memo - Magazine of European Medical Oncology

Hilbe, W.

2012 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-010-0235-2

Scheithauer, W.

2012 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-010-0223-6

As every year, during the Annual Meeting of the American Society for Clinical Oncology (ASCO) 2010, a number of interesting clinical study results in the field of colorectal cancer have been presented and/or updated. This article summarises some of the most import presentations about postoperative adjuvant, neoadjuvant and palliative treatment strategies.

Marosi, C.; Preusser, M.

2012 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-010-0224-5

Bartsch, R.; Ziebermayr, R.

2012 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-010-0226-3

BACKGROUND: In the ASCO Annual Meeting, important recent developments in haematology and oncology were presented. In the 2010 ASCO meeting, interest in the field of metastatic breast cancer focused on Poly-(ADP-Ribose)-Polymerase-1 (PARP-1) inhibitors and novel treatment options in Her2-positive disease. METHODS: For this review article, authors searched proceedings of the 2010 ASCO Annual Meeting. Abstracts providing important new insights were included and discussed. RESULTS: Results from phase I and II studies of new drugs and novel combinations in Her2-positive disease were presented. Data suggested considerable activity of those therapies upon trastuzumab failure. Much interest focused on the role of PARP-1 inhibitors in triple-negative or BRCA-mutated disease. In those trials, PARP inhibitors were given either alone or in combination with conventional chemotherapy. While a combination of olaparib and paclitaxel produced inacceptable myelotoxicity, a combination of veliparib and temozolomide showed activity in BRCA carriers only. The same was true for PARP inhibitors alone: Activity, in general, was limited to patients harbouring BRCA mutations. Further studies evaluated the activity of VEGF and VEGF receptor blockade: While treatment with an anti-VEGF-antibody is active in metastatic breast cancer, the multi-target tyrosine kinase inhibitor sunitinib did not add additional benefit to chemotherapy in two randomized studies. CONCLUSION: No praxis changing data were presented in the field of metastatic breast cancer in the ACSO 2010 Annual Meeting. Still, data on PARP-1 inhibitors and new therapies for Her2-positive tumours yielded insights that will eventually lead the path to novel and effective treatment options.

De Santis, M.; Bachner, M.

2012 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-010-0225-4

In the 2010 ASCO meeting valuable information and even practice-changing results for the medical treatment of castration resistant prostate cancer (CRPC) were presented. Focus was put on bone-targeted treatment, chemotherapy for second line use, combinations of standard chemotherapy with different new drugs and data on a novel antiangiogenic compounds. Denosumab was shown to be superior to zoledronic acid in the treatment of patients with bone metastases of CRPC. Cabazitaxel improved survival in CRPC patients who progressed during or after docetaxel. This substance might become the first standard treatment for second line use. There are still concerns about the dose and toxicity. Both new drugs still need to be approved but will change our practice in the management of bone metastases and in the second line setting and enlarge significantly our small armamentarium of medical treatment of CRPC. So far, there is no proven benefit in adding any drug to standard docetaxel. This fact was confirmed by final data analyses of the combination of docetaxel with bevacizumab or calcitriol. Tasquinimod is a promising novel anti-angiogenic compound that delayed disease progression significantly in asymptomatic CRPC patients. A phase III-trial will reveal the true value of this compound. In conclusion, in the 2010 ASCO meeting, valuable new information concerning the medical treatment of CRPC was conveyed which might indeed change our clinical practice.

Wöll, E.

2012 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-010-0230-7

Gastric cancer is still a devastating disease. Two thirds of the patients are diagnosed in a locally advanced or metastatic stage. Even if surgery is possible, long-term survival is low. Optimal therapy in a curative and a palliative setting is still not clear yet. ASCO 2010 could shed some light on optimal chemotherapy and the introduction of molecular targeted therapy. The aim of this article is to summarize the most important publications at this year's ASCO annual meeting and to put them into context of current therapeutic strategies.

Pall, G.

