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When it comes to erythropoiesis-stimulating agents in cancer patients, there are three distinct schools of thought: These agents are quite straightforward; they are nothing short of a "minefield or morass"; or they are somewhere in between.

MR spectroscopy results can help determine if brain tumor patients with nonspecific lesions may bypass invasive biopsy for conservative management. A study by a multidisciplinary group in Ann Arbor, Mich., found that elevated levels of brain metabolites correlated with evidence of tumor recurrence. The researchers then developed a tumor recurrence model based on their data.

VIENNA-Yes, size does matter, but it is certainly not the only way to monitor the effi cacy of cancer treatment. Th e way in which lesions are measured is extremely important as well, according to a special focus session on the assessment of tumor response at the 2009 European Congress of Radiology.

Researchers from the division of neuro-oncology at the Hospital of the University of Pennsylvania found that the fraction of malignant histologic features in enhancing brain neoplasms that recur after treatment can be predicted by using the relative cerebral blood volume (rCBV) fraction on standard MR imaging studies.

Bioengineers at Duke University in Durham, N.C., have developed a light-based system that provides information about tumor oxygen levels while the tumor is still in vivo. This needle-based technique can provide pathologists with biological specifics of the tumor and help oncologists choose treatment options that would be most effective for that individual patient, according to the researchers.

The likely consolidation of four international drug companies has raised concerns about the range of oncology agents that will remain in the R&D pipeline once the newly merged companies streamline their operations.

Oncolytics Biotech announced positive results from its phase I-II trial of Reolysin, which combines a naturally occurring reovirus with platinum-based chemotherapy agents. The research was shared at the 2009 International Meeting on Replicating Oncolytic Virus Therapeutics, in Banff, Alberta, Canada.

Sen. Edward Kennedy (D-Mass.) and Sen. Kay Bailey Hutchison (R-Tex.) introduced the 21st Century Cancer Access to Life-saving Early detection, Research and Treatment Act. The goal of the ALERT Act is to modernize and advance the national cancer program in the U.S.

Avastin (bevacizumab) is likely to provide clinical benefit to people previously treated for glioblastoma, according to a unanimous vote by the FDA Oncologic Drugs Advisory Committee. The FDA is expected to decide whether to grant accelerated approval of Avastin for glioblastoma by May 5. A global phase III trial evaluating Avastin in people with newly diagnosed glioblastoma will be initiated later this year, according to manufacturer Genentech.

In the realm of cancer prevention, this week’s boon may be next week’s blacklisted substance. A trio of recently released studies offers up a new, chemoprotective spin on familiar compounds.

We have known for some time that endocrine-responsive patients should probably receive an AI, but studies presented at SABCS provided some answers to our questions: Should we start with tamoxifen and then switch to an AI or is the best approach to initiate treatment with an AI from the start?

Chronic lymphocytic leukemia (CLL) is a clonal malignancy that results from expansion of the mature lymphocyte compartment. This expansion is a consequence of prolonged cell survival, despite a varied cell. The affected lymphocytes are of B-cell lineage in 95% of cases, and the remaining cases involve T lymphocytes, representing a distinct disorder.

Although many cancer patients cope well with their disease, psychiatric disorders occur in almost 50% of patients in the setting of malignancy. Untreated psychological and neuropsychiatric disorders can compromise quality of life as well as treatment compliance. Three behavioral syndromes that are often encountered in clinical practice will be discussed here: depression, anxiety, and delirium.

DENVER—Candidate genes and epigenetics are key components in the effort to develop and deploy personalized cancer prevention and treatment. Several studies at the AACR took a closer look at both those research pathways.

