1,497 results match your criteria Cancer J[Journal]


Immune and Cell Therapy in Non-Hodgkin Lymphoma.

Cancer J 2020 May/Jun;26(3):269-277

From the Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA.

The promise of immunotherapy has shone brightly for decades in hematologic malignancies and specifically in non-Hodgkin lymphoma. The last decade has witnessed the emergence of completely novel forms of immunotherapy, including immune checkpoint blockade, bispecific antibodies, and chimeric antigen receptor T cells. These treatments have shown phenomenal, and in some cases possibly curative, successes in various relapsed/refractory lymphomas. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000445DOI Listing
June 2020
4.237 Impact Factor

HIV Lymphoma and Burkitts Lymphoma.

Authors:
Ariela Noy

Cancer J 2020 May/Jun;26(3):260-268

From the Department of Medicine, Memorial Sloan Kettering Cancer Center; and Weill Cornell Medical College, New York, NY.

Despite widely available antiretroviral therapy, lymphoma remains the leading cause of death for human immunodeficiency virus (HIV)-infected persons in economically developed countries. Even a few months of drug interruptions can lead to drops in the CD4 cell count, HIV viremia, and an increased risk of lymphoma. Currently, good HIV control facilitates intensive therapies appropriate to the lymphoma, including autologous and even allogeneic hematopoietic stem cell transplantation. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000448DOI Listing

Diagnosis, Risk Stratification, and Treatment of Peripheral T-Cell Lymphomas: Past and Present.

Cancer J 2020 May/Jun;26(3):253-259

From the Division of Hematology/Oncology, Northwestern University Feinberg School of Medicine, and Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL.

Peripheral T-cell lymphomas represent an evolving class of aggressive T-cell malignancies that are generally refractory to conventional treatments and historically carry a poor prognosis. Recent advances in gene expression profiling have begun to unravel the specific molecular mechanisms of tumorigenesis in these disease processes, allowing for discrete classification schemes that help guide discussions regarding prognosis and therapy options. We outline here a review of the histopathology, epidemiology, clinical features, and treatment strategies currently used in the management of these diseases. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000452DOI Listing

Central Nervous System Lymphoma: Approach to Diagnosis and Treatment.

Cancer J 2020 May/Jun;26(3):241-252

From the Department of Neurology, Memorial Sloan Kettering Cancer Center.

Central nervous system lymphoma (CNSL) is a rare form of extranodal non-Hodgkin lymphoma. Central nervous system lymphoma can be primary (isolated to the central nervous space) or secondary in the setting of systemic disease. Treatment of CNSL has improved since the introduction of high-dose methotrexate and aggressive consolidation regimens. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000449DOI Listing

Advances in Treatment of Follicular Lymphoma.

Cancer J 2020 May/Jun;26(3):231-240

Department of Surgical, Medical and Dental Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy.

Follicular lymphoma (FL) is a heterogeneous disease with varying prognosis owing to differences in clinical, laboratory, and disease parameters. Although generally considered incurable, prognosis for early and advanced stage disease has improved because of therapeutic advances, several of which have resulted from elucidation of the biologic and molecular basis of the disease. The choice of treatment for FL is highly dependent on patient and disease characteristics. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000444DOI Listing

Radiotherapy for Non-Hodgkin Lymphomas.

Cancer J 2020 May/Jun;26(3):217-230

Lymphoma Disease Management Team Memorial Sloan Kettering Cancer Center, New York, NY.

Radiotherapy (RT) plays a diverse and essential role in the contemporary management of non-Hodgkin lymphoma (NHL) and remains the single most powerful monotherapeutic intervention for both aggressive and indolent subtypes. Over the past decade, there have been significant advancements in radiation oncology practice, which have made modern treatments safer and more conformal. Despite this sophistication and evidence supporting a continued role for RT, numerous data suggest that utilization is on the decline. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000453DOI Listing

Role of Microenvironment in Non-Hodgkin Lymphoma: Understanding the Composition and Biology.

Cancer J 2020 May/Jun;26(3):206-216

From the Division of Hematology, Mayo Clinic, Rochester, MN.

