Molecular Determinants and Other Factors to Guide Selection of Patients for Hepatic Resection of Metastatic Colorectal Cancer
Opinion statementTreatment for metastatic colorectal cancer (CRC) has changed significantly over the last few decades as cytotoxic and targeted chemotherapies have evolved and resection of (technically feasible) colorectal liver metastases (CRLM) has become standard of care for eligible patients. Overall, survival for metastatic CRC has considerably improved, but recurrences are common. Numerous clinical risk scores have been suggested to guide patient selection for CRLM resection, but none perfectly predict outcomes; therefore, a personalized approach to metastatic CRC treatment using genetic profiles for risk stratificat...
Source: Current Treatment Options in Oncology - July 5, 2021 Category: Cancer & Oncology Source Type: research

Role of Radiation Therapy for Newly Diagnosed Retroperitoneal Sarcoma
Opinion statementSoft tissue sarcomas (STS) are rare, aggressive, and heterogenous tumors, comprising approximately 1% of adult cancers with over 50 different subtypes. The mainstay of treatment for retroperitoneal sarcomas (RPS) includes surgical resection. The addition of radiation therapy (RT), either preoperatively or postoperatively, has been used to potentially decrease the risk of local recurrence. The recently published results from STRASS (EORTC-STBSG 62092-22092), which randomized patients to receive or not receive preoperative radiation, indicate no abdominal recurrence-free survival benefit (primary endpoint) n...
Source: Current Treatment Options in Oncology - July 2, 2021 Category: Cancer & Oncology Source Type: research

Evaluation and Management of Sleep and Circadian Rhythm Disturbance in Cancer
Opinion statementSleep and circadian rhythm disturbance are among the most commonly experienced symptoms in patients with cancer. These disturbances occur throughout the spectrum of cancer care from diagnosis, treatment, and long into survivorship. The pathogenesis of these symptoms and disturbances is based on common inflammatory pathways related to cancer and its ’ treatments. The evaluation of sleep and circadian disorders requires an understanding of how these symptoms cluster with other cancer-related symptoms and potentiate each other. A thorough evaluation of these symptoms and disorders utilizing validated di...
Source: Current Treatment Options in Oncology - July 2, 2021 Category: Cancer & Oncology Source Type: research

Optimal Management for Residual Disease Following Neoadjuvant Systemic Therapy
Opinion StatementTreatment sequencing in early-stage breast cancer has significantly evolved in recent years, particularly in the triple negative (TNBC) and human epidermal growth factor receptor 2 (HER2)-positive subsets. Instead of surgery first followed by chemotherapy, several clinical trials showed benefits to administering systemic chemotherapy (and HER2-targeted therapies) prior to surgery. These benefits include more accurate prognostic estimates based on the extent of residual cancer that can also guide adjuvant treatment, and frequent tumor downstaging that can lead to smaller surgeries in patients with large tum...
Source: Current Treatment Options in Oncology - July 2, 2021 Category: Cancer & Oncology Source Type: research

Precision Therapy for Brain Tumors in Hereditary Syndromes
Opinion statementNervous system tumors arising in the setting of monogenic, hereditary cancer predisposition syndromes are unique in that the initiating genetic event in tumor formation is known. This knowledge provides a powerful treatment approach if the alteration or pathway can be targeted with a therapeutic agent. A reasonable argument can be made for the use of targeted agents in these tumor patients, even though many of them have FDA approval only for other tumor types. It is our practice to use and employ targeted therapy when standard treatments have failed or represent an unattractive option. Over time, however, ...
Source: Current Treatment Options in Oncology - July 2, 2021 Category: Cancer & Oncology Source Type: research

Multidisciplinary Management of Brain Metastases from Non-Small Cell Lung Cancer in the Era of Immunotherapy
Opinion statementBrain metastases from non-small cell lung cancer often cause neurologic symptoms which lead to initial diagnosis or identification of recurrence. In other patients, they are identified on surveillance imaging or when a patient undergoing treatment develops neurological symptoms. Patients with symptomatic lesions should be started on dexamethasone and evaluated by a neurosurgeon as soon as possible. If feasible, surgery should be offered to decrease intracranial pressure, alleviate symptoms, and prevent irreversible neurological damage. Postoperative stereotactic radiosurgery (SRS) to the resection cavity a...
Source: Current Treatment Options in Oncology - July 2, 2021 Category: Cancer & Oncology Source Type: research

