Cerebral Radiation Necrosis: Incidence, Pathogenesis, Diagnostic Challenges, and Future Opportunities
AbstractPurpose of ReviewCerebral radiation necrosis (CRN) is a major dose-limiting adverse event of radiotherapy. The incidence rate of RN varies with the radiotherapy modality, total dose, dose fractionation, and the nature of the lesion being targeted. In addition to these known and controllable features, there is a stochastic component to the occurrence of CRN —the genetic profile of the host or the lesion and their role in the development of CRN.Recent FindingsRecent studies provide some insight into the genetic mechanisms underlying radiation-induced brain injury. In addition to these incompletely understood ho...
Source: Current Oncology Reports - June 19, 2019 Category: Cancer & Oncology Source Type: research

Is It Time to Revisit the Role of Allogeneic Transplantation in Lymphoma?
AbstractPurpose of ReviewA multitude of new drug and cell therapy approvals for lymphoma has prompted questions about the role of allogeneic blood or marrow transplantation (allo-BMT). We sought to review the latest evidence examining the role of allo-BMT for lymphoma in this evolving landscape.Recent FindingsDespite several new drug classes, there remains a large unmet need, particularly in hard to treat subtypes of lymphoma and for patients with relapsed/refractory disease. Allo-BMT can provide an opportunity for cure due to a potent graft vs lymphoma effect in high-risk relapse/refractory follicular lymphoma, mantle cel...
Source: Current Oncology Reports - June 10, 2019 Category: Cancer & Oncology Source Type: research

Management of Newly Diagnosed Elderly Multiple Myeloma Patients
AbstractPurpose of ReviewGiven the median age at diagnosis of 69, multiple myeloma (MM) is commonly identified among elderly individuals. Over-treatment of the frail may lead to unnecessary morbidity, while under-treatment of fit elderly patients may prevent improvement in organ function; both instances reducing quality of life. Here, we summarize assessments of frailty and include considerations in managing newly diagnosed elderly MM patients.Recent FindingsEligibility criteria for studies of anti-myeloma agents have traditionally relied on performance status and comorbidities; however, geriatric and myeloma-specific frai...
Source: Current Oncology Reports - May 24, 2019 Category: Cancer & Oncology Source Type: research

Follicular Lymphoma: Diagnostic and Prognostic Considerations in Initial Treatment Approach
AbstractPurpose of ReviewFollicular lymphoma is a diverse disease, with a diverse variable biology, clinical presentation, and prognosis. The identification of factors that can predict the specific outcome of follicular lymphoma patients remains an area of need. Here, we review the significant advances made in follicular lymphoma prognosis in the last two decades, particularly with the advent of new genetic models.Recent FindingsTumor burden remains an important predictor of prognosis and is still a standard upon which treatment initiation decisions are made. Clinical prognostic indices, including the follicular lymphoma i...
Source: Current Oncology Reports - May 23, 2019 Category: Cancer & Oncology Source Type: research

Systemic Histiocytosis (Langerhans Cell Histiocytosis, Erdheim –Chester Disease, Destombes–Rosai–Dorfman Disease): from Oncogenic Mutations to Inflammatory Disorders
AbstractPurpose of ReviewProvide an overview of recent progress in decoding the pathogenesis and treatment of systemic histiocytoses.Recent FindingsAdvances in molecular techniques over the last few years, enabling the identification of several MAPK mutations in lesion histiocytes, have revolutionized our understanding of histiocytosis that led to a revised classification and new treatments.SummarySince the 2010 discovery of theBRAFV600E mutation in 57% of Langerhans cell histiocytosis (LCH) lesions, several other kinase mutations have been found, mostly in the MAPK pathway, and also in other key signaling pathways, in LCH...
Source: Current Oncology Reports - May 21, 2019 Category: Cancer & Oncology Source Type: research

Targeted Therapies for the Treatment of Glioblastoma in Adults
AbstractPurpose of ReviewTargeted therapies are part of biomarker-driven strategies that exploit actionable molecular targets and have gained traction following survival benefits demonstrated in various systemic malignancies. In glioblastoma, where therapeutic options remain scarce and prognosis poor, targeted therapies offer an attractive treatment alternative and are actively examined in clinical trials. In this review, we summarize the targeted therapies, including traditional small molecule inhibitors and monoclonal antibodies as well as immunotherapeutic approaches that are examined in clinical trials, and discuss the...
Source: Current Oncology Reports - May 17, 2019 Category: Cancer & Oncology Source Type: research

