Integrating Immunotherapies in Prostate Cancer
Abstract In recent years, immunotherapy has emerged as a viable and promising treatment for prostate cancer. Beyond sipulecuel-T, phase III trials are evaluating multiple vaccine and immune-based therapies in men with this disease. Evidence suggests that many of these therapies are effective at augmenting immune responses and slowing tumor growth rates. Yet prospective data evaluating these responses as surrogates for survival are still needed. In the absence of validated intermediate markers of response, growing data suggests that patients with more indolent disease are more likely to benefit from immunotherapie...
Source: Current Oncology Reports - August 14, 2015 Category: Cancer & Oncology Source Type: research

Chemotherapy in Prostate Cancer
Abstract For approximately a decade, chemotherapy has been shown to prolong life in patients with metastatic castration-resistant prostate cancer (mCRPC). Since that time, however, only two agents have proven to prolong life (docetaxel and cabazitaxel). However, in the last year, the addition of chemotherapy to primary hormonal therapy became a standard of care for high-volume castration-sensitive metastatic disease. Here I will review current prostate cancer chemotherapies, mechanisms of resistance to those therapies, and ongoing clinical studies of chemotherapy combinations and novel chemotherapeutics. (Source:...
Source: Current Oncology Reports - July 28, 2015 Category: Cancer & Oncology Source Type: research

Is There a Role for Homeopathy in Cancer Care? Questions and Challenges
Abstract Patients with cancer commonly use complementary and integrative medicine, including homeopathy. Homeopathy has grown in popularity with the public but is viewed with skepticism by medical academia and is still excluded from conventionally prescribed treatments. In recent years, homeopathy has been used in cancer care in Europe and other countries worldwide. This use raised the question if there is any benefit in utilizing this type of care with cancer patients. The purpose of this manuscript is to explore the evidence related to the benefit of homeopathy in cancer care. Limited research has suggested tha...
Source: Current Oncology Reports - July 26, 2015 Category: Cancer & Oncology Source Type: research

High-Dose Chemotherapy and Autologous Stem Cell Transplant in Older Patients with Lymphoma
Abstract High-dose chemotherapy followed by autologous hematopoietic stem cell transplant (HDT/ASCT) can improve survival in patients with lymphoma. Limited experience is available on the safety and efficacy of HDT/ASCT in elderly patients. In this article, we review the published data on the role of HDT/ASCT in management of lymphoma in older patients. Based on available data, evaluation of comorbidities, functional status, and comprehensive geriatric assessment (CGA) will help identify those who can benefit most from this intervention. Prospective clinical trials focusing on HDT/ASCT in older patients with lymp...
Source: Current Oncology Reports - July 23, 2015 Category: Cancer & Oncology Source Type: research

Development and Integration of Antibody–Drug Conjugate in Non-Hodgkin Lymphoma
Abstract Rituximab, a monoclonal antibody (MAb) against CD20, was the first MAb approved by the US Food and Drug Administration (FDA) for treatment of B cell non-Hodgkin lymphoma (B-NHL). Conjugating toxins to MAb was a technical challenge; however, with improvements in linker technology, immunoconjugates were constructed and revolutionized cancer treatment. Gemtuzumab ozogamicin was the first antibody drug conjugate (ADC) approved by the FDA. Because of the success of brentuximab vedotin and ado-trastuzumab emtansine in treating Hodgkin lymphoma (HL) and HER2-positive breast cancer, respectively, newer ADCs are ...
Source: Current Oncology Reports - July 21, 2015 Category: Cancer & Oncology Source Type: research

Epigenetics and Lymphoma: Can We Use Epigenetics to Prime or Reset Chemoresistant Lymphoma Programs?
Abstract Non-Hodgkin lymphoma is a diverse group of lymphocyte-derived neoplasms. Although a heterogeneous group of malignancies, it has become apparent that epigenetic alterations, such as disturbances of DNA methylation and histone modification, are a common occurrence in both B cell and T cell lymphomas, contributing to lymphomagenesis. As a result, the use of epigenetic targeted therapy has been incorporated into various pre-clinical and clinical studies, demonstrating significant efficacy in lymphoma, with vorinostat becoming the first epigenetic therapy to receive FDA approval in any malignancy. The role of...
Source: Current Oncology Reports - July 4, 2015 Category: Cancer & Oncology Source Type: research

