Authors
Latest:
Next Steps in the Management of EGFR Exon 20 Insertion–Positive mNSCLCClosing out their discussion on mobocertinib data and the EXCLAIM cohort, experts share hope for the future management of the EGFR exon 20 insertion–positive mNSCLC.
Latest:
Robotics in Head and Neck Cancer: Future OpportunitiesA series of promising new advances have emerged in H&N oncology in recent years. Among these are the advancement of highly conformal radiation delivery techniques (e.g. IMRT, protons); the successful introduction of molecular targeted therapies (e.g. cetuximab); the recognition of HPV as a powerful prognostic biomarker; and the development of minimally invasive surgical techniques. The application of transoral robotic surgery (TORS) in H&N cancer is reviewed by Bhayani et al in this issue of ONCOLOGY[1].
Latest:
Navigating a ‘Revolutionary Era’ of Targeted Therapy in Pancreatic CancerThe key to the future of pancreatic cancer treatment is immunotherapy, according to Gregory L. Beatty, MD, PhD.
Latest:
New Targets and New Mechanisms in Lung CancerThis review will describe the well-known use of VEGF antibodies; the current uses of EGFR and ALK tyrosine kinase inhibitors; newer agents being used against MET, FGFR, and other intracellular targets; insights regarding the field of immunotherapy in lung cancer; and finally, newer developments in chemotherapy.
Latest:
ASTRO 2017: Long-Term Data Support Single SBRT Dose in Certain Early Lung CancersThis video reviews long-term results of the NRG Oncology RTOG 0915 trial, a randomized phase II study that compared stereotactic body radiation therapy delivered in one fraction vs four fractions for stage I peripheral non–small-cell lung cancer patients with unresectable disease.
Latest:
Primary Carcinoid Tumors of the Lung: A Role for RadiotherapyPrimary neuroendocrine neoplasms of the lung represent a clinical spectrum of tumors ranging from the relatively benign and slow-growing typical carcinoid to the highly aggressive small-cell lung carcinoma. The rarity of carcinoids has made the role of radiation therapy in their management controversial. This review considers the results of published studies to generate treatment recommendations and identify areas for future research. Surgery remains the standard of care for medically operable disease. Histology plays the most important role in determining the role of adjuvant radiation. Resected typical carcinoids likely do not require adjuvant therapy irrespective of nodal status. Resected atypical carcinoids and large-cell neuroendocrine carcinomas have a significant risk of local failure, for which adjuvant radiation likely improves local control. Definitive radiation is warranted in unresectable disease. Palliative radiation for symptomatic lesions has demonstrated efficacy for all histologies. Collaborative group trials are warranted.
Latest:
Updated ASCO Guidelines for Optimal Small Cell Lung Cancer ManagementPractices are on the cusp of better understanding small cell lung cancer that in turn can help to advance treatment strategies for patients, says Gregory Peter Kalemkerian, MD.
Latest:
Use of Bisphosphonates in Patients With Metastatic Bone DiseaseThe bisphosphonates have now joined an elite group of drugs that have annual sales greater than $1 billion. Although the major therapeutic target of these agents is osteoporosis, their use in cancer, particularly in osteolytic bone disease due to breast cancer and myeloma, is growing very rapidly. Pamidronate (Aredia), the only bisphosphonate currently approved for this indication in the United States, is now prescribed for the majority of patients with myeloma, as well as a substantial number of patients with breast cancer.
Latest:
Clinical Trial Simulation of a 200-µg Fixed Dose of Darbepoetin Alfa in Chemotherapy-Induced AnemiaOur objective was to assess, using clinical trial simulation, the feasibility of a fixed 200-µg dose of darbepoetin alfa (Aranesp) administered every 2 weeks in chemotherapy-induced anemia. A pharmacokinetic/pharmacodynamic
Latest:
ACR Appropriateness Criteria® Postradical Prostatectomy Irradiation in Prostate CancerThe purpose of this article is to present an updated set of American College of Radiology consensus guidelines formed from an expert panel on the appropriate use of radiation therapy in postprostatectomy prostate cancer.
