Abstract:
:Bladder cancer is rare in patients below the age of 50 years, and most patients are in their 60s and 70s. Radical cystectomy is the preferred approach for patients with localized disease in most European countries and the USA, and evidence is growing in favor of neoadjuvant, platinum-based chemotherapy for patients at high risk of local and systemic relapse. Transurethral resection (TUR) followed by radiotherapy with or without concomitant chemotherapy appears to be a reasonable alternative, particularly in the UK and Canada. However, the elderly pose several treatment dilemmas, including the increased risk of perioperative complications, the management of orthotopic neobladder or different types of urinary diversion, as well as the higher risk of adverse events caused by pelvic radiotherapy and systemic chemotherapy. Multidimensional parameters such as biologic prognostic factors, performance status, functional independence, comorbidities and cognitive function of the patient should be collected in order to tailor treatment to the patient's life expectancy and preferences. Optimized integration of TUR followed by bladder removal (or radiotherapy), with or without adjunctive chemotherapy, can be recommended for otherwise healthy patients. Palliative measures, such as TUR followed by external radiotherapy alone or monochemotherapy, should be reserved for partially impaired patients with moderate comorbidities, in order to maximize the balance of benefits and toxicities. This review summarizes recent data concerning surgery, radiotherapy and systemic chemotherapy for bladder cancer in the elderly, and discusses pros and cons of the currently available therapeutic options.
journal_name
Expert Rev Anticancer Therjournal_title
Expert review of anticancer therapyauthors
Basso U,Bassi P,Sava T,Monfardini Sdoi
10.1586/14737140.4.6.1017keywords:
subject
Has Abstractpub_date
2004-12-01 00:00:00pages
1017-35issue
6eissn
1473-7140issn
1744-8328pii
ERA040608journal_volume
4pub_type
杂志文章,评审abstract::Since its approval by the US FDA in 1986, prostate-specific antigen (PSA) has been employed to monitor men with a diagnosis of prostate cancer. In 1994, PSA was approved for use in prostate cancer screening and has been employed worldwide. However, due to the limited specificity of PSA for the disease, novel biomarker...
journal_title:Expert review of anticancer therapy
pub_type: 杂志文章,评审
doi:10.1586/era.09.168
更新日期:2010-01-01 00:00:00
abstract::Atypical hyperplasia and lobular carcinoma in situ are rare proliferative breast lesions, growing inside ducts and terminal ducto-lobular units. They represent a marker of increased risk for breast cancer and a non-obligate precursor of malignancy. Evidence available on diagnosis and management is scarce. They are fre...
journal_title:Expert review of anticancer therapy
pub_type: 杂志文章,评审
doi:10.1586/14737140.2016.1143362
更新日期:2016-01-01 00:00:00
abstract:INTRODUCTION:Gastric cancer is one of a few gastrointestinal malignancies in which immunotherapy has shown meaningful activity. Pembrolizumab is the first and only immune checkpoint inhibitor to be FDA-approved in gastric cancer. Areas Covered: This review summarizes the current and emerging clinical evidence for immun...
journal_title:Expert review of anticancer therapy
pub_type: 杂志文章,评审
doi:10.1080/14737140.2018.1526084
更新日期:2018-12-01 00:00:00
abstract:INTRODUCTION:Fertility impairment due to treatments is a major concern for adolescents and young adult patients who survived cancer. Areas covered: Chemotherapy may determine a detrimental effect on ovary function, leading to infertility, and premature ovarian failure. Embryo and oocyte cryopreservation is a standard s...
journal_title:Expert review of anticancer therapy
pub_type: 杂志文章,评审
doi:10.1080/14737140.2017.1316195
更新日期:2017-05-01 00:00:00
abstract::Anemia in cancer patients is frequent but often under-recognized and under-treated. This may be related to misconceptions about the impact of anemia on cancer patients and ill-defined guidelines for treatment, as well as the inadequacies of current therapy. Darbepoetin alfa, a novel erythropoiesis-stimulating protein ...
