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S. Knox
Latest Article

Iodine I 131 Tositumomab for Patients With Follicular Non-Hodgkin’s Lymphoma (NHL): Overall Clinical Trial Experience by Histology

Iodine-131 tositumomab (Bexxar) is a new radioimmunotherapy in development for the treatment of patients with low-grade or transformed low-grade non-Hodgkin’s lymphoma. The data from five phase I-III studies, which enrolled patients with low-

S. Kroll
Latest Article

Iodine-131 Tositumomab for Patients With Low-Grade or Transformed Low-Grade Non-Hodgkin’s Lymphoma: Complete Response Data

Tositumomab/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

S. Lawrence Librach, MD
Latest Article

Palliative Care and Oncology: Integration Leads to Better Care

Patients with advanced progressive cancer require care plans that address their physical, emotional, and psychosocial needs, as well as their goals of care.

S. Mundle
Latest Article

Encouraging Improvement in Cytopenias of Patients With Myelodysplastic Syndromes With Thalidomide

Myelodysplastic syndrome patients present with variable cytopenias even though their bone marrows are generally hypercellular. Excessive cytokine-induced apoptosis of hematopoietic cells in the marrows has been proposed as a possible

S. Percy Ivy, MD
Latest Article

Challenges and Opportunities for Immunotherapies in Gynecologic Cancers

The advent of immunotherapy presents us with new treatment approaches in gynecologic cancers, with preliminarily promising outcomes. Multiple clinical trials are currently being conducted to better define the role of immunotherapy. Further investigation is warranted to develop and identify predictive biomarkers.

S. Peter Kang, MD
Latest Article

Treatment of Metastatic Colorectal Cancer: From Cytotoxic Agents to Molecular Agents and Multitargeted Strategies

Colorectal cancer (CRC) is the third most common cancer and the second leading cause of cancer-related death in United States. For nearly 50 years, fluorouracil has been the only anticancer drug proven to benefit patients with metastatic CRC (mCRC), and it continues to be the backbone on which most treatment regimens are built. In the past 10 years, development of the topoisomerase I inhibitor irinotecan (Camptosar), the third-generation platinum analog oxaliplatin (Eloxatin), and the oral fluoropyrimidine capecitabine (Xeloda) advanced mCRC treatment and opened up an era of combination chemotherapy. More recently, monoclonal antibodies such as bevacizumab (Avastin), cetuximab (Erbitux), and panitumumab (Vectibix) have become available for use in mCRC treatment in combination with cytotoxic agents and as monotherapies. The addition of these targeted agents to the mCRC treatment armamentarium has resulted in more therapeutic options and improved treatment outcomes for the patients. The prospect of mCRC treatment is ever promising as more targeted agents such as vatalanib are being introduced and as intelligent combination regimens are being designed based upon a better understanding of pharmacokinetics. In this article we review various treatment options, including cytotoxic and targeted agents, currently available for patients with mCRC.

S. R. Patel, MD
Latest Article

Soft-Tissue and Bone Sarcomas

Sarcomas are a heterogenous group of tumors originating from mesenchymal tissues. According to American Cancer Society estimates, approxiately 8,070 new cases will be diagnosed in 1995, including 6,000 cases of soft-tissue sarcomas and 2,070 cases of bone tumors [1].

S. Song
Latest Article

Monoclonal Antibodies That Mimic the Action of Intravenous Immunoglobulin Can Inhibit Immune Thrombocytopenia

Intravenous immunoglobulin (IVIG) is prepared from large pools of plasma from healthy donors and is widely used to treat autoimmune diseases, especially immune thrombocytopenic purpura (ITP). Human polyclonal antierythrocyte antibodies, such as anti-D, can also be effective at treating ITP in individuals expressing the appropriate antigen. The demand for IVIG and anti-D exceeds the supply, and the development of a recombinant product to replace these human-derived blood products would be highly desirable. We have hypothesized that monoclonal antibodies directed against red cells may be effective in inhibiting immune forms of thrombocytopenia.

