Volume 18, Issue 5, May 2013

Trastuzumab is now the standard of care for metastatic and early breast cancer; however, questions remain regarding the optimal schedule of trastuzumab in the adjuvant setting. This commentary discusses the results from recent clinical trials with regard to the optimal duration of trastuzumab treatment, as well as the benefits of providing trastuzumab sequentially versus concurrently to chemotherapy.

Several single‐nucleotide polymorphisms (SNPs) associated with breast cancer risk have been identified through genome‐wide association studies. This study investigated the association of eight risk SNPs with breast cancer disease‐free survival and overall survival rates. Results suggest that two previously identified breast cancer risk susceptibility loci may influence breast cancer prognosis or comorbid conditions associated with overall survival.

This study examined first‐line treatment patterns and clinical outcomes in patients with HER2‐positive, hormone receptor (HR)‐positive metastatic breast cancer in a real‐world setting. With or without chemotherapy, dual targeting of HRs and HER2 receptors was found to be associated with significantly prolonged progression‐free survival and overall survival times.

The efficacy and tolerability of two different schedules of paclitaxel, carboplatin, and trastuzumab for HER2‐positive, locally aggressive (stage IIB–IIIC) breast cancers were evaluated in this phase II trial. The results indicate that more frequent administration might improve the possibility of eradicating invasive cancer in the breast and axilla, especially in the luminal‐B (HER2‐positive) subtype.

DNA variants of uncertain significance are common outcomes of testing for susceptibility to cancer. A statistically rigorous model that provides a pathogenicity score for each variant has been developed to aid in the clinical management of patients undergoing genetic testing. The pathogenicity score that is generated by this model maps to the IARC system for clinical management, which will assist clinicians in the medical management of those patients who obtain a VAS result upon testing.

Two new drugs, everolimus and sunitinib, have been approved for the treatment of patients with pancreatic neuroendocrine tumors. However, potential challenges await other new drugs in this area. The strengths and weaknesses of the most recent neuroendocrine tumor studies, how limitations can lead to potential pitfalls, and increasing the number of drugs are discussed.

This systematic review and meta‐analysis examined the use of routine postoperative administration of vitamin D and calcium to reduce the incidence of symptomatic postoperative hypocalcemia after total thyroidectomy. A significant decrease in postoperative hypocalcemia was identified in patients who received routine supplementation of oral calcium or vitamin D, especially with the combined administration of both supplements.

This retrospective institutional experience from the Massachusetts General Hospital Cancer Center reports the overall response rate, R0 resection rate, progression‐free survival, and safety/toxicity of neoadjuvant FOLFIRINOX and chemoradiation in patients with locally advanced pancreatic cancer. FOLFIRINOX demonstrated substantial activity in patients with LAPC, although recurrences after resection and toxicities raise important questions about how to best treat these patients.

Despite advances in therapy options, few guidelines or reviews address the optimal timing or methodology for the radiographic detection of metastatic disease in patients with advanced prostate cancer. This review discusses the current status of predicting the presence of metastatic disease, with a particular emphasis on the detection of the M0 to M1 transition, and reviews current data on newer imaging technologies that are changing the way metastases are detected.

Several new agents—cabazitaxel, abiraterone acetate, enzalutamide, and radium‐223—are changing the treatment options and management of patients with metastatic castration‐resistant prostate cancer. This review article is summarizes the latest data on novel agents and current treatment strategies for patients with metastatic castration‐resistant prostate cancer.

This comprehensive literature review was conducted to better understand and discuss issues related to therapeutic recommendations that are particular to older patients with head and neck cancer (HNC). It was found that older patients with HNC do not have worse survival rates but may experience higher treatment‐related toxicities than their younger peers, specifically as the intensity of treatment increases, with comorbidities and functional age being better predictors of treatment tolerance and development of toxicities compared with chronological age.

Two cases of ACC of the larynx were treated with CRT for organ preservation. The patients completed a course of combined chemoradiotherapy with weekly carboplatin and paclitaxel and radiotherapy. Both patients are alive with local regional control and functional larynx, therefore, chemoradiation with weekly carboplatin and paclitaxel may be a potential alternative to the current treatment.

It is unknown whether changes in study sponsorship have affected prospective research on head and neck squamous cell carcinoma. Our study determined that there has been a significant increase in the proportion of industry‐sponsored research from 1980 to 2010, with an emphasis on pharmacotherapy.

Clinical outcomes of liver transplantation (LT) for hepatocellular carcinoma (HCC) in HIV‐coinfected patients were assessed. The study involved 30 HIV‐positive patients affected by HCC who underwent LT with 155 HIV‐uninfected patients who received the same treatment. LT for HCC is a feasible procedure and the presence of HIV does not particularly affect the post‐LT outcome.

Disparity exists between patients with lung cancer enrolled in clinical trials and patients treated in the community setting. This study assessed the real‐world effectiveness of cytotoxic agents that became available for the treatment of non‐small cell lung cancer (NSCLC) in the last 2 decades using the Surveillance, Epidemiology, and End Results–Medicare database. Study findings support the effectiveness of currently approved drugs for the treatment of advanced NSCLC in the real‐world oncology practice.

This literature review focuses on the efficacy and safety of busulfan (BU)‐based conditioning regimens for autologous stem cell transplantation in patients with multiple myeloma. A BU‐melphalan regimen demonstrated superior efficacy and a satisfactory safety profile, particularly when the i.v. formulation of BU was used.

The introduction of the hypomethylating agents azacitidine and decitabine has been a major advancement in the treatment of patients with higher‐risk myelodysplastic syndromes, chronic myelomonocytic leukemia, and acute myeloid leukemia who are ineligible for more intensive treatments. This concise drug review summarizes the current state of treatment with azacitidine and decitabine.

On May 10, 2012, a conditional marketing authorization valid throughout the European Union was granted for pixantrone for the treatment of adult patients with multiply relapsed or refractory aggressive non‐Hodgkin's B‐cell lymphoma. This article summarizes the scientific review of the application leading to approval in the European Union.

The number of patients that decline conventional cancer treatment is substantial enough to warrant close attention. Effective patient‐doctor communication is crucial in addressing this challenge.

Advocates of the Pulmonary Metastasectomy in Colorectal Cancer trial describe trial design and goals, in agreement with others that such a trial is necessary to solve the question of whether or not surgery is beneficial in patients with metastatic colorectal cancer and, ultimately, to assist patients and clinical teams in deciding for or against pulmonary metastectomy.

This response to Migliore et al. further discusses the surgical resection of patients with lung metastases from colorectal cancers.