New Treatment Options in Advanced Stage Follicular Lymphoma

In patients with advanced-stage follicular lymphoma (FL) there are many treatment options available. Besides watchful waiting in asymptomatic patients, current first-line treatment strategies include rituximab ± single-agent chemotherapy, chemoimmunotherapy and radioimmunotherapy. In case of relapse, the use of chemoimmunotherapy, radioimmunotherapy and autologous haematopoietic stem cell transplantation (HSCT) results in enhanced response rates, progression-free survival (PFS) and overall survival (OS) compared with chemotherapy alone. However, long-term results are marred by high relapse rates and the risk of secondary malignancies after autologous HSCT. To date, in patients with relapsed/chemoresistant disease, myeloablative/reduced intensity conditioning protocols in combination with allogeneic HSCT presumably constitute the only curative approach but are associated with high treatment-related mortality. Although advances in supportive care have resulted in improved outcomes, reliable strategies for adequate patient selection are mandatory. In the palliative setting, low-dose involved-field irradiation constitutes an effective treatment option in order to control local symptoms with potential long-lasting response.

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New Treatment Options Have Changed the Survival of Patients With Follicular Lymphoma

Journal of Clinical Oncology ◽

10.1200/jco.2005.03.1674 ◽

2005 ◽

Vol 23 (33) ◽

pp. 8447-8452 ◽

Cited By ~ 297

Author(s):

Richard I. Fisher ◽

Michael LeBlanc ◽

Oliver W. Press ◽

David G. Maloney ◽

Joseph M. Unger ◽

...

Keyword(s):

Follicular Lymphoma ◽

Treatment Options ◽

Progression Free Survival ◽

Study Groups ◽

Initial Therapy ◽

Chop Chemotherapy ◽

Free Survival ◽

Impact On Survival ◽

History Of ◽

New Treatment

Background The natural history of follicular lymphoma is believed not to have changed over the last 30 years. Median survivals have ranged from 7 to 10 years, and the disease is considered incurable. However, multiple new treatment options have been developed in the last decade, and their impact on survival of follicular lymphoma remains unknown. Patients and Methods In the current analysis, we identified all previously untreated, advanced-stage, follicular lymphoma patients treated with the following three sequential treatment approaches: cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy ± nonspecific immunostimulants (Southwest Oncology Group [SWOG] 7426 and 7713: 1974 to 1983); prednisone, methotrexate, doxorubicin, cyclophosphamide, and etoposide (ProMACE) plus mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) ± interferon (SWOG 8809: 1988 to 1994); and CHOP followed by monoclonal antibody (MoAb) therapy (SWOG 9800 and 9911: 1998 to 2000). We assessed the patients' progression-free survival (PFS) and overall survival (OS). The MoAb trials included CHOP followed by rituximab (SWOG 9800) and CHOP followed by 131I-tositumomab (SWOG 9911). Results The PFS curves for the CHOP and ProMACE-MOPP studies are overlapping, with 4-year PFS estimates of 46% and 48%, respectively. However, the PFS rate of the CHOP + MoAb studies is significantly improved at 61% (P = .005). The OS curves show improvement with each succeeding study. The 4-year estimate of OS is 69% for the CHOP regimens, 79% for the ProMACE-MOPP study, and 91% for the CHOP + MoAb regimens (P < .001). These conclusions were retained after adjusting for differences in prognostic factors between the study groups. Conclusion The results of this study suggest that OS for patients with follicular lymphoma has improved over time and that the choice of initial therapy may matter.

