Management of treatment-related toxicities in advanced medullary thyroid cancer
Purpose of review Tyrosine kinase inhibitors (TKI), predominantly vandetanib and cabozantinib, are increasingly used for management of advanced medullary thyroid cancer. This review aims to discuss the major and serious adverse events associated with TKI. Recent findings The choice of TKI depends on the patient's existing comorbidities. Patients who have long QT interval should avoid vandetanib and those at risk of gastrointestinal perforation should avoid cabozantinib. Hypertension is common during the first 3 months. Treatments include ACE inhibitors, calcium channel blockers (avoiding verapamil and diltiazem, which...
Source: Current Opinion in Oncology - May 1, 2019 Category: Cancer & Oncology Tags: ENDOCRINE TUMORS: Edited by Christiane Jungels Source Type: research

Adrenal tumors: when to search for a germline abnormality?
Purpose of review Over the last 20 years, the genetic landscape of adrenal tumours has been transformed by the identification of multiple susceptibility genes for the various tumour types. We review these recent developments here, and describe current recommendations for genetic testing in patients with tumours of the adrenal medulla and extra-adrenal paraganglia or the adrenal cortex. Recent findings Phaeochromocytomas (adrenal medulla tumours) and paragangliomas, aldosterone-producing adenomas, primary macronodular adrenal hyperplasia, primary pigmented nodular adrenocortical disease and adrenocortical carcinoma (ad...
Source: Current Opinion in Oncology - May 1, 2019 Category: Cancer & Oncology Tags: ENDOCRINE TUMORS: Edited by Christiane Jungels Source Type: research

The evolving role of diet in prostate cancer risk and progression
Purpose of review This overview examines the rationale for dietary interventions for prostate cancer by summarizing the current evidence base and biological mechanisms for the involvement of diet in disease incidence and progression. Recent findings Recent data have further solidified the association between insulin resistance and prostate cancer with the homeostatic model assessment of insulin resistance. Data also show that periprostatic adipocytes promote extracapsular extension of prostate cancer through chemokines, thereby providing a mechanistic explanation for the association observed between obesity and high-g...
Source: Current Opinion in Oncology - May 1, 2019 Category: Cancer & Oncology Tags: GENITOURINARY SYSTEM: Edited by Arif Hussain Source Type: research

PET imaging in renal cancer
Purpose of review Worldwide, over 400 000 new cases of kidney cancer were diagnosed and over 175 000 deaths anticipated in 2018. It is ranked as the 14th most common cancer in women and 9th most common in men. Imaging is important for initial detection, staging, and monitoring to assist treatment planning, but conventional anatomic imaging is limited. Although functional PET/CT has proven helpful in the diagnosis and management of many cancers, its value in renal cell carcinoma (RCC) is still in evolution. Recent findings FDG is probably the most useful radiotracer in RCC, although CAIX imaging can be helpful in c...
Source: Current Opinion in Oncology - May 1, 2019 Category: Cancer & Oncology Tags: GENITOURINARY SYSTEM: Edited by Arif Hussain Source Type: research

Targeting advanced urothelial carcinoma-developing strategies
Conclusion The development of novel therapies targeting the immune and molecular pathways of advanced urothelial carcinoma is promising for the improvement of outcomes in this lethal disease. Ongoing efforts are poised to optimize therapeutic options in the post-chemotherapy arena. In the era of precision medicine, the future of urothelial carcinoma lies in using less cytotoxic chemotherapy, more targeted therapy and immunotherapy, and possibly a combination of these therapeutic approaches. (Source: Current Opinion in Oncology)
Source: Current Opinion in Oncology - May 1, 2019 Category: Cancer & Oncology Tags: GENITOURINARY SYSTEM: Edited by Arif Hussain Source Type: research

Contemporary treatments in prostate cancer focal therapy
Purpose of review Radical treatments for prostate cancer are associated with significant morbidity, including incontinence and erectile dysfunction. Advances in the field of prostate MRI and desire to reduce treatment morbidities have led to a rapid growth in focal treatments for prostate cancer. Here, we review novel focal prostate cancer treatments and their associated recent clinical data, with a particular focus on data reported within the last 24 months. Recent findings High-intensity focal ultrasound, focal laser ablation, irreversible electroporation, focal cryotherapy, and photodynamic therapy have been used a...
Source: Current Opinion in Oncology - May 1, 2019 Category: Cancer & Oncology Tags: GENITOURINARY SYSTEM: Edited by Arif Hussain Source Type: research