Lymphoma microenvironment is a dynamic and well-orchestrated network of various immune and stromal cells that is indispensable for tumor cell survival, growth, migration, immune escape, and drug resistance. Recent progress has enhanced our knowledge of the pivotal role of microenvironment in lymphomagenesis. Understanding the characteristics, functions, and contributions of various components of the tumor niche, along with its bidirectional interactions with tumor cells, is paramount. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000446DOI Listing

Molecular Classification and Treatment of Diffuse Large B-Cell Lymphoma and Primary Mediastinal B-Cell Lymphoma.

Cancer J 2020 May/Jun;26(3):195-205

From the Lymphoid Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD.

Diffuse large B-cell lymphoma (DLBCL) encompasses a group of aggressive B-cell non-Hodgkin lymphomas with striking genetic heterogeneity and variable clinical presentations. Among these is primary mediastinal B-cell lymphoma (PMBL), which has unique clinical and molecular features resembling Hodgkin lymphoma. Treatment of DLBCL is usually curative, but identifiable subsets at highest risk for treatment failure may benefit from intensified chemotherapy regimens and/or targeted agents added to frontline therapy. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000450DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7285963PMC

Molecular Diagnostics of Non-Hodgkin Lymphoma.

Cancer J 2020 May/Jun;26(3):186-194

Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY.

Non-Hodgkin lymphoma encompasses a diverse group of B-cell and T-cell neoplasms. Current classification is based on clinical information, histologic assessment, immunophenotypic characteristics, and molecular alterations. A wide range of genetic alterations, including large chromosomal structural rearrangements, aneuploidies, point mutations, and copy number alterations, have been reported across all types of lymphomas. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000447DOI Listing

Lymphoma Classification.

Cancer J 2020 May/Jun;26(3):176-185

Hematopathology Section, Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD.

Twenty-five years after the Revised European American Classification of Lymphoid Neoplasms classification was published, its principle of an integrative approach to disease definition based on several parameters still prevails and has been adopted and expanded in the following World Health Organization classifications of tumors of the hematopoietic organs. The latest World Health Organization classification revised in 2017 comprises more than 80 entities of mature lymphoid neoplasms (B-cell, T-cell, and Hodgkin lymphomas), which are defined according to their morphology, immunophenotype, genetic lesions and molecular profiles, clinical features, and cellular derivation. The classification also recognizes both incipient and indolent lymphoid neoplasms with a low potential of progression. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000451DOI Listing

Introduction by the Guest Editor.

Authors:
Anas Younes

Cancer J 2020 May/Jun;26(3):175

From the Memorial Sloan-Kettering Cancer Center, New York, NY.

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http://dx.doi.org/10.1097/PPO.0000000000000454DOI Listing

Oligometastatic Disease and Interventional Oncology: Rationale and Research Directions.

Cancer J 2020 Mar/Apr;26(2):166-173

From the Section of Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT.

Oligometastatic disease (OMD) is generally defined as a stage of clinically or radiographically demonstrated metastatic disease limited in total disease burden and without rapid spread. Interventional oncology performs local therapies for primary and metastatic cancers, including OMD. Interventional oncology treatments can be pursued both as definitive therapy and for palliative purposes. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000442DOI Listing

Radiation in the Treatment of Oligometastatic and Oligoprogressive Disease: Rationale, Recent Data, and Research Questions.

Cancer J 2020 Mar/Apr;26(2):156-165

From the Department of Radiation Oncology, London Health Sciences Centre, London, Ontario, Canada.

The use of local ablative therapy or metastasis-directed therapy is an emerging management paradigm in oligometastatic and oligoprogressive cancer. Recent randomized evidence has demonstrated that stereotactic ablative radiotherapy (SABR) targeting all metastatic deposits is tolerable and can improve progression-free and overall survival. While SABR is noninvasive, minimally toxic, and generally safe, rare grade 5 events have been reported. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000436DOI Listing

Surgeon's Perspective to Local Therapy in Oligometastatic Cancer.

Authors:
Daniel J Boffa

Cancer J 2020 Mar/Apr;26(2):149-155

From Yale University School of Medicine, New Haven, CT.

