scholarly journals The Emerging Therapeutic Landscape of Advanced Melanoma

2018 ◽  
Vol 24 (5) ◽  
pp. 549-558 ◽  
Author(s):  
Vanessa Henriques ◽  
Teresa Martins ◽  
Wolfgang Link ◽  
Bibiana I. Ferreira
Keyword(s):  
Skin Cancer ◽  
Metastatic Melanoma ◽  
Treatment Options ◽  
Acquired Resistance ◽  
Treatment Modalities ◽  
Specific Therapy ◽  
Novel Treatments ◽  
The Past ◽  
Therapeutic Landscape ◽  
Paradigm Shifting

Melanoma is the deadliest form of skin cancer being responsible for 80% of skin cancer deaths. Furthermore, the incidence of metastatic melanoma has increased over the past three decades with a mortality rate that continues to rise faster than most of all other cancers. The last few years have witnessed an unparalleled change in treatment options for patients with metastatic melanoma by the development of new therapeutic strategies like targeted therapies and immunotherapies that highly improved the patient’s prognosis. Despite the paradigm- shifting success of these novel treatments, their effectiveness is still limited by intrinsic or acquired resistance. The objective of this review is to provide an overview of the new available treatment modalities, criteria to select patients who might benefit from a specific therapy, mechanisms of innate and acquired resistance to these treatments and to discuss strategies to overcome drug resistance.

scholarly journals The therapeutic landscape of advanced melanoma

2020 ◽  
Vol 13 (3) ◽  
pp. 306-308 ◽  
Author(s):  
Erika Richtig
Keyword(s):  
Metastatic Melanoma ◽  
Checkpoint Inhibitors ◽  
Treatment Options ◽  
Short Review ◽  
Advanced Melanoma ◽  
Oncolytic Viruses ◽  
Therapeutic Landscape ◽  
The World ◽  
Melanoma Treatment ◽  
Tumor Entities

Summary The therapeutic landscape of advanced and metastatic melanoma has changed dramatically in the last ten years. Targeted therapies as well as checkpoint inhibitors and oncolytic viruses have launched a broad revolution within this field. First presented at ASCO 2011, changes in melanoma treatment giving “light at the end of the tunnel” have also changed the treatment of many other tumor entities. So oncologists all over the world can offer their patients these treatment options with higher efficacy than we ever had. But despite all optimism we are still losing about half of our patients with metastatic melanoma along the way. In this short review the therapeutic landscape of advanced melanoma is described.

The Management of Corneal Neovascularisation – Update on New Clinical Data and Recommendations of Treatment

2016 ◽  
Vol 10 (02) ◽  
pp. 86 ◽  
Author(s):  
Natasha Spiteri ◽  
Vito Romano ◽  
Matthias Brunner ◽  
Bernhard Steger ◽  
Stephen B Kaye ◽  
...  
Keyword(s):  
Gene Therapy ◽  
Risk Factor ◽  
Clinical Data ◽  
Treatment Options ◽  
Experimental Treatment ◽  
Treatment Modalities ◽  
The Past ◽  
Recent Advances ◽  
The Future ◽  
Subsequent Failure

Vascularisation of the cornea may occur as a sight-threatening response to various insults to the cornea, such as infection, trauma and inflammation, and is a well-recognised risk factor for rejection and subsequent failure of corneal grafts. Various different treatment modalities have been used in the past, with varying levels of success. In this review, we discuss the pathogenesis of corneal neovascularisation, look at recent advances in the assessment of these patients and give an overview of currently available treatment options, both medical and surgical. We also discuss current experimental treatment for corneal neovascularisation, such as gene therapy, which may provide further treatment options in the future.

