Volume 5, Number 1 (January 2008)

Letter from the Editor

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The good, the bad, and the hopeful

Lee S. Schwartzberg, MD, FACP, Editor-in-Chief

The West Clinic, Memphis, TN

This past year was one of triumphs and disappointments: drugs to improve survival in two notoriously difficult cancers and signal advances in multiple myeloma and breast cancer. But there were setbacks too: the Centers for Medicare and Medicaid meddled in the practice of medicine, telling oncologists how to prescribe ESAs, without evidence to back up their rationale. Congress failed to enact legislation to correct the flaws of the Medicare Modernization Act. So what’s ahead? There’s reason for some optimism.

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Community Dialogue

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Talking with the ASCO presidential candidates

Community Oncology interviews Douglas W. Blayney, MD, Medical Director, University of Michigan Comprehensive Cancer Center, and Barbara L. McAneny, MD, CEO, New Mexico Cancer Center

As the American Society of Clinical Oncology (ASCO) continues to broaden its global reach and influence, many private oncology practitioners in the United States are increasingly asking whether the organization represents their interests. The society, which boasts more than 25,000 members, is widely considered the world’s leading professional organization representing physicians who treat people with cancer. We wanted to find out from the two physicians vying to lead ASCO in 2008 their views on the challenges facing community oncologists.

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Current Clinical Trials

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Carbohydrate restriction in patients with advanced cancer: a protocol to assess safety and feasibility with an accompanying hypothesis

Eugene J. Fine, MD, MS,1 C. J. Segal-Isaacson, EdD, Richard Feinman, PhD, and Joseph Sparano, MD

Albert Einstein College of Medicine, Bronx, NY; SUNY Health Sciences Center, Brooklyn, NY; and Montefiore Medical Center, Weiler Division, Bronx, NY

In a low-carbohydrate diet, the increased availability of fatty acids and ketone bodies may inhibit aggressive glycolytic cancers. Studies have reported reduced tumor growth in animals whose dietary carbohydrate has been replaced with fat. The authors are recruiting for a safety and feasibility clinical study using dietary carbohydrate restriction. Eligible patients are those with advanced glucose-dependent solid cancers that are PET-avid. This article offers details on the hypothesis and protocol for the study as well as contact information for referral.

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Review Article

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Management of metastatic colorectal cancer: the impact of clinical trials reported at ASCO 2007

Leonard Saltz, MD

Memorial Sloan-Kettering Cancer Center, New York, NY

Chemotherapy regimens incorporating a fluoropyrimidine with irinotecan or oxaliplatin and the biologic agents bevacizumab, cetuximab, and panitumumab have improved treatment outcomes in patients with metastatic colorectal cancer (mCRC). However, controversies abound regarding regimen selection, schedule of administration, treatment toxicity, the role of sequential versus combination therapy, and the most appropriate strategy for utilization of newer, targeted biologic agents. The latest findings from trials evaluating potential advances in the therapy of mCRC and their impact on clinical practice are reviewed and evaluated in this article.

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Adverse Events Alert

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Bevacizumab-associated diverticulitis

June M. McKoy, MD, MPH, JD, Jyoti Patel, MD, D. Mark Courtney, MD, Carlos R. Bolden, BS, and Charles L. Bennett, MD, PhD, MPP

The Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Division of Geriatric Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL; Division of Hematology/Oncology, Feinberg School of Medicine, Northwestern University, Chicago, IL; Department of Emergency Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL; Feinberg School of Medicine, Northwestern University, Chicago, IL; and VA Midwest Center for Health Services and Policy Research, Jesse Brown VA Medical Center, Chicago, IL

A severe side effect is noted and reported and some commonsense cautions are called for.

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Brief Communications

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Adenocarcinoma with choriocarcinoma and an endodermal sinus element in a patient with metastatic stomach cancer

Renuka Gupta, MD, Sagar Verma, MD, Mathur Siddarath, MD, Deepthi Bollineni, MD, Harinder Sawhney, MD. and Pradeep Chandra, MD

Department of Medicine, Wyckoff Heights Medical Center, Brooklyn, NY

Gastric adenocarcinoma with a yolk-sac component is a rare malignant neoplasm.

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Practice Survival

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Caring in five minutes

Stuart H. Bloom, MD, MS

Hubert H. Humphrey Cancer Center, Robbinsdale, MN

There’s no shortcut to caring for cancer patients. Even with time at a premium, the author prefers it that way.

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Community Practice Profile

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Rocky Mountain Cancer Centers–Boulder

Partnering with a local hospital, this cancer center caters to patients’ medical and emotional needs. The first of our series.

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Washington Update

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Congress puts a Band-Aid on Medicare

Ted Okon

Community Oncology Alliance, Washington, DC

With only days remaining before the last recess of 2007, Congress opted for a short-term and unsatisfactory fix.

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Community Oncology Conference Preview

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Poster abstracts from the 3rd Annual Community Oncology Conference, February 1–2, 2008, Washington, DC

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The opinions expressed herein are those of the authors or advertisers. The authors, editors, and publishers make every effort to ensure that no inaccurate or misleading data, opinion, or statement is published in this journal and that drug names, dosages, and recommendations are accurate. However, readers should confirm all dosage schedules against the manufacturer’s package information data. The Publisher, Editorial Board, and their employees accept no liability whatsoever for the consequences of any inaccurate or misleading data, opinion, or statement.