Oligometastatic cancer has been recognized as a distinct clinical entity for over 100 years. For decades surgeons have been devising strategies to identify patients with oligmetastatic cancer that have the potential to be cured by surgically removing the oligometastases ("curative intent metastasectomy"). More recently, several studies have suggested there may be benefits to local therapy in oligometastatic cancer patients that are less likely to be cured. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000441DOI Listing

Oligometastatic Disease and Local Therapies: A Medical Oncology Perspective.

Cancer J 2020 Mar/Apr;26(2):144-148

From the Yale Cancer Center, Yale University, New Haven, CT.

Numerous studies in a variety of solid tumor malignancies have demonstrated prolonged progression-free and overall survival with the addition of definitive local therapies to systemic therapies in patients with a limited number of metastases. A subset of patients with oligometastases (1-5 metastases) may experience long-term disease remission or cure after local therapies such as surgery or stereotactic body radiation therapy to metastatic sites. This article reviews the literature in oligometastatic disease and considers a theoretical rationale for a curative approach in a subset of oligometastatic solid tumor patients. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000439DOI Listing

Oligometastatic and Oligoprogression Disease and Local Therapies in Prostate Cancer.

Cancer J 2020 Mar/Apr;26(2):137-143

From the Departments of Radiation Oncology and Molecular Radiation Sciences.

Our understanding of metastatic disease is rapidly advancing, with recent evidence supporting an oligometastatic state currently defined by patients having a limited (typically ≤5) number of metastatic deposits. The optimal management of these patients is also shifting toward increased integration of local therapies, with emerging evidence suggesting metastasis-directed therapy can improve overall survival. Additionally, the use of stereotactic ablative radiation therapy within castration-sensitive oligometastatic prostate cancer cohorts appears to forestall the need to initiate systemic therapy, which has unfavorable side effect profiles, such as androgen deprivation therapy, while itself being associated with little toxicity. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000432DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7101059PMC

Local Ablative Therapies for Oligometastatic and Oligoprogressive Non-Small Cell Lung Cancer.

Cancer J 2020 Mar/Apr;26(2):129-136

From the Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT.

More than half of all patients with non-small cell lung cancer (NSCLC) have metastatic disease at the time of diagnosis. A subset of these patients has oligometastatic disease, which exists in an intermediary state between locoregional and disseminated metastatic disease. In addition, some metastatic patients on systemic therapy may have limited disease progression, or oligoprogression. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000433DOI Listing

Imaging and Image-Guided Thermal Ablation for Oligometastatic Colorectal Cancer Liver Disease.

Cancer J 2020 Mar/Apr;26(2):124-128

From the Department of Interventional Oncology/Radiology, Memorial Sloan Kettering Cancer Center, New York, NY.

Colorectal cancer affects more than 1 million people worldwide, and half of this population develops liver metastases. Image-guided thermal ablation is an acceptable local therapy for the management of oligometastatic colorectal cancer liver disease, in patients who are noneligible for surgery, or present with recurrence after hepatectomy. Continuous technological evolutions, understanding of tumor variability through disease biology and genetics, and optimization of ablation parameters with ablation margin assessment have allowed patients with resectable small-volume disease to be treated by thermal ablation with curative intent. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000440DOI Listing

Circulating Tumor DNA Biomarkers for Early Detection of Oligometastasis.

Cancer J 2020 Mar/Apr;26(2):116-123

Department of Radiation Oncology, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC.

Oligometastasis represents an intermediate disease stage between localized and widely metastatic cancer. Efficient identification of patients with oligometastasis remains a barrier for accrual on clinical trials of oligometastasis-directed therapy. Here we review the prospect of circulating tumor DNA-based monitoring to promote sensitive, specific, and cost-efficient detection of cancer recurrence during posttreatment surveillance. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000437DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7285872PMC

Radiomics, Radiogenomics, and Next-Generation Molecular Imaging to Augment Diagnosis of Hepatocellular Carcinoma.

Cancer J 2020 Mar/Apr;26(2):108-115

From the Laboratory of Molecular Radiotherapy, Molecular Imaging Program, Radiation Oncology Branch, National Cancer Institute.

