Abstract:
PURPOSE OF REVIEW:To describe how to better identify frail multiple myeloma patients and to treat them appropriately. RECENT FINDINGS:Proteasome inhibitors, such as bortezomib, carfilzomib, and ixazomib, and immunomodulatory agents (IMiDs), such as thalidomide, lenalidomide, and pomalidomide, have significantly improved the outcome of multiple myeloma patients in the last decade. However, both in clinical trials and in daily clinical practice, elderly multiple myeloma patients have shown lesser benefit. This is mainly due to less stringent use of proteasome inhibitors and IMiDs, increased toxicity, and subsequent early discontinuation of therapy in elderly. SUMMARY:Multiple myeloma typically affects elderly patients. Approximately one-third of patients are older than 75 years at diagnosis. Moreover, at least 30% are frail, both due to disease-related symptoms and (age-related) decline in physical capacity, presence of comorbidities, frailty, polypharmacy, nutritional status, and cognitive impairment. Treatment regimens that are investigated in clinical trials for transplant-ineligible patients have largely been investigated in fit, rather than frail patients, the latter being typically excluded or highly underrepresented therein. Data on the feasibility and efficacy of current standards of care are therefore lacking in frail patients. Preliminary data suggest a higher toxicity and discontinuation rate, loss of efficacy, and impaired quality of life in frail patients. Geriatric assessment helps to identify frail patients according to their functional and cognitive status. Both the International Myeloma Working Group (IMWG)-frailty index and Revised Myeloma Comorbidity Index constitute recently proposed algorithms that easily identify intermediate-fit and frail patients. Ongoing and future clinical trials, specifically designed for frail patients, will hopefully define frailty-directed treatment selection.
journal_name
Curr Opin Oncoljournal_title
Current opinion in oncologyauthors
Zweegman S,Engelhardt M,Larocca A,EHA SWG on ‘Aging and Hematology’.doi
10.1097/CCO.0000000000000395subject
Has Abstractpub_date
2017-09-01 00:00:00pages
315-321issue
5eissn
1040-8746issn
1531-703Xjournal_volume
29pub_type
杂志文章,评审abstract::Diarrhea is a common event in the clinical history of cancer patients. It can be caused by the presence of tumor or it can be a side effect of treatment. The latter problem is occurring more often because new drugs (CPT-11) or drug combinations (fluorouracil plus interferon or leucovorin) have diarrhea as the dose-lim...
journal_title:Current opinion in oncology
pub_type: 杂志文章,评审
doi:10.1097/00001622-199507000-00006
更新日期:1995-07-01 00:00:00
abstract::The behavior of renal cell carcinoma remains one of the most unpredictable of the genitourinary neoplasms. Once this disease has spread beyond the confines of the kidney, it is extremely difficult to control. This year, emphasis has focused on the characteristic cytogenetic and chromosomal changes that are seen in thi...
journal_title:Current opinion in oncology
pub_type: 杂志文章,评审
doi:10.1097/00001622-199206000-00002
更新日期:1992-06-01 00:00:00
abstract::Contrary to the case with bacterial infections, progress in the diagnosis and treatment of invasive mycoses in cancer patients has been unsatisfactory. Amphotericin B deoxycholate has remained the drug of choice for severe invasive fungal infections for nearly 40 years. However, its infusion-related side effects, as w...
journal_title:Current opinion in oncology
pub_type: 杂志文章,评审
doi:10.1097/00001622-199709040-00002
更新日期:1997-07-01 00:00:00
abstract:PURPOSE OF REVIEW:The possibility of complete recovery for a lung cancer patient depends on very early diagnosis, as it allows total surgical resection. Screening for this cancer in a high-risk population can be performed using a radiological approach, but this holds a certain number of limitations. Liquid biopsy could...
