bluuebunny/crossref_metadata_2025 huggingface dataset:
Initial Experience with Determination of hTERC and MYCC Amplification in Cervical Intraepithelial Neoplasia and Cervical Carcinoma in the Czech Republic
Authors: Moukova Lucie , Vranova Vladimira , Slamova Iva , Kissova Miroslava , Kuglik Petr ,   Gynaecological Oncologist, Department of Gynaecological Oncology, Masaryk Memorial Cancer Institute,   Clinical Cytogeneticist,   Cytogeneticist,   Cytogeneticist,   Associate Professor and Medical Geneticist, Laboratory of Molecular Cytogenetics, Faculty of Science, Institute of Experimental Biology, Masaryk University, Brno, Czech Republic
Published: October 2015

Tumours are frequently characterised by series of cytogenetic abnormalities. Amplifications of the human telomerase gene hTERC (3q26) and myelocytomatosis-C proto-oncogeneMYCC(8q24) have been associated with cervical intraepithelial neoplasia (CIN) and carcinoma of the uterine cervix. The results of genetic analysis allow to select patients at high risk of progression from CIN to carcinoma. Our group conducted a study in which the chromosomal abnormalities found in the cytology specimens of 26 patients with either cervical cancer or CIN were analysed using the recently developed triple-colour human papillomavirus-fluorescencein situhybridisation (HPV-FISH) assay. HPV infection was proven in 22 (85 %) patients. Amplification ofMYCCandhTERCwas found in 11 (42 %) and 16 (62 %) patients, respectively. Based on these results, the patients were divided into high-risk, medium-risk and low-risk groups. The study confirmed that the HPV-FISH assay can be used as an effective diagnostic procedure to identify patients carrying high-risk HPV infection and chromosomal aberrations associated with the development of malignancy. Patients in the high-risk group would require more frequent folllow-up and aggressive therapy.
Balloon Kyphoplasty in the Treatment of Vertebral Compression Fractures in Cancer Patients
Authors: Bastian Leonard ,   Director, Department Of Orthopaedics, Klinikum Leverkusen GmbH, Leverkusen, Germany
Published: October 2015

Patients with cancer are at increased risk of painful vertebral compression fractures (VCFs). The Cancer Patient Fracture Evaluation (CAFE) trial was the first randomised controlled study to compare the safety and effectiveness of balloon kyphoplasty (BKP – a minimally invasive procedure) with non-surgical fracture management in the treatment of VCFs in patients with cancer. Data from the CAFE trial demonstrated that BKP is a safe and effective treatment option that quickly reduces pain and improves physical function and vertebral body height in patients with cancer and painful VCFs. Data from peer-reviewed published studies support the CAFE trial findings.
Weighing Bone-targeted Treatment Options for Patients with Solid Tumours and Skeletal Complications from Metastatic Disease
Authors: Fallowfield Lesley , Moos Roger von , Costa Luis , Stopeck Alison , Clemons Mark , Clarke Noel , Braun Ada , Chung Karen ,   Director and Professor, Sussex Health Outcomes Research & Education in Cancer (SHORE-C), University of Sussex, Brighton, UK,   Medical Director and Professor, Department of Oncology, Kantonsspital Graubünden, Chur, Switzerland,   Director and Professor, Department of Oncology, Centro Hospitalar Lisboa Norte, Hospital de Santa Maria, Instituto de Medicina Molecular, Lisbon, Portugal,   Director and Associate Professor, Arizona Hemophilia and Thrombosis Center, The University of Arizona Cancer Center, Tucson, Arizona, US,   Associate Professor, Division of Medical Oncology, The Ottawa Hospital Cancer Centre, Ottawa, Ontario, Canada,   Professor, Urological Oncology, University of Manchester, Manchester, UK,   Executive Medical Director, Global Development, Amgen Inc., Thousand Oaks, California, US,   Director, Global Health Economics, Amgen Inc., Thousand Oaks, California, US
Published: October 2015

The complications of metastatic bone disease (MBD) in advanced cancer, especially skeletal-related events (SREs), are a significant cause of morbidity that can seriously impair the quality of patients’ lives. Treatments that prevent SREs, reduce or delay the onset of pain and preserve function and activities of daily living are central to good patient care. In this article, we discuss results from clinical trials that show the relative benefits and harms of different bone-targeted agents, which may be given orally, intravenously or subcutaneously. These data, when considered alongside various patient characteristics, can provide oncologists with better opportunities to individualise care. Optimal management with treatments that enhance efficacy and adherence mean that clinicians can improve the outlook for their patients with MBD, who may consequently experience fewer SREs and less pain and enjoy a better overall quality of life.
Drug-eluting Beads in the Treatment of Hepatocellular Carcinoma and Colorectal Cancer Metastases to the Liver
Authors: Blümmel Jacques , Reinhardt Sven , Schäfer Markus , Gilbert Carl , Sun Lee , Ren Jane ,   Senior Scientist in R…D,   Chemist in R…D,   Biochemist in R…D,   Senior R…D Project Manager,   Director, Material Technology,   Senior Vice President and Chief Technology Officer, CeloNova BioSciences, Inc., San Antonio, Texas, US
Published: October 2015

