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Resection for Thoracic Metastases From SarcomaIn this article, we provide an extensive review of patient selection criteria and surgical approaches, as well as of controversies regarding resection for metastatic sarcoma.
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Ground-Glass Opacity Lung Nodules in the Era of Lung Cancer CT Screening: Radiology, Pathology, and Clinical ManagementThis review focuses on the radiologic and pathologic features of ground-glass opacity nodules, along with the clinical management of these lesions.
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Neoadjuvant Endocrine Therapy for Breast Cancer: An Overlooked Option?For many oncologists, neoadjuvant treatment for breast cancer issynonymous with preoperative cytotoxic chemotherapy, regardless oftumor characteristics. Preoperative therapy with an endocrine agent isgenerally considered suitable only for the frail elderly or the medicallyunfit. However, favorable information regarding third-generationaromatase inhibitors in the treatment of all stages of breast cancerprompts a reconsideration of this bias. In light of the fact thatneoadjuvant therapy with aromatase inhibitors is restricted to postmenopausalwomen with strongly estrogen-receptor–positive tumors, the assumptionthat neoadjuvant combination chemotherapy is more efficaciousthan a third-generation aromatase inhibitor can be reasonablyquestioned. It is particularly remarkable that the outcome of a comparisonof adjuvant tamoxifen vs anastrozole (Arimidex)-the Arimidex,Tamoxifen Alone or in Combination (ATAC) trial-in more than 6,000patients was predicted by a neoadjuvant trial that showed an efficacyadvantage for a third-generation aromatase inhibitor (letrozole[Femara]) compared to tamoxifen in a sample of 337 patients afteronly 4 months of treatment. The potential of the neoadjuvant setting inefforts to identify new biologic agents that could build on the effectivenessof adjuvant aromatase inhibitors is therefore beginning to be appreciated.Finally, neoadjuvant therapy with an aromatase inhibitorcould be considered a sensitivity test of endocrine therapy that might beincorporated into strategies to individualize treatment according to response.For this possibility to be realized, however, a better understandingof the relationship between surrogates from the neoadjuvant settingand the long-term outcome of adjuvant aromatase inhibitor therapywill have to be established through practice-setting clinical trials.
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New Treatment Options and Management Considerations in Borderline Resectable Pancreatic CancerIn this article we will discuss the definitions of resectability, describe the current diagnostic tests for pancreatic cancer, and review strategies for maximizing treatment outcomes in patients with resectable pancreatic cancer.
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Hyperthermia as a Treatment for Bladder CancerModern cancer care is characterized by a focus on organ-sparing multi-modal treatments. In the case of non–muscle-invasive bladder cancer this is particularly true; treatment is focused on reducing the frequency of low-risk recurrences and preventing high-risk progression. Deep regional hyperthermia is an oncologic therapeutic modality that can help achieve these two goals. The combination of hyperthermia with chemotherapy and radiotherapy has improved patient outcomes in several tumor types. In this review, we highlight the biology of therapeutic fever-range hyperthermia, discuss how hyperthermia is administered and dosed, demonstrate how heat can be added to other treatment regimens, and summarize the data supporting the role of hyperthermia in the management of bladder cancer.
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UFT Plus Leucovorin for Metastatic Colorectal Cancer: Japanese ExperienceIn the United States and Europe, the combination of oral UFT plus leucovorin has been reported to produce objective responses and survival rates similar to those achieved with standard intravenous 5-fluorouracil plus leucovorin in patients with metastatic colorectal cancer, with reduced toxicity.
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Commentary (Zhong/Lynn): Some Elements of Prognosis in Terminal CancerThe claim that physicians make substantial, systematically optimistic errors in prognostication undergirds the article by Lamont and Christakis. This claim seems to contrast with our experience in the Study to Understand Prognoses and Preferences for
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Benefits, Barriers, and Challenges to Using Proton Therapy for Cancer TreatmentThis video reviews the benefits of proton therapy and some of the barriers and challenges preventing the integration of the technology into regular practice.
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Commentary (Dotan/Herr): Management of Patients With Muscle-Invasive and Metastatic Bladder CancerOptimal therapy for locally advancedbladder cancer aimsto prevent local recurrence,reduce the probability of distant metastasis,and improve survival. Radicalcystectomy coupled with a pelviclymph node dissection is the mainstaytreatment of locally invasive bladdercancer, curing the majority ofpatients with organ-confined bladdertumors, about half with extravesicaldisease, and a significant minoritywith lymph node metastases. Althoughradical cystectomy providesgood local and regional control of invasivebladder cancer, the recurrencefreeand overall survival rates are stillonly 63%–72% and 59%–66%, respectively,among all patients. Themajor predictors for disease-specificsurvival of patients following radicalcystectomy for bladder cancer are thepathologic stage of the primary tumorand status of lymph nodes at time ofcystectomy. Freedom from recurrenceat 5 years after cystectomy is 63%–72% for patients with organ-confineddisease and only 25%-37% for non-organ-confined disease.
