Journal Spotlight
VISTA Checkpoint Implicated in Pancreatic Cancer Immunotherapy Resistance
The ASCO Post
Researchers have identified a new potential immunotherapy target in pancreatic cancer, which so far has been notoriously resistant to treatment with immune checkpoint blockade drugs effective against a variety of other cancers. A research team from The University of Texas MD Anderson Cancer Center f...
Biologic Age and Elevated Risk of Breast Cancer
The ASCO Post
Biologic age—a DNA-based estimate of a person’s age—may be associated with the development of breast cancer, according a report published by Jacob K. Kresovich, PhD, of the National Institute of Environmental Health Sciences (NIEHS), and colleagues in the Journal of the National Cancer Institute.1 ...
New ASCO Guideline on Head and Neck Cancer Clarifies Lymph Node Management
Tim Donald, ELS
A NEW ASCO guideline, “Management of the Neck in Squamous Cell Carcinoma of the Oral Cavity and Oropharynx: ASCO Clinical Practice Guideline,” aims to clarify issues in lymph node management.1 “This guideline represents a true multidisciplinary synthesis of some important new information about...
Radical Prostatectomy or Watchful Waiting: 29-Year Follow-up of Scandinavian Trial
Matthew Stenger
AS REPORTED in The New England Journal of Medicine by Anna Bill-Axelson, MD, PhD, Lars Holmberg, MD, PhD, both of Uppsala University Hospital, and and colleagues, the 29-year follow-up of the Scandinavian Prostate Cancer Group Study Number 4 (SPCG-4) trial has shown that radical prostatectomy is ass...
Prostatectomy vs Watchful Waiting: Clinical Dilemma Centers on Aggressive vs Indolent Disease
Hind Rafei, MD, and Brian F. Chapin, MD
THE MANAGEMENT of localized prostate cancer remains controversial. Although the widespread use of prostate-specific antigen (PSA) testing has resulted in a dramatic increase in the diagnosis and treatment of prostate cancer, many men do not benefit from intervention because the disease is ...
ASCO Endorses Active Surveillance Guideline for Low-Risk Prostate Cancer
Kathy Holliman, MEd
ASCO ENDORSES and reinforces the evidence-based American Urological Association (AUA), American Society for Radiation Oncology (ASTRO), and the Society of Urologic Oncology (SUO) Guideline published in 2018 in the Journal of Urology. ASCO’s endorsement of a guideline on clinically localized prostate...
New ASCO Guideline Makes Safe Handling of Hazardous Drugs a Priority
ASCO HAS PUBLISHED a new guideline, “Safe Handling of Hazardous Drugs: ASCO Standards,” to promote the safety of pharmacists, nurses, and all staff who handle potentially dangerous medicines, such as chemotherapy compounds.1 Safety is pivotal in the entire drug workflow, including drug mixing and pr...
Tisagenlecleucel Active in Adult Relapsed or Refractory Diffuse Large B-Cell Lymphoma
Matthew Stenger
As reported in The New England Journal of Medicine by Stephen J. Schuster, MD, of Abramson Cancer Center, University of Pennsylvania, and colleagues, the international phase II JULIET trial has shown high response rates with the chimeric antigen receptor (CAR) T-cell therapy tisagenlecleucel in...
National Consensus Project Releases 4th Edition of Clinical Practice Guidelines for Quality Palliative Care
Matthew Stenger
As reported by Betty R. Ferrell, PhD, MA, FAAN, FPCN, of the Division of Nursing Research and Education, City of Hope Medical Center, Duarte, California, and colleagues in the Journal of Palliative Medicine, the National Consensus Project (NCP) of the National Coalition for Hospice and Pal...
Addition of Elotuzumab to Pomalidomide and Dexamethasone in Previously Treated Patients With Multiple Myeloma
Matthew Stenger
AS REPORTED in The New England Journal of Medicine by Meletios A. Dimopoulos, MD, of the National and Kapodistrian University of Athens, and colleagues, the phase II ELOQUENT-3 trial has shown that the addition of elotuzumab to pomalidomide and dexamethasone significantly prolonged progression-...
Reshaping the Treatment Landscape in Refractory Multiple Myeloma
Shaji K. Kumar, MD
THE TREATMENT approaches for multiple myeloma, both newly diagnosed and relapsed disease, continue to undergo major transformation as new agents and combinations are being introduced.1 This change has been driven by the introduction of novel drug classes such as monoclonal antibodies, as well a...
Lorlatinib Shows Overall and Intracranial Activity in ALK-Positive NSCLC
Matthew Stenger
IN A GLOBAL phase II study reported in The Lancet Oncology, Benjamin J. Solomon, MBBS, of Peter MacCallum Cancer Centre, Melbourne, and colleagues found that lorlatinib showed high overall and intracranial activity in patients with advanced ALK-positive non–small cell lung cancer (NSCLC) who were tr...
PACIFIC Trial of Durvalumab Sets Standard in Stage III Unresectable NSCLC
Karen L. Reckamp, MD, MS
IMMUNOTHERAPY HAS revolutionized the treatment of lung cancer over the past several years. Although lung cancer is associated with immunosuppression at baseline for most patients, the addition of immune checkpoint inhibitors can overcome that suppression and lead to antitumor immune responses. ...
Addition of Atezolizumab to Nab-Paclitaxel in Advanced Triple-Negative Breast Cancer: IMpassion130 Trial
Matthew Stenger
AS REPORTED in The New England Journal of Medicine by Peter Schmid, MD, PhD, of the Barts Cancer Institute, Queen Mary University of London, and colleagues, the phase III IMpassion130 trial has shown that the addition of atezolizumab to nanoparticle albumin-bound (nab)-paclitaxel significantly ...
IMpassion130 Trial: Changing the Treatment Landscape in Metastatic Triple-Negative Breast Cancer
Kevin Kalinsky, MD, MS, and Dawn Hershman, MD, MS
THE IMPASSION130 trial—reported in The New England Journal of Medicine by Schmid et al1 and reviewed in this issue of The ASCO Post—was an eagerly awaited study in newly diagnosed metastatic triple-negative breast cancer. To briefly review, 902 patients were randomly assigned in a 1:1 fash...
Minimally Invasive vs Open Abdominal Radical Hysterectomy in Early-Stage Cervical Cancer
Matthew Stenger
TWO STUDIES recently reported in The New England Journal of Medicine indicate that minimally invasive radical hysterectomy is associated with poorer survival outcomes than open abdominal radical hysterectomy in women with early-stage cervical cancer. As reported by Pedro T. Ramirez, MD, of The Unive...
Durvalumab Improves Overall Survival After Chemoradiotherapy in Unresectable, Stage III NSCLC
Matthew Stenger
AS REPORTED in The New England Journal of Medicine by Scott J. Antonia, MD, PhD, of H. Lee Moffitt Cancer Center and Research Institute, and colleagues, the phase III PACIFIC trial has shown significantly improved overall survival, a coprimary endpoint, with the programmed cell death ligand 1 (...
ASCO and ESMO Publish Joint Assessment of Their Value Frameworks
Jo Cavallo
TO BETTER UNDERSTAND the performance characteristics of ASCO’s Value Framework Net Health Benefit Score version 2 (ASCO-NHB v2)1 and the European Society for Medical Oncology’s (ESMO’s) Magnitude of Clinical Benefit Scale version 1.1 (ESMO-MCBS v1.1),2 ASCO and ESMO undertook a joint project to iden...
Encorafenib Plus Binimetinib vs Vemurafenib in Advanced BRAF-Mutant Melanoma
Matthew Stenger
AS REPORTED in The Lancet Oncology by Reinhard Dummer, MD, of the University Hospital Zurich Skin Cancer Center, and colleagues, the phase III COLUMBUS trial has shown a significant improvement in overall survival with the combination of the BRAF inhibitor encorafenib (Braftovi) and the MEK inh...
Encorafenib and Binimetinib: A New Benchmark in Metastatic Melanoma Therapy?
William H. Sharfman, MD
IN JULY 2018, the U.S. Food and Drug Administration (FDA) approved the combination of the oral BRAF inhibitor encorafenib (Braftovi) and the oral MEK inhibitor binimetinib (Mektovi) for BRAF V600E– or V600K– positive metastatic melanoma. The FDA approval was based on the results of the COLUMBUS...
ASTRO/ASCO/AUA Guideline for Early-Stage Prostate Cancer Supports Use of Hypofractionated Radiotherapy
The ASCO Post
Three prominent medical organizations have issued a new clinical guideline for physicians treating men with early-stage prostate cancer using external-beam radiation therapy (EBRT). Developed by a panel of experts from the American Society for Radiation Oncology (ASTRO), ASCO, and the American Urolo...
Quality of Life With Postmastectomy Radiotherapy vs No Radiotherapy in Intermediate-Risk Breast Cancer
The ASCO Post
In a 2-year follow-up of the phase III SUPREMO trial reported in The Lancet Oncology, Galina Velikova, PhD, of the Leeds Cancer Centre, St. James’s University Hospital, United Kingdom, and colleagues found worse chest wall symptoms in women with intermediate-risk breast cancer who did vs did no...
Duvelisib vs Ofatumumab in Relapsed or Refractory CLL/SLL
Matthew Stenger
As reported in Blood by Ian W. Flinn, MD, PhD, Director of the Lymphoma Research Program at Sarah Cannon Research Institute, and colleagues, the phase III DUO trial has shown significantly prolonged progression-free survival with the phosphoinositide 3-kinase (PI3K)-δ/γ inhibitor duvelisib (Cop...
Corticosteroid Use at Start of PD-1/PD-L1 Inhibitor Therapy Affects Outcomes in NSCLC
Matthew Stenger
IN A STUDY reported in the Journal of Clinical Oncology, Kathryn C. Arbour, MD, of Memorial Sloan Kettering Cancer Center, and colleagues found that baseline treatment with corticosteroids was associated with poorer efficacy of programmed cell death protein 1/programmed cell death ligand 1 (PD-...
Corticosteroids and Immunotherapy: Guilty or Guilt By Association?
Thomas E. Stinchcombe, MD
FIRST-LINE TREATMENT options for advanced non–small cell lung cancer (NSCLC) include single- agent immunotherapy for patients with a programmed cell death ligand 1 (PD-L1) tumor proportion score of at least 50% or in combination with chemotherapy in unselected patients.1-3 Single immunotherapy ...
Cabozantinib Improves Survival in Patients With Previously Treated Hepatocellular Carcinoma
Matthew Stenger
As reported in The New England Journal of Medicine by Ghassan K. Abou‑Alfa, MD, of Memorial Sloan Kettering Cancer Center, and colleagues, the second interim analysis of the phase III CELESTIAL trial has shown a significant improvement in overall and progression-free survival with cabozantinib (Come...
Rituximab/Lenalidomide vs Rituximab/Chemotherapy in Advanced Untreated Follicular Lymphoma
Matthew Stenger
In the phase III RELEVANCE trial reported in The New England Journal of Medicine by Franck Morschhauser, MD, PhD, of The University of Lille, Centre Hospitalier Universitaire Lille, France, and colleagues, no difference in the complete response rate or interim progression-free survival was found bet...
Mogamulizumab Improves Progression-Free Survival vs Vorinostat in Cutaneous T-Cell Lymphoma
Matthew Stenger
As reported by Youn H. Kim, MD, of Stanford Cancer Institute, Stanford University School of Medicine, and colleagues in The Lancet Oncology, the phase III MAVORIC trial showed that the anti-C-C chemokine receptor 4 (CCR4) monoclonal antibody mogamulizumab (Poteligeo) significantly improved progressi...
Talazoparib Improves Progression-Free Survival in Advanced Breast Cancer With Germline BRCA Mutation
Matthew Stenger
As reported in The New England Journal of Medicine by Jennifer K. Litton, MD, of The University of Texas MD Anderson Cancer Center, and colleagues, the phase III EMBRACA trial has shown significantly improved progression-free survival with the poly (ADP-ribose) polymerase (PARP) inhibitor talaz...
Addition of Bevacizumab to Neoadjuvant Therapy in BRCA1/2-Mutant Triple-Negative Breast Cancer
Matthew Stenger
In an analysis from the GeparQuinto trial reported in the Journal of Clinical Oncology, Peter A. Fasching, MD, of Erlangen University Hospital, Comprehensive Cancer Center Erlangen-EMN, and colleagues found that the addition of bevacizumab (Avastin) to neoadjuvant chemotherapy increased the lik...