Current Status of Immunotherapies for Treating Pancreatic Cancer
AbstractPurpose of ReviewDespite all efforts, pancreatic ductal adenocarcinoma (PDAC) remains a disease that causes substantial morbidity and mortality, with a 5-year survival rate of 7%. Innovative paradigms for treating PDAC are urgently needed.Recent FindingsWe discuss the advances and difficulties in using immunotherapy and developing immunotherapeutic vaccines for PDAC. Current excitement about antigen-specific immunotherapy has been propelled by advances in multiple areas, such as next-generation sequencing to identify neoantigens and manufacturing to produce immunotherapeutic vaccines. Antigen-specific immunotherapy...
Source: Current Oncology Reports - May 17, 2019 Category: Cancer & Oncology Source Type: research

Correction to: Systemic Therapy of Central Nervous System Metastases of Breast Cancer
The original version of this article, which published inCurrent Oncology Reports, Volume 21, Issue 6, June 2019, contained an error in addressing the indication for use of neratinib in early stage breast cancer. (Source: Current Oncology Reports)
Source: Current Oncology Reports - May 17, 2019 Category: Cancer & Oncology Source Type: research

Issues with Fertility in Young Women with Breast Cancer
AbstractPurpose of ReviewThere are competing risks and benefits of cancer therapies and fertility preservation in young women with breast cancer. Here we discuss the impact of therapy on fertility, fertility preservation options, and emerging information in fertility issues for the breast cancer patient.Recent FindingsAll systemic forms of breast cancer treatment can impact future fertility. Pre-therapy fertility preservation may offer the best opportunity for future fertility. Shared decision making with the individual patient and clinical scenario is important. Early referral to a fertility specialist should be offered t...
Source: Current Oncology Reports - May 16, 2019 Category: Cancer & Oncology Source Type: research

How Do We Follow Up Patients With Endometrial Cancer?
AbstractPurpose of ReviewIn this review, we present the existing evidence regarding follow-up care after endometrial cancer, including content of follow-up and type of provider. We furthermore discuss the future perspectives for follow-up care and research in the field.Recent FindingsRecently published randomized controlled trials show that nurse-led telephone follow-up and patient-initiated follow-up are feasible alternatives to routine hospital-based follow-up.SummaryNo randomized or prospective study has evaluated the effect of routine follow-up on survival. Hence, current knowledge is derived from retrospective studies...
Source: Current Oncology Reports - May 15, 2019 Category: Cancer & Oncology Source Type: research

Immunotherapy in Older Adults with Cancer
AbstractPurpose of ReviewThe purpose of this review is to examine the latest research and data on the use of immunotherapy in older adults with cancer in order to identify key gaps in the literature for future research.Recent FindingsImmune checkpoint inhibitors are gaining approval and being incorporated into routine clinical use for numerous malignancies across age groups due to their overall efficacy and favorable side effect profiles.SummaryAlthough immune checkpoint inhibitors appear both safe and effective in older adults, deliberate study of immunotherapies in older adults is highly warranted given the paucity of da...
Source: Current Oncology Reports - May 7, 2019 Category: Cancer & Oncology Source Type: research

The Effects of Brain Tumours upon Medical Decision-Making Capacity
AbstractPurpose of ReviewInformed consent is the integral part of good medical practice in patients with brain tumours. Capacity to consent may be affected by the brain disorder or its treatment. We intend to draw upon the current neuro-oncology literature to discuss the influence intracranial tumours have upon patients ’ capacity to consent to treatment and research.Recent FindingsWe performed a systematic review of studies of capacity to consent for treatment or research in patients with intracranial tumours. The search retrieved 1597 papers of which 8 were considered eligible for review.SummaryAlthough there are o...
Source: Current Oncology Reports - May 2, 2019 Category: Cancer & Oncology Source Type: research

How Each Component of Betel Quid Is Involved in Oral Carcinogenesis: Mutual Interactions and Synergistic Effects with Other Carcinogens —a Review Article
AbstractPurpose of ReviewThe roles of the components of betel quid in oral carcinogenesis remain unclear. The purpose of the present review is to highlight the effect of each component of betel quid and to discuss the synergistic effects of other carcinogens along with betel quid in the development of oral cancer in habitual betel quid chewers.Recent FindingsBetel quid may synergistically participate in carcinogenesis by disrupting the compositions of oral microbiota, accompanied by endotoxins secretion and reactive oxygen species (ROS) production. Microbiome dysbiosis mediated by synergistic effects of betel quid chewing,...
Source: Current Oncology Reports - April 26, 2019 Category: Cancer & Oncology Source Type: research