The tumor microenvironment in renal cell cancer
Purpose of review In addition to the provision of nutrients and growth factors that facilitate tumor cell proliferation and metastasis, the tumor microenvironment (MEV) restricts immune surveillance of tumor-associated antigens and limits the efficacy of immune checkpoint inhibitors, tumor vaccines, and other immune therapies. This review will focus on the immunosuppressive mechanisms operative within the tumor MVE of renal cell carcinoma. Recent findings Several of the immunosuppressive mechanisms within the tumor MEV have been identified and are potentially druggable. Clinical trials with agents that target several ...
Source: Current Opinion in Oncology - May 1, 2019 Category: Cancer & Oncology Tags: GENITOURINARY SYSTEM: Edited by Arif Hussain Source Type: research

Optimization of therapies for men with advanced prostate cancer: a review of recent developments with a look toward the future
Purpose of review Summarizes the rapid progress being made in treatment of advanced prostate cancer. Recent findings Debate remains regarding the optimal sequencing of therapies in metastatic castration-sensitive prostate cancer with attention focused on the use of abiraterone versus docetaxel. Randomized trials now show a potential advantage to next-generation antiandrogens in the setting of nonmetastatic castration-resistant prostate cancer. Patient-specific genomic anomalies, in particular DNA repair defects, provide targets for therapy with poly(ADP-ribose) polymerase inhibitors alone and in combination with other...
Source: Current Opinion in Oncology - May 1, 2019 Category: Cancer & Oncology Tags: GENITOURINARY SYSTEM: Edited by Arif Hussain Source Type: research

Immunotherapy in nonmuscle invasive bladder cancer: current and emerging treatments
Purpose of review There is a significant unmet need for efficacious second-line treatment options for patients who have failed bacillus Calmette-Guerin (BCG) therapy for nonmuscle invasive urothelial carcinoma (NMIBC). Recent advances in our understanding of systemic immunotherapy have transformed the management of advanced urothelial carcinoma and have led to the development of multiple novel agents. Using this insight, these agents are now being investigated for use in NMIBC. Recent findings Although BCG has been used to treat high-risk NMIBC for decades, new applications of immunotherapy include the use of exogenou...
Source: Current Opinion in Oncology - May 1, 2019 Category: Cancer & Oncology Tags: GENITOURINARY SYSTEM: Edited by Arif Hussain Source Type: research

Targeting the androgen receptor and overcoming resistance in prostate cancer
Purpose of review Prostate cancer (PCa) is diagnosed in one out of every nine men and is the second leading cause of cancer death among men. Although therapies targeting the androgen receptor (AR) are highly effective, development of resistance is universal and remains a major therapeutic challenge. Nonetheless, signaling via AR is frequently maintained despite standard androgen-signaling inhibition. We review the current understanding of mechanisms of resistance as well as therapeutic approaches to improving treatment of PCa via targeting of the AR. Recent findings Resistance to AR-targeting therapies may be mediated...
Source: Current Opinion in Oncology - May 1, 2019 Category: Cancer & Oncology Tags: GENITOURINARY SYSTEM: Edited by Arif Hussain Source Type: research

New approaches in salivary gland carcinoma
We report here the few available data in SGCs. Summary A strategy based on molecular screening and targeted therapy seems to be the best approach for treating patients with SGCs, in the future. More data on ICI's efficacy and biomarkers of response are required to define the place of immunotherapy in the management of SGCs. (Source: Current Opinion in Oncology)
Source: Current Opinion in Oncology - May 1, 2019 Category: Cancer & Oncology Tags: HEAD AND NECK: Edited by Joël Guigay Source Type: research

The emergence of long-term survivors in recurrent and metastatic squamous cell head and neck cancer
Purpose of review The systemic therapies available in recurrent and metastatic head and neck squamous cell carcinoma to date are palliative-intent treatments in most cases. However, a small subgroup of patients derives unconventional benefit and become long-term survivors, achieving cure in some cases. This review focusses on this group of patients, discusses recent literature and suggests plausible molecular hypothesis. Recent findings Human papillomavirus-related disease is known to confer a better prognosis in metastatic patients, probably because of its greater sensitivity to systemic therapies. This group of pati...
Source: Current Opinion in Oncology - May 1, 2019 Category: Cancer & Oncology Tags: HEAD AND NECK: Edited by Joël Guigay Source Type: research

