memo - Magazine of European Medical Oncology

2017 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-017-0360-2

Pircher, Andreas

2017 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-017-0363-z

Rinnerthaler, Gabriel

2017 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-017-0364-y

Young, Robin; Woll, Penella

2017 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-017-0365-xpmid: 29250195

Angiosarcomas are rare aggressive endothelial tumours, and are associated with a poor prognosis. Due to their vascular nature, there is great interest in their response to anti-angiogenic agents. A number of small prospective studies have reported angiosarcoma response to vascular-targeted agents, including agents that target vascular endothelial growth factor. To date, the response to these agents has been disappointing, and similar to the response observed in other soft tissue sarcoma subtypes. This short review will summarise the recent data in this field.

Gampenrieder, Simon; Westphal, Theresa; Greil, Richard

2017 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-017-0362-0pmid: 29250196

Based on a strong rationale for anti-VEGF (vascular endothelial growth factor) treatment in breast cancer and promising preclinical data, great hopes have been placed on the anti-VEGF antibody bevacizumab. Clinical trials, however, reported conflicting results. In metastatic human epidermal growth factor receptor 2(HER2)-negative breast cancer, the addition of bevacizumab to standard chemotherapy improved consistently progression-free survival (PFS), however, without effect on overall survival (OS). In early breast cancer bevacizumab increased the pathologic complete response rate (pCR) after neoadjuvant therapy, but adjuvant trials did not demonstrate an effect on long-term survival. Unfortunately, despite extensive research, there is still no biomarker for bevacizumab efficacy available, making patient selection difficult. This review summarizes all phase III trials investigating efficacy and toxicity of bevacizumab in early, locally advanced and metastatic breast cancer. It recapitulates the main toxicities, gives an overview on biomarker studies and discusses the role and future aspects of antiangiogenic therapy in breast cancer.

Haidl, Friederike; Pfister, David; Heidenreich, Axel; Heidegger, Isabel

2017 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-017-0375-8pmid: 29250197

The use of antiangiogenic agents in cancer therapy has become an attractive target in oncological research. However, concerning the uro-oncological field, current guidelines only recommend the use of antiangiogenic agents in metastatic renal cell cancer. Yet in recent years, several approaches for sequential treatment with angiogenesis inhibitors in other urogenital malignancies apart from renal cell cancer are ongoing. Thus, the present review article aims to provide an overview about clinical studies with antiangiogenic agents in prostate-, bladder-, testicular-, as well as penile cancer patients. For this, a literature search was conducted using Medline; moreover we performed a systematic review of data presented at this year’s important urooncological meetings. Preliminary data revealed that there are several promising studies ongoing in prostate-, bladder-, testicular-, as well as penile cancer; however, larger studies should be conducted to optimize the use of antiangiogenic agents in clinical practice.

Pichler, Renate; Heidegger, Isabel

2017 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-017-0344-2pmid: 29250198

The era of antiangiogenic drugs targeting the vascular endothelial growth factor (VEGF) signaling pathway has become a mainstay in the treatment of metastatic renal cell carcinoma (mRCC), showing primary responses in 65–70% of patients. Nevertheless, most of those patients progress to angiogenesis inhibitors over time due to different modes of resistance (adaptive and intrinsic). Both in vitro and in vivo analyses provided evidence that PD-L1 upregulation in hypoxia conditions is dependent on hypoxia-inducible factor (HIF)-2alpha and is associated with an overexpression of VEGF. Thus, additional blockade of PD-L1 along with inhibition of angiogenesis pathways seems to represent a novel and innovative treatment concept in mRCC. In this short review, we provide an overview on ongoing phase III trials combining antiangiogenic therapies with checkpoint inhibitors in the first-line setting. Moreover, we critically analyze the impact of recently approved therapeutic antiangiogenic agents and checkpoint inhibitors after progression to first-generation tyrosine kinase inhibitors and their mode of action. In addition, response and resistance hypotheses and biomarkers to antiangiogenic therapy in clinical practice are critically discussed.

