Authors

Current Trends in the Management of Ductal Carcinoma In Situ

This review will summarize the current trends in the diagnosis and management of DCIS and will highlight ongoing trials that are shaping future management of this entity.

Prostate Cancer: What Did We Learn From the 2012 Annual Scientific Meeting of ASCO?

This review summarizes recent findings in clinical prostate cancer research reported at the 2012 Annual Scientific Meeting of the American Society of Clinical Oncology (ASCO) and addresses their relevance to clinical practice.

Current Status and Optimal Use of Radiosurgery

The field of stereotactic radiosurgery is rapidly advancing as a result of both improvements in radiosurgical equipment and better physician understanding of the clinical applications of stereotactic radiosurgery. This

Early Engagement by Healthcare Professionals Helps Overcome Public Skepticism About Biobanking

Enlivening the public discussion about cancer biobanking will speed up the collection of specimens for research supporting the goal of personalized medicine. Biobanking is particularly important in minority populations, who experience a disproportionally greater burden of cancer incidence and mortality. But rather than unilaterally creating and launching a public education program, community medicine specialists in Florida first solicited public input.

Defining the Role of Hepatic Arterial Infusion Chemotherapy in Metastatic Colorectal Cancer

In their article, Drs. Whisenant andVenook review data regarding thevalue of hepatic arterial infusion(HAI) chemotherapy for hepatic colorectalmetastases. In fact, their analysisreveals the absence of anymaterial progress in HAI therapy sincethe first reports of continuous infusionof chemotherapy through the hepaticartery.[1] During the sameperiod, there has been dramatic improvementin hepatic imaging, outcomefrom hepatic resection, systemicchemotherapy, and survival followingtreatment of hepatic colorectalmetastases. Failure of HAI therapy toadvance in parallel with other treatmentsfor liver metastases-whetherused prior to or after resection, or asdefinitive treatment for unresectabledisease apparently confined to the liver-suggests a limited role for HAItherapy in this disease. Several pointswarrant discussion.

Maintenance Therapy for Superficial Bladder Cancer

Transurethral resection remains the standard for first-line treatment of transitional cell carcinoma of the bladder. This technique clearly defines the pathologic grade and is essential in determining the clinical stage of

QOL and Outcomes Research in Prostate Cancer Patients With Low Socioeconomic Status

The VA Cancer of the Prostate Outcomes Study (VA CaPOS) is collecting quality-of-life (QOL) information from prostate cancer patients, spouses, and physicians at six VA medical centers. Currently, 601 men with prostate

Head and Neck Cancer

Head 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.

Pancreatic, Hepatic, and Biliary Carcinoma

Pancreatic, hepatic, and biliary carcinomas in adults represent three of the most challenging malignancies facing the oncologist. Although groups at high risk for these malignancies are recognized, screening and early-detection strategies have not been successful.

Adjuvant Therapy for Breast Cancer: Current Approaches and Strategies for a Better Future

Worldwide, breast cancer is by far the most frequent cancer affecting women, with over 1 million new cases each year, and the leading cause of female cancer-related deaths. During the past decade, substantial progress has been made in the treatment of breast cancer, due to focused collaborative efforts in education, practice, and research.

Clinical Presentation and Pathophysiology of EGFRI Dermatologic Toxicities

This review summarizes the pathophysiology and clinical presentation of the cutaneous toxicities associated with EGFR inhibition. Such effects include papulopustular reactions, xerosis, pruritus, fissures, nail changes, hair changes, telangiectasias, hyperpigmentation, and mucositis. Most management strategies for these toxicities have been based on anecdotal experience; clinical trials are needed to provide uniform characterization to allow for evidence-based treatment strategies.

Current Clinical Trials in Prostate Cancer

Treatment of Estrogen Deficiency Symptoms in Women Surviving Breast Cancer, Part 6

Problem: Several million women worldwide have survived breast cancer but are currently advised against the use of estrogen for the management of menopausal symptoms and for the prevention of early cardiovascular death and osteoporosis.

Epirubicin/Taxane Combinations in Breast Cancer: Experience From Several Italian Trials

Doxorubicin/paclitaxel (Taxol) combinations are very active in advanced breast cancer, with objective response rates up to 90%, but have shown a high incidence of cardiotoxicity. A phase I/II trial replacing

Treating Chemotherapy-Induced Thrombocytopenia: Is It Time for Oncologists to Use Thrombopoietin Agonists?

Clinical trials of the new thrombopoietin receptor agonists in the management of chemotherapy-induced thrombocytopenia are needed to address concerns about the safety and practical efficacy new agents before we accept them as standard therapies.

Cancer and Male Factor Infertility

With the increasing success of multimodality anticancer therapy, most men of reproductive age will survive their malignancy. Reproductive function is a principal concern of these men. Health-care providers are shifting the

The Evolving Approach to Management of Cancer Cachexia

Cancer patients are often referred for cachexia intervention treatments late in their disease trajectory-that is, at a point where attempts to reverse the weight loss process may be less beneficial. In addition, healthcare professionals frequently under-recognize the prevalence of cancer cachexia, and this may contribute to delayed treatment of weight loss, often until the refractory stage.

