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Breast Cancer Following Radiation for Hodgkin Lymphoma: Clinical Scenarios and Risk-Reducing StrategiesWe review available strategies for screening and risk reduction through chemoprevention or risk-reducing surgery, as well as challenges for management of breast cancer in patients with prior exposure to radiation for Hodgkin lymphoma.
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Optimal First-Line Therapy for Previously Untreated Chronic Lymphocytic Leukemia: The Case for Kinase InhibitorsGiven the favorable results seen thus far, there is no doubt that the treatment of patients with chronic lymphocytic leukemia is entering an exciting new era with the advent of these novel, relatively nontoxic and nonmyelosuppressive, oral agents.
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CYP2D6 Testing in Breast Cancer: Ready for Prime Time?This article will review and summarize the current data regarding the influence of the major cytochrome P450 2D6 (CYP2D6) genotypes and CYP2D6 inhibitors on tamoxifen metabolism and clinical efficacy. We will discuss the clinical relevance and limitations of this data and how to best incorporate our current understanding of CYP2D6 genotyping into our clinical practice and discussions with patients.
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Impact of UFT on Tumoral TS and DPD Levels in Colorectal CancerThis was an open lable, pilot translational clinical pharmacology study of a brief (7 day) course of UFT, 300 mg/m²/day, in combination with leucovorin, 90 mg/day, in six patients with newly diagnosed advanced colorectal cancer.
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Triple-Negative Breast Cancer in the Post-Genomic EraClearly there is no single therapy for all patients with TNBC, given the molecular heterogeneity of this subtype. However, new insights from further genomic analysis of TNBC suggest approaches to rational clinical trial design, and patients will undoubtedly benefit as we define the most appropriate therapeutic targets in management of this aggressive disease.
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How to Address Sexual Problems in Female Cancer PatientsSexual health is an important aspect of human life, and cancer does not (and should not) change that. Data suggest that issues related to sexual function are quite common among women treated for cancer. However, clinicians often spend little to no time on the topic.
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Prevention and Management of Radiation ToxicityThe aim of radiation oncology is the achievement of uncomplicated locoregional control of malignancy by the use of radiation therapy (RT). Accomplishing this goal requires precise knowledge of tumoricidal and tolerance doses of the various normal tissues at risk within the RT field.
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Synopsis of Angiogenesis Inhibitors in OncologyAngiogenesis is a dynamic process essential for primary tumor growth and metastases. New insights into the basic understanding of the biologic processes responsible for angiogenesis have led to the characterization of potential therapeutic targets. Several strategies for the development of antiangiogenic therapeutic modalities have been employed, including agents that (1) decrease the activity of specific angiogenic factors, (2) decrease the activity of endothelial survival factors, (3) increase the activity of naturally occurring antiangiogenic agents, or (4) indirectly downregulate angiogenic and survival factor activity.
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Use of Molecular Biomarkers to Inform Adjuvant Therapy for Colon CancerIn this review, we will discuss adjuvant chemotherapy in non-metastatic colon cancer, the existing prognostic and predictive molecular biomarkers in the field, and how to integrate these molecular biomarkers into the decision about whether to administer adjuvant therapy.
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Multiple Myeloma and Other Plasma Cell DyscrasiasThis management guide covers the symptoms, diagnosis, screening, staging, and treatment of multiple myeloma, smoldering myeloma, and other plasma cell dyscrasias.
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Neuroendocrine Tumors of the Gastrointestinal TractNeuroendocrine tumors manifest in the gastrointestinal tract mainly as carcinoid and pancreatic islet-cell tumors. They comprise an interesting group of rare neoplasms that are derived from neuroendocrine cells interspersed within the gastrointestinal system amd throughout the body. Neuroendocrine tumors are well known for producing various hormonal syndromes and for their indolent clinical course in most patients, although some of these tumors do not produce hormones of clinical significance. Patients may have symptoms for many years before the diagnosis is suspected and confirmed.
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Opioids in Cancer Pain: Common Dosing ErrorsMany individuals with advanced malignancy continue to sufferfrom pain and, consequently, impaired quality of life. The clinicalscenarios in advanced cancer pain are complex, and successful managementmay require a more sophisticated and individualized approachthan suggested by the World Health Organization guidelines.In patients referred to the Harry R. Horvitz Center for PalliativeMedicine in Cleveland, numerous commonly occurring errors inopioid use have been noted. This article describes these errors andoffers strategies with which to improve outcomes for patients sufferingwith cancer pain.
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ACR Appropriateness Criteria® Borderline and Unresectable Pancreas CancerThese guidelines review the use of radiation, chemotherapy, and surgery in borderline and unresectable pancreas cancer. Radiation technique, dose, and targets were evaluated, as was the recommended chemotherapy, administered either alone or concurrently with radiation. This report will aid clinicians in determining guidelines for the optimal treatment of borderline and unresectable pancreatic cancer.
