Authors
Latest:
Commentary (Speight): Update on Malignant MesotheliomaMalignant pleural mesothelioma(MPM) is an invasivelocally aggressive tumorthat is nearly always fatal. Historically,treatments resulting in durable controlhave seemed unobtainable andfostered a somewhat fatalistic managementapproach. Until recently, nonovel therapies had emerged that offeredreal hope for improvement inthe poor median overall and progression-free survival. In this issue ofONCOLOGY, Dr Antman and colleaguesprovide an overview of theepidemiology, natural history, andmanagement strategies for malignantmesothelioma, with an emphasis onMPM.[1]
Latest:
Active Surveillance for Prostate Cancer: How to Do It RightIn this review of active surveillance for favorable-risk prostate cancer, we will discuss the rationality of this approach, the biological evidence for employing active surveillance in Gleason pattern 3 and 4 prostate cancer, patient selection for active surveillance, clinical trial data on active surveillance, and the role of prostate cancer biomarkers and imaging studies for clinical decision making in patients with low-risk disease.
Latest:
Early-Stage Breast Cancer and Adjuvant TherapyCarcinoma of the breast is the most common cancer in women in the United States and is second only to lung cancer as a cause of cancer death in women. The incidence of breast cancer has risen steadily over the past decade, with the most dramatic increase seen in smaller primary breast tumors, partly because widespread use of screening mammography permits earlier detection [1].
Latest:
Man With Locally Advanced, High-Risk Prostate Cancer Asks About Adding Chemotherapy to His TreatmentA 55-year-old Hispanic male presents with a family history of gastric cancer in one sibling and prostate cancer in an older brother. CT performed in March 2015 for IMT surveillance showed a heterogeneous prostate with local invasion involving the bladder, seminal vesicles, and perirectal fat.
Latest:
Oncology Peer Review On-The-Go: Successful Diagnosis and Treatment of Occult Prostate Cancer Despite Multiple Negative Prostate Biopsies and Negative Prostate MRIsJudd W. Moul, MD, spoke with CancerNetwork® about the latest research from the journal ONCOLOGY® on the treatment of a patients with evidence of prostate cancer despite multiple negative prognostic tests.
Latest:
Prophylaxis Against Fungal Infections and Cytomegalovirus Disease After Bone Marrow TransplantationAmong the serious complications associated with bone marrow transplantation are invasive fungal infections caused by organisms such as Candida and Aspergillus species and end-organ disease caused by
Latest:
Sexuality and Body Image Concerns After Treatment for Breast CancerThe patient, KC, is a 41-year-old Caucasian female. She has been married to SC for 16 years and has three children, aged 14, 11, and 9 years old. She has always been a homemaker with plenty of energy and says that she has been “the rock” during any crisis. KC was diagnosed with T2N1M0 poorly differentiated invasive ductal carcinoma of the breast with lobular features in 2007. She decided to have a mastectomy without immediate reconstruction because she did not know if reconstruction was what she wanted. She has also undergone four courses of chemotherapy (doxorubicin [Adriamycin] and paclitaxel [Taxol]) followed by radiation therapy.
Latest:
Management of Infections in Patients With Acute LeukemiaSeveral recent studies have addressed the management of infectious problems in patients with acute leukemia. Although those studies have served to emphasize the fundamental management principles formulated and proven
Latest:
What Is the Optimal Therapy for Childhood AML?Improvement in pediatric acute myelogenous leukemia (AML) over the past 30 years has been only modest. Although rates of complete remission induction have climbed steadily to 85% or 90%, cure rates remain in the 50% to 60% range. These figures may inspire envy from medical oncologists treating adults with AML, but they lag far behind the successes in treating pediatric acute lymphocytic leukemia (ALL).
