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ONCOLOGY Vol 30 No 11

Chemotherapy-induced peripheral neuropathy is a serious yet common side effect of cancer treatment. This devastating complication, which typically manifests as tingling and numbness in the hands and feet, has an enormous influence on patients’ quality of life.

We review here the recommendations of the American Society of Clinical Oncology, as well as some new and promising approaches to neuropathy, including new neuromodulation techniques.

Several critical issues need to be addressed during the next several years if we are to reach the true potential of new agents like ibrutinib, idelalisib, venetoclax, ofatumumab, and obinutuzumab—which conceivably could ultimately cure CLL.

This article describes the clinical data that led to approval of these B-cell receptor inhibitors for the treatment of CLL, and highlights newer agents in clinical development that target the same kinases as the currently available therapies.

In the United States, approximately 20% of patients with colorectal cancer present with distant metastasis at diagnosis. In 25% of cases, the peritoneal cavity is the only site of metastatic disease, which is not indicative of a generalized systemic disease, as is the case with lung or liver metastases.

A 44-year-old patient with a history of stage IIB colorectal cancer at the hepatic flexure, invading the duodenum and pancreas, was initially diagnosed in September 2005 and received modified Whipple surgery and 8 cycles of adjuvant chemotherapy with capecitabine and oxaliplatin every 3 weeks.

Lung resection is gaining momentum among thoracic surgeons because it allows the operating surgeon the convenience of performing a dissection that in many ways is similar to open surgery, yet that has the advantages of a minimally invasive approach. Hopefully, surgical robotics, along with VATS, will make it possible for the thoracic surgery community to offer minimally invasive lung resection to nearly all early-stage lung cancer patients.

This review highlights those efforts and the role of minimally invasive surgery for early-stage lung cancer in light of evolving technology, the emerging understanding of the biology of early-stage lung cancer, and lung cancer screening.

Although ibrutinib-related atrial fibrillation (IRAF) occurs in up to 11% of patients in clinical trials, these studies have rarely fully characterized bleeding events or risk factors for bleeding when ibrutinib is combined with anticoagulation. Furthermore, guidelines do not provide direction regarding the preferred anti-arrhythmic agent for IRAF.

The blood-brain barrier and the blood-cerebrospinal fluid barrier are major physical impediments to therapeutics targeting central nervous system neoplasms. We review this topic from the perspective of a group whose focus is on the neurovascular unit.

This review describes the anatomy of the blood-brain barrier and currently available methods to quantify the entry of therapeutic compounds into the brain. It also summarizes data from a variety of approaches designed to improve drug delivery to the central nervous system.

In this interview we discuss a recent report from the International Agency for Research on Cancer that evaluated the evidence linking obesity to cancer risk.

 

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