ONCOLOGY Vol 16 No 10 | Oncology

Anastrozole Approved for Use in Early Breast Cancer

October 01, 2002

The US Food and Drug Administration has approved anastrozole (Arimidex) for the adjuvant treatment of hormone-receptor-positive early breast cancer in postmenopausal women. The approval is based on research from the Arimidex,

US Senate Passes Eliminate Colorectal Cancer Act

October 01, 2002

The US Senate Health, Education, Labor, and Pensions Committee has passed the Eliminate Colorectal Cancer Act (S.710), legislation introduced by Sen. Jesse Helms (R-NC) and Sen. Edward M. Kennedy (D-Mass). The bill, with the companion

Cigarette Smoking Among Adults United States, 2000

October 01, 2002

One of the national health objectives for 2010 is to reduce the prevalence of cigarette smoking among adults to £ 12% (objective 27.la). To assess progress toward this objective, the Centers for Disease Control and Prevention (CDC) analyzed

FDA Approves Kytril for Postoperative Nausea and Vomiting

October 01, 2002

The US Food and Drug Administration (FDA) has approved granisetron (Kytril) for the prevention and treatment of postoperative nausea and vomiting. The approval was based on the results of recent clinical trials.

Optimal Use of Antiemetics in the Outpatient Setting

October 01, 2002

Steven Grunberg, one of the pioneer clinical investigators in the development of modern antiemetics, describes various approaches to the management of this important complication of cytotoxic chemotherapy. Dr. Grunberg describes the use of phenothiazines and antidopaminergic agents as antiemetics, the discovery that steroids could serve as effective adjuvant antiemetic agents, and the development of the serotonin (5-HT3)-receptor antagonists. Thus, we have compazine, metoclopromide, decadron, and a set of 5-HT3 antagonists-ondansetron (Zofran), dolasetron (Anzemet), and granisetron (Kytril)-in our therapeutic armamentarium.

NIH, Drug Industry Target Barriers to Patient Accrual in Clinical Trials

October 01, 2002

A new partnership between the National Institutes of Health and five major drug companies will provide a total of $6 million to several cancer centers to find ways to increase accrual to early clinical trials. The five pharmaceutical firms involved in the

Medicare Puts PET for Thyroid Cancer, Soft-Tissue Sarcoma on Hold

October 01, 2002

An advisory group to the Centers for Medicare and Medicaid Services (CMS) has delayed a decision on whether to recommend Medicare coverage for positron-emission tomography (PET) with F-18-fluorodeoxyglucose (FDG) in the

Investigators Question Effect of Race on Prostate Cancer Survival

October 01, 2002

African-American patients with advanced prostate cancer survived slightly longer than white patients, according to a multi-institutional study led by Dana-Farber Cancer Institute researchers. The findings, which were reported at the 38th annual

Capecitabine With Docetaxel Demonstrates Survival Advantage in Breast Cancer Patients

October 01, 2002

The results of a phase III trial of capecitabine (Xeloda) in combination with docetaxel (Taxotere) for the treatment of metastatic breast cancer were published in a recent issue of the Journal of Clinical Oncology (20:2812-2823, 2002). Based on

Use of Fulvestrant for Advanced Breast Cancer Supported by Pivotal Phase III Data

October 01, 2002

The results of two clinical trials evaluating fulvestrant (Faslodex) for the treatment of advanced breast cancer in postmenopausal women with disease progression following antiestrogen therapy were published in a recent issue of the Journal

The Breast Cancer Wars

October 01, 2002

United States seems to have a predilection for declaring "war" on its internal problems, be they poverty, drugs, or cancer. In the latter part of the past century particularly, military metaphors became part of the vocabulary used by Americans to

Study Shows More Women With Advanced Breast Cancer Respond to Letrozole Than to Anastrozole

October 01, 2002

In an international study of the two leading aromatase inhibitors, data demonstrate that 50% more women with advanced breast cancer respond to letrozole (Femara) than to anastrozole (Arimidex); ie, more women treated with letrozole achieved at

HER2 Gene Test Information Included in Trastuzumab Labeling

October 01, 2002

Received approval from the US Food and Drug Administration (FDA) to include information about Abbott’s PathVysion-a fluorescence in situ hybridization (FISH) test-in the product insert for trastuzumab (Herceptin). FISH is used to detect human

Current Status of Prophylactic Mastectomy

October 01, 2002

With the advent of methods for determining genetic susceptibility to breast cancer, there is a growing focus on prevention as a primary strategy. In this context, more women will receive information about the role of prophylactic mastectomy as a definitive management strategy. Drs. Ghosh and Hartmann have provided a thorough review of the salient issues in prophylactic mastectomy. Their discussion of the procedure and its history set the stage for further discussion of the relative efficacy of prophylactic mastectomy in reducing the risk of breast cancer in women.

Current Status of Prophylactic Mastectomy

October 01, 2002

Ghosh and Hartmann present an excellent overview on the risk reduction that prophylactic mastectomy offers the high-risk patient. Dr. Hartmann and the Mayo Clinic remain leaders in this field. As cited in their recent series, the risk of developing breast cancer is reduced 89.5% to 100% in high-risk women who choose to undergo prophylactic mastectomy.[1] In the same year, Meijers-Heijboer et al supported these findings, documenting a 100% relative risk reduction.[2] The fact that prophylactic surgery offers a dramatic reduction in the risk of breast cancer to high-risk patients appears unquestionable.

