authors: Solomon JP, Arcila ME Tags: Cancer J Source Type: research

Molecular Classification and Treatment of Diffuse Large B-Cell Lymphoma and Primary Mediastinal B-Cell Lymphoma.
Abstract Diffuse large B-cell lymphoma (DLBCL) encompasses a group of aggressive B-cell non-Hodgkin lymphomas with striking genetic heterogeneity and variable clinical presentations. Among these is primary mediastinal B-cell lymphoma (PMBL), which has unique clinical and molecular features resembling Hodgkin lymphoma. Treatment of DLBCL is usually curative, but identifiable subsets at highest risk for treatment failure may benefit from intensified chemotherapy regimens and/or targeted agents added to frontline therapy. Recent comprehensive genomic analyses have identified distinct genetic subtypes of DLBCL with ch...
Source: Cancer Journal - May 1, 2020 Category: Cancer & Oncology Authors: Roschewski M, Phelan JD, Wilson WH Tags: Cancer J Source Type: research

Role of Microenvironment in Non-Hodgkin Lymphoma: Understanding the Composition and Biology.
Abstract Lymphoma microenvironment is a dynamic and well-orchestrated network of various immune and stromal cells that is indispensable for tumor cell survival, growth, migration, immune escape, and drug resistance. Recent progress has enhanced our knowledge of the pivotal role of microenvironment in lymphomagenesis. Understanding the characteristics, functions, and contributions of various components of the tumor niche, along with its bidirectional interactions with tumor cells, is paramount. It offers the potential to identify new therapeutic targets with the ability to restore antitumor immune surveillance and ...
Source: Cancer Journal - May 1, 2020 Category: Cancer & Oncology Authors: Khurana A, Ansell SM Tags: Cancer J Source Type: research

Radiotherapy for Non-Hodgkin Lymphomas.
Abstract Radiotherapy (RT) plays a diverse and essential role in the contemporary management of non-Hodgkin lymphoma (NHL) and remains the single most powerful monotherapeutic intervention for both aggressive and indolent subtypes. Over the past decade, there have been significant advancements in radiation oncology practice, which have made modern treatments safer and more conformal. Despite this sophistication and evidence supporting a continued role for RT, numerous data suggest that utilization is on the decline. In this review, we discuss the rationale for RT in 4 commonly encountered scenarios: combined modal...
Source: Cancer Journal - May 1, 2020 Category: Cancer & Oncology Authors: Imber BS, Yahalom J Tags: Cancer J Source Type: research

Advances in Treatment of Follicular Lymphoma.
Abstract Follicular lymphoma (FL) is a heterogeneous disease with varying prognosis owing to differences in clinical, laboratory, and disease parameters. Although generally considered incurable, prognosis for early and advanced stage disease has improved because of therapeutic advances, several of which have resulted from elucidation of the biologic and molecular basis of the disease. The choice of treatment for FL is highly dependent on patient and disease characteristics. Several tools are available for risk stratification, although limitations in their routine clinical use exist. For limited disease, treatment ...
Source: Cancer Journal - May 1, 2020 Category: Cancer & Oncology Authors: Luminari S, Trotman J, Federico M Tags: Cancer J Source Type: research

Central Nervous System Lymphoma: Approach to Diagnosis and Treatment.
Abstract Central nervous system lymphoma (CNSL) is a rare form of extranodal non-Hodgkin lymphoma. Central nervous system lymphoma can be primary (isolated to the central nervous space) or secondary in the setting of systemic disease. Treatment of CNSL has improved since the introduction of high-dose methotrexate and aggressive consolidation regimens. However, results after treatment are durable in only half of patients, and long-term survivors may experience late neurotoxicity, impacting quality of life. Given the rarity of this disease, few randomized prospective trials exist. This leaves many questions unanswer...
Source: Cancer Journal - May 1, 2020 Category: Cancer & Oncology Authors: Correia CE, Schaff LR, Grommes C Tags: Cancer J Source Type: research