2012 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-010-0228-1

Lung cancer remains a disease difficult to treat. Accordingly, results from recently conducted clinical trials are eagerly awaited. Every year, the American Society of Clinical Oncology (ASCO) – Annual Meeting provides the oncological community with a large number of such studies, with some of them potentially changing current treatment standards. The aim of this review is therefore to give a concise overview on this year's Annual Meeting presentations covering the field of lung cancer with an emphasis on randomized phase III trials of immediate clinical importance.

Grünberger, Th.

2012 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-010-0231-6

Therapeutic management of metastatic colorectal cancer continues to be rapidly changing. Several papers highlighted possible new treatment modalities during this year's ASCO. A selection of these will be summarized in this article. In a multidisciplinary setting, experts have recently decided to categorize mCRC patients and especially those with liver only disease into three groups: resectable patients, unresectable and most likely never curable patients and those with borderline resectable disease at presentation. The article focuses upon this selection and summarizes some new aspects presented in Chicago. The conclusion of the majority of the presentations is an individualized treatment for each patient delivered by a multidisciplinary team.

Soltermann, A.; Opitz, I.; Tischler, V.; Thies, S.; Morra, L.; Stahel, R. A.; Weder, W.; Moch, H.

2012 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-010-0227-2

Both NSCLC and MPM are composed of different histotypes. These histotypes are clinically relevant, since both mutational profiles and response to chemotherapeutic drugs are different. Next to histotype markers, predictors such as EGFR are increasingly required in clinical pathology, also on cell blocks from pleural effusions. Such effusions can arise from both lung adenocarcinoma and MPM, thus are a valid resource for new biomarkers. We identified the epithelial-mesenchymal transition N-glycoprotein periostin in effusions from lung AC by shotgun mass spectrometry. EMT is an important transdifferentiation concept, whereby polarized epithelial cells detach from their solid lattice and become migratory and invasive via acquisition of a fibroblastoid phenotype. The EMT programme is regulated by a complex signalling network, leading to an upregulation of mesenchymal proteins like vimentin, associated with loss of E-cadherin. The EMT protein periostin was correlated with clinico-pathological parameters of tumour progression, the squamous cell histotype of NSCLC and the sarcomatoid of MPM, respectively. Importantly, EMT is related to the cancer stem cell phenotype, conferring increased drug resistance. Both NSCLC and MPM tumour cells are embedded in a prominent desmoplastic stroma. A microenvironment therapy could comprise a combination of inhibitors directed against tumour cell surface receptors, neo-vessels, extracellular matrix fibres and immune cells. Derivatives of the human monoclonal scFv antibodies L19 and F16, specific to the splice isoforms of fibronectin (with extracellular domain B) and tenascin-C (Al domain) are clinically effective, thus intracavitary chemotherapy with pleural infusion is a phase 1/2 study rationale for advanced lung AC or MPM.

Ressler, S.; Mlineritsch, B.; Greil, R.

2012 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-010-0232-5

Breast cancer is increasingly recognized a disease very heterogenous in its biological and clinical behaviour. Triple negative breast cancer lacks the expression of estrogen-, progesterone receptors and Her2/neu protein and is characterized by its unique clinical and prognostic features. This review describes the biology, pathology, prognosis, current treatment options and future directions.

Papakonstantinou, G.; Koutsis, D.; Spyridonidis, A.

2012 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-010-0229-0

Symptoms and successive pancytopenia in patients with known smouldering multiple myeloma lead unavoidably to the diagnosis of a therapy requiring symptomatic myeloma. Nevertheless, additional diseases can appear in a pre-existing smouldering myeloma and slowly change the physical course of the disease imitating myeloma-related symptoms and organ dysfunction. An unneeded, faulty systemic therapy for multiple myeloma in these cases can have a fatal outcome. This is the first report of a patient with a known smouldering multiple myeloma developing progressive symptoms and pancytopenia due to visceral leishmaniasis. After therapy with a liposomal preparation of amphotericin B all symptoms and the pancytopenia disappeared. An additional disease should be always carefully excluded before initiating a systemic therapy for smouldering myeloma developing indications for systemic therapy.