Current oncology reports
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Current oncology reports · Apr 2013
ReviewTargeting the adrenal gland in castration-resistant prostate cancer: a case for orteronel, a selective CYP-17 17,20-lyase inhibitor.
Androgen and the androgen receptor (AR) pathway remain the key targets for emerging new therapies against castration-resistant prostate cancer (CRPC). Adrenal androgens and intratumoral testosterone production appear to be sufficient to activate AR in the castration-resistant setting. This process re-engages AR and allows it to continue to be the primary target responsible for prostate cancer progression. ⋯ A new CYP17 inhibitor, with more selective inhibition of 17,20-lyase over 17α-hydroxylase, orteronel (TAK-700), is currently undergoing phase III clinical trials in pre- and postchemotherapy CRPC. In a completed phase II trial in CRPC patients, orteronel demonstrated its efficacy by lowering the levels of circulating androgens, reducing prostate-specific antigen (PSA) levels, and decreasing the levels of circulating tumor cells. Ongoing studies evaluating orteronel in CRPC will further define its safety and role in the management of this disease.
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Current oncology reports · Apr 2013
ReviewTransoral microsurgery for treatment of laryngeal and pharyngeal cancers.
Minimally invasive surgery has evolved over the last two decades to encompass all fields of surgery, including curative intent cancer surgery of the head and neck. Much evidence is in favor of routine use of transoral laser resection, which can be considered the method of choice for treatment of early laryngeal carcinomas (T1-T2) of the glottis and the supraglottis on the basis of oncologic, functional, and cost considerations. The results of transoral laser microsurgery in patients with moderately advanced (T3) supraglottic cancer are comparable to those of open supraglottic laryngectomy with regard to local control and survival rates, and they are superior to those of primary radiotherapy with respect to organ preservation. Transoral laser microsurgery as a unique treatment should also be considered as an alternative to other organ preservation protocols in the early stages (I-II) of hypopharyngeal and oropharyngeal carcinomas.
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Current oncology reports · Apr 2013
Enzalutamide, a second generation androgen receptor antagonist: development and clinical applications in prostate cancer.
Enzalutamide, formerly known as MDV3100, is an oral second generation androgen receptor (AR) inhibitor that was chosen from a screen of agents and shown in preclinical studies to have greater affinity for the AR than its predecessors without any agonistic effects. The pre-clinical work that led to the interest in studying this agent and the history of the clinical development of enzalutamide from first in man phase 1 through phase 3 and regulatory approval are reviewed. ⋯ The availability of enzalutamide is put into context with the five other agents that modify survival outcomes in metastatic castration resistant prostate cancer. Some of the new challenges confronting the field regarding sequencing and combinations of these agents and the potential for a change in the natural history of the disease, are also discussed.
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Current oncology reports · Dec 2012
Multicenter StudyThe automatic clinical trial: leveraging the electronic medical record in multisite cancer clinical trials.
Submission of data into clinical trial electronic data capture (EDC) systems currently requires redundant entry of data that already exist in the electronic medical record (EMR). Being able to automatically transfer data from the EMR to the EDC system would save many hours of arduous effort, especially for multisite data-intensive oncology trials. Standardization of the way in which data are stored in and retrieved from the EMR and techniques for mining data from the unstructured narrative will provide opportunities for transferring data from the EMR to the EDC system. As different EMRs proliferate, other technology in the form of data mining or middle-tier applications is certain to provide assistance in this effort.
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Trials with tamoxifen have clearly shown that the risk of developing oestrogen receptor-positive breast cancer can be reduced by at least 50 % with prophylactic agents. The current challenge is to find new agents which achieve this or better efficacy, but with fewer side effects. ⋯ The IBIS-II trial is currently investigating anastrozole in healthy postmenopausal women. New agents are needed for receptor negative breast cancer and premenopausal women, and several possibilities are currently under investigation.