Contemporary Management of Retroperitoneal Soft Tissue Sarcomas
Abstract Management of retroperitoneal soft tissue sarcomas (RP STS) can be very challenging. In contrast to the more common extremity STS, the two predominant histologic subtypes encountered in the retroperitoneum are well-differentiated/dedifferentiated liposarcoma and leiomyosarcoma. Surgery remains the mainstay of treatment for RP STS. Preoperative planning and anticipation of the need for resection of adjacent organs/structures are critical. The extent of surgery, including the role of compartmental resection, is still controversial. Radiation therapy may be an important adjunct to surgery to provide locoreg...
Source: Current Oncology Reports - June 21, 2015 Category: Cancer & Oncology Source Type: research

Cytoreductive Surgery Followed by Hyperthermic Intraperitoneal Chemotherapy in DSRCT: Progress and Pitfalls
Abstract Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) is an approach for local control of desmoplastic small round cell tumor (DSRCT). DSRCT is a rare sarcoma which presents with multiple intra-abdominal masses. Overall survival has been 15–30 %. Because of the poor prognosis of DSRCT, novel treatment strategies were necessary. Cytoreductive surgery (CRS) and HIPEC has been recently trialed as part of multimodality therapy in DSRCT. CRS and HIPEC allows complete resection of the sometimes hundreds of intra-abdominal tumor implants, followed by the delivery of hyperthermic...
Source: Current Oncology Reports - June 21, 2015 Category: Cancer & Oncology Source Type: research

The Role of Radiotherapy in Small Cell Lung Cancer: a Revisit
Abstract Small cell lung cancer is staged as either limited (potentially curable) or extensive (incurable), based on the extent of disease in the chest. Limited stage disease is treated with concurrent chemotherapy and thoracic radiotherapy followed by prophylactic cranial irradiation (PCI). The conventional approach to extensive disease is chemotherapy only, with radiotherapy reserved for site-specific palliation. Recent reports suggest increasing applications for radiotherapy. The administration of PCI to extensive stage patients demonstrating response to chemotherapy is now recommended due to local control and...
Source: Current Oncology Reports - June 14, 2015 Category: Cancer & Oncology Source Type: research

When Is It Safe to Omit Surgery in Primary Peritoneal Cancer With Small Volume Disease?
Abstract Primary peritoneal cancer (PPC) is considered a very rare condition, with mesotheliomas deemed the only true PPC when considering the cellular content and embryological derivation of the peritoneum. However, in women, PPC are seen in much greater abundance than that in men and the type of cancer detected is often that of a serous epithelial carcinoma, histologically similar to serous ovarian carcinomas. The management is also similar, i.e. surgery and platin-based chemotherapy. The definition clinically of PPC is that of widespread carcinomatosis with normal-sized ovaries. The carcinomatosis is often ext...
Source: Current Oncology Reports - June 5, 2015 Category: Cancer & Oncology Source Type: research

Novel Agents in Mantle Cell Lymphoma
Abstract Mantle cell lymphoma (MCL) is an uncommon B-cell non-Hodgkin lymphoma, comprising approximately 6–8 % of all non-Hodgkin lymphomas. MCL is biologically and clinically heterogeneous, and there is no standard treatment for MCL. Although untreated MCL often responds well to frontline combination chemotherapy, relapsed, refractory MCL can be challenging to treat and traditional cytotoxic chemotherapy is typically not highly effective. In recent years, increased insight into the molecular and genomic diversity of MCL and the pathogenesis of the disease has given rise to the development of many new ...
Source: Current Oncology Reports - June 5, 2015 Category: Cancer & Oncology Source Type: research

Adnectin-Targeted Inhibitors: Rationale and Results
Abstract Adnectins are a family of binding proteins derived from the 10th type III domain of human fibronectin (10Fn3), which is part of the immunoglobulin superfamily and normally binds integrin. The 10Fn3 has the potential for broad therapeutic applications given its structural stability, ability to be manipulated, and its abundance in the human body. The most commonly studied adnectin is CT-322, which is an inhibitor of vascular endothelial growth factor receptor-2. A bispecific adnectin, El-Tandem, has also been developed and binds to epidermal growth factor receptor and insulin-like growth factor-1 receptor ...
Source: Current Oncology Reports - June 5, 2015 Category: Cancer & Oncology Source Type: research