Treatment of inoperable elderly head and neck cancer patients
Purpose of review Elderly head and neck cancer (HNC) patients are very rarely enrolled in clinical trials, and even more so in dedicated trials in curative or palliative setting. As a result, no standards of treatment exist for this population and thus, adaptation of standard treatments is commonly used. Recent findings The choice between a monotherapy and a platinum–cetuximab combination is based on the performance status, which is not suitable and/or sufficient to evaluate the patient ability to receive a systemic treatment combined or not with radiotherapy. The evaluation of functional age using geriatric ass...
Source: Current Opinion in Oncology - May 1, 2019 Category: Cancer & Oncology Tags: HEAD AND NECK: Edited by Joël Guigay Source Type: research

Immunotherapy in recurrent and or metastatic squamous cell carcinoma of the head and neck
Purpose of review Checkpoint inhibitors (CPI) are revolutionizing the treatment of advanced cancers including recurrent and or metastatic squamous cell carcinoma of the head and neck (RM-SCCHN). Recent findings In this review, we will summarize the results of prospective trials evaluating CPI and particularly antiprogrammed death 1 (PD-1)/antiprogrammed death-ligand 1 (PD-L1) in RM-SCCHN. Summary Nivolumab and Pembrolizumab, two anti-PD-1 CPI, were associated with longer overall survival than standard chemotherapy in pretreated RM-SCCHN in two randomized phase 3 trials (respectively CHECKMATE-141 and KEYNOTE-040). ...
Source: Current Opinion in Oncology - May 1, 2019 Category: Cancer & Oncology Tags: HEAD AND NECK: Edited by Joël Guigay Source Type: research

Current role of primary surgical treatment in patients with head and neck squamous cell carcinoma
The objective of this review article is to discuss the current role of surgery as the primary treatment modality in patients with head and neck squamous cell carcinoma (HNSCC). Recent findings HNSCC represents one of the cancer locations where the primary treatment modality is the most under discussion. Indeed, the respective roles of primary surgical resection followed, as necessary, by adjuvant radiotherapy or definitive chemoradiotherapy remain controversial. The results of organ preservation trials and the drastic rise in the incidence of human papillomavirus-induced oropharyngeal tumors, which are known to be highl...
Source: Current Opinion in Oncology - May 1, 2019 Category: Cancer & Oncology Tags: HEAD AND NECK: Edited by Joël Guigay Source Type: research

Molecular genetics of head and neck squamous cell carcinoma
Purpose of review The aim of this review is to summarize the current knowledge on the genomic characterization of squamous cell carcinomas of the head and neck (HNSCC) and discusses how these abnormalities could be incorporated into a therapeutic approach. Recent findings Tobacco and HPV infection, the two main risk factors of HNSCC, allow the definition of two groups with distinct anatomoclinical and genetic features. As tobacco and HPV infection are not exclusive, exposure to both risk factors is associated with an intermediate prognostic. HPV-positive, nontobacco-related HNSCCs are associated with a better prognosi...
Source: Current Opinion in Oncology - May 1, 2019 Category: Cancer & Oncology Tags: HEAD AND NECK: Edited by Joël Guigay Source Type: research

Potential role of cyclin-dependent kinase 4/6 inhibitors in the treatment of squamous cell carcinoma of the head and neck
Purpose of review Human papillomavirus (HPV)-negative squamous cell carcinoma of the head and neck (SCCHN) is mainly driven by genetic aberrations involved in the cell cycle pathway resulting in cyclin-dependent kinase (CDK) 4 and 6 activation. This supports the investigation of the activity of CDK4/6 inhibitors in this disease. We review the therapeutic potential of CDK4/6 inhibitors in SCCHN. Recent findings CDK4/6 inhibitors in monotherapy have demonstrated cytostatic activity in HPV-negative SCCHN. Combination with epidermal growth factor inhibitors, with phosphatidylinositol-3-kinase/protein kinase B/mammalian ta...
Source: Current Opinion in Oncology - May 1, 2019 Category: Cancer & Oncology Tags: HEAD AND NECK: Edited by Joël Guigay Source Type: research

