bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intraperitoneal Therapy of Ovarian Cancer
Authors: Markman Maurie 
Published: February 2020

Abstract
Purpose. This is a review of the rationale for the intraperitoneal administration of antineoplastic agents in the management of ovarian cancer.
Patients and Methods. Patients have been treated in a number of clinical trials to define the toxicity profile and efficacy of intraperitoneal therapy in this clinical setting.
Results. Phase I-II trials have confirmed that a number of cytotoxic and biological agents can be administered into the peritoneal cavity as treatment of ovarian cancer with an acceptable toxicity profile and with the attainment of surgically documented responses (including complete responses). In addition, a recently reported phase III trial comparing initial treatment of small-volume residual advanced ovarian cancer with either intravenous or intraperitoneal cisplatin concluded that the intraperitoneal route of drug administration was associated with a longer survival and less toxicity.
Discussion. In the salvage (second-line) setting, responses to intraperitoneally administered antineoplastic agents are seen principally in individuals with small-volume residual disease (largest tumor mass ≤ 0.5-1 cm in maximum diameter) who have previously responded to initial systemic treatment (i.e., documented chemosensitive cancers). Patients with cancers resistant to initial systemic chemotherapy or with larger tumor bulk should probably be treated by alternative strategies. Initial treatment of ovarian cancer with cisplatin delivered by the intraperitoneal route is a reasonable therapeutic option, based on currently available data.
Conclusion. The intraperitoneal delivery of antineoplastic agents remains an interesting and potentially important management strategy for a select group of individuals (small-volume residual disease) with advanced ovarian cancer. Further exploration of a more defined role for this therapeutic approach in ovarian cancer is indicated.
Can Surgical Treatment Results in Gastric Cancer Be Improved?
Authors: Songun Ilfet , Velde Cornelis J.H. 
Published: February 2020

Abstract
Patients with gastric cancer have a poor prognosis. Surgery is the only treatment modality offering hope for cure. However, even after curative surgery, the five-year survival rate is still about 30%. Even though the incidence of early gastric cancer is up to 40% of all cases (surgically curable) in Japan, in Western countries most of the patients are diagnosed at an advanced stage, when curative surgery is no longer possible. Most patients die of locoregional recurrence or distant metastasis. Therefore, every attempt should be made to increase early diagnosis and to find additional prognostic factors which can be determined preoperatively. Operations with extended lymphadenectomy are associated with higher morbidity and mortality rates, while a possible survival benefit is not proven in Western countries. The five-year survival results of two large prospectively randomized, controlled trials (the Dutch Gastric Cancer Trial and the British Medical Research Council Trial) comparing limited lymphadenectomy (D1) to extended lymphadenectomy (D2) are still being awaited. In light of increased morbidity and mortality rates associated with extended lymphadenectomy, the limits of surgical possibilities for the treatment of gastric cancer seem to be reached. Adjuvant radiotherapy and chemotherapy are demonstrated to not give an additional survival advantage compared to surgery only. Development of more active combination chemotherapy regimens and results in locally advanced gastric cancer are encouraging. Therefore, to evaluate the place of preoperative chemotherapy in potentially operable gastric cancer, two randomized trials have been initiated in the Netherlands and Great Britain. Gastric cancer should be considered a malignancy which requires a multidisciplinary approach of a specialized team consisting of committed specialists. New treatment modalities should only be applied to patients in clinical trial settings with dedicated clinicians.
Staging Laparotomy in the Management of Hodgkin's Disease: Is it Still Necessary?
Authors: Multani Pratik S. , Grossbard Michael L. 
Published: February 2020

