Table of Contents
Overview
Definition of Oncology
Oncology is a multifaceted field dedicated to the study, diagnosis, treatment, and research of cancer, which is characterized by the abnormal growth of cells that can invade surrounding tissues and spread to other parts of the body. This discipline encompasses several key concepts essential for understanding cancer, including cancer initiation, progression, and the various types of cancer that exist.[2.1] A sophisticated understanding of oncology is crucial for healthcare professionals, particularly interventional radiologists, as it forms one of the four pillars of cancer care alongside medical, surgical, and radiation oncology.[3.1] Cancer itself is defined as a collection of related diseases where cells divide uncontrollably, leading to the formation of tumors and the potential for metastasis.[4.1] The field of oncology not only focuses on the clinical aspects of cancer but also integrates research aimed at improving treatment strategies and patient outcomes.Role of Oncologists
Oncologists play a crucial role in the management and treatment of cancer, which is characterized by a diverse array of types and subtypes, each with distinct biological mechanisms and treatment responses. With over 100 different types of cancer, oncologists must personalize treatment options based on the unique biological characteristics of each cancer type, including genetic and epigenetic alterations that drive tumor development and progression.[42.1] The treatment modalities employed by oncologists have evolved significantly, particularly with the advent of targeted therapies and immunotherapies. For instance, the introduction of small molecule targeted agents, antibody-drug conjugates (ADCs), and cell-based therapies has transformed the landscape of cancer treatment.[41.1] Oncologists utilize these advanced therapies, such as Gefitinib and Erlotinib for non-small cell lung cancer, and Bevacizumab, which targets tumor blood supply, to tailor treatment plans that enhance efficacy and minimize side effects.[41.1] Moreover, the approval of innovative therapies, including oncolytic viruses like T-VEC and Delytact, as well as the small molecule inhibitor Sotorasib for specific KRAS mutations, exemplifies the ongoing advancements in oncology.[43.1] Oncologists are also guided by clinical practice guidelines, such as those from the National Comprehensive Cancer Network (NCCN), which recommend combinations of therapies like atezolizumab and bevacizumab for hepatocellular carcinoma, reflecting the importance of integrating immunotherapy and anti-angiogenic strategies in treatment regimens.[43.1]History
Milestones in Cancer Research
Milestones in cancer research have significantly shaped the field of oncology, leading to improved patient outcomes and treatment strategies. One of the pivotal moments in this history occurred in the mid-1970s with landmark studies on adjuvant chemotherapy for breast cancer. The National Surgical Adjuvant Breast and Bowel Project (NSABP) published a study in 1975 that tested a single drug, while an Italian study reported on a drug combination. These studies contributed to a decline in breast cancer mortality rates by 1991, thanks to advancements in chemotherapeutic agents, hormone treatments, and early diagnostic tools.[47.1] The approval of several key drugs by the FDA marked further significant milestones. Tamoxifen, initially developed as a birth control treatment, was approved for breast cancer therapy, followed by trastuzumab, a monoclonal antibody targeting HER2-positive breast cancer. Additionally, sipuleucel-T, a cancer treatment vaccine utilizing a patient's immune cells, was approved for metastatic prostate cancer, showcasing the evolution of treatment modalities.[45.1] The introduction of ado-trastuzumab emtansine (T-DM1) for patients previously treated with trastuzumab and/or taxane drugs further exemplified the advancements in targeted therapies.[45.1] The 2010s and 2020s saw the emergence of precision oncology, which integrates cancer genomics into treatment decision-making. This approach has revolutionized the understanding of tumor biology, allowing for personalized therapies that enhance patient outcomes.[48.1] Notable advancements included the FDA's approval of Sotorasib, the first small molecule inhibitor targeting specific KRAS gene mutations, and the combination of atezolizumab and bevacizumab as a preferred treatment for hepatocellular carcinoma.[50.1] Research into molecular biology has also played a crucial role in developing targeted therapies. For instance, studies have demonstrated how small molecules and genetic mutations can influence critical protein interactions in cancer cells, paving the way for innovative treatment strategies.[49.1] Moreover, the role of patient advocacy has evolved alongside these advancements, significantly impacting patient care and outcomes. Advocacy groups have become essential in guiding patients through complex treatment options and fostering supportive communities.[52.1] Initiatives like the Engagement of Patients with Advanced Cancer (EPAC) study have shown that patient engagement in advance care planning can lead to improved experiences and reduced acute care use at the end of life.[51.1] These milestones collectively illustrate the dynamic nature of cancer research and its ongoing commitment to enhancing patient care through innovative treatments and supportive advocacy.Recent Advancements
Innovations in Treatment Approaches
Recent advancements in oncology have led to significant innovations in treatment approaches, particularly through the development and approval of novel therapies. The approval of T-VEC in 2015 and Delytact in 2021 for melanoma and malignant glioma, respectively, exemplifies the resurgence of oncolytic viruses as a viable cancer treatment modality.[87.1] Furthermore, the FDA's approval of Sotorasib in 2020 marked a milestone as the first small molecule inhibitor targeting specific KRAS gene mutations, highlighting the shift towards precision medicine in oncology.[87.1] In addition to these targeted therapies, the integration of immunotherapy and anti-angiogenic therapy has become increasingly prominent in the management of various cancers. The National Comprehensive Cancer Network (NCCN) guidelines in 2021 recommended the combination of atezolizumab and bevacizumab as the preferred first-line treatment for patients with hepatocellular carcinoma (HCC), underscoring the evolving landscape of cancer care.[87.1] This shift reflects a broader trend towards utilizing combination therapies to enhance treatment efficacy and improve patient outcomes. Moreover, advancements in biomarker identification and validation have played a crucial role in personalizing cancer treatment strategies. Recent studies have demonstrated the potential of innovative biomarker strategies, such as genomic loss of heterozygosity (gLOH), to identify patients who would benefit from specific therapies.[92.1] High-throughput techniques have facilitated the validation of potential biomarkers across large prospective studies, thereby enhancing the understanding of mechanisms underlying cancer immunotherapies.[93.1] The continuous progress in molecular biology technologies has led to the discovery of sensitive and specific tumor biomarkers, significantly promoting personalized medicine and improving patient outcomes.[94.1] Despite these advancements, challenges remain, particularly concerning cancer resistance. The phenomenon of cancer resistance, characterized by the ability of cancer cells to evade treatment effects, continues to pose significant obstacles in therapy effectiveness.[105.1] Understanding the mechanisms contributing to tumor progression and drug resistance is essential for developing effective strategies to prevent the emergence of drug-tolerant cancer cells.[106.1] Key findings indicate that tumor heterogeneity, including the presence of cancer stem cells and variations in the tumor microenvironment, plays a critical role in promoting resistance.[107.1] As the field of oncology continues to evolve, the integration of patient-centered communication is vital for ensuring that advancements in treatment approaches are effectively communicated to patients. Observational studies have linked patient-centered communication to improved quality of life and treatment outcomes, emphasizing the need for effective communication strategies in oncology.[90.1] By fostering an environment that respects patient involvement in decision-making and provides timely, understandable information, healthcare providers can enhance the overall treatment experience for patients.[91.1]Emerging Therapies and Technologies
Recent advancements in oncology have led to the emergence of innovative therapies and technologies that are transforming cancer treatment. One significant development is the approval of new anticancer therapeutics by the U.S. Food and Drug Administration (FDA), which included 14 new drugs and two new imaging agents from August 2022 to July 2023. Notably, this period saw the introduction of the first antibody-drug conjugate for ovarian cancer treatment, as well as several new molecularly targeted therapies and immunotherapeutics aimed at rare cancers, including blood cancers.[85.1] Additionally, the FDA approved two new immune checkpoint inhibitors and a groundbreaking gene therapy for bladder cancer, reflecting a broader trend towards personalized medicine in oncology.[85.1] The field of precision oncology has also made significant strides, particularly in the identification and validation of cancer biomarkers. Advances in understanding cancer biology and the immune microenvironment have facilitated the development of tailored treatments that align with the unique profiles of individual tumors.[95.1] However, challenges remain in the translational studies aimed at biomarker discovery, including the need for method validation and standardized procedures.[96.1] Artificial intelligence (AI) and machine learning (ML) are increasingly being integrated into oncology, enhancing the accuracy of genetic and molecular profiling. These technologies are being utilized for various applications, including cancer risk stratification, diagnosis, and the development of cancer medications.[97.1] AI has shown promise in improving diagnostic accuracy, with systems developed that outperform human specialists in detecting breast cancer and achieving high specificity and sensitivity in prostate cancer diagnosis.[98.1] Furthermore, the confluence of AI with new technologies is expected to revolutionize diagnostic approaches and therapeutic strategies, ultimately improving patient outcomes.[100.1]Types Of Oncology
Medical Oncology
