ONCOLOGY Vol 23 No 3

The article “PET Scan in the Diagnosis and Management of Breast Cancer” by Jame Abraham and coworkers is a complete, updated review of the existing scientific literature about clinical indications for positron-emission tomography (PET) in this malignancy.

The Surveillance, Epidemiology, and End Results (SEER) program of the National Cancer Institute (NCI) collects cancer survival and incidence information from population-based cancer registries, encompassing 26% of the US population.[1]

In 2008, more than 184,000 new patients were diagnosed with breast cancer, the most commonly diagnosed malignancy in women in the United States. Despite great advances over the past few years in screening, detection, and treatment, more than 40,000 women died from the disease in 2008.[1] Early breast cancer is considered a curable disease, but the curative potential of patients with locally advanced or metastatic disease is limited.

Anthracycline cardiotoxicity has been of clinical concern for more than 3 decades. Many hundreds of papers have been written about this unusual form of toxic cardiomyopathy, and yet, we are still putting pieces of the puzzle together. Our cumulative knowledge helps us to predict the risk of cardiac damage with fair accuracy for most patients, but others demonstrate an unpredictable sensitivity to anthracyclines and suffer devastating consequences. Strategies to prevent anthracycline cardiotoxicity have been developed but are underutilized.

In the current issue of ONCOLOGY, Hershman and Shao provide a comprehensive review of anthracycline-induced cardiotoxicity (AIC). Risk factors for AIC include age (≤ 18 or ≥ 65 years) at time of treatment, increasing cumulative dose or dose intensity of anthracyclines, mediastinal radiation therapy (RT), and female gender.[1-4]

Positron-emission tomography (PET) technology has drastically improved in the past few years, with the development of hybrid imaging devices combining PET and computed tomography (CT), which have essentially replaced stand-alone PET scanners in most centers.

The National Comprehensive Cancer Network (NCCN) has announced the addition of a survivorship section to the NCCN Clinical Practice Guidelines in Oncology for colon and rectal cancers, as well as other key updates in colorectal cancer. The NCCN also recently updated its guidelines for breast cancer and breast cancer risk reduction. These changes reflect leading developments in the treatment of cancer patients and represent the standard of clinical policy in oncology in both community and academic settings.

The US Food and Drug Administration (FDA) has accepted Amgen’s submission and filed a Biologics License Application (BLA) for denosumab, the first fully human monoclonal antibody in late stage clinical development that specifically targets RANK ligand, an essential regulator of osteoclasts. The indications for which Amgen is seeking FDA approval are treatment and prevention of postmenopausal osteoporosis (PMO) in women and treatment and prevention of bone loss in patients undergoing hormone ablation therapy for either prostate or breast cancer.

Polymedco, Inc, announced the availability of the BTA Stat test-a point of care technology for the early detection of recurrent bladder cancer. This method uses monoclonal antibodies to detect the presence of bladder tumor–associated antigen in urine. It is a single-step, rapid immunochromatographic assay for bladder tumor-associated antigen in voided urine.

The US Food and Drug Administration granted marketing approval for plerixafor (Mozobil), a drug intended to be used in combination with granulocyte colony-stimulating factor to mobilize hematopoietic stem cells to the bloodstream for collection and subsequent autologous transplantation in patients with non- Hodgkin’s lymphoma and multiple myeloma. The product has also been granted orphan drug designation.

A recently published study in The New England Journal of Medicine (360:679-691, 2009) shows that in premenopausal women with early breast cancer, administering zoledronic acid (Zometa) along with postsurgical hormone therapy provided a reduction in risk of recurrence or death that was 36% beyond that achieved with hormone therapy alone.

Women facing a recent breast cancer diagnosis may find additional cancer in the same or opposite breast with further testing using breastspecific gamma imaging (BSGI), according to a study published in the February 2009 American Journal of Surgery (197:159-163, 2009)

Patients with endometrial cancer who have minimally invasive robotic-assisted hysterectomies tend to have quicker surgeries and shorter hospital stays compared with patients who have similar laparoscopic surgical procedures, according to new research from The Ohio State University Comprehensive Cancer–James Cancer Hospital and Solove Research Institute.

Northwest Biotherapeutics, Inc, announced longterm follow-up data for the second half of 2008, from its prior phase I and phase I/II clinical trials with DCVax-Brain in patients with glioblastoma multiforme. During the update period from June 15, 2008, through January 1, 2009, none of the 20 patients treated with standard of care plus DCVax-Brain died.

A new analysis finds that when colorectal cancer patients seek out health information from the Internet and news media, they are more likely to be aware of and receive the latest treatments for their disease. To be published in the April 1, 2009, issue of CANCER, the study indicates that patients can influence their own treatment, in some cases in inappropriate ways.

Anthracyclines are among the most effective and widely prescribed anticancer agents. They were first isolated from cultures of Streptomyces peucetius by Dr. Federico Arcamone in the early 1960s.[1] Anthracyclines have since become an essential component of breast cancer treatment, and their use in combination regimens as adjuvant therapy is the standard of care for most women with early-stage disease.[2] Two commonly used anthracyclines in breast cancer are doxorubicin and epirubicin, a semisynthetic derivative of doxorubicin.

The entry of new technology into medical practice is complex. New technology in radiation oncology includes advances in imaging (including anatomic and molecular/functional imaging) and radiation therapy planning and delivery involving intensity-modulated radiation therapy (IMRT), stereotactic radiation therapy (SRT), and therapy with particles such as protons and carbon ions.

The recommendation to minimize sun exposure to prevent skin cancer has produced a pandemic of vitamin D deficiency. Vitamin D has generated considerable interest in the past decade, as accumulating evidence from both retrospective and prospective epidemiologic studies suggests an association between vitamin D deficiency and increased risk of autoimmune, infectious, and cardiovascular diseases, as well as cancer.