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Paclitaxel and UFT Plus Oral Calcium Folinate in Pretreated Metastatic Breast CancerThis phase I study was designed to determine the maximum tolerated dose (MTD) and dose-limiting side effects of combination treatment with paclitaxel (Taxol) and UFT (uracil and tegafur in a 4:1 molar ratio) plus oral
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Continuous Low-Dose GM-CSF as Salvage Therapy in Refractory Recurrent Breast or Female Genital Tract CarcinomaGranulocyte-macrophage colony-stimulating factor (GM-CSF,sargramostim [Leukine]) is a powerful cytokine that is able to stimulatethe generation of dendritic cells. Adjuvant treatment with continuous lowdoseGM-CSF has been shown to prolong survival of stage III/IV melanomapatients. Data on continuous low-dose GM-CSF therapy in tumorsother than prostate cancer are still lacking.
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The Evolving Role of Cytoreductive Surgery for Metastatic Renal Cell CarcinomaMetastatic renal cell carcinoma is a devastating disease associatedwith poor survival. Immunotherapy is the mainstay of treatment, butresponse rates are low. The role of cytoreductive surgery in thepresence of metastatic disease is evolving. From both retrospective andrecently published randomized clinical trials, it is now apparent thatamong patients with metastatic renal cell carcinoma and good performancestatus, cytoreductive surgery followed by immunotherapy improvessurvival. However, this approach is likely to be detrimental inpatients with poor performance status. Clinical trials of novel agentsremain a priority in this disease.
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The Search for AntiestrogensVictor Vogel’s excellent review of the clinical basis for preventing breast cancer in high-risk women demonstrates the significant advances that have been made through the clinical trials mechanism. However, it is the progress in deciphering the link between hormones and the development and growth of breast cancer that is the true success story in this setting.
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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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Activity of Rituximab in Extranodal Marginal Zone Lymphomas (MALT Type)This phase II study aimed to evaluate the tolerability and activity of the monoclonal anti-CD20 antibody rituximab (Rituxan) in patients with either untreated or relapsed biopsy-proven extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT) type, with measurable or evaluable disease.
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Relapsed Follicular Lymphoma: Response to a Fludarabine/Mitoxantrone Regimen and the Monoclonal Anti-CD20 Antibody RituximabOur objective was to determine the efficacy of a fludarabine (Fludara)/mitoxantrone (Novantrone) regimen combined with the monoclonal anti-CD20 antibody rituximab (Rituxan) to induce clinical and molecular remissions in patients with relapsed
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Encouraging Improvement in Cytopenias of Patients With Myelodysplastic Syndromes With ThalidomideMyelodysplastic syndrome patients present with variable cytopenias even though their bone marrows are generally hypercellular. Excessive cytokine-induced apoptosis of hematopoietic cells in the marrows has been proposed as a possible
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Docetaxel vs Mitomycin Plus Vinblastine in Anthracycline-Resistant Metastatic Breast CancerThis nonblinded, multicenter, randomized phase III study compares the median time to progression (primary endpoint), response rate, and quality of life, safety, and survival of
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Nodal Marginal Zone Lymphoma: What Do We Really Know?Typically, when one authors a commentary piece, a good template to follow is to start with some background material, review the major findings of the paper in question, and then focus on areas of controversy and unanswered questions.
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AL Amyloidosis: Who, What, When, Why, and WhereIn the current issue of ONCOLOGY, Gertz and Dispenzieri provide a scholarly review of the early recognition, diagnosis, and treatment of immunoglobulin light-chain (AL) amyloidosis.
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New Combinations With Epirubicin in Advanced Breast CancerSeveral trials have shown that anthracyclines and taxanes can be combined to achieve response rates ranging from 70% to 90%, with complete responses ranging from 19% to 41%. In an attempt to increase the activity while
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Chronicling Strides in Understanding and Managing Rectal CancerAdvances in the treatment of rectal cancer, such as TME and CMT, have lengthened survival time and enhanced the quality of life. However, radiation therapy may have a negative impact on quality of life, especially in males. Future research needs to focus not only on survival but also on postoperative quality of life.
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New Developments: A Look to the FutureInflammatory cytokines plus the human immunodeficiency virus Tat protein apparently trigger the development of early Kaposi's sarcoma. Activated spindle cells provide a self-perpetuating, autocrine-supported mechanism for further development of hyperplastic lesions. In more advanced stages, a true neoplastic process may develop. [ONCOLOGY 10(Suppl):34-36, 1996]
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Navigating Treatment Options in Low-Risk Myelodysplastic SyndromesThis video explores the current treatment landscape for lower-risk MDS patients, including the various agents and sequencing strategies employed to best optimize outcomes.
