Authors
Latest:
Cisplatin, Fluorouracil, Celecoxib, and RT in Resectable Esophageal Cancer: Preliminary ResultsEsophageal cancer frequently expresses cyclooxygenase-2 (COX-2)enzyme. In preclinical studies, COX-2 inhibition results in decreasedcell proliferation and potentiation of chemotherapy and radiation. Wereport preliminary results of a phase II study conducted by the HoosierOncology Group in patients with potentially resectable esophageal cancer.All patients received cisplatin at 75 mg/m2 given on days 1 and 29and fluorouracil (5-FU) at 1,000 mg/m2 on days 1 to 4 and 29 to 32with radiation (50.4 Gy beginning on day 1). Celecoxib (Celebrex) wasadministered at 200 mg orally twice daily beginning on day 1 untilsurgery and then at 400 mg orally twice daily until disease progressionor unexpected toxicities, or for a maximum of 5 years. Esophagectomywas performed 4 to 6 weeks after completion of chemoradiation. Theprimary study end point was pathologic complete response (pCR). Secondaryend points included response rate, toxicity, overall survival, andcorrelation between COX-2 expression and pCR. Thirty-one patientswere enrolled from March 2001 to July 2002. Respective grade 3/4 toxicitieswere experienced by 58%/19% of patients, and consisted of granulocytopenia(16%), nausea/vomiting (16%), esophagitis (10%), dehydration(10%), stomatitis (6%), and diarrhea (3%). Seven patients (24%)required initiation of enteral feedings. There have been seven deathsso far, resulting from postoperative complications (2), pulmonary embolism(1), pneumonia (1), and progressive disease (3). Of the 22 patients(71%) who underwent surgery, 5 had pCR (22%). We concludethat the addition of celecoxib to chemoradiation is well tolerated. ThepCR rate of 22% in this study is similar to that reported with the use ofpreoperative chemoradiation in other trials. Further follow-up is necessaryto assess the impact of maintenance therapy with celecoxib onoverall survival.
Latest:
Autologous Transplantation: Basic Concepts and ControversiesHigh-dose chemotherapy (HDCT) with autologous stem-cell is effective against a wide range of malignant diseases. This approach is increasingly used for treating hematologic malignancies and selected solid tumors. Since 1990, the number of autologous transplantations has exceeded the number of allogeneic transplantations.
Latest:
Naoto Ueno, MD, PhD, Discusses QOL With Trastuzumab Deruxtecan in HR+, HER2-Low Metastatic Breast CancerTreatment with fam-trastuzumab deruxtecan-nxki yielded promising patient-reported outcomes in patients with hormone receptor–positive, HER2-low metastatic breast cancer, according to Naoto Ueno, MD, PhD.
Latest:
Clinical Management of EGFRI Dermatologic Toxicities: The Japanese PerspectiveEpidermal growth factor receptor inhibitors (EGFRIs) have demonstrated clinical activity in patients with non–small-cell lung cancer, pancreatic cancer, and colorectal cancer. EGFRIs are generally well tolerated, but reversible dermatologic toxicities are commonly associated with their use. Limited clinical evidence has characterized these adverse reactions as a class effect. For panitumumab (Vectibix), mild-to-moderate dermatologic toxicities are the most common associated adverse reactions. This report details the Japanese experience in the management of dermatologic toxicities associated with panitumumab use. Treatment selection for skin toxicity in Japan is also detailed, with a flowchart depicting strategies to treat various stages of dermatologic toxicities. Panitumumab was well tolerated in Japanese patients with advanced solid tumors, with a safety profile similar to that seen in non-Japanese patients.
Latest:
Testicular CancerThis testicular cancer management guide covers the diagnosis, staging, and treatment of germ-cell tumors and seminoma.
Latest:
Clinical Issues in the Surgical Management of Screen-Identified Lung CancersThis review outlines the diagnostic and therapeutic challenges associated with the increased number of screen-identified indeterminate lung nodules, highlighting currently recommended follow-up and management algorithms, as well as the various methods of nodule localization, tissue diagnosis, and definitive local therapeutic modalities.
