ONCOLOGY Table Of Contents

New cases of lung cancer will be diagnosed in an estimated 164,100 Americans in 2000, and approximately 25% or 41,000 of those cases will be small-cell lung cancer (SCLC). Despite initial sensitivity to chemotherapy, only 10%

The authors have provided an excellent review of contemporary approaches to the treatment of spinal metastatic disease. With improved diagnostics, advances in spinal fixation techniques, and a more rational approach to achieving decompression

Over the last decade, a group of new agents with differing mechanisms of action have shown great promise in early clinical studies in non–small-cell lung cancer (NSCLC). These include the taxanes docetaxel (Taxotere) and

The increase in serious gram-positive infections has increased the need for treatment of gram-positive infections in patients with hematologic malignancies. Common gram-positive pathogens exhibit a variety of resistance

Gemcitabine (Gemzar) was originally approved for use in combination with cisplatin (Platinol) for the treatment of advanced non–small-cell lung cancer (NSCLC). Research began to focus on combining gemcitabine with newer

Radioimmunotherapy with iodine I-131 tositumomab (Bexxar) produced tumor shrinkage in 97% of previously untreated patients with advanced-stage, low-grade non-Hodgkin’s lymphoma, according to a recent study at the University of Michigan

Dr. Potters has provided an excellent and timely overview of transperineal interstitial permanent prostate brachytherapy (TIPPB). The historical context, as the title suggests, nicely illustrates the lessons already learned and those still to be learned. There are a few points I would like to discuss in further detail.

The article by Drs. Girardi and Edelson is an extensive review of the history, diagnosis, and current management of cutaneous T-cell lymphoma (CTCL). This entity is classified in the Revised European-American Lymphoma/World Health Organization

Because the majority of patients with stage IIIA N2 non–small-cell lung cancer (NSCLC) ultimately die of distant metastases, recent efforts to improve their intermediate- and long-term survival have focused on neoadjuvant

At the meeting in July 1999, symposium faculty also led sessions that answered questions from the participants. New applications for the management of non–small-cell lung (NSCLC) cancer provide the focus for these discussions, which

Bloodstream infections cause significant morbidity and mortality for patients with hematologic malignancy. Antimicrobial drugs are the most reliable currently available treatment for infection, but several issues must be

Irinotecan has appeared to have significant activity against previously treated and untreated small-cell lung cancer (SCLC). The major toxicities of irinotecan are neutropenia and diarrhea, although there is interpatient

A number of randomized clinical trials and meta-analyses now support the conclusion that combined modality regimens that include cisplatin (Platinol)-based chemotherapy improve survival in stage III non–small-cell lung

At the outset of their article, Drs. Gerszten and Welch state that their primary goal is to review factors that affect surgical intervention in patients with metastatic spinal disease. On their way to achieving this goal, the authors touch on some of the

The author of this reference, Dr. John J. Mulvihill, has a long-standing reputation for studying the complexities of human genetic disorders. His experiences, many publications, and collaborations have focused on various topics, including definition of the

Hepatocellular carcinoma (HCC) is the most common solid organ tumor worldwide. In recent decades, diagnosis and treatment of this cancer has evolved significantly. The article by Drs. Nakakura and Choti summarizes many of the advances in this field, delineates the current evidence-based treatment options, and defines promising areas for future study.

Drs. Girardi and Edelson provide a concise discussion of current issues surrounding the management of patients with cutaneous T-cell lymphomas. They discuss a number of current theories regarding etiology and pathogenesis and provide a

As Drs. Nakakura and Choti point out, the incidence of hepatocellular carcinoma (HCC) is rising in many countries including the United States, mainly as the result of a steady increase in hepatitis C infections. Unfortunately, it now seems that the hepatitis C virus is more carcinogenic than the hepatitis B virus, judging from the frequency with which HCC develops among patients with hepatitis C- vs hepatitis B-induced cirrhosis.[1] Numerous studies have demonstrated changes in various oncogenes and tumor suppressor genes, but no consistent sequence of genetic changes has emerged similar to the adenoma-carcinoma sequence in colon cancer.

