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New Approaches to Myelodysplastic Syndrome Treatment
Opinion statementThe treatment of myelodysplastic syndromes (MDS) begins with risk stratification using a validated tool such as the International Prognostic Scoring System (IPSS) or its revised version (IPSS-R). This divides patients into lower- and higher- risk categories. Although treatment objectives in lower-risk MDS (LR-MDS) have traditionally been directed at improving cytopenias (usually anemia) as well as quality of life, recent data supports a potential role for early intervention in delaying transfusion dependency. In addition, careful individualized risk stratification incorporating clinical, cytogenetic, and m...
Source: Current Treatment Options in Oncology - March 23, 2022 Category: Cancer & Oncology Source Type: research

Does Cannabidiol Have a Benefit as a Supportive Care Drug in Cancer?
Opinion statementCannabinoids have been purported as having a wide range of therapeutic uses although currently, there is minimal evidence to support these claims. Patients with advanced cancer experience many distressing symptoms, with some turning to medicinal cannabis to help alleviate these. Focus has fallen on cannabidiol (CBD) as a potential treatment for a variety of symptoms in advanced cancer due to the lack of psychoactive side effects and the potential molecular mechanisms of action associated with this cannabinoid. Many cannabinoid products are easily available in the community, and more countries are legalizin...
Source: Current Treatment Options in Oncology - March 22, 2022 Category: Cancer & Oncology Source Type: research

Optimal Strategies for Colorectal Cancer Screening
Opinion statementColorectal cancer (CRC) imposes significant morbidity and mortality, yet it is also largely preventable with evidence-based screening strategies. In May 2021, the US Preventive Services Task Force updated guidance, recommending screening begin at age 45 for average-risk individuals to reduce CRC incidence and mortality in the United States (US). The Task Force recommends screening with one of several screening strategies: high-sensitivity guaiac fecal occult blood test (HSgFOBT), fecal immunochemical test (FIT), multi-target stool DNA (mt-sDNA) test, computed tomographic (CT) colonography (virtual colonosc...
Source: Current Treatment Options in Oncology - March 22, 2022 Category: Cancer & Oncology Source Type: research

Family Meetings in Palliative Care: Benefits and Barriers
Opinion statementSpecialists in palliative care view the family meeting as a means to engage patients and their families in a serious illness discussion that may clarify the values of patients and caregivers, provide information, determine care preferences, and identify sources of illness-related distress and burden. The family meeting is considered the best practice for achieving patient- and family-centered care in palliative care. Although studies of the family meeting are limited, those extant suggest that these interventions may reduce caregiver distress, mitigate the perception of unmet needs, prepare family members ...
Source: Current Treatment Options in Oncology - March 22, 2022 Category: Cancer & Oncology Source Type: research

Reshaping Treatment Paradigms for Advanced Renal Cell Cancer Patients and Improving Patient Management
Opinion statementThe treatment of renal cell carcinoma (RCC) is one of the great success stories in the field of oncology, which was revolutionized with the development of therapies aimed at disrupting crucial pathways. Tumor biology of RCC has provided insight into the disease through elucidation of the role of vascular endothelial growth-factor (VEGF) and the mammalian target of rapamycin (mTOR). Targeted agents against VEGF and mTOR, as well as agents targeting relevant immunomodulatory pathways, have shown clinical benefit for advanced disease. The targeted agents are highly effective in achieving a response and surviv...
Source: Current Treatment Options in Oncology - March 22, 2022 Category: Cancer & Oncology Source Type: research

Nectin-4: a Novel Therapeutic Target for Skin Cancers
Opinion statementNectin-4 is a tumor-associated antigen that is highly expressed on various cancer cells, and it has been further proposed to have roles in tumor development and propagation ranging from cellular proliferation to motility and invasion. Nectin-4 blockade reduces tumor proliferation and induces apoptosis in several malignancies. Nectin-4 has been used as a potential target in antibody-drug conjugate (ADC) development. Enfortumab vedotin, an ADC against Nectin-4, has demonstrated efficacy against solid tumor malignancies. Enfortumab vedotin has received US Food and Drug Administration approval for treating uro...
Source: Current Treatment Options in Oncology - March 21, 2022 Category: Cancer & Oncology Source Type: research

The Evolving Neoadjuvant Treatment Paradigm for Patients with Locoregional mismatch Repair Proficient Rectal Cancer
Opinion statementThe standard of care for locally advanced rectal cancer (LARC) has included preoperative chemoradiation, total mesorectal excision surgery and post operative adjuvant chemotherapy based on histopathology. The current therapeutic landscape in LARC has many different options with different directions of travel — depending on the goal of treatment. Enthusiasm for delivering total neoadjuvant therapy (TNT) for patients with locally advanced rectal cancer (LARC) is increasing in the light of recently published randomised phase III trials — RAPIDO and PRODIGE-23. There is a wide diversity of different pot en...
Source: Current Treatment Options in Oncology - March 21, 2022 Category: Cancer & Oncology Source Type: research

