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One Size Fits Some: Approaching Rare Malignancies of the Urinary Tract
Opinion StatementUrothelial carcinoma is the predominant cancer of the urinary tract but when divergent and subtype histology (non-urothelial) are identified at time of pathologic diagnosis, therapeutic and diagnostic challenges transpire. To this end, pathologic review to confirm any non-urothelial histology is key since these subtypes can often be overlooked. Few prospective trials are dedicated to understanding these non-urothelial histologic types; however, current, and past trials did allow patients with these non-urothelial histologic types to enroll, and inferences can be made about treatment efficacy and survival. ...
Source: Current Treatment Options in Oncology - February 5, 2024 Category: Cancer & Oncology Source Type: research

Evaluation of Homologous Recombination Deficiency in Ovarian Cancer
Opinion statementHomologous recombination deficiency (HRD) is an important biomarker guiding selection of ovarian cancer patients who will derive the most benefit from poly(ADP-ribose) polymerase inhibitors (PARPi). HRD prevents cells from repairing double-stranded DNA damage with high fidelity, PARPis limit single-stranded repair, and together these deficits induce synthetic lethality. Germline or somatic BRCA mutations represent the narrowest definition of HRD, but do not reflect all patients who will have a durable PARPi response. HRD can also be defined by its downstream consequences, which are measured by different me...
Source: Current Treatment Options in Oncology - February 1, 2024 Category: Cancer & Oncology Source Type: research

Integrating Systemic Therapies into the Multimodality Therapy of Patients with Craniopharyngioma
In conclusion, targeted therapy with BRAF/MEK inhibitors holds great promise for improving outcomes and quality of life for patients with BRAF-mutated craniopharyngiomas. However, additional research is needed to address the questions that remain about its optimal use and integration into comprehensive treatment plans. (Source: Current Treatment Options in Oncology)
Source: Current Treatment Options in Oncology - February 1, 2024 Category: Cancer & Oncology Source Type: research

Research Progress on the Use of Metformin in Leukemia Treatment
This article reviews the application status and possible mechanism of metformin in the treatment of leukemia to further understand the anticancer mechanism of metformin and expand its clinical applicati on. (Source: Current Treatment Options in Oncology)
Source: Current Treatment Options in Oncology - January 30, 2024 Category: Cancer & Oncology Source Type: research

Desmoid Tumors: Current Perspective and Treatment
Opinion statementDesmoid tumors are rare tumors with a tendency to infiltrate locally. The lack of a standard treatment approach makes choosing the most appropriate treatment for patients challenging. Most experts recommend watchful observation for asymptomatic patients as spontaneous regression of tumor is observed in up to 20% of patients. Upfront resection of the desmoid tumor has fallen out of favor due to high morbidity and high relapse rates associated with the tumor. Systemic therapy has evolved over several decades. Where chemotherapy, hormonal therapy, and non-steroidal anti-inflammatory drugs were used over the l...
Source: Current Treatment Options in Oncology - January 25, 2024 Category: Cancer & Oncology Source Type: research

Impact of PSMA PET on Prostate Cancer Management
Opinion statementPSMA-PET has been a practice-changing imaging biomarker for the management of men with PCa. Research suggests improved accuracy over conventional imaging and other PET radiotracers in many contexts. With multiple approved PSMA-targeting radiotracers, PSMA PET will become even more available in clinical practice. Its increased use requires an understanding of the prospective data available and caution when extrapolating from prior trial data that utilized other imaging modalities. Future trials leveraging PSMA PET for treatment optimization and management decision-making will ultimately drive its clinical u...
Source: Current Treatment Options in Oncology - January 25, 2024 Category: Cancer & Oncology Source Type: research

Management of Paraneoplastic Syndromes in the Era of Immune Checkpoint Inhibitors
Opinion statementOur understanding of paraneoplastic neurologic syndromes (PNS) has blossomed over the past few decades. Clinicians have access to more robust diagnostic criteria and have a heightened index of suspicion for these disorders. Nonetheless, treatment, which typically includes immunosuppression, and response to treatment, varies. Due to persistent difficulty in making a definitive diagnosis, we favor empiric treatment when a possible diagnosis of PNS is suspected, and other alternative causes have substantially been excluded (e.g., infections, toxic-metabolic derangements, metastasis, or leptomeningeal disease)...
Source: Current Treatment Options in Oncology - January 10, 2024 Category: Cancer & Oncology Source Type: research

Current Standards, Multidisciplinary Approaches, and Future Directions in the Management of Extrahepatic Cholangiocarcinoma
Opinion statementBiliary tract cancers are molecularly and anatomically diverse cancers which include intrahepatic cholangiocarcinoma, extrahepatic (perihilar and distal) cholangiocarcinoma, and gallbladder cancer. While recognized as distinct entities, the rarer incidence of these cancers combined with diagnostic challenges in classifying anatomic origin has resulted in clinical trials and guideline recommended strategies being generalized patients with all types of biliary tract cancer. In this review, we delve into the unique aspects, subtype-specific clinical trial outcomes, and multidisciplinary management of patients...
Source: Current Treatment Options in Oncology - January 5, 2024 Category: Cancer & Oncology Source Type: research