Things are changing for head and neck squamous cell carcinomas
No abstract available (Source: Current Opinion in Oncology)
Source: Current Opinion in Oncology - May 1, 2019 Category: Cancer & Oncology Tags: HEAD AND NECK: Edited by Joël Guigay Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Oncology)
Source: Current Opinion in Oncology - May 1, 2019 Category: Cancer & Oncology Tags: EDITORIAL INTRODUCTIONS Source Type: research

p53, stem cell biology and childhood blastomas
Purpose of review Childhood blastomas, unlike adult cancers, originate from developing organs in which molecular and cellular features exhibit differentiation arrest and embryonic characteristics. Conventional cancer therapies, which rely on the generalized cytotoxic effect on rapidly dividing cells, may damage delicate organs in young children, leading to multiple late effects. Deep understanding of the biology of embryonal cancers is crucial in reshaping the cancer treatment paradigm for children. Recent findings p53 plays a major physiological role in embryonic development, by controlling cell proliferation, differ...
Source: Current Opinion in Oncology - March 1, 2019 Category: Cancer & Oncology Tags: CANCER BIOLOGY: Edited by Pierre Hainaut Source Type: research

Chordoma: update on disease, epidemiology, biology and medical therapies
Purpose of review Chordoma is an exceedingly rare subtype of bone sarcoma. This review aims to provide a comprehensive insight into chordoma epidemiology, and an update on the recent advances in disease, biology and medical therapies. Recent findings The incidence of chordoma is approximately 0.08/100 000 and the 5-year overall age-adjusted relative survival is 72% in the United States and 61% in Europe. Over the last years, significant steps forwards have been done in the comprehension of chordoma complexity, with insights gained into the biology and morphology of this disease. New entities have been described and ...
Source: Current Opinion in Oncology - February 8, 2019 Category: Cancer & Oncology Tags: SPECIAL COMMENTARY Source Type: research

Mosaicism, aging and cancer
Purpose of review Genetic mosaicism is the presence of a somatic mutation in a subset of cells that differs from the inherited germline genome. Detectable genetic mosaicism is attractive as a potential early biomarker for cancer risk because of its established relationship with aging, introduction of potentially deleterious mutations, and clonal selection and expansion of mutated cells. The aim of this review is to survey shared risk factors associated with genetic mosaicism, aging and cancer risk. Recent findings Studies have associated aging, cigarette smoking and several genetic susceptibility loci with increased r...
Source: Current Opinion in Oncology - February 8, 2019 Category: Cancer & Oncology Tags: CANCER BIOLOGY: Edited by Pierre Hainaut Source Type: research

Post-transcriptional regulations of cancer stem cell homeostasis
Purpose of review Although extensively studied for over a decade, gene expression programs established at the epigenetic and/or transcriptional levels do not fully characterize cancer stem cells (CSC). This review will highlight the latest advances regarding the functional relevance of different key post-transcriptional regulations and how they are coordinated to control CSC homeostasis. Recent findings In the past 2 years, several groups have identified master post-transcriptional regulators of CSC genetic programs, including RNA modifications, RNA-binding proteins, microRNAs and long noncoding RNAs. Of particular in...
Source: Current Opinion in Oncology - February 8, 2019 Category: Cancer & Oncology Tags: CANCER BIOLOGY: Edited by Pierre Hainaut Source Type: research

Targeting the interplay between metabolism and epigenetics in cancer
Purpose of review Metabolic perturbation is a hallmark of cancer favoring tumor progression. It is now demonstrated that cell metabolism has an impact on gene expression through epigenetic modifications. In this review, we expose recent evidences of metabolic-driven epigenetic perturbations in cancer and subsequent therapeutic opportunities. Recent findings The intimate link between metabolism and epigenetics and its rewiring in carcinogenesis is a hot topic. Chromatin-modifying enzymes involved in the dynamics of methylation or acetylation require small metabolites as cofactors or substrates, thus orchestrating the i...
Source: Current Opinion in Oncology - February 8, 2019 Category: Cancer & Oncology Tags: CANCER BIOLOGY: Edited by Pierre Hainaut Source Type: research

p53, stem cell biology and childhood blastomas
Purpose of review Childhood blastomas, unlike adult cancers, originate from developing organs in which molecular and cellular features exhibit differentiation arrest and embryonic characteristics. Conventional cancer therapies, which rely on the generalized cytotoxic effect on rapidly dividing cells, may damage delicate organs in young children, leading to multiple late effects. Deep understanding of the biology of embryonal cancers is crucial in reshaping the cancer treatment paradigm for children. Recent findings p53 plays a major physiological role in embryonic development, by controlling cell proliferation, differ...
Source: Current Opinion in Oncology - February 8, 2019 Category: Cancer & Oncology Tags: CANCER BIOLOGY: Edited by Pierre Hainaut Source Type: research