Latest:
Surgical Approach to Organ Preservation in the Treatment of Cancer of the LarynxNonsurgical approaches to preservation of the larynx in the treatment of laryngeal carcinoma include either radiation alone or chemotherapy and radiation in combination. In light of the common use of total laryngectomy,
Latest:
Routine 3D Treatment Planning: Opportunities, Challenges, and HazardsThree-dimensional (3D) treatment planning refers to the use of software and hardware tools to design and implement more accurate and conformal radiation therapy. This is a major advance in oncology that should lead to
Latest:
Surgical Approach to Organ Preservation in the Treatment of Cancer of the LarynxIn the past 10 years, the introduction of combined chemotherapy and radiation as an alternative to total laryngectomy for patients with advanced laryngeal cancer ushered in a new treatment paradigm termed "organ preservation." The adoption of
Latest:
Reassessing Adjuvant Treatment of Early-Stage Breast Cancer in Elderly Women: Focus on Findings from 2007 ASCO MeetingApproximately 212,920 new cases of invasive breast cancer were estimated to occur in the United States in 2006.1 The incidence rate has continued to rise slowly over the past 20 years due to the continued increase of breast cancer in women aged 50 and older (375 cases per 100,000 women), peaking at 75 to 79 years of age (525 per 100,000 women).
Latest:
3 Things You Should Know About Immunotherapy in DLBCLHere are 3 things you should know about immunotherapy in diffuse large B-cell lymphoma.
Latest:
Commentary (Dalbagni): Current Management of Unusual Genitourinary CancersThis two-part article by Krieg and Hoffman, published last month and concluded in this issue, explores the current management of penile cancer (part 1) and urethral cancer in both men and women (part 2). My remarks will focus on female and male urethral cancer.
Latest:
Outlook for 2017: Acute Leukemias, MDS, and CLLThis look ahead at hematologic malignancies in 2017 focuses on new agents being studied for the treatment of acute leukemias, myelodysplastic syndromes, and chronic lymphocytic leukemia.
Latest:
Commentary (Tricot): Tandem Transplantation in Multiple MyelomaIn the early 1980s, McElwain andcolleagues demonstrated thathigh-dose melphalan (Alkeran,100–400 mg/m2) was very effectivein patients with aggressive (plasmacell leukemia) or refractory myeloma.[1] Other researchers subsequentlyconfirmed these results.[2-4]Unfortunately, the duration of cytopeniaassociated with such treatmentwas excessive (3 to 4 weeks), leadingto a treatment-related mortalityrate of 10% to 20%.
Latest:
Guillermo Garcia-Manero, MD, on Eprenetapopt-Azacytidine Combo in TP53+ MDSThe MD Anderson expert discussed the phase 3 trial – designed to evaluate frontline eprenetapopt in combination with azacytidine (Vidaza) in patients with TP53-mutant positive myelodysplastic syndrome (MDS) – that recently completed full enrollment.
Latest:
Uracil/Tegafur Plus Oral Calcium Folinate in Advanced Breast CancerUracil and tegafur (in a molar ratio of 4:1 [UFT]) has proven activity against breast cancer and is delivered in an easy-to-administer oral formulation. Orzel, which combines UFT with the oral biomodulator, calcium folinate, may
Latest:
Myelodysplastic SyndromesMyelodysplastic syndromes (MDS) are a group of hematologic malignancies of the pluripotent hematopoietic stem cells. These disorders are characterized by ineffective hematopoiesis, including abnormalities in proliferation, differentiation, and apoptosis.
Latest:
Immune Targeting in Gastrointestinal Malignancies: Finding the Right Combination for the Right SiteAdvanced gastrointestinal malignancies are a major oncologic challenge for which successful durable personalized therapies are currently lacking.