Abstract
Approximately 3,500 cases of stage I and II Hodgkin's disease are diagnosed each year in the United States. Traditionally, those patients who are considered candidates for primary radiation therapy undergo staging laparotomy (pathologic staging) to rule out definitively the presence of occult subdiaphragmatic disease. An appreciation of the risks of laparotomy and a recognition of the effectiveness of salvage chemotherapy in patients who fail primary radiation therapy have permitted the increased use of clinical staging as the basis for treatment of these patients. This article summarizes the literature regarding the need for staging laparotomy in early stage Hodgkin's disease and suggests alternative approaches to the management of these patients based on clinical criteria and prognostic factors.
Interleukin 12: Basic Biology and Potential Applications in Cancer Treatment
Authors: Robertson Michael J. , Ritz Jerome 
Published: February 2020

AbstractInterleukin 12 is a heterodimeric cytokine that has potent effects on innate and adaptive immunity. Interleukin 12 induces interferon γ secretion by T cells and natural killer cells, enhances the proliferation of activated T cells and natural killer cells, augments the cytolytic activity of cytotoxic T lymphocytes and natural killer cells, and supports the differentiation of Th1 helper effector cells. Interleukin 12 stimulates in vitro antitumor activity of lymphocytes from patients with cancer and in vivo antitumor activity in many murine tumor models. Current data indicate that CD4 T cells, CD8 T cells, natural killer cells and interferon γ may contribute to the antitumor effects of interleukin 12 therapy. However, further investigation is required to elucidate the precise mechanisms involved in the antitumor activity of interleukin 12.
Pediatric Clinical Trials
Authors: Pratt Charles B. 
Published: February 2020

AbstractClinical trials specifically tailored to the unique tumors and leukemias of children have resulted in increased survival rates approaching or exceeding 70% for most diseases. These studies have been carried out by investigators at large, independent institutions or through the auspices of the Children's Cancer Group or Pediatric Oncology Group. The National Cancer Institute has also supported pediatric disease—focused efforts for rhabdomyosarcoma, Wilms tumor, Ewing's sarcoma, osteosarcomas and other diseases. The present-day training of pediatric hematology/oncology fellows assures continuing contributions to the biology of childhood malignant lesions through applications of translational research.
Alternative and Complementary Cancer Treatments
Authors: Cassileth Barrie R. 
Published: February 2020

Abstract
Alternative and complementary therapies differ importantly, and the distinction between the two is crucial for clinical oncologists. “Alternative” or unproven therapies are treatments used independent of surgery, radiation and chemotherapy. They can be dangerous directly and also by delaying patients' receipt of mainstream care. In contrast, complementary therapies typically are adjuncts to mainstream medicine. They can provide symptom control and noninvasive palliation with minimal side effects, improve patients' well-being and enhance cancer medicine. Complementary therapies represent a desired addition and balance to technologically sophisticated cancer care.
The Importance of Drug Scheduling in Cancer Chemotherapy: Etoposide as an Example
Authors: Hande Kenneth R. 
Published: February 2020

Abstract
Etoposide is a drug whose antineoplastic activity is dependent on the schedule of drug administration. This article reviews the rationale for a prolonged schedule of etoposide administration and the therapeutic results of use of such a schedule in the treatment of cancer. The pharmacology of etoposide is also reviewed, with particular attention paid to the pharmacokinetics of oral etoposide and etoposide plasma concentrations associated with cytotoxicity.
New Concepts for the Development and Use of Antifolates
Authors: Chu Edward , Grem Jean L. , Johnston Patrick G. , Allegra Carmen J. 
Published: February 2020

