Beyond ibrutinib: novel BTK inhibitors for the treatment of chronic lymphocytic leukemia
Purpose of the review
Ibrutinib was the first Bruton tyrosine kinase inhibitor (BTKi) approved for clinical use, contributing to a dramatic change in the treatment landscape of chronic lymphocytic leukemia (CLL). This review provides an overview of next-generation BTKi that have been recently approved or are being investigated for the treatment of CLL, specifically highlighting differences and similarities compared to ibrutinib.
Recent findings
Acalabrutinib presented comparable response rates to ibrutinib with lower rates of adverse events and is currently approved for the treatment of CLL. Zanubrutinib display...
Source: Current Opinion in Oncology - October 13, 2022 Category: Cancer & Oncology Tags: HEMATOLOGIC MALIGNANCIES: Edited by Miguel A. Sanz and María-Victoria Mateos Source Type: research
Advances in the treatment of light chain amyloidosis
Purpose of review
After many years, the management of systemic light chain (AL) amyloidosis is entering the era of evidence-based medicine, with three recently published randomized clinical trials, a regimen (daratumumab, cyclophosphamide, bortezomib, and dexamethasone, daratumumab-CyBorD) labeled for upfront therapy, more clinical trials ongoing, and published guidelines. In this review, we discuss how current practice is changing based on this data.
Recent findings
Daratumumab-CyBorD grants unprecedentedly high rates of hematologic and organ response and became the novel standard-of-care in AL amyloidosis. The...
Source: Current Opinion in Oncology - October 13, 2022 Category: Cancer & Oncology Tags: HEMATOLOGIC MALIGNANCIES: Edited by Miguel A. Sanz and María-Victoria Mateos Source Type: research
Modern treatment approaches to adult acute T-lymphoblastic and myeloid/T-lymphoblastic leukemia: from current standards to precision medicine
Purpose of review
To review the most recent advancements in the management of adult T-cell acute lymphoblastic leukemia (T-ALL), we summarize insights into molecular diagnostics, immunotherapy, targeted therapy and new techniques of drug sensitivity profiling that may support further therapeutic progress in T-ALL subsets.
Recent findings
With current induction/consolidation chemotherapy and/or risk-oriented allogeneic stem cell transplantation programs up to 95% adult T-ALL patients achieve a remission and>50% (up to 80% in adolescents and young adults) are cured. The group of patients who fail upfront therapy, ...
Source: Current Opinion in Oncology - October 13, 2022 Category: Cancer & Oncology Tags: HEMATOLOGIC MALIGNANCIES: Edited by Miguel A. Sanz and María-Victoria Mateos Source Type: research
Novel therapeutic agents for myelofibrosis after failure or suboptimal response to JAK2 inhbitors
Purpose of review
JAK2 inhibitors have changed the therapeutic strategies for the management of primary and secondary myelofibrosis. Ruxolitinib, the first available agent, improved disease-related symptoms, spleen volume, and overall survival compared to conventional chemotherapy. It has been revealed that after 3 years of treatment, about 50% of patients discontinued ruxolitinib for resistance and/or intolerance and should be candidate to a second line of treatment.
Recent findings
Second-generation tyrosine kinase inhibitors have been tested in this setting, but all these new drugs do not significantly impa...
Source: Current Opinion in Oncology - October 13, 2022 Category: Cancer & Oncology Tags: HEMATOLOGIC MALIGNANCIES: Edited by Miguel A. Sanz and María-Victoria Mateos Source Type: research
The role of next-generation sequencing in acute myeloid leukemia
Purpose of review
The development of high-throughput techniques like next-generation sequencing (NGS) has unraveled the genetic profile of cancer. In this review, we discuss the role of NGS on the diagnostic, risk stratification, and follow-up of patients with acute myeloid leukemia (AML).
Recent findings
NGS has become an essential tool in clinical practice for AML management. Therefore, efforts are being made to improve its applications, automation, and turnaround time. Other high-throughput techniques, such as whole genome sequencing or RNA-sequencing, can be also used to this end. However, not all institutio...
