Precision Medicine in the Treatment of Melanoma
This article reviews the newest and most up-to-date advances in precision medicine within melanoma practice. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - November 20, 2019 Category: Surgery Authors: Kimberly Aderhold, Melissa Wilson, Adam C. Berger, Shoshana Levi, Joseph Bennett Source Type: research

Genomics Testing and Personalized Medicine in the  Preoperative Setting
This article discusses the current evidence highlighting the potential of PGx with various drug categories (including opioids, nonopioid analgesics, sedatives, β-blockers, antiemetics, and anticoagulants) used in the perioperative process and the challenges of integ rating PGx into a health care system and relevant workflows. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - November 20, 2019 Category: Surgery Authors: Rodney A. Gabriel, Brittany N. Burton, Richard D. Urman, Ruth S. Waterman Source Type: research

Individualizing Care
The evolving research landscape, with advances in the omics technologies, availability of large-scale patient cohorts, and forthcoming availability of novel drugs in primary biliary cholangitis (PBC), is creating a unique opportunity for developing a precision medicine (PM) program. PM has potential to change the paradigm of management. Diagnostic work-up of PBC patients may include information on genetic variants and molecular signature to define a particular subtype of disease and provide an estimate of treatment response and survival. To reach this point, specific interventions, such as sequencing more genomes, creating...
Source: Surgical Oncology Clinics of North America - November 20, 2019 Category: Surgery Authors: Laura Cristoferi, Alessandra Nardi, Pietro Invernizzi, George Mells, Marco Carbone Source Type: research

Personalized Medicine in Gynecologic Cancer
Personalized medicine in gynecologic oncology is an evolving field. In recent years, tumor profiling and large databases such as TCGA and NCI-Match have provided us with enormous amounts of molecular data. Several therapies that capitalize on novel genetic and immune discoveries including VEGF inhibitors, PARP inhibitors, and cancer vaccinations are discussed in this article. Additionally, we have seen direct to consumer marketing play an important role in cancer care and prevention as patients have increased ability to access genetic testing. This presents a unique challenge to gynecologic oncology providers as we learn t...
Source: Surgical Oncology Clinics of North America - November 20, 2019 Category: Surgery Authors: Logan Corey, Ana Valente, Katrina Wade Source Type: research

Diffuse Large B-Cell Lymphoma and High-Grade B-Cell Lymphoma
Diffuse large B-cell lymphoma (DLBCL), the most common subtype of non-Hodgkin lymphoma, is characterized by both clinical and molecular heterogeneity. Despite efforts to tailor therapy for individual patients, treatment remains uniform and a subset of patients have poor outcomes. The past decade has witnessed a dramatic expansion of our understanding of the genomic underpinnings of this disease, especially with the application of next-generation sequencing. In this review, the authors highlight the current genomic landscape of DLBCL and how this information provides a potential molecular framework for precision medicine-ba...
Source: Surgical Oncology Clinics of North America - November 20, 2019 Category: Surgery Authors: Jennifer L. Crombie, Philippe Armand Source Type: research

Oral Cancer
This article reviews the current understanding of initiation, progression, and metastasis of OSCC from both genetic and epigenetic perspectives. In addi tion, the applications and integration of omics technologies in biomarker discovery and drug development for treating OSCC are reviewed. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - November 20, 2019 Category: Surgery Authors: Chia-Cheng Li, Zhen Shen, Roxanne Bavarian, Fan Yang, Aditi Bhattacharya Source Type: research

Precision Medicine in Colorectal Surgery
This article reviews advances in precision medicine for colorectal carcinoma that have influenced screening and treatment, and potentially prevention. Advances in molecular techniques have made it possible for better patient selection for therapies; therefore, mutational analysis should be performed at diagnosis to guide treatment. Future efforts should focus on validating these treatments in specific subgroups and on understanding the mechanisms of resistance to therapies to enable treatment optimization, promote efficacy, and reduce treatment costs and toxicities. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - November 20, 2019 Category: Surgery Authors: Sangeetha Prabhakaran, Joseph Leong, Nicholas J. Petrelli, Vijay P. Khatri Source Type: research

