for GISTs rapidly changed after the introduction of effective molecularly targeted therapy (such as imatinib and sunitinib). Because of these changes, the NCCN organized a multidisciplinary panel composed of experts in medical oncology, molecular
George D. Demetri, Robert S. Benjamin, Charles D. Blanke, Jean-Yves Blay, Paolo Casali, Haesun Choi, Christopher L. Corless, Maria Debiec-Rychter, Ronald P. DeMatteo, David S. Ettinger, George A. Fisher, Christopher D. M. Fletcher, Alessandro Gronchi, Peter Hohenberger, Miranda Hughes, Heikki Joensuu, Ian Judson, Axel Le Cesne, Robert G. Maki, Michael Morse, Alberto S. Pappo, Peter W. T. Pisters, Chandrajit P. Raut, Peter Reichardt, Douglas S. Tyler, Annick D. Van den Abbeele, Margaret von Mehren, Jeffrey D. Wayne, and John Zalcberg
Manish A. Shah and David P. Kelsen
-term survivors are possible; many studies report that approximately 10% to 15% of patients newly diagnosed with metastatic disease will survive for 2 years and as many as 3% will survive 5 years. Finally, with the integration of molecularly targeted therapy
Christie Hancock and Jacob Bitran
reported molecular targets were recorded. Details of the changes in clinical management based on the NGS and survival time after the NGS test was ordered were also analyzed. Results: Forty-three patient cases were reviewed that had NGS testing obtained
Neelima Vidula, Leif W. Ellisen, and Aditya Bardia
Therapeutic Agents in Development for Advanced TNBC Molecular Heterogeneity of TNBC Genomic analyses have demonstrated that TNBC is a heterogeneous disease. Molecular profiling has classified TNBC into biologically relevant subtypes with molecular targets
to supportive care providers. Goals of trial design should include not only molecular targeting but also supportive care objectives, such as reducing pain, anxiety, depression, cachexia, and fatigue. A β-blocker could potentially be part of these
George D. Demetri, Margaret von Mehren, Cristina R. Antonescu, Ronald P. DeMatteo, Kristen N. Ganjoo, Robert G. Maki, Peter W.T. Pisters, Chandrajit P. Raut, Richard F. Riedel, Scott Schuetze, Hema M. Sundar, Jonathan C. Trent, and Jeffrey D. Wayne
be useful in predicting response to TKI therapy, identifying new molecular targets for tumor progression, and studying pathogenesis. NCCN GIST Task Force Panel Recommendations for Diagnosing GIST Careful morphologic examination of adequate
Rachel A. Bender Ignacio, Lilie L. Lin, Lakshmi Rajdev, and Elizabeth Chiao
therapies with tumor or viral molecular targets, and 7 trials evaluating screening interventions or topical or ablative therapies. ICIs, Gene Therapy, and Other Immunotherapies Among the immunomodulatory or gene therapy trials, most were phase I or I
Iulia Giuroiu and Diane Reidy-Lagunes
Pancreatic neuroendocrine tumors (panNETs) are a type of neuroendocrine tumor with 5-year overall survival rates of approximately 50% when metastasis is present at diagnosis. Tumor grade, as defined by Ki-67 proliferation index, influences overall survival, with low-grade tumors portending a better outcome than intermediate- and high-grade tumors. This case report follows the clinical course and management of a patient with an insulin-secreting metastatic panNET who died 10 years after diagnosis after a treatment course with regional therapy and multiple forms of cytotoxic and molecularly targeted agents. This report presents the various treatment options available for patients with insulin-secreting metastatic panNETs.
Patricia Thompson and Mayer Fishman
The purpose of this article is to review the systemic management options for patients with metastatic renal cancer. We reviewed the literature regarding systemic management of metastatic renal cancer. Treatment options of chemotherapy agents, immunotherapy, molecularly targeted agents, allogeneic stem cell transplantation, vaccines, and other manipulations of the immune system are discussed. No chemotherapy agent used alone or in combination has consistently produced responses to substantiate its routine use. Interleukin-2 (IL-2) and interferon-α (IFN-α) have shown response rates ranging from 10% to 20%. Some studies have shown that retinoids may enhance the antitumor activity of IFN-α. Molecularly targeted agents and angiogenic agents are being actively pursued and several studies are showing response rates above 30%. Although nonmyeloablative allogeneic stem cell transplantation shows some promising results, they also have limitations to its use. Therapy strategies that incorporate vaccines as part of comprehensive immune manipulations are also being studied. The systemic treatment of patients with advanced renal cell cancer continues to be a significant challenge. Immunotherapy treatment has shown response in up to 20% of patients. Unfortunately, most do not respond. The current technologies are promising and may be the key step for introduction of better treatments for renal cancer care.
Patrick C. Ma and Ravi Salgia
Small cell lung cancer (SCLC) is known to have an aggressive phenotype and often presents with distant metastasis. Despite frequent initial response to chemotherapy, it inevitably relapses within 2 years in the majority of patients. Because of the poor overall prognosis of the disease and its unique tumor biology, the opportunity for improving clinical outcome of patients with development of novel therapeutics is great. This review provides current insights into the novel molecular targets in SCLC. Cellular signal transduction pathways and their relationship to cellular functions also are discussed. Discussion of the role receptor tyrosine kinases (RTKs) have in SCLC therapeutic inhibition is emphasized. In particular, the recent development of small molecule inhibitors of RTKs such as c-Kit, c-Met, and VEGF-R and the potential for clinical trials are highlighted.