S. Spies
Latest Article

Ibritumomab Tiuxetan Radioimmunotherapy Is Safe and Well Tolerated in Patients With Relapsed or Refractory B-Cell Non-Hodgkin’s Lymphoma

Ibritumomab tiuxetan (Zevalin) consists of an anti-CD20 murine IgG1 kappa monoclonal antibody covalently bound to tiuxetan (MX-DTPA), which stably chelates yttrium-90 for therapy. Ibritumomab tiuxetan therapy involves pretreatment with

S. Tiong Ong, MBBCH, MRCP (UK)
Latest Article

Current Management of Acute Lymphoblastic Leukemia in Adults

Intensive remission chemotherapy followed by post-remission consolidation and maintenance therapies has achieved complete remission rates of 75% to 90% and 3-year survival rates of 25% to 50% in adults with acute lymphoblastic leukemia (ALL). These results, although promising, are still less favorable than those achieved in childhood ALL. However, various novel experimental and clinical approaches show promise for improving cure rates. Also, specific therapies directed at high-risk subgroups with ALL are beginning to emerge. Detection of specific chromosomal abnormalities at diagnosis identifies patients who are at risk of failing to achieve remission, as well as those who are likely to have short, intermediate, or prolonged disease-free intervals after successful remission induction. Such prognostic information may, ultimately, be used to assign risk categories and to individualize post-remission therapy. [ONCOLOGY 9(5):433-450, 1995]

S. Van Belle
Latest Article

A Phase II Randomized Study of Doxorubicin Alternated With Docetaxel vs Sequential Administration of Four Cycles of Docetaxel Followed by Four Cycles of Doxorubicin as First-Line Chemotherapy in Metastatic Breast Cancer Patients

From March 1996 to March 1998, 106 patients with untreated metastatic breast cancer (MBC) were treated with docetaxel (Taxotere) (100 mg/m²) and doxorubicin (75 mg/m²) on an alternating cycle-by-cycle (doxorubicin, docetaxel, doxorubicin, etc) or sequential (four cycles of docetaxel, then four cycles of doxorubicin) basis, every 3 weeks, for a maximum of eight cycles.

S. Vincent Rajkumar, MD
Latest Article

Management of Monoclonal Gammopathy of Undetermined Significance (MGUS) and Smoldering Multiple Myeloma (SMM)

Observation is the standard of care. However, clinical trials are ongoing to determine whether early therapy with newer agents can prolong the time to progression-and most importantly, prolong survival.

S. Yousuf Zafar, MD
Latest Article

Cancer Treatment Can Result in ‘Financial Toxicity’ for Patients and Families

As part of our coverage of the 2017 ASCO Annual Meeting, we discuss the impact of financial toxicity on cancer patients and their families.

S.R.D. Johnston
Latest Article

UFT/Leucovorin Plus Bolus Epirubicin and Cyclophosphamide in Advanced/Metastatic Breast Cancer

This article describes the design and early results of an open-label, nonrandomized phase I/II trial of oral UFT plus leucovorin therapy in combination with bolus injections of epirubicin and cyclophosphamide in patients with advanced or metastatic breast cancer. This study was designed as a cohort dose-escalation study with the principal aims being to determine dose-limiting toxicity, overall toxicity, maximum tolerated dose, tumor response, and time to disease progression.

Sabarinath Venniyil Radhakrishnan, MD
Latest Article

Current Strategies for the Immunotherapy of Multiple Myeloma

Here we outline the most promising novel cellular immune strategies for patients with multiple myeloma. In addition, we highlight combinatorial approaches that, it is hoped, will further optimize cellular immunotherapies for myeloma and lead to deep and durable responses and, possibly, even cures.

Sabha Ganai, MD, PhD
Latest Article

Understanding the Kinetics of Cancer: Implications from Prevention to Prognostication

The choices that patients and clinicians make when dealing with cancer are dictated by time, whether they are arranging for screening mammography and colonoscopy, compiling treatment plans, or determining follow-up intervals and the age of freedom from follow-up.

Sabino Zani, MD
Latest Article

A Role for Hepatic Metastasectomy in Stage IV Melanoma and Breast Cancer: Reestablishing the Surgical Modality

This review summarizes the existing literature that addresses the topic of metastasectomy in patients with melanoma and breast cancer.

