| 1. |
- Berta, Judit, et al.
(författare)
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Thoracic irradiation as consolidation therapy in patients with extensive-stage small cell lung cancer
- 2023
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Ingår i: Current Opinion in Oncology. - 1040-8746. ; 35:1, s. 54-60
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Forskningsöversikt (refereegranskat)abstract
- Purpose of reviewSmall cell lung cancer (SCLC) is marked by an exceptionally high proliferative rate and poor prognosis. Given its high propensity to metastasize, nearly two-thirds of SCLC patients are diagnosed with extensive-stage (ES) disease when surgery is not a treatment option anymore. Over several decades, only minimal changes have been made in the therapeutic armamentarium of ES-SCLC. Recently, however, several new therapeutic avenues were defined, thus renewing the hope for patients with this recalcitrant cancer. Here, we present an overview of the most current therapeutic advances in ES-SCLC focusing in particular on consolidative thoracic radiation therapy (cTRT) and chemo-immunotherapy.Recent findingsThe incorporation of immunotherapy in the standard-of-care of ES-SCLC patients and the resulting outcomes are both a remarkable hallmark of progress and a disappointment. Indeed, chemo-immunotherapy with or without cTRT and prophylactic cranial irradiation contributes to longer survival outcomes with minimal toxicity rates in well selected and properly monitored patients. Nevertheless, the gain in overall survival is still modest relative to that seen in many other solid tumors.SummaryDespite the encouraging results, further clinical trials are needed to determine the efficacy and safety of these therapeutic approaches, and moreover, to identify new predictive biomarkers of response.
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| 2. |
- Bälter, Katarina, et al.
(författare)
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The effect of dietary guidelines on cancer risk and mortality
- 2012
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Ingår i: Current Opinion in Oncology. - : LIPPINCOTT WILLIAMS & WILKINS. - 1040-8746 .- 1531-703X. ; 24:1, s. 90-102
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Forskningsöversikt (refereegranskat)abstract
- Purpose of review Dietary guidelines are important tools for educating the general public and helping health professionals promote good health and prevent chronic diet-related diseases. However, it is of major public health relevance that the effect of the guidelines per se is evaluated to make sure that they serve their purpose. The aim of this article is to review the current research on dietary guidelines and their effect on cancer risk and mortality. Recent findings Since the last 30-40 years, most industrialized countries have had dietary guidelines. The guidelines are based on thorough reviews of the current scientific evidence regarding dietary intake and health. Potential health benefits associated with good adherence to the guidelines have been evaluated in observational studies during the last 15 years, with an increase in the number of studies during the most recent years. Summary Available data on the potential association between dietary guidelines and cancer are limited and inconclusive. A meta-analysis of studies on overall cancer risk shows no protective effect for good adherence to the dietary guidelines as compared with poor adherence. However, good adherence was associated with a 21% reduced risk of colorectal cancer, and 22% reduced cancer-specific mortality.
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| 3. |
- Eriksson, Barbro
(författare)
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New drugs in neuroendocrine tumors : rising of new therapeutic philosophies?
- 2010
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Ingår i: Current Opinion in Oncology. - 1040-8746 .- 1531-703X. ; 22:4, s. 381-386
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Forskningsöversikt (refereegranskat)abstract
- PURPOSE OF REVIEW: There has been a major progress in the understanding of tumor biology during the past decades and, as a consequence, new potential targets for medical treatment of cancer have been identified. Some of the new so-called targeted therapies may prove to be of value also in neuroendocrine tumors (NETs). This review focuses on recent progress in the treatment of NETs, discussing new agents and also optimization/improvement of currently available therapies. RECENT FINDINGS: New molecular-targeted therapies, exploiting some of the well known biological properties of NETs, such as presence of somatostatin, peptide and tyrosine kinase receptors and high vascularity, are currently being evaluated in clinical trials. Recent phase II and III data indicate that the multitarget tyrosine kinase inhibitor sunitinib has antiproliferative effects in NETs. Similarly, the mammalian target of rapamycin inhibitor everolimus has demonstrated antitumor activity in both carcinoids and pancreatic endocrine tumors. In addition, two oral chemotherapeutic agents, temozolomide and capecitabine, show promising effects and may replace streptozotocin-based regimens. The use of angiogenesis inhibitors has its rationale and bevacizumab has been tested in combination with other drugs. Radiolabeled somatostatin analogues are established as a well tolerated, effective treatment but timing is still unclear and long-term side effects need to be assessed. SUMMARY: Recent phase II studies have provided very promising new treatment options for NET patients. Phase III trials are needed to confirm the results and combinations of different treatment modalities are needed to make optimal use of the new modalities. Ideally, predictors of response should be developed and the new definitions of response necessitates careful monitoring with biomarkers and imaging procedures including functional imaging. Whether the new therapies prolong survival of the patients should also be established.
