scholarly journals Targeted therapy in advanced desmoid tumors: Current perspectives

2020 ◽  
Vol 11 (3) ◽  
pp. 9-16
Author(s):  
Amrallah A. Mohammed ◽  
Hani EL-Tanni ◽  
Hani M. EL-Khatib
Keyword(s):  
Targeted Therapy ◽  
Treatment Options ◽  
Aggressive Fibromatosis ◽  
Local Tumor Control ◽  
The Body ◽  
Treatment Modalities ◽  
Tumor Control ◽  
Desmoid Tumors ◽  
Treatment Needs ◽  
Medline Search

Abstract Background Desmoid tumors/aggressive fibromatosis (DTs/AF) are cytological bland fibrous neoplasms originating from the musculoaponeurotic structures throughout the body. The exact cause still remains unknown, however, they may present sporadically or as a manifestation of a hereditary syndrome called familial adenomatous polyposis (FAP). Although they lack the capacity to establish metastases, DTs/AF may be devastated and occasionally fatal. As a result of the heterogeneity of DTs/AF, treatment needs to be individualized to improve local tumor control and maintain patients’ quality of life. Therefore, after a multidisciplinary approach, all treatment options should be discussed with patients. Where systemic chemotherapy has been shown to be unsuccessful with marked side effects in case of advanced DTs/AF, new therapeutic options are needed. Methods A Medline search was conducted and published articles in different studies from 2000 to the present were reviewed. Conclusion More research is needed to illustrate both the prognostic and predictive factors of the targeted therapy and the value of their combinations with or without other treatment modalities to get the best result for the treatment of advanced DTs/AF.

Desmoid-Type Fibromatosis in Children: A Step Forward in the Cooperative Group Setting

2012 ◽  
pp. 593-597
Author(s):  
Natalie Pounds ◽  
Stephen X. Skapek
Keyword(s):  
Clinical Trials ◽  
Desmoid Tumor ◽  
Aggressive Fibromatosis ◽  
Local Tumor Control ◽  
Therapeutic Interventions ◽  
Tumor Control ◽  
Group Setting ◽  
Soft Tissue Neoplasm ◽  
Life Threatening ◽  
Prospective Phase

Overview: Desmoid-type (aggressive) fibromatosis (desmoid tumor) is a soft tissue neoplasm that can occur in both children and adults. Although it is formally classified as an intermediate-grade neoplasm because of its propensity for locally invasive growth, it can lead to severe and life-threatening problems. Because metastases do not arise from desmoid tumor, therapeutic interventions have historically focused on surgery or radiation to achieve local tumor control. These approaches may be ineffective or impractical for some children. In those cases, systemic therapy with cytotoxic or noncytotoxic therapy has been used. Because of the relative rarity of this neoplasm in children, knowledge on the use of chemotherapy is based largely on anecdotal reports or retrospective series. Limited conclusions can be drawn, though, from these types of reports. In the last 10 years, two prospective phase II clinical trials of chemotherapy for children with desmoid tumor have been conducted in cooperative clinical trials centered in North America. We review the results of those clinical trials and suggest future directions for systematically approaching this disease to better define the role of chemotherapy for children with desmoid tumor.

scholarly journals Bioactive Nanoparticles for Cancer Immunotherapy

2018 ◽  
Vol 19 (12) ◽  
pp. 3877 ◽  
Author(s):  
Suchithra Poilil Surendran ◽  
Myeong Ju Moon ◽  
Rayoung Park ◽  
Yong Yeon Jeong
Keyword(s):  
Effective Treatment ◽  
Cancer Immunotherapy ◽  
Treatment Options ◽  
High Specificity ◽  
Plga Nanoparticles ◽  
The Body ◽  
Treatment Modalities ◽  
Therapeutic Drugs ◽  
Promising Area ◽  
The Many

