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Biological Basis of Radiation SensitivityRosen and colleagues have provided a comprehensive review of the biological basis of radiation sensitivity, including recent insights into the DNA damage response. They correctly emphasize that local control of tumors is still a major clinical problem, and that a better understanding of the biological basis for radiation resistance/sensitivity has significant potential to be exploited for therapeutic gain. They also assert that further progress in local tumor control is unlikely to be achieved by technologic improvements in the delivery of such radiation therapies as three-D (3D) conformal radiotherapy, intensity-modulated radiation therapy (IMRT), altered fractionation, or even chemosensitization.
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HPV and Penile Cancer: Perspectives on the Future Management of HPV-Positive DiseaseOver the past 5 years, several studies have investigated the molecular profiling of penile carcinomas, examining both genomic and epigenetic alterations. These studies have revealed distinct molecular pathways associated with HPV status.
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The Biodistribution and Pharmacokinetics of Stealth Liposomes in Patients with Solid TumorsLiposomes have been proposed as potential vehicles for drug therapy targeted to solid tumors, in particular, because of the increased permeability of these tumors to macromolecules. The recent development of Stealth
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Cancer, Unproven Therapies, and MagicCommonly used by cancer patients, unproven therapies are treatments that the practitioner claims can alter the disease process although there is no proof to support the claim. The reasons for the popularity of uproven
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Accelerated Partial-Breast Irradiation: The Current State of Our KnowledgeAccelerated partial-breast irradiation is a shorter, alternative radiation technique for select patients with favorable early-stage breast cancer. We review here the different modalities of delivery and discuss the possible benefits and harms associated with these treatments.
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Topotecan in Combination With Cisplatin for the Treatment of Stage IVB, Recurrent, or Persistent Cervical Cancer: Review 1I read with great interest the paper by Michael Brave and colleagues from the US Food and Drug Administration (FDA). The authors describe the FDA's review supporting this first approval of a chemotherapeutic drug for advanced cervical cancer. This decision was made after a Gynecologic Oncology Group trial (GOG-0179) conducted at 94 American study centers demonstrated a survival benefit in patients with stage IVB, recurrent, or persistent carcinoma of the cervix who received cisplatin plus topotecan (Hycamtin) compared with those who received cisplatin alone.
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Surgical Management of Neuroendocrine Tumors: Treatment of Localized and Metastatic DiseaseTumors of neuroendocrine origin arising from the pancreas, luminal gastrointestinal tract, and other tissues differ greatly in their malignant potential.
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The Role of Neck Dissection Following Definitive ChemoradiationThe presence of regional nodal metastases represents a significantadverse prognostic factor for patients with squamous cell carcinoma ofthe head and neck. Early-stage head and neck cancers, localized to theprimary site without regional lymph node metastases have excellentcure rates with either surgery or radiation therapy. The presence ofregional metastases results in cure rates that are approximately half ofthose obtainable in early-stage disease. Therefore, due to the significantadverse impact of neck metastases on prognosis, the treatment ofthe neck remains a vital part of the decision-making process in determiningtherapy for head and neck cancer.
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The Variegated Morphology of HPV-Related Neoplasms of the PenisOur commentary aims to expand on the evolution and present state of the art in the pathology of HPV in penile cancer and precancerous lesions.
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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.
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Radiotherapy Is NOT Essential to Cure Diffuse Large B-Cell Non-Hodgkin LymphomaDLBCL of any stage remains a systemic disease with early hematogenous spread. Thus, arguments advocating the role of IFRT do not truly address disease biology, and all future efforts to cure patients will require improved systemic therapy.
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Lymphatic Mapping in the Treatment of Breast CancerDeveloped initially for the treatment of malignant melanoma, lymphatic mapping and sentinel lymph node biopsy have recently been introduced into the treatment of early breast cancer. In breast cancer patients, harvested
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Cryoglobulinemic DiseaseIn spite of the complicated etiologic, clinical, and pathologic scenario of cryoglobulinemia, physicians can play a key role in its successful management by early recognition of the most common clinical presentations.
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Diagnosis of Invasive Lobular Carcinoma in a Young Woman Presenting With Pleomorphic Lobular Carcinoma in Situ on Core BiopsyA 40-year-old premenopausal woman with a new diagnosis of invasive lobular carcinoma occurring in a background of lobular carcinoma in situ presents to a multidisciplinary second opinion clinic.
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Follicular Lymphoma: a Focus on Current and Emerging TherapiesThis review article written by Kirk E. Cahill, MD, and Sonali M. Smith, MD, discusses standard and emerging therapies for the treatment of follicular lymphoma.
