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Principles of Medical Oncology and Chemotherapy

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Interventional Oncology
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Abstract

This chapter provides an overview of the process that the medical oncologist undertakes when diagnosing and treating the patient diagnosed with a solid tumor. The use of molecular pathology, clinical patient assessment, and staging systems is reviewed. Local therapy (interventional techniques and surgery), along with adjuvant therapy, are discussed. Finally, chemotherapy and molecularly targeted therapies and their roles in prolonging survival and quality of life in the advanced cancer patient are reviewed.

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References

  1. Varadhachary GR, Abbruzzese JL, Lenzi R. Diagnostic strategies for unknown primary cancer. Cancer. 2004;100(9):1776–85.

    Article  PubMed  CAS  Google Scholar 

  2. Cochran AJ, Lu HF, Li PX, Saxton R, Wen DR. S-100 protein remains a practical marker for melanocytic and other tumours. Melanoma Res. 1993;3(5):325–30.

    Article  PubMed  CAS  Google Scholar 

  3. Early Breast Cancer Trialists’ Collaborative Group (EBCTCG). Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet. 2005;365(9472):1687–717.

    Article  Google Scholar 

  4. Forbes JF, Cuzick J, Buzdar A, Howell A, Tobias JS, Baum M. Effect of anastrozole and tamoxifen as adjuvant treatment for early-stage breast cancer: 100-month analysis of the ATAC trial. Lancet Oncol. 2008;9(1):45–53.

    Article  PubMed  Google Scholar 

  5. Romond EH, Perez EA, Bryant J, et al. Trastuzumab plus adjuvant chemotherapy for operable HER2-positive breast cancer. N Engl J Med. 2005;353(16):1673–84.

    Article  PubMed  CAS  Google Scholar 

  6. Van Cutsem E, Kang Y, Chung H, et al. Efficacy results from the ToGA trial: a phase III study of trastuzumab added to standard chemotherapy in first-line human epidermal growth factor receptor 2-positive advanced gastric cancer. J Clin Oncol. 2009;27(Suppl):18s. Abstract LBA4509.

    Google Scholar 

  7. Sequist LV, Martins RG, Spigel D, et al. First-line gefitinib in patients with advanced non-small-cell lung cancer harboring somatic EGFR mutations. J Clin Oncol. 2008;26(15):2442–9.

    Article  PubMed  CAS  Google Scholar 

  8. Giaccone G, Gallegos Ruiz M, Le Chevalier T, et al. Erlotinib for frontline treatment of advanced non-small cell lung cancer: a phase II study. Clin Cancer Res. 2006;12(20 Pt 1):6049–55.

    Article  PubMed  CAS  Google Scholar 

  9. Van Cutsem E, Kohne CH, Hitre E, et al. Cetuximab and chemotherapy as initial treatment for metastatic colorectal cancer. N Engl J Med. 2009;360(14):1408–17.

    Article  PubMed  Google Scholar 

  10. National Cancer Institute. Cancer staging. Available at: http://www.cancer.gov/cancertopics/factsheet/Detection/staging. Accessed 8 Apr 2010.

  11. Raymond E, Boige V, Faivre SS, et al. Dosage adjustment and pharmacokinetic profile of irinotecan in cancer patients with hepatic dysfunction. J Clin Oncol. 2002;20:4303–12.

    Article  PubMed  CAS  Google Scholar 

  12. Keefe DL. Trastuzumab-associated cardiotoxicity. Cancer. 2002;95(7):1592–600.

    Article  PubMed  CAS  Google Scholar 

  13. Singal PK, Iliskovic N. Doxorubicin-induced cardiomyopathy. N Engl J Med. 1998;339:900–5.

    Article  PubMed  CAS  Google Scholar 

  14. Sleijfer S. Bleomycin-induced pneumonitis. Chest. 2001;120(2):617–24.

    Article  PubMed  CAS  Google Scholar 

  15. National Comprehensive Cancer Network. NCCN guidelines for pulmonary function testing. Available at: http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed 8 Apr 2010.

  16. Powell JW, Dexter E, Scalzetti EM, Bogart JA. Treatment advances for medically inoperable non-small-cell lung cancer: emphasis on prospective trials. Lancet Oncol. 2009;10(9):885–94.

    Article  PubMed  Google Scholar 

  17. Scott WJ, Howington J, Feigenberg S, Movsas B, Pisters K. Treatment of non-small cell lung cancer stage I and stage II* ACCP evidence-based clinical practice guidelines (2nd edition). Chest. 2007;132(3 Suppl):234S–42.

    Article  PubMed  Google Scholar 

  18. Oken MM, Creech RH, Tormey DC, et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol. 1982;5(6):649–55.

    Article  PubMed  CAS  Google Scholar 

  19. Vermorken JB, Trigo J, Hitt R, et al. Open-label, uncontrolled, multicenter phase II study to evaluate the efficacy and toxicity of cetuximab as a single agent in patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck who failed to respond to platinum-based therapy. J Clin Oncol. 2007;25(16):2171–7.

    Article  PubMed  CAS  Google Scholar 

  20. Mamounas EP, Tang G, Fisher B, et al. Association between the 21-gene recurrence score assay and risk of locoregional recurrence in node-negative, estrogen receptor-positive breast cancer: results from NSABP B-14 and NSABP B-20. J Clin Oncol. 2010;28(10):1677–83.

    Article  PubMed  Google Scholar 

  21. Sauer R, Becker H, Hohenberger W, et al. Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med. 2004;351(17):1731–40.

