Volume 20, Issue 2, February 2015

Bevacizumab has been FDA-approved for use in combination with single-agent chemotherapy for platinum-resistant ovarian cancer; however, its optimal role remains unclear. In this editorial, the timing, efficacy, safety, and rationale for use of bevacizumab in ovarian cancer are discussed.

This review considers the potential utility of positron emission tomography (PET) tracers in the setting of response monitoring in breast cancer, with a special emphasis on glucose metabolic changes assessed with ¹⁸F-fluorodeoxyglucose. It discusses the different PET timing and metabolic criteria to define response that have been evaluated in previous studies. The development of new radiotracers of specific molecular pathways of breast cancer cells is also a challenging and promising research area.

Multiple tyrosine kinase inhibitors have activity in differentiated thyroid cancer refractory to radioactive iodine (RAI). Selection of a targeted agent should depend on disease trajectory, side effect profile, and goals of therapy. Clinical guidance on the use of these agents in RAI-refractory thyroid cancer is warranted.

ColoPrint is a gene expression classifier that distinguishes patients with low or high risk of disease relapse. Results of this study showed that this classifier significantly improved prognostic accuracy, independent of microsatellite status or clinical variables, to facilitate the identification of patients with stage II colorectal cancer at higher risk of recurrence who might be considered for additional treatment.

Although complete surgical resection of adenocarcinoma of the gastroesophageal junction (GEJ) remains the cornerstone of treatment for resectable disease, long-term outcomes are poor and recurrence rates are high with surgery alone in patients presenting with locally advanced disease. This review discusses why the treatment of locally advanced GEJ tumors remains controversial, discusses various multimodal approaches, the respective pros and cons, evaluates the role of radiation therapy, highlights some ongoing and planned clinical trials, and suggests areas that need further research.

In the pivotal phase III MPACT trial, nab-paclitaxel plus gemcitabine demonstrated improved survival compared with gemcitabine alone. This analysis of the phase III study confirms the survival benefit of nab-paclitaxel plus gemcitabine across many prespecified prognostic factors and the broad utility of this regimen for patients with advanced pancreatic cancer.

Borderline ovarian tumors (BOTs) have been a challenge for patients, pathologists, and oncologists. For the group of patients with invasive implants, there is no consensus regarding standard therapy. This meta-analysis examines the benefits, or lack thereof, of platinum-based adjuvant treatment for BOT, showing that at present there is no evidence to support this treatment form.

This study highlights the need for better understanding of the factors affecting head and neck cancer outcomes in elderly patients. Results showed older patients with early stage disease did as well as younger patients with cancer outcomes but had increased mortality from other causes, and at advanced stages, those treated with multimodality therapy had similar overall survival to younger patients. Information about life expectancy in these patients may help guide treatment decisions.

Given the widespread use of bevacizumab in clinical practice, it is important to raise clinicians’ awareness of the potential risks of this treatment. The authors aimed to provide an overview of the most common side effects of bevacizumab and to suggest a practical approach for their management.

Immunotoxins are a novel class of antibody-based therapeutics currently in clinical development. This review of the field will help physicians better inform patients about the potential benefits and toxicities of these experimental treatments.

The Institute of Medicine's National Cancer Policy Forum convened a public workshop to examine the needs of the nearly 70,000 adolescents and young adults (AYAs) between the ages of 15 and 39 that are diagnosed with cancer each year. This article highlights potential action items to improve the care and outcomes for AYA patients with cancer.

Based on a positive opinion from the European Medicines Agency, a marketing authorization valid throughout the European Union (EU) was issued for axitinib (Inlyta) for the treatment of advanced renal cell carcinoma after failure of prior treatment with sunitinib or a cytokine. This paper summarizes the scientific review of the application leading to approval in the EU.

This study evaluated the knowledge of cancer pain management in oncologists and specialists in hospice and palliative medicine and in pain medicine through a survey including vignettes that depicted cancer patients with complex chronic pain conditions. The findings raise serious concerns about the depth of knowledge of various pain treatment choices depicted in the vignettes and underscore a need for education of specialists who treat cancer pain and for more effective referral to specialists with knowledge of cancer pain.

A systematic review was performed to evaluate the antitumor effects and toxicity of ascorbate treatment. There is no high-quality evidence to suggest that ascorbate supplementation in cancer patients either enhances the antitumor effects of chemotherapy or reduces its toxicity. Given the high financial and time costs to patients of this treatment, high-quality placebo-controlled trials are needed.

This report describes a patient with ALK-rearranged non-small cell lung cancer who developed diffuse leptomeningeal carcinomatosis as the only “site” of progression after a prolonged response to crizotinib and who has been treated successfully with a second-generation ALK inhibitor alone for >15 months.

A medical oncologist considers the authentic meaning of the word unessential with regard to the cost of care.

Cardiopulmonary exercise testing (CPET) should continue to be taken into consideration when screening cancer patients for participation in exercise training programs. The benefits of CPET for cancer patients are better examined through longitudinal rather than cross-sectional studies.

The primary goal is to ensure that exercise training is safe for all cancer patients without creating unnecessary barriers to exercise participation. On the basis of the study findings, the conclusion that exercise testing does not need to be an aspect of pre-exercise clearance for the majority of cancer patients remains appropriate. Nevertheless, these findings are preliminary, and it is hoped that they will stimulate further work.