Diagnosis, Risk Stratification, and Treatment of Peripheral T-Cell Lymphomas: Past and Present.
Abstract Peripheral T-cell lymphomas represent an evolving class of aggressive T-cell malignancies that are generally refractory to conventional treatments and historically carry a poor prognosis. Recent advances in gene expression profiling have begun to unravel the specific molecular mechanisms of tumorigenesis in these disease processes, allowing for discrete classification schemes that help guide discussions regarding prognosis and therapy options. We outline here a review of the histopathology, epidemiology, clinical features, and treatment strategies currently used in the management of these diseases. P...
Source: Cancer Journal - May 1, 2020 Category: Cancer & Oncology Authors: Pearse WB, Pro B Tags: Cancer J Source Type: research

HIV Lymphoma and Burkitts Lymphoma.
This article examines HIV lymphoma and includes Burkitt lymphoma in the general population. PMID: 32496459 [PubMed - in process] (Source: Cancer Journal)
Source: Cancer Journal - May 1, 2020 Category: Cancer & Oncology Authors: Noy A Tags: Cancer J Source Type: research

Immune and Cell Therapy in Non-Hodgkin Lymphoma.
Abstract The promise of immunotherapy has shone brightly for decades in hematologic malignancies and specifically in non-Hodgkin lymphoma. The last decade has witnessed the emergence of completely novel forms of immunotherapy, including immune checkpoint blockade, bispecific antibodies, and chimeric antigen receptor T cells. These treatments have shown phenomenal, and in some cases possibly curative, successes in various relapsed/refractory lymphomas. This review summarizes the most notable successes and promising findings as well as some of the attendant failures. These treatments will doubtlessly transform the t...
Source: Cancer Journal - May 1, 2020 Category: Cancer & Oncology Authors: Merryman RW, Houot R, Armand P, Jacobson C Tags: Cancer J Source Type: research

Introduction by the Guest Editor: Oligometastatic Disease in Cancer.
PMID: 32205531 [PubMed - in process] (Source: Cancer Journal)
Source: Cancer Journal - March 1, 2020 Category: Cancer & Oncology Authors: Kim HS Tags: Cancer J Source Type: research

Definition, Biology, and History of Oligometastatic and Oligoprogressive Disease.
Abstract Historical theories of metastasis have been informed by the seed and soil hypothesis, the Halsteadian paradigm proposing an orderly spread from local to distant sites, and the presumption that cancer is an inherently systemic process even in the earliest cases. The more contemporary spectrum theory now suggests that the propensity for distant spread exists along a continuum of metastatic virulence. Tumors with limited metastatic potential represent one subset along this spectrum that could potentially be cured with local ablative therapy. Integrating clinical and molecular features to biologically inform ...
Source: Cancer Journal - March 1, 2020 Category: Cancer & Oncology Authors: Foster CC, Pitroda SP, Weichselbaum RR Tags: Cancer J Source Type: research

Prognostic and Predictive Biomarkers in Oligometastatic Disease.
Abstract Metastatic lesions are largely responsible for cancer-related deaths and are synonymous with a poor prognosis. However, this is not always true for patients with oligometastases whose disease may be amenable to curative-intent local therapies. It has been proposed that an "intermediate state" (oligometastasis) exists in between locoregional and advanced disease states; however, the clinical definition of oligometastasis varies, and there is limited understanding of how tumor biology differs between oligometastases and polymetastases. There is evidence that local therapies can extend survival in ...
Source: Cancer Journal - March 1, 2020 Category: Cancer & Oncology Authors: Barnum KJ, Weiss SA Tags: Cancer J Source Type: research

Radiomics, Radiogenomics, and Next-Generation Molecular Imaging to Augment Diagnosis of Hepatocellular Carcinoma.
We present current imaging methods and explore emerging research that may improve diagnosis and monitoring of local, oligometastatic, and disseminated cancers exhibiting heterogeneous uptake of [F]F-fluorodeoxyglucose, using hepatocellular carcinoma as an example. PMID: 32205534 [PubMed - in process] (Source: Cancer Journal)
Source: Cancer Journal - March 1, 2020 Category: Cancer & Oncology Authors: Bell M, Turkbey EB, Escorcia FE Tags: Cancer J Source Type: research

