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George R. Simon, MD, FACP
Latest Article

Molecular Profiling for Cytotoxics and Targeted Agents: Ready for Prime Time?

Lung cancer is the leading cause of cancer-related mortality. Improved understanding in the molecular biology and genetics of lung cancer has resulted in the identification of individual genes, gene expression profiles, and molecular pathways that may be useful for clinical management decisions.

George Raptis, MD
Latest Article

Paclitaxel for Breast Cancer: The Memorial Sloan-Kettering Cancer Center Experience

The proven safety profile and antitumor activity of paclitaxel (Taxol) in the treatment of metastatic breast cancer led investigators at Memorial Sloan-Kettering Cancer Center (MSKCC) to further examine the agent's potential in the treatment of advanced breast cancer. Efficacy and tolerability studies of paclitaxel as single-agent therapy were undertaken, along with parallel investigations of quality-of-life parameters. The studies examined the effects of 96-hour infusion schedules of paclitaxel and are currently assessing the feasibility of a weekly 1-hour infusion schedule. Researchers at MSKCC also compared the results of a variety of two- and three-drug paclitaxel-containing regimens to determine possible synergism and better define safety profiles. They examined the combination of paclitaxel and edatrexate, as well as a promising combination of paclitaxel and a monoclonal antibody directed at growth factor receptors. The latter ongoing trial will include both laboratory studies that examine possible cellular mechanisms for the combination's observed synergy and a clinical trial that combines paclitaxel with a monoclonal antibody directed against the epidermal growth factor. In conclusion, the investigators discuss the optimal integration of paclitaxel into doxorubicin/cyclophosphamide (Cytoxan, Neosar)-based adjuvant therapy for node-positive stage II-III resectable breast cancer. [ONCOLOGY 11(Suppl):20-28, 1997]

George Shashaty, MD
Latest Article

Deferasirox for the Treatment of Chronic Iron Overload in Transfusional Hemosiderosis

This report describes the Food and Drug Administration's review of data and analyses leading to the approval of the oral iron chelator, deferasirox for the treatment of chronic iron overload due to transfusional hemosiderosis.

George T. Y. Chen, PhD
Latest Article

Emerging Technology in Cancer Treatment: Radiotherapy Modalities

Dr. Hevezi provides a broadoverview of the numeroustechnical innovations thathave been commercialized and arenow available to many centers for theradiation treatment of cancers. Hisreview describes computed tomography(CT) simulation, stereotactic radiosurgery,intensity-modulated radiotherapy(IMRT), and advances inbrachytherapy. The article's breadth ofcoverage necessarily limits details.

George T.y. Chen, PhD
Latest Article

Routine 3D Treatment Planning: Opportunities, Challenges, and Hazards

Three-dimensional (3D) treatment planning refers to the use of software and hardware tools to design and implement more accurate and conformal radiation therapy. This is a major advance in oncology that should lead

George Wilding, MD
Latest Article

Will Current Clinical Trials Answer the Most Important Questions About Prostate Adenocarcinoma?

Outlined in the article by Thompson and Seay are a series of questions relevant to the spectrum of stages of prostate cancer ranging from prevention to the treatment of advanced disease. Given the prevalence of prostate cancer, the morbidity of the disease, and the death rate from prostate cancer of more than 40,000 men in the United States each year, these questions warrant answers as soon as possible.

Georgia M. Beasley, MD
Latest Article

Treatment of In-Transit Melanoma: An Opportunity to Discover Critical Knowledge

While patients with in-transit disease represent a wide spectrum of disease that requires individualized therapy, great opportunity exists to learn from our treatment interventions in these individuals.

Georgia Schilling, MD
Latest Article

UFT/Leucovorin Plus Weekly Irinotecan in Advanced or Metastatic Colorectal Cancer

This is an open-label, nonrandomized phase I trial to determine the safety and maximum tolerated dose of irinotecan with a fixed dose of UFT plus oral leucovorin in patients with advanced or metastatic colorectal cancer.

Georgiana K. Ellis, MD
Latest Article

Myalgias and Arthralgias Associated With Paclitaxel

Paclitaxel-induced myalgias and arthralgias occur in a significantfraction of patients receiving therapy with this taxane, potentiallyimpairing physical function and quality of life. Paclitaxel-inducedmyalgias and arthralgias are related to individual doses; associationswith the cumulative dose and infusion duration are less clear. Identificationof risk factors for myalgias and arthralgias could distinguisha group of patients at greater risk, leading to minimization of myalgiasand arthralgias through the use of preventive therapies. Optimalpharmacologic treatment and possibilities for the prevention of myalgiasand arthralgias associated with paclitaxel are unclear, partially dueto the small number of patients treated with any one medication. Theeffectiveness of nonsteroidal anti-inflammatory drugs (NSAIDs) is themost frequently documented pharmacologic intervention, although noclear choice exists for patients who fail to respond to NSAIDs. However,the increasing use of weekly paclitaxel could necessitate daily administrationof NSAIDs for myalgias and arthralgias and leave patients at riskfor adverse effects. This concern may also limit the use of corticosteroidsfor the prevention and treatment of paclitaxel-induced myalgias andarthralgias. Data from case reports suggest that gabapentin (Neurontin),glutamine, and, potentially, antihistamines (eg, fexofenadine [Allegra])could be used to treat and/or prevent myalgias and arthralgias. Giventhe safety profile of these medications, considerable enthusiasm existsfor evaluating their effectiveness in the prevention and treatment ofpaclitaxel myalgias and arthralgias, particularly in the setting ofweekly paclitaxel administration.

