Optimizing treatments for recurrent or metastatic head and neck squamous cell carcinoma.
This article will comprehensively review the current systemic treatment of R/M HNSCC. Expert Commentary: For the time being, the EXTREME regimen (cetuximab in combination with platinum and 5-fluorouracil) still remains standard of care in previously untreated R/M HNSCC patients who are candidates for combination chemotherapy. Single agents with well documented activity in HNSCC include methotrexate, cisplatin, 5-FU, docetaxel, and paclitaxel. The anti-PD-1 monoclonal antibody nivolumab can be considered the current standard of care in patients with R/M HNSCC progressing after platinum-based therapy based on the results of ...
Source: Expert Review of Anticancer Therapy - July 13, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Immune-checkpoint inhibitors to treat cancers in specific immunocompromised populations: a critical review.
Authors: Babey H, Quéré G, Descourt R, Le Calloch R, Lanfranco L, Nousbaum JB, Cornec D, Tison A, Chouaid C Abstract INTRODUCTION: Because of their efficacy against numerous cancers, immune-checkpoint inhibitors (ICIs), anti-cytotoxic T-lymphocyte antigen-4 (CTLA4) and anti-programmed cell-death (PD-1) monoclonal antibodies, are being used ever more often in oncology. However, some patients were excluded from clinical trials because of their comorbidities, despite their potentially higher cancer frequencies, as is the case for immunocompromised patients. Areas covered: We analyzed reported preclinical...
Source: Expert Review of Anticancer Therapy - July 12, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Anticancer therapy and lung injury: molecular mechanisms.
Authors: Li L, Mok H, Jhaveri P, Bonnen MD, Sikora AG, Eissa NT, Komaki RU, Ghebre YT Abstract INTRODUCTION: Chemotherapy and radiation therapy are two mainstream strategies applied in the treatment of cancer that is not operable. Patients with hematological or solid tumor malignancies substantially benefit from chemotherapeutic drugs and/or ionizing radiation delivered to the site of malignancy. However, considerable adverse effects, including lung inflammation and fibrosis, are associated with the use of these treatment modalities. Areas covered: As we move towards the era of precision health, we are compelled to...
Source: Expert Review of Anticancer Therapy - July 12, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Imaging of pancreatic neuroendocrine tumors: recent advances, current status and controversies.
Authors: Lee L, Ito T, Jensen RT Abstract INTRODUCTION: Recently there have been a number of advances in imaging pancreatic neuroendocrine tumors (panNETs), as well as other neuroendocrine tumors (NETs), which have had a profound effect on the management and treatment of these patients, but in some cases are also associated with controversies. Areas covered: These advances are the result of numerous studies attempting to better define the roles of both cross-sectional imaging, endoscopic ultrasound, with or without fine needle aspiration, and molecular imaging in both sporadic and inherited panNET syndromes; the in...
Source: Expert Review of Anticancer Therapy - July 6, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Highlighting the need for reliable clinical trials in glioblastoma.
Authors: Mandel JJ, Youssef M, Ludmir E, Yust-Katz S, Patel A, de Groot JF Abstract INTRODUCTION: Several recent phase III studies have attempted to improve the dismal survival seen in glioblastoma patients, with disappointing results despite prior promising phase II data. Areas covered: A literature review of prior phase II and phase III studied in glioblastoma was performed to help identify possible areas of concern. Numerous issues in previous phase II trials for glioblastoma were found that may have contributed to these discouraging outcomes and discordant results. Expert Commentary: These concerns include the ...
Source: Expert Review of Anticancer Therapy - July 6, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Current and future therapeutic approaches for the treatment of follicular lymphoma.
Authors: Pulsoni A, Cappelli LV, Ballotta L, Canichella M, Serrao A, Annechini G, D'Elia GM, Foà R Abstract INTRODUCTION: Nowadays follicular lymphoma (FL) is considered a virtually incurable disease. Nevertheless, an improvement of prognostic criteria must be pursued in order to achieve new treatment strategies based on a personalized approach. Areas covered: Prognostic scores, old and recent, as well as innovative and experimental therapeutic approaches are constantly evaluated when it comes to discussing the proper approach to FL, due to its extremely variable presentation at diagnosis. For asymptomatic, ...