Advances in Organ Preservation for Laryngeal Cancer
Opinion statementAt the University of Wisconsin, all treatment of head and neck cancer patients begins with discussion at our multi-disciplinary tumor board. Most patients with T4 disease, with existing laryngeal dysfunction, considered unlikely to complete definitive CRT or who have a high risk of persistent aspiration after non-operative management undergo total laryngectomy. A laryngeal sparing approach is attempted on most other patients. Radiotherapy is delivered over 6.5 weeks, preferably with concurrent weekly cisplatin. If the patient is hesitant of chemotherapy or has contraindications to cisplatin, concurrent cet...
Source: Current Treatment Options in Oncology - March 18, 2022 Category: Cancer & Oncology Source Type: research

Promising Blood-Based Biomarkers for Melanoma: Recent Progress of Liquid Biopsy and Its Future Perspectives
Opinion statementBecause the recent success of novel therapeutic approaches has dramatically changed the clinical management of melanoma, less invasive and repeatable monitoring tools that can predict the disease status, drug resistance, and the development of side effects are increasingly needed. As liquid biopsy has enabled us to diagnose and monitor disease status less invasively, substantial attention has been directed toward this technique, which is gaining importance as a diagnostic and/or prognostic tool. It is evident that microRNA, cell-free DNA, and circulating tumor cells obtained via liquid biopsy are promising...
Source: Current Treatment Options in Oncology - March 17, 2022 Category: Cancer & Oncology Source Type: research

Novel Approaches for the Treatment of Patients with Richter ’s Syndrome
Opinion statementIn the last 10 –15 years, the way to treat cancers has dramatically changed towards precision medicine approaches. These treatment options are mainly based on selective targeting against signaling pathways critical for or detrimentally activated in cancer cells in cancer cells, as well as exploiting molecules t hat are specifically expressed on neoplastic cells, also known as tumor-associated antigens. These considerations hold true also in the hematological field where a plethora of novel targeted agents have reached patients’ bedside, significantly improving clinical responses. Chronic lymphocytic l...
Source: Current Treatment Options in Oncology - March 16, 2022 Category: Cancer & Oncology Source Type: research

In Utero Development and Immunosurveillance of B Cell Acute Lymphoblastic Leukemia
Opinion statementAcute lymphoblastic leukemia (ALL) is the most frequent type of pediatric cancer with a peak incidence at 2 –5 years of age. ALL frequently begins in utero with the emergence of clinically silent, preleukemic cells. Underlying leukemia-predisposing germline and acquired somatic mutations define distinct ALL subtypes that vary dramatically in treatment outcomes. In addition to genetic predisposition, a s econd hit, which usually occurs postnatally, is required for development of overt leukemia in most ALL subtypes. An untrained, dysregulated immune response, possibly due to an abnormal response to infecti...
Source: Current Treatment Options in Oncology - March 16, 2022 Category: Cancer & Oncology Source Type: research

Understanding and Supporting Informal Cancer Caregivers
Opinion statementInformal caregivers invest a significant amount of time and effort to provide cancer patients with physical, psychological, information, and social support. These challenging tasks can harm their own health and well-being, while a series of social-ecological factors may also influence the outcomes of cancer caregiving. Several instruments have been developed to help clinicians and researchers understand the multi-dimensional needs and concerns of caregivers. A growing body of evidence indicates that supportive interventions including psychoeducation, skills training, and therapeutic counseling can help imp...
Source: Current Treatment Options in Oncology - March 14, 2022 Category: Cancer & Oncology Source Type: research

What Clinical Trials Are Needed for Treatment of Leiomyosarcoma?
Opinion statementLeiomyosarcoma is one of the most common subtypes of soft tissue sarcomas accounting for approximately 20% of sarcomas. As leiomyosarcoma patients frequently develop metastatic disease, effective systemic therapies are needed to improve clinical outcomes. The overall activity of the currently available conventional systemic therapies and the prognosis of patients with advanced and/or metastatic disease are poor. As such, the treatment of this patient population remains challenging. As a result, there is a clear unmet medical need, and designing and performing meaningful clinical studies are of utmost impor...
Source: Current Treatment Options in Oncology - March 11, 2022 Category: Cancer & Oncology Source Type: research

Immunotherapy and Biomarkers in Sarcoma
Opinion statementSarcoma describes a rare and heterogeneous group of diseases. Current treatment options for metastatic sarcoma are quite limited. Conventional treatments with chemotherapy or anti-angiogenic agents result in a non-durable response and a survival rate of approximately 12 to 18 months. In addition, the benefits of such treatments remain limited in some sarcoma subtypes only. Immunotherapy is an emerging treatment for several cancer types with promising outcomes. Studies at the cellular level have shown a relatively high immunogenicity in some subtypes of sarcoma. It is therefore hypothesized that sarcoma may...
Source: Current Treatment Options in Oncology - March 9, 2022 Category: Cancer & Oncology Source Type: research

Which FLT3 Inhibitor for Treatment of AML?
Opinion statementTreatment options in acute myeloid leukemia (AML) have improved significantly over the last decade with better understanding of disease biology and availability of a multitude of targeted therapies. The use of FLT3 inhibitors (FLT3i) in FLT3-mutated (FLT3mut) AML is one such development; however, the clinical decisions that govern their use and dictate the choice of the FLT3i are evolving. Midostaurin and gilteritinib are FDA-approved in specific situations; however, available data from clinical trials also shed light on the utility of sorafenib maintenance post-allogeneic stem cell transplantation (allo-S...
Source: Current Treatment Options in Oncology - March 8, 2022 Category: Cancer & Oncology Source Type: research