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Iodine-131 Tositumomab for Patients With Low-Grade or Transformed Low-Grade Non-Hodgkin’s Lymphoma: Complete Response DataTositumomab/iodine-131 tositumomab (Bexxar) is a radioimmunotherapeutic agent in development for patients with low-grade or transformed non-Hodgkin’s lymphoma (NHL). This analysis focuses
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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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21st Century Challenge of Ovarian Cancer in the ElderlyGiven that in the 21st century many believe 70 years of age is the new 60 and 80 years of age is the new 70, any article on ovarian cancer in the elderly depends on one’s definition of elderly. To put this in a 21st century perspective, in a thoughtful article on aging in The New Yorker (“The Way We Age Now,” April 30, 2007), Atul Gawande points out, “for most of our hundred-thousand-year existence-all but the past couple of hundred years-the average life span of human beings has been 30 years or less (research suggests that subjects of the Roman Empire had an average life expectancy of 28 years).
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Current Application of Selective COX-2 Inhibitors in Cancer Prevention and TreatmentThe multistep process of carcinogenesis, which can take many years, provides many opportunities for intervention to inhibit disease progression. Effective chemoprevention agents may reduce the risk of cancer by inhibiting the initiation stage of carcinoma through induction of apoptosis or DNA repair in cells harboring mutations, or they may act to prevent promotion of tumor growth. Similarly, chemoprevention may entail blocking cancer progression to an invasive phenotype.
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Quality-of-Life Improvement in Patients Receiving Paclitaxel/Platinum RegimensThe combination regimen of paclitaxel (Taxol) and cisplatin (Platinol) for non–small-cell lung cancer has shown improved response rates in some phase II trials, and because of its safety profile, it could offer patients with this
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PET Scanning: Worth the Cost in Cancer? Not for All Cancers-It’s Not Reliable Enough YetIn order for a test to be reliable, it must be reproducible and minimize test-retest variability. Yet, as with many imaging tests, FDG-PET has variance in standard uptake value (SUV) calculations, and even if standardization could be achieved, there is the issue of treatment effects, which introduce additional complexities.
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Epidemic Kaposi’s SarcomaKaposi’s sarcoma (KS) is the most common malignancy associated with human immunodeficiency virus-1 (HIV-1) infection and can result in significant morbidity. The clinical course of KS is quite variable, although for the
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Thalidomide-Induced Cessation of Weight Loss and Improved Sleep in Advanced Cancer Patients With CachexiaThe cachexia of malignancy is considered mediated through excess production of tumor necrosis factor–alpha and other cytokines. Thalidomide (Thalomid), a sedative/hypnotic, has been shown to inhibit tumor necrosis factor–alpha production.
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Commentary (Crispens/Rothenberg): Epidermal Growth Factor Receptor Inhibitors for the Treatment of Epithelial Ovarian CancerOvarian cancer is the deadliestof the gynecologic malignancies.Approximately threequartersof patients present with advanced-stage disease. With aggressivecytoreductive surgery followed byplatinum-based chemotherapy, mostpatients will achieve remission. Despitethis initially good response totreatment, most patients experiencerecurrence and ultimately die of theirdisease. Novel treatment strategies areneeded. Molecularly targeted therapiesoffer the promise of improvedefficacy with decreased toxicity. Inthis article, Drs. Stephanie Blank, RichardChang, and Franco Muggiapresent an excellent summary of thecurrent status of epidermal growth factorreceptor (EGFR) inhibitors in thetreatment of ovarian cancer. They describethe promise of these drugs aswell as some of the questions regardingthe best way to integrate theminto therapy for ovarian cancer.
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Management of Leptomeningeal Disease From Solid TumorsMetastasis of solid tumors to the cerebrospinal fluid is a serious complication of cancer. Although it can occur with any type of cancer, tumors with a high propensity for CNS involvement (brain metastases) are the most likely to spread to the cerebrospinal fluid.
