scholarly journals Metastatic colorectal cancer. Evolution of treatment strategies: surgeons’ point of view

2021 ◽  
Vol 11 (1) ◽  
pp. 42-59
Author(s):  
V.  A. Aliev ◽  
Z.  Z. Mamedli ◽  
Yu.  A. Barsukov ◽  
Z.   A. Dudaev ◽  
P.  A. Tikhonov ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Combined Modality Therapy ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Distant Metastases ◽  
Point Of View ◽  
Cancer Evolution ◽  
Risks And Benefits ◽  
Clinical Research Data

This article explores evolution of treatment options in colorectal cancer with synchronous metastatic disease, role of surgical approach on different stages of combined‑modality therapy, including “liver first” strategy. Prospects of perioperative and neoadjuvant polychemotherapy in patients with colorectal cancer with synchronous distant metastases to liver, data on possibility of using radiation therapy in treatment of primary tumor and liver metastases, as well as risks and benefits of this approach and available clinical research data are analyzed.

scholarly journals Update on the role of pembrolizumab in patients with unresectable or metastatic colorectal cancer

2021 ◽  
Vol 14 ◽  
pp. 175628482110244
Author(s):  
Vanessa Wookey ◽  
Axel Grothey
Keyword(s):  
Colorectal Cancer ◽  
Immune Checkpoint ◽  
Checkpoint Inhibitors ◽  
Treatment Options ◽  
Standard Of Care ◽  
Cancer Type ◽  
Cancer Therapies ◽  
Multiple Cancer ◽  
Multiple Treatment

Colorectal cancer (CRC) is the third most common cancer type in both men and women in the USA. Most patients with CRC are diagnosed as local or regional disease. However, the survival rate for those diagnosed with metastatic disease remains disappointing, despite multiple treatment options. Cancer therapies for patients with unresectable or metastatic CRC are increasingly being driven by particular biomarkers. The development of various immune checkpoint inhibitors has revolutionized cancer therapy over the last decade by harnessing the immune system in the treatment of cancer, and the role of immunotherapy continues to expand and evolve. Pembrolizumab is an anti-programmed cell death protein 1 immune checkpoint inhibitor and has become an essential part of the standard of care in the treatment regimens for multiple cancer types. This paper reviews the increasing evidence supporting and defining the role of pembrolizumab in the treatment of patients with unresectable or metastatic CRC.

scholarly journals B Cells and Antibodies as Targets of Therapeutic Intervention in Neuromyelitis Optica Spectrum Disorders

2021 ◽  
Vol 14 (1) ◽  
pp. 37
Author(s):  
Jan Traub ◽  
Leila Husseini ◽  
Martin S. Weber
Keyword(s):  
B Cells ◽  
Neuromyelitis Optica ◽  
Plasma Cells ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Therapeutic Interventions ◽  
Complement Factor ◽  
Major Subset ◽  
Spectrum Disorders

The first description of neuromyelitis optica by Eugène Devic and Fernand Gault dates back to the 19th century, but only the discovery of aquaporin-4 autoantibodies in a major subset of affected patients in 2004 led to a fundamentally revised disease concept: Neuromyelits optica spectrum disorders (NMOSD) are now considered autoantibody-mediated autoimmune diseases, bringing the pivotal pathogenetic role of B cells and plasma cells into focus. Not long ago, there was no approved medication for this deleterious disease and off-label therapies were the only treatment options for affected patients. Within the last years, there has been a tremendous development of novel therapies with diverse treatment strategies: immunosuppression, B cell depletion, complement factor antagonism and interleukin-6 receptor blockage were shown to be effective and promising therapeutic interventions. This has led to the long-expected official approval of eculizumab in 2019 and inebilizumab in 2020. In this article, we review current pathogenetic concepts in NMOSD with a focus on the role of B cells and autoantibodies as major contributors to the propagation of these diseases. Lastly, by highlighting promising experimental and future treatment options, we aim to round up the current state of knowledge on the therapeutic arsenal in NMOSD.

scholarly journals Towards Personalization in the Curative Treatment of Gastric Cancer

2020 ◽  
Vol 10 ◽  
Author(s):  
Astrid E. Slagter ◽  
Marieke A. Vollebergh ◽  
Edwin P. M. Jansen ◽  
Johanna W. van Sandick ◽  
Annemieke Cats ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Standard Of Care ◽  
Molecular Characteristics ◽  
Perioperative Chemotherapy ◽  
Current Standard ◽  
Common Cancer ◽  
Resectable Gastric Cancer

Gastric cancer is the fifth most common cancer worldwide and has a high mortality rate. In the last decades, treatment strategy has shifted from an exclusive surgical approach to a multidisciplinary strategy. Treatment options for patients with resectable gastric cancer as recommended by different worldwide guidelines, include perioperative chemotherapy, pre- or postoperative chemoradiotherapy and postoperative chemotherapy. Although gastric cancer is a heterogeneous disease with respect to patient-, tumor-, and molecular characteristics, the current standard of care is still according to a one-size-fits-all approach. In this review, we discuss the background of the different treatment strategies in resectable gastric cancer including the current standard, the specific role of radiotherapy, and describe the current areas of research and potential strategies for personalization of therapy.

scholarly journals Chemokines—What Is Their Role in Colorectal Cancer?