Sentinel Lymph Node Biopsy and Complete Lymph Node Dissection for Melanoma
AbstractPurpose of ReviewThe main surgical treatment for invasive malignant melanoma consists of wide surgical and examination of the sentinel node and in selected cases complete lymph node dissection. The aim of this review is to present data for the optimal surgical management of patients with malignant melanoma.Recent FindingsA surgical excision margin of 1 –2 cm is recommended for invasive melanoma depending on the thickness of the melanoma. Sentinel node biopsy may be considered for patients with at least T1b melanomas thickness 0.8 to 1.0 mm or less than 0.8 mm Breslow thickness with ulceration, ...
Source: Current Oncology Reports - April 26, 2019 Category: Cancer & Oncology Source Type: research

Acupuncture and Vitamin D for the Management of Aromatase Inhibitor-Induced Arthralgia
AbstractPurpose of ReviewAromatase inhibitor-induced arthralgia (AIA) is a very common syndrome which significantly affects breast cancer survivors ’ quality of life, and it often leads to non-compliance with aromatase inhibitor (AI) therapy. However, the treatment of AIA remains a clinical challenge. Here, we will review the current data for acupuncture and vitamin D in the management of AIA.Recent FindingsAcupuncture has been shown to improve AIA symptoms, but it has not consistently been proven to offer significantly more clinical benefit than sham acupuncture. Similarly, while some vitamin D trials have shown ben...
Source: Current Oncology Reports - April 17, 2019 Category: Cancer & Oncology Source Type: research

Changes in the 8th Edition of the American Joint Committee on Cancer (AJCC) Staging of Head and Neck Cancer: Rationale and Implications
This article reviews the changes in the staging of head and neck cancers published in the 8th edition of the AJCC/UICC TNM staging system. (Source: Current Oncology Reports)
Source: Current Oncology Reports - April 17, 2019 Category: Cancer & Oncology Source Type: research

The Current and Evolving Role of Radiation Therapy for Central Nervous System Metastases from Breast Cancer
AbstractPurpose of ReviewFor patients with breast cancer who develop brain metastases, radiation therapy (RT) provides local control. Here, we review the current role for central nervous system RT, particularly focusing on the evolving role for stereotactic radiosurgery (SRS).Recent FindingsSRS treats only known CNS disease as opposed to whole-brain radiation therapy (WBRT), which treats the entire brain parenchyma. SRS has been found to cause less neurocognitive decline than WBRT. SRS is currently utilized in patients with four or fewer brain metastases, but several ongoing trials are examining the use of SRS for greater ...
Source: Current Oncology Reports - April 16, 2019 Category: Cancer & Oncology Source Type: research

Systemic Therapy of Central Nervous System Metastases of Breast Cancer
AbstractPurpose of the ReviewHistorically, systemic treatment options for patients with breast cancer brain metastases have been very limited. This review focuses on important considerations for systemic therapy as well as ongoing clinical trials evaluating novel agents.Recent FindingsFor patients with hormone receptor-positive brain metastases, endocrine therapy or chemotherapy options can be considered. The role of CDK4/6 inhibitors is being explored in ongoing trials. Patients with HER2-positive disease have a number of treatment options, including ado-trastuzumab emtansine (TDM1) or lapatinib-capecitabine, and there is...
Source: Current Oncology Reports - April 8, 2019 Category: Cancer & Oncology Source Type: research

Cardiovascular Disease and Cancer: Is There Increasing Overlap?
AbstractPurpose of ReviewCancer and cardiovascular disease are the leading causes of mortality in the USA. In this review, we highlight these shared disease pathways and provide a framework for a systems-based approach to reduce overall risk burden.Recent FindingsFrom traditional risk factors such as age and tobacco use to more recently recognized entities including clonal hematopoiesis, we are gaining insights into shared mechanisms. Because of these overlapping risks, providers on each level of patient care (primary care providers, cardiologists, oncologists) need to recognize and reduce these underlying risk factors.Sum...
Source: Current Oncology Reports - April 6, 2019 Category: Cancer & Oncology Source Type: research

Qigong or Tai Chi in Cancer Care: an Updated Systematic Review and Meta-analysis
AbstractPurpose of ReviewQigong and Tai Chi are two increasingly popular mind-body interventions with the potential to address the multifaceted needs of cancer survivors. The aim of this updated review and meta-analysis was to quantitatively evaluate the treatment effects of Qigong/Tai Chi on cancer survivors since 2014.Recent FindingsThere were statistically significant and clinically meaningful effects in favor of Qigong/Tai Chi interventions for symptoms of fatigue and sleep quality. There were positive trends, but not statistically significant effects, observed for anxiety, stress, depressive symptoms, and overall qual...
Source: Current Oncology Reports - April 6, 2019 Category: Cancer & Oncology Source Type: research