Circulating Tumor DNA Biomarkers for Early Detection of Oligometastasis.
Abstract Oligometastasis represents an intermediate disease stage between localized and widely metastatic cancer. Efficient identification of patients with oligometastasis remains a barrier for accrual on clinical trials of oligometastasis-directed therapy. Here we review the prospect of circulating tumor DNA-based monitoring to promote sensitive, specific, and cost-efficient detection of cancer recurrence during posttreatment surveillance. Thus, an impetus for the development and implementation of clinical-grade circulating tumor DNA assays should be for the positive impact they will have on clinical investigatio...
Source: Cancer Journal - March 1, 2020 Category: Cancer & Oncology Authors: Routman DM, Chera BS, Gupta GP Tags: Cancer J Source Type: research

Imaging and Image-Guided Thermal Ablation for Oligometastatic Colorectal Cancer Liver Disease.
Abstract Colorectal cancer affects more than 1 million people worldwide, and half of this population develops liver metastases. Image-guided thermal ablation is an acceptable local therapy for the management of oligometastatic colorectal cancer liver disease, in patients who are noneligible for surgery, or present with recurrence after hepatectomy. Continuous technological evolutions, understanding of tumor variability through disease biology and genetics, and optimization of ablation parameters with ablation margin assessment have allowed patients with resectable small-volume disease to be treated by thermal abla...
Source: Cancer Journal - March 1, 2020 Category: Cancer & Oncology Authors: Vasiniotis Kamarinos N, Sofocleous CT Tags: Cancer J Source Type: research

Local Ablative Therapies for Oligometastatic and Oligoprogressive Non-Small Cell Lung Cancer.
Abstract More than half of all patients with non-small cell lung cancer (NSCLC) have metastatic disease at the time of diagnosis. A subset of these patients has oligometastatic disease, which exists in an intermediary state between locoregional and disseminated metastatic disease. In addition, some metastatic patients on systemic therapy may have limited disease progression, or oligoprogression. Historically, treatment of metastatic NSCLC was palliative in nature, with little expectation of long-term survival. However, an accumulation of evidence over the past 3 decades now demonstrates that local ablative therapy...
Source: Cancer Journal - March 1, 2020 Category: Cancer & Oncology Authors: Jairam V, Park HS, Decker RH Tags: Cancer J Source Type: research

Oligometastatic and Oligoprogression Disease and Local Therapies in Prostate Cancer.
Abstract Our understanding of metastatic disease is rapidly advancing, with recent evidence supporting an oligometastatic state currently defined by patients having a limited (typically ≤5) number of metastatic deposits. The optimal management of these patients is also shifting toward increased integration of local therapies, with emerging evidence suggesting metastasis-directed therapy can improve overall survival. Additionally, the use of stereotactic ablative radiation therapy within castration-sensitive oligometastatic prostate cancer cohorts appears to forestall the need to initiate systemic therapy, which...
Source: Cancer Journal - March 1, 2020 Category: Cancer & Oncology Authors: Deek MP, Tran PT Tags: Cancer J Source Type: research

Oligometastatic Disease and Local Therapies: A Medical Oncology Perspective.
This article reviews the literature in oligometastatic disease and considers a theoretical rationale for a curative approach in a subset of oligometastatic solid tumor patients. In oligometastatic colorectal cancer patients with liver-only metastases and in non-small cell lung cancer patients with disease control after primary therapy and with limited nodal involvement, aggressive local therapies should be considered. Clinical trials and further biomarker validation across disease types are necessary to clarify which subsets of patients may define a theorized "oligometastatic state" and therefore benefit from agg...
Source: Cancer Journal - March 1, 2020 Category: Cancer & Oncology Authors: Hafez N, Gettinger S Tags: Cancer J Source Type: research

Surgeon's Perspective to Local Therapy in Oligometastatic Cancer.
Abstract Oligometastatic cancer has been recognized as a distinct clinical entity for over 100 years. For decades surgeons have been devising strategies to identify patients with oligmetastatic cancer that have the potential to be cured by surgically removing the oligometastases ("curative intent metastasectomy"). More recently, several studies have suggested there may be benefits to local therapy in oligometastatic cancer patients that are less likely to be cured. This has transformed the practice of local therapy in this setting away from "curative intent" to a broader purpose of "lesion...
Source: Cancer Journal - March 1, 2020 Category: Cancer & Oncology Authors: Boffa DJ Tags: Cancer J Source Type: research