Latest:
Prophylaxis Against Fungal Infections and Cytomegalovirus Disease After Bone Marrow TransplantationAmong the serious complications associated with bone marrow transplantation are invasive fungal infections caused by organisms such as Candida and Aspergillus species and end-organ disease caused by
Latest:
Gemcitabine and Irinotecan in Locally Advanced or Metastatic Biliary Cancer: Preliminary ReportChemotherapy has had limited success in biliary tract cancer. Of thenewer agents, gemcitabine (Gemzar) and irinotecan (CPT-11, Camptosar)both have single-agent activity in patients with advanced disease.We conducted a phase II trial to study the efficacy and toxicity of thecombination of gemcitabine plus irinotecan in patients with locallyadvanced or metastatic biliary tract cancer. The study has enrolled 14patients with histologically or cytologically documented cancer of thebiliary tract or gallbladder with bidimensionally measurable disease,Eastern Cooperative Oncology Group performance status 0 or 1,decompressed biliary tree, and no prior exposure to chemotherapy.Gemcitabine at 1,000 mg/m2 and irinotecan at 100 mg/m2 were bothadministered on days 1 and 8, every 21 days. In patients who had lessthan grade 3 hematologic and less than grade 2 nonhematologic toxicityfollowing cycle 1, the dose of irinotecan was increased to 115 mg/m2 forsubsequent cycles. A total of 65 cycles of chemotherapy have beenadministered, with an average of 4.5 cycles per patient (range: 1 to 11cycles). The median treatment duration was 3 months (range: 0.75 to 8months). An objective partial response was determined radiographicallyin two patients (14%) while stable disease for periods ranging from 4to 11.5 months was noted in six patients (43%). Toxicity consisted ofgrade 3/4 neutropenia in seven patients (50%) with no episodes offebrile neutropenia, grade 3/4 thrombocytopenia in four (28%), grade3 diarrhea in two (14%), and grade 3 nausea in one patient. Thecombination of gemcitabine plus irinotecan appears to possess modestclinical activity, and it is well tolerated in patients with advanced biliarycancer. Patient accrual is ongoing to this study.
Latest:
YogaYoga, an ancient tradition that originated approximately 5,000 years ago in Central Asia, is a complete system of mental and physical practices for health and well-being. Predominantly practiced within the philosophical context of Ayurvedic medicine in India, yoga as a mind-body therapy is now also increasingly popular in the West, practiced by approximately 15 million individuals.
Latest:
Navigating Cancer Pain Management in the Midst of the Opioid EpidemicTwo public health crises, the epidemics of chronic pain and of opioid misuse, are creating challenges for cancer pain management.
Latest:
Commentary (Masciari/Garber): Evaluation and Management of Women With BRCA1/2 MutationsThe review by Beth Peshkin andClaudine Isaacs in this issue ofONCOLOGY is an excellentoverview of the recognition, evaluation,and clinical management ofwomen with BRCA1 and BRCA2mutations. It is comprehensive andpractical, and emphasizes the approachthat a risk assessment and clinicalgenetics program might take tothe evaluation of an individual concernedabout the possibility thathereditary breast/ovarian cancer predispositionmight be present in herkindred. The authors clearly and conciselypresent the risks of breast, ovarian,and other cancers associated withBRCA1 and BRCA2 mutation carrierstatus, as well as some of the issues thathave arisen in the estimation of thoserisks. They provide a review of factorsthat may modify gene penetrance(cancer risks), and devote the finalsegment of their article to a clear andrational discussion of the surveillanceand preventive options available forthe management of the associatedbreast and ovarian cancer risks.
Latest:
Judy Garber on PARP Inhibitors for Triple-Negative Breast CancerIn this Q&A we discuss the role of PARP inhibitors in cancer treatment, their role in triple-negative breast cancer patients and look forward to ongoing trials in this setting.
Latest:
Future Directions in the Adjuvant Treatment of Colon CancerAdjuvant chemotherapy has been shown to alter the natural history of patients with resected colon cancer. Two regimens (fluorouracil [5-FU] plus levamisole (Ergamisol) and 5-FU plus leucovorin) have been found most
Latest:
Gemcitabine, Paclitaxel, and Trastuzumab in Metastatic Breast CancerA phase II trial evaluated the effectiveness and toxicity of combination paclitaxel (Taxol), gemcitabine (Gemzar), and trastuzumab (Herceptin) as first-line therapy for patients with newly diagnosed HER2-overexpressing
Latest:
UFT Plus Calcium Folinate Plus Radiotherapy for Recurrent Rectal CancerUracil and tegafur (in a molar ratio of 4:1 [UFT]) plus calcium folinate comprise the components of the oral agent, Orzel, which appears to have activity comparable to intravenously administered 5-fluorouracil. This article
Latest:
Granulocytic Sarcoma in a Patient With Myelodysplastic SyndromeOur case illustrates the fact that MDS-associated GS can be treated palliatively with radiation and hypomethylating agents in an appropriate setting. With the growing geriatric patient population, effective treatment options are needed in this disease.
