ONCOLOGY Vol 15 No 3 | Oncology

Monoclonal Antibodies in Hematologic Malignancies: Clinical Status

March 01, 2001

The 42nd Annual Meeting of the American Society of Hematology (ASH), held December 1-5, 2000, in San Francisco, featured a record number of abstracts focusing on the revolutionary clinical applications of monoclonal antibodies to a wide

Phase I Study of Interleukin-12 in Combination With Rituximab in Patients With B-Cell Non-Hodgkin’s Lymphoma

March 01, 2001

Rituximab (Rituxan) is a genetically engineered chimeric murine/human monoclonal antibody that binds specifically to CD20 on pre-B and mature B lymphocytes. While binding of the Fab domain may induce apoptosis, the Fc domain recruits immune

Self-Referral Rules Finalized by HCFA

March 01, 2001

Oncologists who have a financial interest in-or are thinking about investing in-a related business that provides such things as magnetic resonance imaging, computed tomography, or radiology services should pay attention to the final rules from the

Cancer Nursing: Principles and Practice, 5th Edition

March 01, 2001

Cancer Nursing: Principles and Practice is widely considered to be the basic textbook on cancer nursing. With this edition, every chapter has been updated to reflect the latest research and references, and many of the chapters now include

Thalidomide Analogs Active Against Multiple Myeloma

March 01, 2001

Laboratory studies evaluating the activity of Celgene’s immunomodulatory drugs (IMiDs) on multiple myeloma cells suggest that these agents may be beneficial in the treatment of multiple myeloma. Researchers from the Dana-Farber Cancer Institute

Bexarotene May Extend Survival in Lung Cancer Patients

March 01, 2001

At a recent meeting of the National Cancer Institute, the European Organization for Research and Treatment of Cancer, and the American Association for Cancer Research in Amsterdam, results from a phase I/II clinical trial were presented that

New Rule on Medical Record Confidentiality

March 01, 2001

Physicians will have 2 years to develop the consent forms and compliance programs dictated by the medical records confidentiality rule published by the Clinton administration on December 28. Some provider groups, particularly in the health

A Pilot Study of Rituximab in Patients With Relapsed Hodgkin’s Disease of Classical Type

March 01, 2001

We have previously reported that normal B lymphocytes in lymph nodes and peripheral blood of patients with Hodgkin’s disease (HD) express CD40 ligand (CD40L) and CD30 ligand (CD30L). Both ligands can activate NF-kb and promote

Rituximab in the Treatment of Autoimmune Hemolytic Anemia

March 01, 2001

Based on a previously published experience (Blood 92:3409, 1998), 5 additional patients with autoimmune hemolytic anemia (AIHA) have since been treated with rituximab (Rituxan). We present a summary of all 6 patients (5 female, 1 male;

Trends in Cigarette Smoking Among High School Students: United States, 1991-19

March 01, 2001

One of the 10 leading health indicators that reflect the major health concerns in the United States is cigarette smoking among adolescents. To examine changes in cigarette smoking among high school students in the United States from 1991 to 1999, the

FDA Grants Marketing Clearance for New Formulation of Fluorouracil

March 01, 2001

The US Food and Drug Administration (FDA) recently granted marketing clearance for a new formulation of fluorouracil (5-FU) as treatment of actinic keratoses. This "Microsponge" formulation of the antimetabolite, manufactured by Advanced

Irinotecan in Gastrointestinal Malignancies

March 02, 2001

The purpose of the annual investigators’ workshops sponsored by The University of Texas M. D. Anderson Cancer Center has been to review the latest data on new agents, with a particular focus on

Noninherited Genetic Alteration Discovered for Breast and Ovarian Cancers

March 01, 2001

A study headed by the National Institutes of Health (NIH) human genome scientists on the genetic patterns of inherited breast cancer has uncovered unexpected findings regarding nonhereditary breast and ovarian cancers. These unanticipated findings,

Commentary (Cohen/Vokes): Gene Therapy for Head and Neck Cancers

March 01, 2001

This issue of Oncology features an excellent review of gene therapy for head and neck cancers. Lamont and colleagues have highlighted the principles of genetic intervention, the current state of available therapies, and the results of human trials in an organized and coherent manner.

Imaging Prostate Cancer: Current and Future Applications

March 01, 2001

Prostate cancer is now the most commonly diagnosed noncutaneous neoplasm in men.[1] While there are many questions of profound clinical significance related to the management of this neoplasm, few are as critical as those regarding the limitations of current imaging modalities for clinicians involved in the management of these patients. As such, the thorough, if somewhat depressing, overview of the current status of imaging in prostate cancer by El-Gabry et al provides timely insight into both where we are and where we need to go.

Systemic Therapy for Older Women With Breast Cancer

March 01, 2001

Cancer and aging seem to go hand in hand. Most cancers and most cancer deaths occur in individuals over age 65 years. Likewise, as we age, osteoarthritis, heart disease, diabetes, and memory lapses seem to become part of our daily burden. Drs. Kimmick and Muss have detailed a strategy for managing breast cancer in older women. However, as they point out, there are several problems with defining optimal therapy for the elderly.

