1.Optimizing outcome for patients with mantle cell lymphoma
Journal of Leukemia & Lymphoma 2012;21(7):385-389
Intensive multidrug regimens,such as rituximah plus fractionated cyclophsphamide,vincristine,doxorubicin,and dexamethasone(R-HyperCVAD),are now being used to improve outcomes in patients with mantle cell lymphoma(MCL).In addition to these combinations,novel targeted agents,including bortezomib,bendamustine,and lenalidomide,are also being integrated into the treatment paradigm.Given the wide array of therapies available,making and implementing treatment decisions has become a complex process,requiring interdisciplinary collaboration.This article discussesed the pharmacist's role in this collaboration,as well as the administration of standard and novel therapies for MCL and the management of treatment related toxicities.
2.Doubts and strategies in the treatment of follicular lymphoma
Journal of Leukemia & Lymphoma 2012;21(6):325-329,334
In the past 5 years,the treatment paradigm for patients with follicular lymphoma(FL) has undergone significant changes,with the development of effective new agents that are now being used in the upfront,maintenance,and relapsed/refractory settings.Although these new therapies have led to improvements in patient outcomes,numerous questions remain regarding their optimal use in the treatment of the disease.In this article,the questions related to the timing of therapy for asymptomatic patients,strategies for treating advanced and relapsed/refractory disease,the safety and efficacy of rituximab maintenance and the evolving role of transplantation in the era of novel agents were responded.The latest data from clinical trials of investigational agents that are showing promise in FL were also discussed.
4.Pay attention to the long-term toxicities of therapy on lymphoma
Journal of Leukemia & Lymphoma 2010;19(11):641-645
There are an increasing number of survivors of successful treatment of lymphomas over the past 30 years. Although these survivors may be cured of their lymphoma, long-term morbidity and mortality are associated with late toxicities of the treatment. Identification of these late complications will lead to strategies to manage them when they occur and hopefully decrease the risk of their development. Secondary malignancies and treatment associated cardiovascular disease are the leading causes of late morbidity and mortality.Musculoskeletal difficulties, endocrine abnormalities, including sterility and thyroid disease, and heart and lung damage, have also been seen.The late complications of primary treatment of lymphoma and autologous stem cell transplantation usually for relapsed disease are the subjects of this paper.
5.The incidence,natural history, biology, and treatment of transformed lymphomas
Journal of Leukemia & Lymphoma 2010;19(4):193-195
1 or 2 grade FL followed by a diffuse large cell lymphoma(DLCL) ot a Burkitt/Burkitt-like lymphoma is TL.TL maintains a phenotype suggestive of germinal center derivation.The most common immunophenotype is the same as that of FL, CD+10/bcl-6+. Obtaining a biopsy of TL is enhanced if the biopsy is directed to the site with the greatest SUV. The risk of transformation of about 30% at 10 years after the initial diagnosis of FL.The median duration of survival after transformation generally ranging from 1 to 2 years.HDCT-ASCT, allogeneic tranplantation,radioimmunotherapy and bendamustine are the possible therapy for TL.
6.New therapeutic strategy of fludarabine-resistant relapsed and refractory chronic lymphocytic leukemia
Journal of Leukemia & Lymphoma 2013;22(9):520-523
Chronic lymphocytic leukemia (CLL) remains an incurable disease.Rituximab and fludarabine are two of the most effective agents in CLL update.Despite the widespread use of highly effective chemoimmunotherapy,fludarabine-refractory CLL remains a challenging problem associated with poor overall survival.Approved therapeutic options for these patients remain limited.Fortunately,allogenetic stem cell transplantation (allo-SCT) and several novel targeted therapeutics in clinical trails hold promise of significant benefit for these patients' population.This review discusses the activity of available and novel targeted therapeutics besides allo-SCT in fludarabine-refractory or fludarabine-resistant CLL.
7.Advances and the current status in chemotherapy-free management for indolent lym-phomas
Chinese Journal of Clinical Oncology 2016;43(5):216-219
Indolent B-cell lymphomas constitute a slow growing cancer of the lymphatic system. These lymphomas mainly include fol-licular lymphoma, chronic lymphocytic leukemia/small lymphocytic lymphoma, Waldenstom macroglobulinemia, marginal zone lym-phoma, and low malignant mantle cell lymphoma. These lymphomas are sensitive to chemotherapy and/or immunochemotherapy, but they cannot be cured. Furthermore, patient age at diagnosis, patient age at time of first onset or subsequent relapses, and compli-cations often influence the chemotherapy curative effect. At present, recent progress has been achieved in our understanding of dys-regulated pathways and immunologic anti-tumor responses in indolent lymphoma. In particular, the breakthrough of non-cytotoxic drugs renderschemo-freetreatment a near-future reality. In this review, we highlight these promising approaches, such as the com-bination of anti-CD20 antibodies with immunomodulatory drugs, mAbs directed against other surface antigens, and programmed cell death 1 (PD-1) receptor inhibitor or B-cell receptor signaling pathway inhibitors. Future phase III studies will evaluate the efficacy of these drugs in the context of non-chemotherapy and further clarify treatment status.
8.Advances in therapeutic options of peripheral T-cell lymphoma
Chinese Journal of Clinical Oncology 2016;43(4):166-169
To date, the treatment of peripheral T-cell lymphomas (PTCL) has lagged behind B-cell malignancies. Traditionally, para-digms for diffuse large B-cell lymphoma were applied to patients with PTCL, but the outcomes were poor. Recently, the FDA has ap-proved four drugs for patients with relapsed/refractory PTCL, and the Japanese government has approved of anti-CCR4 monoclonal an-tibody for patients with adult T-cell leukemia/lymphoma. Clinical studies are exploring the combination of these new agents into stan-dard CHOP-based regimens for patients with newly diagnosed PTCL. Recent studies have revealed that PTCL may be associated with epigenetic dysregulation and is thus sensitive to histone deacetylase inhibitors. These advances provide a new understanding of PTCL, whose therapeutic options will be presented in this review.
9.Progress in medical treatment for colorectal cancer in 2016 American Society of Clinical Oncology ;annual meeting
Cancer Research and Clinic 2016;28(9):577-581
The American Society of Clinical Oncology(ASCO) annual meeting was held in June 3-7, 2016 in Chicago. This review will present a brief introduction of the progress in medical treatment for colorectal cancer in this annual meeting, such as preoperative neoadjuvant chemotherapy/concurrent chemoradiotherapy and postoperative adjuvant chemotherapy for advanced colorectal cancer, chemotherapy for inoperable advanced colorectal cancer, targeted therapy and immunotherapy.
10.Clinical progress of bendamustine in the treatment of lymphoma and leukemia
Journal of Leukemia & Lymphoma 2013;22(8):456-461,465
Bendamustine is a kind of nitrogen mustard derivatives consisting of a 2-chloroethylamine alkylating group and a benzimidazole ring.This special structure grants its anti-cancer mechanism different from other common alkylating agents with double function.Since approved,bendanustine has been widely used to treat henatologic malignancies and solid tumors such as breast cancer.In 2008,the FDA approved bendamustine injection for the treatment of chronic lymphocytic leukemia and indolent B cell non-Hodgkin's lymphoma.In recent years,scholars in China and abroad have carried out a series of clinical researches on single bendamustine and bendamsutine combinational chemotherapy,especially in hematologic malignancies,which obtained certain clinical efficacy.In this paper,the pharmacological actions,pharmacokinetics and clinical progress of bendamustine in lymphoma and leukemia are reviewed.