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Adjuvant Treatment of Early Stage Non–Small-Cell Lung CancerCure rates for non–small-cell lung cancer (NSCLC) remain low and the prognosis for patients with even stage IA disease is poor. Complete surgical resection is still the first-line treatment for NSCLC, but many investigators
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Maintenance Chemotherapy With UFT for Head and Neck CarcinomaA prospective randomized trial to evaluate the efficacy of maintenance chemotherapy after surgical treatment of head and neck carcinoma was performed at 67 institutions. A comparison was made between the following two groups: the treatment group, which received 1-year oral administration of UFT at 300 mg/d following curative surgical treatment (UFT arm), and the nontreatment group, which received curative surgery alone (control arm).
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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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A Novel Weekday - on/Weekend - off UFT ScheduleIn a step toward a clinical trial, the tumor response and survival of a weekday-on/weekend-off schedule of UFT was compared with its conventional daily schedule in a cancer-bearing rat model. The dose-intensive schedule-600 mg of UFT for 5 days followed by 2 drug-free days-amounts to a weekly dose similar to the conventional schedule of 400 mg/day. The weekday-on/weekend-off schedule provided increased survival and significantly greater antitumor activity than the conventional daily schedule, with no difference in adverse reactions.
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UFT Plus Leucovorin for Metastatic Colorectal Cancer: Japanese ExperienceIn the United States and Europe, the combination of oral UFT plus leucovorin has been reported to produce objective responses and survival rates similar to those achieved with standard intravenous 5-fluorouracil plus leucovorin in patients with metastatic colorectal cancer, with reduced toxicity.
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UFT Plus Leucovorin for Metastatic Colorectal Cancer: Japanese ExperienceIn the United States and Europe, the combination of oral UFT plus leucovorin has been reported to produce objective responses and survival rates similar to those achieved with standard intravenous 5-fluorouracil plus leucovorin in patients with metastatic colorectal cancer, with reduced toxicity.
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UFT Plus Cisplatin in Advanced Non-Small-Cell Lung Cancer: Interim Analysis of 67 PatientsA single-institution phase II study indicated that combination chemotherapy using UFT (tegafur and uracil) plus cisplatin (Platinol) in patients with non-small-cell lung cancer was active with less host toxicity than other cisplatin-
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Molecular Genetics of Hereditary Ovarian CancerApproximately 10% of all epithelial ovarian carcinoma cases are associated with inheritance of an autosomal-dominant genetic mutation conferring a predisposition to cancer with variable penetrance. Two such manifestations
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Multidisciplinary Management of Pediatric Soft-Tissue SarcomaSoft-tissue sarcomas comprise approximately 7% of all pediatric malignancies. Surgery, chemotherapy, and radiation therapy have significantly improved survival.
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Optimizing the Benefit of CNS Radiation Therapy in the Pediatric Population-PART 1: Understanding and Managing Acute and Late ToxicitiesMinimizing late treatment toxicities in these patients remains an important priority due to both the young age of the patients and the high cure rate that can be achieved.
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Commentary (Tepper/Kim): Are We Overtreating Some Patients With Rectal Cancer?Adjuvant therapy, almost bydefinition, overtreats patients.It is the holy grail of those ofus involved in adjuvant therapy to definethe patients who are going to failso that we can decrease the incidenceof tumor recurrence and avoid givingadditional therapy to patients who havebeen cured by their primary treatment.
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Irinotecan in Combination With Radiation Therapy for Small-Cell and Non-Small-Cell Lung CancerLung cancer is the leading cause of cancer-related death in the United States. There was rapid progress in the treatment of lung cancer during past decades, but local control and survival rates are still poor.
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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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Morbidity of Contemporary Radical Retropubic Prostatectomy for Localized Prostate CancerComplication rates in 1,000 consecutive patients who underwent radical retropubic prostatectomy for clinically localized prostate cancer between November 1989 and January 1992 were assessed and compared to complication rates in a historical group of patients operated on by primarily the same surgeons prior to 1987. In the contemporary series, there were no operative deaths, only 22% of patients required blood transfusion, and only six (0.6%) patients suffered rectal injuries. Early complications, including myocardial infarction, pulmonary embolism, bacteremia, and wound infection, occurred in less than 1% of patients. Vesical neck contracture, the most common late complication, developed in 87 patients (8.7%). At 1 year post-surgery, 80% of patients were completely continent, and fewer than 1% were totally incontinent. [ONCOLOGY 9(5):379-389, 1995]
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Hossein Borghaei, DO, MS, Discusses Future Research Directions in NSCLC Based on the Lung-MAP TrialHossein Borghaei, DO, MS, discussed where investigators may drive future research following the phase 2 Lung-MAP trial examining pembrolizumab and ramucirumab in previously treated advanced non–small cell lung cancer.
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Howard A. Burris, MD, Talks QOL With Durvalumab/Chemo in Advanced Biliary Tract Cancer From TOPAZ-1 TrialHoward A. Burris, MD, highlighted previous findings of the phase 3 TOPAZ-1 trial assessing durvalumab plus gemcitabine and cisplatin vs placebo plus gemcitabine and cisplatin in advanced biliary tract cancer and patient-reported outcomes data that were presented at 2022 ASCO.
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A Clinician’s Perspective on ASCO 2001: Going After the Epidermal Growth Factor ReceptorAmong the most exciting new anticancer products presented at the 2001 ASCO meeting were new drugs that block the epidermal growth factor receptor (EGFR). About 30% to 90% of carcinomas express high levels of EGFR. These include, among others, head and neck cancer, lung cancer, pancreatic cancer, colon cancer, breast cancer, ovarian cancer, and bladder cancer.
