Cancer Treatment Today

Lay Summary: Role of Herceptin in adjuvant therapy of breast cancer. Two large randomized controlled clinical trials sponsored by the National Cancer Institute involving more than 3300 patients with early-stage HER-2 positive invasive breast cancer found that those patients who received trastuzumab in combination with standard chemotherapy (doxorubicin and cyclophosphamide followed by paclitaxel) had a statistically significant 52% decrease in risk

Lay Summary: Maintenance rituximab is becoming more common although questions remain about its benefit for DLBCL. The impact of maintenance treatment with rituximab on overall survival is one of the most important open questions for patients with indolent non-Hodgkin lymphoma. Recent randomized trials performed by the German Low Grade Lymphoma Study Group (GLSG) and by the EORTC demonstrated the superiority of rituximab maintenance after immunochemotherapy

More than 50% of patients with esophageal cancer have metastatic disease at presentation. The use of chemotherapy for this patient group is increasing with the intention of local and distant tumor control, improving quality of life and prolongation of survival. A number of agents have been investigated as sole therapy for esophageal cancer, including cisplatin, irinotecan, bleomycin, mitomycin, 5-fluorouracil, paclitaxel, methotrexate, vinorelbine,

Lay Summary: Erbitux with Avastin is a promising but investigational therapy at this time. On February 12, 2004, the FDA approved cetuximab (Erbitux) under its accelerated approval program as a combination treatment with irinotecan for the treatment of patients with metastatic colorectal cancer; or alone if patients cannot tolerate irinotecan. The approval of cetuximab by the FDA was largely based on the findings of a randomized, controlled study

Lay Summary: Revlimid is promising for CLL. Revlimid is an orally administered derivative of thalidomide, which is a very active agent for the treatment of multiple myeloma but has serious side effects, especially thromboembolism. Revlimid is reported to have less toxicity than thalidomide but retains antimyeloma effects. Revlimid has recently been approved by the FDA for review of treatment of myelodysplastic syndromes (MDS) wih a 5q- mutation and

Rosai and Dorfman first described sinus histiocytosis with massive lymphadenopathy in 1969 as a benign lymphohistiocytic proliferative condition involving lymph nodes. The classic clinical presentation of Rosai-Dorfman disease is massive painless cervical lymphadenopathy, but can also include nasal obstruction, tonsillar enlargement, or hearing abnormalities. It and may be accompanied by leukocytosis, elevated erythrocyte sedimentation rate (ESR),

Lay Summary: Some important questions have been raised about the combination of irinotecan and panitumumab. Vectibix is a recombinant, human IgG2 kappa monoclonal antibody that binds specifically to the human Epidermal Growth Factor Receptor (EGFR). Vectibix is specifically indicated for for the treatment of EGFR-expressing, metastatic colorectal carcinoma with disease progression on or following fluoropyrimidine-, oxaliplatin-, and irinotecan- containing

Tarceva is FDA approved after standard chemo has failed or for maintenance after treatment of advanced or metastatic disease. It is not currently FDA approved as first line therapy even for stage IV. TARCEVA (erlotinib) monotherapy is indicated for the maintenance treatment of patients with locally advanced or metastatic non-small cell lung cancer whose disease has not progressed after four cycles of platinum-based first-line chemotherapy. However,

1. Rituximab has been useful in cases of sev ere lupus as well as lupus nephritis. Recent data suggests that it work particularly well with cyclophospamide. Previous studies on rituximab (both published in peer-reviewed journals and presented at various national and international meetings) have been extremely encouraging for the use of rituximab in SLE or Sjögren's syndrome.The combination of cyclophosphamide and rituximab is an exciting new therapy

Lay Summary: Nexavar is being investigated for treatment of sarcoma. Nexavar is currently FDA approved for renal cell carcinoma and hepatocellular carcinoma . Sorafenib (Nexavar) is designed to interfere with growth of new blood vessels and the growth of new cancer cells.Inhibition of KIT signaling provides a direct anti-tumor effect in most GIST tumors and inhibition of VEGF receptors and PDGFR-β provide antiangiogenesis effects (similar to Sutent).