Clinical advances in hematology & oncology : H&O
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Clin Adv Hematol Oncol · Oct 2011
ReviewImproving frontline treatment for chronic myeloid leukemia: emerging evidence for use of nilotinib and dasatinib.
The approval of imatinib in 2001 changed the landscape of chronic myeloid leukemia (CML) management, becoming the standard of care and improving the survival rates of patients. With the prevalent use of imatinib worldwide, it was observed that up to one-third of patients are resistant to or intolerant of imatinib therapy, fueling the search for safer and more effective agents. The newer and more potent tyrosine kinase inhibitors nilotinib and dasatinib were first indicated for the treatment of imatinib-resistant/-intolerant patients, for whom these agents are both safe and efficacious. ⋯ In addition, progression to advanced disease was significantly lower for nilotinib, and a trend toward lower progression was observed with dasatinib. Although both nilotinib and dasatinib are generally well tolerated in the frontline setting, they have different safety profiles that may affect their selection as treatment. Understanding the efficacy, safety profiles, and patterns of resistance to various BCR-ABL1 mutations of these newer agents, as well as implementing management strategies to treat adverse events, will help physicians to provide the best therapy options for their patients with CML.
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Clin Adv Hematol Oncol · Oct 2003
ReviewParticipation in cancer trials: recruitment of underserved populations.
One approach to address cancer health disparities is to focus on the under-representation by minority populations in cancer trials. Recruitment strategies include: 1) characterizing the target populations, 2) involve members of the population in planning, 3) take the message to the population, 4) give something back to the community, 5) enhance credibility with a community spokesperson, 6) identify and remove barriers, 7) improve staff sensitivity, and 8) educate the population about the trial. To recruit minorities to clinical trials, we have developed the Accrual to Clinical Trials (ACT) framework for understanding and enhancing the recruitment of participants to cancer trials.
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Clin Adv Hematol Oncol · Dec 2003
ReviewThe role of prophylactic cranial radiation in the treatment of non-small-cell lung cancer.
Patients with lung cancer face a substantial risk of developing brain metastases. Prophylactic cranial irradiation therapy has been demonstrated to significantly decrease the incidence of central nervous system metastasis and improve overall survival in patients with small-cell lung cancer. ⋯ However, the role of prophylactic cranial irradiation in patients with non-small-cell lung cancer is less well defined. As treatment modalities improve and patients live longer their risk of developing central nervous system recurrence increases, and methods to prevent this demand exploration.
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Clin Adv Hematol Oncol · Oct 2015
ReviewPD-1/PD-L1 immune checkpoint blockade in non-small cell lung cancer.
The programmed death 1 (PD-1) pathway is an immune checkpoint that has been implicated in tumoral immune escape, and has emerged as a major focus of immunotherapy in non-small cell lung cancer (NSCLC). Multiple agents have progressed through clinical development in recent years, including antibodies targeting both PD-1 and its key ligand, programmed death ligand 1 (PD-L1). This article reviews PD-1/PD-L1 blockade in NSCLC, including completed clinical trials, ongoing studies, future directions, and challenges.