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Lawrence Einhorn, MD

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Hematology/Oncology

Professor of Medicine, Distinguished Professor of Medicine, Livestrong Foundation Professor of Oncology

Academic Office

Indiana Cancer Pavilion, Suite 473
535 Barnhill Dr
Indianapolis IN 46202-5289 Map

Contact Information

Phone: (317) 944-3515
Fax: (317) 274-3646
Email:

Research Interests

Clinical trials in solid tumor oncology

Clinical Interests

Solid tumor oncology, especially G. U. and lung cancer

Education and Training

Fellowship M.D. Anderson, Houston, TX
Fellowship Indiana University School of Medicine, Indianapolis, IN
Residency Indiana University School of Medicine, Indianapolis, IN
Medicine (M.D.) Iowa, University Of
Pre-Medicine Studies Indiana University

Board Certifications

Internal Medicine 1971
Oncology 1975

Professional Organizations

Association of American Physicians
National Academy of Science

Publications (69)¹

Utilization of sperm banking and barriers to its use in testicular cancer patients.
Journal: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
Authors: Sonnenburg DW; Brames MJ; Case-Eads S; Einhorn LH;
Publication Date: 2015 Feb 15

Abstract

Testicular cancer is the most common carcinoma in 20- to 40-year-old men. Eighty percent of patients with metastases achieve disease-free status with chemotherapy with or without surgical resection. Standard first-line chemotherapy is bleomycin, etoposide, and cisplatin (BEP) for three to four courses or etoposide and cisplatin (EP) for four courses. Forty percent of patients receiving chemotherapy will have permanently reduced sperm counts impairing future fertility. Sperm banking is an effective method of maintaining fertility. This retrospective study was performed to assess utilization and results from sperm banking, as well as the barriers to its use.
View details for PubMedID 25680764
Salvage Therapy in Patients with Germ Cell Tumors.
Journal: American Society of Clinical Oncology educational book / ASCO. American Society of Clinical Oncology. Meeting
Authors: Einhorn LH;
Publication Date: 2015

Abstract

Testicular cancer is the most curable metastatic solid tumor. Initial chemotherapy is evidence based with risk stratification into three prognostic categories: good, intermediate, and advanced disease. Guidelines for disease management following progression after initial cisplatin combination chemotherapy are less clear. Options include salvage surgery for patients with anatomically confined relapse, standard-dose cisplatin combination chemotherapy, or high-dose chemotherapy with carboplatin plus etoposide with peripheral blood stem cell transplantation. Proper interpretation of a presumed relapse can be complicated. Growing masses on imaging studies might reflect a growing teratoma. Persistent elevations of serum human chorionic gonadotropin (hCG) or alpha fetoprotein (AFP) are only an indication for salvage therapy if there is a definitive rise in the tumor marker. Elevated and rising serum hCG as the only evidence of recurrence can be because of cross reactivity with luteinizing hormone or usage of marijuana rather than progressive cancer. Elevated liver function tests can cause rising serum AFP.
View details for PubMedID 25993183
The impact of bleomycin on retroperitoneal histology at post-chemotherapy retroperitoneal lymph node dissection of good risk germ cell tumors.
Journal: The Journal of urology
Authors: Cary KC; Pedrosa JA; Kaimakliotis HZ; Masterson TA; Einhorn LH; Foster RS;
Publication Date: 2014 Sep 22

Abstract

Induction chemotherapy for International Germ Cell Cancer Collaborative Group (IGCCCG) good risk metastatic testicular cancer includes 3 cycles of bleomycin, etoposide and cisplatin (BEP x3) or 4 cycles of etoposide and cisplatin (EP x4). We examine differences in active cancer in the retroperitoneum between patients receiving BEP x3 compared to EP x4.
View details for PubMedID 25254937
Surgical management of late relapse on surveillance in patients presenting with clinical stage I testicular cancer.
Journal: Urology
Authors: Rice KR; Beck SD; Pedrosa JA; Masterson TA; Einhorn LH; Foster RS;
Publication Date: 2014 Oct

Abstract

To determine survival outcomes in clinical stage I germ cell tumor (GCT) patients requiring retroperitoneal lymph node dissection (RPLND) for late relapse (LR) occurring while on surveillance.
View details for PubMedID 25260450
"Somatic-type" malignancies arising from testicular germ cell tumors: a clinicopathologic study of 124 cases with emphasis on glandular tumors supporting frequent yolk sac tumor origin.
Journal: The American journal of surgical pathology
Authors: Magers MJ; Kao CS; Cole CD; Rice KR; Foster RS; Einhorn LH; Ulbright TM;
Publication Date: 2014 Oct

Abstract

Somatic-type malignancies (SMs) in patients with testicular germ cell tumors (GCT) are rare and mostly attributed to "transformation" of teratoma, although yolk sac tumor (YST) origin has also been proposed. We studied 124 cases of "SM" of testicular GCT origin from 106 patients to evaluate their morphology, immunohistochemical features (especially the utility of SALL4), and relationship to YST. Primitive neuroectodermal and nephroblastomatous tumors were excluded because of prior studies. Patients ranged in age from 15 to 68 years (mean, 33 y). The tumors ranged from 0.7 to 30 cm (mean, 7.6 cm) and involved the retroperitoneum (64%), abdomen/pelvis (10%), lung (10%), mediastinum (6%), supraclavicular region/neck (4%), testis (4%), and thigh (1%). Most initial diagnoses were sarcomas (n=68) or carcinomas (n=51). On review and immunohistochemical analysis, 7 of 45 adenocarcinomas were reclassified as glandular YSTs (GYST) on the basis of glypican-3 (GPC3) and/or a-fetoprotein positivity and scant/absent reactivity for EMA and CK7. These occasionally (29%) had subnuclear and sometimes supranuclear vacuoles (endometrioid-like), whereas adenocarcinomas were more frequently mucinous (17%) or enteric-type (11%) than endometrioid-like (9%). Both expressed CDX2 frequently (83% and 63%, respectively). MUC protein 2, 4, 5, and 6 expression was more common in adenocarcinomas (7% to 36%) than in GYSTs (0% to 20%) but was infrequent. Both were often positive for SALL4, BerEP4, and MOC31; all were negative for TTF-1. On follow-up (GYST: range, 23 to 169 mo; mean, 81mo; adenocarcinoma: range, 1 to 170 mo; mean, 55 mo), 50% and 33% of patients with GYST and adenocarcinoma, respectively, died of disease. We reclassified 26 of 76 sarcomatoid tumors as sarcomatoid YSTs (SYST) on the basis of positive reactivity for both AE1/3 and GPC3. These tumors often had spindled and epithelioid cells in a fibromyxoid stroma. SYSTs were often (60%) SALL4 positive, whereas sarcomas were all negative. On follow-up (SYST: range, 1 to 259 mo; mean, 62 mo; sarcoma: range, 1 to 327 mo; mean, 70 mo), 50% and 29% of patients with SYST and sarcoma, respectively, died of disease, with most mortality occurring in those with high-grade tumors. We conclude that, on the basis of a panel of immunoreactivities, a significant number of "SMs" in testicular GCT patients are more accurately classified as either GYSTs or SYSTs. Ambiguous glandular tumors should be evaluated for GPC3, a-fetoprotein, CK7, and EMA reactivity and sarcomatoid ones for GPC3, AE1/3, and SALL4 reactivity.
View details for PubMedID 24921638
Phase II clinical trial of oxaliplatin and bevacizumab in refractory germ cell tumors.
Journal: American journal of clinical oncology
Authors: Jain A; Brames MJ; Vaughn DJ; Einhorn LH;
Publication Date: 2014 Oct

