Current oncology reports
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Current oncology reports · Jan 2016
ReviewOctreotide and Lanreotide in Gastroenteropancreatic Neuroendocrine Tumors.
Neuroendocrine tumors are heterogeneous, rare malignancies that arise most commonly in the gastrointestinal tract and pancreas. They often secrete vasoactive substances resulting in carcinoid syndrome and the tumor cells exclusively express somatostatin receptors. ⋯ We discuss the available data to support their use as symptom controlling and antiproliferative agents. This article also reviews the guidelines (National Comprehensive Cancer Network and North American Neuro Endocrine Tumor Society), cost-analysis (suggesting the cost-effectiveness of lanreotide autogel compared to higher doses of octreotide long acting release formulation in refractory patients), and future directions of somatostatin analogs in the management of patients refractory to conventional doses of octreotide and lanreotide.
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Current oncology reports · Oct 2015
ReviewSystemic Therapy for HER2-Positive Central Nervous System Disease: Where We Are and Where Do We Go From Here?
Patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer are at an increased risk of developing brain metastases. The incidence and prevalence of central nervous system (CNS) disease are increasing due to improved survival, which can be attributed to better systemic therapies for extracranial disease. The current standard of care for brain metastases includes a combination of surgery and/or radiation. ⋯ None of the available anti-HER2 agents (trastuzumab, lapatinib, pertuzumab, and ado-trastuzumab emtansine (T-DM1)) are currently approved for the treatment of brain metastases. Research is underway evaluating novel anti-HER2 agents, which have demonstrated CNS activity. This article discusses the current data on using anti-HER2 therapies to treat CNS disease as well as the newer anti-HER2 agents, which may overcome the current challenges faced in treating brain metastases in the HER2-positive patient population.
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Current oncology reports · Jul 2015
ReviewNovel immunologic approaches in lymphoma: unleashing the brakes on the immune system.
Immunotherapy is a promising therapeutic strategy in the treatment of lymphoma. The programmed death-1 (PD-1)/PD-ligand immune checkpoint pathway has been manipulated by tumor cells and serves as a mechanism of tumor evasion from the anti-tumor immune response. ⋯ We review the clinical studies demonstrating efficacy and safety of PD-1 antibodies in relapsed/refractory Hodgkin, follicular, and diffuse large B cell lymphoma. Principles learned in the development of immune checkpoint blockade provide the foundation for immunotherapy under clinical investigation.
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Current oncology reports · Aug 2013
ReviewCancer in adolescents and young adults in countries with limited resources.
Cancer in adolescents and young adults (AYA) represents a higher fraction of all cancer in countries that are still undergoing a demographic transition. Such countries tend to have much younger populations, and therefore unless they have a particularly low incidence of cancer in this age group, will have a higher burden of cancer (absolute number of cases with cancer) in AYA. Cancers in AYA are comprised of the tail end of the incidence curve of cancers that have their peak incidence, or occur almost exclusively in childhood, the beginning of the incidence curve of cancers that primarily affect the elderly, and a third set of cancers that have their peak incidence (or are at least common) in the AYA age group (e.g., testicular cancer, sarcomas, melanoma, thyroid cancer). ⋯ Late effects are important in this young population in HIC, and protocol adaptations or design in LMIC should take into consideration the significant fraction of cured patients with late effects who were treated in HIC in an era where improving response and survival rates was the paramount consideration-the situation that applies today in less developed countries. Special adolescent units which better deal with psychological issues of young cancer patients are rare in LMIC and the psychosocial issues faced by adolescents are much less studied. Although survival is the first consideration, attention to psychosocial and financial issues may reduce existing delays in initiating therapy and also the fraction of patients that abandon therapy.
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Current oncology reports · Apr 2013
ReviewTargeting the adrenal gland in castration-resistant prostate cancer: a case for orteronel, a selective CYP-17 17,20-lyase inhibitor.
Androgen and the androgen receptor (AR) pathway remain the key targets for emerging new therapies against castration-resistant prostate cancer (CRPC). Adrenal androgens and intratumoral testosterone production appear to be sufficient to activate AR in the castration-resistant setting. This process re-engages AR and allows it to continue to be the primary target responsible for prostate cancer progression. ⋯ A new CYP17 inhibitor, with more selective inhibition of 17,20-lyase over 17α-hydroxylase, orteronel (TAK-700), is currently undergoing phase III clinical trials in pre- and postchemotherapy CRPC. In a completed phase II trial in CRPC patients, orteronel demonstrated its efficacy by lowering the levels of circulating androgens, reducing prostate-specific antigen (PSA) levels, and decreasing the levels of circulating tumor cells. Ongoing studies evaluating orteronel in CRPC will further define its safety and role in the management of this disease.