Latest:
Radiation Dermatitis42-year-old Caucasian female who was in her usual state of health when her first mammogram showed suspicious calcifications and a spiculated mass in the upper outer quadrant of the right breast. An ultrasound-guided biopsy showed an invasive ductal carcinoma. She underwent a lumpectomy, with the excised tumor measuring 1.2 cm. The tumor was estrogen and progesterone positive and HER2/neu negative.
Latest:
Neoadjuvant Therapy As a Platform for Drug Development: Current Controversies and Regulatory PerspectivesThis commentary addresses our perspectives from a regulatory standpoint, as well as some controversies related to the use of neoadjuvant therapy as a platform for drug development.
Latest:
Clinical Hereditary Cancer Syndromes and Gene Panel TestingFor some time, genetic testing has been predictive and prognostic. It is now assuming a therapeutic role as well. An example is the targeting of breast cancer patients with BRCA mutations for treatment with PARP inhibitors.
Latest:
Optimal Treatment in the Postorchiectomy Management of Clinical Stage I SeminomaDrs. Lawrentschuk and Fleshner have written an excellent review on therapeutic options following orchiectomy for stage I seminoma. Their practical review discusses the roles of active surveillance, radiation therapy, and chemotherapy with one cycle of carboplatin (area under the concentration-time curve [AUC] 7) in this setting and provides important perspectives on the management controversies for practicing oncologists.
Latest:
Improving Cancer Clinical Trial Participation and Eligibility CriteriaAhead of the 2017 ASCO Annual Meeting, we discuss eligibility criteria and participation in cancer clinical trials.
Latest:
Health-Related Quality of Life in Cancer Prevention Clinical TrialsClinical trials of agents to prevent cancer in populations at risk are relatively recent. To date, these consist of a few large population-based studies. Trials in this area focus on the prevention of cancer in individuals with specific predetermined risk
Latest:
Preventing Prostate Cancer Overdiagnosis From Becoming OvertreatmentThe controversy surrounding PSA screening is one of the most heated in oncology. The potential benefits include prevention of prostate cancer morbidity and mortality, but the men potentially harmed through overdiagnosis and overtreatment outnumber those who benefit.
Latest:
Cost of Cancer: There Is More to It Than Containing Chemotherapy CostsIncluding the entire course of care in the efforts to improve quality and contain costs will make the short-term implementation more complex and perhaps controversial. However it will reflect the way that contemporary oncology care is delivered, and will allow for holistic care management and an optimization of cost.
Latest:
Health-Related Quality of Life in Cancer Clinical TrialsThe Clinical Trials Referral Resource that appeared in the April issue of ONCOLOGY began a series on health-related quality of life (HRQOL). Part I of this series, which concludes this month, focuses on HRQOL questions in cancer treatment trials. Part II (on investigator-initiated HRQOL research) and part III (on HRQOL research as part of cancer prevention trials) will appear in upcoming issues. Information about these studies can be obtained from the contacts listed for each trial or from Edward L. Trimble, MD, MPH, at the Cancer Therapy Evaluation Program (CTEP), trimble@ctep.nci.nih.gov or (301) 496-1196
Latest:
Hypofractionated RT Improves Specific QOL in Breast Cancer With ReconstructionHypofractionated radiotherapy yields less financial toxicity than conventionally fractionated radiotherapy in patients with breast cancer who have undergone reconstruction following mastectomy.
Latest:
Novel Concepts in Radioimmunotherapy for Non-Hodgkin's LymphomaTositumomab/iodine-131 tositumomab (Bexxar) and ibritumomab tiuxetan (Zevalin) are radioimmunoconjugates targeting the CD20 antigen. Both agents are approved in the United States for use in relapsed or refractory, indolent or transformed, B-cell lymphoma. These agents are well tolerated and have the highest levels of single-agent activity observed in these histologies. This review will summarize the key trials that led to approval of both I-131 tositumomab and ibritumomab tiuxetan, and then focus on four novel therapeutic concepts in radioimmunotherapy: retreatment, therapy of de novo indolent lymphoma, therapy of aggressive histologies, and incorporation in high-dose therapy programs utilizing autologous stem cell support.