Ultrasound, computed tomography, magnetic resonance imaging, and [F]F-fluorodeoxyglucose positron emission tomography are invaluable in the clinical evaluation of human cancers. Radiomics and radiogenomics tools may allow clinicians to standardize interpretation of these conventional imaging modalities, while better linking radiographic hallmarks to disease biology and prognosis. These advances, coupled with next-generation positron emission tomography imaging tracers capable of providing biologically relevant tumor information, may further expand the tools available in our armamentarium against human cancers. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000435DOI Listing

Prognostic and Predictive Biomarkers in Oligometastatic Disease.

Cancer J 2020 Mar/Apr;26(2):100-107

From the Department of Medicine.

Metastatic lesions are largely responsible for cancer-related deaths and are synonymous with a poor prognosis. However, this is not always true for patients with oligometastases whose disease may be amenable to curative-intent local therapies. It has been proposed that an "intermediate state" (oligometastasis) exists in between locoregional and advanced disease states; however, the clinical definition of oligometastasis varies, and there is limited understanding of how tumor biology differs between oligometastases and polymetastases. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000438DOI Listing

Definition, Biology, and History of Oligometastatic and Oligoprogressive Disease.

Cancer J 2020 Mar/Apr;26(2):96-99

From the Department of Radiation and Cellular Oncology, The University of Chicago Medicine, Chicago, IL.

Historical theories of metastasis have been informed by the seed and soil hypothesis, the Halsteadian paradigm proposing an orderly spread from local to distant sites, and the presumption that cancer is an inherently systemic process even in the earliest cases. The more contemporary spectrum theory now suggests that the propensity for distant spread exists along a continuum of metastatic virulence. Tumors with limited metastatic potential represent one subset along this spectrum that could potentially be cured with local ablative therapy. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000434DOI Listing

Introduction by the Guest Editor: Oligometastatic Disease in Cancer.

Authors:
Hyun S Kim

Cancer J 2020 Mar/Apr;26(2):95

From the Section of Interventional Radiology, Department of Radiology and Biomedical Imaging.

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http://dx.doi.org/10.1097/PPO.0000000000000443DOI Listing

Radiotherapy in the Management of Metastatic Hormone-Sensitive Prostate Cancer: What Is the Standard of Care?

Cancer J 2020 Jan/Feb;26(1):87-93

From the Departments of Radiation Oncology and Molecular Radiation Sciences.

Systemic therapy has historically been the backbone of treatment for patients with metastatic disease. However, recent evidence suggests metastasis-directed therapy in those with oligometastatic disease (≤5 lesions) may improve progression-free and overall survival. Within prostate cancer-specific cohorts, metastasis-directed therapy also appears to delay the time to initiation of androgen deprivation therapy while also generally being associated with a mild toxicity profile and has thus garnered interest as a means to delay systemic therapy. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000429DOI Listing
January 2020

Treatment of Primary in Metastatic Prostate Cancer: What Is the Standard of Care?

Cancer J 2020 Jan/Feb;26(1):83-86

Department of Clinical Oncology, The Christie NHS Foundation Trust.

Until recently, men with metastatic prostate cancer were commenced on androgen deprivation therapy at diagnosis, followed by sequential lines of treatment with the development of castration resistance. However, the results of recent clinical trials, which revealed that the addition of radiotherapy to the prostate to a dose of 55 to 60 Gy in 20 fractions over 4 weeks in patients with low-volume metastatic hormone-sensitive prostate cancer, in addition to androgen deprivation therapy and another systemic treatment option, either docetaxel, abiraterone, enzalutamide, or apalutamide, has led to a paradigm change in the management of this disease. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000430DOI Listing
January 2020

Factors to Guide Treatment Selection for Hormone-Sensitive Metastatic Prostate Cancer.

Cancer J 2020 Jan/Feb;26(1):76-82

From the Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan Medical School.

For decades, the mainstay of treatment for metastatic hormone-sensitive prostate cancer has been androgen deprivation therapy. In recent years, 4 systemic therapies-docetaxel, abiraterone, enzalutamide, and apalutamide-have improved overall survival for men with metastatic hormone-sensitive prostate cancer when combined with androgen deprivation therapy, raising the question of which treatment to choose. The role for metastasis-directed therapy with surgery or radiation among these new treatments has also yet to be defined. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000423DOI Listing
January 2020

Metastatic Hormone-Sensitive Prostate Cancer: A Review of the Current Treatment Landscape.