New perspectives in Merkel cell carcinoma
Purpose of review Merkel cell carcinoma (MCC), a rapidly progressing skin cancer, has poor prognosis. We reviewed the epidemiology, pathogenesis, diagnosis and treatment of MCC, with a focus on recent therapeutic advancements. Recent findings Risk factors for MCC, such as old age, immunosuppression, polyomavirus infection and exposure to UV radiation have already been identified, but the underlying mechanisms leading to carcinogenesis still need clarification. On the basis of recent advances, immunotherapy – in particular, inhibition targeting the programmed cell death protein 1/programmed death-ligand 1 (PD1)/P...
Source: Current Opinion in Oncology - February 8, 2019 Category: Cancer & Oncology Tags: MELANOMA AND OTHER SKIN NEOPLASMS: Edited by Véronique del Marmol Source Type: research

Sunbeds and melanoma risk: time to close the debate
Purpose of review In spite of the established scientific evidence on the association of sunbed use with melanoma risk, some have recently expressed scepticism about the carcinogenicity of indoor tanning. This may have raised confusion among both physicians and patients. The purpose of this review is to make the point about the real impact of sunbed use on melanoma risk in light of the most recently published evidence. Recent findings Seven themes were covered: recent studies on age at first sunbed exposure and melanoma risk; sunbed use and melanoma at different body sites; sunbed use and development of additional prim...
Source: Current Opinion in Oncology - February 8, 2019 Category: Cancer & Oncology Tags: MELANOMA AND OTHER SKIN NEOPLASMS: Edited by Véronique del Marmol Source Type: research

Immune checkpoint blockade for organ transplant patients with advanced cancer: how far can we go?
Purpose of review Checkpoint inhibitors (CPIs) provide impressive response rates among immunocompetent patients with various solid tumors. So far, organ transplant recipients have been excluded from clinical studies due to the putative risk of allograft rejection however 48 cases of liver and renal transplant patients treated with CPI were already described in literature. Recent findings Here we discuss 19 cases of liver and 29 cases of renal transplant patients who received CPI for advanced cancer. Disease control rate [stable disease, complete response (CR) and partial response (PR) together] was 35% (21% for liver ...
Source: Current Opinion in Oncology - February 8, 2019 Category: Cancer & Oncology Tags: MELANOMA AND OTHER SKIN NEOPLASMS: Edited by Véronique del Marmol Source Type: research

Editorial: New Frontiers in Skin Cancer
No abstract available (Source: Current Opinion in Oncology)
Source: Current Opinion in Oncology - February 8, 2019 Category: Cancer & Oncology Tags: MELANOMA AND OTHER SKIN NEOPLASMS: Edited by Véronique del Marmol Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Oncology)
Source: Current Opinion in Oncology - February 8, 2019 Category: Cancer & Oncology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Revisiting tumor patterns and penetrance in germline TP53 mutation carriers: temporal phases of Li–Fraumeni syndrome Erratum
No abstract available (Source: Current Opinion in Oncology)
Source: Current Opinion in Oncology - November 30, 2018 Category: Cancer & Oncology Tags: ERRATUM Source Type: research

Impact of ovarian function suppression in premenopausal women with estrogen receptor-positive early breast cancer
Purpose of review This manuscript aims at providing an updated overview on the role of adding ovarian function suppression to tamoxifen or an aromatase inhibitor as adjuvant endocrine therapy in premenopausal women with estrogen receptor-positive early breast cancer. Recent findings Until recently, tamoxifen alone was the only recommended adjuvant treatment option for premenopausal women with estrogen receptor-positive disease. However, recent important evidence has contributed to significantly modify the endocrine treatment landscape in this setting. Summary With the only exception of patients with low-risk clinic...
Source: Current Opinion in Oncology - November 30, 2018 Category: Cancer & Oncology Tags: BREAST CANCER: Edited by Giuseppe Curigliano Source Type: research

Escalation and de-escalation in HER2 positive early breast cancer
Purpose of review Current standard for HER2+ early breast cancer patients includes chemotherapy and trastuzumab for 1 year. The purpose of this article is to review available evidence on escalated treatment strategies for high-risk patients and de-escalated treatments for patients at low risk of relapse or high risk of cardiac toxicity. Recent findings Recent results have led to the approval of two adjuvant escalated treatment strategies: pertuzumab and trastuzumab combined with chemotherapy for up to 1 year for high-risk patients; extension of adjuvant anti-HER2 treatment with 1 year of neratinib. However, these trea...
Source: Current Opinion in Oncology - November 30, 2018 Category: Cancer & Oncology Tags: BREAST CANCER: Edited by Giuseppe Curigliano Source Type: research