Treating Nonmetastatic Castration-Resistant Prostate Cancer: Implications of the PROSPER Trial
Konrad H. Stopsack, MD, MPH, and Philip Kantoff, MD
A MAN in his early 70s sits in our office. His general health is good, and he is feeling well. Yet he is deeply worried. Four years ago, when his prostate-specific antigen (PSA) level rapidly increased after radical prostatectomy and subsequent radiation therapy, he was started on androgen...
Suboptimal Use of Initial Chemotherapy in Newly Diagnosed Acute Myeloid Leukemia
Matthew Stenger
IN A STUDY of National Cancer Database data reported in Blood Advances, Vijaya Raj Bhatt, MD, of the University of Nebraska Medical Center, and colleagues found that 25% of patients with newly diagnosed acute myeloid leukemia (AML) did not receive initial chemotherapy, despite evidence that che...
Chemotherapy for Acute Myeloid Leukemia: Where Should It Be Given?
Elihu H. Estey, MD
USING THE National Cancer Database, Bhatt et al1 recently reported that of the 61,775 adults with acute myeloid leukemia (AML), those who received chemotherapy from 2003 to 2011 lived longer than those who, in those same years, did not; the study is reviewed in this issue of The ASCO Post. Alth...
Active Surveillance of Lung Subsolid Nodules May Reduce Unnecessary Surgery and Overtreatment
The ASCO Post
Subsolid nodules can be considered a biomarker of lung cancer risk and should be managed with long-term active surveillance. Conservative management of subsolid nodules may reduce unnecessary surgery and overtreatment in patients with multiple comorbidities and aggressive lung cancer arising from lu...
First Large-Scale Survey of APPs in Oncology Shows Growing Role for Nurse Practitioners and Physician Assistants
The ASCO Post
Advanced practice providers (APPs) have increasingly become integral members of the oncology care delivery team, according to the first large-scale study of nurse practitioners (NPs) and physician assistants (PAs) in oncology. The study was conducted collaboratively by ASCO, the American Academy of ...
Most Oncologists Have Discussed Medical Marijuana With Patients, Survey Finds
The ASCO Post
DATA FROM a new survey show that as many as 80% of oncologists have discussed medical marijuana use with their patients. According to the authors, this is the first nationally representative survey to examine oncologists’ practices and beliefs on the subject since the implementation of state medical...
Enzalutamide Prolongs Metastasis-Free Survival in Patients With Nonmetastatic, Castration-Resistant Prostate Cancer
Matthew Stenger
AS REPORTED in The New England Journal of Medicine by Maha Hussain, MD, of the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, and colleagues, the phase III PROSPER trial has shown a 71% reduction in the risk of metastasis or death with enzalutamide (Xtandi) vs placebo in ...
New Tool for Assessing Frailty in Patients With Newly Diagnosed Multiple Myeloma
The ASCO Post
A NEW “frailty index” may predict overall survival for patients newly diagnosed with multiple myeloma, according to a study published in JCO Clinical Cancer Informatics.1 Frailty is a critical factor in treatment decision-making for many patients with multiple myeloma, as many of these patients are ...
ACS Nutrition and Physical Activity Guidelines for Cancer Survivors and Outcomes After Colon Cancer Diagnosis
Matthew Stenger
IN A STUDY reported in JAMA Oncology, Erin L. Van Blarigan, ScD, of the University of California, San Francisco, and colleagues found that adherence to American Cancer Society (ACS) nutrition and physical activity guidelines for cancer survivors was associated with improved survival among patie...
Following a Healthy Diet and Avoiding Alcohol May Reduce Overall Cancer Risk
The World Cancer Research Fund/American Institute for Cancer Research has estimated that in developed countries, about 35% of breast cancers and 45% of colorectal cancers could be prevented with better adherence to nutritional recommendations. A large prospective study evaluating adherence to nutrit...
Opportunities, Issues, and Challenges for Biosimilars in Oncology
Matthew Stenger
In an article published recently in TheNew England Journal of Medicine, Gary H. Lyman, MD, MPH, FACP, FRCP (Edin), FASCO, of Fred Hutchinson Cancer Research Center in Seattle, and colleagues reviewed opportunities, issues, and challenges posed by the advent of biosimilar medications, focusing on bio...
No Survival Benefit for Atezolizumab inPD-L1–Positive Urothelial Cancer
Matthew Stenger
As reported in The Lancet by Thomas Powles, MD, of Barts Cancer Institute, Queen Mary University of London, and colleagues, the phase III IMvigor211 trial showed no survival benefit for atezolizumab vs physician’s choice of chemotherapy in platinum-treated locally advanced or metastatic urothelial c...
Outcomes in Patients With Melanoma Treated With Anti–PD-1 Antibody Beyond Disease Progression
Matthew Stenger
A POOLED analysis by the U.S. Food and Drug Administration (FDA) has shown a benefit of treatment beyond disease progression on Response Evaluation Criteria in Solid Tumors (RECIST) in some patients receiving anti–programmed cell death protein 1 (anti–PD-1) antibodies for unresectable or metast...
Treatment Beyond Disease Progression in Melanoma: Challenge Centers on Knowing Who May Benefit
Sarah A. Weiss, MD, and Mario Sznol, MD
Dr. Weiss is Assistant Professor (Medical Oncology), Developmental Therapeutics, Melanoma Program, Yale Cancer Center. Dr. Sznol is Professor of Medicine (Medical Oncology); Co-Director, Cancer Immunology Program, Yale Cancer Center Co-Director, Yale SPORE in Skin Cancer, New Haven, Connecticut. ...
Testicular Cancer Survivors and Adequate Screening for Long-Term Heart Disease
TESTICULAR CANCER is among the most common cancers in young men. The majority of patients are cured of their disease, but a newly published study shows many remain at risk for later complications from chemotherapy or other treatments. The study, published by Mohammad Abu Zaid, MD, Assistant Professo...
Outcomes of Tisagenlecleucel Therapy in Children and Young Adults With B-Cell Acute Lymphoblastic Leukemia
Matthew Stenger
As reported in The New England Journal of Medicine by Shannon L. Maude, MD, PhD, of Perelman School of Medicine, University of Pennsylvania, Philadelphia, and colleagues, the phase II ELIANA trial has shown that the anti-CD19 chimeric antigen receptor (CAR) T-cell therapy tisagenlecleucel (Kymriah) ...
ASCO Clinical Practice Guideline: Optimizing Anticancer Therapy in Metastatic Non-castrate Prostate Cancer
Matthew Stenger
As reported in the Journal of Clinical Oncology by Michael J. Morris, MD, of Memorial Sloan Kettering Cancer Center and Weill Cornell Medicine, and colleagues, ASCO has released a clinical practice guideline on optimizing anticancer therapy in men with metastatic non-castrate prostate canc...
Patients With AML Have Reduced Risk of Early Mortality at NCI-Designated Cancer Centers
RESEARCHERS AT the University of California (UC), Davis, have shown that patients with acute myeloid leukemia (AML) who received their care at a National Cancer Institute (NCI) cancer center in California had a dramatically reduced risk of early mortality. Using data from the California Cancer Regis...
Disparities Found in Lung Cancer Care, Survival in United States vs England
DESPITE STEADY declines in death rates in recent years, lung cancer remains the leading cause of cancer deaths in wealthy countries. In a study published by Anita Andreano, MD, of the University of Milan-Ciocco, and colleagues in the Journal of Thoracic Oncology,1 Yale researchers collaborated with ...
Durable Complete Responses After Discontinuation of Pembrolizumab in Metastatic Melanoma
Matthew Stenger
As reported in the Journal of Clinical Oncology by Caroline Robert, MD, PhD, of Institut Gustave Roussy, Villejuif, France, and colleagues, a high proportion of patients with metastatic melanoma achieving a complete response on pembrolizumab (Keytruda) in the phase Ib KEYNOTE-001 trial maintained th...
CheckMate 214: Nivolumab Plus Ipilimumab Improves Survival vs Sunitinib in Advanced Renal Cell Cancer
Matthew Stenger
As reported in The New England Journal of Medicine by Robert J. Motzer, MD, of Memorial Sloan Kettering Cancer Center, and colleagues, the phase III CheckMate 214 trial has shown an overall survival advantage with nivolumab (Opdivo) plus ipilimumab (Yervoy) vs sunitinib (Sutent) in patients with pre...
ASCO Clinical Practice Guideline: Management of Immune-Related Adverse Events From Immune Checkpoint Inhibitor Therapy
Matthew Stenger
As reported in the Journal of Clinical Oncology by Julie R. Brahmer, MD, of Johns Hopkins Kimmel Cancer Center, and colleagues, ASCO has released a clinical practice guideline on management of immune-related adverse events in patients receiving immune checkpoint inhibitor therapy.1 Immune ...
MRI-Targeted vs Standard Biopsy in Prostate Cancer Diagnosis: The PRECISION Trial
Matthew Stenger
In the international PRECISION trial reported in The New England Journal of Medicine, Veeru Kasivisvanathan, MRCS, of University College London, and colleagues found that magnetic resonance imaging (MRI)-targeted biopsy resulted in a significantly higher rate of diagnosis of clinically signific...
Role of MRI in Detection of Clinically Significant Prostate Cancer: ‘Practice-Affirming’ Results From The PRECISION Trial
Lucas W. Dean, MD and Karim Touijer, MD, MPH
Simultaneously presented at the 2018 European Association of Urology meeting and published in The New England Journal of Medicine, the PRECISION trial will go down as a landmark study for solidifying the role of magnetic resonance imaging (MRI) in prostate cancer diagnosis.1 This trial pro...
Adding Hyperthermic Intraperitoneal Chemotherapy to Cytoreductive Surgery Improves Outcomes in Advanced Ovarian Cancer
Matthew Stenger
In a Dutch/Belgian phase III trial reported in The New England Journal of Medicine by Willemien J. van Driel, MD, PhD, of the Netherlands Cancer Institute, and colleagues, the addition of hyperthermic intraperitoneal chemotherapy (aka HIPEC) to interval cytoreductive surgery following neoadjuva...
How a Recent Study Heats up the Debate Over Intraperitoneal Chemotherapy in Newly Diagnosed Advanced Ovarian Cancer
Bradley J. Monk, MD, FACS, FACOG
Based on pharmacokinetic and preclinical data, there appears to be a biologic advantage to the use of intraperitoneal chemotherapy in treating some malignancies confined to the abdomen. Since most ovarian, fallopian tube, and peritoneal cancers present and recur in the peritoneal cavi...
Once-Weekly vs Every-3-Week Cisplatin Chemoradiation in Locally Advanced Head and Neck Cancer
Matthew Stenger
In an Indian phase III trial reported in the Journal of Clinical Oncology, Vanita Noronha, MD, of Tata Memorial Hospital, Mumbai, and colleagues found that curative-intent adjuvant chemoradiation with cisplatin at 100 mg/m2 every 3 weeks produced better locoregional control vs cisplatin at 30 m...
Targeted Sequencing Detection of Molecular Minimal Residual Disease and Prognosis in Acute Myeloid Leukemia
Matthew Stenger
In a study reported in The New England Journal of Medicine, Mojca Jongen-Lavrencic, MD, PhD, of Erasmus MC Cancer Institute, and colleagues found that molecular minimal residual disease identified by next-generation sequencing during complete remission was associated with an increased risk of r...
Molecular Minimal Residual Disease Detection Shows Further Promise in Acute Myeloid Leukemia
Andrew Dunbar, MD, and Martin Tallman, MD
Extended next-generation sequencing genomic profiling in acute myeloid leukemia (AML) has revealed remarkable heterogeneity and molecular complexity of the disease and provided critical insights into the genetic mechanisms underpinning of preleukemic and leukemic pathogenesis.1,2 Despite s...
Treatment of Malignant Pleural Mesothelioma: ASCO Clinical Practice Guideline
Matthew Stenger
As reported by Hedy L. Kindler, MD, of the University of Chicago, and colleagues in the Journal of Clinical Oncology, ASCO has released a clinical practice guideline on the treatment of malignant pleural mesothelioma.1 The guideline was based on a systematic literature search and expert pa...
Sentinel Lymph Node Biopsy and Management of Regional Lymph Nodes in Melanoma: ASCO/SSO Clinical Practice Guideline Update
Matthew Stenger
AS REPORTED IN the Journal of Clinical Oncology by Sandra L. Wong, MD, of Dartmouth-Hitchcock Medical Center, and colleagues, ASCO and the Society of Surgical Oncology (SSO) have issued an update to the ASCO/SSO clinical practice guideline on sentinel lymph node biopsy and management of regional lym...