Acute Myeloid Leukemia Mutations and Future Mechanistic Target to Overcome Resistance
Opinion statementCytogenetics and mutation identification in acute myeloid leukemia have allowed for more targeted therapy. Many therapies have been approved by the FDA in the last 3 years including gilteritinib and azacitidine but the overall survival has remained stagnant at 25%. The inability to achieve complete remission was related to the residual leukemic stem cells (LSCs). Thus, the relationship between bone marrow niche and LSCs must be further explored to prevent treatment relapse/resistance. The development of immunotherapy and nanotechnology may play a role in future therapy to achieve the complete remission. Na...
Source: Current Treatment Options in Oncology - July 2, 2021 Category: Cancer & Oncology Source Type: research

How to Sequence Therapies in Peripheral T Cell Lymphoma
Opinion statementPeripheral T cell lymphoma (PTCL) represents a heterogeneous group of rare lymphoproliferative disorders. Historically, there has been a lack of pathobiological understanding of PTCL. With the exception of ALK-positive anaplastic large cell lymphoma, patients with PTCL have less favorable outcomes, with most patients relapsing shortly after conventional anthracycline-containing multi-agent chemotherapy. The standard management approach for PTCL involves induction therapy followed by autologous stem cell transplantation. Patients with relapsed/refractory PTCL have dismal outcomes and limited treatment optio...
Source: Current Treatment Options in Oncology - July 2, 2021 Category: Cancer & Oncology Source Type: research

Clinical Trial Considerations in Neuro-oncology
Opinion statementClinical trials play a critical role in discovering new treatments, but the path to regulatory approval can be cumbersome and time consuming. Efforts to increase the efficiency and interpretability of clinical trials within the neuro-oncology community have focused on standardization of response assessment, development of consensus guidelines for clinical trial conduct, decentralization of clinical trials, removal of barriers to clinical trial accrual, and re-examination of patient eligibility criteria. (Source: Current Treatment Options in Oncology)
Source: Current Treatment Options in Oncology - July 2, 2021 Category: Cancer & Oncology Source Type: research

Antiproliferative Systemic Therapies for Metastatic Small Bowel Neuroendocrine Tumours
Opinion statementNeuroendocrine neoplasms (NENs) are a heterogeneous group of malignancies with rising incidence and prevalence. Outcome and therapy of small bowel neuroendocrine tumours (SBNETs) is variable, depending on the grade, differentiation, tumour burden, as well as the site of the tumour origin. Because of this, multidisciplinary approach is essential. Large randomized clinical trials, with somatostatin analogues (PROMID, CLARINET) or with peptide receptor radionuclide therapy (PRRT) with 177-lutetium (NETTER-1 trial) as well as the mammalian target of rapamycin inhibitor (mTOR) everolimus (RADIANT trials), repre...
Source: Current Treatment Options in Oncology - June 29, 2021 Category: Cancer & Oncology Source Type: research

Therapeutic Advances in the Management of Patients with Advanced RET Fusion-Positive Non-Small Cell Lung Cancer
Opinion statementScreening for activating driver gene alterations at the time of diagnosis is the standard of care for advanced non-small cell lung cancer (NSCLC). ActivatingRET fusions are identified in approximately 1 –2% of NSCLCs and have emerged as a targetable driver alteration. Selpercatinib and pralsetinib are RET-selective tyrosine kinase inhibitors (TKIs) with encouraging efficacy, intracranial activity, and tolerability that we recommend as first-line therapy. As with use of TKIs in other oncogene-addi cted NSCLCs, development of acquired resistance is pervasive and should be specifically delineated throug...
Source: Current Treatment Options in Oncology - June 24, 2021 Category: Cancer & Oncology Source Type: research

Cardiotoxicity of Radiation Therapy: Mechanisms, Management, and Mitigation
Opinion StatementRadiation therapy is a key component of modern-day cancer therapy and can reduce the rates of recurrence and death from cancer. However, it can increase risk of cardiovascular (CV) events, and our understanding of the timeline associated with that risk is shorter than previously thought. Risk mitigation strategies, such as different positioning techniques, and breath hold acquisitions as well as baseline cardiovascular risk stratification that can be undertaken at the time of radiotherapy planning should be implemented, particularly for patients receiving chest radiation therapy. Primary and secondary prev...
Source: Current Treatment Options in Oncology - June 10, 2021 Category: Cancer & Oncology Source Type: research