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Prophylactic Cranial Irradiation Improved Survival in Metastatic SCLCThis video examines the results of a retrospective study that compared chemotherapy alone or with prophylactic cranial irradiation in extensive-stage SCLC patients with no brain metastases.
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Deferasirox for the Treatment of Chronic Iron Overload in Transfusional HemosiderosisThis report describes the Food and Drug Administration's review of data and analyses leading to the approval of the oral iron chelator, deferasirox for the treatment of chronic iron overload due to transfusional hemosiderosis.
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Highlighting Childhood Brain CancersIn this interview we discuss updates, challenges, and contributing factors associated with pediatric brain cancers.
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An Alternative Algorithm for Dosing Transdermal Fentanyl for Cancer-Related PainMany cancer patients are undermedicated and inappropriately managed for pain, leading to a diminished quality of life. Patients with moderate to severe pain often require opioid analgesics. Recently published guidelines
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Topotecan in Combination With Cisplatin for the Treatment of Stage IVB, Recurrent, or Persistent Cervical CancerTopotecan, a camptothecin analog previously approved for the treatment of ovarian cancer and small-cell lung cancer, was granted regular approval by the US Food and Drug Administration (FDA) on June 14, 2006, for use in combination with cisplatin to treat women with stage IVB, recurrent, or persistent carcinoma of the cervix not amenable to curative treatment with surgery and/or radiation therapy. The purpose of this summary is to review the database supporting this approval.
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A Novel Weekday - on/Weekend - off UFT ScheduleIn a step toward a clinical trial, the tumor response and survival of a weekday-on/weekend-off schedule of UFT was compared with its conventional daily schedule in a cancer-bearing rat model. The dose-intensive schedule-600 mg of UFT for 5 days followed by 2 drug-free days-amounts to a weekly dose similar to the conventional schedule of 400 mg/day. The weekday-on/weekend-off schedule provided increased survival and significantly greater antitumor activity than the conventional daily schedule, with no difference in adverse reactions.
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Momelotinib May Become ‘No. 1 Choice’ for Second-Line Therapy in Myelofibrosis, Expert SaysMomelotinib continues to show benefit in reducing splenic symptoms and anemia in myelofibrosis in the second-line setting, making it a likely first treatment choice, according to an expert from the University of Texas MD Anderson Cancer Center.
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Race and Cancer Genetics: Lessons From BRCA1The study of cancer in specific populations can offer clues useful in determining the extrinsic and intrinsic factors influencing cancer in all populations. Extrinsic factors are sometimes called "environmental" in the broadest sense of the word. They are modifiable or mutable. Intrinsic factors are more inherent to the individual. They are almost always genetic and are immutable or unchangeable. Targeting research on specific populations is and should be a significant ethical issue.
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Gemcitabine, Paclitaxel, and Trastuzumab in Metastatic Breast CancerA phase II trial evaluated the effectiveness and toxicity of combination paclitaxel (Taxol), gemcitabine (Gemzar), and trastuzumab (Herceptin) as first-line therapy for patients with newly diagnosed HER2-overexpressing
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Recent Advances in the Treatment of Pediatric Brain TumorsCentral nervous system (CNS) cancers are the second most frequent malignancy in childhood. In recent years, significant advances in surgery, radiotherapy, and chemotherapy have improved survival in children with these tumors. However, a significant proportion of patients with CNS tumors suffer progressive disease despite such treatment.
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Novel Combinations With OxaliplatinOxaliplatin (Eloxatin) is a novel antineoplastic platinum derivative that may exert its cytotoxic effects by blocking DNA replication/transcription, thus resulting in cell death in proliferating cells, as well as apoptosis.
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Researchers identify regulatory protein domains that contribute to tumor cell survival and cancer progressionThe p90 ribosomal S6 kinase protein contributes to tumor cell proliferation and survival, the genetic disease Carney complex, and cardiac hypertrophy.
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Follow-up Care for Cancer: Making the Benefits Equal the CostThe article by Schwartz and colleagues is important and timely, and brings into focus an essential component of the practice of oncology. Posttreatment follow-up is not often emphasized in the training of our residents and fellows, and is often based on
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Fatigue and DyspneaFatigue and dyspnea are two of the most common symptoms associated with advanced cancer. Fatigue is also commonly associated with cancer treatment and occurs in up to 90% of patients undergoing chemotherapy.
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Granulocytic Sarcoma in a Patient With Myelodysplastic SyndromeOur case illustrates the fact that MDS-associated GS can be treated palliatively with radiation and hypomethylating agents in an appropriate setting. With the growing geriatric patient population, effective treatment options are needed in this disease.