Currently, immunotherapy is considered to be one of the effective treatment modalities for cancer. All the developments and discoveries in this field up to the recent Nobel Prize add to the interest for research into this vast area of study. Targeting tumor environment as well as the immune system is a suitable strategy to be applied for cancer treatment. Usage of nanoparticle systems for delivery of immunotherapeutic agents to the body being widely studied and found to be a promising area of research to be considered and investigated further. Nanoparticles for immunotherapy would be one of the effective treatment options for cancer therapy in the future due to their high specificity, efficacy, ability to diagnose, imaging, and therapeutic effect. Among the many nanoparticle systems, polylactic-co-glycolic acid (PLGA) nanoparticles, liposomes, micelles, gold nanoparticles, iron oxide, dendrimers, and artificial exosomes are widely used for immunotherapy of cancer. Moreover, the combination therapy found to be the more effective way of treating the tumor. Here, we review the current trends in nanoparticle therapy and efficiency of these nanosystems in delivering antigens, adjuvants, therapeutic drugs, and other immunotherapeutic agents. This review summarizes the currently available bioactive nanoparticle systems for cancer immunotherapy.

scholarly journals Photodynamic Therapy in Advanced Tracheobronchial Cancers

1999 ◽  
Vol 5 (4) ◽  
pp. 245-251 ◽  
Author(s):  
Tom G. Sutedja
Keyword(s):  
Photodynamic Therapy ◽  
Tracheobronchial Tree ◽  
Local Tumor Control ◽  
Treatment Modalities ◽  
Tumor Control ◽  
Tissue Necrosis ◽  
Endoscopic Techniques ◽  
Lung Cancer Patients ◽  
Secondary Tissue ◽  
Effectiveness Studies

Photodynamic therapy (PDT) has been introduced in the early eighties for treating patients with malignancies in the tracheobronchial tract. After intravenous injection of the photosensitizers, the tumor area in the tracheobronchial tree is illuminated bronchoscopically using a laser fiber to transmit light of a specific wavelength during the procedure. Secondary tissue necrosis ensues, because of the thrombosis of the tumor vasculature leading to late tissue hypoxia. Ample data have shown that PDT is effective to obtain full depth tissue necrosis with relative sparing of the normal tissue. Local tumor control can be achieved. Competitive endoscopic techniques such as lasers and electrocautery are applicable to debulk tumor in a less selective but more immediate manner. Skin photosensitivity is a potential morbidity of PDT, especially in using the first generation photosensitizers. This limits its palliative potential. More selective and more phototoxic sensitizers in combination with the use of portable diode laser, may improve the clinical usefulness of PDT in the management of lung cancer patients. However, cost-effectiveness studies comparing PDT and other local bronchoscopic treatment modalities such as thermal lasers, electrocautery, cryotherapy, brachytherapy, whether or not in addition to external radiotherapy and chemotherapy, should be conducted to define its definite role in the palliative treatment of advanced obstructive bronchial cancers.

Transcatheter and Ablative Therapeutic Approaches for Solid Malignancies

2007 ◽  
Vol 25 (8) ◽  
pp. 978-986 ◽  
Author(s):  
Eleni Liapi ◽  
Jean-Francois H. Geschwind
Keyword(s):  
Focused Ultrasound ◽  
Local Tumor Control ◽  
High Intensity Focused Ultrasound ◽  
Tumor Control ◽  
Curative Intent ◽  
Medline Search ◽  
Ablative Therapies ◽  
Technological Advances ◽  
Solid Malignancies ◽  
Bland Embolization