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ASCO GU: Early Treatment and Active Surveillance of Prostate Cancer PatientsAhead of the ASCO GU meeting, we spoke with two symposium committee members, Dr. Mack Roach, of the University of California, San Francisco, and Dr. Hans T. Chung, of the University of Toronto, about early treatment and surveillance of prostate cancer patients.
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Radium-223 vs EBRT for Multiple Painful Bone Metastases: Is Less More?There is no question that radiopharmaceuticals have a role in the management of patients with metastatic bone disease. There is also no question that fractionated external beam radiotherapy (EBRT) is highly effective and generally well tolerated when delivered with large open or focal fields.
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Weekly Irinotecan and Concurrent Radiation Therapy for Stage III Unresectable NSCLCIn preclinical studies, the topoisomerase I inhibitor irinotecan (Camptosar, CPT-11) has demonstrated activity as a radiosensitizer, probably due to its ability to inhibit potentially lethal radiation damage repair. We conducted a
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Cutaneous T-Cell Lymphoma: Current and Emerging TherapiesJulia Dai, MD, and Madeleine Duvic, MD, present a comprehensive review of the current state of research and treatment in cutaneous T-cell lymphoma.
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AIDS-Related Cancers in the Era of Highly Active Antiretroviral TherapyThe National Cancer Institute’s Dr. Robert Biggar has probably studied the impact of the acquired immunodeficiency syndrome (AIDS) epidemic on cancer trends at least as thoroughly as anyone in the field. His long-term experience is reflected in this comprehensive and well-written overview, which summarizes the evidence concerning highly active antiretroviral therapy (HAART). Indeed, patients are developing fewer opportunistic infections and living significantly longer than they did before the advent of these potent anti-human immunodeficiency virus (HIV) drugs. However, the question remains as to what extent this treatment might also change the incidence of cancers?
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Treatment of Metastatic Pancreatic Adenocarcinoma: New Options and Promising StrategiesAll improvements in outcomes for patients with metastatic pancreatic adenocarcinoma have occurred with the use of cytotoxic agents, which will probably remain the mainstay of treatment for advanced pancreatic adenocarcinoma.
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Managing Acute Myeloid Leukemia in the ElderlyAcute myeloid leukemia (AML) is a disease of the elderly, with the majority of patients diagnosed in their 6th and 7th decade of life. Older patients with AML are less likely to achieve complete remission after induction chemotherapy, and they suffer from higher rates of leukemia relapse compared to younger cohorts. Suboptimal outcomes are the result of adverse biologic characteristics of leukemia in the elderly, as well as the presence of medical comorbidities and patient or physician preferences as to initiating treatment. In addition, there is a distinct lack of randomized, prospective data to guide management decisions for the treatment of AML in the elderly. Patients who are over age 75, with poor performance status, multiple comorbidities, or poor prognostic features, should be considered for a clinical trial or palliative therapy. Elderly patients who are candidates for standard induction chemotherapy and achieve complete remission are unlikely to benefit from intensive postremission therapy and should be referred to a clinical trial when possible. Further prospective trials are needed to identify a tolerable, effective treatment regimen for older patients with AML.
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Finding Ways to Break the Mold in GU OncologyLeaders in genitourinary oncology spoke about key research advances as well as personal experiences in navigating the field.
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The Evolving Landscape of Prostate Cancer ManagementMaha Hussain, MD, FACP, FASCO, spoke about BRCA testing and ctDNA as diagnostic tools and PSMA-imaging and -targeted approaches in prostate cancer.
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ACR Appropriateness Criteria® Management of Vaginal CancerThis article represents the consensus opinion of an expert panel and may be used to inform clinical recommendations in vaginal cancer management.
