FALL 2005 | ||||
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From the 30th Annual Congress of the Oncology Nursing Society Breast and Colorectal Cancer Treatment What the Nurse Needs to Know |
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About this CE activity
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BREAST CANCER |
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Oral fluoropyrimidines for the treatment of breast cancer Karmanos Cancer Institute, Wayne State University, Detroit, Michigan Chemotherapy for breast cancer has relied primarily on intravenous (IV) administration of cytotoxic agents. Yet, as is the case with many other tumor types, oral chemotherapeutics such as oral cyclophosphamide and the oral fl uoropyrimidine capecitabine are being used increasingly for breast cancer therapy. Capecitabine is a prodrug that mimics continuous infusion 5-fluorouracil but is associated with less toxicity. This article highlights key clinical trials of capecitabine in breast cancer for pretreated metastatic disease and neoadjuvant therapy. Ongoing trials are evaluating the potential of capecitabine in combination with novel targeted therapies and whether treatment with sequential single agents is superior to capecitabine-based combination regimens. Oral chemotherapeutics such as capecitabine may produce antitumor activity equal to that of IV cytotoxics but with less toxicity and better quality of life for women with breast cancer.
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COLORECTAL CANCER |
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Fluoropyrimidines in the treatment of colorectal cancer Louisiana State University School of Medicine, New Orleans, Louisiana Treatment of advanced colorectal cancer has improved significantly over the past few decades. Initially, chemotherapy options were limited to 5-fluorouracil (5-FU) coupled with the biochemical modulator leucovorin, but efficacy was low and survival poor. Combination regimens employing newer chemotherapeutics including irinotecan (Camptosar), oxaliplatin (Eloxatin), and oral capecitabine (Xeloda) have resulted in increased efficacy and prolonged survival in both the first- and second-line settings. The recent incorporation of monoclonal antibodies such as bevacizumab (Avastin) and cetuximab (Erbitux) into such regimens also improves outcomes. This review summarizes the progress in chemotherapy of metastatic colorectal cancer by highlighting key trials with these agents for front-line and salvage therapy.
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SUPPORTIVE CARE |
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Capecitabine: considerations for oncology nursing practice Rush University Medical Center, Chicago, Illinois The use of oral chemotherapy has been increasing steadily over the past several decades as more agents become available that are as effective as intravenous (IV) drugs, often with reduced toxicity. Oral compounds also offer other advantages, such as improved pharmacodynamics, patient convenience, and, often, lower cost compared with IV chemotherapeutics. In light of the growing number of oral agents, it is imperative that oncology nurses be informed about these drugs and associated toxicities. This review focuses on one such oral chemotherapeutic, capecitabine (Xeloda), which is indicated for adjuvant therapy of Dukes’ C colon cancer and for treatment of metastatic breast and colorectal cancer. Awareness of pivotal trial data related to its efficacy and primary toxicities (nausea/vomiting, diarrhea, hand-foot syndrome, fatigue) is essential for maintaining effective therapy and management of adverse effects. Nurses also can provide patient education to ensure prompt recognition of toxicities and adherence to prescribed oral chemotherapy.
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CE post test
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CE answer sheet and evaluation
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Supported by an unrestricted educational grant from Roche Oncology |
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© 2005 by Elsevier Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without permission in writing from the publisher. |
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