The purpose of this article is to present in a concise manner an overview of the most widely used locoregional transcatheter and ablative therapies for solid malignancies. An extensive MEDLINE search was performed for this review. Therapies used for liver cancer were emphasized because these therapies are used most commonly in the liver. Applications in pulmonary, renal, and bone tumors were also discussed. These approaches were divided into catheter-based therapies (such as transcatheter arterial chemoembolization, bland embolization, and the most recent transcatheter arterial approach with drug-eluting microspheres), ablative therapies (such as chemical [ethanol or acetic acid injection]), and thermal ablative therapies (such as radiofrequency ablation, laser induced thermotherapy, microwave ablation, cryoablation, and extracorporeal high-intensity focused ultrasound ablation). A brief description of each technique and analysis of available data was reported for all therapies. Locoregional transcatheter and ablative therapies continue to be used mostly for palliation, but have also been used with curative intent. A growing body of evidence suggests clear survival benefit, excellent results regarding local tumor control, and improved quality of life. Clinical trials are underway to validate these results. Image-guided transcatheter and ablative approaches currently play an important role in the management of patients with various types of cancer—a role that is likely to grow even more given the technological advances in imaging, image-guidance systems, catheters, ablative tools, and drug delivery systems. As a result, the outcomes of patients with cancer undoubtedly will improve.

VOLUMETRIC FOLLOW-UP OF MENINGIOMAS

Neurosurgery ◽  
2007 ◽  
Vol 61 (2) ◽  
pp. 281-287 ◽  
Author(s):  
Guenther C. Feigl ◽  
Madjid Samii ◽  
Gerhard A. Horstmann
Keyword(s):  
Tumor Volume ◽  
Treatment Options ◽  
Gamma Knife Radiosurgery ◽  
Local Tumor Control ◽  
World Health ◽  
Tumor Control ◽  
Accurate Analysis ◽  
Standardized Protocol ◽  
Health Organization

Abstract OBJECTIVE The most important treatment options for meningiomas are microsurgery, radiotherapy, and gamma knife radiosurgery (GKRS). The efficacy of GKRS in terms of local tumor control and tumor volume (TV) reduction can best be determined by accurate analysis of changes in tumor size in pre- and post-GKRS images. In this prospective study, we set the focus on evaluating TV changes and treatment outcome of meningiomas using a quantitative volumetric follow-up protocol after GKRS. METHODS Consecutive patients with World Health Organization Grade I and II meningiomas were included in this study. Most patients underwent a microsurgical TV reduction before being treated with GKRS. Follow-up examinations were performed according to a standardized protocol and included magnetic resonance imaging and quantitative volumetric tumor analyses as well as thorough neurological examinations. RESULTS Complete follow-up data was available for 211 patients (243 tumors) with a mean age of 57.9 years. TVs ranging from 0.1 to 48.3cm3 were treated with GKRS using prescription doses ranging from 10 to 22 Gy. The achieved overall tumor control rate determined with quantitative TV analyses after GKRS was 93.4%; a mean TV reduction of 42.1% was achieved in 74.5% of all treated patients. CONCLUSION Results of this study show that a quantitative volumetric follow-up study of meningiomas is a useful method to demonstrate the efficacy of GKRS for meningiomas. Statistically significant TV reductions with a low rate of side effects can be achieved with GKRS.

scholarly journals A Prospective Phase II Study Evaluating Intraoperative Electrochemotherapy of Hepatocellular Carcinoma

Cancers ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3778
Author(s):  
Mihajlo Djokic ◽  
Maja Cemazar ◽  
Masa Bosnjak ◽  
Rok Dezman ◽  
David Badovinac ◽  
...  
Keyword(s):  
Clinical Study ◽  
Phase Ii ◽  
Treatment Options ◽  
Progression Free Survival ◽  
Complete Response ◽  
Local Tumor Control ◽  
Tumor Control ◽  
Durable Response ◽  
Phase Ii Clinical Study ◽  
Prospective Phase