Drug-eluting beads (DEBs) may become a standard of care in the treatment of unresectable liver cancers. DEBs have a significant advantage by offering simultaneous embolisation, and sustained release of antineoplastic agents in a controlled manner, resulting in a localisation of the drug in the targeted tumour, while minimising its systemic exposure. This article reviews current treatment options for liver cancer and concentrates on the benefits of DEBs for patients with unresectable liver cancer. Preclinical and clinical studies suggest smaller microspheres and extended release characteristics as key properties that will enable DEB device technologies to become a standard of care for unresectable liver cancer. A new, tightly size-calibrated DEB ≤100 μm, Embozene TANDEM™, was designed to meet these requirements.
Liver Transplantation for Cholangiocarcinoma
Authors: Thelen Armin , Benckert Christoph , Jonas Sven ,   Attending Physician,   Attending Physician,   Director, Department of Visceral, Transplantation, Thoracic and Vascular Surgery, Leipzig University, Germany
Published: October 2015

The treatment of intra- and extrahepatic cholangiocarcinomas remains a medical challenge. Due to the poor efficacy of conventional chemotherapy, surgical treatment modalities represent the only chance of attaining long-term survival and cure. The introduction of new procedures, in particular extended liver resections – which were enabled by increasing surgical expertise and the implementation of multimodal treatment protocols – led to an increasing number of curatively treated patients and significant improvements in long-term results after curative resection. However, numerous patients are not suitable for radical resection because of local tumour growth, intrahepatic metastases, infiltration of main vascular and biliary structures or insufficient remnant liver function. In unresectable tumours, liver transplantation is a curative treatment option for many patients and represents the only chance to achieve long-term survival and cure. Yet, cholangiocarcinomas are not currently a standard indication for liver transplantation, because of the organ shortage and the resulting necessity to allocate available organs to patients with the best prognosis. In recent years, the results of liver transplantation for the different types of cholangiocarcinoma have improved following the application of new treatment protocols. The most promising long-term results were achieved in hilar cholangiocarcinoma by using neoadjuvant radiochemotherapy prior to transplantation. Long-term survival rates were not inferior to those seen in patients receiving a transplantation for benign liver diseases or early-stage hepatocellular carcinoma. The improved long-term outcomes of transplantation for intra- and extrahepatic cholangiocarcinomas have led to a renewed interest for liver transplantation as a treatment for these tumour entities.
Role of 4D Stereotactic Radiotherapy with the CyberKnife® System in the Treatment of Lung Cancer
Authors: Nuyttens Joost J , Bondiau Pierre-Yves ,   Radiation Oncologist, Department of Radiation Oncology, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam, The Netherlands,   Professor of Radiation Oncology, Centre Antoine-Lacassagne, Nice, France
Published: October 2015

Lung cancer remains in 2012 the leading cause of cancer-related deaths within the European Union. Although surgery still constitutes the standard treatment for lung cancer, it is not feasible for a large number of patients. Treatment of lung tumours thus requires an innovative treatment solution. The ability of the CyberKnifeR stereotactic radiotherapy system to track and automatically correct for respiratory motion allows an increase of the radiation dose, and thus gives the opportunity to improve the efficacy of the treatment. In this article, an overview of this technology and its clinical benefits is provided and shows that it can offer an effective and safe option in the treatment of lung tumours, whether they are primary and early-stage, recurrent or secondary, as well as peripheral or central.
Microwave Ablation of Lung Tumours – Clinical Update
Authors: Vogl Thomas J , Naguib Nagy , Gruber-Rouh Tatjana , Nour-Eldin Nour-Eldin Abdelrehim ,   Director,   Radiologist, Institute for Diagnostic and Interventional Radiology, Johann Wolfgang Goethe University Hospital, Frankfurt am Main, Germany,   Radiologist, Institute for Diagnostic and Interventional Radiology, Johann Wolfgang Goethe University Hospital, Frankfurt am Main, Germany,   Radiologist, Institute for Diagnostic and Interventional Radiology, Johann Wolfgang Goethe University Hospital, Frankfurt am Main, Germany
Published: October 2015

Thermal ablation offers an intriguing therapeutic option to improve local tumour control and survival in patients with early-stage non-small cell lung cancer or patients with limited metastatic disease from non-lung primaries who are not candidates for surgery, either because of poor cardiopulmonary reserve, anatomic constraints limiting resection, failure of traditional therapies, or refusal of operative approaches. The new field of interventional oncology needs adequate knowledge of the therapeutic tools, advantages and limitations of each method, when and how to apply them, as well as of the new integrative protocols that improve their efficacy. This article provides a clinical review of the role of microwave ablation therapy of primary and metastatic tumours.
Stem Cells in Acute Lymphoblastic Leukaemia
Authors: Elder Alex , Heidenreich Olaf , Vormoor Josef ,   Postdoctoral Fellow, Newcastle Cancer Centre at the Northern Institute for Cancer Research, Newcastle University,   Professor of Molecular Haematopoiesis, Newcastle Cancer Centre at the Northern Institute for Cancer Research, Newcastle University,   Sir James Spence Professor of Child Health, Newcastle Cancer Centre at the Northern Institute for Cancer Research, Newcastle University, and Honorary Consultant Paediatric Oncologist, Great North Children’s Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
Published: October 2015

