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Chronic Myeloid LeukemiaChronic myeloid leukemia (CML) is a clonal myeloproliferative disorder resulting from the neoplastic transformation of the primitive hematopoietic stem cell.
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Toward a Breast Cancer Vaccine:Work in ProgressAs outlined in the review byDrs. Emens and Jaffee entitled“Toward a Breast CancerVaccine: Work in Progress,” the developmentof anticancer vaccines hasclosely paralleled advances in the fieldof immunology. Basic immunologyhas provided and will continue toprovide important insights intohuman immunity that directly relateto the design and study of immunotherapeutics.To date, the mostimportant scientific observations applicableto immunotherapy include thefollowing:
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UFT/Oral Calcium Folinate Plus Weekly Paclitaxel for Metastatic Breast CancerPaclitaxel (Taxol) is one of the most active drugs in the treatment of ovarian and breast cancers. Combination therapy with paclitaxel and 5-fluorouracil (5-FU) exhibits high activity in anthracycline-pretreated breast cancer,
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A Phase II Randomized Study of Doxorubicin Alternated With Docetaxel vs Sequential Administration of Four Cycles of Docetaxel Followed by Four Cycles of Doxorubicin as First-Line Chemotherapy in Metastatic Breast Cancer PatientsFrom March 1996 to March 1998, 106 patients with untreated metastatic breast cancer (MBC) were treated with docetaxel (Taxotere) (100 mg/m²) and doxorubicin (75 mg/m²) on an alternating cycle-by-cycle (doxorubicin, docetaxel, doxorubicin, etc) or sequential (four cycles of docetaxel, then four cycles of doxorubicin) basis, every 3 weeks, for a maximum of eight cycles.
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UFT/Leucovorin vs 5-FU/Leucovorin in Colon CancerAdjuvant chemotherapy has been shown to alter the natural history of resected colon cancer. Two regimens (fluorouracil [5-FU] plus leucovorin and 5-FU plus levamisole) have been found to prolong disease-free survival and overall survival in affected patients.
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Phase II Study of Rituximab in Combination With Fludarabine in Patients With Chronic Lymphocytic LeukemiaThis phase II trial investigated the safety and efficacy of a combined-modality treatment with rituximab (Rituxan) and fludarabine (Fludara) in patients with fludarabine- and anthracycline-naive chronic lymphocytic lymphoma (CLL).
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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/GermanyBACKGROUND: Extended-field radiotherapy is effective in patients with early-stage Hodgkin’s disease, and more than
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Therapeutic Activity of Humanized Anti-CD20 Monoclonal Antibody and Polymorphism in IgG FcReceptor FcgRIIIa GeneRituximab (Rituxan) is a chimeric IgG1 anti-CD20 monoclonal antibody increasingly used in the treatment of non-Hodgkin’s lymphoma (NHL). Previous in vitro studies have suggested the role of antibody-dependent cellular cytotoxicity (ADCC) and FcgR-positive effector cells (natural killer and macrophage) in the antitumor effects of anti-CD20 antibodies, but the actual mechanism of rituximab action in vivo remains largely unknown. The FCGR3A gene coding for the FcgRIIIa receptor displays a functional dimorphism with either a phenylalanine (FCGR3A-158F) or a valine (FCGR3A-158V) at amino acid 158, with a higher affinity of human IgG1 and increased ADCC for the latter. The aim of this study was thus to determine the influence of this FCGR3A polymorphism on clinical and molecular responses to rituximab.
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Acute Myelogenous LeukemiaAcute myelogenous leukemia (AML) is a disorder marked by infiltration of the bone marrow by abnormal hematopoietic progenitors. These cells are unable to differentiate in a normal fashion into myeloid, erythroid, and/or megakaryocytic cell lines and, unlike normal progenitors, are capable of infiltrating vital organs.
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Ponatinib Dose-Ranging Study in Chronic-Phase CML: SummaryJorge E. Cortes, MD and Hagop Kantarjian, MD share a summary on ponatinib in CML and ALL and exploration of potential future studies.
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Chemoradiation in NSCLC: Focus on the Role of GemcitabineResearch to identify the optimal drugs for use in chemoradiotherapyhas led to the development of the potent radiosensitizing agentgemcitabine (Gemzar), which has exhibited excellent activity in non-small-cell cancer. When used in sequential chemoradiotherapy regimens,gemcitabine has been associated with response rates of 57% to68%. A full dose of gemcitabine (1,000 mg/m2) can be safely used asinduction therapy, and there is no definitive indication of enhancementof radiotoxicity. In addition, results from phase I/II trials supportthe efficacy of concurrent gemcitabine/radiation therapy in improvingoverall response rates and overall survival. Rates of 68%, 37%, and28%, respectively, for 1-, 2-, and 3-year survival have been reported forgemcitabine/cisplatin chemotherapy administered concurrently withradiotherapy. Although the optimal dose has yet to be determined, aweekly dose of 300 mg/m2 appears to be effective with an acceptabletoxicity level. Additional clinical trials are warranted to assess the longtermefficacy and safety of gemcitabine in combination with other chemotherapeuticagents and radiation therapy for treatment of non-smallcelllung cancer.
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How We Treat Tumor Lysis SyndromeWhen tumor cells are rapidly broken down and their contents released into the extracellular space, the released ions and compounds can cause metabolic disturbances too great to be neutralized by the body's normal mechanisms.
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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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Management of Colorectal Cancer in Older PatientsAn increasing body of evidence suggests that geriatric patients can benefit from and tolerate standard chemotherapy similarly to younger patients in the settings of both early- and advanced-stage colorectal cancer. Assessment of this unique population requires more comprehensive evaluation in addition to routine history, physical examination, and laboratory tests. Specific considerations of their physiologic functional changes will help physicians better manage these patients. Ongoing studies are now designed to better understand the decision-making process, safety profile, and efficacy of various treatment regimens in geriatric patients.
