scholarly journals Adjuvant Treatment in Pancreatic Cancer: Shaping the Future of the Curative Setting

2021 ◽  
Vol 11 ◽  
Author(s):  
Annalisa Pappalardo ◽  
Emilio Francesco Giunta ◽  
Giuseppe Tirino ◽  
Luca Pompella ◽  
Piera Federico ◽  
...  
Keyword(s):  
Early Stage ◽  
Current Treatment ◽  
Point Of View ◽  
Ductal Adenocarcinoma ◽  
Adjuvant Setting ◽  
Therapeutic Approaches ◽  
Treatment Scenario ◽  
Clinical Point ◽  
Localized Disease

Pancreatic ductal adenocarcinoma (PDAC) is a lethal disease even in the early stages, despite progresses in surgical and pharmacological treatment in recent years. High potential for metastases is the main cause of therapeutic failure in localized disease, highlighting the current limited knowledge of underlying pathological processes. However, nowadays research is focusing on the search for personalized approaches also in the adjuvant setting for PDAC, by implementing the use of biomarkers and investigating new therapeutic targets. In this context, the aim of this narrative review is to summarize the current treatment scenario and new potential therapeutic approaches in early stage PDAC, from both a preclinical and clinical point of view. Additionally, the review examines the role of target therapies in localized PDAC and the influence of neoadjuvant treatments on survival outcomes.

scholarly journals The Emerging Role of Microbiota and Microbiome in Pancreatic Ductal Adenocarcinoma

Biomedicines ◽  
2020 ◽  
Vol 8 (12) ◽  
pp. 565
Author(s):  
Sona Ciernikova ◽  
Maria Novisedlakova ◽  
Danka Cholujova ◽  
Viola Stevurkova ◽  
Michal Mego
Keyword(s):  
Pancreatic Ductal Adenocarcinoma ◽  
Malignant Tumors ◽  
Current Knowledge ◽  
Early Stage ◽  
Poor Response ◽  
Response To Therapy ◽  
Oral Microbiome ◽  
Ductal Adenocarcinoma ◽  
The Impact

Pancreatic ductal adenocarcinoma (PDAC) is one of the most aggressive malignant tumors due to the absence of biomarkers for early-stage detection and poor response to therapy. Since mounting evidence supports the role of microbiota composition in tumorigenesis and cancer treatment, the link between microbiome and PDAC has been described. In this review, we summarize the current knowledge regarding the impact of the gut and oral microbiome on the risk of PDAC development. Microenvironment-driven therapy and immune system interactions are also discussed. More importantly, we provide an overview of the clinical trials evaluating the microbiota role in the risk, prognosis, and treatment of patients suffering from PDAC and solid tumors. According to the research findings, immune tolerance might result from the microbiota-derived remodeling of pancreatic tumor microenvironment. Thus, microbiome profiling and targeting represent the potential trend to enhance antitumor immunity and improve the efficacy of PDAC treatment.

scholarly journals Current and Future Role of Tyrosine Kinases Inhibition in Thyroid Cancer: From Biology to Therapy

2020 ◽  
Vol 21 (14) ◽  
pp. 4951
Author(s):  
María San Román Gil ◽  
Javier Pozas ◽  
Javier Molina-Cerrillo ◽  
Joaquín Gómez ◽  
Héctor Pian ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Tyrosine Kinases ◽  
Genetic Alterations ◽  
Point Of View ◽  
Adequate Treatment ◽  
Comprehensive Review ◽  
Tumor Characterization ◽  
Therapeutic Algorithm ◽  
Clinical Point

Thyroid cancer represents a heterogenous disease whose incidence has increased in the last decades. Although three main different subtypes have been described, molecular characterization is progressively being included in the diagnostic and therapeutic algorithm of these patients. In fact, thyroid cancer is a landmark in the oncological approach to solid tumors as it harbors key genetic alterations driving tumor progression that have been demonstrated to be potential actionable targets. Within this promising and rapid changing scenario, current efforts are directed to improve tumor characterization for an accurate guidance in the therapeutic management. In this sense, it is strongly recommended to perform tissue genotyping to patients that are going to be considered for systemic therapy in order to select the adequate treatment, according to recent clinical trials data. Overall, the aim of this article is to provide a comprehensive review on the molecular biology of thyroid cancer focusing on the key role of tyrosine kinases. Additionally, from a clinical point of view, we provide a thorough perspective, current and future, in the treatment landscape of this tumor.

