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Pre-clinical Research on Bladder Toxicity After Radiotherapy for Pelvic Cancers: State-of-the Art and Challenges.

Despite the dramatic advancements in pelvic radiotherapy, urinary toxicity remains a significant side-effect. The assessment of clinico-dosimetric predictors of radiation cystitis (RC) based on clinical data has improved substantially over the last decade; however, a thorough understanding of the physiopathogenetic mechanisms underlying the onset of RC, with its variegated acute and late urinary symptoms, is still largely lacking, and data from pre-clinical research is still limited. The aim of this review is to provide an overview of the main open issues and, ideally, to help investigators in

Essential Concepts for the Management of Metastatic Spine Disease: What the Surgeon Should Know and Practice.

Study designLiterature review.ObjectiveTo provide an overview of the recent advances in spinal oncology, emphasizing the key role of the surgeon in the treatment of patients with spinal metastatic tumors.MethodsLiterature review.ResultsTherapeutic advances led to longer survival times among cancer patients, placing significant emphasis on durable local control, optimization of quality of life, and daily function for patients with spinal metastatic tumors. Recent integration of modern diagnostic tools, precision oncologic treatment, and widespread use of new technologies has transformed the tre

Cardiotoxicity of Chemotherapy: A Multi-OMIC Perspective.

Chemotherapy-induced cardiotoxicity is a critical issue in cardio-oncology, as cancer treatments often lead to severe cardiovascular complications. Approximately 10% of cancer patients succumb to cardiovascular problems, with lung cancer patients frequently experiencing arrhythmias, cardiac failure, tamponade, and cardiac metastasis. The cardiotoxic effects of anti-cancer treatments manifest at both cellular and tissue levels, causing deformation of cardiomyocytes, leading to contractility issues and fibrosis. Repeated irradiation and chemotherapy increase the risk of valvular, pericardial, or

Efficacy and Safety of Panitumumab in Patients With RAF/RAS-Wild-Type Glioblastoma: Results From the Drug Rediscovery Protocol.

BackgroundThe prognosis of malignant primary high-grade brain tumors, predominantly glioblastomas, is poor despite intensive multimodality treatment options. In more than 50% of patients with glioblastomas, potentially targetable mutations are present, including rearrangements, altered splicing, and/or focal amplifications of epidermal growth factor receptor (EGFR) by signaling through the RAF/RAS pathway. We studied whether treatment with the clinically available anti-EGFR monoclonal antibody panitumumab provides clinical benefit for patients with RAF/RAS-wild-type (wt) glioblastomas in the D

Clinical development of galunisertib (LY2157299 monohydrate), a small molecule inhibitor of transforming growth factor-beta signaling pathway.

Transforming growth factor-beta (TGF-β) signaling regulates a wide range of biological processes. TGF-β plays an important role in tumorigenesis and contributes to the hallmarks of cancer, including tumor proliferation, invasion and metastasis, inflammation, angiogenesis, and escape of immune surveillance. There are several pharmacological approaches to block TGF-β signaling, such as monoclonal antibodies, vaccines, antisense oligonucleotides, and small molecule inhibitors. Galunisertib (LY2157299 monohydrate) is an oral small molecule inhibitor of the TGF-β receptor I kinase that specifically

Tailored treatment strategies for cancer patients during COVID-19 pandemic.

The global pandemic of respiratory disease caused by the novel human coronavirus (SARS-CoV-2) has caused indefinite global distress, uncertainty, and disturbance. This pandemic has had direct and indirect impacts for the healthcare systems across the world, but certain subgroups of patients have been particularly affected. Among these groups are patients with cancer, who as a result of their immunosuppressed status either from the disease itself or as a consequence of treatment, are at increased risk of severe COVID-19 infection and complications. The pandemic has also led to limited resources

Evolving role of biomaterials in diagnostic and therapeutic radiation oncology.

Radiation therapy to treat cancer has evolved significantly since the discovery of x-rays. Yet, radiation therapy still has room for improvement in reducing side effects and improving control of cancer. Safer and more effective delivery of radiation has led us to novel techniques and use of biomaterials. Biomaterials in combination with radiation and chemotherapy have started to appear in pre-clinical explorations and clinical applications, with many more on the horizon. Biomaterials have revolutionized the field of diagnostic imaging, and now are being cultivated into the field of theranostic

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… As such, the International Commission on Radiological Protection (ICRP) has developed guidelines for the protection from radiation exposure which focus mainly on developing radiation monitoring, health surveillance and managing contaminated commodities [ 21 ]. …

Current controversies in classification, management, and prevention of bisphosphonate-related osteonecrosis of the jaw.

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Surgery of the tumors of the spine.

Spinal tumors encompass a heterogeneous group of primary and metastatic lesions requiring individualized management strategies based on tumor biology, patient prognosis, and mechanical stability. Decision-making frameworks, such as NOMS, SINS, and Tokuhashi score, provide structured guidance for selecting metastatic patients for surgery and defining individualized treatment strategies. En bloc resection remains the gold standard for selected primary malignant tumors, whereas separation surgery combined with stereotactic radiosurgery represents the cornerstone of modern metastatic spine disease

Risk Factors and Prevention of Cancer and CVDs: A Chicken and Egg Situation.