Sabrina M. Witherby, MD
Latest Article

Managing Early-Stage Breast Cancer in Your Older Patients

As the aging population in the United States continues to grow, the incidence of diseases of the elderly, such as breast cancer, are increasing. Many more elderly women are expected to be diagnosed with new breast cancers, most of them in an early stage. Appropriate treatment of these women is important, as they have poorer outcomes when undertreated. In this review, we will discuss the biology and treatment of early breast cancer in elderly women. We will focus on the role of comorbidity and its effect on life expectancy, treatment decisions, current recommendations for primary treatment with surgery, radiation and neoadjuvant strategies, and adjuvant treatment including local radiation therapy and systemic treatment with endocrine therapy, chemotherapy, and newer agents. Finally we will discuss the importance of clinical trials in the elderly.

Sadhana Jackson, MD
Latest Article

Optimizing the Delivery of Antineoplastic Therapies to the Central Nervous System

This review describes the anatomy of the blood-brain barrier and currently available methods to quantify the entry of therapeutic compounds into the brain. It also summarizes data from a variety of approaches designed to improve drug delivery to the central nervous system.

Said M. Baidas, MD
Latest Article

Mantle Cell Lymphoma: Clinicopathologic Features and Treatments

Mantle cell lymphoma (MCL) accounts for approximately 6% of non-Hodgkin’s lymphomas. Patients usually present with advanced disease, with a tendency for extranodal involvement. MCL is an aggressive lymphoma with moderate chemosensitivity, but it remains one of the most difficult therapeutic challenges. Complete response rates to chemotherapy range from 20% to 40%, with median survivals of 2½ to 3 years. Anthracycline-containing regimens do not prolong survival compared with nonanthracycline regimens. Single-agent rituximab (Rituxan) has produced response rates of about 30%, and when combined with an anthracycline-containing regimen, response rates increase to above 90%; however, an impact on survival has not yet been demonstrated. More intensive regimens such as hyperCVAD (hyperfractionated cyclophosphamide [Cytoxan, Neosar], vincristine, doxorubicin [Adriamycin], dexamethasone, methotrexate, cytarabine) with either stem cell transplant or rituximab have been associated with promising results.

Saijun Fan, MD, PhD
Latest Article

Biological Basis of Radiation Sensitivity

Recent studies have elucidated some of the molecular and cellular mechanisms that determine the sensitivity or resistance to ionizing radiation. These findings ultimately may be useful in devising new strategies to improve the

Saima N. Waqar, MD
Latest Article

Influenza Vaccination in Patients With Cancer: an Overview

Influenza infection is a potential cause of additional morbidity and mortality in patients who are immunocompromised because of cancer or its treatment. Of particular note, influenza infection may delay or interrupt chemotherapy and necessitate hospitalization. Successful immunization depends on an intact immune system that can produce antibodies in response to antigen exposure. Patients with cancer often have a suppressed immune system, resulting from their disease and/or immunosuppressive therapies, and as a consequence they may have a suboptimal serologic response to influenza vaccination. Since vaccination is the only proven method for preventing influenza infection, the Advisory Committee on Immunization Practices recommends seasonal influenza vaccination for adults without contraindications who have disease- or medication-related immunosuppression. Patients with cancer should be given the trivalent inactivated vaccine. Preliminary data suggest that administering the vaccine between cycles of chemotherapy may yield the best results.

Saira Nasim, MBBS, MRCPI
Latest Article

Adjuvant Hormonal Therapy for Premenopausal Breast Cancer: Incorporating Clinical Experience

The article “Adjuvant Hormonal Therapy in Premenopausal Women With Operable Breast Cancer: Not-So-Peripheral Perspectives” by Richard Love, published in this issue of ONCOLOGY,

Sajid Ansari, MD
Latest Article

Commentary (Brand et al): Pancreatic Cancer in the Older Patient

Pancreatic cancer is a disease seen predominantly in elderly patients. Compared to younger patients, older patients are more likely to present with early-stage disease and, therefore, may be candidates for aggressive local