Management of congenital subglottic hemangioma: Trends and success over the past 17 years

2005 ◽  
Vol 132 (2) ◽  
pp. 226-231 ◽  
Author(s):  
Mohamed A. Bitar ◽  
Roger V. Moukarbel ◽  
George H. Zalzal
Keyword(s):  
Carbon Dioxide ◽  
Side Effects ◽  
Success Rate ◽  
Study Design ◽  
Complication Rate ◽  
Carbon Dioxide Laser ◽  
Treatment Options ◽  
Surgical Excision ◽  
Treatment Modalities ◽  
The Past

OBJECTIVE: To evaluate the success and complications of various treatment options of congenital subglottic hemangioma. STUDY DESIGN AND SETTINGS: Reported cases were grouped by treatment modalities and corresponding outcome evaluated. RESULTS: From 1986 through 2002, 372 patients were reported in 28 series. Carbon dioxide laser had 88.9% success rate yet 5.5 % significant subglottic stenosis. It shortened the tracheotomy duration by 13.7 months. Corticosteroids were not that beneficial (useful in only 24.5%) with 12.9% side effects. Intralesional corticosteroids were successful in 86.4% with 5.6% complication rate. Surgical excision (as young as 2.5 months), was useful in 98% with 10% complication rate, using cartilage grafts in 34%. Other modalities were less popular. CONCLUSION: Treatment should be individualized. Guidelines are suggested. Priority is given to secure the airways. The CO2 laser is useful when used cautiously. Steroids may be beneficial. Excision is for stubborn cases.

scholarly journals Energy-Based Devices for Functional Vaginal Problems: Issues and Answers

2021 ◽  
Author(s):  
Alyssa Bujnak ◽  
Carly A. Crowder ◽  
Michael L. Krychman
Keyword(s):  
Study Design ◽  
Medical Devices ◽  
Treatment Options ◽  
Current Treatment ◽  
Treatment Modalities ◽  
Efficacy And Safety ◽  
Management Options ◽  
Serious Adverse Events ◽  
Novel Treatments ◽  
Vaginal Rejuvenation

Abstract Vaginal rejuvenation is a marketing term that encompasses surgical and medical treatments for functional vaginal/vulvar problems including but not limited to genitourinary syndrome of menopause (GSM), sexual dysfunction, vaginal laxity, and stress urinary incontinence (SUI) and for esthetic concerns including dissatisfaction with vulvovaginal appearance. Multiple treatment options have become available for indications of functional vaginal problems. Noninvasive management options including the use of more novel treatments such as energy-based devices have gained interest. Previously, studies regarding the efficacy and safety of the energy-based devices for functional vaginal problems were mostly limited to cohort studies without sham treatment, control groups, randomization, or double blinding. As a result of this insufficient data in 2018, the FDA released a statement of warning against the use of energy-based devices in the treatment of functional vaginal problems or vaginal cosmetic procedures (Https://Www.Fda.Gov/Medical-Devices/Safety-Communications/Fda-Warns-Against-Use-Energy-Based-Devices-Perform-Vaginal-Rejuvenation-or-Vaginal-Cosmetic. 1–4, 2018). Purpose of Review This article reviews the most current treatment modalities in the realm of vaginal rejuvenation therapy with an emphasis on the efficacy and safety of the energy-based devices. Recent Findings In the most recent literature, there have been studies with improvements in study design that support the efficacy and the short-term safety of the energy-based devices. Summary More recent studies with improved study design evidence that the use of energy-based devices results in improvements in functional vaginal problems and that serious adverse events appear to be rare. The availability of these devices as treatment options for functional vaginal problems has the potential to impact patient by improving their symptoms and quality of life. Caution still remains however regarding their safety following a longer period of time after their use.

scholarly journals Hedgehog/GLI signaling in tumor immunity - new therapeutic opportunities and clinical implications

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Sandra Grund-Gröschke ◽  
Georg Stockmaier ◽  
Fritz Aberger
Keyword(s):  
Immune Response ◽  
De Novo ◽  
Negative Impact ◽  
Checkpoint Inhibitors ◽  
Inflammatory Diseases ◽  
Treatment Options ◽  
Acquired Resistance ◽  
Cell Formation ◽  
Cancer Hallmarks ◽  
Novel Treatments