Medical oncology is a specialized branch of oncology that focuses on the treatment of cancer using systemic therapies. These therapies primarily include chemotherapy, immunotherapy, and targeted therapy, which are designed to kill cancer cells or inhibit their growth.[123.1] Medical oncologists play a crucial role in the management of cancer patients, often coordinating with other specialists to develop comprehensive treatment plans tailored to individual patient needs.[127.1] In addition to administering treatments, medical oncologists are responsible for conducting thorough assessments of patients, which encompass evaluating their physical condition and medical history. This assessment is vital for determining the most appropriate treatment options and for monitoring the patient's response to therapy.[127.1] The integration of personalized medicine into medical oncology has further enhanced treatment efficacy, as it allows for therapies to be tailored based on the genetic and molecular characteristics of both the patient and the tumor.[126.1] Moreover, the field of medical oncology is continuously evolving, with advancements in cancer treatment technologies necessitating ongoing education and professional development for oncologists. This evolution is critical for ensuring that oncologists remain informed about the latest therapeutic options and can provide optimal care to their patients.[126.1] As the landscape of cancer treatment changes, medical oncologists are increasingly required to collaborate with multidisciplinary teams to ensure cohesive, patient-centered care.[128.1]Surgical Oncology
Surgical oncology encompasses a range of surgical procedures aimed at the treatment of cancer, with techniques evolving significantly over the years. Historically, simple mastectomy was the predominant surgical treatment for breast cancer until the 1970s, when pivotal trials by Veronesi and Fisher introduced breast conservation surgery (BCS) as a viable alternative. By 2002, randomized controlled trials demonstrated that BCS combined with radiotherapy provided equivalent overall survival rates compared to mastectomy, supported by 20 years of follow-up data.[132.1] Advancements in surgical techniques have led to less invasive procedures, enhancing both the effectiveness of cancer treatment and the cosmetic outcomes for patients. Modern surgical approaches in breast conservation and reconstruction have resulted in good to excellent cosmetic results for most women undergoing breast-conserving therapy.[134.1] The role of the surgeon remains critical in the definitive treatment of breast malignancies, as surgical intervention continues to be a cornerstone of cancer management.[133.1] In the broader context of oncology, surgical procedures such as resection, excision, and reconstruction are vital components of cancer treatment strategies. Oncosurgery, a specialized field within surgical oncology, tailors treatment options to the specific types and stages of cancer, ensuring that patients receive the most appropriate care.[135.1] Additionally, robotic surgery has emerged as a technique utilized for treating various cancers, including those of the colon, prostate, and uterus, reflecting the ongoing innovation in surgical methods.[136.1] Decision-making in surgical oncology is influenced by a multitude of factors, including patient characteristics, surgeon experience, and the availability of clinical guidelines. Studies have shown that factors such as patient age, personal views of surgeons, and geographical location can significantly impact surgical decision-making processes.[154.1] For instance, young women diagnosed with breast cancer often face unique concerns related to fertility and body image, which can further complicate treatment decisions.[155.1] In Newfoundland and Labrador, the rate of mastectomy is notably higher than in other regions, highlighting the variability in surgical approaches based on local practices and patient demographics.[156.1]In this section:
Specialized Areas Of Oncology
Pediatric Oncology
Over the past decade, significant advancements in pediatric oncology have emerged, greatly enhancing treatment options and outcomes for young patients. Clinical and pharmaceutical innovations initially developed for adult cancer indications have begun to transition into pediatric oncology, leading to the FDA's approval of 23 targeted drugs specifically for pediatric cancer indications. This shift has integrated targeted therapies into the standard of care for children with high-risk and refractory cancers.[173.1] The understanding of pediatric tumors has also improved, particularly through new immunotherapy treatments and insights into the genetic mechanisms underlying these cancers. Scott Armstrong, MD, PhD, chair of Pediatric Oncology at Dana-Farber Cancer Institute, highlights that recent developments have been pivotal in combating childhood cancers.[174.1] Over the last 50 years, pediatric cancer outcomes have seen remarkable improvements; for instance, the survival rate for pediatric acute lymphoblastic leukemia has increased from approximately 59% in 1975 to around 90% in 2020. Immunotherapy has played a crucial role in revolutionizing the treatment of aggressive pediatric leukemias and lymphomas.[175.1] The Children's Oncology Group (COG), an NCI-funded network, has been instrumental in conducting clinical trials that contribute significantly to the advancements in treatment and the rising cure rates for various childhood cancers.[176.1] Despite these advancements, pediatric cancers exhibit distinct biological characteristics compared to adult cancers, which can complicate treatment strategies. Pediatric cancers, which account for about 1% of all cancer diagnoses in the U.S., often have fewer genetic mutations than adult cancers, with some childhood cancer genomes containing as few as ten mutations.[192.1] This genetic simplicity, along with the fact that children typically develop different types of cancers—such as leukemia, brain tumors, lymphomas, and sarcomas—compared to the more common adult cancers like lung and breast cancer, necessitates tailored treatment approaches.[193.1]Hematology Oncology
Hematology oncology is a specialized field within oncology that focuses on the diagnosis and treatment of blood cancers, including leukemia, lymphoma, and multiple myeloma. This subspecialty combines the expertise of hematology, which deals with blood disorders, and oncology, which is concerned with cancer treatment. Hematologists-oncologists are trained to manage complex cases involving both blood disorders and cancer, providing comprehensive care that addresses the unique challenges presented by these conditions. The training for hematology oncologists typically involves completing a residency in internal medicine followed by a fellowship in hematology and oncology. This rigorous training equips them with the necessary skills to perform various diagnostic procedures, such as bone marrow biopsies, and to administer treatments that may include chemotherapy, targeted therapy, and immunotherapy.[169.1] In addition to clinical practice, hematology oncologists often engage in research to advance the understanding of blood cancers and improve treatment protocols. They may participate in clinical trials that explore novel therapies, contributing to the development of new treatment options that can enhance patient outcomes.[171.1] The integration of new therapies into existing treatment protocols is a critical aspect of hematology oncology. Oncologists must consider various factors when determining the best course of action for patients, including the specific type of blood cancer, the patient's overall health, and the potential side effects of treatments.[199.1] This careful consideration ensures that patients receive personalized care tailored to their individual needs and circumstances.Treatment Approaches
Local Treatments
Local treatments for cancer, such as radiation therapy, are essential components of oncology that aim to target tumors while minimizing damage to surrounding healthy tissue. One of the most significant advancements in this area is proton therapy, which is known for its precision. This technique allows for higher doses of radiation to be delivered directly to the tumor, thereby reducing the amount of radiation exposure to healthy tissues. As a result, patients experience fewer side effects, such as fatigue and hair loss, and a lower risk of long-term health problems associated with radiation exposure.[217.1] Despite the effectiveness of radiation therapy, misconceptions about its nature and effects can significantly impact patient decisions regarding treatment. Many patients hold beliefs that can deter them from undergoing necessary procedures. For instance, common misconceptions include the idea that radiation therapy can only be administered once, that patients will emit radiation, or that radiation will be excreted in urine or stool.[236.1] These misunderstandings can lead to unnecessary anxiety and may cause patients to avoid potentially life-saving treatments.[238.1] Addressing these misconceptions is crucial for improving patient outcomes. By providing accurate information about how radiation therapy works and its actual effects on the body, healthcare providers can help patients make informed decisions about their treatment options.[240.1] This understanding not only alleviates fears but also encourages patients to engage more fully with their treatment plans, ultimately enhancing their overall experience and outcomes in cancer care.[239.1]Systemic Treatments
Systemic treatments for cancer encompass a variety of therapeutic modalities that aim to target cancer cells throughout the body, as opposed to local treatments that focus on specific tumors. These systemic approaches include chemotherapy, immunotherapy, targeted therapy, and hormone therapy, among others. Chemotherapy involves the use of drugs that can kill rapidly dividing cancer cells, while immunotherapy harnesses the body's immune system to fight cancer more effectively.[209.1] Targeted therapies are designed to interfere with specific molecules involved in tumor growth and progression, exemplified by the FDA approval of Sotorasib, which targets specific KRAS gene mutations.[221.1] In addition to these established treatments, recent advancements have introduced innovative modalities such as oncolytic virus therapy, which has gained attention for its potential in treating various cancers, including melanoma and malignant glioma.[222.1] The resurgence of oncolytic viruses as a treatment option was marked by the approvals of T-VEC in 2015 and Delytact in 2021, highlighting their role in the evolving landscape of cancer therapy.[221.1] Furthermore, the combination of immunotherapy agents, such as atezolizumab and bevacizumab, has been recommended as a first-line treatment for hepatocellular carcinoma, emphasizing the importance of integrating immunotherapy with anti-angiogenic strategies.[221.1] Healthcare providers often recommend a combination of these systemic treatments tailored to the individual patient's cancer type and stage, as well as their overall health status.[220.1] The decision-making process involves a multidisciplinary approach, where oncologists evaluate the best practices for care delivery, ensuring that treatment plans are personalized to optimize patient outcomes.[221.1]In this section:
Challenges In Oncology
Drug Resistance
