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Current Oncology is published by MDPI from Volume 28 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Multimed Inc..

Curr. Oncol., Volume 15, Issue 3 (June 2008) – 10 articles

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29 KiB  
Editorial
Trastuzumab: A Cardiologist’s Perspective
by Marc André Côté
Curr. Oncol. 2008, 15(3), 162-163; https://0-doi-org.brum.beds.ac.uk/10.3747/co.v15i3.300 - 01 Jun 2008
Viewed by 305
Abstract
A review of the randomized clinical trials of adjuvant trastuzumab in human epidermal growth factor receptor (HER2)—positive breast cancer demonstrates the great benefit of this monoclonal antibody whose potential cardiotoxicity is a fascinating problem for the cardiologist 1. [...]
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Article
The 3rd Annual Ontario Thoracic Cancer Conference at Niagara-on-the-Lake
by M. Dahele, Y. Ung, A. Bezjak, R. Burkes, P. Ellis, A. Behzadi, H. Solow, S. Laffan and M. Korec
Curr. Oncol. 2008, 15(3), 155-161; https://0-doi-org.brum.beds.ac.uk/10.3747/co.v15i3.287 - 01 Jun 2008
Cited by 6 | Viewed by 392
Abstract
The 3rd Annual Ontario Thoracic Cancer Conference was held March 28–30, 2008, in Niagara-on-the-Lake, bringing together those in community and academic practice throughout the province who have an interest in thoracic oncology. [...]
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Article
Drug-Induced Immune Thrombocytopenic Purpura Secondary to Sunitinib
by M. Trinkaus, M. Trudeau and J. Callum
Curr. Oncol. 2008, 15(3), 152-154; https://0-doi-org.brum.beds.ac.uk/10.3747/co.v15i3.233 - 01 Jun 2008
Cited by 13 | Viewed by 406
Abstract
Sunitinib (Sutent: Pfizer, New York, NY, U.S.A.) is an oral multi-targeted tyrosine kinase inhibitor approved for use in various solid tumour malignancies. Many side effects secondary to sunitinib have been documented. In particular, sunitinib administration is known to result in thrombocytopenia, with the [...] Read more.
Sunitinib (Sutent: Pfizer, New York, NY, U.S.A.) is an oral multi-targeted tyrosine kinase inhibitor approved for use in various solid tumour malignancies. Many side effects secondary to sunitinib have been documented. In particular, sunitinib administration is known to result in thrombocytopenia, with the cause being attributed to myelosuppression. Here, we present the first case report to demonstrate immune-mediated thrombocytopenia secondary to sunitinib administration. Full article
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Article
Single versus Multiple Fractions of Palliative Radiotherapy for Bone Metastases: A Randomized Clinical Trial in Iranian Patients
by F. Amouzegar–Hashemi, H. Behrouzi, A. Kazemian, B. Zarpak and P. Haddad
Curr. Oncol. 2008, 15(3), 151; https://0-doi-org.brum.beds.ac.uk/10.3747/co.v15i3.203 - 01 Jun 2008
Cited by 44 | Viewed by 520
Abstract
Background: Despite high-level evidence in the literature, the use of single-fraction radiotherapy (RT) for management of painful bone metastases is not widely practiced in the world, as highlighted in several practice-pattern surveys. Fractionation of palliative RT for bone metastases has [...] Read more.
