Oncology

Acute lymphoblastic leukaemia (ALL) is the most common leukaemia in children and third most common in adults. Although the majority of children and adults with ALL achieve a complete remission with intensive chemotherapy, relapse will occur in 20% and 50% respectively. As further intensification risks greater toxicity and may not...

The agents currently approved for use in metastatic renal cell carcinoma (mRCC) can be divided broadly into two categories: (1) vascular endothelial growth factor receptor (VEGFR)-directed therapies or (2) inhibitors of the mammalian target of rapamycin (mTOR). The latter category includes everolimus and temsirolimus, both approved for distinct indications in...

Non-small cell lung cancer (NSCLC) presents one of the greatest clinical challenges in oncology. The prevalence of cigarette smoking is the major cause for the high incidence that makes NSCLC the commonest cause of cancer-related death in the western world. Patients frequently present late, with locally advanced or metastatic disease....

We present the case of a 67-year-old man with a three month history of right sided facial nerve palsy reporting to our clinic for evaluation of a recently seen suspicious mass in the right lung. Subsequently he was diagnosed with advanced NSCLC right lung and started on palliative chemotherapy. Furthermore,...

The worldwide incidence of head and neck cancer exceeds half a million cases annually with squamous-cell histology as the most predominant. Almost half of newly diagnosed cases have advanced disease at diagnosis. The high morbidity and mortality associated with the malignancy has brought more attention to this cancer. The improvement...

Palonosetron, the second generation 5-hydroxytryptamine-3 receptor antagonist (5-HT3RA), has shown superior efficacy in preventing the delayed phase of highly emetogenic chemotherapy induced nausea and vomiting (CINV) when administered in combination with dexamethasone in a randomized phase III trial, as compared with granisetron, a first generation drug in the same class....

Pemetrexed is a third generation multi-target agent able to inhibit at least three crucial enzymes involved in the folate pathway. Pemetrexed is indicated in combination with cisplatin as first line treatment of malignant pleural mesothelioma (MPM) and in mono-chemotherapy as second line treatment of advanced non-small-cell lung cancer (NSCLC). In...

Manipulation of the hypothalamic-pituitary-gonadal axis via androgen deprivation therapy has been in use since the 1940’s for the treatment of advanced prostate cancer. Androgen deprivation may be achieved via surgical castration or pharmacological castration. Pharmacological castration is preferred by patients due to its decreased psychological impact on body image and...

Capecitabine is an oral 5-fluorouracil pro-drug with activity in metastatic breast cancer. As a single agent, response rates of 30%–30% and 15%–30% have been reported in first-line and more heavily pretreated populations, respectively. Capecitabine in combination with chemotherapy and biologic agents has resulted in significant improvement in the clinical...

Treatment of benign prostatic hyperplasia (BPH) has evolved over that last 10 years consequent to the results of several important clinical trials. Although the primary concern for patients is their symptoms, we as urologists are further concerned about the progression of disease and complications of the disease. Two classes of...

Trastuzumab is a therapeutic humanised monoclonal antibody targeting the Her2 receptor tyrosine kinase. Her2 is over-expressed, due to gene amplification, in approximately 30% of breast cancers and confers a worse prognosis. Trastuzumab has been used clinically for over a decade and is now used routinely in the treatment of Her2-positive...

Imiquimod 5% cream (Aldara) was approved by the Food and Drug Administration for the treatment of non-facial superficial basal cell carcinomas (sBCC) in 2004 and has become one of the most commonly used topical treatments for this variant of basal cell carcinoma. Application of the cream once a day, 5...

Purpose: Melatonin has neuroprotective effects in animal studies and has been suggested to decrease adverse reactions of chemotherapy including neuropathy. This pilot trial aimed at assessing whether melatonin, given during taxane chemotherapy for breast cancer, will decrease the incidence and/or severity of neuropathy. Methods: Twenty two consecutive patients beginning chemotherapy...

Hand-foot syndrome (HFS), also known as palmar-plantar erythrodysesthesia, is a relatively frequent dermatologic toxic reaction associated with several chemotherapeutic drugs used in cancer treatment. The lesions are typically localised in the palmar and plantar surfaces of the hands and feet in patients who are taking oral capecitabine or other drugs...