Drug resistance in oncology is a significant challenge that complicates treatment strategies and contributes to cancer progression. Tumor heterogeneity is a primary factor in treatment failure, as it arises from both genetic mutations and epigenetic alterations influenced by the tumor microenvironment (TME).[267.1] This heterogeneity manifests at the single-cell level, where variations in gene expression and copy number can lead to differential responses to therapies across various cancer types, including neuroendocrine prostate cancer and non-small-cell lung cancer.[268.1] The TME itself plays a crucial role in mediating therapeutic resistance. It consists of a complex network of stromal cells and extracellular matrix components that interact dynamically with cancer cells, promoting clonal evolution and multidrug resistance.[271.1] For instance, tumor-associated macrophages exhibit heterogeneity and can polarize towards either an antitumorigenic (M1) or protumorigenic (M2) phenotype, further complicating treatment outcomes.[270.1] This plasticity can lead to immune escape, where cancer cells adapt to evade the immune response, particularly following therapies such as androgen deprivation.[270.1] Innovative therapeutic approaches are being explored to address these challenges. Strategies include targeting the TME through stromal reprogramming, immune microenvironment modulation, and the use of extracellular matrix-targeting agents.[272.1] These methods aim to disrupt the interactions between cancer cells and their microenvironment, potentially enhancing treatment efficacy and overcoming resistance mechanisms. Understanding the intricate interplay between tumor heterogeneity and the TME is essential for developing effective cancer therapies and improving patient outcomes.[271.1]Access to Care
Access to healthcare is a critical determinant of health, particularly in the context of cancer care, where disparities are pronounced among underserved communities. These disparities are often linked to socio-economic factors that create barriers to accessing timely and effective treatment. For instance, cancer remains a leading cause of morbidity and mortality globally, with low- and middle-income countries (LMICs) accounting for 57% of new cancer patients and 65% of cancer-related deaths. However, profound health system challenges hinder the implementation of comprehensive cancer services in these regions, including prevention, screening, diagnosis, and treatment.[265.1] Specific socio-economic factors contributing to these disparities include racial and ethnic minority status, economic disadvantages, and disability status, which can exacerbate the risks associated with cancer development and access to care.[264.1] Furthermore, sexual and gender minority (SGM) patients face unique challenges that often lead to poorer cancer outcomes due to discrimination, insufficient research, and a lack of specialized care.[262.1] The interplay of these factors not only affects individual access to care but also impacts overall health outcomes within these populations.[263.1] To address these disparities, community engagement has emerged as a vital strategy. Successful models of community engagement can disseminate culturally relevant health information, thereby increasing awareness and understanding of cancer disparities and prevention measures.[278.1] By investing in cultural understanding and linguistic accessibility, community engagement efforts can significantly improve access to timely and appropriate cancer care, ultimately reducing disparities in treatment and healthcare outcomes.[278.1] Moreover, initiatives such as the 2022-2024 World Cancer Day theme, "Close the Care Gap," emphasize the need for a multifaceted approach to bridge inequities in cancer care.[279.1] This includes integrating patient navigation, financial assistance, and clinical support to ensure that every patient receives equitable treatment, regardless of their background.[279.1] Systematic reviews have identified cost-effective strategies that focus on improving cancer screening uptake among socioeconomically disadvantaged populations, which can be replicated in various locations to address these inequalities.[281.1] In addition, programs like the National Breast and Cervical Cancer Early Detection Program and the Colorectal Cancer Control Program are designed to promote equitable access to cancer screening and treatment, particularly among high-risk groups.[283.1] These initiatives highlight the importance of a multipronged approach that involves individuals, communities, health systems, and government entities to eliminate structural racism and systemic barriers to cancer care.[282.1] By addressing these challenges, it is possible to create a more equitable landscape for cancer treatment and survivorship.In this section:
Future Directions
Precision Medicine
Precision medicine in oncology is increasingly characterized by the integration of advanced technologies and novel therapeutic strategies aimed at tailoring treatment to individual patient profiles. Recent advancements in disease biology have highlighted the correlation between genome instability and anti-tumor immune responses, leading to the development of innovative treatment modalities such as CAR-T cell therapy and precision companion diagnostics that enhance targeted therapies.[292.1] This shift towards precision medicine is further supported by the emergence of cancer immunotherapy, which includes strategies like cancer vaccinations and immune checkpoint blockade therapy, aimed at harnessing the body's immune system to combat cancer more effectively.[293.1] The role of artificial intelligence (AI) in precision medicine is becoming increasingly significant, as AI technologies are reshaping the landscape of oncology by improving diagnostic accuracy and treatment personalization. AI applications have demonstrated the ability to outperform traditional expert opinion-based scoring systems in various cancer applications, leading to a greater integration of AI-informed methods into clinical practice.[308.1] Specifically, AI is being utilized in the detection, diagnosis, and treatment of the most common cancers, including breast, prostate, lung, and colorectal cancers.[310.1] These AI-driven approaches not only enhance the precision of cancer diagnostics but also facilitate the development of personalized treatment plans that are tailored to the unique genetic and molecular characteristics of each patient's tumor.[309.1] Moreover, the development of cancer vaccines represents a unique aspect of precision medicine, as they can prime new T cells to target a broader array of tumor antigens, potentially leading to more durable immune responses.[294.1] The neoantigen prediction process, which involves identifying tumor-specific mutations and validating their ability to elicit specific T cell responses, exemplifies the systematic approach being adopted in precision oncology.[294.1] As research continues to evolve, the integration of digital health interventions and evidence-based cancer control policies will further enhance the efficacy of precision medicine in oncology, ensuring that treatment strategies are both effective and equitable across diverse populations.[291.1]Immunotherapy Developments
Recent advancements in immunotherapy, particularly in the context of personalized medicine, are poised to significantly enhance cancer treatment protocols. The integration of personalized immunotherapy with cancer precision medicine has been facilitated by substantial progress in cancer genomics, particularly through next-generation sequencing technologies. This approach enables genomic and molecular profiling to guide the selection of the most appropriate treatments for individual cancer patients, although its clinical application remains limited to a small proportion of patients.[304.1] Moreover, the development of companion diagnostics (CDx) has been instrumental in identifying which treatments will be most effective for specific tumors, thereby enhancing the efficacy and safety of personalized treatment models. Recent innovations have focused on creating more accurate tumor models, such as organoids, and leveraging the specificity of the immune system to develop effective cancer vaccines and monoclonal antibodies (mAbs).[305.1] These personalized treatment approaches have demonstrated improved patient outcomes, including higher response rates and progression-free survival in clinical trials that utilized specific biomarkers for patient selection.[305.1] In addition, the exploration of neoantigen-based therapies has shown promise in personalizing immunotherapy. Clinical trials have indicated that patients with DNA repair gene mutations, which result in higher tumor mutational burden (TMB), exhibit significantly better recurrence-free survival compared to those without such mutations. Trials involving personalized neoantigen vaccines combined with anti-PD-1 antibodies have reported encouraging results, with objective response rates observed across various cancer types, including melanoma and non-small cell lung cancer.[306.1] Furthermore, advancements in Chimeric Antigen Receptor T (CAR-T) cell therapy have revolutionized cancer treatment, particularly for hematological malignancies. CAR-T therapy has demonstrated high response rates and the potential for long-term remissions, although challenges such as high costs and adverse reactions remain.[323.1] Recent studies have confirmed the efficacy of CD19 CAR-T therapy in treating relapsed/refractory follicular lymphoma, achieving an overall response rate of 98.2%.[324.1]References
[2] PDF — Key Concepts • Cancer initiation • Cancer progression • Cancer types Related PIP Digests • Understanding Cancer: Tumour Grading and Cancer Staging • Understanding Cancer: Hallmarks of Cancer What is Cancer? 1 Cancer is a collection of related diseases where some cells divide without stopping and spread into surrounding tissues.
[3] Cancer Concepts and Principles: Primer for the Interventional ... — INTRODUCTION. A sophisticated understanding of the rapidly changing field of oncology, including a broad knowledge of oncologic disease and the therapies available to treat them, is fundamental to the interventional radiologist providing oncologic therapies and necessary to affirm interventional oncology as one of the four pillars of cancer care alongside medical, surgical and radiation oncology.
[4] Overview of Cancer - Cancer - Merck Manual Consumer Version — Overview of Cancer. video. A cancer is an abnormal growth of cells (usually derived from a single abnormal cell). The cells have lost normal control mechanisms and thus are able to multiply continuously, invade nearby tissues, migrate to distant parts of the body, and promote the growth of new blood vessels from which the cells derive nutrients
[41] Exploring treatment options in cancer: Tumor treatment strategies — Emerging as fervently pursued modalities are small molecule targeted agents, antibody-drug conjugates (ADCs), cell-based therapies, and gene therapy. In this review, we discussed the different treatment modalities, including small molecule targeted drugs, peptide drugs, antibody drugs, cell therapy, and gene therapy. The new millennium brought targeted therapies for non-small cell lung cancer with drugs like Gefitinib and Erlotinib, and the first anti-angiogenic drug, Bevacizumab, which targeted tumor blood supply. ADCs exert their therapeutic effects through a process that begins with the specific binding of the antibody component of the ADC to antigens on the surface of tumor cells. Once in the body, CAR-NK cells utilize their CAR to recognize and bind to specific tumor antigens, leading to their activation and the subsequent release of cytotoxic granules and cytokines to eliminate cancer cells.