Background: Despite high-level evidence in the literature, the use of single-fraction radiotherapy (RT) for management of painful bone metastases is not widely practiced in the world, as highlighted in several practice-pattern surveys. Fractionation of palliative RT for bone metastases has not been addressed in Iran, where the most common clinical practice is the use of 30 Gy in 10 fractions. Thus, we decided to perform a randomized clinical trial to compare responses in our patients with those reported in the international literature. Patients and Methods: Adult patients with multiple painful uncomplicated bone metastases were randomized to 8 Gy in a single fraction or 30 Gy in 10 fractions. Pain was graded by the patients on a scale of 1 to 4 just before and again 1 month after the end of RT. Palliative response was defined as “complete” (pain reduction of 2 grades or more), “partial” (pain reduction of 1 grade or more, but less than 2 grades), and “no response” (pain reduction of less than 1 grade). Results: We randomized 70 patients in this trial (63% women; mean age: 51.6 years). Sites of treatment included spine (n = 27), sacrum or pelvis (n = 25), extremities (n = 14), ribs (n = 3), and sternum (n = 1). Patients graded their pain before RT in a range from 1.8 to 4.0 (mean: 3.2). All patients finished their scheduled course of RT without incident. Unfortunately, 5 patients died less than 1 month after the end of RT, and 7 did not return for any follow-up and could not be contacted. As a result, only 58 patients (31 who received multiple fractions, and 27 who received a single fraction) were available for evaluation of pain 1 month after treatment. At that time, pain was graded in a range from 1.0 to 4.0 (mean: 2.0). The reduction in pain grade ranged from –0.8 to 2.6 (mean: 1.1). We observed 8 (14%) complete responses, 33 (57%) partial responses, and 17 (29%) no responses, for an overall response rate of 71%. The number of responders was 21 (78%) among those who received a single fraction and 20 (65%) among those who received multiple fractions (p > 0.1). The mean reduction in pain was 1.1 in both groups. The 10- fraction group contained a higher number of complete responders (11 of 31 as compared with 6 of 27 in the 1- fraction group)—a result that was not statistically significant. The mean reduction in pain was 1.4 in patients 50 years of age or younger and 0.9 in patients more than 50 years of age (p = 0.01). Of the 8 complete responses, 7 (87.5%) were seen in the patients 50 years of age or younger, and the mean age of patients with a complete response (38.7 years) was significantly lower than that of patients with a partial response or no response (53.7 years, p = 0.017). By logistic regression, patient sex, primary tumour, RT site, and type of treatment (single-fraction vs. multifraction) did not have any significant effect on pain reduction. The only factor with a significant effect was age (p = 0.002). Conclusions: Our trial showed no significant difference in pain relief after palliative radiotherapy with 1 or 10 fractions in Iranian patients. The overall response rate was 71%, similar to results in the international literature. Younger patients responded better. Full article
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Article
The Mcgill University Department of Oncology: Structure Depicts the Shape of Evolving Knowledge
by G. Batist and G.A. Shinder
Curr. Oncol. 2008, 15(3), 143-150; https://0-doi-org.brum.beds.ac.uk/10.3747/co.v15i3.214 - 01 Jun 2008
Cited by 3 | Viewed by 360
Abstract
The McGill University Department of Oncology has changed and expanded since its inception in 1990, responding to the move to interdisciplinary clinical care, teaching, and research. Although the traditional Divisions have been maintained to correspond to University and Royal College interfaces, the department [...] Read more.
The McGill University Department of Oncology has changed and expanded since its inception in 1990, responding to the move to interdisciplinary clinical care, teaching, and research. Although the traditional Divisions have been maintained to correspond to University and Royal College interfaces, the department has steadily been generating a variety of cross-departmental and interdisciplinary programs in which new insights into clinical care and biology are being generated. In research areas ranging from psychosocial and fundamental to translational and clinical therapeutics, interdisciplinarity and an emphasis on clinician–scientists are critical features. Full article
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Article
The Cost Burden of Trastuzumab and Bevacizumab Therapy for Solid Tumours in Canada
by A. Drucker, C. Skedgel, K. Virik, D. Rayson, M. Sellon and T. Younis
Curr. Oncol. 2008, 15(3), 136-142; https://0-doi-org.brum.beds.ac.uk/10.3747/co.v15i3.249 - 01 Jun 2008
Cited by 34 | Viewed by 687
Abstract
Objective: Monoclonal antibodies (MAbs) such as trastuzumab and bevacizumab have become important yet expensive components of systemic cancer therapy across a variety of disease sites. We assessed the potential cost implications of adopting trastuzumab and bevacizumab therapy in the context of their [...] Read more.
