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Classification of Cancer Pain SyndromesChronic pain occurs in about one-third of all cancer patients and in about three-quarters of those with advanced disease.[1] A major factor in the undertreatment of cancer pain is inadequate pain assessment.[2] Pain assessment provides the basis for inferred pathophysiology that directs diagnostic evaluation and treatment decisions. Pain syndrome identification plays an important role in this process-much of clinical medicine is based on pattern recognition of symptoms and signs, leading to a specific diagnosis and therapeutic strategy.
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Nivolumab/Ipilimumab Combo Approved for Advanced RCCIn a pivotal trial, combination of nivolumab and ipilimumab yielded improvement in OS and ORR of poor-risk RCC patients.
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Rituximab Plus CHOP in the Treatment of Elderly Patients With Diffuse Large B-Cell Lymphoma: An Update of the GELA StudyAt the 2000 Annual Meeting of the American Society of Hematology, we presented the benefits of rituximab (Rituxan) combined with CHOP (cyclophosphamide [Cytoxan, Neosar], doxorubicin HCl, vincristine [Oncovin], prednisone), known as R-CHOP, in comparison with CHOP alone for the treatment of elderly patients with diffuse large B-cell lymphoma (DLCL).
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Stereotactic Body Radiotherapy in the Management of Painful Bone MetastasesBone metastases are a common feature of many solid cancers, especially those originating from the prostate, breast, lung, kidney, melanoma, and other sites. Up to 80% of patients with these cancers will develop painful bony disease during the course of their disease.
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Induction Chemotherapy for Resectable Non–Small-Cell Lung CancerDrs. Patel, Blum, and Argirishave provided a detailed, thoroughreview of induction chemotherapyfor non–small-cell lungcancer (NSCLC). They also discussstaging and the relative merits of avariety of invasive and noninvasivetechniques for staging lung cancer.
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Nanoparticle-Delivered Chemotherapy: Old Drugs in New PackagesThis article reviews the rationale for nanoparticle formulations of existing or previously investigated cytotoxic drugs, describe currently approved nanoparticle formulations of drugs, and discusses some of the most promising clinical trials currently underway.
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Focus on Transitional Disease: A Critical Interval to Delay Progression of Prostate CancerONCOLOGY® editorial board member E. David Crawford, MD, and colleagues, propose a new model for guiding the treatment of prostate cancer that focuses on a “transitional state,” which occurs during the interval of progression to metastatic castration-resistant prostate cancer.
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What Are the Most Common Esophageal MetastasesA rare occurrence, cancer in the esophagus requires an individualized treatment plan.
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The Allegheny General Modification of the Harvard Breast Cosmesis Scale for the Retreated BreastRepeat lumpectomy and retreatment radiotherapy following ipsilateral breast tumor recurrence (IBTR) by either external-beam irradiation or brachytherapy in lieu of salvage mastectomy is an area of significant recent clinical interest. Multiple authors have reported their results, with encouraging numbers of patients avoiding mastectomy.[1‑4]
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Hematopoietic Cell Transplantation, Second EditionHematopoietic Cell Transplantation, edited by Drs. Thomas, Blume, and Forman, is an excellent updated second edition of their comprehensive textbook designed for both practitioners involved in transplantation and those interested in the science of stem-cell transplantation.
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2 Cycles of ABVD Plus Radiotherapy Is More Effective Than Radiotherapy Alone in Early Stage HD-Interim Ahan Radiotherapy Alone in Early Stage HD-Interim Analysis of the HD7 Trial of the GHSG Clinic of Internal Medicine I University of Cologne/GermanyBACKGROUND: Extended-field radiotherapy is effective in patients with early-stage Hodgkin’s disease, and more than
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Novel Approaches in the Treatment of Non-Small-Cell Lung CancerA wealth of data indicates that certain genetic abnormalities can target specific cytotoxic drugs and intervene at an early step as a mechanism of resistance in the treatment of non-small-cell lung cancer. Therefore prescribing
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GM-CSF and IL-2 Combination as Adjuvant Therapy in Cutaneous MelanomaCytokines have been used in the treatment of patients with cutaneousmelanoma. Granulocyte-macrophage colony-stimulating factor(GM-CSF, sargramostim [Leukine]) leads to dendritic cell/macrophagepriming and activation, and also increases interleukin-2 (IL-2)receptor expression on T lymphocytes. IL-2 creates lymphokineactivatedkiller cells and tumor-infiltrating lymphocyte cells. In thisopen-label, single-arm study of 16 high-risk patients, we combined thesetwo agents to take advantage of their different but complementary functions.All patients underwent potentially curative surgery. Postoperatively,each patient received GM-CSF at 125 μg/m2/d subcutaneously(SC) for 14 days; this was followed by IL-2 at 9 million IU/m2/d SC for4 days, and then 10 to 12 days of no treatment. In addition, patientswho had large tumors that could yield over 100 million live tumor cellsreceived autologous melanoma vaccines. The duration of follow-upranged from 21 to 42 months (median: 27 months). During follow-up,five patients developed metastases. This program was carried out on anoutpatient basis, and no hospitalization was required. It was well toleratedwith minimal side effects. The combination treatment regimen ofGM-CSF and IL-2 with or without autologous vaccine used adjuvantlyappears to benefit high-risk melanoma patients; further clinical testingof this regimen is warranted.
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The Changing Scenario in Oncologist-Patient Communication: We Need to AdaptOf all diseases, cancer probably elicits the strongest emotional reaction, and this is even more true if one is an affected patient.
