Critical reviews in oncology/hematology
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Crit. Rev. Oncol. Hematol. · Dec 2016
ReviewQuality end-of-Life cancer care: An overdue imperative.
This review assesses the current status of end-of-life care based on large-scale, multiyear nationwide surveys of treatment modality, setting, and cost of care during terminal patients' last months of life. It shows that end-of-life care goals often remain suboptimal. ⋯ In order to bridge the existing gap between care received and care expected and achieve quality end-of-life and promote death with dignity, we propose both to view the person rather than the disease as the unit of care and a pragmatic definition of end-of-life. Such a strategy should facilitate selecting an optimal time to transition from disease-targeted treatment to palliative care.
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Crit. Rev. Oncol. Hematol. · Nov 2016
ReviewStromal COX-2 signaling are correlated with colorectal cancer: A review.
Cyclooxygenase-2 (COX-2) and its product prostaglandin E2 (PGE2) play a critical role in development and progression of colorectal cancer. Yet the detailed mechanistic pathways of COX-2 mediated signaling are still controversial and the role of COX-2 interaction in epithelial-stromal compartments on colorectal carcinogenesis is not well-understood either. In this review, we provide experimental evidence to support that (1) COX-2 signaling plays a major role in development and progression of colorectal cancer; (2) Stromal fibroblasts are a major source of COX-2 and PGE2; (3) Stromal-epithelial interaction mediated by COX-2 signaling promotes colorectal carcinogenesis and (4) Inhibition of stromal COX-2 signaling is necessary to control colorectal cancer. In conclusion, the evidences summarized in the review reflect recent advances and insight in mechanistic studies of colorectal cancer which can help the audiences to further understand the etiology and the control of this disease.
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Crit. Rev. Oncol. Hematol. · May 2016
Review Meta AnalysisCorrelation between PD-L1 expression and outcome of NSCLC patients treated with anti-PD-1/PD-L1 agents: A meta-analysis.
A meta analysis of the correlation between PD-L1 levels and outcomes of PD-1/PD-L1 inhibitors in advanced non small cell lung cancer (NSCLC) has been performed. ⋯ The current analysis of data indicates that the benefit from PD-1 inhibitors versus docetaxel in second line treatment of NSCLC is limited to the PD-L1>1% subpopulation. Moreover, a possible dose effect relationship between the intensity of PD-L1 staining and the potential benefit from PD-1/PD-L1 targeted agents does exist with higher intensity associated with higher ORR.
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Crit. Rev. Oncol. Hematol. · May 2016
ReviewMyeloma bone and extra-medullary disease: Role of PET/CT and other whole-body imaging techniques.
Multiple myeloma (MM) is the second most common hematological malignancy. Although it can affect different organs, the bone compartment stands out both in terms of prevalence and clinical impact. Despite the striking advances in MM therapy, bone disease can remarkably affect the patient's quality of life. ⋯ It is emphasized that whole body low-dose computed tomography should be the preferred imaging technique at baseline. However, bone marrow infiltration and extra-medullary manifestations are better detected by whole body magnetic resonance imaging. Positron emission tomography/computed tomography, on the other hand, combines the benefits of the two mentioned imaging procedures and is particularly useful not only for the detection of osteolytic lesions unrevealed by conventional X-ray, but also in the assessment of prognosis and therapeutic response.
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Crit. Rev. Oncol. Hematol. · Mar 2016
Review Meta AnalysisCan KRAS and BRAF mutations limit the benefit of liver resection in metastatic colorectal cancer patients? A systematic review and meta-analysis.
Clinical trials investigated the potential role of both KRAS and BRAF mutations, as prognostic biomarkers, in colorectal cancer (CRC) patients who underwent surgical treatment of CRC-related liver metastases (CLM), showing conflicting results. This meta-analysis aims to review all the studies reporting survival outcomes (recurrence free survival (RFS), and/or overall survival (OS)) of patients undergoing resection of CLM, stratified according to KRAS and/or BRAF mutation status. ⋯ This meta-analysis suggests both KRAS and BRAF mutations as poor, prognostic biomarkers, associated with worse survival outcomes, in patients undergoing hepatic resection of CLM.