Reflection and Reaction
Aug 27, 2010
Time for universal HIV and HBV screening for patients with cancer
Francesca Cainelli,
Sandro Vento
Screening for HIV and HBV in patients with cancer is seemingly obvious in view of the increased incidence of several cancers in HIV-infected patients,1,2 the risk of increased treatment-related morbidity and mortality in HIV-infected patients,3 and the possible reactivation of HBV in patients who are treated with chemotherapy, which can lead to death.4 However, in practice, things are not so straightforward.
Articles
Aug 24, 2010
Bortezomib, melphalan, and prednisone versus bortezomib, thalidomide, and prednisone as induction therapy followed by maintenance treatment with bortezomib and thalidomide versus bortezomib and prednisone in elderly patients with untreated multiple myeloma: a randomised trial
María-Victoria Mateos,
Albert Oriol,
Joaquín Martínez-López,
Norma Gutiérrez,
Ana-Isabel Teruel,
Raquel de Paz,
José García-Laraña,
Enrique Bengoechea,
Alejandro Martín,
Joaquín Díaz Mediavilla,
Luis Palomera,
Felipe de Arriba,
Yolanda González,
Jose-Mariano Hernández,
Ana Sureda,
José-Luis Bello,
Joan Bargay,
Francisco-Javier Peñalver,
José-María Ribera,
María-Luisa Martín-Mateos,
Ramón García-Sanz,
María-Teresa Cibeira,
María-Luisa Martín Ramos,
María-Belén Vidriales,
Bruno Paiva,
María-Angeles Montalbán,
Juan-José Lahuerta,
Joan Bladé,
Jesús-Fernando San Miguel
Reduced-intensity induction with a bortezomib-based regimen, followed by maintenance, is a safe and effective treatment for elderly patients with multiple myeloma.
Reflection and Reaction
Aug 24, 2010
Optimising bortezomib in newly diagnosed multiple myeloma
S Vincent Rajkumar
One of the most important issues in the treatment of myeloma nowadays is how to best incorporate novel agents early in the disease course to improve survival while reducing toxic effects and cost.1 No other drug for myeloma shows the need to balance efficacy and safety more so than does bortezomib. Bortezomib is a first-in-class proteasome inhibitor with significant activity in almost every stage of myeloma.2 However, the risks of severe peripheral neuropathy associated with bortezomib pose a dilemma for patients with newly diagnosed myeloma, who in the absence of high-risk features can expect improved survival, often longer than 7–10 years.
Reflection and Reaction
Aug 13, 2010
Pre-exercise screening and prescription guidelines for cancer patients
Lee W Jones,
Neil D Eves,
Jeffrey Peppercorn
Over the past decade, research and clinical interest in the therapeutic effectiveness of exercise after cancer diagnosis has greatly increased.1 Positive findings from the first generation of exercise oncology studies, and growing patient demand led the American College of Sports Medicine (ACSM) to assemble an expert panel to formulate exercise guidelines for patients with cancer.2 This comment presents a practical approach to screening and prescribing exercise for patients with cancer.
Personal View
Jul 29, 2010
Reconstruction of the maxilla and midface: introducing a new classification
James S Brown,
Richard J Shaw
Most patients requiring midface reconstruction have had ablative surgery for malignant disease, and most require postoperative radiotherapy. This type of facial reconstruction attracts controversy, not only because of the many reconstructive options, but also because dental and facial prostheses can be very successful in selected cases. This Personal View is based on a new classification of the midface defect, which emphasises the increasing complexity of the problem. Low defects not involving the orbital adnexae can often be successfully treated with dental obturators.
Review
Jul 27, 2010
Radiolabelled receptor-tyrosine-kinase targeting drugs for patient stratification and monitoring of therapy response: prospects and pitfalls
Vladimir Tolmachev,
Sharon Stone-Elander,
Anna Orlova
Transmembrane receptor tyrosine kinases (RTKs) are overexpressed in many malignancies. RTK signalling triggers cell proliferation, suppression of apoptosis, increased motility, and recruitment of neovasculature. Overexpressed RTKs are the molecular targets for an increasing number of anticancer drugs. Monoclonal antibodies block the ligands or their binding sites and prevent receptor dimerisation, thereby hindering RTK signalling. The antibody-dependent cellular cytotoxicity can boost the therapeutic effect.