Abstract
Approximately one-third of all cases of colorectal carcinoma present in an advanced and, therefore, incurable stage. For these patients, the development of new chemotherapeutic strategies is of central importance. Biochemical modulation of 5-fluorouracil (5-FU) has resulted in approximately a twofold increase in activity of 5-FU. Recent preclinical investigations suggest that interferon can also modulate the activity of 5-FU and may result in enhanced response rates in patients. One of the critical mechanisms of resistance to 5-FU appears to be the acute induction in thymidylate synthase (TS) levels following therapy with inhibitors of this enzyme. This mechanism is based on a novel autoregulatory feedback pathway wherein the TS protein regulates its own translational efficiency. Regulatory function of the enzyme is dependent on its state of occupancy by either the physiologic ligands or inhibitors, including fluoropyrimidines and antifolates. Ongoing efforts are directed toward utilizing knowledge of this protein/messenger RNA interaction for therapeutic benefit. Given the importance of TS, our laboratory has developed antibodies capable of quantitating the levels of this enzyme in fresh or paraffin-embedded tissues. Preliminary investigations suggest that the level of TS has prognostic importance in patients with rectal carcinoma and may be used to predict responsiveness to fluoropyrimidine agents. Novel strategies utilizing dual modulation of 5-FU with leucovorin and interferon are under investigation in both the advanced and adjuvant disease settings. Emerging mechanistic concepts regarding TS, along with the development of new, more potent inhibitors will hopefully result in future therapeutic gains.
Management of Tracheal Neoplasms
Authors: Compeau Christopher G. , Keshavjee Shaf 
Published: February 2020

Abstract
Patients with tracheal involvement from primary or secondary neoplasms usually present with relatively nonspecific symptoms of cough, wheeze, and shortness of breath. Prompt diagnosis often requires a high index of suspicion. Tomography or computed tomography of the chest will often confirm the presence of a tracheal lesion. A detailed rigid bronchoscopic assessment by an experienced thoracic surgeon is essential for establishing the extent of tracheal involvement. Although advanced tumor stage often precludes surgical resection, the application of current operative techniques allows a significant number of tracheal tumors to be completely excised and primarily reconstructed. Adjuvant radiotherapy is often employed with surgical resection to improve local control and enhance the potential for cure.
Peripheral Blood Stem Cells: Transplantation and Beyond
Authors: Lie Albert K.W. , To L. Bik 
Published: February 2020

AbstractPeripheral blood stem cells are rapidly becoming a major source of hemopoietic stem cells for transplantation in patients with various hematological and oncological conditions. Clinical results of peripheral blood stem cell transplantation (PBSCT) have shown benefits of earlier hemopoietic recovery, lower morbidity, and greater cost-effectiveness compared with conventional bone marrow transplant. Moreover, the relative ease of obtaining large amounts of stem cells has made multicycle transplantation a viable option in the treatment of malignancies, allowing further escalation of chemotherapy dose intensity. The extension of PBSCT into the use of allogeneic and cord blood cells so far has been met with encouraging results, and the latter holds promise to increasing donor availability to patients requiring transplantation. Developments in cytokine research and ex vivo manipulation of hemopoietic stem cells are enabling new approaches to anticancer treatment involving tumor purging, immunomodulation, ex vivo expansion of stem cells and gene therapy. PBSCT may also become a therapeutic option in certain nonmalignant diseases. This review will discuss the current clinical practice and future developments in PBSCT.
The Role of CA-125 in the Management of Ovarian Cancer
Authors: Markman Maurie 
Published: February 2020

Abstract
Over more than a decade of clinical use, CA-125 has proven itself to be one of the most useful tumor markers in cancer medicine. The major clinical utility of this serum marker is in following the clinical course of women with known ovarian cancer. Other potential uses of CA-125 include the evaluation of the effectiveness of new antineoplastic agents in this malignancy, and in the modification of treatment strategies in individuals whose CA-125 levels fail to decline at an acceptable rate following the institution of therapy. At the present time, the use of CA-125 as a method to screen for ovarian cancer should be considered investigational.
Genetic Testing for Cancer Risk Assessment: A Review
Authors: Grogan L. , Kirsch I.R. 
Published: February 2020