Anticoagulation of Cardiovascular Conditions in the Cancer Patient: Review of Old and New Therapies
AbstractPurpose of ReviewThe anticoagulation strategies for various cardiac-specific pathologies including atrial fibrillation are changing. Applying these strategies in patients with concomitant active cancer requires additional considerations. Here, we review the most recent changes in the anticoagulation management of common cardiac diseases and their application in cancer patients.Recent FindingsThere are a range of indications for therapeutic anticoagulation in cancer patients including venous thromboembolism (VTE), atrial fibrillation/flutter (AF/AFL), prosthetic heart valves, and intracardiac thrombi. Certain cancer...
Source: Current Oncology Reports - April 4, 2019 Category: Cancer & Oncology Source Type: research

Cervical Esophageal Cancers: Challenges and Opportunities
AbstractPurpose of the ReviewCervical esophageal cancers (CECs) are a rare subset of esophageal cancers that are distinct in their management and outcomes. This review explores current data on the optimal management of this disease.Recent FindingsWhile outcomes for CEC have been suboptimal, several strategies have been proven beneficial in recent years. These include selective surgical resection or salvage surgery, chemoradiation (CRT) vs. radiation (RT) alone, dose escalation, IMRT, and induction chemotherapy.SummaryThe optimal management of CEC to achieve the best oncological outcomes and minimize morbidity appears to be...
Source: Current Oncology Reports - April 4, 2019 Category: Cancer & Oncology Source Type: research

The Emerging Role of Minimal Residual Disease Testing in Diffuse Large B-Cell Lymphoma
AbstractPurpose of ReviewDiffuse large B cell lymphoma (DLBCL) is characterized by clinical heterogeneity that is not fully accounted for by pathologic features. Furthermore, real-time treatment modifications and detection of relapse are typically guided by radiographic imaging modalities which are imperfect. Here, we review the potential utility of minimal residual disease (MRD) assessment for informing treatment decisions and detecting relapse.Recent FindingsThe most promising method of MRD detection is based on analysis of circulating tumor DNA in the peripheral blood of patients with DLBCL. This approach can predict ou...
Source: Current Oncology Reports - April 2, 2019 Category: Cancer & Oncology Source Type: research

Targeting DNA Repair Defects for Precision Medicine in Prostate Cancer
AbstractPurpose of ReviewGenomic studies of localized and metastatic prostate cancer have identified a high prevalence of clinically actionable alterations including mutations in DNA repair genes. In this manuscript, we review the current knowledge on DNA repair defects in prostate cancer and provide an overview of how these alterations can be targeted towards a personalized prostate cancer management.Recent FindingsTwenty to 25% of metastatic prostate cancers harbor defects in DNA repair genes, most commonly in the homologous recombination genes. These defects confer increased sensitivity to platinum chemotherapy or poly ...
Source: Current Oncology Reports - March 27, 2019 Category: Cancer & Oncology Source Type: research

Controversies in the Approach to Initial Therapy of Hodgkin Lymphoma
AbstractPurpose of ReviewAvailability of highly effective novel agents has altered the approach to initial therapy in patients with classical Hodgkin lymphoma (cHL). We will review controversies in the following areas: (1) the role of radiation in early unfavorable disease and the optimal treatment strategies for (2) advanced-stage disease and (3) elderly patients.Recent FindingsStrategies incorporating brentuximab vedotin into frontline treatment of cHL yielded favorable results in non-randomized elderly studies and were compared to ABVD in advanced disease among adults. Meanwhile, four cycles of escalated BEACOPP yielded...
Source: Current Oncology Reports - March 27, 2019 Category: Cancer & Oncology Source Type: research

Central Nervous System Involvement of Natural Killer and T Cell Neoplasms
AbstractPurpose of ReviewPeripheral natural killer (NK) and T cell neoplasms comprise approximately 10 –15% of non-Hodgkin lymphomas. There are 27 different subtypes of peripheral NK and T cell neoplasms, each of which is relatively uncommon. Treatment has been largely extrapolated from case series, retrospective reports, and paradigms developed for the aggressive B cell lymphomas. This review expl ores the current knowledge of the characteristics, outcome, and treatment of CNS T cell and NK neoplasms.Recent FindingsPrimary and secondary CNS NK and T cell malignancies confer significant morbidity and poor prognosis. ...
Source: Current Oncology Reports - March 27, 2019 Category: Cancer & Oncology Source Type: research

