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Management of Triple-Negative Breast Cancer in Older Patients: How Is It Different?In this review, we will discuss the role of geriatric assessment, alternative treatment modalities for older women with triple-negative breast cancer, and other special considerations for this patient population.
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Helping Patients to Cope With CIPNOwing to the success of today’s cancer treatments, many cancer survivors are now living through and beyond the cancer experience.
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Oncologic Emergencies and Paraneoplastic SyndromesThis management guide covers the oncologic emergencies such as superior vena cava syndrome, deep venous thrombosis, pulmonary embolism, and other paraneoplastic syndromes.
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Chemotherapy of Intermediate-Grade Non-Hodgkin's Lymphoma: Is "More" or "Less" Better?While it would seem obvious that dose intensity is an important determinant of treatment outcome in aggressive lymphomas, actually there are very few prospective data to support this hypothesis. Circumstantial evidence derived from retrospective analyses suggests that dose intensity is of clinical significance.
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Promoting Smoking Cessation Among Cancer Patients: A Behavioral ModelThe smoking cessation clinical practice guideline recently published by the Agency for Health Care Policy and Research (AHCPR) summarizes current knowledge on smoking cessation treatments. Among its
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The New Face of Head and Neck Cancer: The HPV EpidemicThis review discusses current paradigms in the diagnosis and management of HPV-OPSCC, and we emphasize pertinent research questions to investigate going forward, including whether to deintensify treatment in these patients.
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Chronic Myelogenous Leukemia: Update on Biology and TreatmentChronic myelogenous leukemia (CML) is an intriguing disease for reasons that point to important biological differences between this and other types of leukemia:
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A 38-Year-Old Man With Pancreatic CancerMichael H. Levy, MD: This 38-year-old white male first came to his physician in January of 1993 complaining of epigastric and low back pain. In March of 1993, he was diagnosed with pancreatic cancer that was metastatic to his
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A 15-Year-Old Boy With Primitive Neurectodermal TumorDr. Peter Staats presented the case of a 15-year-old, 40-kg boy with a primitive neurectodermal tumor located in
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Management of Sleep-Wake Disturbances Comorbid With CancerIn both primary care and oncology settings, screening patients for sleep-wake disturbances comorbid with cancer and their daytime consequences can reduce the economic burden of untreated sleep problems.
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Immunologic and Biologic Properties of the Primary Tumor During Prolonged Neoadjuvant ChemoimmunotherapyPatients with locally advanced cancers have a poor prognosis when treated with radiotherapy and/or surgery alone. The appearance of distant metastases shortly after removal of the primary tumor indicates that micrometastases are already present at the time of diagnosis. We observed a favorable outcome in patients with locally advanced breast cancer treated with a prolonged regimen of neoadjuvant chemotherapy plus granulocyte-macrophage colony-stimulating factor (GM-CSF [Leukine]) compared with patients receiving fewer chemotherapy cycles prior to surgery and radiotherapy. These results can partly be explained by the dose-intensive regimen used, but biologic and immunologic processes inherent to the prolonged presence of the primary tumor and its draining lymph nodes might also contribute to the beneficial outcome. The effects of the prolonged presence of the primary tumor during chemotherapy and GM-CSF administration on the antitumor immune response, and more specifically the functional properties of dendritic cells and T cells, are currently being investigated in a multicenter randomized clinical trial comparing prolonged neoadjuvant chemotherapy plus cytokines with a conventional treatment schedule. Aside from investigations concerning the immune system, other biologic processes, such as tumor angiogenesis, are being investigated at the same time. [ONCOLOGY 16(Suppl 1):32-39, 2002]
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Exposure to In Utero Chemotherapy Did Not Affect Children’s Development, BehaviorIn this video we discuss two poster presentations on childhood development and behavior after in utero exposure to chemotherapy for maternal cancer in pregnancy.
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Chemoradiation Therapy for Organ Preservation in Localized Male Urethral CarcinomaMore research is needed to define the optimal radiotherapy and chemotherapy regimen for male urethral carcinoma. However, modern chemoradiation is a feasible treatment option for motivated men with urethral carcinoma who want to preserve their organs.
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Clinical Management of Uveal and Conjunctival MelanomaIn this review, we discuss current management strategies, as well as future directions, for the management of uveal and conjunctival melanoma.
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The Management of Nongastric MALT LymphomasNo definite guidelines exist for the management of nongastric MALT lymphoma. Retrospective series have included patients treated with different modalities, and excellent cause-specific and overall survival have been demonstrated, independent of the type of treatment adopted.
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Biomarkers Could Predict Bladder Cancer ProgressionThis video examines a study that used liquid biopsies to monitor disease progression in patients with bladder cancer.
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CLL Therapy: The Increasing Importance of Predictive MarkersIt is easy to anticipate that as the complex biology of CLL continues to unfold, new prognostic and predictive biomarkers will be recognized. The discovery of genetic mutations that are key regulators of the development, growth, and proliferation of CLL leukemic cells augurs an alluring future.
