EDITORIALS

Smoke, then Fire: Lung Cancer Screening Studies Under Further Scrutiny

Bruce A. Chabner
The Oncologist 2008; 13: 348-349; doi:10.1634/theoncologist.2008-0079
[Full Text] [PDF]  

Current Status of Prognostic Profiling in Breast Cancer

Lajos Pusztai
The Oncologist 2008; 13: 350-360; doi:10.1634/theoncologist.2007-0216
[Abstract] [Full Text] [PDF]  

SUMMARY: Breast cancer is a clinically heterogeneous disease largely as a result of abnormal gene expression within tumors. Coordinated efforts among oncologists, pathologists, surgeons, laboratory scientists, statisticians, and regulators will be essential in the quest to incorporate genetic profiling and molecular hypotheses into clinical trial planning and conduct.

Trastuzumab plus Paclitaxel or Docetaxel in HER-2–Negative/HER-2 ECD–Positive Anthracycline- and Taxane-Refractory Advanced Breast Cancer

Alexandros Ardavanis, Panteleimon Kountourakis, Flora Kyriakou, Savoula Malliou, Ioannis Mantzaris, Anastasia Garoufali, Ioulia Yiotis, Andreas Scorilas, Nikolaos Baziotis, Gerasimos Rigatos
The Oncologist 2008; 13: 361-369; doi:10.1634/theoncologist.2007-0207
[Abstract] [Full Text] [PDF]  

SUMMARY: This study considers trastuzumab salvage therapy plus a taxane in heavily pretreated trastuzumab-naive relapsed breast cancer patients with high serum levels of HER-2 extracellular domain (ECD). This is the first study assessing anti-HER-2–based treatment in HER-2–negative advanced breast cancer patients according to HER-2 ECD positivity.

Commentary: Can Circulating HER-2 Extracellular Domain Predict Response to Trastuzumab in HER-2–Negative Breast Cancer?

Francisco J. Esteva
The Oncologist 2008; 13: 370-372; doi:10.1634/theoncologist.2008-0050
[Full Text] [PDF]  

SUMMARY: This commentary evaluates the study of Ardavanis et al. in this issue and makes recommendations for further studies of HER-2 extracellular domain circulating levels as a prognostic indicator in metastatic breast cancer.

Targeted Therapies for the Treatment of Breast Cancer in the Post-trastuzumab Era

Fausto Petrelli, Mary Cabiddu, Marina Elena Cazzaniga, Marco Cremonesi, Sandro Barni
The Oncologist 2008; 13: 373-381; doi:10.1634/theoncologist.2007-0173
[Abstract] [Full Text] [PDF]  

SUMMARY: Targeted therapies for breast cancer are evolving rapidly. As a result, several questions have emerged about their application in clinical practice. This article discusses these dilemmas that are currently faced by clinical oncologists.

Utility of Radiolabeled Somatostatin Receptor Analogues for Staging/Restaging and Treatment of Somatostatin Receptor–Positive Pediatric Tumors

Geetika Khanna, David Bushnell, M. Sue O'Dorisio
The Oncologist 2008; 13: 382-389; doi:10.1634/theoncologist.2007-0175
[Abstract] [Full Text] [PDF]  

SUMMARY: This paper reviews the distribution of somatostatin receptors in normal tissues and tumor cells and discusses the pediatric oncologic applications of somatostatin receptor-targeted imaging and therapy.

Chemotherapy in Elderly Patients with Colorectal Cancer

Claus-Henning Köhne, Gunnar Folprecht, Richard M. Goldberg, Emmanuel Mitry, Philippe Rougier
The Oncologist 2008; 13: 390-402; doi:10.1634/theoncologist.2007-0043
[Abstract] [Full Text] [PDF]  

SUMMARY: Colorectal cancer primarily affects the elderly; however, much of the defining clinical research in this field has excluded subjects of advanced age. The management of frail elderly patients and those with a short life expectancy should be focused on palliation, while fit elderly patients can receive aggressive therapy in a similar fashion to younger patients.

Intraperitoneal Chemotherapy for Women with Epithelial Ovarian Cancer

Edward L. Trimble, Sharon Thompson, Michaele C. Christian, Lori Minasian
The Oncologist 2008; 13: 403-409; doi:10.1634/theoncologist.2007-0058
[Abstract] [Full Text] [PDF] [Editor's Note]  

SUMMARY: This paper addresses the rationale behind i.p. chemotherapy for women with advanced epithelial ovarian cancer, the data supporting its use, the selection of appropriate patients for i.p. chemotherapy, how best to avoid and manage the toxicities observed with i.p. chemotherapy, and directions for future research.

Intraperitoneal Chemotherapy in Patients with Advanced Ovarian Cancer: The Con View

Ignace Vergote, Frederic Amant, Karin Leunen, Isabelle Cadron, Toon Van Gorp, Patrick Neven, Patrick Berteloot
The Oncologist 2008; 13: 410-414; doi:10.1634/theoncologist.2007-0224
[Abstract] [Full Text] [PDF] [Editor's Note]  

SUMMARY: This paper presents the reasons why i.p. chemotherapy cannot be accepted as standard of care for first-line systemic treatment of advanced ovarian carcinoma.

