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The combination of lenalidomide (Revlimid) with melphalan and prednisone (R-MP) is highly active and well tolerated in older adults with newly diagnosed multiple myeloma.

Focus groups, mentoring, and expanded recruitment efforts have helped Roswell Park Cancer Institute (RPCI) keep its vacancy rate low in the midst of a nursing shortage

An evaluation of the US Environmental Protection Agency's most recent assessment of dioxin has concluded that EPA understated the uncertainly about the chemical's health risks and may have overstated the risk of human cancer.

In an ideal world, palliative care would be integrated into therapeutic care from the time of cancer diagnosis—not limited to hospice or end-of-life care.

"Tumor flare reaction is a new side effect associated with lenalidomide (Revlimid), an immunomodulatory agent being investigated as a treatment for chronic lymphocytic leukemia [CLL],"

The FDA has granted expanded approval to Enzon's Oncaspar (pegaspargase) as part of multidrug chemotherapy for treating children and adults with newly diagnosed acute lymphoblastic leukemia (ALL

In a hearing convened by House Ways and Means Subcommittee on Health chairwoman Nancy Johnson (R-CT), Congress sought input on the effects of the new average sales price (ASP) payment system for cancer drug reimbursement on the delivery and access of cancer care. American Society of Clinical Oncology (ASCO) interim executive vice president and chief executive officer, Joseph S. Bailes, MD, testified at the hearing.

Merck & Co.'s antiemetic Emend (aprepitant) has been granted expanded approval by the FDA to prevent postoperative nausea and vomiting (PONV). Emend, a substance P/neurokinin 1 (NK-1) receptor antagonist, works through a mechanism distinct from that of the 5-HT3 receptor antagonists. Approval was based on two randomized double-blind studies of 1,658 patients undergoing open abdominal surgery. Emend was previously approved for the prevention of chemotherapy-induced nausea and vomiting.

Bioavailability studies show that oral spray delivery of the antiemetic 5-HT3 antagonist ondansetron is equivalent to oral delivery with ondansetron tablets (Zofran), Wayne Yates, MBA, and Greg Berk, MD, of Hana Biosciences, said at the American Society of Clinical Oncology 42nd Annual Meeting (abstract 8622). Hana Biosciences has submitted a New Drug Application to the FDA for the oral spray (brand name Zensana) for the prevention of nausea and vomiting associated with chemotherapy or radiotherapy, and the prevention of postoperatively induced nausea and vomiting.

Alemtuzumab (Campath) is well tolerated when given as front-line therapy for progressive B-cell chronic lymphocytic leukemia (BCLL) and produces a higher response rate than chlorambucil (Leukeran).

Insufficient time is a major source of stress and burnout in the practice of oncology, but oncologists can use a variety of strategies to increase their efficiency and get more satisfaction from their work and from life

The aromatase inhibitors (AIs) anastrozole (Arimidex), letrozole (Femara), and exemestane (Aromasin) are significantly more effective than the selective estrogen-receptor modulator (SERM) tamoxifen in preventing recurrence in estrogen receptor-positive early breast cancer. Aromatase inhibitors are likely to replace SERMs as first-line adjuvant therapy for many patients. However, AIs are associated with significantly more osteoporotic fractures and greater bone mineral loss. As antiresorptive agents, oral and intravenous bisphosphonates such as alendronate (Fosamax), risedronate (Actonel), ibandronate (Boniva), pamidronate (Aredia), and zoledronic acid (Zometa) have efficacy in preventing postmenopausal osteoporosis, cancer treatment-related bone loss, or skeletal complications of metastatic disease. Clinical practice guidelines recommend baseline and annual follow-up bone density monitoring for all patients initiating AI therapy. Bisphosphonate therapy should be prescribed for patients with osteoporosis (T score < -2.5) and considered on an individual basis for those with osteopenia (T score < -1). Modifiable lifestyle behaviors including adequate calcium and vitamin D intake, weight-bearing exercise, and smoking cessation should be addressed. Adverse events associated with bisphosphonates include gastrointestinal toxicity, renal toxicity, and osteonecrosis of the jaw. These safety concerns should be balanced with the potential of bisphosphonates to minimize or prevent the debilitating effects of AI-associated bone loss in patients with early, hormone receptor-positive breast cancer.

