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Treatment of elderly patients with refractory/relapsed multiple myeloma: oral drugs adherence and the COVID-19 outbreak.

Once the treatment of refractory/relapsed multiple myeloma in the elderly is greatly influenced by the adherence of patients and family members, clinicians should be aware of patients' behavior and lifestyle, as it may influence the individual treatment plan for each patient. Furthermore, treatment with oral chemotherapy is of special value during the COVID-19 outbreak. Multidisciplinary healthcare involvement is crucial in the management of polypharmacy, adverse events and dose adjustment due to comorbidities and natural loss of renal function with age. Oral drugs simplify intake, reduce hosp

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… The Oncologist. 2019. … ESMO recommended oncologists to adjust their routines and suggested bolstering telemedicine services, reducing clinic visits, and switching to subcutaneous or oral therapies, rather than intravenous ones, whenever possible [ 78 ]. …

Pazopanib in advanced soft tissue sarcomas.

Pazopanib is the first and only tyrosine kinase inhibitor currently approved for the treatment of multiple histological subtypes of soft tissue sarcoma (STS). Initially developed as a small molecule inhibitor of vascular endothelial growth factor receptors, preclinical work indicates that pazopanib exerts an anticancer effect through the inhibition of both angiogenic and oncogenic signaling pathways. Following the establishment of optimal dosing and safety profiles in early phase studies and approval for the treatment of advanced renal cell carcinoma, pazopanib was investigated in STS. A landm

Drug repurposing in malignant pleural mesothelioma: a breath of fresh air?

Drug repurposing is the use of known drugs for new indications. Malignant pleural mesothelioma (MPM) is a rare cancer with a poor prognosis. So far, few treatments have been approved in this disease. However, its incidence is expected to increase significantly, particularly in developing countries. Consequently, drug repurposing appears as an attractive strategy for drug development in MPM, since the known pharmacology and safety profile based on previous approvals of repurposed drugs allows for faster time-to-market for patients and lower treatment cost. This is critical in low- and middle-in

Bone-Targeted Agents for the Management of Breast Cancer Patients with Bone Metastases.

Despite advances in adjuvant therapy for breast cancer, bone remains the most common site of recurrence. The goal of therapy for these patients is palliative and focused on maximizing the duration and quality of their life, while concurrently minimizing any disease or treatment-related complications. Bone metastases predispose patients to reduced survival, pain, impaired quality of life and the development of skeletal-related events. With an increased understanding of the pathophysiology of bone metastasis, effective treatments for their management have evolved and are now in widespread clinic

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… Optimizing the use of bone-targeted agents in patients with metastatic cancers: A practical guide for medical oncologists. Support. Care Cancer. 2011;19:1687–1696. doi: 10.1007/s00520-011-1230-9. 11. Jensen A.O., Jacobsen J.B., Norgaard M., Yong M., Fryzek J.P., Sørensen H.T. … De-escalated administration of bone-targeted agents in patients with breast and prostate cancer—A survey of canadian oncologists. J. Bone Oncol. 2013 doi: 10.1016/j.jbo.2013.03.001. in press. 94. …

Improvement of primary vulvar Langerhans cell histiocytosis with lenalidomide.

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Искусственный интеллект в педиатрической нейрорадиологии: текущий ландшафт, проблемы и будущие направления.

В настоящем обзоре содержится информация о нынешнем ландшафте искусственного интеллекта (АИ) в области педиатрической и эмбриональной нейрорадиологии, критическая оценка текущей практики, барьеров на пути к клиническому усыновлению и будущего потенциала. Мы искали рецензированные исследования за последнее десятилетие, сфокусировавшись на сегментации изображений, обнаружении повреждений, классификации, прогнозировании и поддержке клинического решения при педиатрической съемке мозга. Особое внимание было уделено уникальным педиатрическим факторам, таким, как развитие мозга и нехватка данных. Мет

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… Fig. 3 a Artificial intelligence (AI) augments the capabilities of neuro-oncologists/radiation-oncologists by enabling integrated diagnosis, offering deeper insights into the disease, facilitating precise prognosis by predicting outcomes, and assisting in patient stratification to tailor treatment plans … Reproduced from [ 29 ] with permission under the open-access terms of the Nature Portfolio journals Fig. 3 a Artificial intelligence (AI) augments the capabilities of neuro-oncologists/radiation-oncologists by enabling integrated diagnosis, offering deeper insights into the disease, facilitating precise …

Adolescent and Young Adult (AYA) Cancer Survivorship Practices: An Overview.