There has been significant debate over the identity of cancer stem cell populations in acute lymphoblastic leukaemia (ALL), with different groups reporting seemingly contradictory results. The latest findings suggest that tumour-propagating capacity is found within a high percentage of ALL blasts and that these cells have diverse immunophenotypes, which suggests that ALL follows a stochastic cancer stem cell model – as opposed to a hierarchical model. Recent data add a layer of complexity to the tumour evolution process by showing that the leukaemia-propagating compartment consists of multiple genetically diverse subclones related by Darwinian-style evolutionary trees. Differences in the cell of origin may also affect tumour development. In this article, we discuss the applicability of cancer stem cell models to ALL in the context of these recent findings.
The Patient-centred Oncology Information System – Automating your Oncology Workflow For Optimal Patient Care
Authors: Enever Peter ,   St James Hospital Leeds, UK
Published: October 2015

Radiation therapy has become among the safest and most effective methods for treating cancer. Technology continues to play a critical role in managing and supporting advanced treatment techniques and ensuring safer practice. For clinicians, the ability to tailor the technology to meet their specific oncology workflows is a challenge. This article discusses how, by being able to automate clinical workflow in the electronic medical record (EMR), not only delivers greater department efficiency but can help support better outcomes through optimising patient care, before, during and after treatment.
A Review of Treatment in Non-small-cell Lung Cancer
Authors: Pallis Athanasios G ,   Medical Oncologist, Department of Medical Oncology, University General Hospital of Heraklion
Published: October 2015

Non-small-cell lung cancer (NSCLC) accounts for approximately 85 % of all lung cancer cases. For patients with early-stage disease, surgery followed by adjuvant chemotherapy is the optimal treatment. For patients with locally advanced disease, the standard approach is chemoradiotherapy, since it offers a small but statistically significant prolongation in survival compared with the sequential approach. It should be noted, however, that this approach is associated with significant toxicity and it only applies to patients with good performance status. For patients with metastatic disease, chemotherapy represents the cornerstone of treatment and results in a median survival of approximately 10 months. Recently, the addition of bevacizumab or cetuximab to chemotherapy doublets and the use of gefitinib and erlotinib has improved the outcome in selected patients with advanced NSCLC. Hopefully, advances in understanding the molecular biology of cancer and mechanisms of tumourigenesis will facilitate the discovery and development of novel ‘targeted agents’ and will further improve outcomes for these patients.
Optimising Therapeutic Options for Patients with Advanced Pancreatic Neuroendocrine Tumours
Authors: Yao James , Phan Alexandria T ,   Associate Professor and Deputy Chair,   Gastrointestinal Medical Oncology, Associate Professor, The University of Texas, MD Anderson Cancer Center, Houston, Texas, US
Published: October 2015

Pancreatic neuroendocrine tumours (pNETs) are a rare form of pancreatic cancer. Several therapeutic options exist for pNETS; however, there is no algorithm to determine the optimum sequence of therapies. Approved treatments for pNETs include somatostatin analogues (SSAs), streptozocin-based chemotherapy and targeted therapies such as everolimus and sunitinib. Unapproved therapies include systemic peptide receptor-targeted radiotherapy (PRRT), temozolomide-based chemotherapy, liver resection, liver transplantation, hepatic artery embolisation with or without chemotherapy and selective internal radiation therapy (SIRT). An individualised approach to the treatment of pNETs is described. Firstly, it is necessary to decide whether it is appropriate to treat at all. For those wi th symptoms, it is necessary to define the treatment goal: symptomatic or oncological control. Symptoms may direct treatment decisions; for example in patients with hypogycaemia, everolimus would be the most effective therapy. In high-volume disease where tumour reduction is the highest priority, streptozocin-based chemotherapy would be a more appropriate choice. For patients with disease progression and a moderate-to-high tumour volume, targeted therapy is the preferred choice. Following the failure of first-line therapies, second-line options include other targeted agents and cytotoxic chemotherapy. PRRT is recommended only after failure of prior therapy. Treatment decisions of pNETs should be made in a patient-oriented manner and on a case-by-case basis.
The Need for a New Fluoropyrimidine in Advanced Gastric Cancer Treatment
Authors: Cutsem Eric Van , Haller Daniel G , Sobrero Albert , Yamada Yasuhide , Douillard Jean-Yves , Moehler Markus ,   Professor, University of Leuven and Head of Digestive Oncology, University Hospital Gasthuisberg, Leuven, Belgium,   Deenie Greitzer Professor of Gastrointestinal Medical Oncology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, US,   Head of Medical Oncology Unit, San Martino Hospital, Genova, Italy,   Head of Gastrointestinal Oncology Division, National Cancer Center Hospital, Tokyo, Japan,   Professor, University of Nantes, Rene Gauducheau Cancer Centre, Nantes, France,   Head of Gastrointestinal Oncology, Mainz University Hospital, Mainz, Germany
Published: October 2015