Optimal Use of Antiemetics in the Outpatient Setting

October 01, 2002

In his article, Dr. Grunberg charts the history of our understanding of chemotherapy-induced nausea and vomiting, and the discovery and development of drugs for its prevention. He places appropriate emphasis on the serotonin (5-HT3) antagonists-notably, ondansetron, granisetron, and dolasetron-which have revolutionized the field over the past decade.

HER2 Testing and Correlation With Efficacy of Trastuzumab Therapy

October 01, 2002

The emerging era of targeted cancer therapies has focused laboratory scientists and clinicians on the need to define and understand molecular targets of novel drugs. For breast cancer patients and doctors, this trend is not news-efforts have been under way for decades to identify the estrogen and progesterone receptors and define the value of these markers as predictors of response to hormonal therapy.

Brachytherapy in the Treatment of Head and Neck Cancer

October 01, 2002

Quon and Harrison have performed a considerable service to patients with head and neck cancers by reminding the oncology community that a state-of-the-art treatment team must include state-of-the-art brachytherapy

Capecitabine in the Treatment of Advanced Breast Cancer

October 02, 2002

This supplement to ONCOLOGY includes a collection of papers focusing on the clinical development and use of capecitabine (Xeloda), a novel agent with significant activity in patients suffering from metastatic breast cancer. It is now clear that this

Development and Characterization of Darbepoetin Alfa

October 01, 2002

Studies on human erythropoietin (EPO) demonstrated that there is a direct relationship between the sialic acid-containing carbohydrate content of the molecule and its serum half-life and in vivo biological activity, but an

HER2 Testing and Correlation With Efficacy of Trastuzumab Therapy

October 01, 2002

The need for accurate detection of HER2 status is becoming more apparent, as therapeutic decisions are influenced by this information in both the adjuvant and advanced-stage setting. Since the US Food and Drug

Optimal Use of Antiemetics in the Outpatient Setting

October 01, 2002

Nausea and vomiting are the toxicities of chemotherapy most feared by the cancer patient. However, increased understanding of the mechanisms of nausea and vomiting has led to greatly improved control of this toxicity.

Optimizing the Treatment of Anemia in Cancer Patients

October 01, 2002

Cancer-related anemia, in addition to having detrimental effects on quality of life and adding the risk and inconvenience of blood transfusions, may also be associated with decreased survival or time to progression. Yet

Current Status of Prophylactic Mastectomy

October 01, 2002

The management of women at high risk for breast cancer presents a clinical dilemma to the health-care provider as well as to the woman herself. Current options include surveillance, prophylactic surgery (mastectomy and/or

HER2 Testing and Correlation With Efficacy of Trastuzumab Therapy

October 01, 2002

The emerging era of targeted cancer therapies has focused laboratory scientists and clinicians on the need to define and understand molecular targets of novel drugs. For breast cancer patients and doctors, this trend is not news-efforts have been under way for decades to identify the estrogen and progesterone receptors and define the value of these markers as predictors of response to hormonal therapy.

Brachytherapy in the Treatment of Head and Neck Cancer

October 01, 2002

Drs. Quon and Harrison have written an excellent review on the role of brachytherapy in the management of head and neck cancer. Brachytherapy is a time-honored technique, and the authors have carefully reviewed the pertinent literature extolling its virtues. However, there are many papers that fail to document efficacy of brachytherapy over conventional techniques, demonstrating that, similar to surgery, the technique is both patient- and operator-dependent.

Brachytherapy in the Treatment of Head and Neck Cancer

October 01, 2002

Brachytherapy is a therapeutic modality that may provide a significant improvement in the therapeutic ratio when appropriately applied, and hence, is an appealing treatment strategy for the head and neck. For several

Commentary (Coit): Management of Small Bowel Adenocarcinoma

October 01, 2002

Malignant small bowel tumors are extremely rare, accounting for 0.1% to 0.3% of all malignancies. Fewer than 2,400 new cases of small bowel malignancy are reported in the United States each year.[1] Malignant tumors, which account for about two-thirds of all primary small bowel tumors, consist of four primary subtypes: adenocarcinoma, carcinoid tumor, lymphoma, and sarcoma (or gastrointestinal [GI] stromal tumor). Each malignancy is characterized by unique predisposing factors, anatomy, and biology. The prevalence, pattern, and relevance of both regional lymph node and distant metastases differ. As a result, the study of malignant small bowel tumors, taken as an aggregate, is fraught with difficulty.

Management of Small Bowel Adenocarcinoma

September 30, 2002

Small bowel adenocarcinoma is a relatively rare malignancy. Only limited information is available on the incidence, prognosis, and role of chemotherapy in the treatment of this disease. We present a review of currently

New Directions With Capecitabine Combinations in Advanced Breast Cancer

October 02, 2002

Capecitabine (Xeloda) offers a unique mode of action. The drug is currently being combined with other active agents in the treatment of advanced breast cancer. The recent demonstration of improved disease-free and overall

Commentary (Coia): Management of Small Bowel Adenocarcinoma

October 01, 2002

Dr. Kummar and her coauthors have tackled the difficult task of reviewing small bowel adenocarcinoma so that we might have a better understanding of this uncommonly encountered malignancy. The task is unusually difficult, not because of the need to critically review reams of publications on the topic, but rather because so little literature exists on the topic of optimal management. Nonetheless, the authors have succeeded in educating the reader on several important issues, including the need for close follow-up of patients with small bowel adenocarcinoma, who are not only at risk for recurrence but also have a relatively high risk of other gastrointestinal tumors. Additionally, the authors identify factors associated with poor prognosis, including age > 75 years, lack of surgical resection, advanced disease stage, and tumor arising in the duodenum.