New Options and New Questions: How to Select and Sequence Therapies for Patients with Metastatic Melanoma

2012 ◽  
pp. 524-530 ◽  
Author(s):  
Keith T. Flaherty ◽  
Jeff A. Sosman ◽  
Michael B. Atkins
Keyword(s):  
Tumor Immunology ◽  
Immune Checkpoint Inhibitor ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Braf Inhibitor ◽  
Current Status ◽  
Molecularly Targeted Agents ◽  
New Treatment ◽  
Braf Mutant ◽  
Selection Of

Overview: Recent advances in the understanding of the melanoma biology and tumor immunology have yielded new treatment strategies for patients with advanced melanoma. Within the past year, the selective BRAF inhibitor vemurafenib and immune checkpoint inhibitor ipilimumab have been added to the treatment armamentarium. In addition, other molecularly targeted agents and immunotherapies are showing considerable promise. The availability of multiple, effective treatment options for patients with melanoma, although long sought, has complicated treatment decisions. This article will review the advances in our understanding of melanoma biology and tumor immunology, the current status of immunotherapy, the advances in molecularly targeted therapy for patients with BRAF mutant melanomas, the possible approaches to patients with BRAF wild-type (WT) tumors, and the current considerations for treatment selection of individual patients.

scholarly journals Novel Immunotherapeutic Approaches for Neuroblastoma and Malignant Melanoma

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Fabio Morandi ◽  
Francesco Frassoni ◽  
Mirco Ponzoni ◽  
Chiara Brignole
Keyword(s):  
Malignant Melanoma ◽  
Age Of Onset ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Biological Knowledge ◽  
Huge Amount ◽  
High Stage ◽  
New Treatment ◽  
Near Future ◽  
Primary Tissue

Neuroblastoma (NB) and malignant melanoma (MM), tumors of pediatric age and adulthood, respectively, share a common origin, both of them deriving from the neural crest cells. Although NB and MM have a different behavior, in respect to age of onset, primary tissue involvement and metastatic spread, the prognosis for high stage-affected patients is still poor, in spite of aggressive treatment strategies and the huge amount of new discovered biological knowledge. For these reasons researchers are continuously attempting to find out new treatment options, which in a near future could be translated to the clinical practice. In the last two decades, a strong effort has been spent in the field of translational research of immunotherapy which led to satisfactory results. Indeed, several immunotherapeutic clinical trials have been performed and some of them also resulted beneficial. Here, we summarize preclinical studies based on immunotherapeutic approaches applied in models of both NB and MM.

Evolving Concepts for Use of Stem Cells and Tissue Engineering for Cardiac Regeneration

2016 ◽  
pp. 279-313
Author(s):  
Jahnavi Sarvepalli ◽  
Rajalakshmi Santhakumar ◽  
Rama Shanker Verma
Keyword(s):  
Tissue Engineering ◽  
Stem Cell ◽  
Cell Therapy ◽  
Stem Cell Therapy ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Basic Research ◽  
Underlying Mechanism ◽  
Repair Mechanisms ◽  
New Treatment

The incidence of cardiovascular disease (CVD) in adults are increasing worldwide with impaired repair mechanisms, leading to tissue and organ failure. With the current advancements, life expectancy has improved and has led to search for new treatment strategies that improves tissue regeneration. Recently, stem cell therapy and tissue engineering has captured the attention of clinicians, scientists, and patients as alternative treatment options. The overall clinical experience of these suggests that they can be safely used in the right clinical setting. Ultimately, large outcome trials will have to be conducted to assess their efficacy. Clinical trials have to be carefully designed and patient safety must remain the key concern. At the same time, continued basic research is required to understand the underlying mechanism of cell-based therapies and cell tissue interactions. This chapter reviews the evolving paradigm of stem cell therapy and tissue engineering approaches for clinical application and explores its implications.

Augmentation and combination of antidepressants with each other and with antipsychotics

2011 ◽  
Vol 26 (S2) ◽  
pp. 698-698
Author(s):  
L. Timmerman
Keyword(s):  
Drug Treatment ◽  
Remission Rate ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Augmentation Therapy ◽  
First Line ◽  
Severe Problem ◽  
Medline Search ◽  
New Treatment ◽  
Line Drug

IntroductionNonrespons in first -line drug treatment of patients suffering from depression in psychiatric outpatient populations is a severe problem.The non respons rate is up tot 30% and the non remission rate more than 50% in the first line of treatment with antidepressants in this population.ObjectiveTo devellop more rapid and efficious drug treatment strategies in depression.AimsDuring the last few years several strategies to improve outcome in depression have been under investigation. A few have proven to be valuable.MethodsMedline search 2005–2010 into treatment resistent depression, combination therapy, augmentation therapy, drug therapy.ResultThere is growing evidence for the value of the combination of antidepressants and of combining antidepressants with antipsychotics.Treatment options as pindolol addition to antidepressants, substance P or folic acid addition do not seem of clinical significance yet.The same is true for treatment methods who directly influence the glucocorticoid system such as glucocorticoid receptor antagonists.NMDA antagonists look promising but more research into this option is needed.ConclusionsThere are two outstanding and much promising relatively new treatment options with: Combinations of antidepressants and with combinations of an antidepressant with an antipsychotic.