Cardiovascular diseases and cancer are the two primary causes of mortality worldwide. Although traditionally regarded as distinct pathologies, they share numerous pathophysiological mechanisms and risk factors, including chronic inflammation, insulin resistance, obesity, and metabolic dysregulation. Notably, several cancers have been identified as closely linked to cardiovascular diseases, including lung, breast, prostate, and colorectal cancers, as well as hematological malignancies, such as leukemia and lymphoma. Additionally, renal and pancreatic cancers exhibit a significant association wi

Zoledronic acid in metastatic castrate-sensitive prostate cancer: A state-of-the-art review.

Prostate cancer is the most common cancer in men in developed countries. Despite its slow growing pattern, metastatic disease to bone occurs and results in a significant number of deaths. Since more than eight decades, the classical androgen deprivation therapy (ADT) leads to clinical response in most patients with metastatic castration-sensitive prostate cancer (mCSPC). Moving backward docetaxel and androgen receptor pathway inhibitors (ARPI) from castrate-resistant setting to castrate sensitive setting improves overall survival (OS) compared to ADT alone. Recently, studies suggested that tri

Evaluating Integrative Cancer Clinics With the Claim Assessment Profile: An Example With the InspireHealth Clinic.

BackgroundThe evaluation of freestanding integrative cancer clinical programs is challenging and is rarely done. We have developed an approach called the Claim Assessment Profile (CAP) to identify whether evaluation of a practice is justified, feasible, and likely to provide useful information.ObjectivesA CAP was performed in order to (1) clarify the healing claims at InspireHealth, an integrative oncology treatment program, by defining the most important impacts on its clients; (2) gather information about current research capacity at the clinic; and (3) create a program theory and path model

Genetic Therapy and Molecular Targeted Therapy in Oncology: Safety, Pharmacovigilance, and Perspectives for Research and Clinical Practice.

The impressive advances in the knowledge of biomarkers and molecular targets has enabled significant progress in drug therapy for crucial diseases such as cancer. Specific areas of pharmacology have contributed to these therapeutic outcomes-mainly targeted therapy, immunomodulatory therapy, and gene therapy. This review focuses on the pharmacological profiles of these therapeutic classes and intends, on the one hand, to provide a systematic definition and, on the other, to highlight some aspects related to pharmacovigilance, namely the monitoring of safety and the identification of potential t

Radiotherapy based management during Covid-19 pandemic - A systematic review of presented consensus and guidelines.

Treatment management of cancer patients in the radiation oncology departments during the current COVID-19 pandemic is challenging. A systematic review of published consensus/guidelines on the role of radiotherapy prioritization, suggested treatment protocols, and set up management was undertaken based on the PRISMA protocol and through PubMed/PMC, Scopus, Google Scholar, Web of Science databases until 01/20/2021. One hundred and sixty-eight publications or regional consensus were included. Summary of recommendations contained: (1) using hypo-fractionated (Hypo-F) regimens for therapeutic/palli

Intradural plasmacytoma originating from the filum terminale in the setting of multiple myeloma: illustrative case.

BackgroundMultiple myeloma (MM) has the propensity to spread to vertebral bodies; however, extramedullary plasmacytomas involving the central nervous system are extremely rare.ObservationsThe authors report the first intradural extramedullary plasmacytoma in the lumbar region of the spine in a patient with preexisting MM. They present a 50-year-old female with severe back and radicular pain and progressive neurological deficit.LessonsMM is typically treated with chemotherapy and radiation therapy. However, in this unique case, resection proved to be a key part of treatment.

Image-Guided Percutaneous Ablation for Primary and Metastatic Tumors.

Image-guided percutaneous ablation methods have been further developed during the recent two decades and have transformed the minimally invasive and precision features of treatment options targeting primary and metastatic tumors. They work by percutaneously introducing applicators to precisely destroy a tumor and offer much lower risks than conventional methods. There are usually shorter recovery periods, less bleeding, and more preservation of organ parenchyma, expanding the treatment options of patients with cancer who may not be eligible for resection. Image-guided ablation techniques are c

Epidemiology of infections in cancer patients.

Although major advances in the care of cancer patients over the past several decades have resulted in improved survival, infectious complications remain a significant cause of morbidity and mortality. To successfully identify, treat, and prevent infections, a comprehensive understanding of risk factors that predispose to infection and of commonly encountered pathogens is necessary. In addition, clinicians must keep abreast of the changing epidemiology of infections in this population. As therapeutic modalities continue to evolve, as established pathogens become increasingly drug resistant, and

The Rise of Oncoendocrinology: How Modern Cancer Therapies Are Reshaping Endocrine Practice.

The emergence of immune checkpoint inhibitors, targeted therapies, CAR T-cell therapy, and antibody-drug conjugates has transformed modern oncology, significantly improving survival across a wide range of malignancies. However, these advances have also introduced a growing spectrum of endocrine and metabolic complications, redefining the scope of endocrine practice. Therapy-induced endocrinopathies, including thyroid dysfunction, hypophysitis, adrenal insufficiency, diabetes, pancreatitis, dyslipidemia, gonadal dysfunction, and metabolic syndrome, are recognized as clinically significant and o

Advances in Gold Nanoparticle-Based Combined Cancer Therapy.

According to the global cancer observatory (GLOBOCAN), there are approximately 18 million new cancer cases per year worldwide. Cancer therapies are largely limited to surgery, radiotherapy, and chemotherapy. In radiotherapy and chemotherapy, the maximum tolerated dose is presently being used to treat cancer patients. The integrated development of innovative nanoparticle (NP) based approaches will be a key to address one of the main issues in both radiotherapy and chemotherapy: normal tissue toxicity. Among other inorganic NP systems, gold nanoparticle (GNP) based systems offer the means to fur

DNA Damaging Drugs

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