Updated ASCO/SSO Guideline on Sentinel Lymph Node Biopsy in Melanoma: Addressing Fundamental Clinical Questions
John F. Thompson, MD, FRACS, FACS
Dr. Thompson is Professor of Melanoma and Surgical Oncology, Sydney Medical School, The University of Sydney, and Senior Surgeon, Melanoma Institute Australia, Sydney. IN THE MID-1990s, the surgical management of patients presenting with primary cutaneous melanomas changed forever when the sen...
Combined Immune Checkpoint and VEGF Inhibition as First-Line Therapy in Advanced Clear Cell Kidney Cancer
Matthew Stenger
In a dose-finding, dose-expansion phase Ib trial (JAVELIN Renal 100) reported in The Lancet Oncology, Toni K. Choueiri, MD, of Dana-Farber Cancer Institute and Brigham and Women’s Hospital, and colleagues determined the maximum tolerated dose of the immune checkpoint inhibitor avelumab (Bavencio) in...
Role of Bone-Modifying Agents in Multiple Myeloma
Matthew Stenger
As reported in the Journal of Clinical Oncology by Kenneth C. Anderson, MD, of Dana-Farber Cancer Institute, and colleagues, ASCO has issued a clinical practice guideline update on the role of bone-modifying agents in multiple myeloma.1 The update was performed by an expert panel systemati...
Axicabtagene Ciloleucel CAR T-Cell Therapy Active in Refractory Large B-Cell Lymphoma
Matthew Stenger
As reported at the 2017 American Society of Hematology (ASH) Meeting & Exposition and in The New England Journal of Medicine by Sattva S. Neelapu, MD, of The University of Texas MD Anderson Cancer Center, and colleagues, a phase II trial has shown high activity of autologous anti-CD19 chimeric a...
Nut Consumption in Patients With Stage III Colon Cancer
The ASCO Post
People with stage III colon cancer who regularly eat tree nuts are at significantly lower risk of cancer recurrence and mortality than those who don’t, according to findings published by Fadelu et al in the Journal of Clinical Oncology.1 Study Findings The study followed 826 participants in the CA...
Encorafenib Plus Binimetinib Improves Progression-Free Survival vs Vemurafenib in Advanced BRAF-Mutant Melanoma
Matthew Stenger
IN THE PHASE III COLUMBUS trial reported in The Lancet Oncology, Reinhard Dummer, MD, of University Hospital Zurich, and colleagues found that the combination of the BRAF inhibitor encorafenib and the MEK inhibitor binimetinib improved progression-free survival vs vemurafenib (Zelboraf) in pati...
Breast Cancer Care in U.S. Territories Seems to Lag Behind Care in Continental United States
The ASCO Post
OLDER WOMEN residing in U.S. territories are less likely to receive recommended or timely care for breast cancer compared with similar women residing in the continental United States, according to Yale researchers, whose findings were published in Health Affairs.1 “Inferior breast c...
Osimertinib Improves Progression-Free Survival vs Standard EGFR Inhibitors in EGFR-Mutant NSCLC
Matthew Stenger
AS REPORTED in The New England Journal of Medicine by Jean-Charles Soria, MD, PhD, of Gustave Roussy Cancer Campus and University Paris-Sud, and colleagues, the phase III FLAURA trial has shown a significant progression-free survival benefit with the third-generation epidermal growth factor rec...
Osimertinib: A New Standard of Care in Initial Treatment of EGFR-Mutant NSCLC
Suresh S. Ramalingam, MD
Dr. Ramalingam is Professor of Hematology and Medical Oncology, Emory University School of Medicine, Winship Cancer Institute, Atlanta. MUTATIONS IN the epidermal growth factor receptor (EGFR) gene were discovered in 2004. These mutations, localized most commonly to exon 19 or 21, vary in prev...
Interventions to Address Sexual Problems in People With Cancer: ASCO Clinical Practice Guideline Adaptation of CCO Guideline
Matthew Stenger
AS REPORTED in the Journal of Clinical Oncology by Jeanne Carter, PhD, of Memorial Sloan Kettering Cancer Center, and colleagues, ASCO has issued a clinical practice guideline adaptation of the Cancer Care Ontario (CCO) guideline on interventions to address sexual problems in people with c...
It Starts With a Discussion: ASCO Guideline on Interventions to Address Sexual Problems in People With Cancer
Anne Katz, PhD, RN, FAAN
Dr. Katz is a certified sexuality counselor at CancerCare Manitoba, Canada. SEXUALITY AND SEXUAL functioning are important to cancer survivors, and considering the significant number of survivors, this is an issue that should not be ignored. In a survey of cancer survivors who had completed treatme...
Does Treatment With Tumor-Treating Fields Plus Temozolomide Influence Quality of Life in Patients With Newly Diagnosed Glioblastoma?
The ASCO Post
A DETAILED quality-of-life analysis of the phase III EF-14 trial of tumor-treating fields (Optune) in combination with temozolomide for the treatment of newly diagnosed glioblastoma was published by Taphoorn et al in JAMA Oncology.1 This secondary endpoint analysis showed the addition of tumor-treat...
ASCO Clinical Practice Guideline Update: Use of Larynx-Preservation Strategies in the Treatment of Laryngeal Cancer
Matthew Stenger
AS REPORTED in the Journal of Clinical Oncology by Arlene A. Forastiere, MD, of The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, and colleagues, ASCO has issued a clinical practice guideline update on the use of larynx-preservation strategies in the treatment of laryngeal ca...
Retrospective Analysis Suggests Obesity Associated With Longer Survival for Men With Metastatic Melanoma
The ASCO Post
OBESE PATIENTS with metastatic melanoma who are treated with targeted or immune therapies live significantly longer than those with a normal body mass index (BMI), according to a study published in The Lancet Oncology of 1,918 patients in 6 independent clinical cohorts.1 This effect—referred to as...
USPSTF Recommends Against Screening for Ovarian Cancer in Asymptomatic Women
The ASCO Post
THE U.S. PREVENTIVE Services Task Force (USPSTF) recently published a final recommendation statement and evidence summary on screening for ovarian cancer. Based on its review of the evidence, the USPSTF recommends against screening for ovarian cancer in women who do not have any signs or symptoms ...
Avelumab Active in Advanced Urothelial Carcinoma After Platinum Failure
Matthew Stenger
AS REPORTED in The Lancet Oncology by Manish R. Patel, MD, of Florida Cancer Specialists/Sarah Cannon Research Institute, and colleagues, the anti–programmed cell death ligand 1 (PD-L1) antibody avelumab (Bavencio) produced durable responses in patients with locally advanced or metastatic urothelial...
ASCO/CCO Focused Guideline Update on Role of Bone-Modifying Agents in Metastatic Breast Cancer
Matthew Stenger
AS REPORTED BY Catherine Van Poznak, MD, FASCO, of the University of Michigan, Ann Arbor, and colleagues in the Journal of Clinical Oncology, ASCO and Cancer Care Ontario (CCO) have collaborated in providing a focused update for the ASCO clinical practice guideline on the role of bone-modifying...
ASCO Endorses ASTRO Guideline on Stereotactic Body Radiotherapy for Early-Stage NSCLC
Matthew Stenger
As reported in the Journal of Clinical Oncology by Bryan J. Schneider, MD, of the University of Michigan, Ann Arbor, and colleagues, ASCO has endorsed the recently released American Society for Radiation Oncology (ASTRO) evidence-based guideline on stereotactic body radiotherapy (SBRT) in ...
Cancer Statistics, 2018: U.S. Cancer Mortality Continues Decades-Long Drop
The ASCO Post
THE CANCER death rate dropped 1.7% from 2014 to 2015, continuing a drop that began in 1991 and has reached 26%, resulting in nearly 2.4 million fewer cancer deaths during that time. The data are reported in “Cancer Statistics, 2018,” the American Cancer Society’s comprehensive annual report on can...
Reports From the Journal of Clinical Oncology
Matthew Stenger
BREAST CANCER Survival in Metastatic Triple-Negative Breast Cancer Explored in Retrospective Study In a study reported in the Journal of Clinical Oncology, Stover et al found that cell-free (cf) DNA tumor fraction ≥ 10% was associated with worse survival in metastatic triple-negative breast canc...
Bosutinib Improves Response Rate vs Imatinib as First-Line Treatment of Chronic Myeloid Leukemia
Matthew Stenger
IN THE PHASE III BFORE trial reported in the Journal of Clinical Oncology by Jorge E. Cortes, MD, of The University of Texas MD Anderson Cancer Center, and colleagues, the SRC/ABL kinase inhibitor bosutinib (Bosulif) improved response rates vs imatinib in the first-line treatment of patients wi...
Reports From the Journal of Clinical Oncology
The ASCO Post
Immunotherapy in PD-L1–Positive Advanced Cervical Cancer Pembrolizumab (Keytruda) treatment was active in patients with programmed cell death ligand 1 (PD-L1)–positive advanced cervical cancer enrolled in the phase Ib KEYNOTE-028 trial. The findings were reported by Jean-Sebastien Frenel, MD, of t...
Bosutinib for First-Line Use in Chronic Myeloid Leukemia: Is Three a Crowd?
Ellin Berman, MD
BOSUTINIB ( BOSULIF) is the latest tyrosine kinase inhibitor that has shown a superior molecular response profile when compared with imatinib.1,2 An orally available dual SRC/ABL1 inhibitor, the drug was shown in preclinical studies to have a potent inhibitory activity against BCR-ABL1 and mini...
Outcomes Associated With Higher Fiber Intake After Colorectal Cancer Diagnosis
Matthew Stenger
IN A STUDY reported in JAMA Oncology, Mingyang Song, MD, ScD, of Massachusetts General Hospital and Harvard Medical School, and colleagues found that higher fiber intake after diagnosis of nonmetastatic colorectal cancer is associated with improved colorectal cancer–specific and overa...
Fiber Is Only One Component in Improving Outcomes in Cancer Survivors
Wendy Demark-Wahnefried, PhD, RD
SINCE 2003, every iteration of the American Cancer Society’s Nutrition Guidelines for Cancer Survivors has advocated for a plant-based diet with ample quantities of whole grains, as well as vegetables and fruits.1-3 This recommendation has been based primarily on data that such foods ...
European Union Expert Group Releases Position Statement on Lung Cancer Screening in Europe
Matthew Stenger
AS REPORTED in The Lancet Oncology by Matthijs Oudkerk, MD, of the University of Groningen, the Netherlands, and colleagues, a European Union (EU) expert group has issued a position statement on low-dose computed tomography (CT) screening for lung cancer, proposing a near-term phased implementation ...
PI3K Inhibition With Copanlisib in Relapsed or Refractory Indolent Lymphoma
Matthew Stenger
AS REPORTED in the Journal of Clinical Oncology by Martin Dreyling, MD, PhD, of University Hospital, Ludwig Maximilians University of Munich, and colleagues, the phase II CHRONOS-1 trial has shown a high response rate and durable responses with the phosphatidylinositol 3-kinase (PI3K) inhibitor...
Another PI3K Inhibitor Welcome For Use in Indolent Lymphoma
Brad Kahl, MD
PHOSPHATIDYLINOSITOL 3-KINASE (PI3K) signaling is important for the proliferation and survival of malignant B cells. Copanlisib (Aliqopa) is a novel pan-class PI3K inhibitor with predominant activity against PI3K-alpha and PI3K-delta isoforms. As reviewed in this issue of The ASCO Pos...
Pembrolizumab in PD-L1–Positive Advanced Cervical Cancer
Matthew Stenger
As reported in the Journal of Clinical Oncology by Jean-Sebastien Frenel, MD, of the Institut de Cancerologie de l’Ouest, Centre Rene Gauducheau, Saint-Herblain, France, and colleagues, pembrolizumab (Keytruda) treatment was found to be active in patients with programmed cell death ligand 1 (PD...
Durvalumab Consolidation After Chemoradiotherapy Improves Progression-Free Survival in Stage III Non–Small Cell Lung Cancer
Matthew Stenger
As reported by Scott J. Antonia, MD, PhD, of the H. Lee Moffitt Cancer Center and Research Institute, and colleagues in The New England Journal of Medicine, an interim analysis of the phase III -PACIFIC trial showed improved progression-free survival with the programmed cell death protein 1 (PD...
Obinutuzumab-Based First-Line Treatment Improves Progression-Free Survival vs Rituximab-Based Treatment in Follicular Lymphoma
Matthew Stenger
In the phase III GALLIUM trial reported in The New England Journal of Medicine by Robert Marcus, MBBS, of University College London, and colleagues, obinutuzumab (Gazyva)-based therapy significantly prolonged progression-free survival vs rituximab (Rituxan)-based therapy in patients with previously ...