Source: Current Opinion in Oncology - October 13, 2022 Category: Cancer & Oncology Tags: HEMATOLOGIC MALIGNANCIES: Edited by Miguel A. Sanz and María-Victoria Mateos Source Type: research
Surgical management of skull base meningiomas and vestibular schwannomas
Purpose of review
The aim of this study is to discuss surgical management of meningiomas and schwannomas of skull base.
Recent findings
Meningiomas and schwannomas are typically benign neoplasm with a good prognosis after surgery. Patients should be treated individually related to several features: size and localization of tumor and its proximity with deep critical neurovascular structures, neurological status, age and comorbidity. Also, the widespread use of neuroimaging and the progressive and constant aging of the populations inevitably result in the increase of detection rate of incidental (asymptomatic) neo...
Source: Current Opinion in Oncology - October 13, 2022 Category: Cancer & Oncology Tags: BRAIN AND NERVOUS SYSTEM: Edited by Marc Sanson and Anna-Luisa Di Stefano Source Type: research
New perspectives in liquid biopsy for glioma patients
Purpose of review
Gliomas are the most common primary tumors of the central nervous system. They are characterized by a disappointing prognosis and ineffective therapy that has shown no substantial improvements in the past 20 years. The lack of progress in treating gliomas is linked with the inadequacy of suitable tumor samples to plan translational studies and support laboratory developments. To overcome the use of tumor tissue, this commentary review aims to highlight the potential for the clinical application of liquid biopsy (intended as the study of circulating biomarkers in the blood), focusing on circulating t...
Source: Current Opinion in Oncology - October 13, 2022 Category: Cancer & Oncology Tags: BRAIN AND NERVOUS SYSTEM: Edited by Marc Sanson and Anna-Luisa Di Stefano Source Type: research
Vascular complications in patients with brain tumors
Purpose of review
Venous thromboembolism (VTE) and other vascular events are common in patients with brain tumors, but their optimal management is not firmly established, in large part due to the competing risk of intracranial hemorrhage (ICH) in this population.
Recent findings
There is conflicting evidence on whether therapeutic anticoagulation increases the risk of ICH in patients with brain tumors, with several metanalysis and retrospective cohort studies showing an increased risk and others showing no differences. Current guidelines recommend anticoagulating brain tumors patients with VTE with either low-mo...
Source: Current Opinion in Oncology - October 13, 2022 Category: Cancer & Oncology Tags: BRAIN AND NERVOUS SYSTEM: Edited by Marc Sanson and Anna-Luisa Di Stefano Source Type: research
Clinical management of brain tumors in pregnancy
Purpose of review
We review the diagnostic tools, treatment options, and clinical management for brain tumors diagnosed in pregnancy with consideration for management approaches that are best suited to preserve maternal and fetal health.
Recent findings
Women of child-bearing age are at risk of developing brain tumors and are at increased risk compared with male counterparts for tumors that are hormonally driven. Brain tumors are rare neoplasms, and diagnosis of brain tumors in pregnancy is uncommon, such that management guidelines and treatment recommendations are lacking for most tumor types. We discuss the st...
Source: Current Opinion in Oncology - October 13, 2022 Category: Cancer & Oncology Tags: BRAIN AND NERVOUS SYSTEM: Edited by Marc Sanson and Anna-Luisa Di Stefano Source Type: research
Management of epilepsy in brain tumor patients
Purpose of review
A concise review of recent findings in brain tumor-related epilepsy (BTRE), with focus on the effect of antitumor treatment on seizure control and the management of antiepileptic drugs (AEDs).
Recent findings
Isocitrate dehydrogenase mutation and its active metabolite d-2-hydroxyglutarate seem important contributing factors to epileptogenesis in BTRE. A beneficial effect of antitumor treatment (i.e. surgery, radiotherapy, and chemotherapy) on seizure control has mainly been demonstrated in low-grade glioma. AED prophylaxis in seizure-naïve BTRE patients is not recommended, but AED treatment sh...
