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A 60-Year-Old Man With Progressive Anemia While Receiving Checkpoint Blockade Therapy for Relapsed MyelofibrosisA 60-year-old man with a history of coronary artery disease and JAK2 V617F–positive polycythemia vera presented to our bone marrow transplantation clinic with progressive fatigue, splenomegaly, and cytopenias.
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Pancreatic, Neuroendocrine GI, and Adrenal CancersThis management guide covers the risk factors, symptoms, diagnosis, staging, and treatment of pancreatic cancer, pancreatic cystic neoplasms, pancreatic endocrine tumors (PETs), carcinoid tumors of the GI tract, adrenocortical carcinoma, and pheochromocytoma.
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PD-L1 Testing in Lung CancerThis video reviews the use of PD-L1 testing in selecting patients for frontline lung cancer treatment with pembrolizumab and examines which patients might not be appropriate for immunotherapy.
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Optimal Use of Bone-Targeted Agents in Breast CancerIt is quite obvious that bone morbidity has a negative impact on our patients with breast cancer. The use of bone-modifying agents in this setting can yield significant quality-of-life benefits.
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Requirements for Effective Lung Screening Programs Coming Into FocusIn this interview we discuss the requirements for the effective implementation of a lung cancer screening program.
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Prophylactic Surgery in Hereditary Breast/Ovarian Cancer SyndromeDrs. Levine and Gemignanihave provided a comprehensivereview of the literatureregarding the management of patientswith hereditary breast/ovarian cancersyndrome. As noted, over 200,000new cases of breast cancer and 25,000new cases of ovarian cancer are estimatedfor 2003.[1] Only a small portionof these cases will be hereditary;however, these are the cases that maybenefit from preventive measures. Thepotential for risk-reducing strategiesin these patients has become a criticalissue over the past several years. Thisreview highlights the salient featuresof identifying “at-risk” patients, aswell as the benefits and limitations ofsurgical prophylaxis.
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Special Considerations for Nutrition Intervention With Oncology PatientsFor several decades, the nutritional deterioration ofpatients diagnosed with cancer has been recognized,and attempts have been made to prevent orreverse it. However, with all the advancements intechnology and medicine, it is somewhat surprisingto find that little has altered in the approach or themanagement of cancer patients suffering from acompromised nutritional status or altered metabolismdue to either the treatment or the disease process.
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Minimally Invasive Surgery for Early-Stage Lung Cancer: From Innovation to Standard of CareThis review highlights those efforts and the role of minimally invasive surgery for early-stage lung cancer in light of evolving technology, the emerging understanding of the biology of early-stage lung cancer, and lung cancer screening.
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The Maze of PARP Inhibitors in Ovarian CancerThe development of poly(ADP-ribose) polymerase (PARP) inhibitors as a new class of anticancer agents has created a tremendous amount of hope in the ovarian cancer community, especially in the high-risk, difficult-to-screen, hereditary ovarian cancer population.
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Applications of Genomic Sequencing in Pediatric CNS TumorsThis review will discuss examples of clinical applications of tumor and germline genomic testing for children with central nervous system (CNS) tumors, as well as promising investigative strategies.
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Current Advances in Non–Proteasome Inhibitor–Based Approaches to the Treatment of Relapsed/Refractory Multiple MyelomaMultiple myeloma (MM) remains incurable despite the current approaches used in initial therapy, including more effective induction therapy, one or more autologous stem-cell transplants, and consolidation/maintenance strategies.
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Lower Genital Tract Neoplasia in Women With HIV InfectionWomen who are infected with human immunodeficiency virus (HIV) are at greater risk for the development of lower genital tract neoplasia than are HIV-negative women. Among HIV-positive women, those who are more
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New Concepts Regarding Testosterone and Prostate Cancer: A Breath of Fresh AirAre there ways in which testosterone administration may be beneficial? Basic science and a number of clinical experiences have suggested for years that steroid hormones may have bifunctional roles.
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Defining the Role of Post-Mastectomy Radiotherapy: The New EvidenceI will briefly comment on two points discussed by Pierce and Lichter in their thorough review: (1) the recently published Oxford overview analysis of locoregional therapies [1], and (2) which patients may benefit from postmastectomy radiotherapy.
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Management of Pain in Special Populations of Cancer PatientsChildren, the elderly, AIDS patients, and former narcotic drug abusers pose special problems in pain management that may lead to undermedication even more frequently than occurs in the general population of cancer patients with pain. A multidisciplinary panel of six pain experts with clinical experience in caring for these special groups met in Santa Fe, New Mexico, to discuss assessment methods and pharmacologic approaches to the treatment of pain in these patients. A summary of the roundtable discussion follows.