[42] Cancer Biology, Epidemiology, and Treatment in the 21st Century ... — Cancer is a disease that begins with genetic and epigenetic alterations occurring in specific cells, some of which can spread and migrate to other tissues.4 Although the biological processes affected in carcinogenesis and the evolution of neoplasms are many and widely different, we will focus on 4 aspects that are particularly relevant in tumor biology: genomic and epigenomic alterations that lead to cell transformation, the cells where these changes occur, and the processes of invasion and metastasis that, to an important degree, determine tumor aggressiveness. The genomics of cancer can be defined as the study of the complete sequence of DNA and its expression in tumor cells. Cancer.
[43] Exploring treatment options in cancer: tumor treatment strategies - Nature — The approval of T-VEC in 2015 and Delytact in 2021 for melanoma and malignant glioma, respectively, highlighted the resurgence of oncolytic viruses as a cancer treatment modality.19,20 The 2020 s have seen further advancements with the FDA approval of Sotorasib, the first small molecule inhibitor targeting specific KRAS gene mutations.21 In 2021, the National Comprehensive Cancer Network (NCCN) guidelines highlighted the combination of atezolizumab and bevacizumab as the preferred first-line treatment option for patients with hepatocellular carcinoma (HCC).22 This recommendation underscores the importance of immunotherapy and anti-angiogenic therapy in the frontline management of this aggressive form of cancer, reflecting the evolving landscape of cancer care and the continuous efforts to improve patient outcomes (Fig. 1).
[45] Milestones in Cancer Research and Discovery - NCI — FDA approves tamoxifen, an antiestrogen drug originally developed as a birth control treatment, for the treatment of breast cancer. FDA approves trastuzumab, a monoclonal antibody that targets cancer cells that overexpress the HER2 gene, for the treatment of women with HER2-positive metastatic breast cancer. FDA approves sipuleucel-T, a cancer treatment vaccine that is made using a patient's own immune system cells (dendritic cells), for the treatment of metastatic prostate cancer that no longer responds to hormonal therapy. FDA approves ado-trastuzumab emtansine (T-DM1) for the treatment of patients with HER2-positive breast cancer who were previously treated with trastuzumab and/or a taxane drug. NCI and the ECOG-ACRIN Cancer Research Group launch the NCI-MATCH (Molecular Analysis for Therapy Choice) clinical trial to test more than 20 drugs and drug combinations based on molecular analysis of tumors in people with cancer.
[47] Two Hundred Years of Cancer Research | NEJM — In the mid-1970s, two landmark studies of adjuvant chemotherapy in breast cancer were published: one from the NSABP, which tested a single drug and was reported by Fisher and colleagues in 1975,15 and one from Italy, which tested a drug combination and was reported by Bonadonna et al. By 1991, thanks to the availability of multiple effective chemotherapeutic agents and hormone treatments, improved diagnostic tools for early diagnosis, and intelligently designed clinical trials, the rate of death from breast cancer began to fall, a trend that has continued.36 Early diagnosis and lumpectomy coupled with systemic therapy have greatly reduced the morbidity associated with breast-cancer treatment, with good cosmetic effects. Another paradigmatic change in cancer treatment occurred in 2006, when Druker et al.37 showed the efficacy of a drug (imatinib) that targeted the unique molecular abnormality in chronic myeloid leukemia.
[48] Precision oncology: Using cancer genomics for targeted therapy advancements — Precision oncology: Using cancer genomics for targeted therapy advancements - ScienceDirect Precision oncology: Using cancer genomics for targeted therapy advancements The integration of precision medicine with cancer genomics emphasizes the significance of utilizing genetic data in treatment decision-making, enabling personalized care and enhancing patient outcomes. Cancer genomics has revolutionized our understanding of tumor biology by leveraging genetic data for personalized therapies . This review explores the advancements in cancer genomics, its impact on treatment strategies, and the challenges in clinical application. Cancer genomics has shifted from histopathology-based classifications to a more detailed understanding of tumors through genetic analysis . The field of cancer genomics is expanding, but the transition from genetic discovery to therapeutic applications remains challenging.
[49] New research: Big step toward targeted molecular therapies for cancer ... — In a pair of papers recently published in Nature, a team of scientists led by Harvard’s Department of Chemistry and Chemical Biology (CCB) has demonstrated how both small molecules and genetic mutations can alter the same critical protein interactions in cancer cells. “Our research has centered on understanding how specific mutations in medulloblastoma, a pediatric brain cancer, mimic the action of ‘molecular glues’ to drive oncogenic processes,” said senior author Brian Liau, associate professor of chemistry and chemical biology. This research, however, unveils a new scaffold and mechanism that can be used to design molecular glues to influence specific protein interactions and functions. Going forward, Liau’s lab plans to further explore these molecular strategies, searching for more instances of genetic mutations that can induce new protein interactions to aid chemical design.
[50] Exploring treatment options in cancer: tumor treatment strategies — The approval of T-VEC in 2015 and Delytact in 2021 for melanoma and malignant glioma, respectively, highlighted the resurgence of oncolytic viruses as a cancer treatment modality.19,20 The 2020 s have seen further advancements with the FDA approval of Sotorasib, the first small molecule inhibitor targeting specific KRAS gene mutations.21 In 2021, the National Comprehensive Cancer Network (NCCN) guidelines highlighted the combination of atezolizumab and bevacizumab as the preferred first-line treatment option for patients with hepatocellular carcinoma (HCC).22 This recommendation underscores the importance of immunotherapy and anti-angiogenic therapy in the frontline management of this aggressive form of cancer, reflecting the evolving landscape of cancer care and the continuous efforts to improve patient outcomes (Fig. 1).
[51] The Power of Patient Advocacy: 10-Year Study Reveals Increased Survival ... — A decade-long journey toward improving end-of-life care for patients with advanced cancer has demonstrated positive effects on survival, health-care use, and cost of care, according to data presented at the 2023 ASCO Quality Care Symposium.1 As Dr. Patel explained, the Engagement of Patients with Advanced Cancer (EPAC) study was initiated about 10 years ago to understand the long-term effects of patient engagement in advance care planning, given high rates of patients being unaware of their treatment plans, high rates of preventable and unwanted acute care use, and high rates of undertreated symptoms. A 10-year follow-up study of a 6-month advance care planning intervention showed significant improvement in patients’ experiences and hospice utilization, with a reduction in end-of-life acute care use.
[52] Understanding the Role of Patient Advocacy Groups in Cancer Care — Understanding the Role of Patient Advocacy Groups in Cancer Care - Moments Log When it comes to navigating the complex world of cancer treatment, patient advocacy groups play a crucial role in guiding individuals and their families through the often overwhelming landscape of options. When it comes to navigating the complex world of cancer care, patient advocacy groups play a crucial role in building a supportive community for those affected by the disease. application applications architecture art backend build building cancer cloud cuisine culinary cultural culture data design development discovering explore exploring global guide health hidden history implementing infra infrastructure investment japanese java microservices mindful native pattern patterns power services spring strategies systems techniques traditional travel web world
[85] Advancing Cancer Science and Medicine | AACR Cancer Progress Report 2023 — Advances in novel and innovative approaches to surgery, radiotherapy, chemotherapy, molecularly targeted therapy, and immunotherapy—the five pillars of cancer treatment—are saving and improving lives. From August 1, 2022, to July 31, 2023, FDA has approved 14 new anticancer therapeutics and two new imaging agents and has expanded the use of 12 previously approved anticancer therapeutics to treat additional cancer types. Included in the FDA approvals are the first antibody–drug conjugate for the treatment of ovarian cancer, several new molecularly targeted therapeutics and immunotherapeutics to treat rare cancers including blood cancers, two new immune checkpoint inhibitors, and a first of a kind gene therapy to treat bladder cancer. In the United States, the annual decline in overall cancer death rate among men, women, children, and adolescents and young adults has accelerated over the past two decades (see Cancer in 2023) (325)Cronin KA, et al.
[87] Exploring treatment options in cancer: tumor treatment strategies - Nature — The approval of T-VEC in 2015 and Delytact in 2021 for melanoma and malignant glioma, respectively, highlighted the resurgence of oncolytic viruses as a cancer treatment modality.19,20 The 2020 s have seen further advancements with the FDA approval of Sotorasib, the first small molecule inhibitor targeting specific KRAS gene mutations.21 In 2021, the National Comprehensive Cancer Network (NCCN) guidelines highlighted the combination of atezolizumab and bevacizumab as the preferred first-line treatment option for patients with hepatocellular carcinoma (HCC).22 This recommendation underscores the importance of immunotherapy and anti-angiogenic therapy in the frontline management of this aggressive form of cancer, reflecting the evolving landscape of cancer care and the continuous efforts to improve patient outcomes (Fig. 1).
