Expert review of anticancer therapy
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Expert Rev Anticancer Ther · Dec 2016
ReviewThe role of alectinib in the treatment of advanced ALK-rearranged non-small-cell lung cancer.
The identification of anaplastic lymphoma kinase (ALK) gene rearrangements in subsets of non-small cell lung cancer patients has provided with unparalleled opportunities to hinder the progression of this disease through targeting the activity of these specific molecules. Unfortunately most patients develop disease progression in less than a year of treatment with crizotinib, the first-generation ALK-inhibitor. ⋯ Expert commentary: Second generation ALK inhibitors as alectinib and ceritinib can overcome crizotinib-resistant mutations and improve central nervous system control. Novel third-generation inhibitors and combination of agents give hope of achieving an even longer disease control in the next decade.
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The treatment of melanoma is evolving rapidly over the past few years. Areas covered: We conducted a comprehensive review of the literature on the role of nivolumab in melanoma Expert commentary: Nivolumab is approved by FDA and EMA for the treatment of patients with metastatic melanoma. Nivolumab is superior to chemotherapy and to ipilimumab in previously untreated patients and to chemotherapy in ipilimumab pre-treated patients. ⋯ Definitive survival data on this combination are pending and the selection of patients most likely to benefit from this combination and its pharmacoeconomics are to be elucidated. Prospectively validated predictive markers are lacking. Of particular interest are immune-related adverse events which should be managed according to published guidelines.
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Expert Rev Anticancer Ther · Aug 2016
Meta Analysis Comparative StudyDenosumab versus zoledronic acid to prevent aromatase inhibitors-associated fractures in postmenopausal early breast cancer; a mixed treatment meta-analysis.
A mixed treatment analysis of the comparative effectiveness of denosumab versus zoledronic acid in the prevention of fractures in early postmenopausal breast cancer patients treated with aromatase inhibitors has been conducted. ⋯ This analysis demonstrated that in postmenopausal patients receiving adjuvant aromatase inhibitors, immediate denosumab decreases the risk of fractures compared to delayed treatment at the cutoff of 36 months. Immediate zoledronic acid, however, does not provide the same level of fractures' protection in this category of patients.
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Expert Rev Anticancer Ther · Jul 2016
Review Comparative StudyStereotactic radiosurgery for intracranial metastases: linac-based and gamma-dedicated unit approach.
For intracranial metastases, the role of stereotactic radiosurgery (SRS) or fractionated stereotactic radiotherapy is well recognized. ⋯ Historically, the first technology, for stereotactic device able to irradiate a brain tumor volume, was Gamma Knife® (GK). Due to the technological advancement of linear accelerator (Linac), there was a continuous increasing interest in SRS Linac-based applications. In those decades, it was assumed a superiority of GK compared to SRS Linac-based for brain tumor in terms of dose conformity and rapid fall-off dose close to the target. Expert commentary: Recently, due to the Linac technologic advancement, the choice of SRS GK-based is not necessarily so exclusive. The current review discussed in details the technical and clinical aspects comparing the two approaches for brain metastases.