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Cardiovascular Toxicity of Biologic Agents for Cancer TherapyThis review will focus on newer FDA-approved targeted therapies associated with type II chemotherapy-related cardiac dysfunction, or generally reversible cardiotoxicity, and will provide the latest information on the incidence and clinical spectrum of cardiotoxicity associated with each therapy, modifiable risk factors where known, and the mechanisms of cardiotoxicity.
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Radiation Therapy in Resectable/Resected Pancreatic Adenocarcinomas: Clearing Up the FogSurgical resection remains the sole modality that has proven capable of "curing" pancreatic cancer.
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Neal D. Shore, MD, Reviews Data for LuPSMA 177 in mCRPC at 2021 ASCODuring a discussion at 2021 ASCO, Neal D. Shore, MD, said he was most excited to see data from the phase 3 VISION trial of lutetium-177-PSMA-617 in metastatic castration-resistant prostate cancer.
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Commentary (Denlinger/Meropol): The Horizon of Antiangiogenic Therapy for Colorectal CancerOlszewski and colleagues reviewpreclinical and clinicaldata regarding vascular endothelialgrowth factor (VEGF) inhibitors,with particular attention to thedevelopment of bevacizumab (Avastin)in patients with colorectal cancer.The translation from biologic conceptto clinical proof of concept has beenstriking in its rapidity. However, manyimportant questions remain, and thisstory is only beginning to unfold. Inthis commentary, we will highlightsome of those questions that bear onthe optimal use of VEGF inhibitors inpatients with colorectal cancer.
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ACR Appropriateness Criteria® Adjuvant Management of Early-Stage Endometrial CancerAfter a review of the published literature, the panel voted on three variants to establish best practices for the utilization of imaging, radiotherapy, and chemotherapy after primary surgery for early-stage endometrial cancer.
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Thymoma: Current ConceptsThis review considers the status of the different histological classifications thus far presented for thymomas and offers an analysis of the association between histology and clinical behavior.
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Solutions Are Necessary to Increase Real-World Prostate Cancer Drug UseFinancial constraints and a lack of education among some patients and providers must be addressed to improve the real-world use of certain prostate cancer therapies, says Neeraj Agarwal, MD.
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Integrated PET-CT: Evidence-Based Review of Oncology IndicationsPositron-emission tomography(PET)–computed tomography(CT) has added a new dimensionto the imaging of cancers andcombination PET-CT scanners are becomingincreasingly universal. Theuse of combination scanners has increasedrapidly over the past 2 years-industry estimates are that the majorityof PET units sold throughout the worldwill be combination PET-CT scanners-and the authors have providedtheir own clinical experience and areview of the literature. While there issubstantial literature on the clinicalutility of PET alone, the use of PETCTis relatively new. The authors suggestthere is incremental benefit tothe addition of structural information(ie, CT) obtained at the same time asthe functional PET imaging.
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A Pharmacoeconomic Comparison of UFT and 5-FU Chemotherapy for Colorectal Cancer in South AmericaThe escalating role played by managed care organizations in the health-care system is reflected in the increased demand for cost-effectiveness analyses (CEAs) to assess the balance between economic impact
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Is Hypofractionation the Solution? The Financial Implications of Breast Cancer TreatmentsHypofractionated external beam WBI seems like a great option until the APBI data mature from NSABP 39/RTOG 0413. In the meantime, we will have to see whether the ACA’s mission to bend the cost curve in the face of added demand for cancer care will succeed and how our treatment decisions will be affected by this new healthcare model.
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Future Perspectives: Treating Multiple Myeloma With Novel RegimensAn overview of what’s next, in terms of the use of various frontline treatment regimens, that include novel agents to manage patients with newly diagnosed multiple myeloma.
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Therapy for Peripheral T-Cell Lymphomas: Where We Are and Where We Hope to BeOur standard therapies for peripheral T-cell lymphoma may cure a subset of patients, and thus far novel agents have not changed the outcomes for the majority.
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ACR Appropriateness Criteria® Postradical Prostatectomy Irradiation in Prostate CancerThe purpose of this article is to present an updated set of American College of Radiology consensus guidelines formed from an expert panel on the appropriate use of radiation therapy in postprostatectomy prostate cancer.
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Plastic Surgery: A Component in the Comprehensive Care of Cancer PatientsPlastic surgery represents a small but critical component of the comprehensive care of cancer patients. Its primary role in the treatment of cancer patients is to extend the ability of other surgeons and specialists to more
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Neuropathic Cancer Pain: The Role of Adjuvant AnalgesicsNeuropathic pain may be defined as pain related to abnormal somatosensory processing in either the peripheral or central nervous system. This pathophysiologic label is typically applied when the painful symptom is associated
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Are We Ready to Screen for Inherited Susceptibility to Cancer?The discovery of inherited gene mutations that increase the risk of certain cancers could greatly expand the use of predictive genetic testing in healthy individuals. In families with hereditary forms of cancer, the use of genetic tests to determine whether family members have inherited suseptibility mutations (ISMs} may improve out come.
