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A review of neurotoxicities associated with immunotherapy and a framework for evaluation.

Immuno-oncology agents, including immune checkpoint inhibitors (ICIs) and chimeric antigen receptor T (CAR-T) cell therapies, are increasing in use for a growing list of oncologic indications. While harnessing the immune system against cancer cells has a potent anti-tumor effect, it can also cause widespread autoimmune toxicities that limit therapeutic potential. Neurologic toxicities have unique presentations and can progress rapidly, necessitating prompt recognition. In this article, we review the spectrum of central and peripheral neurologic immune-related adverse events (irAEs) associated

Innovation in Oncology Drug Development.

Significant progress has been made in our understanding of the molecular lesions responsible for tumor cells to exhibit uncontrolled growth while circumventing normal mechanisms of apoptosis and their ability to migrate and invade normal tissues while evading recognition and destruction by the immune system. This understanding has enabled the development of therapies specifically targeted to these lesions coupled to innovative treatment regimens to most effectively use these new targeted therapies with precision in selected subpopulations of patients. Innovation at the scientific and clinical

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… Integration of Clinical Trials as a Clinical Care Option Comprehensive clinical management has routinely comprised the integration of medical, surgical, and radiation oncologists plus supportive staff. … The Oncologist. 2001;6(3):230–232. 37. Chabner B. Approval after phase I: ceritinib runs the three-minute mile. The Oncologist. 2014;19(6):577–578. doi: 10.1634/theoncologist.2014-0143. 38. Wapner J. …

Treatment-induced bone loss and fractures in cancer patients undergoing hormone ablation therapy: efficacy and safety of denosumab.

Hormone ablation therapy (HALT) for breast or prostate cancer accelerates the development of osteoporosis in both men and women by causing estrogen deficiency, which increases the risk for fracture by promoting bone resorption mediated by osteoclasts. Denosumab, a fully human monoclonal antibody that inhibits osteoclast formation and function, increases bone mass in patients undergoing hormone ablation therapy. In the HALT study of 1,468 men with prostate cancer on androgen-deprivation therapy, denosumab significantly reduced the risk of new vertebral fractures, increased bone mineral density

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… Oncologist. 2008;13:187–95. doi: 10.1634/theoncologist.2007-0152. 77. Coleman RE. Supportive care in oncology. Support Care Cancer. 2005;13:959–60. doi: 10.1007/s00520-005-0860-1. 78. Greenspan SL, Nelson JB, Trump DL, et al. … Bisphosphonate treatment recommendations for oncologists. Oncologist. 2005;10( Suppl 1):19–24. doi: 10.1634/theoncologist.10-90001-19. 83. Fleisch H. Bisphosphonates: mechanisms of action. Endocr Rev. 1998;19:80–100. doi: 10.1210/edrv.19.1.0325. 84. Greenspan SL, Nelson JB, Trump DL, et al. …

Stereotactic arrhythmia radioablation for intramural basal septal ventricular tachycardia originating near the His bundle.

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… Materials and methods A multidisciplinary team of cardiac electrophysiologists, radiation oncologists, and radiation physicists developed a planning target volume (PTV) based upon fusion of 3-dimensional EA maps, cardiac breath hold MRI, and CT simulation following a custom body mold fixation device … Preprocedure planning by a multidisciplinary team of cardiac electrophysiologists, cardiac imaging specialists, radiation oncologists, and radiation physicists was critical to ensuring maximal accuracy of target volume treatment and minimizing potential radiation-related effects to surrounding structures …

Оценка физической активности и продвижения среди выживших от рака в кардиоонкологической помощи: квалитативное исследование.

ФОН: Сердечно-сосудистые заболевания и рак являются основными причинами заболеваемости и смертности по всему миру, при этом выжившие от рака сталкиваются с повышенным риском сердечно-сосудистых заболеваний из-за общих факторов риска и кардиотоксичных терапий. Физическая активность (ФА) является хорошо доказанной стратегией для улучшения сердечно-сосудистого здоровья и результатов выживания; однако большинство выживших от рака не соответствуют рекомендациям по ФА. Понимание многоуровневых влияний на вовлеченность в ФА и ее продвижение является необходимым для улучшения реализации в кардиоонколо

Cancer Cure and Consequences on Survivorship Care: Position Paper from the Italian Alliance Against Cancer (ACC) Survivorship Care Working Group.