Precision Medicine in Surgical Oncology
This issue of the Surgical Oncology Clinics of North America is devoted to covering the important emerging topic of Precision Medicine in Surgical Oncology. As surgeons, it is critical that we integrate new knowledge about precision medicine into the diagnosis and surgical management of patients with cancer. The guest editors are Dr Vijay Khatri and Dr Nicholas Petrelli. Both Drs Khatri and Petrelli are recognized leaders in surgery with particular expertise in emerging innovative therapies for patients with cancer. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - November 20, 2019 Category: Surgery Authors: Timothy M. Pawlik Tags: Foreword Source Type: research

Precision Medicine
If the definition of precision medicine is looked up just about anywhere, in so many words it will be described as medical care to optimize efficiency or therapeutic benefit for particular groups of patients, especially by using genetic or molecular profiling. There is no question that we are in the era of precision medicine as demonstrated by the variety of topics dedicated to precision medicine in cancer treatment and prognosis in this issue of the Surgical Oncology Clinics of North America. It is an era that allows oncologists to accurately predict which treatment strategy will be effective for a particular cancer. (Sou...
Source: Surgical Oncology Clinics of North America - November 20, 2019 Category: Surgery Authors: Vijay P. Khatri, Nicholas J. Petrelli Tags: Preface Source Type: research

Precision Medicine in Surgical Oncology
SURGICAL ONCOLOGY CLINICS OF NORTH AMERICA (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - November 20, 2019 Category: Surgery Authors: Vijay P. Khatri, Nicholas J. Petrelli Source Type: research

Copyright
ELSEVIER (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - November 20, 2019 Category: Surgery Source Type: research

Contributors
TIMOTHY M. PAWLIK, MD, MPH, MTS, PhD, FACS, FRACS (Hon) (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - November 20, 2019 Category: Surgery Source Type: research

Contents
Timothy M. Pawlik (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - November 20, 2019 Category: Surgery Source Type: research

Forthcoming Issues
Management of GI and Pancreatic Neuroendocrine Tumors (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - November 20, 2019 Category: Surgery Source Type: research

Genomics and the History of Precision Oncology
Progress toward the implementation of a molecular characterization paradigm in cancer drug development over the past 20  years has markedly enhanced our capability to select patients who are more likely to benefit from cancer therapy. Improvements in genomic and related diagnostic testing platforms have permitted evaluation of the efficacy of treatment assignment based on predefined biologic features of a patient’ s tumor or germline using master protocols that may include many malignancies and their molecularly characterized subsets. With this approach, a wide range of new targeted and immunologic treatment app...
Source: Surgical Oncology Clinics of North America - October 29, 2019 Category: Surgery Authors: Deborah B. Doroshow, James H. Doroshow Source Type: research

Precision Medicine and Targeted Therapies in Breast Cancer
This article describes the foundation and future of targeted therapy and precision medicine in breast cancer. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - October 29, 2019 Category: Surgery Authors: Ian Greenwalt, Norah Zaza, Shibandri Das, Benjamin D. Li Source Type: research

Precision Medicine in Pediatric Oncology
This article describes how precision medicine is being applied to pediatric oncology and the unique challenges being faced with these efforts. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - October 29, 2019 Category: Surgery Authors: Kieuhoa T. Vo, D. Williams Parsons, Nita L. Seibel Source Type: research

Precision Medicine in Lung Cancer Treatment
Lung cancer remains second most common cancer in men and women in the United States. More than 50% of patients are diagnosed in the advanced stage. Traditionally, chemotherapy has been the backbone of management of stage IV lung cancer. A better understanding of the molecular pathogenesis has led to rapid development of targeted therapy and immunotherapy. This has led to significant improvement in survival of patients with lung cancer stages III to IV. These drugs are being studied in early stage lung cancer. Several trials are ongoing to improve the survival and quality of life of our patients. (Source: Surgical Oncology ...
Source: Surgical Oncology Clinics of North America - October 16, 2019 Category: Surgery Authors: Dhaval R. Shah, Gregory A. Masters Source Type: research

Current Imaging Standards for Nonmetastatic Benign and Malignant Liver Tumors
This article discusses current consensus guidelines for imaging of liver masses, as well as masses found on surveillance imaging. The ability to accurately characterize lesions requires proper use and understanding of the technology and expert interpretation. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - August 29, 2019 Category: Surgery Authors: Janelle F. Rekman, Philip Smith, Morgan Bonds, David Coy, Scott Helton Source Type: research