The Promise of Nutrient-Derived Bioactive Compounds and Dietary Components to Ameliorate Symptoms of Chemotherapy-Related Cognitive Impairment in Breast Cancer Survivors
Opinion statementOne of the most burdensome symptoms reported by breast cancer patients is chemotherapy-related neurocognitive impairment. It is estimated that of the 11 million cancer survivors in the USA, 22% of them are breast cancer patients. The National Cancer Institute classified chemotherapy-related cognitive impairment (CRCI) as one of the most debilitating sequelae of cancer therapy, limiting this patient population from recommencing their lives prior to the diagnosis of breast cancer. Currently, there are no strategies that are established to prevent, mitigate, or treat CRCI. In addition to surviving cancer, qua...
Source: Current Treatment Options in Oncology - June 10, 2021 Category: Cancer & Oncology Source Type: research

BCL-2 Inhibition as Treatment for Chronic Lymphocytic Leukemia
This article will focus on the treatment approach of CLL patients with BCl2 antag onists. Treatment strategy (combined versus monotherapy; continuous versus limited duration therapy), toxicity profile, and future directions will be exposed in this review. (Source: Current Treatment Options in Oncology)
Source: Current Treatment Options in Oncology - June 10, 2021 Category: Cancer & Oncology Source Type: research

Cardiovascular Complications Associated with Contemporary Lung Cancer Treatments
Opinion statementLung cancer is the most common form of cancer in humans and the leading cause of cancer-related death worldwide. Traditionally, lung cancer has been diagnosed as either small cell lung cancer (SCLC) or non-small cell lung cancer (NSCLC). However, recent developments in molecular pathology have revolutionized the diagnosis and treatment of the disease, thus improving patient prognosis and increasing the number of survivors. In advanced NSCLC cases, molecularly targeted drugs for patients with positive driver gene mutation/rearrangement, and immune checkpoint inhibitors for those with a positive biomarker, h...
Source: Current Treatment Options in Oncology - June 10, 2021 Category: Cancer & Oncology Source Type: research

Allogeneic Stem Cell Transplantation in Patients with High-Risk Multiple Myeloma: Utopia or Continuous Challenge in Aiming for Cure?
Opinion statementNowadays, several novel agents have been introduced in the treatment of multiple myeloma, not only resulting in high response rates and prolonged survival but also offering good quality of life. However, the potential of cure, especially for patients with advanced or unfavorable disease features, remains elusive. Allogeneic hematopoietic stem cell transplantation, based mainly on the graft vs. myeloma effect, can offer prolonged disease control and probability of cure but unfortunately at the cost of considerable transplant-related toxicity rates. Therefore, the role of allogeneic hematopoietic stem cell t...
Source: Current Treatment Options in Oncology - June 10, 2021 Category: Cancer & Oncology Source Type: research

Systemic Treatment of Gastroenteropancreatic Neuroendocrine Carcinoma
Opinion statementTreatment recommendations for advanced gastroenteropancreatic neuroendocrine carcinomas (GEP-NEC) are based on uncontrolled, mainly retrospective data. Chemotherapy can offer palliative relief, but long-lasting complete responses or cures are rare. The European Neuroendocrine Tumour Society (ENETS) and European Society for Medical Oncology (ESMO) recommend platinum-based chemotherapy as first-line treatment. This has been the golden standard since the late 1980s and has been evaluated in mostly retrospective clinical studies. However, progression is inevitable for most patients. Unfortunately, data on effe...
Source: Current Treatment Options in Oncology - June 10, 2021 Category: Cancer & Oncology Source Type: research

Beyond Microsatellite Instability: Evolving Strategies Integrating Immunotherapy for Microsatellite Stable Colorectal Cancer
Opinion statementAdvanced colorectal cancer (CRC) is a heterogeneous disease, characterized by several subtypes with distinctive genetic and epigenetic patterns. During the last years, immune checkpoint inhibitors (ICIs) have revamped the standard of care of several tumors such as non-small cell lung cancer and melanoma, highlighting the role of immune cells in tumor microenvironment (TME) and their impact on cancer progression and treatment efficacy. An “immunoscore,” based on the percentage of two lymphocyte populations both at tumor core and invasive margin, has been shown to improve prediction of treatment ...
Source: Current Treatment Options in Oncology - June 10, 2021 Category: Cancer & Oncology Source Type: research

