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Introduction to Cancer, Conventional Therapies, and Bionano-Based Advanced Anticancer Strategies
Published in D. Sakthi Kumar, Aswathy Ravindran Girija, Bionanotechnology in Cancer, 2023
Chemotherapy is the use of anticancer drugs to destroy cancer cells. The drugs work by killing cancer cells or interfering with tumor growth. Chemotherapy is usually considered one of the most effective cancer treatment methods; however, this type of therapy can induce severe side effects, as it can also destroy healthy cells. The adverse effects depend upon the type of cancer and the type of drugs used to treat it. Generally, the side effects are not associated with the treatment effectiveness, and once the treatment process is over, the side effects may stop. Normally, chemotherapy agents are prescribed to a patient in measured dosages and in specific intervals of time. Sometimes a combination chemotherapy is used, during which two or more drug agents are used at the same time [114].
Oncology
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Lung cancers are classed as small cell carcinoma (SCLC) or the non-small cell carcinomas (NSCLC), which include squamous cell (epidermoid) carcinoma, adenocarcinoma, and large cell carcinoma. Staging by TNM is designated after use of chest X-ray. fiberoptic bronchoscopy, computed tomography, and routine laboratory tests to identify any metastases. In early stages of NSCLC, surgery is the treatment of choice. Radiation is used as an adjunct and for nonsurgical candidates. Combination chemotherapy regimens are also being used increasingly for NSCLC and as the standard treatment for both limited and extensive SCLC.
The Carcinoid Tumors
Published in E. George Elias, CRC Handbook of Surgical Oncology, 2020
The palliative control of carcinoid tumors by chemotherapy has been very limited. Five drugs have been utilized in the management of symptomatic carcinoid tumors, namely, 5-fluorouracil, cyclophosphamide, streptozotocin, adriamycin, and imidazolecarboxamide (DTIC). Combination chemotherapy had been claimed to be more beneficial. Two therapeutic combinations have been reported to give the highest concentrate: (1) 5-fluorouracil + streptozotocin giving a 33% response rate and (2) cyclophosphamide + streptozotocin giving a 27% response rate. However, the duration of such responses is short.6
Differences in adjuvant chemotherapy and oncological outcomes according to margin status in patients with stage III colon cancer
Published in Acta Oncologica, 2023
H. G Smith, D. M. Skovgaards, N. H. Bui, D. Chiranth, C. Qvortrup, N. H. Schlesinger
Post-operative chemotherapy use according to margin status is shown in Table 2. A total of 613 patients (74.3%) were referred for chemotherapy following surgery, with 472 (56.7%) receiving it. Further details regarding the reasons for the omission of chemotherapy in those patients who were referred for it are provided in Supplementary Table 1. No statistically significant differences in the proportion of patients referred for or receiving post-operative chemotherapy according to margin status were noted. No difference in the time from surgery to the start of chemotherapy was noted between groups, with similar proportions of patients receiving single or oxaliplatin-based combination chemotherapy. The proportion of patients who completed long-course chemotherapy (6 months) was similar in both R0 and R1LNM groups.
Disparity in use of modern combination chemotherapy associated with facility type influences survival of 2655 patients with advanced pancreatic cancer
Published in Acta Oncologica, 2022
Morten Ladekarl, Louise Skau Rasmussen, Jakob Kirkegård, Inna Chen, Per Pfeiffer, Britta Weber, Halla Skuladottir, Kell Østerlind, Jim Stenfatt Larsen, Frank Viborg Mortensen, Henriette Engberg, Henrik Møller, Claus Wilki Fristrup
Most striking, the use of multidrug chemotherapy was highly different among facility types. Of these, the Folfirinox regimen was introduced in Denmark at tertiary facilities in 2011 [27], whereas gemcitabine/nab-paclitaxel was used from 2012. Because combination chemotherapy has more side effects and is usually more expensive and logistically complex, the speed of introduction and use of such treatments may reflect quality of care and available resources. In our study we found both a longer delay in the introduction and a sustained reduced use of combination chemotherapy in secondary facilities. Interestingly, Canale et al. observed no difference in use of combination chemotherapy according to geography and found no disparities in survival among 659 patients with advanced PC treated in the British Colombia in Canada [28], whereas in a Danish study of PC in all stages, rural residency compared to urban was associated with a slightly worse outcome. This difference disappeared, however, after adjustment for cancer-directed treatment [29]. Similarly, in the current multivariate analysis with adjustment for type of chemotherapy, the prognostic influence of facility type became insignificant, indicating that the difference in use of combination chemotherapy in first line treatment at secondary and tertiary facilities was a major determinant for differences in outcome.
BRAF V600E mutated metastatic colorectal cancer: current progress and future directions
Published in Expert Opinion on Biological Therapy, 2021
While direct cross-trial comparison cannot be made, triplet therapy in both the BEACON and ANCHOR CRC trials yielded a median PFS of approximately 4.5 mos. Thus, resistance develops similarly in the first- and second-line settings, highlighting the need to explore biomarkers of resistance. One approach that is currently being evaluated is combination chemotherapy with targeted therapy. The phase III BREAKWATER trial will compare encorafenib plus cetuximab with or without chemotherapy as a first-line therapy for BRAF V600Emut mCRC (NCT04607421). In addition, the majority of BRAF V600Emut tumors are classified as CMS1 subtype, which is associated with activation of immune pathways and response to immunotherapy. Consequently, many early-phase trials are examining novel combinations of targeted therapy and immunotherapy. A phase II trial of dabrafenib plus trametinib plus PDR001 (anti-PD-1) for the treatment of BRAF V600Emut mCRC (NCT03668431) reported early results with an ORR of 33% [20]. In addition, a phase I/II trial of encorafenib plus cetuximab and nivolumab in MSS BRAF V600Emut mCRC is currently enrolling (NCT04017650). Lastly, ERK inhibitors (NCT04294160) and other drugs targeting MAPK-independent pathways (NCT04294160, NCT02906059, NCT01351103) are being explored.