The aromatase inhibitors (AIs) anastrozole (Arimidex), letrozole (Femara), and exemestane (Aromasin) are significantly more effective than the selective estrogen-receptor modulator (SERM) tamoxifen in preventing recurrence in estrogen receptor-positive early breast cancer. Aromatase inhibitors are likely to replace SERMs as first-line adjuvant therapy for many patients. However, AIs are associated with significantly more osteoporotic fractures and greater bone mineral loss. As antiresorptive agents, oral and intravenous bisphosphonates such as alendronate (Fosamax), risedronate (Actonel), ibandronate (Boniva), pamidronate (Aredia), and zoledronic acid (Zometa) have efficacy in preventing postmenopausal osteoporosis, cancer treatment-related bone loss, or skeletal complications of metastatic disease. Clinical practice guidelines recommend baseline and annual follow-up bone density monitoring for all patients initiating AI therapy. Bisphosphonate therapy should be prescribed for patients with osteoporosis (T score < -2.5) and considered on an individual basis for those with osteopenia (T score < -1). Modifiable lifestyle behaviors including adequate calcium and vitamin D intake, weight-bearing exercise, and smoking cessation should be addressed. Adverse events associated with bisphosphonates include gastrointestinal toxicity, renal toxicity, and osteonecrosis of the jaw. These safety concerns should be balanced with the potential of bisphosphonates to minimize or prevent the debilitating effects of AI-associated bone loss in patients with early, hormone receptor-positive breast cancer.

Cases of osteonecrosis of the jaw (ONJ) have been reported with an increasing frequency over the past few years. ONJ is most often identified in patients with cancer who are receiving intravenous bisphosphonate therapy but it has also been diagnosed in patients receiving oral bisphosphonates for nonmalignant conditions. The condition involves exposed bone of the maxilla or mandible. Although it is often associated with a recent dental surgical procedure, spontaneous ONJ can also occur. Patients commonly present with symptoms. Through case reporting and clinical experience, there is a suggestion that the incidence of ONJ in patients with cancer receiving intravenous bisphosphonates ranges between 1% and 10%. Management of ONJ focuses on maximizing oral health, conservative actions with mouth rinses, antibiotics, and avoidance of unnecessary invasive dental procedures. The currently available data on ONJ are reviewed here.

As the aging population in the United States continues to grow, the incidence of diseases of the elderly, such as breast cancer, are increasing. Many more elderly women are expected to be diagnosed with new breast cancers, most of them in an early stage. Appropriate treatment of these women is important, as they have poorer outcomes when undertreated. In this review, we will discuss the biology and treatment of early breast cancer in elderly women. We will focus on the role of comorbidity and its effect on life expectancy, treatment decisions, current recommendations for primary treatment with surgery, radiation and neoadjuvant strategies, and adjuvant treatment including local radiation therapy and systemic treatment with endocrine therapy, chemotherapy, and newer agents. Finally we will discuss the importance of clinical trials in the elderly.

As the aging population in the United States continues to grow, the incidence of diseases of the elderly, such as breast cancer, are increasing. Many more elderly women are expected to be diagnosed with new breast cancers, most of them in an early stage. Appropriate treatment of these women is important, as they have poorer outcomes when undertreated. In this review, we will discuss the biology and treatment of early breast cancer in elderly women. We will focus on the role of comorbidity and its effect on life expectancy, treatment decisions, current recommendations for primary treatment with surgery, radiation and neoadjuvant strategies, and adjuvant treatment including local radiation therapy and systemic treatment with endocrine therapy, chemotherapy, and newer agents. Finally we will discuss the importance of clinical trials in the elderly.

As the aging population in the United States continues to grow, the incidence of diseases of the elderly, such as breast cancer, are increasing. Many more elderly women are expected to be diagnosed with new breast cancers, most of them in an early stage. Appropriate treatment of these women is important, as they have poorer outcomes when undertreated. In this review, we will discuss the biology and treatment of early breast cancer in elderly women. We will focus on the role of comorbidity and its effect on life expectancy, treatment decisions, current recommendations for primary treatment with surgery, radiation and neoadjuvant strategies, and adjuvant treatment including local radiation therapy and systemic treatment with endocrine therapy, chemotherapy, and newer agents. Finally we will discuss the importance of clinical trials in the elderly.

