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Highlighting “Trickle-Down” Progress in Developing Rare Lymphoma TreatmentCAR T-cell therapy initially developed for mantle cell lymphoma was subsequently assessed in marginal zone lymphoma.
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Longer Term Data Confirm Subcutaneous Rituximab Efficacy in Follicular LymphomaIn this video we discuss longer term results of the phase III SABRINA study, which tested the safety and efficacy of subcutaneous rituximab in patients with follicular lymphoma.
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Eltrombopag for the Treatment of Chronic Immune (Idiopathic) Thrombocytopenic PurpuraOn November 20, 2008, the US Food and Drug Administration (FDA) granted accelerated approval for eltrombopag (Promacta Tablets, GlaxoSmithKline) for the treatment of thrombocytopenia in patients with chronic immune thrombocytopenic purpura (ITP) who have had an insufficient response to corticosteroids, immunoglobulin therapy, or splenectomy.
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Reducing Racial Disparities in the Treatment of Lung CancerThis video discusses possible methods to help reduce racial disparities in the treatment and outcomes of early-stage lung cancer.
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Commentary (Glass): NCI's Cancer Information Systems-Bringing Medical Knowledge to CliniciansIn 1995, everyone is on the "Information Superhighway." The National Cancer Institute, not to be upstaged, has developed its Cancer Information Systems into a powerful and easy-to-use resource for all to use. The article by Hubbard, Martin, and
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Expanding Options for Pancreatic Cancer...So Where Do We Go From Here?In light of two recent positive clinical trials for advanced pancreatic cancer, we are currently facing an interesting situation that those of us who treat this disease have not had to deal with previously: what to do with this expanding array of choices?
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Current Management of Depression in Cancer PatientsIn their paper, Schwartz and colleagues review the risk factors for depression and suicide in patients with cancer and argue convincingly that screening for depression can be simply and quickly performed. They also delineate the efficacy and potential adverse effects of psychotherapeutic or psychopharmacologic treatments for these patients. Buttressing the identification and treatment of depression in the cancer patient are vital, ongoing scientific developments that flow from an increased understanding of interactions among the brain, endocrine system, and immune system. This rapidly evolving body of neurobiological knowledge has catalyzed fundamental changes in how we conceptualize depression in cancer patients and has important ramifications regarding the treatment and prevention of depressive syndromes in this setting.
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Approval of Olaparib Combo Impacts SOC in BRCA-Mutant Metastatic CRPCAndrew J. Armstrong, MD, MSc, spoke about the recent approval of olaparib plus abiraterone acetate and prednisone in patients with BRCA-mutant metastatic castration-resistant prostate cancer.
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In Hormone-Naive Metastatic Prostate Cancer, Should All Patients Now Receive Docetaxel? No, Not YetMeta-analyses of patients with low-volume metastatic hormone-sensitive prostate cancer will likely be required to attain sufficient power to address the role of docetaxel in this setting.
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gSevere, debilitating fatigue is common in cancer patients. For many,it is the symptom that interferes most with normal routines. Virtuallyevery modality used to treat cancer may cause fatigue, as can complicationsof the disease such as sleep disturbances, infections, malnutrition,hypothyroidism, and anemia. There is a significant overlap betweendepression and fatigue in many patients. Given the high prevalenceof cancer-related fatigue, frequent assessment of patients is essential.The evaluation should include an attempt to identify reversiblecauses of fatigue, and screening for depression. However, many cancerpatients suffer from fatigue even in the absence of any identifiable,reversible cause. For these patients, consideration can be given to suitableexercise programs, educational support and counseling, and energyconservation strategies. A trial of a stimulant medication is alsoreasonable. Given the heterogeneity of patients, individualized approachesare needed. For anemic patients undergoing chemotherapy,erythropoietic agents can increase hemoglobin levels. The impact ofthese drugs on fatigue and quality of life is uncertain. Recent reports ofincreased mortality and thrombotic events in cancer patients treatedwith epoetin require further investigation.
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Vitamin B3 Supplement Reduced Occurrences of Basal and Squamous Cell CarcinomasIn this video, Dr. Martin discusses the phase III ONTRAC study, which found that the use of nicotinamide, a form of vitamin B3, reduced the incidence of non-melanoma skin cancers by 23% among a group of high-risk patients.
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Healthcare Financing and the Cost of Cancer CareControlling healthcare spending has been, and appears destined to remain, at the center of the public policy debate at each level of government, given that much of the healthcare bill is paid by taxpayers.