A multidisciplinary panel of experts and cancer patients developed a position paper to highlight recent evidence on "cancer cure" (ie, the possibility of achieving the same life expectancy as the general population) and discuss the consequences of this concept on follow-up and rehabilitation strategies. The aim is to inform clinicians, patients, and health-care policy makers about strategies of survivorship care for cured cancer patients and consequences impacting patient lives, spurring public health authorities and research organizations to implement resources to the purpose. Two identifiabl

Post-operative survival and use of systemic therapy in metastatic long-bone disease: 12 years of institutional experience.

BACKGROUND: Survival prediction in metastatic long-bone disease is essential for surgical decision-making, yet the performance of legacy prognostic models has declined in the era of immunotherapy and molecularly targeted agents. As these systemic therapies become routine, treatment patterns themselves may influence survival in ways not captured by earlier models. We, therefore, quantified preoperative systemic therapy use over the last decade and evaluated its association with postoperative overall survival in patients undergoing surgery for long-bone metastases. METHODS: We conducted a retro

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… Given the rapid evolution of systemic cancer therapies and increasingly personalized treatment strategies, it is essential that orthopedic oncologists—and the predictive models they rely on—remain aligned with current oncologic practices. … Oncologist. 2020;25(11):981–992. doi: 10.1634/theoncologist.2020-0193. 44. Ramagopalan S., Leahy T.P., Ray J., Wilkinson S., Sammon C., Subbiah V. …

Перспективы медицинских работников и пациентов с повторной/редактированной миеломой в отношении приоритетных направлений лечения и новообразований.

ПППОСА: В связи с новыми методами лечения, включая химерик антигенный рецептор T-клетка (CAR-T) и биконкретные антитела (BSAbs), медицинские работники (HCP) сталкиваются с трудностями, связанными с лечением пациентов с повторной/рефрактурной множественной миеломой (RRMMM). В рамках этого исследования, проведенного в рамках самых крупных обследований, посвященных ОРМ, были изучены неудовлетворенные потребности в доступе к медицинскому обслуживанию, препятствия на пути использования новых методов лечения и принятия решений о лечении. МЕТОДЫ: Это исследование, основанное на результатах обследован

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… Materials and Methods Study Design The study used a 30-minute, web-based quantitative survey sent between March and June 2024 to 1301 patients with RRMM and 983 oncologists across 7 countries (US, UK, France, Germany, Italy, Spain, and Japan). … Survey Participants The target population included oncologists and patients with RRMM. …

Randomized phase 2 study of valproic acid combined with simvastatin and gemcitabine/nab-paclitaxel-based regimens in untreated metastatic pancreatic adenocarcinoma patients: the VESPA trial study protocol.

BackgroundMetastatic pancreatic ductal adenocarcinoma (mPDAC) patients have very poor prognosis highlighting the urgent need of novel treatments. In this regard, repurposing non-oncology already-approved drugs might be an attractive strategy to offer more-effective treatment easily tested in clinical trials. Accumulating evidence suggests that epigenetic deregulation is a hallmark of cancer contributing to treatment resistance in several solid tumors, including PDAC. Histone deacetylase inhibitors (HDACi) are epigenetic drugs we have investigated preclinically and clinically as anticancer agen

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… Furthermore, an independent data monitoring committee, comprising SMC members plus a statistician and a medical oncologist not involved in the study, will monitor data on progress and safety to ensure the safety of study participants and preserve clinical trial integrity. … Cardiac side effects of molecular targeted therapies: towards a better dialogue between oncologists and cardiologists. Crit Rev Oncol Hematol. 2011;80(3):369–79. 44. Miyabayashi K, Nakagawa H, Koike K. …

Exploration of the quantitative-effectiveness association between acupuncture temporal parameters and chemotherapy-induced peripheral neuropathy in cancer patients: a dose-response meta-analysis of randomized controlled trials.

BackgroundChemotherapy-induced peripheral neuropathy (CIPN) is one of the commonly reported symptoms impacting cancer survivors. This study evaluated and compared the effectiveness of acupuncture treatments for CIPN.MethodsWe searched six databases from their inception to August 2024 to identify eligible randomized controlled trials (RCTs). Primary outcome were pain scores. Secondary outcomes were quality of life including FACT/GOG-Ntx and EORTC QLQ-C30. The robust error meta-regression (REMR) method was used to evaluate the dose-response relationship across treatment parameters, including num

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… Prevention, diagnosis and management of chemotherapy-induced peripheral neuropathy: a cross-sectional study of French oncologists’ professional practices. Support Care Cancer. (2021) 29:4033–43. doi: 10.1007/s00520-020-05928-6 5. … Oncologist. (2020) 25:310–8. doi: 10.1634/theoncologist.2019-0489 29. Molassiotis A, Suen LKP, Cheng HL, Mok TSK, Lee SCY, Wang CH, et al. …

Stereotactic radiotherapy for patients with bone metastases: a selected group with low rate of radiation treatment during the last month of life?

