journal article
LitStream Collection
Home
Urban, Iveta; Primavesi, Florian; Bogner, Klaus; Bartsch, Claudia; Trattner, Marlene; Schmid, Alexandra; Stättner, Stefan
2022 memo - Magazine of European Medical Oncology
doi: 10.1007/s12254-021-00791-5
Summary Hepatocellular carcinoma (HCC) is one of the most common cancers with an increasing incidence and high mortality rate worldwide. Surgical resection is still an essential curative-intent treatment for improving the prognosis of patients with HCC. Due to the concomitance of HCC with cirrhosis, chronic liver disease, alcohol consumption and its complications, clinical treatment is challenging. Despite the rational approaches to prevention that have been developed, many patients are diagnosed at an advanced stage and are not eligible for surgical treatment, for example, because of poor underlying liver function or extrahepatic disease spread. The recurrence rates after curative resection still remain high. The implementation of neoadjuvant therapy in HCC management plays an important role in preventing tumor progression, but also shows promising results in downstaging HCC to enable surgical resection. The absence of randomized controlled trials leaves uncertainty in improving outcome, and consensus guidelines are lacking. In this review article, we summarize the clinical efficacy of evolving neoadjuvant treatments for patients with intermediate or advanced stage HCC.
Elnahas, Waleed; Metwally, Islam H.; Elkashef, Wagdi
2022 memo - Magazine of European Medical Oncology
doi: 10.1007/s12254-021-00717-1
Summary Background Colorectal cancer (CRC) commonly presents with distant metastasis, either at presentation (synchronous) or during the disease course (metachronous). Although the most common site of spread includes liver, lung and peritoneum, thyroid metastasis is also rarely reported with unknown natural history. Case presentation We report a patient with metachronous colorectal cancer recurrence within the thyroid gland and include an exhaustive literature review of the condition. In all, 68 patients were reported in the literature either as case reports or in case series studies. Conclusion Thyroid metastasis from CRC mainly present metachronous, more frequently from colon cancer, being an isolated site of spread or associated with oligometastasis in most patients. Thyroid metastasectomy is reported with good survival. Further reporting and comparing survival of those patients to other sites of spread is encouraged.
2022 memo - Magazine of European Medical Oncology
doi: 10.1007/s12254-021-00785-3
Summary Immunotherapy is a breakthrough in different tumor entities. Recently, immunotherapy became an important treatment modality in gastrointestinal (GI) malignancies. In GI malignancies, immunotherapy with or without chemotherapy or targeted agents is revolutionizing the treatment landscape and our daily clinical practice. In this review, we discuss the relevance of immunotherapy in GI malignancies and provide a perspective on promising upcoming treatment strategies.
2022 memo - Magazine of European Medical Oncology
doi: 10.1007/s12254-021-00745-x
Summary Neoadjuvant therapy is well-accepted in the treatment of borderline resectable and locally advanced PC, the benefit of neoadjuvant chemotherapy in patients with resectable disease, however, is currently not so clear. Here we provide an up date on the literature.
Puhr, Hannah Christina; Ilhan-Mutlu, Aysegul
2022 memo - Magazine of European Medical Oncology
doi: 10.1007/s12254-021-00762-w
Summary Recent innovative advances, especially concerning immunotherapeutic agents and targeted therapies, have changed the face of modern oncology. The year 2020 represents a milestone in the treatment of gastroesophageal cancer because several trials showed promising survival benefits, at least for a specific subgroup of patients. Not only immunotherapeutic agents, but also targeted therapies seem to be beneficial, particularly when the target is well defined and the threshold value is selected appropriately. Thus, many new innovative treatment strategies are underway and might lead to a further paradigm change in the therapy of patients with advanced gastric tumors. This review gives a concise overview of these new therapeutic options and recently approved strategies as well as ongoing studies.