Trends in Management of Oligometastatic Hormone-Sensitive Prostate Cancer
AbstractPurpose of ReviewSystemic therapy for patients with hormone-sensitive oligometastatic prostate cancer is non-curative and associated with toxicities. Meanwhile, this population presents unique clinical opportunities to improve outcomes, including the demonstrated benefits of radiotherapy to the primary tumor or oligometastatic sites.Recent FindingsRecently published randomized studies have demonstrated benefits with the addition of radiotherapy to the primary disease or metastatic lesions in patients with synchronous or metachronous disease. The introduction of novel PET imaging has improved the sensitivity and spe...
Source: Current Oncology Reports - March 27, 2019 Category: Cancer & Oncology Source Type: research

The Impact of Obesity on Breast Cancer Diagnosis and Treatment
AbstractPurpose of ReviewObesity is a recognized risk factor for the development of breast cancer and recurrence even when patients are treated appropriately. We reviewed the literature that addresses the impact of obesity on diagnosis and the individual therapeutic interventions, and present a summary of the findings.Recent FindingsCompared to non-obese women with breast cancer, obese women with breast cancer have a worse disease-free and overall survival despite appropriate local and systemic therapies. In brief, obese breast cancer patients experience more complications related to surgery, radiation, and chemotherapy. F...
Source: Current Oncology Reports - March 27, 2019 Category: Cancer & Oncology Source Type: research

Chimeric Antigen Receptor –Engineered T Cell Therapy in Lymphoma
AbstractPurpose of ReviewChimeric antigen receptor (CAR) T cells are a form of adoptive therapy employing autologous T cells engineered with an artificial receptor, able to recognize tumor antigens through an HLA-independent mechanism. We will review data on safety and efficacy outcomes with CAR T cell therapy in lymphomas.Recent FindingsMulticenter trials evaluating three CAR T cell products targeting CD19 have shown that they are highly effective and induce durable remissions in a substantial proportion of patients with relapsed or refractory aggressive B cell non-Hodgkin lymphoma (NHL). The most common toxicities were c...
Source: Current Oncology Reports - March 27, 2019 Category: Cancer & Oncology Source Type: research

Immune Checkpoint Inhibitors in Acute Myeloid Leukemia: Novel Combinations and Therapeutic Targets
AbstractPurpose of ReviewImmune checkpoint therapy has dramatically changed the therapeutic landscape of solid malignancies. Here, we review the scientific rationale and current data evaluating immune checkpoint inhibitors in acute myeloid leukemia (AML).Recent FindingsImmune checkpoint inhibitor monotherapy has shown limited clinical activity in AML. Initial results from early-phase clinical trials suggest that rational combinations of immune checkpoint inhibition with hypomethylating agents (HMAs) are safe and potentially more promising. There are currently no data directly comparing immune checkpoint inhibition to stand...
Source: Current Oncology Reports - March 23, 2019 Category: Cancer & Oncology Source Type: research

Targeting Barriers of Systems of Care in a Growing Multi-disciplinary Field
AbstractPurpose of ReviewCardio-oncology is a growing multi-disciplinary field that focuses on treating and preventing cardiovascular complications in cancer survivors and patients. This review summarizes the current clinical needs and system-based approaches to target barriers of care.Recent FindingsThe field of cardio-oncology has experienced significant growth in recent years, and an increasing number of programs have been developed across the nation to provide improved and multi-disciplinary care to this patient population. Despite this burgeoning growth, practitioners in the field continue to face important challenges...
Source: Current Oncology Reports - March 11, 2019 Category: Cancer & Oncology Source Type: research

Current Status and Future Directions of Immunotherapy in Renal Cell Carcinoma
AbstractPurpose of ReviewRenal cell carcinoma (RCC) was recognized as an immunologically sensitive cancer over 30  years ago. The first therapies to affect the course of RCC were cytokines (interferon alfa-2B and interleukin-2). Subsequently, drugs that inhibit HIF (hypoxia-inducible factor)/VEGF (vascular endothelial growth factor) signaling demonstrated overall survival advantages (tyrosine kinase inhibitors and mTor inhibitors).Recent FindingsIn the last 3  years, the immune checkpoint inhibitors (ICIs) have become the standard of care treatments in the first and second lines for RCC. Emerging data show that c...
Source: Current Oncology Reports - March 8, 2019 Category: Cancer & Oncology Source Type: research

