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With more effective local therapy achieved by concurrent chemoradiotherapy for patients with advanced squamous cell carcinoma of the head and neck, the occurrence of distant relapse is becoming increasingly observed. In a Phase 2 study, six weekly doses of carboplatin and paclitaxel prior to concurrent chemoradiotherapy resulted in comparable local control and fewer distant relapses when compared to prior studies from this group. The role for induction chemotherapy and the agents selected remains to be established.
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In a Phase 3 trial including 268 patients with advanced biliary tract cancers, response rates were improved in patients receiving erlotinib with chemotherapy (gemcitabine/oxaliplatin) compared to chemotherapy alone. However, progression-free survival was not enhanced except for the subset with cholangiocarcinoma.
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In this Phase 2 trial, 32 heavily pretreated patients including those who received adjuvant temozolamide, were treated with daily low-dose temozolamide at 50 mg/m2 and twice-weekly Bevacizumab. The treatment was well tolerated with a median progression-free survival of 15.8 weeks and a median overall survival of 37 weeks. However, this was lower than those reported in studies with single-agent bevacizumab and bevacizumab/irinotecan combination.
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A 48-year-old woman, who is 8 years post-hysterectomy for excessive menstrual bleeding, just completed a four-cycle course of chemotherapy (doxorubicin and cyclophosphamide), for a 2.8 cm, high-grade breast cancer with a negative sentinel node biopsy.
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An 84-year-old community-dwelling retired physician who maintains an active lifestyle and regularly attends community hospital meetings and lectures is seen for advice regarding management. He has a longstanding history of mild hypertension currently controlled by diet and hydrochlorothiazide.
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Potentially operable patients with Stage I non-small cell lung cancer who were treated with stereotactic ablative radiotherapy (SABR) between 1993-2010 were retrospectively identified in a prospectively collected database. Despite the median age of 76 years and the median comorbidity score of 2 in these 177 potentially operable patients, the 3-year survival was 85%. Post-SABR 30-day mortality was 0%, while predicted 30-day mortality for a lobectomy, derived using the Thoracoscore predictive model, would have been 2.6%. Local control at 3 years was 93%.
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Host-related immunoproliferation may contribute to the pathogenesis of certain clonal myeloid disorders such as myelofibrosis and myelodysplasia.
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Two very recent publications address the management of newly diagnosed multiple myeloma. In the first, two bortezomib-containing three-drug regimens proved equally effective as a more complex four-drug regimen in achieving meaningful initial responses. The second demonstrated the value of maintenance lenalidomide for achieving longer progression-free survival.
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The patient is a 56-year-old woman with known meningioma first resected in 1999 followed by external beam irradiation. In 2005, she developed progressive right leg weakness and had a second operation and course of radiation.
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The practice of tanning by artificial means, such as by sunlamps or sunbeds, continues to be popular, particularly in young people despite the acknowledged risk for increased skin cancer.
