Forum of Clinical Oncology最新文献

{"title":"The expanding new era of cancer immunotherapy","authors":"E. Kotteas, K. Syrigos","doi":"10.1515/fco-2016-0003","DOIUrl":"https://doi.org/10.1515/fco-2016-0003","url":null,"abstract":"","PeriodicalId":38592,"journal":{"name":"Forum of Clinical Oncology","volume":"7 1","pages":"1 - 3"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67374786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting the PD-1/PD-L1 axis in the treatment of lung cancer","authors":"A. Matikas, S. Aggelaki","doi":"10.1515/fco-2015-0021","DOIUrl":"https://doi.org/10.1515/fco-2015-0021","url":null,"abstract":"Abstract In recent years major advances in the field of molecular profiling of non-small cell lung cancer led to the identification of targetable driver mutations and revolutionized the treatment of specific patient subsets. However, the majority of NSCLC tumors do not harbor these genomic events. On the other hand, current studies have confirmed an expanding role for immunotherapy in lung cancer and new agents, such as inhibitors of the programmed cell death-1 (PD-1)/programmed cell death ligand 1 (PD-L1) axis have been introduced in the treatment armamentarium. The monoclonal antibodies nivolumab and pembrolizumab targeting PD-1 resulted in superior survival when compared to standard second line chemotherapy within the context of randomized trials and received regulatory approval. Moreover, several other anti-PD-L1 antibodies have demonstrated encouraging preliminary efficacy and multiple clinical trials in various settings during the disease trajectory are currently underway. Early immunotherapy trials have also illustrated the potential of PD-1 blockade in small cell lung cancer treatment, a disease for which major advances in systemic therapy are lacking. The currently available clinical data on PD-1/PD-L1 inhibition in lung cancer are summarized in this review.","PeriodicalId":38592,"journal":{"name":"Forum of Clinical Oncology","volume":"7 1","pages":"17 - 27"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/fco-2015-0021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67375119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metastatic Renal Cell Carcinoma: Sunitinib as First-Line Treatment; Results of a Retrospective Study","authors":"H. El-Hadaad, H. Wahba, Hayam Fathy Abd-El Hay Ghazy","doi":"10.1515/fco-2015-0017","DOIUrl":"https://doi.org/10.1515/fco-2015-0017","url":null,"abstract":"Abstract Background: Targeted agents were introduced over past years because of better understanding of oncogenetic mechanisms in metastatic renal cell carcinoma (mRCC). These agents include tyrosine kinase inhibitors (TKIs) such as sorafenib, sunitinib, pazopanib and axitinib. Methods: Review of recorded data from patients’ files with mRCC were analysed during the period from August 2008 to December 2014. Those patients were treated by sunitinib as first-line therapy. The data included patients characteristics such as age, sex, ECOG performance status (ECOG PS), number and sites of metastasis and pathological type. Also, we reviewed response to sunitinib therapy, its adverse events and progression-free survival (PFS). Results: This study included 26 patients; median age was 56 years with male predominance (76.9%) and 61.5% of patients were of ECOG PS0. Lymph nodes were the most common site of metastasis (38.5%) and 46.2% presented with ≥3 sites of disease. Clear cell pathology was reported in 96.2%. No grade IV adverse events to sunitinib reactions were observed. Thrombocytopenia was the most predominant haematological reaction (46%) followed by neutropenia (38.6%), whilst fatigue was the most reported non-haematological one (50%) followed by diarrhoea (42.3%). Partial response (PR) was found in 30.8% and stable disease (SD) in 46.2%. One-year PFS was 57.7% with median PFS time of 12 months. Conclusion: This study proved effectiveness and safety of sunitinib as first-line treatment for mRCC. However, this is a retrospective study and relatively small numbers of patients were included, so prospective studies with larger number of patients are needed for further evaluation.","PeriodicalId":38592,"journal":{"name":"Forum of Clinical Oncology","volume":"6 1","pages":"23 - 27"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/fco-2015-0017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67374860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare access for cancer patients in the era of economic crisis. Results from the HOPE III