ONCOLOGICAL DISEASE (US) – VOLUME 3 ISSUE 2 – FALL 2007

The sixth edition of US Oncological Disease is designed to summarize developments in cancer care, create insights, and provide a platform for the discussion of healthcare needs in oncology. The invited authors summarize advances in the treatment of cancers that are commonly encountered in the general practice of oncology: hematological, breast, gynecological, lung, prostate, and […]

More than 350 cancer genes have been identified to date (see www.sanger.ac.uk/genetics/CGP) using a combination of epidemiological, genetic, and laboratory techniques. Decades of research into cancer genes have established some basic principles of tumorigenesis, including the roles of tumor suppressor genes and oncogenes, the loss and gain of which, whether through copy number changes or […]

‘Epigenetics’ is a term used to describe heritable states of gene expression that are not due to changes in DNA sequence. Epigenetic phenomena have been shown to play an important role in carcinogenesis and tumor progression. Such phenomena also represent potential therapeutic targets for cancer treatment as they are potentially reversible. Two such phenomena are […]

Advances in radiotherapy and chemotherapy have had a significant beneficial impact on treating cancer. However, despite the increasing sophistication of cancer therapies, oral complications remain a major source of illness for cancer patients. The National Cancer Institute estimates that the frequency of oral complications during radiation therapy to fields involving the oral cavity is 100%, […]

In 1933, cancer researchers recognised a need to share knowledge and expertise globally, and founded the International Union Against Cancer (UICC).1 Since then, the UICC has grown into a respected forum for all cancer professionals. Today, the UICC is the leading international non-governmental organisation (NGO) dedicated exclusively to the global control of cancer.2 Currently, cancer […]

Iron plays a vital role in the metabolic processes of all living organisms. It is involved in oxygen transport, DNA synthesis, and energy generation. As with many nutritional metals, an excess of iron is dangerous, and therefore within the body iron equilibrium is carefully regulated. Unlike other metals, however, iron is highly conserved in the […]

Immunomodulatory Drugs

Chronic myeloid leukemia (CML) is characterized by the uncontrolled proliferation of hematopoietic cells carrying the Philadelphia chromosome (Ph), the product of reciprocal translocation between chromosomes 9 and 22, t(9;22)(q34.1;q11.2). Its molecular counterpart, the resultant BCR-ABL fusion gene, encodes a constitutively active form of the ABL tyrosine kinase (TK) that induces malignancy through the activation of […]

Chronic myeloid leukemia (CML) is the only molecularly defined myeloid disorder to date and is distinguished by a unique chromosomal abnormality—the Philadelphia (Ph) chromosome—and expression of the BCR-ABL fusion oncoprotein.1 The treatment of CML was transformed by innovative molecularly targeted therapy, tyrosine kinase inhibitors (TKIs), namely imatinib mesylate (Gleevec®, Novartis). In addition to its inhibitory […]

Chronic myeloid leukemia (CML) is the first malignancy to be associated with a specific and consistent chromosomal abnormality. Present in >90% of CML patients, the Philadelphia (Ph) chromosome is the product of a t(9;22)(q34;q11) reciprocal translocation, leading to a fusion between the ABL proto-oncogene to the BCR breakpoint cluster region. The deregulated Abl tyrosine kinase […]

Secondary acute myeloid leukemia (sAML) evolves from a prior myelodysplastic syndrome (MDS) or myeloproliferative disorder (MPD), or occurs due to prior exposure to leukemogenic therapy—also called treatmentrelated AML (tAML).1 Patients with sAML have an extremely poor prognosis, with only approximately 25% achieving remission following therapy with the standard regimen of bolus daunorubicin for three days […]

The past decade has witnessed tremendous progress in oncology. In lymphoma, methods such as gene expression profiling have led to the identification of exciting new targets for drug discovery. The most important advance of this decade has been the introduction of the anti- CD20 antibody rituximab. The addition of rituximab to cyclophosphamide, hydroxydaunorubicin (aka doxorubicin), […]

While chemotherapy and radiation remain the mainstays in the initial treatment of Hodgkin’s disease (HD) and non-Hodgkin’s lymphomas (NHL), patients with relapsed disease or those who fail to enter remission are rarely cured using these conventional methods.1,2 Therefore, approaches using adoptive immunotherapies offer attractive alternative options for this subgroup of patients. While infused monoclonal antibodies […]

The diagnosis and treatment of breast cancer has been transformed, from the aggressive treatment of what was thought to begin as a local disease to a more evolved approach to what is now known to be a systemic disease. Years ago, the only breast biopsy option available was an open breast procedure. As technology developed, […]

