Authors

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Commentary (Czito et al): Combined-Modality Treatment for Operable Pancreatic Adenocarcinoma

Drs. Pisters, Wolff, Crane, andEvans have provided an excellentoverview of contemporaryapproaches to staging, surgicalmanagement, and treatment ofpatients with potentially resectablepancreatic cancer. Given the impressiveadvances in our understandingof the biology and genetics of pancreaticcancer, we would agree thatcurrent opportunities for progressagainst this malignancy are encouraging.The reality, however, is thatmortality rates still exceed 95%.While the article addresses the clinicalmanagement of patients with operablepancreatic cancer, this subsetof patients constitutes only 10% to15% of all patients with the disease.This group as well as patients withlocally advanced and metastatic diseaseare in need of new and innovativetreatment strategies. In thisreview, we will highlight several ofthe points made by the authors.

Douglas Van Nostrand, MD

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I-131 for Thyroid Cancer Metastases

In this interview we discuss which distant metastases in thyroid cancer are appropriate targets for I-131 treatment, appropriate dosing, and more.

Douglas W. Arthur, MD

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On the Road to Intraoperative Radiotherapy: More 'Proceed With Caution' Signs

The prospect of even more compressed radiotherapy options for women requiring adjuvant breast radiotherapy is exciting. However, we urge readers to be cautious in their interpretation of the current intraoperative literature as they implement their programs.

Douglas W. Blayney, MD

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Imaging data transfer methods ‘chaotic and disjointed’

Some clinicians are so discouraged by nonstandard CD-ROMs generated at imaging centers they are calling on the radiology community to improve the way it transfers imaging data to referring physicians.

Douglas Yee, MD

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Targeting IGF-1R: at a Crossroad

In this issue of ONCOLOGY, Golan and Javle provide an excellent update on targeting the insulin-like growth factor 1 receptor (IGF-1R) in gastrointestinal cancers.

Dron Gauchan, MD

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How Quickly Can Ovarian Cancer Develop From Early to Advanced Stages?

If an annual screening test could detect ovarian tumors smaller than 0.5 cm, could it reduce deaths from serous ovarian cancer by 50%? What grade 3 or higher toxicities are associated with olaparib maintenance therapy. Test your knowledge in our latest quiz.

Dulabh Monga, MD

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Neoadjuvant Endocrine Therapy for Breast Cancer: An Overlooked Option?

Locally advanced breast canceraccounts for up to 70% ofbreast cancer cases worldwide.[1] In the past decade, neoadjuvantsystemic therapy has emerged asa therapeutic option for early breastcancer. The main goal of neoadjuvanttreatment is to downstage breast tumors,rendering them operable or permittingbreast-conserving surgery.The therapy has been used increasinglyin patients who have large breasttumors and are candidates for mastectomy,but in whom tumor shrinkageallows for less extensive surgeryand better cosmetic results.[2] Thedegree of the tumor’s responsivenessto preoperative therapy could serveas a surrogate for the response ofmicrometastasis to therapy and theconsequent outcome.[3]

Dulcy E. Wolverton, MD

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Don’t Be Fooled by DCIS

A 46-year-old woman had a routine screening mammogram that showed new calcifications in the posterior left breast. A diagnostic mammogram showed several small punctate calcifications, and a 6-month interval follow-up was recommended.

Dung T. Le, MD

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Integrating Immunotherapy Into Colorectal Cancer Care

Until recent studies were reported, immunotherapy was thought to be ineffective for colorectal cancer; this article provides guidance on how to incorporate immunotherapy into this setting.

Dwaine Rieves, MD

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Eltrombopag for the Treatment of Chronic Immune (Idiopathic) Thrombocytopenic Purpura

On November 20, 2008, the US Food and Drug Administration (FDA) granted accelerated approval for eltrombopag (Promacta Tablets, GlaxoSmithKline) for the treatment of thrombocytopenia in patients with chronic immune thrombocytopenic purpura (ITP) who have had an insufficient response to corticosteroids, immunoglobulin therapy, or splenectomy.

