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CATNON Trial: Concurrent Versus Adjuvant Temozolomide in Treating WHO Grade 3 Astrocytomas Without 1p/19q CodeletionPanelists discuss how they determine the optimal timing of temozolomide administration - concurrent or adjuvant - for WHO grade 3 astrocytomas lacking 1p/19q codeletion, drawing on evidence from the CATNON trial to inform their decision-making process.
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Use of Erlotinib or Gefitinib as Initial Therapy in Advanced NSCLCTyrosine kinase inhibitors (TKIs) targeting the epidermal growth factor receptor (EGFR), such as erlotinib (Tarceva) and gefitinib (Iressa), have shown remarkable activity in a portion of patients with non–small-cell lung cancer (NSCLC).
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An Overview of Adenocarcinoma of the Small IntestineEven though the small intestine contains 90% of the gastrointestinal tract mucosa and is located between the stomach and large intestine, two organs with a high cancer incidence, adenocarcinoma of the small intestine is 1/50th as common as adenocarcinoma of the large bowel. In several other respects, small-intestinal adenocarcinoma resembles large bowel adenocarcinoma; eg, it arises from adenomatous polyps, co-occurs in the same individuals, and has a similar pattern of incidence rates by country. Small-intestinal adenocarcinoma is diagnosed prior to surgery in only about 50% of cases and often occurs in conjunction with small bowel obstruction. The mainstay of treatment is surgery; prognosis depends on stage at presentation. Little is known about the use of radiotherapy and chemotherapy in this malignancy, but most physicians utilize therapeutic strategies modeled on the management of large-intestinal adenocarcinoma. Clarification of the reason for the low incidence of small-intestinal adenocarcinoma could lead to new interventions for the prevention of colorectal cancer. [ONCOLOGY 11(4):529-536, 1997]
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Today's Forecast for the Adjuvant Treatment of Pancreatic Cancer: Clear or Cloudy?Despite attempted curative resection of localized adenocarcinoma of the pancreas, most patients experience a recurrence and die of their disease. The Gastrointestinal Tumor Study Group, European Organisation for Research and Treatment of Cancer, and European Study Group for Pancreatic Cancer trials have suggested the benefit of adjuvant therapy. However, the relatively few randomized trials available have not established a definite standard of care due to study limitations. Although these trials, and the recently published Charité Onkologie (CONKO)-001 trial, have shown a definite advantage of adjuvant chemotherapy, the most effective chemotherapy and the role of radiation therapy remain unclear. This review will discuss the data available from reported trials of adjuvant and neoadjuvant therapy in pancreatic cancer, address the issues leading to the ongoing controversies, and consider future directions for clinical trials.
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Primary Immunoprevention: The Great Unmet Need for Controlling Breast CancerPerhaps we can now hope that primary immunoprevention of cancers that are engaged as people age may receive the attention, support, and legitimacy that will soon result in similar breakthrough stature.
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Paraganglioma: A Potentially Challenging TumorThe development of metastatic disease in patients with paraganglioma is an unusual and challenging event. This case report and review describes the specific features of this disease and the multiple therapeutic options.
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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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Bladder Cancer Treatment: Optimize, Don't CompromisePatient selection based on a much more comprehensive biologic assessment of both host and tumor is likely the key to further advances in the treatment of all bladder cancer patients. Until such time, there can be no compromise in the careful application of the rigorous therapy required to optimize outcomes.
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Vincent T. DeVita on His New Book, “The Death of Cancer,” and the Current State of Cancer CareThe mandate of the National Cancer Act of 1971 was “to support research and the application of the results of research, to reduce the incidence, morbidity, and mortality from cancer,” and we have done that.
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Adjuvant and Neoadjuvant Therapy for Pancreatic CancerThere are a number of important issues regarding neoadjuvant and adjuvant therapy for pancreatic cancer that must be considered as we design clinical trials in an effort to improve survival for this disease.
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Malignant Pleural Mesothelioma: Factors Influencing the PrognosisHere we examine recent advances in the knowledge of this severe and heterogeneous malignancy, and we analyze the clinical significance of prognostic factors.
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MRI-Based Treatment Decision Making for Rectal CancerThere are a number of clinicopathologic variables that predict outcome in rectal cancer. In the era of postoperative chemoradiation treatment, these were more easily identified and were used to help select patients for adjuvant therapy.
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Treatment of Acute Lymphoblastic Leukemia in Adults: Applying Lessons Learned in ChildrenIn this article we discuss the challenges and new advances in adult ALL, as well as our approach to the treatment of these patients.
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Chemotherapy for Soft-Tissue SarcomasIn patients with high-risk localized disease, the use of systemic chemotherapy should be strongly considered to delay recurrence and/or reduce the patient’s risk of developing metastatic disease. In patients with metastatic disease, systemic chemotherapy remains the mainstay of treatment.