study","authors":"K. Souliotis, E. Agapidaki, M. Papageorgiou","doi":"10.1515/fco-2015-0020","DOIUrl":"https://doi.org/10.1515/fco-2015-0020","url":null,"abstract":"Abstract Background: Despite the documentation of addressing healthcare disparities in detection and treatment of cancer and health outcomes for cancer patients, the inequalities persist. Cancer patients of several vulnerable groups suffer disproportionally the effect of economic crisis on health and healthcare. Patients & Methods: A cross sectional survey was carried out between July and October 2014 in order to assess the cancer patients’ barriers to healthcare access. A total of 426 cancer patients, members of cancer patient organization participated in the study. Data were collected by using an online, self reported questionnaire evaluating three main areas: healthcare access (7 items), economic status and financial burden of the disease (17 items) and the alteration on several aspects related to the disease (8 items) from 2009 to 2014. Results: Approximately 31% of cancer patients reported that they faced barriers to healthcare access for cancer treatment during the last 12 months. The main barriers included long waiting time for a medical appointment (51%) and inability to visit a private physician due to the incapability to pay the out of pocket cost (44%). One in four patient encountered obstacles in medication access which resulted to treatment delay (46%), worsened health status (96%) and increased out of pocket costs (39%). Conclusions: Results suggest that there are vulnerable groups among cancer patients in Greece who suffer disproportionally more the impact of economic crisis on health and healthcare. Healthcare reforms and targeted interventions should be implemented in order to effectively address the inequities in access for cancer patients.","PeriodicalId":38592,"journal":{"name":"Forum of Clinical Oncology","volume":"6 1","pages":"11 - 7"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/fco-2015-0020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67375035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the prognostic benefit of identifying the probable primary site in cancer of unknown primary","authors":"J. Das, S. Gilani","doi":"10.1515/fco-2015-0015","DOIUrl":"https://doi.org/10.1515/fco-2015-0015","url":null,"abstract":"Abstract With the development of site-specific cancer therapy, identifying the primary origin allows the oncologist to personalise therapy for patients with the cancer of unknown primaries (CUPs). At present, immunohistochemistry (IHC) screening is the standard method used to postulate the primary site in CUP. In this retrospective study, we evaluated the prognostic benefit of identifying the primary site in CUP. All 84 patients who presented with suspected CUP to the Royal Stoke University Hospital between 2011 and 2012 were included in our study. Forty-eight percent (40/84) of these patients were unable to undergo necessary investigations to identify primary sites because of poor performance status. IHC screening was able to postulate the primary site in 59% (26/44) of the remaining patients with confirmed CUP. Therefore, the primary site was not identified in a significant proportion of patients with CUP. The median survival of confirmed CUP with probable primary site was 2.0 months (95% confidence interval (CI): 1.2 to 2.9 months), whereas the median survival of confirmed CUP with no probable primary site was 4.1 months (95% CI: 1.5 to 9.7 months). This difference in survival time was statistically significant. In addition, using the Cox regression model, we found that patients with confirmed CUP with primary sites had prognostically unfavourable diseases with a shorter median survival, regardless of the age of disease onset, gender, sites of metastases or number of metastases. One approach to improve the survival would be to start systemic therapy at the earliest possible opportunity rather than waiting for all investigation results, such as IHC.","PeriodicalId":38592,"journal":{"name":"Forum of Clinical Oncology","volume":"6 1","pages":"22 - 28"},"PeriodicalIF":0.0,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67374992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"OLAPARIB: A promising PARP Inhibitor for the treatment of ovarian cancer","authors":"N. Soupos, K. Laschos, E. Bournakis, E. Kostouros, G. Aravantinos","doi":"10.1515/fco-2015-0014","DOIUrl":"https://doi.org/10.1515/fco-2015-0014","url":null,"abstract":"Abstract Olaparib is a potent