Cancer treatment reviews
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Platinum compounds are a class of chemotherapy agents that posses a broad spectrum of activity against several solid malignancies. Oxaliplatin (OXL) is a third-generation organoplatinum compound with significant activity mainly against colorectal cancer (CRC). Peripheral neuropathy is a well recognized toxicity of OXL, usually resulting in dose modification. ⋯ However, the clinical data are still controversial. We herein review and discuss the pathogenesis, incidence, risk factors, diagnosis, characteristics and management of OXLIPN. We also highlight areas of future research.
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Cancer treatment reviews · May 2008
ReviewAromatase inhibitor-induced arthralgia: clinical experience and treatment recommendations.
It is well documented that the aromatase inhibitors (AIs) are superior to tamoxifen as adjuvant endocrine therapy in postmenopausal women with hormone receptor-positive breast cancer. However, compared with tamoxifen, an elevated incidence of arthralgia has been observed during AI treatment. Concerns have been raised that AI-induced arthralgia may dissuade patients from completing their full AI treatment course, and may also deter physicians from prescribing an AI if they feel that patients may be at risk of permanent joint damage. ⋯ In this paper, we discuss the potential mechanisms behind AI-induced arthralgia, review the frequency with which arthralgia occurs, and propose for the first time an algorithm specifically for the treatment of AI-induced arthralgia. As with joint pain in non-breast cancer patients, a sequential approach to disease management is recommended, involving modifying the patient's lifestyle in addition to taking a stratified approach to pharmacological intervention with analgesia and anti-inflammatory medication. Knowing that joint symptoms can be managed in most patients may encourage patient-physician communication and treatment compliance.
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Cancer treatment reviews · Feb 2008
ReviewMolecular-targeted therapies: lessons from years of clinical development.
Over the past decade, molecular-targeted therapies have been added to cytotoxic and anti-endocrine drugs in the treatment of cancer, with the aim to target the molecular pathways that underlie the carcinogenic process and maintain the cancer phenotype. Success with some of these agents has suggested that identification and validation of the drug target is the starting point for the route of development of active, safe and effective drugs. Main molecular targets used to the development of anticancer drugs are cell surface receptors, signal transduction pathways, gene transcription targets, ubiquitin-proteasome/heat shock proteins and tumour microenvironment components (especially antiangiogenic agents). Here, we review the development of the main molecular targeted non-cytotoxic agents studied in cancer, highlighting lessons derived from the development of these novel drugs and proposing new horizons for the clinical development of molecular-targeted therapies.
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Cancer treatment reviews · Jan 2008
Case ReportsRecurrent disease four years after surgery and adjuvant chemotherapy.
A 71-year-old man with previous primary resection was found to have extensive liver metastases. Chemotherapy was initiated with FOLFIRI plus bevacizumab, in hopes of reducing the hepatic tumor burden; this resulted in manageable toxicity and was sufficiently effective to allow resection. ⋯ The subsequent administration of FOLFOX for 8 cycles and FOLFIRI plus cetuximab were unable to prevent further decline. Detailed explanation of the selection of appropriate surgical and chemotherapeutic options are provided throughout the case discussion.
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Cancer treatment reviews · Nov 2007
ReviewParticipation of adolescents with cancer in clinical trials.
Adolescent patients with cancer reside in a "no-man's land" between the world of pediatric oncology and that of "adult" medical oncology. As compared to younger and older patients, adolescents and young adults are under-represented on clinical trials. This relative lack of participation in clinical protocols has been associated to a lack of progress in survival improvement over the last years. ⋯ This solution, however, is probably appropriate for the tumor, but not necessarily for the patient. Adolescents are neither old children nor young adults, and are very complicated individuals, with unique socio-psychological problems and needs, that may be addressed only by dedicated professionals, adequately trained and supported. The ultimate challenge is the development of a new discipline, adolescent/teenage and young adult oncology, devoted to the care of these patients.