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| 4. |
- Glimelius, Bengt
(författare)
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Adjuvant chemotherapy in rectal cancer : state of the art and future perspectives
- 2020
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Ingår i: Current Opinion in Oncology. - : LIPPINCOTT WILLIAMS & WILKINS. - 1040-8746 .- 1531-703X. ; 32:4, s. 377-383
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Forskningsöversikt (refereegranskat)abstract
- Purpose of review The value of adjuvant chemotherapy in rectal cancer is controversial with opinions varying from ‘not be used’ since randomized trials have not shown significant gains to ‘be used as in colon cancer’ as the need is the same and colon and rectal cancers are quite similar. This review will look upon data critically and with open eyes.Recent findings With the exception of one randomized phase II trial (ADORE) revealing a significant gain in disease-free survival using one more effective regimen (mFOLFOX) than bolus 5-fluorouracil leucovorin, no new data have been presented. However, bringing up aspects in previous trials, either considered irrelevant for the present situation or overall negative, of what adjuvant treatment can achieve, a small reduction (hazard ratio about 0.8) in the risk of recurrence is present. This reduction is not fundamentally different from that in colon cancer considering that adjuvant treatment for rectal cancer cannot be initiated as rapidly as it can after a colon cancer diagnosis.Summary Adjuvant chemotherapy after rectal cancer surgery reduces recurrence risks but the benefit is limited and for most patients not clinically relevant. Neoadjuvant therapy can be more effective but results from randomized trials are not yet available.
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| 5. |
- Horvath, Lilla, et al.
(författare)
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Potential subtype-specific therapeutic approaches in small cell lung cancer
- 2024
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Ingår i: Current Opinion in Oncology. - 1040-8746. ; 36:1, s. 51-56
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Forskningsöversikt (refereegranskat)abstract
- PURPOSE OF REVIEW: Small cell lung cancer (SCLC) remains one of the most aggressive thoracic malignancies with an especially dismal prognosis. While the detection of various targetable driver mutations and immune checkpoints have revolutionized the treatment of non-small cell lung cancer (NSCLC), there has been only modest therapeutic innovation over the past decades in SCLC. In this review, we aim to provide a brief summary on the clinical relevance of recent research findings, which could soon pave the way towards a more personalized and targeted management of SCLC patients. RECENT FINDINGS: Substantial research on the biological and molecular heterogeneity of SCLC has been conducted in the last years. Recent results from comprehensive profiling studies have shown that unique major SCLC subtypes can be distinguished based on the relative expression of key transcription regulators (ASCL1, NEUROD1, POU2F3) or distinct inflammatory features. Understanding the differing molecular characteristics of these distinct subtypes has resulted in the identification of specific therapeutic vulnerabilities. SUMMARY: The recently introduced molecular SCLC subtype classification represents a substantial progress towards a personalized and more efficacious approach in SCLC. The consequences of this paradigm shift provide hope for improved patient care and clinical outcomes in this exceptionally lethal thoracic malignancy.
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| 6. |
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| 7. |
- Melin, Beatrice
(författare)
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Genetic causes of glioma : new leads in the labyrinth
- 2011
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Ingår i: Current Opinion in Oncology. - Philadelphia, PA : Current Science. - 1040-8746 .- 1531-703X. ; 23:6, s. 643-647
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Tidskriftsartikel (refereegranskat)abstract
- Purpose of review: A small percentage of gliomas are caused by inheritance in cancer syndromes but there is also a general familial aggregation of glioma. Recently, low penetrant genes associated with glioma risk have been identified. Recent findings: Seven independent chromosomal loci have robustly been associated with glioma risk: 5p15.33 (rs2736100, TERT), 8q24.21 (rs4295627, CCDC26), 9p21.3 (rs4977756, CDKN2A-CDKN2B), 20q13.33 (rs6010620, RTEL1), and 11q23.3 (rs498872, PHLDB1), and two loci at 7p11.2 (rs11979158 and rs2252586, EGFR). Several of these genes are obvious candidates in their role for chromosomal integrity and glioma progression. Moreover, all loci but the EGFR and CDKN2A genes display a pattern of association to certain glioma subtypes. Summary: The causes of glioma have until recently been unknown for most cases, partly due to lack of statistically powered studies enabling subclassification of glioma subtypes. The novel chromosomal loci associated with different glioma subtypes have provided us with an additional understanding of causes of glioma. All low penetrant genes contribute with a modest increased risk and cannot by themselves be used for risk prediction. Nevertheless, they could provide a tool to understand the underlying biology of glioma progression and to be used in future studies of gene-environment studies of specific glioma subtypes.
