ONCOLOGY Vol 22 No 11

Khatcheressian and coauthors’ article about futile care in oncology addressed an important but uncommonly discussed aspect of oncology.[1] There are several other points that were not brought up in the excellent discussion.

Localized pancreatic cancer, whether resectable or unresectable, is a separate entity from metastatic pancreatic cancer. Multiple studies have demonstrated that even in the setting of unresectable disease, the progression-free and overall survival of patients with localized pancreatic cancer exceeds that associated with metastatic pancreatic cancer.

Surgical resection offers the only potential cure for pancreatic adenocarcinoma. Unfortunately, while perioperative outcomes have improved dramatically in recent years, few patients present with tumors that are amenable to resection, and even after resection of apparently localized disease, long-term survival is poor.

Early-stage breast cancer patients who receive a more intensive course of radiation to their whole breast over 3 weeks is as effective as the standard, less-intensive 5-week whole-breast radiation and offers patients more convenience at a lower cost, thereby providing a better quality of life, according to a randomized, long-term study presented September 22, 2008, in the plenary session at the 50th Annual Meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO), held in Boston.

For men with locally advanced prostate cancer, the addition of radiation treatment to antiandrogen hormone therapy reduces the risk of dying of prostate cancer by 50% compared to those who have antiandrogen hormone treatment alone, according to a randomized study presented September 22, 2008, during the plenary session of the American Society for Therapeutic Radiology and Oncology’s 50th Annual Meeting in Boston.

Acupuncture is as effective and longer-lasting in managing the common debilitating side effects of hot flashes, night sweats, and excessive sweating (vasomotor symptoms) associated with breast cancer treatment and has no treatment side effects compared to conventional drug therapy, according to a first-of-its-kind study presented September 24, 2008, at the American Society for Therapeutic Radiology and Oncology’s 50th Annual Meeting in Boston.

Men over 70 years of age with early-stage prostate cancer have a 20% higher mortality if they are treated first with hormone therapy before being treated with radiation seed implants (brachytherapy), compared to men who are treated with brachytherapy alone, according to the largest cohort study of its kind presented September 23, 2008, at the 50th Annual Meeting of the American Society for Therapeutic Radiology and Oncology in Boston.

Long-term survivors of adult cancers are almost twice as likely to report psychological distress severe enough to cause moderate to serious problems functioning in social, work or school situations, compared to the general population, according to a large, national study presented September 24, 2008, at the American Society for Therapeutic Radiology and Oncology’s 50th Annual Meeting in Boston.

SCIENTIFIC NAMES: Silybum marianum, Carduus marianum

The challenge presented by adenocarcinoma of the pancreas is reflected by the fact that the incidence of this disease-almost 38,000 cases predicted in the United States for 2008[1]-approximates its mortality rate.

This installment of Second Opinion examines the case of a patient with a new diagnosis of breast cancer presenting to our multidisciplinary breast cancer second opinion clinic.

Carcinomas arising from the breast represent a heterogeneous group of tumors of distinct biologic subtypes that have been shown to be diverse in terms of response to therapy and prognostic outcomes.

Data presented at the European Society of Medical Oncology (ESMO) meeting in Stockholm show that the IRESSA Pan-ASia Study (IPASS) exceeded its primary objective, demonstrating superior progression-free survival (PFS) for oral gefitinib (Iressa), compared with intravenous carboplatin/paclitaxel chemotherapy (hazard ratio [HR] = 0.74, P < .0001) in the overall population of clinically selected patients with advanced non–small-cell lung cancer (NSCLC) in Asia.

Eli Lilly and Company announced it received approval from the US Food and Drug Administration (FDA) for the use of pemetrexed (Alimta), in combination with cisplatin, in the first-line treatment of locally advanced and metastatic non–small-cell lung cancer (NSCLC), for patients with nonsquamous histology. Pemetrexed is not indicated for treatment of patients with squamous cell NSCLC.

ProStrakan Group announced the US Food and Drug Administration (FDA) approval of granisetron transdermal system (Sancuso), the first and only patch to provide up to 5 consecutive days of control of chemotherapy-induced nausea and vomiting (CINV).

The Metastatic Breast Cancer Advocacy Working Group, a cooperative of patient advocates from seven countries, released a consensus report urging other advocacy groups, health-care corporations and professionals, government, academia, community/religious organizations, and all other relevant breast cancer stakeholders worldwide to take action on three priority areas for women living with metastatic breast cancer (MBC)

As Calabrich and colleagues illustrate in their comprehensive review in this issue of ONCOLOGY, there is a seemingly endless array of mechanisms by which the HER2-positive breast cancer cell can escape the control of trastuzumab (Herceptin).

The human epidermal growth factor receptor 2 (HER2) is a transmembrane receptor with tyrosine kinase activity overexpressed in about 20% to 25% of invasive carcinomas of the breast.

In 2008, it is estimated that over 1 million women worldwide will be diagnosed with breast cancer, of which 172,695 will be classified as “triple-negative.”[1] The triple-negative phenotype encompasses a breast tumor subtype that is clinically negative for expression of the estrogen and progesterone receptors (ER and PR) and lacks overexpression of the HER2 protein, with unique prognostic and therapeutic implications.