Expert review of anticancer therapy
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Expert Rev Anticancer Ther · May 2010
ReviewGlioma stem cell signaling: therapeutic opportunities and challenges.
The field of cancer research has experienced significant momentum from the discovery that most malignant tumors harbor subpopulations of cancer cells with stem cell features. Consequently, identification and characterization of so-called 'cancer-initiating cells' or 'cancer stem cells' has also provided novel insights into the biology of malignant brain tumors. ⋯ Novel treatment strategies are being developed to selectively target the molecular pathways relevant to cancer stem cells. This review summarizes important signaling pathways employed by both normal and cancer stem cells and highlights promising molecular-targeted therapies interfering with those signaling pathways in malignant gliomas.
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Expert Rev Anticancer Ther · Apr 2010
Review Comparative StudyPalliative thoracic radiotherapy for lung cancer.
Despite an increasing use of chemotherapy in the palliative setting for lung cancer, the role of palliative thoracic radiotherapy should not be disregarded. It offers quick and efficient palliation, with improvement observed in approximately two-thirds of treated patients. ⋯ Higher radiation doses delivered via protracted schedules give a modest survival benefit for good performance patients. The current review covers the issues related to the use of palliative thoracic radiotherapy, such as total dose, fractionation, delayed versus immediate use, external-beam radiotherapy versus endobronchial brachytherapy, combination with chemotherapy, re-irradiation and palliation with radiation in small-cell lung cancer.
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Expert Rev Anticancer Ther · Mar 2010
ReviewPhase II clinical trials in oncology: are we hitting the target?
The number of novel and molecularly targeted agents in the last decade that need screening for preliminary efficacy in Phase II trials has increased. Many of these agents have a cytostatic mode of action that is difficult to assess using traditional Phase II designs. ⋯ The different end points, single versus multiarm and randomized designs, the use of biomarkers and Bayesian approaches are also reviewed. The final design chosen will depend on the characteristics and circumstances of each individual study.
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Expert Rev Anticancer Ther · Mar 2010
ReviewTransoral laser microsurgery for early laryngeal cancer.
The decision to treat patients suffering from glottic cancer with either radiotherapy or surgery is both complex and controversial. Transoral laser microsurgery is a surgical technique that offers an attractive alternative therapy for laryngeal cancer. ⋯ In this article we examine the surgical technique and discuss the oncologic and functional outcomes of transoral laser microsurgery. Furthermore, we offer a vision of the future of endoscopic laser surgery for the management of cancer of the larynx and the upper aerodigestive tract.
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Expert Rev Anticancer Ther · Feb 2010
ReviewTrastuzumab and lapatinib beyond trastuzumab progression for metastatic breast cancer: strategies and pitfalls.
The discovery of HER2 gene amplification and protein overexpression in approximately 15-20% of breast cancers and access to the tailored humanized antibody, trastuzumab (Herceptin), have heralded a new era in breast cancer therapy. Trastuzumab combined with chemotherapy has caused marked tumor responses and increased overall survival in patients with metastatic breast cancer, and has also increased survival in the adjuvant setting after radical surgery. ⋯ In this event, possible options include the replacement of trastuzumab with lapatinib, the continuation of trastuzumab after disease progression with changed chemotherapy and the suspension of the use of targeted agents. New-generation tyrosine kinase inhibitors, which have a broader target, are now considered the key to treatment for breast cancer.