Dwayne G. Stupack, PhD

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The Biology of Integrins

Adhesion molecules have traditionally been thought of simply as receptors that permit anchorage to other cells or to the underlying extracellular matrix (ECM). However, within the past decade it has become apparent that adhesion molecules such as integrins mediate critical cytosolic signaling events that have a dramatic impact upon cell proliferation, survival, and motility. Integrins act to regulate both physiologic and pathologic events, including complex processes such as angiogenesis, tumor growth, and metastasis. For these reasons, integrins have become attractive targets for drug development, and several effective integrin antagonists are now under clinical evaluation. In turn, the use of integrin-targeted reagents has provided additional mechanistic insights into the workings of the receptor. In particular, it has become apparent that integrins are "mechanosensory" receptors that operate in a context-dependent manner. While integrins that ligate substrate-immobilized ligands typically transduce positive signals into the cell, antagonized or unligated integrins promote negative signaling into the cell, leading to cell cycle arrest or apoptosis. Thus, integrins appear to fulfill a biosensor function, wherein they constantly interrogate the local ECM, and modulate cell behavior accordingly. These new roles that integrins play reinforce the choice of integrins as a therapeutic target, even as they lead us to reassess and optimize current clinical strategies.

Dwight Moulin, MD

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Classification of Cancer Pain Syndromes

Chronic pain occurs in about one-third of all cancer patients and in about three-quarters of those with advanced disease.[1] A major factor in the undertreatment of cancer pain is inadequate pain assessment.[2] Pain assessment provides the basis for inferred pathophysiology that directs diagnostic evaluation and treatment decisions. Pain syndrome identification plays an important role in this process-much of clinical medicine is based on pattern recognition of symptoms and signs, leading to a specific diagnosis and therapeutic strategy.

Dylan Fisher

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Nivolumab/Ipilimumab Combo Approved for Advanced RCC

In a pivotal trial, combination of nivolumab and ipilimumab yielded improvement in OS and ORR of poor-risk RCC patients.

E. Baumelou

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Rituximab Plus CHOP in the Treatment of Elderly Patients With Diffuse Large B-Cell Lymphoma: An Update of the GELA Study

At the 2000 Annual Meeting of the American Society of Hematology, we presented the benefits of rituximab (Rituxan) combined with CHOP (cyclophosphamide [Cytoxan, Neosar], doxorubicin HCl, vincristine [Oncovin], prednisone), known as R-CHOP, in comparison with CHOP alone for the treatment of elderly patients with diffuse large B-cell lymphoma (DLCL).

E. Brian Butler, MD

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Stereotactic Body Radiotherapy in the Management of Painful Bone Metastases

Bone metastases are a common feature of many solid cancers, especially those originating from the prostate, breast, lung, kidney, melanoma, and other sites. Up to 80% of patients with these cancers will develop painful bony disease during the course of their disease.

E. Carmack Holmes, MD

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Induction Chemotherapy for Resectable Non–Small-Cell Lung Cancer

Drs. Patel, Blum, and Argirishave provided a detailed, thoroughreview of induction chemotherapyfor non–small-cell lungcancer (NSCLC). They also discussstaging and the relative merits of avariety of invasive and noninvasivetechniques for staging lung cancer.

E. Claire Dees, MD

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Nanoparticle-Delivered Chemotherapy: Old Drugs in New Packages

This article reviews the rationale for nanoparticle formulations of existing or previously investigated cytotoxic drugs, describe currently approved nanoparticle formulations of drugs, and discusses some of the most promising clinical trials currently underway.

E. David Crawford, MD

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Focus on Transitional Disease: A Critical Interval to Delay Progression of Prostate Cancer

ONCOLOGY® editorial board member E. David Crawford, MD, and colleagues, propose a new model for guiding the treatment of prostate cancer that focuses on a “transitional state,” which occurs during the interval of progression to metastatic castration-resistant prostate cancer.

E. David Crawford, MD, Series Editor

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What Are the Most Common Esophageal Metastases

A rare occurrence, cancer in the esophagus requires an individualized treatment plan.