Source: Expert Review of Anticancer Therapy - July 5, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Management Strategies for Recurrent Endometrial Cancer.
Authors: Connor EV, Rose PG Abstract INTRODUCTION: Endometrial cancer is the most common gynecologic malignancy in the developed world, and its incidence is increasing. Mortality from this cancer has not improved in recent decades and is primarily driven by high-grade carcinomas that are more likely to present at an advanced stage and ultimately are more likely to recur. The prognosis for recurrent endometrial cancer is poor, especially for the 50% of these women that present with extrapelvic disease recurrence. As a standard of care, recurrent disease has been treated with platinum-based chemotherapy; however, new...
Source: Expert Review of Anticancer Therapy - July 5, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Determining treatment intensity in elderly patients with multiple myeloma.
Authors: Salvini M, D'Agostino M, Bonello F, Boccadoro M, Bringhen S Abstract INTRODUCTION: In the majority of cases, multiple myeloma is a disease occurring in elderly patients. In the last decades, a major improvement in myeloma patients' outcome has been achieved with the introduction of several new drugs. However, this positive outcome was less likely to occur in elderly patients. Areas covered: An overall increase of myeloma cases in elderly patients is expected in the next years. This patient population is highly heterogeneous in terms of physiological functions and ability to resist stressing conditions such...
Source: Expert Review of Anticancer Therapy - July 5, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

The evolution and rise of stereotactic body radiotherapy (SBRT) for spinal metastases.
Authors: Vellayappan BA, Chao ST, Foote M, Guckenberger M, Redmond KJ, Chang EL, Mayr NA, Sahgal A, Lo SS Abstract INTRODUCTION: Owing to improvements in clinical care and systemic therapy, more patients are being diagnosed with, and living longer with, spinal metastases (SM). In parallel, tremendous technological progress has been made in the field of radiation oncology. Advances in both software and hardware are able to integrate three- (and four-) dimensional body imaging with spatially accurate treatment delivery methods. This is able to improve the efficacy, shorten the overall treatment schedule and potential...
Source: Expert Review of Anticancer Therapy - June 28, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Future applications of FGF/FGFR inhibitors in cancer.
Authors: Ghedini GC, Ronca R, Presta M, Giacomini A Abstract INTRODUCTION: Deregulation of the fibroblast growth factor (FGF)/FGF receptor (FGFR) network occurs frequently in tumors due to gene amplification, activating mutations and oncogenic fusions. Thus, the development of FGF/FGFR-targeting therapies is the focus of several basic, preclinical and clinical studies. Areas covered: This review will recapitulate the status of current FGF/FGFR-targeted drugs. Expert commentary: Non-selective FGF/FGFR inhibitors have been approved for cancer treatment but evidence highlights various complications affecting their use...
Source: Expert Review of Anticancer Therapy - June 26, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Avelumab: is it time to get excited?
Authors: Marciscano AE, Gulley JL, Kaufman HL PMID: 29939083 [PubMed - as supplied by publisher] (Source: Expert Review of Anticancer Therapy)
Source: Expert Review of Anticancer Therapy - June 26, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

The Eighth Edition American Joint Committee on Cancer (AJCC) melanoma staging system: implications for melanoma treatment and care.
This article provides an overview of important changes in the eighth edition AJCC staging system from the seventh edition based on analyses of a large international melanoma database. The clinical implications of these changes for melanoma treatment are also discussed. Expert commentary: A standardized and contemporary cancer staging system that facilitates accurate risk stratification is essential to guide patient treatment. The eighth edition of the AJCC staging system is currently the most widely accepted approach to melanoma staging and classification at initial diagnosis. PMID: 29923435 [PubMed - as supplied by pu...
Source: Expert Review of Anticancer Therapy - June 24, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Maintenance and continuous therapy for multiple myeloma.