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Diffuse Large B-Cell Lymphoma: Current Treatment ApproachesThis article examines clinical and biological features of DLBCL patients with poor outcomes, and reviews recent studies addressing alternatives to standard front-line management strategies together with unresolved questions.
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The Horizon of Antiangiogenic Therapy for Colorectal CancerVascular endothelial growth factor (VEGF) plays a crucial role inthe growth and metastatic spread of cancer. Bevacizumab (Avastin) isthe first commercially available VEGF inhibitor, earning US Food andDrug Administration (FDA) approval in February 2004. In combinationwith fluorouracil (5-FU)-based chemotherapy, this agent significantlyprolongs overall and progression-free survival of patients withmetastatic colorectal cancer. This review details the emerging role ofthe drug, its unique side effects, and other practical considerations relatedto bevacizumab therapy. Ongoing trials attempting to define additionalindications for bevacizumab as well as the development ofother promising angiogenesis inhibitors are also reviewed.
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The Evolving Space of HER2+ Breast CancerKey opinion leaders discuss recent advancements and future directions in the HER2+ breast cancer space.
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Peripheral T-Cell Lymphoma: New Therapeutic StrategiesIn this article we briefly review the labeled indications for new agents for cutaneous and peripheral T-cell lymphoma, focus on data from the last 1 to 2 years, and on data from ongoing clinical trials, with the hope that in doing so we can help elucidate difficult treatment decisions.
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Cancer Management Chapter 23: Primary and metastatic brain tumorsIntracranial neoplasms can arise from any of the structures or cell types present in the cranial vault, including the brain, meninges, pituitary gland, skull, and even residual embryonic tissue. The overall annual incidence of primary brain tumors in the United States is 14 cases per 100,000 population.
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Independent Physician Associations and Outpatient Palliative Care: Challenges and OpportunitiesThe demand for early palliative care (PC) involvement has never been greater in the setting of capitated healthcare delivery systems. The review by Alesi et al is timely in that it illustrates innovative practice partnerships with oncology groups during a time when PC is being thrust into mainstream outpatient care.[1]
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Brachytherapy Boost Techniques for Locally Advanced Prostate CancerVicini and colleagues present an informative, compelling review of both past and recent clinical investigations of the use of brachytherapy in patients with prostate cancer, particularly those with locally advanced disease. The tables presented at the
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POINT: Is Immediate Radical Cystectomy Justified When Non–Muscle-Invasive Bladder Cancer First Presents as High-Grade T1 Urothelial Carcinoma on Re-Resection?After a thorough repeat TURBT, disease control can be achieved with intravesical BCG and a bladder-sparing approach.
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Commentary (Barker/Garden): The Multidisciplinary Management of Paragangliomas of the Head and NeckWe have reviewed with interestthe article by Drs. Huand Persky and would liketo congratulate them on an excellentand comprehensive overview of theevaluation and management ofparagangliomas of the head and neck.Their review begins with an excellentlydetailed description of thedisease and staging work-up. Withmodern imaging, most paragangliomasare convincingly diagnosed basedon typical location (carotid bifurcation,nodose ganglia of the vagusnerve, middle ear along tympanic plexus,or near jugular bulb) and characteristicradiographic appearance(hypervascular, intensely enhancingmass). A tissue diagnosis is usuallyunnecessary for such lesions.
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The Use of Serum hCG as a Marker of Tumor Progression and of the Response of Metastatic Urothelial Cancer to Systemic ChemotherapyA 55-year-old woman with a history of metastatic melanoma in remission for 8 years presented to the emergency department with gross hematuria. A CT scan, ordered because the patient was in menopause, demonstrated a bladder tumor.
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Adil Daud, MD, on the Importance of Testing Patients with Melanoma for BRAF MutationsAdil Daud, MD, spoke about the emergence of next-generation sequencing and the importance of testing patients with melanoma for BRAF mutations.
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Evaluation and Management of Testicular Cancer After Late RelapseThe clinical quandary by Langer et al discusses a contralateral late relapse of the original right nonseminomatous germ cell tumors.
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Circulating Tumor DNA as a Liquid Biopsy: Current Clinical Applications and Future DirectionsHere we review the clinical data supporting these different plasma genotyping methodologies, and present a practical approach to the interpretation of the results of these tests.
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Implementing Survivorship Care Plans Within an Electronic Health RecordSurvivorship care is “a distinct phase of care for cancer survivors that includes four components: (1) prevention and detection of new cancer or recurrent cancer; (2) surveillance for cancer spread, recurrence, or second cancers; (3) intervention for consequences of cancer and its treatment; and (4) coordination between specialists and primary care providers to ensure that all of the survivor’s health needs are met.”
