Deborah K. Armstrong, MD

It is important to help patients with recurrent ovarian cancer recognize and acknowledge when further therapy is likely to be futile. For some patients this might occur very early in their disease course, while for others it may be after many years of treatment.

In 2006, after a third consecutive large-scale US phase III trial conducted by the Gynecologic Oncology Group (GOG) confirmed that use of intraperitoneal (IP) chemotherapy in optimally resected stage III epithelial ovarian cancer results in superior overall survival (OS) and/or progression-free survival (PFS),[

Ovarian cancer is a unique malignancy. While the disease can spread hematogenously or via the lymphatic system, the bulk of the tumor is found on peritoneal surfaces. This peritoneal disease results from shedding of ovarian tumor cells into the peritoneal cavity, circulation of these cells throughout the abdomen and pelvis, and eventual implantation onto peritoneal surfaces.

Intraperitoneal (IP) chemotherapy is a preferred treatment option that should be offered to all women for front-line treatment of stage III optimally debulked ovarian cancer. Patients should be provided with information on the survival and toxicity for both IP and intravenous (IV) therapies, as well as practical information about the administration of each regimen, so that they may play an active role in the decision-making process. When making a decision between IP and IV therapeutic options, the experience and preference of the oncologist are critical factors in determining appropriate therapy for each woman.

Drs. Partridge and Schapira areto be complimented on a conciseand comprehensive reviewof pregnancy before, during, andafter a diagnosis of breast cancer. Aswomen are able and willing to deferpregnancy until later in life, the issuesaddressed in this article will be encounteredwith increasing frequencyin oncology.

Breast cancer is the most commonmalignancy diagnosed inAmerican women today. Giventhe frequency of the diagnosis, approachesthat reduce breast cancerincidence also have the potential toprovide a major impact on morbidityof the disease and its treatment, costto the individual and to society, andoverall cancer mortality. In their paper,Rastogi and Vogel present a conciseand comprehensive review of thefour prospective randomized clinicaltrials of tamoxifen for chemopreventionof breast cancer, as well as ongoingand future studies examininghormonal alternatives to tamoxifen.

Despite nearly 20 years of study, the importance of chemotherapy dose intensity in breast cancer remains unclear. Substantial preclinical data suggest a dose-response relationship, and consistent data document that