Latest:
Controversies in the Management of Stage I SeminomaCurrent controversies in the treatment of stage I seminoma center on the relative roles of surveillance, adjuvant radiotherapy (RT), and adjuvant single-agent chemotherapy. Surveillance has been studied in over 800 patients,
Latest:
Routine 3D Treatment Planning: Opportunities, Challenges, and HazardsThree-dimensional (3D) treatment planning refers to the use of software and hardware tools to design and implement more accurate and conformal radiation therapy. This is a major advance in oncology that should lead to
Latest:
Reassessments of ESAs for Cancer Treatment in the US and EuropeAnemia is a widely prevalent complication among cancer patients. At the time of diagnosis, 30% to 40% of patients with non-Hodgkin lymphoma or Hodgkin lymphoma and up to 70% of patients with multiple myeloma are anemic; rates are higher among persons with myelodysplastic syndromes. Among patients with solid cancers or lymphomas, up to half develop anemia following chemotherapy. For almost 2 decades, erythropoiesis-stimulating agents (ESAs) were the primary treatment for cancer-related anemia. However, reassessments of benefits and risks of ESAs for cancer-associated anemia have occurred internationally. We reviewed guidelines and notifications from regulatory agencies and manufacturers, reimbursement policies, and utilization for ESAs in the cancer and chronic kidney disease settings within the United States, Europe, and Canada. In 2008 the US Food and Drug Administration (FDA) restricted ESAs from cancer patients seeking cure. Reimbursement is limited to hemoglobin levels < 10 g/dL. In the United States, ESA usage increased 340% between 2001 and 2006, and decreased 60% since 2007. The European Medicines Agency (EMEA) recommended that ESA benefits do not outweigh risks. In Europe between 2001 and 2006, ESA use increased 51%; since 2006, use decreased by 10%. In 2009, Canadian manufacturers recommended usage based on patient preferences. In Canada in 2007, approximately 20% of anemic cancer patients received ESAs, a 20% increase since 2004. In contrast to Europe, where ESA use has increased over time, reassessments of ESA-associated safety concerns in the United States have resulted in marked decrements in ESA use among cancer patients.
Latest:
Bevacizumab Plus Chemo in Early Stage HER2-Negative Breast CancerDr. Gunter von Minckwitz discusses the recent paper he authored that showed that bevacizumab in addition to neoadjuvant chemotherapy significantly increased the rate of pathological complete response in patients with early stage HER2-negative breast cancer.
Latest:
Neoadjuvant Therapy With Gemcitabine in Breast CancerPrimary systemic therapy (ie, preoperative or neoadjuvant) increasesthe possibility for breast-conserving surgery in patients with primarybreast cancer. Patients with pathologic complete response to primarysystemic therapy have improved survival compared with those with persistenttumors. Several phase II trials have evaluated gemcitabine-containingdoublet or triplet regimens as primary systemic therapy for breastcancer, results of which have shown promising clinical and pathologicresponse rates with manageable toxicity. Results of a phase I/II studyof gemcitabine (Gemzar)/epirubicin (Ellence)/docetaxel (Taxotere), orGEDoc, with prophylactic filgrastim (Neupogen), as primary systemictherapy in 77 evaluable patients with primary breast cancer are reportedherein. Dose-limiting toxicities were grade 3 febrile neutropenia(n = 1) and grade 3 diarrhea (n = 2) at the fourth dose level ofGEDoc tested (gemcitabine at 800 mg/m2 days 1 and 8, epirubicin at90 mg/ m2 day 1, and docetaxel at 75 mg/m2 day 1). As assessed byultrasound, 92% of patients responded overall (22% complete response),and 79% of patients could undergo breast-conserving surgery. Thepathologic complete response rate in resected breast tissue was 26%.
Latest:
UFT/Leucovorin Plus Weekly Paclitaxel in the Treatment of Solid TumorsThe palliation of symptoms and improvement of quality of life are important aspects of therapy in patients with incurable metastatic cancer. This article describes the preliminary results of a phase I study of uracil and tegafur, an orally available fluorouracil (5-FU) derivative combined with oral leucovorin plus weekly intravenous paclitaxel.
Latest:
Paclitaxel and Epirubicin as First-Line Therapy for Patients With Metastatic Breast CancerPaclitaxel (Taxol) has aroused considerable interest for its high single-agent activity in breast cancer and novel mechanism of action. Epirubicin (Farmorubicin), the 4'epimer of doxorubicin (Adriamycin), also has high activity in
Latest:
Cancer Chemotherapy in the Elderly PatientThe management of older patients with cancer is historically challenging because of a lack of prospective data regarding the appropriate management of this population. In this review, we address some of the issues and challenges surrounding the treatment of older cancer patients, including the withholding of medically appropriate treatment based on chronologic age, the historical omission of elderly from clinical trials, and the impact of geriatric assessment, and age-related changes in pharmacokinetics and pharmacodynamics. Finally, we conclude by discussing the existing evidence related to cancer treatment in the elderly, focusing primarily on the malignancies most commonly seen in older patients, and making general treatment recommendations where applicable.
