Current oncology reports
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Currently, the management of localized renal cell carcinoma (RCC) is surgical. Unfortunately, many cases of high-risk RCC recur following resection and develop metastatic disease, an event that usually results in death. Because previous attempts to improve survival with adjuvant therapy have been unsuccessful, the US Food and Drug Administration's approval of three new agents for metastatic RCC has generated renewed interest in evaluating agents in the adjuvant setting for high-risk RCC. This article discusses the rationale for the use of these and other novel agents and reviews currently ongoing adjuvant trials as well as considerations for the development of new trials for adjuvant therapies.
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Cancer-related constipation is common and a significant detractor from patient quality of life. It has many possible causes and is still not well understood. Information is lacking on therapies for cancer-related constipation among current medications approved by the US Food and Drug Administration (FDA). ⋯ The role of these agents in cancer-related constipation remains to be seen. On the horizon are two investigational peripherally acting opioid receptor antagonists, alvimopan and methylnaltrexone. Preliminary results in cancer-related constipation suggest that these agents may be important additions to our treatment repertoire.
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Bone and soft tissue sarcomas represent rare tumors that can be cured by local treatment at early stages of disease. However, advanced or metastatic disease is rarely cured, and very few drugs have shown efficacy in this setting. ⋯ The response rate and durable stable disease in early studies, as well as the tolerability profile, recommend these drugs as promising candidates for further clinical studies. This article discusses preliminary results from clinical trials in patients with advanced or metastatic sarcoma as well as future perspectives.
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The result of a lung cancer screening program should be fewer lung cancer-specific deaths in the screened population. Studies evaluating chest imaging as a screening tool for lung cancer have not shown a reduction in lung cancer-specific mortality to date. ⋯ Current guidelines remain vague as randomized trials are being completed and technologic advances are occurring. The ultimate face of a successful lung cancer screening program is yet to be defined.
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Current oncology reports · May 2007
ReviewCombined-modality therapy for esophageal and gastroesophageal junction cancers.
The optimal management of locoregional esophageal cancer is controversial. Preoperative concomitant chemoradiotherapy (two courses of cisplatin and 5-fluorouracil plus 50 Gy of radiation) may provide benefit in survival and local control compared with surgery alone and is a reasonable alternative to surgery alone in stages IIB, III, and possibly stage IVa disease. ⋯ Preoperative chemotherapy without radiation also provides a survival benefit compared with surgery alone, but data are insufficient to conclude it is superior to preoperative chemoradiotherapy. Control of distant disease remains a problem with preoperative chemotherapy and preoperative chemoradiotherapy.