Abstract

Salvage chemotherapy has curative potential in germ cell tumors (GCTs). However, novel therapies are still needed for patients failing to be cured with standard salvage chemotherapy. Bevacizumab in combination with chemotherapy has clinical activity in many solid tumors. This is the first study of bevacizumab with oxaliplatin in refractory GCT patients.
View details for PubMedID 23388561
Survival analysis of pure seminoma at post-chemotherapy retroperitoneal lymph node dissection.
Journal: The Journal of urology
Authors: Rice KR; Beck SD; Bihrle R; Cary KC; Einhorn LH; Foster RS;
Publication Date: 2014 May 9

Abstract

Viable seminoma encountered at post-chemotherapy retroperitoneal lymph node dissection for pure testicular seminoma is rare due to the chemosensitivity of this germ cell tumor. In this study we define the natural history of viable seminoma at post-chemotherapy retroperitoneal lymph node dissection.
View details for PubMedID 24813309
Pitfalls in management of patients with germ cell tumors and slight elevation of serum a-fetoprotein.
Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology
Authors: Albany C; Einhorn L;
Publication Date: 2014 May 19
Chemotherapy-induced peripheral neurotoxicity and ototoxicity: new paradigms for translational genomics.
Journal: Journal of the National Cancer Institute
Authors: Travis LB; Fossa SD; Sesso HD; Frisina RD; Herrmann DN; Beard CJ; Feldman DR; Pagliaro LC; Miller RC; Vaughn DJ; Einhorn LH; Cox NJ; Dolan ME; Platinum Study Group;
Publication Date: 2014 Mar 12

Abstract

In view of advances in early detection and treatment, the 5-year relative survival rate for all cancer patients combined is now approximately 66%. As a result, there are more than 13.7 million cancer survivors in the United States, with this number increasing by 2% annually. For many patients, improvements in survival have been countered by therapy-associated adverse effects that may seriously impair long-term functional status, workplace productivity, and quality of life. Approximately 20% to 40% of cancer patients given neurotoxic chemotherapy develop chemotherapy-induced peripheral neurotoxicity (CIPN), which represents one of the most common and potentially permanent nonhematologic side effects of chemotherapy. Permanent bilateral hearing loss and/or tinnitus can result from several ototoxic therapies, including cisplatin- or carboplatin-based chemotherapy. CIPN and ototoxicity represent important challenges because of the lack of means for effective prevention, mitigation, or a priori identification of high-risk patients, and few studies have applied modern genomic approaches to understand underlying mechanisms/pathways. Translational genomics, including cell-based models, now offer opportunities to make inroads for the first time to develop preventive and interventional strategies for CIPN, ototoxicity, and other treatment-related complications. This commentary provides current perspective on a successful research strategy, with a focus on cisplatin, developed by an experienced, transdisciplinary group of researchers and clinicians, representing pharmacogenomics, statistical genetics, neurology, hearing science, medical oncology, epidemiology, and cancer survivorship. Principles outlined herein are applicable to the construction of research programs in translational genomics with strong clinical relevance and highlight unprecedented opportunities to understand, prevent, and treat long-term treatment-related morbidities.
View details for PubMedID 24623533
Very late relapse of germ cell tumor as a teratoma: a case report and review of the literature.
Journal: Journal of surgical case reports
Authors: Arafat W; Albany C; Ulbright TM; Foster R; Einhorn LH;
Publication Date: 2014 Jun 2

Abstract

Very late relapses of germ cell tumors (GCTs) are rare. There are few reports of relapses occurring beyond 20 years of initial treatment. Here we describe a case of a very late relapse of Stage I testicular non-seminomatous germ cell tumor 27 years after orchiectomy. The relapse presented as a retroperitoneal mass in the precaval lymph nodes with negative tumor markers. It was resected and pathology confirmed it as metastatic teratoma. This case emphasizes the importance of lifelong surveillance for patients with GCTs.
View details for PubMedID 24887427
Management of germ cell tumors with somatic type malignancy: pathological features, prognostic factors and survival outcomes.
Journal: The Journal of urology
Authors: Rice KR; Magers MJ; Beck SD; Cary KC; Einhorn LH; Ulbright TM; Foster RS;
Publication Date: 2014 Jun 18

Abstract

Germ cell tumors with somatic type malignancy are rare, occurring in approximately 2.7% to 8.6% of germ cell tumor cases. Prognostic factors and optimal management remain poorly defined.
View details for PubMedID 24952240
Testicular cancer: a reflection on 50 years of discovery.
Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology
Authors: Hanna N; Einhorn LH;
Publication Date: 2014 Jul 14
Why oncologists should support single-payer national health insurance.
Journal: Journal of oncology practice / American Society of Clinical Oncology
Authors: Drasga RE; Einhorn LH;
Publication Date: 2014 Jan
Barriers to mental health service use and preferences for addressing emotional concerns among lung cancer patients.
Journal: Psycho-oncology
Authors: Mosher CE; Winger JG; Hanna N; Jalal SI; Fakiris AJ; Einhorn LH; Birdas TJ; Kesler KA; Champion VL;
Publication Date: 2014 Feb 3

Abstract

This study examined barriers to mental health service use and preferences for addressing emotional concerns among lung cancer patients (N=165) at two medical centers in the Midwestern United States.
View details for PubMedID 24493634
Phase I Study of Amrubicin and Cyclophosphamide in Patients With Advanced Solid Organ Malignancies: HOG LUN 07-130.
Journal: American journal of clinical oncology
Authors: Jalal SI; Hanna N; Zon R; Masters GA; Borghaei H; Koneru K; Badve S; Prasad N; Somaiah N; Wu J; Yu Z; Einhorn L;
Publication Date: 2014 Dec 10

