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The Different Faces of Disseminated Intravascular Coagulation in Solid Tumors: How to Identify and Manage“Treat the underlying cause” has been the classic mantra for the treatment of disseminated intravascular coagulation. Whenever feasible in disseminated intravascular coagulation associated with solid tumors, this principle appears to hold good.
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Neoadjuvant Treatment for Surgically Resectable Metastatic Colorectal Cancer: Is There an Optimal Succession?It remains difficult to decipher which patients are appropriate candidates for conversion therapy vs upfront surgery. Therefore, in predicting potential outcomes, several factors should be considered. Here, we will attempt to address such factors and provide insights.
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A Multidisciplinary Approach to Treating Resectable NSCLCSurgeons, radiation oncologists, and medical oncologists gathered to discuss treatment options and approaches for NSCLC.
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Anti-Angiogenesis Therapy in Gynecologic MalignanciesThe purpose of this paper is to provide a review of site-specific treatment options that involve the targeting of angiogenesis in gynecologic malignancies.
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Nurses Play Important Part in Recognizing Skin Toxicities, AbnormalitiesAs part of our coverage of ONS, we discuss dermatologic issues in oncology patients, including skin-related toxicities and assessment techniques used to identify skin-related issues.
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The Absent-Minded Professor: An Unusual Complication of MelanomaThe University of Colorado Health Sciences Center holds weekly second opinion conferences focusing on cancer cases that represent most major cancer sites. Patients seen for second opinions are evaluated by an oncologist.
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Circulating Tumor DNA as a Predictive Biomarker for Clinical Outcomes With Margetuximab and Pembrolizumab in Pretreated HER2-Positive Gastric/ Gastroesophageal AdenocarcinomaDaniel V. T. Catenacci, MD, and colleagues present findings from a study of circulating tumor DNA as a predictive biomarker for gastric and gastroesophageal cancer.
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Targeting Angiogenesis in Solid TumorsA growing number of novel antiangiogenic agents are entering clinical trials to study their clinical safety and efficacy. A few, such as bevacizumab (Avastin), sorafenib (Nexavar), and sunitinib (Sutent), have received US Food and Drug Administration approval and are already in widespread clinical use. As knowledge about the intricacies of intracellular signaling within multiple tumor types expands, agents with the capacity to impact these pathways are being incorporated into additional clinical trials alone and in combination with other targeted and/or traditional antineoplastic agents. Early clinical trials have focused on highly vascular tumor types, as well as those known to significantly overexpress the VEGF (vascular endothelial growth factor) receptor family. This article aims to review the status of antiangiogenic therapy in selected tumor types and discuss areas for further research.
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Breast Cancer: Never Too Young for a Functional Assessment?Geriatricians would argue that biological age alone should not be used to estimate a patient's anticipated tolerance for cancer therapy.
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A Man With Changes in the Urinary Bladder: Benign Metaplasia or Adenocarcinoma?The patient is a 39-year-old man who presents with pelvic lymphadenopathy. He has a history of ureteral reflux disease, recurrent nephrolithiasis, right nephrectomy, ileal loop diversion of the left ureter, and radical cystectomy for “bladder cancer,” which he underwent 3 years ago. The lymphadenopathy was discovered incidentally during recent imaging.
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Current Controversies in the Management of Hodgkin's LymphomaDespite significant improvements in the treatment of Hodgkin's lymphoma over the past 2 decades, physicians continue to face dilemmas in therapy for the disease, and many cured patients live with complications of treatment. Newer therapeutic options are still needed for the disease, to minimize complications and to improve the treatment of patients in relapse. This review considers the treatment of Hodgkin's lymphoma in younger patients, addressing such issues as which patients with early-stage disease may require radiotherapy, what prognostic factors provide information that can affect treatment choices in patients with advanced disease, and what we have learned about treatment complications in this setting.
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PARP Inhibition in Epithelial Ovarian Cancer: High Hopes Undergo a Reality CheckThis article reviews the trials that have been conducted with PARP inhibitors in epithelial ovarian cancer, fallopian tube cancer, and primary peritoneal cancer, and places the impact of those results in the larger context of PARP inhibitor development.
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Hearing Loss in Pediatric Cancer Survivors Treated With CisplatinCisplatin is effective in treating several types of childhood cancers (eg, CNS tumors, osteosarcoma, hepatoblastoma, neuroblastoma, germ cell tumors). It is the most ototoxic drug used clinically, and hearing loss is a well-recognized toxicity of cisplatin therapy.
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Anaphylaxis: Implications of Monoclonal Antibody Use in OncologyThe phenomenon of anaphylaxis was discovered by Portier and Richet in 1903.[1,2] They injected dogs with toxins from sea anemone with the intent of generating protective antibodies. Unexpectedly, they found that certain dogs became ill with a rapid heartbeat and collapse. Because this syndrome was the precise opposite of protection or prophylaxis, they termed it anaphylaxis.
