Current oncology reports
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Current oncology reports · Apr 2011
ReviewAbiraterone acetate, a novel adrenal inhibitor in metastatic castration-resistant prostate cancer.
The androgen receptor remains the key player in patients with castration-resistant prostate cancer (CRPC). Available agents capable of blocking early adrenal androgen production have limited activity and can lead to significant toxicities. Abiraterone acetate, a pregnenolone analog, is a small molecule that irreversibly inhibits CYP17, a rate-limiting enzyme in androgen biosynthesis. ⋯ Recently, a randomized phase 3 trial evaluating abiraterone acetate in docetaxel-refractory CRPC patients demonstrated a survival improvement over placebo-treated patients (14.8 vs 10.9 months; HR 0.646; P < 0.0001). A similar trial in the pre-chemotherapy setting has completed accrual and is undergoing analysis. Here we review the rationale and clinical development of abiraterone acetate in men with CRPC.
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Accuracy and reproducibility in determining response to therapy and tumor progression can be difficult to achieve for nervous system tumors. Current response criteria vary depending on the pathology and have several limitations. ⋯ However, the Response Assessment in Neuro-Oncology (RANO) Working Group has published new recommendations in high-grade gliomas and is working on recommendations for other nervous system tumors. This article reviews current response criteria for high-grade glioma, low-grade glioma, brain metastasis, meningioma, and schwannoma.
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The prevalence of overweight and obesity is increasing worldwide, and the evidence base for a link between obesity and cancer is growing. In the United States, approximately 85,000 new cancer cases per year are related to obesity. Recent research has found that as the body mass index increases by 5 kg/m2, cancer mortality increases by 10%. ⋯ The goal of this review is to provide an update of recent research, with a focus on epidemiologic studies on the link between obesity and cancer. In addition, we will briefly review hypothesized mechanisms underlying the relationship between obesity and cancer. High priorities for future research involve additional work on the underlying mechanisms, and trials to examine the effect of lifestyle behavior change and weight loss interventions on cancer and intermediate biomarkers.
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Current oncology reports · Jul 2010
Review Case ReportsHow to discuss errors and adverse events with cancer patients.
Medical error has been increasingly recognized as a source of harm. The risk of harm can be even greater in cancer care with its potentially life-limiting disease and toxic treatments. ⋯ Despite these difficulties, the experience of disclosure of medical error to date has shown that it can strengthen relationships, reduce litigation and the associated costs, and be beneficial to both the patient and physician. Disclosure can be approached in many of the same ways as any other difficult communication situations, with training and preparation helping to improve the process.
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Current oncology reports · Jul 2010
ReviewLung cancer screening: an update, discussion, and look ahead.
Over the past few years there has been a great deal of debate about the status of lung cancer screening. The debate has focused on at least three areas: the unmet need to prove a mortality reduction from the screening tests being studied, the potential for these screening tests to produce harm, and the possible cost-effectiveness of an image-based screening program. In this manuscript, I review the chest imaging cohort and controlled trials that have been added to the evidence base over the past few years. I then discuss the evidence related to the areas that are currently debated, describe the ongoing trials that will help to clarify these issues, and speculate about the future.