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Psychiatric Assessment and Symptom Management in Elderly Cancer PatientsThe number of older adults in the general population continues togrow. As their numbers rise, the elderly and the management of theirmedical problems must be of increasing concern for health-care professionals.Within this older population, cancer is a leading cause ofmorbidity and mortality. Although many studies have looked at the psychiatricimplications of cancer in the general population, few studiestackle the issues that may face the older adult with cancer. This articlefocuses on the detection and treatment of depression, anxiety, fatigue,pain, delirium, and dementia in the elderly cancer patient.
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Targeted therapies address hard-to-treat liver tumorsNot long ago, our approach to treating difficult metastatic tumors was to “spray and pray.” We knew that chemotherapy and other traditional treatment approaches could cause great damage and had a limited chance of successfully destroying the entire tumor. At the time, a proven safer and more effective option did not exist, and patients were desperately in need of treatment. Fortunately, as our knowledge of the complexities of advanced liver tumors has grown, so has our ability to develop treatments that target and treat tumors while avoiding harmful side effects to normal tissue.
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A 72-Year-Old Man With Prostate CancerThe patient, L.E., is a 72-year-old white male who has been under our care for 10 years. He initially presented to our clinic in 1992, with a diagnosis of localized prostate cancer.
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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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COUNTERPOINT: Standard vs Investigational Agents as Upfront Treatment for High-Risk AMLAs we learn more about the biology of AML, it appears that 7+3 only rarely clears residual leukemic clones in patients with higher-risk disease. New therapies are needed that can target and eradicate resistant subclones early in the disease course.
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Advancing Research, Novel Technologies to Deliver Exceptional Cancer CareThe Jack & Sheryl Morris Cancer Center offers “state-of-the-art” surgical suites and advanced radiation technology, says Andrew M. Evens, DO, MBA, MSc.
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ASCO: Advances in the Management of Gastrointestinal CancersAs part of our coverage of the ASCO Annual Meeting, we discuss advances in the management of upper gastrointestinal (GI) tract tumors, as well as highlighting clinical trial results that will be reported at the meeting.
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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.
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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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Clinical Status and Optimal Use of Rituximab for B-Cell LymphomasThe article by Dr. McLaughlin and coauthors provides both a useful summary of the clinical trials involving rituximab (IDEC C2B8 [Rituxan]) and a practical guide for its administration. Their review summarizes the most recent clinical results with this monoclonal antibody, which have just been published in the Journal of Clinical Oncology.[1] The review also includes a section on the potential mechanism of action of rituximab. Several areas merit comment.
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Tailored Therapy in Diffuse Gliomas: Using Molecular Classifiers to Optimize Clinical ManagementWe review the current data regarding the prognostic and predictive value of IDH mutation and 1p/19q codeletion in gliomas. We also discuss possible management algorithms using these biomarkers to tailor surgical and adjuvant therapy for specific diffuse gliomas.
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PSA Screening: The Case in FavorThe facts presented about screening should be tailored to the patient’s exact situation, and the patient’s values should be used to guide the final decision. For younger, healthy men, PSA screening should continue to be strongly considered.
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Evidence Moves OTC Prevention of mCRC Closer to RealityAhead of the 2015 ASCO Annual Meeting, we are discussing over-the-counter therapies for patients with metastatic colorectal cancer with Andrew T. Chan, MD, MPH.
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Treating Small-Cell Lung Cancer: More Consensus Than ControversyAlmost 40% of patients with newly diagnosed small-cell lung cancer (SCLC) have disease confined to the ipsilateral hemithorax and within a single radiation port, ie, limited-stage disease. The median survival for this group of patients after treatment is approximately 15 months, with one in every four patients surviving 2 years. Current optimal treatment consists of chemotherapy with platinum/etoposide, given concurrently with thoracic radiation. Surgery may represent an option for very early-stage disease, but its added value is uncertain. Prophylactic cranial irradiation (PCI) is used for patients with limited-stage SCLC who have achieved a complete response following initial therapy, as it decreases the risk of brain metastases and provides an overall survival benefit. Newer targeted agents are currently being evaluated in this disease and hold the promise of improving current outcomes seen in patients with early-stage disease.
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Prevalence of Complementary and Alternative Medicine Use in Cancer PatientsInterest in complementary and alternative medicine (CAM) has grown dramatically over the past several years. Cancer patients are always looking for new hope, and many have turned to nontraditional means. This study was
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Update on Low Malignant Potential Ovarian TumorsLow malignant potential (LMP) ovarian tumors represent a small subset of epithelial ovarian cancers that were first identified 70 years ago but were recognized in a systematic way only within the last 30 years. These lesions
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Early Engagement in Physical Activity and Exercise Is Key in Managing Cancer CachexiaDespite consensus on the diagnosis and staging of cancer anorexia/cachexia syndrome, there is currently no accepted standard of care, and affected patients remain widely undertreated.