[90] Effect of a Patient-Centered Communication Intervention on Oncologist ... — Importance: Observational studies demonstrate links between patient-centered communication, quality of life (QOL), and aggressive treatments in advanced cancer, yet few randomized clinical trials (RCTs) of communication interventions have been reported. Objective: To determine whether a combined intervention involving oncologists, patients with advanced cancer, and caregivers would promote
[91] Assessing Patient-Centered Communication in Cancer Care: Measures for ... — Although conceptualized in various ways, patient-centered communication (PCC) typically involves directing patients to the care they need when they need it, respecting the patient as a person, providing timely information that is understandable and relevant, supporting patient and family (as appropriate) involvement in decision making, and making decisions based on the evidence and consistent
[92] Innovations in Precision Oncology: Biomarker-Driven Approaches for ... — The insights gained from recent studies have enhanced our understanding of these mechanisms and opened new avenues for targeted cancer therapies, making personalized treatment more attainable. Innovative biomarker strategies: Patent WO 2023/131894 A1 introduces genomic loss of heterozygosity (gLOH) as a biomarker to identify patients who would
[93] Novel technologies and emerging biomarkers for personalized cancer ... — Recent technological advances in high-throughput techniques will not only allow potential biomarkers to be validated across large prospective studies, but will also facilitate the discovery of novel biomarkers and enhance our understanding of the mechanisms underlying cancer immunotherapies.
[94] Tumor biomarkers for diagnosis, prognosis and targeted therapy — Over the past decades, continuous progress has been made in exploring and discovering novel, sensitive, specific, and accurate tumor biomarkers, which has significantly promoted personalized medicine and improved the outcomes of cancer patients, especially advances in molecular biology technologies developed for the detection of tumor biomarkers. Moreover, several PCR assays approved by the FDA are used for the diagnosis of KRAS mutation status in formalin-fixed paraffin-embedded tissue, thereby guiding anti-EGFR antibody treatment for metastatic CRC.87 Similarly, qPCR assays are effective in the detection of MRD in leukemia, such as the quantification of BCR-ABL-positive cells post-induction chemotherapy/transplantation in acute lymphoblastic leukemia (ALL).85 PCR technology is also widely used to detect abnormal genes and abnormal mRNA amplification in tumors, such as MYCN amplification in neuroblastoma.88 Ligand-targeted PCR is essential for the detection of folate receptor-positive circulating tumor cells as a potential diagnostic biomarker in pancreatic cancer.89
[95] Cancer biomarkers: Emerging trends and clinical implications for ... — Cancer biomarkers have transformed oncology, enabling treatments tailored to each tumor's unique profile. This review highlights the field's progress due to advancements in understanding cancer biology, testing methods, and understanding of the immune microenvironment to advance precision oncology for improved patient outcomes.
[96] Cancer biomarker discovery and translation: proteomics and beyond — In summary, genomic analysis has led to the discovery of many genetic variants that are currently used as cancer biomarkers in lab-developed tests, but in the absence of corresponding proteomic and cell signaling data, these mutations have limited diagnostic, prognostic and therapeutic value. Additionally, translational studies aimed at cancer biomarker discovery with the goal of identifying genomic, proteomic, or other carcinogenic profiles to be used in a clinical setting, face numerous challenges including method validation, standardization of sample collection and testing procedures, as well as storage and accessibility to patient data. The NCI EDRN initiative is a prime example of a successful multi-organization translational research program aimed at the discovery of cancer biomarkers for early detection and risk assessment, where collaboration among academic institutions, industry, and government has been able to address challenges including analytical and clinical validation that require large specimen cohorts and standardized sample preparation .
[97] Machine Learning and AI in Cancer Prognosis, Prediction, and Treatment ... — The ability to accurately predict which treatment regimens are best suited for each patient based on their distinct molecular, genetic, and tumor-based features is a challenging task in oncologic care that AI is intended to solve.33 To assess whether AI and its subfield including machine learning can help in oncology care, a large number of studies investigated the applications of AI in cancer risk stratification, diagnoses, cancer medication development, and molecular tumor characterization.34–36 According to these researches, ML can help in cancer prediction and diagnosis by analyzing pathology profiles, imaging studies, and its ability to convert pictures to “mathematical sequences.” In January 2020, researchers developed an artificial intelligence system based on a “Google DeepMind algorithm” capable of outperforming human “breast cancer” detection specialists.36,37 In July 2020, the University of Pittsburgh developed an AI system-based machine learning technique with the highest accuracy in diagnosing prostate cancer, with a specificity of 98% and sensitivity of 98%.38 A very recent study used an improved ViT (Vision Transformer) architecture, which they called ViT-Patch, is validated on a publicly available dataset, and the results of the experiments reveal that it is effective for both malignant detection and tumor localization.39
[98] Realizing the promise of machine learning in precision oncology: expert ... — Background The ability of machine learning (ML) to process and learn from large quantities of heterogeneous patient data is gaining attention in the precision oncology community. Some remarkable developments have taken place in the domain of image classification tasks in areas such as digital pathology and diagnostic radiology. The application of ML approaches to the analysis of DNA data
[100] Convergence of evolving artificial intelligence and machine learning ... — The confluence of new technologies with artificial intelligence (AI) and machine learning (ML) analytical techniques is rapidly advancing the field of precision oncology, promising to improve diagnostic approaches and therapeutic strategies for patients with cancer. The applications of AI/ML in precision oncology are extensive and include the generation of synthetic data, e.g., digital twins, in order to provide the necessary information to design or expedite the conduct of clinical trials. In this clinically focused overview, we provide a technological and clinical perspective on the use of AI/ML in precision oncology to increase our understanding of tumor biology and to aid in the development of biomarkers that improve treatment selection in patients with cancer.
[105] Hallmarks of cancer resistance: iScience - Cell Press — Despite significant advances in our understanding of cancer biology and the development of novel therapeutic approaches, the phenomenon of cancer resistance remains a persistent challenge. This resistance is characterized by the remarkable ability of cancer cells to evade the cytotoxic effects of treatments, thereby compromising the effectiveness of therapies and, ultimately, endangering the
[106] A protracted war against cancer drug resistance | Cancer Cell ... — A comprehensive understanding of the underlying mechanisms contributing to the complex story of tumor progression and drug resistance will help facilitate the development of effective approaches that are aimed at preventing the clonal selection of drug-tolerant cancerous cells and maximizing patient benefits. This so-called “tumor evolution” describes the presence of multiple divergent cancer cell subpopulations in the same tumor or patient, promoting primary/metastatic lesions and cancer relapse as well as drug resistance after therapeutic failure . Differences in TME are another form of tumor heterogeneity contributing cancer drug resistance by preventing immune clearance of malignant cells, hindering drug absorption and stimulating paracrine growth factors to signal cancer cell growth, etc .
[107] Multilevel Mechanisms of Cancer Drug Resistance - MDPI — Key findings include the following: (1) Up to 63% of somatic mutations can be heterogeneous within individual tumors, contributing to resistance development; (2) cancer stem cells demonstrate enhanced DNA repair capacity and altered metabolic profiles; (3) the tumor microenvironment, including cancer-associated fibroblasts and immune cell populations, plays a crucial role in promoting resistance; and (4) selective pressure from radiotherapy drives the emergence of radioresistant phenotypes through multiple adaptive mechanisms. The activation of alternative signalling pathways represents a crucial mechanism of cancer drug resistance, enabling tumor cells to circumvent targeted therapies and maintain their survival and proliferation capabilities. "Multilevel Mechanisms of Cancer Drug Resistance" International Journal of Molecular Sciences 25, no.
[123] Oncology Explained: Definition, Branches, and Treatment Scope — The major types of oncology include: Medical Oncology: Focuses on treating cancer with chemotherapy, immunotherapy, and targeted therapy. Radiation Oncology: Uses high-energy radiation to kill cancer cells. Surgical Oncology: Involves the removal of tumors and affected tissues through surgery.
[126] Role of an Oncology Nurse in Cancer Treatment - Nurseslab.in — The future of oncology nursing . As advancements in cancer treatment continue, the role of oncology nurses is evolving. Innovations in personalized medicine, immunotherapy, and targeted treatments require them to stay current with the latest developments in the field. Continuous education and professional development are fundamental for
[127] The Role of an Oncology Nurse in Cancer Treatment — An oncology nurse is a central component for patients undergoing cancer treatment. Their role involves a thorough assessment, including physical condition and medical history, as well as reviewing the treatment plan with the care team. Cancer treatment plans vary but often include chemotherapy, immunotherapy, targeted therapy, or radiation. An
[128] Uniting for greater impact: The crucial role of oncology nurses in ... — In this evolving landscape, the role of the oncology nurse is critical to unite diverse healthcare professionals and ensure cohesive, patient-centered care. Asia-Pacific Journal of Oncology Nursing (APJON) has seen an increase in submissions on multidisciplinary care based on advances in cancer therapeutics, supportive care, and digital health.