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Medulloblastoma: Molecular Classifications and Prognostic AssociationsOf particular relevance for clinicians is the possible recommendation of omitting concurrent chemotherapy with CSI in adults, due to the lower marrow reserves and overall lack of data for clear efficacy of concurrent chemotherapy in adults. Additional refinement of these therapeutic regimens for adult medulloblastoma awaits further advances in both the molecular prognostic associations for these tumors and the potentially exciting development of targeted therapies for specific molecular subtypes.
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Commentary (Kirkwood et al): Radiotherapy for Cutaneous Malignant Melanoma: Rationale and IndicationsThe rigorous assessment of thebenefits of radiotherapy formelanoma has been confoundedby superstition on one hand, andreligious fervor on the other. In thisissue, Ballo and Ang have reviewedthe use of radiotherapy for melanoma,focusing primarily on the controversialtopic of adjuvant postoperativeradiotherapy to the primary tumor bedand regional lymphatics.
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Commentary (Homesley/Muss): Role of Chemotherapy Dose Intensification in the Treatment of Advanced Ovarian CancerWe agree with Drs. Fennelly and Schneider that data from prior clinical trials performed in patients with suboptimally debulked ovarian cancer indicate that increasing the dose intensity of cisplatin (Platinol) does not translate into meaningfully higher response rates, longer response durations, or improved survival. The Gynecologic Oncology Group study is most persuasive in showing that doubling the standard dose of cisplatin and cyclophosphamide (Cytoxan, Neosar) while delivering the same total dose does not improve outcome [1].
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Breast Cancer Patients Who Are Obese at Diagnosis: Alea Iacta Est? or "Is the Die Cast?"Obesity rates in the United States have increased twofold in adults and threefold in children during the past 30 years.[1] Beyond its detrimental effects on cardiovascular health, obesity increases the risk of several cancers, including postmenopausal breast cancer,[2] and it is also associated with a higher risk of recurrence and death in those who develop breast cancer.[3]
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PSA After Radiation for Prostate CancerThe introduction of prostate-specific antigen (PSA) as a reliabletumor marker for prostate cancer brought significant changes in theend points used for outcome reporting after therapy. With regard to adefinition of failure after radiation, a consensus was reached in 1996that took into account the particular issues of an intact prostate aftertherapy. Over the next several years, the consensus definition issued bythe American Society for Therapeutic Radiology and Oncology(ASTRO) was used and studied. Concerns and criticisms were raised.The sensitivity and specificity of this definition vs other proposals hasbeen investigated, and differences in outcome analyzed and compared.Although the ASTRO definition came from analysis of datasets on external-beam radiation and most of the work on this topic has been withthis modality, failure definitions for brachytherapy must be exploredas well. The concept of a universal definition of failure that might beapplied to multiple modalities, including surgery, should also be investigated,at least for comparative study and research purposes.
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Paclitaxel as First-Line Treatment for Metastatic Breast CancerWhen administered as a single agent in pretreated patients with advanced breast cancer, paclitaxel (Taxol) exhibits remarkable antitumor activity. This trial was undertaken to compare paclitaxel with standard
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Expanding Androgen- and Androgen Receptor Signaling–Directed Therapies for Castration-Resistant Prostate CancerThis article reviews the most recent advances in androgen receptor-directed therapies for castration-resistant prostate cancer, and new agents under development.
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Avelumab Produces Durable Responses in Metastatic Merkel Cell CarcinomaIn this video we discuss promising results of the anti–PD-L1 agent avelumab in patients with metastatic Merkel cell carcinoma who had previously been treated with chemotherapy.
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Biomarkers for Response to Anti–PD-1/Anti–PD-L1 Immune Checkpoint Inhibitors: A Large Meta-AnalysisArshiya Mariam, BS, and colleagues report the findings of a large meta-analysis assessing the ability of various biomarkers to predict responses to immune checkpoint inhibition.
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Myalgias and Arthralgias Associated With PaclitaxelPaclitaxel-induced myalgias and arthralgias occur in a significantfraction of patients receiving therapy with this taxane, potentiallyimpairing physical function and quality of life. Paclitaxel-inducedmyalgias and arthralgias are related to individual doses; associationswith the cumulative dose and infusion duration are less clear. Identificationof risk factors for myalgias and arthralgias could distinguisha group of patients at greater risk, leading to minimization of myalgiasand arthralgias through the use of preventive therapies. Optimalpharmacologic treatment and possibilities for the prevention of myalgiasand arthralgias associated with paclitaxel are unclear, partially dueto the small number of patients treated with any one medication. Theeffectiveness of nonsteroidal anti-inflammatory drugs (NSAIDs) is themost frequently documented pharmacologic intervention, although noclear choice exists for patients who fail to respond to NSAIDs. However,the increasing use of weekly paclitaxel could necessitate daily administrationof NSAIDs for myalgias and arthralgias and leave patients at riskfor adverse effects. This concern may also limit the use of corticosteroidsfor the prevention and treatment of paclitaxel-induced myalgias andarthralgias. Data from case reports suggest that gabapentin (Neurontin),glutamine, and, potentially, antihistamines (eg, fexofenadine [Allegra])could be used to treat and/or prevent myalgias and arthralgias. Giventhe safety profile of these medications, considerable enthusiasm existsfor evaluating their effectiveness in the prevention and treatment ofpaclitaxel myalgias and arthralgias, particularly in the setting ofweekly paclitaxel administration.
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Integrating PARP Inhibitors Into Advanced Prostate Cancer TherapeuticsExperts in the field review integration of approved PARP inhibitors into advanced prostate cancer clinical practice.
