ONCOLOGY Vol 23 No 9

We have presented the first case of a patient with metastatic ATGCT with peritoneal carcinomatosis, who responded to treatment with a VEGFR tyrosine kinase inhibitor. Because of the relative paucity of such cases in the literature, no clear treatment strategy exists. For patients with metastatic ATGCT, enrollment in clinical trials testing novel therapies, including angiogenesis inhibitors, is a reasonable option.

Granulosa cell tumors of the testis are very rare neoplasms. While most appear to have a benign course, they occasionally metastasize.

Promoters of metabolic therapies claim that special diets, detoxification, and immune stimulation can treat and prevent a variety of diseases including arthritis, multiple sclerosis, and cancer.

Genentech announced that the US Food and Drug Administration (FDA) has approved bevacizumab (Avastin) plus interferon- alfa for people with metastatic renal cell carcinoma, the most common type of kidney cancer.

A phase I clinical trial enrolled its first patient only 2 days after FDA clearance of the experimental drug for a first-in-human cancer trial, a milestone that normally takes 3 to 6 months. Investigators from The University of Texas M.D.

AstraZeneca announced the company has submitted a New Drug Application to the FDA for an investigational drug, vandetanib ( Zactima) 100 mg, for use in combination with chemotherapy for the treatment of advanced non–small-cell lung cancer in patients previously treated with one prior anticancer therapy.

This feature examines the case of a patient with newly diagnosed breast cancer in the setting of a first-trimester pregnancy presenting to our multidisciplinary breast cancer clinic.

About 30,000 new cases of thyroid cancer are diagnosed annually in the United States.[1] The incidence among men has risen more dramatically than any other malignancy in recent years (2.4% annual increase).[2] Thyroid cancers arise from one of two cell types, namely follicular and parafollicular cells.

In this helpful review, the authors catalog a number of the novel molecular agents now being examined for treatment of radioiodine-resistant, metastatic differentiated thyroid cancer. They also call for increased systematic study of outcomes through recruitment of patients into large-scale trials.

The paper by Higgins et al published in this issue highlights the important advances that have been made in the treatment of advanced thyroid cancer over the past few years. Patients with iodine-refractory metastatic thyroid cancer have suffered badly due to the reputation of thyroid cancer as being a “good” cancer to have.

Over the past 3 decades, the incidence rate of testicular seminoma has continually risen, and the majority of cases have been clinical stage I.[1] Nevertheless, the overall survival for all testicular cancers has improved significantly (P < .05) over the same period, from 83% to 96%.[2]

Lawrentschuk and Fleshner accurately depict the difficulty in choosing among observation, prophylactic radiation, and adjuvant chemotherapy for clinical stage I testicular seminoma. The physican has competing priorities of avoiding unnecessary treatment while minimizing the overall burden of both therapy and surveillance testing. The patient has to contend with defined risks that exist with any of the three options.

Adjuvant radiotherapy to the regional lymph nodes following orchiectomy has been the standard of care for seminoma for over 50 years. The ipsilateral hemipelvis, retroperitoneum, and mediastinum were all regions thought to be important for reducing the risk of recurrence.

Drs. Lawrentschuk and Fleshner have written an excellent review on therapeutic options following orchiectomy for stage I seminoma. Their practical review discusses the roles of active surveillance, radiation therapy, and chemotherapy with one cycle of carboplatin (area under the concentration-time curve [AUC] 7) in this setting and provides important perspectives on the management controversies for practicing oncologists.