ONCOLOGY Vol 23 No 8

In their Areas of Confusion article, “Management of Relapsed Mantle Cell Lymphoma: Still a Treatment Challenge,” Ruan et al attempt to make the case that the relative merits of different upfront approaches for mantle cell lymphoma (MCL) are difficult to appreciate due to the differences in eligible patient populations and limited randomized data.

Dr. Ruan and colleagues provide an excellent summary of available treatment options, as well as new drugs on the horizon, for the management of relapsed mantle cell lymphoma (MCL). As the authors emphasize, treatment of relapsed MCL is strongly influenced by the patient’s first-line therapy and needs to be individualized based on both patient and disease characteristics.

This case shows the importance of searching for antineural antibodies in oncologic patients with new neurologic deficits, and of having a judicious workup for occult malignancies in patients with known antineural antibodies.

Reishi mushroom is widely used in Asia and around the world as an immunostimulant. With extracts derived from both the cap and the stem of the mushroom, its biologic activity is thought be due to beta-glucan polysaccharides and compounds called triterpenes.

In this month’s Clinical Quandaries case report, a 49-year-old man was diagnosed with an extragonadal seminoma. The diagnosis was made on a fine-needle aspiration of a 7-cm supraclavicular mass. Beta–human chorionic gonadotropin and alpha-fetoprotein levels were normal. The only cancer history for this patient was a basal cell carcinoma of the nose. The patient complaints were fatigue; sensory and motor dysfunction in the hands, legs, and abdomen; unsteady gait; and blurry vision.

Mantle cell lymphoma (MCL) is a distinct subtype of non-Hodgkin lymphoma that occurs most commonly in older patients with advanced-stage disease.

Pfizer announced results from a randomized phase III trial of sunitinib malate (Sutent) in patients with advanced pancreatic islet cell (neuroendocrine) tumors

Merck KGaA of Darmstadt, Germany, has initiated a global phase III trial of BLP25 liposome vaccine (L-BLP25, Stimuvax) in patients with hormone receptor–positive, locally advanced, recurrent or metastatic breast cancer.

US Oncology, Inc, announced the launch of iKnowMed-an oncology-specific electronic health record (EHR) system designed by oncologists for oncologists-to the open market.

Breast cancer is the most commonly diagnosed cancer among women in the United States.[1] Since the early 1990s, breast cancer mortality has steadily declined,[2] and statistical modeling using a Bayesian approach attributes these declining mortality rates to both earlier diagnosis and more effective treatments.[3]

As breast cancer remains the most commonly diagnosed cancer among women in the United States, there has been a decline in breast cancer–related mortality for the past 2 decades; this is likely related to diagnosis at an earlier stage and the availability of more effective treatment regimens.

Authors Winkfield and Harris kindly submit to the reader an article that reemphasizes the link between local control (LC) and overall survival (OS).

On August 22, 2008, the US Food and Drug Administration (FDA) granted marketing approval (licensure) to romiplostim (Nplate, Amgen Inc) for the treatment of thrombocytopenia in patients with chronic immune (idiopathic) thrombocytopenic purpura (ITP) who have had an insufficient response to corticosteroids, immunoglobulins, or splenectomy.

Romiplostim (Nplate) was the first thrombopoietin (TPO) receptor agonist to receive regulatory approval by the US Food and Drug Administration (FDA) for treatment of thrombocytopenia in patients with chronic immune (idiopathic) thrombocytopenic purpura (ITP) who have had an insufficient response to corticosteroids, immunoglobulins, or splenectomy.

The introduction of mandatory risk evaluation and mitigation strategy (REMS) programs, in which patients must participate in order to receive a new therapy, provides an opportunity to examine an issue affecting ethical oversight and publication of scientific study results.