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Increased Efficacy Through Moderate Dose Escalation of Chemotherapy: Interim Report From the HD9 Randomized Trial for Advanced Hodgkin’s DiseaseThis report aims to assess the effect of increased drug dose on the efficacy and toxicity of the BEACOPP regimen with
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Multimodal Approach to Anaplastic Thyroid CancerIn this article, we endeavor to clarify the role of radiation therapy and chemotherapy in the treatment of ATC; we note important contributions of the historical literature, and we review more contemporary strategies adopted by several renowned institutions.
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Current Status and Future Potential of Advanced Technologies in Radiation OncologyPart 2. State of the Science by Anatomic SiteOn November 30–December 2, 2006, the Radiation Research Program of the Division of Cancer Treatment and Diagnosis of the National Cancer Institute (NCI) hosted a workshop entitled “Advanced Technologies in Radiation Oncology: Evaluating the Current Status and Future Potential of Proton and Other Heavy Charged-Particle Radiation Therapy, Intensity Modulated Radiation Therapy and Stereotactic Radiation Therapy.”
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506U78 in Indolent Leukemias: Pharmacokinetics of Arabinosylguanine Triphosphate Arabinosylguanine Triphosphate During TherapyThe success of purine nucleoside analogs in the treatment and management of indolent leukemias has generated interest in
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Pegylated Liposomal Doxorubicin: Antitumor Activity in Epithelial Ovarian Cancer or Cancers of Peritoneal OriginAfter pegylated liposomal doxorubicin (PEG-LD) (Doxil) was shown to be active in ovarian tumors, several trials were developed at the University of Southern California to determine its safety and efficacy in a variety of gynecologic and peritoneal malignancies. Completed phase I and phase II trials have found PEG-LD to be safe and effective in the treatment of platinum- and paclitaxel-refractory epithelial ovarian carcinoma. A new phase II trial is currently underway in similarly refractory patients with ovarian and other related cancers and various degrees of pretreatment. In addition, the efficacy of PEG-LD is being explored in combination with paclitaxel (Taxol), with cisplatin, and with hyperthermia. [ONCOLOGY 11(Suppl 11):38-44, 1997]
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Efficiency of In Vivo Purging With Rituximab Followed by High-Dose Therapy With Autologous Peripheral Blood Stem Cell Transplantation in B-Cell Non-Hodgkin’s Lymphomas: A Single-Institution StudyHigh-dose therapy (HDT) with peripheral blood stem cell transplantation is a treatment option for patients with advanced follicular, marginal, and mantle cell lymphoma. In this setting, frequent contamination of peripheral blood stem cell harvests by
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Another Path: Palliative Care From Day-of-DiagnosisDoctors von Gunten, Lutz, and Ferris accurately point out some of the reasons for the tragic underutilization of hospice care and ways oncologists might address this issue.
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Palliative Pelvic Exenteration: Patient Selection and ResultsIn the past, the mere mention that a patient with persistent or recurrent pelvic cancer might benefit from a palliative pelvic exenteration was met with vigorous opposition. This was due, in part, to the fact that the term "palliative pelvic exenteration" was new and not clearly defined. There was also concern that the mortality, morbidity, and overall cost previously associated with pelvic exenterative procedures were out of keeping with the concept of palliation for cancer. However, much experience with pelvic exenterative surgery has been gained during the past 40 years, and the mortality, morbidity, length of stay, and overall cost of the procedure have decreased significantly. This has made the concept of pelvic exenteration for palliation reconcilable in carefully selected patients in the 1990s.
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Rituximab Plus CHOP in the Treatment of Elderly Patients With Diffuse Large B-Cell Lymphoma: An Update of the GELA StudyAt the 2000 Annual Meeting of the American Society of Hematology, we presented the benefits of rituximab (Rituxan) combined with CHOP (cyclophosphamide [Cytoxan, Neosar], doxorubicin HCl, vincristine [Oncovin], prednisone), known as R-CHOP, in comparison with CHOP alone for the treatment of elderly patients with diffuse large B-cell lymphoma (DLCL).