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The role of tazemetostat in relapsed/refractory follicular lymphoma

Therapeutic Advances in Hematology ◽

10.1177/20406207211015882 ◽

2021 ◽

Vol 12 ◽

pp. 204062072110158

Author(s):

Gottfried von Keudell ◽

Gilles Salles

Keyword(s):

Follicular Lymphoma ◽

Disease Progression ◽

Therapeutic Option ◽

Treatment Options ◽

Subsequent Treatment ◽

Mutation Status ◽

Upfront Therapy ◽

New Treatment ◽

Made In

Large strides have been made in the treatment of follicular lymphoma (FL) over the last few years. Although the majority of patients respond to upfront therapy, many experience disease progression with a progressive shortening of subsequent treatment free intervals. New treatment options are therefore crucial for such patients. Tazemetostat is a first-in-class, selective, oral inhibitor of enhancer of zester homolog 2 (EZH2), a histone methyltransferase that is mutated in about a quarter of FL cases. Tazemetostat was recently approved for the treatment of patients with relapsed FL after 2 or more prior lines of therapy in the presence of an EZH2 mutation and for those without any other available therapeutic option, independently of EZH2 mutation status. In this review, we will summarize the background and key data that led to the development of tazemetostat, and, ultimately, to its approval for this indication.

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New Treatment Options Have Changed the Natural History of Follicular Lymphoma.

Blood ◽

10.1182/blood.v104.11.583.583 ◽

2004 ◽

Vol 104 (11) ◽

pp. 583-583 ◽

Cited By ~ 5

Author(s):

Richard I. Fisher ◽

Michael LeBlanc ◽

Oliver W. Press ◽

David G. Maloney ◽

Thomas P. Miller

Keyword(s):

Monoclonal Antibody ◽

Overall Survival ◽

Natural History ◽

Follicular Lymphoma ◽

Treatment Strategy ◽

Treatment Options ◽

Progression Free Survival ◽

Free Survival ◽

History Of ◽

New Treatment

Abstract The natural history of follicular lymphoma has not changed over the last 30 years (Horning, S.J., Seminars in Oncology20: 1993, 75–88). Median survivals have ranged from 7 – 10 years and the disease is generally considered incurable as there has been no plateau in the survival curve. However, multiple new treatment options, including biologic agents, have been developed in the last decade and their impact on the natural history of follicular lymphoma remains unknown. In order to determine the cumulative effects of all these new treatment options, we identified all previously untreated, advanced stage, follicular lymphoma patients treated with three sequential treatment approaches: CHOP chemotherapy +/− nonspecific immunostimulants (SWOG 7426 and 7713: 1974 – 1978), ProMACE-MOPP +/− interferon (SWOG 8809: 1988 – 1994), and CHOP followed by monoclonal antibody therapy (SWOG 9800 and 9911: 1998 – 2000) and determined their Progression-Free Survival (PFS) and Overall Survival (OS). More specificially, the monoclonal antibody trials included CHOP followed by rituximab (SWOG 9800) and CHOP followed by 131I-Tositumomab (SWOG 9911). The PFS are shown below: Progression-Free Survival by Treatment Strategy TREATMENT N DEATH/PROGRESSION 4-YR PFS CHOP + MoAb 179 75 61% ProMACE 425 290 48% CHOP 356 257 46% The results demonstrate that the PFS remained unchanged until the recent studies that utilized CHOP followed by a monoclonal antibody for initial treatment. The results of OS from these three groups are shown below. Overall Survival by Treatment Strategy TREATMENT N DEATH 4-YR OS CHOP + MoAb 179 18 91% ProMACE 425 189 79% CHOP 356 226 69% In contrast to the PFS, OS has increased with each subsequent study. These data are consistent with the hypotheses that initial therapy with chemotherapy followed by a monoclonal antibody has a significant impact on PFS (p= .005) and OS (p < .0001) and that, even in earlier studies where we could not demonstrate improved initial treatment, sequential new treatment options have also changed the OS (p < .0001) and thus the natural history of follicular lymphoma.

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Management of thoracic aortic lesions - the future is endovascular

VASA ◽

10.1024/0301-1526/a000183 ◽

2012 ◽

Vol 41 (3) ◽

pp. 163-176 ◽

Cited By ~ 6

Author(s):

Weidenhagen ◽

Bombien ◽

Meimarakis ◽

Geisler ◽

A. Koeppel

Keyword(s):