Authors: Richardson PG, Laubach J, Gandolfi S, Facon T, Weisel K, O'Gorman P Abstract INTRODUCTION: In multiple myeloma (MM), maintenance therapy is a longer and less intensive treatment course than initial therapy that is administered after induction to delay disease progression. Maintenance and continuous therapy have been shown to suppress minimal residual disease and deepen and prolong responses, with the goal of improving progression-free survival and overall survival. Areas covered: In this review, we have summarized current clinical trial data on maintenance and continuous therapy in newly-diagnosed MM and r...
Source: Expert Review of Anticancer Therapy - June 24, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Niraparib for the treatment of ovarian cancer.
Authors: Essel KG, Moore KN Abstract INTRODUCTION: Niraparib, an orally available selective inhibitor of poly(adenosine diphosphate-ribose) polymerase (PARP) is the first PARP inhibitor approved for use in patients with ovarian cancer who do not harbor a germline or somatic mutation in the breast cancer gene (BRCA). Overall niraparib is well tolerated and its toxicities, primarily hematologic, are manageable especially with recently released initial dose modification guidelines based on weight and baseline platelet count. The role of niraparib as maintenance following front-line platinum-based chemotherapy as well ...
Source: Expert Review of Anticancer Therapy - June 19, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Treatment of advanced breast cancer with a metronomic schedule of oral vinorelbine: what is the opinion of Italian oncologists?
CONCLUSION: Metronomically administered oral vinorelbine, either as monotherapy or in combination with other drugs, is effective in the long-term treatment of patients with advanced breast cancer. The clinical profiles of patients should be carefully considered to determine the appropriate treatment strategy. PMID: 29902087 [PubMed - as supplied by publisher] (Source: Expert Review of Anticancer Therapy)
Source: Expert Review of Anticancer Therapy - June 15, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Hypofractionated radiation treatment in the management of breast cancer.
Authors: Gupta A, Ohri N, Haffty BG Abstract INTRODUCTION: The standard treatment for early-stage breast cancer is breast conservation therapy, consisting of breast conserving surgery followed by adjuvant radiation treatment (RT). Conventionally-fractionated whole breast irradiation (CF-WBI) has been the standard RT regimen, but recently shorter courses of hypofractionated whole breast irradiation (HF-WBI) have been advocated for patient convenience and reduction in healthcare costs and resources. Areas covered: This review covers the major randomized European and Canadian trials comparing HF-WBI to CF-WBI with lon...
Source: Expert Review of Anticancer Therapy - June 15, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Spotlight on atezolizumab and its potential as an oncology agent.
Authors: Redman JM, Madan RA PMID: 29877103 [PubMed - as supplied by publisher] (Source: Expert Review of Anticancer Therapy)
Source: Expert Review of Anticancer Therapy - June 9, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Proposed use of self-regulating temperature nanoparticles for cancer therapy.
Authors: Zhang W, Wu C, Silva SRP PMID: 29873269 [PubMed - as supplied by publisher] (Source: Expert Review of Anticancer Therapy)
Source: Expert Review of Anticancer Therapy - June 8, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Therapeutic strategies for upper tract urothelial carcinoma.
Authors: Freifeld Y, Krabbe LM, Clinton TN, Woldu SL, Margulis V Abstract INTRODUCTION: Many controversies exist regarding the appropriate management of patients with upper tract urothelial carcinoma (UTUC), including staging, surgical management, use of systemic therapy and prevention of bladder recurrence. Due to the rarity of this condition, high level evidence is often lacking and in many cases guidelines are extrapolated from existing evidence on urothelial bladder cancer. Areas covered: This review paper summarizes the evidence on proper diagnosis and staging, surgical techniques, prevention of bladder recurr...
Source: Expert Review of Anticancer Therapy - June 2, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Digital breast tomosynthesis (3D mammography) for breast cancer screening and for assessment of screen-recalled findings: review of the evidence.
