Molecular Profiling in Colon Cancer: Where Are We Now?

Abstract

Purpose of Review

Despite intense investigation, colorectal carcinoma (CRC) remains the second leading cause of cancer-related mortality in both men and women in the USA. With the advent of biologics and targeted therapies in oncology, molecular characterization of tumors has become of critical importance. This review seeks to outline the recent advances in the molecular profiling of CRC by highlighting the basic science background that has led to the diagnostic ability to portend prognosis and alter therapy.

Recent Findings

Building on existing knowledge of driver mutations has led to a better understanding of the molecular phenotypes of CRC and a transition from cytotoxic chemotherapy alone to targeting one aberration and now to considering multiple distinct targets for concerted therapy.

Summary

Utilizing genomic and epigenomic alterations, collectively grouped into distinct transcriptomic subtypes, now plays a vital role from initial diagnosis to continued treatment of virtually all colorectal carcinomas.

http://ift.tt/2weCXXU

Curative-intent treatment of recurrent colorectal liver metastases: a comparison between ablation and resection

Publication date: Available online 26 August 2017
Source:European Journal of Surgical Oncology (EJSO)
Author(s): Aurélien Dupré, Robert P. Jones, Rafael Diaz-Nieto, Stephen W. Fenwick, Graeme J. Poston, Hassan Z. Malik
BackgroundLiver-limited recurrence after resection of colorectal liver metastases is a frequent occurrence, and can in some cases be treated with curative intent. Although surgical re-resection remains standard of care, there is growing interest in the role of ablation in this setting. The aim of this study was to compare the outcomes after curative-intent ablation and resection in patients with recurrent colorectal liver metastases.MethodsWe retrospectively analysed data from 366 consecutive patients who underwent liver resection for colorectal liver metastases between June 2010 and August 2015. Sixty-four developed liver-limited recurrence which was treated with curative intent, thirty-three (51.6%) by ablation and 31 (48.4%) by repeat resection.ResultsPatient groups were well matched, with surgically resected patients showing higher pre-operative carcinoembryonic antigen levels and larger metastases. There were fewer post-operative complications and shorter length of stay in the ablation group (p<0.02). After a median follow-up of 36.2 months, median overall survival was the same for both the resected and ablated groups at 33.3 months. Median progression-free survival was longer for patients treated with surgery (10.2 months) compared to ablation (4.3 months) (p=0.002).ConclusionsAblation or resection for liver-limited recurrence after surgery for colorectal liver metastases is associated with improved overall survival compared with systemic chemotherapy alone, and should always be considered for patients with resectable liver recurrence. Although ablation seemed to be associated with a shorter progression-free survival, post-procedure morbidity was significantly lower. The choice between ablation and resection should therefore be made on a personalised basis.



http://ift.tt/2vyPraR

The toxic influence of dibromoacetic acid on the hippocampus and pre-frontal cortex of rat: involvement of neuroinflammation response and oxidative stress

Abstract

Dibromoacetic acid (DBA) exsits in drinking water as a by-product of disinfection as a result of chlorination or ozonation processes. Hippocampus and pre-frontal cortex are the key structures in memory formation and weanling babies are more sensitive to environmental toxicant than adults, so this study was conducted to evaluate the potential neurotoxicity effects of DBA exposure when administered intragastrically for 4 weeks to weanling Sprague-Dawley rats, at concentration of 0, 20, 50, 125 mg/kg via the neurobehavioral and neurochemical effects. Results indicated that animals weight gain and food consumption were not significantly affected by DBA. However, morris water maze test showed varying degrees of changes between control and high-dose group. Additionally, the level of malondialdehyde (MDA) and generation of reactive oxygen species (ROS) in the hippocampus and pre-frontal cortex of rats increased significantly. The activities of total superoxide dismutase (SOD) and the glutathione (GSH) content in the hippocampus and pre-frontal cortex of rats decreased significantly after treatment with DBA. Treatment with DBA increased the protein and mRNA expression of Iba-1, NF-κB, TNF-α, IL-6, IL-1β and HO-1 in the hippocampus and pre-frontal cortex of rats. These data suggested that DBA had a toxic influence on the hippocampus and pre-frontal cortex of rats, and that the mechanism of toxicity might be associated with the neuroinflammation response and oxidative stress.

http://ift.tt/2w7xYKn

The role of enteric neurons in the development and progression of colorectal cancer

