Biomarkers of Outcome in Patients With Localized Prostate Cancer Treated With Radiotherapy
Prostate cancer represents one of the most prevalent malignancies in the world. Although subsets of prostate cancer are aggressive and can metastasize, it is also evident that most patients harbor indolent disease. Although current risk-stratification approaches use both clinical and pathologic factors, it is clear that biomarkers can be used to improve on these approaches. In this article, we review the currently published literature on prostate cancer molecular biomarkers, primarily in the context of radiation therapy, focusing on those found in serum, plasma, urine, and within the tumor biopsy itself. (Source: Seminars ...
Source: Seminars in Radiation Oncology - December 14, 2016 Category: Cancer & Oncology Authors: William A. Hall, Colleen A. Lawton, Ashesh B. Jani, Alan Pollack, Felix Y. Feng Source Type: research
Introduction
The landscape of prostate cancer and its management has undergone significant changes over the past decade. Notably, there has been a decrease in the use of PSA screening since such testing was offered a Grade D recommendation by the United States Preventative Services Task Force (USPSTF) guidelines in late 2011.1 As a result, large observational database studies have suggested a relative decrease in incident prostate cancer and low-risk disease in the United States.1 There has also been a shift in management toward active surveillance for lower-risk disease and radical prostatectomy for higher-risk disease, seemingly at t...
Source: Seminars in Radiation Oncology - December 14, 2016 Category: Cancer & Oncology Authors: Jason A. Efstathiou Source Type: research
Successes and Failures of Combined Modalities in Upper Gastrointestinal Malignancies: New Directions
Upper gastrointestinal malignancies generally have moderate to poor cure rates, even in the earliest stages, thereby implying that both local and systemic treatments have room for improvement. Therapeutic options are broadening, however, with the development of new immunotherapies and targeted agents, which can have synergistic effects with radiotherapy. Here we discuss the current state of combined modality therapy for upper gastrointestinal malignancies, specifically recent successes and setbacks in trials of radiation therapy with targeted therapies, vaccines, immunotherapies, and chemotherapies. (Source: Seminars in Radiation Oncology)
Source: Seminars in Radiation Oncology - September 10, 2016 Category: Cancer & Oncology Authors: Daniel S. Jamorabo, Steven H. Lin, Salma K. Jabbour Source Type: research
Recent Advances and Prospects for Multimodality Therapy in Pancreatic Cancer
The outcomes for treatment of pancreatic cancer have not improved dramatically in many decades. However, the recent promising results with combination chemotherapy regimens for metastatic disease increase optimism for future treatments. With greater control of overt or occult metastatic disease, there will likely be an expanding role for local treatment modalities, especially given that nearly a third of pancreatic cancer patients have locally destructive disease without distant metastatic disease at the time of death. (Source: Seminars in Radiation Oncology)
Source: Seminars in Radiation Oncology - September 10, 2016 Category: Cancer & Oncology Authors: Awalpreet S. Chadha, Allison Khoo, Maureen L. Aliru, Harpreet K. Arora, Jillian R. Gunther, Sunil Krishnan Source Type: research
New Strategies for Multimodality Therapy in Treating Locally Advanced Cervix Cancer
Cervical cancer is the fourth most common cause of cancer of women worldwide. In the developing world, it comprises 12% of all cancers of women. Since 1999, the mainstay of treatment for locally advanced cervical cancer (LACC) has been concurrent cisplatin-based chemoradiation. However, outcomes in this disease remain suboptimal, with long-term progression-free survival and overall survival rates of approximately 60%. There are several new strategies of combined modality treatment under evaluation in LACC, including chemotherapy before and after treatment as well as novel agents such as poly-adenosine diphosphate ribose po...
Source: Seminars in Radiation Oncology - September 10, 2016 Category: Cancer & Oncology Authors: Jonathan Verma, Bradley J. Monk, Aaron H. Wolfson Source Type: research
Successes and Failures of Combined Modality Therapies in Head and Neck Cancer
The paradigms for treating head and neck squamous cell carcinoma are changing as new subgroups are defined. The technical successes of improved radiation therapy are many; however, the success of novel combined therapies are few. With the emergence of human papillomavirus and the development of immunooncology agents, such as checkpoint inhibitors, are we ready to reevaluate how we use radiation and chemotherapy for locally advanced and metastatic disease —will we remain the fire or become the fire starter? (Source: Seminars in Radiation Oncology)
Source: Seminars in Radiation Oncology - September 10, 2016 Category: Cancer & Oncology Authors: Daniel W. Bowles, Eric Deutsch, David Raben Source Type: research
Translation of Targeted Radiation Sensitizers into Clinical Trials
Over the past century, technologic advances have promoted the evolution of radiation therapy into a precise treatment modality allowing for the maximal administration of dose to tumors while sparing normal tissues. Coinciding with this technological maturation, systemic therapies have been combined with radiation in an effort to improve tumor control. Conventional cytotoxic agents have improved survival in several tumor types but cause increased toxicity due to effects on normal tissues. An increased understanding of tumor biology and the radiation response has led to the nomination of several pathways whose targeted inhib...