Risk stratification in early breast cancer in premenopausal and postmenopausal women: integrating genomic assays with clinicopathological features
Purpose of review There is growing consensus that genomic assays provide useful complementary information to clinicopathological features in oestrogen receptor-positive breast cancers. Here, ongoing research with multigene tests used for postmenopausal breast cancer and new emerging prognostic and predictive markers for pre and postmenopausal women are summarised. Recent findings Results of the TAILORx trial have shown that women with an intermediate risk score do not benefit from adjuvant chemotherapy. Prosgina has been further investigated in a contemporary patient population in postmenopausal women and its use has ...
Source: Current Opinion in Oncology - November 30, 2018 Category: Cancer & Oncology Tags: BREAST CANCER: Edited by Giuseppe Curigliano Source Type: research

Biomarkers for immune checkpoint inhibitors in advanced nonsmall cell lung cancer
Purpose of review Immune checkpoint inhibitors have been established as a new class of anticancer drugs for patients with advanced nonsmall cell lung cancer. Predictive biomarkers might help to select those patients who will derive the greatest benefit from these expensive drugs. This review summarizes the current status of predictive biomarkers for immune checkpoint inhibitors in advanced nonsmall cell lung cancer. Recent finding Programmed death ligand 1 (PD-L1) staining on tumor cells and immune cells has been studied as a predictive biomarker for immune checkpoint inhibitors. Higher PD-L1 levels appeared to be ass...
Source: Current Opinion in Oncology - November 30, 2018 Category: Cancer & Oncology Tags: LUNG AND MEDIASTINUM: Edited by Robert Pirker Source Type: research

Role of immunotherapy in stage III nonsmall cell lung cancer
Purpose of review Despite aggressive treatment based on definitive chemoradiotherapy, 5-year overall survival in unresectable stage III nonsmall cell lung cancer remains poor (15–20%). The novel immunotherapy based on immune checkpoint inhibitors (ICIs) presents as the therapeutic ‘Holly Grail’ in lung cancer treatment. Recent findings Preclinical models provide evidence of immunotherapy–radiotherapy (IM-RT) synergy. The exposure to ionizing radiation turns tumor in an in-situ vaccine, primes the innate immune system, increases immunotherapy efficacy by overcoming the immunosuppressive microenv...
Source: Current Opinion in Oncology - November 30, 2018 Category: Cancer & Oncology Tags: LUNG AND MEDIASTINUM: Edited by Robert Pirker Source Type: research

Immunotherapy in patients with early stage resectable nonsmall cell lung cancer
Purpose of review ‘Early-stage’ nonsmall cell lung cancer (NSCLC) refers to stage I and stage II disease, and selected cases of stage IIIA disease where complete tumor resection is feasible. Surgery is the standard treatment for early NSCLC, but the overall 5-year survival remains below 50%. The addition of adjuvant cisplatin-based chemotherapy to surgery improved 5-year survival rates by 5–10%, but no significant therapeutic innovation has been established thereafter. We review recent and ongoing studies looking how immunotherapy may improve the outcome of these patients. Recent findings Antigen-spe...
Source: Current Opinion in Oncology - November 30, 2018 Category: Cancer & Oncology Tags: LUNG AND MEDIASTINUM: Edited by Robert Pirker Source Type: research

Treatment of anaplastic lymphoma kinase-positive non-small cell lung cancer: update and perspectives
We describe recent developments in the rapidly evolving field of anaplastic lymphoma kinase-targeting agents. Recent findings Five targeted drugs are currently available in the clinic via regular approval or named patient programs, including crizotinib, ceritinib, alectinib, brigatinib and lorlatinib. Further drugs are tested in clinical trials. This review summarizes published data, together with drug-specific information on dosing and toxicity. Moreover, we discuss different clinical scenarios and potential treatment options in patients with tumor progression, based on current literature and our own experience. Summa...
Source: Current Opinion in Oncology - November 30, 2018 Category: Cancer & Oncology Tags: LUNG AND MEDIASTINUM: Edited by Robert Pirker Source Type: research