Source: Current Opinion in Oncology - October 13, 2022 Category: Cancer & Oncology Tags: BRAIN AND NERVOUS SYSTEM: Edited by Marc Sanson and Anna-Luisa Di Stefano Source Type: research
Prognostic factors in primary central nervous system lymphoma
Purpose of review
Primary central nervous system lymphoma (PCNSL) is a rare and aggressive extranodal diffuse large B cell lymphoma. Despite its apparent immunopathological homogeneity, PCNSL displays a wide variability in outcome. Identifying prognostic factors is of importance for patient stratification and clinical decision-making. The purpose of this review is to focus on the clinical, neuroradiological and biological variables correlated with the prognosis at the time of diagnosis in immunocompetent patients.
Recent findings
Age and performance status remain the most consistent clinical prognostic factors. ...
Source: Current Opinion in Oncology - October 13, 2022 Category: Cancer & Oncology Tags: BRAIN AND NERVOUS SYSTEM: Edited by Marc Sanson and Anna-Luisa Di Stefano Source Type: research
WHO 2021 and beyond: new types, molecular markers and tools for brain tumor classification
Purpose of review
The fifth edition of the WHO classification of central nervous system tumors was published in 2021. It implemented major advances in the current diagnostic practice such as DNA methylation profiling. The review addresses how our understanding of the diversity of brain tumors has recently much improved through omics analysis and derived molecular biomarkers.
Recent findings
Latest impactful studies identifying new diagnostic or prognostic biomarkers in frequent tumors and describing new rare tumor types are summarized about adult and pediatric gliomas, rare neuroepithelial tumors, ependymomas, m...
Source: Current Opinion in Oncology - October 13, 2022 Category: Cancer & Oncology Tags: BRAIN AND NERVOUS SYSTEM: Edited by Marc Sanson and Anna-Luisa Di Stefano Source Type: research
Future development of chimeric antigen receptor T cell therapies for patients suffering from malignant glioma
Purpose of review
Chimeric antigen receptor (CAR) T cell therapy has been successful in some haematologic malignancies, but the central nervous system (CNS) presents unique obstacles to its use against tumours arising therein. This review discusses recent improvements in the delivery and design of these cells to improve the efficacy and safety of this treatment against malignant gliomas.
Recent findings
The immunosuppressive environment of the CNS affects the functionality of CAR T cells, but recent developments using metabolic manipulation and cytokine delivery have shown that the performance of CAR T cells can...
Source: Current Opinion in Oncology - October 13, 2022 Category: Cancer & Oncology Tags: BRAIN AND NERVOUS SYSTEM: Edited by Marc Sanson and Anna-Luisa Di Stefano Source Type: research
Deciphering diffuse glioma immune microenvironment as a key to improving immunotherapy results
Purpose of review
Immunotherapeutic approaches have yet to demonstrate their clinical efficacy in diffuse gliomas. Evidence is mounting that the central nervous system is subject to immune surveillance, but brain tumours manage to escape due to factors intrinsic to their tumoral immune microenvironment (TME). This review aims to discuss the recently characterized molecular bases of the glioma TME and the potentially actionable targets to improve immunotherapeutic results in these hard-to-treat cancers.
Recent findings
Single-cell studies defined the composition of the glioma immune TME and its peculiarities comp...
Source: Current Opinion in Oncology - October 13, 2022 Category: Cancer & Oncology Tags: BRAIN AND NERVOUS SYSTEM: Edited by Marc Sanson and Anna-Luisa Di Stefano Source Type: research
Radiation therapy on the axilla after neoadjuvant chemotherapy
Purpose of review
The introduction of primary systemic therapy has established a new treatment paradigm for breast cancer patients. However, recommendations for regional node irradiation after neoadjuvant chemotherapy are not supported by level I evidence, yet.
Recent findings
In addition to strategies optimising systemic treatments and surgery, current discussions focus on tailoring radiation therapy for breast cancer. Especially in view of the increasingly pivotal role of neoadjuvant chemotherapy, gauging the extent of radiation therapy in the breast and nodal volumes.
Summary
The current review focuses...
Source: Current Opinion in Oncology - October 13, 2022 Category: Cancer & Oncology Tags: BREAST CANCER: Edited by Giuseppe Curigliano Source Type: research
