scholarly journals Therapeutic Advances in Oncology

2021 ◽  
Vol 22 (4) ◽  
pp. 2008
Author(s):  
Jinsha Liu ◽  
Priyanka Pandya ◽  
Sepideh Afshar
Keyword(s):  
Small Molecules ◽  
New Technologies ◽  
Treatment Options ◽  
Current Treatment ◽  
Bispecific Antibodies ◽  
Gene Therapies ◽  
Therapeutic Modalities ◽  
The Past ◽  
Drug Conjugates ◽  
Novel Targets

Around 77 new oncology drugs were approved by the FDA in the past five years; however, most cancers remain untreated. Small molecules and antibodies are dominant therapeutic modalities in oncology. Antibody-drug conjugates, bispecific antibodies, peptides, cell, and gene-therapies are emerging to address the unmet patient need. Advancement in the discovery and development platforms, identification of novel targets, and emergence of new technologies have greatly expanded the treatment options for patients. Here, we provide an overview of various therapeutic modalities and the current treatment options in oncology, and an in-depth discussion of the therapeutics in the preclinical stage for the treatment of breast cancer, lung cancer, and multiple myeloma.

MICROSURGICAL TREATMENT OF SYMPTOMATIC SACRAL PERINEURIAL CYSTS

Neurosurgery ◽  
2007 ◽  
Vol 60 (6) ◽  
pp. 1059-1066 ◽  
Author(s):  
Dongsheng Guo ◽  
Kai Shu ◽  
Rudong Chen ◽  
Changshu Ke ◽  
Yanchang Zhu ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Treatment Options ◽  
Current Treatment ◽  
Cerebrospinal Fluid Leakage ◽  
Local Defect ◽  
Microsurgical Treatment ◽  
The Past ◽  
Return Visits

Abstract OBJECTIVE The aim of this study was to investigate the microsurgical results of symptomatic sacral perineurial cysts of 11 patients and to discuss the treatment options of the past 10 years. METHODS We retrospectively reviewed the records of 11 patients with symptomatic sacral perineurial cysts who underwent microsurgical treatment at Tongji Hospital, Huazhong University of Science and Technology from 1993 through 2006. The philosophy was to perform total or partial cyst wall removal, to imbricate the remaining nerve sheath if possible, and to repair local defect with muscle, Gelfoam (Pharmacia & Upjohn, Kalamazoo, MI), and fibrin glue. Patient outcomes were assessed by comparing the preoperative and postoperative examination results. The average follow-up time obtained from return visits to the neurosurgery clinic or by telephone questionnaires ranged from 2 months to 13 years. A literature search and analysis of current treatment options were performed. RESULTS Nine of the 11 patients (82%) experienced complete or substantial relief of their preoperative symptoms. One patient (Patient 4) experienced worsening of bladder dysfunction after surgery and recovered slowly to subnormal function during the subsequent 2 months. The symptoms of Patient 9 did not resolve, and magnetic resonance imaging showed that the cyst had reoccurred. The patient underwent reoperation 3 months later without any improvement. One patient (Patient 11) experience a cerebrospinal fluid leakage complication. Neither new postoperative neurological defects nor infection were observed in our series. In the literature, there are six different treatment options under debate and controversially discussed. CONCLUSION Microsurgical treatment yielded the best long-term resolution of patient symptoms to date and should be recommended to appropriately selected patients.

scholarly journals Pediatric Nasolacrimal Duct Obstruction

2018 ◽  
Vol 11 (2) ◽  
pp. 87
Author(s):  
Shani Golan ◽  
Gary J Lelli Jr ◽  
◽  
Keyword(s):  
Operative Time ◽  
New Technologies ◽  
Pediatric Population ◽  
Treatment Options ◽  
Nasolacrimal Duct ◽  
Current Treatment ◽  
Nasolacrimal Duct Obstruction ◽  
Craniofacial Anomalies ◽  
Anatomic Variations ◽  
Duct Obstruction

Nasolacrimal duct obstruction (NLDO) is common in the pediatric population and presents as persistent epiphora, recurrent conjunctivitis, crusting of the eyelids, and occasionally dacryocystits. It is typically congenital and occurs at the level of the valve of Hasner. Treatment options for pediatric NLDO include non-surgical and surgical procedures. Treatment may be carried out either in-office or in the operating room. In this review, we discuss the pathogenesis of pediatric NLDO and provide an update on current treatment options, including medical management with massage, which remains highly successful, and surgery, which may be warranted in children over the age of 3 years, those with anatomic variations and craniofacial anomalies, patients unresponsive to medical therapy and probing, and patients with acquired NLDO. In addition, we explore the benefits of new technologies and endoscopic approaches, including shorter operative time and no scarring, as well as the ability to perform bilateral procedures and simultaneously address any additional intranasal pathology.