Latest:
Opioid Analgesia in Aged Cancer PatientsPain in older cancer patients is a common event, and many times it is undertreated. Barriers to cancer pain management in the elderly include concerns about the use of medications, the atypical manifestations of pain in the elderly, and side effects related to opioid and other analgesic drugs. The care of older cancer patients experiencing pain involves a comprehensive assessment, which includes evaluation for conditions that may exacerbate or be exacerbated by pain, affecting its expression, such as emotional and spiritual distress, disability, and comorbid conditions. It is important to use appropriate tools to evaluate pain and other symptoms that can be related to it. Pain in older cancer patients should be managed in an interdisciplinary environment using pharmacologic and nonpharmacologic interventions whose main goals are decreasing suffering and improving quality of life. In this two-part article, the authors present a review of the management of pain in older cancer patients, emphasizing the roles of adequate assessment and a multidisciplinary team approach.
Latest:
Building Efficiency and Scaling With a Remote Genetic Counseling ProgramSmita K. Rao, MBBS, MS, et al gave an overview of implementing genetic counseling into oncology practices through telemedicine.
Latest:
Sorafenib for HCC: A Pragmatic PerspectiveThe diagnosis and treatment of hepatocellular carcinoma (HCC) constitute a complex and challenging clinical paradigm.
Latest:
Treatment of HIV-Associated Lymphomas: The Latest Approaches for Optimizing OutcomesIn those with DLBCL, Burkitt lymphoma, and Hodgkin lymphoma, cure is often achieved. Furthermore, in the salvage setting, whether auto-HCT or allo-HCT is used, the same appears to be true. A great deal of progress has been made in the treatment of lymphoma in patients with HIV infection, but more remains to be done before outcomes are comparable to those of the general population.
Latest:
Unmet Needs and Future Perspectives on the Treatment of EGFR-Mutated NSCLCThe expert panel concludes with thoughts on unmet needs and future perspectives on the treatment of patients with EGFR-mutated non–small cell lung cancer.
Latest:
Interstitial Brachytherapy Should Be Standard of Care for Treatment of High-Risk Prostate CancerGiven the poor outcomes observed with radical prostatectomy (RP) and external-beam radiation therapy (EBRT), some in the urologic community contend that high-risk disease is not curable with currently available treatment strategies.[1,2] In fact, there is a growing contingent of clinicians who advocate the use of chemotherapy in conjunction with RP. With the established efficacy of brachytherapy, these efforts are likely excessive.
Latest:
Changing Treatment Landscape for Follicular LymphomaThis video examines the evolution in treatment and survival outcomes for patients with follicular lymphoma and highlights trials testing newer agents such as immunotherapies in this population.
Latest:
Controversies in Oncologist-Patient Communication: A Nuanced Approach to Autonomy, Culture, and PaternalismThis article addresses some of the most common major challenges in oncologist-patient communication with a nuanced approach to the concepts of autonomy, paternalism, and culture.
Latest:
Therapeutic Options Following Orchiectomy for Stage I SeminomaOver the past 3 decades, the incidence rate of testicular seminoma has continually risen, and the majority of cases have been clinical stage I.[1] Nevertheless, the overall survival for all testicular cancers has improved significantly (P < .05) over the same period, from 83% to 96%.[2]
Latest:
Molecular Determinants of the Inflammatory Breast Cancer PhenotypeSince its early descriptions by Lee and Tannenbaum in 1924, inflammatory breast cancer (IBC) has been recognized as the most aggressive and lethal form of primary breast cancer. With distinct clinical, pathologic, biologic, and molecular features, IBC presents unique challenges and opportunities to breast oncologists and breast cancer researchers.
Latest:
Commentary (Landry et al): Current Perspectives on Anal CancerThe article by Drs. Bendell andRyan reviews the associationbetween anal cancer and humanpapillomavirus (HPV) infectionand discusses current managementstrategies for patients with squamouscell carcinoma of the anal canal. Theauthors should be complimented ona thorough review of the literature,which supports that association andthe use of chemoradiation as the goldstandard for treatment of this groupof patients.