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Docetaxel Combined With Vinorelbine: Phase I Results and New Study DesignsThis was a phase I dose-finding and pharmacokinetic study of vinorelbine (Navelbine) and docetaxel (Taxotere) as first-line chemotherapy for metastatic breast cancer. Vinorelbine dose, 20 or 22.5 mg/m², on days 1 and 5, was followed on day 1 by docetaxel every 21 days, in doses increasing from 60 to 100 mg/m².
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Phase I/II Trial of Irinotecan, Carboplatin, and Paclitaxel in Advanced or Metastatic NSCLCThis multicenter study enrolled 73 patients with locally advanced or metastatic non–small-cell lung cancer (NSCLC). The study design was based on the hypothesis that the non-overlapping toxicities of a 3-drug
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Classification of Cancer Pain SyndromesChronic pain occurs in about one-third of all cancer patients and in about three-quarters of those with advanced disease.[1] A major factor in the undertreatment of cancer pain is inadequate pain assessment.[2] Pain assessment provides the basis for inferred pathophysiology that directs diagnostic evaluation and treatment decisions. Pain syndrome identification plays an important role in this process-much of clinical medicine is based on pattern recognition of symptoms and signs, leading to a specific diagnosis and therapeutic strategy.
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Commentary (Flores/Rusch): Diffuse Malignant Mesothelioma of the Pleural Space and Its ManagementDrs. Zellos and Sugarbaker nicely summarize the current treatment strategies for malignant pleural mesothelioma. The management of this disease remains controversial, and several aspects of the review merit discussion.
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Special Issues in Breast Cancer ManagementThis section will examine several controversial or uncommon topics in breast cancer: use of dose-intensive therapy, estrogen replacement therapy, male breast cancer, and breast cancer in pregnancy. The section on dose-intensive therapy will trace the development and clinical rationale for the use of this therapy. For additional information, refer to the section on autologous bone marrow transplantation. Estrogen replacement therapy in patients previously treated for breast cancer is an area of active investigation and controversy.
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Gallbladder and Biliary Tract Carcinoma: A Comprehensive Update, Part 2Gallbladder carcinoma and carcinoma of the bile ducts are relativelyrare cancers in the United States. These cancers are often diagnosedin an advanced stage due to their nonspecific symptomatologyand until recently have been associated with a dismal prognosis. Recentadvances in imaging and surgical techniques along with emergingoptions in palliative chemotherapy have improved the outlook inthese cancers. While complete surgical resection remains the only hopeof cure in both these cancers, palliative biliary decompression and chemotherapyresult in substantial improvement in quality of life. Part 1 ofthis review, which appeared in last month’s issue, provided a relevantand comprehensive update of molecular pathology, imaging modalities,and surgical care. In part 2, we examine palliative care and systemictherapy in gallbladder and biliary tract carcinomas, as well asthe use of liver transplantation in the treatment of cholangiocarcinomas.These strategies are of relevance to internists as well as oncologistscaring for these patients.
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Risks and Benefits of Tamoxifen TherapyTamoxifen is the most widely prescribed endocrine therapy for breast cancer, with more than 7.5 million woman-years of clinical experience. Tamoxifen has both antiestrogenic and estrogenic activity. The antiestrogenic activity
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The Future of NSCLC: Molecular Profiles Guiding Treatment DecisionsThe authors of "ALK-Targeted Therapy for Lung Cancer: Ready for Prime Time," in this issue of ONCOLOGY, address the newest developments in the field of targeted therapies for advanced non–small-cell lung cancer (NSCLC).
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Neuroendocrine (Small-Cell) Carcinomas: Why They Teach Us Essential Lessons About Prostate CancerAggressive variants of prostate cancer often take the form of neuroendocrine or small-cell carcinomas, which frequently lack androgen receptor expression and respond poorly to hormonal therapies.
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Docetaxel/Gemcitabine: Salvage Chemotherapy in Anthracycline-Pretreated Patients With Advanced Breast CancerDocetaxel (Taxotere) and gemcitabine (Gemzar) are active agents against breast cancer. Several phase I studies evaluated different schedules of their combination and clearly demonstrated that docetaxel and gemcitabine can
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Recurrent Urothelial Carcinoma With Pulmonary MetastasisA 56-year-old woman was referred to our institution for a left nephroureterectomy after the diagnoses of a nonfunctioning left kidney and noninvasive papillary urothelial carcinoma of the distal left ureter (Ta grade 1). Following the procedure, surveillance cystoscopy and computed tomography (CT) scan of the abdomen and pelvis demonstrated a large bladder tumor with pan-urothelial extension.
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Every-2-Week Darbepoetin Alfa Is Comparable to rHuEPO in Treating Chemotherapy-Induced AnemiaThe safety and efficacy of darbepoetin alfa (Aranesp) at 3.0 µg/kg administered every 2 weeks and recombinant human erythropoietin (rHuEPO) given as 40,000 U weekly or 150 U/kg three times weekly were evaluated by
