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Book Review: Cancer Therapy in the Twenty-First Century. I. Molecular and Immunologic ApproachesThe first volume of Cancer Therapy in the Twenty-First Century provides background information on some of the molecular and immunologic approaches that are becoming increasingly important in the diagnosis and management of cancer
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Artificial Intelligence in Oncology: Current Applications and Future DirectionsIn this review, we introduce the fundamentals of artificial intelligence and provide an overview of its current applications, pitfalls, and future directions in oncology.
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Moving Beyond 'Best Supportive Care'In their article, Dr. Jamie Von Roenn and Dr. Jennifer Temel demonstrate the value of enhanced symptomatic and palliative care for symptom reduction, improvement in quality of life, and, in some instances, better survival.
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Epidermal Growth Factor Receptor Inhibitors and Colorectal CancerThe epidermal growth factor receptor (EGFR) plays an importantrole in cell growth, differentiation, and survival. Targeting EGFR inpatients with colorectal cancer has become an important therapeutictool. Recently, a monoclonal antibody against the extracellular domainof the receptor (cetuximab [Erbitux]) has been approved for the treatmentof patients with EGFR-positive metastatic disease refractory toirinotecan (Camptosar)-based therapy. The role of other targeted agentsagainst EGFR, including other monoclonal antibodies as well as inhibitorsof the intracellular tyrosine kinase domain, will also be discussed.
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Commentary (Landry et al): Current Perspectives on Anal CancerThe article by Drs. Bendell andRyan reviews the associationbetween anal cancer and humanpapillomavirus (HPV) infectionand discusses current managementstrategies for patients with squamouscell carcinoma of the anal canal. Theauthors should be complimented ona thorough review of the literature,which supports that association andthe use of chemoradiation as the goldstandard for treatment of this groupof patients.
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Understanding Complex Tumor HeterogeneityWhile personalized medicine is seen as a way to target an individual cancer patient’s tumors, using targeted agents, immunotherapy, and chemotoxic drugs, researchers are increasingly finding that not only do the cancers of individuals vary widely, but that tumors within a patient can also be quite different at the molecular level.
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Strategies for Identification and Clinical Evaluation of Promising Chemopreventive AgentsStrategies for chemopreventative drug development are based on the use of well-characterized agents, intermediate biomarkers correlating to cancer incidence, and suitable cohorts for efficacy studies. Since
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An Argument for Aggressive Resection in MelanomaAny minimization of therapy in the name of reducing morbidity requires careful consideration. Reducing morbidity in melanoma is certainly a laudable goal, but locoregional disease control and cure must remain our primary objectives.
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Current Surgical Management of Metastatic Spinal DiseaseAt 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
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Caring for Cancer Patients in the Future: A Perfect Storm on the Horizon?This timely manuscript by Bunnell and Shulman highlights critical issues that challenge our ability to provide care to cancer patients in the next 20 years. Each of the concerns the authors identify has a momentum of its own. In combination, they have the makings of a perfect health care storm. The time to further address these matters is now.
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Xerostomia as a Complication of Cancer TreatmentCancer is a devastating, life-altering disease. As our technology and knowledge base for the treatment of carcinomas expand, however, more and more patients' lives are being spared or prolonged. Unfortunately, the quality of life for many of these
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Near Misses: Free Lessons for Safer CareYou are a Registered Nurse working in a busy oncology unit. While assessing one of your patients, you notice that the bag of morphine used in his patient-controlled analgesia (PCA) system is running low.
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Unrelated Donor StemCell Transplantation: The Role of the National Marrow Donor ProgramApproximately 70% of patientswith life-threatening diseasestreatable with allogeneic bloodstem cell transplantation do not havematched related donors. The NationalMarrow Donor Program (NMDP) wasestablished in 1986 to provide humanleukocyte antigen (HLA)-matched,volunteer unrelated donors for thesepatients. The NMDP performs thistask by maintaining a registry of morethan 4.9 million volunteer donors ofmarrow and peripheral blood stemcells (PBSC) and 12 cord blood bankscontaining more than 25,000 units ofumbilical cord blood.
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Chau T. Dang, MD, Discusses the APHINITY TrialThe breast cancer expert spoke about the results presented in the trial, noting the benefit seen with longer follow-up.
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Irinotecan in the Management of Patients With Pancreatic CancerSynergy with no overlapping toxicities has been demonstrated for the combination of irinotecan ( Camptosar, CPT-11) and gemcitabine (Gemzar) in vitro. Results of a single-institution phase I study in which patients with
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QOL and Outcomes Research in Prostate Cancer Patients With Low Socioeconomic StatusThe VA Cancer of the Prostate Outcomes Study (VA CaPOS) is collecting quality-of-life (QOL) information from prostate cancer patients, spouses, and physicians at six VA medical centers. Currently, 601 men with prostate
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Health Literacy, Communication, and Treatment Decision-Making in Older Cancer PatientsThe 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.
