Your AI-Trained Oncology Knowledge Connection!
Two decades have elapsed since publication of the first papers describing the examination of the pancreas via the stomach and the duodenum using an ultrasound probe fixed to an endoscope tip. Initial attempts to image the pancreas in this fashion proved difficult and frustrating, but they were promising enough that instrument makers and gastrointestinal endoscopists persisted in developing increasingly effective devices.
Patients with signs and symptoms suggestive of a pancreatic neoplasm typically undergo initial imaging with transabdominal ultrasound or computed tomography. This evaluation often reveals the presence of a pancreatic mass or fullness.
Drs. Levy and Wiersema have provided an authoritative review of the role of endoscopic ultrasonography in the diagnosis and staging of pancreatic cancer. As outlined in their article, endoscopic ultrasound has emerged as an important tool in the diagnostic evaluation of many patients with suspected pancreatic neoplasms. We concur that endoscopic ultrasound is part of the standard preoperative evaluation of patients with biochemically confirmed insulinoma and gastrinoma syndromes and of at-risk patients with multiple endocrine neoplasia type 1. Endoscopic ultrasound and endoscopic ultrasound-guided fine-needle aspiration (FNA) can also accurately determine the etiology of a cystic pancreatic neoplasm by differentiating between mucinous, serous, and inflammatory (pseudocyst) lesions.
ROCHESTER, Minnesota-Fluorouracil (5-FU)-based chemotherapy after surgery can be given safely to selected elderly patients with stage II/III colon cancer, and these patients derive the same benefits from the treatment as do their younger counterparts, according to results of a pooled analysis of seven clinical trials.
SAN FRANCISCO-Two phase II chemotherapy regimens combining gemcitabine (Gemzar) and docetaxel (Taxotere) in patients with advanced pancreatic cancer show higher response rates than gemcitabine alone and suggest further explorations of the combination are warranted, according to presentations at the 37th Annual Meeting of the American Society of Clinical Oncology (ASCO).
Advances in diagnostic and therapeutic radiology and a better understanding of cell biology are being applied in practical ways to modulate treatment morbidity. Conformal radiotherapy targets the cancer precisely and can be combined with new systemically administered radiosensitizers.
SAN FRANCISCO-In patients with advanced pancreatic cancer, the combination of gemcitabine (Gemzar) followed by oxaliplatin (investigational in the United States) (GEMOX) is active with low toxicity, Christophe Louvet, MD, Hôpital St-Antoine, Paris, France, said at the 37th Annual Meeting of the American Society of Clinical Oncology (ASCO abstract 506).
LOS ANGELES-Positron emission tomography (PET) changed the disease management of more than 60% of patients with colorectal cancer, according to a survey of referring physicians. The most striking change occurred among patients for whom surgery was the intended treatment: 41% of these patients had their treatment changed from surgery to medical treatment. Another 13.5% saw the surgical approach changed as a result of the PET findings.
SAN FRANCISCO-Raltitrexed (Tomudex) in combination with oxaliplatin may be used as a replacement for the de Gramont regimen in advanced colorectal cancer, said Vincenzo Catalano, MD, Medical Oncology, Pesaro, Italy.
This article will review the pertinent data on the use of chemotherapy for all stages of pancreatic cancer. For patients with metastatic disease, fluorouracil (5-FU) was the standard of care for several decades until a single
This article will review the pertinent data on the use of chemotherapy for all stages of pancreatic cancer. For patients with metastatic disease, fluorouracil (5-FU) was the standard of care for several decades until a single
This article will review the pertinent data on the use of chemotherapy for all stages of pancreatic cancer. For patients with metastatic disease, fluorouracil (5-FU) was the standard of care for several decades until a single
This article will review the pertinent data on the use of chemotherapy for all stages of pancreatic cancer. For patients with metastatic disease, fluorouracil (5-FU) was the standard of care for several decades until a single
NEW YORK CITY-Irinotecan (Camptosar), oxaliplatin, and other new agents have shown promising activity in rectal cancer and are now being tested in combination regimens with 5-fluorouracil (5-FU) and in new chemoradiotherapy regimens, according to Bruce Minsky, MD.
LITTLE ROCK, Arkansas-The antiangiogenic properties of thalidomide (Thalomid) as well as its ability to inhibit tumor necrosis factor-alpha (TNF-alpha) suggest that thalidomide might be a useful addition to regimens for treating advanced cancers. Rangaswamy Govindarajan, MD, said that thalidomide may enhance the response rate of metastatic colorectal cancer to irinotecan (Camptosar) while also reducing irinotecan-related gastrointestinal toxicities. Dr. Govindarajan is assistant professor of medicine at the University of Arkansas for Medical Science in Little Rock, Arkansas.
