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Related Concept Videos

Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists01:29

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Dopamine receptor antagonists, also known as antipsychotic agents, are critical in managing chemotherapy-induced vomiting. These antiemetic agents block dopamine receptors in the chemoreceptor trigger zone (CTZ), inhibiting signal transmission to the vomiting center. Antipsychotic agents encompass phenothiazines (PTZ), butyrophenones, benzamides, and thienobenzodiazepines (Zyprexa), which are utilized for their antiemetic and sedative properties.
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Cancer therapies are various modes of treatment, such as surgery, radiation therapy, and chemotherapy that are administered to cancer patients.
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Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists01:27

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5-HT3 receptor antagonists, such as dolasetron, granisetron (Kytril), ondansetron (Zofran), and palonosetron (Axoli), are crucial in managing chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea. These drugs selectively block 5-HT3 receptors in the visceral vagal and spinal afferent nerves, chemoreceptor trigger zone, and the vomiting center. They have a rapid onset of action and can be given as a single dose before chemotherapy. Ondansetron and granisetron, in particular,...
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Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
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Immunotherapy is a treatment that boosts or manipulates the immune system to fight diseases, including cancer. For instance, by stimulating an immune response through vaccinations against viruses that cause cancers, like hepatitis B virus and human papillomavirus, these diseases can be prevented. Nonetheless, some cancer cells can avoid the immune system due to their rapid mutation and division. The immune response to many cancers involves three phases: elimination, equilibrium, and escape.
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Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists01:28

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Neurokinin 1 (NK1) receptors are distributed across the GI tract, vagal afferents, and key CNS regions including the central vomiting center and chemoreceptor trigger zone (CTZ) Chemotherapy agents stimulate enterochromaffin cells in the gastrointestinal (GI) tract to release large amounts of substance P (SP). SP is a neuropeptide released by specific sensory nerves in response to many different stressors, including those in the GI mucosa affected by chemotherapy.  SP binds and activates...
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Adjuvant Chemotherapy.

Jessica A Hellyer1, Heather A Wakelee1

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Thoracic Surgery Clinics
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Improving early-stage non-small cell lung cancer survival requires better adjuvant therapies. Current strategies show limited success, but personalized approaches targeting minimal residual disease or specific mutations show promise.

Keywords:
AdjuvantChemotherapyTargeted agents

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Area of Science:

  • Oncology
  • Cancer Research
  • Clinical Trials

Background:

  • Early-stage non-small cell lung cancer (NSCLC) survival rates need improvement.
  • Adjuvant chemotherapy offers a modest survival benefit at 5 years for NSCLC patients.
  • Previous attempts to enhance adjuvant therapy with vaccines or unselected tyrosine kinase inhibitors failed to improve outcomes.

Purpose of the Study:

  • To review the current landscape of adjuvant therapy for early-stage non-small cell lung cancer.
  • To highlight the limitations of existing adjuvant treatment intensification strategies.
  • To discuss promising personalized approaches for adjuvant therapy in NSCLC.

Main Methods:

  • Literature review of adjuvant therapy in early-stage non-small cell lung cancer.
  • Analysis of outcomes from clinical trials investigating intensified adjuvant treatments.
  • Examination of ongoing research in personalized adjuvant medicine, including minimal residual disease detection and targeted therapies.

Main Results:

  • Adjuvant chemotherapy provides a small but statistically significant improvement in 5-year overall survival for early-stage NSCLC.
  • Intensified adjuvant treatments, cancer vaccines, and tyrosine kinase inhibitors in unselected patients have not yielded significant improvements.
  • Research into immune checkpoint inhibitors is ongoing and reported separately.

Conclusions:

  • Personalized adjuvant therapy strategies are crucial for improving outcomes in early-stage non-small cell lung cancer.
  • Selecting patients based on minimal residual disease or targeting specific tumor driver mutations represents a promising future direction.
  • Further research is needed to validate and implement these personalized approaches effectively.