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Adjuvant Therapy for Colorectal Cancer: Increasingly Complex as Patients AgeThe treatment of older patients with colorectal cancer is not always straightforward. As highlighted in the article by Dr. Ades, the heterogeneity of physiologic aging, the increasing prevalence of comorbid disease with age, and changing preferences with aging make counseling about adjuvant therapy more complex for older patients than for younger patients.
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Commentary (Kelly/Goldberg): CEA Monitoring in Colorectal CancerCarcinoembryonic antigen (CEA) monitoring in patients with stage I-IV colorectal cancer has been, and remains, a controversial issue in oncology practice. Recommendations vary from bimonthly monitoring to no monitoring in the surveillance setting (for stage I-III disease). In the metastatic setting, there are no clear guidelines for CEA follow-up, although continued monitoring in such patients is common in the oncology community. This manuscript reviews the accuracy of CEA testing, its value as a prognostic indicator, and its role in surveillance and response assessment. The limitations of the test in the adjuvant and metastatic settings are illustrated through several case reports from the Colorectal Oncology Clinic at Roswell Park Cancer Institute. Guidelines for CEA monitoring are provided, based on a detailed literature review and institutional experience.
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Recognizing and Managing Side Effects Associated With Novel Targeted Therapies:Nursing management of patients with advanced malignancies presents a formidable challenge. In addition to the discomfort and debilitation these diseases can cause, side effects of traditional treatment modalities such as surgery, chemotherapy, and radiation may lead to severe and sometimes fatal sequelae. New targeted therapies promise an effective treatment with more easily tolerated and managed side effects. Basic understanding of the drugs' mechanism of action contributes to the successful management of the toxicities that can be manifested. Effective patient education results in improved compliance with treatment regimens and potentially improved clinical outcomes. Nursing intervention remains a vital component in the successful use of these novel agents.
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Perspectives on COVID-19 Prophylaxis and VaccinationTo close the discussion, panelists reflect on their practices’ guidance on long-acting antibody prophylaxis and vaccination against COVID-19 for patients with graft-versus-host-disease (GVHD).
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Role of Obesity and Exercise in Breast Cancer SurvivorsAfter malignancies of the skin, breast cancer is the most common cancer
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Genetic Counseling in Hereditary Nonpolyposis Colorectal CancerRecent identification of gene mutations responsible for hereditary nonpolyposis colorectal cancer (HNPCC) has made possible the presymptomatic diagnosis of at-risk family members. If DNA testing shows that a family member is a gene carrier, that individual's lifetime cancer risk is approximately 90%. If the test is negative, the family member's cancer risk drops to that of the general population.
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Oral Fluoropyrimidine-Based Combination Therapy in Gastrointestinal CancerSignificant emphasis has been placed recently on designing more effective fluorouracil (5-FU)-based combination protocols for gastrointestinal cancer. Promising results were seen with 5-FU/leucovorin in combination with
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Rational Design of Irinotecan Administration Based on Preclinical ModelsMost clinical drug regimens for irinotecan (CPT-11 [Camptosar]) have been empirically based on classic in vivo pharmacokinetic and pharmacodynamic considerations. We propose an alternative approach that attempts to
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HIPEC for Colorectal Cancer With Peritoneal CarcinomatosisThis video reviews the use of hyperthermic intraperitoneal chemotherapy with cytoreductive surgery in colorectal cancer with peritoneal carcinomatosis.
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ASCO GU: Early Treatment and Active Surveillance of Prostate Cancer PatientsAhead of the ASCO GU meeting, we spoke with two symposium committee members, Dr. Mack Roach, of the University of California, San Francisco, and Dr. Hans T. Chung, of the University of Toronto, about early treatment and surveillance of prostate cancer patients.
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Pemetrexed in Transitional Cell Carcinoma of the UrotheliumCurrently, the four-drug combination of methotrexate, vinblastine,doxorubicin (Adriamycin), and cisplatin (MVAC) or the two-drug combinationof gemcitabine and cisplatin (GC) represents the standard ofcare for patients with locally advanced and metastatic transitional cellcarcinoma of the urothelium. Recently, there has been a plethora ofdata from other chemotherapeutic regimens. Promising new agents,such as the multitargeted antifolate pemetrexed (Alimta), and new drugcombinations have demonstrated increased efficacy and/or decreasedtoxicity compared with current regimens. Currently, data are availablefrom three phase II studies utilizing pemetrexed or the combination ofpemetrexed/gemcitabine (Gemzar) in patients with locally advanced andmetastatic transitional cell carcinoma of the urothelium. Further investigationof combinations of pemetrexed and other active drugs inthe treatment of patients with locally advanced and metastatic diseaseis warranted.
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Avoiding Undertreatment, Overtreatment in Geriatric Breast Cancer PatientsThis video reviews how to ensure that older breast cancer patients are receiving the most appropriate care and highlights population studies that can help inform individual treatment decisions.
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UFT/Leucovorin Combined With Paclitaxel for Anthracycline-Pretreated Advanced Breast CancerTaxanes are the most active drugs in the treatment of metastatic breast and ovarian cancer. Weekly therapy with paclitaxel produces notable activity, with remarkably low toxicity.
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CHARTA Shows Survival Benefit of Four-Drug Regimen for Advanced CRCThis video examines results of the CHARTA trial, which tested first-line FOLFOX plus bevacizumab with or without irinotecan in patients with advanced colorectal cancer.