    Article  PubMed  CAS  Google Scholar 

  22. Gualdi GF, Casciani E, Guadalaxara A, d’Orta C, Polettini E, Pappalardo G. Local staging of rectal cancer with transrectal ultrasound and endorectal magnetic resonance imaging: comparison with histologic findings. Dis Colon Rectum. 2000;43(3):338–45.

    Article  PubMed  CAS  Google Scholar 

  23. Shenkier T, Weir L, Levine M, et al. Clinical practice guidelines for the care and treatment of breast cancer: 15. Treatment for women with stage III or locally advanced breast cancer. CMAJ. 2004;170(6):983–94.

    Article  PubMed  Google Scholar 

  24. Burris 3rd HA, Moore MJ, Andersen J, et al. Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer: a randomized trial. J Clin Oncol. 1997;15(6):2403–13.

    PubMed  CAS  Google Scholar 

  25. Chabner B, Longo DL, editors. Cancer chemotherapy and biotherapy: principles and practice. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2001.

    Google Scholar 

  26. DeVita Jr VT, Lawrence TS, Rosenburg SA, editors. DeVita, Hellman, and Rosenberg’s cancer: principles & practice of oncology. 8th ed. Philadelphia: Lippincott Williams & Wilkins; 2008.

    Google Scholar 

  27. Dumontet C, Sikic BI. Mechanisms of action of and resistance to antitubulin agents: microtubule dynamics, drug transport, and cell death. J Clin Oncol. 1999;17(3):1061–70.

    PubMed  CAS  Google Scholar 

  28. Yeo W, Mok TS, Zee B, et al. A randomized phase III study of doxorubicin versus cisplatin/interferon alpha-2b/doxorubicin/fluorouracil (PIAF) combination chemotherapy for unresectable hepatocellular carcinoma. J Natl Cancer Inst. 2005;97(20):1532–8.

    Article  PubMed  CAS  Google Scholar 

  29. Park SH, Lee Y, Han SH, et al. Systemic chemotherapy with doxorubicin, cisplatin and capecitabine for metastatic hepatocellular carcinoma. BMC Cancer. 2006;6:3.

    Article  PubMed  Google Scholar 

  30. Louafi S, Boige V, Ducreux M, et al. Gemcitabine plus oxaliplatin (GEMOX) in patients with advanced hepatocellular carcinoma (HCC): results of a phase II study. Cancer. 2007;109(7):1384–90.

    Article  PubMed  CAS  Google Scholar 

  31. Llovet JM, Ricci S, Mazzaferro V, et al. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med. 2008;359(4):378–90.

    Article  PubMed  CAS  Google Scholar 

  32. Motzer RJ, Hutson TE, Tomczak P, et al. Sunitinib versus interferon alfa in metastatic renal-cell carcinoma. N Engl J Med. 2007;356(2):115–24.

    Article  PubMed  CAS  Google Scholar 

  33. Escudier B, Eisen T, Stadler WM, et al. Sorafenib in advanced clear-cell renal-cell carcinoma. N Engl J Med. 2007;356(2):125–34.

    Article  PubMed  CAS  Google Scholar 

  34. Yang JC, Haworth L, Sherry RM, et al. A randomized trial of bevacizumab, an anti-vascular endothelial growth factor antibody, for metastatic renal cancer. N Engl J Med. 2003;349(5):427–34.

    Article  PubMed  CAS  Google Scholar 

  35. Hudes G, Carducci M, Tomczak P, et al. Temsirolimus, interferon alfa, or both for advanced renal-cell carcinoma. N Engl J Med. 2007;356(22):2271–81.

    Article  PubMed  CAS  Google Scholar 

  36. Berry DA, Cirrincione C, Henderson IC, et al. Estrogen-receptor status and outcomes of modern chemotherapy for patients with node-positive breast cancer. JAMA. 2006;295(14):1658–67.

    Article  PubMed  CAS  Google Scholar 

  37. Pound CR, Partin AW, Eisenberger MA, Chan DW, Pearson JD, Walsh PC. Natural history of progression after PSA elevation following radical prostatectomy. JAMA. 1999;281(17):1591–7.

    Article  PubMed  CAS  Google Scholar 

  38. National Comprehensive Cancer Network. NCCN guidelines for colorectal cancer post-treatment surveillance. Available at: http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed 17 June 2011.

  39. Rustin GJ, van der Burg ME, on behalf of MRC and EORTC collaborators. A randomized trial in ovarian cancer (OC) of early treatment of relapse based on CA125 level alone versus delayed treatment based on conventional clinical indicators (MRC OV05/EORTC 55955 trials). J Clin Oncol. 2009;27(Suppl):18s (suppl; Abstract 1)

    Google Scholar 

  40. Eisenhauer EA, Therasse P, Bogaerts J, et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer. 2009;45(2):228–47.

    Article  PubMed  CAS  Google Scholar 

  41. Chun YS, Vauthey JN, Boonsirikamchai P, et al. Association of computed tomography morphologic criteria with pathologic response and survival in patients treated with bevacizumab for colorectal liver metastases. JAMA. 2009;302(21):2338–44.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Janet E. Murphy .

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Murphy, J.E., Ryan, D.P. (2012). Principles of Medical Oncology and Chemotherapy. In: Mueller, P., Adam, A. (eds) Interventional Oncology. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-1469-9_1

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  • DOI: https://doi.org/10.1007/978-1-4419-1469-9_1

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  • Online ISBN: 978-1-4419-1469-9

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