Current oncology reports
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Current oncology reports · May 2017
ReviewThe Evolving Role of the Estrogen Receptor Mutations in Endocrine Therapy-Resistant Breast Cancer.
Recurrent ligand-binding domain ESR1 mutations have recently been detected in a substantial number of patients with metastatic ER+ breast cancer and evolve under the selective pressure of endocrine treatments. In this review, we evaluate the current understanding of the biological and clinical significance of these mutations. ⋯ Currently, we are lacking prospective studies to confirm these results and to determine the optimal treatment combinations for patients with the ESR1 mutations. In addition, the clinical development of novel agents to overcome resistance engendered by these mutations is also needed.
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Current oncology reports · Jan 2017
ReviewThe Emerging Role of "Liquid Biopsies," Circulating Tumor Cells, and Circulating Cell-Free Tumor DNA in Lung Cancer Diagnosis and Identification of Resistance Mutations.
Therapeutic advances in the treatment of lung cancer are in part due to a more complete understanding of its genomic portrait. The serial monitoring of tumor genotypes, which are instable and prone to changes under selective pressure, is becoming increasingly needed. ⋯ The "liquid biopsies" have the potential to overcome many of these hurdles, allowing a rapid and accurate identification of de novo and resistant genetic alterations and a real-time monitoring of treatment responses. In this review, we provide insights into new liquid diagnostic platforms and discuss the role of circulating tumor cells and circulating tumor DNA in the diagnosis and identification of resistance mutations in lung cancer.
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There is a common perception that excess adiposity, commonly approximated by body mass index (BMI), is associated with reduced cancer survival. A number of studies have emerged challenging this by demonstrating that overweight and early obese states are associated with improved survival. ⋯ Our review highlights that many observations of the obesity paradox in cancer reflect methodological mechanisms including the crudeness of BMI as an obesity measure, confounding, detection bias, reverse causality, and a specific form of the selection bias, known as collider bias. It is imperative for the oncologist to interpret the observation of the obesity paradox against the above methodological framework and avoid the misinterpretation that being obese might be "good" or "protective" for cancer patients.
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Current oncology reports · Aug 2016
ReviewEchocardiography and Alternative Cardiac Imaging Strategies for Long-Term Cardiotoxicity Surveillance of Cancer Survivors Treated with Chemotherapy and/or Radiation Exposure.
Cardiotoxicity from chemotherapy is a leading cause of morbidity and mortality in cancer survivors. Cardiotoxic effects include left ventricular systolic dysfunction, coronary artery disease, hypertension, bradycardia, arrhythmias, pericardial disease, valvular disease, and radiation-induced restrictive cardiomyopathy. ⋯ Regimens for cardiotoxicity surveillance prior to and during chemotherapy administration have been proposed; however, optimal screening for and treatment of long-term cancer survivors have yet to be clarified. This review focuses on the most common imaging modalities for assessing cardiac dysfunction along with newer imaging technologies, and reviews suggested long-term surveillance strategies in cancer survivors following chemotherapy and radiation therapy.
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Current oncology reports · Feb 2016
ReviewCommunication About Sexuality in Advanced Illness Aligns With a Palliative Care Approach to Patient-Centered Care.
Treatment-related sexual complications are common in cancer patients although rarely discussed in the palliative care setting. Sexuality is an important survivorship issue and remains relevant even in the terminal setting. There are multiple barriers in dialoguing about intimacy and sexual functioning from the patient and provider perspectives. ⋯ They can explore how sexual dysfunction can impair functioning and utilize an interdisciplinary approach to manage symptoms. Palliative care providers can help patients identify their goals of care and explore what anticipated sexual changes and treat-related side effects are tolerable and intolerable to the patient's quality of life. Principles on addressing sexuality in the palliative setting and practical ways of incorporating sexual history into the palliative care assessment are provided.