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Management of Pain in Special Populations of Cancer PatientsChildren, the elderly, AIDS patients, and former narcotic drug abusers pose special problems in pain management that may lead to undermedication even more frequently than occurs in the general population of cancer patients with pain. A multidisciplinary panel of six pain experts with clinical experience in caring for these special groups met in Santa Fe, New Mexico, to discuss assessment methods and pharmacologic approaches to the treatment of pain in these patients. A summary of the roundtable discussion follows.
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Rituximab as a Single Agent and in Combination With Interferon Alfa-2a as Treatment of Untreated and First-Relapse Follicular or Other Low-Grade Lymphomas: A Randomized Phase II Study (M 39035)Rituximab (Rituxan) is approved for use in patients with relapsed and refractory follicular lymphoma. Considering the immune modulating effect of interferon alfa-2a (IFN [Roferon-A]) and its efficacy as a single agent in follicular lymphoma, a
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Metastatic Adrenocortical Carcinoma With a Prolonged Response to MitotaneAdrenocortical carcinoma is a rare disease, with an annual incidence rate ranging from 0.5 to 2.0 cases per million individuals.
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Psychosocial Consequences of DNA Analysis for MEN Type 2Multiple endocrine neoplasia type 2 (MEN-2) is characterized by medullary thyroid carcinoma in combination with pheochromocytomas and, sometimes, parathyroid adenomas. Since 1993, the psychosocial implications of DNA analysis for MEN-2 have been studied in the Netherlands. This article summarizes the first results of that study. Individuals who applied for DNA analysis cited the need to reduce uncertainty as the major reason for wanting the test. An unfavorable test outcome resulted in anxiety and depression but also relief.
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Gemcitabine and Irinotecan in Locally Advanced or Metastatic Biliary Cancer: Preliminary ReportChemotherapy has had limited success in biliary tract cancer. Of thenewer agents, gemcitabine (Gemzar) and irinotecan (CPT-11, Camptosar)both have single-agent activity in patients with advanced disease.We conducted a phase II trial to study the efficacy and toxicity of thecombination of gemcitabine plus irinotecan in patients with locallyadvanced or metastatic biliary tract cancer. The study has enrolled 14patients with histologically or cytologically documented cancer of thebiliary tract or gallbladder with bidimensionally measurable disease,Eastern Cooperative Oncology Group performance status 0 or 1,decompressed biliary tree, and no prior exposure to chemotherapy.Gemcitabine at 1,000 mg/m2 and irinotecan at 100 mg/m2 were bothadministered on days 1 and 8, every 21 days. In patients who had lessthan grade 3 hematologic and less than grade 2 nonhematologic toxicityfollowing cycle 1, the dose of irinotecan was increased to 115 mg/m2 forsubsequent cycles. A total of 65 cycles of chemotherapy have beenadministered, with an average of 4.5 cycles per patient (range: 1 to 11cycles). The median treatment duration was 3 months (range: 0.75 to 8months). An objective partial response was determined radiographicallyin two patients (14%) while stable disease for periods ranging from 4to 11.5 months was noted in six patients (43%). Toxicity consisted ofgrade 3/4 neutropenia in seven patients (50%) with no episodes offebrile neutropenia, grade 3/4 thrombocytopenia in four (28%), grade3 diarrhea in two (14%), and grade 3 nausea in one patient. Thecombination of gemcitabine plus irinotecan appears to possess modestclinical activity, and it is well tolerated in patients with advanced biliarycancer. Patient accrual is ongoing to this study.
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Key Takeaways on Optimizing Multiple Myeloma CareCaitlin Costello, MD, offers concluding remarks and guidance to healthcare providers on optimizing multiple myeloma patient care.
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Future Directions of Monoclonal Antibody Use in Personalized Lung Cancer TherapyWith the new direction in research and clinical trials, treating patients who most benefit from treatment with minimal toxicity will continue to be the mainstay of personalized cancer therapy.
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Palliative Care and Oncology Partnerships in Real PracticeThis article addresses the practical application of palliative care (PC) in the outpatient oncology setting.
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Early Palliative Care: Moving From ‘Why’ to ‘How’Integrating palliative care from the time of diagnosis can support both patients and families through difficult periods and prepare them for the journey ahead. It can improve quality of life while curtailing healthcare spending and increasing satisfaction with oncology care.
