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How Can We Optimize Treatment of HER2-Positive Metastatic Breast Cancer?Third, how much do we really know about de novo and acquired resistance to trastuzumab and lapatinib? There are several possible clinical relevant mechanisms of trastuzumab resistance, including crosstalk with other receptors, amplification of the PI3K/AKT pathway, alteration of the trastuzumab binding domain, and loss of HER2 expression.
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Circulating Tumor DNA as a Liquid Biopsy: Current Clinical Applications and Future DirectionsHere we review the clinical data supporting these different plasma genotyping methodologies, and present a practical approach to the interpretation of the results of these tests.
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Tailoring Treatment for Multiple Myeloma Patients With Relapsed and Refractory DiseaseResponses to treatment of relapsed and refractory multiple myeloma are characteristically short, and median survival is as brief as 6 months. Although prognostic factors in the context of relapsed and refractory disease require further characterization, high-risk patients include those with certain cytogenetic abnormalities, high β2-microglobulin, and low serum albumin.
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Quality of Life in Low-Grade Non-Hodgkin’s LymphomaLow-grade non-Hodgkin’s lymphoma (NHL) is an indolent form of the disease with a generally slow course of progression. Although still usually incurable, low-grade disease has shown responsiveness to some of the newer
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A Rare Case of Metastatic Renal Epithelioid AngiomyolipomaThe patient is a 43-year-old man who was initially evaluated at an outside institution for unexplained anemia and who was found to have a large right kidney mass. He underwent a radical nephrectomy for a 19-cm large-cell, poorly differentiated neoplasm, consistent with pleomorphic, epithelioid angiomyolipoma (EAML) with extensive necrosis and cytologic atypia.
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SUNSHINE: High-Dose Vitamin D Improved PFS in Colorectal CancerThis video highlights results of the SUNSHINE study, which found that high-dose vitamin D added to standard treatment slowed disease progression in newly diagnosed metastatic colorectal cancer.
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Implementing Survivorship Care Plans Within an Electronic Health RecordSurvivorship care is “a distinct phase of care for cancer survivors that includes four components: (1) prevention and detection of new cancer or recurrent cancer; (2) surveillance for cancer spread, recurrence, or second cancers; (3) intervention for consequences of cancer and its treatment; and (4) coordination between specialists and primary care providers to ensure that all of the survivor’s health needs are met.”
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The Breast: Comprehensive Management of Benign and Malignant Diseases, Second EditionThis second edition of the text edited by Bland and Copeland represents a comprehensive reference that reviews the history, pathobiology, and current clinical management of diseases of the breast. Much more than a book about breast
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Breast Cancer Stem Cells: A New Target for TherapyThe cancer stem cell (CSC) theory was first proposed to explain the fact that only a small proportion of leukemia or solid tumor cells have the capacity to induce growing tumors in immunodeficient mice.[1,2]
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Chemotherapy for Resectable and Advanced Pancreatic CancerThis article will review the pertinent data on the use of chemotherapy for all stages of pancreatic cancer. For patients with metastatic disease, fluorouracil (5-FU) was the standard of care for several decades until a single
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Are Cancer Patients Subject to Employment Discrimination?We sought to determine whether patients undergoing treatment for cancer had experienced discrimination in employment and, if so, how that discrimination was manifested. We also sought to determine what variables affected the rate of discrimination, including age, gender, occupation, and employer size.
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Infusional 5-FU, Folinic Acid, Paclitaxel, and Cisplatin for MetastaticOur phase II study results demonstrating high efficacy and low toxicity for a weekly schedule of high-dose, 24-hour infusional 5-fluorouracil(5-FU)/folinic acid (HD5-FU/FA) in intensively pretreated patients with metastatic
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Eovist Injection and Resovist Injection: Two New Liver-Specific Contrast Agents for MRIIn this short review, we describe two new liver-specific contrast agents for MRI that are in clinical development. The main differences among the liver-specific contrast agents available at present are also discussed briefly.
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UFT and Mitomycin Plus Tamoxifen for Stage II, ER-Positive Breast CancerA trial was designed to examine the combination of UFT and mitomycin (Mutamycin) plus tamoxifen (Nolvadex) as postoperative adjuvant therapy in the treatment of patients with stage II, estrogen receptor (ER)-positive
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UFT and Its Metabolites Inhibit Cancer-Induced Angiogenesis via a VEGF - Related PathwayTreatment with UFT for spontaneous lung metastasis of murine renal carcinoma (RENCA) after resection of the primary tumor has resulted in significant prolongation of the life span of tumor-bearing animals. UFT inhibited the growth of metastatic nodules in the lung, apparently via decreased density of microvessels in the metastatic foci. Subsequent experiments used dorsal air sac assay to directly trace newly forming microvessels.
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Tumor Heterogeneity: The Lernaean Hydra of Oncology?Intratumor heterogeneity is one of the biggest challenges in cancer diagnosis and treatment. Despite morphologic and clinical recognition of tumor heterogeneity, an understanding of it at a molecular level has only begun to emerge in recent years.