Optimizing the Use of Neoadjuvant Endocrine Therapy
Abstract Nowadays, neoadjuvant endocrine therapy is a clinically acceptable (and sometimes preferred) strategy in patients with operable estrogen receptor-positive (ER+) breast cancer. Despite the overall effectiveness of endocrine therapy in breast cancer in all settings, de novo (primary) and acquired (secondary) endocrine therapy resistance remains a major clinical problem. Neoadjuvant endocrine therapy trials for breast cancer are not only a great opportunity to determine which ER+ breast cancers can be treated without chemotherapy, but also a great strategy to develop insights into the biologic basis for the...
Source: Current Oncology Reports - May 26, 2015 Category: Cancer & Oncology Source Type: research

The Biology of Aging and Lymphoma: a Complex Interplay
Abstract The probability to develop non-Hodgkin lymphoma grows with age. The biological links between aging and lymphoma are not well described in the literature, and different hypothesis may be raised to explain this complex relationship. First, the impact of chronological age favoring the accumulation of genetic alterations can contribute to the multisteps proces of lymphomagenesis. Then, the age-related defects in cancer protection and the age-related clonal restriction in hematopoietic stem cell may also promote lymphoma development. Finally, the senescent and immunosenescence phenotype might represent a...
Source: Current Oncology Reports - May 24, 2015 Category: Cancer & Oncology Source Type: research

Integrating Oncogeriatric Tools into the Management of Chronic Lymphocytic Leukemia: Current State of the Art and Challenges for the Future
Abstract Although the achievement of deep and long lasting remissions is a realistic goal of therapy in the fit patient with chronic lymphocytic leukemia (CLL), this disease typically affects elderly patients who also show one or more concomitant pathological conditions or functional limitations that have an additive effects on the reduction of patient’s life expectancy and represent major limitations in the adoption of standard therapies. In these unfit but typical patients with CLL, the goals of treatment may vary from achieving good remissions without severe toxicity to simple palliation. Differently fro...
Source: Current Oncology Reports - May 19, 2015 Category: Cancer & Oncology Source Type: research

Clinical Development of Siltuximab
Abstract Siltuximab is a chimeric monoclonal antibody targeting interleukin-6 (IL-6), which in the fall of 2014 became the first FDA-approved treatment of the rare disease idiopathic multicentric Castleman’s disease (MCD). MCD is a non-clonal lymphoproliferative disorder in which common symptoms include fever, night sweats, weight loss, and fatigue. Symptoms are driven by an overall hypercytokinemia, predominantly IL-6. While under clinical development, siltuximab was studied in several other disease states including multiple myeloma, non-Hodgkin lymphomas, and several solid tumors in which it did not demon...
Source: Current Oncology Reports - May 19, 2015 Category: Cancer & Oncology Source Type: research

Novel Immunologic Approaches in Lymphoma: Unleashing the Brakes on the Immune System
Abstract Immunotherapy is a promising therapeutic strategy in the treatment of lymphoma. The programmed death-1 (PD-1)/PD-ligand immune checkpoint pathway has been manipulated by tumor cells and serves as a mechanism of tumor evasion from the anti-tumor immune response. The recent development of anti-PD-1 antibodies has offered a therapeutic strategy for restoring the function of exhausted antigen-specific T cells and enhancing the endogenous anti-tumor immunity. We review the clinical studies demonstrating efficacy and safety of PD-1 antibodies in relapsed/refractory Hodgkin, follicular, and diffuse large B cell...
Source: Current Oncology Reports - May 19, 2015 Category: Cancer & Oncology Source Type: research

Ultrasound in Gynecological Cancer: Is It Time for Re-evaluation of Its Uses?
Abstract Ultrasound is the primary imaging modality in gynecological oncology. Over the last decade, there has been a massive technology development which led to a dramatic improvement in the quality ultrasound imaging. If performed by an experienced sonographer, ultrasound has an invaluable role in the primary diagnosis of gynecological cancer, in the assessment of tumor extent in the pelvis and abdominal cavity, in the evaluation of the treatment response, and in follow-up. Ultrasound is also a valuable procedure for monitoring patients treated with fertility-sparing surgery. Furthermore, it is an ideal techniq...
Source: Current Oncology Reports - May 17, 2015 Category: Cancer & Oncology Source Type: research

