1,721,476 research outputs found
Investigational drugs for head and neck cancer
No full textIntroduction: In the treatment of advanced/metastatic head and neck cancer ( HNC), resistance to chemotherapy and to anti-EGFR agents remains a major issue, and new molecular drugs are eagerly awaited. Over the last decade, knowledge of the genetic landscape of HNC has rapidly grown. However, no tailored therapeutic intervention targeting HNC molecular abnormalities is currently available outside from clinical trials. Areas covered: In this review, the authors analyze new drugs in the HNC setting which have been investigated in recently published trials or are currently being investigated. The article excludes strategies directed towards the EGFR pathway and antivascular agents. Expert opinion: Agents acting on the PI3K axis have a strong biological rationale and show the preliminary signs of activity, in particular when combined with other agents. There is limited clinical data of the other discussed pathways; the CMET/HGF pathway as a possible modulator of anti-EGFR drug sensitivity and agents directed towards MEK, WEE-1, NOTCH represent new interesting approaches to HNC. It is of the utmost importance to try and incorporate the molecular dissection of the tumor profiles in clinical trials with such agents. Moreover, the mutational status of other cross-talking pathways should be assessed, since potential resistance mechanisms can be recognized and possibly overcome by a careful selection of patients and combination regimens. Immunotherapy represents a growing field in HNC and its wider application will impact on future therapeutic strategies, including the association with chemotherapy, targeted agents and radiation
Treatment of cutaneous squamous cell carcinoma with immune checkpoint inhibitors in special populations
Full text linkCutaneous squamous cell carcinoma (cSCC) may develop in patients with dysregulated immune activation (pre-existing autoimmune diseases or immunosuppression due to hematopoietic/solid organ transplant recipients), patients with a compromised immune function (long-term immunosuppression), and patients carrying chronic viral infections, or those affected by lymphoproliferative diseases. It should be also considered that patients presenting with immunosuppression have a high incidence of cSCC (65-250-times higher than general population), highlighting the central role played by the immune system in the development of cSCC. All these cases must be considered as "special populations" for treatment with immune checkpoint inhibitors (ICIs), as the safety and activity of these drugs have not been studied on these specific cases, since these patients were excluded from clinical trials leading to approval of ICIs. It is therefore important to gain as much information as possible from the analysis of real-life data, to derive an indication to be adopted in everyday clinical setting. Moreover, therapeutic alternatives other than ICIs are scarce, mainly consisting in chemotherapy and anti-EGFR agents, whose activity is lower than immunotherapy and whose toxicity (particularly with chemotherapy) are not sustainable by this frail population. Here, we describe the current evidence of treatment with ICIs in special populations and conclude that it is necessary to find a balance between treatment risks (toxicities) and benefits (efficacy), as well as engaging a multidisciplinary team of experts to thoroughly manage and treat these patients
The Benefit of a Multidisciplinary Approach to the Patient Treated with (Chemo) Radiation for Head and Neck Cancer
No full textIn the past two decades, multidisciplinary care has emerged as new way to manage cancer given the need to gather together specific areas of expertise and to discuss the variety of treatment approaches available for each patient. Of all the cancer subtypes, head and neck cancer might be considered one of the most valid areas, from an oncological point of view, for a multidisciplinary approach to be applied. Head and Neck Cancer is a complex disease area due to its varied histology and subsites, its numerous feasible treatments, its multiple typical comorbidities, and its treatment-induced toxicities whose management requires the simultaneous involvement of several professionals as part of the same health care team. However, the benefits of a multidisciplinary team approach in this particular area have not yet been properly documented in terms of survival outcomes. Moreover, there are some concerns and the limitations of a multidisciplinary team approach for Head and Neck Cancer patients are still open to question: cost-efficiency, the implications from a medical law perspective, the level of expertise required and the timing of each intervention (fixed or as required; before, during or after oncological treatment), and the role of the leader with other interested specialists to optimize all multidisciplinary care mechanisms
Prognostic and predictive factors in recurrent and/or metastatic head and neck squamous cell carcinoma: A review of the literature
No full textBossi, P., Alfieri, S., Strojan, P., Takes, R.P., López, F., Mäkitie, A., Saba, N.F., Rodrigo, J.P., Bradford, C., Suarez, C., Zafereo, M., Forastiere, A.A., Vermorken, J.B., Quer, M., Sanabria, A., Simo, R., de Bree, R., Rinaldo, A., Ferlito, A
Description of adverse events in publications of clinical trials: Much room for improvement [La descrizione delle tossicità negli studi clinici: Molti aspetti da migliorare]
No full textMay we rely on induction chemotherapy again as a biological selection of radiosensitive head and neck cancer?
No full textMultidisciplinary approach for poor prognosis sinonasal tumors: Phase II studies of chemotherapy, surgery, photon and heavy ion radiotherapy integration for more effective and less toxic treatment-Trials in progress
No full text
Peripherally or centrally inserted central catheters: what is the best vascular access device for cancer patients?
No full textChoosing the appropriate vascular access device is a pivotal step to guarantee vessel health and preservation in cancer patients. The first turning point is the determination of the need for central venous catheters (CVCs) followed by the selection of the CVC that will complete the prescribed treatment while minimizing complications and satisfying patients’ needs and expectations. Peripherally inserted central catheters (PICCs) have steadily grown over the years as an alternative to centrally inserted central catheters and totally implantable catheters based on several advantages including avoidance of placement-associated mechanical complications, easier transitions from hospital to intermediate care settings and home, but also increase in healthcare expenditure, supportive reimbursement policies, and ability to train existing staff. Notwithstanding PICCs have been perceived for a long time as associated with fewer complications, reduced costs, and higher patients’ satisfaction compared to other CVCs, recent evidence has raised concerns about their safety profile without any benefits for longer-term costs neither for patients’ satisfaction. This commentary offers a comprehensive overview on PICC-related (1) complications, (2) costs, and (3) patients’ satisfaction to help healthcare professionals in the choice of the vascular device during their clinical practice. Based on the most recent literature, we finally suggested that the choice of the CVC should depend on the clinical situation with totally implantable catheters being the preferred device for patients who need intermittent long-term and high-dose chemotherapy, while PICCs may be a better choice for patients who need short-term chemotherapy or continuous short-term supportive therapy
- …