Abstract
Both environmental factors and an inherited predisposition influence carcinogenesis. The direct role of inheritance in the development of cancer is evident in familial cancer syndromes. These syndromes predispose to cancer through the inheritance of a mutation in a single gene in affected carriers. While many inherited cancer syndromes are rare, an inherited predisposition is directly responsible for 5%-10% of all colon and breast cancers. Complex multigenic inheritance plays an important role in cancer predisposition for the population at large. The identification of genes responsible for an inherited predisposition to colon and breast cancer syndromes has directed public attention to genetic testing for susceptibility to cancer. Assays are currently available to determine individual susceptibility to specific cancers. Cancer genetic testing is currently a time-consuming and complex procedure which requires expertise in its application, interpretation, and follow-up strategic planning. This review discusses cancer genetics and its application to individual and family cancer risk assessment with particular emphasis on breast and colon cancer.
Megakaryocyte Growth and Development Factor: A Review of Early Clinical Studies
Authors: Abraham Rick , Basser Russell L. 
Published: February 2020

Abstract
Megakaryocyte growth and development factor (MGDF), a Mpl ligand, recently entered clinical trials worldwide and has been demonstrated to have potent biological activity. MGDF administration causes a dose-dependent increase in platelet count but no effect on white cell count or hematocrit. These platelets are morphologically and functionally normal. When administered following moderately myelosuppressive chemotherapy, MGDF significantly enhances platelet recovery, although scheduling in relation to chemotherapy may be important in optimizing the full effects. MGDF mobilizes progenitor cells of multiple hematopoietic lineages, and may enhance the effects of filgrastim on peripheral blood progenitor cell levels after chemotherapy. MGDF is well tolerated and does not cause toxicity similar to that observed with other thrombopoietic cytokines. Numerous studies are under way to help determine the precise role of MGDF in clinical practice.
Burnout: Caring for the Caregivers
Authors: Penson Richard T. , Dignan Fiona L. , Canellos George P. , Picard Carol L. , Lynch Thomas J. 
Published: February 2020

AbstractShortly before his death in 1995, Kenneth B. Schwartz, a cancer patient at Massachusetts General Hospital (MGH), founded The Kenneth B. Schwartz Center at MGH. The Schwartz Center is a nonprofit organization dedicated to supporting and advancing compassionate health care delivery, which provides hope to the patient, support to caregivers, and encourages the healing process. The center sponsors the Schwartz Center Rounds, a monthly multidisciplinary forum where caregivers reflect on important psychosocial issues faced by patients, their families, and their caregivers, and gain insight and support from fellow staff members.Burnout describes the end result of stress in the professional life of a physician or caregiver and combines emotional exhaustion, depersonalization and low personal accomplishment. This problem is common in health care workers in every specialty and may affect not only personal satisfaction, but also the quality of care delivered to patients. Burnout is particularly relevant in oncology where caregivers work closely with patients who have life-threatening illnesses and therapy often has only a limited impact. Burnout was discussed in the rounds with an emphasis on factors which precipitate or prevent stress among health care workers. Presentations were made by Dr. Canellos of the Dana Farber Cancer Institute, and Dr. Picard of the Institute for Health Professions. Staff discussed the main issues contributing to burnout including the health care system, lack of time and inadequate training. They considered preventative measures including psychological support of the health care team, communication and management skills, and effective coping mechanisms.
Coexistence of Pregnancy and Malignancy
Authors: Pavlidis Nicholas A. 
Published: February 2020

Abstract
Cancer complicating pregnancy is a rare coexistence. The incidence is approximately 1 in 1,000 pregnancies. The most common cancers are those more frequently seen during the reproductive age of a woman. Breast cancer, cervical cancer, Hodgkin's disease, malignant melanoma, and leukemias are the most frequently diagnosed malignancies during gestation.
The diagnostic and therapeutic management of the pregnant patient with cancer is especially difficult because it involves two persons, the mother and the fetus.
In this paper we review: A) the therapeutic and diagnostic management of these patients; B) the safety of diagnostic and therapeutic procedures; C) the metastatic pattern of the maternal tumors to the placenta and fetus, and D) the potential recommendations for therapeutic abortion.
Hyperprogression and Immune Checkpoint Inhibitors: Hype or Progress?
Authors: Adashek Jacob J. , Kato Shumei , Ferrara Roberto , Lo Russo Giuseppe , Kurzrock Razelle 
Published: February 2020