Review
Jul 08, 2010
Fertility-sparing surgery in patients with cervical cancer
Lukas Rob,
Petr Skapa,
Helena Robova
There are several types of fertility saving procedures that can be done in patients with cervical cancer, which differ in terms of surgical approach and extent of paracervical resection. This review assesses oncological and pregnancy results after different procedures. The oncological results of vaginal radical trachelectomies (VRT) and abdominal radical trachelectomies (ART) are similar for tumours less than 2 cm in size, and are now considered safe surgical procedures. Oncological outcomes of VRT and ART in tumours larger than 2 cm are also identical, but the results cannot be considered satisfactory.
Review
Jul 07, 2010
Isocitrate dehydrogenase-1 mutations: a fundamentally new understanding of diffuse glioma?
Nanne K Kloosterhof,
Linda BC Bralten,
Hendrikus J Dubbink,
Pim J French,
Martin J van den Bent
The discovery of somatic mutations in the gene encoding isocitrate dehydrogenase-1 (IDH1) in glioblastomas was remarkable because the enzyme was not previously identified with any known oncogenic pathway. IDH1 is mutated in up to 75% of grade II and grade III diffuse gliomas. Apart from acute myeloid leukaemia, other tumour types do not carry IDH1 mutations. Mutations in a homologous gene, IDH2, have also been identified, although they are much rarer. Although TP53 mutations and 1p/19q codeletions are mutually exclusive in gliomas, in both of these genotypes IDH1 mutations are common.
Review
Jul 05, 2010
Radionuclide and hybrid imaging of recurrent prostate cancer
Ambros J Beer,
Matthias Eiber,
Michael Souvatzoglou,
Markus Schwaiger,
Bernd Joachim Krause
Prostate cancer is one of the most common cancers in men, leading to substantial morbidity and mortality. After definitive therapy with surgery or radiation, many patients have biochemical relapse of disease—ie, an increase in their prostate-specific antigen level—which often precedes clinically apparent disease by months or even years. Therefore, imaging of the site and extent of tumour recurrence (local, regional, distant, or a combination) is of great interest. Conventional morphological imaging methods showed limited accuracy for assessment of recurrent prostate cancer; however, in recent years, functional and molecular imaging have offered the possibility of imaging molecular or cellular processes of individual tumours, often with more accuracy than morphological imaging.
Review
Jun 28, 2010
Treatment non-adherence in teenage and young adult patients with cancer
Helena J Kondryn,
Claire L Edmondson,
Jonathan Hill,
Tim OB Eden
Adhering to treatment can be a significant issue for many patients diagnosed with chronic health conditions and this has been reported to be greater during the adolescent years. However, little is known about treatment adherence in teenage and young adult (TYA) patients with cancer. To increase awareness of the adherence challenges faced by these patients, we have reviewed the published work. The available evidence suggests that a substantial proportion of TYA patients with cancer do have difficulties, with reports that up to 63% of patients do not adhere to their treatment regimens.
Review
Jun 10, 2010
Lung cancer after treatment for breast cancer
Paul Lorigan,
Raffaele Califano,
Corinne Faivre-Finn,
Anthony Howell,
Nick Thatcher
Breast cancer is the most common cancer in women, and the second most common cause of cancer death after lung cancer. Improvements in the outcome of breast cancer mean that more patients are living longer and are, therefore, at risk of developing a second malignancy. The aim of this review is to present the current understanding of the risk of lung cancer arising in patients previously treated for early stage breast cancer. We review data on the effect of treatment factors (ie, surgery type, radiotherapy technique, and adjuvant chemotherapy) and patient factors (ie, age and smoking) on the risk of developing a subsequent lung cancer.
Review
May 26, 2010
Angiosarcoma
Robin J Young,
Nicola J Brown,
Malcolm W Reed,
David Hughes,
Penella J Woll
Angiosarcomas are rare soft-tissue sarcomas of endothelial cell origin that have a poor prognosis. They can arise anywhere in the body, most commonly presenting as cutaneous disease in elderly white men, involving the head and neck and particularly the scalp. They can be caused by therapeutic radiation or chronic lymphoedema and hence secondary breast angiosarcomas are an important subgroup. Recent work has sought to establish the molecular biology of angiosarcomas and identify specific targets for treatment.