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Repeat lumpectomy and retreatment radiotherapy following ipsilateral breast tumor recurrence (IBTR) by either external-beam irradiation or brachytherapy in lieu of salvage mastectomy is an area of significant recent clinical interest. Multiple authors have reported their results, with encouraging numbers of patients avoiding mastectomy.[1‑4]

Five may be the magic number to determine whether a patient can undergo therapeutic monitoring with a test for circulating tumor cells or must undergo an FDG-PET/CT exam, according to research out of M.D. Anderson Cancer Center.

Roche announced that enrollment in a phase III clinical trial testing bevacizumab (Avastin) plus chemotherapy for women with early-stage breast cancer was suspended after six patients who were given the drug developed congestive heart failure. Study protocols required that enrollment be stopped if six or more cases of congestive heart failure occurred in the first 200 patients, according to the company.

An analysis by researchers at the University of Michigan Comprehensive Cancer Center shows that costs vary widely for different treatment regimens and from one delivery method to another. Yet receiving more treatments and spending extra on more sophisticated technology may do little good, at least when it comes to pain relief.

Resistance to rituximab (Rituxan) has emerged as a considerable problem as the drug has become widely used to treat B-cell lymphomas, such as non-Hodgkin’s lymphoma, follicular lymphoma, and diffuse large B-cell lymphoma. A recent study in Blood suggested that resistance to rituximab is related to downregulation of CD20 expression via epigenetic mechanisms.

The first proton-beam therapy center in Loma Linda, Calif., opened almost 20 years ago, and today six are operating in the U.S. Another center will open by the end of 2009 with several more planned in the next two years, including centers in continental Europe and the UK. A growing body of research affirms the efficacy of proton-beam therapy (see Table).

Subtle clues to the better management of cancer patients may lie hidden in images otherwise used exclusively for diagnosis. German researchers at ECCO/ESMO 2009 have found that ultrasound images of lymph nodes may contain clues to whether and to what extent melanoma has begun to spread. The discovery raises the possibility that ultrasound might help oncologists predict a patient’s probable survival without the need for sentinel node biopsy (abstract O9303).

Stage II colon cancer patients who are negative for microsatellite instability and lymphocytic infiltrate should not undergo adjuvant chemotherapy, according to surgeons at Oregon Health and Science University and Legacy Health System, both in Portland.

Bayer has announced that Marijn Dekkers, PhD, will succeed Werner Wenning as CEO starting October 1, 2010.

Pathologists at the Yale University School of Medicine in New Haven, Conn., studied the relationship between the Oncotype Dx recurrence score and the cell cycle-related antigen Ki-67 in 32 breast carcinomas and evaluated for a potential association.

The comparison of brachytherapy and surgery may be done on several levels. This review focuses the comparison on toxicity, the “soft” endpoints of biochemical relapse-free survival and clinical relapse-free survival, and the “hard” endpoint of prostate cancer–specific mortality.

Standard treatment options for prostate cancer patients include surveillance, surgery, external-beam radiotherapy, brachytherapy, the combination of external-beam and brachytherapy, and the combination of radiotheraputic modalities with hormonal therapy, for appropriately chosen patients.

Question 1: Breast cancer remains among the most frequent diagnoses of cancer in women in the United States. Importantly research indicates that deaths due to breast cancer are decreasing, in part due to advances in treatment and earlier detection. Could you please comment about the advances in breast cancer imaging that have helped to facilitate earlier detection?Question 2: Could you briefly comment on the role of each of these modalities used in breast imaging?A. X-Ray mammography (digital and film screen)B. UltrasoundC. Molecular imagingD. Breast-specific gamma imagingQuestion 3: Could you please discuss indications for breast-specific gamma imaging and the clinical data to support these indications?Question 4: Are you able to cite an example as to how you used breast-specific gamma imaging in the clinic?Question 5: Could you please discuss the role of imaging in staging and treating breast cancer most appropriately? Is there new or novel technology that oncologists should be aware of when imaging is used for optimal visualization to assist in staging a woman diagnosed with breast cancer?Question 6: In your own clinical experience, what advances have you witnessed in breast imaging, particularly in regard to breast cancer, over the past 5 years?Question 7: Do you have any final comments you would like to make to our audience about advances or trends in breast imaging as it pertains to women with breast cancer?