Abstract
There are currently seven approved immune checkpoint inhibitors (ICIs) for the treatment of various cancers. These drugs are associated with profound, durable responses in a subset of patients with advanced cancers. Unfortunately, in addition to individuals whose tumors show resistance, there is a minority subgroup treated with ICIs who demonstrate a paradoxical acceleration in the rate of growth or their tumors—hyperprogressive disease. Hyperprogressive disease is associated with significantly worse outcomes in these patients. This phenomenon, though still a matter of dispute, has been recognized by multiple groups of investigators across the globe and in diverse types of cancers. There are not yet consensus standardized criteria for defining hyperprogressive disease, but most commonly time to treatment failure less than 2 months and an increase in pace of progression of at least twofold between pre-immunotherapy and on-treatment imaging has been used. In some patients, the change in rate of progression can be especially dramatic—up to 35- to 40-fold. MDM2 amplification and EGFR mutations have been suggested as genomic correlates of increased risk of hyperprogression, but these correlates require validation. The underlying mechanism for hyperprogression is not known but warrants urgent investigation.
Exercise Intolerance in Anthracycline-Treated Breast Cancer Survivors: The Role of Skeletal Muscle Bioenergetics, Oxygenation, and Composition
Authors: Beaudry Rhys I. , Kirkham Amy A. , Thompson Richard B. , Grenier Justin G. , Mackey John R. , Haykowsky Mark J. 
Published: February 2020

AbstractBackgroundPeak oxygen consumption (VO2) is reduced in women with a history of breast cancer (BC). We measured leg blood flow, oxygenation, bioenergetics, and muscle composition in women with BC treated with anthracycline chemotherapy (n = 16, mean age: 56 years) and age- and body mass index–matched controls (n = 16).Materials and MethodsWhole-body peak VO2 was measured during cycle exercise. 31Phosphorus magnetic resonance (MR) spectroscopy was used to measure muscle bioenergetics during and after incremental to maximal plantar flexion exercise (PFE). MR imaging was used to measure lower leg blood flow, venous oxygen saturation (SvO2), and VO2 during submaximal PFE, and abdominal, thigh, and lower leg intermuscular fat (IMF) and skeletal muscle (SM).ResultsWhole-body peak VO2 was significantly lower in BC survivors versus controls (23.1 ± 7.5 vs. 29.5 ± 7.7 mL/kg/minute). Muscle bioenergetics and mitochondrial oxidative capacity were not different between groups. No group differences were found during submaximal PFE for lower leg blood flow, SvO2, or VO2. The IMF-to-SM ratio was higher in the thigh and lower leg in BC survivors (0.36 ± 0.19 vs. 0.22 ± 0.07, p = .01; 0.10 ± 0.06 vs. 0.06 ± 0.02, p = .03, respectively) and were inversely related to whole-body peak VO2 (r = −0.71, p = .002; r = −0.68, p = .003, respectively). In the lower leg, IMF-to-SM ratio was inversely related to VO2 and O2 extraction during PFE.ConclusionSM bioenergetics and oxidative capacity in response to PFE are not impaired following anthracycline treatment. Abnormal SM composition (increased thigh and lower leg IMF-to-SM ratio) may be an important contributor to reduced peak VO2 during whole-body exercise among anthracycline-treated BC survivors.Implications for PracticePeak oxygen consumption (peak VO2) is reduced in breast cancer (BC) survivors and is prognostic of increased risk of cardiovascular disease-related and all-cause mortality. Results of this study demonstrated that in the presence of deficits in peak VO2 1 year after anthracycline therapy, skeletal muscle bioenergetics and oxygenation are not impaired. Rather, body composition deterioration (e.g., increased ratio of intermuscular fat to skeletal muscle) may contribute to reduced exercise tolerance in anthracycline BC survivors. This finding points to the importance of lifestyle interventions including caloric restriction and exercise training to restore body composition and cardiovascular health in the BC survivorship setting.