Expert review of anticancer therapy
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Expert Rev Anticancer Ther · May 2008
ReviewBevacizumab for the treatment of advanced non-small-cell lung cancer.
Until recently, advances in non-small-cell lung cancer (NSCLC) care have been limited; new chemotherapy regimens have not significantly impacted patient survival. With our improved understanding of tumor biology, novel biological therapies targeting key tumorigenic processes targeting factors essential for tumor growth, such as angiogenesis, have been developed that improve patient outcomes beyond those achieved with chemotherapy alone. One of these, bevacizumab (Avastin), specifically targets VEGF, which is key to the malignant growth and progression of solid tumors. ⋯ Furthermore, bevacizumab-based therapy significantly delays disease progression and has a well-characterized and acceptable safety profile. Based on these data, bevacizumab has received approval for the first-line treatment of NSCLC in the USA and Europe. A number of ongoing trials will potentially expand the eligible patient population for bevacizumab and further define its role in NSCLC treatment.
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Brain metastases are a common site of metastasis from malignant melanoma, and are associated with a poor prognosis. Diagnosis of brain metastasis may also have significant implications for quality of life, and management can be difficult due to rapid progression of disease and resistance to conventional therapies. In this article, we will review the published evidence for treatment modalities for melanoma-induced brain metastases and outline future directions for research. ⋯ External-beam radiation alone appears effective in palliating symptoms. Chemotherapy alone is relatively ineffective, though combined chemotherapy with external-beam radiation is being investigated. Future directions include combined-modality therapy, the incorporation of novel agents, and careful consideration of the structure of clinical trials for this disease.
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Expert Rev Anticancer Ther · May 2008
ReviewImmunotherapy against angiogenesis-associated targets: evidence and implications for the treatment of malignant glioma.
Angiogenesis, the growth of new blood vessels from previously existing vasculature, is a requirement for tumor growth and metastasis. The first US FDA-approved drugs targeting angiogenesis have shown potential in the treatment of malignant gliomas. Immunotherapy as a treatment modality lends itself well to specifically targeting angiogenesis in tumors and may represent a powerful tool in the treatment of malignant gliomas. This review focuses on developments in immunotherapy targeting angiogenesis and tumor-vascular-specific endothelial cells using a variety of immunotherapeutic strategies including monoclonal antibodies and conjugated immunotoxins, as well as cellular, peptide, DNA and dendritic cell vaccines.