Authors: Li T, Marinovich ML, Houssami N Abstract INTRODUCTION: Digital breast tomosynthesis (DBT) addresses some of the limitations of digital mammography (DM) by reducing the effect of overlapping tissue. Emerging data have shown that DBT increases breast cancer (BC) detection and reduces recall in BC screening programs. Studies have also suggested that DBT improves assessment of screen-recalled findings. Areas covered: Studies of DBT for population BC screening and those for assessment of screen-detected findings were reviewed to provide an up-to-date summary of the evidence on DBT in the screening setting. A sy...
Source: Expert Review of Anticancer Therapy - June 1, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

How will the CHHiP trial affect the future of prostate radiotherapy?
Authors: Dearnaley D, Hall E PMID: 29774771 [PubMed - as supplied by publisher] (Source: Expert Review of Anticancer Therapy)
Source: Expert Review of Anticancer Therapy - May 26, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Combination therapies for the treatment of HER2-positive breast cancer: current and future prospects.
Authors: Brandão M, Pondé NF, Poggio F, Kotecki N, Salis M, Lambertini M, de Azambuja E Abstract INTRODUCTION: HER2-positive disease is an aggressive subtype of breast cancer that has been revolutionized by anti-HER2 directed therapies. Multiple drugs have been developed and are currently in clinical use, including trastuzumab, lapatinib, pertuzumab, T-DM1, and neratinib, alone or combined in 'dual HER2-blockade' regimens. Areas covered: A comprehensive literature review was performed regarding the current state and the future of combination regimens containing anti-HER2 agents, focusing on their effi...
Source: Expert Review of Anticancer Therapy - May 26, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Nivolumab for the treatment of colorectal cancer.
Authors: Smith KM, Desai J Abstract INTRODUCTION: Despite a variety of therapies for advanced metastatic colorectal cancer being available, the outcomes in this malignancy remain sub-optimal. Immunotherapy has been slow to impact the management of this patient group. Checkpoint inhibitors, such as nivolumab, have had disappointing results when used broadly. However, for the subset of patients with microsatellite unstable colorectal cancer the use of checkpoint inhibitors such as nivolumab appears to be transformative, and will provide a new therapeutic option for patient with advanced disease. Areas covered: Nivolu...
Source: Expert Review of Anticancer Therapy - May 26, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Pocket colposcope: could it improve attendance and increase access to cervical cancer screening programmes?
Authors: Hariprasad R, Mehrotra R PMID: 29768062 [PubMed - as supplied by publisher] (Source: Expert Review of Anticancer Therapy)
Source: Expert Review of Anticancer Therapy - May 17, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

A look at treatment strategies for relapsed multiple myeloma.
Authors: Cetani G, Boccadoro M, Oliva S Abstract INTRODUCTION: Multiple myeloma treatment considerably improved during the past decade, thanks to novel effective drugs, a better understanding of myeloma biology and clonal heterogeneity, and an improved management of toxicities. The choice of regimen at relapse is usually based on prior response, toxicities, age and comorbidities of relapsed patients. Areas covered: A review was performed of the most recent and effective therapeutic strategies for the relapsed myeloma setting, by documenting the latest clinical evidence from phase II and III clinical trials. Of note...
Source: Expert Review of Anticancer Therapy - May 17, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

The development of fluorescence guided surgery for pancreatic cancer: from bench to clinic.
This article reviews different approaches for delivery of a fluorescence signal, their pre-clinical and clinical developments for fluorescence guided surgery, the advantages/challenges of each, and their potential for advancements in the future. Expert commentary: A variety of molecular imaging techniques are available for delivering tumor-specific fluorescence signals. Significant advancements have been made in the past 10 years due to the large body of literature on targeted therapies and this has translated into rapid developments of tumor-specific probes. PMID: 29768067 [PubMed - as supplied by publisher] (Source: ...
Source: Expert Review of Anticancer Therapy - May 17, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Fulvestrant for the treatment of advanced breast cancer.
This article discusses the journey of fulvestrant licensing, its efficacy in combination with other endocrine therapies and the future role it may have within breast cancer treatment. Expert Commentary: Within phase III trials, fulvestrant has demonstrated equivalent or improved clinical efficacy when compared with established endocrine agents. In the recent decade, fulvestrant has achieved licensing as a second line agent in non-operative advanced breast cancer at initially 250mg, increasing to 500mg. Presently, fulvestrant is licensed globally as first line endocrine management for advanced breast cancer in post-menopaus...
