memo - Magazine of European Medical Oncology

2016 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-016-0260-x

Hilbe, Wolfgang; Radlherr, Waltraud

2016 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-016-0254-8

Hofer, Silvia; Kessler, Manfred; Godau, Jeanne; Weiler, Daniela; Frontzek, Karl; Rushing, Elisabeth; Aebi, Stefan

2016 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-016-0262-8

Intravascular lymphoma (IVL), a rare, extranodal form of non-Hodgkin lymphoma (NHL), can cause infarcts by occluding small arteries of the brain. Owing to its heterogeneous clinical manifestations and unfavorable prognosis, the diagnosis is often made postmortem. Patients can present with a range of motor or sensory deficits, rapid cognitive impairment, aphasia or signs of myelitis, often with nonspecific radiographic findings.Timely recognition of a treatable disease is essential to prevent permanent neurocognitive defects. We present a case who could be treated successfully with chemotherapy.

Bohn, Jan-Paul; Gastl, Guenther; Steurer, Michael

2016 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-016-0269-1pmid: 27429657

Classic hairy cell leukemia (HCL) is a rare indolent B‑cell-lymphoproliferative disorder, first described as a distinct disease entity in 1958. After more than two decades without effective chemotherapeutic options and a dismal prognosis of less than 5 years, only the introduction of interferon‑α (IFN‑α) allowed for response rates between 80–90 % and survival improvement. Nowadays, however, patients are rarely treated with IFN-α as purine analogues were found to be highly effective in HCL facilitating a near normal life span in most cases. Moreover, novel therapeutic tools for patients with relapsed or refractory disease after purine analogues have emerged such as rituximab and, more recently, vemurafenib. In the absence of long-term safety data for these novel agents, however, IFN-α may still represent a viable therapeutic option when the profound immunosuppressive side effects of purine analogues are to be avoided. We herein report a HCL patient, who has received multiple lines of therapy, including pentostatin, cladribine, and a total of 164 months of treatment with IFN‑α yielding long-term disease control. Our case illustrates that long-term administration of IFN-α with adequate dose-adjustments according to toxicity and disease activity is feasible in HCL and may still be a viable therapeutic option when purine analogues are considered unsuitable.

Fuereder, Thorsten

2016 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-016-0270-8pmid: 27429658

Over the past years immuno-oncology has evolved and become a novel promising strategy for cancer therapy. Immune checkpoint inhibitors such as pembrolizumab or nivolumab, which target the interaction between programmed death receptor 1/programmed death ligand 1 (PD-1/PDL-1) and PDL-2, have been recently approved for the treatment of various malignancies and are currently being investigated in clinical phase III trials for head and neck squamous cell carcinoma (HNSCC). Data available from these trials indicate substantial activity accompanied by a favorable safety and toxicity profile in this patient population. This review article focuses on the molecular background, gives an overview of current clinical data of checkpoint inhibitors in HNSCC, and points out future challenges such as the need for appropriate biomarkers for these novel compounds.

Foedermayr, Mathilde; Sebesta, Miriam; Rudas, Margaretha; Berghoff, Anna; Promberger, Regina; Preusser, Matthias; Dubsky, Peter; Gnant, Michael; Steger, Guenther; Weltermann, Ansgar; Zielinski, Christoph; Zach, Otto; Bartsch, Rupert

2016 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-016-0261-9

Despite recent improvements, triple-negative breast cancer (TNBC) remains a breast cancer subtype with poor prognosis. TP53 mutations are commonly associated with TNBC, suggesting a role in breast cancer carcinogenesis. In addition to mutations, several reports focused on TP53 polymorphisms and their association with breast cancer risk and outcome. TP53 codon Pro72Arg polymorphism may predict response to anti-cancer therapy as Pro72 is apparently less effective in the induction of apoptosis.

Gampenrieder, Simon; Rinnerthaler, Gabriel; Greil, Richard

2016 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-016-0268-2pmid: 27429659

Endocrine therapy represents the basis for the treatment of estrogen receptor-positive breast cancer, but several tumors harbor intrinsic resistance and acquired resistance to endocrine therapy is inevitable in metastatic disease. Combination strategies of endocrine therapy with targeted agents are aimed to overcome endocrine resistance. The selective CDK4/6 inhibitor palbociclib has shown promising results in metastatic luminal breast cancer when used in combination with endocrine therapy both in the first-line setting as in pretreated women. The drug showed a manageable safety profile with uncomplicated neutropenia as the most frequent side effect. Approval was already granted in the US and is also awaited during 2016 for Europe.