Abstract

Relapsed small cell lung cancer (SCLC) has limited treatment options. Anthracyclines and cyclophosphamide have shown synergy in many tumors. Amrubicin (AMR) and cyclophosphamide both have single-agent activity in SCLC. This phase I trial evaluated the combination of AMR and cyclophosphamide in refractory solid organ malignancies and in relapsed SCLC.
View details for PubMedID 25503432
High-dose chemotherapy for recurrent ovarian germ cell tumors.
Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology
Authors: Reddy Ammakkanavar N; Matei D; Abonour R; Einhorn LH;
Publication Date: 2014 Dec 1
Extragonadal germ cell tumors: clinical presentation and management.
Journal: Current opinion in oncology
Authors: Albany C; Einhorn LH;
Publication Date: 2013 May

Abstract

The extragonadal germ cell tumors (EGCTs) represent a unique entity, and as such require specialized management. This review article will discuss the diagnosis, prognosis and treatment modalities for EGCTs.
View details for PubMedID 23422328
Metastatic Malignant Transformation of Teratoma to Primitive Neuroectodermal Tumor (PNET): Results With PNET-based Chemotherapy.
Journal: American journal of clinical oncology
Authors: Al-Hader AA; Jain A; Al-Nasrallah N; Einhorn LH;
Publication Date: 2013 Jun 24

Abstract

Metastatic germ cell cancers are highly chemosensitive and have 80% cure rate with cisplatin-based chemotherapy. Postchemotherapy teratoma can usually be surgically resected. However, teratoma, which is pluripotent tissue, can undergo malignant transformation along mesodermal elements to primitive neuroectodermal tumor (PNET). Unlike teratoma, PNET can metastasize and render a patient unresectable and incurable. We report the results of treatment of patients with malignant transformation to PNET with cyclophosphamide+doxorubicin+vincristine (CAV) alternating with ifosfamide+etoposide (IE).
View details for PubMedID 23799289
Support service use and interest in support services among lung cancer patients.
Journal: Lung cancer (Amsterdam, Netherlands)
Authors: Mosher CE; Hanna N; Jalal SI; Fakiris AJ; Einhorn LH; Birdas TJ; Kesler KA; Champion VL;
Publication Date: 2013 Aug 6

Abstract

This study examined support service use and interest in support services among lung cancer patients (N = 165) at two comprehensive medical centers in the midwestern United States.
View details for PubMedID 23932457
Economic and social changes among distressed family caregivers of lung cancer patients.
Journal: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
Authors: Mosher CE; Champion VL; Azzoli CG; Hanna N; Jalal SI; Fakiris AJ; Birdas TJ; Okereke IC; Kesler KA; Einhorn LH; Monahan PO; Ostroff JS;
Publication Date: 2012 Sep 4

Abstract

Although costs of lung cancer care have been documented, economic and social changes among lung cancer patients' family caregivers have yet to be fully examined. In addition, research has not focused on caregivers with greater need for support services. This study examined various economic and social changes among distressed family caregivers of lung cancer patients during the initial months of cancer care in the USA.
View details for PubMedID 22945881
Support service use and interest in support services among distressed family caregivers of lung cancer patients.
Journal: Psycho-oncology
Authors: Mosher CE; Champion VL; Hanna N; Jalal SI; Fakiris AJ; Birdas TJ; Okereke IC; Kesler KA; Einhorn LH; Given BA; Monahan PO; Ostroff JS;
Publication Date: 2012 Sep 3

Abstract

This study examined support service use and interest in support services among distressed family caregivers of patients recently entering comprehensive cancer care facilities.
View details for PubMedID 22941782
Primary teratoma of the lesser sac: lesser sac teratoma.
Journal: Case reports in oncological medicine
Authors: Hardesty BM; Ulbright TM; Touloukian C; Einhorn LH;
Publication Date: 2012 Mar 26

Abstract

Germ cell tumors predominantly involve the gonads but may rarely be found outside of the gonads, primarily in midline structures. We describe the case of a 27-year-old male with an asymptomatic 8?cm teratoma located within the lesser sac of his omentum. This is the fourth case of a teratoma located within the lesser sac of the omentum, which provides the opportunity to make some comparisons. Finally, we discuss some of the etiologic theories behind extragonadal germ cell tumors and how they relate to teratomas in the lesser sac.
View details for PubMedID 22606456
The "growing teratoma syndrome" in primary mediastinal nonseminomatous germ cell tumors: criteria based on current practice.
Journal: The Journal of thoracic and cardiovascular surgery
Authors: Kesler KA; Patel JB; Kruter LE; Birdas TJ; Rieger KM; Okereke IC; Einhorn LH;
Publication Date: 2012 Jun 17

Abstract

Criteria for the growing teratoma syndrome in patients with primary mediastinal nonseminomatous germ cell tumors have not been well established according to current practice.
View details for PubMedID 22713299
Signet ring cell carcinoma of the testis: clinicopathologic and molecular evidence for germ cell tumor origin--a case report.
Journal: The American journal of surgical pathology
Authors: Williamson SR; Kum JB; Shah SR; Einhorn LH; Eble JN; Cheng L; Ulbright TM; Idrees MT;
Publication Date: 2012 Feb

Abstract

Development of a somatic-type malignancy from a mixed germ cell tumor is a rare but recognized event and typically represented by sarcoma or, less commonly, by carcinoma. This phenomenon is generally believed to result from progression of a teratomatous component. In many cases, because of intermingling of other germ cell tumor components, the diagnosis is apparent; however, in rare cases, metastatic carcinoma to the testis or a novel primary tumor may be a diagnostic consideration. In this study, we report the clinicopathologic, immunohistochemical, and molecular features of a 53-year-old man, whose testicular tumor was composed entirely of signet ring cells, mimicking metastatic carcinoma. Subsequent retroperitoneal lymph node dissection revealed metastatic deposits composed of teratoma and yolk sac tumor, in addition to signet ring cell carcinoma. Fluorescence in situ hybridization for abnormalities of chromosome 12p revealed the presence of i(12p) in both the teratoma and signet ring cell carcinoma in the metastasis and in signet ring cells in the testis, supporting a common germ cell origin. Our report indicates that signet ring carcinoma cells in an orchiectomy specimen, although usually strongly suggestive of metastatic adenocarcinoma from a primary tumor in another organ, may be a primary testicular neoplasm of germ cell tumor origin. This is the first report of testicular signet ring cell carcinoma of germ cell tumor derivation.
View details for PubMedID 22251944
Randomized, double-blind, placebo-controlled, phase III cross-over study evaluating the oral neurokinin-1 antagonist aprepitant in combination with a 5HT3 receptor antagonist and dexamethasone in patients with germ cell tumors receiving 5-day cisplatin combination chemotherapy regimens: a hoosier oncology group study.
Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology
Authors: Albany C; Brames MJ; Fausel C; Johnson CS; Picus J; Einhorn LH;
Publication Date: 2012 Aug 20