First-Line Pembrolizumab in Cisplatin-Ineligible Advanced Urothelial Cancer
Matthew Stenger
As reported in The Lancet Oncology by Arjun V. Balar, MD, of Perlmutter Cancer Center of New York York Langone Medical Center, and colleagues, first-line pembrolizumab (Keytruda) produced durable responses in cisplatin-ineligible patients with locally advanced and unresectable or metastatic urotheli...
SITC Spearheads Initiative for Management of Immunotherapy-Related Side Effects
The ASCO Post
The first consensus recommendations on the recognition and clinical management of immune-related side effects from cancer immunotherapy were recently published in the Journal for ImmunoTherapy of Cancer (JITC).1 The article, “Managing Toxicities Associated With Immune Checkpoint Inhibitors: Con...
ASCO Issues Statement on Alcohol Consumption and Cancer Risk
Matthew Stenger
As reported in the Journal of Clinical Oncology by Noelle K. LoConte, MD, of the University of Wisconsin, Madison, and colleagues, ASCO has issued a statement on the association of alcohol consumption with cancer risk that outlines proposals for promoting awareness of the association, supportin...
Surgeon-Initiated Gene-Expression Profile Testing in Early-Stage Breast Cancer Reduces Time to Start of Chemotherapy
Matthew Stenger
In a single-center study reported in the Journal of Oncology Practice, Katya Losk, MPH, of Dana-Farber Cancer Institute, and colleagues found that an intervention including surgeon initiation of gene-expression profile testing with Oncotype DX significantly reduced the time to testing, receipt of te...
Reports From JCO and JOP
The ASCO Post
Staying up-to-date with peer-reviewed oncology literature is a daunting task. To assist readers, The ASCO Post has summarized a number of studies recently published in the Journal of Oncology Practice (JOP) and the Journal of Clinical Oncology (JCO). Survival as Quality Metric in Cancer Care In a ...
ASCO Releases Guideline to Help Oncologists Improve Communication With Patients—and Their Own Well-Being
Jo Cavallo
In September 2017, ASCO published a new guideline in the Journal of Clinical Oncology that outlines best practices for communicating effectively with patients and their family members.1 The guideline is the result of recommendations from a multidisciplinary panel of experts in a number of fields, in...
Role of the E7 Gene in High-Risk HPV
The ASCO Post
NATIONAL CANCER INSTITUTE (NCI) researchers have found that for the most common high-risk type of human papillomavirus (HPV) to cause cervical cancer, an important viral gene may need to have a precise DNA sequence. The findings, published by Mirabello et al in Cell,1 contribute to a better understa...
Dacomitinib Prolongs Progression-Free Survival vs Gefitinib in First-Line Treatment of EGFR-Mutant NSCLC
Matthew Stenger
THE PHASE III ARCHER 1050 trial has shown superior progression-free survival with the second-generation irreversible epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor dacomitinib vs gefitinib (Iressa) in the first-line treatment of advanced EGFR-mutant non–small-cell l...
Study Finds More Patients Treated for and Surviving Early-Stage NSCLC
The ASCO Post
WITH THE ADVANCEMENT of surgical and radiation therapy strategies for stage I non–small cell lung cancer (NSCLC), more patients are being treated, resulting in higher survival rates, according to a study published online in The Annals of Thoracic Surgery.1 “More and more patients are being cu...
Balancing Immune-Related Adverse Events With Efficacy of Dual Checkpoint Inhibitor Therapy in Melanoma
Alexander N. Shoushtari, MD
MUCH PROGRESS has been made in the past decade in the treatment of patients with newly diagnosed metastatic melanoma. In the front-line setting, programmed cell death protein 1 (PD-1) monotherapy (nivolumab [Opdivo] and pembrolizumab [Keytruda]) and combined PD-1 plus cytotoxic T-lymphocyte–ass...
Nivolumab/Ipilimumab in Patients With Advanced Melanoma Who Did or Did Not Discontinue Induction Treatment due to Adverse Events
Matthew Stenger
IN A RETROSPECTIVE pooled analysis of the CheckMate 069 and 067 studies reported in the Journal of Clinical Oncology, Dirk Schadendorf, MD, of the University Hospital Essen and the German Cancer Consortium, and colleagues found little difference in the efficacy of combined nivolumab (...
ASCO Clinical Practice Guideline Update on Antiemetics in Patients With Cancer
Matthew Stenger
AS REPORTED BY Paul J. Hesketh, MD, of Lahey Hospital and Medical Center, Burlington, Massachusetts, and colleagues in the Journal of Clinical Oncology, ASCO has updated its clinical practice guideline on the use of antiemetics in patients with cancer.1 The update was based on an expert pa...
Phase III Trial Shows No Survival Benefit to Adding First-Line Ipilimumab to Chemotherapy in Advanced Squamous NSCLC
Matthew Stenger
IN A PHASE III trial reported by Ramaswamy Govindan, MD, of Washington University School of Medicine, and colleagues in the Journal of Clinical Oncology, the addition of first-line ipilimumab (Yervoy) to paclitaxel/carboplatin did not improve overall survival in patients with advanced squamous ...
No Progression-Free Survival Benefit With First-Line Nivolumab vs Chemotherapy in Advanced PD-L1–Positive NSCLC
Matthew Stenger
AS REPORTED BY David P. Carbone, MD, PhD, of The Ohio State University Comprehensive Cancer Center, Columbus, and colleagues in The New England Journal of Medicine, the phase III CheckMate 026 trial has shown no progression-free survival benefit for first-line nivolumab (Opdivo) vs platinum-bas...
Regional Radiation Therapy Reduces Risk of Regional Recurrence in Node-Positive Cutaneous Melanoma
Matthew Stenger
IN A LARGE single-institution study reported in the Journal of the National Comprehensive Cancer Network, Tobin Strom, MD, and colleagues found that regional radiotherapy was associated with a reduced risk of regional recurrence in patients with node-positive cutaneous melanoma, inclu...
Carfilzomib Improves Overall Survival vs Bortezomib in Relapsed/Refractory Multiple Myeloma
Matthew Stenger
AT A PRESPECIFIED interim analysis, the phase III ENDEAVOR trial has shown a significant overall survival benefit for carfilzomib (Kyprolis) vs bortezomib (Velcade) in patients with relapsed/refractory multiple myeloma, as reported by Meletios A. Dimopoulos, MD, of the National and Ka...
Carfilzomib May Be a Strong Candidate for Salvage Therapy in Relapsed/Refractory Multiple Myeloma—but Questions Remain
George Somlo, MD
WITH THE INCLUSION of proteasome inhibitors and immunomodulatory agents first into salvage and then as components of first-line, consolidation, and maintenance regimens, response rates, depth of response, and median progression-free and overall survival have all improved for patients ...
ASCO Guideline on Stage IV NSCLC Therapy Updated
The ASCO Post
An update of the ASCO clinical practice guideline on the systemic treatment of patients with stage IV non–small cell lung cancer (NSCLC) clarifies the role of immunotherapy in this setting. The update was published by Hanna et al in the Journal of Clinical Oncology.1 “This guideline updat...
MSLT-II Completion Lymph Node Dissection Trial: Practice Changing but Not Likely Practice Abandoning
Merrick I. Ross, MD
PROBABLY THE MOST IMPORTANT advance in the treatment of newly diagnosed primary melanoma has been the incorporation of sentinel lymph node biopsy as part of initial surgical management. The routine use of sentinel lymph node biopsy, often termed “sentinel lymphadenectomy,” in appropriately sele...
Journal of Clinical Oncology Literature Update
The ASCO Post
STAYING UP-TO-DATE in the fast-paced world of oncology literature is a daunting task at best. To assist with that task, The ASCO Post has assembled an assortment of studies recently published in the Journal of Clinical Oncology. Sorafenib Dosing and Outcomes in Hepatocellular Cancer IN A RE...
Blood-Based Biomarker: Predicting Efficacy of Immunotherapy in Patients With Melanoma
Caroline Helwick
IN WHAT APPEARS TO BE the largest blood-based biomarker study of a checkpoint inhibitor, an RNA transcript–based gene classifier was able to predict for melanoma patients’ response to tremelimumab. The study was recently published in the Journal for ImmunoTherapy of Cancer.1 “Our study, in ma...
Overview of the Phase III MSLT-II Trial
Matthew Stenger
THE PHASE III MSLT- II TRIAL showed that completion dissection was not associated with improved melanoma-specific overall survival vs observation in patients with sentinel-node metastasis, although a benefit was observed in regional disease control. The findings were reported in The New England...
Nivolumab in Advanced DNA Mismatch Repair–Deficient or Microsatellite Instability–High Colorectal Cancer
Matthew Stenger
THE PHASE II CHECKMATE 142 TRIAL has shown that nivolumab (Opdivo) produces durable responses in previously treated recurrent or metastatic DNA mismatch repair–deficient (dMMR)/ microsatellite instability–high (MSI-H) colorectal cancer. These study findings were reported in The Lancet...
Immunotherapy for Metastatic Mismatch Repair–Deficient Colorectal Cancer: Game-Changer for Small Group of Patients
Karuna Ganesh, MD, PhD, and Luis A. Diaz, Jr, MD
PATIENTS WITH DNA mismatch repair–deficient (dMMR) metastatic colorectal cancer display a high level of microsatellite instability (MSI-H)1 and demonstrate poor chemosensitivity and shorter overall survival than patients with mismatch repair–proficient (pMMR) metastatic metastatic colorectal cancer....
News From JCO and JOP
Matthew Stenger
STAYING UP-TO-DATE in the fast-paced world of oncology literature is a daunting task at best. To assist with that task, The ASCO Post has assembled an assortment of studies recently published in the Journal of Clinical Oncology (JCO) and the Journal of Oncology Practice (JOP). Future installments wi...
No Improvement in Melanoma-Specific Survival With Completion Dissection vs Observation for Sentinel-Node Metastasis
Matthew Stenger
THE PHASE III MSLT- II TRIAL showed that completion dissection was not associated with improved melanoma-specific overall survival vs observation in patients with sentinel-node metastasis, although a benefit was observed in regional disease control. The findings were reported in The New England...
New Response Evaluation Criteria for Lymphoma Clinical Trials: RECIL 2017
Matthew Stenger
New criteria for evaluating response in lymphoma clinical trials—RECIL 2017—have been developed by an International Working Group with the aim of harmonizing criteria with the RECIST criteria used for solid tumors.1 The new criteria were reported by Anas Younes, MD, of Memorial Sloan Kettering Cance...
Long-Term Follow-up in PIVOT Trial Shows No Significant Benefit of Surgery vs Observation for Overall or Prostate Cancer Mortality
Matthew Stenger
After 19.5 years of follow-up in the PIVOT trial, radical prostatectomy was not associated with significantly improved all-cause or prostate cancer mortality vs observation among men with localized prostate cancer.1 The long-term follow-up was reported in The New England Journal of Medicine by Timot...
Journal of Clinical Oncology Literature Update
Matthew Stenger
Staying up-to-date in the fast-paced world of oncology literature is a daunting task at best. To assist with that task, The ASCO Post has assembled an assortment of studies recently published in the Journal of Clinical Oncology. The topics range from therapy for stage IV non–small cell lung cancer t...
Deep Androgen Suppression Plus Abiraterone and Prednisone: Effective Strategy for Hormone-Naive Prostate Cancer
Anis Hamid, MBBS, and Christopher J. Sweeney, MBBS
ANTAGONISM OF THE ANDROGEN AXIS remains a cornerstone of systemic therapy for high-risk localized and metastatic prostate cancer, reflecting the central role of androgen-dependent biologic mechanisms in hormone-naive disease. Despite the use of standard androgen-deprivation therapy, men wi...
New ASCO Recommendations for Controlling Nausea and Vomiting Related to Cancer Treatment
The ASCO Post
AN UPDATE of the ASCO Clinical Practice Guideline covers new medicines for nausea and vomiting related to cancer treatment. The update, issued by Hesketh et al in the Journal of Clinical Oncology,1 provides new evidence-based information on the appropriate use of olanzapine, neurokinin 1 (NK1) ...
CheckMate 040: Nivolumab Is Active in Advanced Hepatocellular Carcinoma
Matthew Stenger
NIVOLUMAB (OPDIVO) has been found to produce durable responses in patients with advanced hepatocellular carcinoma in the phase I/II CheckMate 040 trial. These findings were reported in The Lancet by Anthony B. El-Khoueiry, MD, of USC Norris Comprehensive Cancer Center, and colleagues....