Publication date: Available online 25 August 2017
Source:Biochimica et Biophysica Acta (BBA) - Reviews on Cancer
Author(s): Glenn Rademakers, Nathalie Vaes, Simone Schonkeren, Alexander Koch, Keith A. Sharkey, Veerle Melotte
The enteric nervous system (ENS) is the neural network belonging to the gastrointestinal tract, which is essential for regulating gut functions. The importance of the ENS is underscored by the existence of severe gastrointestinal diseases, such as Hirschsprung's disease and intestinal pseudo-obstruction, which arise when the ENS fails to develop normally or becomes dysregulated. Moreover, it is known that enteric neurons are involved in intestinal inflammation and gut homeostasis. So far, the role of the ENS in colorectal cancer (CRC) carcinogenesis remains poorly understood, even though processes like perineural invasion and neoneurogenesis are important factors in the CRC field. Here we summarize how enteric neurons are affected during CRC and discuss the influence of enteric neurons, either direct or indirect, on CRC development and/or progression. Finally, we illustrate how the ENS could be targeted as a potential anti-cancer therapy, establishing the ENS as an integral part of the tumor microenvironment.



http://ift.tt/2wHZGi4

High-dose treatment for malignant rhabdoid tumor of the kidney: No evidence for improved survival—The Gesellschaft für Pädiatrische Onkologie und Hämatologie (GPOH) experience

Abstract

Background

Malignant rhabdoid tumor of the kidney (MRTK) is the most aggressive childhood renal tumor with overall survival (OS) rates ranging from 22% to 42%. Whether high-dose chemotherapy with autologous stem-cell transplantation (HDSCT) in an intensive first-line treatment offers additional benefit is an ongoing discussion.

Methods

A retrospective analysis of all 58 patients with MRTK from Austria, Switzerland, and Germany treated in the framework of consecutive, prospective renal/rhabdoid tumor studies SIOP9/GPO, SIOP93-01/GPOH (where SIOP is International Society of Pediatric Oncology and GPOH is German Society of Pediatric Oncology and Hematology), SIOP2001/GPOH, and European Rhabdoid Tumor Registry from 1991 to 2014.

Results

Median age at diagnosis was 11 months. Fifty percent of patients had metastases or multifocal disease at diagnosis (Stage IV). Local stage distribution was as follows: not done/I/II/III—1/6/11/40. Fifteen (26%) patients underwent upfront surgery. Thirty-seven (64%) patients achieved a complete remission, 17 (29%) relapsed, 34 (59%) died of disease progression, and two (3%) died of treatment-related complication. Mean time to the first event was 3.5 months. Two-year EFS/OS (where EFS is event-free survival) for the whole group was 37 ± 6%/38 ± 6%. Metastases/multifocal disease, younger age, and local stage III were associated with significantly inferior survival. Eleven (19%) patients underwent HDSCT (carboplatin + thiotepa, n = 6; carboplatin + etoposide + melphalan, n = 4; others, n = 1); 2-year OS in this group was 60 ± 15% compared to 34 ± 8% in the non-HDSCT group (P = 0.064). However, the time needed from radiologic to histologic diagnosis, stem-cell harvest, and HDSCT must also be taken into account to avoid selection bias by excluding the highest risk group with early progression (<90 days). Thus, 2-year EFS only for patients without progression until day 90 was 60 ± 16% consolidated by HDSCT compared to 62 ± 11% without (P = 0.8).

Conclusion

Our retrospective analysis suggests comparable outcomes for patients with and without HDSCT, if adjusted for early disease progression.

http://ift.tt/2gey8Ki

Sirolimus therapy in the treatment of pseudomyogenic hemangioendothelioma

Abstract

Pseudomyogenic hemangioendothelioma (PMH) is a rare, mostly indolent vascular tumor. Extensive cases are treated with amputation as chemotherapy seems to be ineffective. Recently, promising results were published using mammalian target of rapamycin (mTOR) inhibitors in tumors of vascular origin. Here, we present a case of a child with advanced PMH relapsing after surgery and chemotherapy. Sirolimus achieved significant clinical improvement and stabilization of the lesions without any remarkable toxicity. This case contributes to the growing evidence regarding the efficacy of mTOR inhibitors, such as sirolimus, in multifocal PMH.