Abstract

Aprepitant, a 5-HT3 receptor antagonist (5HT3-RA), and dexamethasone are standard antiemetic therapy for prevention of single-day, cisplatin-induced nausea and vomiting. We conducted a double-blind, placebo-controlled phase III cross-over study that compared aprepitant to placebo combined with standard antiemetic prophylaxis (a 5HT3-RA and dexamethasone) in patients receiving 5 days of cisplatin combination chemotherapy for testicular cancer.
View details for PubMedID 22915652
Salvage therapy with high-dose chemotherapy and peripheral blood stem cell transplant in patients with primary mediastinal nonseminomatous germ cell tumors.
Journal: Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
Authors: Suleiman Y; Siddiqui BK; Brames MJ; Abonour R; Einhorn LH;
Publication Date: 2012 Aug 11

Abstract

Salvage therapy with high-dose chemotherapy (HDCT) and bone marrow transplant (BMT) or peripheral blood stem cell transplant (PBSCT) has curative potential in patients with recurrent germ cell tumor. However, patients with primary mediastinal nonseminomatous germ cell tumors (PMNSGCTs) have had poor results with any form of salvage chemotherapy including HDCT. We switched from BMT to PBSCT in 1996. One hundred sixteen of 184 patients (63%) with recurrent or refractory germ cell tumors treated from 1996 to 2004 were alive and continuously disease-free. PMNSGCTs were excluded from that study because of poor results in the patient population with HDCT and BMTs. In 2006, we resumed treating patients with recurrent PMNSGCT with 2 consecutive courses of HDCT consisting of carboplatin 700 mg/m(2) × 3 plus etoposide 750 mg/m(2) × 3 and each followed by an infusion of autologous peripheral-blood hematopoietic stem cells with a second course 3 to 4 weeks later. Twelve patients were treated: 11 as initial salvage chemotherapy and 1 as fourth-line therapy. Eight of the 12 patients had major thoracic resections at the time of the relapse after initial chemotherapy. Three of the 12 patients achieved complete remission (CR; 10, 15, and 50 months' duration). One patient remains continuously with no evidence of disease (NED) at 50 months. An additional patient is currently NED at 52 months with HDCT and subsequent surgery. Median survival for the 12 patients was 11 months (range, 4-52 months). Results with tandem transplant for recurrent PMNSGCT remain poor compared to primary testis cancer, but durable CR and probable cure can be achieved in a small subset of patients with PMNSGCT. In our opinion, salvage surgical resection if anatomically feasible is the preferred option for patients with PMNSGT progressing after initial chemotherapy.
View details for PubMedID 22892555
Salvage chemotherapy with high-dose carboplatin and etoposide with peripheral blood stem cell transplant in patients with relapsed pure seminoma.
Journal: American journal of clinical oncology
Authors: Agarwala AK; Perkins SM; Abonour R; Brames MJ; Einhorn LH;
Publication Date: 2011 Jun

Abstract

To evaluate rates of complete remission and overall survival for patients with relapsed pure seminoma treated with high-dose carboplatin and etoposide followed by peripheral blood stem cell transplant.
View details for PubMedID 20523207
Updated survival and outcomes for older adults with inoperable stage III non-small-cell lung cancer treated with cisplatin, etoposide, and concurrent chest radiation with or without consolidation docetaxel: analysis of a phase III trial from the Hoosier Oncology Group (HOG) and US Oncology.
Journal: Annals of oncology : official journal of the European Society for Medical Oncology / ESMO
Authors: Jalal SI; Riggs HD; Melnyk A; Richards D; Agarwala A; Neubauer M; Ansari R; Govindan R; Bruetman D; Fisher W; Breen T; Johnson CS; Yu M; Einhorn L; Hanna N;
Publication Date: 2011 Dec 9

Abstract

Concurrent chemoradiation with etoposide and cisplatin (EP/XRT) is standard treatment for inoperable stage III locally advanced non-small-cell lung cancer (LA-NSCLC). Consolidation docetaxel (D; Taxotere) after EP/XRT resulted in increased toxicity but no improvement in survival compared with observation (O). We report updated survival for the entire study population and include an analysis of efficacy and tolerability of EP/XRT with or without D in patients aged = 70 years.
View details for PubMedID 22156624
Lung cancer, thyroid cancer or both: An unusual case presentation.
Journal: Journal of thoracic disease
Authors: Albany C; Jain A; Ulbright TM; Einhorn LH;
Publication Date: 2011 Dec

Abstract

Cancer metastasis to the thyroid is rare. Primary sites that have been reported to metastasize to the thyroid gland include breast and kidney. There are very few case reports describing metastasis of a lung primary cancer to the thyroid gland. We describe a case of a never-smoker patient with metastatic adenocarcinoma of the lung and a malignant thyroid mass presenting simultaneously. The thyroid biopsy could not distinguish whether it was a metastasis or incidentally found thyroid primary carcinoma. Based on EGFR mutational status it was determined that he has a primary lung cancer and thyroid metastasis. He was started on erlotinib and has had a marked response in both the lung and the thyroid masses. The presence of mutations within the EGFR gene can help distinguish lung adenocarcinoma from other carcinomas like thyroid cancer. This is the first published case of primary lung adenocarcinoma with metastasis to thyroid and with EGFR mutation.
View details for PubMedID 22263102
Legends in urology.
Journal: The Canadian journal of urology
Authors: Einhorn LH;
Publication Date: 2011 Aug
Survival after resection for metastatic testicular nonseminomatous germ cell cancer to the lung or mediastinum.
Journal: The Annals of thoracic surgery
Authors: Kesler KA; Kruter LE; Perkins SM; Rieger KM; Sullivan KJ; Runyan ML; Brown JW; Einhorn LH;
Publication Date: 2011 Apr

Abstract

Since the advent of cisplatin-based chemotherapy, nonseminomatous germ cell tumors (NSGCT) have been considered one of the most curable solid neoplasms and a model for multimodality cancer therapy. We undertook an institutional review of testicular NSGCT patients who underwent operations to remove lung or mediastinal metastases after chemotherapy in the cisplatin era to determine outcomes.
View details for PubMedID 21440128
Is retroperitoneal histology predictive of liver histology at concurrent post-chemotherapy retroperitoneal lymph node dissection and hepatic resection?
Journal: The Journal of urology
Authors: Jacobsen NE; Beck SD; Jacobson LE; Bihrle R; Einhorn LH; Foster RS;
Publication Date: 2010 Sep

