ONCOLOGY Vol 23 No 12

Native to India, boswellia is used extensively in Ayurveda, the traditional medical system of India, to treat arthritis. Extracts from the gum resin of boswellia have been tested in clinical trials and found effective for asthma and ulcerative colitis. More research is needed to determine if boswellia can benefit those with osteoarthritis. Boswellic acid has been found to display antitumor activity in bladder, cervical, and other cancer cell lines as well as anti-inflammatory activity.

In this issue of ONCOLOGY, Dr. Czito and colleagues from Duke University School of Medicine and the University of Texas Southwestern describe the potential benefit of incorporating intensity-modulated radiation therapy (IMRT) into the combined-modality treatment of anal canal cancer.[1] As the authors well delineate, the treatment of anal canal cancer has progressed from radical surgery to organ preservation with the use of definitive chemoradiotherapy.

Dr. Czito and colleagues provide an intriguing overview on adapting and using more technically advanced techniques to deliver radiation therapy for anal cancer patients. The paper starts with a brief history of the treatment of anal cancer, moving from abdominoperineal resection to combined-modality therapy with radiation and chemotherapy and discusses the trials showing that combined chemoradiotherapy is superior to radiation alone in terms of local control and colostomy-free survival.[1,2] Adding mitomycin to fluorouracil (5-FU) has been scrutinized for increasing toxicity but has been shown to decrease colostomy rates compared to cisplatin/5-FU or 5-FU alone.[3,4]

The combined-modality care of the patient with colon or rectal cancer metastatic to the liver demands a team approach. It is little wonder that there is much confusion about this topic, given the number of unique treatment options that are delivered in a sequential and reiterative process. The concept of multidisciplinary approaches to complex cancer challenges has been adopted for a variety of tumor types and situations.

The management of patients with colorectal cancer that has metastasized to the liver is a common clinical problem

With approximately 150,000 new cases annually, colorectal carcinoma is a major cause of cancer-related morbidity in the United States. Nearly 50% of these patients will develop metastatic liver disease at sometime in the course of their illness, and approximately one-third of this group will have disease confined to the liver.

Historically, the treatment of squamous cell carcinoma of the anal canal has been an abdominoperineal resection (APR), resulting in loss of the anus and rectum with need for a permanent colostomy.

In their recent commentary (Oncology 23:639-641, 2009), Labriola and colleagues reviewed the data on “natural” hormone replacement and breast cancer risk. The “natural” agents were bioidentical and phytoestrogen supplements to manage vasomotor symptoms in breast cancer patients.

Our commentary in the July 2009 issue of ONCOLOGY concluded that the current level of evidence for safety and efficacy of “natural” hormone replacement therapy (NHRT) is not conclusive.

One of the greatest challenges facing the physician caring for patients with chronic lymphocytic leukemia (CLL) is the heterogeneity of this disease. Over the past decade, there have been major advances in understanding the pathophysiology of CLL, and in the identification of biomarkers that are helpful to predict the clinical course for individual patients. Over the same period, the available therapeutic options have developed dramatically, exemplified by the introduction of combination therapy with purine analogs and monoclonal antibodies, resulting in significant opportunities to induce complete remission (CR) in CLL patients.

Chronic lymphocytic leukemia (CLL) is a heterogeneous disease with an extremely variable course. Survival after diagnosis can range from months to decades. As the pathogenesis of the disease is increasingly understood, we begin to unfold the molecular patterns that define the different prognostic subgroups and to develop strategies to predict the clinical course.

Chronic lymphocytic leukemia (CLL) is the most common form of adult leukemia in the Western hemisphere. Both the Rai and Binet staging systems have been important clinical tools for predicting outcomes of this heterogeneous disease.

Novartis announced recently that nilotinib (Tasigna) 200-mg capsules met its primary endpoint in the first head-to-head comparison with the company’s groundbreaking drug imatinib mesylate (Gleevec) tablets.

Data published in the Journal of Clinical Oncology show that patients with advanced neuroendocrine tumors (NET) of the midgut who were treated with octreotide acetate (Sandostatin LAR Depot) experienced a 66% reduction in risk of disease progression vs placebo.

The US Food and Drug Administration approved GlaxoSmithKline’s pazopanib (Votrient), the sixth drug to be approved for kidney cancer since 2005.

Lymphoblastic lymphoma (LBL) is a rare disease, comprising about 2% of all non-Hodgkin lymphomas (NHLs) in adults.[1] It is a highly aggressive subtype of lymphoma, most commonly of precursor T-cell origin, occurring most frequently in adolescents and young adults, with male predominance and frequent mediastinal, bone marrow, and central nervous system (CNS) involvement.

The US Food and Drug Administration (FDA) has approved GlaxoSmithKline’s human papillomavirus bivalent (types 16 and 18) vaccine, recombinant (Cervarix) for the prevention of cervical precancers and cervical cancer associated with oncogenic human papillomavirus (HPV) types 16 and 18 for use in girls and young women (aged 10–25).

Sanofi-aventis US announced that the US Food and Drug Administration (FDA) has granted marketing approval for rasburicase (Elitek) to be used for the initial management of plasma uric acid (PUA) levels in adult patients with leukemia, lymphoma, and solid tumor malignancies who are receiving anticancer therapy expected to result in tumor lysis syndrome (TLS) and subsequent elevations of plasma uric acid.

The US Food and Drug Administration approved ofatumumab (Arzerra) for patients with chronic lymphocytic leukemia (CLL) whose cancer is no longer being controlled by other forms of chemotherapy. The product was approved under the FDA’s accelerated approval process, which allows earlier approval of drugs that meet unmet medical needs.

Lymphoblastic lymphoma (LBL) is a rare disease, most commonly of T-cell origin, that shares biologic features with acute lymphoblastic leukemia (ALL). Indeed, LBL and ALL are considered a single entity (lymphoblastic leukemia/lymphoma, T and B types) in the World Health Organization (WHO) classification of precursor lymphoid neoplasms.