Müldür, Ercan; Hilbe, Wolfgang
2022 memo - Magazine of European Medical Oncology
doi: 10.1007/s12254-021-00779-1
Summary For patients suffering from localized and advanced stage esophageal cancer, long-term outcomes remain poor. However, as already seen in other tumors, the introduction of immune checkpoint inhibitors has led to practice-changing results in the treatment of esophageal cancer. In this short review, five emerging studies are presented and discussed, which have changed standard of care in this disease.
Schöche, Johannes; Niedersüß-Beke, Dora
2022 memo - Magazine of European Medical Oncology
doi: 10.1007/s12254-021-00787-1
Summary Agents targeting vascular endothelial growth factor (VEGF) or epidermal growth factor receptor (EGFR) are part of systemic therapy in advanced colorectal cancer. It is well known that only certain molecular subpopulations profit from EGFR antibodies, restricting those therapeutics to a smaller fraction of patients. Recently investigated, the monitoring of temporally changing RAS mutational status by liquid biopsy might allow the application of EGFR antibodies to an additional subset of patients. In addition, KRAS G12C inhibitors combined with anti-EGFR antibodies are currently under investigation in clinical trials and could provide another effective therapy in case of KRAS G12C mutations. Beyond RAS, therapy guided by microsatellite instability (MSI) status, BRAF mutations, HER2 overexpression and NTRK fusions are welcome additions to targeted treatment in advanced colorectal cancer.
Prochazka, Katharina T.; Uhl, Barbara
2022 memo - Magazine of European Medical Oncology
doi: 10.1007/s12254-021-00778-2
Summary In recent years, treatment of patients exhibiting chronic lymphocytic leukemia has changed extensively due to advances in the development of targeted therapies. The Bcl‑2 inhibitor venetoclax demonstrated outstanding results when used in mono- as well as combination therapy. Minimal residual disease (MRD) measurement has become an important endpoint in most studies and shows high prognostic potential. With upcoming combination strategies, the role of MRD measurement has also increased and is likely to become a routine marker in future clinical practice.
2022 memo - Magazine of European Medical Oncology
doi: 10.1007/s12254-021-00776-4
Summary Chronic lymphocytic leukemia (CLL) treatment strategies have improved and changed dramatically in the last few years. Currently, patients are mostly treated with so-called novel agents, including Bruton tyrosin kinase (BTK) inhibitors and BCL‑2 inhibitors. CLL is a chronic disease; therefore, a proportion of patients will require multiple lines of therapy. In this review, we present the current treatment options for patients with CLL and discuss potential optimal treatment combinations.
2022 memo - Magazine of European Medical Oncology
doi: 10.1007/s12254-021-00755-9
Summary The treatment landscape of chronic lymphocytic leukemia (CLL) has shifted from chemotherapy-based approaches to targeted agents in the last decade. However, evolving drug resistance and accumulating toxicity remain challenges that still limit patients’ clinical outcomes. Furthermore, currently licensed targeted agents such as inhibitors of Bruton’s tyrosine kinase (BTK) and anti-apoptotic protein B‑cell lymphoma 2 (BCL2) do not adequately compensate for the poor clinical outcomes associated with high-risk genetics such as TP53 alterations. New insights into disease biology facilitated design and investigation of several new targeted agents with encouraging results in early clinical trials. This short review focuses on novel actionable targets and investigational drugs aimed at circumventing acquired resistance and avoiding accumulating toxicity.
Scheiner, Bernhard; Pinter, Matthias
2022 memo - Magazine of European Medical Oncology
doi: 10.1007/s12254-021-00747-9
Summary We present a case of a male patient with advanced hepatocellular carcinoma who developed hepatic and dermatological immune-related adverse events during treatment with the immune checkpoint inhibitor nivolumab. We discuss relevant aspects regarding the management of immune-related hepatic adverse events, including the incidence and onset of the event, the requirement for immune-modulating medication, resuming of immunotherapy, and the association between the occurrence of immune-related adverse events and the outcome.