oral inhibitor of PARP 1 & 2 with biological activity in various solid tumours for patients with germline and/or sporadic BRCA mutations. The aim of this review is to present the results of the various studies which show Olaparib’s efficacy in ovarian cancer","PeriodicalId":38592,"journal":{"name":"Forum of Clinical Oncology","volume":"6 1","pages":"1 - 7"},"PeriodicalIF":0.0,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/fco-2015-0014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67374703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of Pazopanib in Soft Tissue Sarcoma: A comprehensive review of the literature","authors":"G. Fotopoulos, G. Pentheroudakis","doi":"10.1515/fco-2015-0012","DOIUrl":"https://doi.org/10.1515/fco-2015-0012","url":null,"abstract":"Abstract INTRODUCTION: Sarcomas are a rare and heterogeneous group of tumours of mesenchymal origin. Single agent pazopanib showed activity in a phase II clinical trial designed to screen various soft tissue sarcoma subtypes [10] and a phase III [11] clinical trial followed resulting in FDA approval in 2012 for use in metastatic soft tissue sarcoma exposed to prior chemotherapy. METHODS: We conducted an independent computerised review of PubMed and ScienceDirect database up to May 2015 using combinations of terms such as soft tissue sarcoma, pazopanib, STS ,VEGFR2, TKIs ,angiogenesis, advanced sarcoma treatment, targeted therapy for sarcoma AIM: Our aim was to explore the role of pazopanib in soft tissue sarcoma (STS) treatment, its mode of action, the clinical trials supporting its approval, safety and efficacy, how the product fits into the real world and its contribution to the development of targeted therapy for STS CONCLUSION: Pazopanib is a valid, innovative and cost-effective approach in the treatment of advanced pre-treated STS","PeriodicalId":38592,"journal":{"name":"Forum of Clinical Oncology","volume":"6 1","pages":"13 - 21"},"PeriodicalIF":0.0,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/fco-2015-0012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67374425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicopathologic Profile and Outcome of Extranodal Diffuse Large B-Cell NHL: Egyptian National Cancer Institute Experience","authors":"O. Khorshed, A. Helal, Y. Sallam, A. Salama, M. Amin","doi":"10.1515/fco-2015-0013","DOIUrl":"https://doi.org/10.1515/fco-2015-0013","url":null,"abstract":"Abstract Background: Primary extranodal diffuse large B-Cell lymphoma (PE-DLBCL) accounts for about one-third of all cases of DLBCL. We reviewed the clinical and pathological characteristics of cases with PE-DLBCL presented to NCI, Egypt. Patients and methods: We retrospectively studied patients with pathologically documented PE-DLBCL presented to the National Cancer Institute between January 2008 and December 2010. Revision of histopathology and sub-classification of patients to germinal centre (GC) DLBCL and non-GC-DLBCL through immunostaining of CD10, BCL-6 and MUM-1 were done. Cases that were CD10+/BCL-6±/ MUM-1- were categorised as GC-DLBCL, while cases that were CD10-/BCL-6±/MUM-1+ were categorised as non-GC-DLBCL. Clinical data regarding baseline characteristics, chemotherapy given and the response to chemotherapy was collected. Results: A total of 57 patients of PE-DLBCL were included in the study. Mean age was 48.9 years (range 21-78), and 32 patients (56.1%) were females. Most frequent locations were gastrointestinal and liver (29.9% and 22.9 %; respectively). Forty-two patients (73.7%) were sub-classified as non-GC-DLBCL. The patients who were stage III/IV were more common (52.6%). Fifty-two patients received CHOP, 5 received CVP, and 6 patients received radiotherapy after finishing chemotherapy. Complete response rate (CR) was 64.9%, there was no difference in the CR (66.7%, 64.3%) and Overall Survival (53.3%, 52.4%) in GC-DLBCL group in comparison to non-GC-DLBCL group (p = 0.24 and 0.6; respectively). The CR and OS for patients with low international prognostic index (IPI) were significantly better than patients with intermediate or high IPI (p = 0.008 and 0.08, respectively). Conclusion: Non-GC-DLBCL is more common than GC-DLBCL in PE-DLBCL in Egyptian population. The most affected sites are gastrointestinal and liver reflecting the association between high frequency of hepatitis B and C and hepatic non-Hodgkin’s lymphoma (NHL). Stage of the disease and IPI remains the most important prognostic factor for PE-DLBCL.","PeriodicalId":38592,"journal":{"name":"Forum of Clinical