[132] Surgical techniques in breast cancer: an overview — when deciding the optimum surgery for patients with breast cancer. Breast conservation surgery Evolution Historically, a simple mastectomy has been the surgical treat-ment of choice for breast cancer up until the 1970s when land-mark trials from Veronesi and Fisher paved the way to performing breast conservation surgery.1,2 In 2002, results from
[133] Current surgical management of breast cancer — Over the years, surgery for breast cancer has become less invasive in both the breast and axilla.[1-4] Surgical techniques have advanced to provide better cosmesis in breast conservation and also in breast reconstruction for woman who require mastectomy. Because definitive treatment of breast malignancy continues to be surgical, the surgeon remains a crucial member of the
[134] Patient education: Surgical procedures for breast cancer - UpToDate — This article will focus on the surgical treatment of breast cancer. An introduction to breast cancer and an overview of treatment for breast cancer are also available. ... Cosmetic outcomes — With modern surgical techniques, cosmetic results are good to excellent in most women after breast-conserving therapy (ie, the treated and untreated
[135] Types of Surgical Procedures in Oncology: Exploring Resection ... - Medanta — Conclusion Surgical procedures in oncology, including resection, excision, and reconstruction, play a vital role in the management of cancer. Oncosurgery, a specialised field within surgical oncology, offers tailored treatment options for different types and stages of cancer.
[136] Less Invasive Cancer Surgery Techniques — Robotic surgery is sometimes used to treat cancers of the colon, prostate, and uterus. Stereotactic radiation therapy As doctors have learned how to better control the energy waves used in radiation therapy, newer radiation techniques have been developed that blur the lines between traditional types of treatment.
[154] Factors Affecting Surgical Decision-making—A Qualitative Study — Few studies have explored the variability of surgical treatment options and compared which procedure may or may not be superior to the others.7–16 We sought to acquire a better understanding of the factors that influence surgeons’ decision-making when there is a lack of guidelines or Class 1 evidence to help them, using qualitative research methodology.1,3 Table 2 shows surgeons’ responses to survey questions including the number of participants who felt that their patients’ age influences their surgical decision-making, the number of participants who felt that their experience working as a surgeon has an influence on their surgical decision-making, the number of participants who felt that their personal views in surgical decision-making outweigh the current prevailing methods of treatment done by the majority of other surgeons, the number of participants who felt that their geographical location (i.e. country, city) influences their surgical decision-making, and participants’ views on whether non-financial incentives have an effect on their surgical decision-making.
[155] Factors Affecting Surgical Decisions in Newly Diagnosed Young Women ... — Introduction. In the United States, more than 12,000 women under the age of 40 are diagnosed with breast cancer each year. 1 While treatment decisions for breast cancer patients of all ages are affected by multiple factors, young women with breast cancer often have concerns and priorities accentuated by their life stage (e.g., fertility, impact on a young family, starting a career, body image
[156] Factors influencing surgical treatment decisions for breast cancer: a ... — Background: The rate of mastectomy is much higher in Newfoundland and Labrador than in any other province in Canada, even for women diagnosed at an early stage. In this paper, we present qualitative data from women who have made a decision for surgical treatment and from breast surgeons in an effort to better explicate factors influencing breast cancer (bca) surgical decision-making.
[169] Types Of Oncologists And Their Specialties In Oncology — Types of Oncologists. Depending upon the nature, stage, and location of cancer, there are different oncologists offering their specialized services for cancer treatment. The field of oncology has three main divisions-medical, surgical and radiation. There are also several sub-specialities. Medical Oncologist
[171] Types of Oncologists | What Are The Different Types of Oncologists — Oncology is the specialized branch of medicine devoted to the research, diagnosis, and treatment of cancer. Like many other health conditions, there are different types of cancer, which leads to further specialization in the field of oncology to reflect the various medical procedures used in cancer treatment.
[173] Pediatric precision oncology: "better three hours too soon than a ... — Clinical and pharmaceutical advances developed over the past decade for adult cancer indications have begun to move into pediatric oncology, expanding treatment options for young high-risk and refractory patients. As a result, the FDA has approved 23 targeted drugs for pediatric cancer indications, moving targeted drugs into the standard of care.
[174] 5 Recent Advancements in Pediatric Cancer Treatment — Scott Armstrong, MD, PhD. From new immunotherapy treatments to improved understanding of the genetic mechanisms of pediatric tumors, the past year has brought many important advances against childhood cancers.We sat down with Scott Armstrong, MD, PhD, chair of Pediatric Oncology at Dana-Farber Cancer Institute, to discuss some of these developments.
[175] Innovations in Cancer Treatment of Children - Pediatrics — In the past 50 years, pediatric cancer outcomes have greatly improved. Some cancers, such as pediatric acute lymphoblastic leukemia, have demonstrated steady improvements in outcome throughout this time, with a 3-year survival in 1975 of ∼59% and a 5-year survival in 2020 of ∼90%. 1-4 Immunotherapy continues to revolutionize the treatment of aggressive pediatric leukemias and lymphomas
[176] Progress against Childhood Cancer with Better Data, Trials — Clinical trials conducted by the Children's Oncology Group (COG), an NCI-funded network of researchers and hospitals, have been among the biggest contributors to improvements in the treatment of children with cancer and the continued increase in cure rates for several childhood cancers.
[192] The Difference Between Pediatric and Adult Cancers | Banner — "Pediatric cancers make up about 1% of all cancer diagnoses in the U.S.," said Joseph Torkildson, MD, a pediatric hematologist and oncologist with Banner Children's. "About 1.6 million cases of adult cancer are diagnosed annually, while about 16,000 cases of pediatric cancer are diagnosed. The causes for childhood cancer are most likely
[193] How is Childhood Cancer Different from Adult Cancer? - ACCO — Here's a breakdown of how childhood cancer is different from adult cancer. Children get different cancers than adults do. The most common cancers that adults get are lung, breast, colorectal and prostate cancer, but these are extremely rare in children. The most common cancers in children are leukemia, brain tumors, lymphomas and sarcomas.
[199] Factors influencing treatment decision‐making for cancer patients in ... — Factors influencing treatment decision‐making for cancer patients in low‐ and middle‐income countries: A scoping review - PMC In this scoping review, we evaluated existing literature related to factors influencing treatment decision‐making for patients diagnosed with cancer in low‐ and middle‐income countries, noting factors that influence decisions to pursue treatment with curative versus non‐curative intent. In this scoping review, we evaluated existing literature related to treatment decision‐making for patients diagnosed with cancer in low‐ and middle‐income countries, identifying discrete factors that influenced decision‐making for patients, families and caregivers, healthcare professionals, and community members.
[209] Cancer Treatment: Types, Options & What To Expect - Cleveland Clinic — Cancer Treatment Cancer Treatment What is cancer treatment? What are the types of cancer treatment? Healthcare providers may recommend one or (more commonly) a combination of cancer treatments, including: It can also make other cancer treatments more effective. Healthcare providers use stem cell transplants to treat blood cancers that haven’t responded to other treatments or that have returned after remission. You may need a transplant to replenish your blood cells after receiving treatments that destroy cancerous stem cells, like radiation and chemotherapy. Your healthcare provider may use words like “local” or “systemic” to describe the cancer treatments you’ll need. Cancer treatment may involve surgery or other procedures that target cancer cells: What are the side effects of cancer treatment? Still, these treatments work by killing cancer cells.
[217] What Is Proton Beam Therapy and How It Works? Pros and Cons — This helps protect the healthy tissue surrounding the cancer, minimizing side effects. Because proton therapy is so precise, it allows for higher doses of radiation directly to the tumor while reducing the amount of radiation to healthy tissue, which lowers the risk of side effects like fatigue, hair loss, or long-term health problems. This
[220] Treatment For Cancer | Cancer Treatment Options - American Cancer Society — It's important to learn about all your treatment options to make the decision that is best for your situation. Types of Cancer Treatment Many procedures and drugs are available to treat cancer, with many more being studied. Some are "local" treatments like surgery and radiation therapy, which are used to treat a specific tumor or area of the body. Drug treatments (such as chemotherapy, immunotherapy, or targeted therapy) are often called "systemic" treatments because they can affect the entire body.
[221] Exploring treatment options in cancer: tumor treatment strategies - Nature — The approval of T-VEC in 2015 and Delytact in 2021 for melanoma and malignant glioma, respectively, highlighted the resurgence of oncolytic viruses as a cancer treatment modality.19,20 The 2020 s have seen further advancements with the FDA approval of Sotorasib, the first small molecule inhibitor targeting specific KRAS gene mutations.21 In 2021, the National Comprehensive Cancer Network (NCCN) guidelines highlighted the combination of atezolizumab and bevacizumab as the preferred first-line treatment option for patients with hepatocellular carcinoma (HCC).22 This recommendation underscores the importance of immunotherapy and anti-angiogenic therapy in the frontline management of this aggressive form of cancer, reflecting the evolving landscape of cancer care and the continuous efforts to improve patient outcomes (Fig. 1).
