memo - Magazine of European Medical Oncology

2017 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-017-0347-z

Rumpold, Holger;Winder, Thomas

2017 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-017-0350-4

Steger, Guenther G.

2017 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-017-0356-y

Britschgi, Christian

2017 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-017-0355-z

Summary The last few years have seen an explosion of novel treatment options for patients diagnosed with lung cancer, mostly for those with stage IV non-small cell lung cancer. On the one hand, this was due to the development of modern diagnostic tools permitting accurate molecular diagnoses leading to the identification of several oncogenic driver mutations which can be therapeutically targeted. On the other hand, the advent of immunotherapy in medical oncology in general, but in thoracic oncology in particular, has changed the treatment landscape first in second-line systemic treatment, but recently also in first-line treatment in patients with programmed death ligand-1 (PD-L1) expression in their tumors of >50%. Despite those advances, the majority of patients we treat in our daily routine will still receive chemotherapy: a so-called druggable aberration is only found in approximately 20% of cases. Some 25% present with an activating KRAS mutation, which despite decades of research still cannot be directly targeted. In the remainder, no genomic aberration of direct clinical consequences has been identified. On the other hand, the rate of PD-L1 positivity >50% at diagnosis has been reported to be between 24.9 and 30.2%. Overall, this leaves the majority of patients without any of those options in first-line therapy and they will receive standard of care chemotherapy. This minireview discusses the latest developments in the field of chemotherapy for non-small cell lung cancer.

Ranftler, Matthias;Strasser-Weippl, Kathrin

2017 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-017-0348-y

Summary In the era of targeted therapies and immunotherapy for cancer, the focus in breast cancer (BC) research has shifted away from classical chemotherapy. Many BC patients, however, still need chemotherapy and thus benefit from the development of new chemotherapeutic agents or regimens. In the past decade, the approval of eribulin and trastuzumab emtansine (T-DM1) have been important advances in this regard. Improved ways of delivery of paclitaxel, anthracyclines, and vinorelbine have also had a considerable clinical impact. Finally, optimizing the use of well-known drugs, such as carboplatin, capecitabine, or adjuvant chemoimmunotherapy in low-risk early BC, has brought about progress in the field of chemo(immuno)therapy.

Wöll, Ewald

2017 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-017-0354-0

Summary Chemotherapy is still the most important component of systemic therapy in gastric cancer. It is not replaced by targeted agents so far. Novel chemotherapies like 5‑fluorouracil (5FU) prodrugs are applied. Agents such as nanoliposomal irinotecan or nanoparticle albumin-bound paclitaxel are still under investigation. In patients overexpressing the epithelial growth factor receptor 2 (HER2), the addition of trastuzumab to classical chemotherapy improves overall survival (OS) substantially and in second line setting the monoclonal antibody ramucirumab shows single agent activity as well as activity in combination with paclitaxel.

Kieler, Markus;Unseld, Matthias;Bianconi, Daniela;Prager, Gerald W.

2017 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-017-0352-2pmid: 28989542

Summary Despite decades of research, pancreatic ductal adenocarcinoma (PDAC) is still one of the most lethal malignant diseases with a devastating 5‑year overall survival of only 4–5%. Indeed, long-term survival was not affected by the introduction of new systemic cytotoxic chemotherapies which remain the key cornerstone in the treatment of metastatic PDAC. In the first-line setting, FOLFIRINOX based upon the results of the PRODIGE/ACCORD trial and gemcitabine with albumin-bound paclitaxel (GNP) based upon the MPACT trial have both been approved as therapeutic options for patients with no significant comorbidities and good performance status. As there is no direct comparison between these regimens, the choice in first-line treatment depends on the toxicity profile, patient’s preferences and reimbursability. In the second-line setting, the results of the NAPOLI-1 trial have led to the approval of nanoliposomal irinotecan (nal-iri) in combination with 5‑fluorouracil (5-FU) for the treatment of patients with mPDAC progressing under gemcitabine-based chemotherapy and therefore this regimen is the first to be approved for use in second-line therapy.

Winder, Thomas

2017 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-017-0351-3

Summary Substantial progress has been achieved in the management of metastatic colorectal cancer (mCRC) over the last two decades. The overall survival has increased from 10 months to more than 30 months. These improvements are due to the integration of multiple cytotoxic agents and targeted therapies, as well as individualized treatment strategies using molecular and clinical factors. More specific, molecular characteristics such as RAS mutation status and clinical factors such as performance status, tumor burden, tumor-related symptoms and comorbidities are crucial in selecting treatment strategies. Here I review the landscape of cytotoxic chemotherapy for mCRC, regional chemotherapy strategies to accumulate cytotoxics within the tumor and reflect on future directions for treatment of mCRC.

