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Commentary (Remick): Management of Anal Cancer in the HIV-Positive PopulationThe article by Kauh and colleaguesprovides a timely reviewof the therapeutic approachto invasive carcinoma of theanus in human immunodeficiency virus(HIV)-infected patients, which isan emerging clinical problem. Importantlimitations of the published experience,however, need to be pointedout; given the present pursuit of moretargeted anticancer therapy, new avenuesare being explored, even in themanagement of HIV-associated analcancer.
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Unexpected N2 Lymph Node Involvement Found During Surgery for Early-Stage NSCLCDuring investigation of an episode of self-limiting abdominal pain, a 63-year-old Caucasian female never-smoker was found to have an asymptomatic right lower lobe pulmonary mass. A positron-emission tomography/computed tomography (PET/CT) scan revealed the right lower lobe mass to be 25 × 32 mm with a standardized uptake value (SUV) of 10.2, without evidence of hilar or mediastinal lymphadenopathy or of distant metastases.
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An Overview Cost-Utility Analysis of Prostate Cancer ScreeningThe value of prostate cancer screening remains controversial because of the high prevalence of the disease and the fact that many tumors detected through screening are not destined to lead to morbidity or mortality, rendering
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'Economies of Scale' Yield Multiple Benefits for a Private, Physician-Run Oncology PracticeThe community oncology practice is the nation’s headquarters in the war on cancer. Eighty-five percent of all cancer patients receive their treatment in local community oncology practices.
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Current Clinical Trials in Small-Cell Lung CancerLung cancer is the number one cause of cancer death for both men and women in the United States. In the year 2001, it is
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Palliative RT Research in Prostate Cancer: Understanding the Past, Anticipating the FutureMoving forward, perhaps no recent development in the use of RT in metastatic prostate cancer has captured greater attention than the use of radium-223 in metastatic castration-resistant prostate cancer (mCRPC).
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Vaccinations Against Infectious Diseases in Hematopoietic Stem Cell Transplant RecipientsBlood and marrow transplantation, a curative treatment for avariety of serious diseases, induces a period of sustained immunosuppressionpredisposing recipients to opportunistic infections. Both forthe protection of the individual transplant recipient and as a matter ofpublic health policy, the US Centers for Disease Control and Prevention(CDC) has developed guidelines for the use of vaccination in theprevention of infectious disease following transplantation. This reviewexamines the primary clinical research supporting vaccinationpolicies in this target population. Widely accepted recommendationsfor transplant recipients based on scientific data are sparse, as fewlarge studies have been conducted in this population. Anecdotalreports, expert advice, summaries, and limited series involving lessthan 50 patients using surrogate end points form the basis of thescientific literature, with the result being a wide variation in practice.Although based largely on inadequate scientific data, the CDC recommendationsoffer a pragmatic approach to the prevention of opportunisticdisease in hematopoietic transplant recipients and serve as auseful starting point for standardization of practice while defining thedirection of future studies in transplant recipients and other immunocompromisedhosts.
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Evaluating the Role of Serine Protease Inhibition in the Management of Tumor MicrometastasesConservation of blood is apriority during surgery, owingto shortages of donor bloodand risks associated with transfusionof blood products.[9,10] However,blood transfusions have been linkedto a number of negative postoperativesequelae, including poorer prognosisafter cardiac and cancer surgery.[11-21] In this context, recognition thatallogeneic transfusion-associatedimmunomodulation can increasemorbidity in allogeneically transfusedpatients has become a major concernin transfusion medicine.[9,22,23]
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Active Surveillance for Low-Risk Localized Prostate CancerIn this review, we summarize contemporary data pertaining to active surveillance, a safe and appropriate strategy for select patients with low-risk cancer characteristics who undergo monitoring at regular intervals.
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Pancreatic Cancer: Recognizing an Hereditary PredispositionAlthough candidate genes for hereditary pancreatic cancer have been identified (Figure 1), namely p16 and BRCA2, pancreatic cancer patients having an inherited predisposition will not be easy to recognize on clinical grounds.
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Development of PARP Inhibitors: An Unfinished StoryIn this issue of ONCOLOGY, Comen and Robson provide a timely overview of poly(ADP-ribose) polymerase (PARP) inhibitors and their potential for the treatment of breast cancer. The authors highlight the recent demonstration of synthetic lethality between PARP inhibition and loss of either of the breast cancer susceptibility genes, BRCA1 and BRCA2, as well as the development of PARP inhibitors that are suitable for clinical therapy. However, many questions pertaining to both the basic biology of PARP inhibition and the potential clinical implications of PARP inhibitors still need to be addressed. In the following commentary, we highlight some of these remaining challenges.
