Seminars in oncology
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Seminars in oncology · Feb 2006
ReviewDiagnosis, management, and evaluation of chemotherapy-induced peripheral neuropathy.
Peripheral neuropathy induced by cancer chemotherapy represents a large unmet need for patients due to the absence of treatment that can prevent or mitigate this common clinical problem. Chemotherapy-induced peripheral neuropathy (CIPN) diagnosis and management is further compounded by the lack of reliable and standardized means to diagnose and monitor patients who are at risk for, or who are symptomatic from, this complication of treatment. ⋯ The incidence and severity of CIPN is commonly under-reported by physicians as compared with patients. The development of new and reliable methods for the assessment of CIPN as well as safe and effective treatments to prevent this complication of treatment would represent important medical advancements for cancer patients.
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Seminars in oncology · Feb 2006
ReviewOptimizing therapy in previously treated non-small cell lung cancer.
The past decade has seen the identification of several novel cytotoxic agents. More recently, targeted therapies with single-agent activity or that enhance the efficacy of chemotherapy in advanced non-small cell lung cancer have been identified. ⋯ The cytotoxic agents docetaxel, pemetrexed, and topotecan, as well as the epidermal growth factor receptor tyrosine kinase inhibitors erlotinib and gefitinib, have been evaluated in phase III trials in previously treated populations. This review summarizes the results of these phase III studies with a particular focus on predictors of favorable outcome, attempts to provide a rational approach to therapeutic selection in this patient population, and discusses ongoing pivotal trials and future strategies in this field.
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Seminars in oncology · Dec 2005
Comparative StudyOverview of adjuvant therapy for resected gastric cancer: differences in Japan and the United States.
Survival in adjuvant chemotherapy following resected gastric cancer has been studied by both Japanese and Western investigators using varied chemotherapy regimens in different target patients. Gastrectomy with D2 lymphadenectomy is the standard in Japan, and trials of adjuvant therapy in these patients have shown no survival advantages over surgery alone. In the United States, where 5-year survival rates in patients with gastric cancer are much lower following potentially curative surgery, adjuvant therapy has shown a survival benefit. ⋯ The Japanese viewpoint on the use of adjuvant therapy in patients with gastric cancer following potentially curative resection is that the quality of surgery, including diagnostic and pathologic procedures, is a more important prognostic factor than adjuvant chemotherapy. Also, they have determined from previously conducted clinical trials that patients with stage 1-2 tumors should be excluded from the target populations of randomized trials. Until the results of INT-0116 became available, there had been no improvement, or only marginal improvement, in overall or disease-free survival for patients receiving adjuvant chemotherapy following gastric cancer resection in the United States and Europe.
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Seminars in oncology · Dec 2005
ReviewFront-line therapy for advanced colorectal cancer: emphasis on chemotherapy.
For four decades, 5-fluorouracil was the only option available for patients with metastatic colorectal cancer. It provided a response rate of 15% to 20%, with a median survival of approximately 1 year. ⋯ Use of two to three lines of combination therapies has raised the median survival to almost 2 years. New and promising targeted and cytotoxic therapies are currently being studied and will ideally continue to extend the median survival as well as improve the quality of life of patients with colorectal cancer.