1,721,244 research outputs found
Liquid biopsy and blood-based minimal residual disease evaluation in multiple myeloma
Full text linkNovel drug availability has increased the depth of response and revolutionised the outcomes of multiple myeloma patients. Minimal residual disease evaluation is a surrogate for progression-free survival and overall survival and has become widely used not-only in clinical trials but also in daily patient management. Bone marrow aspiration is the gold standard for response evaluation, but due to the patchy nature of myeloma, false negatives are possible. Liquid biopsy and blood-based minimal residual disease evaluation consider circulating plasma cells, mass spectrometry or circulating tumour DNA. This approach is less invasive, can provide a more comprehensive picture of the disease and could become the future of response evaluation in multiple myeloma patients
Minimal residual disease in multiple myeloma: an important tool in clinical trials
No full text: Minimal residual disease (MRD) detection represents a great advancement in multiple myeloma. New drugs are now available that increase depth of response. The International Myeloma Working Group recommends the use of next-generation flow cytometry (NGF) or next-generation sequencing (NGS) to search for MRD in clinical trials. Best sensitivity thresholds have to be confirmed, as well as timing to detect it. MRD has proven as the best prognosticator in many trials and promises to enter also in clinical practice to guide future therapy. © 2022 Bentham Science Publishers
Emerging drugs in chronic myelogenous leukaemia
No full textChronic myelogenous leukaemia (CML) is characterised by a t(9;22)(q34;q11) translocation, which produces a fusion BCR-ABL protein with constitutive tyrosine kinase activity that is central to the pathogenesis of CML representing an ideal target for therapeutic intervention. Targeting BCR-ABL by imatinib has revolutionised the clinical course of CML. All patients in early chronic phase treated with imatinib achieve a complete haematological response, with 80-90% achieving a complete cytogenetic response. However, BCR-ABL transcripts remain detectable in the great majority of them, and approximately 16% chronic phase CML patients are resistant to or relapse after imatinib treatment, mainly through pre-existing or acquired point mutations in the binding pocket. Thus, other targeted approaches are being developed to overcome imatinib resistance. These include two novel tyrosine kinase inhibitors (nilotinib and dasatinib) that are producing clinical responses in different clinical settings, while other similar compounds are under evaluation in preclinical studies. Furthermore, additive immunotherapeutic strategies are emerging to synergise with imatinib in the elimination of molecular residual disease. This paper reviews the current details regarding these approaches and their developments
Nivolumab in relapsed/refractory Hodgkin lymphoma: towards a new treatment strategy?
Full text linkChemo-refractory Hodgkin lymphoma (HL), especially after failure of high-dose therapy and autologous stem cell transplantation (ASCT), has a very poor prognosis. Nivolumab, an anti-PD-1 monoclonal antibody, demonstrated durable responses and manageable toxicity in a significant proportion of HL patients who fail both ASCT and brentuximab vedotin. Although anti-PD-1 treatment is often well tolerated, immune-related adverse events (iAE) were frequently observed. New perspectives could be represented by treatment discontinuation in patients with prolonged response or toxicity with the possibility of a re-treatment at relapse, subsequent chemotherapy or a modification of the dose-intensity or treatment duration. The efficacy of anti-PD-1 re-treatment was demonstrated in several cases and we have successfully managed 1 case with this strategy. With the main aim of avoiding the relapse-related psychophysical stress for the patient with manageable toxicity, we have successfully administered nivolumab every 4 weeks to 3 patients in prolonged complete remission, who presented with iAE during treatment. We believe that nivolumab should not only represent a bridge to allogeneic SCT, but it may play an important role also beyond the approved indication and current standard clinical care
Lenalidomide maintenance in myeloma
No full textWe strongly agree with Rajkumar
(Haematological cancer: Lenalidomide
maintenance—perils of a premature
denouement. Nat. Rev. Clin. Oncol. 9,
372–374; 2012)1 that it is premature to
recommend lenalidomide maintenance
to all patients with myeloma, but we would
also like to underline other aspects of
the problem not discussed in the recent
commentary article.
It is our assertion that not every patient
with myeloma needs maintenance therapy.
In addition to considering the risk–benefit
ratio for a patient during maintenance
therapy, we are convinced that the wellknown
concept of disease plateau—which
was established decades before the novelagent
era in myeloma2—is also applicable
in the setting of maintenance ther apy.
Furthermore, a small percentage of patients
(15%, but this could improve with novel
agents used in the pre- transplant setting)
after autologous stem-cell transplantation
(ASCT) achieve disease-free survival or
progression-free survival of longer than
10 years.3 For those patients, any maintenance
therapy is useless or, even worse,
harmful
La prevenzione della nausea e del vomito nel paziente ematologico con i 5-HT3 antagonisti.
No full text
- …
