Clinical advances in hematology & oncology : H&O
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Clin Adv Hematol Oncol · Sep 2004
ReviewDevelopment of targeted therapies for B-cell non-Hodgkin lymphoma and multiple myeloma.
The design of innovative, more effective, and less toxic therapy of B-cell lymphoma is emerging in parallel to a better understanding of the mechanisms of action of target-specific agents targeting the neoplastic B cell. Rituximab has changed the treatment paradigm of patients with B-cell lymphomas and is considered the first effective targeted therapy approved by the US Food and Drug Administration (FDA) for the treatment of lymphoproliferative disorders. Despite its good efficacy and safety profile, sustained complete remissions have been documented in a relatively small proportion of patients treated with rituximab monotherapy. ⋯ While rituximab has been incorporated into multiple chemotherapy regimens (ie, CVP, CHOP, FND, etc.) a significant number of lymphoma patients either relapse after initial responses or fail to respond as a consequence of either intrinsic or acquired resistance. Scientific efforts are being focused toward developing new strategies to improve rituximab activity. In this report we provide an overview of recent developments in target-specific therapies and review past, ongoing, and future research tiling this diverse group of exciting novel agents.
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Clin Adv Hematol Oncol · Sep 2004
ReviewThe treatment of colorectal carcinoma: standard chemotherapy and beyond.
Significant advances in the management of colorectal cancer patients have occurred within the past 5 years. New cytotoxic agents as well as novel targeted therapies have notably prolonged the survival of colorectal cancer patients with advanced disease. ⋯ Our improved scientific understanding of colorectal cancer will form the basis for further development of new methods to treat this common malignancy. The introduction of targeted therapeutics into the management of colorectal cancer is likely to extend the overall survival of patients further.
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Clin Adv Hematol Oncol · May 2004
ReviewPalonosetron: a unique 5-HT3 receptor antagonist indicated for the prevention of acute and delayed chemotherapy-induced nausea and vomiting.
Despite the advance in supportive care that occurred with the introduction of selective serotonin subtype 3 (5-HT3) receptor antagonists, control of chemotherapy-induced nausea and vomiting (CINV) with first-generation agents (ondansetron, dolasetron, and granisetron) is less than ideal. Palonosetron is a unique 5-HT3 receptor antagonist whose distinctive pharmacologic characteristics (ie, high 5-HT3 receptor binding affinity, prolonged half-life) result in superior clinical benefit. Superiority of palonosetron over ondansetron and dolasetron in the prevention of both acute and delayed CINV has been observed in each phase III trial conducted. ⋯ Unlike other 5-HT3 receptor antagonists, palonosetron is also indicated for prevention of delayed nausea and vomiting associated with initial and repeat courses of moderately emetogenic cancer chemotherapy. Palonosetron exhibits an excellent tolerability profile, with frequency, severity, and duration of adverse reactions similar to that of comparator agents. Unlike older agents that are considered therapeutically interchangeable at equipotent doses, palonosetron should be considered a clinically distinct and superior treatment for the prevention of CINV.
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The human epidermal growth factor receptor (HER) family of receptor tyrosine kinases is part of a network of pathways that are involved in the development and progression of prostate cancer. HER-kinase receptors include epidermal growth factor receptor (EGFR), HER2, HER3, and HER4, which must combine as dimers to affect signaling. Different combinations of receptors produce different qualities and levels of pathway activation. ⋯ Data points towards the importance of inhibiting multiple members of the HER-kinase family to achieve more complete blockade of this axis for cancers other than HER2-overexpressing breast cancer. Multiple pharmaceutical agents that block the HER-kinase axis are currently being tested for patients with prostate cancer. These include antibodies, tyrosine kinase inhibitors, and novel strategies which seek to decrease HER2 expression.