Worldwide, more than 1.2 million adolescents and young adults (AYAs; those aged 15-39 years) are diagnosed with cancer each year. Although considerable variability exists according to cancer site and stage of disease, the 5-year relative survival at the time of diagnosis has been estimated at >80% for all AYA patients with cancer combined. Extensive survivorship research in recent decades has focused on patients diagnosed with cancer as children (39 years), yet few studies to date have reported outcomes specifically for patients diagnosed as AYAs. With increasing incidence and improving surviv

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… Facilitating the cooperation between pediatric and adult medical oncologists for relevant tumor types is of importance as the best treatment regimen (pediatric or adult) needs to be chosen [ 12 , 123 , 125 , 127 , 130 , 131 , 132 ]. … Identifying and Addressing the Needs of Adolescents and Young Adults with Cancer: Summary of an Institute of Medicine Workshop Oncologist 2015 20 186 195 10.1634/theoncologist.2014-0265 25568146 PMC4319626 155. Marjerrison S. Barr R.D. …

Atypical Presentation of Multiple Myeloma Affecting Appendicular Skeleton Associated with Pathological Neck of Femur and Proximal Humerus Fractures - A Case Report.

INTRODUCTION: The increasing incidence of atraumatic neck of femur (NOF) fractures, often linked to age-related bone weakening, is a notable clinical trend. This case report highlights a 72-year-old male presenting with NOF and proximal humerus fractures post-trivial fall, revealing lytic lesions suggestive of multiple myeloma (MM). Despite inconclusive skeletal and metabolic evaluations, a comprehensive surgical approach confirmed MM, emphasizing the importance of thorough diagnostic and therapeutic management in complex cases. CASE REPORT: A 72-year-old male presented with a trivial fall re

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… Managing patients with suspected pathological fractures is intricate, demanding thorough diagnostic evaluation, meticulous pre-operative preparation, and establishment of a definitive surgical strategy, underscoring the need for collaboration among radiologists, hemato-oncologists, and orthopedic surgeons …

Falls among geriatric cancer patients: a systematic review and meta-analysis of prevalence and risk across cancer types.

BackgroundFalls represent a significant health concern among the older adults, particularly geriatric cancer patients, due to their increased susceptibility from both age-related and cancer treatment-related factors. This systematic review and meta-analysis aimed to synthesize global data on the prevalence and risk of falls in this population to inform targeted fall prevention strategies.MethodsFollowing PRISMA 2020 guidelines, we conducted a comprehensive search of PubMed, Embase, and Web of Science up to October 2024. Articles were screened using Nested Knowledge software by two independent

Mindfulness vs. sleep education during autologous hematopoietic cell transplantation for multiple myeloma: Feasibility of a randomized controlled pilot study.

BackgroundSleep disturbance is common in patients receiving hematopoietic stem cell transplantation (HCT). Mindfulness-based interventions (MBIs) can improve sleep quality during and following cancer treatment by reducing treatment-related symptoms and enhancing immune function.MethodsWe conducted a randomized controlled pilot study investigating the feasibility of implementing Mindfulness Awareness Practices for Insomnia (MAP-I) in patients with multiple myeloma (MM) undergoing autologous HCT. Patients were randomized to receive either MAP-I or a Sleep Health Education (SHE) intervention, bot

Repurposing nirogacestat, a gamma secretase enzyme inhibitor in desmoid tumors.