Latest:
Commentary (Starling/Cunningham)-Cetuximab-Associated Infusion Reactions: Pathology and ManagementCetuximab (Erbitux), a chimeric antiepidermal growth factor receptor monoclonal antibody currently used to treat metastatic colorectal cancer, is in clinical development for several other solid tumors. Although cutaneous manifestations are the most common toxicities associated with cetuximab, they are rarely life-threatening. Cetuximab-related infusion reactions are less common, but they may become severe and cause fatal outcomes if not managed appropriately. Little about the specific etiology of these events is known; however, an overview of infusion reactions observed with other compounds may shed some light and help characterize cetuximab-related reactions. For physicians administering cetuximab, familiarity with acute reaction treatment protocols and preparedness to identify and manage symptoms promptly and effectively are most important to minimize potential risks.
Latest:
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.
Latest:
Radiation Therapy in Resectable/Resected Pancreatic Adenocarcinomas: Clearing Up the FogSurgical resection remains the sole modality that has proven capable of "curing" pancreatic cancer.
Latest:
Neal D. Shore, MD, Reviews Data for LuPSMA 177 in mCRPC at 2021 ASCODuring a discussion at 2021 ASCO, Neal D. Shore, MD, said he was most excited to see data from the phase 3 VISION trial of lutetium-177-PSMA-617 in metastatic castration-resistant prostate cancer.
Latest:
Commentary (Denlinger/Meropol): The Horizon of Antiangiogenic Therapy for Colorectal CancerOlszewski and colleagues reviewpreclinical and clinicaldata regarding vascular endothelialgrowth factor (VEGF) inhibitors,with particular attention to thedevelopment of bevacizumab (Avastin)in patients with colorectal cancer.The translation from biologic conceptto clinical proof of concept has beenstriking in its rapidity. However, manyimportant questions remain, and thisstory is only beginning to unfold. Inthis commentary, we will highlightsome of those questions that bear onthe optimal use of VEGF inhibitors inpatients with colorectal cancer.
Latest:
ACR Appropriateness Criteria® Adjuvant Management of Early-Stage Endometrial CancerAfter a review of the published literature, the panel voted on three variants to establish best practices for the utilization of imaging, radiotherapy, and chemotherapy after primary surgery for early-stage endometrial cancer.
Latest:
Thymoma: Current ConceptsThis review considers the status of the different histological classifications thus far presented for thymomas and offers an analysis of the association between histology and clinical behavior.
Latest:
Solutions Are Necessary to Increase Real-World Prostate Cancer Drug UseFinancial constraints and a lack of education among some patients and providers must be addressed to improve the real-world use of certain prostate cancer therapies, says Neeraj Agarwal, MD.
Latest:
Integrated PET-CT: Evidence-Based Review of Oncology IndicationsPositron-emission tomography(PET)–computed tomography(CT) has added a new dimensionto the imaging of cancers andcombination PET-CT scanners are becomingincreasingly universal. Theuse of combination scanners has increasedrapidly over the past 2 years-industry estimates are that the majorityof PET units sold throughout the worldwill be combination PET-CT scanners-and the authors have providedtheir own clinical experience and areview of the literature. While there issubstantial literature on the clinicalutility of PET alone, the use of PETCTis relatively new. The authors suggestthere is incremental benefit tothe addition of structural information(ie, CT) obtained at the same time asthe functional PET imaging.
Latest:
A Pharmacoeconomic Comparison of UFT and 5-FU Chemotherapy for Colorectal Cancer in South AmericaThe escalating role played by managed care organizations in the health-care system is reflected in the increased demand for cost-effectiveness analyses (CEAs) to assess the balance between economic impact
Latest:
Is Hypofractionation the Solution? The Financial Implications of Breast Cancer TreatmentsHypofractionated external beam WBI seems like a great option until the APBI data mature from NSABP 39/RTOG 0413. In the meantime, we will have to see whether the ACA’s mission to bend the cost curve in the face of added demand for cancer care will succeed and how our treatment decisions will be affected by this new healthcare model.
Latest:
Future Perspectives: Treating Multiple Myeloma With Novel RegimensAn overview of what’s next, in terms of the use of various frontline treatment regimens, that include novel agents to manage patients with newly diagnosed multiple myeloma.
Latest:
Therapy for Peripheral T-Cell Lymphomas: Where We Are and Where We Hope to BeOur standard therapies for peripheral T-cell lymphoma may cure a subset of patients, and thus far novel agents have not changed the outcomes for the majority.
