ONCOLOGY Vol 16 No 7

The addition of paclitaxel before surgery to primary systemic therapy with doxorubicin, followed by CMF

Fujirebio Diagnostics recently announced that its CA 19-9 radioimmunoassay for monitoring of pancreatic cancer patients received marketing clearance from the US Food and Drug Administration (FDA). The CA 19-9 radioimmunoassay is the first

Any new medical textbook must compete for readership under new rules. It is not just the numerous other books being published but also the wealth of information on the Internet that vies for the time and attention of the inquiring reader. Web-based general search engines and medical literature tools have made the previous frequent trips to the hospital library nearly obsolete for many of us. There is ready access to original references or discussion about almost any topic in cancer care. A successful book on cancer treatment, therefore, must provide more-something unique for the practicing physician, student, or teacher. Ideally, it will present a useful synthesis, interpretation, and, with luck, clinical wisdom

Imatinib mesylate (Gleevec) has a lasting effect on advanced gastrointestinal stromal tumors (GISTs), while greatly reducing

Enrollment in the National Lung Screening Trial (NLST), which was projected to have begun this spring, has been delayed. The National Cancer Institute (NCI) apparently wants to ensure that it makes every effort to listen to the complaints of critics.

Previous research has demonstrated that many patients enrolled in clinical trials incorrectly believe that the primary purpose of

New data for 1999 show that death rates for all cancers continued to decline in the United States. However, the number of cancer cases is expected to rise in coming years due to the growth and aging of the population, according to a recent report. The "Annual Report to the Nation on the Status of Cancer, 1973-1999, Featuring Implications of Age and Aging on the US Cancer Burden" was published in a recent issue of the journal Cancer (94:2766-2792, 2002).

Aggressive ovarian cancer may be linked to the presence of thrombocytosis, report investigators from Cedars-Sinai Medical Center in Los Angeles.

Combination Chemotherapy Should Be Standard of Care for Lung Cancer

Patients and physicians differ significantly in their perceptions of phase I clinical trial outcomes and the content of treatment

Sanofi-Synthelabo announced the commercial availability of Eligard (leuprolide acetate, 7.5 mg) for the palliative treatment of advanced prostate cancer at the 2002 annual meeting of the American Urological Association. Recommended in the prostate

Two studies published recently in the Journal of Clinical Oncology showed promising response rates for docetaxel (Taxotere)-based therapy over existing therapies for several types of cancer

Dr. Yee and his colleagues have offered a comprehensive overview of the epidemiology, diagnosis, and therapy of both gallbladder carcinoma and cholangiocarcinoma. They correctly note the infrequency of these two neoplasms, with approximately 7,500 cases diagnosed in the United States each year, two-thirds of which are gallbladder cancer. Unfortunately, neither the incidence rate nor prognosis of these neoplasms has changed substantially since biliary tumors were last reviewed in this journal[1]; the median 5-year survival rate has remained at 5%. Some progress has been made, however, in our understanding of the etiology of cancers of the biliary tract, and a body of literature continues to emerge exploring the question of how best to approach screening and prophylaxis in high-risk populations.

Over the past 2 decades, two major trends in the treatment of breast cancer-breast-conserving therapy and neoadjuvant (or preoperative) chemotherapy-have converged to stimulate interest in the use of neoadjuvant chemotherapy to facilitate breast conservation in women presenting with large tumors. After being established as the treatment of choice for locally advanced or inoperable breast cancer, theoretical considerations and the desire to extend breast-conserving therapy to more patients with large tumors have resulted in an increase in the use of neoadjuvant chemotherapy in operable patients. Drs. Green and Hortobagyi have provided us with a comprehensive review of the background and the current state of neoadjuvant chemotherapy for breast cancer.

Malignant pleural mesothelioma is a relatively rare malignancy with an annual incidence in the United States of approximately 3,000 cases. Based on asbestos exposure demographics, incidence should peak in the United States in the next 10 to 20 years. Peto et al have suggested that the incidence in Western Europe may continue to climb for substantially longer, possibly reaching as high as 1/100 among middle-aged men.[1,2] In developing countries (often bereft of asbestos regulation), the incidence is not known

In December 2000, ONCOLOGY’s Jim McCarthy sent me a letter, inviting me to prepare an article for the journal on "The Current Status of Chemotherapy Sensitivity Assays." I was informed that the paper would be referred to one or two reviewers, who would write a commentary to be published alongside the paper. The commentary, I was told, might be "entirely laudatory, highly critical, or somewhere in between," and the result, "both lively and informative."