The gamma secretase (GS) enzyme controls cell-cell adhesion, neural stem cell proliferation, neo-angiogenesis, spinal maturation, and metabolism of amyloid precursor proteins (APP). Pathological production of abnormal amyloid-beta isoforms and senile plaques serves as the basis for pathogenesis of Alzheimer's disease (AD). GS enzyme inhibitors such as semagacestat and avagacestat were explored in AD but the studies were paused because of adverse events attributed to their influence on the Notch pathway.Crosstalk between Notch and Wnt signaling pathways created a potential role for GS inhibitor

Clinician and administrator perspectives on outpatient administration of ciltacabtagene autoleucel in relapsed or refractory multiple myeloma.

IntroductionChimeric antigen receptor (CAR) T-cell therapy (CAR T therapy) is a treatment option for patients with relapsed or refractory multiple myeloma that has led to unprecedented treatment outcomes. Among CAR T therapies available, ciltacabtagene autoleucel (cilta-cel) is a good candidate for outpatient administration due to its generally predictable safety profile. There are multiple advantages of outpatient administration of cilta-cel, including reduced healthcare burden, expanded access, and patient autonomy. This mixed methods qualitative study aimed to identify key factors for outpa

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… the US; (2) based in a certified facility that has the ability to conduct outpatient administration of RRMM CAR Ts, including cilta-cel; (3) has experience administering cilta-cel, including at least one patient in the outpatient setting; (4) is a member of a CAR T care team, including hematologists/oncologists … The map shows the complexities of the processes involved throughout the patient journey from the center decision to allow outpatient administration of cilta-cel, all the way to discharge to community practice/close coordination with primary oncologist. …

The erectile and ejaculatory implications of the surgical management of rectal cancer.

Colorectal cancer is a significant cause of cancer-related deaths worldwide. Although advances in surgical technology and technique have decreased mortality rates, surviving patients often experience sexual dysfunction as a common complication. The development of the lower anterior resection has greatly decreased the use of the radical abdominoperineal resection surgery, but even the less radical surgery can result in sexual dysfunction, including erectile and ejaculatory dysfunction. Improving the knowledge of the underlying causes of sexual dysfunction in this context and developing effectiv

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… radiation therapy in patients with suspected or proven T3‐T4 disease and/or regional lymph node involvement. 67 Kunneman et al. conducted a four‐round Delphi study on the benefits/harms of preoperative radiation therapy and found poor congruence between topics important to patients and those addressed by oncologists … A Delphi consensus study among rectal cancer patients and radiation oncologists. Radiother Oncol. 2015;114:212–7. 69. Rew KT, Heidelbaugh JJ. Erectile dysfunction. Am Fam Physician. 2016;94(10):820–7. 70. McMahon CG. Current diagnosis and management of erectile dysfunction. …

Oral ixazomib-dexamethasone vs oral pomalidomide-dexamethasone for lenalidomide-refractory, proteasome inhibitor-exposed multiple myeloma: a randomized Phase 2 trial.

Multiple myeloma (MM) patients typically receive several lines of combination therapy and first-line treatment commonly includes lenalidomide. As patients age, they become less tolerant to treatment, requiring convenient/tolerable/lenalidomide-free options. Carfilzomib and/or bortezomib-exposed/intolerant, lenalidomide-refractory MM patients with ≥2 prior lines of therapy were randomized 3:2 to ixazomib-dexamethasone (ixa-dex) (n = 73) or pomalidomide-dexamethasone (pom-dex) (n = 49) until progression/toxicity. Median progression-free survival (mPFS) was 7.1 vs 4.8 months with ixa-dex vs pom-d

Adaptation and Evaluation of a Symptom-Monitoring Digital Health Intervention for Patients With Relapsed and Refractory Multiple Myeloma: Pilot Mixed-Methods Implementation Study.

