Mainstream Oncology Research Articles

Complementary or alternative medicine in cancer care—myths and realities

Complementary therapies are adjuncts to mainstream care, used primarily for symptom control and to enhance physical and emotional strength during and after mainstream cancer treatment. These therapies are rational, noninvasive and evidence-based that have been subjected to study to determine their value, document the problems they aim to ameliorate and define the circumstances under which they are beneficial. By contrast, 'alternative' therapies are generally promoted as such-for use as actual antitumour treatments. Typically they lack biological plausibility and scientific evidence of safety and efficacy, and many are outright fraudulent. Combining the helpful complementary therapies with mainstream oncology care to address patients' physical, psychological and spiritual needs constitutes the practice of integrative oncology. By providing patients' nonpharmacological treatment modalities that reduce symptom burden and improve quality of life, physicians enable patients to have an active role in their care, which in turn improves the physician-patient relationship, the quality of cancer care and the well-being of patients and their families.

Ipilimumab and Its Toxicities: A Multidisciplinary Approach

The treatment for metastatic melanoma has evolved significantly in the past few years. Ipilimumab, an immunotherapy, is now in mainstream oncology practice given that it has shown improved overall survival in randomized clinical trials. Other immune modulating agents, such as programmed death receptor-1 and programmed death receptor ligand-1 antibodies, are showing promise in early clinical trials. This manuscript will review ipilimumab and its most common side effects. Immune-related adverse events (irAEs) are important to recognize early, and their presentation, timing of onset, and general recommendations for workup and management will be reviewed. Assembling a multidisciplinary team, as well as thorough education of the patient, is recommended to optimize patient care.

The Pink Ribbon Survivors Network: An Internet resource for breast cancer survivorship education for patients and the health care providers that care for them.

329 Background: The authors identified a need to provide three online tools for the benefit of breast cancer survivors and health care providers: 1) An online collection of relevant publications from all cancer specialties regarding breast cancer survivorship housed in one virtual library. 2) An online collection of guidelines and relevant publications as a resource for primary care providers to access clinical information on medical care and psychosocial issues regarding breast cancer survivorship. 3) An online collection of resources, organizations, and supportive programs and selected readings for breast cancer survivors. These readings would be organized in a "Curriculum for Recovery" Library. We were motivated by the belief that, "all breast cancer survivors are underserved, if their healthcare providers are undereducated." Methods: Using the Joomla software system, a free, online website has been developed. This site houses the three virtual libraries, on separate landing pages, described above. Additional resources for breast cancer survivors are also housed on the website. Results: The Pink Ribbon Survivors Network now provides a resource of over 500 separate listings designed to educate and support breast cancer survivors, and health care professionals. The online professional libraries were created from abstracts available from medical journals and similar mainstream oncology publications. The libraries are continuously updated with new publications. These collective libraries will serve as unique breast cancer survivorship tools for women and their health care providers, for new publications, and for resources. Conclusions: This abstract establishes that a system using internet technology can provide virtual resources for breast cancer survivors, cancer specialists, and primary health care providers. This is now a functional online system for the 2.5 million breast cancer survivors and nearly 500,000 health care providers involved in the care of these survivors. The organization’s website is www.PinkRibbonSurvivorsNetwork.org.

Cancer epigenetics reaches mainstream oncology

Epigenetics is one of the most promising and expanding fields in the current biomedical research landscape. Since the inception of epigenetics in the 1940s, the discoveries regarding its implications in normal and disease biology have not stopped, compiling a vast amount of knowledge in the past decade. The field has moved from just one recognized marker, DNA methylation, to a variety of others, including a wide spectrum of histone modifications. From the methodological standpoint, the successful initial single gene candidate approaches have been complemented by the current comprehensive epigenomic approaches that allow the interrogation of genomes to search for translational applications in an unbiased manner. Most important, the discovery of mutations in the epigenetic machinery and the approval of the first epigenetic drugs for the treatment of subtypes of leukemias and lymphomas has been an eye-opener for many biomedical scientists and clinicians. Herein, we will summarize the progress in the field of cancer epigenetics research that has reached mainstream oncology in the development of new biomarkers of the disease and new pharmacological strategies.

