ONCOLOGY Vol 27 No 8

The ACR Appropriateness Criteria®, and their mission to improve the knowledge of practicing oncologists and the level of care our patients receive, is wholly consistent with the goals of ONCOLOGY. We are hopeful that our readership will find the ACR Appropriateness Criteria® a valuable resource in their day-to-day practice. I personally look forward to future guidelines in this series.

To make the punishment fit the crime, you would want the decision of whether or not to use adjuvants to be informed by the degree of risk that the DCIS would recur. What factors can predict for an increased risk of recurrence, or more importantly, the risk of an invasive breast cancer occurring?

The preponderance of data support the accuracy of molecular assay diagnoses in about 80% to 90% of patients with known advanced primary cancers and in patients with cancer of unknown primary origin.

Over the past few years, significant efforts have focused on developing and validating molecular biomarkers to better define the subset of patients with stage II disease who might derive benefit from adjuvant therapy.

At this juncture, various commercially available assays for colon cancer may be of little added value, and accelerated biomarker development with clinical validation is desperately needed.

The real promise of improving patient outcomes in IgD and IgE multiple myeloma lies in multi-drug combinations, next-generation agents, and immunotherapy.

The use of newer methods of disease assessment that focus on minimal residual disease may facilitate the long-term evaluation of IgD and IgE myeloma patients, even if the rare Ig subtype is not identified at diagnosis.

How often do we choose the “second best” treatment as initial therapy for our patients with cancer? The management of chronic myeloid leukemia should be no different.

I am very comfortable in using imatinib as initial therapy in most patients who present in chronic phase, with the possible exception of patients with more advanced disease and higher Sokal scores.

The management of patients receiving treatment with oral oncolytics presents challenges such as cost, adherence, monitoring of side effects, and safe handling.

In a new series, beginning this month and running into early 2014, experts on five “unusual dysproteinemias” will share their insights into diagnosis and management.

A 22-year-old man presented to the emergency department with a 5-cm painful testicular mass that had increased in size over the previous month. Tumor markers were drawn and an inguinal orchiectomy was performed.

Although survival of patients with IgD or IgE multiple myeloma is shorter in comparison to those with IgG or IgA multiple myeloma, the outcome for patients with IgD and IgE subtypes is improving with the use of novel agents and autologous transplantation.

The present guidelines review epidemiology, pathology, presentation, workup, staging, prognostic factors, and treatment options for patients with localized nodal indolent lymphoma, with an emphasis on radiation guidelines, including radiation dose, field design, and radiation techniques.

In this review, we will discuss adjuvant chemotherapy in non-metastatic colon cancer, the existing prognostic and predictive molecular biomarkers in the field, and how to integrate these molecular biomarkers into the decision about whether to administer adjuvant therapy.