Objective: Monoclonal antibodies (MAbs) such as trastuzumab and bevacizumab have become important yet expensive components of systemic cancer therapy across a variety of disease sites. We assessed the potential cost implications of adopting trastuzumab and bevacizumab therapy in the context of their potential utilization in breast, lung, and colorectal cancers. Design: We first estimated MAb costs per patient and treatment indication and then included the MAb acquisition cost and the costs of medical resource utilizations required for therapy delivery. Drug costs were based on 2005 average Canadian wholesale prices, assuming full drug delivery and uncomplicated cycles. A direct-payer perspective was undertaken, and results are reported in Canadian dollars. Potential lifetime costs were then derived according to constructed schema, which account for absolute numbers of target patients and systemic therapy utilization. We subsequently estimated costs of MAb therapy relative to total costs of conventional management without MAb therapy. Results: Trastuzumab costs $49,915 and $28,350 per patient treated in the adjuvant and metastatic breast cancer settings, respectively; bevacizumab costs $48,490 and $39,614 per patient treated in the metastatic lung and colorectal cancer settings, respectively. Potential lifetime absolute costs to Canada’s health care system were approximately $127 million and $299 million for trastuzumab and bevacizumab respectively, corresponding to an average increase in health care expenditure of approximately 19% for breast cancer and 21% for lung and colorectal cancer over conventional management without MAbs. Conclusions: Novel Mab-based therapies such as trastuzumab and bevacizumab will likely add a significant cost burden to Canada’s publicly funded health care system. Full article
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Article
Adjuvant Hormonal Therapy for Stage I Endometrial Cancer
by L. Gien, J. Kwon, T.K. Oliver, M. Fung-Kee-Fung, the Members of the Gynecology Cancer Disease Site Group and Cancer Care Ontario’s Program in Evidence-Based Care
Curr. Oncol. 2008, 15(3), 126-135; https://0-doi-org.brum.beds.ac.uk/10.3747/co.v15i3.204 - 01 Jun 2008
Cited by 20 | Viewed by 516
Abstract
Question: What is the role of hormonal therapy as adjuvant therapy in patients with stage I endometrial cancer? Perspectives: There is little consensus on the role of adjuvant treatment for patients with stage I endometrial cancer. Although the use of hormonal [...] Read more.
Question: What is the role of hormonal therapy as adjuvant therapy in patients with stage I endometrial cancer? Perspectives: There is little consensus on the role of adjuvant treatment for patients with stage I endometrial cancer. Although the use of hormonal therapy has been established in advanced disease, less agreement has emerged concerning the benefits of adjuvant hormonal therapy for patients with early-stage disease. The objective of the present evidence series was to review the existing literature on the role of hormonal therapy as adjuvant therapy in patients with stage I endometrial cancer. Outcomes: Reports were sought that included at least one of the following outcomes: overall survival, disease-free survival, recurrence (local, or distant, or both), adverse effects, and quality of life. Because of the potential for long-term adverse effects with adjuvant hormonal treatment in this patient population, especially with regard to thromboembolic or cardiovascular events, the rates of non-cancer-related death were also of interest. Methodology: The MEDLINE, EMBASE, and Cochrane Library databases were systematically searched for randomized controlled trials, practice guidelines, systematic reviews, and meta-analyses. The resulting evidence informed the development of the clinical practice guideline. The systematic review with meta-analyses and practice guideline were approved by the Report Approval Panel of the Program in Evidence-Based Care, and by the Gynecology Cancer Disease Site Group (DSG). Results: Nine randomized trials and one published meta-analysis comparing adjuvant hormonal therapy with no adjuvant therapy in women with stage I endometrial cancer constituted the evidence base. One trial reported a statistically significant survival benefit with adjuvant progestogen as compared with no further treatment (97% vs. 69%, p < 0.001). In that trial, the treatment group had a higher number of patients with less myometrial invasion, and a lower number of patients with advanced-stage disease. These differences in baseline characteristics between the randomized groups were considered to be clinically important. In addition, the results of that trial were not consistent with those of other trials, and the trial was a source of statistical heterogeneity when data were pooled across trials. In two of the nine randomized trials, statistically significant recurrence-free benefits were detected with adjuvant hormonal therapy as compared with no further therapy. In one trial, the difference between the rates of recurrence was 16%; however, the methodologic concerns related to that that trial limited its relevance. In the