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The Oncologist, the Patient and CKN — Sharing Knowledge

Combining Radiation Therapy and Androgen Deprivation for Localized Prostate Cancer – A Critical Review

Photo Credit: Wikimedia Commons.

Summary by Dr. Luis Souhami MD – McGill University Health Centre

In our paper we critically reviewed major publications that evaluated the use of radiation therapy (RT) combined with androgen deprivation for localized prostate cancer. Also, a brief summary of some important preclinical studies was made in order to reinforce a better understanding of the biological basis for this approach.  For didactic purposes, we have clustered prospective randomized trials in two major groups: one including studies basically testing hormonal therapy before RT (neoadjuvant therapy) and other using hormonal therapy concomitantly and/or after RT. Based on this scheme, we endeavoured to properly define most appropriate treatment recommendations for each risk category.

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Access to Thalidomide for the Treatment of Multiple Myeloma in Canada

Multiple myleoma stain. Photo credit: Wikimedia Commons

Summary by Dr. Leonard Minuk

Multiple myeloma is an incurable plasma cell neoplasm that is characterized by multiple relapses requiring many lines of therapy to maintain disease control. Therapy has dramatically changed over the last 10 years to include multiple novel agents (such as thalidomide, lenalidomide, and bortezomib) as well as autologous stem cell transplantation, improving outcomes but also increasing the cost and complexity of treatment …

Current standard treatment is divided mainly according to age. Patients who are 65 are treated with standard melphalan and prednisone with the addition of either thalidomide (MPT regimen) or bortezomib (VMP regimen). Relapsed disease is managed with thalidomide, bortezomib, lenalidomide, or alkylating agents, often in combination with steroids. There is much debate and ongoing research into the appropriate sequencing and combination of these various drugs.

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Targeted Therapies in Metastatic Non-small Cell Lung Cancer

Textbook image of the respiratory system. Credit: Clipart Etc.

Summary by Dr. Vera Hirsh

Lung cancer remains one of the most common cancers worldwide and a leading cause of cancer-related deaths, with an estimated 1.6 million new cases and nearly 1.4 million deaths annually. The majority of patients with non small cell lung cancer (NSCLC) will present with advanced stage disease at diagnosis. But even when diagnosed at an early stage, a large number of patients will eventually experience disease relapse with metastases. Five-year survival rate of lung cancer patients is only 15%. Furthermore, patients with advanced lung cancer may experience debilitating symptoms and toxicities related to their treatments, which can seriously effect their quality of life.

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Bevacizumab in Combination with FOLFIRI Chemotherapy in Patients with Metastatic Colorectal Cancer

Chemotherapy drugs. Photo credit: Wikimedia Commons

Summary by Dr. George Dranitsaris

Bevacizumab represents one of the first targeted agents that was been approved for the treatment of metastatic colorectal cancer (mCRC) in Canada. One of the reasons that the drug has generated so much interest is its high acquisition cost and the potential for serious, although relatively uncommon toxicities. One of the best methods to assess drug performance and safety is in the natural hospital setting. Therefore in this study, our objective was to evaluate safety and efficacy in the first series of patients that had received this agent in our province in the first two years of availability.

We identified 43 patients with mCRC who had received bevacizumab in combination with first line FOLFIRI chemotherapy. We adopted a longitudinal data collection format where the occurrences of adverse events following each cycle of treatment were assessed. Toxicity outcomes such as gastrointestinal (GI) perforations, bleeding, diarrhea, myelosuppression, proteinuria, and venous thromboembolic events (VTEs) were collected and graded using the NCI common toxicity criteria (V 3.0). Time to treatment failure (TTF) and overall survival (OS) were determined using the method of Kaplan–Meier.

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