Source: Expert Review of Anticancer Therapy - May 13, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Progressive tissue biomarker profiling in non-muscle-invasive bladder cancer.
Authors: D'Andrea D, Hassler MR, Abufaraj M, Soria F, Ertl IE, Ilijazi D, Mari A, Foerster B, Egger G, Shariat SF Abstract INTRODUCTION: The recurrence rate of non-muscle-invasive bladder cancer (NMIBC) is up to 60% within the first year of therapy. Accurate risk stratification is necessary for patient counselling, follow-up scheduling and individualized therapeutic decision making. Current prognostic models rely on clinicopathologic features, but their discrimination remains limited when in external cohorts. Despite intense efforts regarding the value of biomarkers in prognosticating outcomes in NMIBC, clinical ut...
Source: Expert Review of Anticancer Therapy - May 10, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Lenvatinib for the treatment of kidney cancer.
Authors: Študentová H, Vitásková D, Melichar B Abstract INTRODUCTION: Sequential administration of single targeted agents has evolved as the dominant paradigm in advanced RCC treatment. Lenvatinib plus everolimus is the first combination therapy in advanced RCC to show improvement in efficacy compared to monotherapy in advanced RCC while maintaining manageable toxicity profile. Areas covered: This review gives a brief overview of the contemporary clinical data on lenvatinib including its mechanism of action, pharmacokinetics, efficacy and safety profile in combination with everolimus. Th...
Source: Expert Review of Anticancer Therapy - May 10, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Challenges and concerns of persistent opioid use in cancer patients.
Authors: Manchikanti L, Manchikanti KN, Kaye AD, Kaye AM, Hirsch JA Abstract INTRODUCTION: As a result of advancements in the diagnosis and treatment of cancer, two-thirds of individuals suffering with cancer survive more than 5 years after diagnosis, resulting in a large proportion of patients with chronic cancer pain alone or associated with chronic noncancer pain. There is a paucity of literature in reference to diagnosis and management of chronic cancer pain, specifically in relation to persistent opioid use, its effectiveness, and adverse consequences. Areas Covered: This review covers the prevalence of chroni...
Source: Expert Review of Anticancer Therapy - May 10, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Surgical approaches for the treatment of perihilar cholangiocarcinoma.
Authors: Kimbrough CW, Cloyd JM, Pawlik TM Abstract INTRODUCTION: Since their initial description, perihilar cholangiocarcinoma (pCCA) has remained one of the more clinically challenging scenarios encountered by hepatobiliary surgeons. Surgery remains the only potentially curative therapy, but requires complex, technically demanding operations with high associated morbidity and mortality. Over the last several decades, advances in surgical technique and perioperative management have improved patient outcomes. Areas Covered: Achievement of optimal outcomes requires a multidisciplinary approach from a team of provide...
Source: Expert Review of Anticancer Therapy - May 7, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Adjuvant therapy for advanced renal cell carcinoma.
Authors: Meissner MA, McCormick BZ, Karam JA, Wood CG Abstract INTRODUCTION: Locally advanced, non-metastatic renal cell carcinoma (RCC) is conventionally managed with surgery. However, patients are at a high risk of RCC recurrence and have poor survival outcomes. An effective adjuvant systemic treatment is needed to improve on these outcomes. Targeted molecular and immune-based therapies have been investigated, or are under investigation, but their role in this setting remains unclear. Areas covered: A comprehensive search of PubMed and ClinicalTrials.gov was performed for relevant literature. The following topics...
Source: Expert Review of Anticancer Therapy - May 2, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Might robotic-assisted surgery become commonplace in endometrial cancer treatment?
Authors: Zanagnolo V, Achilarre MT, Maruccio M, Garbi A PMID: 29708002 [PubMed - as supplied by publisher] (Source: Expert Review of Anticancer Therapy)
Source: Expert Review of Anticancer Therapy - May 2, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Prostate cancer with cribriform morphology: diagnosis, aggressiveness, molecular pathology and possible relationships with intraductal carcinoma.