E. Day Werts, PhD

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The Allegheny General Modification of the Harvard Breast Cosmesis Scale for the Retreated Breast

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]

E. Donnall Thomas, MD

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Hematopoietic Cell Transplantation, Second Edition

Hematopoietic Cell Transplantation, edited by Drs. Thomas, Blume, and Forman, is an excellent updated second edition of their comprehensive textbook designed for both practitioners involved in transplantation and those interested in the science of stem-cell transplantation.

E. Dühmke

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2 Cycles of ABVD Plus Radiotherapy Is More Effective Than Radiotherapy Alone in Early Stage HD-Interim Ahan Radiotherapy Alone in Early Stage HD-Interim Analysis of the HD7 Trial of the GHSG Clinic of Internal Medicine I University of Cologne/Germany

BACKGROUND: Extended-field radiotherapy is effective in patients with early-stage Hodgkin’s disease, and more than

E. Felip, MD

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Novel Approaches in the Treatment of Non-Small-Cell Lung Cancer

A wealth of data indicates that certain genetic abnormalities can target specific cytotoxic drugs and intervene at an early step as a mechanism of resistance in the treatment of non-small-cell lung cancer. Therefore prescribing

E. George Elias, MD, PhD, FACS

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GM-CSF and IL-2 Combination as Adjuvant Therapy in Cutaneous Melanoma

Cytokines have been used in the treatment of patients with cutaneousmelanoma. Granulocyte-macrophage colony-stimulating factor(GM-CSF, sargramostim [Leukine]) leads to dendritic cell/macrophagepriming and activation, and also increases interleukin-2 (IL-2)receptor expression on T lymphocytes. IL-2 creates lymphokineactivatedkiller cells and tumor-infiltrating lymphocyte cells. In thisopen-label, single-arm study of 16 high-risk patients, we combined thesetwo agents to take advantage of their different but complementary functions.All patients underwent potentially curative surgery. Postoperatively,each patient received GM-CSF at 125 μg/m2/d subcutaneously(SC) for 14 days; this was followed by IL-2 at 9 million IU/m2/d SC for4 days, and then 10 to 12 days of no treatment. In addition, patientswho had large tumors that could yield over 100 million live tumor cellsreceived autologous melanoma vaccines. The duration of follow-upranged from 21 to 42 months (median: 27 months). During follow-up,five patients developed metastases. This program was carried out on anoutpatient basis, and no hospitalization was required. It was well toleratedwith minimal side effects. The combination treatment regimen ofGM-CSF and IL-2 with or without autologous vaccine used adjuvantlyappears to benefit high-risk melanoma patients; further clinical testingof this regimen is warranted.

E. Hemanth Raj, MS, MCh, PhD

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The Changing Scenario in Oncologist-Patient Communication: We Need to Adapt

Of all diseases, cancer probably elicits the strongest emotional reaction, and this is even more true if one is an affected patient.

E. Iakhnina

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In Vivo Purging With Rituximab Prior to Stem Cell Collection Is Associated With Persistent Molecular Evidence of t(14;18) That Often Disappears Post-Transplant in Patients With Follicular Lymphoma

We previously reported that “in vivo purging” with rituximab (Rituxan) during stem-cell collection is safe and does not adversely affect engraftment. We now report on our transplant experience with rituximab. From June 1998 to December

E. James Seidmon, MD

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Management of Locally Advanced Prostate Cancer

The treatment of advanced prostate cancer continues to be an enigma. Every few years, it seems, a new variation in treatment is espoused and offered to the public. To date, two trends seem to have emerged: For men under 70 years of age, there seems to be a consensus that definitive treatment should be pursued for low-grade, low-stage, localized tumors. Prostatectomy or radiation therapy may cure or at least increase survival; for men over age 70, less vigorous treatment is often the preferred choice [1,2]. Nevertheless, outside of these two points of agreement, many other controversial questions remain and will persist for some time.

E. Kimby

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Rituximab as a Single Agent and in Combination With Interferon Alfa-2a as Treatment of Untreated and First-Relapse Follicular or Other Low-Grade Lymphomas: A Randomized Phase II Study (M 39035)

Rituximab (Rituxan) is approved for use in patients with relapsed and refractory follicular lymphoma. Considering the immune modulating effect of interferon alfa-2a (IFN [Roferon-A]) and its efficacy as a single agent in follicular lymphoma, a

E. Lepage