Current Oncology

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Open AccessArticle

Safety of Adjuvant Endocrine Therapies in Hormone Receptor–Positive Early Breast Cancertissues

by S. Sehdev, G. Martin, L. Sideris, W. Lam and S. Brisson

Curr. Oncol. 2009, 16(s1), 14-23; https://doi.org/10.3747/co.v16i0.457 - 01 Jul 2009

Cited by 18 | Viewed by 529

Postmenopausal patients with hormone-sensitive early breast cancer are typically treated with adjuvant endocrine therapy, which significantly reduces the risk of recurrence. Because treatment is of a long duration, side effects from adjuvant therapy can be problematic. The aromatase inhibitors (AIs) are [...] Read more.

Postmenopausal patients with hormone-sensitive early breast cancer are typically treated with adjuvant endocrine therapy, which significantly reduces the risk of recurrence. Because treatment is of a long duration, side effects from adjuvant therapy can be problematic. The aromatase inhibitors (AIs) are replacing tamoxifen as first-line treatment agents for early breast cancer. Here, we present the side-effect data associated with AIs in relation to bone, gynecologic, and cardiovascular health and to arthralgia and myalgia. Although AIs have been shown to decrease bone density, increase arthralgia, and affect vaginal health, these adverse events are usually manageable, and several strategies can be followed to improve quality of life in women on AI treatment. To optimize adherence to therapy. It is important that these issues are addressed so that women can benefit from treatment. Full article

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Open AccessReview

An Updated Review on the Efficacy of Adjuvant Endocrine Therapies in Hormone Receptor–Positive Early Breast Cancer

by S. Verma, S. Sehdev, A. Joy, Y. Madarnas, J. Younus and J. A. Roy

Curr. Oncol. 2009, 16(s1), 1-13; https://doi.org/10.3747/co.v16i0.455 - 01 Jul 2009

Cited by 5 | Viewed by 410

Abstract

The third-generation aromatase inhibitors (AIs) are largely replacing tamoxifen in the adjuvant treatment of early-stage breast cancer in postmenopausal women with hormone receptor–positive tumours. To date, multiple trials have been conducted comparing tamoxifen treatment with an AI, and all have [...] Read more.

The third-generation aromatase inhibitors (AIs) are largely replacing tamoxifen in the adjuvant treatment of early-stage breast cancer in postmenopausal women with hormone receptor–positive tumours. To date, multiple trials have been conducted comparing tamoxifen treatment with an AI, and all have demonstrated improved disease-free survival with AI treatment. Trials have included direct 5-year comparisons between tamoxifen and an AI, switching to an AI within 5 years after initial tamoxifen treatment, or extending treatment with an AI after 5 years of completed tamoxifen treatment. Some of these trials have been completed; others are ongoing; and head-to-head trial comparisons of individual AIs are also in progress. The present article summarizes the data obtained from various clinical trials of hormonal therapy for early breast cancer. It also reviews recent data so as to shed light on the current status of these therapies. The focus is on the efficacy of treatment with an AI. Toxicity is discussed in the second article in this supplement. Full article

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Open AccessReview

Review of Guidelines on the Treatment of Metastatic Renal Cell Carcinoma

by D. Soulières

Curr. Oncol. 2009, 16(s1), 67-70; https://doi.org/10.3747/co.v16i0.438 - 01 May 2009

Cited by 7 | Viewed by 299

Abstract

Guidelines on the management of metastatic renal cell carcinoma (RCC) have emerged over the last couple of years because of the introduction of effective new targeted therapies. However, current guidelines are not always contemporary because of older data whose relevance is [...] Read more.

Guidelines on the management of metastatic renal cell carcinoma (RCC) have emerged over the last couple of years because of the introduction of effective new targeted therapies. However, current guidelines are not always contemporary because of older data whose relevance is unclear in the context of the new therapies. Moreover, many of the relevant trials were interrupted prematurely because of significant advantages in progression-free survival. These circumstances sometimes make interpretation of the data and characterization of subgroups rather difficult. The current paper reviews the major guidelines available on the management of metastatic RCC and tries to put them into context. Full article

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Open AccessArticle

Managing Toxicities and Optimal Dosing of Targeted Drugs in Advanced Kidney Cancer

by B. Seruga, H. K. Gan and J. J. Knox

Curr. Oncol. 2009, 16(s1), 52-59; https://doi.org/10.3747/co.v16i0.402 - 01 May 2009

Cited by 11 | Viewed by 439

Abstract

The toxicities of new, targeted drugs may diminish their effectiveness in advanced kidney cancer if those toxicities are not recognized and properly addressed early in patient treatment. Most of the drug-related toxicities in advanced kidney cancer are manageable with supportive care, obviating a [...] Read more.

