Patients treated with platinum-based chemotherapy frequently experience neurotoxic symptoms, which may lead to premature discontinuation of therapy. Despitediscontinuation of platinum drugs, these symptoms can persist...Patients treated with platinum-based chemotherapy frequently experience neurotoxic symptoms, which may lead to premature discontinuation of therapy. Despitediscontinuation of platinum drugs, these symptoms can persist over a long period of time. Cisplatin and oxaliplatin, among all platinum drugs, have significant neurotoxic potential. A distal dose-dependent symmetrical sensory neuropathy is the most common presentation of platinum neurotoxicity. DNA damage-induced apoptosis of dorsal root ganglion(DRG) neurons seems to be the principal cause of neurological symptoms. However, DRG injury alone cannot explain some unique symptoms such as cold-aggravated burning pain affecting distal extremities that is observed with oxaliplatin administration. In this article, we briefly reviewed potential mechanisms for the development of platinum drugs-associated neurological manifestations.展开更多
Human epidermal growth factor receptor 2(HER2) signaling pathway activation has been identified as a contributor to de novo or acquired resistance to epidermal growth factor receptor(EGFR) inhibitors in a small subset...Human epidermal growth factor receptor 2(HER2) signaling pathway activation has been identified as a contributor to de novo or acquired resistance to epidermal growth factor receptor(EGFR) inhibitors in a small subset of patients with metastatic colorectal cancer(mCRC). Dual anti-HER2-targeted treatment exhibits strong antitumor activity in preclinical models of HER2-positive mCRC, supporting its testing in clinical trials. The HERACLES trial at four Italian academic cancer centers has confirmed the effectiveness of dual blockage of HER2 with trastuzumab plus lapatinib in patients with heavily pretreated HER2-positive mCRC, refractory to the anti-EGFR antibodies cetuximab or panitumumab. Here, we reviewed the preclinical studies exploring the role of HER2 signaling in the development of anti-EGFR therapy resistance and discussed the status of clinical trials assessing the activity of HER2 inhibitors in this setting.展开更多
The treatment of metastatic colorectal cancer(mCRC)harboring BRAF V600 mutations is challenging.These tumors are often refractory to standard treatment.Therefore,the patients may exhibit rapid clinical deterioration,d...The treatment of metastatic colorectal cancer(mCRC)harboring BRAF V600 mutations is challenging.These tumors are often refractory to standard treatment.Therefore,the patients may exhibit rapid clinical deterioration,depriving them of the chance to receive salvage therapy.In newly diagnosed patients with good performance status,the administration of an intensive chemotherapy regimen like FOLFOXIRI(5-fluorouracil,leucovorin,oxaliplatin,and irinotecan)along with the antiangiogenic agent bevacizumab can modify this aggressive behavior of the disease and improve patient clinical outcomes.The recently published results of the BEACON(Binimetinib,Encorafenib,and Cetuximab Combined to Treat BRAF-Mutant Colorectal Cancer)study demonstrated that a combination therapy consisting of BRAF,epidermal growth factor receptor,and mitogen-activated protein kinase kinase inhibitors could be a useful second-or third-line alternative.This review summarizes the current treatment strategies for BRAF-mutant mCRC.展开更多
文摘Patients treated with platinum-based chemotherapy frequently experience neurotoxic symptoms, which may lead to premature discontinuation of therapy. Despitediscontinuation of platinum drugs, these symptoms can persist over a long period of time. Cisplatin and oxaliplatin, among all platinum drugs, have significant neurotoxic potential. A distal dose-dependent symmetrical sensory neuropathy is the most common presentation of platinum neurotoxicity. DNA damage-induced apoptosis of dorsal root ganglion(DRG) neurons seems to be the principal cause of neurological symptoms. However, DRG injury alone cannot explain some unique symptoms such as cold-aggravated burning pain affecting distal extremities that is observed with oxaliplatin administration. In this article, we briefly reviewed potential mechanisms for the development of platinum drugs-associated neurological manifestations.
文摘Human epidermal growth factor receptor 2(HER2) signaling pathway activation has been identified as a contributor to de novo or acquired resistance to epidermal growth factor receptor(EGFR) inhibitors in a small subset of patients with metastatic colorectal cancer(mCRC). Dual anti-HER2-targeted treatment exhibits strong antitumor activity in preclinical models of HER2-positive mCRC, supporting its testing in clinical trials. The HERACLES trial at four Italian academic cancer centers has confirmed the effectiveness of dual blockage of HER2 with trastuzumab plus lapatinib in patients with heavily pretreated HER2-positive mCRC, refractory to the anti-EGFR antibodies cetuximab or panitumumab. Here, we reviewed the preclinical studies exploring the role of HER2 signaling in the development of anti-EGFR therapy resistance and discussed the status of clinical trials assessing the activity of HER2 inhibitors in this setting.
文摘The treatment of metastatic colorectal cancer(mCRC)harboring BRAF V600 mutations is challenging.These tumors are often refractory to standard treatment.Therefore,the patients may exhibit rapid clinical deterioration,depriving them of the chance to receive salvage therapy.In newly diagnosed patients with good performance status,the administration of an intensive chemotherapy regimen like FOLFOXIRI(5-fluorouracil,leucovorin,oxaliplatin,and irinotecan)along with the antiangiogenic agent bevacizumab can modify this aggressive behavior of the disease and improve patient clinical outcomes.The recently published results of the BEACON(Binimetinib,Encorafenib,and Cetuximab Combined to Treat BRAF-Mutant Colorectal Cancer)study demonstrated that a combination therapy consisting of BRAF,epidermal growth factor receptor,and mitogen-activated protein kinase kinase inhibitors could be a useful second-or third-line alternative.This review summarizes the current treatment strategies for BRAF-mutant mCRC.