http://ift.tt/2ixQCWQ

Exercise right heart catheterization for pulmonary hypertension identified on screening echocardiography in adult survivors of childhood cancer: A report from the St. Jude Lifetime Cohort

Abstract

Pulmonary hypertension, determined noninvasively by tricuspid regurgitant jet velocity on Doppler echocardiography, was previously identified in 25% of long-term survivors who received chest-directed radiotherapy. To validate noninvasively defined pulmonary hypertension, survivors (mean age 48 years), exposed to chest radiotherapy, underwent right heart catheterization with planned cardiopulmonary exercise testing during catheterization. Eight participants had an elevated mean pulmonary artery pressure at rest (≥25 mm Hg) or with subsequent exercise (>30 mm Hg), evidence of hemodynamically confirmed pulmonary hypertension by right heart catheterization. Cardiopulmonary exercise testing further defined the magnitude and etiology of cardiopulmonary limitations in this life-threatening late effect.

http://ift.tt/2geSxPu

Hypercalcaemia secondary to ectopic parathyroid hormone expression in an adolescent with metastatic alveolar rhabdomyosarcoma

Abstract

We report the case of a 14-year-old male with metastatic alveolar rhabdomyosarcoma, presenting with hypercalcaemia (3.89 mmol/l) and elevated parathyroid hormone (PTH) level (10.2 pmol/l). Imaging demonstrated extensive bony lytic damage, with "floating teeth" in the mandible. Normalisation of calcium levels and bony reformation of the mandible occurred following chemotherapy; PTH levels decreased initially but remained above normal levels. Imaging did not demonstrate any evidence of parathyroid abnormality. Tumour ectopic PTH secretion is a very rare cause of hypercalcaemia of malignancy in children. Hypercalcaemia with an elevated PTH, in the absence of parathyroid-related cause, should prompt investigation for underlying malignancy.

http://ift.tt/2ixQCpO

Oral health and hematopoietic stem cell transplantation: A longitudinal evaluation of the first 28 days

Abstract

Background

Mucositis is well described after pediatric hematopoietic stem cell transplant (HSCT) but other aspects of oral health such as dental plaque and gingivitis are poorly understood. The aim of this study was to describe dental plaque, gingivitis, and mucositis early after HSCT.

Methods

We conducted a prospective longitudinal observational study to describe dental plaque, gingivitis, and mucositis in the peritransplant period. We conducted comprehensive oral evaluations that included the Miyazaki tongue coating, modified simplified oral hygiene, modified gingivitis of Suomi and Barbano, and mucosal ulceration indices at baseline on days 0, +7, +14, and +28.

Results

Data were collected from 19 patients with a median age of 8.0 years (5.1–12.8) at time of HSCT. Sixteen patients (85%) had plaque accumulation that progressively worsened, 16 (85%) developed severe gingival inflammation, 13 (68%) developed mucositis, and 11 (58%) had oral ulcerations. All oral indices worsened from baseline during the study period. Gingivitis and oral plaque persisted in most patients at day +28 while mucositis and oral ulcerations slightly improved.

Discussion

Gingivitis, dental plaque, mucositis, and oral ulcerations are common after HSCT. Additional studies are needed to ascertain methods that decrease plaque and gingivitis development and severity.

http://ift.tt/2gey3pY

Qu’attend l’oncologue radiothérapeute du physicien et inversement

Publication date: Available online 25 August 2017
Source:Cancer/Radiothérapie
Author(s): I. Barillot
La coopération entre oncologue radiothérapeute et physicien est indispensable pour garantir la qualité et la sécurité des irradiations de nos patients. On aurait tort de considérer que l'intervention des physiciens dans le processus de prise en charge des patients se borne à la mise à disposition d'équipements étalonnés, réglés et contrôlés et à garantir la validité de la distribution de dose et du temps de traitement, alors que l'oncologue radiothérapeute a la maîtrise complète de toutes les activités cliniques liées à l'irradiation. L'intervention des physiciens à l'étape d'acquisition des données anatomiques et dans toute la phase d'optimisation du traitement est déjà une réalité. La reconnaissance de la profession de physicien médical comme une profession de santé vient légitimer cette intervention. Faut-il limiter la coopération entre le médecin et le physicien à ces tâches communes et à la participation à la permanence des soins ? Peut-on envisager une véritable synergie d'action qui dépasse le domaine du soin ? La réponse à la question : « qu'attend l'oncologue radiothérapeute du physicien et inversement ? » peut apporter des éléments pour renforcer la coopération de demain.The cooperation between radiation oncologists and physicists is essential to guarantee the quality and safety of the irradiation of our patients. It would be wrong to consider that the intervention of physicists in the patient management process is limited to the provision of calibrated and controlled equipment and to guarantee the validity of the dose distribution and the treatment time, while the radiation oncologist has the complete control of all clinical activities related to irradiation. The intervention of physicists at the stage of acquisition of anatomical data and throughout the phase of optimization of the treatment is already a reality. The recognition of the profession of medical physicist as a health profession comes to legitimize this intervention. Should physician–physicist cooperation be limited to these common tasks and participation in continuing care? Can we consider a true synergy of action that goes beyond the field of care? The answer to the question: "what does the radiation oncologist expect from the physicist and inversely?" may bring elements to reinforce tomorrow's cooperation.