Georgie Cusack, RN, MS
Latest Article

Monoclonal Antibodies and Side-Effect Management

Monoclonal antibodies are increasingly becoming a standard part of clinical cancer treatment. Eight monoclonal antibodies are approved by the Food and Drug Administration for the treatment of cancer in the United States. Oncology nurses are expected to be familiar with these agents, their indications, and their adverse effects, to provide appropriate care and symptom management to patients receiving these agents, and to adequately educate patients and families about these treatments and their specific and overlapping side effects. Monoclonal antibody mechanisms of action and indications, infusion guidelines, and symptom management are outlined in this article.

Gerald C. Mingin, MD
Latest Article

Retroperitoneal Neuroblastoma Causing Urinary Obstruction in a 5-Month-Old Boy

The patient is a 5-month-old Caucasian boy with no developmental abnormalities who presented Christmas Eve 2004 to his pediatrician with increasing fussiness, emesis, and inability to tolerate oral intake. He had a temperature of 100.2°F but otherwise normal vital signs. Physical exam at that time revealed a distended abdomen. He was sent home with a diagnosis of viral gastroenteritis.

Gerald Chodak, MD
Latest Article

The Economics of Prostate Cancer Screening

As health-care costs escalate, health-care planners must determine how the allocation of health-care dollars should be prioritized. One approach is to assess the cost of achieving a quality-adjusted year of life and then allocating the dollars in descending order, from least to most expensive, until all available money has been expended. Of course, calculating the cost per life-year is the real challenge because it is usually determined from mathematical decision models, which include many assumptions that may be subject to criticism.

Gerald E. Hanks, MD
Latest Article

Prostate-Specific Antigen as a Marker of Disease Activity in Prostate Cancer: Part 2

Despite the impact of prostate-specific antigen (PSA) testing on the detection and management of prostate cancer, controversy about its usefulness as a marker of disease activity continues. This review, based on a

Gerald J. Gleich, MD
Latest Article

Anaphylaxis: Implications of Monoclonal Antibody Use in Oncology

The phenomenon of anaphylaxis was discovered by Portier and Richet in 1903.[1,2] They injected dogs with toxins from sea anemone with the intent of generating protective antibodies. Unexpectedly, they found that certain dogs became ill with a rapid heartbeat and collapse. Because this syndrome was the precise opposite of protection or prophylaxis, they termed it anaphylaxis.

Gerald L. Andriole, MD
Latest Article

Improving the Early Detection of Prostate Cancer: A Balancing Act

Improved early detection of prostate cancer would ideally involve a noninvasive test that allows clinicians to distinguish aggressive cancers from relatively indolent ones. This distinction is especially important given that relatively few men who undergo screening are destined to die of prostate cancer.

Gerald L. Denardo, MD
Latest Article

Radioimmunotherapy: A New Treatment Modality for B-Cell Non-Hodgkin’s Lymphoma

We applaud Ghobrial andWitzig for their comprehensiveand balanced article on"Radioimmunotherapy: A New TreatmentModality for B-cell Non-Hodgkin's Lymphoma." Theseauthors have provided a review thatwill serve the oncologist and oncologypatient well. They have not engagedin arcane and tedious discussionof which anti-CD20 monoclonal antibody(ibritumomab tiuxetan [Zevalin]or tositumomab/iodine-131[I-131] tositumomab [Bexxar]), or radionuclide(yttrium-90 [Y-90] orI-131), or dosing method is better.Wisely, Ghobrial and Witzig have providedaccurate distillates of the manypublications on these exciting drugs.Because no rigorous body of dataclearly indicates that one drug is betterthan the other, these debates onlyconfuse the oncologist and are betterleft to the "technocrat."

Gerald L. Glandon, PhD
Latest Article

Economic and Quality of Life Outcomes: Managed Care Perspectives

A variety of economic factors have created a growing demand for health care reform and the rapid expansion of managed care plans. Absence of a clear, commonly accepted definition of managed care constitutes one of the

Gerald P. Murphy, MD
Latest Article

Prostate-Specific Antigen: What’s New in 1997

This review of prostate-specific antigen (PSA) by Pannek and Partin, two experts in the prostate marker field, comes at a very good time-a point at which great changes are occurring after a relatively long period of stability. I expect that this trend will continue. Moreover, given the rapid developments occurring in this area, some of the statements made in both the review and my commentary will probably need to be modified within the next 12 months, with further revisions necessary thereafter.