The aim of this clinical study was to investigate the effectiveness and long-term safety of electrochemotherapy as an emerging treatment for HCC in patients not suitable for other treatment options. A prospective phase II clinical study was conducted in patients with primary HCC who were not suitable for other treatment options according to the Barcelona Clinic Liver Cancer classification. A total of 24 patients with 32 tumors were treated by electrochemotherapy. The procedure was effective, feasible, and safe with some procedure-related side effects. The responses of the 32 treated nodules were: 84.4% complete response (CR), 12.5% partial response (PR), and 3.1% stable disease (SD). The treatment was equally effective for nodules located centrally and peripherally. Electrochemotherapy provided a durable response with local tumor control over 50 months of observation in 78.0% of nodules. The patient responses were: 79.2% CR and 16.6% PR. The median progression-free survival was 12 months (range 2.7–50), and the overall survival over 5 years of observation was 72.0%. This prospective phase II clinical study showed that electrochemotherapy was an effective, feasible, and safe option for treating HCC in patients not suitable for other treatment options.

scholarly journals Surgical debridement of infected necrobiotic xanthogranuloma: a case report and review of the literature

2020 ◽  
Vol 7 (12) ◽  
pp. 4172
Author(s):  
Jasmine J. Mui ◽  
Martin Jones
Keyword(s):  
Case Report ◽  
Surgical Resection ◽  
Current Literature ◽  
Treatment Options ◽  
Severe Infection ◽  
The Body ◽  
Surgical Debridement ◽  
Memorial Hospital ◽  
Treatment Modalities ◽  
General Surgeon

Necrobiotic xanthogranuloma (NXG) is a rare skin disorder characterized by the development of large violaceous plaques all over the body. Rarely, these plaques become infected and require surgical debridement. The current literature is lacking on outcomes of surgical intervention in this patient population. Hence this case report aims to describe surgical management for a patient with NXG presenting to The Shoalhaven District Memorial Hospital and review the literature on the pathophysiology and current treatment modalities for this condition. A 61-year-old man presented to The Shoalhaven District Memorial Hospital with an infected NXG plaque on his left calf unresponsive to intravenous antibiotics. He has had a previously infected lesion on his right shin debrided by our surgical team in 2015, with plaque recurrence on the superior-medial aspect. His current infection was managed with surgical excision of the necrotic core of the NXG plaque while sparing the healthy surrounding plaque tissue. This is in accordance to the current literature which demonstrates poor cosmetic outcomes with complete surgical resection of healthy plaques, with a 42% recurrence with increased size and nodularity.1, 2 NXG appears to be related to autoimmune monoclonal paraproteinemia and associated with hematological malignancy. Therefore, management is primarily medical with surgical resection only indicated in cases of severe infection. NXG presents a rare challenge to the general surgeon given the lack of evidence for surgical debridement. Understanding the underlying pathophysiology, treatment options and healing patterns in this disorder will allow the surgeon to assess and manage infected lesions with minimal cosmetic disfigurement

Ocular Melanoma

2010 ◽  
Vol 134 (12) ◽  
pp. 1778-1784
Author(s):  
Nora V. Laver ◽  
Margaret E. McLaughlin ◽  
Jay S. Duker
Keyword(s):  
Metastatic Disease ◽  
Needle Aspiration ◽  
Tumor Location ◽  
Local Tumor Control ◽  
Treatment Modalities ◽  
Tumor Control ◽  
The Novel ◽  
Risk Of Death ◽  
Melanocytic Lesions

Abstract Context—Intraocular melanoma of the ciliary body and choroid is the most common primary ocular malignant tumor in adults and the most common noncutaneous melanoma. Objective—To describe the most salient clinical features, histopathologic findings, and treatment modalities of intraocular melanoma, as well as the novel therapies currently being tested. Data Sources—Clinically, it is important to determine which lesions carry a worse prognosis so as to offer patients the best treatment modalities available. Tumor location, size, histopathology, cytogenetic abnormalities, and tumor profiling are all used in determining the risk of death from metastatic disease of uveal melanocytic lesions. Despite successful local tumor control, up to 50% of patients have metastatic disease within 15 years of diagnosis; there is no effective treatment for metastatic disease. Conclusions—Pathologists should be aware of the importance of tumor gross description, cellular histopathology classification, the use of fine-needle aspiration biopsy coupled with cytogenetics, and the new classification of uveal malignant melanomas that is based on chromosome 3 status.