Targeting BRCA and PALB2 in Pancreatic Cancer
Opinion statementAn important subgroup of pancreatic ductal adenocarcinomas (PDACs) harbor pathogenic variants inBRCA1,BRCA2, orPALB2. These tumors are exquisitely sensitive to platinum-based chemotherapy and patients may experience deep and durable responses to this treatment. PARP inhibitors offer potential respite from the cumulative toxicities of chemotherapy as they significantly extend progression-free survival compared to a chemotherapy holiday. Given the lack of proven survival benefit, the decision to use a maintenance PARP inhibitor rather than continue chemotherapy should be individualized. Interestingly, in bot...
Source: Current Treatment Options in Oncology - January 4, 2024 Category: Cancer & Oncology Source Type: research

Metastatic Hormone –Sensitive Prostate Cancer in the Era of Doublet and Triplet Therapy
Opinion StatementTreatment for metastatic hormone –sensitive prostate cancer has undergone significant evolution in recent years, leading to substantial improvements in overall survival. Men are living longer than ever before with a median survival now which is almost 6 years. The timing and extent of metastatic disease combined with individual p atient factors helps treatment recommendation of doublet therapy including androgen deprivation (ADT) plus either chemotherapy or androgen receptor signaling inhibition (ARSI) or triplet therapy with ADT+ARSI+chemotherapy. New treatments must continue to be developed to enhance ...
Source: Current Treatment Options in Oncology - January 4, 2024 Category: Cancer & Oncology Source Type: research

Intraperitoneal and Hyperthermic Intraperitoneal Chemotherapy for the Treatment of Ovarian Cancer
Opinion statementIn our clinical practice, we have shifted away from the use of adjuvant normothermic intraperitoneal (IP) chemotherapy, particularly following the publication of GOG 252. Our decision is rooted in the accumulating evidence indicating a lack of demonstrable superiority, alongside the recognized toxicities and logistical challenges associated with its administration. This strategic departure is also influenced by the rising utilization of maintenance therapies such as bevacizumab and PARP inhibitors, which present viable alternatives for improving patient outcomes. Our utilization of hyperthermic IP chemothe...
Source: Current Treatment Options in Oncology - January 4, 2024 Category: Cancer & Oncology Source Type: research

Treatment of node-positive endometrial cancer: chemotherapy, radiation, immunotherapy, and targeted therapy
Opinion StatementThe standard of treatment for node-positive endometrial cancer (FIGO Stage IIIC) in North America has been systemic therapy with or without additional external beam radiation therapy (RT) given as pelvic or extended field RT. However, this treatment paradigm is rapidly evolving with improvements in systemic chemotherapy, the emergence of targeted therapies, and improved molecular characterization of these tumors. The biggest question facing providers regarding management of stage IIIC endometrial cancer at this time is: what is the best management strategy to use with regard to combinations of cytotoxic ch...
Source: Current Treatment Options in Oncology - January 4, 2024 Category: Cancer & Oncology Source Type: research

Hypnosis for Symptom Management in Adult Cancer Patients: What is the Evidence?
Opinion StatementAs a palliative care specialist and a hypnotherapist, I use therapeutic communication and conversational hypnosis daily in my patient – doctor relationship. Formal hypnotherapy sessions are integrated in my practice whenever patients are open or wish for such an approach in relation to a specific symptom, for better overall management of their disease burden and/or enhanced well-being. Although hypnosis has been used for centuri es in medical practice and for thousands of years in healing practices in ancient cultures all over the world, the evidence remains scarce. Nevertheless, in the last 10 years se...
Source: Current Treatment Options in Oncology - January 4, 2024 Category: Cancer & Oncology Source Type: research

Therapeutic Management of Malignant Wounds: An Update
Opinion statementMalignant fungating wounds (MFW) are severe skin conditions generating tremendous distress in oncological patients with advanced cancer stages because of pain, malodor, exudation, pruritus, inflammation, edema, and bleeding. The classical therapeutic approaches such as surgery, opioids, antimicrobials, and application of different wound dressings are failing in handling pain, odor, and infection control, thus urgently requiring the development of alternative strategies. The aim of this review was to provide an update on the current therapeutic strategies and the perspectives on developing novel alternative...
Source: Current Treatment Options in Oncology - January 4, 2024 Category: Cancer & Oncology Source Type: research

Updates on Management of Biochemical Recurrent Prostate Cancer
Opinion StatementPatients with biochemical recurrent prostate cancer (BCR) are a heterogeneous group, whereby a personalized approach to management is critical. Patients with high-risk features such as PSA doubling time (PSADT)  ≤ 9–12 months warrant earlier imaging for metastasis detection and consideration for intensified therapy (beyond intermittent androgen deprivation alone) during this phase of BCR-only disease. The BCR phase represents a unique opportunity to impact disease survival and delay metastasis prog ression. There is compelling evidence from the EMBARK trial that ADT monotherapy is no longer the opt...
Source: Current Treatment Options in Oncology - January 3, 2024 Category: Cancer & Oncology Source Type: research