scholarly journals Personalized Medicine to Improve Treatment of Dopa-Responsive Dystonia—A Focus on Tyrosine Hydroxylase Deficiency

2021 ◽  
Vol 11 (11) ◽  
pp. 1186
Author(s):  
Gyrid Nygaard ◽  
Peter D. Szigetvari ◽  
Ann Kari Grindheim ◽  
Peter Ruoff ◽  
Aurora Martinez ◽  
...  
Keyword(s):  
Tyrosine Hydroxylase ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Current Status ◽  
Dopamine Synthesis ◽  
Hydroxylase Deficiency ◽  
Catecholamine Biosynthesis ◽  
Improve Treatment ◽  
Key Enzyme ◽  
Gch1 Gene

Dopa-responsive dystonia (DRD) is a rare movement disorder associated with defective dopamine synthesis. This impairment may be due to the fact of a deficiency in GTP cyclohydrolase I (GTPCHI, GCH1 gene), sepiapterin reductase (SR), tyrosine hydroxylase (TH), or 6-pyruvoyl tetrahydrobiopterin synthase (PTPS) enzyme functions. Mutations in GCH1 are most frequent, whereas fewer cases have been reported for individual SR-, PTP synthase-, and TH deficiencies. Although termed DRD, a subset of patients responds poorly to L-DOPA. As this is regularly observed in severe cases of TH deficiency (THD), there is an urgent demand for more adequate or personalized treatment options. TH is a key enzyme that catalyzes the rate-limiting step in catecholamine biosynthesis, and THD patients often present with complex and variable phenotypes, which results in frequent misdiagnosis and lack of appropriate treatment. In this expert opinion review, we focus on THD pathophysiology and ongoing efforts to develop novel therapeutics for this rare disorder. We also describe how different modeling approaches can be used to improve genotype to phenotype predictions and to develop in silico testing of treatment strategies. We further discuss the current status of mathematical modeling of catecholamine synthesis and how such models can be used together with biochemical data to improve treatment of DRD patients.

A Review of the Management of Hepatocellular Carcinoma: Standard Therapy and a Look to New Targets

2012 ◽  
pp. 275-280
Author(s):  
Andrew X. Zhu
Keyword(s):  
Hepatocellular Carcinoma ◽  
Treatment Options ◽  
Mechanisms Of Action ◽  
Targeted Agents ◽  
Adjuvant Setting ◽  
Advanced Hcc ◽  
Molecularly Targeted Agents ◽  
Drug Eluting Beads ◽  
Drug Eluting ◽  
New Treatment

Overview: Management of hepatocellular carcinoma (HCC) continues to be challenging, but new treatment options are evolving. A multidisciplinary evaluation will help make the best treatment decisions for each patient. Although we continue to improve the outcomes of curative treatment with resection, liver transplant, and radiofrequency ablation (RFA), many new liver-directed regional therapies including drug-eluting beads, radioembolization, and radiation are emerging. Sorafenib remains the only approved agent for advanced HCC, and its role in the adjuvant setting following resection or RFA, with transarterial chemoembolization, or in combination with other targeted agents or chemotherapy in the advanced stage is under investigation. Many molecularly targeted agents with novel mechanisms of action are under active development.

Current status of chemotherapy for advanced pancreatic and gastric cancer.

1985 ◽  
Vol 3 (7) ◽  
pp. 1032-1039 ◽  
Author(s):  
M J O'Connell
Keyword(s):  
Gastric Cancer ◽  
Survival Benefit ◽  
Advanced Pancreatic Cancer ◽  
Treatment Strategies ◽  
Disease Free Survival ◽  
Current Status ◽  
Term Survival ◽  
Clinical Investigator ◽  
New Treatment

There is currently no effective systemic therapy for advanced pancreatic cancer. No definitive controlled data exist that demonstrate a survival benefit for any particular regimen yet developed. A statistically significant short-term survival benefit has been seen in three consecutive GITSG trials using the FAMe regimen in patients with advanced gastric cancer. Occasional long-term responders have been seen with a variety of regimens, but there is no evidence of improved long-term (more than two years) disease-free survival with any regimen reported to date. Continuing research with emphasis on new drug development, innovative alterations in chemotherapy combinations and administration schedules, or entirely new treatment strategies, are clearly required to allow the clinical investigator and the clinical practitioner to achieve their common goal--improved long-term survival for patients with advanced pancreatic and gastric cancer.