The effective use of cancer chemotherapy requires a thorough understanding of the principles of neoplastic cell growth kinetics, basic pharmacologic mechanisms of drug action, pharmacokinetic and pharmacodynamic variability, and mechanisms of drug resistance. Recent scientific advances in the field of molecular oncology have led to the identification of large numbers of potential targets for novel anticancer therapies. This has resulted in a tremendous expansion of the drug development pipeline, and in the present era, the diversity of clinically useful novel anticancer therapeutic agents is growing at an unprecedented rate. However, the great enthusiasm that surrounds these new agents must be tempered by the challenges they present in optimizing their clinical use and in rationally integrating them with existing anticancer therapies. This discussion focuses on the basic principles underlying the development of modern combination chemotherapy, and it is followed by a description of the major classes of chemotherapeutic drugs and their mechanisms of action.

In 2008, it was estimated that head and neck cancers comprised ­2% to 3% of all cancers in the United States and accounted for 1% to 2% of all cancer deaths. This total includes 22,900 cases of oral cavity cancer, 12,250 cases of laryngeal cancer, and 12,410 cases of pharyngeal cancer. Most patients with head and neck cancer have metastatic disease at the time of diagnosis (regional nodal involvement in 43% and distant metastasis in 10%).

Despite the widespread perception that herbal products are safe because they are “natural,” few products have been subjected to rigorous research.

The authors review the current trends in health literacy, patient-physician communication, and the medical treatment decision process, focusing attention on the older cancer patient population.

This chapter provides a brief overview of the principles of radiation therapy. The topics to be discussed include the physical aspects of how radiation works (ionization, radiation interactions) and how it is delivered (treatment machines, treatment planning, and brachytherapy). Recent relevant techniques of radiation oncology, such as conformal and stereotactic radiation therapy, also will be presented. These topics are not covered in great tech­nical detail. It is hoped that a basic understanding of radiation treatment will benefit those practicing in other disciplines of cancer management. This chapter does not address the principles of radiobiology, which guide radiation oncologists in determining issues of treatment time, dose, and fractionation or in combining radiation with sensitizers, protectors, and chemotherapy or hormones.

When caring for patients with a new cancer diagnosis, oncology nurses generally have clear and distinct plans to assist each patient through the phases of diagnosis and treatment. Nurses provide guidance, support, and well-defined patient education regarding the planned treatment, as well as anticipatory guidance regarding management of side effects and emotional responses to diagnosis and treatment.

Surgical oncology, as its name suggests, is the specific application of surgical principles to the oncologic setting. These principles have been derived by adapting standard surgical approaches to the unique situations that arise when treating cancer patients.

Hospice care continues to be underutilized. Indeed, owing to untimely referrals, many patients who begin hospice care unfortunately die shortly thereafter, having never received the full benefits provided by hospice. In her excellent article, Dr. Prince-Paul provides a case example that demonstrates the familiar multifaceted issues faced by cancer patients nearing end of life and discusses how hospice care could be of tremendous benefit to the patient, family, and professional.

Ms. D is a 45-year-old woman with ovarian cancer and hepatic metastatic disease. She has received multimodal treatment over the past 5 years. Ms. D lives in her own home, is divorced, and is a single parent of two adolescent children. Her mother is her primary caregiver and also has a deteriorating health condition.

Change is in the air-and I don’t just mean the arrival of spring. The current national focus on health care is clearly evident from many quarters, including policy makers, health care institutions, and clinical staff. In addition to the discussion on health care coverage, there is an increasing emphasis on patient-centered care. As a result, we have before us a unique opportunity to assure the inclusion of survivorship and end-of-life care as formal parts of the health care continuum.

Champions Biotechnology has obtained royalty rights to Concordia Pharmaceuticals’ Salirasib (farsnesyl thiosalicylic acid), an RAS antagonist.

Oncolytics will start a U.S. phase II trial on Reolysin (reovirus serotype 3) and chemotherapy for NSCLC. Oncolytics said that Reolysin, in combination with certain chemotherapeutics, results in more efficient and synergistic anti-cancer activity than when each agent is used on its own.

Thoracic CT scans in cancer patients require careful inspection in order to pinpoint previously undetected lesions, according to a study by Canadian radiologists. Jean-Charles Vinet, MD, and colleagues found that PET/CT detected an additional 20% of lesions from the supraclavicular notch to the adrenals that were not found on chest CT alone.