The lancet oncology
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The lancet oncology · Jun 2018
Randomized Controlled Trial Multicenter StudyNGR-hTNF in combination with best investigator choice in previously treated malignant pleural mesothelioma (NGR015): a randomised, double-blind, placebo-controlled phase 3 trial.
Malignant pleural mesothelioma is an aggressive cancer with highly vascularised tumours. It has poor prognosis and few treatment options after failure of first-line chemotherapy. NGR-hTNF is a vascular-targeting drug that increases penetration of intratumoral chemotherapy and T-cell infiltration by modifying the tumour microenvironment. In this trial, we aimed to investigate the efficacy and safety of NGR-hTNF in patients with malignant pleural mesothelioma who had progressed during or after a first-line treatment. ⋯ MolMed.
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The lancet oncology · Jun 2018
Review Practice GuidelineElderly patients with metastatic renal cell carcinoma: position paper from the International Society of Geriatric Oncology.
Therapy for metastatic renal cell carcinoma should be tailored to the circumstances and preferences of the individual patient. Age should not be a barrier to effective treatment. Systematic geriatric screening and assessment contributes to the goal of personalised management, in addition to the involvement of a multidisciplinary team. ⋯ Overall, it seems that age alone does not appreciably affect efficacy. Among the pivotal studies that were included, there is a striking scarcity of analyses that relate toxic effects to patient age. Even if the adverse effects of therapy are no more frequent or severe in elderly patients than in their younger counterparts, the practical, psychological, and functional impact of treatment may be greater, especially if toxic effects are chronic and cumulative.
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The lancet oncology · Jun 2018
Multicenter Study Comparative StudyRisk-adapted therapy for young children with medulloblastoma (SJYC07): therapeutic and molecular outcomes from a multicentre, phase 2 trial.
Young children with medulloblastoma have a poor overall survival compared with older children, due to use of radiation-sparing therapy in young children. Radiotherapy is omitted or reduced in these young patients to spare them from debilitating long-term side-effects. We aimed to estimate event-free survival and define the molecular characteristics associated with progression-free survival in young patients with medulloblastoma using a risk-stratified treatment strategy designed to defer, reduce, or delay radiation exposure. ⋯ American Lebanese Syrian Associated Charities, St Jude Children's Research Hospital, NCI Cancer Center, Alexander and Margaret Stewart Trust, Sontag Foundation, and American Association for Cancer Research.
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The lancet oncology · Jun 2018
ReviewGut dysbiosis: a potential link between increased cancer risk in ageing and inflammaging.
Cancer incidence substantially increases with ageing in both men and women, although the reason for this increase is unknown. In this Series paper, we propose that age-associated changes in gut commensal microbes, otherwise known as the microbiota, facilitate cancer development and growth by compromising immune fitness. ⋯ Studies in animal models and the importance of commensals in cancer immunotherapy suggest that this status can be reversible. Thus, interventions that alter the composition of the gut microbiota might reduce inflammaging and rejuvenate immune functions to provide anticancer benefits in frail elderly people.