scholarly journals Atezolizumab and bevacizumab for hepatocellular carcinoma: mechanism, pharmacokinetics and future treatment strategies

2021 ◽  
Author(s):  
Xiufeng Liu ◽  
Yi Lu ◽  
Shukui Qin
Keyword(s):  
Hepatocellular Carcinoma ◽  
Immune Checkpoint Inhibitor ◽  
Early Stage ◽  
Treatment Strategies ◽  
Future Directions ◽  
Early Stage Disease ◽  
Combination Strategies ◽  
Common Cancer ◽  
Stage Disease ◽  
Inhibitor Combination

Hepatocellular carcinoma (HCC) is a common cancer globally and a leading cause of cancer-related deaths. Although early-stage disease may be curable by resection, liver transplantation or ablation, many patients present with unresectable disease and have a poor prognosis. Combination treatment with atezolizumab (targeting PD-L1) and bevacizumab (targeting VEGF) in the recent IMbrave150 study was shown to be effective with an acceptable safety profile in patients with unresectable HCC. Herein, we discuss this novel combination in the context of the liver immune environment, summarize the mechanism and pharmacokinetics of atezolizumab and bevacizumab, and examine recent data on other immune checkpoint inhibitor combination strategies as well as future directions in the treatment of patients with advanced HCC.

Hepatic, neuroendocrine, and general oncological emergencies

2013 ◽  
pp. 329-341
Author(s):  
Daniel Marks ◽  
Marcus Harbord
Keyword(s):  
Hepatocellular Carcinoma ◽  
Viral Infection ◽  
Neuroendocrine Tumours ◽  
Early Stage ◽  
Hepatic Malignancy ◽  
Early Stage Disease ◽  
Emergency Presentation ◽  
Common Cancer ◽  
Stage Disease

Emergency presentation of hepatic malignancy Emergency presentations of neuroendocrine tumours General oncological emergencies Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide. It usually develops on the background of cirrhosis, most frequently as a result of chronic hepatotropic viral infection. Untreated, the majority of patients die within 1y of diagnosis. However, there are now a number of potentially curative options for patients diagnosed with early stage disease, and overall 5y survival is between 50–70% in specialist centres....

scholarly journals Clinical and histopathological pattern of colorectal malignancies, the experience in a tertiary hospital in south-western region, Saudi Arabia

2018 ◽  
Vol 5 (11) ◽  
pp. 4684
Author(s):  
Majed Saleh M. Aldayhum ◽  
Anas Abdullah R. Alshehri ◽  
Dlaim H. AlQahtani ◽  
Eman Yahia Alfussaily ◽  
Suha Abdulrahman S. Althibait ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Clinical Presentation ◽  
Early Stage ◽  
Tertiary Hospital ◽  
Central Hospital ◽  
Early Stage Disease ◽  
Common Cancer ◽  
Stage Disease ◽  
Common Grade ◽  
The Mean

Background: Colorectal cancer is the third most common cancer all over the world and the second leading cause of the cancer death in both sexes. CRC is the second most common cancer in Kingdom Saudi Arabia. However, this aspect was not recently studied.Methods: This is a retrospectively cohort based study. We collected and analyzed the records of the patients with CRC diagnosed at Aseer Central Hospital, Abha, Saudi Arabia from January 2008 to June 2016. A pre-specified data sheet was used to collect information regarding socio-demographics, age, Altitude, site of tumor, clinical presentation, outcome and prognosis as well as histopathological pattern of cancer and the stages of disease. Descriptive statistics was performed using SPSS.Results: A total of 291 cases of CRC were registered in the Aseer Central Hospital. 171 cases 58.87% were males while 120 cases 41.2% were females. The mean age of patients (SD) at the time of diagnosis was 59.38 years. At the time of diagnosis, 219 patients 84.6% presented with early stage disease and 40 15.4% had distant metastasis advanced stage. The most frequent CRC located in sigmoid 26.5%, rectal 23.7%and 14% in ascending. The moderately differentiate adenocarcinoma grade of tumor is being the most common grade among all variants 75.6%.Conclusions: In this study, we have nearly similar results found in previously published study by Alshehri et al. Males considered most affected, most of the patients were more than 50 years, 84.6% of the patients came with early stage disease. Left side colon were the most common site of CRC.

Therapeutic Targets and Opportunities in Endometrial Cancer: Update on Endocrine Therapy and Nonimmunotherapy Targeted Options

2020 ◽  
pp. 245-255
Author(s):  
Helen J. MacKay ◽  
Victor Rodriguez Freixinos ◽  
Gini F. Fleming
Keyword(s):  
Endometrial Cancer ◽  
Endocrine Therapy ◽  
Metastatic Disease ◽  
Early Stage ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Targeted Treatment ◽  
Early Stage Disease ◽  
New Era ◽  
Stage Disease

Worldwide, the incidence of endometrial cancer is increasing. Although the prognosis remains good for patients diagnosed with early-stage disease, for those diagnosed with recurrent or metastatic disease, options have been limited, and prognosis is short. Optimizing and identifying new well-tolerated treatments for women living with endometrial cancer is a top priority. A new era is dawning where we are starting to see the integration of clinically relevant genomic and pathologic data to inform and refine treatment strategies for women with endometrial cancer. Here, we focus on reviewing nonimmunotherapy-based targeted treatment options and emerging directions for women with endometrial cancer.

