ONCOLOGY Vol 12 No 1

Topotecan hydrochloride (Hycamtin), as a single agent or in combination with other agents, may offer a new treatment option for people suffering from small-cell lung cancer, according to results from five clinical trials reviewed at the 15th

In a lecture at Fox Chase Cancer Center, noted breast cancer researcher Bernard Fisher proclaimed his triumph against agencies that had accused him of scientific misconduct in his directorship of the National Surgical Adjuvant Breast and Bowel

Researchers presented new strategies to protect patients from life-threatening infections caused by dose-intensive anticancer therapy at a symposium held in conjunction with the 39th Annual Meeting of the American Society of Hematology (ASH).

Geron Corporation announced in Nature Genetics that it has, for the first time, produced telomerase activity in normal, mortal human cells using the recently cloned gene for the human telomerase catalytic protein.

The finding of a high frequency of genetic markers for both breast and ovarian cancers among Ashkenazi Jewish women has prompted a call for genetic testing for all breast and ovarian cancer victims in this population, regardless of family history.

Some bacteria in the environment may already have a natural resistance to certain antibiotics, due only to genetic variation and not to antibiotic exposure. These bacteria could provide a key to the rational design of new antibiotics, say researchers in

Dr. Hoffman and colleagues have persisted in their efforts to provide a safe, reliable pelvic prosthesis to protect the small bowel during high-dose radiation therapy. I started using this type of plastic device in the early 1980s as part of the management of advanced primary and recurrent rectal cancer.[1,2] Similar to data reported by Drs. Hoffman, Sigurdson, and Eisenberg in this issue, my colleagues and I at the National Cancer Institute also noted a learning curve that accompanied our experience. We reported our experience with two iliac artery fistulas that occurred after extensive radiation therapy, possibly due to the prosthesis.[3] Sepsis within the irradiated field and surrounding the prosthesis led to a prosthesis-related death in one patient. A second patient who had multiple postoperative complications died of a pulmonary embolus.

Ms. Clarke provides an excellent overview of the rehabilitation process for the head and neck cancer patient. She highlights pretreatment and posttreatment rehabilitation issues and details the nature of each multidisciplinary intervention. I concur with the rehabilitation process that she describes and second the importance of multidisciplinary interventions beginning prior to treatment.

Dr. Hicks and his associates have written an excellent article that summarizes current knowledge about the biologic behavior of differentiated carcinoma of the thyroid gland and explores current controversies related to its management. Their review is reasonably complete, citing most of the important recent references on the subject. Regarding treatment con- troversies, the authors discuss the differing philosophies of various investigators and place into perspective the data supporting these opposing viewpoints.

Although head and neck cancer accounts for only about 5% of all malignancies, the functional and cosmetic changes that result from the tumor or its treatment pose a challenge to the health-care community. In today’s health-care environment, we are being forced or at least encouraged to decrease the length of hospital stay for patients following all types of surgical procedures. As a result, the inpatient census for most units has decreased substantially, causing many specialized patient care units to close.

The article by Hoffman, Sigurdson, and Eisenberg updates their experience in the use of temporary saline-filled tissue expanders (TEs) for small bowel exclusion. In their initial prospective study of 34 patients with a median time of patient surveillance after TE placement of 18 months, the authors demonstrated that small bowel was displaced from more than 95% of the radiation therapy treatment volume in 70% of 27 evaluable patients and from more than 75% of the treatment volume in 89% of patients.[1]

Endometrial cancer is the most common type of female genital cancer in the United States, with an estimated 32,000 new cases and 5,600 deaths per year. During the first half of the 20th century, the incidence of cervical cancer was greater than

After the patient has been evaluated preoperatively, exploratory laparotomy is essential for definitive diagnosis and staging. The patient should be advised of the potential for malignancy based on the physical as well as imaging studies, and an

Invasive cancer of the uterine cervix is either the leading or second leading cause of death from cancer among women worldwide and is the leading cause of death from cancer among women in developing countries. In some developing