Radiation in the Treatment of Oligometastatic and Oligoprogressive Disease: Rationale, Recent Data, and Research Questions.
Abstract The use of local ablative therapy or metastasis-directed therapy is an emerging management paradigm in oligometastatic and oligoprogressive cancer. Recent randomized evidence has demonstrated that stereotactic ablative radiotherapy (SABR) targeting all metastatic deposits is tolerable and can improve progression-free and overall survival. While SABR is noninvasive, minimally toxic, and generally safe, rare grade 5 events have been reported. Given this and recognizing the often-uncertain prognosis of patients with metastatic disease, equipoise persists regarding the therapeutic window within which to deplo...
Source: Cancer Journal - March 1, 2020 Category: Cancer & Oncology Authors: Zayed S, Correa RJM, Palma DA Tags: Cancer J Source Type: research

Oligometastatic Disease and Interventional Oncology: Rationale and Research Directions.
We describe the rationale for their application to OMD and discuss future directions for research. PMID: 32205542 [PubMed - in process] (Source: Cancer Journal)
Source: Cancer Journal - March 1, 2020 Category: Cancer & Oncology Authors: Murali N, Ludwig JM, Nezami N, Kim HS Tags: Cancer J Source Type: research

Introduction by the Guest Editor: The Rapidly Evolving Treatment Landscape of Prostate Cancer-The Convergence of Treatment Paradigms of Localized and Metastatic Diseases.
PMID: 31977378 [PubMed - in process] (Source: Cancer Journal)
Source: Cancer Journal - January 1, 2020 Category: Cancer & Oncology Authors: Spratt DE Tags: Cancer J Source Type: research

Neoadjuvant Approaches Prior To Radical Prostatectomy.
Abstract Patients with high-risk localized prostate cancer benefit from multimodality therapy of curative intent. Androgen-deprivation therapy (ADT) combined with radiation improves survival in this population. However, prior clinical trials of neoadjuvant ADT and surgery failed to consistently demonstrate a survival advantage. The development of novel, more potent hormonal agents presents an opportunity to revisit the potential for neoadjuvant therapy to improve long-term outcomes for patients with localized prostate cancer. We review recent advances in neoadjuvant approaches for prostate cancer and emerging clin...
Source: Cancer Journal - January 1, 2020 Category: Cancer & Oncology Authors: Ryan ST, Patel DN, Parsons JK, McKay RR Tags: Cancer J Source Type: research

Genomic Strategies to Personalize Use of Androgen Deprivation Therapy With Radiotherapy.
Abstract The use of combination RT and androgen deprivation therapy in many prostate cancer curative-intent treatment scenarios is supported by level 1 evidence. However, in our current clinical paradigm, we have no ability to determine a priori which patients truly benefit from combination therapy and therefore apply the combination RT and androgen deprivation therapy intensification strategy to all patients, which results in overtreatment or undertreatment of the majority of our patients. Genomics has the ability to more deeply and objectively characterize the disease, in turn refining our prognostication capabi...
Source: Cancer Journal - January 1, 2020 Category: Cancer & Oncology Authors: Glicksman RM, Berlin A Tags: Cancer J Source Type: research

Next Generation of Androgen Deprivation Therapy Combined With Radiotherapy for N0 M0 Prostate Cancer.
Abstract Androgen deprivation therapy in combination with definitive radiation therapy is a standard of care for both intermediate-/high-risk localized prostate, locally advanced prostate cancer. Newer hormonal therapies have shown promising results in patients with castration-resistant disease and are now being investigated in early stages, in combination with radiation therapy. In this section, we review the body of evidence elucidating the mechanism of synergy and immune modulation effect of androgen deprivation therapy and radiation therapy, summarize the pivotal studies supporting its use in the nonmetastatic...
Source: Cancer Journal - January 1, 2020 Category: Cancer & Oncology Authors: Barata P, Layton J, Lewis B, Sartor O Tags: Cancer J Source Type: research