Cancer J 2020 Jan/Feb;26(1):64-75

Divisions of Medical Oncology and Urology, Duke Cancer Institute, Durham, NC.

Purpose: In recent years, the treatment options for metastatic hormone-sensitive prostate cancer (mHSPC) have expanded significantly. In addition to androgen deprivation therapy, the systemic treatments now include docetaxel, abiraterone, enzalutamide, and apalutamide. Radiation to the primary is also an option for select low-volume patients. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000418DOI Listing
January 2020

Pathologically Node-Positive Prostate Cancer: Casting for Cure When the Die Is Cast?

Cancer J 2020 Jan/Feb;26(1):58-63

Department of Urology, University of Michigan Medical School, Ann Arbor, MI.

The postoperative management of men with lymph node involved prostate cancer (pN+) remains a challenge as there is a general lack of randomized trial data and a range of management strategies. Retrospective studies suggest a variable clinic course for patients with pN+ prostate cancer. Some men progress rapidly to metastatic disease despite further therapies, whereas other men can have a period of prolonged quiescence without adjuvant androgen deprivation therapy (ADT) or radiation therapy (RT). Read More

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http://dx.doi.org/10.1097/PPO.0000000000000426DOI Listing
January 2020

Clinically Lymph Node Positive Prostate Cancer: At the Intersection of Focal and Systemic Disease Control.

Cancer J 2020 Jan/Feb;26(1):53-57

Clinically node-positive prostate cancer is often found at the time of diagnosis by cross-sectional imaging and remains poorly understood. Advanced imaging modalities such as magnetic resonance imaging nanoparticles or positron emission tomography-based molecular imaging stand to rapidly change the field and hopefully will bring better diagnostic clarity. This will allow for prospective clinical trials using radiographic, clinical, or molecular parameters to establish who may benefit from both localized and systemic treatment intensification and who may avoid overtreatment. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000421DOI Listing
January 2020

Surrogate Endpoints in Localized Prostate Cancer.

Cancer J 2020 Jan/Feb;26(1):48-52

Radiation Oncology, University of Michigan, Ann Arbor, MI.

Randomized clinical trials assessing novel therapies in men with localized prostate cancer frequently require large patient numbers and more than a decade of follow-up to demonstrate improvements in overall survival. As the landscape of treatment options for prostate cancer is rapidly changing, clinical trials requiring long follow-up threaten to impede treatment improvements and run the risk of results being obsolete by the time that they are reported in publication. To address these issues, there has been tremendous interest in identifying an intermediate clinical endpoint that can be assessed earlier in the disease course to serve as a robust surrogate for overall survival in men with localized prostate cancer. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000422DOI Listing
January 2020

Molecular Imaging of Newly Diagnosed Prostate Cancer.

Authors:
Scott Williams

Cancer J 2020 Jan/Feb;26(1):43-47

From the Division of Radiation Oncology, Peter MacCallum Cancer Centre; and Division of Radiation Oncology, University of Melbourne, Melbourne, Victoria, Australia.

Positron emission tomography (PET) is a valuable imaging in evaluating many malignancies. There are various molecular imaging tracers that are currently being utilized with prostate cancer (PC). Several PET agents imaging different molecular processes in PC have reached the clinic. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000427DOI Listing
January 2020

Stereotactic Ablative Body Radiotherapy for Intermediate- or High-Risk Prostate Cancer.

Authors:
Andrew Loblaw

Cancer J 2020 Jan/Feb;26(1):38-42

From the Odette Cancer Centre, Sunnybrook Health Sciences Centre; and Department of Radiation Oncology, and Institute of Health Care Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.

Stereotactic ablative radiotherapy (SABR) is a relatively novel form of high precision radiotherapy. For low- and intermediate risk patients, ultrahypofractionation (UHF - more than 5 Gy per day) has been compared to conventionally fractionated or moderately hypofractionated radiotherapy in two large randomized studies. A third smaller randomized study examined the question of the optimal frequency of treatments. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000425DOI Listing
January 2020

Comparing Radiotherapy to Prostatectomy for High-Risk Prostate Cancer: A Narrative Review of Mortality and Quality-of-Life Outcomes.