The article by Drs. Gerszten and Welch is a broad, general, and philosophic review of the surgical options that are currently available for the care of our unfortunate patients with metastatic spinal disease. The authors document the poor outcomes of

Neutropenic patients with cancer are a heterogeneous group of patients who carry a variable risk for infection. When such patients present with fever, appropriate empiric antibiotic therapy is initiated and continued until

The search for new combination chemotherapeutic regimens for the treatment of non–small-cell lung cancer is motivated not only by the desire to increase the objective tumor response and survival rates, but also by the desire

The Hellenic Cooperative Oncology Group conducted a randomized phase III trial to compare paclitaxel (Taxol) 200 mg/m² IV 3-hour infusion on day 1 plus carboplatin (Paraplatin) at an area under the curve (AUC) of 6 (group

New clinical data presented at the 41st meeting of the American Society of Hematology (ASH) expand on previously published results on the use of thalidomide (Thalomid) in treating advanced and refractory multiple myeloma. The studies

Hepatocellular carcinoma (HCC) is responsible for a significant amount of morbidity and mortality throughout the world. In many countries, including the United States, a definite increase in the incidence of HCC has been

Nosocomial bloodstream infections across the United States and in Europe are increasingly attributable to gram-positive species— a trend that represents a reversal of the gram-negative predominance of the previous

In our previous phase I/II studies, both the cisplatin (Platinol), gemcitabine (Gemzar), and vinorelbine (Navelbine) (PGV), and cisplatin, gemcitabine, and paclitaxel (Taxol) (PGT) regimens produced a median survival of

In preclinical studies, the topoisomerase I inhibitor irinotecan (Camptosar, CPT-11) has demonstrated activity as a radiosensitizer, probably due to its ability to inhibit potentially lethal radiation damage repair. We conducted a

Platinum compounds, either cisplatin (Platinol) or carboplatin (Paraplatin), in combination with a number of new chemotherapeutic agents, have demonstrated improved response or survival compared to cisplatin alone or older

Five-year follow-up data presented at the annual meeting of the American Urological Association (AUA) in Atlanta showed that the use of cryoablation as first-line treatment for prostate cancer can be as effective as radiation therapy. The five-center,

The purpose of this study was to evaluate the combination of gemcitabine (Gemzar), paclitaxel (Taxol), and carboplatin (Paraplatin) in patients with advanced non–small-cell lung cancer (NSCLC). Previously untreated

Based on the positive results of two independent, corroborative, placebo-controlled phase III clinical studies in head and neck cancer, Matrix Pharmaceuticals, Inc, has announced plans to submit a new drug application for a cisplatin/epinephrine

Ductal lavage, an advanced technique for collecting epithelial cells from the breast milk ducts for cytologic examination, enables the detection of premalignant and malignant cells in women who have had normal mammograms and physical exams.

This multicenter study enrolled 73 patients with locally advanced or metastatic non–small-cell lung cancer (NSCLC). The study design was based on the hypothesis that the non-overlapping toxicities of a 3-drug

The objective of this study was to determine the effects of docetaxel (Taxotere) on survival, clinical benefits, quality of life, and safety parameters for chemonaive patients with advanced non–small-cell lung cancer (NSCLC), when compared to best supportive care (BSC) (no chemotherapy or systemic anticancer therapy permitted).