Thoracic Aorta ◽

Clinical Decision Making ◽

Treatment Options ◽

Clinical Decision ◽

Clinical Results ◽

Treatment Modalities ◽

Traumatic Rupture ◽

Descending Thoracic Aorta ◽

New Treatment ◽

Aneurysm Dissection

Open surgical repair of lesions of the descending thoracic aorta, such as aneurysm, dissection and traumatic rupture, has been the state-of-the-art treatment for many decades. However, in specialized cardiovascular centers, thoracic endovascular aortic repair and hybrid aortic procedures have been implemented as novel treatment options. The current clinical results show that these procedures can be performed with low morbidity and mortality rates. However, due to a lack of randomized trials, the level of reliability of these new treatment modalities remains a matter of discussion. Clinical decision-making is generally based on the experience of the vascular center as well as on individual factors, such as life expectancy, comorbidity, aneurysm aetiology, aortic diameter and morphology. This article will review and discuss recent publications of open surgical, hybrid thoracic aortic (in case of aortic arch involvement) and endovascular repair in complex pathologies of the descending thoracic aorta.

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A Genomic Approach to Characterize the Vulnerable Patient – a Clinical Update

Journal of Interdisciplinary Medicine ◽

10.2478/jim-2019-0023 ◽

2019 ◽

Vol 4 (3) ◽

pp. 141-144

Author(s):

Evelin Szabó ◽

Zsolt Parajkó ◽

Diana Opincariu ◽

Monica Chițu ◽

Nóra Raț ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Ischemia ◽

Treatment Options ◽

Ischemic Heart ◽

Pathophysiological Mechanism ◽

Ischemia And Reperfusion Injury ◽

Myocardial Ischemia And Reperfusion ◽

Vulnerable Patient ◽

Traditional Risk Factors ◽

New Treatment

Abstract Atherosclerosis is the elemental precondition for any cardiovascular disease and the predominant cause of ischemic heart disease that often leads to myocardial infarction. Systemic risk factors play an important role in the starting and progression of atherosclerosis. The complexity of the disease is caused by its multifactorial origin. Besides the traditional risk factors, genetic predisposition is also a strong risk factor. Many studies have intensively researched cardioprotective drugs, which can relieve myocardial ischemia and reperfusion injury, thereby reducing infarct size. A better understanding of abnormal epigenetic pathways in the myocardial pathology may result in new treatment options. Individualized therapy based on genome sequencing is important for an effective future medical treatment. Studies based on multiomics help to better understand the pathophysiological mechanism of several diseases at a molecular level. Epigenomic, transcriptomic, proteomic, and metabolomic research may be essential in detecting the pathological phenotype of myocardial ischemia and ischemic heart failure.

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Proteomic Analysis of the Vitreous Body in Proliferative and Non-Proliferative Diabetic Retinopathy

Current Proteomics ◽

10.2174/1570164617666200302101442 ◽

2020 ◽

Vol 17 ◽

Cited By ~ 1

Author(s):

Van-An Duong ◽

Jeeyun Ahn ◽

Na-Young Han ◽

Jong-Moon Park ◽

Jeong-Hun Mok ◽

...

Keyword(s):