Cancer J 2020 Jan/Feb;26(1):29-37

From the Department of Radiation Oncology, Sidney Kimmel Medical College & Cancer Center at Thomas Jefferson University, Philadelphia, PA.

There is currently a lack of level 1 evidence regarding the relative efficacy of radical prostatectomy compared with radiotherapy combined with androgen deprivation therapy for high-risk prostate cancer. There has recently been an improved optimization of treatment, achieving superior biochemical outcomes and cancer-specific mortality through the use of combined modality therapy strategies. Combined modality therapies have also increasingly incorporated brachytherapy boost. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000420DOI Listing
January 2020

Next Generation of Androgen Deprivation Therapy Combined With Radiotherapy for N0 M0 Prostate Cancer.

Cancer J 2020 Jan/Feb;26(1):21-28

From the Department of Hematology and Medical Oncology.

Androgen deprivation therapy in combination with definitive radiation therapy is a standard of care for both intermediate-/high-risk localized prostate, locally advanced prostate cancer. Newer hormonal therapies have shown promising results in patients with castration-resistant disease and are now being investigated in early stages, in combination with radiation therapy. In this section, we review the body of evidence elucidating the mechanism of synergy and immune modulation effect of androgen deprivation therapy and radiation therapy, summarize the pivotal studies supporting its use in the nonmetastatic setting, and present the ongoing studies who will likely shape the management of locally advanced disease, in the upcoming years. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000428DOI Listing
January 2020

Genomic Strategies to Personalize Use of Androgen Deprivation Therapy With Radiotherapy.

Cancer J 2020 Jan/Feb;26(1):13-20

From the Department of Radiation Oncology, University of Toronto.

The use of combination RT and androgen deprivation therapy in many prostate cancer curative-intent treatment scenarios is supported by level 1 evidence. However, in our current clinical paradigm, we have no ability to determine a priori which patients truly benefit from combination therapy and therefore apply the combination RT and androgen deprivation therapy intensification strategy to all patients, which results in overtreatment or undertreatment of the majority of our patients. Genomics has the ability to more deeply and objectively characterize the disease, in turn refining our prognostication capabilities and enabling the individualization of treatments. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000419DOI Listing
January 2020

Neoadjuvant Approaches Prior To Radical Prostatectomy.

Cancer J 2020 Jan/Feb;26(1):2-12

University of California, San Diego, San Diego, CA.

Patients with high-risk localized prostate cancer benefit from multimodality therapy of curative intent. Androgen-deprivation therapy (ADT) combined with radiation improves survival in this population. However, prior clinical trials of neoadjuvant ADT and surgery failed to consistently demonstrate a survival advantage. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000424DOI Listing
January 2020

Targeted Therapies in Chronic Lymphocytic Leukemia: Is 2 (or 3) Better Than 1?

Cancer J 2019 Nov/Dec;25(6):449-454

Division of Hematology-Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Washington, DC.

Small molecule inhibitors, including B-cell receptor antagonists and B-cell lymphoma - 2 inhibitors, have revolutionized the treatment of chronic lymphocytic leukemia (CLL). These agents have improved outcomes for patients of all prognostic backgrounds, thus securing their role in the frontline setting. Impressive activity has been demonstrated both with monotherapy and in combination with other targeted therapeutics. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000410DOI Listing
November 2019

Real-World Evidence for Chronic Lymphocytic Leukemia in the Era of Targeted Therapies.

Cancer J 2019 Nov/Dec;25(6):442-448

Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY.

The landscape of chronic lymphocytic leukemia has transformed in the era of small molecule inhibitor targeted therapies. While randomized controlled trials remain the criterion standard in evaluating new therapies, they are often unable to keep pace with the clinical questions that arise during the use of novel agents. Real-world evidence is generated through analysis of data such as electronic medical records, payer claims, and patient registry databases and can provide invaluable information to supplement randomized controlled trials, such as outcomes in patient populations excluded from clinical trials, rates of discontinuation or dose reductions in clinical practice, survival outcomes, and optimal sequencing of novel agents. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000407DOI Listing
November 2019

Chimeric Antigen Receptor T Cells in Chronic Lymphocytic Leukemia: Are We Any Closer to a Cure?