Abstract

We identified factors predicting liver histology in patients with nonseminomatous germ cell tumor undergoing concurrent post-chemotherapy retroperitoneal lymph node dissection and liver resection.
View details for PubMedID 20643453
Antiemetic therapy for multiple-day chemotherapy and additional topics consisting of rescue antiemetics and high-dose chemotherapy with stem cell transplant: review and consensus statement.
Journal: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
Authors: Einhorn LH; Grunberg SM; Rapoport B; Rittenberg C; Feyer P;
Publication Date: 2010 May 26

Abstract

This paper will evaluate various topics related to chemotherapy-induced nausea and vomiting. The results published reflect a consensus conference convened in Perugia, Italy. The topics discussed include antiemetic therapy of multiple-day chemotherapy, high-dose chemotherapy, and rescue antiemetics.
View details for PubMedID 20505956
Perceptions of masculinity and self-image in adolescent and young adult testicular cancer survivors: implications for romantic and sexual relationships.
Journal: Psycho-oncology
Authors: Carpentier MY; Fortenberry JD; Ott MA; Brames MJ; Einhorn LH;
Publication Date: 2010 May 20

Abstract

To examine adolescent and young adult (AYA) testicular cancer survivors' subjective understanding of the impact of cancer in adolescence and young adulthood, with a particular emphasis on romantic and sexual relationships.
View details for PubMedID 20878864
Primitive neuroectodermal tumors in patients with testicular germ cell tumors usually resemble pediatric-type central nervous system embryonal neoplasms and lack chromosome 22 rearrangements.
Journal: Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc
Authors: Ulbright TM; Hattab EM; Zhang S; Ehrlich Y; Foster RS; Einhorn LH; Cheng L;
Publication Date: 2010 Mar 26

Abstract

Primitive neuroectodermal tumors (PNETs) are one of the most frequent types of 'non-germ cell' tumor in patients with testicular germ cell tumors and have a guarded prognosis when present in metastatic sites after cisplatin-based chemotherapy. Improved treatments, including targeted therapy, require understanding the biology of these neoplasms. We therefore analyzed the morphologic, immunohistochemical and molecular biologic features of 14 PNETs from 14 patients with concurrent or previous testicular germ cell tumors; 12 tumors were from metastatic sites and 2 were primary in the testis. Using standard light microscopic criteria for central nervous system and peripheral PNETs, we classified nine tumors as medulloepithelioma, three as medulloblastoma/supratentorial PNET, one as neuroblastic tumor with abundant neuropil and true rosettes and one as small cell embryonal tumor/PNET (Ewing sarcoma-like). Immunostains directed against INI1, CD57, S-100 protein, NeuN, WT1, neurofilament, CD99, GFAP, synaptophysin, chromogranin, AE1/AE3 cytokeratin, Fli-1 and collagen IV were performed for each case. INI1 was diffusely and strongly positive in all tumors whereas the other stains, except for cytoplasmic WT1 (which showed substantial reactivity in most tumors), were mostly focal to negative, including CD99 (eight negative, six focal) and Fli-1 (all negative). The most consistently reactive 'neuroendocrine' marker was CD57. Each case was also analyzed for chromosome 22 rearrangements using a FISH-based break-apart probe method. Only 1 tumor, classified as medulloepithelioma, was scored positive for chromosome 22 translocation (22% rearranged cells) and the remaining 13 were negative, including the one case that resembled peripheral PNET. We conclude that PNETs derived from testicular germ cell tumors mostly resemble central nervous system PNETs and generally lack the chromosome 22 translocation of peripheral PNETs. Future treatment strategies should take these findings into account.
View details for PubMedID 20348883
Paclitaxel plus bevacizumab in patients with chemosensitive relapsed small cell lung cancer: a safety, feasibility, and efficacy study from the Hoosier Oncology Group.
Journal: Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
Authors: Jalal S; Bedano P; Einhorn L; Bhatia S; Ansari R; Bechar N; Koneru K; Govindan R; Wu J; Yu M; Schneider B; Hanna N;
Publication Date: 2010 Dec

Abstract

Bevacizumab when combined with carboplatin and paclitaxel improves response rates (RRs) and overall survival in patients with advanced non-small cell lung cancer. Paclitaxel has single-agent activity in relapsed small cell lung cancer (SCLC). Angiogenesis seems to play an important role in the pathogenesis of SCLC. This study evaluated the safety and efficacy of paclitaxel plus bevacizumab in patients with chemosensitive relapsed SCLC.
View details for PubMedID 21102263
Results of retroperitoneal lymph node dissection after chemotherapy in patients with pure seminoma in the orchidectomy specimen but elevated serum alpha-fetoprotein.
Journal: BJU international
Authors: Peterson M; Beck S; Bihrle R; Einhorn L; Foster R;
Publication Date: 2009 Jun 2

Abstract

To determine the incidence of necrosis, teratoma, and active cancer in specimens at retroperitoneal lymph node dissection (RPLND) after chemotherapy in patients who presented with a pure seminoma primary tumour and an elevated serum alpha-fetoprotein (AFP) level at diagnosis who underwent surgery.
View details for PubMedID 19493258
Multimodality treatment of germ cell tumors of the mediastinum.
Journal: Thoracic surgery clinics
Authors: Kesler KA; Einhorn LH;
Publication Date: 2009 Feb

Abstract

Germ cell tumors originating in the anterior mediastinal compartment represent a rare but biologically interesting group of neoplasms. Knowledge of the specific biologic behaviors and therapeutic strategies for the three histologic types is important. PMNSGCT represent the most challenging group of malignant germ cell tumors and survival outcome is dependant on both successful chemotherapy and surgery to remove residual disease when feasible. The authors currently believe nonbleomycin-containing regimens will reduce operative risks in this regard. New chemotherapy strategies that reduce the incidence of persistent nonseminatous germ cell or non-germ cell cancer need continued investigation. Although overall survival is inferior to nonseminomatous germ cell tumors of testicular origin, favorable subsets with pathologic evidence of either necrosis or teratoma have been identified. An aggressive surgical approach after cisplatin-based chemotherapy can result in long-term survival, even in patients with persistent nonseminomatous germ cell or non-germ cell cancer, and is warranted in these otherwise young and healthy patients.
View details for PubMedID 19288821
A case of relapsed testicular cancer initially isolated to the spleen.
Journal: American journal of clinical oncology
Authors: Moore AM; Simon SR; Einhorn LH;
Publication Date: 2009 Dec
Long-term outcome for patients with high volume retroperitoneal teratoma undergoing post-chemotherapy surgery.
Journal: The Journal of urology
Authors: Beck SD; Foster RS; Bihrle R; Einhorn LH; Donohue JP;
Publication Date: 2009 Apr 16