Comparing Radiotherapy to Prostatectomy for High-Risk Prostate Cancer: A Narrative Review of Mortality and Quality-of-Life Outcomes.
We present here an outline of efforts to date to understand the implications of treatment on functional outcomes and quality-of-life endpoints. PMID: 31977382 [PubMed - in process] (Source: Cancer Journal)
Source: Cancer Journal - January 1, 2020 Category: Cancer & Oncology Authors: Greenberger BA, Taylor JM, Chen VE, Den RB Tags: Cancer J Source Type: research

Stereotactic Ablative Body Radiotherapy for Intermediate- or High-Risk Prostate Cancer.
Abstract Stereotactic ablative radiotherapy (SABR) is a relatively novel form of high precision radiotherapy. For low- and intermediate risk patients, ultrahypofractionation (UHF - more than 5 Gy per day) has been compared to conventionally fractionated or moderately hypofractionated radiotherapy in two large randomized studies. A third smaller randomized study examined the question of the optimal frequency of treatments. The results of these studies will be reviewed. SABR for high risk prostate cancer has been shown to be feasible and is well tolerated with careful planning and setup techniques. However, there is...
Source: Cancer Journal - January 1, 2020 Category: Cancer & Oncology Authors: Loblaw A Tags: Cancer J Source Type: research

Molecular Imaging of Newly Diagnosed Prostate Cancer.
Abstract Positron emission tomography (PET) is a valuable imaging in evaluating many malignancies. There are various molecular imaging tracers that are currently being utilized with prostate cancer (PC). Several PET agents imaging different molecular processes in PC have reached the clinic. While all of these agents have demonstrated an advantage over conventional imaging, there are considerable differences in the performance of each in staging newly diagnosed PC. In this article, we review the current updates available of different PET tracers, with a strong focus on the emerging role of prostate-specific membran...
Source: Cancer Journal - January 1, 2020 Category: Cancer & Oncology Authors: Williams S Tags: Cancer J Source Type: research

Surrogate Endpoints in Localized Prostate Cancer.
Abstract Randomized clinical trials assessing novel therapies in men with localized prostate cancer frequently require large patient numbers and more than a decade of follow-up to demonstrate improvements in overall survival. As the landscape of treatment options for prostate cancer is rapidly changing, clinical trials requiring long follow-up threaten to impede treatment improvements and run the risk of results being obsolete by the time that they are reported in publication. To address these issues, there has been tremendous interest in identifying an intermediate clinical endpoint that can be assessed earlier i...
Source: Cancer Journal - January 1, 2020 Category: Cancer & Oncology Authors: Hartman HE, Jackson WC Tags: Cancer J Source Type: research

Clinically Lymph Node Positive Prostate Cancer: At the Intersection of Focal and Systemic Disease Control.
Abstract Clinically node-positive prostate cancer is often found at the time of diagnosis by cross-sectional imaging and remains poorly understood. Advanced imaging modalities such as magnetic resonance imaging nanoparticles or positron emission tomography-based molecular imaging stand to rapidly change the field and hopefully will bring better diagnostic clarity. This will allow for prospective clinical trials using radiographic, clinical, or molecular parameters to establish who may benefit from both localized and systemic treatment intensification and who may avoid overtreatment. Recent advances in metastatic h...
Source: Cancer Journal - January 1, 2020 Category: Cancer & Oncology Authors: Reichert ZR, Dess RT Tags: Cancer J Source Type: research

Pathologically Node-Positive Prostate Cancer: Casting for Cure When the Die Is Cast?
Abstract The postoperative management of men with lymph node involved prostate cancer (pN+) remains a challenge as there is a general lack of randomized trial data and a range of management strategies. Retrospective studies suggest a variable clinic course for patients with pN+ prostate cancer. Some men progress rapidly to metastatic disease despite further therapies, whereas other men can have a period of prolonged quiescence without adjuvant androgen deprivation therapy (ADT) or radiation therapy (RT). For men who have undergone radical prostatectomy, randomized trial data indicate that the addition of ADT in pN...
Source: Cancer Journal - January 1, 2020 Category: Cancer & Oncology Authors: Ginsburg KB, Cher ML, Kutikov A, Morgan TM Tags: Cancer J Source Type: research