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HER2-Targeted Therapy for Early-Stage Breast Cancer: A Comprehensive ReviewThis review discusses the treatment of primary, nonmetastatic HER2-positive breast cancer in the adjuvant and neoadjuvant settings-settings in which tremendous progress has been made.
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Zsofia K. Stadler, MD, on the Importance of Germline Analyses in Advanced CancerGermline analysis in patients with advanced cancer may play an important role in selecting FDA-approved treatments and clinical trial participation with germline-targeted therapeutics.
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Double Trouble: A Case of Concurrent De Novo T790M and L858R EGFR Mutations in Treatment-Naive Advanced Non–Small-Cell Lung CancerAn 81-year-old Chinese male never-smoker with a medical history of hypertension and hyperlipidemia presented with a productive cough and a 5-lb weight loss over 3 months.
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Proton Therapy for Prostate CancerThis review discusses the rationale, history, and current status of proton therapy for prostate cancer-and controversies regarding it.
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Optimizing Outcomes With Bevacizumab by Better Targeting Patients and TumorsNumerous preclinical and clinical studies have demonstrated a role for angiogenesis in the growth and progression of breast cancer. Elevated vascular endothelial growth factor (VEGF) levels have been demonstrated in association with poor outcomes, and thus, this finding is an attractive target for therapeutic intervention.
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Breast Implants Linked to Anaplastic Large-Cell LymphomaIn this interview we discuss the link between breast implants and anaplastic large-cell lymphoma, a rare type of T-cell lymphoma.
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Periodontal Disease Linked to Certain Cancer TypesIn this interview we discuss a recent study that linked periodontal disease with an increased cancer risk, specifically melanoma and cancers of the lung, breast, esophagus, and gallbladder.
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Adjuvant Endocrine Therapy in Postmenopausal Breast CancerThis video highlights trials studying the long-term impact of adjuvant tamoxifen and aromatase inhibitors for the treatment of patients with postmenopausal breast cancer.
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Breast Implants Linked to Anaplastic Large-Cell LymphomaIn this interview we discuss the link between breast implants and anaplastic large-cell lymphoma, a rare type of T-cell lymphoma.
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Role of Surgery in MesotheliomaThis video reviews the role of surgery in the management of patients with mesothelioma.
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Using Patient Variables in CML to Guide TreatmentThis video highlights patient variables, including kidney function or history of diabetes, that can help guide treatment in chronic myeloid leukemia.
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Cancer Network Faceoff: Conclusion of the Event and Presentation of AwardsConclusion of the discussion and award presentation.
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Diagnosing and Managing Delirium in Cancer PatientsDelirium is frequently encountered when caring for cancer patients, from initial diagnosis to the advanced stages of the disease; however, it is often missed. Oncologists need to be familiar with the various defining features of the condition, and should be able to identify common underlying causes.
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Large Scrotal Mass With Multifocal Intra-Abdominal, Retroperitoneal, and Pelvic MetastasesA 35-year-old African-American man was referred to our urology clinic by his primary care physician for consultation about a large left scrotal mass. The patient reported a 3-month history of left scrotal swelling that had progressively increased in size and was associated with mild left scrotal pain.
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Newer Strategies for the Management of Low-Grade GliomasGiven the longer course and natural history of low-grade gliomas, the goals of treatment should be to prolong overall survival and minimize neurocognitive decline.
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When Surgery Is Not an Option in Renal Cell Carcinoma: The Evolving Role of Stereotactic Body Radiation TherapyThis review summarizes the current evidence supporting the use of SBRT as treatment for inoperable renal cell carcinoma, as well as provides recommendations for patient selection and reviews the technical aspects of treatment and the expected toxicities.
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PRO: Treatment Intensification in Poor Prognosis Germ Cell TumorsIn this video, Dr. Fizazi argues for treatment intensification for poor-prognosis germ cell tumor patients who display unfavorable marker decline.
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SABCS 2024 Data Show ‘Great Steps Forward’ in Breast Cancer CarePaolo Tarantino, MD, and Matteo Lambertini, MD, PhD discuss findings related to CDK4/6 inhibitors and antibody drug conjugates presented at SABCS 2024.
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Aggressive Treatment De-Escalation Feasible in HPV-Positive Oropharyngeal Cancer?This video highlights 2-year results of a phase II study evaluating aggressive adjuvant chemoradiation dose de-escalation in HPV-positive oropharynx squamous cell carcinoma.
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ASTRO 2017: Aggressive Therapy Fails in High-Risk Endometrial CancerThis video reviews results of a phase III trial that compared pelvic radiation therapy vs vaginal cuff brachytherapy plus chemotherapy in patients with early-stage, high-risk endometrial cancer.