Rethinking Clinical Response and Outcome Assessment in a Biologic Age
Abstract Standardized response criteria for lymphoma are critical for the evaluation of new therapies. Widely adopted recommendations, most recently the Lugano classification, have been developed primarily for assessment of conventional chemotherapeutic regimens. More recently, several classes of drugs, including immunomodulatory agents, B cell receptor pathway targeting kinases, and checkpoint (PD-1, PDL-1) inhibitors have demonstrated impressive activity in a broad range of histologies. However, they may be associated with features during treatment suggestive of progressive disease despite clinical benefit. Imm...
Source: Current Oncology Reports - May 15, 2015 Category: Cancer & Oncology Source Type: research

The Role of Anti-angiogenesis in Non-small-cell Lung Cancer: an Update
Abstract Recognition of the vascular endothelial growth factor (VEGF) pathway as a key mediator of angiogenesis has led to the clinical study of several VEGF and VEGF receptor (VEGFR) targeted therapies in non-small-cell lung cancer (NSCLC). These targeted therapies include neutralizing antibodies to VEGF (bevacizumab and aflibercept) and VEGFR-2 (ramucirumab) and tyrosine kinase inhibitors (TKIs) with selectivity for the VEGFRs. Bevacizumab and ramucirumab are associated with survival advantages in the treatment of advanced NSCLC: bevacizumab in the first-line setting in combination with carboplatin/paclitaxel a...
Source: Current Oncology Reports - May 7, 2015 Category: Cancer & Oncology Source Type: research

Central Nervous System Prophylaxis in Non-Hodgkin Lymphoma: Who, What, and When?
Abstract Secondary central nervous system (CNS) progression in patients with non-Hodgkin lymphoma (NHL) is associated with a particularly poor prognosis. In this review, we summarize and critically evaluate the current literature to guide the practicing clinician in estimating CNS relapse risk in order to select individual patients who may benefit from CNS prophylaxis, covering histologic subtype, anatomic location, and molecular and clinical factors. We summarize the data regarding different prophylaxis strategies used and provide our recommendation regarding who should receive it, what they should receive, and ...
Source: Current Oncology Reports - April 28, 2015 Category: Cancer & Oncology Source Type: research

Tivozanib: Status of Development
Abstract Tivozanib is a potent and highly specific orally available, tyrosine kinase inhibitor that targets vascular endothelial growth factor (VEGF) receptor-1, VEGF receptor-2, and VEGF receptor-3 at very low concentrations with a long half-life (4 days). After its promising activity in xenograft and preclinical models, tivozanib was evaluated in early phase clinical trials in various solid tumors. The phase III trial (TIVO-1) compared tivozanib with sorafenib in metastatic clear cell renal cell carcinoma (RCC). Because of detrimental overall survival (OS), Oncology Drug Advisory Committee (ODAC) voted aga...
Source: Current Oncology Reports - April 21, 2015 Category: Cancer & Oncology Source Type: research

Review of Neoadjuvant Chemotherapy and Trachelectomy: Which Cervical Cancer Patients Would Be Suitable for Neoadjuvant Chemotherapy Followed by Fertility-Sparing Surgery?
Abstract The number of patients given neoadjuvant chemotherapy (NAC) followed by fertility-sparing surgery in cervical cancer is still scarce. Only a few centres perform these procedures, and thus, such procedures remain largely in the experimental stage. Patients that do not fulfil the criteria for standard fertility-sparing procedure can be included in studies with NAC followed by fertility-sparing procedure. We must consider that both oncological and pregnancy outcomes are important. Patients with only microscopic disease after NAC are apparently the best candidates for fertility-sparing surgery. Current data ...
Source: Current Oncology Reports - April 18, 2015 Category: Cancer & Oncology Source Type: research

The Five Steps of Comprehensive Psychosocial Distress Screening
Abstract Despite the growing recognition of the impact psychosocial distress has on the quality of life of patients with cancer, the implementation of the National Comprehensive Cancer Network (NCCN) Distress Management Guidelines and the mandate of evidence-based policy for routine distress screening continue to lag. To speed adoption of the guideline, the American Psychosocial Oncology Society (APOS) and Yale School of Nursing (YSN) launched the Screening for Psychosocial Distress Program in 2014. The program resulted in the development of five steps necessary to carry out routine psychosocial distress screenin...
Source: Current Oncology Reports - April 1, 2015 Category: Cancer & Oncology Source Type: research