Metastatic Hormone-Sensitive Prostate Cancer: A Review of the Current Treatment Landscape.
We describe an overview of the trials that investigated docetaxel (CHAARTED and STAMPEDE-Docetaxel), abiraterone (LATTITUDE and STAMPEDE-Abiraterone), enzalutamide (ARCHES, ENZAMET), apalutamide (TITAN), and radiation to the primary (STAMPEDE-Radiation). DISCUSSION: The treatment of mHSPC is a complex topic, and treatment choice should be individualized. Patient preferences, cost, volume of disease, and side effect profiles are important in determining which option is the best for an individual patient. PMID: 31977388 [PubMed - in process] (Source: Cancer Journal)
Source: Cancer Journal - January 1, 2020 Category: Cancer & Oncology Authors: Kinsey EN, Zhang T, Armstrong AJ Tags: Cancer J Source Type: research

Factors to Guide Treatment Selection for Hormone-Sensitive Metastatic Prostate Cancer.
Abstract For decades, the mainstay of treatment for metastatic hormone-sensitive prostate cancer has been androgen deprivation therapy. In recent years, 4 systemic therapies-docetaxel, abiraterone, enzalutamide, and apalutamide-have improved overall survival for men with metastatic hormone-sensitive prostate cancer when combined with androgen deprivation therapy, raising the question of which treatment to choose. The role for metastasis-directed therapy with surgery or radiation among these new treatments has also yet to be defined. Thus, several factors have come into play to guide treatment selection, including ...
Source: Cancer Journal - January 1, 2020 Category: Cancer & Oncology Authors: Tsao PA, Caram MEV Tags: Cancer J Source Type: research

Treatment of Primary in Metastatic Prostate Cancer: What Is the Standard of Care?
Abstract Until recently, men with metastatic prostate cancer were commenced on androgen deprivation therapy at diagnosis, followed by sequential lines of treatment with the development of castration resistance. However, the results of recent clinical trials, which revealed that the addition of radiotherapy to the prostate to a dose of 55 to 60 Gy in 20 fractions over 4 weeks in patients with low-volume metastatic hormone-sensitive prostate cancer, in addition to androgen deprivation therapy and another systemic treatment option, either docetaxel, abiraterone, enzalutamide, or apalutamide, has led to a paradigm cha...
Source: Cancer Journal - January 1, 2020 Category: Cancer & Oncology Authors: Joseph N, Anjanappa M, Choudhury A Tags: Cancer J Source Type: research

Radiotherapy in the Management of Metastatic Hormone-Sensitive Prostate Cancer: What Is the Standard of Care?
Abstract Systemic therapy has historically been the backbone of treatment for patients with metastatic disease. However, recent evidence suggests metastasis-directed therapy in those with oligometastatic disease (≤5 lesions) may improve progression-free and overall survival. Within prostate cancer-specific cohorts, metastasis-directed therapy also appears to delay the time to initiation of androgen deprivation therapy while also generally being associated with a mild toxicity profile and has thus garnered interest as a means to delay systemic therapy. Here we review the evidence surrounding the use of radiation...
Source: Cancer Journal - January 1, 2020 Category: Cancer & Oncology Authors: Deek MP, Phillips R, Tran PT Tags: Cancer J Source Type: research

Introduction by the Guest Editor: Staying Ahead of the Rapidly Evolving World of Chronic Lymphocytic Leukemia.
PMID: 31764116 [PubMed - in process] (Source: Cancer Journal)
Source: Cancer Journal - November 1, 2019 Category: Cancer & Oncology Authors: Cheson BD Tags: Cancer J Source Type: research