AbstractUncontrolled activation of the Hedgehog/Glioma-associated oncogene (HH/GLI) pathway is a potent oncogenic driver signal promoting numerous cancer hallmarks such as proliferation, survival, angiogenesis, metastasis and metabolic rewiring. Several HH pathway inhibitors have already been approved for medical therapy of advanced and metastatic basal cell carcinoma and acute myeloid leukemia with partially impressive therapeutic activity. However, de novo and acquired resistance as well as severe side effects and unexplained lack of therapeutic efficacy are major challenges that urgently call for improved treatment options with more durable responses. The recent breakthroughs in cancer immunotherapy have changed our current understanding of targeted therapy and opened up promising therapeutic opportunities including combinations of selective cancer pathway and immune checkpoint inhibitors. Although HH/GLI signaling has been intensely studied with respect to the classical hallmarks of cancer, its role in the modulation of the anti-tumoral immune response has only become evident in recent studies. These have uncovered HH/GLI regulated immunosuppressive mechanisms such as enhanced regulatory T-cell formation and production of immunosuppressive cytokines. In light of these exciting novel data on oncogenic HH/GLI signaling in immune cross-talk and modulation, we summarize and connect in this review the existing knowledge from different HH-related cancers and chronic inflammatory diseases. This is to provide a basis for the investigation and evaluation of novel treatments combining immunotherapeutic strategies with approved as well as next-generation HH/GLI inhibitors. Further, we also critically discuss recent studies demonstrating a possible negative impact of current HH/GLI pathway inhibitors on the anti-tumoral immune response, which may explain some of the disappointing results of several oncological trials with anti-HH drugs.

scholarly journals Antigen-Specific Treatment Modalities in MS: The Past, the Present, and the Future

2021 ◽  
Vol 12 ◽  
Author(s):  
Judith Derdelinckx ◽  
Patrick Cras ◽  
Zwi N. Berneman ◽  
Nathalie Cools
Keyword(s):  
Multiple Sclerosis ◽  
Treatment Strategies ◽  
Specific Treatment ◽  
Clinical Development ◽  
Treatment Modalities ◽  
Specific Therapy ◽  
The Past ◽  
Wide Range ◽  
Multiple Sclerosis Patients ◽  
Insight Into

Antigen-specific therapy for multiple sclerosis may lead to a more effective therapy by induction of tolerance to a wide range of myelin-derived antigens without hampering the normal surveillance and effector function of the immune system. Numerous attempts to restore tolerance toward myelin-derived antigens have been made over the past decades, both in animal models of multiple sclerosis and in clinical trials for multiple sclerosis patients. In this review, we will give an overview of the current approaches for antigen-specific therapy that are in clinical development for multiple sclerosis as well provide an insight into the challenges for future antigen-specific treatment strategies for multiple sclerosis.

Conventional and contemporary management approaches for the treatment of vestibular schwannomas: Microsurgery versus radiosurgery, a literature review

2004 ◽  
Vol 4 (1) ◽  
pp. 39-45
Author(s):  
K. Hickey
Keyword(s):  
Treatment Options ◽  
Cranial Nerves ◽  
Vestibular Schwannomas ◽  
Treatment Modalities ◽  
The Past ◽  
Close Proximity ◽  
Technical Advances ◽  
Management Approaches ◽  
Contemporary Management

The management of intracerebral tumours has always provided us with a challenge when deciding upon the best treatment approach. However, when such tumours are benign and located in close proximity to critical structures, tumour management becomes all the more challenging.The treatment of vestibular schwannomas has always posed such problems because of their anatomical proximity to critical structures such as the brainstem and several cranial nerves. Through a comprehensive literature appraisal, this article evaluates the problems associated with conventional treatment options and discusses how technical advances over the past decades have affected disease management and therefore impacted on the range and type of treatment modalities employed. In addition, it highlights the role of alternative contemporary approaches in the management of vestibular schwannomas.