Empiric Antifungal Therapy for the Neutropenic Patient

March 01, 2001

Among 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]

State of the Art of Non-Small-Cell Lung Cancer in the New Millennium

March 03, 2001

Lung cancer is the leading cause of cancer death worldwide, with mortality rates in most developed countries ranging from 35 to 95 fatalities per 100,000 in men and 10 to 20 deaths per 100,000 in women.[1] Non-small-cell lung cancer is the most

Commentary (Frank): Gene Therapy for Head and Neck Cancers

March 01, 2001

Lamont et al have presented a very clear and concise review of current gene therapy strategies in the management of squamous cell carcinoma of the head and neck. While the presentation highlighted the most important work to date in this expanding field, it also made reference to some controversies and challenges that we are now facing. With this in mind, I would like to expand on and clarify several points raised by the authors.

Empiric Antifungal Therapy for the Neutropenic Patient

March 01, 2001

The article written by Drs. Wingard and Leather presents a thoughtful review of the current approaches to empiric antifungal therapy in neutropenic patients. Empiric antifungal therapy has evolved as a standard of care for the prevention of invasive fungal infections in neutropenic patients who remain persistently febrile despite the use of broad-spectrum antibacterial antibiotics.[1-3] Empiric antifungal therapy in this setting provides early treatment for clinically occult invasive fungal infections and systemic prophylaxis for neutropenic patients at highest risk.

Imaging Prostate Cancer: Current and Future Applications

March 01, 2001

The authors have done an excellent job of preparing a complete and unbiased review of various imaging modalities that are currently available or being developed for the evaluation of patients with carcinoma of the prostate. In addition to the review of the literature, the authors have succinctly summarized the technical details that allow the uninitiated to understand the basic principles of these imaging technologies.

Gene Therapy for Head and Neck Cancers

March 01, 2001

Despite advances in surgery, radiotherapy, and chemotherapy, survival of patients with squamous cell carcinoma of the head and neck has not significantly improved over the past 30 years. Locally recurrent or refractory disease is particularly difficult to treat. Repeat surgical resection and/or radiotherapy are often not possible, and long-term results for salvage chemotherapy are poor. Recent advances in gene therapy have been applied to recurrent squamous cell carcinoma of the head and neck. Many of these techniques are now in clinical trials and have shown some efficacy. This article discusses the techniques employed in gene therapy and summarizes the ongoing protocols that are currently being evaluated in clinical trials. [ONCOLOGY 15(3):303-314, 2001]

Novel Approaches in the Treatment of Non-Small-Cell Lung Cancer

March 03, 2001

A wealth of data indicates that certain genetic abnormalities can target specific cytotoxic drugs and intervene at an early step as a mechanism of resistance in the treatment of non-small-cell lung cancer. Therefore prescribing

Triplet Combination Chemotherapy and Targeted Therapy Regimens

March 03, 2001

Current agents for the treatment of non-small-cell lung cancer include gemcitabine (Gemzar), paclitaxel (Taxol), docetaxel (Taxotere), vinorelbine (Navelbine), and irinotecan (CPT-11, Camptosar). Experimental agents include

Gemcitabine and Nonplatinum Combinations in Non-Small-Cell Lung Cancer

March 03, 2001

Gemcitabine (Gemzar), paclitaxel (Taxol), docetaxel (Taxotere), and vinorelbine (Navelbine) are among the most active agents for the treatment of non-small-cell lung cancer and are generally more active than platinum

Gemcitabine for the Treatment of Non-Small-Cell Lung Cancer

March 03, 2001

Platinum-based chemotherapy regimens have been the mainstay of treatment for non-small-cell lung cancer because they improve survival. Although there is no standard platinum-based regimen, combination regimens with

Camptothecin Schedule and Timing of Administration With Irradiation

March 02, 2001

The camptothecins are a new class of chemotherapeutic radiation sensitizers. Clinical trials with camptothecins alone show higher toxicity than predicted by preclinical models, which has created the challenge of finding new

Irinotecan/Gemcitabine Combination Chemotherapy in Pancreatic Cancer

March 02, 2001

Gemcitabine (Gemzar) and irinotecan (CPT-11, Camptosar) are active cytotoxic drugs against pancreatic cancer. Preclinical data evaluating the combination of gemcitabine and irinotecan suggest dose-dependent synergistic