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POINT: Should Radiation Therapy After Surgery for Ductal Carcinoma In Situ Be Standard Practice?At this time RT following BCS remains the standard of care for most patients. Current tools, including prognostic scores and tumor genetics, have failed to identify a cohort for whom RT confers no benefit with respect to invasive recurrences.
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From Radiotherapy to Targeted Therapy: 20 Years in the Management of Non-Small-Cell Lung CancerNon-small-cell lung cancer (NSCLC) is the leading cause of cancer death worldwide. Before 1980, radiotherapy was considered the only real recourse in advanced disease. In 1995, a landmark meta-analysis of trials conducted in the 1980s and early 1990s demonstrated a survival benefit with platinum-based chemotherapy. Newer chemotherapy agents and improved supportive care measures have allowed more patients to benefit from chemotherapy with reduced toxicity. Concurrent platinum-based chemotherapy and radiotherapy has improved the survival in stage III disease, and recently chemotherapy has also demonstrated improved survival in resected early-stage disease. The majority of patients still present with advanced unresec disease for whom the prognosis remains poor, but for key subpopulations the outlook has improved markedly since the emergence of targeted therapies directed against the epidermal growth factor receptor and vascular endothelial growth factor receptor pathways. Patient selection and the incorporation of targeted therapies with cytotoxic chemotherapy are the focus of many ongoing studies, and there is an abundance of new agents undergoing clinical trials. Together, these developments have moved us away from the nihilism of 20 years ago into an era of unprecedented optimism in taking on the many remaining challenges of managing NSCLC in the 21st century.
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Future Directions and Novel Combination Therapies for mCSPCDrs Agarwal and Chowdhury discuss future directions for mCSPC, including potential use of triplet combination therapy.
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2-Minute Drill: Experts Highlight Latest Blood Cancer Research Following 2022 ASHFollowing the 2022 ASH Annual Meeting and Exposition, Peter Voorhees, MD; Amrita Krishnan, MD; and Josh Richter, MD, participated in a rapid-fire question-and-answer 2-Minute Drill program, hosted by CancerNetwork®. Topics ranged from most exciting data in blood cancer, as well as what research needs more follow-up.
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Current Perspectives on Pain in AIDSThe article by Dr. William Breitbart and Lucia DiBiase offers an excellent in-depth review of our current knowledge of the epidemiology, pharmacologic, and nonpharmacologic interventions in the field of pain management in patients with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS).
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Gene Therapy for Ovarian CancerAdvances in molecular virology and biotechnology have led to the engineering of vectors that can efficiently transfer genes to target cells. Gene therapy strategies were developed along two lines: Cytotoxic approaches
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About This Treatment GuideThe Oncology Group, a division of CMPMedica, publisher of the journal ONCOLOGY and the news magazine Oncology News International, as well as the comprehensive cancer website, cancernetwork.com, is pleased to bring you the 10th annual edition of Cancer Management: A Multidisciplinary Approach.
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Cancer Management Chapter 41: Fluid complicationsMalignant pleural effusion complicates the care of approximately 150,000 people in the United States each year. The pleural effusion is usually caused by a disturbance of the normal Starling forces regulating reabsorption of fluid in the pleural space, secondary to obstruction of mediastinal lymph nodes draining the parietal pleura.
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Future Perspectives on HER2+ Breast Cancer TreatmentCarey K. Anders, MD, concludes with a look toward the future of HER2+ breast cancer treatment and provides advice to community oncologists treating patients with breast cancer.
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POINT: Should Radiation Therapy After Surgery for Ductal Carcinoma In Situ Be Standard Practice?At this time RT following BCS remains the standard of care for most patients. Current tools, including prognostic scores and tumor genetics, have failed to identify a cohort for whom RT confers no benefit with respect to invasive recurrences.
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Metastatic Adrenocortical Carcinoma With a Prolonged Response to MitotaneAdrenocortical carcinoma is a rare disease, with an annual incidence rate ranging from 0.5 to 2.0 cases per million individuals.
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Langerhans Cell Histiocytosis: Emerging Insights and Clinical ImplicationsLangerhans cell histiocytosis is a disorder characterized by lesions that include CD207+ dendritic cells along with an inflammatory infiltrate. Langerhans cell histiocytosis has a highly variable clinical presentation, ranging from a single lesion to potentially fatal disseminated disease.