Cancer J 2019 Nov/Dec;25(6):436-441

Lymphoma Program, Robert and Margarita Louis-Dreyfus Professor in Chronic Lymphocytic Leukemia and Lymphoma Clinical Care and Research, Abramson Cancer Center, Division of Hematology/Oncology, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA.

Recent advances in the treatment of chronic lymphocytic leukemia (CLL) have dramatically changed outcomes for patients. Despite these improvements, CLL is still considered incurable. Chimeric antigen receptor-modified T cells have demonstrated the ability to produce long-term remissions in subsets of heavily pretreated patients with B-cell malignancies, including CLL. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000409DOI Listing
November 2019

Resistance Mechanisms to Targeted Agents in Chronic Lymphocytic Leukemia.

Cancer J 2019 Nov/Dec;25(6):428-435

From the Ohio State University Comprehensive Cancer Center, Columbus, OH.

Agents that specifically target pathologic mechanisms of survival have now been approved for the treatment of chronic lymphocytic leukemia in both the treatment-naive and relapsed/refractory settings. These 4 agents include the Bruton tyrosine kinase inhibitor ibrutinib, the B-cell leukemia/lymphoma-2 inhibitor venetoclax, and the phosphatidylinositol-3 kinase inhibitors idelalisib and duvelisib. Although clinical outcomes are improved with all of these inhibitors, acquired resistance does occur and leads to progression of disease. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000406DOI Listing
November 2019

Cost-effectiveness of New Targeted Agents in the Treatment of Chronic Lymphocytic Leukemia.

Cancer J 2019 Nov/Dec;25(6):418-427

Chronic lymphocytic leukemia (CLL) is the most common adult leukemia and is clinically heterogeneous. Integration of oral targeted therapies (OTTs) in the management of CLL has fundamentally altered CLL treatment pathways and improved outcomes for patients with CLL.We review the cost-effectiveness of OTTs in the treatment of CLL. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000411DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141587PMC
November 2020

Relevance of Minimal Residual Disease in the Era of Targeted Agents.

Cancer J 2019 Nov/Dec;25(6):410-417

From the Strategic Research Program on CLL, IRCCS Ospedale San Raffaele and Università Vita-Salute San Raffaele, Milano, Italy.

The evaluation of minimal residual disease (MRD) in chronic lymphocytic leukemia (CLL) has evolved in parallel with the enormous progresses in the therapeutic armamentarium and the application of cutting-edge diagnostic techniques the CLL community witnessed in the past few years. Minimal residual disease is considered an objective measure of disease status defined by the number of residual leukemic cells detected in a sample of peripheral blood and/or bone marrow as proportion of the total white blood cells and defined undetectable if fewer than 1 CLL cell among 10,000 white blood cells (10 or 0.01%) is detected. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000413DOI Listing
November 2019

BCL-2 Inhibitors, Present and Future.

Cancer J 2019 Nov/Dec;25(6):401-409

Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA.

The members of the B-cell leukemia/lymphoma-2 (BCL-2) family of proteins are key regulators of the intrinsic apoptotic pathway; dysregulation of this pathway leads to pathologic survival of cancer cells. B-cell leukemia/lymphoma-2 had long been viewed as a promising target for the treatment of several hematologic malignancies, specifically chronic lymphocytic leukemia (CLL), yet for many years the development of a drug to successfully target this protein remained elusive. The approval of the BCL-2 inhibitor venetoclax for relapsed/refractory del(17p) CLL in 2016 represented the culmination of decades of molecular and clinical research and has paved the way for new combination therapy regimens in CLL, including the venetoclax + rituximab regimen approved for relapsed/refractory CLL in 2018 and the venetoclax + obinutuzumab regimen approved for frontline CLL treatment in 2019. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000408DOI Listing
November 2019

Phosphatidylinositol 3 Kinase δ Inhibitors: Present and Future.