Wass, Romana Elisabeth; Lang, David; Horner, Andreas; Lamprecht, Bernd
2022 memo - Magazine of European Medical Oncology
doi: 10.1007/s12254-021-00756-8
Summary Immune checkpoint blockade (ICB) has fundamentally improved the treatment landscape of advanced lung cancer. Improved tolerability and encouraging duration of response in selected patients are some of the advantages of ICB over conventional cytotoxic chemotherapies. However, immune-related adverse events (irAEs) possibly affecting multiple organs pose challenges in diagnosis and management. Checkpoint inhibitor pneumonitis (CIP) is a rare but clinically highly relevant irAE that can significantly impair quality of life and can be potentially life threatening. Since its heterogeneity in clinical and radiographic presentation, diagnosis can be challenging. Treatment usually consists of discontinuing or delaying the administration of ICB. If there is no sufficient recovery with this measure, steroid therapy is indicated. Although the majority of cases improves with this therapy, steroid-refractory CIP can be a therapeutic challenge as there is currently no evidence-based standard treatment. We herein present a short review of literature and a case report of relapsing CIP under steroid treatment.
2022 memo - Magazine of European Medical Oncology
doi: 10.1007/s12254-021-00766-6
Summary Tremendous advances in modern oncology therapies enable an increasing life expectancy of many cancer entities. Short or long-term cardiovascular side effects, however, gain importance. The current review focuses on recent recommendations for strategies of preventing and treating cardiotoxicity. A personalized assessment of the baseline risk of cardiotoxicity is recommended in all patients, without delaying the initiation of the cancer therapy. A baseline ECG, biomarkers (NT-proBNP, troponin), blood pressure and echocardiography should be obtained in all patients scheduled for potentially cardiotoxic treatments. Cardiac risk factors, e.g., coronary disease, hypertension, elevated lipids, should be promptly treated and optimized. Increased surveillance with more frequent cardiac imaging and sequential biomarker assessment during the cycles is recommended in high-risk cardiac patients. New imaging methods in echocardiography such as speckle tracking global longitudinal strain reflecting early myocardial ventricular deterioration are proposed in recent recommendations. Signs of cardiotoxicity should induce early treatment by, e.g., ACE-inhibitors, beta-blockers and/or other heart failure therapies. Immune therapies, e.g., checkpoint-inhibitors can induce cardiac events such as arrhythmias, acute coronary syndrome with plaque rupture, or myocarditis, even in negative magnetic resonance imaging or normal echocardiography findings. Troponin, BNP and ECG may help to identify these potentially deleterious side effects. Furthermore, there is a bidirectional influence of heart disease and cancer, e.g., by common inflammatory pathways. Pre-existent heart disease leads to worse prognosis in cancer, necessitating close follow-up and cardiac treatment during cancer therapy. On the other hand, cardiovascular mortality is increased after cancer survival and periodic cardiac follow-up is recommended long-term especially after chemotherapy and-or radiation.
2022 memo - Magazine of European Medical Oncology
doi: 10.1007/s12254-021-00773-7
Summary Given the growing use of immune checkpoint inhibitor (ICI) therapy in oncology, the prevalence of endocrine side effects is rapidly increasing. As clinicians are nowadays frequently confronted with these side effects in routine clinical care, awareness, better knowledge of endocrine irAEs and their clinical presentation and diagnosis is crucial for an adequate management. In this short-review we give a compact overview of the recent recommendations for the management of endocrine irAE related to ICIs and highlight difficulties and uncertainties in current clinical practice.