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In Vivo Purging With Rituximab Prior to Stem Cell Collection Is Associated With Persistent Molecular Evidence of t(14;18) That Often Disappears Post-Transplant in Patients With Follicular LymphomaWe previously reported that “in vivo purging” with rituximab (Rituxan) during stem-cell collection is safe and does not adversely affect engraftment. We now report on our transplant experience with rituximab. From June 1998 to December
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Management of Locally Advanced Prostate CancerThe treatment of advanced prostate cancer continues to be an enigma. Every few years, it seems, a new variation in treatment is espoused and offered to the public. To date, two trends seem to have emerged: For men under 70 years of age, there seems to be a consensus that definitive treatment should be pursued for low-grade, low-stage, localized tumors. Prostatectomy or radiation therapy may cure or at least increase survival; for men over age 70, less vigorous treatment is often the preferred choice [1,2]. Nevertheless, outside of these two points of agreement, many other controversial questions remain and will persist for some time.
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Rituximab as a Single Agent and in Combination With Interferon Alfa-2a as Treatment of Untreated and First-Relapse Follicular or Other Low-Grade Lymphomas: A Randomized Phase II Study (M 39035)Rituximab (Rituxan) is approved for use in patients with relapsed and refractory follicular lymphoma. Considering the immune modulating effect of interferon alfa-2a (IFN [Roferon-A]) and its efficacy as a single agent in follicular lymphoma, a
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Radiotherapy Versis Chemotherapy as ConsolidativeTreatment for Stage IIIB-IV Hodgkin’s Disease in First Complete Remission or Good Partial Response: A Study of 559 Patients (H89 Protocol)The role of radiotherapy in combination with chemotherapy in advanced-stage Hodgkin’s disease remains controversial.
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Book Review: Common Bonds: Reflections of a Cancer DoctorAs oncology professionals, what initially drew us into this field was some mix of the mystery and intrigue of cancer with the
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Current Trends in the Management of Ductal Carcinoma In SituThis review will summarize the current trends in the diagnosis and management of DCIS and will highlight ongoing trials that are shaping future management of this entity.
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Prostate Cancer: What Did We Learn From the 2012 Annual Scientific Meeting of ASCO?This review summarizes recent findings in clinical prostate cancer research reported at the 2012 Annual Scientific Meeting of the American Society of Clinical Oncology (ASCO) and addresses their relevance to clinical practice.
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Current Status and Optimal Use of RadiosurgeryThe field of stereotactic radiosurgery is rapidly advancing as a result of both improvements in radiosurgical equipment and better physician understanding of the clinical applications of stereotactic radiosurgery. This
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Early Engagement by Healthcare Professionals Helps Overcome Public Skepticism About BiobankingEnlivening the public discussion about cancer biobanking will speed up the collection of specimens for research supporting the goal of personalized medicine. Biobanking is particularly important in minority populations, who experience a disproportionally greater burden of cancer incidence and mortality. But rather than unilaterally creating and launching a public education program, community medicine specialists in Florida first solicited public input.
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Defining the Role of Hepatic Arterial Infusion Chemotherapy in Metastatic Colorectal CancerIn their article, Drs. Whisenant andVenook review data regarding thevalue of hepatic arterial infusion(HAI) chemotherapy for hepatic colorectalmetastases. In fact, their analysisreveals the absence of anymaterial progress in HAI therapy sincethe first reports of continuous infusionof chemotherapy through the hepaticartery.[1] During the sameperiod, there has been dramatic improvementin hepatic imaging, outcomefrom hepatic resection, systemicchemotherapy, and survival followingtreatment of hepatic colorectalmetastases. Failure of HAI therapy toadvance in parallel with other treatmentsfor liver metastases-whetherused prior to or after resection, or asdefinitive treatment for unresectabledisease apparently confined to the liver-suggests a limited role for HAItherapy in this disease. Several pointswarrant discussion.
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Maintenance Therapy for Superficial Bladder CancerTransurethral resection remains the standard for first-line treatment of transitional cell carcinoma of the bladder. This technique clearly defines the pathologic grade and is essential in determining the clinical stage of
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QOL and Outcomes Research in Prostate Cancer Patients With Low Socioeconomic StatusThe VA Cancer of the Prostate Outcomes Study (VA CaPOS) is collecting quality-of-life (QOL) information from prostate cancer patients, spouses, and physicians at six VA medical centers. Currently, 601 men with prostate
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Status of HPV-Related Cancers and Vaccination TrendsIn this interview we discuss HPV-associated cancers, which are on the rise, and the low vaccination coverage for HPV with Edgar Simard, PhD, MPH, senior epidemiologist of surveillance research, who studies the impact of prevention and screening on cancer incidence at the American Cancer Society.
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Head and Neck CancerHead and neck cancers are a diverse group of diseases, each with its own distinct epidemiologic, anatomic, and pathologic features, natural history, and treatment considerations. Despite improvements in diagnosis and local management, long-term survival rates for patients with this disease have not increased significantly over the past 30 years and are among the lowest for the major cancers.
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Pancreatic, Hepatic, and Biliary CarcinomaPancreatic, hepatic, and biliary carcinomas in adults represent three of the most challenging malignancies facing the oncologist. Although groups at high risk for these malignancies are recognized, screening and early-detection strategies have not been successful.
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Adjuvant Therapy for Breast Cancer: Current Approaches and Strategies for a Better FutureWorldwide, breast cancer is by far the most frequent cancer affecting women, with over 1 million new cases each year, and the leading cause of female cancer-related deaths. During the past decade, substantial progress has been made in the treatment of breast cancer, due to focused collaborative efforts in education, practice, and research.