[222] Recent advances in oncolytic virus therapy for hepatocellular ... - PubMed — Recent advances in oncolytic virus therapy for hepatocellular carcinoma Front Oncol. 2023 Apr 26:13:1172292. doi: 10.3389/fonc.2023.1172292. eCollection 2023. Authors ... The overall efficacy of oncolytic virus therapy is known to be influenced by anti-tumor immunity, toxic killing effect and inhibition of tumor angiogenesis, etc.
[236] Patient Perceptions and Expectations of Radiation Therapy — While patients obtain information about radiation therapy (RT) from their physician, they may receive information from multiple other sources. ... Common misconceptions included beliefs that they could only receive RT once (46%), they will give off radiation (38%), and radiation will be excreted in their urine/stool (33%). The most commonly
[238] 10 Common Myths About Radiation Therapy Busted | AOI — Radiation therapy, also known as radiotherapy, is a cornerstone of modern cancer treatment. Despite its widespread use and proven efficacy, many misconceptions persist. These myths can create unnecessary anxiety for patients and may even deter some from seeking the treatment they need.
[239] Breaking through radiation therapy myths - Mayo Clinic Comprehensive ... — Radiation therapy can play a valuable role in a person's cancer treatment plan. But Dr. Peterson wants to dispel a few myths. "There are many misconceptions when a patient hears the word radiation. One of the most common is that radiation is going to make me sick," she says.
[240] Debunking Common Myths About Radiation Treatment — Radiation treatment is a common but misunderstood therapy for cancer. Get the facts and understand your options for care. ... "Unfortunately, there are many misconceptions about how it works and what it does to the body. Having a better understanding of radiation therapy helps ensure you're making the right decision for your care
[262] Cancer Treatment Disparities in Underserved Communities - Cancer ... — Cancer Treatment Disparities in Underserved Communities - Cancer Research Institute Addressing Cancer Treatment Disparities in Underserved Communities Cancer remains one of the leading causes of death worldwide, but research, scientific advancements, and community support have led to a steady decline in death rates since the early 90s. Despite this incredible progress, there is a nagging issue in the fight against cancer: access, particularly for underserved communities. While general issues with economic factors or access permeate across every population, certain groups of people have been shown to be at higher risk of cancer, with later detection times and poorer overall outcomes. Sexual and gender minority (SGM) patients face a variety of unique challenges but often struggle with cancer outcomes due to discrimination, a lack of research, and a lack of specialized care.
[263] Barriers to cancer treatment for people experiencing socioeconomic ... — Concept Definition; Access to healthcare: Access to healthcare is a key determinant of health and has been conceptualized as the interplay between the delivery, availability, and distribution of healthcare services and the ability of an individual or group to obtain care (e.g., physically access care, perceive the need for care, overcome socioeconomic barriers in accessing care) to achieve the
[264] Economic Perspective of Cancer Care and Its Consequences for Vulnerable ... — Disparities in cancer development and access to care are related to a large extent to those acceptance risks and protective factors that can be directly or indirectly attributed to the economic burden of the respective population, such as on the basis of racial and ethnic minority status, economic disadvantages, disability status, gender
[265] Cancer Care Disparities: Overcoming Barriers to Cancer Control in Low ... — Cancer is a leading cause of morbidity and mortality worldwide. The majority of new patients with cancer and deaths now occur in low- and middle-income countries (LMICs). 1 LMICs account for 57% of new patients with cancer and 65% of deaths. 1,2 However, profound health system challenges impede implementing comprehensive cancer services, including prevention, screening, diagnosis, treatment
[267] Impact of the Tumor Microenvironment on Tumor Heterogeneity and ... — Tumor heterogeneity is considered the major cause of treatment failure in current cancer therapies. This feature of solid tumors is not only the result of clonal outgrowth of cells with genetic mutations, but also of epigenetic alterations induced by physical and chemical signals from the tumor microenvironment (TME).
[268] Tumor heterogeneity reshapes the tumor microenvironment to influence ... — At the single-cell level, tumor heterogeneity is also characterized by the analysis of the single-cell copy number in neuroendocrine prostate cancer 7, the analysis of gene expression in non-small-cell lung cancer (NSCLC) 8, hepatocellular carcinoma 9-11, brain cancer 12, breast cancer 13, kidney cancer 14, head and neck cancer 15, and so on. As mentioned above, the therapeutic targets, cancer cells themselves, and the TME are a three-component system of tumor heterogeneity leading to drug resistance. A typical heterogeneous tumor type, triple-negative breast cancer (TNBC), has been well studied to dissect the complexity by classifying this tumor subtype based on different molecular levels, such as cell populations, gene expression and genetic alterations (Table 1). Drug resistance in tumor immunotherapy could be induced by changes in the expression of cancer immunity genes triggered by intratumor heterogeneity.
[270] Tumor microenvironment heterogeneity an important mediator of prostate ... — Tumor microenvironment heterogeneity an important mediator of prostate cancer progression and therapeutic resistance | npj Precision Oncology Meanwhile, tumor-associated macrophages are well known for their heterogeneity and plasticity, which generally polarize toward two extremes, M1(antitumorigenesis) phenotype and M2 (protumorigenesis) phenotype81, and this heterogeneous macrophage activation is often expressed simultaneously in the TME of prostate cancer82,83,84. For example, following androgen deprivation therapy, there is an increase in tumor-infiltrating lymphocytes in the prostate bed109 and increased PD-L1 expression levels of enzalutamide-treated prostate cancer cells110. However, due to heterogeneous and fluctuated expression of the Muc1 antigen on prostate cancer cells, the immunotherapy could also induce the outgrowth of target-antigen loss variant or emergence of a new tumor phenotype, thereby leading to immune escape134.
[271] Tumor microenvironment complexity and therapeutic implications at a ... — Tumor microenvironment complexity and therapeutic implications at a glance | Cell Communication and Signaling | Full Text Search all BMC articles Tumor microenvironment complexity and therapeutic implications at a glance Tumor microenvironment complexity and therapeutic implications at a glance The dynamic interactions of cancer cells with their microenvironment consisting of stromal cells (cellular part) and extracellular matrix (ECM) components (non-cellular) is essential to stimulate the heterogeneity of cancer cell, clonal evolution and to increase the multidrug resistance ending in cancer cell progression and metastasis. Understanding the underlying cellular and molecular mechanisms governing these interactions can be used as a novel strategy to indirectly disrupt cancer cell interplay and contribute to the development of efficient and safe therapeutic strategies to fight cancer.
[272] Unraveling the tumor microenvironment: Insights into cancer metastasis ... — Unraveling the tumor microenvironment: Insights into cancer metastasis and therapeutic strategies - ScienceDirect Dynamic TME Interactions: Cancer cells and the tumor microenvironment (TME) have an intricate relationship that impacts cancer progression and therapeutic responses. This comprehensive review delves into the pivotal role of the tumor microenvironment (TME) in cancer metastasis and therapeutic response, offering fresh insights into the intricate interplay between cancer cells and their surrounding milieu. Moreover, it investigates innovative therapeutic approaches aimed at targeting the TME, including stromal reprogramming, immune microenvironment modulation, extracellular matrix (ECM)-targeting agents, and personalized medicine strategies, highlighting their potential to augment treatment outcomes. Next article in issue No articles found. For all open access content, the relevant licensing terms apply.
[278] Addressing Cancer Disparities Through Community Engagement: Lessons and ... — This review article aims to explore the role of community engagement in addressing cancer disparities and highlight the lessons learned and best practices from existing initiatives. By examining successful community engagement models and strategies, this article provides insights and recommendations for researchers, healthcare providers, policymakers, and community leaders interested in developing effective approaches to reduce cancer disparities. By engaging community members, accurate and culturally relevant health information can be effectively disseminated, increasing awareness and understanding of cancer disparities and prevention measures . By addressing these barriers, community engagement interventions have improved access to timely and appropriate cancer care, reducing disparities in treatment and healthcare outcomes . By investing in cultural understanding, linguistic accessibility, and tailoring interventions, community engagement efforts can effectively address cancer disparities.
