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Novel Agents for Multiple Myeloma
Multiple myeloma (MM) is a malignant neoplasm of plasma cells that accumulate in bone marrow, leading to bone destruction and marrow failure. It accounts for approximately 1.8% of all hematologic and solid cancers and slightly > 15% of hematologic malignancies in the United States. MM is typically sensitive to different classes of cytotoxic drugs, both as frontline treatment and as treatment for relapsed disease. Unfortunately, even if responses are typically durable, nowadays MM is not considered curable with current approaches. However, MM survival rates have been brilliantly improved thanks to the introduction of novel agents: patients diagnosed after 2010 have had higher rates of novel therapy use and better survival outcomes compared with those of earlier years. Most relevant therapeutic advances over the past decades has been the introduction of novel therapies, such as immune-modifying agents (thalidomide and lenalidomide) and proteasome inhibitors (bortezomib), adopted with or without stem cell transplantation.
Cancer Consult: Expertise in Clinical Practice, Volume 2
CANCER CONSULT New edition covering the specialties of hematology, oncology and cellular therapy, now in two volumes Cancer Consult: Expertise in Clinical Practice, Volume 2: Neoplastic Hematology & Cellular Therapy, Second Edition includes hundreds of answers to practice-based questions covering the new principles of diagnosis, classification, staging, treatment, and outcomes in the rapidly advancing field of cancer. This textbook series also provides expert guidance in the areas of cancer-related uncertainties and controversies, including experience-based discussions. The book’s smaller size allows for easy access during medical rounds. This volume also includes: Up-to-date clinically re...
Evolutionary Biology of Tumor Initiation and Progression
Cancer is characterized by heterogeneous cells with capacity for self renewal, and selective pressures in the microenvironment which constantly change the cell population. This "descent with modification" is consistent with Darwin's definition of evolution, and accordingly, cancer progression can be captured from an evolutionary angle. However, there is also a clear difference between cancer progression and biological evolution. First, contrary to the evolution of complex organisms, cancer originates from cells of multicellular organisms that escape their constraints and behave like unicellular organisms. Therefore, from the beginning, cancer cells have complex genomes that contain abundant genetic materials which they can use to change their phenotype by dynamic rearrangements and modifications. Secondly, epigenetic effects promote cancer evolution in contrast to the evolution of life. Some tumors develop with minimal genetic alterations, and cell plasticity contributes to both initiation and progression in various tumors. However, an evolutionary theory that encompasses these characteristics of cancer remains to be developed.
