1,721,239 research outputs found
CheckMate 9ER patient-reported outcomes: the patient is not willing to give up
Full text linkClinical decisions, in addition to be supported by research evidence, should accommodate patients’ preferences. Before choosing a treatment, we as clinicians should ask ourselves how much the patient is ready and willing to accept in exchange for an uncertain benefit.
Therefore, we must first offer patients clear and accurate information about the potential benefits and harms of the recommended treatment, and secondly we must use valid tools to assess patients’ perceptions of their general health and cancer symptoms over time
Hepatocellular carcinoma, vascular endothelial growth factor receptors‐targeting agents, and hypertension: A much more complicated relationship than expected
No full textHepatocellular carcinoma (HCC) relationship with hypertension is a complicated phenomenon, mainly depending on the causes of the primary liver disease and the potential for drug interactions between concomitant medications and vascular endothelial growth factor receptor inhibitors. Another interesting point worth exploring is how to treat hypertension in HCC patients under anticancer multikinase inhibitor therapy and the possible impact of certain antihypertensive agents on patients' outcome
Mixed neuroendocrine non-neuroendocrine tumors: The quest for evidence
Full text linkMixed neuroendocrine non-neuroendocrine neoplasms (MiNENs) are rare mixed tumors containing both neuroendocrine and non-neuroendocrine components that occupy at least 30% of the whole tumor. Biologically, both components appear to derive from an identical cellular precursor undergoing early dual differentiation or late transdifferentiation. While our understanding of MiNENs has improved in recent years, many areas of uncertainty remain. In this context, setting diagnostic criteria capable of capturing the continuum of disease biology while providing clinically meaningful information in terms of prognosis and response to treatments appears vital to advance the field and improve patients’ outcomes. Evidence is needed to generate robust classification schemes, and multi-institutional cooperation will likely play a crucial role in building adequately powered cohorts to address some of the most pressing questions discussed in this Editorial. What is the minimum representation for each component needed to define MiNENs? How can the epidemiology of MiNENs change according to different diagnostic definitions? How can we generate the clinical evidence nee-ded to optimize the management of MiNENs?
Despite an Abundance of Active Treatment Options for Renal Cell Carcinoma, Shadows Still Obscure the Light
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Concurrent Stereotactic Ablative Radiotherapy and Antiangiogenic Targeted Agents: Redefining the Therapeutic Strategy
No full textIf, on one hand, the prognosis for patients with metastatic renal cell carcinoma (mRCC) has greatly improved with immune-based combinations, on the other hand their effectiveness could theoretically lead to a decrease in the use of locoregional treatments, such as cytoreductive nephrectomy, and radiotherapy (RT).
However, RT as a whole, and stereotactic ablative body RT (SABR) in particular, should be regarded as a key treatment option within the global strategy for this disease. [...
Abstract 2012: In vitro validation of tumor-derived large extracellular vesicles isolation and characterization as suitable tool for liquid biopsy
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Cisplatin-based chemotherapy for the treatment of metastatic collecting duct carcinomas: A real-world, retrospective analysis
Full text linkCollecting duct carcinomas (CDCs) are a particularly rare subtype of kidney cancer, endowed by a particularly poor prognosis. Since no active treatments have been established for CDCs, due to similarities with upper tract urothelial carcinomas, the use of the cisplatin-gemcitabine doublet is usually recommended. Here we report a retrospective analysis of 36 metastatic CDCs treated, as everyday clinical practice, with either cisplatin-gemcitabine or cisplatin-gemcitabine-paclitaxel from 2005 to 2021. Thirty-three patients received gemcitabine (1000 mg/m(2), days 1 and 8) and cisplatin (70 mg/m(2), day 1), while 3 were treated with paclitaxel (80 mg/m(2), days 1 and 8), gemcitabine (1000 mg/m(2), days 1 and 8) and cisplatin (70 mg/m(2), day 1), every 21 days for a maximum of 6 cycles. Eight out of 36 patients (22.2%) experienced a partial response, while 9 others (25%) had a disease stabilization. No benefit was observed in the only 3 patients treated with the triplet. Median PFS was just 6 months, while median OS was 8 months. The commonest grade ≥3 treatment-related adverse events were: neutropenia (75%, 11.1% of febrile neutropenia), anemia (50%), thrombocytopenia (38.8%), and vomiting (8.3%). Dose omissions and dose reductions were common, and few frail patients started the treatment with a 25% dose reduction. In conclusion, our real-world experience confirmed the modest activity and relevant toxicity of cisplatin-based chemotherapy for the treatment of CDCs. More translational studies and novel study designs are thus badly needed in these still orphan tumors
Renal cell carcinoma and viral infections: A dangerous relationship?
Full text linkVirus-related cancers in humans are widely recognized, but in the case of renal cancer, the link with the world of viruses is not clearly established in humans, despite being known in animal biology. In the present review, we aimed to explore the literature on renal cell carcinoma (RCC) for a possible role of viruses in human RCC tumorigenesis and immune homeostasis, hypothesizing the contribution of viruses to the immunogenicity of this tumor. A scientific literature search was conducted using the PubMed, Web of Science, and Google Scholar databases with the keywords “virus” or “viruses” or “viral infection” matched with (“AND”) “renal cell carcinoma” or “kidney cancer” or “renal cancer” or “renal carcinoma” or “renal tumor” or “RCC”. The retrieved findings evidenced two main aspects testifying to the relationship between RCC and viruses: The presence of viruses within the tumor, especially in non-clear cell RCC cases, and RCC occurrence in cases with pre-existing chronic viral infections. Some retrieved translational and clinical data suggest the possible contribution of viruses, particularly Epstein-Barr virus, to the marked immunogenicity of sarcomatoid RCC. In addition, it was revealed the possible role of endogenous retrovirus reactivation in RCC oncogenesis, introducing new fascinating hypotheses about this tumor’s immunogenicity and likeliness of response to immune checkpoint inhibitors
Massive hyper-progression during anti-PD1 immunotherapy in a young patient with metastatic mucinous adenocarcinoma of the right colon: a case report and literature review
Full text linkImmune checkpoint inhibitors (ICIs) have dramatically changed the treatment landscape of both solid and hematological malignancies, including tumors historically considered “non-immunogenic”, such as colorectal cancer (CRC). The increasing use of immunotherapy brought to light novel patterns of response due to its intrinsic mechanism of action. Besides the “pseudo-progression”, another peculiar phenomenon linked to ICIs activity is the “hyper-progression” (HP), namely a paradoxical disease acceleration during immunotherapy. This event, which suggests potentially deleterious effects of immunotherapy, has not been yet completely understood and lacks strict definition criteria, pathogenetic characterization as well as predictive factors. In this report, we present a case of an atypical massive progression in a 40-years old man with metastatic mucinous right colon cancer harboring high microsatellites instability (MSI-H), occurring after 2 cycles of pembrolizumab as first line therapy. Unfortunately, he experienced a widespread cancer dissemination for massive bone colonization and both numerical and volumetric increase of pre-existing node metastasis associated with rapid clinical worsening, which were suggestive for HP. To our knowledge, this is one of the few cases of HP in metastatic CRC that has been reported, particularly with a so rapid clinical deterioration and massive skeletal involvement. Other experiences and further studies are warranted to better understand this phenomenon and anticipate its recognition
Single nucleotide polymorphisms in angiogenesis-related genes and outcomes from antiangiogenic therapies in renal cell carcinoma: really a step towards personalized oncology, or not at all?
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