Effects of Complementary and Integrative Medicine on Cancer Survivorship
Abstract Cancer survivorship has become a topic of great interest in the past few years. Unfortunately, even with successful treatment as well as good follow-up care, many patients continue to experience unmet physical, emotional, and spiritual needs as well as having an unsettling fear, fear of recurrence, a fear which most survivors share, even many years after their treatment ended. As a result, patients are continually looking for additional ways to address these needs and fears. Among the most popular approach is the use of complementary and integrative medicine (CIM). Most studies on CIM use among cancer pa...
Source: Current Oncology Reports - March 7, 2015 Category: Cancer & Oncology Source Type: research

Targeting Breast Cancer with CDK Inhibitors
Abstract Dysregulation of the cell cycle is a classic hallmark of cancer growth and metastatic potential. Re-establishing cell cycle control through CDK inhibition has emerged as an attractive option in the development of targeted cancer therapy. Three oral agents selectively targeting CDK4/6 have been developed: palbociclib, abemaciclib, and LEE011. Preclinical models show optimal activity in hormone receptor positive breast cancer, which may display biologic features suggesting particular dependence on the CDK4/cyclin D1/Rb interaction. Palbociclib has been studied in a randomized phase 2 clinical trial in meta...
Source: Current Oncology Reports - February 26, 2015 Category: Cancer & Oncology Source Type: research

Thrombosis in Leukemia: Incidence, Causes, and Practical Management
Abstract In patients with acute leukemia (AL), coagulation disorders, which include both thrombotic and hemorrhagic events, are part of the clinical spectrum both at diagnosis and during its evolution. The incidence of these events has been reported by several authors in the range of 1–36 %. This heterogeneity appears to be related to the type of patients included, the study design, and patient-related factors as well as the treatment used. The pathophysiology of thrombosis in AL is complex and multifactorial and includes a myriad of factors that contribute to cancer procoagulant state: synthesis of pr...
Source: Current Oncology Reports - February 25, 2015 Category: Cancer & Oncology Source Type: research

Precision Medicine in Breast Cancer: Genes, Genomes, and the Future of Genomically Driven Treatments
Abstract Remarkable progress in sequencing technology over the past 20 years has made it possible to comprehensively profile tumors and identify clinically relevant genomic alterations. In breast cancer, the most common malignancy affecting women, we are now increasingly able to use this technology to help specify the use of therapies that target key molecular and genetic dependencies. Large sequencing studies have confirmed the role of well-known cancer-related genes and have also revealed numerous other genes that are recurrently mutated in breast cancer. This growing understanding of patient-to-patient va...
Source: Current Oncology Reports - February 24, 2015 Category: Cancer & Oncology Source Type: research

Adenocarcinoma of the Cervix: Should We Treat It Differently?
Abstract Worldwide, cervical cancer is a leading cause of mortality among women, causing 265,653 deaths annually. Squamous cell carcinoma (SCC) accounts for 75 % of cervical cancer cases in the USA, while adenocarcinoma (AC) accounts for 25 %. The incidence of SCC is decreasing in the USA, yet AC is increasing. Many differences exist between cervical SCC and AC including anatomic origin, risk factors, prognosis, dissemination, sites of recurrence, and rates of metastasis. Despite differences, current treatment algorithms do not distinguish between cervical SCC and AC. To date, prospective research direc...
Source: Current Oncology Reports - February 24, 2015 Category: Cancer & Oncology Source Type: research

Adjuvant and Neoadjuvant Options in Resectable Gastric Cancer: Is There an Optimal Treatment Approach?
Abstract Gastric cancer is one of the most prevalent and deadliest forms of cancer worldwide. Even though neoadjuvant, perioperative, and adjuvant chemotherapy and/or radiation therapy may improve outcomes compared with surgery alone, the optimal combination of treatment modalities remains controversial. While European and North American trials established perioperative chemotherapy and adjuvant chemoradiation regimens for gastric cancer, Asian countries have focused on the use of adjuvant chemotherapy. This review summarizes results from contemporary randomized controlled trials and meta-analyses to elucidate th...
Source: Current Oncology Reports - February 24, 2015 Category: Cancer & Oncology Source Type: research

Contemporary Surgical Options for Metastatic Colorectal Cancer
Abstract The diagnosis of stage IV colorectal cancer was once associated with a uniformly grim prognosis. Over the last 20 years, advances in chemotherapeutics, surgical technique, and surgical adjuncts have dramatically broadened treatment options and improved outcomes. Among current treatment options, surgery remains the key component of any multidisciplinary approach with surgical data demonstrating the longest survivorship. This review will summarize current and developing surgical advances in the treatment of metastatic colorectal cancer. Specifically, we will discuss how surgical interventions fit with...
Source: Current Oncology Reports - February 24, 2015 Category: Cancer & Oncology Source Type: research