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Cancer of the Cervix: Current Management and New Approaches: Review 2This 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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Management Considerations in Cancer Patients With Rheumatoid ArthritisPatients with cancer and concomitant rheumatoid arthritis pose special challenges. Many therapies for rheumatoid arthritis can increase the risk of adverse events during cancer therapy because they are immunosuppressive.
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Changing Concepts in the Management of Endometrial CancerEndometrial carcinoma was a clinically staged disease until the late 1980s, at which point, staging changed to a surgicopathologically defined system. This change in staging, in turn, altered the clinical management of this
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ACR Appropriateness Criteria® Ductal Carcinoma in SituManagement of ductal carcinoma in situ (DCIS) commonly involves excision, radiotherapy, and hormonal therapy. Radiotherapy is employed for local control in breast conservation. Evidence is evolving for several radiotherapy techniques exist beyond standard whole-breast irradiation.
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Palliative RT Research in Prostate Cancer: Understanding the Past, Anticipating the FutureMoving forward, perhaps no recent development in the use of RT in metastatic prostate cancer has captured greater attention than the use of radium-223 in metastatic castration-resistant prostate cancer (mCRPC).
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Commentary (Frenkel): Chronic Inflammation and CancerThe review by Drs. Shacter and Weitzman is an excellent and timely contribution to the field of carcinogenesis. The issue of chronic inflammation as a progenitor of cancer development has been a controversial one. To prove the importance of chronic inflammation (and the factors released in the process) to carcinogenesis, the authors provide a thorough and logical presentation of the experimental results described in the literature, including their own work. This compilation of the existing data should dispel any doubts about the association of chronic inflammation to cancer. I will review the main points discussed by the authors.
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Book Review: The Alternative Medicine Handbook: The Complete Reference Guide to Alternative and Complementary TherapiesMany oncologists are barraged with questions and declarations from patients regarding therapies and products that
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Time to Change the Treatment Paradigms in Anaplastic Thyroid CarcinomaIn rare diseases, the “magic” lies in close collaboration between individual investigators at academic institutions, the pharmaceutical industry, and funding institutions such as the National Cancer Institute.
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Acute Myeloid Leukemia With Adverse Cytogenetic RiskAcute myeloid leukemia (AML) encompasses multiple disease entities that differ with regard to marrow morphology, cytochemistry, immunophenotype, pretreatment clinical characteristics, and treatment outcome.
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Liposomal Doxorubicin in Combination With Bortezomib for Relapsed or Refractory Multiple MyelomaLiposomal doxorubicin received FDA approval for use in combination with bortezomib in patients with multiple myeloma who have not previously received bortezomib and have received at least one prior therapy.
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T Cell Diversity in Tumor May Influence Ovarian Cancer OutcomesIn this video Dr. Odunsi discusses a new study that found that higher T-cell diversity in ovarian cancer is associated with poor overall survival.
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Guillain-Barré Syndrome After Treatment With Sunitinib Malate?Sunitinib malate (Sutent, SU011248) is an oral multitargeted tyrosine kinase inhibitor used for treatment of renal cell carcinoma and gastrointestinal stromal tumor. We report a case of a patient who developed Guillain-Barré syndrome after initial treatment with sunitinib, with recurrent symptoms upon reintroducing the drug. This is the first report of such an effect. The literature on chemotherapy-induced Guillain-Barré syndrome is also reviewed. Oncology providers should be aware of this rare but potentially serious possible adverse effect of sunitinib.
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Evolution of Treatment Options for Patients With CRPC and Bone Metastases: Bone-Targeted Agents That Go Beyond Palliation of Symptoms to Improve Overall SurvivalThis review will examine agents with potential activity in the palliation and treatment of skeletal metastases of prostate cancer, and will weigh the clinical-outcomes evidence for and against their broad use.
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Diagnosis of Invasive Lobular Carcinoma in a Young Woman Presenting With Pleomorphic Lobular Carcinoma in Situ on Core BiopsyA 40-year-old premenopausal woman with a new diagnosis of invasive lobular carcinoma occurring in a background of lobular carcinoma in situ presents to a multidisciplinary second opinion clinic.
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Cisplatin/Etoposide vs Paclitaxel/Cisplatin/G-CSF vs Paclitaxel/Cisplatin in Non-Small-Cell Lung CancerA phase III trial conducted by Eastern Cooperative Oncology Group (ECOG) investigators assessed the possible impact of paclitaxel on survival, response, and toxicity in patients with
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Quality-of-Life Improvement in Patients Receiving Paclitaxel/Platinum RegimensThe combination regimen of paclitaxel (Taxol) and cisplatin (Platinol) for non–small-cell lung cancer has shown improved response rates in some phase II trials, and because of its safety profile, it could offer patients with this