Fluoropyrimidines have shown efficacy against a variety of cancers and have evolved into a range of different uses and formulations. These drugs have been tested extensively as monotherapies and as part of numerous different chemotherapy combinations. The efficacy and safety profile of bolus intravenous (IV) 5-fluorouracil (5-FU) has been improved by continuous IV administration. The availability of the first 5-FU oral form in Europe, capecitabine, has added a clear value in terms of convenience for patients, while forcing physicians and nurses to learn how to manage the toxicity profile of this compound. S-1 is a new oral formulation combining a 5-FU prodrug (tegafur) and two targeted modulators of its metabolism (gimeracil and oteracil) preserving the efficacy and improving the safety of the prodrug. S-1 has become the backbone treatment for advanced gastric cancer in Japan since its introduction in 1999. Extensive experience from clinical trials, post-marketing studies and patient registries of over 4,000 patients in Japan show that S-1 has improved measures of survival in advanced gastric cancer and has an acceptable safety profile. S-1 has recently been approved for advanced gastric cancer treatment in Europe. Since 5-FU metabolism differs between Asian and Caucasian populations, the introduction of S-1 in Caucasians has necessitated an entirely new clinical trial programme. Phase I trials indicated different dose levels were necessary in Westerners versus Asians (25 versus 40 mg/m2). In the FLAGS study of over 1,000 patients with advanced gastric cancer (the largest study ever conducted in this indication), S-1 plus cisplatin was demonstrated to be non-inferior in efficacy but superior in safety to 5-FU + cisplatin. Based on these results, S-1 was approved in Europe in March 2011 under the trade name Teysuno®. Further clinical trials are in progress to evaluate S-1 in advanced gastric cancer (AGC) and its use as part of triplet therapies is currently being investigated. This will further define the role of S-1 as a key part of advanced gastric cancer management in Western countries.
Evidence-based Molecular Profiling for Solid Tumours – The Future is Now
Authors: Ashfaq Raheela , Voss Andreas ,   Director, Oncologic Pathology, Caris Life Sciences, Irving, Texas, US,   Vice President, Clinical Affairs, Caris Life Sciences Europe, Basel, Switzerland
Published: October 2015

Advances in our understanding of the molecular basis of cancer have shown that biomarkers can help guide therapy in a growing number of cancer types and that targeted therapies are becoming increasingly integral to cancer management. However, how to interpret the rapidly expanding wealth of data on cancer genomics and ensure that the best evidence is effectively translated into an optimal individualised therapeutic strategy, remains a challenge. Caris Target Now™ is a well-established, evidence-based molecular profiling service provided by Caris Life Sciences (Basel, Switzerland). Caris Target Now utilises the latest diagnostic molecular assay technologies to determine the unique biomarkers of a patient’s tumour. This is combined with an extensive review of the published clinical evidence to correlate predictive biomarkers with drug response, in order to reveal the potential benefit (or lack of benefit) of specific therapeutic agents. By this process, Target Now provides tumour-specific information that can be used to help physicians personalise cancer therapy for their patients.
The Use of Extracorporeal Photopheresis for the Treatment of Acute Graft Versus Host Disease
Authors: Das-Gupta Emma ,   Consultant Haematologist, Centre for Clinical Haematology, Nottingham University Hospitals NHS Trust, Nottingham, UK
Published: October 2015

Acute graft versus host disease (aGVHD) is a key complication of haematopoietic stem-cell transplantation. The main first-line therapy is steroids, however less than half of patients respond to this treatment, and some patients relapse following an initial response. Extracorporeal photopheresis (ECP) is a therapy that has shown promising efficacy in several immune-mediated disorders, including aGVHD. Used as a second-line treatment, ECP has been associated with good rates of disease resolution, both overall and for individual organ systems involved in this disorder. The responses to ECP have commonly been seen soon after the start of treatment. Patients who respond to ECP have also been shown to have lower rates of transplant-related mortality and greater overall survival than those who do not respond. ECP is well tolerated by patients, including those with a low performance index and children of low body weight. Data on the use of ECP in treating aGVHD in both adults and children are reviewed here.
Modern Management of Castration-resistant Prostate Cancer
Authors: Heidenreich Axel , Pfister David , Merseburger Axel , Bartsch Georg ,   Department of Urology, RWTH University Aachen,   Department of Urology, RWTH University Aachen,   Department of Urology and Urologic Oncology, Hannover Medical School, Hannover,   Department of Urology, Johann-Wolfgang-Goethe University, Frankfurt, Germany
Published: October 2015

The approval or clinical evaluation of several new agents – cabazitaxel, enzalutamide, sipuleucel-T, radium-223 and abiraterone acetate – has significantly changed the management of patients with metastatic castration-resistant prostate cancer (mCRPC) prior to or after docetaxelbased chemotherapy. All of these agents have resulted in a significant survival benefit compared with their control group. However, treatment responses might differ depending on the associated comorbidities and the extent and the biological aggressiveness of the disease. Furthermore, treatment-associated side effects differ between the various drugs. As new drugs are approved, new treatment strategies and markers to best select which patients will best respond to which drug are needed. It is the aim of this article to (1) summarise the data of established treatment options in mCRPC, (2) highlight new developments of medical treatment, (3) provide clinically useful algorithms for the daily routine and to (4) point out future developments of medical treatment.
Radiotherapy Controversies in the Radical Treatment of Soft-tissue Sarcomas of the Limb
Authors: Esler Claire P , Ashford Robert U ,   Consultant Clinical Oncologist, Department of Oncology,   Consultant Orthopaedic and Musculoskeletal Tumour Surgeon, Department of Orthopaedics, Leicester Royal Infirmary, Leicester, UK,   Honorary Consultant Lecturer, Division of Orthopaedic and Accident Surgery, University of Nottingham, Nottingham, UK
Published: October 2015

Radical treatment of limb soft-tissue sarcomas is typically combination treatment of surgery and radiotherapy. The aim of radical treatment is to achieve excellent local control rates with minimal treatment-related morbidity and adverse effects on the quality of life. This article looks at the use and timing of radiotherapy and associated complications. The arguments for and against neoadjuvant, intraoperative, adjuvant or no radiotherapy will be discussed.
Prevention of Cachexia in Cancer
Authors: Stewart Ross W , Johns Neil , Fearon Kenneth C ,   Clinical Research Fellow,   Clinical Research Fellow,   Professor of Clinical Surgery, School of Clinical Sciences and Community Health, University of Edinburgh, Royal Infirmary, Edinburgh, UK
Published: October 2015