A highly publicized study delineating the trend in incident breast cancer diagnoses in the US was recently reported.1,2 In this study, a sharp decline in age-adjusted incident breast cancer cases was observed among American women in 2003 compared with 2002. Furthermore, an 8.6% decline in age-adjusted annual incidence rates was observed between 2001 and 2004. […]

Despite many advances over the past few years in the adjuvant treatment of breast cancer, a significant number of patients develop metastatic disease. Furthermore, a small yet consistent percentage of women are diagnosed with de novo metastatic disease. Once the disease has spread outside the locoregional area of the breast and draining lymph nodes, it […]

Human papillomavirus (HPV) is thought to be the most common sexually transmitted infection in the US.1 It is estimated that as many as 75–80% of men and women will have contact with HPV at some point in their lives.2 In the US, the highest prevalence of HPV is among females between 20 and 24 years […]

Ovarian cancer is the fifth most common malignancy in women. In the US, approximately 22,000 new cases occur each year.1 In Germany, about 8,000 new cases are diagnosed each year. About 80% of patients suffer from advanced-stage disease (International Federation of Gynaecology and Obstetrics [FIGO] III/IV) with an unfavorable prognosis. Due to the lack of […]

Lung cancer is the leading cause of cancer deaths in the US, with 160,390 deaths estimated in 2007.1 Non-small-cell lung cancers (NSCLC) are the most common type and carry a five-year survival of only 10–15% for all stages.2 Large randomized clinical trials using the bestchemotherapy regimens available have reported similar, but limited, activity, with response […]

Despite an unparalleled campaign over the last 10 years to increase public awareness of risk factors associated with lung cancer, carcinoma of the lung remains the leading cause of cancer-related death in the US and worldwide.1,2 Epidemiological data continue to show that in the US lung cancer accounts for 26 and 31% of cancer deaths […]

Lung cancer afflicts approximately 1.2 million people worldwide and results in a similar number of deaths per year.1 In the US, the number of lung-cancer-related deaths surpasses that of the next four most common cancers combined.2 Currently, almost half of all lung cancers occur inwomen, and more women die of lung cancer than breast cancer […]

Prior to 2000, the outlook for patients with gastrointestinal stromal tumors (GISTs), the most common gastrointestinal (GI) sarcoma, was poor. This life-threatening disease is highly resistant to traditional management with chemotherapy and radiation, and patients with metastatic GISTs had only one viable treatment option: surgical resection. Even with surgery, many patients suffered relapse and experienced […]

In Western countries, colorectal cancer is the fourth leading cause of cancer. In the US it is the second most common cause of cancer-related mortality. Unfortunately, about 35–55% of patients with colorectal cancer develop hepatic colorectal metastases. At present, surgical resection of these lesions represents the main therapeutic option and is the only chance for […]

Before the 1980s, rectal cancer was frequently treated with surgery alone, which resulted in high rates of local failure with significant patient morbidity and mortality. Randomized trials performed in the 1980s and 1990s demonstrated that adjuvant chemotherapy decreased rates of local failure and improved survival compared with resection alone.1,2 These observations led to the adoption […]

The purpose of this article is to review the current treatment options for patients with glioblastoma (GBM). The current standard of care involves maximal safe surgical resection followed by concurrent chemotherapy with radiation followed by adjuvant chemotherapy. Although level 1 evidence supports the use of this treatment, GBM remains incurable and most patients will succumb […]

Measurement of blood levels of prostate-specific antigen (PSA) and greater awareness have led to the detection of prostate cancer at an earlier and potentially more curable stage. As certain kinds of prostate cancer progress very slowly, some patients choose to undergo clinical observation (‘watchful waiting’) rather than active treatment. Alternatively, surgery and radiation therapy (RT) […]

The treatment of patients with glioblastoma multiforme (GBM) is considered to be a palliative venture with no hope of cure. Traditionally, patients are treated with maximal surgical resection based on the premise that, although surgery is not a curative procedure, a major resection leads to longer survival and better quality of life.1 Radiotherapy increases the […]

Each year, there are an estimated one million newly diagnosed cases of colorectal cancer (CRC) worldwide. Approximately half of all patients with CRC will develop metastases, and the majority of these patients will die from the cancer. Without treatment, the median survival for patients with metastatic CRC is five to six months. However, the last […]

Prostate cancer is the most commonly diagnosed cancer and the second leading cause of cancer death in American men, with an estimated 186,320 new cases diagnosed and 28,660 prostate cancer deaths expected in the US in 2008.1 With the use of prostate-specific antigen (PSA)-based screening, the number of prostate biopsies performed to diagnose prostate cancer […]