BACKGROUND: Relapsed and refractory multiple myeloma (RRMM) is a bone marrow cancer that requires systemic treatment, which often results in severe symptom burden. Recent studies have found that electronic patient-reported outcome (ePRO) interventions implemented in the clinic setting have had positive outcomes for other oncology populations. Evidence of the efficacy of a similar approach is lacking for patients with RRMM. OBJECTIVE: Recent recommendations for digital health interventions call for the publication of descriptions of iterative development processes in order to improve reproduci

A Qualitative Investigation on Patient Empowerment in Prostate Cancer.

Purpose: Men with prostate cancer often describe low levels of empowerment. eHealth interventions may represent useful tools to deliver care and education and to meet patients' needs within an empowerment framework. In order to design a platform for cancer patients' empowerment within the H2020 iManageCancer project, the perspective of the target population for the platform was assessed. The present study aims to assess the qualitative experience of prostate cancer patients during treatment in order to provide insights for clinical practice with a particular focus on the design of a web platfo

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… The psycho-oncologists were also invited to the weekly meeting of the multidisciplinary equipe for prostate cancer patients and collected professionals' point of view on patients' needs. … Semi-structured interviews were conducted with each patient by a psycho-oncologist, and lasted 45–75 min. All patients were undergoing radiation therapy treatment at the time of the study. …

Bone-targeted therapies in metastatic castration-resistant prostate cancer: evolving paradigms.

Majority of patients with metastatic castrate resistant prostate cancer (mCRPC) develop bone metastases which results in significant morbidity and mortality as a result of skeletal-related events (SREs). Several bone-targeted agents are either in clinical use or in development for prevention of SREs. Bisphosphonates were the first class of drugs investigated for prevention of SREs and zoledronic acid is the only bisphosphonate that is FDA-approved for this indication. Another bone-targeted agent is denosumab which is a fully humanized monoclonal antibody that binds to the RANK-L thereby inhibi

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… Radiopharmaceuticals are underutilized in clinical practice, mainly because of the concern for significant myelosuppression, the dependency on other subspecialists (i.e., nuclear medicine specialists or radiation oncologists) for administration, and because until results on alpharadin has emerged, no … Oncologist. 2004;9(4):28–37. doi: 10.1634/theoncologist.9-90004-28. 33. Kasting GB, Francis MD. Retention of etidronate in human, dog, and rat. Journal of Bone and Mineral Research. 1992;7(5):513–522. doi: 10.1002/jbmr.5650070507. 34. Matsuzaki K, Udagawa N, Takahashi N, et al. …

A Comprehensive Review of Modern Cancer Therapies Utilizing Oncolytic Viruses.

Oncolytic viruses (OVs) are gaining traction as advanced tools in cancer therapy. They are distinguished by their ability to destroy malignant cells while sparing normal tissue specifically. In addition to their direct tumor-lysing properties, an essential benefit of oncolytic virus therapy is its capacity to activate both the innate and adaptive immune systems. To enhance these therapeutic actions, many OVs have been genetically engineered to encode immune-modulating factors that reestablish or strengthen antitumor immune responses. Recent studies show that combining OVs with other forms of i

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… At that time, oncologists also became interested in a newly discovered group of adenoidal-pharyngeal-conjunctival agents linked to respiratory infections. …

Impact of the COVID-19 pandemic on the diagnosis and treatment of onco-hematologic patients: a discussion paper.

We do not know the precise figure for solid organ tumors diagnosed each year in Spain and it is therefore difficult to calculate whether there has been a decrease in cancer diagnoses as a consequence of the pandemic. Some indirect data suggest that the pandemic has worsened the stage at which some non-hematological neoplasms are diagnosed. Despite the lack of robust evidence, oncology patients seem more likely to have a poor outcome when they contract COVID-19. The antibody response to infection in cancer patients will be fundamentally conditioned by the type of neoplasia present, the treatmen

CAR-T therapy: Trailblazing CAR(ing) in cancer treatment.

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… To overcome this, oncologists recall these soldiers (T cells) and arm them with specialized weapons called chimeric antigen receptors (CARs), that target the enemy’s artillery. …