Epidermal growth factor receptor tyrosine kinase inhibitors in advanced nonsmall cell lung cancer: what is the preferred first-line therapy?
Purpose of review Epidermal growth factor receptor (EGFR) mt+ nonsmall cell lung cancer (NSCLC) were the first molecularly described NSCLC with an established ‘targeted’ therapy inhibiting mutated EGFR [EGFR tyrosine kinase inhibitor (TKI)]. EGFR TKI of first and second generation have led to an unprecedented improvement in objective response rate, progression-free survival (PFS) and overall survival (OS) compared with chemotherapy with a significantly reduced toxicity and improved quality of life. Fast elucidation of the most frequent resistance mechanism against first and second-generation TKI, T790M, led t...
Source: Current Opinion in Oncology - November 30, 2018 Category: Cancer & Oncology Tags: LUNG AND MEDIASTINUM: Edited by Robert Pirker Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Oncology)
Source: Current Opinion in Oncology - November 30, 2018 Category: Cancer & Oncology Tags: EDITORIAL INTRODUCTIONS Source Type: research

T lymphocytes as therapeutic arsenal for patients with hematological malignancies
We present an overview of the clinically available immunotherapeutic platforms centered on T cell lymphocytes for the treatment of hematological malignancies with a special focus on the advances achieved since 2017. Recent findings The most promising strategies of T cell therapies are based on the infusion of unmanipulated donor lymphocytes, antigen-specific T cells, ex-vivo genetically modified T cells or in-vivo manipulation of T cells using antibodies (bispecific and checkpoint inhibitors). To select the most appropriate option for a specific patient, is important to understand not only each platform-specific biologi...
Source: Current Opinion in Oncology - October 12, 2018 Category: Cancer & Oncology Tags: HEMATOLOGIC MALIGNANCIES: Edited by Miguel A. Sanz Source Type: research

Allogeneic stem cell transplantation from unrelated donors in acute leukaemia
Purpose of review To summarize the past and current knowledge of the use of unrelated donors (URDs) in allogeneic stem cell transplantation for patients with acute leukaemia. Recent findings The outcome of URD stem cell transplants in terms of treatment-related mortality, relapse rates, disease free survival and overall survival is comparable to sibling donors. Summary Haematopoietic stem cell transplantation (HSCT) is the therapy of choice in many haematological malignant diseases but only one-third of the patients will have an HLA-matched sibling. The possibility of finding a matched URD is more than 70% because ...
Source: Current Opinion in Oncology - October 12, 2018 Category: Cancer & Oncology Tags: HEMATOLOGIC MALIGNANCIES: Edited by Miguel A. Sanz Source Type: research

Current management of patients with chronic myelomonocytic leukemia
Purpose of review The present review focuses on the current management of patients with chronic myelomonocytic leukemia (CMML) and the most recent developments in the field. Recent findings CMML is a heterogeneous malignant myeloid disorder sharing features of myelodysplastic syndromes (MDS) and myeloproliferative neoplasms and characterized by peripheral blood monocytosis and increased risk of progression to acute leukemia. Its natural course is highly variable and use of CMML-specific prognostic scoring systems is strongly recommended for tailoring treatment. Multiple recent studies have showed that somatic mutation...
Source: Current Opinion in Oncology - October 12, 2018 Category: Cancer & Oncology Tags: HEMATOLOGIC MALIGNANCIES: Edited by Miguel A. Sanz Source Type: research

Myelodysplastic syndromes in children
Purpose of review Myelodysplastic syndromes (MDSs) are rare disorders in children, showing peculiar clinical manifestations and biological features. This review will summarize biological, genetic and clinical features of childhood MDS and will provide an update of the algorithm of treatment of the different disease variants. Recent findings The most recent classification of MDS includes refractory cytopenia of childhood (RCC), advanced and therapy-related MDS. Importantly, in children, these clonal hematopoietic disorders may be often associated with inherited bone marrow failure syndromes, this representing a challen...
Source: Current Opinion in Oncology - October 12, 2018 Category: Cancer & Oncology Tags: HEMATOLOGIC MALIGNANCIES: Edited by Miguel A. Sanz Source Type: research

