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Prostate Cancer Immunotherapy: the Role for Sipuleucel-T and Other Immunologic ApproachesFor many years, the results of large randomized clinical trials of cancer vaccines have not been good.
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AL Amyloidosis: New Drugs and Tests, but Old ChallengesImmunoglobulin light chain (AL) amyloidosis develops in 2% of individuals with monoclonal plasma cell dyscrasias. In this issue of ONCOLOGY, Drs. Gertz and Dispenzieri discuss AL amyloidosis, highlighting progress in the field along with outstanding challenges.
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Oncologic Imaging, Second EditionAlthough the title might be slightly misleading, Oncologic Imaging is actually a compendium of information on the detection, diagnosis, imaging, staging, and treatment of cancer. This is the second edition of a multiauthor book that first appeared in
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Prostate Cancer 2012: Where Do We Stand and Where Are We Heading?Recent progress in our understanding of the pathogenesis of advanced prostate cancer has heralded a new era in treatment. Numerous agents now populate the treatment landscape, and an impressive number of novel agents are in development. However, many questions remain unanswered, paving the path for discovery in the future.
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Empiric Antifungal Therapy for the Neutropenic PatientAmong the most significant complications a neutropenic patient can experience is an invasive fungal infection. In this issue of Oncology, Drs. Wingard and Leather thoroughly review the epidemiology, clinical presentation, and empiric treatment of these infections, particularly those associated with Candida and Aspergillus. They emphasize the need for better methods of identifying individuals at high-risk for invasive fungal infections because those individuals are more likely to benefit from antifungal prophylaxis or empiric therapy. The goal of such a targeted approach is to limit the amount of antifungal agents given, thereby decreasing the number of adverse effects and diminishing the selection of antifungal-resistant species.[1]
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Prostate Cancer Surgical Practice GuidelinesThe Society of Surgical Oncology surgical practice guidelines focus on the signs and symptoms of primary cancer, timely evaluation of the symptomatic patient, appropriate preoperative evaluation for extent of disease, and role of the surgeon in
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Global lung ca staging lexicon undergoes major overhaulThe imminent publication of eagerly anticipated new international guidelines promises to transform the complex area of lung cancer staging. The International Association for the Study of Lung Cancer is expected to publish its updated recommendations in 2009. The seventh edition of the guidelines will include tumor, node, and metastasis classification. The original TNM staging of lung cancer proposed in 1973 was based on 2,155 cases from the database of Clifton Mountain, MD, from M.D. Anderson Cancer Center in Houston.
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Targeting Metastatic Colorectal Cancer in 2008: A Long Way From 5-FUColorectal cancer is one of the leading causes of cancer-related death worldwide, with almost 20% of all patients presenting with metastatic disease at the time of their diagnosis. The treatment regimens and options of metastatic colorectal cancer have significantly changed in the last 10 years, leading to an improvement of response rates to about 50%, progression-free survival of about 10 months, and overall survival reaching over 2 years.
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New Agents for the Treatment of Advanced Bladder CancerThis article will review select novel targets and approaches relevant to urothelial cancer.
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Contemporary Issues Surrounding Small Renal Masses: Evaluation, Diagnostic Biopsy, Nephron Sparing, and Novel Treatment ModalitiesIn this review, we summarize the diagnosis of small renal masses, the role of renal mass biopsy, different treatment strategies, and future directions, including emerging molecular biomarkers.
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Using Molecular Tools to Guide Breast Cancer TreatmentThis video examines the use of molecular diagnostics for guiding adjuvant endocrine therapy in patients with breast cancer.
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Lymphatic Mapping in the Treatment of Breast CancerDeveloped initially for the treatment of malignant melanoma, lymphatic mapping and sentinel lymph node biopsy have recently been introduced into the treatment of early breast cancer. In breast cancer patients, harvested
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Commentary (Gillette/Disaia): Extraovarian Primary Peritoneal CarcinomaDrs. Eltabbakh and Piver present a comprehensive review of the management and prognosis of patients with extraovarian primary peritoneal carcinoma (EOPPC). Increased recognition and more precise definition have led many physicians and scientists to recognize EOPPC as a distinct clinical entity with a unique etiology. However, staging and treatment criteria for EOPPC have been modeled after criteria for papillary serous ovarian cancer, which is clinically and histologically similar. The Gynecologic Oncology Group (GOG) has allowed the inclusion of patients with EOPPC into clinical trials designed for patients with epithelial ovarian cancer.
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T1 High-Grade Bladder Cancer Recurring After BCGTherapy: A Curative Alternative to Radical Cystectomy ExistsDecades of experience now exist to support the use of chemoradiotherapy in the treatment of muscle-invasive bladder cancer. Chemoradiotherapy for T1 tumors that recur following bacillus Calmette-Guérin therapy is promising and provides an important curative alternative for those unable or unwilling to undergo radical cystectomy.
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(18)F-NaF PET/CT and (11)C-Choline PET/CT for the Initial Detection of Metastatic Disease in Prostate Cancer: Overview and Potential UtilizationWe briefly review these two imaging technologies and provide potential utilization strategies based on available data.