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Therapeutic Options Following Orchiectomy for Stage I SeminomaOver the past 3 decades, the incidence rate of testicular seminoma has continually risen, and the majority of cases have been clinical stage I.[1] Nevertheless, the overall survival for all testicular cancers has improved significantly (P < .05) over the same period, from 83% to 96%.[2]
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An Alternative Algorithm for Dosing Transdermal Fentanyl for Cancer-Related PainMany cancer patients are undermedicated and inappropriately managed for pain, leading to a diminished quality of life. Patients with moderate to severe pain often require opioid analgesics. Recently published guidelines
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New and Newer Vascular Targets in OncologyThis review covers progress to date in the identification of molecular targets on blood vessels in cancers, as well as agents that act on those targets, with emphasis on those currently in clinical trials. Current vascular-targeting therapies comprise two general types—antiangiogenic therapy and antivascular therapy. Advances in antiangiogenic therapies, particularly inhibitors of vascular endothelial growth factors and their receptors, have clarified the capacity of these inhibitors to change tumor-associated vessel structure to a more normal state, thereby improving the ability of chemotherapeutics to access the tumors. The responses of other antiangiogenesis target molecules in humans are more complicated; for example, αvβ3 integrins are known to stimulate as well as inhibit angiogenesis, and cleavage of various extracellular proteins/proteoglycans by matrix metalloproteinases produces potent regulators of the angiogenic process. Antivascular therapies disrupt established blood vessels in solid tumors and often involve the use of ligand-based or small-molecule agents. Ligand-based agents, irrespective of the antiangiogenic capacity of the ligand, target antivascular effectors to molecules expressed specifically on blood vessels, such as aminopeptidase N, fibronectin extra-domain B, and prostate-specific membrane antigen. Small-molecule antivascular agents, which are not targeted to molecules on blood vessels, rely on physical differences between the vasculatures in tumors and those in normal tissues.
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Modern Immunotherapy for the Treatment of Advanced Gastrointestinal CancersAlthough immunotherapy is not yet approved for the treatment of gastrointestinal cancers, it is already clear that many gastrointestinal cancers can be sensitive to it. We will review recent clinical trial results demonstrating this, and offer our perspective on the role that immunotherapy might play in the treatment of advanced gastrointestinal malignancies in the years ahead.
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Overview: Management of Treatable but Incurable CancersThe accurate and in-depth documentation of learning gaps is a fundamental aspect of developing continuing education activities. To obtain a better understanding of community-based medical oncology practice patterns, 43 oncologists within the United States were recruited to complete a traditional clinical case–based questionnaire and to contribute specific anonymous demographic and treatment information derived from their actual patients. This information was used to create a cross-sectional case database on two types of cancer in which major clinical advances have been reported in recent years - multiple myeloma and follicular lymphoma. These diseases also are similar in that most patients experience clinically meaningful benefits from systemic treatment but are unlikely to be cured by therapy. As further described in this and the subsequent two articles, this case-based series documents that (a) clinical research advances are being quickly implemented in daily patient care and that (b) although therapeutic strategies vary based on patient age, the short-term outcomes in terms of response to and tolerance of treatment are similar in younger and older patients.
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Current Management of Cancer-Associated Anorexia and Weight LossDrs. Jatoi and Loprinzi provide a comprehensive but succinct overview of the management of cancer-associated anorexia and weight loss. These clinician researchers, who have added much to our understanding of this problem, present a balanced and reasonable approach to the management of these common paraneoplastic syndromes.
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Nutrition as an Integral Component of Supportive CarePalliative care, previously viewed by many as anend-of-life movement, is now recognized as anapproach whose principles should infuse the care ofall patients with a chronic illness throughout the fullcourse of that illness. For example, the World HealthOrganization (WHO) has redefined palliative care asfollows:
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New Practical Approaches to Chemotherapy-Induced Neuropathic Pain: Prevention, Assessment, and TreatmentWe review here the recommendations of the American Society of Clinical Oncology, as well as some new and promising approaches to neuropathy, including new neuromodulation techniques.
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Surgical Approach to Organ Preservation in the Treatment of Cancer of the LarynxThe article by Dr. Weinstein is a discussion of the newer surgical options available for the treatment of patients with laryngeal cancer. Several aspects of the article deserve mention.
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Childhood cancer haunts survivors in unexpected waysRadiation doses to the heart of about 5 Gy or greater in childhood are associated with long-term cardiovascular consequences, including early mortality. Cancer care specialists strive to balance late-stage effects without sacrificing treatment benefits.
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Front-Line TKI Therapy for Chronic-Phase CML: the Luxury of ChoicePhysicians now have the luxury of focusing attention on maximizing outcomes that are already quite favorable, and of devoting more attention to improving quality of life and addressing questions of cost-effectiveness.
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Clinical Trial Simulation of a 200-µg Fixed Dose of Darbepoetin Alfa in Chemotherapy-Induced AnemiaOur objective was to assess, using clinical trial simulation, the feasibility of a fixed 200-µg dose of darbepoetin alfa (Aranesp) administered every 2 weeks in chemotherapy-induced anemia. A pharmacokinetic/pharmacodynamic
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Hormonal Approaches in the Treatment of Bony MetastasesHormonal therapy for prostate cancer designedto reduce testosterone levels has been employed for decades andprovides objective remission rates of 40% to 60% and subjectiveresponse rates of 60% to 85%. Orchiectomy, as
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Radiation Therapy in the Management of Malignant MelanomaMelanoma has historically been considered a radioresistant tumor. Emerging data have challenged this viewpoint. The potential roles of radiation therapy in the treatment of patients with melanoma will be reviewed here.