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| 8. |
- Naredi, Peter, 1955, et al.
(författare)
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Present and future role of surgery in metastatic gastrointestinal malignancies
- 2016
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Ingår i: Current Opinion in Oncology. - : Ovid Technologies (Wolters Kluwer Health). - 1040-8746 .- 1531-703X. ; 28:4, s. 348-352
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Tidskriftsartikel (refereegranskat)abstract
- Purpose of review Metastases from gastrointestinal malignancies are systemic or abdominal disseminations of cancer cells. From a biological perspective surgical resections are questionable but case series show that for some tumour types, surgery influences survival outcome. This review focuses on management and indications for surgery in recent literature of these metastatic gastrointestinal malignancies. A few gastrointestinal malignancies have emerged to be candidates for surgery in case of metastatic disease. Surgery can be considered in selected cases with liver metastases or abdominal dissemination of colorectal cancer, metastases from gastrointestinal stromal tumours or neuroendocrine tumours. On the contrary, recent publications do not support surgery for metastatic disease of any other gastrointestinal origin. The literature has ample examples of small series and anecdotal cases of successful surgical interventions for most tumour types but no new evidence has been presented to support broader indications for surgery. The evidence base for surgery of different metastatic gastrointestinal malignancies is unchanged. There are some clarifications when to perform surgery and the timing of surgery in regard to combined treatments. No new tumour types are added to potential candidates for surgery.
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| 9. |
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| 10. |
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| 11. |
- Sjöblom, Tobias
(författare)
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Systematic analyses of the cancer genome : Lessons learned from sequencing most of the annotated human protein-coding genes
- 2008
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Ingår i: Current Opinion in Oncology. - 1040-8746 .- 1531-703X. ; 20:1, s. 66-71
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Forskningsöversikt (refereegranskat)abstract
- PURPOSE OF REVIEW: The availability of a reference human genome sequence has enabled unbiased mutational analyses of tumor genomes to identify the mutated genes that cause cancer. This review discusses recent insights from such analyses of protein-coding genes in breast and colorectal cancers. RECENT FINDINGS: Mutational analyses of approximately 18,000 human protein-coding genes in breast and colorectal cancers have identified 280 candidate cancer genes. These include known cancer genes, but most had not previously been linked to cancer. There are few frequently mutated cancer genes among hundreds of less frequently mutated candidate cancer genes, and the compendium of mutated genes differs among tumors of the same tissue origin. SUMMARY: Recent work has shown the feasibility of coding cancer genome sequencing, and new technologies promise to facilitate these mutational analyses. Whereas cancer genetics can identify candidate genes in a rapid and scalable fashion, careful functional studies of mutated genes are required for ultimate proof of cancer gene status and translation into clinical utility. The rapid progress of cancer genetics has yielded novel diagnostic and therapeutic modalities, and cancer genome sequencing will accelerate this development to the benefit of cancer patients.
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| 12. |
- Öberg, Kjell
(författare)
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Neuroendocrine tumors of the digestive tract : impact of new classifications and new agents on therapeutic approaches
- 2012
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Ingår i: Current Opinion in Oncology. - 1040-8746 .- 1531-703X.
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Forskningsöversikt (refereegranskat)abstract
- PURPOSE OF REVIEW: Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) constitute a diverse group of neoplasms arising from the diffuse neuroendocrine cell system. During the last 2 years a new classification system, the WHO 2010, has come into clinical practice together with Tumor Nodes Metastases (TNM) staging and grading systems, developed by the European Neuroendocrine Tumor Society/American Joint Cancer Committee. At the same time new targeted agents have been developed for treatment of GEP-NETs and it is important discuss these new agents in relation to the classification and staging system. RECENT FINDINGS: The current article is reviewing the most important clinical trials of targeting agents within the field of neuroendocrine tumors. Tyrosine kinase inhibitors as well as PI3 kinase mTOR inhibitors have been applied in the treatment of neuroendocrine tumors. SUMMARY: Sunitinib and everolimus have recently been registered for treatment of pancreatic neuroendocrine tumors worldwide. The role of these new targeted agents in the treatment algorithm of neuroendocrine tumors will be discussed. A large number of phase I and phase II trials have been performed in GEP-NETs with rather limited results and no significant impact on the clinical management of patients with GEP-NETs. However, there are two phase III trials that have completely changed the treatment landscape for pancreatic neuroendocrine tumors, e.g., sunitinib and everolimus demonstrating an increased progression free survival of 11 vs. 5 months for the placebo group.
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