Expert review of anticancer therapy
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Expert Rev Anticancer Ther · May 2011
ReviewRisk-adapted chemotherapy in childhood medulloblastoma.
Medulloblastoma is the most common malignant brain tumor in children. The treatment strategy in this tumor mainly includes surgery and radiotherapy, but chemotherapy has been successfully applied in medulloblastoma. The survival rates have improved over the last decade with chemotherapy. ⋯ Risk factors have been defined in recent years, but chemotherapy has not been planned according to these defined risk factors on a worldwide basis. The aim of this article was to examine the use of chemotherapy in childhood medulloblastoma according to risk group. A secondary aim was to examine high-dose chemotherapy with autologous stem cell transplantation and the treatment of infant medulloblastoma.
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Expert Rev Anticancer Ther · Apr 2011
ReviewPotential of CXCR4 antagonists for the treatment of metastatic lung cancer.
Despite advances in surgery, chemotherapy and radiotherapy over the last decades, the death rate from lung cancer has remained largely unchanged, which is mainly due to metastatic disease. Because of the overall poor prognosis, new treatment strategies for lung cancer patients are urgently needed, and targeting CXCR4 constitutes such a novel, attractive strategy. Tumor cell migration and metastasis share many similarities with leukocyte trafficking, which is critically regulated by chemokine receptors and adhesion molecules. ⋯ Therefore, targeting the CXCR4-CXCL12 axis is a novel, attractive therapeutic approach in small-cell lung cancer and non-small-cell lung cancer. In this article, we summarize data about the cellular and molecular microenvironment in small-cell lung cancer and non-small-cell lung cancer, as well as the role of CXCR4 in tumor-stroma crosstalk. In addition, we review the current status of the preclinical and clinical development of CXCR4 antagonists.
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Expert Rev Anticancer Ther · Mar 2011
ReviewPredictive markers and driving factors behind Richter syndrome development.
Transformation of chronic lymphocytic leukemia (CLL) to diffuse large B-cell lymphoma (DLBCL) is known as Richter syndrome (RS). In the entire CLL population, the cumulative prevalence of RS development steadily increases at a rate of 1% per year. Considering conventional predictors of CLL, patient subgroups at high risk of developing RS are characterized by the expression of CD38, absence of del13q14, and a lymph node size >3 cm. ⋯ The definition of RS encompasses at least two different conditions: DLBCLs that are clonally related to the pre-existing CLL (accounting for most cases), or DLBCL unrelated to the CLL clone. The transition from CLL to clonally related RS is accompanied by the acquisition of novel genetic alterations that may account for the chemorefractoriness of RS. Genome-wide studies that are currently ongoing are important for identifying novel molecular lesions implicated in RS that might represent a suitable target for future therapeutic strategies.
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Expert Rev Anticancer Ther · Feb 2011
ReviewShould CYP2D6 inhibitors be administered in conjunction with tamoxifen?
Tamoxifen has been used for the treatment or prevention of recurrence in patients with estrogen receptor-positive breast cancers. Because CYP2D6 is known to be a key enzyme responsible for the generation of an active tamoxifen metabolite, 'endoxifen', some studies reported that genetic polymorphisms of CYP2D6 that reduced its enzyme activity or coadministration of CYP2D6 inhibitors were associated with the poor clinical outcomes of breast cancer patients treated with tamoxifen. However, there are some discrepant reports for the association between CYP2D6 genotype and clinical outcomes of tamoxifen therapy, probably because of the heterogeneity in sample collection or analysis, including differences in regimen of tamoxifen treatment. A review of published reports regarding the effects of selective serotonin reuptake inhibitors on the pharmacokinetics and/or efficacy of tamoxifen found that concurrent use of strong CYP2D6 inhibitors, especially paroxetine, and possibly others, should be avoided in patients receiving tamoxifen therapy, but there has not been enough evidence for the effects of weak or moderate inhibitors.
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Expert Rev Anticancer Ther · Jan 2011
New insights on personalized cancer treatments: a report from the ESMO Congress.
The European Society for Medical Oncology (ESMO) Congress is organized by the ESMO every second year, alternating with the European Cancer Organisation-ESMO-European Society for Therapeutic Radiology and Oncology multidisciplinary cancer conference. The ESMO Congress provides current information on the latest research results in medical oncology and offers state-of-the-art educational programs to support medical oncologists in their training and practice. A record number of attendees (16,000 people) made the 35th ESMO Congress a great success, including over 13,000 oncologists and other cancer healthcare professionals, 360 media representatives and 400 cancer patients who participated in a dedicated seminar. To contextualize the magnitude of the data reported, it should be noted that over 63,000 patients have been treated in the randomized studies that were presented.