Clinical Oncology

[Oncogene-targeted therapy of non-small cell lung cancer]

TANJA Cufer

FEBRUARY 15, 2016

Clinical Oncology - 2016;3(01)

[Lung cancer is the leading cause of cancer related deaths thus presenting one of the main public health related issues globally. Non-small cell lung cancer (NSCLC) represents approximately 85% of all lung cancer cases. Historically, platinum-based chemotherapy was the mainstay of systemic therapy for NSCLC, leading to median survival rates of only 8 to 10 months. Major improvement in the treatment of NSCLC was made through the identifi cation of key genetic aberrations (oncogene drivers) that drive tumor initiation, maintenance and progression and development of highly effective oncogene- directed therapies. Oncogene-directed therapies against epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) in conjunction with well-validated methods for the detection of their targets already represent a standard care of advanced NSCLC patients. Encouragingly, in the recent years a number of additional genetic aberrations have emerged as novel molecular targets with potential therapeutic implications in lung cancer. In this review a comprehensive overview of standard oncogene-directed therapies of advanced NSCLC is provided, challenges in overcoming resistance to those therapies are discussed and novel oncogene-directed therapies under development are briefl y presented.]

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Clinical Oncology

[Foreword]

A szerkesztők

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[Prevention and therapy of cervical cancer ]

RÉVÉSZ János, BÍRÓ Mátyás

[The global incidence of cervical cancer is ~530000, the death rate is ~270000 per year. These data shows, that cervical cancer is the fourth common malignancy in woman worldwide and the leading cancer related death in developing countries. HPV infection is the most important factor of carcinogenesis. Immunisation against HPV can prevent infection, and decrease the cancer incidence. In case of invasive cancer the therapeutic principles are surgery and radiotherapy. In case of high risk patients and/or locally advanced disease the adjuvant and neoadjuvant cytostatic treatment has limited evidences. The traditional cytotoxic therapy and the recent antiangiogenic therapy recommended for patients who have extrapelvic metastasis, residual tumor after primary radiotherapy or recidiv non curable tumor by radiotherapy or radical surgery.]

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[Treatment of mesothelioma - an update]

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[Malignant pleural mesothelioma is an aggressive tumor arising from the mesothelial cells lining the pleura. It is an asbestos related disease with increasing incidence both in Europe and in Hungary. This often fatal disease is characterized by rapid progression, and unfortunately, treatment options are very limited to date. Thus every effort should be made to better understand the pathological and molecular biological characteristics of this disease in order to develop new treatment strategies. This summary reviews the treatment options available today as well as the new therapeutic approaches at the experimental and clinical investigation stage.]

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[Follicular lymphoma - a way to personalized and targeted therapy ]

BÖDÖR Csaba, SCHNEIDER Tamás

[Although follicular lymphoma is the most frequent non-Hodgkin’s lymphoma with an indolent clinical course, it is a rare disease. Patients with FL are characterized with a long survival with a relatively good quality of life, however using the current standard chemo-immunotherapy, the disease is considered incurable. The increasing knowledge of the molecular genetic background of the disease and the role of the reactive microenvironment lead to a better understanding of the pathogenesis of follicular lymphoma. Furthermore, the detailed functional characterization of the various cell surface antigens and deciphering the complex network of signaling pathways catalyzed the development of a number of novel targeted therapies (monoclonal antibodies, kinase- and NFκB-inhibitors), while understanding the effects of the cell surface receptors of cytotoxic T-cells initiated development of the monoclonal checkpoint inhibitors. The epigenetic therapies represent a novel therapeutic area with methyltransferase inhibitors demonstrating the most favorable results. Among the novel therapies, the immunomodulatory lenalidomide appears as the most promising and most effective drug, which acts via regulating the microenvironment, and in combination with rituximab in fi rst line setting it demonstrated similar effi cacy to the current standard protocols. Indeed, the rational use of the novel data and drugs paves the way towards personalized and targeted therapies for FL, resulting in more effective treatment and further improvement in patients’ survival, with a very long disease-free survival representing cure.]

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