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The Utility of Molecular Testing in Colorectal Cancer: The Promise Needs ProgressMolecularly profiling colorectal cancer has opened many potential opportunities for the use of this information in therapeutic decision-making. However, at present, only RAS testing in the metastatic setting has a definitive place in the decision-making paradigm.
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PARP Inhibition in Prostate Cancer: A Promising ApproachHaving said that, PARP inhibition is one of the most promising approaches for “precision therapy” so far. Within the next few years and with the help of ongoing clinical trials, we should have a better understanding of whether or not the high expectations raised will be translated into clinical reality.
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A Phase II Study of Doxorubicin/Paclitaxel Plus G-CSF for Metastatic Breast CancerThis phase II trial was conducted to evaluate the percentage of objective responses and the toxicity profile of combination doxorubicin (Adriamycin) and paclitaxel (Taxol) with granulocyte colony-stimulating factor as first-line
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ACR Appropriateness Criteria® Management of Vaginal CancerThis article represents the consensus opinion of an expert panel and may be used to inform clinical recommendations in vaginal cancer management.
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Mutation-Derived Tumor Antigens: Novel Targets in Cancer ImmunotherapyBecause of the abundance of promising preclinical and early-phase clinical data, mutation-derived tumor antigens an exciting new class of targets in cancer immunotherapy.
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Screening and Prevention of Hepatitis B Virus Reactivation During ChemotherapyThe incidence of both hepatitis B virus infection and cancer is common. The use of immunosuppressive therapy in patients with hepatitis B virus can result in reactivation of hepatitis B virus, which can, in turn, lead to significant morbidity and mortality.
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Something Old, Something New: Options for Treating Relapsed Mantle Cell LymphomaDr. Ruan and colleagues provide an excellent summary of available treatment options, as well as new drugs on the horizon, for the management of relapsed mantle cell lymphoma (MCL). As the authors emphasize, treatment of relapsed MCL is strongly influenced by the patient’s first-line therapy and needs to be individualized based on both patient and disease characteristics.
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The Evolving Care of Metastatic Colorectal CancerProgress in the care of mCRC has occurred relatively rapidly, but current methods of management have placed a significant economic burden on the healthcare system.
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Nina Shah, MD, Shares Key Takeaways From Phase 2 KarMMa Trial Sub-Analysis of Ide-Cel in R/R Multiple MyelomaNina Shah, MD, spoke about her key takeaways from a sub-analysis of the phase 2 KarMMa trial assessing correlates of complete response among those treated with idecabtagene vicleucel in relapsed/refractory multiple myeloma.
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Advanced Lab Testing in Lung CancerThe most important marker to test is epidermal growth factor receptor (EGFR). EGFR is the second most common oncogenic driver in lung cancer, present in 15% of adenocarcinoma cases, but the most common mutation to be actionable with an approved drug.
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The Many Controversies of Stage IIIA/IIIB Lung CancerThe first issue deserving comment is the heterogeneity of stage III disease. Stage IIIA N2 non–small-cell lung cancer (NSCLC) includes patients with at least one “incidental” N2 node detected at the time of surgical resection in patients who had a negative mediastinal evaluation (including mediastinoscopy) preoperatively. It also includes patients whose initial computed tomography (CT) and positron-emission tomography (PET) scans show multiple bulky (> 2 cm) nodes that are confirmed by either mediastinoscopy or endobronchial ultrasound-guided bronchoscopy.
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Obesity and Metabolic Disease After Childhood CancerIn this review, childhood cancer survivor populations at risk for metabolic late effects, as well as mechanisms and ongoing intervention studies, will be detailed.
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Propelling Immunotherapy Combinations Into the ClinicThis review summarizes promising new targets and immunotherapy combination strategies currently under clinical development.
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Advancing CLL Treatment: Latest Updates and StrategiesNitin Jain, MD, discusses a novel treatment approach for chronic lymphocytic leukemia, along with stem cell transplantation and other later-line therapies and treatment options for managing CLL.
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POINT: Routine Use of Autologous Stem Cell Transplantation in Multiple MyelomaResults of important studies addressing the optimal consolidation regimen and choice and duration of maintenance therapy are eagerly awaited, but it is evident that ASCT is imperative in the treatment of younger patients with multiple myeloma.
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Incidence and Management of AIDS-Related LymphomaThe article by Drs. Levine, Seneviratne, and Tulpule is an excellent review of the available literature on the incidence and treatment of lymphoma related to the acquired immunodeficiency syndrome (AIDS).
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Cancer Management Chapter 17: Cervical cancerOf the predominant gynecologic cancers, cancer of the uterine cervix is the least common, with only 11,270 new cases anticipated in the United States in 2009. Nevertheless, approximately 4,070 women die of cancer of the uterine cervix annually in the United States.