Cancer Drug Delivery

2016 ◽  
pp. 52-95
Author(s):  
Jai N. Patel ◽  
Jeryl Villadolid
Keyword(s):  
Drug Delivery ◽  
Supportive Care ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Treatment Modalities ◽  
Cancer Drug ◽  
Cellular Mechanisms ◽  
Drug Dosing ◽  
New Treatment ◽  
Cancer Drug Delivery

Advancements in cancer drug delivery have led to the development of personalized oncology care through molecularly-driven targeted therapies. Understanding molecular and cellular mechanisms which drive tumor progression and resistance is critical in managing new treatment strategies which have shifted from empiric to biomarker-directed therapy selection. Biomarker-directed therapies have improved clinical outcomes in multiple malignancies as monotherapy and in combination with other treatment modalities, however the changing scope of treatment options presents new opportunities and challenges for research. Furthermore, pharmacogenetics may provide a rationale method of personalizing anticancer drug dosing and supportive care management for oncology patients. This chapter reviews biomarker classifications and pharmacogenetics in anticancer therapy and supportive care. Examples of biomarker-directed therapies and clinical assays, in addition to future directions of molecular profiling in oncology therapy management are discussed.

scholarly journals Bispecific Antibodies: A Smart Arsenal for Cancer Immunotherapies

Vaccines ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 724
Author(s):  
Gihoon You ◽  
Jonghwa Won ◽  
Yangsoon Lee ◽  
Dain Moon ◽  
Yunji Park ◽  
...  
Keyword(s):  
Tumor Targeting ◽  
Checkpoint Inhibitors ◽  
Clinical Success ◽  
Treatment Options ◽  
Bispecific Antibodies ◽  
Current Status ◽  
Combination Therapies ◽  
Immune Effector ◽  
New Treatment ◽  
Cancer Immunotherapies

Following the clinical success of cancer immunotherapies such as immune checkpoint inhibitors blocking B7/CTLA-4 or PD-1/PD-L1 signaling and ongoing numerous combination therapies in the clinic,3 bispecific antibodies (BsAbs) are now emerging as a growing class of immunotherapies with the potential to improve clinical efficacy and safety further. Here, we describe four classes of BsAbs: (a) immune effector cell redirectors; (b) tumor-targeted immunomodulators; (c) dual immunomodulators; and (d) dual tumor-targeting BsAbs. This review describes each of these classes of BsAbs and presents examples of BsAbs in development. We reviewed the biological rationales and characteristics of BsAbs and summarized the current status and limitations of clinical development of BsAbs and strategies to overcome limitations. The field of BsAb-based cancer immunotherapy is growing, and more data from clinical trials are accumulating. Thus, BsAbs could be the next generation of new treatment options for cancer patients.

scholarly journals Cancer Drug Delivery

2017 ◽  
pp. 185-228
Author(s):  
Jai N. Patel ◽  
Jeryl Villadolid
Keyword(s):  
Drug Delivery ◽  
Supportive Care ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Treatment Modalities ◽  
Cancer Drug ◽  
Cellular Mechanisms ◽  
Drug Dosing ◽  
New Treatment ◽  
Cancer Drug Delivery

Advancements in cancer drug delivery have led to the development of personalized oncology care through molecularly-driven targeted therapies. Understanding molecular and cellular mechanisms which drive tumor progression and resistance is critical in managing new treatment strategies which have shifted from empiric to biomarker-directed therapy selection. Biomarker-directed therapies have improved clinical outcomes in multiple malignancies as monotherapy and in combination with other treatment modalities, however the changing scope of treatment options presents new opportunities and challenges for research. Furthermore, pharmacogenetics may provide a rationale method of personalizing anticancer drug dosing and supportive care management for oncology patients. This chapter reviews biomarker classifications and pharmacogenetics in anticancer therapy and supportive care. Examples of biomarker-directed therapies and clinical assays, in addition to future directions of molecular profiling in oncology therapy management are discussed.

scholarly journals Management of Acute Myeloid Leukemia: Current Treatment Options and Future Perspectives

Cancers ◽  
2021 ◽  
Vol 13 (22) ◽  
pp. 5722
Author(s):  
Maximilian Fleischmann ◽  
Ulf Schnetzke ◽  
Andreas Hochhaus ◽  
Sebastian Scholl
Keyword(s):  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Current Treatment ◽  
Current Status ◽  
Epigenetic Therapy ◽  
Comprehensive Overview ◽  
Secondary Resistance ◽  
Acute Myeloid

Treatment of acute myeloid leukemia (AML) has improved in recent years and several new therapeutic options have been approved. Most of them include mutation-specific approaches (e.g., gilteritinib for AML patients with activating FLT3 mutations), or are restricted to such defined AML subgroups, such as AML-MRC (AML with myeloid-related changes) or therapy-related AML (CPX-351). With this review, we aim to present a comprehensive overview of current AML therapy according to the evolved spectrum of recently approved treatment strategies. We address several aspects of combined epigenetic therapy with the BCL-2 inhibitor venetoclax and provide insight into mechanisms of resistance towards venetoclax-based regimens, and how primary or secondary resistance might be circumvented. Furthermore, a detailed overview on the current status of AML immunotherapy, describing promising concepts, is provided. This review focuses on clinically important aspects of current and future concepts of AML treatment, but will also present the molecular background of distinct targeted therapies, to understand the development and challenges of clinical trials ongoing in AML patients.

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