What Is the Best Strategy for Incorporating New Agents into the Current Treatment of Follicular Lymphoma?

2012 ◽  
pp. 481-487
Author(s):  
Sonali M. Smith
Keyword(s):  
Follicular Lymphoma ◽  
Target Identification ◽  
Treatment Options ◽  
Current Treatment ◽  
Tumor Burden ◽  
Conceptual Approach ◽  
New Agents ◽  
Drug Conjugates ◽  
Resistant Disease ◽  
Treatment Naïve

Overview: Although there is increasing knowledge about the pathobiology of follicular lymphoma (FL), the incorporation of new agents is challenged by the long clinical course and inherent heterogeneity of the disease. Furthermore, a longstanding concept in FL is that although most patients have an indolent initial phase of disease, this is typically followed by sequentially shorter remission durations and justifies the continued intense search for new rationally designed agents. Ideally, there would be personalized prognostic tools, preemptive target identification, and means to predict response in individual patients. Short of having these tools, one conceptual approach is to consider FL as a series of clinical disease states divided between treatment-naïve (low tumor burden and high tumor burden), relapsed (typically still chemoimmunotherapy-sensitive), and multiply relapsed (usually chemoimmunotherapy-resistant) disease. By applying what is known about the biology of FL along with the available agents, new treatment options can be better defined and tested within these clinical contexts. During the last few years, novel chemotherapeutics, biologic agents, monoclonal antibodies, antibody drug conjugates, and maintenance strategies are all either replacing or adding onto existing strategies. These new agents and approaches challenge the notion of inevitably shorter response durations, and offer hope of improved clinical outcomes compared with traditional sequential cytotoxic therapy.

scholarly journals Current Treatment Options for Intervertebral Disc Pathologies

Cartilage ◽  
2020 ◽  
Vol 11 (2) ◽  
pp. 143-151 ◽  
Author(s):  
Stephen M. Eisenstein ◽  
Birender Balain ◽  
Sally Roberts
Keyword(s):  
Intervertebral Disc ◽  
Annulus Fibrosus ◽  
Clinical Symptoms ◽  
Treatment Options ◽  
Complex Structure ◽  
Current Treatment ◽  
Central Nucleus ◽  
Cartilage Endplate ◽  
The Past ◽  
Research World

The complex structure of the intervertebral disc within the spine is well suited to its mechanical function. However, it is also prone to degeneration, which is associated with various clinical symptoms and conditions, ranging from disc herniation to back pain to spinal stenosis. Most patients’ conditions are managed conservatively but a small proportion progress to having surgery. This may be decompression (to remove tissue such as the disc, bone, or hypertrophic ligaments impinging on nerves) or fusion of the normally mobile intervertebral joint to immobilize it and so reduce pain. These used to involve fairly major surgical procedures, but in the past decade there has been much progress to make the surgery more refined and less invasive, for example using endoscopic approaches. Simultaneously, the research world has been studying and developing tissue engineering and cellular techniques for attempting to regenerate the intervertebral disc, whether simply the central nucleus pulposus or a complete intricate assembly to replicate the native structure of this and the surrounding annulus fibrosus, cartilage endplate, and bone. To date, none of the complex entities have been trialed, while cellular approaches are easier to utilize, have progressed to clinical trials, and may offer a better solution.

scholarly journals Evolving AAV-delivered therapeutics towards ultimate cures

2021 ◽  
Author(s):  
Xiangjun He ◽  
Brian Anugerah Urip ◽  
Zhenjie Zhang ◽  
Chun Christopher Ngan ◽  
Bo Feng
Keyword(s):  
Gene Therapy ◽  
Gene Editing ◽  
Treatment Options ◽  
Genetic Diseases ◽  
The United States ◽  
European Medicines Agency ◽  
Gene Therapies ◽  
Therapeutic Modalities ◽  
United States Food