http://ift.tt/2wdnAix

Brachytherapy for prostate cancer: Present and future

Publication date: Available online 25 August 2017
Source:Cancer/Radiothérapie
Author(s): J.-M. Hannoun-Lévi
Based on recent, important publications on the impact of brachytherapy in the management of prostate cancer, we analysed already validated indications and the "under investigations" use of brachytherapy. Published studies (MEDLINE), randomized trials and recommendations were reviewed, as well as Delphi consensus when available. While low-dose rate brachytherapy remains a standard of care for low-risk eligible patients, three randomized trials are now available to consider that combination of external beam radiation therapy with brachytherapy boost (low- or high-dose rate) appears as a recommended treatment for intermediate and high-risk patients. Other indications of prostate brachytherapy (monotherapy and salvage) remain under evaluation. For low-risk patients with good urinary status, low-dose rate brachytherapy alone should be offered. For low-intermediate risk prostate cancer, low-dose rate brachytherapy alone may be offered as monotherapy, while for high-intermediate risk prostate cancer, a combination of external beam radiation therapy (with or without androgen deprivation therapy) plus brachytherapy boost (low- or high-dose rate) should be offered to eligible patients. For patients with high-risk prostate cancer receiving external beam radiation therapy and androgen deprivation therapy, brachytherapy boost (low- or high-dose rate) should be offered to eligible patients. High-dose rate brachytherapy as monotherapy (single dose for low-risk/multifractionated for intermediate and high-risk) must be explored under clinical investigations, as well as salvage brachytherapy for local recurrence.



http://ift.tt/2wxUtsP

Rechutes oligométastatiques ganglionnaires pelviennes au cours des cancers de la prostate : rôle de la prise en charge par radiothérapie

Publication date: Available online 25 August 2017
Source:Cancer/Radiothérapie
Author(s): S. Supiot, M. Doré, E. Rio
Le programme hospitalier de recherche clinique (PHRC) Oligopelvis 2 est basé sur l'hypothèse que la radiothérapie pelvienne de rattrapage pourrait prolonger l'intervalle entre une première et une deuxième séquence d'hormonothérapie intermittente chez des patients atteints d'oligométastases ganglionnaires pelviennes d'un cancer de la prostate. Il s'agit étude de phase 3 qui comparera une hormonothérapie intermittente (bras standard) et la même hormonothérapie avec une radiothérapie pelvienne extensive de rattrapage (bras expérimental).The Oligopelvis 2 studies is based on the assumption that salvage pelvic radiotherapy may prolong the interval between the first and the second intermittent hormone therapy sequence in pelvic lymph node oligometastatic prostate cancer. This phase 3 study will compare intermittent hormone therapy (standard arm) alone or combined with salvage pelvic radiotherapy (experimental arm).



http://ift.tt/2wdIRJ0

miRNA-221 of exosomes originating from bone marrow mesenchymal stem cells promotes oncogenic activity in gastric cancer

http://ift.tt/2wHeu0G

Mismatch repair deficient metastatic colon cancer and urothelial cancer: A case report of sequential immune checkpoint therapy

.


http://ift.tt/2vxWDUL

Deletion of eIF2β lysine stretches creates a dominant negative that affects the translation and proliferation in human cell line: A tool for arresting the cell growth

.


http://ift.tt/2vfyPJY

Therapeutic implications of bioactive sphingolipids: A focus on colorectal cancer

.