[279] Closing the Care Gap Through Addressing Disparities in Oncology — The 2022-2024 World Cancer Day theme, "Close the Care Gap," demonstrates this need to bridge inequities in cancer care and ensure that every patient, regardless of background, receives timely and effective treatment. Addressing these disparities requires a multifaceted approach, integrating patient navigation, financial assistance, clinical
[281] Economic Evaluations of Interventions Addressing Inequalities in Cancer ... — This finding supports another systematic review that assessed the impact of interventions addressing socioeconomic inequalities in cancer care and health outcomes in high-income countries, in which most of the interventions (85%) were focused on improving cancer screening uptake among socioeconomically disadvantaged populations. 6 Previous
[282] Overcoming Cancer Disparities: Science-based Public Policy | AACR — Creating equitable cancer care will require a multipronged approach to support individuals, communities, health systems, and local, state, and federal governments to eliminate structural racism and systemic barriers to cancer prevention, screening, treatment, and survivorship care. CDC’s many disease prevention programs provide access to cancer care and build health equity, such as the National Program of Cancer Registries (NPCR), the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), Racial and Ethnic Approaches to Community Health (REACH), and the Colorectal Cancer Control Program (see sidebar on CDC Programs to Promote Health Equity). Special categories of hospitals, such as Safety Net Hospitals, Critical Access Hospitals, and Sole Community Hospitals, are essential for providing access to health care for their respective patient populations and addressing cancer disparities (966,967).
[283] What CDC Is Doing to Achieve Equity in Cancer Control — The Colorectal Cancer Control Program works with health systems to use and strengthen strategies to increase colorectal cancer screening, especially among groups that are most at risk. The National Comprehensive Cancer Control Program promotes equitable access to high-quality and affordable cancer screening, treatment, and care options.
[291] Future Directions in Cancer Control | 2022 Overview and Highlights ... — Promote cancer control research that leads to equitable and optimal health outcomes for all populations Cancer control research will be accelerated through the enhancement, expansion, accessibility to, and use of new and existing data resources. Support will be for research that is both proactive (to develop evidence that informs new cancer control policies) and reactive (to evaluate potential benefits and harms of existing cancer control policies). Expand and enhance digital health research to develop and test the efficacy and effectiveness of technology-based interventions that support cancer prevention and control Through a facilitated process, this group identified themes across submissions and coalesced around the six priorities: health equity, data strategies, evidence-based policies, digital health, modifiable risk factors, and climate change.
[292] The Future of Precision Oncology - PMC - PubMed Central (PMC) — New discoveries in disease biology, such as the correlation between genome instability and anti-tumor immune responses , the development of novel treatment modalities, such as CAR-T cell therapy , and improvements in technologies to couple precision companion diagnostics to targeted therapies , have also led to the successful clinical development of a range of precision medicines for patients with cancer.
[293] Current status and future directions of cancer immunotherapy — Most recently, cancer immunotherapy field is growing tremendously, such as utilization of cancer vaccinations, chimeric antigen receptor (CAR) T-cell therapy and immune checkpoint blockade therapy 10, 11. At present, new strategies aiming at blocking of immune checkpoint regulators, overcoming immune tolerance such as engineered T cell therapy, or the identification of novel tumor antigens through next-generation sequencing opened a new era of cancer immunotherapy 62-64. Cancer immunotherapy using tumor antigen-reactive T cells. 106.Liu E, Tong Y, Dotti G, Shaim H, Savoldo B, Mukherjee M, Cord blood NK cells engineered to express IL-15 and a CD19-targeted CAR show long-term persistence and potent anti-tumor activity. Tumor Immunology and Immune Checkpoint Inhibitors in Non-Small Cell Lung Cancer. Immune checkpoint inhibitors targeting programmed cell death-1 (PD-1) in cancer therapy.
[294] Cancer vaccines: current status and future directions — Cancer vaccines, however, offer a unique advantage by priming new T cells, potentially targeting a broader array of tumor antigens and inducing more durable immune responses . A The neoantigen prediction process follows a systematic three-step pipeline: Prediction involves identifying tumor-specific mutations based on patient HLA typing through tumor DNA, RNA, and protein sequencing using computational tools; Filtration ranks the predicted neoantigens by assessing features such as expression levels, the likelihood of being processed and presented on major histocompatibility complex (MHC), MHC binding affinity, and antigen specificity; Validation is carried out through experimental methods to confirm the ability of neoantigens to elicit specific T cell responses.
[304] Personalized immunotherapy in cancer precision medicine — Personalized immunotherapy in cancer precision medicine - PubMed With the significant advances in cancer genomics using next-generation sequencing technologies, genomic and molecular profiling-based precision medicine is used as a part of routine clinical test for guiding and selecting the most appropriate treatments for individual cancer patients. Although many molecular-targeted therapies for a number of actionable genomic alterations have been developed, the clinical application of such information is still limited to a small proportion of cancer patients. Cancer immunotherapies, which target neoantigens, could lead to a precise treatment for cancer patients, despite the challenge in accurately predicting neoantigens that can induce cytotoxic T cells in individual patients. Precise prediction of neoantigens should accelerate the development of personalized immunotherapy including cancer vaccines and T-cell receptor-engineered T-cell therapy for a broader range of cancer patients. doi: 10.3390/cancers16193254.
[305] The growing role of precision and personalized medicine for cancer ... — Companion diagnostics (CDx) help identify which treatments will be most effective for a specific patient’s tumor, and novel cell therapies are used to target the cancer with minimal damage to healthy tissues, making the PPM model more effective and safer. Recent work has focused on the development of more accurate tumor models (organoids) and harnessing the specificity of the immune system to develop effective cancer vaccines or mAbs. The personalized treatment approach has resulted in improved patient outcomes in terms of response rate and progression-free survival in Phase I clinical trials that selected patients using a specific biomarker versus those that did not174.
[306] Personalized immunotherapy in cancer precision medicine - PMC — We found that patients with DNA repair gene mutations, resulting in higher TMB, showed significantly better recurrence-free survival than patients without DNA repair gene mutations (hazard ratio, 0.46; P = 0.044) and that an oligoclonal expansion of tumor-infiltrating T cells, represented by lower TCR diversity, was observed in tumors with higher neoantigen load in WES data of 78 patients with muscle-invasive bladder cancer43,44. Recently, Ott et al.81 conducted a clinical trial for personalized neoantigen vaccines with anti-PD-1 antibodies in 60 patients with melanoma, non-small cell lung cancer (NSCLC), or bladder cancer and found that neoantigen-specific CD4+ and CD8+ T-cell responses were observed in all of the patients and that objective response rates were 59%, 39%, and 27% for melanoma, NSCLC, and bladder cancer, respectively.
[308] Artificial Intelligence in Oncology: Current Capabilities, Future ... — Artificial intelligence in oncology has already passed the critical threshold of outperforming expert opinion-based scoring systems in several cancer applications, 9,100,101 leading to an increase in its clinical implementation. With this traction, it is expected that AI-informed methods will continue to be explored and gradually integrated
[309] Artificial intelligence in oncology: current applications and future ... — Artificial intelligence (AI) is concretely reshaping the landscape and horizons of oncology, opening new important opportunities for improving the management of cancer patients. ... Artificial intelligence in oncology: current applications and future perspectives Br J Cancer. 2022 Jan;126(1):4-9. doi: 10.1038/s41416-021-01633-1. Epub 2021 Nov
[310] Artificial Intelligence in Oncology: Current Landscape ... - PubMed — Artificial Intelligence in Oncology: Current Landscape, Challenges, and Future Directions - PubMed Artificial intelligence (AI) in oncology is advancing beyond algorithm development to integration into clinical practice. AI applications are structured according to cancer type and clinical domain, focusing on the four most common cancers and tasks of detection, diagnosis, and treatment. Significance: AI is increasingly being applied to all aspects of oncology, where several applications are maturing beyond research and development to direct clinical integration. The review highlights AI applications in each of the clinical categories, with a specific focus on Breast, Prostate, Lung, and Colorectal cancers. Like many other domains in medicine, AI in oncology faces significant challenges to effective development and clinical translation. Generative AI in oncological imaging: Revolutionizing cancer detection and diagnosis.
[323] Recent advances and current challenges in CAR-T cell therapy - Springer — Specifically, an individualized cell-based modality which involves the removal of some of the patient’s own white blood cells, including T cells, has revolutionized research in this field. This study focuses on the recent advances and current challenges of Chimeric Antigen Receptor- T (CAR-T) cell therapy and its regulations in the United States (US) and European Union (EU). Benefits of CAR-T cell therapy include high response rates and the potential of long-term remissions in some haematological malignancies. However, the drawbacks are still evident including high costs, adverse reactions, and limited efficacy to solid tumours. The future of CAR-T cell therapy holds enormous promise but improving its safety, effectiveness, and availability are still barriers to its successful implementation.
[324] Advances in CAR-T cell therapy for hematologic and solid malignancies ... — A real-world study from the French DESCAR-T registry confirmed previous efficacy data from the pivotal ELARA trial, showing that with a median follow-up of 9.8 months, CD19 CAR-T therapy with tisagenlecleucel in 129 cases of R/R follicular lymphoma achieved a 98.2% ORR, including 85.8% best CR, with only 1.8% experiencing progression as the best response, 12-month PFS and OS rates of 62.6% and 84.9%, respectively (both medians were not reached), and < 1% grade 3–4 CRS and/or ICANS . In conclusion, as detailed in Tables 1 and 2, these updates from the 2024 ESMO Congress underscore the continuous innovation and advances in CAR-T cell therapy for hematologic and solid malignancies, bringing new optimism to patients battling various cancers.