Current Management of Angiosarcoma: Recent Advances and Lessons From the Past
Opinion statementDespite their rarity, angiosarcomas are one of the most aggressive soft tissue sarcomas. Management can often be challenging due to their location and infiltrative nature. A multidisciplinary treatment approach is always warranted, but the recurrence remains high even for localized tumors despite multimodality treatment. In the metastatic setting, cytotoxic chemotherapies, targeted therapies, and, more recently, immunotherapy are used. The sequence of systemic therapies remains currently a topic of active investigation. Over the last couple of years, there have been significant advances in understanding an...
Source: Current Treatment Options in Oncology - June 7, 2021 Category: Cancer & Oncology Source Type: research

Indications for Allogeneic HCT in Adults with Acute Lymphoblastic Leukemia in First Complete Remission
Opinion statementAcute lymphoblastic leukemia (ALL) in adults is associated with poor outcomes as compared to children when treated with chemotherapy, leading to a considerably inferior cure rate. Historically, consolidation with allogeneic hematopoietic cell transplant (alloHCT) was routinely recommended for eligible adults with ALL in first complete remission (CR1) if a donor was available, since randomized studies showed superiority over continuing chemotherapy. With the increasing use of pediatric-inspired frontline regimens in young adults with ALL and the availability of novel salvage agents for relapsed/refractory B...
Source: Current Treatment Options in Oncology - June 7, 2021 Category: Cancer & Oncology Source Type: research

Novel Biological Insights and New Developments in Management of Burkitt Lymphoma and High-Grade B-Cell Lymphoma
Opinion StatementBurkitt lymphoma (BL) is highly curable, and prompt institution of therapy is critical to achieving optimal outcomes. Although current “standard” approaches are very effective in disease eradication, treatment-related toxicity makes optimal delivery of curative therapy a challenge, especially in older and immunocompromised individuals. Reduced intensity approaches with fewer toxic complications have been the focus of some recen t studies. A critical question is if they can replace “standard” approaches by maintaining high curability with improved tolerability. Additionally, new mole...
Source: Current Treatment Options in Oncology - June 7, 2021 Category: Cancer & Oncology Source Type: research

Current Status of CAR T Cell Therapy for Leukemias
Opinion statementChimeric antigen receptor (CAR) T-cell therapy has become the standard of care for children and young adults with relapsed and refractory B-cell acute lymphoblastic leukemia (B-ALL), and it is a highly promising therapy under investigation for adults with relapsed disease. Despite having potentially life-threatening toxicities, such as cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome, the benefits of CAR T-cell therapy far outweigh these risks, particularly as increased experience and improved supportive care measures are mitigating these toxicities. CAR T cells can resu...
Source: Current Treatment Options in Oncology - June 7, 2021 Category: Cancer & Oncology Source Type: research

Multidisciplinary Management of Adolescent and Young Adult Patients with Hodgkin Lymphoma
Opinion statementSuccessful management of adolescent and young adult patients with Hodgkin lymphoma (HL) requires a multidisciplinary approach to care with special attention paid to the unique medical, logistical, and psychosocial challenges faced by this group. The emotional and social changes and big life transitions that occur between the ages of 15 and 39 result in a broad scope of supportive care needs that differ from children or adults in similar circumstances. Currently, care of adolescent and young adult (AYA) patients with HL may be fractured across the pediatric-adult cancer care continuum resulting in this grou...
Source: Current Treatment Options in Oncology - June 7, 2021 Category: Cancer & Oncology Source Type: research

Current Management of Chronic Neutrophilic Leukemia
Opinion statementChronic neutrophilic leukemia (CNL) is a rare myeloproliferative neoplasm (MPN) characterized by oncogenic driver mutations in colony-stimulating factor 3 receptor (CSF3R). Due in large part to the rarity of the disease and dearth of clinical trials, there is currently no standard of care for CNL. Available therapies range from conventional oral chemotherapy to targeted JAK inhibitors to hematopoietic stem cell transplant (HSCT), the latter representing the only potentially curative modality. For this reason, coupled with CNL ’s typically aggressive clinical course, allogeneic HSCT remains the primar...
Source: Current Treatment Options in Oncology - June 7, 2021 Category: Cancer & Oncology Source Type: research

Investigative Landscape in Advanced Non-Melanoma Skin Cancers
Opinion StatementAdvanced non-melanoma skin cancers have been challenging to treat due to limited treatment options. Treatment paradigm has shifted with the approval of immunotherapeutic agents cemiplimab and pembrolizumab which have been a key development and have changed the landscape of advanced or metastatic squamous cell skin cancers. Hedgehog inhibitors, vismodegib and sonidegib, remain upfront options for advanced or metastatic basal cell carcinomas. Current clinical trials are continuing to evaluate the use of immune checkpoint inhibitors and hedgehog pathway inhibitors. There is further need for ongoing research a...
Source: Current Treatment Options in Oncology - June 7, 2021 Category: Cancer & Oncology Source Type: research

