Harnessing the Immune System to Tackle Small Cell Lung Cancer
Immunotherapy has improved first-line therapy for small cell lung cancer and has activity in the relapsed setting as well. The immunobiology of small cell lung cancer poses challenges for immunotherapy, and efforts are underway to unlock to the potential of immunotherapy through the identification of meaningful disease subsets and the development of novel combination therapies. (Source: The Cancer Journal)
Source: The Cancer Journal - November 1, 2020 Category: Cancer & Oncology Tags: Review Articles Source Type: research
How I Treat Non–Small Cell Lung Cancer Refractory to Immunotherapy
Lung cancer is a leading cause of cancer-related mortality despite continued advances in diagnostic and therapeutic strategies. Although the development of immune checkpoint inhibitors has revolutionized the treatment landscape for advanced non–small cell lung cancer, many patients either have primary resistance to these agents or eventually develop secondary resistance necessitating a change to an alternate therapy. Understanding novel patterns of response to immunotherapy is crucial in determining appropriate selection and sequencing of treatment. Chemotherapy remains the standard of care in immunotherapy-refractory di...
Source: The Cancer Journal - November 1, 2020 Category: Cancer & Oncology Tags: Review Articles Source Type: research
What Is the Standard First-Line Treatment for Advanced Non–Small Cell Lung Cancer?
The initial treatment regimens for advanced non–small cell lung cancer (NSCLC) have drastically evolved over the last 15 years with the rapid development of improved genomic sequencing technologies and the emergence of immune checkpoint inhibitors. Highly active oral kinase inhibitors are now approved for several molecularly defined subsets of NSCLC, including those harboring alterations in the EGFR, ALK, ROS1, BRAF, MET, RET, and NTRK genes, although acquired resistance to these targeted therapies remains a significant clinical challenge. In lung cancers lacking targetable mutations, programmed death 1/programmed death ...
Source: The Cancer Journal - November 1, 2020 Category: Cancer & Oncology Tags: Review Articles Source Type: research
Overview of Lung Cancer Immunotherapy
Anti–PD-(L)1 therapy represents a turning point in lung cancer immunotherapy, moving from previously ineffective enhancer strategies to immune checkpoints as standard first- and second-line therapies. This unprecedented success highlights the importance of mechanisms to escape immune attack, such PD-1/PD-L1 axis, and emphasize the importance to better understand the tumor immune microenvironment. Analyzing the specifics of immune response against lung tumor cells and how malignant cells progressively adapt to this pressure may help to understand which are the key aspects to guide the development of new therapeutic strate...
Source: The Cancer Journal - November 1, 2020 Category: Cancer & Oncology Tags: Review Articles Source Type: research
Introduction by the Guest Editors
No abstract available (Source: The Cancer Journal)
Source: The Cancer Journal - November 1, 2020 Category: Cancer & Oncology Tags: From the Guest Editor Source Type: research
Novel Therapeutic Approaches and the Evolution of Drug Development in Advanced Kidney Cancer
Therapies currently approved in renal cell carcinoma (RCC) include tyrosine kinase inhibitors, immune checkpoint inhibitors, and inhibitors of mTOR signaling. Increased understanding of the biology of clear cell and non–clear cell RCC has led to development of agents that target hypoxia-inducible factor 2 and MET, while there is ongoing exploration of targeting immune pathways other than the programmed death ligand 1 or cytotoxic T-lymphocyte–associated protein 4 checkpoints. Drug development in RCC is moving toward the study of combination therapies and attempting to use a risk-adapted approach in treatment. While the...
Source: The Cancer Journal - September 1, 2020 Category: Cancer & Oncology Tags: Review Articles Source Type: research
The Critical Role of the Oncology Nurse as a Partner in the Management of Patients With Advanced Kidney Cancer: Toxicity Management, Symptom Control, and Palliative Care
The treatment of advanced renal cell carcinoma has changed dramatically since 2005 with the approval of 12 regimens including oral, intravenous, and combination strategies. These approvals have changed the treatment paradigm for these patients and developed new challenges and a critical role for oncology nurses to ensure that the treatment plan and adverse events are managed effectively. The majority of these regimens include an oral anticancer drug, which requires patients and their caregivers to understand the medication, the potential adverse events, the importance of medicine adherence, and the importance of early and ...
Source: The Cancer Journal - September 1, 2020 Category: Cancer & Oncology Tags: Review Articles Source Type: research
The Reintroduction of Radiotherapy Into the Integrated Management of Kidney Cancer
The incidence of renal cell carcinoma (RCC) has been increasing, with a moderate subgroup of individuals who later develop metastatic disease. Historically, metastatic RCC has been managed with systemic therapy because RCC was believed to be radioresistant. Local therapies, such as stereotactic body radiation therapy, also known as stereotactic ablative radiotherapy, which utilize focused high-dose-rate radiation delivered over a limited number of treatments, have been successful in controlling local disease and, in some cases, extending survival in patients with intracranial and extracranial metastatic RCC. Stereotactic a...