UFT Plus or Minus Calcium Folinate for Metastatic Colorectal Cancer in Older Patients

Two studies were carried out to determine the activity and evaluate the toxicity of oral chemotherapy with uracil and tegafur in a 4:1 molar ratio (UFT) plus or minus calcium folinate in elderly patients with advanced colorectal

UFT in Combination as Adjuvant Therapy for Breast Cancer

Between 1989 and 1993, 409 evaluable patients with breast cancer have been treated with tegafur and uracil (UFT) in an adjuvant setting in two different trials. Data from both trials were reviewed in December 1995 after a

Assessing the ‘Fit’ Older Patient for Chemotherapy

Making appropriate treatment decisions for older adults with cancer is one of the most important challenges that oncologists face in daily practice, as the therapy selected depends on an assessment of the patient’s “fitness.”

Uracil/Tegafur Plus Oral Calcium Folinate in Advanced Breast Cancer

Uracil and tegafur (in a molar ratio of 4:1 [UFT]) has proven activity against breast cancer and is delivered in an easy-to-administer oral formulation. Orzel, which combines UFT with the oral biomodulator, calcium folinate, may

Empiric Antifungal Therapy for the Neutropenic Patient

Among the most significant complications a neutropenic patient can experience is an invasive fungal infection. In this issue of Oncology, Drs. Wingard and Leather thoroughly review the epidemiology, clinical presentation, and empiric treatment of these infections, particularly those associated with Candida and Aspergillus. They emphasize the need for better methods of identifying individuals at high-risk for invasive fungal infections because those individuals are more likely to benefit from antifungal prophylaxis or empiric therapy. The goal of such a targeted approach is to limit the amount of antifungal agents given, thereby decreasing the number of adverse effects and diminishing the selection of antifungal-resistant species.[1]

Commentary (Neuwelt/Dahlborg): Current Management of Primary Central Nervous System Lymphoma

Dr. DeAngelis has written a succinct and accurate assessment of management of primary central nervous system lymphoma. Non-AIDS-related primary central nervous system lymphoma is a rare, highly malignant primary brain tumor. However, its incidence is increasing, as are AIDS-related tumors of this type. Patients with primary central nervous system lymphoma usually have widespread infiltration throughout the brain, rendering aggressive resection of no benefit. There is a significant incidence of leptomeningeal and ocular involvement (the latter a "sanctuary site," thus posing a particular therapeutic dilemma).

Use of Transcription Factors as Agents and Targets for Drug Development

Cancer is a genetic disease wherein mutations of growth regulatory genes result in abnormal proliferative capacity, recognized clinically as the occurrence of a malignant tumor. Transcription factors govern the expression of genes, be they "housekeeping" or regulatory. These factors organize the first crucial step in establishing the function of the gene, namely, the transcription of information in DNA into messenger RNA (mRNA). Translation of mRNA results in the synthesis of the oncogenic protein. Hence, the design of therapeutic agents targeted at transcription factors regulating the initial flow of "bad" information from "damaged" genes should be the ultimate goal of efforts to develop new weapons in the therapeutic armamentarium of the oncologist and, indeed, the general internist.

An Alpha Edge?

One would hope that survival data from at least one more phase III or phase IV clinical trial will convincingly show a prolongation of survival due to treatment with Alpharadin. This will not be inexpensive therapy.

Malignant Gliomas in Older Adults With Poor Prognostic Signs

The median survival time of adults with supratentorial malignant glioma treated in clinical studies with surgery, 6 weeks of external-beam radiotherapy, and carmustine (BiCNU) is approximately 1 year. This poor survival time

Palliative Care and Oncology: Integration Leads to Better Care

Patients with advanced progressive cancer require care plans that address their physical, emotional, and psychosocial needs, as well as their goals of care.

The Adjuvant Treatment of Stage III Colon Cancer: Might Less Be More?

In this article, we review the findings of the IDEA study and discuss the optimal duration of oxaliplatin-based adjuvant chemotherapy using patient-based risk factors.

A 60-Year-Old Man With Progressive Anemia While Receiving Checkpoint Blockade Therapy for Relapsed Myelofibrosis

A 60-year-old man with a history of coronary artery disease and JAK2 V617F–positive polycythemia vera presented to our bone marrow transplantation clinic with progressive fatigue, splenomegaly, and cytopenias.

Imaging Tumoral Hypoxia: Oxygen Concentrations and Beyond

The role of hypoxia as a key determinant of outcome for human cancers has encouraged efforts to noninvasively detect and localize regions of poor oxygenation in tumors. In this review, we will summarize existing and developing techniques for imaging tumoral hypoxia. A brief review of the biology of tumor oxygenation and its effect on tumor cells will be provided initially. We will then describe existing methods for measurement of tissue oxygenation status. An overview of emerging molecular imaging techniques based on radiolabeled hypoxic markers such as misonidazole or hypoxia-related genes and proteins will then be given, and the usefulness of these approaches toward targeting hypoxia directly will be assessed. Finally, we will evaluate the clinical potential of oxygen- and molecular-specific techniques for imaging hypoxia, and discuss how these methods will individually and collectively advance oncology.