Pursuing Combination Strategies With Checkpoint and Tyrosine Kinase Inhibitors in Hepatocellular Carcinoma
Josep M. Llovet, MD, PhD
PRIMARY LIVER CANCER is the second leading cause of cancer-related death worldwide. Hepatocellular carcinoma accounts for 90% of liver cancer, with around 800,000 new cases diagnosed globally each year.1 In contrast to the stable or declining trends observed for most neoplasms, the in...
ASCO/Cancer Care Ontario Joint Guideline Update: Brachytherapy for Patients With Prostate Cancer
Matthew Stenger
AS REPORTED by Joseph Chin, MD, of London Health Sciences Centre, London, Ontario, and colleagues in the Journal of Clinical Oncology, ASCO and Clinical Care Ontario (CCO) have issued a joint update to the prior CCO guideline on use of brachytherapy in patients with prostate cancer.1,2 The...
Brachytherapy for Prostate Cancer: An Old Form of Radiation Treatment That Is Still One of the Most Effective
Jordan A. Holmes, MD, MPH, and Ronald C. Chen, MD, MPH
BRACHYTHERAPY HAS a long track record in treating cancer, dating back to the first reported use of an implanted radioactive source in 1901, and brachytherapy for the treatment of prostate cancer dates back to 1914, when Pasteu and Degrais used a radium source inserted through a urethral ca...
Anti–Trop-2 Antibody-Drug Conjugate Produces Durable Responses in Metastatic Triple-Negative Breast Cancer
Matthew Stenger
AS REPORTED in the Journal of Clinical Oncology by Aditya Bardia, MD, MPH, of Massachusetts General Hospital Cancer Center and Harvard Medical School, and colleagues, the anti–Trop-2 antibody-drug conjugate sacituzumab govitecan has been found to produce durable responses in patients ...
Sacituzumab Govitecan in Heavily Pretreated Metastatic Triple-Negative Breast Cancer: A Step in the Right Direction
Francisco J. Esteva, MD, PhD
IN A SINGLE-ARM multicenter trial reported by Bardia and colleagues1 and reviewed in this issue of The ASCO Post, the use of sacituzumab govitecan (IMMU-132) showed a response rate of 30% and a clinical benefit rate of 46% in heavily pretreated patients with metastatic triple-negative...
A New Triumvirate in Estrogen Receptor–Positive Metastatic Breast Cancer
Neil Vasan, MD, PhD, and Maura N. Dickler, MD
THE BODY OF EVIDENCE supporting the use of cell-cycle inhibitors in combination with endocrine therapy for estrogen receptor–positive metastatic breast cancer now has another agent in the spotlight. The phase III MONARCH 2 trial—reported at the 2017 ASCO Annual Meeting and by Sledge et al ...
Trends in Thyroid Cancer Incidence and Mortality in the United States
Matthew Stenger
THE REPORTED INCIDENCE of thyroid cancer has markedly increased in the United States in recent decades, largely reflecting an increase in reported rates of papillary thyroid cancer. It has been unclear whether the increase in incidence is reflected in mortality rates over time. In a study of Su...
Are Thyroid Cancer Incidence and Mortality Rates Truly Increasing in the United States?
Lori J. Wirth, MD, and Manisha H. Shah, MD
THYROID CANCER diagnoses are increasing at a rate faster than any other malignancy in the United States. In 2017, there will be 56,870 new cases, accounting for 3.4% of all cancers, and 2,010 people will die of thyroid cancer.1 This represents a more than 200% increase in incidence since t...
U.S. Preventive Services Task Force Recommends Against Screening for Thyroid Cancer in Asymptomatic Individuals
Matthew Stenger
AS REPORTED in JAMA, the U.S. Preventive Services Task Force (USPSTF) has recommended against thyroid cancer screening in asymptomatic individuals.1 The current USPSTF statement is an update of a 1996 USPSTF recommendation statement. The recommendation was based on Task Force review of evidence...
Alectinib: A New Standard for First-Line Therapy of ALK-Rearranged NSCLC?
Alex A. Adjei, MD, PhD, FACP
ANAPLASTIC LYMPHOMA KINASE (ALK) was first identified in anaplastic large cell lymphoma. The ALK gene itself is not oncogenic, but it can become oncogenic by at least three mechanisms: by forming a fusion gene with a number of other partner genes, by copy number gain, or by mutations ...
Improved Overall Survival With Blinatumomab vs Chemotherapy in Advanced Acute Lymphoblastic Leukemia
Matthew Stenger
IN THE PHASE III TOWER TRIAL reported in The New England Journal of Medicine, Hagop Kantarjian, MD, of The University of Texas MD Anderson Cancer Center, and colleagues found that blinatumomab (Blincyto) treatment improved overall survival vs chemotherapy in heavily pretreated patients with B-c...
Blinatumomab in Advanced Acute Lymphoblastic Leukemia: A Brighter Therapeutic Outlook
Richard M. Stone, MD
NEW DRUGS that will improve the outcome of adult patients who develop a deadly disease such as acute leukemia are badly needed; combinations of cytotoxic chemotherapeutic drugs may have reached an upper limit of utility. Agents that eradicate leukemia by alternative mechanisms would b...
MammaPrint Test Addressed in ASCO Breast Cancer Guideline Update
The ASCO Post
New recommendations on the use of the MammaPrint genomic test issued on July 10 will help guide decisions on adjuvant systemic therapy for women with early breast cancer. The recommendations update the ASCO 2016 clinical practice guideline on the use of biomarkers in these patients. The g...
Cancer Care Ontario and ASCO Clinical Practice Guideline: Use of Adjuvant Bisphosphonates and Other Bone-Modifying Agents in Breast Cancer
Matthew Stenger
As reported in the Journal of Clinical Oncology by Sukhbinder Dhesy-Thind, MD, MSc, FRCPC, of Juravinski Cancer Centre, Hamilton Health Sciences, and colleagues, Cancer Care Ontario and ASCO have issued a clinical practice guideline on the use of adjuvant bisphosphonates and other bone-modifying age...
Pembrolizumab Improves Overall Survival vs Chemotherapy in Second-Line Therapy for Advanced Urothelial Carcinoma
Matthew Stenger
IN THE PHASE III KEYNOTE-045 trial reported in The New England Journal of Medicine, Joaquim Bellmunt, MD, PhD, of Dana-Farber Cancer Institute, and colleagues found that pembrolizumab (Keytruda) significantly improved overall survival vs investigator choice of chemotherapy as second-l...
Pembrolizumab in Second-Line Therapy for Advanced Urothelial Carcinoma
Jonathan E. Rosenberg, MD
THE TREATMENT OF metastatic urothelial carcinoma experienced a long period of stagnation until the recognition that targeting the programmed cell death protein 1 (PD-1) pathway could yield deep and durable responses.1-3 Cisplatin-based combination chemotherapy has been the reference standard fo...
Pembrolizumab Is Active in Platinum- and Cetuximab-Refractory Head and Neck Cancer
Matthew Stenger
IN THE PHASE II KEYNOTE-055 trial, pembrolizumab (Keytruda) was found to produce durable responses in patients with platinum- and cetuximab (Erbitux)-refractory head and neck squamous cell carcinoma.1 Results of the trial were reported by Joshua Bauml, MD, of the University of Pennsyl...
Pembrolizumab and Cetuximab-Treated Head and Neck Cancer: Activity Confirmed But No Surprises
Laura Q.M. Chow, MD
WITH THE RECENT efficacy findings, improvements in survival, and resultant U.S. Food and Drug Administration (FDA) approvals of programmed cell death protein 1 (PD-1) immune checkpoint inhibitors across multiple solid tumor indications, the publication of yet another positive trial adds to the ...
No Survival Benefit When Pravastatin Is Added to Standard Chemotherapy in Small Cell Lung Cancer
Matthew Stenger
In a UK phase III study (LUNGSTAR) reported in the Journal of Clinical -Oncology, Michael J. Seckl, MD, PhD, of Imperial College London, and colleagues found that adding pravastatin to first-line standard chemotherapy did not improve overall survival in patients with small cell lung cancer (SCLC)....
Pembrolizumab Is Highly Active in Relapsed/Refractory Classical Hodgkin Lymphoma
Matthew Stenger
AS REPORTED in the Journal of Clinical Oncology by Robert Chen, MD, of City of Hope National Medical Center, and colleagues, the phase II KEYNOTE-087 trial has shown that the programmed cell death protein 1 (PD-1) inhibitor pembrolizumab (Keytruda) is highly active in patients with relapse...
Encouraging Results With Pembrolizumab in Relapsed/Refractory Classical Hodgkin Lymphoma
Stephen M. Ansell, MD, PhD
AN EFFECTIVE antitumor immune response relies on cytotoxic T cells that are activated and able to target the malignant clone. As T cells become activated, they upregulate suppressive receptors including programmed cell death protein 1 (PD-1). Upregulation of inhibitory signals is impo...
Addition of Adjuvant Capecitabine to Gemcitabine Improves Survival in Patients With Resected Pancreatic Cancer
Matthew Stenger
IN THE EUROPEAN phase III ESPAC-4 trial reported in The Lancet, John P. Neoptolemos, MD, of the Liverpool Clinical and Cancer Research UK Trials Unit, University of Liverpool, and colleagues found that adding adjuvant capecitabine to gemcitabine significantly improved overall survival...
Has a New Standard Really Been Established for the Adjuvant Treatment of Pancreatic Cancer?
Andrew H. Ko, MD
THE PAST YEAR has undoubtedly been a disappointing one as far as clinical advances in pancreatic cancer go. No fewer than five high-profile randomized phase II or III trials in this setting reported negative results in 2016, ranging from next-generation cytotoxic agents1 to novel immu...
No Efficacy Difference Between Adjuvant Letrozole and Anastrozole in Postmenopausal Women With Early Breast Cancer
Matthew Stenger
As reported in the Journal of Clinical Oncology by Ian E. Smith, MD, of The Royal Marsden Hospital and Institute of Cancer Research, and colleagues, final results of the phase III FACE trial showed no difference in disease-free or overall survival for adjuvant letrozole vs anastrozole in postmenopau...
Second Cancers May Be Deadlier in Child, Adolescent, and Young Adult Patients
Second cancers in children and adolescents and young adults (AYAs) are far deadlier than they are in older adults and may partially account for the relatively poor outcomes of cancer patients between the ages of 15 and 39 overall, a new study by researchers at the University of California, Davis has...
Adding Idelalisib to Bendamustine/Rituximab in Relapsed/Refractory CLL
Matthew Stenger
As reported by Andrew D. Zelenetz, MD, of Memorial Sloan Kettering Cancer Center, and colleagues in The Lancet Oncology, interim analysis of a phase III trial has shown the superiority of adding the phosphoinositide-3-kinase δ inhibitor idelalisib (Zydelig) to bendamustine/rituximab (Rituxan) in pat...
Two Studies Show Scalp Cooling Reduces Hair Loss in Women Receiving Chemotherapy for Breast Cancer
Matthew Stenger
An interim analysis of the SCALP trial, reported in JAMA by Julie Nangia, MD, of Baylor College of Medicine, and colleagues, showed that use of a scalp-cooling device significantly reduced hair loss in women receiving chemotherapy for stage I or II breast cancer compared with no scalp cooling.1 The ...
Mutations in Myelodysplastic Syndrome Associated With Poorer Outcome After Stem Cell Transplantation
Matthew Stenger
In a study reported in The New England Journal of Medicine, R. Coleman Lindsley, MD, PhD, of Dana-Farber Cancer Institute, and colleagues found that a number of mutations present in patients with myelodysplastic syndromes (MDS) were associated with poorer clinical outcome after allogeneic hematopoie...
Annual Report to the Nation: Cancer Death Rates Continue to Decline
Overall cancer death rates continue to decrease in men, women, and children for all major racial and ethnic groups, according to the latest Annual Report to the Nation on the Status of Cancer, 1975–2014, published by Jemal et al in the Journal of the National Cancer Institute.1 The report finds that...
Strides Being Made in Advanced Urothelial Cancer
Caroline Helwick
According to Srikala S. Sridhar, MD, MSc, FRCPC, of the Princess Margaret Cancer Centre, Toronto, Canada, “It’s an exciting time in the field of urothelial cancer,” thanks to the emergence of new therapies such as the immune checkpoint inhibitors and other approaches that aim to improve both ou...
ASCP/CAP/AMP/ASCO Guideline on Molecular Biomarkers in Colorectal Cancer
Matthew Stenger
As reported in the Journal of Clinical Oncology by Antonia R. Sepulveda, MD, PhD, of Columbia University, and colleagues, a joint guideline on the use of molecular biomarkers for evaluation of colorectal cancer has been developed by an expert panel from the American Society for Clinic...