AbstractGene therapy has entered a new era after decades-long efforts, where the recombinant adeno-associated virus (AAV) has stood out as the most potent vector for in vivo gene transfer and demonstrated excellent efficacy and safety profiles in numerous preclinical and clinical studies. Since the first AAV-derived therapeutics Glybera was approved by the European Medicines Agency (EMA) in 2012, there is an increasing number of AAV-based gene augmentation therapies that have been developed and tested for treating incurable genetic diseases. In the subsequent years, the United States Food and Drug Administration (FDA) approved two additional AAV gene therapy products, Luxturna and Zolgensma, to be launched into the market. Recent breakthroughs in genome editing tools and the combined use with AAV vectors have introduced new therapeutic modalities using somatic gene editing strategies. The promising outcomes from preclinical studies have prompted the continuous evolution of AAV-delivered therapeutics and broadened the scope of treatment options for untreatable diseases. Here, we describe the clinical updates of AAV gene therapies and the latest development using AAV to deliver the CRISPR components as gene editing therapeutics. We also discuss the major challenges and safety concerns associated with AAV delivery and CRISPR therapeutics, and highlight the recent achievement and toxicity issues reported from clinical applications.

scholarly journals Latest advances in the management of classical Hodgkin lymphoma: the era of novel therapies

2021 ◽  
Vol 11 (7) ◽  
Author(s):  
Razan Mohty ◽  
Rémy Dulery ◽  
Abdul Hamid Bazarbachi ◽  
Malvi Savani ◽  
Rama Al Hamed ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Treatment Options ◽  
Complete Response ◽  
Current Treatment ◽  
Novel Therapies ◽  
Classical Hodgkin Lymphoma ◽  
Hematopoietic Stem ◽  
Drug Conjugates ◽  
Check Point Inhibitors ◽  
Frontline Therapy

AbstractHodgkin lymphoma is a highly curable disease. Although most patients achieve complete response following frontline therapy, key unmet clinical needs remain including relapsed/refractory disease, treatment-related morbidity, impaired quality of life and poor outcome in patients older than 60 years. The incorporation of novel therapies, including check point inhibitors and antibody–drug conjugates, into the frontline setting, sequential approaches, and further individualized treatment intensity may address these needs. We summarize the current treatment options for patients with classical Hodgkin lymphoma from frontline therapy to allogeneic hematopoietic stem cell transplantation and describe novel trials in the field.

scholarly journals Changing Paradigms in the Treatment of Advanced Urothelial Carcinoma: A 2020 Update

EMJ Oncology ◽  
2020 ◽  
Keyword(s):  
Targeted Therapies ◽  
Treatment Options ◽  
Growth Factor Receptor ◽  
Standard Of Care ◽  
The Past ◽  
Drug Conjugates ◽  
Regulatory Status ◽  
Platinum Based Chemotherapy ◽  
Treatment Paradigm ◽  
Advanced Urothelial Carcinoma

Advanced urothelial cancer (aUC) is invariably lethal and standard of care, platinum-based chemotherapy has changed little over the past 25 years. However, the past 5 years have been transformational with the advent of immunotherapies and targeted therapies. In this review, the authors focus on the therapies that are showing the greatest promise and have changed, or will imminently impact, the treatment landscape of aUC. Checkpoint inhibition is showing deep and durable responses in some patients and trial activity is concentrated on identifying the most suitable position within the treatment paradigm along with the most appropriate patients and therapeutic combinations. Novel targeted therapies in aUC are gaining renewed interest with nectin-4 antibody drug conjugates and fibroblast growth factor receptor inhibitors, both receiving recent regulatory approvals. Bispecific antibodies, capable of binding to two targets at the same time, are also showing promise. This review discusses the preclinical data, the relevant past, and present clinical trials along with regulatory status to provide a concise overview of the current and impending treatment options for aUC.

scholarly journals Microplate-Based Assay for Identifying Small Molecules That Bind a Specific Intersubunit Interface within the Assembled HIV-1 Capsid

2015 ◽  
Vol 59 (9) ◽  
pp. 5190-5195 ◽  
Author(s):  
Upul D. Halambage ◽  
Jason P. Wong ◽  
Bruce J. Melancon ◽  
Craig W. Lindsley ◽  
Christopher Aiken
Keyword(s):  
Small Molecules ◽  
Signal To Noise Ratio ◽  
Treatment Options ◽  
Current Treatment ◽  
Biologically Active ◽  
Current Therapy ◽  
Chemical Library ◽  
Compound Libraries ◽  
Therapeutic Development ◽  
Hiv 1