The cachexia syndrome is seen across a wide range of chronic diseases and is especially evident in the cancer patient. Weight loss causes difficulties for the patient and clinician alike as it reduces quality of life and also reduces tolerance of anti-cancer therapy. It is now recognised that cachexia exists through a range of phases (pre-cachexia, cachexia syndrome and refractory cachexia); however, not all patients traverse the entire spectrum. The risk of progression varies and depends on numerous clinical factors that should be taken into account when risk stratifying and counselling patients about weight loss and possible interventions. Tumour type, tumour stage, co-morbidities, systemic inflammation, low food intake and response to anti-cancer therapy all play roles in determining whether a patient will be at risk of cachexia progression. The acknowledgement that multiple components are responsible for the development of cachexia has led to the view that any cachexia intervention strategy should target all components i.e. multimodal therapy for a multimodal problem. There is growing acceptance that anti-cachexia therapy must form a major component of supportive oncology and be given along with anti-cancer therapy. The critical concern remains when to start such treatment and in which individuals?
NGR-hTNF plus Doxorubicin in Relapsed Ovarian Carcinoma
Authors: Lorusso Domenica , Mancini Maria , Sarno Italo , Lambiase Antonio , Raspagliesi Francesco ,   Assistant Professor,   Assistant, Department of Gynaecologic Oncology, National Cancer Institute of Milan, Italy,   Assistant, Department of Gynaecologic Oncology, National Cancer Institute of Milan, Italy,   Clinical Director, MolMed, Milan, Italy,   Director, Department of Gynecologic Oncology, National Cancer Institute of Milan, Italy.
Published: October 2015

Ovarian cancer (OC) is the most deadly gynaecological cancer. Despite surgery and first-line chemotherapy, between 60 % and 70 % of OC patients will recur with poor prognosis. Several studies suggest anti-tumour activity of tumour necrosis factor (TNF) when given systematically, but the high toxicity of the drug has limited its use. NGR-human TNF (hTNF) consists of TNF coupled with the peptide NGR that selectively binds to CD13, which is overexpressed on tumour blood vessels. NGR-hTNF is able to increase the intratumoural doxorubicin distribution by altering tumour vasculature. The activity and toxicity profile of NGR-hTNF–doxorubicin combination in recurrent OC will be described.
Colorectal Cancer – Management of Metastatic Disease
Authors: Sugarbaker Paul H ,   Medical Director, Center for Gastrointestinal Malignancies at MedStar Washington Hospital Center, Washington, DC and Chief, Program in Peritoneal Surface Oncology at MedStar Washington Cancer Institute, Washington, DC, US
Published: October 2015

Metastases from colon cancer occur to the regional lymph nodes, the liver and the peritoneal surfaces. Rectal cancer may disseminate to these sites and also to the lungs. These metastases may occur synchronously with the detection of primary disease or metachronously in follow-up. The timing of the metastatic process is important in terms of treatment possibilities. Each anatomical site for metastatic disease has the potential for an individualised management strategy. Systemic chemotherapy as an adequate management plan for all sites of colorectal metastatic disease is not compatible with a high standard of care. Formulation of an optimal plan combining surgery with regional and systemic chemotherapy is a necessary function of the multidisciplinary team.
Patient-reported Outcome Measures for Women with Vulvar Neoplasia – Current Situation and Future Directions
Authors: Senn Beate , Eicher Manuela , Mueller Michael D , Engberg Sandra , Spirig Rebecca ,   Professor and Head of Institute for Applied Nursing Sciences IPW, University of Applied Sciences FHS St Gallen, Switzerland,   Dean of Research, Development and Services, University of Applied Science Western Switzerland, School of Health Fribourg and Visiting Professor, Institute of Nursing Science, Faculty of Medicine, University of Lausanne, Switzerland,   Professor in Ordinary, Head Physician in Gynecology and Gynecological Oncology and Co-Director, Department of Obstetrics and Gynecology, Inselspital, University Hospital Bern, Switzerland,   Professor, Institute of Nursing Science, Faculty of Medicine, University of Basel and Associate Professor/Associate Dean, School of Nursing, University of Pittsburgh, Pennsylvania, US,   Professor, Institute of Nursing Science, Faculty of Medicine, University of Basel and Head, Centre of Clinical Nursing Science, University Hospital Zurich, Switzerland
Published: October 2015