Stragier, Elisabeth; Prenen, Hans

2017 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-017-0359-8

Angiogenesis is a very important step in the development of cancer. Several antiangiogenic biological agents have been studied during the past two decades for the treatment of colorectal cancer, both in adjuvant and metastatic settings. The first and most intensively studied is bevacizumab, a humanized monoclonal antibody against the vascular endothelial growth factor. Since its approval in 2004, other antiangiogenic agents have been evaluated in clinical trials and some subsequently approved for the treatment of metastatic colorectal cancer such as aflibercept, ramucirumab, and regorafenib. In general, antiangiogenic agents show a modest efficacy in patients with metastatic colorectal cancer but not in the adjuvant setting. Also, there are no predictive biomarkers that could aid in selecting responsive patients. In this review we summarize the results of the completed large clinical trials investigating the efficacy of antiangiogenic therapies in colorectal cancer.

Fridrik, Michael

2017 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-017-0372-ypmid: 29250199

Abstracts concerning indolent and aggressive lymphoma and multiple myeloma with clinical relevance from the ASCO 2017 meeting are discussed.

Magnes, Teresa; Egle, Alexander; Greil, Richard; Melchardt, Thomas

2017 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-017-0358-9pmid: 29250200

At the annual ASCO meeting clinically relevant data concerning the management of advanced head and neck cancer that will influence clinical practice in the future were presented.

Absenger, Gudrun; Terzic, Jasmin; Bezan, Angelika

2017 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-017-0373-xpmid: 29250201

In the past few years there have been major changes in the treatment landscape in oncology; lung cancer is affected by those changes like almost no other solid tumor. The rise of further second- and third-line tyrosine kinase inhibitors offers sequential therapy for patients with mutated non-small-cell lung cancer. Immunotherapy has found its way into clinical routine and presents us with new challenges in managing side effects, evaluating treatment response and deciding on how long we treat our patients. The treatment algorithm of lung cancer has changed in the last month and further practice-changing trials are coming up, so treating lung cancer patients shows nowadays a more challenging perspective with the possibility of subsequently applied individual therapies. This article provides a brief overview of the highlights presented at the ASCO (American Society of Clinical Oncology) annual meeting this year in Chicago.

Bartsch, Rupert; Bergen, Elisabeth

2017 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-017-0368-7pmid: 29250202

At the 2017 ASCO Annual Meeting, several pertinent studies in the field of breast cancer were presented and some are deemed as being potentially practice changing. BrighTNess was the first phase III study to investigate the addition of carboplatin to standard neoadjuvant chemotherapy in triple-negative breast cancer; while toxicity was increased in the experimental group, a significantly higher pathologic complete remission (pCR) rate was observed as well suggesting that adding carboplatin to neoadjuvant anthracycline, cyclophosphamide and taxane-containing regimens is efficacious in otherwise healthy patients. In metastatic breast cancer patients harbouring BRCA germ-line mutations, the PARP(poly [ADP-ribose] polymerase)-inhibitor olaparib was superior to conventional chemotherapy defining a potential novel treatment standard in this high-risk population. In the adjuvant setting, the APHINITY trial compared dual HER2-directed antibody therapy with trastuzumab plus pertuzumab to trastuzumab alone. A small benefit in favour of the combination was observed which was more pronounced in node-positive subjects. In hormone-receptor positive metastatic disease, several studies evaluating the role of CDK4/6 (cyclin-dependendent kinases 4 and 6) inhibitors were presented with data again indicating that adding CDK4/6 inhibitors to endocrine therapy results in a clinically relevant prolongation of progression-free survival.

Szkandera, Joanna

2017 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-017-0346-0

Soft tissue sarcomas (STS) are a rare and heterogeneous group of malignant tumors that substantially differ in the underlying biology, natural course and treatment response. In locally advanced or metastatic disease, systemic treatment represents the main therapeutic approach. Anthracycline-based chemotherapy and its combination with ifosfamide has been used as the gold standard in the first-line treatment of advanced disease for decades; however, as increasing evidence favors the use of histology-tailored therapy, novel cytotoxic agents and targeted therapies are currently under intense investigation. Additionally, immunotherapeutic agents have been explored in several STS studies, showing promising results in specific histological subtypes. This article provides a brief overview of the standard systemic treatment options in advanced STS and a summary of the highlights of the STS trials presented at the American Society of Clinical Oncology (ASCO) annual meeting 2017.

Radl, Bianca; Mlineritsch, Brigitte

2017 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-017-0371-zpmid: 29250203

At this year’s ASCO annual meeting several important studies in the field of gynecological cancer were presented. Here we report a personal selection of the most interesting and clinically relevant data.

