Expert review of anticancer therapy
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Expert Rev Anticancer Ther · Jul 2010
ReviewPoly(ADP-ribosyl)ation polymerases: mechanism and new target of anticancer therapy.
Poly(ADP-ribose)polymerase (PARP) is a ubiquitously present nuclear enzyme that is not only involved in many important cellular pathways but also contributes to chromosomal structure and genomic stability. The development of highly selective and potent PARP inhibitors has become of increasing clinical interest because of their promising efficacy in patients with breast or ovarian cancer. ⋯ In particular patients with either deficiency or dysfunction of BRCA, which is involved in DNA double strand break repair, appear to benefit from PARP inhibition. This article summarizes the present knowledge regarding the physiological function of PARP and ([poly]ADP-ribose) PAR, the functional product of PARP, the development of PARP inhibitors, the recent clinical data of PARP inhibitors in cancer treatment and the selection of patients who may benefit from PARP inhibition.
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Expert Rev Anticancer Ther · Jul 2010
ReviewIntranasal fentanyl: from pharmacokinetics and bioavailability to current treatment applications.
Fentanyl, a short-acting synthetic pure opiate, offers an excellent option for the treatment of cancer and chronic pain. While oral administration is not an option, its high potency and lipophilicity have made intranasal administration feasible. Intranasal fentanyl has a bioavailability of 89%, with a short onset of action ( approximately 7 min) and duration times ( approximately 1 h). ⋯ Intranasal fentanyl has been investigated to assess its potential as a well-tolerated acute postoperative breakthrough pain relief medication. It has been shown to be superior to oral transmucosal fentanyl for the treatment of cancer breakthrough pain. Similar analgesic effects to fentanyl or morphine intravenously and orally, with a similar safety profile, have been reported for postoperative or acute pain treatment of children and adults in the prehospital and hospital settings.
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Expert Rev Anticancer Ther · May 2010
ReviewGlioma stem cell signaling: therapeutic opportunities and challenges.
The field of cancer research has experienced significant momentum from the discovery that most malignant tumors harbor subpopulations of cancer cells with stem cell features. Consequently, identification and characterization of so-called 'cancer-initiating cells' or 'cancer stem cells' has also provided novel insights into the biology of malignant brain tumors. ⋯ Novel treatment strategies are being developed to selectively target the molecular pathways relevant to cancer stem cells. This review summarizes important signaling pathways employed by both normal and cancer stem cells and highlights promising molecular-targeted therapies interfering with those signaling pathways in malignant gliomas.
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Expert Rev Anticancer Ther · Apr 2010
Review Comparative StudyPalliative thoracic radiotherapy for lung cancer.
Despite an increasing use of chemotherapy in the palliative setting for lung cancer, the role of palliative thoracic radiotherapy should not be disregarded. It offers quick and efficient palliation, with improvement observed in approximately two-thirds of treated patients. ⋯ Higher radiation doses delivered via protracted schedules give a modest survival benefit for good performance patients. The current review covers the issues related to the use of palliative thoracic radiotherapy, such as total dose, fractionation, delayed versus immediate use, external-beam radiotherapy versus endobronchial brachytherapy, combination with chemotherapy, re-irradiation and palliation with radiation in small-cell lung cancer.
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Expert Rev Anticancer Ther · Mar 2010
ReviewPhase II clinical trials in oncology: are we hitting the target?
The number of novel and molecularly targeted agents in the last decade that need screening for preliminary efficacy in Phase II trials has increased. Many of these agents have a cytostatic mode of action that is difficult to assess using traditional Phase II designs. ⋯ The different end points, single versus multiarm and randomized designs, the use of biomarkers and Bayesian approaches are also reviewed. The final design chosen will depend on the characteristics and circumstances of each individual study.