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Current Status of Robot-Assisted Radical Prostatectomy: Progress Is InevitableThere is no question that the robot has leveled the playing field. It has allowed more surgeons to offer patients a minimally invasive approach. In terms of perioperative outcomes, there is clear evidence showing shorter hospital stays, less blood loss, lower complication rates, and shorter convalescence with robotic-assisted laparoscopic prostatectomy.
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Oncology Peer Review On-The-Go: Cancer-Related Fatigue Outcome Measures in Integrative OncologyAuthors Dori Beeler, PhD; Shelley Wang, MD, MPH; and Viraj A. Master, MD, PhD, spoke with CancerNetwork® about a review article on cancer-related fatigue published in the journal ONCOLOGY®.
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The Oncology Nurse's Role in the Informed Consent ProcessCancer clinical trials are a necessary component of the effort to improve cancer prevention, diagnosis, and treatment. Essential to this process is the informed consent of the individuals who participate in these research studies. The purpose of this article is to describe patient, provider, and informed consent process issues with presentations of data reported in the current literature. The role of nursing in the facilitation of informed consent is discussed.
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The Role of Adjuvant Radiation in Endometrial CancerEndometrial cancer is the most common gynecologic malignancy, with an estimated 40,100 cases and 7,470 deaths in 2008. This malignancy represents 6% of all cancers, and 3% of cancer deaths in women. Endometrial cancer is more prevalent in older women, with an incidence of 1 in 142 for women 40 to 59 years old, increasing to 1 in 81 women over 70 years old.[1] Median age at diagnosis is 62.[2] The mortality of endometrial cancer has decreased from 4.18 to 4.12 per 100,000 from 1991 to 2004.
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New Approach Prevents Invasiveness of Ductal Carcinoma In Situ of the BreastDuctal carcinoma in situ (DCIS) is the most commonly diagnosed, noninvasive type of breast cancer in women. In this interview Dr. Lance Liotta and Professor Virginia Espina, whose laboratory has been one the first to successfully culture living DCIS cells, discuss novel ways to stop breast cancer before it becomes invasive and malignant.
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A 35-Year-Old Woman With a Change in HER2 Expression Following Neoadjuvant Chemotherapy for Invasive Breast CancerA 35-year-old woman noticed a mass in her right breast and underwent a diagnostic workup, including a mammogram that revealed a 2.4-cm mass and ultrasound that showed two adjacent masses, as well as enlarged axillary lymph nodes.
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Lung Cancer Prevention and ScreeningIn this interview we discuss lung cancer prevention, the recent low-dose CT screening recommendations from the USPSTF, hurdles in preventing the disease, and more.
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Retrovirus-Associated MalignanciesAlthough investigators knew before 1980 that retroviruses could cause various forms of leukemia, lymphoma, and solid tumors in animals, not until then was the first human oncogenic retrovirus, human T-cell leukemia/lymphoma virus-I (HTLV-I), isolated [1].
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Screening for Emotional Distress in Older Patients With Lung CancerAn estimated 219,440 new cases of lung cancer were expected in 2009, accounting for about 15% of cancer diagnoses.
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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.
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Gamma Knife Radiosurgery for 5 to 10 Brain Metastases: May Not Be Reasonable as Sole Upfront TreatmentUntil prospective randomized clinical data accrue and mature, this controversial issue will continue to suffer from overinterpretation of inadequate supporting data.
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When to Consider Adjuvant/Neoadjuvant Therapy for Adult Soft-Tissue SarcomaIn patients with adult soft-tissue sarcoma (ASTS), the use and timing of adjuvant chemotherapy or chemoradiotherapy remains controversial. The appropriate target population is generally accepted as International Union Against Cancer (UICC)/American Joint Committee on Cancer (AJCC) stage III extremity or trunk sarcomas (ie, > 5 cm, grade 3/4, located deep to the superficial fascia, with no evidence of metastases). After definitive local treatment, the 5-year disease-free and overall survival rates in this population are approximately 52% and 56%.
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From Whole-Gland to Targeted Cryoablation for the Treatment of Unilateral or Focal Prostate CancerRecently, third-generation cryosurgery has been widely introduced into clinical practice using argon-driven, ultrathin 17-gauge cryoprobes in accordance with the Joule-Thompson principle.[1-3] Contemporary cryosurgery includes these technologic advances along with the routine utilization of ultrathin needles incorporating a thermal monitoring system (TMS) for temperature surveillance, transrectal ultrasound (TRUS) imaging, and a urethral warming catheter to minimize morbidity associated with the procedure.[4-7]