journal_title:Expert review of anticancer therapy
pub_type: 杂志文章,评审
doi:10.1586/14737140.2.4.377
更新日期:2002-08-01 00:00:00
abstract::The characterization of the mantle cell lymphoma (MCL) entity had a major impact on patient management and has played a profound role in improving therapy. Although the prognosis is improving in MCL, there is no definitive proof that the therapies currently available will lead to cure. Few randomized studies have been...
journal_title:Expert review of anticancer therapy
pub_type: 杂志文章,评审
doi:10.1586/era.12.99
更新日期:2012-09-01 00:00:00
abstract::En bloc removal of the prostate has traditionally been an integral component of radical cystectomy for men with bladder cancer owing to a high incidence of occult prostatic malignancy. However, the risk of functional morbidity following this procedure is considerable and can delay patient acceptance of cystectomy, whi...
journal_title:Expert review of anticancer therapy
pub_type: 杂志文章,评审
doi:10.1586/14737140.7.7.1003
更新日期:2007-07-01 00:00:00
abstract:INTRODUCTION:Endometrial cancer is a common gynecologic malignancy in the United States, and the recurrence rate depends on the disease stage at diagnosis. Recurrence can affect several areas and follow different patterns. AREAS COVERED:The role of surgery at the time of recurrence is not clearly defined. In this revi...
journal_title:Expert review of anticancer therapy
pub_type: 杂志文章,评审
doi:10.1080/14737140.2016.1190650
更新日期:2016-07-01 00:00:00
abstract::Although testicular cancer is currently a rare disease, the incidence is rising. The most important risk factor remains cryptorchism and there is a variable association with testicular microlithiasis. Serum tumor markers remain important for diagnosis, and they have prognostic value and can be used to monitor therapy ...
journal_title:Expert review of anticancer therapy
pub_type: 杂志文章,评审
doi:10.1586/14737140.4.4.669
更新日期:2004-08-01 00:00:00
abstract::In the new era of 'precision' cancer medicine, new drug development has shifted from cytotoxic chemotherapy to molecularly targeted agents. Eribulin mesylate, a microtubule-destabilizing agent, is the only 'classical' cytotoxic agent approved for the treatment of breast cancer in the last 7 years. This synthetic analo...
journal_title:Expert review of anticancer therapy
pub_type: 杂志文章,评审
doi:10.1586/14737140.2014.920693
更新日期:2014-06-01 00:00:00
abstract::Ductal carcinoma-in situ (DCIS) is a non-obligate precursor for invasive breast cancer and concern exists regarding the potential for overdiagnosis and overtreatment as the natural history of DCIS progression to invasive breast cancer may never occur or take decades in some cases. Preoperative systemic therapy window ...
journal_title:Expert review of anticancer therapy
pub_type: 杂志文章,评审
doi:10.1586/14737140.2015.1043897
更新日期:2015-01-01 00:00:00
abstract::Anticancer therapy relies on targeting highly proliferative cells. Commonly used chemotherapy does not selectively target individual cancer cells. The identification of distinct cancer stem cells that have the unique ability to engraft tumors and maintain cancer self-renewal may prove vital in the development of novel...
journal_title:Expert review of anticancer therapy
pub_type: 杂志文章,评审
doi:10.1586/era.13.17
更新日期:2013-04-01 00:00:00
abstract::Breast cancer (BC) comprises a group of different diseases characterized by changes in tissue structure and gene expression. Recent advances in molecular biology have shed new light on the participation of genes and their products in the biology of BC. MicroRNAs (miRNAs) are small noncoding endogenous RNA molecules th...
journal_title:Expert review of anticancer therapy
pub_type: 杂志文章,评审
doi:10.1586/era.11.40
更新日期:2011-08-01 00:00:00
abstract::Bladder cancer is the most frequently occurring tumor of the urinary system, with over 10,000 new diagnoses each year in the UK. Approximately 70% of these are non-muscle-invasive and limited to the mucosa (Ta) or submucosa (T1). These tumors are generally managed with transurethral resection followed by adjuvant intr...