Abstract

We determined outcomes in patients with testicular cancer with large volume (greater than 10 cm) retroperitoneal teratoma treated with post-chemotherapy retroperitoneal lymph node dissection.
View details for PubMedID 19371895
Phase III study of cisplatin, etoposide, and concurrent chest radiation with or without consolidation docetaxel in patients with inoperable stage III non-small-cell lung cancer: the Hoosier Oncology Group and U.S. Oncology.
Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology
Authors: Hanna N; Neubauer M; Yiannoutsos C; McGarry R; Arseneau J; Ansari R; Reynolds C; Govindan R; Melnyk A; Fisher W; Richards D; Bruetman D; Anderson T; Chowhan N; Nattam S; Mantravadi P; Johnson C; Breen T; White A; Einhorn L; Hoosier Oncology Group; US Oncology;
Publication Date: 2008 Nov 10

Abstract

Concurrent chemoradiotherapy is standard treatment for patients with inoperable stage III non-small-cell lung cancer (NSCLC). A phase II study by the Southwest Oncology Group using consolidation docetaxel after cisplatin (P), etoposide (E), and radiation (XRT) resulted in a median survival time (MST) of 26 months. This randomized phase III trial evaluated whether consolidation docetaxel was responsible for this improved survival.
View details for PubMedID 19001323
Summary report 7th Annual Targeted Therapies of the Treatment of Lung Cancer.
Journal: Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
Authors: Einhorn LH; Bonomi P; Bunn PA Jr; Camidge DR; Carbone DP; Choy H; Dubinett SM; Gandara DR; Gaspar LE; Govindan R; Johnson DH; Minna JD; Scagliotti G; West HJ; Herbst RS;
Publication Date: 2008 May
Apparent surgical cure for metastatic small cell lung cancer.
Journal: Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
Authors: Pant-Purohit M; Cheng L; Einhorn L;
Publication Date: 2008 Jun
Recommendations on the use of 18F-FDG PET in oncology.
Journal: Journal of nuclear medicine : official publication, Society of Nuclear Medicine
Authors: Fletcher JW; Djulbegovic B; Soares HP; Siegel BA; Lowe VJ; Lyman GH; Coleman RE; Wahl R; Paschold JC; Avril N; Einhorn LH; Suh WW; Samson D; Delbeke D; Gorman M; Shields AF;
Publication Date: 2008 Feb 20

Abstract

The rationale was to develop recommendations on the use of (18)F-FDG PET in breast, colorectal, esophageal, head and neck, lung, pancreatic, and thyroid cancer; lymphoma, melanoma, and sarcoma; and unknown primary tumor. Outcomes of interest included the use of (18)F-FDG PET for diagnosing, staging, and detecting the recurrence or progression of cancer.
View details for PubMedID 18287273
A 25-year single institution experience with surgery for primary mediastinal nonseminomatous germ cell tumors.
Journal: The Annals of thoracic surgery
Authors: Kesler KA; Rieger KM; Hammoud ZT; Kruter LE; Perkins SM; Turrentine MW; Schneider BP; Einhorn LH; Brown JW;
Publication Date: 2008 Feb

Abstract

The treatment of primary mediastinal nonseminomatous germ cell tumors (PMNSGCT) with cisplatin-based chemotherapy, followed by surgical resection of residual disease, has been established. We reviewed our institution's 25-year experience in the cisplatin era to determine surgical risks and predictors of survival after surgery for PMNSGCT.
View details for PubMedID 18222228
Delayed effects of whole brain radiotherapy in germ cell tumor patients with central nervous system metastases.
Journal: International journal of radiation oncology, biology, physics
Authors: Doyle DM; Einhorn LH;
Publication Date: 2008 Apr 1

Abstract

Central nervous system (CNS) metastases are uncommon in patients with germ cell tumors, with an incidence of 2-3%. CNS metastases have been managed with whole brain radiotherapy (WBRT) and concomitant cisplatin-based combination chemotherapy. Our previous study did not observe serious CNS toxicity (Int J Radiat Oncol Biol Phys 1991;22:17-22). We now report on 5 patients who developed delayed significant CNS toxicity.
View details for PubMedID 18374223
Gefitinib plus celecoxib in chemotherapy-naïve patients with stage IIIB/IV non-small cell lung cancer: a phase II study from the Hoosier Oncology Group.
Journal: Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
Authors: Agarwala A; Fisher W; Bruetman D; McClean J; Taber D; Titzer M; Juliar B; Yu M; Breen T; Einhorn LH; Hanna N;
Publication Date: 2008 Apr

Abstract

Gefitinib, an inhibitor of the epidermal growth factor receptor (EGFR) pathway, has single agent activity in non-small cell lung cancer (NSCLC). Preclinical studies demonstrate significant interactions between the EGFR and cyclooxygenase 2 (COX-2) pathways and that simultaneous inhibition may have benefits over EGFR inhibitors alone.
View details for PubMedID 18379355
Is full bilateral retroperitoneal lymph node dissection always necessary for postchemotherapy residual tumor?
Journal: Cancer
Authors: Beck SD; Foster RS; Bihrle R; Donohue JP; Einhorn LH;
Publication Date: 2007 Sep 15

Abstract

Traditionally, postchemotherapy (PC) surgery for metastatic nonseminomatous germ cell tumor (NSGCT) has used a full bilateral retroperitoneal lymph node dissection (RPLND) from the crus of the diaphragm to the bifurcation of the common iliac arteries, from ureter to ureter. With the primary landing zone well defined in low-volume retroperitoneal disease, the authors performed modified dissections in the PC setting in a select population; and, herein, they report disease outcome.
View details for PubMedID 17665498
Is the blood-brain barrier relevant in metastatic germ cell tumor?
Journal: International journal of radiation oncology, biology, physics
Authors: Azar JM; Schneider BP; Einhorn LH;
Publication Date: 2007 Sep 1

Abstract

Germ cell tumors are uniquely chemosensitive and curable, even with advanced metastatic disease. Central nervous system recurrence can terminate a complete remission in other chemosensitive tumors, such as small cell lung cancer, because of the blood-brain barrier (BBB). We propose to document that the BBB is also relevant in germ cell tumors despite their dramatic chemosensitivity.
View details for PubMedID 17707269
Post chemotherapy RPLND in patients with elevated markers: current concepts and clinical outcome.
Journal: The Urologic clinics of North America
Authors: Beck SD; Foster RS; Bihrle R; Einhorn LH; Donohue JP;
Publication Date: 2007 May