Cardio-oncology Training in the COVID-19 Era
Opinion StatementCardio-oncology is a field dedicated to the prevention, diagnosis, and management of cardiovascular disease in cancer patients before, during, and after cancer therapy. It is an emerging field with limited opportunities for structured education and training. In the year 2021, we cannot define the requirements of cardio-oncology training without acknowledging the impact of the global coronavirus disease 19 (COVID-19) pandemic. While this pandemic poses significant health risks to patients with cancer and cardiovascular disease as well as the providers who care for them, it also allows novel opportunities fo...
Source: Current Treatment Options in Oncology - June 7, 2021 Category: Cancer & Oncology Source Type: research

Selection of Oral Therapeutics in China for the Treatment of Colorectal Cancer
Opinion statementIntravenous administration of fluoropyrimidine-based chemotherapy has been the backbone of treatment in colorectal cancer (CRC) for decades. The availability of oral capecitabine has improved the tolerability and simplified combination schedules. In addition to capecitabine, several other oral drugs have proven efficacy, particularly in palliative treatment lines. Clinical guidelines describe several available third-line treatment options for metastatic CRC (mCRC), but few insights are provided to guide the selection and sequence. In this review, we describe the available evidence and most recent data conc...
Source: Current Treatment Options in Oncology - June 7, 2021 Category: Cancer & Oncology Source Type: research

Radiation Necrosis from Stereotactic Radiosurgery —How Do We Mitigate?
Opinion statementIntracranial stereotactic radiosurgery (SRS) is an effective and convenient treatment for many brain conditions. Data regarding safety come mostly from retrospective single institutional studies and a small number of prospective studies. Variations in target delineation, treatment delivery, imaging follow-up protocols and dose prescription limit the interpretation of this data. There has been much clinical focus on radiation necrosis (RN) in particular, as it is being increasingly recognized on follow-up imaging. Symptomatic RN may be treated with medical therapy (such as corticosteroids and bevacizumab) w...
Source: Current Treatment Options in Oncology - June 7, 2021 Category: Cancer & Oncology Source Type: research

Proton Therapy for HPV-Associated Oropharyngeal Cancers of the Head and Neck: a De-Intensification Strategy
Opinion statementThe rise in the incidence of human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPC), the relatively young age at which it is diagnosed, and its favorable prognosis necessitate the use of treatment techniques that reduce the likelihood of side effects during and after curative treatment. Intensity-modulated proton therapy (IMPT) is a form of radiotherapy that de-intensifies treatment through dose de-escalation to normal tissues without compromising dose to the primary tumor and involved, regional lymph nodes. Preclinical studies have demonstrated that HPV-positive squamous cell ca...
Source: Current Treatment Options in Oncology - June 4, 2021 Category: Cancer & Oncology Source Type: research

What the Cardiologist Needs to Know About Cancer Immunotherapies and Complications
Opinion statementImmunotherapies have transformed the current landscape for cancer treatment and demonstrated unparalleled improvements in survival rates. Now, a third of cancer patients are eligible for treatment with the most widely used class of immunotherapy, immune checkpoint inhibitors (ICIs). As more patients are treated with these novel agents, it is critical for both oncologists and subspecialists to establish a better understanding of the adverse events which can occur. The incidence of myocarditis associated with ICI therapy has been reported to be between 0.27 and 1.14%, 5 times that of myocarditis from other c...
Source: Current Treatment Options in Oncology - May 26, 2021 Category: Cancer & Oncology Source Type: research

Precision and Immunoprevention Strategies for Tobacco-Related Head and Neck Cancer Chemoprevention
Opinion statementTo date, there is no FDA-approved chemoprevention approach for tobacco-related HNSCC. Effective chemoprevention approaches validated in sufficiently powered randomized trials are needed to reduce the incidence and improve survival. In this review, we recap the challenges encountered in past chemoprevention trials and discuss emerging approaches, with major focus on green chemoprevention, precision prevention, and immunoprevention. As our current depth of knowledge expands in the arena of cancer immunotherapy, the field of immunoprevention is primed for new discoveries and successes in cancer prevention. (S...
Source: Current Treatment Options in Oncology - May 15, 2021 Category: Cancer & Oncology Source Type: research