Supportive Care: Large Studies Ease Yoga, Exercise Into Mainstream Oncology

Supportive Care: Large Studies Ease Yoga, Exercise Into Mainstream Oncology

Mind–Body Therapies in Integrative Oncology

There is growing interest in mind-body therapies as adjuncts to mainstream cancer treatment, and an increasing number of patients turn to these interventions for the control of emotional stress associated with cancer. Increased research funding has enabled many such interventions to be evaluated for their efficacy, including studies of mind-body interventions to reduce pain, anxiety, insomnia, anticipatory, and treatment-related nauseas, hot flashes, and improved mood. Mind-body treatments evaluated for their utility in oncology include relaxation therapies, biofeedback, meditation and hypnosis, yoga, art and music therapy, tai chi, and qigong. Although studies are not always methodologically sound and results mixed, a growing number of well-designed studies provide convincing evidence that mind-body techniques are beneficial adjuncts to cancer treatment. The evidence is sufficient to recommend further investigation and adoption of these techniques in mainstream oncology care.

Prenatal Diagnosis, Preimplantation Genetic Diagnosis, and Cancer: Was Hamlet Wrong?

Prenatal Diagnosis, Preimplantation Genetic Diagnosis, and Cancer: Was Hamlet Wrong?

Translational Oncology: Transforming Cancer Care

More than any other discipline, oncology has been transformed by extraordinary scientific advancements that have occurred during the last decade. On a daily basis, we are thinking increasingly of cancer not by its particular pathologic features, but by its specific genetic alterations. The newest treatments are based on manipulating molecular targets present in a tumor rather than globally attempting to inhibit all cell growth. The pace at which bench-to-bedside research is having an impact on the clinical practice of oncology is extraordinary. It is an exciting and hopeful time to be involved in cancer research and care. The explosion of new approaches in cancer therapy, diagnosis, prevention, and prediction of response leads to some interesting challenges. How can we keep informed of the myriad discoveries that will impact patient care in the near future? How can we learn about genetic pathways and environmental alterations occurring in cancer that are increasingly being exploited for clinical purpose? As the therapeutic road from the laboratory to the clinic shortens, our need for the most up-to-date information increases. Translational oncology has become mainstream oncology—it is what we do each day in the laboratory and in the clinic. Over the last few years, the Journal of Clinical Oncology (JCO) has produced a series on translational oncology topics and original papers. The series was received with enthusiasm by our readers, as well as basic and clinical scientists who found JCO an ideal venue for the publication of their work. In acknowledgment of the seamless integration of translational oncology into cancer care, JCO has now integrated the translational oncology series into each issue. Cutting-edge research and review articles concerning the most important scientific advances influencing clinical practice are published side by side with randomized clinical trials that change current standards of care. This evolution of JCO will provide both the daily tools needed for clinical practice as well as an immediate future vision of the practice of oncology. JCO welcomes novel research submissions from authors who have “one hand on the bench and the other on the patient.” Original research in fields such as tumor immunology, genomics, proteomics, epigenetics, and angiogenesis represent the future of cancer care. Some examples of the types of research that JCO encourages for submission include: • Early phase studies that report an unusual clinical response or an unexpected adverse effect that speaks to the mechanism of an action, or studies that present novel biomarkers that contribute significantly to our understanding of a drug’s effect; • Biomarkers, with biologic importance, that have been validated as useful clinical tools; and • Preclinical studies that address critical issues and bring insight to complex clinical problems. If research results might impact oncology practice within the next few years, it is critical that JCO readers learn of the key findings. As practitioners who care for patients with cancer, we must have at our fingertips the latest information that will bring hope, remission, and, potentially, survival. JCO’s expansion to include all aspects of cancer research important to our practice and our patients will give us the information to move into the future.