Authors: Montironi R, Cimadamore A, Gasparrini S, Mazzucchelli R, Santoni M, Massari F, Cheng L, Lopez-Beltran A, Scarpelli M Abstract INTRODUCTION: The Gleason grading system is one of the most important prognostic factors in prostate cancer (PCa). From the 2005 to the 2014 conference organized by the International Society of Urological Pathology (ISUP), the histological criteria for the Gleason patterns were improved, resulting in the shrinkage of the Gleason pattern (GP) 3 and expansion of the GP 4. Areas Covered: Cribriform, fused, ill-defined and glomeruloid glands are part of the morphologic spectrum of the c...
Source: Expert Review of Anticancer Therapy - April 29, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Prognostic biomarkers for cholangiocarcinoma and their clinical implications.
This article provides an up-to-date review of biomarkers with promising characteristics to be prognostic markers for CCA reported in the past 5 years. The biomarkers are sub-classified into tissue and serum markers. Proteins, RNAs, peripheral blood cells etc., that are associated with aggressive phenotypes, signal pathways, chemo-drug resistance and those that reflect the survival time of CCA patients are evaluated for their prognostic prediction values. Expert commentary: CCAs are heterogeneous tumors of different histo-pathological subtypes and genetic influences and, therefore, potential markers should be validated in l...
Source: Expert Review of Anticancer Therapy - April 22, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

The role of neoadjuvant chemotherapy in ovarian cancer.
Authors: Elies A, Rivière S, Pouget N, Becette V, Dubot C, Donnadieu A, Rouzier R, Bonneau C Abstract INTRODUCTION: Ovarian cancer is mostly diagnosed at advanced stage. Better survival is achieved through complete debulking surgery and chemotherapy. Historically, neoadjuvant chemotherapy (NAC) has been introduced for unresectable disease to decrease tumor load and perform a unique complete surgery. Four randomized control trials have compared primary debulking surgery to NAC, but there is still controversy about the use of neoadjuvant chemotherapy and questions about its modalities. Areas covered: We made a...
Source: Expert Review of Anticancer Therapy - April 12, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Total pathological complete response versus breast pathological complete response in clinical trials of reference and biosimilar trastuzumab in the neoadjuvant treatment of breast cancer.
Authors: Stebbing J, Baranau Y, Manikhas A, Lee SJ, Thiruchelvam P, Leff D, Esteva FJ Abstract INTRODUCTION: Trastuzumab is a key drug in the neoadjuvant treatment of breast cancers that overexpress the human epidermal growth factor receptor 2 (HER2). Pathological complete response (pCR) is commonly used as an endpoint in neoadjuvant clinical trials of trastuzumab as evidence suggests it may be a surrogate for long-term survival. Several biosimilar candidates of originator or 'reference' trastuzumab are in development and have used pCR as a primary endpoint to assess therapeutic equivalence between treatments. The ...
Source: Expert Review of Anticancer Therapy - March 29, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

The effects of radiotherapy on the survival of patients with unresectable non-small cell lung cancer.
Authors: Tini P, Nardone V, Pastina P, Pirtoli L, Correale P, Giordano A Abstract INTRODUCTION: Lung cancer represents the leading cause of cancer mortality across the worlds. At present, less than 30% of the patients can undergo curative surgery, while the majority of them (65%) are diagnosed with metastatic disease and directed to systemic treatments whose effects on the outcome of these patients depends by their performance status, disease-stage, histology, targetable-driving-mutation, and susceptibility to immunotherapy. In this context there is a subset of patients (25%) with locally advanced stage disease who...
Source: Expert Review of Anticancer Therapy - March 29, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Olaparib for the treatment of breast cancer.
