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The Precision Medicine Approach in Oncology
Published in David E. Thurston, Ilona Pysz, Chemistry and Pharmacology of Anticancer Drugs, 2021
There is an unmet clinical need to develop an early blood biomarker test for pancreatic cancer. At present, pancreatic cancer is usually identified only when symptoms develop, by which time the tumor and/or its metastases have advanced to the stage of being fatal for the patient. More than half of pancreatic cancer cases are diagnosed at later stages for which one-year and five-year survival rates are only 15% and 2%, respectively. Therefore, early detection is essential, since the only accepted cure for pancreatic cancer is surgical removal of all tumor tissue, and only 9% of pancreatic cancer cases are currently diagnosed with local disease.
Cervical and uterine cancers
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
Rosemarie Forstner, Andrea Rockall
Undifferentiated endometrial sarcoma (UES), previously high-grade ESS, presents a rare aggressive malignancy with the similar origin as ESS. Unlike the latter, it tends to develop in older age, with a mean of 61 years at diagnosis. Five-year-survival rate ranges from 25% to 55% (229).
Waldenström Macroglobulinemia
Published in Dongyou Liu, Handbook of Tumor Syndromes, 2020
The International Prognostic Scoring System for Waldenström Macroglobulinemia (ISSWM) is used for stratification of patients with WM. Each of the five adverse parameters included in the IPSSWM score (age >65 years, hemoglobin ≤11.5 g/dL, platelets ≤100 × 109/L, β2-microglobulin >3 mg/L, and IgM level >7 g/dL) are assigned 1 point, except for age >65 years, which is assigned 2 points. The total score, at the time of initiation of therapy, stratifies patients into low (score ≤1), intermediate (score = 2), or high-risk categories (score ≥3). Five-year survival rates are 87%, 68%, and 36% for low-, intermediate-, and high-risk patients, respectively (Table 82.3) [74]. Elevated lactate dehydrogenase (LDH) has been shown to further stratify high-risk WM patients. High-risk WM patients with elevated LDH had a median overall survival of 37 months compared to 104 months for those high-risk patients with low LDH [75].
The nanoprodrug of polytemozolomide combines with MGMT siRNA to enhance the effect of temozolomide in glioma
Published in Drug Delivery, 2023
Haoyue Xu, Yongkang Zhang, Linfeng Li, Yanhong Ren, Feng Qian, Lansheng Wang, Hongwei Ma, Ankang Quan, Hongmei Liu, Rutong Yu
Glioma can emerge in different parts of the central nervous system (CNS), which is known as the most common and deadliest primary malignant brain tumor (Yang et al., 2022; Tan et al., 2020). The standard treatment of glioma is customized to the individual patient, including chemotherapy, radiation therapy, surgery or observation (Otvos et al., 2021). However, because of the ability to invade/infiltrate and genetic heterogeneity, the therapeutic effect of glioma remains unsatisfactory (Nicholson & Fine, 2021; Johnson et al., 2021). Moreover, the ability to deliver the chemotherapeutic drug to the tumor site is limited by the blood-brain barrier (BBB), a highly specialized structure of the vascular tree that restricts diffusion and transport from the blood to the brain (Islam et al., 2021; Hanafy et al., 2021). This also contributes to the poor survival and prognosis of glioma. The five-year survival rate is only 5.6%, with a median overall survival duration of 14.6 months (Wang et al., 2021; Karlsson et al., 2021). As a result, post-operative chemotherapy in combination with surgery is critical for individuals with brain gliomas.
Prognostic significance of positive peritoneal cytology in endometrial cancer patients
Published in Journal of Obstetrics and Gynaecology, 2022
Nadereh Behtash, Shahrzad Sheikhhasani, Vahid Nezamabadi
The patients may have different symptoms including vaginal discharge, abnormal uterine bleeding, pelvic pain or abdominal, alteration in bladder or bowel function, early satiety, abdominal distension, in patients with progressive stages, and resembling the ovarian carcinoma symptoms (Ranjbar et al. 2015). Postmenopausal bleeding is the initial sign as in most cases. About 75% of patients are constrained to the initial phases when diagnosing. Moreover, five-year survival rates of around 95% would be experienced by these patients. However, spreading extrauterine tissues by the disease, survival is reduced to 67% and 23%, for those with distant or regional disease, respectively (Jemal et al. 2008). The proposed risk factors include unopposed oestrogen exposure, obesity, late menopause, diabetes, nulliparity, polycystic ovarian syndrome, anovulation, oestrogen secreting ovarian tumours, and tamoxifen administration (Soliman et al. 2005; 2006; Renehan et al. 2008; Zhou et al. 2008).
Recent advances in targeted drug delivery for the treatment of pancreatic ductal adenocarcinoma
Published in Expert Opinion on Drug Delivery, 2022
Cancer has become a major public health problem worldwide since its emergence and the leading cause of death in the world[1,2]. Pancreatic cancer is one of the deadliest cancers, with high lethality, aggressiveness and poor prognosis. Pancreatic ductal adenocarcinoma accounts for roughly 90% of all malignant pancreatic tumors[3]. In the United States, its five-year survival rate is about 9%, and because of its poor prognosis, there are almost as many deaths as cases, and it is the seventh leading cause of death due to cancer, and in the European Union, it may overtake breast cancer as the third leading cause of cancer death in the future[2,4]. The five-year survival rate for pancreatic cancer has remained virtually unchanged over the last few decades, because pancreatic cancer is typically diagnosed at an advanced stage, when it responds poorly to chemotherapy, resulting in a low success rate of treatment[5]. At the same time, surgery is the only way to cure pancreatic cancer, but only 20% of patients are suitable for surgery[6]. Ninety percent of patients who can have their tumors surgically removed experience cancer recurrence[7].