journal_title:Current opinion in oncology
pub_type: 杂志文章,评审
doi:10.1097/CCO.0000000000000343
更新日期:2017-01-01 00:00:00
abstract::Gene transfer for the treatment of cancer is a rapidly expanding field. Recent studies can be divided into four main areas: 1) transfer of suicide genes that convert inactive prodrugs into cytotoxic compounds, 2) transfer of genes encoding cytokines and stimulatory markers to enhance immunogenicity against tumors, 3) ...
journal_title:Current opinion in oncology
pub_type: 杂志文章,评审
doi:10.1097/00001622-199611000-00010
更新日期:1996-11-01 00:00:00
abstract::Infection with HIV is associated with an increased risk of systemic and primary central nervous system non-Hodgkin's lymphoma. Patients with systemic non-Hodgkin's lymphoma usually present with high- or intermediate-grade histology and extranodal dissemination. Although the prognosis for such patients is poor, some pa...
journal_title:Current opinion in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1995-09-01 00:00:00
abstract:PURPOSE OF REVIEW:To evaluate the application of narrative within medical practice. Illness like cancer constitutes a biographical disruption that occurs several times during the disease, from diagnosis to complications and treatments. This review analyzes the interest of narrative ethics in medicine with a focus on ca...
journal_title:Current opinion in oncology
pub_type: 杂志文章,评审
doi:10.1097/CCO.0000000000000085
更新日期:2014-07-01 00:00:00
abstract:PURPOSE OF REVIEW:Neuroendocrine tumors (previously referred to as carcinoids) are ill-understood, enigmatic malignancies that, although slow-growing compared with adenocarcinomas, can behave aggressively. In 2004, they comprised 1.25% of all malignancies; their incidence is increasing by approximately 6% per year. The...
journal_title:Current opinion in oncology
pub_type: 杂志文章,评审
doi:10.1097/CCO.0b013e3282f1c595
更新日期:2008-01-01 00:00:00
abstract::Lymphomas include a vast number of pathologic conditions in which the search for new active drugs follows different routes. Hodgkin's disease and high-grade non-Hodgkin's lymphoma are very sensitive to chemotherapy, responding well to existing regimens; the inability to cure seems to be caused by acquired drug resista...
journal_title:Current opinion in oncology
pub_type: 杂志文章,评审
doi:10.1097/00001622-199409000-00006
更新日期:1994-09-01 00:00:00
abstract::Biologic approaches to lymphoma treatment are now a practical reality rather than a vaguely perceived hope for the future. Interferon alfa seems to have been established as a life-extending therapy for selected patients with follicular lymphoma. Humanized anti-CD20 monoclonal antibody (rituximab) has an authentic 50% ...
journal_title:Current opinion in oncology
pub_type: 杂志文章,评审
doi:10.1097/00001622-199909000-00005
更新日期:1999-09-01 00:00:00
abstract::Kaposi sarcoma (KS), an unusual tumor of vascular origin, was one of the first recognized manifestations of AIDS. In the past few years, it has become clear that human herpesvirus-8 (HHV-8) is critical to the development of KS in the setting of immunosuppression, such as that seen with HIV infection. Other genetic and...
journal_title:Current opinion in oncology
pub_type: 杂志文章,评审
doi:10.1097/00001622-200003000-00013
更新日期:2000-03-01 00:00:00
abstract::Chronotherapy consists in the administration of medicines according to biological rhythms. Further insight into the mechanisms of the circadian system has led to adapting the delivery of cancer chemotherapy to rhythms in drug metabolism or cell proliferation. The pharmacology of anticancer agents has long been known t...
journal_title:Current opinion in oncology
pub_type: 杂志文章,评审
doi:10.1097/00001622-199607000-00012
更新日期:1996-07-01 00:00:00
abstract:PURPOSE OF REVIEW:To provide examples of mitochondria-specific metabolic events that influence tumor cell biology, and of metabolism-related mitochondrial biomarkers and therapeutic targets in cancer cells. RECENT FINDINGS:Cancer cell mitochondria are rewired to optimally serve the cancer cell under various conditions...