http://ift.tt/2vydx5w

DEVELOPING DRUGS IN CANCER-RELATED BONE PAIN

Publication date: Available online 25 August 2017
Source:Critical Reviews in Oncology/Hematology
Author(s): Maurizio Lucchesi, Gaetano Lanzetta, Andrea Antonuzzo, Antonio Rozzi, Iacopo Sardi, Claudio Favre, Carla Ida Ripamonti, Daniele Santini, Grazia Armento
IntroductionCancer-related bone pain is a frequent and important key problem for metastatic patients that may reduce quality of life, with related limitations in daily activities and morbidity. Often traditional approach to pain may fail given the complex pathophysiology of this phenomenon.MethodsThe aim of this review is to describe promising therapies for cancer-related bone pain, from the pathophysiology to the clinical trials currently ongoing. Moreover, any new evidence for better approach to cancer-related bone pain with the traditional drugs is also considered.ConclusionsIn clinical practice opioids remain the most important pharmacologic treatment for severe pain related to bone cancer. Regard developing drugs, anti-NGF and anti-TrkA are the most investigated new drug in this setting, but a future role in clinical practice is still uncertain.



http://ift.tt/2xB2UAA

Triplet (FOLFOXIRI) versus doublet (FOLFOX or FOLFIRI) backbone chemotherapy as first-line treatment of metastatic colorectal cancer: a systematic review and meta-analysis

Publication date: Available online 25 August 2017
Source:Critical Reviews in Oncology/Hematology
Author(s): Rui Pedro Marques, Gonçalo S Duarte, Carmelo Sterrantino, Helena Luna Pais, António Quintela, Ana Paula Martins, João Costa
Uncertainty exists regarding the comparative effectiveness of triplet chemotherapy (FOLFOXIRI) as backbone first-line chemotherapy for metastatic colorectal cancer (mCRC). We conducted a systematic review and meta-analysis of randomized-controlled trials (RCTs) comparing triplet versus doublet chemotherapy (FOLFOX or FOLFIRI) as first-line therapy in mCRC. Methods and reporting followed PRISMA and SAMPL guidelines.Eight RCTs were included, comprising 1732 patients. In pooled analysis, FOLFOXIRI was associated with improvements in efficacy outcomes, notably with a 25% survival increase (95%CI: 10–37%). FOLFOXIRI was also associated with increased toxicity, with a non-significant 25% increase in the risk of patients experiencing grade ≥3 adverse events (95% CI: −3 to 61%) and with a 1.83 (95% CI: 1.62–2.07) increase in the rate ratio of grade ≥3 adverse events.Moderate quality evidence suggests that first-line FOLFOXIRI provides clinically meaningful efficacy benefits in this setting, at the expense of increased toxicity. Further research is warranted to better characterize safety and to evaluate the most beneficial combination with targeted agents.



http://ift.tt/2xljs0d

Long-term effects of radiation therapy on white matter of the corpus callosum: a diffusion tensor imaging study in children

Abstract

Background

Despite improving survival rates, children are at risk for long-term cognitive and behavioral difficulties following the diagnosis and treatment of a brain tumor. Surgery, chemotherapy and radiation therapy have all been shown to impact the developing brain, especially the white matter.

Objective

The purpose of this study was to determine the long-term effects of radiation therapy on white matter integrity, as measured by diffusion tensor imaging, in pediatric brain tumor patients 2 years after the end of radiation treatment, while controlling for surgical interventions.

Materials and methods

We evaluated diffusion tensor imaging performed at two time points: a baseline 3 to 12 months after surgery and a follow-up approximately 2 years later in pediatric brain tumor patients. A region of interest analysis was performed within three regions of the corpus callosum. Diffusion tensor metrics were determined for participants (n=22) who underwent surgical tumor resection and radiation therapy and demographically matched with participants (n=22) who received surgical tumor resection only.

Results

Analysis revealed that 2 years after treatment, the radiation treated group exhibited significantly lower fractional anisotropy and significantly higher radial diffusivity within the body of the corpus callosum compared to the group that did not receive radiation.

Conclusion

The findings indicate that pediatric brain tumor patients treated with radiation therapy may be at greater risk of experiencing long-term damage to the body of the corpus callosum than those treated with surgery alone.

http://ift.tt/2wH2exh

HRCT findings of childhood follicular bronchiolitis

Abstract

Background

Follicular bronchiolitis is a lymphoproliferative form of interstitial lung disease (ILD) defined by the presence of peribronchial lymphoid follicles. Follicular bronchiolitis has been associated with viral infection, autoimmune disease and immunodeficiency. The most common clinical manifestation is respiratory distress in infancy followed by a prolonged course with gradual improvement. We found no reports of systematic review of high-resolution computed tomography (HRCT) findings in pediatric follicular bronchiolitis.