Updates on Hematologic Malignancies in the Older Adult: Focus on Acute Myeloid Leukemia, Chronic Lymphocytic Leukemia, and Multiple Myeloma
AbstractPurpose of ReviewHematologic malignancies are common and difficult to treat in older adults. In this review, we focus on recent updates in diseases with several novel agents relevant to older adults —acute myeloid leukemia (AML), chronic lymphocytic leukemia (CLL), and multiple myeloma (MM).Recent FindingsIn AML, CPX-351 offers a new induction chemotherapy for secondary AML that prolongs survival, and venetoclax and IDH inhibitors are efficacious and well tolerated. In CLL, chemoimmunotherapy is being replaced by monoclonal antibodies and small molecule inhibitors that are more effective and better tolerated....
Source: Current Oncology Reports - March 8, 2019 Category: Cancer & Oncology Source Type: research

Novel Imaging in Detection of Metastatic Prostate Cancer
AbstractPurpose of ReviewThis review aims to highlight the limitations of current standard-of-care prostate cancer (PCa) imaging and discuss novel clinical imaging in advanced disease.Recent FindingsPCa staging through imaging is important for proper selections in clinical treatment. Traditional imaging techniques for metastatic disease (i.e., computed tomography [CT], magnetic resonance imaging [MRI], and radionuclide bone scan) have suboptimal performance in early recurrent or metastatic disease. Novel positron emission tomography agents including radiolabeled prostate specific membrane antigen (PSMA), choline, and anti-...
Source: Current Oncology Reports - March 5, 2019 Category: Cancer & Oncology Source Type: research

Cancer Biomarkers for Integrative Oncology
AbstractPurpose of ReviewThere has been an increasing interest in using complementary and alternative medicine (CAM) approaches to treat cancer. It is therefore relevant and timely to determine if CAM biomarkers can be identified and developed to guide cancer diagnosis and treatment. Herein, we review the status of cancer biomarkers in CAM research and treatment to stimulate further research in this area.Recent FindingsStudies on promising anti-cancer natural products, such as PHY906, honokiol, bryostatin-1, and sulforaphane have demonstrated the existence of potential cancer biomarker(s). Additional studies are required t...
Source: Current Oncology Reports - March 5, 2019 Category: Cancer & Oncology Source Type: research

Management of Ductal Carcinoma In Situ (DCIS) of the Breast: Present Approaches and Future Directions
AbstractPurpose of ReviewDuctal carcinoma in situ (DCIS; intraductal carcinoma) of the breast is commonly found in an asymptomatic woman on routine screening mammography. The purpose of this review is to describe current approaches to the management of DCIS as well as areas for future investigation.Recent FindingsRandomized trials have demonstrated that adding radiation treatment after breast conservation surgery (lumpectomy; surgical excision) reduces the rate of ipsilateral local recurrence by about half, and that adding hormonal therapy reduces the rate of all breast cancer events (ipsilateral plus contralateral). Early...
Source: Current Oncology Reports - March 5, 2019 Category: Cancer & Oncology Source Type: research

Evidence-Based Practice: Temozolomide Beyond Glioblastoma
AbstractPurpose of ReviewTemozolomide is a first-line treatment for newly diagnosed glioblastoma. In this review, we will examine the use of temozolomide in other contexts for treating gliomas, including recurrent glioblastoma, glioblastoma in the elderly, diffuse low- and high-grade gliomas, non-diffuse gliomas, diffuse intrinsic pontine glioma (DIPG), ependymoma, pilocytic astrocytoma, and pleomorphic xanthoastrocytoma.Recent FindingsTemozolomide improved survival in older patients with glioblastoma, anaplastic gliomas regardless of 1p/19q deletion status, and progressive ependymomas. Temozolomide afforded less toxicity ...
Source: Current Oncology Reports - March 5, 2019 Category: Cancer & Oncology Source Type: research

Cardiovascular Complications Associated with Multiple Myeloma Therapies: Incidence, Pathophysiology, and Management
AbstractPurpose of ReviewMultiple myeloma is a common hematologic malignancy characterized by recurrent relapsing disease course requiring use of various therapies. Over the past few decades, significant advancements in the treatment of myeloma have occurred including routine use of proteasome inhibitors and immunomodulatory drugs. These have effectively improved survival; however, some also have increased risk of cardiovascular toxicity. Here, we will review the incidence, pathophysiology, and management of cardiovascular complications associated with antimyeloma agents.Recent FindingsCardiovascular complications associat...
Source: Current Oncology Reports - March 5, 2019 Category: Cancer & Oncology Source Type: research