Source: The Cancer Journal - September 1, 2020 Category: Cancer & Oncology Tags: Review Articles Source Type: research
Advanced Non–Clear Cell Kidney Cancer: In Search of Rational Treatment Approaches
Non–clear cell renal cell carcinoma (nccRCC) accounts for approximately 25% of RCC diagnoses. Although broadly labeled as “nccRCC,” they comprised a host of histologies that include papillary, chromophobe, unclassified, and others. Moreover, these histological variants are further subclassified on the basis of genomic profiling, thereby highlighting nccRCC to be anything but a homogenous cohort of RCC. The heterogeneity of nccRCC has proved challenging in developing therapeutics for this population. Although ccRCC therapeutic data have been commonly extrapolated for the treatment of nccRCC, the overall poor outcome o...
Source: The Cancer Journal - September 1, 2020 Category: Cancer & Oncology Tags: Review Articles Source Type: research
Immune Related Adverse Events: Classification and Management Approaches in Advanced Kidney Cancer
Recent therapeutic advancements have incorporated immune checkpoint inhibitors (ICIs) into the management of metastatic renal cell carcinoma. Pivotal phase III trials have resulted in Food and Drug Administration approval for anti–programmed death 1/programmed death ligand 1 ICIs, either in combination with anti–cytotoxic T-lymphocyte antigen 4 ICIs or with vascular endothelial growth factor–directed targeted therapies, as standard-of-care frontline regimens. Immune checkpoint inhibitors offer improved clinical outcomes when compared to previous treatment options. However, these agents also present unique toxicity pr...
Source: The Cancer Journal - September 1, 2020 Category: Cancer & Oncology Tags: Review Articles Source Type: research
The Immunotherapy Revolution in Kidney Cancer Treatment: Scientific Rationale and First-Generation Results
The recent discovery of immune checkpoint inhibitors (ICIs) has revolutionized cancer treatment, including the treatment for renal cell carcinoma (RCC). Following the eras of cytokines and molecularly targeted therapies including vascular endothelial growth factor–directed agents and mammalian target of rapamycin (mTOR) inhibitors, ICIs have become the latest addition to the RCC armamentarium. To understand the scientific rationale behind this revolution in RCC treatment, we have reviewed the fundamental discoveries underlying the transition from old (cytokines) to new (ICIs) immunotherapies. We summarize the pivotal tri...
Source: The Cancer Journal - September 1, 2020 Category: Cancer & Oncology Tags: Review Articles Source Type: research
Targeting Metabolic Pathways in Kidney Cancer: Rationale and Therapeutic Opportunities
Alterations in cellular sugar, amino acid and nucleic acid, and lipid metabolism, as well as in mitochondrial function, are a hallmark of renal cell carcinoma (RCC). The activation of oncogenes such as hypoxia-inducible factor and loss of the von Hippel-Lindau function and other tumor suppressors frequently occur early on during tumorigenesis and are the drivers for these changes, collectively known as “metabolic reprogramming,” which promotes cellular growth, proliferation, and stress resilience. However, tumor cells can become addicted to reprogrammed metabolism. Here, we review the current knowledge of metabolic add...
Source: The Cancer Journal - September 1, 2020 Category: Cancer & Oncology Tags: Review Articles Source Type: research
Epigenetic Dysregulation in Advanced Kidney Cancer: Opportunities for Therapeutic Interventions
Understanding the complex epigenome of advanced renal cell carcinoma may lead to novel epigenomic-based pharmaceutical strategies and identify new targets for therapeutic interventions. Epigenetic changes, such as DNA methylation and histone acetylation, modulate the activity of significant oncogenic signaling pathways by regulating gene expression. Such pathways include the WNT–β-catenin pathway, the von Hippel-Lindau–hypoxia-inducible factor pathway, and epithelial-mesenchymal transition pathway. Common genetic alterations in histone modifier genes in renal cell carcinoma may not only be responsible for the pathogen...
Source: The Cancer Journal - September 1, 2020 Category: Cancer & Oncology Tags: Review Articles Source Type: research
The von Hippel-Lindau Tumor Suppressor Gene: Implications and Therapeutic Opportunities
The discovery of the von Hippel-Lindau (VHL) gene marked a milestone in our understanding of clear cell renal cell carcinoma (ccRCC) pathogenesis. VHL inactivation is not only a defining feature of ccRCC, but also the initiating event. Herein, we discuss canonical and noncanonical pVHL functions, as well as breakthroughs shaping our understanding of ccRCC evolution and evolutionary subtypes. We conclude by presenting evolving strategies to therapeutically exploit effector mechanisms downstream of pVHL. (Source: The Cancer Journal)
Source: The Cancer Journal - September 1, 2020 Category: Cancer & Oncology Tags: Review Articles Source Type: research
Cytoreductive Nephrectomy in Patients Presenting With Advanced Disease: Have We Finally Answered the Question?
Determining the appropriate patients for cytoreductive nephrectomy (CN) has evolved with the integration of more effective systemic therapies for patients with metastatic renal cell carcinoma (mRCC). While previously considered to be first-line therapy for mRCC, CN has not demonstrated a significant survival advantage over systemic therapy in more recent randomized trials when compared with targeted therapy. Conversely, multiple observational studies demonstrate a therapeutic benefit for CN. This review synthesizes the current literature regarding patient selection for CN and further evaluates the role of CN in the current...
Source: The Cancer Journal - September 1, 2020 Category: Cancer & Oncology Tags: Review Articles Source Type: research