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Principles of Oncologic PharmacotherapyThe effective use of cancer chemotherapy requires a thorough understanding of the principles of neoplastic cell growth kinetics, basic pharmacologic mechanisms of drug action, pharmacokinetic and pharmacodynamic variability, and mechanisms of drug resistance. Recent scientific advances in the field of molecular oncology have led to the identification of large numbers of potential targets for novel anticancer therapies. This has resulted in a tremendous expansion of the drug development pipeline, and in the present era, the diversity of clinically useful novel anticancer therapeutic agents is growing at an unprecedented rate. However, the great enthusiasm that surrounds these new agents must be tempered by the challenges they present in optimizing their clinical use and in rationally integrating them with existing anticancer therapies. This discussion focuses on the basic principles underlying the development of modern combination chemotherapy, and it is followed by a description of the major classes of chemotherapeutic drugs and their mechanisms of action.
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Nuclear Medicine Imaging in Breast Cancer: Current Strategies and Future DirectionsThe article “PET Scan in the Diagnosis and Management of Breast Cancer” by Jame Abraham and coworkers is a complete, updated review of the existing scientific literature about clinical indications for positron-emission tomography (PET) in this malignancy.
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Breast Imaging Pioneer Sheds Light on Screening TechnologyDr. Conant is a pioneer in the development of digital mammography, and a leader in research on the use and benefits of early mammography screening and on the role of MRI and PET scanning. She is also the recipient of grants from the National Institutes of Health to compare standard surgical biopsy with digital mammography and stereotactic core breast biopsy.
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Treatment of Early-Stage Pancreatic CancerEarly trials of adjuvant therapy in pancreatic cancer had multiple limitations including small sample size, population heterogeneity, and inability to distinguish between components of combined modality treatment.
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Study may answer critics' fears about preop breast MRIGreater utilization of dynamic contrast-enhanced MRI at the University of California, San Diego, over a 6-year period helped improve surgery planning for tough breast cancer cases without hiking mastectomy rates
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Neoadjuvant Therapy for Soft-Tissue SarcomasThe aim of this review is to discuss current neoadjuvant treatment options for soft-tissue sarcomas.
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Non–Small-Cell Lung Cancer After Mantle Radiation: A Case Report and Brief ReviewIn this case report, we present a non-Hodgkin lymphoma survivor who was incidentally found to have non–small-cell lung cancer 30 years after undergoing treatment that included mantle radiation. We discuss the treatment-related risk factors for lung cancer in this population and potential implications for long-term follow-up.
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Chronic Inflammation and Cancer: The Role of the MitochondriaWe review the evidence implicating a strong association between chronic inflammation and cancer, with an emphasis on colorectal and lung cancer.
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COUNTERPOINT: Is Lymphadenectomy Required in Endometrial Cancer for Adequate Surgical Staging?The question that should be posed to those who advocate for lymphadenectomy as a tool to guide the adjuvant therapy of endometrial cancer is: At what cost to the patient is lymphadenectomy performed?
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Proteomics to Diagnose Human Tumors and Provide Prognostic InformationProteomics is a rapidly emerging scientific discipline that holds greatpromise in identifying novel diagnostic and prognostic biomarkers forhuman cancer. Technologic improvements have made it possible to profileand compare the protein composition within defined populationsof cells. Laser capture microdissection is a tool for procuring pure populationsof cells from human tissue sections to be used for downstreamproteomic analysis. Two-dimensional polyacrylamide gel electrophoresis(2D-PAGE) has been used traditionally to separate complex mixturesof proteins. Improvements in this technology have greatly enhancedresolution and sensitivity providing a more reproducible and comprehensivesurvey. Image analysis software and robotic instrumentationhave been developed to facilitate comparisons of complex protein expressionpatterns and isolation of differentially expressed proteins spots.Differential in-gel electrophoresis (DIGE) facilitates protein expressionby labeling different populations of proteins with fluorescent dyes.Isotope-coded affinity tagging (ICAT) uses mass spectroscopy for proteinseparation and different isotope tags for distinguishing populationsof proteins. Although in the past proteomics has been primarilyused for discovery, significant efforts are being made to developproteomic technologies into clinical tools. Reverse-phase protein arraysoffer a robust new method of quantitatively assessing expressionlevels and the activation status of a panel of proteins. Surface-enhancedlaser-desorption/ionization time-of-flight (SELDI-TOF) mass spectroscopyrapidly assesses complex protein mixtures in tissue or serum. Combinedwith artificial intelligence–based pattern recognition algorithms,this emerging technology can generate highly accurate diagnostic information.It is likely that mass spectroscopy–based serum proteomicswill evolve into useful clinical tools for the detection and treatment ofhuman cancers.
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Marker Predicts Outcomes in mCRPC Treated With AR-Targeted TherapyThis video examines the results of a study that looked at the prognostic value of androgen receptor full-length detection using a CTC-based mRNA assay in metastatic castration-resistant prostate cancer patients starting treatment with AR-targeted agents.
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Screening and Prevention of Hepatitis B Virus Reactivation During ChemotherapyThe incidence of both hepatitis B virus infection and cancer is common. The use of immunosuppressive therapy in patients with hepatitis B virus can result in reactivation of hepatitis B virus, which can, in turn, lead to significant morbidity and mortality.
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Biweekly Gemcitabine, Doxorubicin, and Paclitaxel as First-Line Treatment in Metastatic Breast CancerIn a single-center, open, phase II trial, we assessed the toxicity and activity of a triple combination therapy-doxorubicin at 30 mg/m2 (day 1), paclitaxel (Taxol) at 135 mg/m2 (day 2), and gemcitabine (Gemzar) at 2,500 mg/m2