Activin Receptor Inhibitors—Dalantercept
Abstract Development of anti-angiogenic therapy including the vascular endothelial growth factor (VEGF) antibodies and VEGF-tyrosine kinase receptors has been a major landmark in cancer therapy leading improvement in survival in several cancers. While anti-angiogenic therapy is effective in some settings, resistance often develops owing to evasive, alternative pathways. Novel targets for anti-angiogenic therapy are urgently required to provide treatment alternatives in patients whose tumors are unresponsive to approved anti-angiogenic agents; one such pathway is the bone morphogenetic proteins (BMP 9 and BMP 10) ...
Source: Current Oncology Reports - February 24, 2015 Category: Cancer & Oncology Source Type: research

Radical Surgery in Ovarian Cancer
Abstract While there is an ongoing debate regarding the timing of the maximal surgical effort in epithelial ovarian cancer, it is well established that patients with suboptimal tumor debulking derive no benefit from the surgical procedure. The amount of residual disease after cytoreductive surgery has been repeatedly identified as a strong predictor of survival, and accordingly, the surgical effort to achieve the goal of complete gross tumor resection has been constantly evolving. Centers that have adopted the concept of radical surgery in patients with advanced ovarian cancer have reported improvements in their ...
Source: Current Oncology Reports - February 24, 2015 Category: Cancer & Oncology Source Type: research

Pediatric Brainstem Gliomas: New Understanding Leads to Potential New Treatments for Two Very Different Tumors
Abstract Pediatric brainstem gliomas include low-grade focal brainstem gliomas (FBSG) and high-grade diffuse intrinsic pontine gliomas (DIPG). These tumors share a crucial and eloquent area of the brain as their location, which carries common challenges for treatment. Otherwise, though, these two diseases are very different in terms of presentation, biology, treatment, and prognosis. FBSG usually present with greater than 3 months of symptoms, while DIPG are usually diagnosed within 3 months of symptom onset. Surgery remains the preferred initial treatment for FBSG, with chemotherapy used for persistent...
Source: Current Oncology Reports - February 22, 2015 Category: Cancer & Oncology Source Type: research

Metaplastic Breast Cancer: Clinical Overview and Molecular Aberrations for Potential Targeted Therapy
Abstract Metaplastic breast cancer is a rare subtype of invasive mammary carcinoma, with an aggressive behavior and usually poor outcome. Responses to systemic chemotherapy are suboptimal compared to patients with standard invasive ductal carcinoma. Limited data are available in regards to best treatment modalities, including chemotherapy. This review gives an overview of metaplastic breast cancer and its clinical and pathologic characteristics, in addition to treatment strategies, clinical trials, and future directions. (Source: Current Oncology Reports)
Source: Current Oncology Reports - February 19, 2015 Category: Cancer & Oncology Source Type: research

The Neoadjuvant Treatment of Rectal Cancer: A Review
Abstract Rectal adenocarcinoma is an important cause of cancer-related deaths worldwide, and key anatomic differences between the rectum and the colon have significant implications for management of rectal cancer, especially in the curative setting. For stage II and III rectal cancers, combined chemoradiotherapy offers the lowest rates of local and distant relapse, and is delivered neoadjuvantly to improve tolerability and optimize surgical outcomes, particularly when sphincter-sparing surgery is an endpoint. We review both pivotal trial data that has shaped the current standard of care, fluoropyrimidine-based ch...
Source: Current Oncology Reports - February 19, 2015 Category: Cancer & Oncology Source Type: research

The Role of Transoral Robotic Surgery in the Management of Oropharyngeal Squamous Cell Carcinoma: a Current Review
Abstract The incidence of oropharyngeal squamous cell carcinoma (OPSCC) is increasing in the USA despite a decline in traditional risk factors. This trend is attributed to human papillomavirus (HPV)-associated malignancies and is particularly notable in a younger patient demographic with fewer comorbid diseases and longer life expectancies. Therefore, both oncologic and functional outcomes are important to consider when managing OPSCC in the modern era. The historical management of OPSCC was typically surgical, but traditional open approaches resulted in significant morbidity. As the paradigm shifted, organ-prese...
Source: Current Oncology Reports - February 17, 2015 Category: Cancer & Oncology Source Type: research