This article discusses concerns about women with vulvar neoplasia (vulvar intraepithelial neoplasia and vulvar cancer) and the available surgical treatment options. Given the gaps in the evidence base in terms of women with vulvar neoplasia and surgical treatment the women with vulvar Neoplasia-Patient Reported Outcome (WOMAN-PRO) research project focused on complications, symptoms and associated distress of women with surgically treated vulvar neoplasia. The main results of the research project are summarised, showing complications identified by clinicians, experiences reported by patients, the newly developed WOMAN-PRO instrument and symptom occurrence of each of 31 symptoms and the degree to which symptoms distressed women during the first seven days after discharge following surgical treatment for their vulvar neoplasia. Furthermore, based on the major findings of the project, suggestions for further research and clinical practice and conclusions are presented. We conclude that including patient self-report as a major element in follow-up care has the potential to enhance the quality of supportive care.
Cancer Survivorship: A Positive Side Effect of More Successful Cancer Treatment
Authors: Moser Elizabeth Charlotte , Ramadan Safaa , Bean John , Meunier Françoise ,   Chair of EORTC Cancer Survivorship Task Force and Radiation Oncologist, Champalimaud Cancer Centre, Lisbon, Portugal,   Clinical Research Physician, EORTC Headquarters, Brussels, Belgium,   Medical Science Writer, EORTC Headquarters, Brussels, Belgium,   Director General, EORTC Headquarters, Brussels, Belgium
Published: October 2015

Over the past decades, survival rates of cancer patients have increased impressively through the introduction of screening, new drugs and more personalised multi-modality treatments. This success in treating cancer has resulted in a large and rapidly increasing number of cancer survivors. Unfortunately, now that cancer is controlled in many patients, it has become clear that the life expectancy and quality of life of cancer survivors may be compromised by a spectrum of late adverse treatment effects. Some cancer survivors encounter second malignancies, severe cardiovascular or other morbidities which impair normal life in an important way. Some patients may be confronted with difficulties such as societal discrimination due to slower performance, chronic fatigue or partial inability, acceptance for work, education, insurance or credit history. To address these new issues, the EORTC is launching a variety of initiatives. Early in 2013, the EORTC Cancer Survivorship Task Force was created. The 1st EORTC Cancer Survivorship Summit will take place 30–31 January 2014 to facilitate interaction between clinicians, researchers, social workers, patients, insurers, bankers and policy makers. This summit will address the situation and needs of cancer survivors and guide future research and health policies in Europe in this field.
The Potential of Ghrelin in Cancer Anorexia–Cachexia
Authors: Garcia Jose M , Jatoi Aminah , Fabbro Egidio Del ,   Assistant Professor, Michael E DeBakey Veterans Affairs Medical Center, Division of Endocrinology, Diabetes, and Metabolism, Departments of Medicine and Molecular and Cell Biology, Huffington Center on Aging, Baylor College of Medicine, Houston, Texas, US,   Professor, Department of Oncology, Mayo Clinic, Rochester, Minnesota, US,   Associate Professor, Director, Palliative Care Program, Division of Hematology, Oncology and Palliative Care, Department of Internal Medicine, Massey Cancer Center, Virginia Commonwealth University, Virginia, US
Published: October 2015

The cancer anorexia–cachexia syndrome (CACS) is often seen in patients with incurable malignancies and is associated with increased mortality, decreased efficacy of anticancer treatments and poor quality of life. However, there are currently no effective therapies for CACS. Since CACS is a multifactorial syndrome with a complex pathophysiology, therapeutic interventions for CACS might potentially include anabolic agents as well as anti-inflammatory effects. Ghrelin affects numerous key pathways in the regulation of body weight and body composition through increased appetite and growth hormone (GH) secretion. Preliminary clinical data indicate that the administration of ghrelin and ghrelin receptor agonist such as anamorelin have beneficial effects on appetite and body weight in patients with CACS. Anamorelin is currently in phase III clinical trials.
Current Trends and Future Directions in the Management of Delayed Nausea and Vomiting
Authors: Rapoport Bernardo L , Demetriou Georgia S ,   Specialist Physician and Medical Oncologist, The Medical Oncology Center of Rosebank, Johannesburg, South Africa,   Specialist Physician and Medical Oncologist, Department of Internal Medicine, Division of Medical Oncology, University of the Witwatersrand and Wits Donald Gordon Medical Center, Johannesburg, South Africa
Published: October 2015

The prophylaxis of chemotherapy-induced nausea and vomiting benefited greatly from the introduction of neurokinin-1 (NK1) receptor antagonists (RAs). Current emesis guidelines recommend that NK1 receptor antagonists be combined with 5-HT3 receptor antagonists and dexamethasone for highly emetic chemotherapy and moderately emetic chemotherapy. The first such medication, aprepitant, was approved in the US in 2003. Fosaprepitant, an intravenous prodrug of aprepitant, is also available as a single dose on day 1 in combination with other antiemetics. Fosaprepitant is rapidly converted to the active aprepitant and exhibits a similar half-life to orally administered aprepitant. In addition, receptor-binding studies have shown aprepitant striatal NK1 receptor occupancy of 90 % for over 48 hours after exposure. These characteristics may allow aprepitant, fosaprepitant and the newer NK1 RAs to be administered in a single dose on day 1. Olanzapine may prove to be a novel approach in the treatment of CINV, particularly in the management of nausea.
Measuring the Quality of Life of Patients with Cancer
Authors: Zikos Efstathios , Coens Corneel , Bean John , Ediebah Divine , Bottomley Andrew ,   Quality of Life Researcher,   Biostatistician,   Medical Science Writer,   Fellow, Quality of Life,   Assistant Director, EORTC Headquarters, Brussels, Belgium
Published: October 2015