Intrahepatic Cholangiocarcinoma
Intrahepatic cholangiocarcinoma (ICC) arises from the epithelial cells of the intrahepatic and extrahepatic bile ducts and occurs proximal to the segmental biliary ducts. Risk factors include chronic hepatitis and cirrhosis, biliary inflammatory diseases, and hepatobiliary flukes, although in most cases, no known risk factor is identified. ICC is highly aggressive, with long-term survival only observed in patients with a complete R0 surgical resection. Technical and physiologic resectability should be considered when performing an operative plan. Nodal involvement is among the most important prognostic factors associated w...
Source: Surgical Oncology Clinics of North America - August 29, 2019 Category: Surgery Authors: Ramy El-Diwany, Timothy M. Pawlik, Aslam Ejaz Source Type: research

Molecular Characteristics of Biliary Tract and Primary Liver Tumors
With the recent decline in cost of high-throughput next-generation sequencing, detailed characterization of biliary tract and primary liver tumors continues to evolve. Recent studies have elucidated molecular signatures that reflect distinct pathways of carcinogenesis reflective of viral, parasitic, and toxin-related etiologic factors. With greater elucidation of the molecular pathogenesis of disease, novel targets that may be potential clinically actionable continue to be identified. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - August 29, 2019 Category: Surgery Authors: Susan Tsai, T. Clark Gamblin Source Type: research

Gallbladder Cancer
Managing patients with incidental gallbladder cancer requires stratifying patients risk for recurrence and an appreciation for the recurrence patterns characterizing this malignancy. Although standard management includes reresection to remove sites at risk of harboring residual disease and to achieve negative resection margin status, the decision to perform surgery is tempered by an early and frequent distant recurrence, the most common cause of surgical failure. High-risk patients may benefit from neoadjuvant chemotherapy before reresection. The goal of curative-intent reresection is achieving R0 margin status and optimal...
Source: Surgical Oncology Clinics of North America - August 29, 2019 Category: Surgery Authors: Leonid Cherkassky, Michael D ’Angelica Source Type: research

Staging of Biliary and Primary Liver Tumors
Hepatobiliary malignancies are a diverse group of neoplasms involving the liver, gallbladder, and bile ducts. Although intrahepatic cholangiocarcinoma, perihilar cholangiocarcinoma, hepatocellular carcinoma, and gallbladder adenocarcinoma share many biological and anatomic features, they have distinct clinical presentations and natural histories that require individual consideration. Here, we discuss the incidence, outcomes, patient presentation, initial workup, pathologic diagnoses, staging classification, imaging and surgical staging, and determinants of resectability for each malignancy. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - August 29, 2019 Category: Surgery Authors: Geoffrey W. Krampitz, Thomas A. Aloia Source Type: research

Inoperable Biliary Tract and Primary Liver Tumors
Primary liver tumors are most commonly hepatocellular carcinoma and intrahepatic cholangiocarcinoma. Although surgical resection offers a chance for cure, these tumors generally present at a late, inoperable stage, necessitating an understanding of noncurative and palliative treatment options. These options include ablative therapies, including radiofrequency ablation; intra-arterial therapies, including transcatheter chemoembolization; biliary decompression; radiotherapy; systemic therapies, including traditional chemotherapeutic agents; and molecular therapies, such as sorafenib. Selection of nonoperative treatment depen...
Source: Surgical Oncology Clinics of North America - August 29, 2019 Category: Surgery Authors: Sophia K. McKinley, Akhil Chawla, Cristina R. Ferrone Source Type: research

Biliary Tract and Primary Liver Tumors
Biliary tract and primary liver tumors can be divided into intrahepatic and extrahepatic sites. Hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma are the most common primary liver malignancies, making up 75% and 15% of cases, respectively. In the United States, there has been an increase in incidence of HCC and cholangiocarcinoma over the last 2  decades, and it is probable that the incidence of both will continue to climb. Gallbladder cancer, however, is the most frequent biliary tract cancer, comprising 80% to 90% of biliary tract cancers worldwide. Underlying epidemiology and cause are discussed. (...
Source: Surgical Oncology Clinics of North America - August 29, 2019 Category: Surgery Authors: Alan W. Hemming Source Type: research