Long-Term Experience with (Laterally) Extended Endopelvic Resection (LEER) in Relapsed Pelvic Malignancies
Abstract Gynecologic cancers recurring in the pelvis are generally advanced in malignant progression limiting curative treatment approaches. The cancer field theory links cancer progression to reversed morphogenesis and allows the exact anatomical delineation of the cancer field, i.e., the tissue compartment of potential tumor infiltration related to the tumor’s ontogenetic stage. Cancer surgery is redefined with the resection of ontogenetic stage-related cancer fields instead of the mere removal of the malignant tumor with an uninvolved tissue margin. Most gynecologic pelvic malignancies recurring in the p...
Source: Current Oncology Reports - February 17, 2015 Category: Cancer & Oncology Source Type: research

Surgical Salvage of Recurrent Nasopharyngeal Carcinoma
Abstract Nasopharyngeal carcinoma is a unique tumour which is endemic in southern China including Hong Kong. Whilst the treatment results for the primary cancer has been encouraging, management of recurrent tumours has been challenging. Compared to other surgical approaches, the maxillary swing operation provides wide access to the bilateral nasopharynx and the ipsilateral parapharyngeal space, allowing resection of tumours with adequate margins. Among the 312 patients who had received salvage nasopharyngectomy via the maxillary swing approach, the chance of achieving microscopically clear resection margins was 7...
Source: Current Oncology Reports - February 17, 2015 Category: Cancer & Oncology Source Type: research

Respecting the Spiritual Side of Advanced Cancer Care: a Systematic Review
Abstract Spirituality is among the resources that many turn to as they deal with a diagnosis of advanced cancer. Researchers have made much progress in exploring and understanding spirituality’s complex and multifaceted role in the midst of metastatic disease. As a result, spirituality is seen as an important aspect of a holistic and respectful approach to clinical care for patients and their loved ones. In this article, we provide a systematic review of the literature related to the interface between spirituality and metastatic cancer. We included articles published from January 2013 to June 2014. Twenty-t...
Source: Current Oncology Reports - February 13, 2015 Category: Cancer & Oncology Source Type: research

Immunotherapy for the Treatment of Breast Cancer
Abstract Decades of research are now leading to therapeutics that target the molecular mechanisms of the cancer-specific immune response. These therapeutics include tumor antigen vaccines, dendritic cell activators, adjuvants that activate innate immunity, adoptive cellular therapy, and checkpoint blockade. The advances in targeted immunotherapy have led to clinical advances in the treatment of solid tumors such as melanoma, prostate cancer, lung cancer, and hematologic malignancies. Preclinical and translational studies suggest that patients with breast cancer may also benefit from augmenting effective immune re...
Source: Current Oncology Reports - February 13, 2015 Category: Cancer & Oncology Source Type: research

Assessing the Role of Platinum Agents in Aggressive Breast Cancers
Abstract As anticipated by their structure and mechanism of action, platinum analogs exhibit clinically significant antitumor activity in the more aggressive forms of breast cancer, both alone and in combination with other cytotoxic agents and targeted therapies. In early-stage human epidermal growth factor receptor-2 (HER2)-positive breast cancer, the administration of carboplatin together with a taxane (usually docetaxel) and trastuzumab (and pertuzumab in the neoadjuvant setting) is a standard of care regimen. In BRCA1 mutation carriers, neoadjuvant treatment with single-agent cisplatin results in a high patho...
Source: Current Oncology Reports - February 10, 2015 Category: Cancer & Oncology Source Type: research

Targeting the Androgen Receptor in Breast Cancer
Abstract The androgen receptor (AR) is expressed in the majority of breast cancer and across the three main breast cancer subtypes. Historically, the oncogenic role of AR has best been described in molecular apocrine breast cancers, an estrogen receptor (ER)−/AR+ subtype which has a steroid response signature similar to that in the ER-positive breast cancer. The signalling effect of AR is likely to be different across breast cancer subtypes, and particularly important is its interaction with ER signalling. Despite the high frequency of AR expression in breast cancer, it is still not a standard clinical prac...
Source: Current Oncology Reports - February 10, 2015 Category: Cancer & Oncology Source Type: research