2020 ◽  
Vol 27 (1) ◽  
pp. 107327482090338 ◽  
Author(s):  
Sara Pączek ◽  
Marta Łukaszewicz-Zając ◽  
Barbara Mroczko
Keyword(s):  
Colorectal Cancer ◽  
Current Knowledge ◽  
Early Stage ◽  
Distant Metastases ◽  
Cell Types ◽  
Diagnosis And Prognosis ◽  
Novel Biomarkers ◽  
Specific Receptors ◽  
Common Malignancy

Colorectal cancer (CRC) is one of the leading causes of cancer-related death. It is the second most frequently diagnosed malignancy in Europe and third worldwide. Colorectal malignancies diagnosed at an early stage offer a promising survival rate. However, advanced tumors often present distant metastases even after the complete resection of a primary tumor. Therefore, novel biomarkers of CRC are sorely needed in the diagnosis and prognosis of this common malignancy. A family of chemokines are composed of small, secreted proteins. They are best known for their ability to stimulate the migration of several cell types. Some investigations have indicated that chemokines are involved in cancer development, including CRC. This article presents current knowledge regarding chemokines and their specific receptors in CRC progression. Moreover, the prime aim of this review is to summarize the potential role of these proteins as biomarkers in the diagnosis and prognosis of CRC.

Adherence in Pain Medicine

2017 ◽  
Author(s):  
Michael E. Schatman ◽  
Oscar J. Benitez
Keyword(s):  
Treatment Adherence ◽  
Treatment Options ◽  
Point Of View ◽  
Clinical Psychologists ◽  
Pain Medicine ◽  
Adherence To Treatment

This chapter reviews adherence to treatment options in pain medicine from the clinician’s point of view. Adherence is discussed in the context of principle-based ethics through the four tenets of autonomy, nonmaleficence, beneficence, and justice. Treatment adherence for pain medicine on the part of the clinician transcends mere compliance with opioid prescriptions and policies. Adherence is addressed as a broad-based approach that can be clinically appropriate when principle-based ethics are followed. The shortage of clinical therapists and the corresponding role of clinical psychologists are discussed. Ways to find a balance between the issues of abuse and underprescribing are also addressed.

scholarly journals Role of the Myokine Irisin on Bone Homeostasis: Review of the Current Evidence

2021 ◽  
Vol 22 (17) ◽  
pp. 9136
Author(s):  
Amanda Kornel ◽  
Danja J. Den Hartogh ◽  
Panagiota Klentrou ◽  
Evangelia Tsiani
Keyword(s):  
Bone Resorption ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Current Treatment ◽  
Current Evidence ◽  
Signaling Proteins ◽  
Bone Homeostasis ◽  
Menopausal Women ◽  
Post Menopausal

Bone is a highly dynamic tissue that is constantly adapting to micro-changes to facilitate movement. When the balance between bone building and resorption shifts more towards bone resorption, the result is reduced bone density and mineralization, as seen in osteoporosis or osteopenia. Current treatment strategies aimed to improve bone homeostasis and turnover are lacking in efficacy, resulting in the search for new preventative and nutraceutical treatment options. The myokine irisin, since its discovery in 2012, has been shown to play an important role in many tissues including muscle, adipose, and bone. Evidence indicate that irisin is associated with increased bone formation and decreased bone resorption, leading to reduced risk of osteoporosis in post-menopausal women. In addition, low serum irisin levels have been found in individuals with osteoporosis and osteopenia. Irisin targets key signaling proteins, promoting osteoblastogenesis and reducing osteoclastogenesis. The present review summarizes the existing evidence regarding the effects of irisin on bone homeostasis.

scholarly journals Prognostic meaning of tissue inhibitors of matrix metalloproteinases TIMP-1 and TIMP-2 in patients with colorectal cancer