The toxicities of new, targeted drugs may diminish their effectiveness in advanced kidney cancer if those toxicities are not recognized and properly addressed early in patient treatment. Most of the drug-related toxicities in advanced kidney cancer are manageable with supportive care, obviating a need for long interruptions, dose reductions, or permanent discontinuation of the treatment. Full article

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Open AccessArticle

Role of Cytokine Therapy for Renal Cell Carcinoma in the Era of Targeted Agents

by R. Koneru and S. J. Hotte

Curr. Oncol. 2009, 16(s1), 40-44; https://doi.org/10.3747/co.v16i0.417 - 01 May 2009

Cited by 25 | Viewed by 543

Abstract

Starting in the late 1980s, cytokines were considered the mainstay of treatment for locally advanced or metastatic renal cell carcinoma (RCC) because of a lack of improved survival with either chemotherapy or hormonal therapy alone. The cytokine agents interferon alfa ( [...] Read more.

Starting in the late 1980s, cytokines were considered the mainstay of treatment for locally advanced or metastatic renal cell carcinoma (RCC) because of a lack of improved survival with either chemotherapy or hormonal therapy alone. The cytokine agents interferon alfa (IFNα) and interleukin-2 (IL-2) have been the most evaluated, but a low overall response rate and a marginal survival advantage, coupled with significant toxicity, make these therapies less than ideal. Although complete tumour responses have occasionally been seen with high-dose IL-2, this therapy is associated with significant morbidity and mortality, and its approval has been based on limited nonrandomized evidence. Newer anti-angiogenesis agents have been evaluated as single agents and in combination with INFα, and these are now considered the standard of care for most patients with RCC. However, cytokines may still occasionally be recommended when angiogenesis inhibitors are not available or are contraindicated. In the present paper, we discuss the evidence for the use of cytokine therapy in the setting of pre– and post–targeted therapy for RCC. Full article

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Open AccessArticle

Inhibition of mtor in Kidney Cancer

by A. Kapoor

Curr. Oncol. 2009, 16(s1), 33-39; https://doi.org/10.3747/co.v16i0.419 - 01 May 2009

Cited by 13 | Viewed by 425

Abstract

The mammalian target of rapamycin (mTOR) has been shown to be an important target mechanism in the treatment of renal cell carcinoma (RCC). In first-line treatment for patients with disease having poor prognostic features, temsirolimus, an mTOR inhibitor [...] Read more.

The mammalian target of rapamycin (mTOR) has been shown to be an important target mechanism in the treatment of renal cell carcinoma (RCC). In first-line treatment for patients with disease having poor prognostic features, temsirolimus, an mTOR inhibitor approved for treatment of advanced RCC, has demonstrated benefit over interferon alfa in both overall and progression-free survival. Everolimus, a second mTOR inhibitor that has showed activity in RCC, led to improved progression-free survival in a comparison with placebo in patients whose RCC progressed after treatment with vascular endothelial growth factor receptor tyrosine kinase inhibitors (sunitinib, sorafenib, or both). There is now compelling clinical evidence for the effectiveness of targeting mTOR in the treatment of RCC. Full article

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Open AccessArticle

Sorafenib in the Management of Metastatic Renal Cell Carcinoma

by C. Guevremont, C. Jeldres, P. Perrotte and P. I. Karakiewicz

Curr. Oncol. 2009, 16(s1), 27-32; https://doi.org/10.3747/co.v16i0.430 - 01 May 2009

Cited by 13 | Viewed by 488

Abstract

Purpose: Sorafenib represents one of the two standards of care for patients with metastatic renal cell carcinoma (mRCC). In the present review, we provide information regarding the use of sorafenib in first and second lines. We also describe results for dose [...] Read more.

Purpose: Sorafenib represents one of the two standards of care for patients with metastatic renal cell carcinoma (mRCC). In the present review, we provide information regarding the use of sorafenib in first and second lines. We also describe results for dose escalation strategies. Finally, we provide data addressing the efficacy of sorafenib in patients with mRCC of non-clear-cell histology. Recent Findings: Sorafenib is a valid first-line agent. Sorafenib response rates and toxicity are not affected by patient age or site of metastasis. The sequence of first-line sorafenib followed by second-line sunitinib resulted in a longer duration of response than did the opposite sequence. Sorafenib efficacy in first-line therapy can be potentiated by co-administration of low-dose interferon. Moreover, in first-line therapy, impressive response rates were recorded when the dose of sorafenib was escalated beyond the standard 400 mg twice daily. Similarly impressive response rates were observed with dose escalation in second-line therapy. It is notable that dose escalation after failure of standard sorafenib dose also prolongs progression-free survival. Finally, the efficacy of sorafenib is not limited to clear-cell histology, but also applies to chromophobe and papillary mRCC variants. Summary: Sorafenib is a highly effective and well-tolerated agent for first- and second-line patients with clear-cell, chromophobe, or papillary mRCC variants. Full article