The Shifting Paradigm in Chronic Lymphocytic Leukemia: Is Chemotherapy Still Relevant?
Abstract Chemoimmunotherapy (CIT) was the standard treatment for patients with chronic lymphocytic leukemia for the last 2 decades. Recently, with the introduction of targeted therapies, the role of CIT has declined significantly. In the first-line setting, the role of CIT is limited to young fit patients with mutated immunoglobulin heavy chain variable region and without del(17p)/TP53 mutation. There is a limited role for CIT in relapsed chronic lymphocytic leukemia. PMID: 31764117 [PubMed - in process] (Source: Cancer Journal)
Source: Cancer Journal - November 1, 2019 Category: Cancer & Oncology Authors: Jain N, OʼBrien S Tags: Cancer J Source Type: research

Targeted Therapy in Chronic Lymphocytic Leukemia.
Abstract Despite a prevailing view that advances in cancer therapy will come through selective targeting of enzymes encoded by mutated oncogenes responsible for the neoplastic phenotype, recent advances in the treatment of patients with chronic lymphocytic leukemia (CLL) have instead exploited knowledge of its biology. Indeed, CLL cells depend on interactions with cells and soluble factors present in the tumor microenvironment for proliferation and survival. B-cell receptor signaling and chemokine-receptor signaling play prominent roles. Elucidation of these signaling pathways has defined physiologic targets for d...
Source: Cancer Journal - November 1, 2019 Category: Cancer & Oncology Authors: Kipps TJ, Choi MY Tags: Cancer J Source Type: research

Bruton Tyrosine Kinase Inhibitors: Present and Future.
Abstract Bruton tyrosine kinase (BTK) is a nonreceptor tyrosine kinase that plays a central role in the signal transduction of the B-cell antigen receptor and other cell surface receptors, both in normal and malignant B lymphocytes. B-cell antigen receptor signaling is activated in secondary lymphatic organs and drives the proliferation of malignant B cells, including chronic lymphocytic leukemia (CLL) cells. During the last 10 years, BTK inhibitors (BTKis) are increasingly replacing chemotherapy-based regimen, especially in patients with CLL and mantle cell lymphoma (MCL). Bruton tyrosine kinase inhibitors are pa...
Source: Cancer Journal - November 1, 2019 Category: Cancer & Oncology Authors: Burger JA Tags: Cancer J Source Type: research

Phosphatidylinositol 3 Kinase δ Inhibitors: Present and Future.
This article reviews the clinical data on efficacy and toxicity across the class and discusses ongoing efforts to understand and mitigate the likely on-target autoimmune toxicity. PMID: 31764120 [PubMed - in process] (Source: Cancer Journal)
Source: Cancer Journal - November 1, 2019 Category: Cancer & Oncology Authors: Brown JR Tags: Cancer J Source Type: research

BCL-2 Inhibitors, Present and Future.
Abstract The members of the B-cell leukemia/lymphoma-2 (BCL-2) family of proteins are key regulators of the intrinsic apoptotic pathway; dysregulation of this pathway leads to pathologic survival of cancer cells. B-cell leukemia/lymphoma-2 had long been viewed as a promising target for the treatment of several hematologic malignancies, specifically chronic lymphocytic leukemia (CLL), yet for many years the development of a drug to successfully target this protein remained elusive. The approval of the BCL-2 inhibitor venetoclax for relapsed/refractory del(17p) CLL in 2016 represented the culmination of decades of m...
Source: Cancer Journal - November 1, 2019 Category: Cancer & Oncology Authors: Ryan CE, Davids MS Tags: Cancer J Source Type: research

Relevance of Minimal Residual Disease in the Era of Targeted Agents.
ve; L Abstract The evaluation of minimal residual disease (MRD) in chronic lymphocytic leukemia (CLL) has evolved in parallel with the enormous progresses in the therapeutic armamentarium and the application of cutting-edge diagnostic techniques the CLL community witnessed in the past few years. Minimal residual disease is considered an objective measure of disease status defined by the number of residual leukemic cells detected in a sample of peripheral blood and/or bone marrow as proportion of the total white blood cells and defined undetectable if fewer than 1 CLL cell among 10,000 white blood cells (10 or 0.01...
Source: Cancer Journal - November 1, 2019 Category: Cancer & Oncology Authors: Heltai S, Ghia P, Scarfò L Tags: Cancer J Source Type: research

