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Systemic Therapy of Metastatic Melanoma: On the Road to CureIn this article, we summarize the systemic therapies now available for melanoma, with a focus on the recently approved agents for cutaneous melanoma; discuss important considerations in selecting a treatment from the available options; and highlight some of the promising investigational approaches for this disease.
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Phase I Study of Docetaxel and Concomitant Chest RadiationData from the Radiation Therapy Oncology Groupand Eastern Cooperative Oncology Group indicate that increased survival
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Tislelizumab Shows Improvements in Efficacy Vs Chemo in Esophageal CancerThe toxicity profile of tislelizumab also appears to look better compared with chemotherapy in metastatic esophageal squamous cell carcinoma.
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Iodine-131 Tositumomab For Patients With Small Lymphocytic Lymphoma (SLL): Overall Clinical Trial ExperienceTositumomab and iodine -131 tositumomab (Bexxar) is a new radioimmunotherapy in development for the treatment of low-grade or transformed, low-grade non-Hodgkin’s lymphoma (NHL).
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Docetaxel vs Mitomycin Plus Vinblastine in Anthracycline-Resistant Metastatic Breast CancerThis nonblinded, multicenter, randomized phase III study compares the median time to progression (primary endpoint), response rate, and quality of life, safety, and survival of
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Ibritumomab Tiuxetan Radioimmunotherapy Is Safe and Well Tolerated in Patients With Relapsed or Refractory B-Cell Non-Hodgkin’s LymphomaIbritumomab tiuxetan (Zevalin) consists of an anti-CD20 murine IgG1 kappa monoclonal antibody covalently bound to tiuxetan (MX-DTPA), which stably chelates yttrium-90 for therapy. Ibritumomab tiuxetan therapy involves pretreatment with
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Initial Control of Chemotherapy-Induced Nausea and Vomiting in Patient Quality of LifeThe side effects commonly experienced by patients receiving chemotherapy for the treatment of cancer can challenge many aspects of daily life. Nausea and vomiting, the most common side effects reported by patients, affect the ability to continue with usual life activities and, thus have a pronounced impact on quality of life.
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Rituximab as a Single Agent and in Combination With Interferon Alfa-2a as Treatment of Untreated and First-Relapse Follicular or Other Low-Grade Lymphomas: A Randomized Phase II Study (M 39035)Rituximab (Rituxan) is approved for use in patients with relapsed and refractory follicular lymphoma. Considering the immune modulating effect of interferon alfa-2a (IFN [Roferon-A]) and its efficacy as a single agent in follicular lymphoma, a
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Efficacy and Safety of Tositumomab/Iodine-131 Tositumomab in the Expanded Access Study: Interim Report From Two InstitutionsRelapsed or refractory low-grade non-Hodgkin’s lymphoma (NHL) and transformed low-grade NHL are incurable diseases. Tositumomab/iodine-131 tositumomab (Bexxar) is a novel
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Resection of Liver Metastases: State of the ArtIn this article, we present current surgical perspectives on the management of liver metastases, with a focus on state-of-the-art resection, by drawing on clinical data provided in the medical literature. Metastases from
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Commentary (Chen/Feigal): Inclusion of Comorbidity in a Staging System for Head and Neck CancerThe tumor, node, metastases (TNM) cancer staging system is widely accepted by physicians as a predictor of prognosis and as a guide to therapy. Multiple national and international organizations, including the American Joint Committee on Cancer and the TNM Committee of the International Union Against Cancer have periodically evaluated and revised this international staging system since it was first proposed over four decades ago [1].
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In Vivo Purging With Rituximab Prior to Stem Cell Collection Is Associated With Persistent Molecular Evidence of t(14;18) That Often Disappears Post-Transplant in Patients With Follicular LymphomaWe previously reported that “in vivo purging” with rituximab (Rituxan) during stem-cell collection is safe and does not adversely affect engraftment. We now report on our transplant experience with rituximab. From June 1998 to December
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UFT Plus Cisplatin With Concurrent Radiotherapy for Locally Advanced Non–Small-Cell Lung CancerA phase II study of combined-modality treatment consisting of uracil and tegafur (in a molar ratio of 4:1 [UFT]) plus cisplatin (Platinol) and concurrent radiotherapy was conducted to evaluate the activity of this regimen in
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Don’t Be Fooled by DCISA 46-year-old woman had a routine screening mammogram that showed new calcifications in the posterior left breast. A diagnostic mammogram showed several small punctate calcifications, and a 6-month interval follow-up was recommended.