journal_title:Current opinion in oncology
pub_type: 杂志文章,评审
doi:10.1097/CCO.0000000000000336
更新日期:2017-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Current treatment modalities provide limited improvement in the natural course of lung cancer, and prognosis remains poor. Lung cancer is a malignancy with great molecular heterogeneity. The complexity of the signalling process leading to cancer cell proliferation and to the neoplastic phenotype suppo...
journal_title:Current opinion in oncology
pub_type: 杂志文章,评审
doi:10.1097/CCO.0b013e328011beec
更新日期:2007-03-01 00:00:00
abstract::Recent papers dealing with the effect of biologic response modifiers on the therapeutic activity of anticancer drugs are reviewed. Preclinical findings indicate that both interferons and tumor necrosis factor-alpha are able to synergize with different cytotoxic drugs in increasing both tumor cytotoxicity or cytostasis...
journal_title:Current opinion in oncology
pub_type: 杂志文章,评审
doi:10.1097/00001622-199112000-00017
更新日期:1991-12-01 00:00:00
abstract:PURPOSE OF REVIEW:Mycosis fungoides and Sézary syndrome arise from malignant T cells that reside in skin, and subsequently are capable of circulating between skin, lymph nodes, and blood. The pathophysiologic mechanisms that cause and result in different behaviors of the skin-homing-malignant T cells in different stage...
journal_title:Current opinion in oncology
pub_type: 杂志文章,评审
doi:10.1097/CCO.0000000000000243
更新日期:2016-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Neoplasms of the endocrine pancreas, commonly referenced as pancreatic islet cell tumors, are rare, often well differentiated endocrine neoplasms, whose biology remains poorly characterized. This article reviews the current clinical management of pancreatic islet cell tumors and describes the molecula...
journal_title:Current opinion in oncology
pub_type: 杂志文章,收录出版,评审
doi:10.1097/01.cco.0000198974.59239.3c
更新日期:2006-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Management of the epithelial ovarian cancer (EOC) remains a therapeutic challenge, with continued poor overall survival (OS). Given low chemotherapy response rates for recurrent disease and short survival times, new treatment options with improved therapeutic indices for targeting cancer's vulnerabili...
journal_title:Current opinion in oncology
pub_type: 杂志文章,评审
doi:10.1097/CCO.0b013e3283564230
更新日期:2012-09-01 00:00:00
abstract:KEY POINTS:(1) Surgery is the standard primary treatment for early stage endometrial cancer, with local adjuvant therapies such as pelvic radiotherapy and vaginal brachytherapy most often used in patients with high risk of recurrence. (2) There are currently very few well designed studies evaluating local therapies in ...
journal_title:Current opinion in oncology
pub_type: 杂志文章,评审
doi:10.1097/01.cco.0000284643.94948.44
更新日期:2007-09-01 00:00:00
abstract:PURPOSE OF REVIEW:The psychosocial needs of adolescent and young adult (AYA) siblings of cancer patients are easily overlooked. Accordingly, the evidence base informing short and long-term outcomes for these young people is sparse. This review provides an overview of recent research highlighting the experiences, unmet ...
journal_title:Current opinion in oncology
pub_type: 杂志文章,评审
doi:10.1097/CCO.0000000000000194
更新日期:2015-07-01 00:00:00
abstract:PURPOSE OF REVIEW:The aim of this review is to describe the major steps leading to the immunosuppressive tumor microenvironment and to summarize some of the new immunotherapies that interfere with these mechanisms. RECENT FINDINGS:Immunotherapy has improved the outcome of relapsed/metastatic head and neck squamous cel...
journal_title:Current opinion in oncology
pub_type: 杂志文章,评审
doi:10.1097/CCO.0000000000000623
更新日期:2020-05-01 00:00:00
abstract:PURPOSE OF REVIEW:A small percentage of gliomas are caused by inheritance in cancer syndromes but there is also a general familial aggregation of glioma. Recently, low penetrant genes associated with glioma risk have been identified. RECENT FINDINGS:Seven independent chromosomal loci have robustly been associated with...
