Chemoradiotherapy in Cancer Treatment: Rationale and Clinical Applications

Rallis, Kathrine S; Yau, Thomas Ho Lai; Sideris, Michail

doi:10.21873/anticanres.14746

Cited by 67 publications

(33 citation statements)

References 50 publications

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“…Combination immunotherapy with radiation is set to replace standard chemoradiotherapy protocols in other solid tumours (113). Radiotherapy can modulate the immune system and mount an immune response causing immunogenic cell death by enhancing tumour antigen retrieval (114).…”

Section: Neurocognitivementioning

confidence: 99%

Molecular Genetics and Targeted Therapies for Paediatric High-grade Glioma

Rallis

George

Woźniak

et al. 2022

Cancer Genomics Proteomics

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Brain tumours are the leading cause of paediatric cancer-associated death worldwide. High-grade glioma (HGG) represents a main cause of paediatric brain tumours and is associated with poor prognosis despite surgical and chemoradiotherapeutic advances. The molecular genetics of paediatric HGG (pHGG) are distinct from those in adults, and therefore, adult clinical trial data cannot be extrapolated to children. Compared to adult HGG, pHGG is characterised by more frequent mutations in PDGFRA, TP53 and recurrent K27M and G34R/V mutations on histone H3. Ongoing trials are investigating novel targeted therapies in pHGG. Promising results have been achieved with BRAF/MEK and PI3K/mTOR inhibitors. Combination of PI3K/mTOR, EGFR, CDK4/6, and HDAC inhibitors are potentially viable options. Inhibitors targeting the UPS proteosome, ADAM10/17, IDO, and XPO1 are more novel and are being investigated in early-phase trials. Despite preclinical and clinical trials holding promise for the discovery of effective pHGG treatments, several issues persist. Inadequate blood-brain barrier penetration, unfavourable pharmacokinetics, dose-limiting toxicities, long-term adverse effects in the developing child, and short-lived duration of response due to relapse and resistance highlight the need for further improvement. Future pHGG management will largely depend on selecting combination therapies which work synergistically based on a sound knowledge of the underlying molecular target pathways. A systematic investigation of multimodal therapy with chemoradiotherapy, surgery, target agents and immunotherapy is paramount. This review provides a comprehensive overview of pHGG focusing on molecular genetics and novel targeted therapies. The diagnostics, genetic discrepancies with adults and their clinical implications, as well as conventional treatment approaches are discussed.Intracranial and intraspinal tumours are the most common solid tumours in paediatrics (1). They are the second leading cause of cancer-associated death in children and adolescents under the age of 19 in the USA and Canada (1), with an average annual age-adjusted incidence of 6.06 per 100,000 in the USA between 2012 and 2016 (2). Brain tumours are now the leading cause of paediatric-cancer-associated death worldwide, surpassing deaths from childhood leukaemia (3). Gliomas represent the highest proportion of childhood brain tumours (4, 5) accounting for 60% of paediatric brain tumour cases (5, 6), of which approximately half are classified as high grade (6, 7).

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Section: Neurocognitivementioning

confidence: 99%

Molecular Genetics and Targeted Therapies for Paediatric High-grade Glioma

Rallis

George

Woźniak

et al. 2022

Cancer Genomics Proteomics

Self Cite

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“…Considering the recent success achieved with anticancer immunotherapies including immune checkpoint inhibitors, the combination of cHDR-RT and immunotherapy has emerged as an exciting field of research with the potential for significant clinical benefit (42).…”

Section: Discussionmentioning

confidence: 99%

Non-melanoma Skin Cancer Treated by Contact High-dose-rate Radiotherapy (Brachytherapy): A Mono-institutional Series and Literature Review

Tagliaferri

Ciardo

Fionda

et al. 2021

In Vivo

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Background/Aim: Non-melanoma skin cancers (NMSC) are the most common neoplasms worldwide and their incidence has been proven to increase in recent years and their treatment should aim at cancer cure as well as cosmetic and functional results. The aim of the study was to report the results of our mono-institutional series of highdose-rate radiotherapy (cHDR-RT) in NMSC, based on a homogenous technique and two different treatment schedules. Patients and Methods: All patients affected by NMSC who were consecutively evaluated and treated at our Interventional Oncology Center from October 2018 to August 2020, were included. Patients underwent cHDR-RT using flap applicators and remotely afterloaded Ir-192 sources. Results: Overall, 51 patients were treated for a total of 67 lesions. Local control (LC) and disease-specific survival (DSS) were 94.0% and 100%, respectively. Grade 1, grade 2, grade 3 and grade 4 acute toxicity rates were 24.6%, 3.5%, 3.5%, and 0.0%, respectively. The cosmetic results were graded as excellent/good, fair, and poor in 73.7%, 19.3%, and 7.0%. Conclusion: cHDR-RT of NMSC is an effective alternative to surgery due to excellent outcomes both in terms of local control and aesthetic results especially in the face.Non-melanoma skin cancers (NMSC) are the most common neoplasms worldwide and their incidence has been proven to increase in the recent years (1). The two most frequent NMSC are squamous cell carcinoma (SCC) and basal cell carcinoma (BCC). Albeit with a better prognosis than other cancers, the NMSC treatment strategies should be properly selected considering the possible negative impact on quality of life of suboptimal cosmetic results (2). Therefore, treatment of NMSC should aim at cancer cure as well as cosmetic and functional results (3). Therapeutic options include surgery, radiotherapy (RT), and topical agents. More recently for locally advanced or metastatic tumors where curative surgery and curative radiotherapy are not feasible, 2313This article is freely accessible online.

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“…After the application of sequential radiotherapy to patients, the overall survival (OS) improved, but elderly patients still have not benefited from it. Therefore, combination therapy with radiotherapy may be of benefit to diverse patients with different states of health ( 117 ).…”

Section: Treatments For Lung Cancermentioning

confidence: 99%

Current treatments for non-small cell lung cancer

et al. 2022

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Despite improved methods of diagnosis and the development of different treatments, mortality from lung cancer remains surprisingly high. Non-small cell lung cancer (NSCLC) accounts for the large majority of lung cancer cases. Therefore, it is important to review current methods of diagnosis and treatments of NSCLC in the clinic and preclinic. In this review, we describe, as a guide for clinicians, current diagnostic methods and therapies (such as chemotherapy, chemoradiotherapy, targeted therapy, antiangiogenic therapy, immunotherapy, and combination therapy) for NSCLC.

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Chemoradiotherapy in Cancer Treatment: Rationale and Clinical Applications

Cited by 67 publications

References 50 publications

Molecular Genetics and Targeted Therapies for Paediatric High-grade Glioma

Molecular Genetics and Targeted Therapies for Paediatric High-grade Glioma

Non-melanoma Skin Cancer Treated by Contact High-dose-rate Radiotherapy (Brachytherapy): A Mono-institutional Series and Literature Review

Current treatments for non-small cell lung cancer

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