Cardiovascular Issues in Hematopoietic Stem Cell Transplantation (HSCT)
Opinion StatementHematopoietic stem cell transplantation (HSCT) is considered, since 1957, a potentially curative therapeutic option for many hemopathies. Although it is an aggressive procedure, improvements in transplantation techniques and supportive strategies have markedly decreased treatment-related mortality, and the prevalence of HSCT survivors is expected to exceed half a million by 2030. At the same time, there is a growing awareness of the potentially negative effects of HSCT-related therapies on the cardiovascular (CV) system, and HSCT survivors constitute a population at high cardiovascular (CV) risk. Cardio-on...
Source: Current Treatment Options in Oncology - April 30, 2021 Category: Cancer & Oncology Source Type: research

New Treatment Strategies for the Inflammatory Breast Cancer
Opinion statementInflammatory breast cancer (IBC) remains the most aggressive type of breast cancer. During the past decade, enormous progress has been made to refine diagnostic criteria and establish multimodality treatment strategies as keys for the improvement of survival outcomes. Multiple genomic studies enabled a better understanding of underlying tumor biology, which is responsible for the complex and aggressive nature of IBC. Despite these important achievements, outcomes for this subgroup of patients remain unsatisfactory compared to locally advanced non-IBC counterparts. Global efforts are now focused on identify...
Source: Current Treatment Options in Oncology - April 24, 2021 Category: Cancer & Oncology Source Type: research

When to Stop TKIs in Patients with Chronic Myeloid Leukemia and How to Follow Them Subsequently
Opinion statementABL1 tyrosine kinase inhibitors (TKI) have dramatically improved the outcome for CML (chronic myeloid leukemia) patients. When TKI therapy is addressed appropriately, it can lead to an optimal molecular response in the majority of CML patients and a life expectancy that approaches that of the general population. However, lifelong TKI therapy may have consequences, including chronic, mostly low-grade, adverse events that can substantially impact patients ’ quality of life, adherence to therapy and, consequently, success of treatment. In the last few years, several groups have demonstrated that approxi...
Source: Current Treatment Options in Oncology - April 17, 2021 Category: Cancer & Oncology Source Type: research

Bone Morphogenic Protein Signaling and Melanoma
Opinion statementMalignant melanoma is a deadly form of skin cancer caused by neoplastic transformation of melanocytic cells. Despite recent progress in melanoma therapy, by inhibition of activated oncogenes or immunotherapy, survival rate for metastatic melanoma patients remains low. The remarkable phenotypic plasticity of melanoma cells allows for rapid development of invasive properties and metastatic tumors, the main cause of mortality in melanoma patients. Phenotypic and molecular analyses of developing tumors revealed that epithelial-mesenchymal transition (EMT), a cellular and molecular mechanism, controls transitio...
Source: Current Treatment Options in Oncology - April 17, 2021 Category: Cancer & Oncology Source Type: research

Cardiovascular Toxicities of Androgen Deprivation Therapy
Opinion statementProstate cancer is the second leading cause of cancer death in men, and cardiovascular disease is the number one cause of death in patients with prostate cancer. Androgen deprivation therapy, the cornerstone of prostate cancer treatment, has been associated with adverse cardiovascular events. Emerging data supports decreased cardiovascular risk of gonadotropin releasing hormone (GnRH) antagonists compared to agonists. Ongoing clinical trials are assessing the relative safety of different modalities of androgen deprivation therapy. Racial disparities in cardiovascular outcomes in prostate cancer patients ar...
Source: Current Treatment Options in Oncology - April 17, 2021 Category: Cancer & Oncology Source Type: research

Circulating Biomarkers for Cardiotoxicity Risk Prediction
Opinion statementImprovements in cancer survival have led to the emergence of cardiovascular disease as an important determinant of adverse outcome in survivors. Cancer therapeutics –related cardiac dysfunction is the most well-known form of cardiotoxicity. However, newer cancer therapies bring a broader range of cardiotoxicities. The optimal method to identify patients at risk of these complications is unclear, but circulating biomarkers comprise one possible approach. Tropo nins and natriuretic peptides have garnered the broadest evidence base for cardiotoxicity risk prediction, but other markers are being investig...
Source: Current Treatment Options in Oncology - April 17, 2021 Category: Cancer & Oncology Source Type: research