What is quality of life? Clinical trials have long been dominated by clinically based endpoints, but research has proved that health-related quality of life (HRQoL) can only be captured accurately by patients themselves using patient-reported outcomes (PROs). The United States Food and Drug Administration defines PROs as the measurement of any aspect of a patient’s health status that comes directly from the patient, that is, a measurement taken without interpretation of the patient’s responses by a physician or anyone else. The EORTC QLQ-C30 is the most widely cancer specific HRQoL questionnaire used for PROs in the world. Developed in 1991 by the EORTC Quality of Life Group, it has been translated into more than 60 languages and has over 40 developed or under development cancer-specific modules. One of the key challenges faced is pooling data and performing meta-analyses of the results of closed trials. The EORTC Patient Reported Outcomes and Behavioural Evidence (PROBE) team is dedicated to the meta-analysis of EORTC randomised clinical trial quality of life results. During the last 5 years, pooled data have revealed important results, such as prognostic indicators of survival, which have informed clinical practice. This research shows how the patient perspective in palliative and curative EORTC trials has been considered of major importance. The inclusion of patient perspective in drug development shows that a more comprehensive HRQoL assessment has taken place over time as better instruments have become available. As clinicians, regulatory bodies and industry acknowledge the value of the patient perspective, we expect that EORTC will continue including HRQoL endpoints where appropriate.
A New Fast-acting Sublingual Fentanyl (Recivit®) for Treating Breakthrough Cancer Pain
Authors: Davies Andrew ,   Consultant in Palliative Medicine, Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK
Published: October 2015

Cancer pain presents a significant clinical challenge. Even when background pain is effectively controlled, patients often experience episodes of breakthrough cancer pain (BTcP), which typically reach maximum intensity in 10 minutes and last for 60 minutes. Immediate-release opioids are often used to treat BTcP, but only produce analgesia after 20–30 minutes and their full analgesic effect after 60–90 minutes, so transmucosal formulations of fentanyl citrate have been developed that produce analgesia more rapidly. A new sublingual transmucosal formulation (the FE tablet) utilises a unique three-layer structure and is available in dosages from 67 μg to 800 μg. This review summarises available data on the new formulation. In phase I trials, it has demonstrated dose proportionality, absolute bioavailability of approximately 70 % and higher plasma fentanyl concentrations than an oral transmucosal fentanyl citrate lozenge. In a prospective, randomised, double-blind, crossover study to evaluate efficacy and safety, pain relief was recorded from 6 minutes after administration onwards and lasted for up to 60 minutes.
Triple Negative Breast Cancer Pathologic Diagnosis and Current Chemotherapy Treatment Options
Authors: Rapoport Bernardo L , Nayler Simon , Demetriou Georgia S , Moodley Shun D , Benn Carol A ,   Specialist Physician and Medical Oncologist, The Medical Oncology Center of Rosebank, Johannesburg, South Africa,   Specialist Histopathologist, Gritzman and Thatcher Inc. and Wits Donald Gordon Medical Center, Johannesburg, South Africa,   Specialist Physician and Medical Oncologist, Department of Internal Medicine Division of Medical Oncology, University of the Witwatersrand and Wits Donald Gordon Medical Center, Johannesburg, South Africa,   Specialist Physician and Medical Oncologist, University of the Witwatersrand and Wits Donald Gordon Medical Center, Johannesburg, South Africa,   Specialist Surgeon, Netcare Milpark Hospital Breast Centre and Helen Joseph Hospital, University of the Witwatersrand, Johannesburg, South Africa
Published: October 2015

Triple negative breast cancer (TNBC) comprises 12–20 % of all breast cancers and are a heterogeneous group of tumours, both clinically and pathologically. These cancers are characterised by the lack of expression of the hormone receptors oestrogen receptor (OR) and progesterone receptor (PR), combined with the lack of either overexpression or amplification of the human epidermal growth factor receptor-2 (HER2) gene. Conventional cytotoxic chemotherapy and DNA damaging agents continue to be the mainstay of treatment of this disease in the neoadjuvant, adjuvant and metastatic setting. The lack of predictive markers in identifying potential targets for the treatment of TNBC has left a gap in directed therapy in these patients. Platinum agents have seen renewed interest in TNBC based on an increasing body of preclinical and clinical data suggesting encouraging activity. However, comparisons between chemotherapy regimens are mostly retrospective in nature and the best agents or drug combinations for TNBC have not been established in prospective randomised trials. Numerous studies have now shown that TNBC has significantly higher pathological complete response (pCR) rates compared with hormone receptor positive breast cancer when treated with neoadjuvant chemotherapy, and pCR correlates well with better outcomes for these patients. Patients with TNBC account for a larger number of deaths in the setting of metastatic breast cancer. There is no preferred treatment for the first-line metastatic setting. Although individual agents are recommended, given the often aggressive nature of TNBC and the presence of extensive visceral disease, the use of a combination of drugs, rather than a single agent, is often advocated. This review article will outline the pathological diagnosis of TNBC and the treatment options available to these patients in the neoadjuvant, adjuvant and metastatic setting, including an assessment of future directions of treatment.
Primary Central Nervous System Anaplastic Large Cell Lymphoma is an Unusual Brain Tumour
Authors: Papadatos-Pastos Dionysis , Hall James , Pettengell Ruth , Bridges Leslie R , Newell Barry , Samol Jens ,   Specialist Trainee in Medical Oncology, St George’s Healthcare NHS Trust,   Specialist Trainee in Radiology, St George’s Healthcare NHS Trust,   Consultant Medical Oncologist, St George’s Healthcare NHS Trust,   Consultant Neuropathologist, St George’s Hospital NHS Trust,   Consultant Pathologist, St George’s Hospital NHS Trust,   Consultant Medical Oncologist, St George’s Healthcare NHS Trust
Published: October 2015