Weiss, Lukas; Huemer, Florian; Greil, Richard

2017 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-017-0366-9pmid: 29250204

A multitude of new molecular and immunologic insights into gastrointestinal tumors have been presented at the ASCO meeting 2017; however, we have focused our update on practice-changing phase 3 trials and tried to set them into clinical perspective. Furthermore, we will elaborate on updated data on immunotherapeutics in gastroesophageal cancers, since drug approvals may be anticipated before convening for the next meeting in 2018.

Müllauer, Leonhard

2017 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-017-0361-1pmid: 29250205

Next generation sequencing (NGS) has unravelled the genetic alterations that underlie the pathogenesis of cancer. It is now becoming integrated into routine clinical diagnostics of malignant tumours. NGS supports diagnosis, identifies therapeutic targets, reveals resistance mechanisms and facilitates disease monitoring. It takes a central function in the implementation of cancer therapies adapted to the molecular alterations of tumours.

Beham-Schmid, Christine

2017 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-017-0367-8pmid: 29250206

Aggressive lymphomas are a heterogeneous group of malignancies reflecting clinical, biological and pathological diversity. Diffuse large B‑cell lymphoma is the most common histological subtype and therefore will constitute the key aspect in this article. This lymphoma affects patients of all age groups with wide range presentations concerning localization, morphology and molecular mechanisms. The median age at presentation is about 60 years with a slight male preponderance. Up to 50% of patients present with advanced disease. About 70% of these lymphomas occur nodal, about 30% extranodal, the most common sites of the latter being the gastrointestinal tract, Waldeyer’s ring, skin, cerebrum, mediastinum, testis, salivary gland, thyroid and bone. However, diffuse large B‑cell lymphoma can involve virtually any organ.Since the last WHO classification 2008 the adoption of new genomic technologies has provided new insights into the biology of these lymphomas and led to the identification of distinct separate molecular entities and novel pathogenic pathways. These findings induced an expanding number of entities in the new WHO classification of 2016, the knowledge of which is essential concerning treatment options and survival of the patients. Therefore, the clinicians request an accurate diagnosis from the investigating pathologist, which can be quite challenging. The diagnosis of lymphomas requires multiple immunohistochemical studies, and often additional tests, such as fluorescent in situ hybridization and/or polymerase chain reaction techniques and occasionally, in particular cases, next generation sequencing for identification of recurrent somatic mutations. This review summarizes relevant aspects of the new WHO classification in aggressive B‑cell lymphomas, especially from a haematopathologist’s point of view.

Seeber, Andreas; Gastl, Günther; Eisterer, Wolfgang; Gampenrieder, Simon; Gerger, Armin; Kieler, Markus; Pichler, Martin; Prager, Gerald; Untergasser, Gerold; Weltermann, Ansgar; Greil, Richard

2017 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-017-0369-6

Personalized medicine is rapidly changing the daily routine for the diagnostic work-up and treatment of cancer patients. Several clinical studies and programs are ongoing worldwide to implement personalized anticancer therapies particularly for relapsed/refractory malignancies. On 28 October 2016, the first meeting of the Austrian Expert Panel for Molecular Cancer Profiling was held in Salzburg with the purpose to identify clinical studies and registry programs focusing on comprehensive molecular tumor profiling and personalized cancer therapies in Austria. Representatives of the four Austrian academic centers and from two teaching hospitals were invited to present and debate the current status, challenges, and perspectives in precision oncology. To date, three clinical programs are recruiting patients with relapsed/refractory malignancies in Austria: the ONCO-T-PROFILE program at the Medical University of Innsbruck, the platform MONDTI at the Medical University of Vienna, and the ICT (Individualized Cancer Treatment) phase II trial at the Medical University of Graz. The aim of both research programs and the phase II trial is to investigate the efficacy of molecular profile-based personalized therapies in refractory and relapsed metastatic cancer patients. Furthermore, in cooperation with the AGMT (Study Group of Medical Tumor Therapy), a clinical registry will be established to monitor and to analyze the benefit of molecular profiling in real life.

Rudresha, A.; Anand, Abhishek; Lakshmaiah, K.; Babu, K.; Lokanatha, D.; Usha, Amirtham; Jacob, Linu; Babu, Suresh; Lokesh, K.; Rajeev, L.; Koppaka, Deepak

2017 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-017-0335-3