There has been a growing recognition in recent years that young adults with cancer are a distinct demographic group with unique needs, issues, and challenges related to their age and developmental stage of life.

For young adult survivors, coming to terms with a life-threatening illness is a unique dilemma.

As oncology nurses, we increasingly encounter issues related to integrative medicine in our community practices, clinics, and hospitals.

Vitamin D-the so-called “sunshine vitamin”-is a fat-soluble substance and is classified more as a pro-hormone or steroid by some

Clues to radiosensitivity promise personalized radiation therapy

In response to the article “Oncology takes blame for rising healthcare cost” (page 1, July 2009), I would like to direct Oncology News International readers to two articles on the “Win-Win” initiative. The full text articles are available online for free at:

In patients with resected pancreatic cancer, adjuvant cisplatin, 5-FU, and interferon chemoradiation produces a median survival of 27 months, according to initial results of the ACOSOG Z05031 trial. However, nearly all patients experience grade 3 or 4 toxicities.

Although preoperative radiotherapy has been shown to improve recurrence and mortality rates in patients with rectal cancer, a quality-of-life analysis by the same researchers suggests that male sexual dysfunction and fecal incontinence may be the trade-offs for those improved outcomes

Researchers in Seoul, Korea, found early-phase contrast-enhanced CT useful for differentiating pulmonary metastases from hepatocellular carcinoma and primary lung cancer. They specifically measured the attenuations of pulmonary nodules on the CT scans.

Harmit Singh Malik, PhD, and Ulrike “Riki” Peters, PhD, both based at the Fred Hutchinson Cancer Research Center in Seattle, received the 2008 Presidential Early Career Award for Scientists and Engineers. Dr. Malik is an evolutionary biologist.

BERLIN-Panitumumab (Vectibix), in combination with FOLFIRI as second-line treatment, significantly improved progression-free survival compared to FOLFIRI alone in patients with KRAS wild-type metastatic colorectal cancer, according to study results that will be presented at ESMO 2009 (see Table). However median overall survival did not achieve statistical significance in the study arm.

Pattern analyses reveal clues to better patient management

Bevacizumab (Avastin) alone or in combination with irinotecan, was well tolerated and active in recurrent glioblastoma, according to phase II trial results. The multicenter, open-label, noncomparative trial evaluated 167 patients randomly assigned to receive bevacizumab (10 mg/kg) alone or in combination with irinotecan (340 mg/m2 or 125 mg/m2), with or without concomitant enzyme-inducing antiepileptic drugs, respectively, once every two weeks.

The risks associated with neoadjuvant hormonal therapy may outweigh the benefits of its use in conjunction with brachytherapy in some older men with prostate cancer, according to research from the radiation oncology program at Boston’s Harvard Medical School.

Biopharmaceutical company Micromet closed $80.5 million in funding last month after a public offering of 14 million shares of common stock. Earlier in the year, the company raised $40 million.

More than a decade has passed since the FDA approved the first pill to fight cancer. Designed to battle metastatic colorectal cancer, capecitabine (Xeloda) marked a significant change in chemotherapy, untethering some cancer patients from office-based intravenous drug infusions. Other such drugs have since been commercially released, including temozolomide (Temodar) and imatinib (Gleevec), but the reimbursement system in this country has failed to keep up.

With the availability of newer drugs for treating multiple myeloma, such as proteosome inhibitors and immunomodulatory drugs (IMiDs), outcomes and depth of response are steadily improving. These developments have led to a debate about whether high-dose chemotherapy and autologous stem cell transplant should still be considered first-line therapy or whether newer drug regimens should replace transplant.