2022 memo - Magazine of European Medical Oncology
doi: 10.1007/s12254-021-00783-5
Summary Palliative care has evolved over the past five decades as an interprofessional specialty to improve quality of life and quality of care for patients with cancer and their families. The main objective in an end-of-life (EOL) situation is to maintain the autonomy and the dignity of the patient as much as possible. Due to the severity of progressive diseases and as a result of the poor general condition of the patient, their autonomy is often endangered. This case report presents a 70-year-old woman who suffered from hepatic and bone metastases from cancer of unknown primary (CUP) in a palliative setting and discusses the supportive treatment opportunities as well as the ethical thoughts about her autonomy.
Mohapatra, Prachi; Mahapatra, Satya Prasad
2022 memo - Magazine of European Medical Oncology
doi: 10.1007/s12254-021-00760-y
Summary Background Moderate thrombocytosis may be present in chronic myeloid leukemia (CML), but extreme thrombocytosis causing acquired von Willebrand syndrome (AvWS) is rare in CML. Case presentation A 64-year-old man, a diagnosed case of CML in chronic phase on imatinib mesylate (400 mg/day) since 2014 with good compliance and response to imatinib therapy presented with sudden onset of black tarry stools for 7 days and 1 episode of epistaxis 3 days prior to presentation. Investigations were suggestive of chronic phase CML with extreme thrombocytosis. The diagnosis of acquired von Willebrand syndrome (AvWS) was confirmed after coagulation studies. Treatment of the patient with high-dose imatinib and hydroxyurea led to normalization of platelet counts, reversal of the coagulation defect, and subsidence of symptoms. Conclusion The present case is being reported as AvWS as the cause of bleeding in patients with CML is very rare and is often missed.
Tığlıoğlu, Pınar; Albayrak, Murat; Tığlıoğlu, Mesut; Öztürk, Hacer Berna Afacan; Aras, Merih Reis; Sağlam, Buğra; Maral, Senem
2022 memo - Magazine of European Medical Oncology
doi: 10.1007/s12254-021-00775-5pmid: 34904019
Summary Objective The aim of this study was to examine the effect of coronavirus disease 2019 (COVID-19) on the malignancy-related clinical course and overall survival, and to determine the factors affecting mortality. Methods This retrospective study included 77 patients with hematological cancer and COVID-19. Patients were sub-grouped for analysis as survivors and non-survivors. Results COVID-19 was seen more frequently in myeloproliferative neoplasms (MPN), non-Hodgkin lymphoma (NHL) and multiple myeloma (MM) patients. Mortality rate due to COVID-19 was 20.8%. No statistically significant difference was determined between the survivor and non-survivor groups with respect to age and gender, presence of any comorbidity, leukocyte, neutrophil, lymphocyte, and monocyte values. Platelet count and hemoglobin count were significantly lower in the group with mortality than in the group with recovery. Conclusion It should be kept in mind that low hemoglobin and platelet levels contribute to mortality. In addition, it is important to protect patients with hematological cancer from COVID-19 and undertake effective vaccination due to its mortal course.
Xiao, Xiao; Fang, Xinchen; Yao, Wen; Huaiping, Zhu
2022 memo - Magazine of European Medical Oncology
doi: 10.1007/s12254-021-00774-6
Summary Objectives This study aimed to investigate the clinical characteristics and prognostic impact of 1q21 gain in patients with newly diagnosed multiple myeloma (MM). Methods This was a retrospective study of 197 patients with newly diagnosed MM. Fluorescence in situ hybridization was performed to detect six cytogenetic abnormalities: gain(1q21), del(17p), del(13q14), t(4;14), t(14;16), and t(11;14). Results We showed that 57.8% of patients with MM had 1q21 gain. The patients with 1q21 gain had lower IgM (0.39 vs 1.14 g/L, P = 0.037) and higher platelet count (177.62109/l vs 148.29109/l, P = 0.018) than those without 1q21 gain, and were more likely to be accompanied by del(13q14) (P < 0.001) or t(4;14) (P = 0.017). Conclusions We showed that 1q21 gain was associated with del(13q14) and t(4;14) increase, but it had no effect on prognosis of patients with newly diagnosed MM.