Cancer Treatment –Induced Bone Loss (CTIBL): State of the Art and Proper Management in Breast Cancer Patients on Endocrine Therapy
Opinion statementAbout 70 –80% of early breast cancer (BC) patients receive adjuvant endocrine therapy (ET) for at least 5 years. ET includes in the majority of cases the use of aromatase inhibitors, as upfront or switch strategy, that lead to impaired bone health. Given the high incidence and also the high prevalence of B C, cancer treatment–induced bone loss (CTIBL) represents the most common long-term adverse event experimented by patients with hormone receptor positive tumours. CTIBL is responsible for osteoporosis occurrence and, as a consequence, fragility fractures that may negatively affect quality of l...
Source: Current Treatment Options in Oncology - April 16, 2021 Category: Cancer & Oncology Source Type: research

Models of Integration of Specialized Palliative Care with Oncology
Opinion statementEvidence from randomized controlled trials and meta-analyses has shown that early integration of specialized palliative care improves symptoms and quality of life for patients with advanced cancer. There are various models of early integration, which may be classified based on setting of care and method of palliative care referral. Most successful randomized controlled trials of early palliative care have used a model of specialized teams providing in-person palliative care in free-standing or embedded outpatient clinics. During the COVID-19 pandemic, telehealth has become a prominent model for palliative ...
Source: Current Treatment Options in Oncology - April 8, 2021 Category: Cancer & Oncology Source Type: research

Drug Development in Neuroendocrine Tumors: What Is on the Horizon?
Opinion statementNeuroendocrine neoplasms (NENs) constitute a heterogenous group of malignancies. Translational research into NEN cell biology is the cornerstone for drug development strategies in this field. Somatostatin receptor type 2 (SSTR2) expression is the hallmark of well-differentiated neuroendocrine tumors (NETs). Somatostatin analogs and peptide receptor radionuclide therapy (PRRT) form the basis of anti-SSTR2 treatment onto new combination strategies, antibody-drug conjugates and bispecific antibodies. Classical pathways involved in NET development (PI3K-Akt-mTOR and antiangiogenics) are reviewed but new potent...
Source: Current Treatment Options in Oncology - March 30, 2021 Category: Cancer & Oncology Source Type: research

Novel Therapies in the Treatment of Hodgkin Lymphoma
Opinion statementPatients with Hodgkin lymphoma (HL) can achieve excellent response and survival rates following frontline combination chemo- and radiation therapy. However, about 10 –15% of patients will experience disease relapse which is associated with poor outcomes. Recent breakthroughs in understanding the mechanisms of oncogenicity and interactions within the tumor microenvironment have resulted in development of novel drugs for treatment of patients with HL. Utilizing this information, treatment of newly diagnosed and relapsed HL has become a rapidly evolving field with multiple clinical trials evaluating nov...
Source: Current Treatment Options in Oncology - March 23, 2021 Category: Cancer & Oncology Source Type: research

Long Non-coding RNAs in Cisplatin Resistance in Osteosarcoma
Opinion StatementOsteosarcoma (OS), the most common primary malignant bone tumor, is a vastly aggressive disease in children and adolescents. Although dramatic progress in therapeutic strategies have achieved over the past several decades, the outcome remains poor for most patients with metastatic or recurrent OS. Nowadays, conventional treatment for OS patients is surgery combined with multidrug chemotherapy including doxorubicin, methotrexate, and cisplatin (CDDP). In this sense, cisplatin (CDDP) is one of the most drugs used in the treatment of OS but drug resistance to CDDP appears as a serious problem in the use of th...
Source: Current Treatment Options in Oncology - March 20, 2021 Category: Cancer & Oncology Source Type: research

Surgical Management of Metastatic Gastrointestinal Stromal Tumors
Opinion statementTreatment with the tyrosine kinase inhibitor (TKI), imatinib is the standard first-line treatment for metastatic gastrointestinal stromal tumors (GISTs). Unfortunately, acquiredc-kit mutations cause secondary resistance to imatinib in a median of 18 –24 months. Sunitinib and regorafenib are multi-kinase inhibitors that can be used as second-line or third-line therapy in imatinib-resistant or -intolerant GISTs, respectively. Ripretinib (a switch-control tyrosine kinase inhibitor) has recently been approved for fourth-line treatment in metastat ic GIST. The TKI avapritinib has been approved for metasta...
Source: Current Treatment Options in Oncology - March 20, 2021 Category: Cancer & Oncology Source Type: research