Dormann, Clemens

2017 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-017-0353-1

Summary With constantly improving cancer therapies, patient’s quality of life, the management of potential side effects and treatment-related symptoms have also made considerable progress. Chemotherapy-induced nausea and vomiting (CINV) still constitutes a major problem for many patients. New developments in the field allow a more comfortable administration of guideline-based antiemetic therapy and may further improve the control of nausea. Therapeutic options for the cancer anorexia–cachexia syndrome (CACS), common in advanced cancers, are still limited and hampered by numerous side effects. Among these, targeting the ghrelin-receptor pathway could be a novel approach; however, data are still immature.

Bozic, Boris;Hölbling, Sophie;Völkel, Vanessa;Sebesta, Christian

2017 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-017-0343-3

Summary Renal insufficiency in patients with multiple myeloma represents a major challenge for the treating physician. In patients with etiologically unclear renal failure it is important to consider multiple myeloma as a possible cause of such renal failure. The diagnosis and treatment of these patients is interdisciplinary, in cooperation with hemato-oncologists, radiologists, nephrologists and intensive care specialists. The main goal of all treatment methods is the rapid reduction of pathological free light chains in the serum, resulting in an improvement of renal function. Equally important is the avoidance of nephrotoxic drugs and iodinated contrast agents in patients with renal insufficiency and multiple myeloma. A few new drugs have been used in the systemic treatment of patients with multiple myeloma (MM) and renal failure with much success, especially the beneficial use of pomalidomide is interesting and other drugs will follow soon.

Petricevic, Branka;Hilbe, Wolfgang;Zojer, Niklas

2017 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-017-0342-4

Summary The patient described here presented with relapsed multiple myeloma progressing after therapy with immunomodulatory agents (thalidomide and lenalidomide) and proteasome inhibitors (bortezomib and carfilzomib). Eventually, the patient achieved an excellent response to the combination of panobinostat, bortezomib and dexamethasone, overcoming resistance to proteasome inhibitors and achieving a sustained VGPR (very good partial remission), which was consolidated with high-dose melphalan and autologous stem-cell transplantation.

Kavianpour, Maria;Ketabchi, Neda;Saki, Najmaldin

2017 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-017-0324-6

Summary Acute lymphoblastic leukemia (ALL) forms a heterogeneous group of disorders with a characteristic set of CD markers. Nowadays, these markers are used for the classification of hematopoietic malignancies and are a basis for diagnosis of leukemia. Unusual expression of CD markers as different immunophenotype of lymphoblasts is known as the aberrant expression of markers. The frequency of this phenomenon has been reported to be nearly 30% in different studies. Immunophenotype of precursor B‑cell leukemia involves the likely expression of myeloid CD markers (CD13 and CD33). In precursor T‑cell leukemia, myeloid markers (CD13 and CD33) are frequent but CD117 is rare. On the other hand, the presence of multiple translocations is also associated with a higher or lower level of aberrant markers that could be effective in changing the prognosis of patients. Further studies are needed to confirm the relationship between aberrant expression with prognosis and response to treatment of ALL.

Burgstaller, Sonja;Thaler, Josef

2017 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-017-0325-5

Summary The patient presented here was diagnosed with multifocal primary cutaneous anaplastic large-cell lymphoma at the age of 80 years. Initially, he received chemotherapy plus prednisolone, which had to be discontinued due to toxicity. Treatment with brentuximab vedotin was then commenced, which promoted reductions in skin lesions of the patient, and was well tolerated. New lesions occurred 6 months after the start of brentuximab vedotin therapy, but were successfully controlled with irradiation. The patient experienced sustained disease control with ongoing brentuximab vedotin administration for more than 1 year. His quality of life is not compromised by this treatment in spite of his advanced age.

Pfeiler, Georg;Bartsch, Rupert;Fitzal, Florian

2017 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-017-0349-x

Baltzer, Pascal A. T.;Kapetas, Panagiotis;Marino, Maria Adele;Clauser, Paola

2017 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-017-0341-5pmid: 28989543

Summary Imaging plays a major role in the diagnosis, treatment, and follow-up of breast cancer. Findings that require further assessment will be detected both at screening and curative mammography. Most findings that are further worked up tend to yield benign diagnoses. Consequently, there is an ongoing search for new tools to reduce recalls and unnecessary biopsies while maintaining or improving cancer detection rates. The clinically most promising methods in this respect are described and discussed in this review.

Exner, Ruth

2017 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-017-0336-2pmid: 28989544

Summary During the San Antonio Breast Cancer Symposium in December 2016, the main topics were systemic treatment of breast cancer and molecular research. But several studies were also presented concerning local therapy: Surgical issues on evaluating resection margins, management of ductal carcinoma in situ (DCIS), surgical challenges after neoadjuvant therapy related to assessment of response or treatment of axillary lymph nodes, and studies about outcome after breast reconstruction and radiation therapy were discussed. In this short review, oral presentations of these topics are summarized.