- Managing in-transit melanoma metastases in the new era of effective systemic therapies for melanoma. [Journal Article]Expert Rev Clin Pharmacol 2019; :1-13ER
- Introduction: Melanoma in-transit metastases (ITMs) occur between the primary tumor site and the regional node field. Most patients with ITMs have a poor prognosis. The treatment of ITMs can be simple if surgical excision is possible, but challenging when ITMs are advanced, multiple or recurrent and impacting quality of life.Areas covered: The management of ITM is still evolving. Patients who are…
Introduction: Melanoma in-transit metastases (ITMs) occur between the primary tumor site and the regional node field. Most patients with ITMs have a poor prognosis. The treatment of ITMs can be simple if surgical excision is possible, but challenging when ITMs are advanced, multiple or recurrent and impacting quality of life.Areas covered: The management of ITM is still evolving. Patients who are disease-free after surgical excision of ITMs are today candidates for adjuvant systemic treatment to reduce recurrence risk. Some who have multiple or advanced ITMs may achieve long-term survival or disease control with systemic therapies alone. Those who do not remain candidates for the numerous locoregional therapies used to treat ITMs, including electrocautery, intralesional injection, topical therapy, electrochemotherapy, isolated limb infusion, isolated limb perfusion, radiation therapy and, rarely, amputation. Relevant publications identified in Pubmed and MEDLINE databases are reviewed.Expert opinion: Patients with multiple ITMs can benefit from use of systemic therapies as primary treatment, in the adjuvant setting and in neoadjuvant trials. Multiple alternative treatment modalities exist for patients unsuitable for systemic therapies or in whom systemic therapies have failed. Trials assessing combined systemic and locoregional therapies for ITMs are in progress.
- Improved durable responses regardless of age following cytoreduction and "no-tourniquet" hyperthermic isolated limb chemotherapy for in transit melanoma of the extremity. [Journal Article]Am J Surg 2019AJ
- CONCLUSIONS: Combining cytoreduction with no-tourniquet HILP/HILI for in-transit metastatic melanoma of the extremity resulted in 100% survival regardless of age at 1 year and 68% 3-year survival in patients over 80 without any increase in adverse events.
- Sodium Tanshinone IIA sulfonate improves post-ischemic angiogenesis in hyperglycemia. [Journal Article]Biochem Biophys Res Commun 2019; 520(3):580-585BB
- CONCLUSIONS: These findings demonstrate STS improves angiogenesis via inhibiting miR-133a expression and increasing GCH-1 protein levels in experimental PAD with diabetes.
- Patient experiences with isolated limb perfusion for malignant melanoma - A qualitative study. [Journal Article]Eur J Oncol Nurs 2019; 43:101672EJ
- CONCLUSIONS: Participants showed greater focus on the healthy parts of their lives, even when negative symptoms occurred after ILP treatment. They also described how healthcare workers focused on their illness. Based on these findings, we suggest the following means of providing good nursing care to ILP patients: give correct information, strive to reduce patients' negative symptoms, support their daily living needs, and provide emotional support to reduce fear of recurrence.
- A key role for the novel coronary artery disease gene JCAD in atherosclerosis via shear stress mechanotransduction. [Journal Article]Cardiovasc Res 2019CR
- CONCLUSIONS: The novel CAD gene JCAD promotes atherosclerotic plaque formation via a role in the endothelial cell shear stress mechanotransduction pathway.
- Current State of Sarcoma Care in Germany: Results of an Online Survey of Physicians. [Journal Article]Oncol Res Treat 2019; 42(11):589-598OR
- CONCLUSIONS: Access to multidisciplinary tumor boards seems to be largely guaranteed in the participants of our survey. The use of guidelines could be further implemented and expanded. The number of treated patients appears to be a significant factor to avoid access problems to treatment options.
- Lymphatic changes in cancer and drug delivery to the lymphatics in solid tumors. [Review]Adv Drug Deliv Rev 2019; 144:16-34AD
- Although many solid tumors use the lymphatic system to metastasize, there are few treatment options that directly target cancer present in the lymphatic system, and those that do are highly invasive, uncomfortable, and/or have limitations. In this review we provide a brief overview of lymphatic function and anatomy, discusses changes that befall the lymphatics in cancer and the mechanisms by whic…
Although many solid tumors use the lymphatic system to metastasize, there are few treatment options that directly target cancer present in the lymphatic system, and those that do are highly invasive, uncomfortable, and/or have limitations. In this review we provide a brief overview of lymphatic function and anatomy, discusses changes that befall the lymphatics in cancer and the mechanisms by which these changes occur, and highlight limitations of lymphatic drug delivery. We then go on to summarize relevant techniques and new research for targeting cancer populations in the lymphatics and enhancing drug delivery intralymphatically, including intralymphatic injections, isolated limb perfusion, passive nano drug delivery systems, and actively targeted nanomedicine.
- Is blood a necessary component of the perfusate during isolated limb perfusion - a randomized controlled trial. [Journal Article]Int J Hyperthermia 2019; 36(1):794-800IJ
- CONCLUSIONS: This study showed no significant improvement with the addition of packed red blood cells into the prime solution in ensuring the metabolic oxygen demand in the treated extremity during ILP, and we, therefore, recommend that a crystalloid-based prime solution should be used.
- Advanced Merkel cell carcinoma of the lower extremity treated with surgery and isolated pelvic and limb perfusion using Melphalan: A case of unexpected long-term survival. [Journal Article]Int J Surg Case Rep 2019; 61:4-8IJ
- CONCLUSIONS: All procedures were tolerated, systemic toxicities were temporary and subsequent clinical and radiological follow-up, following the last combined treatment, indicated that this patient was still alive and disease-free, at 56 months.In this case, surgery combined with locoregional Melphalan chemotherapy was an effective and repeatable treatment for recurrent MMC and resulted in unexpected long-term survival.
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- Isolated limb perfusion and infusion in the treatment of melanoma and soft tissue sarcoma in the era of modern systemic therapies. [Journal Article]J Surg Oncol 2019; 120(3):540-549JS
- CONCLUSIONS: ILI/ILP utilization has decreased for melanoma, but not for STS. Whether trends for ILP and ILI differed could not be determined. ILP/ILI remains an important option to consider for regional disease control.