Nonsurgical Approaches to Treat Biliary Tract and Liver Tumors
This article reviews pertinent studies published within the last 5 years that involve locoregional techniques to manage hepatocellular carcinoma, perihilar and distal cholangiocarcinoma. A major emphasis is placed on photodynamic therapy, radiofrequency ablation, irreversible electroporation, and microwave ablation. Technical advances, combinational therapies, and postintervention outcomes are discussed. Despite widespread application, high-quality evidence does not show superiority of any particular locoregional technique for treating advanced hepatobiliary cancers. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - August 29, 2019 Category: Surgery Authors: Benjamin L. Green, Michael G. House Source Type: research

Approaches and Outcomes to Distal Cholangiocarcinoma
Distal cholangiocarcinoma is a rare malignancy with a dismal prognosis. Because of its location and aggressive nature, patients often present with locally advanced or metastatic disease, and effective treatment options are limited. For patients with resectable disease, surgery is the only chance for cure, but achieving an R0 resection is paramount. Optimal adjuvant therapy in resectable disease remains under investigation. Randomized controlled trials investigating neoadjuvant therapy and its impact on resectability and long-term outcomes are needed to continue to improve the outcomes of patients with distal cholangiocarci...
Source: Surgical Oncology Clinics of North America - August 29, 2019 Category: Surgery Authors: Rachel M. Lee, Shishir K. Maithel Source Type: research

Systemic Therapy for Primary Liver Tumors
In the past decade, there has been significant progress in the treatment of primary liver cancer. There has been increasing knowledge of the molecular alterations occurring in these tumors, which is now being translated into patient care. Ongoing clinical trials will further advance the therapeutic options available to patients, including the introduction of molecular targeted therapeutics and immunotherapy approaches. Critical to the success of these new drugs, is the appropriate use of them in the clinic to maximize efficacy and limit toxicity. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - August 29, 2019 Category: Surgery Authors: Saeed Sadeghi, Anthony Bejjani, Richard S. Finn Source Type: research

Role of Radioembolization for Biliary Tract and Primary Liver Cancer
Hepatocellular carcinoma and intrahepatic cholangiocarcinoma are often amenable to locoregional therapy, including percutaneous ablation, transarterial chemoembolization (TACE), or transarterial radioembolization (TARE). TARE is a technique that delivers a high dose of radiation to the tumor, while limiting the dose to the normal liver parenchyma and the adjacent organs. It has been shown to effectively provide disease control with relatively few toxicities, and in certain cases results in a complete response. It is the preferred therapy as a bridge to liver transplant and can provide necessary compensatory future liver re...
Source: Surgical Oncology Clinics of North America - August 29, 2019 Category: Surgery Authors: Amy C. Taylor, Dilip Maddirela, Sarah B. White Source Type: research

Biliary Tract and Primary Liver Tumors
SURGICAL ONCOLOGY CLINICS OF NORTH AMERICA (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - August 29, 2019 Category: Surgery Authors: T. Clark Gamblin Source Type: research

Copyright
ELSEVIER (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - August 29, 2019 Category: Surgery Source Type: research

Contributors
TIMOTHY M. PAWLIK, MD, MPH, PhD, FACS, FRACS (Hon.) (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - August 29, 2019 Category: Surgery Source Type: research

Contents
Timothy M. Pawlik (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - August 29, 2019 Category: Surgery Source Type: research

Forthcoming Issues
Precision Medicine in Surgical Oncology (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - August 29, 2019 Category: Surgery Source Type: research

Evolving Surgical Options for Hepatocellular Carcinoma
Surgical resection and liver transplant remain the cornerstones of curative treatment options for hepatocellular carcinoma. Determining the best treatment option for each patient is a complex decision based on degree of liver cirrhosis, extent of tumor, and overall patient performance status. A multidisciplinary approach is best. With widespread adoption, the role of laparoscopic liver resection for hepatocellular carcinoma continues to expand. Long-term oncologic outcomes are similar for laparoscopic and open resection, with improved short-term results, mainly blood loss and hospital length of stay. Liver transplant remai...
Source: Surgical Oncology Clinics of North America - August 10, 2019 Category: Surgery Authors: Gregory C. Wilson, David A. Geller Source Type: research