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Open AccessArticle

First-Line Therapy with Sunitinib in Advanced Renal Cell Carcinoma: Interpretation of the Overall Survival Data from asco 2008

by L. Wood

Curr. Oncol. 2009, 16(s1), 24-26; https://doi.org/10.3747/co.v16i0.405 - 01 May 2009

Cited by 1 | Viewed by 456

Abstract

Sunitinib is now a standard first-line therapy for metastatic clear-cell kidney cancer. This paper focuses on interpretation of the overall survival data presented at the 2008 annual meeting of the American Society of Clinical Oncology from the pivotal phase III trial comparing sunitinib [...] Read more.

Sunitinib is now a standard first-line therapy for metastatic clear-cell kidney cancer. This paper focuses on interpretation of the overall survival data presented at the 2008 annual meeting of the American Society of Clinical Oncology from the pivotal phase III trial comparing sunitinib with interferon in the first-line setting. The previously published progression-free survival and response rate data from that study are also summarized. Full article

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Open AccessArticle

State-of-the-Art Treatment of Metastatic Renal Cell Carcinoma

by D. Y. C. Heng and C. Kollmannsberger

Curr. Oncol. 2009, 16(s1), 16-23; https://doi.org/10.3747/co.v16i0.407 - 01 May 2009

Cited by 6 | Viewed by 428

Abstract

Targeted therapy has greatly changed the way in which metastatic renal cell carcinoma (RCC) is treated. Agents that inhibit the vascular endothelial growth factor and mammalian target of rapamycin pathways that otherwise lead to angiogenesis have now become the standard of [...] Read more.

Targeted therapy has greatly changed the way in which metastatic renal cell carcinoma (RCC) is treated. Agents that inhibit the vascular endothelial growth factor and mammalian target of rapamycin pathways that otherwise lead to angiogenesis have now become the standard of care. Much research into the sequence and combination of these agents is ongoing, and new anti-angiogenic agents are being developed. This overview covers the standard treatment of metastatic RCC with targeted therapy, immunotherapy, and surgery. Future directions and ongoing clinical trials are also discussed. Full article

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Open AccessReview

The Contemporary Role of Surgery in Kidney Cancer

by J. B. Lattouf, Q. D. Trinh and F. Saad

Curr. Oncol. 2009, 16(s1), 8-15; https://doi.org/10.3747/co.v16i0.410 - 01 May 2009

Cited by 4 | Viewed by 388

Abstract

The diagnosis and treatment of renal cell carcinoma (RCC) has been the subject of major changes since the late 1980s. Initially, surgery was the only treatment available, but more recently, systemic therapies have been developed, and their introduction has modified some [...] Read more.

The diagnosis and treatment of renal cell carcinoma (RCC) has been the subject of major changes since the late 1980s. Initially, surgery was the only treatment available, but more recently, systemic therapies have been developed, and their introduction has modified some of the surgical indications for RCC. In addition, refinements in surgical technique and the introduction of minimally invasive approaches have revolutionized patient care and bear the promise of even more improvements to come. This paper provides an up-to-date overview of recent developments in the surgical treatment of RCC. Full article

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Open AccessArticle

Natural History and Management of Small Renal Masses

by T. Abou Youssif and S. Tanguay

Curr. Oncol. 2009, 16(s1), 2-7; https://doi.org/10.3747/co.v16i0.409 - 01 May 2009

Cited by 16 | Viewed by 441

Abstract

The recent stage migration observed for renal tumours is contributing to a significant increase in the diagnosis of small renal masses. This evolution has led to a significant change in the approach to renal masses. New options such as observation or energy ablation [...] Read more.

The recent stage migration observed for renal tumours is contributing to a significant increase in the diagnosis of small renal masses. This evolution has led to a significant change in the approach to renal masses. New options such as observation or energy ablation are gaining popularity in a subset of this patient population. In addition, the observed changes directly contribute to the increased use of nephron-sparing surgery. A better understanding of the various characteristics of these masses will allow for a better understanding of the natural history of these masses and for selection of the optimal therapeutic approach. Full article

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Open AccessEditorial

Preface

by Fred Saad

Curr. Oncol. 2009, 16(s1), 1; https://doi.org/10.3747/co.v16i0.446 - 01 May 2009

Viewed by 343

Abstract

It was with pleasure that I accepted to serve as editor of this timely supplement dedicated to kidney cancer. [...] Full article

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Curr. Oncol., Volume 16, Issue s1 (May 2009) – 12 articles

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