Journal of the National Comprehensive Cancer Network : JNCCN
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Opioid-induced bowel dysfunction is a major complication in oncology practice and must be approached aggressively. Every patient starting opioids should be thoroughly instructed in the management of this side effect. Prevention is the key and use of agents such as senna and a stool softener with the initiation of therapy is mandatory, with rapid titration if the initial dose is not effective. ⋯ Other agents then can be added as necessary. Fecal impaction must always be considered and it should be recognized that it may lead to other symptoms such as increased pain, urinary difficulties, or nausea and vomiting. In summary, the words of Dame Cicely Saunders, founder of the hospice movement, must be kept in mind: "Remember the bowels".
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J Natl Compr Canc Netw · Jan 2003
ReviewEpidermal growth factor receptor as a target in cancer therapy.
Epithelial cancers have been found to overexpress the receptor to epidermal growth factor (EGFR). These include head and neck, breast, colon, lung, prostate, kidney, ovary, brain, pancreas, and bladder. ⋯ Antibodies such as IMC-C225 specifically target EGFRs, whereas tyrosine kinase inhibition by many small molecules is less specific but is also effective. This report focuses on EGFR and novel compounds that target it.
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J Natl Compr Canc Netw · Jan 2003
ReviewNew targeted therapies for non-small-cell lung cancer: a focus on the epidermal growth factor receptor.
Advances in chemotherapy and multimodality treatments of patients with non-small-cell lung cancer (NSCLC) have improved outcomes for these patients over the past decade. Unfortunately, gains have been modest, and new therapeutic strategies are eagerly awaited. Therapies that target receptors vital to the proliferation and survival of cancer cells are particularly attractive areas of research. ⋯ Phase II trials involving patients with advanced NSCLC and whose disease is progressive after chemotherapy have demonstrated clear clinical benefit. Studies are ongoing, integrating EGFR-targeted therapy with chemotherapy and radiation in patients with earlier stage NSCLC, as well as in chemoprevention. In all of these settings, a further understanding of the biology of EGFR in relationship to other cellular events will be critical in optimizing therapeutic approaches with these novel agents.
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The U. S. Food and Drug Administration facilitates the development of drugs intended to treat cancer and other serious or life-threatening diseases. ⋯ Drugs that receive priority review are agents that appear to represent significant improvements over existing therapies. A priority NDA is reviewed by the Agency within 6 months; a standard review is accomplished within 10 months. The Agency communicates with sponsors throughout the drug development process, suggesting appropriate trial designs and meaningful endpoints.