Pathophysiology and First-Line Treatment of Osteoarthritis

2002 ◽  
Vol 36 (4) ◽  
pp. 679-686 ◽  
Author(s):  
Jesse H Hogue ◽  
Tracey L Mersfelder
Keyword(s):  
Data Extraction ◽  
Treatment Options ◽  
Primary Treatment ◽  
Data Sources ◽  
Treatment Modalities ◽  
Comparable Efficacy ◽  
Antiinflammatory Drugs ◽  
Medline Search ◽  
Cox 2 ◽  
Cox 2 Inhibitors

OBJECTIVE: To review the pathophysiology of osteoarthritis (OA) and the various treatment modalities, focusing specifically on acetaminophen (APAP), nonsteroidal antiinflammatory drugs (NSAIDs), and cyclooxygenase-2 (COX-2) inhibitors as the primary treatment options. DATA SOURCES: Primary literature and tertiary references were identified by a MEDLINE search (1966–March 2001) and through other secondary sources. STUDY SELECTION AND DATA EXTRACTION: After evaluating the articles and references identified from the data sources, all the information that was judged relevant by the reviewers was included in the review article. DATA SYNTHESIS: OA is the most common joint disorder worldwide. Current research suggests that factors such as inflammation and changes in subchondral bone may play a larger role in the pathophysiology than previously thought. With this research and the development of COX-2 inhibitors, selecting the medication of choice for OA has become difficult. CONCLUSIONS: More research needs to be done before the pathophysiology of OA can be clearly determined. In the meantime, treatment should be based on clinical data and patient response. Studies have shown that APAP and NSAIDs have comparable efficacy, as do traditional NSAIDs and COX-2 inhibitors. APAP is associated with fewer toxicities than are the traditional NSAIDs. Due to their mechanism of action, the new COX-2 inhibitors should result in fewer adverse effects compared with traditional NSAIDs, but evidence from clinical trials has not been conclusive. Therefore, APAP should still be considered the drug of choice for OA.

Treatment of Female Sexual Dysfunction

2003 ◽  
Vol 37 (4) ◽  
pp. 546-555 ◽  
Author(s):  
Kelly R Ragucci ◽  
Nicole S Culhane
Keyword(s):  
Sexual Dysfunction ◽  
Female Sexual Dysfunction ◽  
Data Extraction ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Individual Characteristics ◽  
Treatment Modalities ◽  
Medline Search ◽  
Sexual Pain ◽  
Arousal Disorder

OBJECTIVE: To review the pathophysiology and psychology of female sexual dysfunction (FSD) and describe potential prevention and treatment strategies for the disorder. DATA SOURCES: Articles identified from a MEDLINE search (1966–June 2002) using the term female sexual dysfunction. Additional references were obtained from cross referencing retrieved articles. STUDY SELECTION AND DATA EXTRACTION: After evaluating various review articles, clinical trials, and investigational studies, all information that was deemed relevant by the reviewers was included. DATA SYNTHESIS: FSD is a multicausal and multidimensional problem combining biological, psychological, and interpersonal factors. The American Foundation for Urological Disease classifies FSD into 4 broad categories: sexual desire disorders, arousal disorder, orgasmic disorder, and sexual pain disorders. Depending on specific individual characteristics and category of disorder, a variety of potential treatments are available. Pharmacists can play a role in identifying and managing medication-related adverse effects that may be exacerbating FSD and educating women on treatment modalities. CONCLUSIONS: FSD is a complicated disorder that is often difficult to identify, classify, and treat appropriately. Pharmacists should have an understanding of the potential causes of FSD and the treatment options available so that they may make appropriate recommendations and counsel women effectively.

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