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Who, When, Where, and How: Salvage Prostate Cancer With RadiotherapyDespite the common use of postoperative radiotherapy (RT) in patients managed initially with radical prostatectomy (RP), a number of questions remain. Raldow and colleagues build their arguments around three randomized trials that indicated a significant benefit of immediate adjuvant radiotherapy in patients with high-risk features.
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Epirubicin, Cisplatin, Oral UFT, and Calcium Folinate in Advanced Gastric CarcinomaUFT (uracil and tegafur in a 4:1 molar ratio) plus calcium folinate treatment has favorable activity and tolerable toxicity in patients with advanced gastric carcinoma. High response rates have been reported in patients with
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Current Perspectives on Pain in AIDSConcern about prescribing controlled substances underlies, in part, the undertreatment of pain, even in palliative care settings. That the same is true for human immunodeficiency virus (HIV) patients is therefore not surprising, particularly given injection drug use as a risk factor.
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Docetaxel in Combination With Flourouracil: Study Design and Preliminary ResultsThe relatively recent introduction of a new class of chemotherapeutic agents--the taxoids--has raised hope of improved survival for patients with advanced or metastatic cancer. Following encouraging preclinical results of taxoid combinations, this phase I, nonrandomized trial was designed to evaluate a 1-hour intravenous infusion of docetaxel (Taxotere) on day 1 combined with fluorouracil (5-FU) as a daily intravenous bolus for 5 consecutive days.
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Tobacco Control Since the 1964 Surgeon General's Report: Reflecting Back and Looking ForwardWe now have more tools than ever in the fight against tobacco-related death and disability, but unfortunately, there is not equal access to resources for smoking cessation, early lung cancer diagnosis, and treatment.
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Commentary (Pendergrass/Griffin): What the Physician Needs to Know About Lynch Syndrome: An UpdateDr. Henry Lynch was one ofthe first to recognize the existenceof hereditary nonpolyposiscolorectal cancer (HNPCC).While a relatively small percentage offamilies have this cancer predispositionsyndrome, identification of individualsat risk is now standard of careand includes the potential for the preventionof colorectal cancer. Dr. Lynchand Jane Lynch have written a guidehighlighting key points for physiciansregarding the diagnosis, surveillance,and management of this disorder. Severalaspects of clinical care mentionedin the article are expanded upon here.
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Bacterial Infections in Patients With Solid TumorsEarly and appropriate management of infection in the patient with cancer is critical to optimizing patient outcomes.
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The Promise of Targeted Therapy for Localized Prostate CancerThe morbidities associated with prostate cancer treatments have improved over the years. However, potential overtreatment and the risks of adverse events associated with radical treatment still pose a considerable challenge. Targeted focal therapy (TFT) of prostate cancer appears to be part of a logical continuum in the quest to improve upon the management of early organ-confined disease. TFT is a procedure in which only the cancer in the gland is ablated. The normal gland, sphincter, and in most cases the neurovascular bundles are preserved. Therefore, this approach averts some of the common complications of more radical therapy. Initial experience has been encouraging; however, long-term data and full implementation of emerging advances in imaging are urgently needed before the widespread adoption of this approach. In this review, we present the current status of our knowledge about this procedure and the most important challenges that need to be addressed. We also present the initial results with this approach at our center.
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Long- vs Short-Course Radiation Therapy in Rectal CancerThis video reviews some of the pros and cons of long-course and short-course radiation therapy for the neoadjuvant treatment of rectal cancer.
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UFT Plus Cisplatin With Concurrent Radiotherapy for Locally Advanced Non–Small-Cell Lung CancerA phase II study of combined-modality treatment consisting of uracil and tegafur (in a molar ratio of 4:1 [UFT]) plus cisplatin (Platinol) and concurrent radiotherapy was conducted to evaluate the activity of this regimen in
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Cancer of the Cervix: Current Management and New ApproachesThis article summarizes the current management of patients with newly diagnosed cervical cancer. The topics range from the management of early-stage disease to the phase III randomized studies that have established the current standard of care for patients with locally advanced cancer of the cervix. New approaches to combined-modality therapy with the goal of improving outcomes and decreasing complications are also described.
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Benefits and Pitfalls of Prostate Cancer Screening: “No Proof of Benefit” Does Not Equal “Proof of No Benefit”Prostate cancer screening using prostate-specific antigen (PSA) testing has been a contentious subject.
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CTCs Detected Lung Cancer Recurrence Before PET/CTIn this video we discuss a new study that tested the feasibility of using circulating tumor cells to detect recurrence in patients with locally advanced non–small-cell lung cancer.