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UFT Plus Cisplatin in Advanced Non-Small-Cell Lung Cancer: Interim Analysis of 67 PatientsA single-institution phase II study indicated that combination chemotherapy using UFT (tegafur and uracil) plus cisplatin (Platinol) in patients with non-small-cell lung cancer was active with less host toxicity than other cisplatin-
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The Different Faces of Disseminated Intravascular Coagulation in Solid Tumors: How to Identify and Manage“Treat the underlying cause” has been the classic mantra for the treatment of disseminated intravascular coagulation. Whenever feasible in disseminated intravascular coagulation associated with solid tumors, this principle appears to hold good.
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Neoadjuvant Treatment for Surgically Resectable Metastatic Colorectal Cancer: Is There an Optimal Succession?It remains difficult to decipher which patients are appropriate candidates for conversion therapy vs upfront surgery. Therefore, in predicting potential outcomes, several factors should be considered. Here, we will attempt to address such factors and provide insights.
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A Multidisciplinary Approach to Treating Resectable NSCLCSurgeons, radiation oncologists, and medical oncologists gathered to discuss treatment options and approaches for NSCLC.
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Anti-Angiogenesis Therapy in Gynecologic MalignanciesThe purpose of this paper is to provide a review of site-specific treatment options that involve the targeting of angiogenesis in gynecologic malignancies.
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Nurses Play Important Part in Recognizing Skin Toxicities, AbnormalitiesAs part of our coverage of ONS, we discuss dermatologic issues in oncology patients, including skin-related toxicities and assessment techniques used to identify skin-related issues.
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The Absent-Minded Professor: An Unusual Complication of MelanomaThe University of Colorado Health Sciences Center holds weekly second opinion conferences focusing on cancer cases that represent most major cancer sites. Patients seen for second opinions are evaluated by an oncologist.
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Circulating Tumor DNA as a Predictive Biomarker for Clinical Outcomes With Margetuximab and Pembrolizumab in Pretreated HER2-Positive Gastric/ Gastroesophageal AdenocarcinomaDaniel V. T. Catenacci, MD, and colleagues present findings from a study of circulating tumor DNA as a predictive biomarker for gastric and gastroesophageal cancer.
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Targeting Angiogenesis in Solid TumorsA growing number of novel antiangiogenic agents are entering clinical trials to study their clinical safety and efficacy. A few, such as bevacizumab (Avastin), sorafenib (Nexavar), and sunitinib (Sutent), have received US Food and Drug Administration approval and are already in widespread clinical use. As knowledge about the intricacies of intracellular signaling within multiple tumor types expands, agents with the capacity to impact these pathways are being incorporated into additional clinical trials alone and in combination with other targeted and/or traditional antineoplastic agents. Early clinical trials have focused on highly vascular tumor types, as well as those known to significantly overexpress the VEGF (vascular endothelial growth factor) receptor family. This article aims to review the status of antiangiogenic therapy in selected tumor types and discuss areas for further research.
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Breast Cancer: Never Too Young for a Functional Assessment?Geriatricians would argue that biological age alone should not be used to estimate a patient's anticipated tolerance for cancer therapy.
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A Man With Changes in the Urinary Bladder: Benign Metaplasia or Adenocarcinoma?The patient is a 39-year-old man who presents with pelvic lymphadenopathy. He has a history of ureteral reflux disease, recurrent nephrolithiasis, right nephrectomy, ileal loop diversion of the left ureter, and radical cystectomy for “bladder cancer,” which he underwent 3 years ago. The lymphadenopathy was discovered incidentally during recent imaging.
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Current Controversies in the Management of Hodgkin's LymphomaDespite significant improvements in the treatment of Hodgkin's lymphoma over the past 2 decades, physicians continue to face dilemmas in therapy for the disease, and many cured patients live with complications of treatment. Newer therapeutic options are still needed for the disease, to minimize complications and to improve the treatment of patients in relapse. This review considers the treatment of Hodgkin's lymphoma in younger patients, addressing such issues as which patients with early-stage disease may require radiotherapy, what prognostic factors provide information that can affect treatment choices in patients with advanced disease, and what we have learned about treatment complications in this setting.
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PARP Inhibition in Epithelial Ovarian Cancer: High Hopes Undergo a Reality CheckThis article reviews the trials that have been conducted with PARP inhibitors in epithelial ovarian cancer, fallopian tube cancer, and primary peritoneal cancer, and places the impact of those results in the larger context of PARP inhibitor development.
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Hearing Loss in Pediatric Cancer Survivors Treated With CisplatinCisplatin is effective in treating several types of childhood cancers (eg, CNS tumors, osteosarcoma, hepatoblastoma, neuroblastoma, germ cell tumors). It is the most ototoxic drug used clinically, and hearing loss is a well-recognized toxicity of cisplatin therapy.