Role of MicroRNA in the Diagnosis and Management of Hepatocellular Carcinoma

MicroRNA ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. 25-40 ◽  
Author(s):  
Ioannis A. Ziogas ◽  
Georgios Sioutas ◽  
Konstantinos S. Mylonas ◽  
Georgios Tsoulfas
Keyword(s):  
Hepatocellular Carcinoma ◽  
Malignant Tumors ◽  
Early Stage ◽  
Survival Rates ◽  
Chemotherapeutic Agents ◽  
Diagnostic Methods ◽  
Early Stage Disease ◽  
Stage Disease ◽  
Underlying Mechanisms

Introduction: Hepatocellular Carcinoma (HCC) is one of the most common malignant tumors in the world and comes third in cancer-induced mortality. The need for improved and more specific diagnostic methods that can detect early-stage disease is immense, as it is amenable to curative modalities, while advanced HCC is associated with low survival rates. microRNA (miRNA) expression is deregulated in HCC and this can be implemented both diagnostically and therapeutically. Objective: To provide a concise review on the role of miRNA in diagnosis, prognosis, and treatment of HCC. Method: We conducted a comprehensive review of the PubMed bibliographic database. Results: Multiple miRNAs are involved in the pathogenesis of HCC. Measurement of the levels of these miRNAs either in tumor tissue or in the blood constitutes a promising diagnostic, as well as prognostic tool. OncomiRs are miRNAs that promote tumorigenesis, thus inhibiting them by administering antagomiRs is a promising treatment option. Moreover, replacement of the depleted miRNAs is another potential therapeutic approach for HCC. Modification of miRNA levels may also regulate sensitivity to chemotherapeutic agents. Conclusion: miRNA play a pivotal role in HCC pathogenesis and once the underlying mechanisms are elucidated, they will become part of everyday clinical practice against HCC.

scholarly journals Current frontline approaches in the management of hepatocellular carcinoma: the evolving role of immunotherapy

2018 ◽  
Vol 11 ◽  
pp. 175628481880808 ◽  
Author(s):  
Gagandeep Brar ◽  
Tim F. Greten ◽  
Zachary J. Brown
Keyword(s):  
Hepatocellular Carcinoma ◽  
Survival Rate ◽  
Early Stage ◽  
Standard Of Care ◽  
Good Prognosis ◽  
Current Standard ◽  
Early Stage Disease ◽  
Advanced Hcc ◽  
Stage Disease

Hepatocellular carcinoma (HCC) is a major cause of cancer-associated mortality worldwide and is expected to rise. Patients with early-stage disease may have a good prognosis with a 5-year survival rate of greater than 70%. However, the majority of patients are diagnosed with late-stage disease with a dismal overall survival rate of less than 16%. Therefore, there is a great need for advances in the treatment of advanced HCC, which for approximately the past decade, has been sorafenib. Immunotherapy is an evolving cancer treatment and has shown promise in treating patients with advanced HCC. In this review, we discuss the current standard of care for advanced HCC and then discuss the evolving role of immunotherapies.

scholarly journals New Frontiers in the Medical Therapy of Hepatocellular Carcinoma

Chemotherapy ◽  
2022 ◽  
Author(s):  
Claudia Angela Maria Fulgenzi ◽  
Antonio D'Alessio ◽  
Thomas Talbot ◽  
Alessandra Gennari ◽  
Mark R. Openshaw ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Kinase Inhibitors ◽  
Checkpoint Inhibitors ◽  
Early Stage ◽  
Phase Iii ◽  
Early Stage Disease ◽  
Primary Liver Tumor ◽  
Phase Iii Clinical Trials ◽  
Stage Disease ◽  
Major Treatment

Background: Hepatocellular carcinoma (HCC) is the most common primary liver tumor, and it rates fourth as a cause of cancer-related death. The presence of underlying liver disease and poor chemosensitivity pose major treatment challenges in the management of HCC. However, in the last few years the therapeutic scenario has substantially changed, and immunotherapy in the form of immune checkpoint inhibitors (ICPIs) has become an essential therapeutic strategy in this field. Summary: After controversial results of monotherapy, ICPIs have been mainly investigated in association with anti-angiogenic agents or as dual checkpoint inhibition. The combination of atezolizumab plus bevacizumab has become the new therapeutic standard for unresectable HCC. Currently, a number of ICPIs-based combinations are being studied in phase III clinical trials as front-line therapy for advanced HCC, with growing interest in integration of early-stage disease management in the form of adjuvant or neoadjuvant therapies. With most of the trials investigating ICPIs as first line treatment, the second line scenario relies mainly on tyrosine kinase inhibitors, which however, have not been formally trialed after ICPIs. Key messages: In this review we summarize the main therapeutic advances in the systemic management of HCC focusing on the most relevant ongoing trials. We also discuss the main issues arising from a such rapidly evolving field including therapeutic sequencing and patient stratification.