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Commentary (Vogelzang/Manno): Update on Malignant MesotheliomaIn their historical review of the topicof malignant mesothelioma, Drs.Antman, Hassan, Eisner, and colleaguespoint out that the naturalhistory of malignant pleural mesotheliomahas not changed “over the past2 decades.” We disagree and suggestthat it was altered with the discoverythat the combination of pemetrexed(Alimta) and cisplatin is active in thissetting.[1] Subsequently, the largestphase III trial ever conducted in pleuralmesothelioma showed that mediansurvival improved by nearly4 months for pemetrexed/cisplatinrecipients, compared to treatment withcisplatin alone (13 vs 9 months,P < .001). Based on these data, theUS Food and Drug Administrationapproved pemetrexed, cisplatin, andsupplementation with vitamin B12 andfolic acid for the treatment of pleuralmesothelioma, and this regimen is nowthe standard of care.[2]
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Considering Neoadjuvant Chemotherapy Options in Bladder CancerIn this peer-to-peer discussion Dr. Grivas and Dr. Palmbos examine the role of neoadjuvant chemotherapy in bladder cancer and weigh the various trial data guiding these treatment decisions.
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PSA Screening: The Case in FavorThe facts presented about screening should be tailored to the patient’s exact situation, and the patient’s values should be used to guide the final decision. For younger, healthy men, PSA screening should continue to be strongly considered.
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Active Surveillance in Small Renal MassesIn this interview we discuss a new study that looked at the outcomes of patients with small renal masses who were followed with active surveillance.
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Bone-Targeted Therapy in Early Breast CancerIn this article, we describe the role of bone-targeted therapies, specifically for managing early breast cancer, by reviewing their bone-specific and cancer-specific benefits.
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Metastasis-Directed Therapy in Prostate Cancer. Why, When, and How?Metastasis-directed therapy with stereotactic ablative radiotherapy has emerged as a promising complementary technique for the management of low-volume metastatic prostate cancer.
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A Randomized Trial of Fludarabine and Mitoxantrone Plus Rituximab vs CHOP Plus Rituximab as First-Line Treatment in Patients With Follicular LymphomaThe FM (fludarabine [Fludara], mitoxantrone [Novantrone]) combination is an effective strategy in follicular lymphoma. From October 1999, patients from 12 Italian centers were randomized for a comparative study of FM vs CHOP (cyclophosphamide [Cytoxan, Neosar], doxorubicin HCl, vincristine [Oncovin], prednisone) chemotherapy with the addition of rituximab (Rituxan) in selected cases.
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New Combinations With Epirubicin in Advanced Breast CancerSeveral trials have shown that anthracyclines and taxanes can be combined to achieve response rates ranging from 70% to 90%, with complete responses ranging from 19% to 41%. In an attempt to increase the activity while
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Impact of UFT on Tumoral TS and DPD Levels in Colorectal CancerThis 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.
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UFT/Leucovorin Plus Vinorelbine Combination for Advanced Breast CancerThis phase I study was undertaken to define the maximum tolerated dose, the dose-limiting toxicity, and the recommended dose of UFT plus leucovorin and vinorelbine in combination treatment of patients with metastatic breast cancer previously treated with one chemotherapy regimen. The pharmacokinetics of UFT and vinorelbine were also evaluated.
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UFT/Leucovorin Plus Vinorelbine Combination for Advanced Breast CancerThis phase I study was undertaken to define the maximum tolerated dose, the dose-limiting toxicity, and the recommended dose of UFT plus leucovorin and vinorelbine in combination treatment of patients with metastatic breast cancer previously treated with one chemotherapy regimen. The pharmacokinetics of UFT and vinorelbine were also evaluated.
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Bronchioloalveolar Carcinoma: a Translational PerspectiveIn this issue of Oncology, Levy and colleagues provide a comprehensive review of bronchioloalveolar carcinoma [BAC], with a focus on the management of this rare disease, which represents 4% of all lung cancers.[1] The definition of BAC was revised by the World Health Organization (WHO) in 2004, with changes made to the diagnostic criteria and classification.[2] BAC was defined as an adenocarcinoma of the lung that grows in a lepidic fashion along the alveolar septa without invasion of stroma, blood vessels, or pleura. BAC has been sub-classified into three types: nonmucinous, mucinous, and mixed.
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Aggressive Pituitary TumorsAlthough almost all pituitary tumors are benign adenomas, a surprisingly large number of these tumors invade tissues outside of the pituitary gland. Such invasion, by itself, is not diagnostic of pituitary carcinomas, which are
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Cisplatin and Paclitaxel for Non–Small-Cell Lung Cancer: The European ExperienceMany physicians have questioned whether the additional survival benefit gained from the use of combination chemotherapy in non–small-cell lung cancer has been offset by chemotherapy-induced toxicity, particularly with
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Cryoglobulinemic DiseaseIn spite of the complicated etiologic, clinical, and pathologic scenario of cryoglobulinemia, physicians can play a key role in its successful management by early recognition of the most common clinical presentations.