Authors: Griguolo G, Dieci MV, Guarneri V, Conte P Abstract INTRODUCTION: Mutations in BRCA1 and BRCA2 genes account for around 2-3% of breast cancer events and more than 10% of triple negative breast cancers. Olaparib (Lynparza®), an orally administered PARP inhibitor, demonstrated clinical benefit in a phase III trial for mutated BRCA-positive HER2 negative metastatic breast cancer. Areas covered: This review gives an overview of available preclinical and clinical data regarding olaparib, including its chemistry, mechanism of action, pharmacokinetics and pharmacodynamics, and evidence supporting antitumor eff...
Source: Expert Review of Anticancer Therapy - March 29, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

The diagnosis and management of extramammary Paget's disease.
Authors: Ito T, Kaku-Ito Y, Furue M Abstract INTRODUCTION: Extramammary Paget's disease (EMPD) is a rare neoplastic condition that commonly affects the anogenital area in the elderly. Owing to its low incidence, limited data regarding EMPD's diagnosis and treatment have been available. This review article aims to explore the current knowledge of EMPD to improve the management of this disease. Areas covered: This review outlines the diagnosis and management of EMPD. Articles on this issue that had been published in PubMed were identified and surveyed. We provide an overview of the reported studies, focusing on the r...
Source: Expert Review of Anticancer Therapy - March 27, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Current approaches to challenging scenarios in myeloproliferative neoplasms.
Authors: Zimran E, Hoffman R, Kremyanskaya M Abstract INTRODUCTION: The Philadelphia chromosome-negative myeloproliferative neoplasms (MPNs) including polycythemia vera, essential thrombocythemia and primary myelofibrosis are clonal hematological malignancies that originate at the level of the hematopoietic stem cell, and are characterized by excessive proliferation of cells belonging to one or more of the myeloid lineages. Central to the pathogenesis of the MPNs is constitutive activation of the JAK/STAT signaling pathway due to a family of driver mutations affecting JAK2, CALR or MPL. These disorders share common...
Source: Expert Review of Anticancer Therapy - March 27, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Surgical management of spinal metastases.
Authors: Galgano M, Fridley J, Oyelese A, Telfian A, Kosztowski T, Choi D, Gokaslan ZL Abstract INTRODUCTION: Metastatic spinal disease is a source of significant morbidity in patients with cancer. Recent advancements in adjuvant oncologic therapy has led to increased survival for many patients who harbor neoplastic disease. As a result of this, the chance of developing metastatic spinal disease over the course of a cancer patient's lifespan has increased. Symptomatic metastatic spinal disease can cause significant morbidity including severe pain, neurologic deficit, and loss of ambulation. Current treatment of the...
Source: Expert Review of Anticancer Therapy - March 23, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Nivolumab in squamous cell carcinoma of the head and neck.
Authors: Specenier P Abstract INTRODUCTION: The prognosis of recurrent/metastatic (R/M) squamous cell carcinoma of the head and neck (HNSCC) after failure of first line chemotherapy is dismal. Until the publication of the results of CheckMate 141, not a single agent provided any survival benefit as a second line treatment for R/M HNSCC. Areas covered: A comprehensive review of the literature was conducted on the role of nivolumab in HNSCC. Expert commentary: Nivolumab is approved by the Food and Drug Administration for the treatment of patients based on the results of CheckMate 141 showing an overall survival benef...
Source: Expert Review of Anticancer Therapy - March 23, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Dose intense chemotherapy in the management of poor prognosis and relapsed testicular cancer: experiences and controversies.
Authors: Ng K, Duncan S, Shamash J, Alifrangis C Abstract INTRODUCTION: The treatment of poor prognosis chemotherapy naïve or relapsed testicular cancer is challenging. In poor prognosis treatment naïve disease, the outlook for patients with standard approaches utilising three weekly cisplatin based regimens, most commonly bleomycin, etoposide and cisplatin (BEP) is suboptimal, and one can expect more than half of patients to relapse or progress and need salvage treatment. Recent randomised studies have lent weight to the use of dose intensified treatments in these selected patient groups. In relapsed tes...
Source: Expert Review of Anticancer Therapy - March 21, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Avelumab for the treatment of urothelial cancer.
