Expert review of anticancer therapy
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Expert Rev Anticancer Ther · Aug 2012
ReviewPrimary systemic therapy in HER2-amplified breast cancer: a clinical review.
Primary systemic therapy (PST) in early breast cancer is utilized in locally advanced breast tumors and when breast-conserving surgery is desirable. In addition, the PST setting provides an opportunity to monitor response including histopathological and biomarker examination of the tumor and host tissues before and after systemic therapy. ⋯ Trastuzumab has also shown promising activity in PST/neoadjuvant studies by achieving high rates of complete pathologic response. This is a review of clinical studies that incorporated trastuzumab in PST and/or neoadjuvant chemotherapy, including the results of recently reported studies using trastuzumab in combination with other novel therapies such as lapatinib or pertuzumab.
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Radiotherapy following radical prostatectomy has been controversial and no consensus has developed on the most appropriate use of radiotherapy after radical prostatectomy. In the last decade the results of three randomized controlled trials examining the effects of early radiotherapy after radical prostatectomy in patients with high-risk features (positive surgical margins, extracapsular extension and seminal vesical involvement) have been published. ⋯ Specifically, early radiotherapy reduces the risk of biochemical recurrence, improves clinical disease-free survival, decreases the utilization of salvage androgen suppression and, in the study with longest follow-up, early radiotherapy improves overall survival. This article will review the evidence, provide a commentary on the existing evidence, and describe key issues going forward (timing of radiotherapy, androgen suppression and radiotherapy techniques).
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Expert Rev Anticancer Ther · Apr 2012
ReviewROS1 as a 'druggable' receptor tyrosine kinase: lessons learned from inhibiting the ALK pathway.
ROS1 is one of 58 receptor tyrosine kinases, and one of two orphan receptor tyrosine kinases where its ligand is unknown. ROS1 is evolutionarily related to ALK. ROS1 rearrangement was discovered in glioblastoma in 1987, in non-small-cell lung cancer (NSCLC) in 2007, and in cholangiocarcinoma in 2011. ⋯ Although ROS1 shares only 49% amino acid sequence homology with ALK in the kinase domains, several ALK inhibitors have demonstrated in vitro inhibitory activity against ROS1. With the recent US approval of crizotinib, a multi-targeted ALK/MET kinase inhibitor, for the treatment of ALK-rearranged NSCLC, attention has turned to ROS1-rearranged tumors, especially NSCLC. The next few years should witness a rapid pace of clinical research in ROS1-rearranged tumors utilizing available ALK inhibitors.
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Expert Rev Anticancer Ther · Mar 2012
ReviewImproving end-of-life care for head and neck cancer patients.
Despite improvements in the treatment of head and neck cancer, many patients still succumb to their disease. A litany of medical, psychosocial and ethical challenges arise in managing the end-of-life experiences within this patient population. ⋯ Clinical decision-making for patients dying of head and neck cancer requires proactive consideration of quality of life, functionality, symptom control and other patient-centered objectives, and frequently benefits from palliative care team involvement. Additional research aimed toward optimizing the end of life experience of head and neck cancer patients and their families is greatly needed.
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Expert Rev Anticancer Ther · Feb 2012
ReviewTherapeutic potential of irreversible electroporation in sarcoma.
Irreversible electroporation is a newly developed nonthermal tissue ablation technique in which certain short-duration electrical fields are used to permanently permeabilize the cell membrane to disrupt cellular homeostasis. This disruption of cellular homeostasis initiates apoptosis, which leads to permanent cell death. ⋯ Each of these sarcomas present in different ways, exhibit different behaviors and prognoses, and present unique therapeutic challenges. In this article, a series of recently conducted irreversible electroporation treatment for sarcomas based on local nonthermal ablation are summarized, and the therapeutic potential of this newly developed technique is assessed.