ABSTRACTDespite the availability of >30 effective drugs for managing HIV-1 infection, no current therapy is curative, and long-term management is challenging owing to the emergence and spread of drug-resistant mutants. Identification of drugs against novel HIV-1 targets would expand the current treatment options and help to control resistance. The highly conserved HIV-1 capsid protein represents an attractive target because of its multiple roles in replication of the virus. However, the low antiviral potencies of the reported HIV-1 capsid–targeting inhibitors render them unattractive for therapeutic development. To facilitate the identification of more-potent HIV-1 capsid inhibitors, we developed a scintillation proximity assay to screen for small molecules that target a biologically active and specific intersubunit interface in the HIV-1 capsid. The assay, which is based on competitive displacement of a known capsid-binding small-molecule inhibitor, exhibited a signal-to-noise ratio of >9 and a Z factor of >0.8. In a pilot screen of a chemical library containing 2,400 druglike compounds, we obtained a hit rate of 1.8%. This assay has properties that are suitable for screening large compound libraries to identify novel HIV-1 capsid ligands with antiviral activity.

scholarly journals Biomarker-guided treatment strategies for ovarian cancer identified from a heterogeneous panel of patient-derived tumor xenografts

2020 ◽  
Author(s):  
Adam C. Palmer ◽  
Deborah Plana ◽  
Hui Gao ◽  
Joshua M Korn ◽  
Guizhi Yang ◽  
...  
Keyword(s):  
Gene Expression ◽  
Ovarian Cancer ◽  
Small Molecules ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Standard Of Care ◽  
High Rate ◽  
Expression Data ◽  
Drug Conjugates ◽  
Heterogeneous Panel

ABSTRACTAdvanced ovarian cancers are a leading cause of cancer-related death in women. Such cancers are currently treated with surgery and chemotherapy which is often temporarily successful but exhibits a high rate of relapse after which treatment options are few. Here we assess the responses of a panel of patient-derived ovarian cancer xenografts (PDXs) to 19 mono and combination therapies, including small molecules and antibody-drug conjugates. The PDX panel aimed to mimic the heterogeneity of disease observed in patients, and exhibited a distribution of responsiveness to standard of care chemotherapy similar to human clinical data. Three monotherapies and one drug combination were found to be active in different subsets of PDXs. By analyzing gene expression data we identified gene expression biomarkers predictive of responsiveness to each of three novel targeted therapy regimens. While no single treatment had as high a response rate as chemotherapy, nearly 90% of PDXs were eligible for and responded to at least one biomarker-guided treatment, including tumors resistant to standard chemotherapy. Biomarker frequency was similar in human patients, suggesting the possibility of a new therapeutic approach to ovarian cancer and demonstrating the potential power of PDX-based trials in broadening the reach of precision cancer medicine.

scholarly journals Update on biology and management of mesothelioma

2021 ◽  
Vol 30 (159) ◽  
pp. 200226
Author(s):  
Rachelle Asciak ◽  
Vineeth George ◽  
Najiib M. Rahman
Keyword(s):  
Asbestos Exposure ◽  
Treatment Options ◽  
Gene Mutations ◽  
Current Treatment ◽  
Pleural Mesothelioma ◽  
Incurable Cancer ◽  
The Past ◽  
Current State ◽  
New Treatment

Malignant pleural mesothelioma is an aggressive, incurable cancer that is usually caused by asbestos exposure several decades before symptoms arise. Despite widespread prohibition of asbestos production and supply, its incidence continues to increase. It is heterogeneous in its presentation and behaviour, and diagnosis can be notoriously difficult. Identification of actionable gene mutations has proven challenging and current treatment options are largely ineffective, with a median survival of 10–12 months.However, the past few years have witnessed major advances in our understanding of the biology and pathogenesis of mesothelioma. This has also revealed the limitations of existing diagnostic algorithms and identified new treatment targets.Recent clinical trials have re-examined the role of surgery, provided new options for the management of associated pleural effusions and heralded the addition of targeted therapies. The increasing complexity of mesothelioma management, along with a desperate need for further research, means that a multidisciplinary team framework is essential for the delivery of contemporary mesothelioma care.This review provides a synthesised overview of the current state of knowledge and an update on the latest research in the field.

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