A case is reported in which docetaxel was used to treat a patient with hormone refractory metastatic prostate cancer. The treatment was terminated at the third course of docetaxel following the development of hemorrhagic cystitis. This reaction was unexpected, as it is not a known reaction to docetaxel. Hemorrhagic cystitis...

Chronic myeloid leukemia (CML) is a hematopoietic neoplasm characterized by the Philadelphia chromosome (Ph) and the BCR/ABL oncoprotein. In chronic phase (CP) CML, leukemic cells display multilineage differentiation and maturation capacity. The BCR/ABL inhibitor imatinib exerts profound antileukemic effects in these patients and is considered standard frontline therapy. However, not...

Background: For patients with hormone receptor positive metastatic breast cancer (MBC), both steroidal and non-steroidal aromatase inhibitors (AIs) have demonstrated efficacy as initial and subsequent lines of treatment in trials comparing them with other hormonal agents like tamoxifen and megestrol acetate. Patients with MBC and predominant visceral involvement have...

The treatment of patients with advanced renal cell carcinoma (RCC) has been revolutionized by the development of agents directed against vascular endothelial growth factor (VEGF) signaling. These agents, such as sorafenib and sunitinib, have been advocated as first-line treatments for RCC. However, responses to these agents are neither complete nor...

Breast cancer is a significant problem worldwide. Five years of Tamoxifen has been the established endocrine adjuvant therapy for both pre- and post-menopausal women for several decades, until the more recent introduction of AI’s for use in post-menopausal ER-positive EBC. There are three third generation AI’s currently available commercially these...

Background: We have previously reported on a Phase II study of S-1 monotherapy as a first line, combination therapy of S-1 plus cisplatin as a second line, and weekly paclitaxel monotherapy as a third line therapy in patients with advanced gastric carcinomas. The median survival time (MST) of patients over...

Incorporation of imatinib, a BCR-ABL tyrosine kinase inhibitor, into treatment regimens for Philadelphia-chromosome positive acute lymphoblastic leukemia (ALL) has improved outcomes. Single agent therapy, as well as imatinib in combination with chemotherapy demonstrates high response rates, however durable remissions are rare due to rapid development of resistant disease. The only...

Nausea and vomiting are major concerns for patients who have to receive chemotherapy for an underlying malignancy. In this review, these concerns faced by patients receiving chemotherapy are presented along with discussion of the mechanisms of chemotherapy induced nausea and vomiting. Major targets of the 5HT3 antagonists, the NK1...

Pancreatic adenocarcinoma is associated with advanced presentation and poor survival. Currently approved therapies have minimal effect on patient survival. Pancreatic adenocarcinomas have a high incidence of activated K-RAS, which may confer resistance to epidermal growth factor receptor (EGFR) inhibitors. Mixed lineage kinase-3 (MLK3) is a MAP3K that activates multiple MAPK...

The histone tails of histone octamers play an intricate role in transcription, and aid the histone interaction and binding with the negatively charged DNA phosphate backbone. Histone acetyl transferases and histone deacetylase inhibitors respectively accomplish acetylation and deacetylation of the lysine residue of the histone tail. Vorinostat is the first...

Metastatic renal cell carcinoma is uncommon (only 3% of cancers worldwide) but of poor prognosis. Renal cell carcinoma has traditionally been treated with cytokines (interferon-α or interleukin-2). More recently, a more clear understanding of the molecular and cellular mechanisms of the disease, involving the VEGF receptor and mTOR, has led...

Rituximab, a genetically engineered chimeric monoclonal antibody that specifically binds to CD20, is the first monoclonal antibody approved for the treatment of B-cell lymphoma. The addition of rituximab to chemotherapy has improved progression-free survival and overall survival for patients with diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma. Rituximab-CHOP therapy...

Fulvestrant (Faslodex®) is an estrogen receptor antagonist with no agonist effects that competitively binds to the estrogen receptor with greater affinity than tamoxifen. A systematic review was performed to understand the pharmacology and to examine the evidence supporting the clinical use of fulvestrant in the first-line and second-line settings in...

Cancer patients undergoing chemotherapy are particularly susceptible to drug-drug interactions (DDIs). Practitioners should keep themselves updated with the most current DDI information, particularly involving new anticancer drugs (ACDs). Databases can be useful to obtain up-to-date DDI information in a timely and efficient manner. Our objective was to investigate the DDI...

Introductory Editorial by Dr Karna Dev Bardhan