Imaging Prostate Cancer: Current and Future Applications

March 01, 2001

Various treatment options are available for adenocarcinoma of the prostate-the most common malignant neoplasm among men in the United States. To select an optimum management strategy, we must be able to identify an organ-confined disease (in which local therapy such as surgery or radiation may be beneficial) vs prostate cancer beyond the confines of the gland (for which other treatment approaches may be more appropriate). At present, no standard imaging modality can by itself reliably diagnose and/or stage adenocarcinoma of the prostate. Standard transrectal ultrasound, magnetic resonance imaging (MRI), computed tomography, bone scans, and plain x-ray are not sufficiently reliable when used alone. Fortunately, advances in imaging technology have led to the development of several promising modalities. These modalities include color and power Doppler ultrasonography, ultrasound contrast agents, intermittent and harmonic ultrasound imaging, MR contrast imaging, MRI with fat suppression, MRI spectroscopy, three-dimensional MRI spectroscopy, elastography, and radioimmunoscintigraphy. These newer imaging techniques appear to improve the yield of prostate cancer detection and staging, but are limited in availability and thus require further validation. This article reviews the status of current imaging modalities for prostate cancer and identifies emerging imaging technologies that may improve the diagnosis and staging of this disease. [ONCOLOGY 15(3):325-342, 2001]

Systemic Therapy for Older Women With Breast Cancer

March 01, 2001

Breast cancer is a common problem in older women. As the number of medical illnesses increases with age and the life expectancy decreases, the benefits of systemic therapy for women with breast cancer become questionable. All women over age 65 years are at high enough risk of breast cancer to consider the risk/benefit ratio of preventive therapy with tamoxifen (Nolvadex) or participation in the Study of Tamoxifen and Raloxifene (STAR) trial. Adjuvant chemotherapy and hormonal therapies for early breast cancer significantly improve disease-free and overall survival; recommendations for their use are based on risk of tumor recurrence. Use of tamoxifen in the adjuvant setting in women with receptor-positive tumors is a relatively simple decision in light of its favorable toxicity profile. The delivery of adjuvant chemotherapy is a more complicated decision, and the patient’s wishes, estimated life expectancy, presence of comorbid conditions, and estimated benefit from treatment should be considered. The primary goal of the treatment of metastatic breast cancer is palliation. We discuss trials specific to older women and make appropriate treatment recommendations. Unfortunately, there is a paucity of data from clinical trials in women over age 70 years. However, because the clinical trial is the primary scientific mechanism for testing the efficacy of a treatment, every effort should be made to enter older women into treatment protocols. [ONCOLOGY 15(3):280-299, 2001]

Gemcitabine in Combination With New Platinum Compounds: An Update

March 03, 2001

Combinations of gemcitabine (Gemzar) with cisplatin (Platinol) are among the most active new chemotherapy regimens developed for advanced non-small-cell lung cancer. Carboplatin (Paraplatin) is a platinum analog

Treatment of Elderly Patients With Non-Small-Cell Lung Cancer

March 03, 2001

One of the main reasons for the increased acceptance of chemotherapy for both early and advanced non-small-cell lung cancer is the clinical availability of several new cytotoxic drugs. These less toxic, yet highly effective, new

Empiric Antifungal Therapy for the Neutropenic Patient

March 01, 2001

One of the major challenges facing oncologists today is invasive fungal infection. Difficult to diagnose and deadly when missed, invasive fungal infection-primarily by Candida and Aspergillus organisms-is the major infectious cause of death associated with chemotherapy-induced myelosuppression. In this review, the problem will be described and evidence-based approaches to management, including assessment for risk factors and empiric antifungal therapy, will be discussed. Finally, the future of diagnostic and therapeutic strategies for protecting the immunocompromised patient will be considered. [ONCOLOGY 15(3):351-369, 2001]

Future Directions in Adjuvant Therapy for Stage III Colon Carcinoma

March 02, 2001

The current recommendation for adjuvant chemotherapy for patients with newly diagnosed stage III colon cancer involves 6 months of fluorouracil (5-FU) plus low- or high-dose leucovorin. In clinical trials performed throughout

Cisplatin and Irinotecan in Upper Gastrointestinal Malignancies

March 02, 2001

Irinotecan (CPT-11, Camptosar) a topoisomerase I inhibitor derived from the Chinese shrub Camptotheca acuminata, has broad activity in varied gastrointestinal malignancies, including pancreatic, biliary, esophageal

Brachytherapy for Carcinoma of the Lung

March 01, 2001

An estimated 157,000 patients died of lung cancer in the United States in the year 2000.[1] Although surgery can be curative, only about 20% of patients are amenable to complete surgical resection. Most of the other patients are treated with radiation

Optimizing Chemoradiation in Locally Advanced Non-Small-Cell Lung Cancer

March 03, 2001

Gemcitabine has demonstrated activity in a broad range of solid tumors with good tolerance. In combined modality therapy, gemcitabine has achieved response rates ranging between 30% and 60% in patients with non-small-cell

Rituximab Is Active in Lymphocyte-Predominant Hodgkin’s Disease

March 01, 2001

We designed a phase II trial to determine the efficacy of the chimeric anti-CD20 monoclonal antibody rituximab (Rituxan) in lymphocyte-predominant Hodgkin’s disease (LPHD). A unique subtype of Hodgkin’s disease that expresses the CD20

New Directions in the Treatment of Advanced Colorectal Cancer

March 02, 2001

As the chemotherapy horizons have expanded in colorectal cancer with development of oxaliplatin (Eloxatin) and irinotecan (CPT-11, Camptosar), so too have our approaches to therapy. Numerous immunotherapy and gene