Cardiac Complications in the Adult Bone Marrow Transplant Patient
AbstractPurpose of ReviewDue to advancements in oncologic treatment strategies and techniques, the number of survivors who have undergone hematopoetic stem cell transplant (HCT) continues to increase in the United States; this number is projected to reach 502,000 by the year 2030. There is significant interest within the field of cardio-oncology to identify cardiotoxicity and cardiovascular disease in the HCT population. Epidemiologic studies analyzing both short- and long-term cardiovascular effects, risk stratification modeling, cardioprotective strategies, and expert consensus documents for cardiotoxicity surveillance r...
Source: Current Oncology Reports - March 2, 2019 Category: Cancer & Oncology Source Type: research

How Recent Advances in Biology of Waldenstr öm’s Macroglobulinemia May Affect Therapy Strategy
AbstractPurpose of ReviewWaldenstr öm macroglobulinemia (WM) is a rare lymphoproliferative disorder. Up to now, therapeutic choice was not influenced by the biological characteristics of the disease. Here, we will review how recent advances in biology in WM may affect therapy strategy.Recent FindingsRecently, WM has been described as a new oncogenic model.MyD88 mutation has been described as a key driver mutation and has functional consequences which could be targeted. Other mutations, such asCXCR4 orTP53, have been reported. These mutations are associated with different clinical presentation, prognosis, and treatment...
Source: Current Oncology Reports - February 26, 2019 Category: Cancer & Oncology Source Type: research

Emerging Targeted Therapies for the Treatment of Non-small Cell Lung Cancer
AbstractPurpose of ReviewLung cancer remains the leading cause of cancer-related mortality worldwide. Genetic and molecular profiling of non-small cell lung cancer (NSCLC) has led to the discovery of actionable oncogenic driver alterations, which has revolutionized treatment for this disease. This review will move beyond traditional mutational drivers such as EGFR and ALK and will instead focus on emerging targets and the efficacy of new precision therapies.Recent FindingsHere, we discuss both established and emerging targeted therapy approaches, as well as ongoing challenges for the treatment of NSCLC patients harboring o...
Source: Current Oncology Reports - February 26, 2019 Category: Cancer & Oncology Source Type: research

CDK 4/6 Inhibitors in Breast Cancer: Current Controversies and Future Directions
AbstractPurpose of ReviewTo describe the clinical role of CDK 4/6 inhibitors in hormone receptor-positive (HR+) metastatic breast cancer (HR+ MBC) as well as current controversies and evolving areas of research.Recent FindingsPalbociclib, ribociclib, and abemaciclib are each approved in combination with an aromatase inhibitor or fulvestrant for HR+ MBC. Abemaciclib is also approved as monotherapy for pre-treated patients. Key questions in the field include whether all patients with HR+ MBC should receive a CDK 4/6 inhibitor up front versus later line, impact on overall survival, role of continued CDK 4/6 blockade, mechanis...
Source: Current Oncology Reports - February 26, 2019 Category: Cancer & Oncology Source Type: research

Current Status and Future Direction of Immunotherapy in Urothelial Carcinoma
AbstractPurpose of ReviewSince 2016, five new programmed cell death protein 1/ligand 1 (PD-1/L1) checkpoint inhibitors have been approved for metastatic urothelial carcinoma. This review will summarize the data supporting the widespread use of these agents and highlight areas of ongoing clinical development.Recent FindingsPD-1/L1 axis inhibition has demonstrated clear superiority to chemotherapy for the treatment of metastatic urothelial cancer in the second-line setting. A multitude of ongoing studies are investigating the feasibility and efficacy of incorporating established and novel immunotherapies into earlier lines o...
Source: Current Oncology Reports - February 26, 2019 Category: Cancer & Oncology Source Type: research

Clinical and Genomic Considerations for Variant Histology in Bladder Cancer
AbstractPurpose of ReviewUrothelial carcinoma demonstrates remarkable plasticity in its ability to differentiate into divergent histologic subtypes in both a pure and mixed form. This review presents the most current data pertaining to bladder cancer with variant histology.Recent FindingsRecognition of bladder cancer variants has increased profoundly in the past two decades with their inclusion in the pathologic guidelines and increased awareness among pathologists and urologists. Most of the available literature consists of small single-institutional studies, but there is compelling evidence to support deviation from the ...
Source: Current Oncology Reports - February 26, 2019 Category: Cancer & Oncology Source Type: research