Weiss, Lukas; Huemer, Florian; Mlineritsch, Brigitte; Greil, Richard

2016 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-016-0267-3pmid: 27429660

Increased numbers of tumour infiltrating T‑cells have long been associated with a better prognosis in ovarian cancer, which has led to the general assumption of a relevant impact of T‑cellular anti-tumour immunity in this disease. As a consequence of this knowledge, a multitude of immunologic therapies has emerged over the past years. Although some reports could evidence a successful induction of anti-tumour T‑cells, in general, these attempts did not translate into clinically significant activity. As has already been shown in other tumour entities, immune checkpoint blockade – mainly antibodies directed against PD-1 and PD-L1 – could possibly become a real “game changer” in ovarian cancer in the future.

Andreasen, Lisbeth; Leisby Antonsen, Sofie; Settnes, Annette

2016 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-016-0266-4

In this case report we describe the treatment of a 95-year-old woman with endometrioid adenocarcinoma. She suffered from cardiovascular comorbidity and did not want surgical treatment. Instead a levonorgestrel-releasing intrauterine device (Mirena) was inserted. She had progression of the tumor but with a minimum of symptoms and side effects. At the final examination there were no signs of extra uterine disease. The levonorgestrel-releasing intrauterine device may be an acceptable alternative to surgery in severely comorbid patients, or if the patient refuses surgical treatment.

Fedyanin, Mikhail; Polyanskaya, Elizaveta; Tjulandin, Sergei

2016 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-016-0263-7

It is known that tumor cells have the ability to penetrate into the bloodstream. The identification of such circulating tumor cells (CTC) determines the prognosis in several tumors, including colon cancer. Tumor DNA (ctDNA), which is only a part of the total circulating DNA obtained from the blood of cancer patients, is also further separated from plasma. This separation of the neoplastic derivatives of the primary tumor and metastases (CTC, ctDNA, RNA, proteome) in plasma is called “liquid biopsy.” CTC increasingly represents the pool of tumor cells that can initiate the growth of metastatic lesions, while the ctDNA provides the information about the whole tumor mass. Traditional tissue biopsy gives information based only on one small section of the primary tumor or metastasis, often retrieved before the start of treatment; however, liquid biopsy provides real-time information about the molecular disorders for the whole tumor mass and allows us to estimate the dynamics of the evolutionary tumor changes, the heterogeneity of the disease, and the effect of chemotherapy. With the possibility of obtaining multiple blood samples for analysis during the therapy, in contrast to traditional biopsy, it also allows us to evaluate the mechanisms of resistance to treatment, which in the future will perhaps lead to modification of the treatment in accordance with the detected molecular defects in tumors. Thus, this would facilitate implementing the principles of personalized therapy. In this literature review, we concentrate on liquid biopsy in patients with colon cancer.

Müldür, Ercan

2016 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-016-0265-5

The incidence of prostate cancer is strongly correlated with age, with 35 % of patients aged 65–74 years and 25 % aged 75 years or older being affected [1]. Prostate cancer is third leading cause of cancer death among men aged 80 years and older. Of patients dying of prostate cancer, 41 % are aged 75–84 years, and 30 % above 85 years [2]. Fortunately treatment for metastatic castration-resistant prostate cancer (mCRPC) has evolved dramatically in the last few years.

Attarbaschi, Andishe; Mann, Georg

2016 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-016-0264-6

During the last few decades cure rates in children and adolescents with malignant diseases have approached 75–80 %. While this has been mainly achieved by a reduction of relapses, nowadays, prevention of disease- and therapy-related deaths has come more and more into focus. Initial emergencies in pediatric hematology and oncology represent rare but life-threatening situations which can be recognized by the combination of a patient’s medical history, age, clinical symptoms, laboratory parameters, and imaging studies. In the present review, both disease- and therapy-related oncological emergencies will be described including tracheal collapse and superior vena cava syndrome in case of mediastinal tumors, intussusception and inferior vena cava syndrome in case of abdominal tumors, intracranial hypertension in brain tumors, spinal cord compression in case of dumbbell tumors as well as tumor lysis syndrome and coagulation disorders. Possible differential diagnoses of malignant diseases and type and risk of the diagnostic procedures will be described in detail, emphasizing that all diagnostic procedures should be done appropriately and rapidly at experienced and specialized pediatric hematologic–oncological institutions in order to prevent fatality or irreversible damage.