COLORADO SPRINGS-Researchers from two large North American Intergroup colorectal cancer trials found an unexpectedly high rate of toxic deaths in trials containing irinotecan (Camptosar). No such problems had been apparently observed by oncologists using the combination of irinotecan, 5-fluorouracil (5-FU), and leucovorin (LV) (IFL) in routine clinical practice, and no such problems had been identified in the pivotal registration and European studies.
CHICAGO-A "dealer’s choice" rectal cancer trial in which treatment would be chosen by the physician and patient together has been proposed by the National Cancer Institute (NCI) Gastrointestinal Intestinal Intergroup. The Intergroup now includes research groups from the American College of Surgeons Oncology Group, Cancer and Leukemia Group B, the Eastern Cooperative Oncology Group, the North Central Cancer Treatment Group, the NCI Canada, the National Surgical Adjuvant Breast and Bowel Project (NSABP), the Radiation Therapy Oncology Group, and the Southwest Oncology Group.
WINSTON-SALEM, North Carolina-Preliminary data from a phase II trial of induction irinotecan (Camptosar)/gemcitabine (Gemzar) followed by twice-weekly gemcitabine and radiation in patients with locally advanced pancreatic cancer show partial responses in 2 of 7 evaluable patients. There were no local progressions, and median time to progression of 6 months, according to A. William Blackstock, MD. Dr. Blackstock is assistant professor at Wake Forest University, Winston-Salem, North Carolina, and at the University of North Carolina at Chapel Hill.
PORTLAND, Oregon-"Very preliminary data suggest that cyclooxygenase-2 (COX-2) inhibitors can be safely used in combination with irinotecan (Camptosar), and even more preliminary data suggest that such combinations are active in advanced colorectal cancer," reported Charles Blanke, MD. He explained that COX-2 is overexpressed in the majority of human colorectal cancers. Dr. Blanke is director of the GI Malignancy Program at the Oregon Cancer Institute in Portland.
HOUSTON-Colon cancer researchers are studying a variety of cell surface molecules and receptors as potential targets for new treatments aimed particularly at preventing or treating metastatic disease. Lee Ellis, MD, professor of surgery and cancer biology at the University of Texas M. D. Anderson Cancer Center in Houston, discussed his group’s current work in three new areas: angiopoietins as a target for blocking tumor angiogenesis, integrins, and the insulin growth factor-1 (IGF-1) system.
SAN FRANCISCO-In an effort to extend the activity of gemcitabine (Gemzar) against pancreatic cancer, researchers have paired an investigational chimeric monoclonal antibody, IMC-C225 (cetuximab) with the standard chemotherapy. IMC-C225 selectively binds to epidermal growth factor receptor (EGFR).
SAN FRANCISCO-In advanced colorectal cancer, the combination of oxaliplatin (investigational) and irinotecan (Camptosar) is beneficial as a first-line therapy, according to phase II clinical trial results presented at the 37th Annual Meeting of the American Society of Clinical Oncology (abstract 538).
TAMPA, Florida-Phase II studies have shown that the combination of irinotecan (Camptosar) and gemcitabine (Gemzar) are well tolerated and active in advanced or metastatic pancreatic cancer, and this combination is now being tested in randomized phase II and phase III trials, said Caio Max S. Rocha Lima, MD. Dr. Rocha Lima is assistant professor of medicine at the University of South Florida’s H. Lee Moffitt Cancer Center in Tampa, Florida.
BIRMINGHAM, England-Combining capecitabine (Xeloda) and irinotecan (Camptosar) is feasible at doses effective for treating colorectal cancer, according to David Kerr, MD, DSc. He reviewed early capecitabine/irinotecan trials and said that the combination should be evaluated in phase III trials against metastatic cancer, as adjuvant treatment, and using oral formulations of both drugs. Dr. Kerr is professor of clinical oncology at the CRC Institute for Cancer Studies, Birmingham, England.
HOUSTON-M. D. Anderson Cancer Center researchers have launched a phase I trial combining pelvic radiation, irinotecan (Camptosar), and celecoxib (Celebrex) in patients with metastatic rectal cancer. Christopher H. Crane, MD, assistant professor of radiation oncology at the University of Texas M. D. Anderson Cancer Center described the research leading up to this trial