EXCITE: Experiences of Patients with Adjuvant and Metastatic Melanoma using Disease- Specific Social Media Communities in the Advent of Novel Therapies (Preprint)

2021 ◽  
Author(s):  
Guy Faust ◽  
Alison Booth ◽  
Evie Merinopoulou ◽  
Sonia Halhol ◽  
Heena Tosar ◽  
...  
Keyword(s):  
Social Media ◽  
Targeted Therapy ◽  
Metastatic Melanoma ◽  
Language Processing ◽  
Treatment Options ◽  
Symptom Duration ◽  
Novel Treatments ◽  
Health Related ◽  
Positive Treatment ◽  
The Impact

BACKGROUND Immunotherapy and targeted therapy treatments are novel treatments available for patients with metastatic and adjuvant melanoma. As recently approved treatments, information surrounding the patients and caregiver’s experience with these therapies, perceptions of treatments, and the effect the treatments have on their day-to-day life are lacking. Such insights would be valuable for any future decision making with regards to treatment options. OBJECTIVE This study aimed to use health-related social media data to understand the experience of patients with adjuvant and metastatic melanoma who are receiving either immunotherapy or targeted therapies. This study also included caregivers’ perspectives. METHODS Publicly available social media posts by patients with self-reported adjuvant or metastatic melanoma (and their caregivers) between January 2014 to October 2019 were programmatically extracted, de-identified, cleaned and analysed using a combination of natural language processing and qualitative data analyses. This study identified spontaneously reported symptoms and their impacts, symptom duration, and the impact of treatment for both treatment groups. RESULTS Overall 1,037 users (9,023 posts) and 114 users (442 posts) were included in the metastatic group and adjuvant group, respectively. The most commonly identified symptoms in both groups were fatigue, pain or exanthema. Symptom impacts reported by both groups were physical impacts, impacts on family, and impacts on work. Positive treatment impacts were reported in both groups and covered the areas of work, social and family life, and general health and quality of life. CONCLUSIONS This study explored health-related social media to better understand the experience and perspectives of patients with melanoma receiving immunotherapy or targeted therapy treatments as well as the experience of their caregivers. This exploratory work uncovered the most commonly discussed concerns among patients and caregivers on the forums including symptoms and their impacts, thus contributing to a deeper understanding of the patient/caregiver experience. CLINICALTRIAL None

scholarly journals Treating ITP: What are the options in the era of new guidelines and new drugs?

2020 ◽  
Vol 71 (4) ◽  
pp. 40-46
Author(s):  
Nikola Pantić ◽  
Nada Suvajdžić-Vuković
Keyword(s):  
Treatment Options ◽  
Intravenous Immunoglobulins ◽  
New Drugs ◽  
Treatment Modalities ◽  
Line Treatment ◽  
Novel Treatments ◽  
Thrombopoietin Receptor ◽  
Treatment Gaps ◽  
New Guidelines ◽  
Novel Therapeutic Strategies

Primary immune thrombocytopenia (ITP) is an autoimmune disease characterized by isolated thrombocytopenia. Treating ITP may be challenging since different treatment modalities are available. While choosing the suitable option for every patient, a physician should take into account both patient's medical characteristics and wishes. The first line treatment options include: corticosteroids, intravenous immunoglobulins and intravenous anti-D immunoglobulin. Second line treatment options comprise medical (thrombopoietin receptor agonists, rituximab, fostamatinib, azathioprine, cyclophosphamide, cyclosporin A, hydroxychloroquine, mycophenolate mofetil, danazol, dapsone, vinca-alcaloids) and surgical (splenectomy) approach. However, there are some treatment gaps which remain uncovered with existing treatment modalities. Therefore, development of novel therapeutic strategies is required. The aim of this review is to provide an illustrative overview of novel treatments for adult ITP.

Management of thoracic aortic lesions - the future is endovascular

VASA ◽  
2012 ◽  
Vol 41 (3) ◽  
pp. 163-176 ◽  
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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