ASCP/CAP/AMP/ASCO Colorectal Cancer Biomarker Guideline: A Clinician's Perspective
Leonard Saltz, MD
The joint American Society for Clinical Pathology (ASCP), College of American Pathologists (CAP), Association for Molecular Pathology (AMP), and ASCO guideline reported by Sepulveda et al, and reviewed in this issue of The ASCO Post, represents a collaboration of three pathology societies and A...
177Lu-Dotatate Improves Progression-Free Survival in Advanced Progressive Midgut Neuroendocrine Tumors
Matthew Stenger
In the phase III NETTER-1 trial reported in The New England Journal of Medicine, Jonathan R. Strosberg, MD, of the Moffitt Cancer Center in Tampa, Florida, and colleagues found that the addition of the targeted radiotherapeutic agent lutetium-177 (177Lu)-Dotatate to the long-acting repeatable (...
Major Breakthrough in Development of Systemic Targeted Therapy for Midgut Neuroendocrine Tumors
Allan V. Espinosa, MD, and Manisha H. Shah, MD
This issue of The ASCO Post discusses a recent trial reported by Strosberg et al in The New England Journal of Medicine that is the first phase III randomized international multicenter clinical trial evaluating lutetium-177 (177Lu)-Dotatate as a peptide receptor radionuclide therapy in mid...
Decreasing but Still Elevated Risk for Subsequent Neoplasms in Survivors of Childhood Cancer
Matthew Stenger
In a retrospective multicenter cohort study reported in JAMA, Lucie M. Turcotte, MD, MPH, of the University of Minnesota, Minneapolis, and colleagues found that the risk of subsequent neoplasms in 5-year survivors of childhood cancers decreased between those diagnosed in the 1970s vs ...
Lessons Learned and to Be Learned: Reducing Risk of Subsequent Malignancies in Childhood Cancer Survivors
Lisa Diller, MD
I recently saw a patient in our survivorship clinic. She was treated at age 15 years for Hodgkin lymphoma and is now in her early 50s. During the prior 2 decades, she had developed both bilateral breast cancer and thyroid cancer, as well as multiple basal cell carcinomas, all occurrin...
Lack of Access to Transfusions Limits Hospice Use by Patients With Hematologic Malignancies
A new survey finds that doctors would refer more patients with incurable blood cancers to hospice for end-of-life care if they could receive transfusions, which are generally not available because of hospice reimbursement policies. The findings, published by Oreofe Odejide, MD, MPH, and colleag...
Lenalidomide, Bortezomib, and Dexamethasone With or Without Transplantation in Younger Myeloma Patients
Matthew Stenger
In the French phase III IFM 2009 trial reported in The New England Journal of Medicine by Michel Attal, MD, of the Institut Universitaire du Cancer de Toulouse-Oncopole, and colleagues, consolidation treatment with lenalidomide (Revlimid), bortezomib (Velcade), and dexamethasone (RVD) was associated...
Atezolizumab Improves Overall Survival vs Docetaxel in Previously Treated Non–Small Cell Lung Cancer
Matthew Stenger
In the phase III OAK trial reported in The Lancet by Achim Rittmeyer, MD, of Lungenfachklinik Immenhausen, Germany, and colleagues, treatment with the anti–programmed cell death ligand 1 (PD-L1) antibody atezolizumab (Tecentriq) improved overall survival vs docetaxel in previously treated non–small ...
Survival Benefit of Adding Antiandrogen Therapy to Radiation in Recurrent Prostate Cancer: Final Results of RTOG 9601
Matthew Stenger
As reported in The New England Journal of Medicine by W.U. Shipley, MD, of Massachusetts General Hospital and Harvard Medical School, and colleagues in the NRG Oncology Radiation Therapy Oncology Group (RTOG), the final analysis of the phase III RTOG 9601 trial shows that the addition of antiandroge...
Ipilimumab vs Placebo in Metastatic Chemotherapy-Naive, Castration-Resistant Prostate Cancer Without Visceral Metastases
Matthew Stenger
In the phase III CA184-095trial reported in the Journal of Clinical Oncology, Tomasz M. Beer, MD, FACP, of the Knight Cancer Institute, Oregon Health and Science University, and colleagues found that ipilimumab (Yervoy) did not increase overall survival vs placebo in men with asymptomatic or minimal...
ASCO Provisional Clinical Opinion on Hormonal Therapy for Castration-Resistant Prostate Cancer
On April 25, ASCO issued a provisional clinical opinion on the use of second-line hormonal therapy for men with castration-resistant prostate cancer who have not yet received chemotherapy. The recommendations of this provisional clinical opinion were informed by evidence from a systematic review of ...
Suboptimal Genetic Testing and Counseling Among Women With Newly Diagnosed Breast Cancer
Matthew Stenger
In a population-based study reported in a research letter in JAMA, Allison W. Kurian, MD, of Stanford University School of Medicine, and colleagues found that genetic testing and genetic counseling are suboptimal among women with newly diagnosed breast cancer.1 Study Details The stu...
Provision of Genetic Services to Women With Breast Cancer: We Must Do Much Better
Brittany L. Bychkovsky, MD, MSC, and Judy E. Garber, MD, MPH
Genetic testing for inherited cancer susceptibility is increasingly part of the care of cancer patients and their relatives. Early clinical guidelines recommended BRCA1/2 testing for women diagnosed with breast or ovarian cancer if they also have a significant family cancer history or Ashk...
Germline Genetic Testing and Treatment Decisions in Early-Stage Breast Cancer
Matthew Stenger
As reported in the Journal of Clinical Oncology by Allison W. Kurian, MD, of Stanford University School of Medicine, and colleagues, surveys in a population-based sample of patients recently diagnosed with breast cancer indicate that many undergo genetic risk testing without seeing a ...
ASCO Clinical Practice Guideline: Management of Small Renal Masses
Matthew Stenger
As reported in the Journal of Clinical Oncology by Antonio Finelli, MD, of Princess Margaret Cancer Center, Toronto, and colleagues, ASCO has released a clinical practice guideline on management of small renal masses.1 The guideline was derived from an expert panel literature s...
Managing Small Renal Masses: A Point-by-Point Consideration of ASCO’s Clinical Practice Guideline
Jose A. Karam, MD, FACS
As reviewed in this issue of The ASCO Post, a recent issue of the Journal of Clinical Oncology featured an ASCO Clinical Practice Guideline on the management of small renal masses reported by Finelli and colleagues.1 This comprehensive guideline is written by a group of well-regarded ...
Short-Course Radiotherapy Plus Temozolomide Improves Survival in Older Patients With Glioblastoma
Matthew Stenger
In a phase III trial reported in The New England Journal of Medicine, James R. Perry, MD, of Sunnybrook Health Sciences Centre, Toronto, and colleagues found that adding temozolomide to short-course radiotherapy improved overall survival in patients aged at least 65 years with newly diagnosed g...
Optimizing Treatment for Elderly Patients With Glioblastoma
Isabel Arrellaga-Romany, MD, PhD, and Tracy T. Batchelor, MD, MPH
In 2005, Stupp and colleagues published their landmark paper demonstrating in a randomized phase III trial that the addition of temozolomide to radiation increased overall survival in patients with newly diagnosed glioblastoma. Notably, patients over age 70 years were excluded fr...
First-in-Human Clinical Trial in Children and Young Adults With Leukemia
After phase I results of Seattle Children’s Pediatric Leukemia Adoptive Therapy (PLAT-02) trial, published by Gardner et al in Blood,1 showed T-cell immunotherapy to be effective in sending 93% of patients with relapsed or refractory acute lymphoblastic leukemia (ALL) into complete initial...
Key Gene Controlling Tumor Growth in Gliomas Pinpointed
Cedars-Sinai investigators have identified a stem cell–regulating gene that affects tumor growth in patients with brain cancer and may strongly influence survival rates of patients. The findings, published by Edwards et al in Scientific Reports,1 may move physicians closer to their goal of bett...
CheckMate 275 Supports FDA Approval of Nivolumab in Metastatic Urothelial Carcinoma After Platinum Therapy
Matthew Stenger
As reported in The Lancet Oncology by Padmanee Sharma, MD, PhD, of MD Anderson Cancer Center, and colleagues, the phase II CheckMate 275 trial has shown that nivolumab (Opdivo) produced durable responses in patients with metastatic urothelial cancer who had received at least one prior...
Metastatic Urothelial Carcinoma: A Model Malignancy for Immune Checkpoint Blockade
Matthew D. Galsky, MD
Platinum-based combination chemotherapy became a mainstay of first-line treatment for metastatic urothelial cancer in the 1980s. With combination platinum-based regimens, 40% to 50% of patients achieve an objective response to treatment. However, aside from approximately 5% to 10% of ...
What Is Appropriate Treatment of Oligometastatic Hormone-Sensitive Prostate Cancer?
Caroline Helwick
As the subtleties of metastatic prostate cancer become increasingly recognized, treatment should evolve accordingly, said Jessica M. Clement, MD, Assistant Professor of Medicine at the University of Connecticut Health System and Neag Cancer Center, Farmington. Of particular interest to Dr. Clem...
Zoledronic Acid Every 12 Weeks Noninferior to Every 4 Weeks in Skeletal-Related Event Rate for Breast Cancer With Bone Metastases
Matthew Stenger
In the phase III OPTIMIZE-2 trial reported in JAMA Oncology, Gabriel N. Hortobagyi, MD, of The University of Texas MD Anderson Cancer Center, and colleagues found that an every-12-week schedule of zoledronic acid was noninferior to an every-4-week schedule with regard to skeletal-related event ...
OPTIMIZE-2 Trial Offers Reassuring Data on Deescalation of Bisphosphonate Therapy for Breast Cancer–Related Bone Metastases
Robert Coleman, MD, FRCP
Bisphosphonates were first synthesized more than a century ago, with their initial usage restricted to a range of industrial processes until their potential clinical relevance was appreciated in the late 1960s.1 Then, following development for the treatment of osteoporosis and Paget’s...
Cancer Mortality Trends in the United States Vary Widely by County From 1980 to 2014
Matthew Stenger
In a study reported in JAMA, Ali H. Mokdad, PhD, and colleagues from the University of Washington, Seattle, found that cancer mortality rates in the United States dropped from 240.2 to 192.0 per 100,000 population between 1980 and 2014.1 Mortality rates varied widely among U.S. counti...
On the Variance of Cancer Outcomes by Time and Geography
Otis W. Brawley, MD, MACP
A recent study by Mokdad and colleagues, reviewed in this issue of The ASCO Post, looks at cancer demographic data for 28 cancers and compares mortality rates in 1980 to results in 2014.1 Publishing mortality rates by geographic area and the observation of significant differences is n...
Adding Daratumumab to Lenalidomide/Dexamethasone Increases Progression-Free Survival in Previously Treated Multiple Myeloma
Matthew Stenger
As reported in The New England Journal of Medicine by Meletios A. Dimopoulos, MD, of the National and Kapodistrian University of Athens, and colleagues, the phase III POLLUX trial has shown that the addition of the CD38-targeted antibody daratumumab (Darzalex) to lenalidomide (Revlim...
Monoclonal Antibody Therapy With Daratumumab in Multiple Myeloma: Expanding Therapeutic Horizons
Paul G. Richardson, MD
The advent of successful monoclonal antibody therapy in the treatment of relapsed/refractory myeloma has dramatically improved the prognosis of patients for whom currently approved novel therapies have failed. In 2015, the approval of the combination of elotuzumab (Empliciti) with len...
Equivalent Response Rates With Trastuzumab or a Trastuzumab Biosimilar Plus Taxane in HER2-Positive Metastatic Breast Cancer
Matthew Stenger
In part 1 of the Heritage study, a phase III equivalence trial reported in JAMA, Hope S. Rugo, MD, of the University of California Helen Diller Family Comprehensive Cancer Center, San Francisco, and colleagues found that treatment with trastuzumab (Herceptin) or a proposed trastuzumab...
Study Finds Link Between Telomere Length and Sociodemographic Circumstances Linked to Neighborhood
The ASCO Post
Researchers at Fox Chase Cancer Center have begun to establish a biologic basis for the long-held but not well-tested theory that neighborhood exposures can impact health outcomes. Shannon Lynch, PhD, MPH, Assistant Professor in the Cancer Prevention and Control Program at Fox Chase, led a team...