Gerald Rosen, MD
Latest Article

Commentary (Rosen/Forscher): Current Combined Treatment of High-Grade Osteosarcomas

In this issue of ONCOLOGY, Damron and Pritchard discuss combined therapy for high-grade osteosarcoma. This is a nice review of the current status of osteogenic sarcoma, certainly from the point of view of modern surgical management, and for

Gerald W. Chodak, MD
Latest Article

Commentary (Chodak): Locoregional Therapies for Early-Stage Prostate Cancer

The article by Stock provides a comparison of outcomes following radiation therapy and radical prostatectomy in men with clinically localized prostate cancer. The reliability of this comparison is complicated by the lack of randomized trials and the obvious selection biases inherent in uncontrolled studies. Ultimately, however, the value of either therapy depends critically on the difference between radiation or surgery and watchful waiting--an issue that is not addressed in this article.

Gerald W. Hull, MD
Latest Article

The Evolving Role of Cytoreductive Surgery for Metastatic Renal Cell Carcinoma

Metastatic renal cell carcinoma is a devastating disease associatedwith poor survival. Immunotherapy is the mainstay of treatment, butresponse rates are low. The role of cytoreductive surgery in thepresence of metastatic disease is evolving. From both retrospective andrecently published randomized clinical trials, it is now apparent thatamong patients with metastatic renal cell carcinoma and good performancestatus, cytoreductive surgery followed by immunotherapy improvessurvival. However, this approach is likely to be detrimental inpatients with poor performance status. Clinical trials of novel agentsremain a priority in this disease.

Geraldine P. Schechter, MD
Latest Article

Issues in the Management of Cancer-Related Thrombocytopenia

Drs. Goodnough and DiPersio present an authoritative and informative discussion of the management of thrombocytopenia in the cancer patient, emphasizing the risks of platelet transfusions, the safety of a platelet count threshold of < 10,000/µL for prophylactic transfusions, and issues related to the optimal type of platelet product and dose of platelets. The authors make the important point that although the risk of transmission of viral infections has decreased markedly due to the addition of nucleic acid testing for hepatitis C and human immunodeficiency virus (HIV),[1] sepsis due to bacterial contamination remains a serious risk, particularly for the neutropenic patient.[2] The fever and chills that occur within 6 hours after a platelet transfusion usually are associated with nonhemolytic febrile transfusion reactions, but the more dangerous possibility of bacterial sepsis from contamination should be considered, particularly in the neutropenic patient, and treated empirically until bacterial cultures prove otherwise.

Gerard A. Silvestri, MD, MS
Latest Article

New Testing for Lung Cancer Screening

In this review, the authors discuss past attempts at lung cancer screening, the results of the National Lung Cancer Screening Trial, and innovative tests for lung cancer screening currently being evaluated.

Gerard Bastian, PhD
Latest Article

Impact of UFT on Tumoral TS and DPD Levels in Colorectal Cancer

This was an open lable, pilot translational clinical pharmacology study of a brief (7 day) course of UFT, 300 mg/m²/day, in combination with leucovorin, 90 mg/day, in six patients with newly diagnosed advanced colorectal cancer.

Gerard M. Doherty, MD
Latest Article

Prophylactic Central Lymph Node Dissection: Continued Controversy

Low-risk papillary thyroid carcinoma (PTC), by definition, requires careful balancing of the risks of treatment and the risks of the disease.

Gerard Milano, PhD
Latest Article

Impact of UFT on Tumoral TS and DPD Levels in Colorectal Cancer

This was an open lable, pilot translational clinical pharmacology study of a brief (7 day) course of UFT, 300 mg/m²/day, in combination with leucovorin, 90 mg/day, in six patients with newly diagnosed advanced colorectal cancer.

Gerasimos Aravantinos, MD
Latest Article

Paclitaxel and Carboplatin as First-Line Chemotherapy for Advanced Breast Cancer

In a phase II study, 66 patients with advanced breast cancer (median age 56 years; range, 28 to 75 years) were treated with paclitaxel (Taxol), 175 mg/m² infused over 3 hours, and carboplatin (Paraplatin), dosed to attain an

Gerold Bepler, MD, PhD
Latest Article

Neoadjuvant Chemotherapy for Resectable Non–Small-Cell Lung Cancer

Lung cancer is the most common cancer diagnosed in men and women in the United States, and is the leading cause of cancer death.Over 160,000 individuals died as a result of lung cancer in 2008.[1] This number amounted to more than the number of deaths from colon, breast, and prostate cancers combined. The majority of lung cancer cases are non–small-cell lung cancer (NSCLC), and the poor outcomes are attributed to the high rate of metastases associated with this disease.

Gerry Oster, PhD
Latest Article

Hospitalization for 5-FU Toxicity in Metastatic Colorectal Cancer: Incidence and Cost

Although treatment with 5-fluorouracil (5-FU) plus calcium folinate has been reported to prolong survival in patients with metastatic colorectal cancer, it can also cause significant toxicity, potentially resulting in

Gertraud Maskarinec, MD, PhD
Latest Article

It’s Time for Clinicians to Reconsider Their Proscription Against the Use of Soyfoods by Breast Cancer Patients

Recently published research questions the need for the advised restriction against the use of soyfoods by women with a history of breast cancer.
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