This article will review the pharmacological characteristics of avelumab, the efficacy studies which led to its approval, its safety profile, as well as its place within the management of urothelial carcinoma with immunotherapy. For that matter, we undertook a literature review of all the studies assessing the pharmacology of avelumab and its efficacy within clinical trials. Expert commentary: Avelumab has shown promising antitumor activity and a manageable safety profile in patients with UC. Its dual mechanism of action, blocking the interaction between PD-L1 and PD-1 and promoting antibody-dependent cell-mediated cytotox...
Source: Expert Review of Anticancer Therapy - March 17, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Current and future therapeutic approaches for the treatment of small cell lung cancer.
Authors: Rossi A, Tay R, Chiramel J, Prelaj A, Califano R Abstract INTRODUCTION: Small-cell lung cancer (SCLC) is a very aggressive disease characterized by a high response rate to first-line chemotherapy, but most patients relapse within 1 year with disappointing results to second-line treatments. Chemotherapy has reached a plateau of effectiveness and new therapeutic strategies are needed to change the natural history of SCLC. Areas covered: This review will focus on the current results and the future development of the therapeutic approaches for the treatment of SCLC. Expert commentary: Immunotherapy is becoming...
Source: Expert Review of Anticancer Therapy - March 17, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Comparison of the effects of local treatment strategies in non-metastatic Ewing sarcoma of bone.
Authors: Zhang WT, Zhang WW, He ZY, Sun JY, Zhang L, Xia Q, Wu SG Abstract BACKGROUND: To investigate the optimal local treatment strategies for patients with non-metastatic Ewing sarcoma (ES) of bone. METHODS: Patients with ES of bone were identified using the Surveillance Epidemiology and End Results database. Kaplan-Meier log-rank test and Cox regression models were performed to assess the effect of the types of local treatment strategies on cause-specific survival and overall survival. RESULTS: 560 patients were included with a median age of 16 years. A total of 284, 162 and 114 patients received surger...
Source: Expert Review of Anticancer Therapy - March 16, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Update on early instillation of chemotherapy after transurethral resection of non-muscle-invasive bladder cancer.
Authors: Oosterlinck W, Decaestecker K Abstract INTRODUCTION: Non-muscle-invasive bladder cancer (NMIBC) is a highly recurrent disease. Early bladder chemotherapy instillation (EBCI) after transurethral resection (TURB) is an efficient way to diminish recurrence. However, this method is often challenged. Areas covered: There was a recent publication of a large meta-analysis with the original patient data and the largest study ever on EBCI. Both brought new evidence on EBCI. Also the results of the 2 trials of EBCI with apaziquone appeared. EBCI is discussed among other methods to decrease recurrence. Expert comment...
Source: Expert Review of Anticancer Therapy - March 14, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

CAR T-cell therapy for glioblastoma: ready for the next round of clinical testing?
This article reviews CAR design, tumor associated antigens expressed by GBMs that can be targeted with CAR T cells, preclinical and clinical studies conducted with CAR T cells, and genetic approaches to enhance their effector function. Expert commentary: While preclinical studies have highlighted the potent anti-GBM activity of CAR T cells, the initial foray of CAR T-cell therapies into the clinic resulted only in limited benefits for GBM patients. Additional genetic modification of CAR T cells has resulted in a significant increase in their anti-GBM activity in preclinical models. We are optimistic that clinical testing o...
Source: Expert Review of Anticancer Therapy - March 14, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research

Therapeutic approaches for refractory germ cell cancer.
Authors: Oing C, Seidel C, Bokemeyer C Abstract INTRODUCTION: Most germ cell cancer patients with metastatic disease are cured by cisplatin-based combination chemotherapy. 30% of metastatic patients will develop relapse or progress despite adequate first-line treatment and will require salvage therapy, with about 10% of metastasized patients ultimately developing platinum-resistant and fatal disease. Areas covered: Based on a comprehensive literature search of MEDLINE, EMBASE and conference proceedings of ESMO, ASCO and EAU meetings, this review provides an overview on current and potential future treatment options...
Source: Expert Review of Anticancer Therapy - March 10, 2018 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research