ASCO Clinical Practice Guideline on Prevention and Monitoring of Cardiac Dysfunction in Survivors of Adult Cancers
Matthew Stenger
As reported in the Journal of Clinical Oncology by Saro H. Armenian, DO, MPH, of City of Hope, and colleagues, ASCO has released a clinical practice guideline on prevention and monitoring of cardiac dysfunction in survivors of adult cancers.1 Recommendations were developed by an expert pan...
Cardiac Dysfunction in Survivors of Adult Cancers
Daniel J. Lenihan, MD
The success of cancer therapy has led us to an interesting place. Patients with cancer are certainly concerned about collateral damage that may occur with the treatment of their condition; however, impressive improvements in survival with treatment of many cancers are so compelling th...
ASCO Clinical Practice Guideline Update: Integration of Palliative Care Into Standard Oncology Care
Matthew Stenger
As reported in the Journal of Clinical Oncology, ASCO has released a clinical practice guideline update on integration of palliative care into standard oncology care.1 This update of a 2012 ASCO provisional clinical opinion2 is based on an Expert Panel’s systematic review of data repo...
Mammography-Detected Small Breast Cancers May Represent Overdiagnosis, With Declining Mortality Reflecting Improved Systemic Therapy
Matthew Stenger
In a study using Surveillance, Epidemiology, and End Results (SEER) data reported in The New England Journal of Medicine, H. Gilbert Welch, MD, of Dartmouth Institute for Health Policy and Clinical Practice, and colleagues found that screening mammography has resulted in a substantial...
Markedly Improved Progression-Free Survival With First-Line Ceritinib vs Platinum Chemotherapy in ALK-Rearranged NSCLC
Matthew Stenger
In the phase III ASCEND-4 trial reported in The Lancet, Jean-Charles Soria, MD, of Institut Gustave Roussy, and colleagues found that ceritinib (Zykadia) improved progression-free survival vs platinum-based chemotherapy in the first-line treatment of advanced anaplastic lymphoma kinas...
New First-Line Options for ALK-Positive Lung Cancer on the Horizon
Alice T. Shaw, MD, PhD
Anaplastic lymphoma kinase (ALK) rearrangements define a subset of non–small cell lung cancer (NSCLC) patients for whom ALK inhibitors are highly effective. In PROFILE 1014, the multitargeted ALK inhibitor crizotinib (Xalkori) was shown to be superior to platinum/pemetrexed (Alimta) c...
Adding Bortezomib to Lenalidomide/Dexamethasone Improves Survival in Patients With Newly Diagnosed Multiple Myeloma
Matthew Stenger
In the phase III SWOG S0777 trial reported in The Lancet, Brian G.M. Durie, MD, of Cedars-Sinai Samuel Oschin Cancer Center, and colleagues found that adding bortezomib (Velcade) to lenalidomide (Revlimid)/dexamethasone improved progression-free and overall survival in patients with...
Implications of SWOG S0777 and the Future of Combination Treatments for Multiple Myeloma
Tanya M. Spektor, PhD, and James R. Berenson, MD
The treatment of multiple myeloma is becoming increasingly complicated. This is not only because of the complexity of the disease, but also because of the increasing number of effective combination treatments and continuous development of new drugs. This has resulted in an ever-increasin...
FALCON Trial Informs the Evolving Role of Fulvestrant in Advanced Hormone Receptor–Positive Breast Cancer
Aman U. Buzdar, MD, FACP
Endocrine therapy for breast cancer has evolved over the years. Initial endocrine therapies consisted of ablative procedures (oophorectomy, adrenalectomy, and hypophysectomy). With the availability of pharmaceutical estrogens, progestins, and androgens, ablative procedure utilization begin to d...
Phase III Trial Shows Improved Progression-Free Survival With Fulvestrant vs Anastrozole in Advanced Breast Cancer
Matthew Stenger
In the international phase III FALCON trial, reported in The Lancet, John F.R. Robertson, MD, of the University of Nottingham, United Kingdom, and colleagues found that progression-free survival was improved with intramuscular fulvestrant (Faslodex) vs oral anastrozole in endocrine t...
Many Cancer Survivors Find Online and Telephone Communication With Health-Care Professionals Beneficial
The ASCO Post
Researchers from the School of Health Sciences at the University of Surrey, Guildford, United Kingdom, have completed the first-ever systematic review of cancer survivors’ experience of online and telephone telehealth interventions in cancer care, according to a recent study reported ...
Study Finds Children, Parents Overreport Adherence to Leukemia Treatment
The ASCO Post
New research suggests that young patients with acute lymphocytic leukemia (ALL)—the most common type of pediatric cancer—and their parents are likely to report to their physician that they took more of their anticancer medication than they actually did. The study, published by Landier et al in Bloo...
Osimertinib Improves Progression-Free Survival vs Platinum/Pemetrexed in EGFR T790M–Positive NSCLC
Matthew Stenger
In the phase III AURA3 trial reported in The New England Journal of Medicine by Tony S. Mok, MD, of the Chinese University of Hong Kong, and colleagues, osimertinib (Tagrisso) significantly improved progression-free survival vs platinum/pemetrexed (Alimta) among patients with epiderma...
Bright Future for Osimertinib in EGFR T790M–Positive Lung Cancer
Geoffrey R. Oxnard, MD
The AURA3 study—reported by Mok and colleagues and reviewed in this issue of The ASCO Post—confirms the dramatic activity of osimertinib (Tagrisso) in patients with advanced epidermal growth factor receptor (EGFR)-mutant non–small cell lung cancer (NSCLC) and acquired resistance to pr...
Regorafenib Improves Survival in Patients With Hepatocellular Carcinoma Progressing on Sorafenib
Matthew Stenger
In the phase III RESORCE trial reported in The Lancet, Jordi Bruix, MD, Head of the Barcelona Clinic Liver Cancer Group, University of Barcelona, and colleagues found that regorafenib (Stivarga) improved overall survival vs placebo in patients with hepatocellular carcinoma who had pro...
Regorafenib in Second-Line Setting for Hepatocellular Carcinoma: Balancing Benefit With Toxicity
Josep M. Llovet, MD, PhD
During the past 40 years, hundreds of randomized trials testing treatments for advanced hepatocellular carcinoma have been published.1 Conventional systemic chemotherapy and radiotherapy lack survival advantages for these patients.1,2 In 2007, a phase III trial demonstrated survival ...
First-Line Ribociclib Prolongs Progression-Free Survival in Hormone Receptor–Positive, HER2-Negative Breast Cancer
Matthew Stenger
As reported by The ASCO Post from the recent European Society for Medical Oncology Conference, first-line treatment with ribociclib, a selective inhibitor of cyclin-dependent kinases 4 and 6 (CDK4/6), resulted in significantly longer progression-free survival vs placebo in women with ...
Results From MONALEESA-2: Are All CDK4/6 Inhibitors Equal?
Sara M. Tolaney, MD, MPH
Hormone receptor–positive breast cancer is the most common subtype of breast cancer, and while endocrine therapy has long been a mainstay of therapy for these patients, treatment resistance ultimately develops. Therefore, better therapeutic approaches are needed. There are some data t...
Circulating Tumor DNA Profiling Identifies Clonal Evolution Patterns and Permits Classification of Tumor Subtypes in DLBCL
Matthew Stenger
In a study reported in Science Translational Medicine, Florian Scherer, MD, David M. Kurtz, MD (Conquer Cancer Foundation Young Investigator), Aaron M. Newman, PhD, and colleagues from Stanford University found that analysis of circulating tumor DNA (ctDNA) permits identification of p...
Liquid Biopsies Show Promise in Diffuse Large B-Cell Lymphoma
Mark Roschewski, MD, and Wyndham H. Wilson, MD, PhD
Technologic advances for detecting and analyzing cell-free circulating tumor DNA (ctDNA) from peripheral blood offer a precision method for monitoring diffuse large B-cell lymphoma (DLBCL). Although most patients with DLBCL are cured with initial therapy, those who are not cured have a p...
Telotristat Ethyl Reduces Frequency of Bowel Movements in Patients With Metastatic Neuroendocrine Tumors and Carcinoid Syndrome
Matthew Stenger
In the phase III TELESTAR trial reported in the Journal of Clinical Oncology by Matthew H. Kulke, MD, of Dana-Farber Cancer Institute, and colleagues, telotristat ethyl, an investigational tryptophan hydroxylase inhibitor, significantly reduced the frequency of bowel movements in pat...
Telotristat Ethyl: A Novel Therapy for Carcinoid Syndrome—Not a Panacea but a Step in the Right Direction
Bhavana Konda, MD, MPH, and Manisha H. Shah, MD
The multihumoral manifestations of neuroendocrine tumors include diarrhea, cutaneous flushing, wheezing, and right-sided valvular heart disease.1 Serotonin, a biogenic amine and product of tryptophan metabolism,2 mediates several of these symptoms.3,4 Diarrhea is a cardinal and often dis...
‘Collateral Lethality’ May Offer New Therapeutic Approach to Cancers of the Pancreas, Stomach, and Colon
The ASCO Post
Cancer cells often delete genes that normally suppress tumor formation. These deletions also may extend to neighboring genes, an event known as “collateral lethality,” which may create new options for the development of therapies for several cancers. Scientists at The University of Texas MD And...
ASCO Endorses ASTRO Guideline on Radiation Therapy for Glioblastoma
Matthew Stenger
As reported by Erik P. Sulman, MD, PhD, of MD Anderson Cancer Center, and colleagues in the Journal of Clinical Oncology, ASCO has endorsed the 2016 American Society for Radiation Oncology (ASTRO) evidence-based guideline on radiation therapy for glioblastoma.1 The endorsement was based on...
Radiation Therapy for Glioblastoma: What Is New and What Is Missing in the ASCO-Endorsed ASTRO Guidelines
Walter J. Curran, Jr, MD
An ASCO Special Article in the Journal of Clinical Oncology by Sulman et al,1 reviewed in this issue of The ASCO Post, issued ASCO’s endorsement of the American Society for Radiation Oncology (ASTRO) guidelines on radiation therapy for adult patients diagnosed with glioblastoma. It is...
Nivolumab Improves Overall Survival in Recurrent Platinum-Refractory Squamous Cell Carcinoma of the Head and Neck
Matthew Stenger
In the phase III CheckMate 141 trial reported in The New England Journal of Medicine, Robert L. Ferris, MD, PhD, of the University of Pittsburgh Medical Center and Cancer Institute, and colleagues found that nivolumab (Opdivo) increased overall survival vs standard therapies in patien...
Nivolumab in Squamous Cell Carcinoma of the Head and Neck in CheckMate 141: Game Not Over
Lori J. Wirth, MD
Most patients with squamous cell carcinoma of the head and neck present with locally advanced disease. With combined-modality approaches, the chance of cure ranges from < 50% to up to 80%, depending on the site, stage, and other risk factors, such as human papillomavirus (HPV) stat...
Safety of Stopping Imatinib in CML With Undetectable Minimal Residual Disease for at Least 2 Years
Matthew Stenger
As reported in the Journal of Clinical Oncology by Gabriel Etienne, MD, PhD, of the Institut Bergonié, Bordeaux, and colleagues, long-term follow-up in the French Stop Imatinib (STIM1) study indicates that imatinib can be safely stopped in patients with chronic myeloid leukemia (CML) with undetect...
Diamonds Are Forever, Tyrosine Kinase Inhibitors Are Not?
Jorge Cortes, MD
Sir Donald Munger: “You have been on holiday, I understand. Relaxing, I hope?” James Bond: “Oh, hardly relaxing, but most satisfying.” (Diamonds Are Forever) As tyrosine kinase inhibitors became the mainstay of therapy for patients with chronic myeloid leukemia (CML), our assumption...
Niraparib Maintenance Improves Progression-Free Survival in Platinum-Sensitive Recurrent Ovarian Cancer
Matthew Stenger
In a phase III trial (ENGOT-OV16/NOVA) reported at the 2016 ESMO (European Society for Medical Oncology) Congress and in The New England Journal of Medicine by Mansoor R. Mirza, MD, of the Rigshospitalet–Copenhagen University Hospital, and colleagues, maintenance therapy with the PAR...
PARP Inhibitor Niraparib Yields ‘Unprecedented’ Results in Ovarian Cancer in Phase III Trial
Bradley J. Monk, MD, FACS, FACOG
The first phase III trial of an inhibitor of poly (ADP-ribose) polymerase (PARP) yielded unprecedented results in treating ovarian cancer. The trial was presented at the European Society for Medical Oncology (ESMO) in Copenhagen, Denmark, and electronically reported concurrently in Th...