Testicular Choriocarcinoma: a Rare Variant that Requires a Unique Treatment Approach
Abstract Testicular germ cell tumors represent the most common malignancy among young men. While 5-year overall survival and cure for this population is greater than 95 %, choriocarcinoma is an aggressive subtype of this disease with far worse prognosis—5-year survival for choriocarcinoma is less than 80 %. In order to be able to treat these patients appropriately, a provider must recognize characteristic features of choriocarcinoma including elevated human chorionic gonadotropin in a young man with testicular mass; the astute clinician should also know the signs and symptoms of choriocarcinoma sy...
Source: Current Oncology Reports - February 3, 2015 Category: Cancer & Oncology Source Type: research

Unique Aspects of Caring for Young Breast Cancer Patients
This article will focus on these new developments in areas including endocrine therapy and fertility preservation as well as the unique treatment-related sequelae and psychosocial concerns among young women with breast cancer face. (Source: Current Oncology Reports)
Source: Current Oncology Reports - February 3, 2015 Category: Cancer & Oncology Source Type: research

Update on Treatment of Liver Metastases: Focus on Ablation Therapies
Abstract There is substantial and growing interest in the use of local therapies to treat patients with metastatic cancer, especially those deemed to have “oligometastatic” disease. Much of the literature to date consists of reports on metastasectomy for liver and lung metastases. Non-surgical minimally or non-invasive treatments including thermal ablation, irreversible electroporation, and high-dose radiation therapy (stereotactic ablative radiation therapy) can also be used in the treatment of primary and secondary tumors, including in the treatment of liver metastases. In this review, we discuss th...
Source: Current Oncology Reports - November 22, 2014 Category: Cancer & Oncology Source Type: research

Intraoperative Radiotherapy for Gastrointestinal Malignancies: Contemporary Outcomes With Multimodality Therapy
Abstract The integration of intraoperative radiotherapy (IORT) into the multimodal treatment of gastrointestinal cancer is feasible and leads to high rates of local control. In-field tumoral control using IORT-containing strategies can be achieved in over 90 % of most cases, regardless of the site or status of the tumor (primary or recurrent). Electron beam IORT, or intraoperative electron radiation therapy, is the dominant technology used in institutions reporting data in publications the 21st century. Neither surgery nor systemic therapy is compromised by the integration of IORT-containing radiotherapy. (S...
Source: Current Oncology Reports - November 22, 2014 Category: Cancer & Oncology Source Type: research

Body Image: a Critical Psychosocial Issue for Patients With Head and Neck Cancer
Abstract Increasing attention is being given to evaluating and treating body image difficulties of patients undergoing cancer treatment. Head and neck cancer significantly alters physical appearance and bodily functioning and therefore directly impacts body image. Research involving body image in head and neck cancer patients is growing, and this review considers published findings from 2013 to 2014. Primary attention is given to discussing recent advancements in body image assessment, qualitative studies, descriptive research, and psychosocial intervention studies relevant to body image. Limitations and necessar...
Source: Current Oncology Reports - November 22, 2014 Category: Cancer & Oncology Source Type: research

Defining Value-Driven Care in Head and Neck Oncology
Abstract In the USA, increasing attention is being paid to adopting a value-based framework for measuring and ultimately improving health care delivery. Value is defined as the benefit achieved relative to costs. The numerator of the value equation includes quality of care and outcomes achieved. The denominator includes costs, both financial costs and harms of treatment. Herein, we describe these elements of value as they pertain to head and neck cancer. A particular focus is to identify areas of the value equation where physicians have some control. We examine quality in each of three dimensions: structure, proc...
Source: Current Oncology Reports - November 22, 2014 Category: Cancer & Oncology Source Type: research

Endoscopic Approaches for Early-Stage Esophageal Cancer: Current Options
Abstract Early esophageal cancer is confined to the mucosa or submucosa of the esophagus. While most esophageal cancer is detected at an advanced stage (requiring surgical resection, chemotherapy, and radiation), early-stage mucosal lesions may be detected through Barrett’s surveillance programs or incidentally on diagnostic upper endoscopies performed for other reasons. These early-stage cancers are often amenable to endoscopic therapies, including mucosal resection, ablation, and cryotherapy. Studies suggest equivalent survival rates and reduced morbidity but higher recurrence rates with endoscopic remova...
Source: Current Oncology Reports - November 22, 2014 Category: Cancer & Oncology Source Type: research