BackgroundComplex high-precision radiotherapy, such as stereotactic body radiotherapy (SBRT), should only be offered to patients with sufficiently long survival. In the context of bone metastases radiotherapy, low rates of treatment close to the end of life, e.g. last 30 days (RT30), may serve as a quality of care indicator. While traditional, pain-relieving short-course regimens have been studied comprehensively, real-world SBRT results are still limited.MethodsRetrospective analysis (2010-2023, n = 1117 episodes) of patients with bone metastases treated with traditional single-fraction (8 Gy

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… Nieder C Pawinski A Dalhaug A Continuous controversy about radiation oncologists' choice of treatment regimens for bone metastases: should we blame doctors, cancer-related features, or design of previous clinical studies? … Continuous controversy about radiation oncologists’ choice of treatment regimens for bone metastases: should we blame doctors, cancer-related features, or design of previous clinical studies? Radiat Oncol. 2013;8:85. 23574944 10.1186/1748-717X-8-85 PMC3643865 5. …

Protocol of the optimal study: Optimization of polypharmacy in geriatric oncology - A randomized controlled trial.

BackgroundPolypharmacy is very common in older cancer patients and these patients are particularly vulnerable to drug-drug interactions and adverse drug reactions because they often receive chemotherapy and symptom-relieving agents.MethodsThe primary aim of the randomized, controlled Optimization of Polypharmacy in Geriatric Oncology (OPTIMAL) trial is to test whether an advisory letter with the results of a comprehensive medication review conducted with the Fit fOR The Aged (FORTA) list to the caring physician in rehabilitation clinics improves the quality of life (QoL) of older cancer patien

Longitudinal patient-reported outcomes in patients receiving chimeric antigen receptor T-cell therapy.

Chimeric antigen receptor T-cell therapy (CAR-T) has transformed the treatment for relapsed/refractory hematologic malignancies; however, data on patient-reported outcomes in CAR-T are limited. We conducted a longitudinal study of adults with hematologic malignancies receiving CAR-T. We assessed quality of life (QOL; functional assessment of cancer therapy-general), psychological distress (hospital anxiety and depression scale, patient health questionnaire-9, posttraumatic stress disorder [PTSD] checklist), and physical symptoms (Edmonton symptom assessment scale-revised) at baseline, 1 week,

Myeloma patients' experiences of a supervised physical activity programme: a qualitative study.

PURPOSE: The Myeloma: Advancing Survival Cancer Outcomes Trial (MASCOT) tested the impact of a supervised exercise programme on fatigue, clinical, and patient-reported outcomes in multiple myeloma [MM] patients. The current study explored MM patients' experiences of the programme to guide future interventions. METHODS: Purposive sampling was used to recruit stable MM patients participating in MASCOT. Semi-structured, face-to-face interviews were conducted, transcribed verbatim, and analysed using thematic analysis. RESULTS: Six themes were identified. Key drivers for participation in MASCOT

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… Hardcastle et al. [ 16 ] surveyed 123 international oncologists and found less than half provide PA advice with only 37% quoting the correct recommended guidelines. The main barriers oncologists reported were lack of clinic time, limited access to exercise specialists, and referral pathways. … Knowledge, attitudes, and practice of oncologists and oncology health care providers in promoting physical activity to cancer survivors: an international survey. Support Care Cancer. 2018;26(11):3711–3719. doi: 10.1007/s00520-018-4230-1. 17. …

Selinexor in combination with topotecan in patients with advanced or metastatic solid tumors: Results of an open-label, single-center, multi-arm phase Ib study.

Background Selinexor, a first-in-class, oral selective inhibitor of nuclear export (SINE) compound inhibits Exportin-1(XPO1), had demonstrated synergistic activity with many chemotherapies and conferred in vivo antitumor efficacy in hematologic as well as solid tumors. Methods This open-label, single-center, multi-arm phase 1b study used a standard 3 + 3 design and a "basket type" expansion. Selinexor with intravenous topotecan was given in one of the 13 parallel arms. Patients with advanced or metastatic relapsed/refractory solid tumors following prior systemic therapy, or in whom the additio

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… Shafique M Ismail-Khan R Extermann M Sullivan D Goodridge D Boulware D Hogue D Soliman H Khong H Han HS A phase II trial of selinexor (KPT-330) for metastatic triple-negative breast cancer Oncologist 2019 24 7 887 416 10.1634/theoncologist.2019-0231 30996012 PMC6656474 20. … Nishino M Jagannathan JP Ramaiya NH Van den Abbeele AD Revised RECIST guideline version 1.1: What oncologists want to know and what radiologists need to know AJR American journal of roentgenology 2010 195 2 281 289 10.2214/ajr.09.4110 20651182 26. …

Clinical Implementation of Integrated Genomic Profiling in Patients with Advanced Cancers.