Current Controversies in the Stage-Specific Multidisciplinary Management of Pancreatic Cancer

2014 ◽  
pp. e157-e164 ◽  
Author(s):  
Matthew H. G. Katz ◽  
Jerome Landry ◽  
Hedy Lee Kindler
Keyword(s):  
Pancreatic Cancer ◽  
Systemic Chemotherapy ◽  
Metastatic Cancer ◽  
Clinical Staging ◽  
Newly Diagnosed ◽  
Therapeutic Approaches ◽  
Treatment Regimens ◽  
Localized Disease ◽  
New Strategies

Encouraging therapeutic approaches and treatment regimens for patients with both localized and metastatic pancreatic cancer have emerged over the last 5 years. However, these new strategies have brought important challenges and controversy. Clinical staging criteria are constantly evolving. No system has been uniformly adopted, limiting our understanding of the role of both pancreatectomy and neoadjuvant therapies for localized disease. The role of radiation therapy for the treatment of both resectable and unresectable pancreatic cancer remains unclear despite multiple prospective studies. Although two new systemic chemotherapy regimens have essentially transformed the care of many patients with metastatic cancer, criteria to guide their use in the general population have yet to be clearly established. Herein we provide an overview of these important controversies in the context of a broad update on the stage-specific management of patients with newly diagnosed pancreatic cancer.

scholarly journals Role of MicroRNAs in Renin-Angiotensin-Aldosterone System-Mediated Cardiovascular Inflammation and Remodeling

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Maricica Pacurari ◽  
Paul B. Tchounwou
Keyword(s):  
Gene Expression ◽  
Cardiovascular Disease ◽  
Early Stage ◽  
Inflammatory Factors ◽  
Therapeutic Approaches ◽  
Exact Role ◽  
Renin Angiotensin Aldosterone System ◽  
Renin Angiotensin ◽  
Endogenous Regulators

MicroRNAs are endogenous regulators of gene expression either by inhibiting translation or protein degradation. Recent studies indicate that microRNAs play a role in cardiovascular disease and renin-angiotensin-aldosterone system- (RAAS-) mediated cardiovascular inflammation, either as mediators or being targeted by RAAS pharmacological inhibitors. The exact role(s) of microRNAs in RAAS-mediated cardiovascular inflammation and remodeling is/are still in early stage of investigation. However, few microRNAs have been shown to play a role in RAAS signaling, particularly miR-155, miR-146a/b, miR-132/122, and miR-483-3p. Identification of specific microRNAs and their targets and elucidating microRNA-regulated mechanisms associated RAS-mediated cardiovascular inflammation and remodeling might lead to the development of novel pharmacological strategies to target RAAS-mediated vascular pathologies. This paper reviews microRNAs role in inflammatory factors mediating cardiovascular inflammation and RAAS genes and the effect of RAAS pharmacological inhibition on microRNAs and the resolution of RAAS-mediated cardiovascular inflammation and remodeling. Also, this paper discusses the advances on microRNAs-based therapeutic approaches that may be important in targeting RAAS signaling.

scholarly journals Understanding the accelerator from resources-based perspective

2018 ◽  
Vol 12 (3) ◽  
pp. 258-278 ◽  
Author(s):  
Chul Hyun Uhm ◽  
Chang Soo Sung ◽  
Joo Yeon Park
Keyword(s):  
Early Stage ◽  
Point Of View ◽  
Success Rates ◽  
Access To Resources ◽  
Content Type ◽  
Study Approach ◽  
Start Up ◽  
The Usa ◽  
Start Ups