Regional Chemotherapy for Biliary Tract Tumors and Hepatocellular Carcinoma
Locally advanced hepatocellular carcinoma and intrahepatic cholangiocarcinoma are associated with a grim prognosis. The development of highly effective systemic therapies for these tumors has been challenging; however, numerous locoregional treatment alternatives have emerged, including transarterial hepatic embolization (TAE), transarterial chemoembolization (TACE), drug-eluting bead TACE (DEB-TACE), hepatic arterial infusion chemotherapy (HAI), radioembolization, and stereotactic body radiation therapy. Although there is potential for long-term disease control for these therapies, the evidence to guide adequate patient s...
Source: Surgical Oncology Clinics of North America - August 7, 2019 Category: Surgery Authors: Sebastian Mondaca, Hooman Yarmohammadi, Nancy E. Kemeny Source Type: research

Surgical Considerations of Hilar Cholangiocarcinoma
Cholangiocarcinoma is an aggressive malignancy of the extrahepatic bile ducts. Hilar lesions are most common. Patients present with obstructive jaundice and intrahepatic bile duct dilation. Cross-sectional imaging reveals local, regional, and distant extent of disease, with direct cholangiography providing tissue for diagnosis. The consensus of a multidisciplinary committee dictates treatment. Resection of the extrahepatic bile duct and ipsilateral hepatic lobe with or without vascular resection and transplantation after neoadjuvant protocol are options for curative treatment. The goal of surgery is to remove the tumor wit...
Source: Surgical Oncology Clinics of North America - August 2, 2019 Category: Surgery Authors: Blaire Anderson, M.B. Majella Doyle Source Type: research

Expanding the Surgical Pool for Hepatic Resection to Treat Biliary and Primary Liver Tumors
Surgical management of primary liver and biliary tract tumors has evolved over the past several decades, resulting in improved outcomes in these malignancies with historically poor prognoses. Expansion of patient selection criteria, progress in neoadjuvant and adjuvant therapies, development of techniques to increase future liver remnant, and the select utilization of liver transplantation have all contributed to increasing the patient pool for surgical intervention. Ongoing and future studies need to focus on improving multimodality treatment regimens and further refining the selection criteria for transplantation in orde...
Source: Surgical Oncology Clinics of North America - August 2, 2019 Category: Surgery Authors: Tiffany C. Lee, Mackenzie C. Morris, Sameer H. Patel, Shimul A. Shah Source Type: research

Biliary Tract and Primary Liver Tumors
This issue of the Surgical Oncology Clinics of North America is devoted to the topic of biliary tract and primary liver tumors under the guest editorship of T. Clark Gamblin, Professor of Surgery and Division Chief of Surgical Oncology at the Medical College of Wisconsin. As the Stuart D. Wilson Chair in Surgical Oncology, Dr Gamblin has extensive expertise in the treatment of patients with biliary tract and primary liver cancers. In fact, Dr Gamblin is a nationally and internationally recognized hepatobiliary surgeon who has published over 100 papers on this topic. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - July 26, 2019 Category: Surgery Authors: Timothy M. Pawlik Tags: Foreword Source Type: research

Hepatobiliary Malignancies: The Changing Landscape
This issue of Surgical Oncology Clinics of North America is focused on the management of primary liver cancer and biliary malignancies. Management of these challenging diseases requires a multidisciplinary approach in a field that has made substantial advances in recent years. A panel of experts has contributed to this topic with articles ranging from epidemiology, liver-directed therapy, and systemic therapy to genetic profiling and management options for inoperable patients. Authors have provided an in-depth review of topics and pointed to the patient of tomorrow as the field rapidly expands. (Source: Surgical Oncology C...
Source: Surgical Oncology Clinics of North America - July 25, 2019 Category: Surgery Authors: T. Clark Gamblin Tags: Preface Source Type: research