At the meeting in July 1999, symposium faculty also led sessions that answered questions from the participants. New applications for the management of small-cell lung cancer (SCLC) provide the focus for these discussions, which followed

This phase I/II nonrandomized, open-label study was designed to assess the safety and benefit of sequencing irinotecan (Camptosar, CPT-11) plus paclitaxel (Taxol) immediately after cisplatin (Platinol)/etoposide (VePesid,

Smoking—once a socially accepted behavior—is the leading preventable cause of death and disability in the United States. During the first decades of the 20th century, lung cancer was rare; however, as cigarette smoking became increasingly popular,

New data from a pair of studies presented at the 36th annual meeting of the American Society of Clinical Oncology (ASCO) suggest that capecitabine (Xeloda) doses can be adjusted without compromising efficacy in patients with advanced breast

The House Rules Committee took the somewhat unusual step of blocking a key physician-backed bill from coming to the House floor for a vote. Late at night on May 24, the Committee voted to keep H.R. 1304 from coming to a vote on the House

In October 1999, 40 leading experts from Europe, the United States, and the Far East met in St. Julians, Malta, to discuss recent progress in the management of lung cancer. Emphasis was placed on novel treatment strategies for non–small-cell

Risk prediction in patients with neutropenia and fever in a reliable and timely manner has only become possible in the last decade. Patients have been categorized as high risk or low risk based on certain presenting

The article entitled “The Current Surgical Management of Metastatic Spinal Disease,” by Drs. Peter C. Gerszten and William C. Welch, is a timely, comprehensive review of the current state of the art in the diagnosis and surgical management of spinal

A multi-institutional study demonstrated that prostate cancer patients with aggressive tumors benefited from higher-than-standard doses of radiation. In the trial, 79% of 102 patients receiving radiation therapy for cancer confined to the prostate

Donna Shalala, secretary of the Department of Health and Human Services (HHS), assured a key House Republican that Medicare and Medicaid are taking steps to cut their drug reimbursements. The two agencies—part of HHS’s Health Care

The US Food and Drug Administration recently approved gemtuzumab ozogamicin (Mylotarg) for the treatment of patients 60 years of age and older who are in first relapse with CD33-positive acute myeloid leukemia (AML) and are not considered

Gemcitabine (Gemzar) is a novel deoxycitidine drug that has demonstrated promising single-agent activity in non–small-cell lung cancer and has been proven to be a potent radiosensitizer. Although the exact mechanism of the

The article, “Management of Hepatocellular Carcinoma,” by Drs. Nakakura and Choti, is an excellent, comprehensive overview of the treatment modalities used for one of the most challenging cancers. The thoroughness of this review underscores the current frustration of the clinician in the management of this disease and the inadequacies of available therapies. The authors list more than 17 treatments for the various stages of this disease. However, if any one of the therapies mentioned offered cure to a majority of patients, there would be little need for more review articles or randomized controlled trials. There are few cancers that command such a vast array of differing therapies from so many different specialties.

Despite advances in the treatment of many malignancies, a large number of cancer patients will require evaluation and possible surgical intervention for lesions that have metastasized or directly invaded the spinal column. The need for heightened awareness of and aggressive early intervention for spinal metastases is underscored by many studies that have reported a relationship between pretreatment and posttreatment neurologic function in these patients. Recommendations for operative intervention should be made following an evaluation of the patient by multiple specialties, both medical and surgical. In the last decade, advances in surgical techniques for tumor decompression and spine stabilization, neurophysiologic monitoring, and anesthetic expertise have allowed surgeons to perform more extensive procedures with improved outcomes and reduced morbidity. This article will review the factors favoring an operative recommendation in patients with metastatic spinal disease, preoperative evaluation, and available surgical options. Patients with symptomatic spinal metastases should receive early surgical consultation as part of a multidisciplinary approach to their disease process. [ONCOLOGY 14(7):1013-1024, 2000]

Cutaneous T-cell lymphoma (CTCL) is a malignancy of a distinctive subset of T-helper cells designated “cutaneous T cells” because of their central role in the normal functioning of the skin immune system. Guided by

Current techniques for permanent prostate brachytherapy are associated with excellent biochemical control in patients with localized prostate cancer. Data now available confirm 5- to 10-year results with this treatment

The American Society of Clinical Oncology (ASCO) recently launched a new online education resource—ASCO Grand Rounds— for cancer professionals, featuring biweekly CME-accredited lectures on current topics in cancer. The lectures will