DNA focused panel sequencing has been rapidly adopted to assess therapeutic targets in advanced/refractory cancer. Integrated Genomic Profiling (IGP) utilising DNA/RNA with tumour/normal comparisons in a Clinical Laboratory Improvement Amendments (CLIA) compliant setting enables a single assay to provide: therapeutic target prioritisation, novel target discovery/application and comprehensive germline assessment. A prospective study in 35 advanced/refractory cancer patients was conducted using CLIA-compliant IGP. Feasibility was assessed by estimating time to results (TTR), prioritising/assigni

Epoetin beta for the treatment of chemotherapy-induced anemia: an update.

Epoetin beta belongs to the class of erythropoiesis-stimulating agents (ESAs) that are currently available to treat anemic patients receiving chemotherapy. Chemotherapy-induced anemia affects a high percentage of cancer patients and, due to its negative effects on disease outcome and the patient's quality of life, should be treated when first diagnosed. Initial trials with ESAs have shown efficacy in improving quality of life and reducing the need for blood transfusions in patients with chemotherapy-induced anemia. However, recent meta-analyses have provided conflicting data on the impact of E

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… life for patients. 1 , 8 Fatigue is one of the most debilitating symptoms of anemia and an important issue in cancer management, as it is the symptom most commonly reported by cancer patients, 9 who feel that fatigue has a worse impact than pain on their quality of life. 9 , 10 A high percentage of oncologists … The Fatigue Coalition Semin Hematol 1997 34 3 Suppl 2 4 12 9253778 10 Curt GA Breitbart W Cella D Impact of cancer-related fatigue on the lives of patients: new findings from the Fatigue Coalition Oncologist 2000 5 5 353 360 11040270 10.1634/theoncologist.5-5-353 11 Howell D Keller-Olaman S Oliver …

A systematic review of dosing frequency with bone-targeted agents for patients with bone metastases from breast cancer.

BackgroundBone-targeted agents are usually administered to breast cancer patients with bone metastases every 3-4 weeks. Less frequent ('de-escalated') treatment may provide similar benefits with improved safety and reduced cost.MethodsTo systematically review randomised trials comparing de-escalated treatment with bone-targeted agents (i.e. every 12-16 weeks) to standard treatment (i.e. every 3-4 weeks), a formal systematic review of the literature was performed. Two individuals independently screened citations and full text articles. Random effects meta-analyses of clinically important outcom

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… Bisphosphonate use for the management of breast cancer patients with bone metastases: a survey of Canadian Medical Oncologists. Supportive Care in Cancer. 2004;12(12):852–858. doi: 10.1007/s00520-004-0671-9. 3. Kimmel D.B. … Optimising the use of bone-targeted agents in patients with metastatic cancers: a practical guide for medical oncologists. Supportive Care in Cancer. 2001;19:1687–1696. doi: 10.1007/s00520-011-1230-9. 7. Clemons M., Gelmon K., Pritchard K., Paterson A.H.G. …

Improving management of patients with advanced cancer.

Development of bone metastases in patients with advanced cancer is associated with skeletal-related events (SREs) such as pathologic fractures, spinal cord compression, the requirement for surgery or palliative radiotherapy to bone, and hypercalcemia of malignancy. Skeletal morbidity may reduce patient mobility, limit functional independence, and impair quality of life (QOL). Proactive management of new or worsening bone pain or motor impairment is crucial because of the potential for rapid progression of symptoms. Administration of bisphosphonate therapy as a monthly infusion to patients with

Adverse Cardiac Effects of CAR T-Cell Therapy: Characteristics, Surveillance, Management, and Future Research Directions.

This review summarizes the current literature on the adverse cardiac effects of CAR T-cell therapy. Case reports and series suggest that major adverse cardiovascular events are not uncommon after CAR T-cell therapy; however, limited data exist regarding incidence, pathophysiology, and prevention strategies related to CAR T-associated cardiovascular events. As cellular therapy advances and the indications for its use continue to expand, it is essential to better understand its associated cardiovascular toxicities. Biomarkers, cardiac imaging, longitudinal data from larger populations, and trans