Seminars in oncology
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Seminars in oncology · Dec 1995
Meta Analysis Clinical TrialDocetaxel (Taxotere) in combination: a step forward.
Docetaxel (Taxotere; Rhône-Poulenc Rorer, Antony, France) is a hemisynthetic derivative from European yew that inhibits tubulin depolymerization and enhances the formation of microtubule bundle aggregates, causing cell death. Activity against a variety of tumor types has been reported. Single-agent chemotherapy is rarely curative; hence, combination regimens are the logical next step in the attempt to improve tumor reduction and prolong survival. ⋯ The docetaxel/vinorelbine combination produced responses at all dose levels as front-line therapy for metastatic breast cancer; dose-limiting toxicity was experienced by two patients, but only when the vinorelbine dose was raised to 22.5 mg/m2. In phase II studies in non-small cell lung cancer, preliminary results have shown the docetaxel/cisplatin combination to have a promising level of activity and an acceptable toxicity profile. Future trials will continue to evaluate the role of docetaxel in combination and in sequential regimens, most particularly in metastatic breast cancer and non-small cell lung cancer.
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Skin findings can serve as a clue to internal disease. In this article, cutaneous manifestations of underlying lung malignancy are reviewed. ⋯ Malignancy-associated dermatoses comprise a broad group of hyperproliferative and inflammatory disorders, disorders caused by tumor production of hormonal or metabolic factors, autoimmune connective tissue diseases, among others. In this review, paraneoplastic syndromes associated with lung malignancy are discussed, including ectopic ACTH syndrome, bronchial carcinoid variant syndrome, secondary hypertrophic osteoarthropathy/digital clubbing, erythema gyratum repens, malignant acanthosis nigricans, sign of Leser-Trélat, tripe palms, hypertrichosis lanuginosa, acrokeratosis paraneoplastica, and dermatomyositis.
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Seminars in oncology · Jun 2011
ReviewPharmacologic management of cancer-related pain, dyspnea, and nausea.
Patients with cancer often face significant distress from their symptoms, especially near the end of life. However, prompt palliation of these symptoms can be complex since symptoms may occur in clusters, may be cancer- or treatment-related, and frequently require a multidisciplinary approach to management and a combination of therapeutic regimens. While evidence for many conventional symptom treatments is lacking, an increasing number of randomized clinical trials in palliative oncology means that new treatments will become increasingly evidence-based. Herein, we provide a brief overview and update of current and new strategies for the pharmacologic management of cancer-related pain, dyspnea, and nausea, which are three of the most prevalent treatable symptoms in advanced cancer.
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Seminars in oncology · Oct 2015
ReviewCurrent Perspectives in Immunotherapy for Non-Small Cell Lung Cancer.
In non-small cell lung cancer (NSCLC), the first immune checkpoint inhibitor to be approved by the US Food and Drug Administration was nivolumab, based on a survival advantage over docetaxel in recurrent squamous NSCLC, a difficult-to-treat histology. In addition, several other immune checkpoint inhibitors are also in late-stage development. ⋯ The cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) immune checkpoint inhibitors ipilimumab and tremelimumab are also under investigation in NSCLC, largely as part of combination approaches rather than as monotherapy. PD-L1 expression as a potential biomarker to select patients most likely to respond to inhibitors of the PD-1 pathway has been widely studied.
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Seminars in oncology · Oct 2015
ReviewSocial Media and Oncology: The Past, Present, and Future of Electronic Communication Between Physician and Patient.
The relationship between patient and physician is in flux with the advent of electronic media that are advancing and enhancing communication. We perform a retrospective, current, and forward-looking examination of the technologies by which information is exchanged within the healthcare community. The evolution from e-mail and listservs to blogs and the modern social networks is described, with emphasis on the advantages and pitfalls of each medium, especially in regard to maintaining the standards of privacy and professionalism to which doctors are held accountable. We support the use of contemporary platforms like Twitter and Facebook for physicians to establish themselves as trustworthy online sources of medical knowledge, and anticipate ongoing collaboration between researchers, patients, and their advocates in trial design and accrual.