ONCOLOGY Vol 23 No 9 | Oncology

Therapeutic Options Following Orchiectomy for Stage I Seminoma

August 13, 2009

Over the past 3 decades, the incidence rate of testicular seminoma has continually risen, and the majority of cases have been clinical stage I.[1] Nevertheless, the overall survival for all testicular cancers has improved significantly (P < .05) over the same period, from 83% to 96%.[2]

Choosing Treatment for Stage I Seminoma: Who Should Get What?

August 13, 2009

Lawrentschuk and Fleshner accurately depict the difficulty in choosing among observation, prophylactic radiation, and adjuvant chemotherapy for clinical stage I testicular seminoma. The physican has competing priorities of avoiding unnecessary treatment while minimizing the overall burden of both therapy and surveillance testing. The patient has to contend with defined risks that exist with any of the three options.

Surveillance for Stage I Seminoma: Better the Devil You Know Than the Devil You Don’t?

August 13, 2009

Adjuvant radiotherapy to the regional lymph nodes following orchiectomy has been the standard of care for seminoma for over 50 years. The ipsilateral hemipelvis, retroperitoneum, and mediastinum were all regions thought to be important for reducing the risk of recurrence.

Optimal Treatment in the Postorchiectomy Management of Clinical Stage I Seminoma

August 13, 2009

Drs. Lawrentschuk and Fleshner have written an excellent review on therapeutic options following orchiectomy for stage I seminoma. Their practical review discusses the roles of active surveillance, radiation therapy, and chemotherapy with one cycle of carboplatin (area under the concentration-time curve [AUC] 7) in this setting and provides important perspectives on the management controversies for practicing oncologists.

New Directions in the Systemic Treatment of Metastatic Thyroid Cancer

August 14, 2009

About 30,000 new cases of thyroid cancer are diagnosed annually in the United States.[1] The incidence among men has risen more dramatically than any other malignancy in recent years (2.4% annual increase).[2] Thyroid cancers arise from one of two cell types, namely follicular and parafollicular cells.

Radioiodine-Resistant Differentiated Thyroid Cancer: Hope for the Future

August 14, 2009

In this helpful review, the authors catalog a number of the novel molecular agents now being examined for treatment of radioiodine-resistant, metastatic differentiated thyroid cancer. They also call for increased systematic study of outcomes through recruitment of patients into large-scale trials.

Thyroid Cancer Update: Dramatic Changes in the Treatment of a Rare Disease

August 14, 2009

The paper by Higgins et al published in this issue highlights the important advances that have been made in the treatment of advanced thyroid cancer over the past few years. Patients with iodine-refractory metastatic thyroid cancer have suffered badly due to the reputation of thyroid cancer as being a “good” cancer to have.

Bevacizumab Approved for Metastatic Renal Cell Carcinoma

August 17, 2009

Genentech announced that the US Food and Drug Administration (FDA) has approved bevacizumab (Avastin) plus interferon- alfa for people with metastatic renal cell carcinoma, the most common type of kidney cancer.

Project Zero Delay Accelerates Drug’s Path to Clinical Trial

August 17, 2009

A phase I clinical trial enrolled its first patient only 2 days after FDA clearance of the experimental drug for a first-in-human cancer trial, a milestone that normally takes 3 to 6 months. Investigators from The University of Texas M.D.

New Drug Application Filed for Vandetanib in Second-Line NSCLC

August 17, 2009

AstraZeneca announced the company has submitted a New Drug Application to the FDA for an investigational drug, vandetanib ( Zactima) 100 mg, for use in combination with chemotherapy for the treatment of advanced non–small-cell lung cancer in patients previously treated with one prior anticancer therapy.

Response to Antiangiogenesis Therapy in a Patient With Advanced Adult-Type Testicular Granulosa Cell Tumor

August 18, 2009

We have presented the first case of a patient with metastatic ATGCT with peritoneal carcinomatosis, who responded to treatment with a VEGFR tyrosine kinase inhibitor. Because of the relative paucity of such cases in the literature, no clear treatment strategy exists. For patients with metastatic ATGCT, enrollment in clinical trials testing novel therapies, including angiogenesis inhibitors, is a reasonable option.

Metabolic Therapies

August 18, 2009

Promoters of metabolic therapies claim that special diets, detoxification, and immune stimulation can treat and prevent a variety of diseases including arthritis, multiple sclerosis, and cancer.