Authors:
Jennifer R Brown

Cancer J 2019 Nov/Dec;25(6):394-400

From Harvard Medical School and CLL Center, Dana-Farber Cancer Institute, Boston, MA.

Inhibitors of PI3Kδ hold great potential for the therapy of chronic lymphocytic leukemia and B-cell malignancies. After initially exciting efficacy results with idelalisib, the first-in-class inhibitor, the emergence of unexpected and unpredictable autoimmune toxicities, worse in less heavily treated and younger patients, has decreased the use of the currently available inhibitors. Newer drugs in development are attempting to reduce toxicity with novel schedules and/or combinations. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000414DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082729PMC
November 2020

Bruton Tyrosine Kinase Inhibitors: Present and Future.

Authors:
Jan A Burger

Cancer J 2019 Nov/Dec;25(6):386-393

From the Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX.

Bruton tyrosine kinase (BTK) is a nonreceptor tyrosine kinase that plays a central role in the signal transduction of the B-cell antigen receptor and other cell surface receptors, both in normal and malignant B lymphocytes. B-cell antigen receptor signaling is activated in secondary lymphatic organs and drives the proliferation of malignant B cells, including chronic lymphocytic leukemia (CLL) cells. During the last 10 years, BTK inhibitors (BTKis) are increasingly replacing chemotherapy-based regimen, especially in patients with CLL and mantle cell lymphoma (MCL). Read More

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http://dx.doi.org/10.1097/PPO.0000000000000412DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7083517PMC
November 2020

Targeted Therapy in Chronic Lymphocytic Leukemia.

Cancer J 2019 Nov/Dec;25(6):378-385

From the Moores Cancer Center, University of California, San Diego, La Jolla, CA.

Despite a prevailing view that advances in cancer therapy will come through selective targeting of enzymes encoded by mutated oncogenes responsible for the neoplastic phenotype, recent advances in the treatment of patients with chronic lymphocytic leukemia (CLL) have instead exploited knowledge of its biology. Indeed, CLL cells depend on interactions with cells and soluble factors present in the tumor microenvironment for proliferation and survival. B-cell receptor signaling and chemokine-receptor signaling play prominent roles. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000416DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7039327PMC
November 2019

The Shifting Paradigm in Chronic Lymphocytic Leukemia: Is Chemotherapy Still Relevant?

Cancer J 2019 Nov/Dec;25(6):374-377

Chao Family Comprehensive Cancer Center, University of California Irvine Medical Center, Orange, CA.

Chemoimmunotherapy (CIT) was the standard treatment for patients with chronic lymphocytic leukemia for the last 2 decades. Recently, with the introduction of targeted therapies, the role of CIT has declined significantly. In the first-line setting, the role of CIT is limited to young fit patients with mutated immunoglobulin heavy chain variable region and without del(17p)/TP53 mutation. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000417DOI Listing
November 2019

Introduction by the Guest Editor: Staying Ahead of the Rapidly Evolving World of Chronic Lymphocytic Leukemia.

Authors:
Bruce D Cheson

Cancer J 2019 Nov/Dec;25(6):373

From the Georgetown University Hospital, Lombardi Comprehensive Cancer Center, 3800 Reservoir Rd, N.W. Washington, DC 20007.

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http://dx.doi.org/10.1097/PPO.0000000000000415DOI Listing
November 2019

Evaluation of Traditional Chinese Medicine Herbs in Oncology Clinical Trials.

Cancer J 2019 Sep/Oct;25(5):367-371

From the Guang An Men Hospital, China Academy of Chinese Medical Sciences, Beijing, China.

Despite wide empirical use and demand for traditional Chinese medicine (TCM) herbs worldwide, high-quality clinical trials of TCM herbs in oncology are limited. We developed recommendations for rigorous clinical trials to evaluate their safety and efficacy for oncology patients. To accomplish this goal, the TCM & Cancer Research Committee of the Chinese Pharmaceutical Association convened a working group of oncologists, TCM experts, clinical researchers, biostatisticians, and industry/government representatives to develop principles and approaches for TCM cancer drug clinical trials. Read More

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http://dx.doi.org/10.1097/PPO.0000000000000404DOI Listing
October 2019