Systemic Therapy for Biliary Tract Cancers

Aram F. Hezel, Andrew X. Zhu
The Oncologist 2008; 13: 415-423; doi:10.1634/theoncologist.2007-0252
[Abstract] [Full Text] [PDF]  

SUMMARY: This review discusses the clinical experience with systemic treatment of biliary tract cancer, focusing on the rationale for a first-line regimen as well as future directions in the field.

Therapy Options in Imatinib Failures

Pablo Ramirez, John F. DiPersio
The Oncologist 2008; 13: 424-434; doi:10.1634/theoncologist.2007-0170
[Abstract] [Full Text] [PDF]  

SUMMARY: The development of the Bcr-Abl-targeted imatinib represents a paradigm shift in the treatment of chronic myelogenous leukemia. However, new treatment approaches are required for patients resistant to or intolerant of imatinib. These are discussed in this review.

Commentary: Lung Cancer Screening—Progress or Peril

James L. Mulshine
The Oncologist 2008; 13: 435-438; doi:10.1634/theoncologist.2008-0068
[Full Text] [PDF] [Editorial Expression of Concern]  

SUMMARY: This article presents a commentary on the controversy over a lung cancer screening benefit and suggests that developing systems that minimize harm and maximize screening benefit is vital to the ultimate success of lung cancer screening.

Commentary: CT Screening for Lung Cancer—Caveat Emptor

James R. Jett, David E. Midthun
The Oncologist 2008; 13: 439-444; doi:10.1634/theoncologist.2008-0027
[Full Text] [PDF]  

SUMMARY: There is a great need for a screening test that results in the detection of asymptomatic lung cancer, at a time when there is a substantially better chance for curative treatment. Based on the significant limitations in the results reported to date from nonrandomized, observational screening trials, the authors do not recommend computed tomography screening for lung cancer at this time. Results of two major randomized controlled trials will soon be available.

Dexrazoxane (Totect^TM): FDA Review and Approval for the Treatment of Accidental Extravasation Following Intravenous Anthracycline Chemotherapy

Robert C. Kane, W. David McGuinn, Jr, Ramzi Dagher, Robert Justice, Richard Pazdur
The Oncologist 2008; 13: 445-450; doi:10.1634/theoncologist.2007-0247
[Abstract] [Full Text] [PDF]  

SUMMARY: The U.S. Food and Drug Administration approved dexrazoxane in 2007 for the treatment of extravasation resulting from i.v. anthracycline chemotherapy. This article discusses the studies that led to this approval.

Histologic Alterations from Neoadjuvant Chemotherapy in High-Grade Extremity Soft Tissue Sarcoma: Clinicopathological Correlation

David R. Lucas, Malti P. Kshirsagar, J. Sybil Biermann, Merlin R. Hamre, Dafydd G. Thomas, Scott M. Schuetze, Laurence H. Baker
The Oncologist 2008; 13: 451-458; doi:10.1634/theoncologist.2007-0220
[Abstract] [Full Text] [PDF]  

SUMMARY: Chemotherapy-induced histologic alteration in soft tissue sarcomas may not be a reliable prognostic variable. This study employs a histologic grading system for prognosis that is simple and reproducible and takes into account the major histologic patterns seen after therapy.

Epidermal Growth Factor Receptor Expression and Mutational Analysis in Synovial Sarcomas and Malignant Peripheral Nerve Sheath Tumors

Hussein Tawbi, Dafydd Thomas, David R. Lucas, J. Sybil Biermann, Scott M. Schuetze, Anita L. Hart, Rashmi Chugh, Laurence H. Baker
The Oncologist 2008; 13: 459-466; doi:10.1634/theoncologist.2007-0166
[Abstract] [Full Text] [PDF]  

SUMMARY: This study reveals the absence of known activating mutations of the epidermal growth factor receptor in synovial sarcomas and malignant peripheral nerve sheath tumors, which suggests that trials of small-molecule inhibitors would be of little clinical benefit.

A Phase II Study of Gefitinib for Patients with Advanced HER-1 Expressing Synovial Sarcoma Refractory to Doxorubicin-Containing Regimens

Isabelle Ray-Coquard, Axel Le Cesne, Jeremy S. Whelan, Patrick Schoffski, Binh N. Bui, Jaap Verweij, Sandrine Marreaud, Martine van Glabbeke, Pancras Hogendoorn, Jean-Yves Blay
The Oncologist 2008; 13: 467-473; doi:10.1634/theoncologist.2008-0065
[Abstract] [Full Text] [PDF]  

SUMMARY: A phase II study was conducted to establish the efficacy and safety of gefitinib in HER-1-positive refractory synovial sarcoma. Gefitinib was an ineffective treatment for advanced synovial sarcoma patients failing conventional chemotherapy with doxorubicin and ifosfamide, suggesting that HER-1 is not a critical protein in tumorigenesis in this disease.

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