We present a case of a 64-year-old man who was diagnosed with a primary anaplastic large cell lymphoma of the central nervous system (PCNSAL). He had received radical chemotherapy and radiotherapy for a non-small cell lung cancer (NSCLC) in the past. There is no known association between NSCLC and PCNSAL. We describe the diagnostic and therapeutic challenges associated with these rare intracranial lymphomas and highlight the potential role of newer biological agents in patients with anaplastic lymphoma kinase (ALK-1) positive PCNSAL.
Diagnosis and Work-up of Malignant Melanoma in the Age of Fine Needle Aspiration and Molecular Testing
Authors: Layfield Lester J ,   Professor and Chair, Department of Pathology & Anatomical Sciences, University of Missouri, Columbia, US
Published: October 2015

Melanoma is one of the most aggressive skin cancers and is prone to both local recurrence and distant metastases. Primary treatment usually includes wide excision and sentinel lymph node biopsy. Clinical and pathological staging is important for estimating the potential for metastasis and influences post-resection follow-up protocols. Because stage I and II melanomas metastasize infrequently, asymptomatic patients with these low-stage malignancies do not require routine imaging studies. Patients with positive sentinel lymph nodes often undergo routine examination (for staging) using computed tomography (CT), magnetic resonance imaging (MRI) or positron emission tomography (PET) despite evidence showing a very low yield for such testing. Patients with stage III disease and local recurrence should undergo further testing including serum lactate dehydrogenase (LDH), chest radiograph, CT and PET due to increased risk of systemic metastases. Imaging abnormalities may undergo fine needle aspiration, core biopsy or open biopsy for confirmation of diagnosis and to obtain tissue for ancillary studies. Depending on the availability of treatment protocols ancillary testing may include mutational analysis for BRAF V600-E, CKIT and NRAS.
Molecular Profiling – Challenges and Perspectives
Authors: Dittrich Christian ,   Professor of Medicine, Ludwig Boltzmann Institute for Applied Cancer Research (LBI-ACR VIEnna) – LB Cluster Translational Oncology; Applied Cancer Research – Institution for Translational Research (ACR-ITR VIEnna), Kaiser Franz Josef-Spital, Vienna, Austria
Published: October 2015

Molecular profiling is today’s answer to the eternal unmet need of personalising anticancer therapy. We have never reached such a level of rationality before, based on new technologies, knowledge of systems biology and insights into patho-mechanisms. Whereas we actually focus mainly on mutations of a limited number of cancer genes, we will also have to integrate epigenetic, transcriptional and post-transcriptional changes into our future therapeutic considerations. Overall, we have reached an advanced level of stratified medicine, but are still on the way of targeting the holy grail of real personalisation.
Defibrotide – A New Treatment Approach for Severe Veno-occlusive Disease
Authors: Mountfort Katrina , Mohty Mohamad , Wallhult Elisabeth ,   Senior Medical Writer, Touch Medical Media, Reading, UK,   Professor of Hematology, Saint-Antoine Hospital, Paris, France,   Head of the Hematology and Cellular Therapy Department, University Pierre and Marie Curie, Paris, France,   Section of Haematology and Coagulation, Sahlgrenska University Hospital, Gothenburg, Sweden
Published: October 2015

Severe veno-occlusive disease (VOD) is a serious and life-threatening complication of haematopoietic stem cell transplantation (HSCT), for which the standard of care has until recently been supportive care. VOD is the result of a primary injury to sinusoidal endothelial cells and severe VOD is characterised by sinusoidal narrowing and occlusion, which leads to portal hypertension, multi-organ failure (MOF) and, ultimately, death. Defibrotide regulates multiple pathways involved in the pathological processes underlying VOD and is the first drug to be approved in Europe for the treatment of severe VOD. Defibrotide is indicated for the treatment of severe hepatic VOD in HSCT therapy in adults and infants aged over 1 month. A phase III study found significant increases in complete response (CR) and survival with defibrotide compared with historical controls. These data together with earlier studies and an ongoing expanded access protocol in a large patient cohort demonstrate improved outcomes with defibrotide in severe VOD and highlight the importance of treatment with defibrotide
Brentuximab Vedotin in Relapsed/Refractory Hodgkin’s Lymphoma
Authors: Domingo-Domenech Eva , Comai Alessandra , Sureda Anna ,   Hematology Consultant,   Hematology Resident, Hematology Department, Institut Catala d’Oncologia, Hospital Duran I Reynals, Barcelona, Spain,   Hematology Consultant
Published: October 2015

Although most patients diagnosed with Hodgkin’s lymphoma can be considered long-term disease-free survivors with first-line combined modality protocols, some prove to be primary refractory or to have relapsed disease, ultimately dying from the underlying disorder. Brentuximab vedotin (BV) is a monoclonal antibody drug conjugate targetting the CD30 antigen, which is present in the malignant Reed Sternberg cells. Administered as a single drug, it has demonstrated a 34 % rate of complete remission with an objective response rate of 75 % in a population of patients having previously failed autologous stem cell transplantation (ASCT). Side effects of the drug are also manageable, with sensory peripheral neuropathy the most relevant. BV was recently approved for treating patients having relapse after ASCT and those having failed at least two lines of therapy and in whom ASCT is not an option according to both the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA). BV’s clinical development has recently led to use in much earlier clinical settings.