Current opinion in oncology
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At present, clinicians and healthcare providers are increasingly urged to advance the provision of state-of-the-art palliative care for patients with incurable cancer. This review provides an overview about the recent findings and practical suggestions. ⋯ Patients, families and physicians benefit from shared care concepts of oncology and specialized palliative care. Although this concept is already becoming increasingly implemented in tertiary (comprehensive cancer-) care settings, the potential of this approach should be explored for other clinical settings such as office-based oncology.
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Giant cell tumor (GCT) of bone is a benign, osteolytic neoplasm of bone. The receptor activator of NF-KB ligand (RANKL) pathway has recently been shown to play a key role in the pathogenesis of GCT. ⋯ Denosumab offers a new treatment option for a subset of patients with previously untreatable GCT. The role of denosumab in curative treatment is the subject of ongoing studies.
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To present the model of the Supportive Care in Cancer Unit (SCCU) of the National Cancer Institute (NCI) of Milan. ⋯ The aims of the SCCU of the NCI of Milan are mainly four: to collaborate with the individual specialists of NCI through integrated and ancillary activities while implementing a supportive therapy to treat the side effects, toxicities of oncological therapies, and comorbidities in the patients from the time of diagnosis and throughout the oncology treatment period; to assess all patients' needs through Italian validated versions of assessment tools, in order to ensure early care of the patient in a holistic approach; to support family members, survivors and healthcare professionals; and to promote research (pharmacological and non-pharmacological) and educational programs.Our integrated model of medicine in oncology, which we define 'supportive care', is part of the clinical history of the patients, from the time of diagnosis and during oncological treatments, to facilitate their psychological well being and improve adherence to treatment protocols.
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The treatment of gastrointestinal stromal tumors (GISTs) with tyrosine kinase inhibitors (TKIs), such as imatinib and sunitinib, has produced improved outcomes and survival. However, patients with high-risk tumors still have unacceptably high rates of recurrence and disease progression. In the current review, we examine the various strategies for optimizing the treatment of GISTs. ⋯ The extended duration of TKI treatment, dose optimization, mutation status, and the effects of TKI discontinuation have recently been examined in more detail. As our understanding of TKI therapy grows, an individualized approach to each patient should lead to better outcomes.
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Giant cell tumor of tendon sheath and pigmented villonodular synovitis are synovial-based diseases that are generally treated by surgery. For aggressive and recurrent tumors, treatment alternatives are needed. This review explores a targeted therapeutic strategy. ⋯ Imatinib along with other such inhibitors and monoclonal antibodies to CSF1R are putative drugs that may play an important role in the treatment of these tumors.