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A Phase II Study of Doxorubicin/Paclitaxel Plus G-CSF for Metastatic Breast CancerThis phase II trial was conducted to evaluate the percentage of objective responses and the toxicity profile of combination doxorubicin (Adriamycin) and paclitaxel (Taxol) with granulocyte colony-stimulating factor as first-line
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Cancer Metabolism as a Therapeutic TargetOngoing studies are attempting to understand the reasons that tumor cells engage in aerobic glycolysis in lieu of oxidative phosphorylation. In this review, we discuss known benefits to tumor cells from this metabolic switch, and we highlight key enzymes that play a role in aerobic glycolysis. We also describe novel therapeutic options targeting glucose metabolism.
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Tumor Heterogeneity Is Fundamental to the Tumor EcosystemIt may be necessary to broaden our concept of the malignant process beyond that of a disease to be attacked-to one that reflects a deeper understanding of the fundamentals of living systems.
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Current Clinical Trials of Molecularly Targeted Agents in Children With Cancer, Part 2A number of molecularly targeted agents directed at critical cell survival and cell proliferation pathways have recently entered clinical evaluation in children with cancer. These agents offer the potential for more effective anticancer therapy while simultaneously diminishing acute and long-term toxic effects. Systematic evaluations of targeted agents are essential to achieving continued improvements in outcome for children with cancer. Brief summaries of the rationale for conducting studies of several agents in children are provided below. Following these summaries is a listing of phase I, phase I/II, phase II, and pilot studies of these and other agents in pediatric populations.
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Targeting Metastatic Prostate Cancer: The Search for Innovative Systemic TherapiesMetastatic hormone-resistant prostate cancer has proven largely resistant to cytotoxic therapy. Since 2004, docetaxel (Taxotere)/prednisone has become the standard chemotherapy used to treat advanced hormone-resistant prostate cancer. However, the survival advantage is modest and a significant number of patients do not respond to chemotherapy. It is hoped that an increased understanding of the mechanisms underlying the progression of prostate cancer will lead to new treatment modalities. With the growing number of biologic and targeted agents under development, the potential armamentarium of prostate cancer treatments is steadily growing. However, none of the new treatment modalities has yet been shown to be more effective than standard treatments. This article will provide an overview of targeted or innovative therapies in the treatment of prostate cancer.
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Pleomorphic Lobular Carcinoma in Situ: A Divergent Entity With Emerging SignificanceMany historical evolutions of concepts have emerged regarding lobular neoplasia (LN) since 1865, when Cornil first described this entity as “intraepithelial breast carcinoma in lobules.
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Combination Therapy for Advanced Breast Cancer: Cyclophosphamide, Doxorubicin, UFT, and TamoxifenWe evaluated combination therapy for advanced and recurrent breast cancer with cyclophosphamide (Cytoxan), doxorubicin (Adriamycin), uracil and tegafur (UFT), and tamoxifen (Nolvadex) (CAUT), designed as
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Maintenance Chemotherapy With UFT for Head and Neck CarcinomaA prospective randomized trial to evaluate the efficacy of maintenance chemotherapy after surgical treatment of head and neck carcinoma was performed at 67 institutions. A comparison was made between the following two groups: the treatment group, which received 1-year oral administration of UFT at 300 mg/d following curative surgical treatment (UFT arm), and the nontreatment group, which received curative surgery alone (control arm).
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Endocrine Plus Uracil/Tegafur Therapy for Prostate CancerA prospective, randomized clinical trial was conducted to evaluate the efficacy of endocrine chemotherapy with uracil and tegafur (in a molar ratio of 4:1 [UFT]) in patients with prostate cancer. The study included two
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Cardiovascular Toxicity of Biologic Agents for Cancer TherapyThis review will focus on newer FDA-approved targeted therapies associated with type II chemotherapy-related cardiac dysfunction, or generally reversible cardiotoxicity, and will provide the latest information on the incidence and clinical spectrum of cardiotoxicity associated with each therapy, modifiable risk factors where known, and the mechanisms of cardiotoxicity.