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Docetaxel/Doxorubicin/Cyclophosphamide in the Treatment of Metastatic Breast CancerPreliminary results from phase I trials suggest that the use of docetaxel (Taxotere) and doxorubicin (Adriamycin) is a well tolerated and highly active combination regimen for
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Advance Care Planning Discussions: Why They Should Happen, Why They Don’t, and How We Can Facilitate the ProcessIf we can successfully initiate advance care planning discussions with our patients and families, their end-of-life processes will improve, resulting in better care, less use of the hospital, and more honoring of newly discerned choices.
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UFT Plus Cisplatin With Concurrent Radiotherapy for Locally Advanced Non–Small-Cell Lung CancerA phase II study of combined-modality treatment consisting of uracil and tegafur (in a molar ratio of 4:1 [UFT]) plus cisplatin (Platinol) and concurrent radiotherapy was conducted to evaluate the activity of this regimen in
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Commentary (Yamao/Rothenberg): Coming to Grips With Hand-Foot SyndromeWorldwide, oral fluoropyrimidineshave become attractiveoptions in the treatmentof patients with colorectal cancer.Capecitabine (Xeloda), the only commerciallyavailable oral fluorouracil(5-FU) analog in the United States,was rationally designed to provideprolonged exposure to 5-FU and togenerate 5-FU preferentially withintumor tissue.Capecitabine is absorbedunchanged through the gastrointestinalwall and is converted to 5-FU viaa three-step enzymatic cascade. It isfirst hydrolyzed in the liver by carboxylesteraseto 5'-deoxy-5-fluorocytidine(5'-DFCR). The next stepoccurs in the liver and tumor tissue,where cytidine deaminase converts5'-DFCR to 5'-deoxy-5-fluorouridine(5'-DFUR). Finally, 5'-DFUR isconverted to 5-FU by thymidinephosphorylase, which is preferentiallyexpressed in tumors
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UFT Plus Carboplatin for Head and Neck CancerCisplatin plus fluorouracil (5-FU) is widely accepted as neoadjuvant and adjuvant chemotherapy in the treatment of head and neck squamous cell carcinoma; UFT is also an active agent against this disease. In the first retrospective study, we examined the efficacy of UFT as adjuvant chemotherapy in patients with maxillary cancer.
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Targeting the Insulin Growth Factor Pathway in Gastrointestinal CancersThis review highlights the current status of the research in targeting the insulin growth factor pathway with a specific focus on gastrointestinal cancers.
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Deferasirox for the Treatment of Chronic Iron Overload in Transfusional HemosiderosisThis 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.
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Pegylated Liposomal Doxorubicin: Antitumor Activity in Epithelial Ovarian Cancer or Cancers of Peritoneal OriginAfter pegylated liposomal doxorubicin (PEG-LD) (Doxil) was shown to be active in ovarian tumors, several trials were developed at the University of Southern California to determine its safety and efficacy in a variety of gynecologic and peritoneal malignancies. Completed phase I and phase II trials have found PEG-LD to be safe and effective in the treatment of platinum- and paclitaxel-refractory epithelial ovarian carcinoma. A new phase II trial is currently underway in similarly refractory patients with ovarian and other related cancers and various degrees of pretreatment. In addition, the efficacy of PEG-LD is being explored in combination with paclitaxel (Taxol), with cisplatin, and with hyperthermia. [ONCOLOGY 11(Suppl 11):38-44, 1997]
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The Pharmacologic Management of Cancer PainDr. Cherny’s article on the managementof cancer pain is acomprehensive review thatshould prove to be a helpful resource.As physicians in a palliative care andoncology program, we discuss howwe utilize these principles and whatwe see put into practice by others.Cherny and Catane have already documentedthat the great majority ofoncologists do a substantial amountof palliative care, whether they call itthat or not, and that most oncologistswould be willing to work with palliativecare or symptom managementspecialists.[1] Knowledge is only onepart of the solution, and must be pairedwith better practice by health-care professionalsand help from our patients.Articles like this will only help if oncologistspay attention.