journal_title:Expert review of anticancer therapy
pub_type: 杂志文章,评审
doi:10.1586/era.12.52
更新日期:2012-06-01 00:00:00
abstract::Immunotherapies such as sipuleucel-T present new and unique challenges for the optimal timing and sequencing of therapies for metastatic castration-resistant prostate cancer (mCRPC). Key considerations for the sequencing of sipuleucel-T are its unique proposed mechanism of action, the time required to generate a clini...
journal_title:Expert review of anticancer therapy
pub_type: 杂志文章,评审
doi:10.1586/14737140.2014.848065
更新日期:2014-01-01 00:00:00
abstract::Management of patients with chronic myeloid leukemia has become increasingly difficult over the last few years since there are a variety of treatment options available. The ultimate challenge is to decide the most appropriate treatment strategy for an individual patient. To facilitate this, assessment of an individual...
journal_title:Expert review of anticancer therapy
pub_type: 杂志文章,评审
doi:10.1586/14737140.5.2.343
更新日期:2005-04-01 00:00:00
abstract:INTRODUCTION:Hormone receptor positive (HR+) breast cancer represents the most common subtype of breast cancer. Metastatic HR+ breast cancer may develop resistance to standard hormone therapies, arising from genomic alterations in the estrogen receptor and/or upregulation of other signal transduction pathways. Areas co...
journal_title:Expert review of anticancer therapy
pub_type: 杂志文章,评审
doi:10.1080/14737140.2018.1412259
更新日期:2018-01-01 00:00:00
abstract::The retinoblastoma (RB)-Cyclin (CCN)D1-p16 cell cycle pathway has a crucial role in lung tumorigenesis. Impairment of the RB pathway has been shown to occur in almost all lung tumors. A deregulation at any level of this core RB pathway seems to make cells insensitive to the mitogenic signaling that is required for cel...
journal_title:Expert review of anticancer therapy
pub_type: 杂志文章,评审
doi:10.1586/14737140.6.4.515
更新日期:2006-04-01 00:00:00
abstract::Pancreatic cancer is the fourth leading cause of cancer deaths with a 5-year survival of 4-6%. Clinical challenges remain to be addressed, since few promising approaches to treat pancreatic cancer have been reported. Here we discuss the potential of a new biotherapeutic agent composed of a lysosomal protein (Saposin C...
journal_title:Expert review of anticancer therapy
pub_type: 社论
doi:10.1586/14737140.2014.895937
更新日期:2014-05-01 00:00:00
abstract::Before the advent of rationally designed targeted antineoplastic therapies, cladribine was identified as a lymphocyte-specific cytotoxic agent. Cladribine is a purine nucleoside analogue that is resistant to cellular catabolism. Through diverse mechanisms, cladribine is equally toxic to dividing and nondividing cells,...
journal_title:Expert review of anticancer therapy
pub_type: 杂志文章,评审
doi:10.1586/14737140.8.4.535
更新日期:2008-04-01 00:00:00
abstract::Tumors of the CNS frequently have devastating consequences in terms of cognitive and motor function, personality and mortality. Despite decades of work, current therapies have done little to alter the course of these deadly diseases. The discovery that chaperones/heat-shock proteins play an important role in tumor bio...
journal_title:Expert review of anticancer therapy
pub_type: 杂志文章,评审
doi:10.1586/14737140.6.5.679
更新日期:2006-05-01 00:00:00
abstract::While early-stage endometrial cancer is highly curable after hysterectomy for the majority of patients afflicted with this disease, recurrent and metastatic endometrial cancer continues to pose a significant challenge. The median survival of women with advanced or recurrent uterine cancer on most recent clinical trial...