Source: Seminars in Radiation Oncology - September 10, 2016 Category: Cancer & Oncology Authors: Zachery R. Reichert, Daniel R. Wahl, Meredith A. Morgan Source Type: research
Current Instrumentation and Technologies in Modern Radiobiology Research —Opportunities and Challenges
There is a growing awareness of the gaps in the technical methods employed in radiation biology experiments. These quality gaps can have a substantial effect on the reliability and reproducibility of results as outlined in several recent meta-studies. This is especially true in the context of the newer laboratory irradiation technologies. These technologies allow for delivery of highly localized dose distributions and increased spatial accuracy but also present increased challenges of their own. (Source: Seminars in Radiation Oncology)
Source: Seminars in Radiation Oncology - September 10, 2016 Category: Cancer & Oncology Authors: Eric Ford, Jim Deye Source Type: research
Success and Failures of Combined Modalities in Glioblastoma Multiforme: Old Problems and New Directions
Glioblastoma multiforme (GBM) is an aggressive intracranial tumor characterized by local and distant brain relapse despite aggressive therapy. Current standard treatment includes surgical resection followed by radiation with concurrent and adjuvant temozolomide as part of a combined modality approach. In this review, the historical basis for the current standard treatment is discussed as well as other recent combined modality successes and failures. An overview of emerging combined modality therapies for GBM is presented including immunotherapy, and rationally designed radiosensitizers. (Source: Seminars in Radiation Oncology)
Source: Seminars in Radiation Oncology - September 10, 2016 Category: Cancer & Oncology Authors: Christopher D. Corso, Ranjit S. Bindra Source Type: research
Targeted Therapy for Hepatocellular Carcinoma
Hepatocellular cancer (HCC) is a leading cause of cancer death worldwide, and most patients who are diagnosed with HCC are ineligible for curative local therapy. The targeted agent sorafenib provides modest survival benefits in the setting of advanced disease. Novel systemic treatment options for HCC are sorely needed. In this review, we identify and categorize the drugs and targets that are in various phases of testing for use against HCC. We also focus on the potential for combining these agents with radiotherapy. (Source: Seminars in Radiation Oncology)
Source: Seminars in Radiation Oncology - September 10, 2016 Category: Cancer & Oncology Authors: Nitin Ohri, Andreas Kaubisch, Madhur Garg, Chandan Guha Source Type: research
Radiation —Therapeutic Agent Clinical Trials: Leveraging Advantages of a National Cancer Institute Programmatic Collaboration
A number of oncology phase II radiochemotherapy trials with promising results have been conducted late in the overall experimental therapeutic agent development process. Accelerated development and approval of experimental therapeutic agents have stimulated further interest in much earlier radiation-agent studies to increase the likelihood of success in phase III trials. To sustain this interest, more forward-thinking preclinical radiobiology experimental designs are needed to improve discovery of promising radiochemotherapy plus agent combinations for clinical trial testing. (Source: Seminars in Radiation Oncology)
Source: Seminars in Radiation Oncology - September 10, 2016 Category: Cancer & Oncology Authors: Naoko Takebe, Mansoor M. Ahmed, Bhadrasain Vikram, Eric J. Bernhard, James Zwiebel, C. Norman Coleman, Charles A. Kunos Source Type: research
Exploiting Gene Expression Kinetics in Conventional Radiotherapy, Hyperfractionation, and Hypofractionation for Targeted Therapy
The dramatic changes in the technological delivery of radiation therapy, the repertoire of molecular targets for which pathway inhibitors are available, and the cellular and immunologic responses that can alter long-term clinical outcome provide a potentially unique role for using the radiation-inducible changes as therapeutic targets. Various mathematical models of dose and fractionation are extraordinarily useful in guiding treatment regimens. However, although the model may fit the clinical outcome, a deeper understanding of the molecular and cellular effect of the individual dose size and the adaptation to repeated exp...
Source: Seminars in Radiation Oncology - September 10, 2016 Category: Cancer & Oncology Authors: Adeola Y. Makinde, Iris Eke, Molykutty J. Aryankalayil, Mansoor M. Ahmed, C. Norman Coleman Source Type: research
Current Insights in Radiation Combination Therapies: Influence of Omics and Novel Targeted Agents in Defining New Concepts in Radiation Biology and Clinical Radiation Oncology
Radiotherapy is a critical and integral part of cancer care for over 50% of patients with cancer, where it is either used alone or in combination with other treatment modalities. Studies using an optimal radiotherapy utilization tree estimate that the optimal proportion of cancer patients that should receive external beam radiotherapy is 52%. A further Monte Carlo analysis demonstrated that, with a 95% confidence limit, 51.7%-53.1% of cancer patients should be treated with radiotherapy,1 a projection further supported by recent data from both resource-rich and resource-limited settings. (Source: Seminars in Radiation Oncology)
Source: Seminars in Radiation Oncology - September 10, 2016 Category: Cancer & Oncology Authors: Mansoor M. Ahmed, Amogh Narendra, Pataje Prasanna, C. Norman Coleman, Sunil Krishnan Source Type: research
Definitive Chemoradiotherapy ( “Watch-and-Wait” Approach)
Preoperative chemoradiotherapy (CRT) followed by total mesorectal excision has been the standard of care for locally advanced patients with rectal cancer. Some patients achieve a pathologic complete response (pCR) to CRT and the oncologic outcomes are particularly favorable in this group. The role of surgery in patients with a pCR is now being questioned as radical rectal resection is associated with significant morbidity and long-term effects on quality of life. In an attempt to better tailor therapy, there is an interest in a “watch-and-wait” approach in patients who have a clinical complete response (cCR) after CRT ...
Source: Seminars in Radiation Oncology - June 30, 2016 Category: Cancer & Oncology Authors: Karyn A. Goodman Source Type: research
Magnetic Resonance Imaging and Other Imaging Modalities in Diagnostic and Tumor Response Evaluation
This study reviews the potential role of functional imaging for the diagnosis, treatment monitoring, and assessment of prognosis in patients with rectal cancer. (Source: Seminars in Radiation Oncology)
Source: Seminars in Radiation Oncology - May 27, 2016 Category: Cancer & Oncology Authors: Doenja M.J. Lambregts, Monique Maas, Marcel P.M. Stokkel, Regina G.H. Beets-Tan Source Type: research