other trial, the difference between the rates of recurrence was 5%. In that trial, patients were at a high risk of recurrence. None of the remaining seven randomized trials reported any significant difference in recurrence rates between treatment groups. The meta-analysis identified in the literature detected no statistically significant recurrence-free or overall survival benefit associated with adjuvant hormonal therapy as compared with no adjuvant therapy [odds ratio (OR): 1.05; 95% confidence interval (CI: 0.88 to 1.24). Those results are consistent with the results of the meta-analysis in the present report, which included an additional two trials (OR: 1.10; 95% CI: 0.91 to 1.34). Practice GuidelineTarget Population This clinical recommendation applies to women with newly diagnosed stage I endometrial cancer. Recommendation The available evidence does not demonstrate any benefit for adjuvant hormonal therapy. The use of hormonal therapy is not recommended as adjuvant treatment for patients with stage I endometrial cancer Full article
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Article
Does Preoperative Positron Emission Tomography with Computed Tomography Predict Nodal Status in Endometrial Cancer? A Pilot Study
by D. Nayot, J.S. Kwon, M.S. Carey and A. Driedger
Curr. Oncol. 2008, 15(3), 123-125; https://doi.org/10.3747/co.v15i3.176 - 01 Jun 2008
Cited by 16 | Viewed by 394
Abstract
Fewer than 20% of women with endometrial cancer have positive nodes, and an accurate noninvasive imaging modality to assess lymph node status would be helpful in selecting those who need lymphadenectomy. The objective of this pilot study was to evaluate positron emission tomography [...] Read more.
Fewer than 20% of women with endometrial cancer have positive nodes, and an accurate noninvasive imaging modality to assess lymph node status would be helpful in selecting those who need lymphadenectomy. The objective of this pilot study was to evaluate positron emission tomography with computed tomography (pet–ct) in predicting nodal status before surgery for endometrial cancer. Twelve patients were enrolled at a single tertiary care centre. The sensitivity and specificity of preoperative pet–ct in predicting nodal status were 53.3% and 99.6% respectively. Using pet–ct, all metastatic nodes may not necessarily be detected, especially nodes with microscopic disease. The sensitivity of this imaging modality has to be improved before it can routinely be used in the preoperative evaluation of endometrial cancer. Full article
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Article
Cancer Nutrition and Rehabilitation—Its Time Has Come!
by M.R. Chasen and A.P. Dippenaar
Curr. Oncol. 2008, 15(3), 117-122; https://0-doi-org.brum.beds.ac.uk/10.3747/co.v15i3.244 - 01 Jun 2008
Cited by 36 | Viewed by 637
Abstract
Cancer is a systemic disease that can affect nearly every organ in the body, resulting in a progressive loss of organ function. That loss of function may be initially slow, having minimal effect, or it may be rapid, resulting in more dramatic changes. [...] Read more.
Cancer is a systemic disease that can affect nearly every organ in the body, resulting in a progressive loss of organ function. That loss of function may be initially slow, having minimal effect, or it may be rapid, resulting in more dramatic changes. The usual medical management of patients with cancer has focused more specifically on the administration of cytotoxic treatments. These treatments can potentially eradicate or minimize the tumour, but they may also have toxic side effects that in turn can also affect the patient. individual with a cancer diagnosis to obtain optimal physical, social, psychological, and vocational functioning within the limits created by the disease and its treatment. The McGill Cancer Nutrition and Rehabilitation (CNR) program developed as a result of the everincreasing demand for a focus on addressing individual cancer patients and their needs, as well as on achieving optimal tumour-related outcomes. Using an interdisciplinary approach, the CNR’s global objective is to empower individuals who are experiencing loss of function, fatigue, malnutrition, psychological distress, and other symptoms as a result of cancer or its treatment to improve their own quality of life. All team members—experts in their respective fields—assess all patients. At a subsequent team discussion and planning meeting, a specific 8-week program is designed for each patient. The hoped-for outcome for the CNR program is primarily to empower patients to “take control” or to enable them to improve their own quality of life. This article reviews the philosophy of the CNR’s approach and the roles played by the various members of the team. Full article
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Editorial
In This Issue of Current Oncology
by P. Gold
Curr. Oncol. 2008, 15(3), 116; https://0-doi-org.brum.beds.ac.uk/10.3390/curroncol15030003 - 01 Jun 2008
Viewed by 262
Abstract
This issue of Current Oncology cuts a broad swath through highly topical subjects in cancer biology and cancer care[...] Full article
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