How do different histologic components of mixed endometrial carcinomas affect prognosis? Does it really matter?

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Nikolaos Thomakos ◽  
Stefania Dimopoulou ◽  
Maria Sotiropoulou ◽  
Nikolaos Machairiotis ◽  
Anastasios Pandraklakis ◽  
...  
Keyword(s):  
Early Stage ◽  
Survival Rates ◽  
Treatment Strategies ◽  
Early Stage Disease ◽  
Kaplan Meier ◽  
Stage Disease ◽  
Endometrial Carcinomas ◽  
Clinicopathological Variables ◽  
Disease Free ◽  
Cervical Involvement

AbstractThe aim of this study is to evaluate and compare outcomes of patients with mixed and pure endometrial carcinomas (MEC). We reviewed data of patients with MEC, endometroid (EC), serous (SC), and clear cell (CC) carcinomas between 2002 and 2015. Overall survival (OS) and disease-free (DF) survival rates were evaluated, according to the percentage of histologic components. Clinicopathological variables and treatment strategies were assessed. Furthermore, χ2 tests were used to compare proportions and Kaplan–Meier curves to compare recurrence and survival. Sample consisted of 302 cases with mean age 66.3 years. Early-stage disease was recorded in EC compared with CC and SC. Adnexal involvement was more frequent in MEC compared with EC (p=0.043). Extra uterine metastasis was more frequent in the SC compared to the EC group, while lymphovascular space involvement was more frequent in the MEC and CC compared to the SC (p=0.001). EC had less omentum involvement compared to CC (p=0.035) and SC (p<0.001). Furthermore, cervical involvement was more frequent in CC compared to EC (p=0.011). Recurrence (p=0.265) and OS (p=0.533) were found to be similar in MEC compared with CC, SC, and EC. Moreover, recurrence and OS were similar between EC-CC and EC-SC. There were no differences in recurrence and survival in MEC with a type II component larger than 10% or 20% (p>0.05).

The Treatment of Early-Stage Germ Cell Tumors of the Testis (GCTT)

2012 ◽  
Vol 79 (2) ◽  
pp. 81-88
Author(s):  
Roberto Salvioni ◽  
Nicola Nicolai ◽  
Andrea Necchi ◽  
Tullio Torelli ◽  
Luigi Piva ◽  
...  
Keyword(s):  
Germ Cell ◽  
Early Stage ◽  
Clinical Stage ◽  
Germ Cell Tumors ◽  
Treatment Strategies ◽  
Diagnostic Techniques ◽  
High Tech ◽  
Early Stage Disease ◽  
Appropriateness Of Care ◽  
Stage Disease

The treatment of tumors of the testis represents an ideal model of care for cancer. Many different, intersecting strategies are available for managing germ-cell cancers, particularly in the early-stage disease. Which is ‘right’ remains a matter of debate, and requires balancing efficacy against late effects, bearing in mind the complexity of treatment strategies and the available expertise. The cornerstone of this model of success is linked to the quality and appropriateness of care. The current therapeutic strategy is very complex (Fig. 1). High-tech surgery, medical oncology and radiotherapy are involved at various levels of diagnostic techniques of the latest generation. The choice of therapy, alone or integrated, is often influenced by prognostic factors. In this article we will examine the important points and sometimes the subject of controversy in both diagnosis and treatment of these early-stage tumors (Clinical Stage I: disease confined to the testis; Clinical Stage IIA: retroperitoneal lymph nodes <2 cm).

scholarly journals Modulation of the Autophagy-Lysosomal Pathway in Hepatocellular Carcinoma Using Small Molecules

Molecules ◽  
2020 ◽  
Vol 25 (7) ◽  
pp. 1580 ◽  
Author(s):  
Yu Geon Lee ◽  
Tae–Il Jeon
Keyword(s):  
Hepatocellular Carcinoma ◽  
Small Molecules ◽  
Treatment Strategy ◽  
Energy Homeostasis ◽  
Systemic Treatment ◽  
Early Stage ◽  
Primary Liver Cancer ◽  
Degradation Pathway ◽  
Early Stage Disease ◽  
Stage Disease

Hepatocellular carcinoma (HCC) accounts for approximately 90% of all cases of primary liver cancer; it is the third most frequent cause of cancer-related death worldwide. In early-stage disease, surgical resection and liver transplantation are considered curative treatments. However, the majority of HCC patients present with advanced-stage disease that is treated using palliative systemic therapy. Since HCC is heterogeneous owing to its multiple etiologies, various risk factors, and inherent resistance to chemotherapy, the development of an effective systemic treatment strategy for HCC remains a considerable challenge. Autophagy is a lysosome-dependent catabolic degradation pathway that is essential for maintaining cellular energy homeostasis. Autophagy dysfunction is closely linked with the pathogenesis of various cancers; therefore, the discovery of small molecules that can modulate autophagy has attracted considerable interest in the development of a systemic treatment strategy for advanced HCC. Here, we reviewed the roles of autophagy in HCC and the recent advances regarding small molecules that target autophagy regulatory mechanisms.

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