New Treatment Options for Older Patients with Acute Myeloid Leukemia
Opinion statementThe treatment of acute myeloid leukemia (AML) has evolved considerably over the past several years. Advances in the field have historically benefited younger patients; however, a growing understanding of the molecular basis of leukemogenesis has brought multiple targeted agents to the clinic for patients of all ages. These therapies have expanded the therapeutic landscape for elderly patients from more than best supportive care and low-intensity monotherapy. In general, we currently utilize a backbone regimen of a hypomethylating agent (HMA) or low-intensity chemotherapy with the BCL-2 inhibitor venetoclax...
Source: Current Treatment Options in Oncology - March 20, 2021 Category: Cancer & Oncology Source Type: research

Surgical Management of Skull Base and Spine Chordomas
Opinion StatementManagement of chordoma along the cranial-spinal axis is a major challenge for both skull base and spinal surgeons. Although chordoma remains a rare tumor, occurring in approximately 1 per 1 million individuals, its treatment poses several challenges. These tumors are generally poorly responsive to radiation and chemotherapy, leading to surgical resection as the mainstay of treatment. Due to anatomic constraints and unique challenges associated with each primary site of disease, gross total resection is often not feasible and is associated with high rates of morbidity. Additionally, chordoma is associated w...
Source: Current Treatment Options in Oncology - March 20, 2021 Category: Cancer & Oncology Source Type: research

Biomarkers of Immune Checkpoint Blockade Response in Triple-Negative Breast Cancer
Opinion statementImmune checkpoint blockade (ICB) has revolutionized the treatment landscape across multiple solid tumor types. In triple-negative breast cancer (TNBC), clinical benefit for the addition of ICB to chemotherapy has been shown in both the metastatic and early stage disease settings. A minority of patients with TNBC will truly benefit from ICB, with many tumors unlikely to respond, and ICB can cause additional toxicities for patients to incur. In clinical practice, ICB-based regimens are emerging as standard-of-care treatment options in TNBC subpopulations. Atezolizumab in combination with nab-paclitaxel is re...
Source: Current Treatment Options in Oncology - March 20, 2021 Category: Cancer & Oncology Source Type: research

Correction to: The Role of Laparoscopic Surgery in Localized Pancreatic Neuroendocrine Tumours
A Correction to this paper has been published:https://doi.org/10.1007/s11864-021-00842-3 (Source: Current Treatment Options in Oncology)
Source: Current Treatment Options in Oncology - March 18, 2021 Category: Cancer & Oncology Source Type: research

Neoadjuvant Therapy for Non-melanoma Skin Cancer: Updated Therapeutic Approaches for Basal, Squamous, and Merkel Cell Carcinoma
Opinion statementRecently introduced systemic therapies for locally advanced and metastatic non-melanoma skin cancers (NMSCs) are paving the way for neoadjuvant approach. Although none of the therapeutic options has currently gained indication in this setting, neoadjuvant approach for NMSCs is an open field and we are likely to see huge developments in the near future. Targeted therapy with sonic hedgehog pathway inhibitors is very effective in locally advanced or multiple basal cell carcinomas while immunotherapy with immune checkpoint inhibitors appears to be promising for advanced cutaneous squamous cell carcinoma and M...
Source: Current Treatment Options in Oncology - March 16, 2021 Category: Cancer & Oncology Source Type: research

The Role of Radiation Therapy for Symptomatic Desmoid Tumors
Opinion statementDesmoid tumors have a variable clinical course that ranges from indolence or spontaneous regression to an aggressive pattern marked by local invasion. Up to half may remain stable or regress; watchful waiting is the preferred approach in the initial management of desmoid tumors. Symptomatic or progressive tumors or those that may affect adjacent critical structures require surgery, radiotherapy, or systemic therapy. Although radiotherapy effectively controls desmoid tumors in most cases, concerns regarding late toxicity exist. Definitive radiotherapy for macroscopic disease is indicated when a non-morbid c...
Source: Current Treatment Options in Oncology - March 1, 2021 Category: Cancer & Oncology Source Type: research

Liquid Biopsy in Gastrointestinal Stromal Tumors: Ready for Prime Time?
Opinion statementGastrointestinal stromal tumor (GIST) constitutes a paradigm for clinically effective targeted inhibition of oncogenic driver mutations. Therefore, GIST has emerged as a compelling clinical and biological model to study oncogene addiction and to validate preclinical concepts for drug response and drug resistance. Oncogenic activation of KIT or PDGFRA receptor tyrosine kinases is the essential drivers of GIST progression throughout all stages of the disease. Interestingly, KIT/PDGFRA genotype predicts the response to first-line imatinib and to all tyrosine kinase inhibitors (TKIs) approved or in investigati...
Source: Current Treatment Options in Oncology - February 27, 2021 Category: Cancer & Oncology Source Type: research