Allogeneic hematopoietic stem-cell transplantation from haploidentical donors using ‘ex-vivo’ T-cell depletion in pediatric patients with hematological malignancies: state of the art review
Purpose of review Nowadays, T-cell-depleted haploidentical transplantation is considered a valid approach for children lacking a human leukocyte antigen (HLA) identical donor for allogeneic transplantation. This kind of allogeneic transplant is now widely used especially for pediatric patients with high-risk hematological malignancies. However, relapsing disease and life-threatening viral infections are still relevant clinical problems as a consequence of delayed immune reconstitution. Adoptive cell therapies have been proposed to overcome this problem. Recent findings After initial clinical approach using CD34+ selec...
Source: Current Opinion in Oncology - October 12, 2018 Category: Cancer & Oncology Tags: HEMATOLOGIC MALIGNANCIES: Edited by Miguel A. Sanz Source Type: research

The role of surgical resection in patients with brain metastases
Purpose of review Treatment of brain metastases represent a critical issue and different options have to be considered according to patients and tumour characteristics; in recent years, new therapeutic strategies have been proposed. In this review, we discuss the role of surgical resection on the basis of patient selection, new surgical techniques and the use of intraoperative adjuncts. The integration with postoperative whole brain radiotherapy will be also outlined because alternative treatment options are currently available. Recent findings Surgical removal has been considered the mainstay in the treatment of brai...
Source: Current Opinion in Oncology - October 12, 2018 Category: Cancer & Oncology Tags: BRAIN AND NERVOUS SYSTEM: Edited by Marc Sanson Source Type: research

Diffuse low-grade glioma, oncological outcome and quality of life: a surgical perspective
Purpose of review Because diffuse low-grade glioma (DLGG) is constantly migrating in the brain until malignant transformation, the historic wait-and-watch attitude was replaced by an early therapeutic management. Moreover, advances in cognitive neurosciences allowed an improved understanding of neuroplasticity reactional to DLGG growth. Here, the aim is to reevaluate the role of surgery regarding both oncological and functional outcomes. Recent findings Recent data evidenced the significant benefit of maximal well tolerated resection on survival and quality of life (QoL). By removing a diffuse neoplastic disease up to...
Source: Current Opinion in Oncology - October 12, 2018 Category: Cancer & Oncology Tags: BRAIN AND NERVOUS SYSTEM: Edited by Marc Sanson Source Type: research

Molecular classification of adult gliomas: recent advances and future perspectives
Purpose of review This review summarizes recent advances in the molecular classification of adult gliomas. Recent findings According to the 2016 WHO classification, five main molecular subgroups of adult diffuse gliomas can be distinguished based on the 1p/19q codeletion, isocitrate dehydrogenase (IDH), and histone H3.3 mutation status. In the future, this classification may be further refined based on the integration of additional biomarkers, in particular CDKN2A/B homozygous deletion in IDH-mutant astrocytomas, TERT promoter mutations, EGFR amplification, chromosome 7 gain and chromosome 10 loss in IDH-wildtype astr...
Source: Current Opinion in Oncology - October 12, 2018 Category: Cancer & Oncology Tags: BRAIN AND NERVOUS SYSTEM: Edited by Marc Sanson Source Type: research

Perspectives of immunotherapy in isocitrate dehydrogenase-mutant gliomas
Purpose of review The present review introduces recent progress in eliciting the role of mutant isocitrate dehydrogenase (IDH) in gliomas, especially regarding its mode of action as a modulator of antitumor immune response, and provides rationales for targeting mutant IDH in glioma immunotherapy. Both the development of small molecule inhibitors repressing the enzymatic activity of mutant IDH and novel, mechanism-led combination immunotherapies are discussed. Recent findings Since the discovery of highly frequent IDH mutations in low-grade gliomas and nonsolid malignancies, its tumor cell-intrinsic effects have been i...
Source: Current Opinion in Oncology - October 12, 2018 Category: Cancer & Oncology Tags: BRAIN AND NERVOUS SYSTEM: Edited by Marc Sanson Source Type: research

Neurological paraneoplastic syndromes: an update
Purpose of review To describe recent advances in the diagnosis and treatment of paraneoplastic neurological syndromes (PNS). Recent findings PNS are rare complications of cancer caused by an immune cross-reaction between antigens expressed by tumor cells and neurons. The target of the immune attack can be an intracellular antigen or a cell-surface antigen. Although both types of autoimmunity are ‘paraneoplastic’, as indirectly triggered by the presence of a tumor, they profoundly differ in terms of clinical profile, pathogenesis and outcome. PNS associated with antibodies to intracellular antigens (icPNS) ...
Source: Current Opinion in Oncology - October 12, 2018 Category: Cancer & Oncology Tags: BRAIN AND NERVOUS SYSTEM: Edited by Marc Sanson Source Type: research