Will modern immunotherapies become the standard of care for advanced synchronous or metachronous cancers?
| Autor: | Hampig Raphael Kourie, Ahmad Awada |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Oncology
Cancer Research medicine.medical_specialty medicine.medical_treatment Population Disease Malignancy Neoplasms Multiple Primary Breast cancer Renal cell carcinoma Internal medicine medicine Humans Molecular Targeted Therapy education Neoplasm Staging education.field_of_study Bladder cancer business.industry Cancer Disease Management Neoplasms Second Primary Standard of Care General Medicine Immunotherapy medicine.disease Surgery business |
| Zdroj: | Future oncology (London, England). 11(22) |
| ISSN: | 1744-8301 |
| Popis: | The detection of multiple primary cancers in the same patient has increased in frequency during the last decades. Those diagnosed cancers are either synchronous, detected at the same time or metachronous, occurring after a period of time following the first cancer. A review of the literature of nearly one million cancer patients concluded that the prevalence of multiple primary malignant cancers was between 0.73 and 11.7% [1]. Overall, cancer survivors had a 14% higher risk of developing a new malignancy than would have been expected in the general population [2]. The occurrence of multiple primary cancers can be attributed to different factors, including the facilities of imaging and biopsies of different sites of the disease, the increase of life expectancy either in general population or in cancer patients and finally the major advances in cancer treatment. Other factors can also be incriminated in the development of multiple primary cancers such as hereditary, immunology, environment and carcinogens including viruses, r adiotherapy and chemotherapy [3]. The Surveillance, Epidemiology, and End Results (SEER) Program analyzed database has revealed that the highest incidence of multiple primaries (16%) is found in patients diagnosed with bladder cancer; this incidence does not exceed the 10% in breast cancer [4]. Synchronous cancers, a rare phenomenon compared to metachronous cancers, have recently reported frequently in the literature. The accepted strategy for the management of synchronous cancers is surgery, if the two primaries are resectable or systemic therapy if the tumors are metastatic. In the emerging era of modern immunotherapies in particular checkpoint inhibitors, the question raised is whether those could play a role in the treatment of advanced synchronous or metachronous cancers? During the last two decades, immunotherapies using cytokines were limited to the treatment of renal cell carcinoma and melanomas [5,6]. Nowadays, checkpoint inhibitors are being involved in the treatment of different cancers. The two most actively studied immune-checkpoint “...the adoption of this new concept in the treatment of uncontrolled synchronous or metachronous cancers remains an investigational approach option...” |
| Databáze: | OpenAIRE |
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