Abstract

Elevated serum tumor markers after cisplatin-based chemotherapy usually contraindicate surgery because of the presence of active germ-cell elements; however, some patients have undergone PCRPLND with curative intent. We evaluated the role of surgery to resect retroperitoneal-only marker positive tumor. Residual germ-cell cancer was identified in 50% of patients with elevated tumor markers with one third alive at 5 years; 5-year survival with residual teratoma or necrosis was 77.5% and 85.7%, respectively. Predictors of retroperitoneal teratoma or fibrosis included declining tumor makers at surgery, betaHCG < 100, and first-line chemotherapy. Predictors of death included rising preoperative betaHCG, elevated AFP, redo RPLND, and active germ-cell cancer in the resected specimen. Select patients with elevated tumor markers after chemotherapy are cured with surgery.
View details for PubMedID 17484926
Mediastinal germ cell tumors.
Journal: The Annals of thoracic surgery
Authors: Kesler KA; Einhorn LH;
Publication Date: 2007 May
High-dose chemotherapy and stem-cell rescue for metastatic germ-cell tumors.
Journal: The New England journal of medicine
Authors: Einhorn LH; Williams SD; Chamness A; Brames MJ; Perkins SM; Abonour R;
Publication Date: 2007 Jul 26

Abstract

Metastatic testicular tumors that have not been successfully treated by means of initial chemotherapy are potentially curable with salvage chemotherapy.
View details for PubMedID 17652649
Phase II study of paclitaxel plus gemcitabine salvage chemotherapy for germ cell tumors after progression following high-dose chemotherapy with tandem transplant.
Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology
Authors: Einhorn LH; Brames MJ; Juliar B; Williams SD;
Publication Date: 2007 Feb 10

Abstract

To determine long-term survival and potential cure with salvage chemotherapy with paclitaxel plus gemcitabine after progression after both cisplatin combination chemotherapy and subsequent high-dose chemotherapy with tandem transplantation.
View details for PubMedID 17290059
Palonosetron plus dexamethasone for prevention of chemotherapy-induced nausea and vomiting in patients receiving multiple-day cisplatin chemotherapy for germ cell cancer.
Journal: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
Authors: Einhorn LH; Brames MJ; Dreicer R; Nichols CR; Cullen MT Jr; Bubalo J;
Publication Date: 2007 Apr 14

Abstract

The aims of this study were to assess the safety and antiemetic efficacy of multiple-day dosing of palonosetron plus dexamethasone in patients receiving highly emetogenic multiple-day cisplatin-based chemotherapy for germ cell tumors.
View details for PubMedID 17436025
Surgical therapy for testicular cancer metastatic to the liver.
Journal: HPB : the official journal of the International Hepato Pancreato Biliary Association
Authors: Maluccio M; Einhorn LH; Goulet RJ;
Publication Date: 2007

Abstract

In recent years improved cure rates have been achieved for testicular cancer. A better understanding of the biology of subtypes of testicular cancer and the introduction of surgical intervention has contributed greatly to how we currently approach a young man with testicular cancer. We describe here experience at our institution of the treatment, results and prognostic factors for testicular cancer metastases to the liver. Careful diagnostic work-up and planning of the therapy are required, in cooperation with an experienced team.
View details for PubMedID 18333222
Will we ever have personalized medicine for non-small cell lung cancer?
Journal: Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
Authors: Einhorn LH;
Publication Date: 2006 Sep
Randomized phase III trial comparing irinotecan/cisplatin with etoposide/cisplatin in patients with previously untreated extensive-stage disease small-cell lung cancer.
Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology
Authors: Hanna N; Bunn PA Jr; Langer C; Einhorn L; Guthrie T Jr; Beck T; Ansari R; Ellis P; Byrne M; Morrison M; Hariharan S; Wang B; Sandler A;
Publication Date: 2006 May 1

Abstract

Etoposide and cisplatin (EP) has been a standard treatment for extensive-disease small-cell lung cancer (SCLC). An earlier phase III trial reported improved survival for patients receiving irinotecan plus cisplatin (IP) versus EP. Our trial was designed to determine if a modified weekly regimen of IP would provide superior survival with less toxicity than EP.
View details for PubMedID 16648503
Gefitinib in patients with chemo-sensitive and chemo-refractory relapsed small cell cancers: a Hoosier Oncology Group phase II trial.
Journal: Lung cancer (Amsterdam, Netherlands)
Authors: Moore AM; Einhorn LH; Estes D; Govindan R; Axelson J; Vinson J; Breen TE; Yu M; Hanna NH;
Publication Date: 2006 Feb 20

Abstract

Gefitinib has demonstrated activity in patients with non-small cell lung cancer (NSCLC). Clinical trials have not demonstrated a relationship between response to gefitinib and over-expression of the epidermal growth factor receptor (EGFR). Although, EGFR is not over-expressed in small cell lung cancer (SCLC), we postulated that gefitinib might affect tumor growth through other mechanisms. Agents that are active in NSCLC usually are also effective in SCLC.
View details for PubMedID 16488055
Phase II study of imatinib mesylate in chemotherapy refractory germ cell tumors expressing KIT.
Journal: American journal of clinical oncology
Authors: Einhorn LH; Brames MJ; Heinrich MC; Corless CL; Madani A;
Publication Date: 2006 Feb

Abstract

This phase II study was conducted to determine the activity of imatinib (gleevec) in heavily pretreated patients with KIT-positive metastatic germ cell tumor.
View details for PubMedID 16462496
Phase II study of cisplatin plus epirubicin salvage chemotherapy in refractory germ cell tumors.
Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology
Authors: Bedano PM; Brames MJ; Williams SD; Juliar BE; Einhorn LH;
Publication Date: 2006 Dec 1

Abstract

Initial cisplatin (CIS) combination chemotherapy will cure 70% of patients with disseminated testicular cancer. This phase II clinical trial evaluated the combination of CIS plus epirubicin (CIS-EPI) in patients with metastatic germ cell tumors (GCT) not amenable to cure with standard salvage therapy.
View details for PubMedID 17135640
Emetic potential of daily oral etoposide.
Journal: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
Authors: Einhorn LH; Brames MJ;
Publication Date: 2006 Aug 1

Abstract

Chemotherapeutic agents are classified by their degree of emetogenicity. Highly and moderately emetogenic agents require antiemetic prophylaxis for chemotherapy-induced nausea and vomiting. Intravenous etoposide is listed as having low emetic potential. However, oral etoposide is categorized as having moderate emetogenicity. Daily oral etoposide is used in refractory germ cell cancer patients. We prospectively evaluated the emetic potential of oral etoposide in this patient population.
View details for PubMedID 16896880
Survival outcomes of resected patients who demonstrate a pathologic complete response after neoadjuvant chemoradiation therapy for locally advanced esophageal cancer.
Journal: Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus / I.S.D.E
Authors: Hammoud ZT; Kesler KA; Ferguson MK; Battafarrano RJ; Bhogaraju A; Hanna N; Govindan R; Mauer AA; Yu M; Einhorn LH;
Publication Date: 2006

