Cardiac tumors medical therapy: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Cardiac tumors}} | {{Cardiac tumors}} | ||
{{CMG}}; {{AE}} {{ | {{CMG}}; {{AE}} {{DMakkar}} | ||
==Overview== | ==Overview== | ||
Most of the Cardiac tumors are treated with surgical management. | Most of the Cardiac tumors are treated with surgical management. | ||
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*Systemic neoadjuvant therapy should be aggressively explored in hemodynamically stable patients with localized disease because it permits: (a) quicker removal by shrinking the tumor size and (b) a decrease in the likelihood of systemic recurrence | *Systemic neoadjuvant therapy should be aggressively explored in hemodynamically stable patients with localized disease because it permits: (a) quicker removal by shrinking the tumor size and (b) a decrease in the likelihood of systemic recurrence | ||
==Medical Treatment of Cardiac Tumors== | ==Medical Treatment of Cardiac Tumors== | ||
Malignant recurrent effusions may require the use of a sclerosing agent or drainage with a subxiphisternal windows or percutaneous approach. | |||
{| class="wikitable" | {| class="wikitable" | ||
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|'''[[Sarcoma]]''' || Doxorubicin and Ifosfamide alternative regimen Gemcitabine/Docetaxel | |'''[[Sarcoma]]''' || Doxorubicin and Ifosfamide alternative regimen Gemcitabine/Docetaxel | ||
*Gemcitabine: MOA :Gemcitabine is a nucleoside analogue that induces apoptosis in cancerous cells during DNA formation to exert its antitumor effects.<ref name="pmid28882536">{{cite journal| author=Seddon B, Strauss SJ, Whelan J, Leahy M, Woll PJ, Cowie F | display-authors=etal| title=Gemcitabine and docetaxel versus doxorubicin as first-line treatment in previously untreated advanced unresectable or metastatic soft-tissue sarcomas (GeDDiS): a randomised controlled phase 3 trial. | journal=Lancet Oncol | year= 2017 | volume= 18 | issue= 10 | pages= 1397-1410 | pmid=28882536 | doi=10.1016/S1470-2045(17)30622-8 | pmc=5622179 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28882536 }} </ref> | |||
*Docetaxel: MOA: Stabilizes microtubule assembly.<ref name="pmid28882536">{{cite journal| author=Seddon B, Strauss SJ, Whelan J, Leahy M, Woll PJ, Cowie F | display-authors=etal| title=Gemcitabine and docetaxel versus doxorubicin as first-line treatment in previously untreated advanced unresectable or metastatic soft-tissue sarcomas (GeDDiS): a randomised controlled phase 3 trial. | journal=Lancet Oncol | year= 2017 | volume= 18 | issue= 10 | pages= 1397-1410 | pmid=28882536 | doi=10.1016/S1470-2045(17)30622-8 | pmc=5622179 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28882536 }} </ref> | |||
|- | |- | ||
|'''[[Angiosarcoma]]''' || Paclitaxel | |'''[[Angiosarcoma]]''' || Paclitaxel | ||
*MOA: Dr. Horwitz found that Paclitaxel inhibits cell division by promoting the assembly of stable microtubules, particularly from -tubulin heterodimers. It inhibits their depolymerization; as a result, vulnerable cells are detained in the G2/M stage of mitosis.<ref name="pmid6103535">{{cite journal| author=Schiff PB, Horwitz SB| title=Taxol stabilizes microtubules in mouse fibroblast cells. | journal=Proc Natl Acad Sci U S A | year= 1980 | volume= 77 | issue= 3 | pages= 1561-5 | pmid=6103535 | doi=10.1073/pnas.77.3.1561 | pmc=348536 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6103535 }} </ref> | |||
Other Vinca alkaloids block microtubule arrangement.<ref name="pmid6103535">{{cite journal| author=Schiff PB, Horwitz SB| title=Taxol stabilizes microtubules in mouse fibroblast cells. | journal=Proc Natl Acad Sci U S A | year= 1980 | volume= 77 | issue= 3 | pages= 1561-5 | pmid=6103535 | doi=10.1073/pnas.77.3.1561 | pmc=348536 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6103535 }} </ref> | |||
|- | |- | ||
| '''[[Prominent targeted therapy]]''' || Anti-angiogenic agents | | '''[[Prominent targeted therapy]]''' || Anti-angiogenic agents | ||
*Pazopanib MOA suppression of the intracellular '''tyrosine kinase''' of VEGF receptor (VEGFR) and PDGF receptor (PDGFR) (PDGFR). | *Pazopanib MOA suppression of the intracellular '''tyrosine kinase''' of VEGF receptor (VEGFR) and PDGF receptor (PDGFR) (PDGFR).<ref name="pmid24696596">{{cite journal| author=Germano D, Daniele B| title=Systemic therapy of hepatocellular carcinoma: current status and future perspectives. | journal=World J Gastroenterol | year= 2014 | volume= 20 | issue= 12 | pages= 3087-99 | pmid=24696596 | doi=10.3748/wjg.v20.i12.3087 | pmc=3964381 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24696596 }} </ref> | ||