Angiopoietin-1 and Angiopoietin-2 Inhibitors: Clinical Development
AbstractPurpose of ReviewThe purpose of this review is to discuss the current understanding of the Tie2-angiopoietin system and its role in tumor growth and metastasis. This review also focuses on preclinical and clinical data published to date that have evaluated Tie2-angiopoietin inhibition.Recent FindingsTie2 inhibition has shown significant promise in preclinical models, notable for decreased tumor burden and fewer sites of metastatic disease across various malignancies. However, data from human clinical trials have shown more mixed results. Trebananib, rebastanib, and MEDI3617 are the three Tie2-angiopoietin inhibitor...
Source: Current Oncology Reports - February 26, 2019 Category: Cancer & Oncology Source Type: research

Sinonasal Undifferentiated Carcinoma
AbstractPurpose of ReviewTo provide a comprehensive review of the literature highlighting the recent advances in the diagnosis and management of sinonasal undifferentiated carcinoma (SNUC)Recent FindingsSNUC usually presents at advanced stage and the prognosis is usually poor with high rates of locoregional recurrence and tendency to metastasize. Special attention should be made in differentiating SNUC from other sinonasal malignancies in order to guide the appropriate treatment accordingly. Multimodality treatment is usually recommended for treating SNUC. The use of neoadjuvant chemotherapy may be associated with improved...
Source: Current Oncology Reports - February 26, 2019 Category: Cancer & Oncology Source Type: research

Management of Adrenocortical Carcinoma
AbstractPurpose of ReviewAdrenocortical carcinoma (ACC) is a rare endocrine malignancy typically with poor prognosis. This review aims to summarize the current knowledge regarding the clinical management of ACC.Recent FindingsSurgery remains the cornerstone for localized ACC management. In more advanced cases, debulking surgery when feasible can help with hormonal control and may allow the initiation of systemic therapy. Over the last few years, our understanding of ACC molecular pathogenesis has expanded with no significant change in treatment options. Platinum-based chemotherapy is the gold standard in metastatic ACC des...
Source: Current Oncology Reports - February 23, 2019 Category: Cancer & Oncology Source Type: research

Pegylated Interleukin-10: Clinical Development of an Immunoregulatory Cytokine for Use in Cancer Therapeutics
AbstractPurpose of ReviewInterleukin-10 (IL-10) is a cytokine with anti-inflammatory properties, which induces activation and proliferation of antigen-activated intratumoral CD8+ T cells. This review discusses the evolution of pegylated IL-10 (pegilodecakin) from preclinical investigation through first-in-human studies in oncology.Recent FindingsPegilodecakin was evaluated across multiple advanced solid tumors in a large phase 1/1b trial alone and in combination with chemotherapy or anti-PD-1 antibodies. Pegilodecakin monotherapy had immunologic and clinical activity in renal cell carcinoma (RCC) and uveal melanoma. In com...
Source: Current Oncology Reports - February 21, 2019 Category: Cancer & Oncology Source Type: research

New Treatment Options for Acute Myeloid Leukemia in 2019
AbstractPurpose of ReviewThe extensive genomic characterization of acute myeloid leukemia (AML) led to the identification of a vast number of potential therapeutic targets. We review relevant data that have led to recent approval of new targeted therapies in AML and discuss the most promising drugs currently in development in this disease.Recent FindingsNew formulations of cytotoxic agents, namely CPX-351 and gemtuzumab ozogamicin, improve the outcome of defined subgroup of patients. Midostaurin added to intensive chemotherapy is approved inFLT3-mutated AML. More selectiveFLT3 inhibitors and theIDH inhibitors enasidenib an...
Source: Current Oncology Reports - February 4, 2019 Category: Cancer & Oncology Source Type: research

BET and EZH2 Inhibitors: Novel Approaches for Targeting Cancer
AbstractPurpose of ReviewIncreasing evidence suggests that epigenome plays a central role in cancer development making it a promising target for anticancer treatments. Here, we review two new classes of epigenome-targeting agents: the bromodomain and extraterminal domain proteins (BET) inhibitors and the enhancer of zeste homolog (EZH2) inhibitors.Recent FindingsClinical research evaluating BET and EZH2 inhibitors is still at an early stage; however, both classes of drugs have demonstrated activity among different hematologic malignancies and solid tumors.SummarySeveral studies on BETi and EZH2i are ongoing to better defin...
Source: Current Oncology Reports - February 4, 2019 Category: Cancer & Oncology Source Type: research