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Propelling Immunotherapy Combinations Into the ClinicThis review summarizes promising new targets and immunotherapy combination strategies currently under clinical development.
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Face-Off: Award Presentations and Event ConclusionJudy concludes the event and presents the awards.
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Minimal Residual Disease–Directed Adjuvant Therapy for Patients With Early-Stage Colon Cancer: CIRCULATE-USIbrahim Halil Sahin, MD, and colleagues, explore, the CIRCULATE-US (NRG-GI008; NCT05174169) investigating postoperative ctDNA dynamics in early-stage colon cancer for treatment selection.
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The Role of Amifostine as a RadioprotectorEffective radiotherapy for patients with cancer should include maximal tumor cell killing with minimal injury to normal tissue. Radiation doses that can be delivered, without causing severe damage to surrounding normal
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Combined Radiation and Chemotherapy for Carcinoma of the Anal CanalSphincter-preserving treatment with combined radiation and chemotherapy has replaced abdominoperineal resection as the standard of care for patients with carcinoma of the anal canal. Randomized studies have shown
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Salivary Gland Cancers: The Challenges of Progress in Rare TumorsThe diversity and complexity, combined with the rarity of salivary gland malignancies, lead to definite and distinct challenges in their study, and consequently in advancing treatment options for affected patients.
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Prostate Cancer in a Man With Multiple Previous Cancerspatient is a 67-year-old male with mild obstructive symptoms and an American Urology Association symptom score of 8.[1] He was noted to have a prostate-specific antigen (PSA) level of 3.2 ng/mL. Because this represented a significant increase in his PSA velocity (rate of change over time), he proceeded to have a biopsy, which was positive for prostate cancer. He has no other complaints and visits us for an opinion on the treatment of his prostate cancer.
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Surgical Cytoreduction in Ovarian CancerI would like to compliment the authorson their comprehensive reviewof cytoreductive surgery forovarian cancer. However, some oftheir interpretation of the literaturewarrants amplification, and some conclusionsmerit presentation of an alternativeperspective.
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Contemporary Issues Surrounding Small Renal Masses: Evaluation, Diagnostic Biopsy, Nephron Sparing, and Novel Treatment ModalitiesIn this review, we summarize the diagnosis of small renal masses, the role of renal mass biopsy, different treatment strategies, and future directions, including emerging molecular biomarkers.
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Head and Neck CancerHead and neck cancers are a diverse group of diseases, each with its own distinct epidemiologic, anatomic, and pathologic features, natural history, and treatment considerations. Despite improvements in diagnosis and local management, long-term survival rates for patients with this disease have not increased significantly over the past 30 years and are among the lowest for the major cancers.
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Problems in Lymphoma Management: Special Sites of PresentationThe article by Dr. Connors is an excellent overview of lymphomas involving five sites: the eye, central nervous system (CNS), sinuses, testes, and stomach. The author emphasizes that these lymphomas present unique management challenges even to the experienced oncologist. The tumors are difficult to diagnose, resistant to treatment, or, in the case of gastric lymphoma, occasionally associated with a causative organism that warrants antibiotic treatment.
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Oral Complications of Cancer TherapyDrs. Sonis and Fey provide a nice description of the problems associated with oral mucositis, information available regarding its etiology, and the cost generated by its treatment.
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Current Concepts in Surgical Management of Neck Metastases from Head and Neck CancerThis article will address modified, selective, and radical neck dissection as well as other surgical considerations, and will review the surgical techniques currently available for neck treatment.
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Can Effective Cancer Care Become Affordable Again?Chemotherapy regimens that 10 years ago cost $30,000 have now increased ten-fold. Could a new research facility help make cancer care affordable again?
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Cytoreductive Nephrectomies for Renal Cell CarcinomaDrs Thomas Hutson and Scott Tykodi explain when to consider a debulking surgery for patients with renal cell carcinoma.
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Clinical Trials in Soft Tissue SarcomasSoft tissue sarcomas in adults are rare malignancies with diverse histologies that have historically been classified together, mostly for convenience. In truth,
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Nivolumab/Chemo Approval Adds Options for Urothelial Carcinoma, Expert SaysScott T. Tagawa, MD, MS, FACP, FASCO, discusses the recent approval of nivolumab plus chemotherapy for patients with unresectable or metastatic urothelial carcinoma.
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Recommendation for the Management of Patients With Chemotherapy-Induced DiarrheaRecommendation for the Management of Patients With Chemotherapy-Induced Diarrhea
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Malignant Mesothelioma of the Pleural SpaceMalignant pleural mesothelioma is an aggressive tumor associated with exposure to asbestos. Although this disease is rare, with an annual incidence in the United States of 2,000 to 3,000 cases, a steady rise in cases has
