Clinical Oncology

[The role of EGFR receptor family in the oncological practice]

MÉHES Gábor

DECEMBER 10, 2015

Clinical Oncology - 2015;2(04)

[The EGFR receptor family is a set of membrane tirosine kinase receptors with signifi cant homology which are responsible for cellular activation through intracellular signaling due to ligand binding. The four members of the family (EGFR1, EGFR2/HER2/neu, EGFR3/HER3, EGFR4/HER4) earned special interest in tumor biology while becoming one of the most potent targets of anti-cancer therapies. Changes in the receptor expression or in the kinase activity fundamentally modify cellular functions, survival and tumorigenic potential. Moreover, mutations are associated with reduced or altered treatment effi cacy. The basic function and major genetic and biological mechanisms affecting the function of EGFR receptors and related therapies are subjects of this overview.]

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[Although nowadays there are a lot spoken about the role of physical activity in illness prevention, however it is barely connected to the treatment of malignant diseases. The regular exercises can improve physical performance and fi tness; increase muscle mass; change the body composition and proportion favorably. The positive psychological effects can decrease distress and depression; improve mood of patient; increase self-confi dence and self-respect. Finally, all of these will result in an improved quality of life. The malignant disease and the treatments can draw down either short-term or long-term consequences and side-effects that can largely infl uence or restrict everyday life. Most of them could be essentially reduced by the help of a physiotherapist experienced in oncology adopting a well-defi ned and customized workout.]

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[Current treatment of gastrointestinal lymphomas]

PAKSI Melinda, ISTENES Ildikó, KÖRÖSMEZEY Gábor, DEMETER Judit

[The most common extranodal site involved by lymphoma is the gastrointestinal tract. The majority of extranodal lymphoma cases are of the non-Hodgkin subtype. Usually, the involvement of the gastrointestinal tract by nodal lymphomas is secondary, the primary gastrointestinal localisation is rather rare. The most common pathological types are diffuse large B-cell lymphomas and extranodal marginal zone lymphomas of the mucosa-associated tissue (MALT) subtype. Although the primary gastrointestinal lymphoma can involve any part of the gastrointestinal tract, the stomach is the most frequently involved site. The treatment and prognosis are determinated primarily by the histologic type of lymphoma, the stage of disease and the patient’s age and general condition. Helicobacter pylori (HP) infection is one of the major risk factors for gastric lymphomas, the presence or abscence of which radically infl uences the effectivity of treatment. In case of HP positivity, HP eradication itself can result in complete remission. In most cases the treatment is immuno- and/or combination chemotherapy, which is performed according to the internationally accepted protocols, specifi c to the type of lymphoma. Radiotherapy plays a lesser role in the treatment of GI lymphomas, while surgery is performed almost only in complicated cases, such as haemorrhage, occlusion or perforation.]

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[Should docetaxel be standard of care for patients with metastatic hormone-sensitive prostate cancer? Pro and contra]

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[We revised the medical literature regarding autologous and allogeneic hematopoietic stem cell transplantation (HSCT) in the setting of solid tumors. Autologous-HSCT for solid tumors in adult patients show changing patterns in past decades with decreases numbers for many types of solid tumors. Most marked is the previously well-described increase and decrease in autologous HSCT for breast cancer (BC). Autologous-HSCT for BC has been an area of intense controversy. The role of autologous-HSCT for BC at high risk of recurrence (at least four involved axillary lymph nodes) has been assessed by several randomized trials. Overall, it was shown that high-dose therapy prolonged disease-free survival when used as adjuvant therapy, and showed a benefi t on overall survival in only selected cohorts of patients. In second or further relapsed or primary refractory germ cell tumor, highdose therapy is considered to be a standard therapeutic option, especially when poor prognostic factors are present. In addition, sequential therapy with two to three cycles is felt to be superior to single cycle of HSCT. High-dose therapy can be regarded as a potential clinical option in selected adult patients with Ewing’s sarcoma and medulloblastoma. Currently, in other types of solid tumors the autologous- HSCT is generally not recommended or developmental and only used in the context of prospective studies. Numbers of allogeneic HSCT for solid tumors remained stable low number throughout the recent years. Transient increase is observed over the last decade and is primarily due to renal cell carcinoma, BC and colon cancer. Concepts of allogeneic HSCT for solid tumors do not rely on highdose chemotherapy and tumor load reduction but rather on a graft-versus-tumor effect. Attempts to improve the therapeutic effect of allo-HSCT or other cellular therapies in solid tumors by innovative clinical strategies are underway.]

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