This study evaluated the safety and feasibility of the combination of paclitaxel (Taxol) and epirubicin, the 4¢-epimer of doxorubicin, in women with metastatic breast cancer. A total of 85 patients with histologically proven

Although combination chemotherapy regimens may prolong survival for selected patients with metastatic breast cancer, few, if any, are cured. The standard regimens used in treatment, eg, CMF (cyclophosphamide,

The use of dose-dense therapy is one approach to overcoming the “resistance” of malignant cells to adjuvant therapy caused by inadequate drug exposure. In this approach, active drugs are delivered sequentially at their “ideal” dose level separated by short intertreatment intervals. Thus, dose intensification is achieved by means of rapidly recycled treatments rather than by dramatic dose escalation. To overcome absolute cellular resistance, the addition of new, active, non-cross-resistant drugs holds great promise and has specifically motivated the testing of the taxanes. This article describes the results of clinical trials of dose-dense therapy, with particular emphasis on attempts to incorporate one taxane, paclitaxel (Taxol), into the dose-dense regimen of sequential doxorubicin and cyclophosphamide-the so-called A ® T ® C regimen, and into more conventional regimens.[ONCOLOGY 12(Suppl 1)16-18, 1998]

Thirty-three metastatic breast cancer patients with prior chemotherapy (adjuvant alone, 9 patients; chemotherapy for metastatic disease alone, 13 patients; chemotherapy for both, 11 patients) received paclitaxel (Taxol) 135

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

Paclitaxel (Taxol) is a diterpene originally obtained from the bark of the Pacific Yew Tree, Taxus Brevifolia. Its mechanism of action is unique. it stabilizes microtubule polymerization, thus blocking cells in the G2/M phase of

This phase I-II study aimed to determine the maximum tolerated dose (MTD) of paclitaxel (Taxol), infused over 3 hours, when combined with a fixed dose (90 mg/m²) of epirubicin. Other aims were to investigate the combination’s

Over the past 7 years, 58 saline-filled tissues expanders (TEs) have been temporarily placed in 57 patients. The

A pilot study conducted at the National Cancer Institute in Milan, Italy assessed the efficacy of six or eight cycles of paclitaxel (Taxol) 200 mg/m² q3wks plus doxorubicin (Adriamycin) (60 mg/m² q3wks) in 49 women with

The review article by Forman and Velasco represents a concise, up-to-date summary of current knowledge on the use of therapeutic radiation in patients with a rising post-prostatectomy prostate-specific antigen (PSA). The conclusions reached by the authors are reasonable but conservative. In my opinion, a bit too conservative.

Drs. Forman and Velasco provide a timely and thorough review of the maturing concept of applying radiation therapy to the prostatic fossa after radical prostatectomy. The guidelines for therapy continue to evolve because of the increasing reliance on blood prostate-specific antigen (PSA) level for both detecting a recurrence of disease and evaluating response to radiotherapy.

I agree with Drs. Forman and Velasco that the optimal management of patients with an elevated prostate-specific antigen (PSA) level after prostatectomy remains to be determined. The broader issue, however, is optimizing the management of post-prostatectomy patients who are at risk for recurrence. Hence, the dilemma: Should we wait for a chemically apparent recurrence before instituting treatment? Or, should we, on the basis of available information, quantify the risk of recurrence and the possible side effects of therapy and determine whether or not adjuvant radiotherapy is warranted based on the risk/benefit ratio?

The optimal management of patients with an elevated post-prostatectomy prostate-specific antigen (PSA) level remains to be determined. In the pre-PSA era, many patients received immediate adjuvant radiation therapy on

In this review, we provide a framework for clinical decision-making in the treatment of differentiated thyroid cancer. The clinical discussion and treatment recommendations are relevant to an adult population (more than 16

Smokers may be more likely to consider quitting when they are experiencing high levels of stress, according to a study at Ohio State University.

A preliminary report of a phase II trial of paclitaxel (Taxol) administered in a dose-dense manner as first- and second-line therapy for metastatic breast cancer is presented. Patients who had received one or two prior