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Seventy-Year-Old Man With Large Bladder Mass: Diagnostic and Clinical Challenges of an Uncommon NeoplasmA 70-year-old man presented at our institution for a second opinion regarding diagnosis of a urinary bladder mass. He had a 3-year history of worsening urinary incontinence and urgency, for which he had undergone colonoscopy, as well as testing for prostate issues; all test results were negative.
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ONS: Understanding Spirituality and How It Can Be Used to Help PatientsIn this interview, Tami Borneman, who is presenting a poster at the 38th Annual ONS Congress, will discuss spirituality: what it means, and how spiritual interventions can benefit patients with cancer
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Medicare Rule Raises Dilemma in Recurrent Ovarian CancerEpithelial ovarian cancer is the leading cause of death from gynecologic malignancies. In 1996, an estimated 26,000 new cases were diagnosed, and approximately 14,000 women died of this disease in the United States alone.[1] Between 75% and 80% of ovarian cancer patients present with advanced disease at diagnosis, and these patients have a 5-year survival rate of 21%.[2,3]
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Extranodal NK/T-cell Lymphoma: Basic Questions RemainExtranodal natural killer/T-cell lymphoma (ENKTL), nasal type, is a distinct entity of non-Hodgkin lymphoma with interesting unique biologic and clinicopathologic features. The tumor is characterized by ethnic preponderance, a consistent association with Epstein-Barr virus (EBV) infection, peculiar histopathologic findings, and a predilection to affect primarily the upper aerodigestive tract, inclusive anatomically of the nasal cavity, nasopharynx, paranasal sinuses, oral cavity, hypopharynx, and larynx. The characteristic clinical features are nasal stuffiness, relentless, nonhealing ulcers, or symptoms due to obstruction of the aforementioned areas. Distant metastasis at time of diagnosis is uncommon.
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Immunologic and Biologic Properties of the Primary Tumor During Prolonged Neoadjuvant ChemoimmunotherapyPatients with locally advanced cancers have a poor prognosis when treated with radiotherapy and/or surgery alone. The appearance of distant metastases shortly after removal of the primary tumor indicates that micrometastases are already present at the time of diagnosis. We observed a favorable outcome in patients with locally advanced breast cancer treated with a prolonged regimen of neoadjuvant chemotherapy plus granulocyte-macrophage colony-stimulating factor (GM-CSF [Leukine]) compared with patients receiving fewer chemotherapy cycles prior to surgery and radiotherapy. These results can partly be explained by the dose-intensive regimen used, but biologic and immunologic processes inherent to the prolonged presence of the primary tumor and its draining lymph nodes might also contribute to the beneficial outcome. The effects of the prolonged presence of the primary tumor during chemotherapy and GM-CSF administration on the antitumor immune response, and more specifically the functional properties of dendritic cells and T cells, are currently being investigated in a multicenter randomized clinical trial comparing prolonged neoadjuvant chemotherapy plus cytokines with a conventional treatment schedule. Aside from investigations concerning the immune system, other biologic processes, such as tumor angiogenesis, are being investigated at the same time. [ONCOLOGY 16(Suppl 1):32-39, 2002]
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Navigating Treatment Intensification in Metastatic Hormone-Sensitive Prostate CancerA patient case of a 50-year-old man with hormone-sensitive prostate cancer sparked a debate among oncologists regarding the best course of action.
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Outlook for 2017: Acute Leukemias, MDS, and CLLThis look ahead at hematologic malignancies in 2017 focuses on new agents being studied for the treatment of acute leukemias, myelodysplastic syndromes, and chronic lymphocytic leukemia.