Sakkaraiappan Ramalingam, MD
Latest Article

Carboplatin/Gemcitabine Combination in Advanced NSCLC

The treatment of advanced non–small-cell lung cancer (NSCLC)has evolved rapidly over the past few years. Systemic chemotherapy isassociated with both quality of life and modest survival benefit for patientswith advanced NSCLC. Platinum-based doublet combinationsare the “standard of care.” The US Food and Drug Administration(FDA) has approved gemcitabine (Gemzar), a pyrimidine analog, to beused in combination with cisplatin for the treatment of advanced NSCLCin the first-line setting. Randomized clinical trials have established comparableefficacy with improved therapeutic index for the carboplatin/gemcitabine regimen when compared with cisplatin/gemcitabine andother platinum doublets. Nonhematologic toxicities occur at a lowerfrequency with carboplatin/gemcitabine combinations compared withother “standard” platinum-based doublets, whereas dose-limitingthrombocytopenia, the most common toxicity, rarely requires therapeuticintervention. Both the 3- and 4-week schedules of carboplatin/gemcitabine result in similar efficacy and toxicity profiles, but the3-week regimen is preferred. The combination of carboplatin andgemcitabine is an effective regimen with an acceptable toxicity profilefor the treatment of advanced NSCLC. This regimen can also be usedas a foundation for the development of innovative combinations withmolecularly targeted agents.

Salahadin Abdi, MD, PhD
Latest Article

Chemotherapy-Induced Peripheral Neuropathy: A Challenge for Clinicians

Chemotherapy-induced peripheral neuropathy is a serious yet common side effect of cancer treatment. This devastating complication, which typically manifests as tingling and numbness in the hands and feet, has an enormous influence on patients’ quality of life.

Sally D. Brown, RN
Latest Article

GM-CSF and IL-2 Combination as Adjuvant Therapy in Cutaneous Melanoma

Cytokines have been used in the treatment of patients with cutaneousmelanoma. Granulocyte-macrophage colony-stimulating factor(GM-CSF, sargramostim [Leukine]) leads to dendritic cell/macrophagepriming and activation, and also increases interleukin-2 (IL-2)receptor expression on T lymphocytes. IL-2 creates lymphokineactivatedkiller cells and tumor-infiltrating lymphocyte cells. In thisopen-label, single-arm study of 16 high-risk patients, we combined thesetwo agents to take advantage of their different but complementary functions.All patients underwent potentially curative surgery. Postoperatively,each patient received GM-CSF at 125 μg/m2/d subcutaneously(SC) for 14 days; this was followed by IL-2 at 9 million IU/m2/d SC for4 days, and then 10 to 12 days of no treatment. In addition, patientswho had large tumors that could yield over 100 million live tumor cellsreceived autologous melanoma vaccines. The duration of follow-upranged from 21 to 42 months (median: 27 months). During follow-up,five patients developed metastases. This program was carried out on anoutpatient basis, and no hospitalization was required. It was well toleratedwith minimal side effects. The combination treatment regimen ofGM-CSF and IL-2 with or without autologous vaccine used adjuvantlyappears to benefit high-risk melanoma patients; further clinical testingof this regimen is warranted.

Sally E. Carty, MD, FACS
Latest Article

Radioiodine-Resistant Differentiated Thyroid Cancer: Hope for the Future

In this helpful review, the authors catalog a number of the novel molecular agents now being examined for treatment of radioiodine-resistant, metastatic differentiated thyroid cancer. They also call for increased systematic study of outcomes through recruitment of patients into large-scale trials.

Sally J. Denardo, MD
Latest Article

Radioimmunotherapy: A New Treatment Modality for B-Cell Non-Hodgkin’s Lymphoma

We applaud Ghobrial andWitzig for their comprehensiveand balanced article on"Radioimmunotherapy: A New TreatmentModality for B-cell Non-Hodgkin's Lymphoma." Theseauthors have provided a review thatwill serve the oncologist and oncologypatient well. They have not engagedin arcane and tedious discussionof which anti-CD20 monoclonal antibody(ibritumomab tiuxetan [Zevalin]or tositumomab/iodine-131[I-131] tositumomab [Bexxar]), or radionuclide(yttrium-90 [Y-90] orI-131), or dosing method is better.Wisely, Ghobrial and Witzig have providedaccurate distillates of the manypublications on these exciting drugs.Because no rigorous body of dataclearly indicates that one drug is betterthan the other, these debates onlyconfuse the oncologist and are betterleft to the "technocrat."

Sally Yowell Barbour, PharmD
Latest Article

Hematopoietic Growth Factors

For years, chemotherapy-associated myelosuppression has represented a major limitation to a patient's tolerance of anticancer therapy. In addition, the clinical consequences of chemotherapy-induced myelosuppression (such as febrile neutropenia, dose reductions, or lengthy dose delays) may have had significant negative effects on quality of life or even response to treatment.