Diabetic Retinopathy ◽

Proliferative Diabetic Retinopathy ◽

Microvascular Complications ◽

Treatment Options ◽

Vitreous Body ◽

Control Group ◽

Diabetic Patients ◽

Protein Protein Interaction ◽

Alpha Beta ◽

New Treatment

Background: Diabetic Retinopathy (DR), one of the major microvascular complications commonly occurring in diabetic patients, can be classified into Proliferative Diabetic Retinopathy (PDR) and Non-Proliferative Diabetic Retinopathy (NPDR). Currently available therapies are only targeted for later stages of the disease in which some pathologic changes may be irreversible. Thus, there is a need to develop new treatment options for earlier stages of DR through revealing pathological mechanisms of PDR and NPDR. Objective: The purpose of this study was to characterize proteomes of diabetic through quantitative analysis of PDR and NPDR. Methods: Vitreous body was collected from three groups: control (non-diabetes mellitus), NPDR, and PDR. Vitreous proteins were digested to peptide mixtures and analyzed using LC-MS/MS. MaxQuant was used to search against the database and statistical analyses were performed using Perseus. Gene ontology analysis, related-disease identification, and protein-protein interaction were performed using the differential expressed proteins. Results: Twenty proteins were identified as critical in PDR and NPDR. The NPDR group showed different expressions of kininogen-1, serotransferrin, ribonuclease pancreatic, osteopontin, keratin type II cytoskeletal 2 epidermal, and transthyretin. Also, prothrombin, signal transducer and activator of transcription 4, hemoglobin subunit alpha, beta, and delta were particularly up-regulated proteins for PDR group. The up-regulated proteins related to complement and coagulation cascades. Statherin was down-regulated in PDR and NPDR compared with the control group. Transthyretin was the unique protein that increased its abundance in NPDR compared with the PDR and control group. Conclusion: This study confirmed the different expressions of some proteins in PDR and NPDR. Additionally, we revealed uniquely expressed proteins of PDR and NPDR, which would be differential biomarkers: prothrombin, alpha-2-HS-glycoprotein, hemoglobin subunit alpha, beta, and transthyretin.

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Immunotherapy and potential predictive biomarkers in the treatment of neuroendocrine neoplasia

Future Oncology ◽

10.2217/fon-2020-0703 ◽

2020 ◽

Author(s):

Guanghui Xu ◽

Yuhao Wang ◽

Hushan Zhang ◽

Xueke She ◽

Jianjun Yang

Keyword(s):

Current Knowledge ◽

Checkpoint Inhibitors ◽

Treatment Options ◽

Predictive Biomarkers ◽

The Body ◽

Low Grade ◽

Ablative Therapies ◽

Cancer Types ◽

New Treatment ◽

Well Differentiated

Neuroendocrine neoplasias (NENs) are a heterogeneous group of rare tumors scattered throughout the body. Surgery, locoregional or ablative therapies as well as maintenance treatments are applied in well-differentiated, low-grade NENs, whereas cytotoxic chemotherapy is usually applied in high-grade neuroendocrine carcinomas. However, treatment options for patients with advanced or metastatic NENs are limited. Immunotherapy has provided new treatment approaches for many cancer types, including neuroendocrine tumors, but predictive biomarkers of immune checkpoint inhibitors (ICIs) in the treatment of NENs have not been fully reported. By reviewing the literature and international congress abstracts, we summarize the current knowledge of ICIs, potential predicative biomarkers in the treatment of NENs, implications and efficacy of ICIs as well as biomarkers for NENs of gastroenteropancreatic system, lung NENs and Merkel cell carcinoma in clinical practice.

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Inhibition of Proinflammatory Cytokines in Cutibacterium acnes-Induced Inflammation in HaCaT Cells by Using Buddleja davidii Aqueous Extract

International Journal of Inflammation ◽

10.1155/2020/8063289 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Anh Thu Nguyen ◽

Ki-young Kim

Keyword(s):

Proinflammatory Cytokines ◽

Proinflammatory Cytokine ◽

Treatment Options ◽

Mapk Signaling ◽

Cytokine Expression ◽

Proinflammatory Cytokine Expression ◽

Cutibacterium Acnes ◽

Anti Inflammatory ◽

New Treatment ◽

Hacat Keratinocyte

Acne is an inflammatory skin disorder; although some anti-inflammatory medicines for treating acne are available in a market, they have considerable side effects; therefore, new treatment options are needed. In the present study, among the 16 aqueous extracts of plants collected from Jeju Island in Korea which are used to test anti-inflammatory activity, B. davidii showed the strong decline of the proinflammatory cytokine expression against the inflammatory process caused by C. acnes in Human HaCaT keratinocyte cells. B. davidii downregulated the expression of 57% of COX-2, 41% of iNOS, and proinflammatory cytokines 29% of TNF-α, 32% of IL-1β, 21% of IL-6, and 35% of IL-8. Furthermore, B. davidii inhibited NF-κB and MAPK signaling cascades in keratinocytes that activated by toll-like receptor 2 (TLR-2) in response to C. acnes. Given those results, B. davidii is a potential agent to reduce the proinflammatory cytokine expression against C. acnes-induced inflammation and might provide an alternative to the current medications.

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