ONCOLOGY Vol 23 No 1

Luteinizing hormone-releasing hormone analogs (LHRHa) are often used alone or in combination with tamoxifen to suppress ovarian function in premenopausal women with endocrine-responsive breast cancer. However, aromatase inhitiors (AIs) are now the preferred first-line endocrine treatment for postmenopausal women with breast cancer.

Excellent safety, efficacy, and tolerability profiles have resulted in the rapid integration of oral tyrosine kinase inhibitors into most facets of the treatment of gastrointestinal stromal tumors (GIST).

Melanoma frequently metastasizes to the small bowel. In this installment of Clinical Quandaries, we describe the case of 74-year-old man who presented with this rare but well described manifestation of malignant melanoma

In this issue of ONCOLOGY, Balducci[1] reviews principles for treating elderly patients with antineoplastic therapy. This paper begins by defining baseline terminology such as age and frailty, while providing an overview of applied techniques of discerning a patient’s functional impairment or disability.

In the pre-imatinib era, surgery was the only effective treatment for gastrointestinal stromal tumor (GIST). However, this treatment modality was often either not possible or insufficient for cure due to the aggressive nature of this disease.

Gastrointestinal stromal tumors (GISTs) originate from the interstitial cells of Cajal or a precursor and are the most common mesenchymal neoplasms of the gastrointestinal (GI) tract.[1] Although GISTs often present as localized masses, they are typified by a high risk of metastatic relapse, most commonly in the liver and peritoneum.

Based on the 1995 Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) Overview, tamoxifen is now the standard of care for premenopausal women with hormone receptor–positive early breast cancers.[1]

Developed over a century ago,[1] endocrine therapy remains the most effective and the most clearly targeted form of systemic therapy for breast cancer. Endocrine treatments work best in women whose tumors are positive for estrogen receptors (ER) and/or progesterone receptors (PR).

Small bowel metastases from melanoma are uncommon. While the authors reference two studies that reported a large proportion of patients with small bowel metastases, the true incidence of gastrointestinal (GI) lesions in melanoma patients is much lower.

The optimal endocrine therapy for premenopausal women with hormone receptor–positive early breast cancer remains elusive. Dr. Pritchard presents a thoughtful review of this important topic, including the historic context for the current controversy regarding the utility of ovarian suppression (either by medication or permanent ablation) in the adjuvant treatment of young women with breast cancer.