Cost-effectiveness of New Targeted Agents in the Treatment of Chronic Lymphocytic Leukemia.
Abstract Chronic lymphocytic leukemia (CLL) is the most common adult leukemia and is clinically heterogeneous. Integration of oral targeted therapies (OTTs) in the management of CLL has fundamentally altered CLL treatment pathways and improved outcomes for patients with CLL.We review the cost-effectiveness of OTTs in the treatment of CLL. We used MeSH (Medical Subject Heading) terms and keywords to search the National Library of Medicine online MEDLINE database (PubMed) for articles related to cost-effectiveness of OTTs in CLL care.Oral targeted therapies add considerable expense to the treatment of CLL for patien...
Source: Cancer Journal - November 1, 2019 Category: Cancer & Oncology Authors: Harkins RA, Patel SP, Flowers CR Tags: Cancer J Source Type: research

Resistance Mechanisms to Targeted Agents in Chronic Lymphocytic Leukemia.
Abstract Agents that specifically target pathologic mechanisms of survival have now been approved for the treatment of chronic lymphocytic leukemia in both the treatment-naive and relapsed/refractory settings. These 4 agents include the Bruton tyrosine kinase inhibitor ibrutinib, the B-cell leukemia/lymphoma-2 inhibitor venetoclax, and the phosphatidylinositol-3 kinase inhibitors idelalisib and duvelisib. Although clinical outcomes are improved with all of these inhibitors, acquired resistance does occur and leads to progression of disease. Resistance to targeted therapy can occur through direct mutations of the t...
Source: Cancer Journal - November 1, 2019 Category: Cancer & Oncology Authors: Kittai AS, Woyach JA Tags: Cancer J Source Type: research

Chimeric Antigen Receptor T Cells in Chronic Lymphocytic Leukemia: Are We Any Closer to a Cure?
Abstract Recent advances in the treatment of chronic lymphocytic leukemia (CLL) have dramatically changed outcomes for patients. Despite these improvements, CLL is still considered incurable. Chimeric antigen receptor-modified T cells have demonstrated the ability to produce long-term remissions in subsets of heavily pretreated patients with B-cell malignancies, including CLL. Unfortunately, the majority of patients with CLL do not attain durable responses. Recent studies have focused on understanding the mechanisms and predictors of response in these patients. In this review, we will discuss the literature for ch...
Source: Cancer Journal - November 1, 2019 Category: Cancer & Oncology Authors: Rhodes JM, Schuster SJ Tags: Cancer J Source Type: research

Real-World Evidence for Chronic Lymphocytic Leukemia in the Era of Targeted Therapies.
Abstract The landscape of chronic lymphocytic leukemia has transformed in the era of small molecule inhibitor targeted therapies. While randomized controlled trials remain the criterion standard in evaluating new therapies, they are often unable to keep pace with the clinical questions that arise during the use of novel agents. Real-world evidence is generated through analysis of data such as electronic medical records, payer claims, and patient registry databases and can provide invaluable information to supplement randomized controlled trials, such as outcomes in patient populations excluded from clinical trials...
Source: Cancer Journal - November 1, 2019 Category: Cancer & Oncology Authors: Islam P, Mato AR Tags: Cancer J Source Type: research

Targeted Therapies in Chronic Lymphocytic Leukemia: Is 2 (or 3) Better Than 1?
Abstract Small molecule inhibitors, including B-cell receptor antagonists and B-cell lymphoma - 2 inhibitors, have revolutionized the treatment of chronic lymphocytic leukemia (CLL). These agents have improved outcomes for patients of all prognostic backgrounds, thus securing their role in the frontline setting. Impressive activity has been demonstrated both with monotherapy and in combination with other targeted therapeutics. The most important remaining question is whether to administer small molecule inhibitors in a sequential fashion or in combination with each other and/or anti-CD20-directed therapy. Together...
Source: Cancer Journal - November 1, 2019 Category: Cancer & Oncology Authors: Ujjani C, Cheson BD Tags: Cancer J Source Type: research

Introduction.
PMID: 31567455 [PubMed - in process] (Source: Cancer Journal)
Source: Cancer Journal - September 1, 2019 Category: Cancer & Oncology Authors: Mao JJ Tags: Cancer J Source Type: research