Purpose This study aims to explore Accelerators and their practices in sustaining start-ups within their innovative programs for these companies based on the resource-based perspective. Moreover, with an ever-increasing demand for Accelerators amongst start-up companies, this study also demonstrates the importance of Accelerators, as it pertains to new venture creation. Design/methodology/approach This research uses an exploratory case study approach to examine a comparative view of leading Accelerator companies in the USA and Korea based on resource support. Findings The results of this study show that there are a number of differences between Accelerators of the two countries in terms of the resources they support for early-stage start-ups. The findings also show some similarities. However, in Korea, the Accelerator landscape is limited, where mentorship, resources and investments are not readily accessible, resulting in low success rates for Korean start-up companies. These limitations have had a negative trickle-down effect when providing entrepreneurs with strong access to resources and investors, which highly affects the success rates of early-stage start-ups. Practical implications In terms of the resource-based theory, this study contributes to the growth of early start-ups by emphasizing the role of the accelerator and suggesting the extent and impact that entrepreneurs have access to resources and investors. Originality/value With significant growth in start-ups around the world, the necessity for start-up funding and mentorship has increased drastically. Start-up companies need various types of assets, systems, knowledge and information to achieve their goals. In Accelerators, start-ups receive all the aforementioned resources while also improving their entrepreneurial skills. Start-up companies have many options in seeking investors who support both tangible and intangible resources to boost growth. While there is a wealth of information on traditional funding methods, there are few studies that shed light on the role of Accelerators from the resource-based point of view.

Interview With Francine Shapiro: Historical Overview, Present Issues, and Future Directions of EMDR

2009 ◽  
Vol 3 (4) ◽  
pp. 217-231 ◽  
Author(s):  
Marilyn Luber ◽  
Francine Shapiro
Keyword(s):  
Crisis Intervention ◽  
Somatoform Disorders ◽  
Current Treatment ◽  
Clinical Development ◽  
Historical Overview ◽  
Therapeutic Approaches ◽  
Future Directions ◽  
Wide Range ◽  
Distinct Features

This interview with Dr. Francine Shapiro, originator and developer of Eye Movement Desensitization and Reprocessing (EMDR), provides an overview of the history and evolution of EMDR from its inception to current findings and utilization, as well as future directions in research and clinical development. Dr. Shapiro discusses the psychological traditions that informed the development of EMDR and the Adaptive Information model, as well as the implications for current treatment. The rationale for the application of EMDR to a wide range of disorders is discussed, as well as its integration with other therapeutic approaches. Topics include research on the role of eye movements, the use of EMDR with combat veterans, somatoform disorders, attachment issues, and the distinct features of EMDR that have allowed it to be used for crisis intervention worldwide.

scholarly journals Prospects for using agonists and antagonists of P2 receptors in clinical ophthalmology

2012 ◽  
Vol 93 (3) ◽  
pp. 508-512 ◽  
Author(s):  
A P Ziganshina ◽  
B A Ziganshin ◽  
A N Samoilov ◽  
A U Ziganshin
Keyword(s):  
P2 Receptors ◽  
Point Of View ◽  
Physiological Processes ◽  
Age Related ◽  
Corneal Wound ◽  
Clinical Point ◽  
Fluid Production ◽  
Neuronal Transmission ◽  
Stimulation Of

This literature review focuses on the role of purinergic P2-receptors in the physiology and pathophysiology of the eye, as well as on the possibilities of pharmacologic stimulation of these receptors. The most important studies from the clinical point of view on the involvement of purinergic neuronal transmission in the physiological processes have been analyzed, ranging from normal embryogenesis to cell apoptosis in age-related degenerative diseases of the eye. Data on the effect of agonists and antagonists of P2 receptors on corneal wound healing, lacrimal fluid production, regulation of intraocular pressure, neurotransmission, proliferation of glial tissue in the retina has been presented along with data on the possibilities of modulating these processes by using potential drugs acting via P2 receptors.

scholarly journals Heart failure and senile asthenia syndrome

2018 ◽  
pp. 72-79
Author(s):  
Yu. V. Kotovskaya ◽  
A. V. Rozanov ◽  
D. H. Kurashev ◽  
O. N. Tkacheva
Keyword(s):  
Heart Failure ◽  
Treatment Adherence ◽  
Point Of View ◽  
Geriatric Syndromes ◽  
Patients With Heart Failure ◽  
Clinical Point ◽  
Physiological Reserve ◽  
Reduced Mobility ◽  
Emergency Hospitalization