2020 ◽  
Vol 66 (1) ◽  
pp. 25-32
Author(s):  
Elena Kostova ◽  
Slavica Shubeska Stratrova
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastasis ◽  
Prognostic Markers ◽  
Distant Metastases ◽  
Serum Levels ◽  
Pathological Stage ◽  
Chemotherapy Treatment ◽  
Blood Tests ◽  
Keywords Colorectal Cancer

The aim of this study was to analyze TIMP-1 and TIMP-2 serum levels in patients with colorectal cancer (CRC) and to correlate the results with the pathological stage of the disease and outcome in order to evaluate the role of TIMP-1 and TIMP-2 serum levels as prognostic markers. The investigation has been made on 82 patients with operable CRC without distant metastases, who had undergone blood tests in order to determine the TIMP-1 and TIMP-2 serum levels in the following points of time: preoperatively, as well as 3, 6, 9 and 12 months postoperatively. Significant differences were found between serum levels of TIMP-1 and TIMP-2 obtained preoperatively and postoperatively, as well as significant association of serum TIMP-1 levels obtained preoperatively in CRC patients in stage I and III, in the 3th and in the 6th month (p<0.001) postoperatively as defined points of time with the outcome of CRC patients. Serum TIMP-2 levels obtained preoperatively was significantly associated with the outcome of the CRC patients. Analysis of the obtained TIMP-1 and TIMP-2 serum levels in CRC patients showed statistically significant differences with: disease progression, occurrence of liver metastasis, prior to and post chemotherapy treatment. The results derived a conclusion that the serum levels of TIMP-1 and TIMP-2 could be indicators for occurrence and progression of CRC, as well as valuable and useful markers for following the effects of chemotherapy treatment. Keywords: colorectal cancer, TIMP-1, TIMP-2, prognosis

scholarly journals Struggling with recurrent Clostridium difficile infections: is donor faeces the solution?

2009 ◽  
Vol 14 (34) ◽  
Author(s):  
E van Nood ◽  
P Speelman ◽  
E J Kuijper ◽  
J J Keller
Keyword(s):  
Clostridium Difficile ◽  
Case Reports ◽  
Treatment Options ◽  
Intestinal Flora ◽  
Treatment Strategies ◽  
Case Series ◽  
Oral Vancomycin ◽  
Vancomycin Therapy ◽  
Evidence Based Treatment

Patients with recurrent Clostridium difficile infections (CDI) in hospitals and the community constitute an increasing treatment problem. While most patients with a first infection respond to either metronidazole or oral vancomycin, therapy in recurrent C. difficile infections tends to fail repeatedly. Lack of alternative treatment options can be a tremendous burden, both to patients and their treating physicians. Most guidelines recommend prolonged oral vancomycin pulse and or tapering schedules, but evidence-based treatment strategies are lacking. The role of immunoglobulins, whey prepared from vaccinated cows, probiotics or other antibiotics is unclear. Since 1958 several case series and case reports describe a treatment strategy where faecal infusions are successfully given for the treatment of recurrent CDI. Restoring intestinal flora has been historically thought of as the mechanism responsible for cure in these patients. In the literature, more than 150 patients have received faeces from a healthy donor, either infused through an enema, or through a nasoduodenal or nasogastric tube. We summarise the literature regarding treatment with donor faeces for recurrent CDI, and introduce the FECAL trial, currently open for inclusion.

scholarly journals The role of the family doctor in the early diagnosis of colorectal cancer

2021 ◽  
Vol 16 (3) ◽  
pp. 307-313
Author(s):  
Mihaela Adela IANCU ◽  
◽  
Gabriela GANEA ◽  
Ramona Dorotea CĂLIN ◽  
Irina Anca EREMIA ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Family History ◽  
Early Detection ◽  
Treatment Options ◽  
Family Doctor ◽  
Tobacco Consumption ◽  
Individual Risk ◽  
The Family

The incidence of colorectal cancer is increasing. It is currently the third most common cancer, after lung and breast cancer. Despite the increased incidence, recent advances in early detection, performing the screening according to the recommendations and treatment options have reduced colorectal cancer mortality. The role of the family doctor is to advise and to identify non-modifiable risk factors (age, male sex, race, family history, inflammatory bowel disease) as well as modifiable ones (tobacco consumption, low-fiber, high-fat and high carbohydrate diet, a sedentary lifestyle, obesity), in order to avoid these risk factors by developing a personalized plan for the prevention and early detection of colorectal cancer depending on the individual risk. Genetic testing and a more comprehensive family history documentation by the family doctor can enable those with a hereditary predisposition for the colorectal cancer to take preventive measures. Applying evidence-based prevention strategies reduces the prognosis of colorectal cancer and reduces mortality. Colorectal cancer has an increased survival rate if diagnosed early and treated properly.

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