journal_title:Current opinion in oncology
pub_type: 杂志文章,评审
doi:10.1097/CCO.0b013e32834a6f61
更新日期:2011-11-01 00:00:00
abstract:PURPOSE OF REVIEW:Highlight recent data in lung and breast cancer leptomeningeal disease and address clinical trials that are open for patients. RECENT FINDINGS:Patients with lung and breast cancer leptomeningeal disease have survival outcomes of less than 1 year, despite advances in treatment strategy. Efforts to dev...
journal_title:Current opinion in oncology
pub_type: 杂志文章,评审
doi:10.1097/CCO.0000000000000574
更新日期:2019-11-01 00:00:00
abstract:PURPOSE OF REVIEW:Relapse has become the leading cause of death following allogeneic hematopoietic stem cell transplantation (HSCT). Despite improved understanding of the biology that underlies the graft-versus-leukemia/tumor effect the relapse rate did not decrease over the past 20 years. In general, prognosis is poor...
journal_title:Current opinion in oncology
pub_type: 杂志文章,评审
doi:10.1097/CCO.0b013e328342c6c8
更新日期:2011-03-01 00:00:00
abstract:PURPOSE OF REVIEW:The rising incidence of oropharyngeal squamous cell carcinoma (OPSCC), in large part as a result of the human papillomavirus (HPV), has driven a movement for the change in the management strategies. Renewed interest in minimally invasive approaches of endoscopic head and neck surgery led to introducti...
journal_title:Current opinion in oncology
pub_type: 杂志文章
doi:10.1097/CCO.0000000000000365
更新日期:2017-05-01 00:00:00
abstract::The circumvention of P-glycoprotein function by pharmacologic agents is a major focus of clinical trials aimed at increasing the cytotoxicity of multidrug resistance-associated drugs, including doxorubicin. The success of this approach will likely depend on the clinical significance of P-glycoprotein expression, which...
journal_title:Current opinion in oncology
pub_type: 杂志文章,评审
doi:10.1097/00001622-199311000-00014
更新日期:1993-11-01 00:00:00
abstract:PURPOSE OF REVIEW:Multiple myeloma is a common hematological malignancy arising in the bone marrow. Bone lesions were initially depicted with conventional radiography, although recently F-FDG PET/CT and MRI are recognized as having a clear role in the initial workup and in the evaluation of therapy response. RECENT FI...
journal_title:Current opinion in oncology
pub_type: 杂志文章,评审
doi:10.1097/CCO.0000000000000230
更新日期:2015-11-01 00:00:00
abstract:PURPOSE OF REVIEW:Endometrial cancer is the most common gynaecological malignancy for which platinum-based and anthracycline-based combinations, with/without taxanes, are the most active but toxic treatments. The preliminary results achieved with two molecule-targeted agents suggest that a better knowledge in molecular...
journal_title:Current opinion in oncology
pub_type: 杂志文章,评审
doi:10.1097/CCO.0b013e32830b0deb
更新日期:2008-09-01 00:00:00
abstract:PURPOSE OF REVIEW:Gallbladder carcinoma (GBC), classified as a biliary tract cancer (BTC) along with intrahepatic and extrahepatic cholangiocarcinomas, is a rare disease in Western countries, but a highly prevalent disease in Chile, other countries in Latin America, India and Japan. It commonly presents at an advanced ...
journal_title:Current opinion in oncology
pub_type: 杂志文章,评审
doi:10.1097/CCO.0b013e3283620fd8
更新日期:2013-07-01 00:00:00
abstract::Some of the most dramatic advances in the treatment of cancer have used the immune system in combination with conventional or transplantation chemotherapy. Adoptive immunotherapy has been used for relapses after allogeneic bone marrow transplantation, and it has been particularly effective for chronic myeloid leukemia...
journal_title:Current opinion in oncology
pub_type: 杂志文章,评审
doi:10.1097/00001622-199711000-00014
更新日期:1997-11-01 00:00:00