The role of specific approaches to the management of patients with heart failure (HF) increases steeply with increasing age, as the patients of this age need attention to geriatric problems: reduced mobility, multiple diseases and cognitive impairment. Senile asthenia is a syndrome that reflects a decline in physiological reserve and increased vulnerability to various stressors. Senile asthenia is detected in 15–74% of patients with heart failure, the prevalence depends on the method of diagnosis and the studied population. This review discusses the effects of senile asthenia, comorbidity and geriatric syndromes on diagnosis, treatment, and outcomes in elderly patients with heart failure. The detection of senile asthenia in patients with HF is important from a clinical point of view, since this condition has an adverse effect on the course of heart failure and is associated with a higher incidence of emergency hospitalization and mortality. Bodily exercises can improve mobility, and the introduction of nursing observation can enhance treatment adherence among patients.

scholarly journals Tumor Microenvironment Features and Chemoresistance in Pancreatic Ductal Adenocarcinoma: Insights into Targeting Physicochemical Barriers and Metabolism as Therapeutic Approaches

Cancers ◽  
2021 ◽  
Vol 13 (23) ◽  
pp. 6135
Author(s):  
Tiago M. A. Carvalho ◽  
Daria Di Molfetta ◽  
Maria Raffaella Greco ◽  
Tomas Koltai ◽  
Khalid O. Alfarouk ◽  
...  
Keyword(s):  
Gene Mutations ◽  
Response To Therapy ◽  
Ductal Adenocarcinoma ◽  
Therapeutic Approaches ◽  
Stromal Compartment ◽  
Multiple Gene ◽  
New Concepts ◽  
Acidic Extracellular Ph ◽  
Desmoplastic Stroma

Currently, the median overall survival of PDAC patients rarely exceeds 1 year and has an overall 5-year survival rate of about 9%. These numbers are anticipated to worsen in the future due to the lack of understanding of the factors involved in its strong chemoresistance. Chemotherapy remains the only treatment option for most PDAC patients; however, the available therapeutic strategies are insufficient. The factors involved in chemoresistance include the development of a desmoplastic stroma which reprograms cellular metabolism, and both contribute to an impaired response to therapy. PDAC stroma is composed of immune cells, endothelial cells, and cancer-associated fibroblasts embedded in a prominent, dense extracellular matrix associated with areas of hypoxia and acidic extracellular pH. While multiple gene mutations are involved in PDAC initiation, this desmoplastic stroma plays an important role in driving progression, metastasis, and chemoresistance. Elucidating the mechanisms underlying PDAC resistance are a prerequisite for designing novel approaches to increase patient survival. In this review, we provide an overview of the stromal features and how they contribute to the chemoresistance in PDAC treatment. By highlighting new paradigms in the role of the stromal compartment in PDAC therapy, we hope to stimulate new concepts aimed at improving patient outcomes.

scholarly journals From Biomarkers to Models in the Changing Landscape of Chronic Lymphocytic Leukemia: Evolve or Become Extinct

Cancers ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1782
Author(s):  
Isabel González-Gascón-y-Marín ◽  
Carolina Muñoz-Novas ◽  
Ana-Eugenia Rodríguez-Vicente ◽  
Miguel Quijada-Álamo ◽  
María Hernández-Sánchez ◽  
...  
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
Early Stage ◽  
Predictive Biomarkers ◽  
Scoring Systems ◽  
Point Of View ◽  
Lymphocytic Leukemia ◽  
Prognostic Models ◽  
Resistance Mutations ◽  
Mutational Status

Chronic lymphocytic leukemia (CLL) is an extremely heterogeneous disease. With the advent of oral targeted agents (Tas) the treatment of CLL has undergone a revolution, which has been accompanied by an improvement in patient’s survival and quality of life. This paradigm shift also affects the value of prognostic and predictive biomarkers and prognostic models, most of them inherited from the chemoimmunotherapy era but with a different behavior with Tas. This review discusses: (i) the role of the most relevant prognostic and predictive biomarkers in the setting of Tas; and (ii) the validity of classic and new scoring systems in the context of Tas. In addition, a critical point of view about predictive biomarkers with special emphasis on 11q deletion, novel resistance mutations, TP53 abnormalities, IGHV mutational status, complex karyotype and NOTCH1 mutations is stated. We also go over prognostic models in early stage CLL such as IPS-E. Finally, we provide an overview of the applicability of the CLL-IPI for patients treated with Tas, as well as the emergence of new models, generated with data from patients treated with Tas.

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