The aromatase inhibitors (AIs) anastrozole (Arimidex), letrozole (Femara), and exemestane (Aromasin) are significantly more effective than the selective estrogen-receptor modulator (SERM) tamoxifen in preventing recurrence in estrogen receptor-positive early breast cancer. Aromatase inhibitors are likely to replace SERMs as first-line adjuvant therapy for many patients. However, AIs are associated with significantly more osteoporotic fractures and greater bone mineral loss. As antiresorptive agents, oral and intravenous bisphosphonates such as alendronate (Fosamax), risedronate (Actonel), ibandronate (Boniva), pamidronate (Aredia), and zoledronic acid (Zometa) have efficacy in preventing postmenopausal osteoporosis, cancer treatment-related bone loss, or skeletal complications of metastatic disease. Clinical practice guidelines recommend baseline and annual follow-up bone density monitoring for all patients initiating AI therapy. Bisphosphonate therapy should be prescribed for patients with osteoporosis (T score < -2.5) and considered on an individual basis for those with osteopenia (T score < -1). Modifiable lifestyle behaviors including adequate calcium and vitamin D intake, weight-bearing exercise, and smoking cessation should be addressed. Adverse events associated with bisphosphonates include gastrointestinal toxicity, renal toxicity, and osteonecrosis of the jaw. These safety concerns should be balanced with the potential of bisphosphonates to minimize or prevent the debilitating effects of AI-associated bone loss in patients with early, hormone receptor-positive breast cancer.

Cases of osteonecrosis of the jaw (ONJ) have been reported with an increasing frequency over the past few years. ONJ is most often identified in patients with cancer who are receiving intravenous bisphosphonate therapy but it has also been diagnosed in patients receiving oral bisphosphonates for nonmalignant conditions. The condition involves exposed bone of the maxilla or mandible. Although it is often associated with a recent dental surgical procedure, spontaneous ONJ can also occur. Patients commonly present with symptoms. Through case reporting and clinical experience, there is a suggestion that the incidence of ONJ in patients with cancer receiving intravenous bisphosphonates ranges between 1% and 10%. Management of ONJ focuses on maximizing oral health, conservative actions with mouth rinses, antibiotics, and avoidance of unnecessary invasive dental procedures. The currently available data on ONJ are reviewed here.

Remote robotic nephrectomy performed over the public internet is an inexpensive form of tele-surgery that appears feasible, according to a proof-of-concept study presented at the 101st Annual Meeting of the American Urological Association (abstract 1075).

Current evidence suggests that colonoscopy screening can reduce mortality from colorectal cancer&#151;if these procedures are performed in a high-quality manner, David A. Lieberman, MD, said at the 2006 Gastrointestinal Cancers Symposium.

FDA Approves Priority Review of Merck's Zolinza (Vorinostat)

Montefiore Medical Center has opened a state-of-the-art Center for Radiation Therapy within walking distance of the Montefiore-Einstein Cancer Center. The new 15,000 square foot, two-story radiation therapy center is part of the burgeoning facilities located in the Morris Park campus, which services the approximately 1.25 million residents of the Bronx.

Phase III Trial of Enzastaurin for NHL Patients Initiated

Department of Health and Human Services Secretary Michael Leavitt has appointed John Niederhuber, MD, as the National Cancer Institute's acting director after Andrew C. von Eschenbach, MD, resigned the post he had held for 4.5 years.

Two phase III international randomized trials of sunitinib (Sutent) and of the investigational mTOR kinase inhibitor temsirolimus indicate targeted therapy may provide both clinical and survival benefits to patients with advanced renal cell carcinoma (RCC). Sunitinib is an oral multi-targeted receptor tyrosine kinase inhibitor of the VEGF and PDGF receptors.

This new department summarizes current congressional activity relevant to the delivery of cancer care. Two bills recently introduced in the House of Representatives are designed to improve the quality of care for cancer patients on the Medicare program.

Faced with increasing patient care needs for chemotherapy, a team of nurses and administrators at Roswell Park Cancer Institute (RPCI) performed a study to identify challenges to the current system and develop methods to improve patient flow.

"I am a cancer survivor," Lance Armstrong said at a plenary session of the 2006 American Society of Clinical Oncology annual meeting when he accepted the Society's Special Recognition Award. "Seven-time Tour de France winner will be the fine print on the tombstone," he said.

Prescreening patients before transfer from one cancer facility to another gives the receiving hospital an opportunity to prepare needed services for that patient, "thereby maximizing resources and providing quality care more efficiently," Kathy Rogala-Scherer, RN, Department of Case Management, Roswell Park Cancer Institute (RPCI), said at the 31st Annual Congress of the Oncology Nursing Society (abstract 35).