Authors
Latest:
Beyond Futility: Good Shared End-of-Life Decision-Making Takes Ongoing Discussions, Realistic GoalsDecision-making at the end of life is difficult, and it should be. Rather than face these time consuming and emotionally demanding discussions, doctors too often look to unsuitable conceptual models.
Latest:
The Myelodysplastic Syndromes: Help Is On The Way!Most adult patients with hematopoietic failure due to myelodysplastic syndrome (MDS) are treated with supportive care measures, including hematopoietic growth factors (epoetin alfa, darbepoetin alfa, filgrastim, pegfilgrastim, sargramostim), red blood cell or platelet transfusions, and antimicrobial agents. Allogeneic stem cell transplantation can be curative, but only a small subset of patients are eligible for transplantation, and until recently there were few options other than supportive care for transplant-ineligible patients. Since 2004, the US Food and Drug Administration (FDA) has approved three new therapies specifically for the indication of MDS: two DNA methyltransferase inhibitors (azacitidine and decitabine) and an immunomodulatory agent (lenalidomide). Several other drugs are used by clinicians for treatment of patients with MDS, but are not specifically FDA-approved for this indication. With several therapeutic options available, yet none of them effective in the majority of cases, it can be challenging for clinicians to choose the most appropriate treatment for an individual patient. Here we discuss a risk-based management approach to MDS that incorporates recent data regarding these new therapies. While many questions remain about the optimal use of newer agents, the long-standing perception of MDS as a syndrome where therapeutic nihilism is the only realistic approach is slowly beginning to change.
Latest:
Nonepithelial Malignancies of the BreastChugh and Baker have presenteda concise and contemporaryreview of the commonnonepithelial malignancies of thebreast, focusing mainly on the managementof this heterogeneous groupof neoplasms. Needless to say, appropriatemanagement of any neoplasmis entirely dependent on accurate pathologicdiagnosis. Due to the rarity ofthese nonepithelial malignancies of thebreast, they commonly present difficultiesin pathologic diagnosis. Issuesrelating to the diagnosis of these tumorsmay not be obvious to nonpathologists,and deserve comment.
Latest:
PARP Inhibition in Prostate Cancer: A Promising ApproachHaving said that, PARP inhibition is one of the most promising approaches for “precision therapy” so far. Within the next few years and with the help of ongoing clinical trials, we should have a better understanding of whether or not the high expectations raised will be translated into clinical reality.
Latest:
Salivary Gland Cancers: Biology and Systemic TherapyThis article reviews the pathology and current evidence on systemic therapies for the management of advanced salivary gland cancers that are not amenable to local therapy.
Latest:
Synopsis of Angiogenesis Inhibitors in OncologyAngiogenesis is a dynamic process essential for primary tumor growth and metastases. New insights into the basic understanding of the biologic processes responsible for angiogenesis have led to the characterization of potential therapeutic targets. Several strategies for the development of antiangiogenic therapeutic modalities have been employed, including agents that (1) decrease the activity of specific angiogenic factors, (2) decrease the activity of endothelial survival factors, (3) increase the activity of naturally occurring antiangiogenic agents, or (4) indirectly downregulate angiogenic and survival factor activity.
Latest:
Recent Advances in Preventing Chemotherapy-Induced Nausea and VomitingThis article will address changes in CINV guidelines over the past 5 years and provide updates on recently approved agents and agents that are expected to be approved, based on published phase III trials. It will also explore other factors affecting optimal CINV control, including the role of patient-related risk factors and the role of physician adherence to antiemetic guidelines in reducing the residual risk of CINV.
Latest:
Commentary (Green/Shapiro): Malignant Gliomas in Older Adults With Poor Prognostic SignsDr. Halperin evaluates progress in the treatment of adults with malignant glioma, with emphasis on older patients and those with a poor prognosis. He provides a good review of past clinical trials in this area, including, among others, trials conducted by the Brain Tumor Study Group (subsequently called the Brain Tumor Cooperative Group [BTCG]), with which we have been involved.
Latest:
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.
Latest:
Phase I Study of Docetaxel and Concomitant Chest RadiationData from the Radiation Therapy Oncology Groupand Eastern Cooperative Oncology Group indicate that increased survival
Latest:
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.
Latest:
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).
Latest:
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
Latest:
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
Latest:
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.
Latest:
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
Latest:
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
Latest:
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
Latest:
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].
Latest:
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
Latest:
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
Latest:
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.
Latest:
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
Latest:
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.
Latest:
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
Latest:
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
Latest:
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.
Latest:
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.
Latest:
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.
Latest:
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]