Abstract

A variety of strategies, using chemotherapy, radiation therapy, and surgical resection have been employed in the treatment of locally advanced esophageal cancer. No strategy has proven superior, and poor long-term survival is anticipated. A survival benefit has been suggested for patients who achieve a pathologic complete response (pCR) following neoadjuvant chemoradiation therapy. We examined the collective results at three institutions of patients who achieved a pCR following neoadjuvant chemoradiation therapy. A retrospective, chart-based review was conducted. Kaplan-Meier calculations were used to determine overall and disease-free survival. Between 1995 and 2002, 229 patients were treated with neoadjuvant chemoradiation followed by surgery as a planned approach for locally advanced esophageal cancer. Forty-one patients (18%) demonstrated pCR and were the focus of this study. Histology was adenocarcinoma in 29, squamous in 10, and adenosquamous/undifferentiated in two patients. Forty patients were staged by endoscopic ultrasound prior to neoadjuvant therapy and all demonstrated a T-stage of 2 or higher, while 19 had evidence of nodal metastasis. Four patients died in the perioperative period. The remaining patients have been followed for an average of 46 months. Overall survival at 5 years was 56.4% and a median survival has not been reached. Esophageal cancer patients who demonstrate a pCR following neoadjuvant chemoradiation are a select subset who demonstrate excellent long-term survival. Identification of clinical variables or biomarkers predictive of pCR may therefore optimize treatment strategies of patients with locally advanced esophageal cancer.
View details for PubMedID 16643172
Outcome analysis for patients with elevated serum tumor markers at postchemotherapy retroperitoneal lymph node dissection.
Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology
Authors: Beck SD; Foster RS; Bihrle R; Einhorn LH; Donohue JP;
Publication Date: 2005 Sep 1

Abstract

To evaluate the therapeutic benefit of postchemotherapy retroperitoneal lymph node dissection (PCRPLND) in patients with persistently elevated serum tumor markers.
View details for PubMedID 16135481
Perspective on the development of new agents in thoracic cancers.
Journal: Lung cancer (Amsterdam, Netherlands)
Authors: Einhorn L;
Publication Date: 2005 Oct

Abstract

The development of several targeted agents that play a critical role in the growth and survival of carcinomas has paved the way for a new era in the treatment of patients with thoracic malignancies. The novel antimetabolite pemetrexed has emerged as a key agent in the treatment of advanced malignant pleural mesothelioma (MPM). Inhibitors of the epidermal growth factor receptor (EGFR) are one of many promising targeted therapies for non-small-cell lung cancer (NSCLC). By utilizing agents that specifically target the biochemical and molecular changes underlying cancer, it is possible to envision a future in which combinations of therapies treat cancer on multiple fronts, significantly enhancing tumor responses and improving survival beyond current expectations.
View details for PubMedID 16291431
Pathologic findings and therapeutic outcome of desperation post-chemotherapy retroperitoneal lymph node dissection in advanced germ cell cancer.
Journal: Urologic oncology
Authors: Beck SD; Foster RS; Bihrle R; Einhorn LH; Donohue JP;
Publication Date: 2005 Nov-Dec

Abstract

Increased serum tumor markers after cisplatin-based chemotherapy have usually been considered a contraindication to surgery because of the presence of persistent active germ cell elements. However, a select population of patients with elevated serum tumor markers have undergone post-chemotherapy retroperitoneal lymph node dissection (RPLND) with curative intent. We evaluated the role of surgery to resect retroperitoneal-only marker positive tumor. Long-term survival was observed in 50% of patients. Residual germ cell cancer was identified in 50% of patients, with a third alive at 5 years with no observed benefit from adjuvant chemotherapy. Select patients with increased tumor markers after chemotherapy are cured with surgery.
View details for PubMedID 16301122
Screening studies for fatigue and laboratory correlates in cancer patients undergoing treatment.
Journal: Annals of oncology : official journal of the European Society for Medical Oncology / ESMO
Authors: Shafqat A; Einhorn LH; Hanna N; Sledge GW; Hanna A; Juliar BE; Monahan P; Bhatia S;
Publication Date: 2005 May 26

Abstract

To understand the pathogenesis of fatigue in cancer, we conducted a cross-sectional study using Brief Fatigue Inventory (BFI) and Functional Assessment of Cancer Therapy-Fatigue (FACT-F) instruments to measure fatigue and assessed laboratory studies.
View details for PubMedID 15919683
A phase II study of methylphenidate for the treatment of fatigue.
Journal: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
Authors: Hanna A; Sledge G; Mayer ML; Hanna N; Einhorn L; Monahan P; Daggy J; Bhatia S;
Publication Date: 2005 Aug 12

Abstract

Cancer-related fatigue (CRF) is one of the most distressing symptoms patients experience and is seen well after the completion of treatment. Methylphenidate (Ritalin) use includes the treatment of opiate-induced somnolence, depression, and reduced cognition. This phase II study was performed to evaluate the effects of methylphenidate on CRF.
View details for PubMedID 16096772
Surgical salvage therapy for malignant intrathoracic metastases from nonseminomatous germ cell cancer of testicular origin: analysis of a single-institution experience.
Journal: The Journal of thoracic and cardiovascular surgery
Authors: Kesler KA; Wilson JL; Cosgrove JA; Brooks JA; Messiha A; Fineberg NS; Einhorn LH; Brown JW;
Publication Date: 2005 Aug

Abstract

Cisplatin-based chemotherapy followed by surgical extirpation of residual benign disease represents the usual sequence of curative therapy for metastatic nonseminomatous germ cell cancer of testicular origin. Occasionally, residual disease is malignant in the form of either a persistent nonseminomatous germ cell cancer tumor or degeneration into non-germ cell cancer. We reviewed our institution's experience with patients undergoing salvage operations to remove malignant intrathoracic metastases.
View details for PubMedID 16077406
A retrospective analysis of locally advanced esophageal cancer patients treated with neoadjuvant chemoradiation therapy followed by surgery or surgery alone.
Journal: The Annals of thoracic surgery
Authors: Kesler KA; Helft PR; Werner EA; Jain NP; Brooks JA; DeWitt JM; Leblanc JK; Fineberg NS; Einhorn LH; Brown JW;
Publication Date: 2005 Apr

Abstract

We conducted an institutional review of patients with locally advanced esophageal cancer who had complete pretreatment and surgical staging to identify variables predictive of outcome.
View details for PubMedID 15797035