Current opinion in oncology
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The review examines recent advances in second-line hormonal therapy for the treatment of castrate-resistant prostate cancer (CRPC). ⋯ Novel inhibitors of extra-gonadal androgen synthesis and androgen receptor function demonstrate the continued importance of androgen signaling in CRPC. These agents have improved clinical outcomes for patients with metastatic CRPC.
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The success of poly(ADP-ribose) polymerase inhibition in BRCA1 or BRCA2 deficient tumors as an anticancer strategy provided proof-of-concept for a synthetic lethality approach in oncology. There is therefore now active interest in expanding this approach to include other agents targeting the DNA damage response (DDR). We review lessons learnt from the development of inhibitors against DNA damage response mechanisms and envision the future of DNA repair inhibition in oncology. ⋯ There remains great enthusiasm in oncology practice for pursuing the strategy of synthetic lethality. The future development of antitumor agents targeting the DDR should include detailed correlative biomarker work within early phase clinical studies wherever possible, with clear attempts to identify doses at which robust target modulation is observed.
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Multiple myeloma is a malignant neoplasm of plasma cells, for which there is no known cure. This article examines the efficacy and tolerability of lenalidomide, a potent structural analogue of thalidomide, for second-line treatment of patients with relapsed multiple myeloma. ⋯ Lenalidomide in combination with dexamethasone is approved by the US Food and Drug Administration and the European Medicines Agency for the second-line treatment of patients with multiple myeloma. Lenalidomide is recommended as a treatment option for patients with multiple myeloma in both United States and European treatment guidelines.
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Review
Trastuzumab emtansine in human epidermal growth factor receptor 2-positive breast cancer: a review.
In this review, we aim to update the clinical data of trastuzumab-DM1 (T-DM1) in terms of safety and efficacy, and describe ongoing and future trials evaluating its potential role in the management of patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer. ⋯ T-DM1 has been shown to be a very promising agent for the targeted delivery of chemotherapy and anti-HER2 monoclonal antibody therapy for patients with metastatic, HER2-positive breast cancer. T-DM1 will likely play a role in the management of patients with advanced and early stage HER2-positive breast cancer, but this awaits further study.
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This article reviews the potential benefit of maintenance therapy for patients with follicular lymphoma. ⋯ A first remission is easily obtained but relapses appear unavoidable. Patients achieving a partial response have poorer outcomes compared with those achieving complete remission. Furthermore, it has been demonstrated that among patients with follicular lymphoma who reach complete remission, those obtaining negative minimal residual disease, as assessed by molecular biology, have a better outcome compared with those remaining with residual disease. There is, therefore, a rationale to give additional treatment in an attempt to eradicate or to control the lymphoma cells responsible for relapse. An ideal maintenance regimen would have limited toxicity and should be easy to administer. Results of the International Primary Rituximab and Maintenance study show that 2 years of rituximab maintenance prolongs progression free survival, delays the time to next antilymphoma treatment and improves the quality of response in patients with previously untreated follicular lymphoma. Rituximab maintenance was well tolerated with a limited number of adverse events.