*Sorafenib MOA a potent soluble epoxide hydrolase inhibitor | *Sorafenib MOA a potent soluble epoxide hydrolase inhibitor.<ref name="pmid24696596">{{cite journal| author=Germano D, Daniele B| title=Systemic therapy of hepatocellular carcinoma: current status and future perspectives. | journal=World J Gastroenterol | year= 2014 | volume= 20 | issue= 12 | pages= 3087-99 | pmid=24696596 | doi=10.3748/wjg.v20.i12.3087 | pmc=3964381 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24696596 }} </ref> | ||
|- | |- | ||
|'''[[Undifferentiated pleomorphic sarcomas]]''' || Pembrolizumab | |'''[[Undifferentiated pleomorphic sarcomas]]''' || Pembrolizumab | ||
*MOA:blocks a protein called PD-1 on the surface of certain immune cells called T-cells. Blocking PD-1 triggers the T-cells to find and kill cancer cells. | *MOA:blocks a protein called PD-1 on the surface of certain immune cells called T-cells. Blocking PD-1 triggers the T-cells to find and kill cancer cells.<ref name="pmid31900276">{{cite journal| author=Keung EZ, Burgess M, Salazar R, Parra ER, Rodrigues-Canales J, Bolejack V | display-authors=etal| title=Correlative Analyses of the SARC028 Trial Reveal an Association Between Sarcoma-Associated Immune Infiltrate and Response to Pembrolizumab. | journal=Clin Cancer Res | year= 2020 | volume= 26 | issue= 6 | pages= 1258-1266 | pmid=31900276 | doi=10.1158/1078-0432.CCR-19-1824 | pmc=7731262 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31900276 }} </ref> | ||
|} | |} | ||
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{{WS}} | {{WS}} | ||
[[Category: | [[Category:needs english review]] | ||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
Latest revision as of 20:22, 4 July 2022
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Cardiac tumors Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Cardiac tumors medical therapy On the Web |
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American Roentgen Ray Society Images of Cardiac tumors medical therapy |
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Risk calculators and risk factors for Cardiac tumors medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dheeraj Makkar, M.D.[2]
Overview
Most of the Cardiac tumors are treated with surgical management. Malignant primary cardiac tumors have a predisposition for rapid metastasis spread.
- Systemic neoadjuvant therapy should be aggressively explored in hemodynamically stable patients with localized disease because it permits: (a) quicker removal by shrinking the tumor size and (b) a decrease in the likelihood of systemic recurrence
Medical Treatment of Cardiac Tumors
Malignant recurrent effusions may require the use of a sclerosing agent or drainage with a subxiphisternal windows or percutaneous approach.
| Tumor | Treatment |
|---|---|
| Cardiac Lymphoma | Rituximab is an anti-CD20 monoclonal antibody that typically produces remission in a wide range of B-cell non-Hodgkin lymphomas.
MOA: Activation of antibody-dependent, cell-mediated cytotoxicity, complement-mediated lysis, phagocytosis of antibody-coupled tumor cells, and activation of cell death appear to constitute its mode of action.[1] |
| Sarcoma | Doxorubicin and Ifosfamide alternative regimen Gemcitabine/Docetaxel |
| Angiosarcoma | Paclitaxel
Other Vinca alkaloids block microtubule arrangement.[3] |
| Prominent targeted therapy | Anti-angiogenic agents |
| Undifferentiated pleomorphic sarcomas | Pembrolizumab
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References
- ↑ Nakagawa Y, Ikeda U, Hirose M, Ubukata S, Katsuki TA, Kaminishi Y; et al. (2004). "Successful treatment of primary cardiac lymphoma with monoclonal CD20 antibody (rituximab)". Circ J. 68 (2): 172–3. doi:10.1253/circj.68.172. PMID 14745155.
- ↑ 2.0 2.1 Seddon B, Strauss SJ, Whelan J, Leahy M, Woll PJ, Cowie F; et al. (2017). "Gemcitabine and docetaxel versus doxorubicin as first-line treatment in previously untreated advanced unresectable or metastatic soft-tissue sarcomas (GeDDiS): a randomised controlled phase 3 trial". Lancet Oncol. 18 (10): 1397–1410. doi:10.1016/S1470-2045(17)30622-8. PMC 5622179. PMID 28882536.
- ↑ 3.0 3.1 Schiff PB, Horwitz SB (1980). "Taxol stabilizes microtubules in mouse fibroblast cells". Proc Natl Acad Sci U S A. 77 (3): 1561–5. doi:10.1073/pnas.77.3.1561. PMC 348536. PMID 6103535.
- ↑ 4.0 4.1 Germano D, Daniele B (2014). "Systemic therapy of hepatocellular carcinoma: current status and future perspectives". World J Gastroenterol. 20 (12): 3087–99. doi:10.3748/wjg.v20.i12.3087. PMC 3964381. PMID 24696596.
- ↑ Keung EZ, Burgess M, Salazar R, Parra ER, Rodrigues-Canales J, Bolejack V; et al. (2020). "Correlative Analyses of the SARC028 Trial Reveal an Association Between Sarcoma-Associated Immune Infiltrate and Response to Pembrolizumab". Clin Cancer Res. 26 (6): 1258–1266. doi:10.1158/1078-0432.CCR-19-1824. PMC 7731262 Check
|pmc=value (help). PMID 31900276.