R115777 (Zarnestra) is an orally available methylquinolone derivative from Johnson & Johnson Pharmaceutical Research and Development L.L.C. that is a potent and selective nonpeptidomimetic farnesyltransferase inhibitor (FTI).[1] FTIs represent a new class of agents that were originally developed to inhibit tumors by interfering with posttranslational processing of oncogenic Ras protein. The anticancer activity of FTIs might stem from their ability to effect various proteins other than Ras that can also mediate signal transduction, apoptosis, angiogenesis, and growth.[2]

Drs. Zellos and Sugarbaker have provided a concise yet complete review of the current management of resectable diffuse malignant mesothelioma and have identified areas worthy of further investigation. Although, on occasion, surgical treatment can produce long-term cure, in general, diffuse malignant mesothelioma is a devastating disease. One only has to look at the survival curves provided by the Brigham group to understand that, of 183 patients, only 7 survived for 5 years.[1] However, neither the number eligible for evaluation at 5 years nor the disease-free survival figures were reported.

It is nearly 30 years since the start of clinical trials of adjuvant chemotherapy in patients with operable breast cancer.[1] The rationale for using adjuvant chemotherapy at that time was that surgery and radiotherapy could only control local disease and cure patients who did not already have metastases. Chemotherapy could be used in patients with a poor prognosis to treat undetected micrometastatic disease and thereby reduce the risk of metastatic relapse and death from breast cancer.

Drs. Yee and colleagues have done an excellent job of surveying the treatment of gallbladder cancer and cholangiocarcinomas. These relatively uncommon tumors are among the more difficult encountered by surgical, medical, and radiation oncologists, as evidenced by the lack of new therapies or change in prognosis over the past several decades.

Preoperative therapy delivers treatment at the earliest time in a tumor’s natural history. Is it beneficial or harmful? Should it be undertaken? The article by Drs. Green and Hortobagyi brings most aspects of neoadjuvant therapy under one umbrella and poses several key questions.

Drs. Zellos and Sugarbaker nicely summarize the current treatment strategies for malignant pleural mesothelioma. The management of this disease remains controversial, and several aspects of the review merit discussion.

The article by Dr. William Breitbart and Lucia DiBiase offers an excellent in-depth review of our current knowledge of the epidemiology, pharmacologic, and nonpharmacologic interventions in the field of pain management in patients with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS).

Concern about prescribing controlled substances underlies, in part, the undertreatment of pain, even in palliative care settings. That the same is true for human immunodeficiency virus (HIV) patients is therefore not surprising, particularly given injection drug use as a risk factor.

Diffuse malignant pleural mesothelioma is a rare and aggressive malignancy of the pleura that is usually caused by exposure to asbestos. Between 2,000 and 3,000 new cases are expected to be diagnosed annually in the

Cancers of the gallbladder and biliary tract are uncommon malignancies in the United States with a combined incidence of less than 8,000 new cases per year, about 5,000 of which are gallbladder cancer and about 2,000 to 3,000 of which are cholangiocarcinomas, including intrahepatic, hilar, and distal bile duct cancers.[1] For gallbladder cancer with mucosa-confined disease, the 5-year survival rate is approximately 32%, and for advanced disease, less than 10% of patients survive longer than 1 year.[2]

As active participants in the care of patients with acquired immunodeficiency syndrome (AIDS), oncologists need to be aware of the many facets of pain management in this population. This two-part article, which began in the

Neoplasms of the biliary tract tree are uncommon and have a poor overall prognosis. Although numerous risk factors have been identified, little is known about the pathogenesis of these tumors, and no effective screening

Adjuvant systemic chemotherapy has been shown to prolong survival in all subsets of patients with breast cancer. In addition, among patients with locally advanced breast cancer, neoadjuvant or preoperative chemotherapy has

With President Bush having signed the Hematological Cancer Research Investment and Education Act on May 14, the NCI will have to "expand, intensify, and coordinate programs for the conduct and support of research with respect to blood cancer, and particularly with respect to leukemia, lymphoma, and multiple myeloma."