Oncology","volume":"6 1","pages":"12 - 8"},"PeriodicalIF":0.0,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/fco-2015-0013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67375150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single Fraction versus Multiple Fraction Radiotherapy for treatment of painful bone metastases: A Prospective Study; Mansoura experience","authors":"A. Anter","doi":"10.1515/fco-2015-0007","DOIUrl":"https://doi.org/10.1515/fco-2015-0007","url":null,"abstract":"Abstract Purpose: Assessment of pain response in patients with bone metastasis after treating with two radiation schedules and to compare toxicity profile in both arms. Patients & Methods: A prospective randomised study was designed to include 100 patients from May 2011 to May 2013. Patients with histopathologically proven primary malignancy having symptomatic secondary deposits to bone were selected for the study. Patients were randomised to 8 Gy in a single fraction (arm A) or 20 Gy in five fractions (arm B). Initial pain response was assessed using numeric rating scale, and compared using the same scale 3 months after completion of treatment. Acute toxicities were assessed using the radiation therapy oncology group criteria for adverse events Results: Arm A comprised 51 patients while 49 patients were enrolled in Arm B. Baseline patient characteristics were comparable. Twelve patients were lost to follow-up. So the 3-month pain score assessment was completed by 88 of the 100 patients; A complete response was observed in 20.4% (18 patients) of the 88 patients, and partial response was observed in 54.5% (48 patients), for an overall response rate of 75% (66 of 88 patients); only 10% (9 patients) of the 88 patients had progression of pain. Mild GI toxicity was noted in both arms but differences in two arms were not statistically significant (p = 0.45), no interruption of treatment was required because of side effects. Conclusions: In our study, we found both the radiation fractionation schedules for palliative bone metastasis treatment is equally effective in pain control.","PeriodicalId":38592,"journal":{"name":"Forum of Clinical Oncology","volume":"36 1","pages":"13 - 8"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67374454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Toxicity of Maintenance Pemetrexed Following Induction Treatment with Pemetrexed Plus Cisplatin for Advanced Non-small-cell Non-squamous Carcinoma of the Lung","authors":"D. Kim, A. Kinmond, S. Gilani, S. Giridharan, A. Jegannathen","doi":"10.1515/fco-2015-0008","DOIUrl":"https://doi.org/10.1515/fco-2015-0008","url":null,"abstract":"Abstract INTRODUCTION: The aim of this study is to assess the efficacy and toxicity of maintenance pemetrexed following induction treatment with cisplatin and pemetrexed for patients with advanced non-small cell lung cancer. PATIENTS AND METHODS: Eligible patients following four cycles of intravenous pemetrexed (Alimpta©; 500 mg/m2) and intravenous cisplatin (75 mg/m2) were given 21-day cycles of maintenance pemetrexed (500 mg/m2) until disease progression, unacceptable adverse event or death. From a total 80 patients receiving palliative induction chemotherapy, 17 subsequently received maintenance pemetrexed. RESULTS: The mean number of maintenance cycles completed was 5.9 (range 1-20; median 3.0). The mean progression-free survival (PFS) was 5.2 months (range: 2-15; median: 2.0) and the 1-year PFS was 17%. Treatment was discontinued due to disease progression (71%), adverse event (21%) and death from study disease (7%). Grade 3-4 laboratory and non-laboratory adverse events were seen in 11.8 and 17.6% of patients, respectively. Anaemia was the most common adverse event (71% of all patients; 65% grade 1-2; 5.9% grade 3-4). The most common reason for withdrawal due to adverse event was declining renal function. There was a statistically significant correlation between worsening performance status and reducing number of maintenance cycles completed (Spearman’s rank; R = −0.511, p = 0.036). DISCUSSION: The median PFS was lower than in previous studies with a higher than previously reported frequency of adverse events. Clinicians must monitor renal function and full blood counts vigilantly, especially in patients with performance status greater than 0.","PeriodicalId":38592,"journal":{"name":"Forum of Clinical Oncology","volume":"6 1","pages":"14 - 18"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67374532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}