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Tseng W.W.,University of Southern California | Tseng W.W.,Hoag Family Cancer Institute | Amini B.,University of Texas M. D. Anderson Cancer Center | Madewell J.E.,University of Texas M. D. Anderson Cancer Center
Journal of Surgical Oncology | Year: 2015

Despite optimal treatment, patients with soft tissue sarcoma are at risk for recurrence and therefore appropriate surveillance is critical. At minimum, regularly scheduled clinical assessments and chest X-rays are necessary. Consensus guidelines are available; however, surveillance strategies must be personalized based on the risk for recurrence and inherent disease biology. Further research is needed on a number of issues, including the impact of surveillance on clinical outcome and the utility of molecular surveillance. J. Surg. Oncol. 2015 111:641-645. © 2014 Wiley Periodicals, Inc. © 2014 Wiley Periodicals, Inc.

Tseng W.W.,University of Southern California | Tseng W.W.,Hoag Family Cancer Institute | Somaiah N.,University of Texas M. D. Anderson Cancer Center | Engleman E.G.,Stanford University
Human Vaccines and Immunotherapeutics | Year: 2014

Soft tissue sarcomas (STS) are rare, heterogeneous tumors of mesenchymal origin. Despite optimal treatment, a large proportion of patients will develop recurrent and metastatic disease. For these patients, current treatment options are quite limited. Significant progress has been made recently in the use of immunotherapy for the treatment of other solid tumors (e.g. prostate cancer, melanoma). There is a strong rationale for immunotherapy in STS, based on an understanding of disease biology. For example, STS frequently have chromosomal translocations which result in unique fusion proteins and specific subtypes have been shown to express cancer testis antigens. In this review, we discuss the current status of immunotherapy in STS, including data from human studies with cancer vaccines, adoptive cell therapy, and immune checkpoint blockade. Further research into STS immunology is needed to help design logical, subtype-specific immunotherapeutic strategies. © 2014 Taylor & Francis Group, LLC

Khoury M.,University of Southern California | Sim G.C.,H. Lee Moffitt Cancer Center and Research Institute | Harao M.,The Surgical Center | Radvanyi L.,H. Lee Moffitt Cancer Center and Research Institute | And 7 more authors.
BMJ Case Reports | Year: 2015

Liposarcomas are soft tissue sarcomas of adipocyte origin. We describe a case of a dedifferentiated retroperitoneal liposarcoma with an unusual presentation on recurrence as a large, multicystic tumour. The patient was a 72-year-old woman who had undergone multiple treatments including two prior resections. For her most recent locoregional disease recurrence, the patient was offered surgical debulking for symptom palliation. At this operation, performed after two cycles of chemotherapy, the tumour cyst fluid was analysed and found to have a predominance of immune cells with no identifiable malignant cells. This case and the results of our tumour cyst fluid analysis raise several interesting considerations for the management of this unique situation in a rare disease. Copyright 2015 BMJ Publishing Group. All rights reserved.

Dillman R.O.,Hoag Institute for Research and Education | Dillman R.O.,Hoag Family Cancer Institute | McClure S.E.,Hoag Institute for Research and Education
Clinical Lung Cancer | Year: 2014

Background National data demonstrate minimal improvement in survival for patients diagnosed with lung cancer despite a number of apparent advances during the past 3 decades. We wished to know how demographic characteristics, staging, therapy, and survival have changed over time for patients with lung cancer who were accessioned to the cancer registry of a large community hospital in southern California.Patients and Methods Clinical features and survival data were collected on patients diagnosed during each of the successive 6-year eras of 1986 to 1991 (n = 812), 1992 to 1997 (n = 1072), 1998 to 2003 (n = 1209), and 2004 to 2009 (n = 1365).Conclusion Survival has steadily improved for patients in this community who were diagnosed with lung cancer. The explanations for this improvement are multifactorial, but include earlier stage at diagnosis, decreases in histologic types associated with active smoking, and increased use of systemic therapies.Results Median survival improved from 11 to 13 to 16 to 26 months and overall 5-year survival steadily improved from 16.5% to 19.1% to 24.0% to 31.1%. The proportion of patients with localized disease at diagnosis increased from 18.4% to 24.1% to 24.9% to 31.6%. Improvements in relative survival were much greater than have occurred nationally. Other obvious trends over time were increasing age of patients, increasing proportions with diagnoses of adenocarcinoma with concomitant decreases in squamous cell and small cell histologies, and decreases in the proportion of large cell carcinoma with reciprocal increases in neuroendocrine diagnoses. The use of chemotherapy for patients with local disease tripled in the most recent era. © 2014 Elsevier Inc.

Hanna D.L.,University of Southern California | Hanna D.L.,Hoag Family Cancer Institute | Lenz H.-J.,University of Southern California
Expert Review of Clinical Pharmacology | Year: 2016

Although the survival of metastatic colorectal cancer (mCRC) patients has improved five-fold over the last century, CRC remains a significant global health burden. Impressive strides have been made in identifying new regimens, employing maintenance strategies to limit treatment toxicities, and combining multidisciplinary approaches to achieve cure in oligometastatic disease. Attempts at personalized integration of targeted agents have been limited by the ability to identify molecularly enriched patient populations most likely to benefit. In this review, we discuss novel therapeutics and regimens recently approved and in development for mCRC. In addition, we discuss using older agents in novel combination and maintenance strategies, and highlight evidence for implementing pharmacogenomic data and non-invasive monitoring into the personalized management of mCRC patients. © 2016 Informa UK Limited, trading as Taylor & Francis Group.

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