journal_title:Expert review of anticancer therapy
pub_type: 杂志文章,评审
doi:10.1586/era.09.54
更新日期:2009-07-01 00:00:00
abstract::Nonmelanoma skin cancer is the most prevalent malignant disease among light-skinned individuals in the USA, accounting for approximately 1 million new cases annually. Solar ultraviolet radiation is known to be the major cause of skin cancer. The idea that diet, particularly dietary fat, may play a role in modulating c...
journal_title:Expert review of anticancer therapy
pub_type: 杂志文章,评审
doi:10.1586/14737140.5.5.801
更新日期:2005-10-01 00:00:00
abstract::Whereas radical cystectomy is the standard of care in high-grade, invasive bladder tumors, the extent of lymphadenectomy and its diagnostic and/or therapeutic potential is controversial. Independent predictors for lymph node involvement are T-stage, histological grading and lymphovascular invasion. Preoperative assess...
journal_title:Expert review of anticancer therapy
pub_type: 杂志文章,评审
doi:10.1586/14737140.6.6.871
更新日期:2006-06-01 00:00:00
abstract::Although available targeted therapies provide some clinical efficacy, a need remains for antiangiogenic therapies with alternative mechanisms in order to provide better outcomes and the ability to circumvent resistance. Inhibition of multiple VEGF targets may produce enhanced efficacy and more durable responses throug...
journal_title:Expert review of anticancer therapy
pub_type: 杂志文章
doi:10.1586/era.11.5
更新日期:2011-03-01 00:00:00
abstract:INTRODUCTION:The treatment of chronic myeloid leukemia (CML) has been drastically changed by the approval of tyrosine kinase inhibitors (TKIs). CML is now managed as a chronic disease requiring both long-term treatment and close molecular monitoring in the majority of patients. AREAS COVERED:Evidence suggests that in ...
journal_title:Expert review of anticancer therapy
pub_type: 杂志文章
doi:10.1080/14737140.2020.1829483
更新日期:2020-12-01 00:00:00
abstract::Recurrent non muscle invasive bladder cancer (NMIBC) represents a therapeutic challenge, especially in the case of Bacillus Calmette Guerin (BCG)-failures. Chemohyperthermia (CHT) has been tested as adjuvant therapy in selected categories of patients with promising results. The aim of this systematic review is to expl...
journal_title:Expert review of anticancer therapy
pub_type: 杂志文章,评审
doi:10.1586/14737140.2016.1135743
更新日期:2016-01-01 00:00:00
abstract::Fludarabine is a prodrug that is converted to the free nucleoside 9-beta-D-arabinosyl-2-fluoroadenine (F-ara-A), which enters cells and accumulates mainly as the 5'-triphosphate, F-ara-ATP. F-ara-ATP has multiple mechanisms of action, which are mostly directed toward DNA. Collectively, these actions affect DNA synthes...
journal_title:Expert review of anticancer therapy
pub_type: 杂志文章,评审
doi:10.1586/14737140.6.9.1141
更新日期:2006-09-01 00:00:00
abstract::Since its introduction almost 40 years ago, intravesical BCG for non-muscle invasive bladder cancer remains one of the most successful cancer immunotherapies. However, up to 40% of patients will progress after BCG therapy and develop invasive bladder cancer. Despite its extensive clinical use, we are only beginning to...
journal_title:Expert review of anticancer therapy
pub_type: 杂志文章,评审
doi:10.1586/14737140.2015.1015419
更新日期:2015-05-01 00:00:00
abstract::Introduction: Pembrolizumab is an immune checkpoint inhibitor with high specificity for binding to the programmed cell death 1 (PD-1) receptor. It has been approved by the FDA in patients with recurrent or metastatic cervical cancer with disease progression on or after chemotherapy whose tumors express the programmed ...
journal_title:Expert review of anticancer therapy
pub_type: 杂志文章
doi:10.1080/14737140.2021.1850279
更新日期:2020-11-26 00:00:00