The Current Landscape of Immune Checkpoint Inhibition for Solid Malignancies
Immunotherapy has led to unprecedented improvement in the treatment and prognosis of high-risk resectable and metastatic disease across cancer types. Nowhere is this better highlighted than in the management of advanced and metastatic melanoma with the introduction of molecularly targeted therapies and immune checkpoint inhibitors. Following their success in melanoma, immunotherapies have also been evaluated and their use approved in the management across a variety of other solid malignancies in the neoadjuvant, adjuvant, and advanced/metastatic setting. This review provides an overview of the current landscape of immune c...
Source: Surgical Oncology Clinics of North America - May 10, 2019 Category: Surgery Authors: Emily Z. Keung, Jennifer A. Wargo Source Type: research

Immunotherapy for Solid Malignancies
SURGICAL ONCOLOGY CLINICS OF NORTH AMERICA (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - May 10, 2019 Category: Surgery Authors: Alfred E. Chang Source Type: research

Copyright
ELSEVIER (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - May 10, 2019 Category: Surgery Source Type: research

Contributors
TIMOTHY M. PAWLIK, MD, MPH, PhD, FACS, FRACS (Hon.) (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - May 10, 2019 Category: Surgery Source Type: research

Contents
Timothy M. Pawlik (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - May 10, 2019 Category: Surgery Source Type: research

Forthcoming Issues
Biliary Tract and Primary Liver Tumors (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - May 10, 2019 Category: Surgery Source Type: research

Immunotherapy for Solid Malignancies
This issue of the Surgical Oncology Clinics of North America is devoted to focusing on the role of immunotherapy for solid malignancies. The guest editor is Dr Alfred Chang. Dr Chang is the Hugh Cabot Professor of Surgery at the University of Michigan. Dr  Chang has expertise in the areas of breast cancer, melanoma, sarcomas, liver tumors, and colorectal cancer. He has held leadership roles at the University of Michigan Rogel Cancer Center. Dr Chang runs a laboratory program that has been externally funded for more than 25 years. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - April 20, 2019 Category: Surgery Authors: Timothy M. Pawlik Tags: Foreword Source Type: research

The Dawn of a New Age in Cancer Immunotherapy
It was over one hundred years ago that immunotherapy for cancer was first explored by Dr William Coley with the intratumoral injection of bacterial extracts that resulted in tumor regression in select cases. The emergence of surgical procedures, radiation therapy, and chemotherapy eventually became the mainstay of cancer therapies and relegated immune treatments as an unfulfilled pipedream. Nevertheless, it has been apparent that the immune system can play a role in tumor biology as evident by cases of spontaneous tumor regression and increased cancer incidence among immunosuppressed patients. (Source: Surgical Oncology Cl...
Source: Surgical Oncology Clinics of North America - April 20, 2019 Category: Surgery Authors: Alfred E. Chang Tags: Preface Source Type: research

Vaccine Strategy in Melanoma
The incidence of melanoma continues to increase even as advances in immunotherapy have led to survival benefits in advanced stages. Vaccines are capable of inducing strong, antitumor immune responses with limited toxicity. Some vaccines have demonstrated clinical benefit in clinical trials alone; however, others have not despite inducing strong immune responses. Recent advancements have improved vaccine design, and combining vaccines with other immunotherapies offers promise. This review highlights the underlying principles of vaccine development, common components of vaccines, and the remaining challenges and future direc...
Source: Surgical Oncology Clinics of North America - April 15, 2019 Category: Surgery Authors: Minyoung Kwak, Katie M. Leick, Marit M. Melssen, Craig L. Slingluff Source Type: research

Role of Surgery in Combination with Immunotherapy
Improvements in systemic immunotherapy are changing the treatment of patients with advanced melanoma and many other tumors. Surgeons may be increasingly called on to manage isolated sites of immunorefractory disease or to provide palliative surgery as a bridge to systemic therapy. Here, the authors describe the biologic rationale for using surgery in patients with immunorefractory disease, provide background on the evolving role of metastasectomy for advanced melanoma, and summarize data on the use of neoadjuvant immunotherapy. Finally, the authors discuss the direction of clinical research in this rapidly evolving field. ...
Source: Surgical Oncology Clinics of North America - April 15, 2019 Category: Surgery Authors: Nicholas D. Klemen, Mackenzie L. Shindorf, Richard M. Sherry Source Type: research