Objective

The purpose of this study was to describe the HRCT findings of follicular bronchiolitis in children and correlate these imaging findings with histopathology.

Materials and methods

A 5-year retrospective review of all pathology-proven cases of follicular bronchiolitis was performed. Inclusion criteria were age <18 years and an HRCT within 6 months of lung biopsy. HRCTs were reviewed by three observers and scored using the system previously described by Brody et al.

Results

Six patients met the inclusion criteria with age range at HRCT of 7–82 months (median: 39.5 months). Pulmonary nodules (n=6) were the most common HRCT finding followed by focal consolidation (n=5), bronchiectasis (n=4) and lymphadenopathy (n=3). Tree and bud opacities and nodules on CT correlated with interstitial lymphocytic infiltrates and discrete lymphoid follicles on pathology.

Conclusion

The salient HRCT findings of childhood follicular bronchiolitis are bilateral, lower lung zone predominant pulmonary nodules and bronchiectasis with infantile onset of symptoms. These characteristic HRCT findings help differentiate follicular bronchiolitis from other forms of infantile onset ILD.

http://ift.tt/2xBlVmo

RASSF1A hypermethylation is associated with ASXL1 mutation and indicates an adverse outcome in non-M3 acute myeloid leukemia

http://ift.tt/2veFc0a

AKT inhibition is an effective treatment strategy in ARID1A-deficient gastric cancer cells

http://ift.tt/2vxgtj6

Metabolic conditions and breast cancer risk among Los Angeles County Filipina Americans compared with Chinese and Japanese Americans

Abstract

Accumulating evidence suggests that the aggregation of common metabolic conditions (high blood pressure, diabetes, dyslipidemia) is a risk factor for breast cancer. Breast cancer incidence has risen steadily in Asian American women, and whether these metabolic conditions contribute to breast cancer risk in certain Asian American subgroups is unknown. We investigated the role of physician-diagnosed hypertension, high cholesterol, and diabetes separately, and in combination, in relation to the risk of breast cancer in a population-based case-control study of 2,167 Asian Americans diagnosed with breast cancer and 2,035 age and ethnicity matched control women in Los Angeles County. Compared to Asian American women who did not have any of the metabolic conditions, those with 1, 2, or 3 conditions showed a steady increase in risk (respective odds ratios (ORs) were 1.12, 1.42, 1.62; P trend=0.001) with adjustment for covariates including body mass index. Similar significant trends were observed in Filipina Americans (P trend=0.021), postmenopausal women (P trend =0.001), Asian women who were born in the United States (US) (P trend =0.032) and migrants who have lived in the US for at least 20 years (P trend=0.008), but not migrants who lived in the US for <20 years (P trend=0.62). These results suggest that westernization in lifestyle (diet, physical inactivity) and corresponding increase in adiposity have contributed to the rising prevalence of these metabolic conditions, which in turn, are associated with an increase in breast cancer. This article is protected by copyright. All rights reserved.

http://ift.tt/2vy2A3Z

Clinical utility of emerging liquid biomarkers in advanced prostate cancer

Publication date: Available online 25 August 2017
Source:Cancer Genetics
Author(s): Gillian Vandekerkhove, Kim N Chi, Alexander W Wyatt
The therapeutic landscape of advanced prostate cancer (PCa) has rapidly expanded in recent years. Despite significant improvements in patient overall survival, it remains challenging to determine the optimal therapy and sequence of therapies for individual patients. The development of molecular biomarkers will be key for patient stratification, and for monitoring response and resistance to therapy. In this context, minimally-invasive blood-based 'liquid' biopsies are attractive as a practical surrogate for solid tumor tissue, providing a window into metastatic disease. Circulating tumor cells and circulating cell-free tumor DNA in particular have demonstrated remarkable potential to inform on PCa patient outcomes through the detection of specific genomic and transcriptomic alterations. This review covers recent advances in the development of clinically-informative liquid biomarkers for advanced PCa.



http://ift.tt/2wd8oly

Follow-up recommendations: the challenge, the opportunity and our future

http://ift.tt/2vx7MoY