Addition of Palbociclib to Letrozole in Previously Untreated Advanced Estrogen Receptor–Positive, HER2-Negative Breast Cancer
Matthew Stenger
In the phase III PALOMA-2 trial reported in The New England Journal of Medicine, Richard S. Finn, MD, of the David Geffen School of Medicine at the University of California, Los Angeles, and colleagues found that the addition of palbociclib (Ibrance) to letrozole significantly improved progression-f...
Study Identifies Factors in Clonal Evolution of Chemotherapy-Resistant Urothelial Carcinoma
Matthew Stenger
In a study reported in Nature Genetics, Bishoy M. Faltas, MD, of Weill Cornell Medicine, and colleagues identified factors in the clonal evolution of chemotherapy-resistant urothelial carcinoma.1 As stated by the investigators: “Chemotherapy-resistant urothelial carcinoma has no uniformly curative t...
Updated ASTRO Guideline Expands Pool of Suitable Candidates for Accelerated Partial-Breast Irradiation
The ASCO Post
On November 17, 2016, the American Society for Radiation Oncology (ASTRO) issued an updated clinical practice statement for accelerated partial-breast irradiation for early-stage breast cancer. The updated guideline reflects recent evidence that greater numbers of patients may benefit from accelerat...
Concerns About Safety of Generic Oncology Drugs Made in Developing Countries
Matthew Stenger
In an article in The Lancet Oncology, Y. Tony Yang, ScD, of George Mason University, Charles L. Bennett, MD, PhD, MPP, of the University of South Carolina and colleagues from the United States, Europe, and Japan examined clinical, policy, safety, and regulatory considerations for gene...
No Progression-Free Survival Difference With Temozolomide vs Radiotherapy in High-Risk Low-Grade Glioma
Matthew Stenger
In a phase III intergroup trial reported in The Lancet Oncology, Brigitta G. Baumert, MD, of the European Organisation for Research and Treatment of Cancer (EORTC), Brussels, and colleagues found no progression-free survival difference between temozolomide chemotherapy and radiotherapy alone in pa...
Palliative Care Improves Quality of Life, Relieves Symptoms
The ASCO Post
People living with serious illness who receive palliative care have better quality of life and fewer symptoms than those who don’t receive palliative care, according to a new study by researchers at the University of Pittsburgh School of Medicine. Published by Dio Kavalieratos, PhD, A...
Adjuvant Sunitinib Improves Disease-Free Survival in High-Risk Renal Cell Carcinoma After Nephrectomy
Matthew Stenger
In the phase III S-TRAC trial reported at the recent European Society for Medical Oncology meeting and in The New England Journal of Medicine by Alain Ravaud, MD, PhD, of Bordeaux University Hospital, and colleagues, adjuvant sunitinib (Sutent) significantly prolonged disease-free sur...
Pembrolizumab Improves Outcomes vs Platinum-Based Chemotherapy in Advanced PD-L1–Positive NSCLC
Matthew Stenger
In the phase III KEYNOTE-024 trial reported in The New England Journal of Medicine by Martin Reck, MD, PhD, of the German Center of Lung Research, Grosshansdorf, and colleagues, pembrolizumab (Keytruda) significantly improved progression-free and overall survival vs platinum-based che...
Phase III Trial Shows No Survival Benefit of Adding First-Line IMA901 Vaccine to Sunitinib in Advanced Renal Cell Carcinoma
Matthew Stenger
In the phase III IMPRINT trial reported in The Lancet Oncology, Brian I. Rini, MD, of the Cleveland Clinic Taussig Cancer Institute, and colleagues found no overall survival benefit of adding the multipeptide cancer vaccine IMA901 to sunitinib (Sutent) in the first-line treatment of l...
Adding Olaratumab to Doxorubicin Increases Overall Survival in Advanced Soft-Tissue Sarcoma
Matthew Stenger
As reported by William D. Tap, MD, of Memorial Sloan Kettering Cancer Center, and colleagues in The Lancet, the addition of the anti-PDGFRα (platelet-derived growth factor receptor alpha) antibody olaratumab to doxorubicin resulted in prolonged progression-free and overall survival in phase II ...
Adult Survivors of Childhood Cancers Report Long-Term Health Issues
Jo Cavallo
Although progress in treatment and supportive care for children with cancer has resulted in improved survival of these patients, some survivors experience ongoing medical conditions from their cancer or its treatment, including poor general health, poor mental health, functional impairment, act...
Study Finds Cabozantinib of Clinical Benefit vs Sunitinib in Advanced Renal Cell Carcinoma
Jo Cavallo
A randomized phase II clinical trial evaluating cabozantinib (Cabometyx) compared with standard-of-care sunitinib (Sutent) as first-line therapy for patients with advanced renal cell carcinoma has found that cabozantinib reduced the rate of disease progression or death by 34% compared with sunitinib...
Chemotherapy May Be Avoidable in Some Women With Early-Stage Breast Cancer Based on Clinical and Genomic Risks
Matthew Stenger
In the phase III MINDACT trial reported in The New England Journal of Medicine, Fatima Cardoso, MD, of Champalimaud Clinical Center–Champalimaud Foundation, Lisbon, and colleagues found that adjuvant chemotherapy may be avoidable in women with early-stage breast cancer who are at high...
Development and Validation of a Quality Assurance Score for Robot-Assisted Radical Cystectomy
The ASCO Post
What are the factors that add up to the best outcomes for patients who have surgery to treat cancer? Looking for a better way to measure quality of care and share best practices in surgical oncology, a team from Roswell Park Cancer Institute developed a quality assessment tool and validated it in a ...
New Blood Test for Colorectal Cancer Recurrence: Twice as Sensitive as CEA Test
The ASCO Post
In a new report published by Young et al in Cancer Medicine,1 a two-gene circulating tumor DNA (ctDNA) blood test for postsurgical monitoring of colorectal cancer recurrence has been shown to detect twice the number of recurrence cases as carcinoembryonic antigen (CEA) testing, a standard-of-care co...
Breast Cancer Study Finds Higher Mortality Rate in Black Women Than White Women, and the Disparity Is Growing
The ASCO Post
The Avon Foundation for Women recently released a new study on the racial disparities in breast cancer mortality in the 50 largest cities in the United States between 2005 and 2014. Published in Cancer Epidemiology,1 the study was conducted by Sinai Urban Health Institute in collaboration with the B...
SGO and ASCO Clinical Practice Guideline on Neoadjuvant Chemotherapy for Newly Diagnosed Advanced Ovarian Cancer
Matthew Stenger
As reported by Alexi A. Wright, MD, MPH, of Dana-Farber Cancer Institute, and colleagues in the Journal of Clinical Oncology, ASCO and the Society of Gynecologic Oncology (SGO) have released a clinical practice guideline on neoadjuvant therapy for patients with newly diagnosed stage IIIC or I...
Margins for Breast-Conserving Surgery With Whole-Breast Irradiation in Ductal Carcinoma in Situ
Matthew Stenger
A clinical practice guideline on margins for breast-conserving surgery with whole-breast irradiation in ductal carcinoma in situ has been jointly developed by the Society of Surgical Oncology (SSO), the American Society for Radiation Oncology (ASTRO), and ASCO.1-3 The recommendations wer...
Barriers and Opportunities Reported in the Study of Human Papillomavirus Education and Immunization Efforts
The ASCO Post
Human papillomavirus (HPV) vaccination rates remain low across the United States, with fewer than 40% of girls and just over 21% of boys receiving the recommended vaccine series. Research from Roswell Park Cancer Institute has identified barriers that need to be overcome to improve vaccination rates...
Rise in Oropharyngeal Cancer Incidence in the UK Not Solely Driven by HPV
The ASCO Post
The rise in the incidence of oropharyngeal squamous cell carcinoma in the United Kingdom from 2002 to 2011 was not solely attributable to a rise in the incidence of human papillomavirus (HPV)-positive disease, according to a study published in Cancer Research,1 which reported that the proportion of ...
Similar 10-Year Survival With Active Monitoring, Surgery, or Radiotherapy for PSA-Detected Clinically Localized Prostate Cancer
Matthew Stenger
In the UK ProtecT trial reported in The New England Journal of Medicine, Freddie C. Hamdy, FRCS, FMedSci, of the University of Oxford, and colleagues found no significant differences in prostate cancer–specific or overall mortality among men with clinically localized prostate cancer d...
Study Finds Adding Daratumumab to Bortezomib/Dexamethasone Improves Progression-Free Survival in Relapsed/Refractory Multiple Myeloma
Matthew Stenger
In the phase III CASTOR trial reported in The New England Journal of Medicine, Antonio Palumbo, MD, of the University of Turin, and colleagues found that adding the anti-CD38 antibody daratumumab (Darzalex) to bortezomib (Velcade) and dexamethasone markedly improved progression-free s...
Phase III Trial Finds No Survival Benefit of Adding Ipilimumab to Etoposide/Platinum in Newly Diagnosed Extensive-Stage SCLC
Matthew Stenger
In a phase III trial (CA184-156) reported in the Journal of Clinical Oncology by Martin Reck, MD, PhD, of LungenClinic Grosshansdorf, Germany, and colleagues, the addition of the anti–CTLA-4 (cytotoxic T-lymphocyte–associated protein 4) checkpoint inhibitor ipilimumab (Yervoy) to etop...
ASCO Clinical Practice Guideline on Management of Chronic Pain in Survivors of Adult Cancers
Matthew Stenger
As reported in the Journal of Clinical Oncology by Judith A. Paice, PhD, RN, of Northwestern University, and colleagues, ASCO has released a clinical practice guideline on management of chronic pain in survivors of adult cancers.1 The guideline was based on literature review by an exp...
First-Line Nivolumab Alone and Combined With Platinum-Based Chemotherapy in Advanced NSCLC
Matthew Stenger
The phase I CheckMate 012 study examined the effects of nivolumab (Opdivo) monotherapy and nivolumab combined with platinum-based doublets as first-line treatments in patients with advanced non–small cell lung cancer (NSCLC). Encouraging efficacy and safety findings were reported in the Jo...
ASCO and AACI Initiative to Reduce Administrative and Regulatory Burden in Cancer Clinical Trials
Matthew Stenger
As reported in the Journal of Clinical Oncology, Julie M. Vose, MD, MBA, FASCO, of the University of Nebraska Medical Center, Omaha, and colleagues have provided a summary of the groundwork of an initiative by ASCO and the Association of American Cancer Institutes (AACI) to identify a...
Everolimus in Advanced HER2-Positive Breast Cancer With PIK3CA Mutation, PTEN Loss, or Hyperactive PI3K Pathway
Matthew Stenger
In an analysis of the phase III BOLERO-1 and -3 trials reported in the Journal of Clinical Oncology, Fabrice André, MD, of Institut Gustav-Roussy, Paris, France, and colleagues found that the addition of everolimus (Afinitor) to trastuzumab (Herceptin) and chemotherapy was associated ...
Continuation of Docetaxel May Improve Survival in Metastatic Castration-Resistant Prostate Cancer
Matthew Stenger
The number of docetaxel cycles completed was associated with improved overall survival among men with metastatic castration-resistant prostate cancer receiving docetaxel, prednisone, and lenalidomide (Revlimid) or docetaxel/prednisone, in the phase III Mainsail trial. de Morrée et al reported t...
Testosterone-Related Genetic Mutation Associated With Poorer Survival in Prostate Cancer
Matthew Stenger
A collaborative Cleveland Clinic–Mayo Clinic team of researchers has shown for the first time that patients with advanced prostate cancer are more likely to die earlier of their disease if they carry a specific testosterone-related genetic abnormality. The findings, published by Hearn et al in The L...
New USPSTF Recommendations for Colorectal Cancer Screening
Matthew Stenger
As reported in JAMA, the U.S. Preventive Services Task Force (USPSTF) has issued new recommendations for colorectal cancer screening.1 In brief, the USPSTF recommends colorectal cancer screening starting at age 50 years and continuing until age 75 years (grade A recommendation = “The USPSTF recomme...
ASCO, ASTRO, and SSO Issue Joint Update to Guideline on Postmastectomy Radiotherapy for Women With Breast Cancer
The ASCO Post
Earlier this month, ASCO, in collaboration with the American Society for Radiation Oncology (ASTRO) and the Society for Surgical Oncology (SSO), jointly issued an update to a clinical practice guideline for physicians treating women with breast cancer who have undergone a mastectomy. ...
Neoadjuvant Veliparib/Carboplatin and Neratinib ‘Graduate’ From Adaptive Randomization I-SPY 2 Trial in Early Breast Cancer
Matthew Stenger
As reported by Hope S. Rugo, MD, and John W. Park, MD, both of the University of California, San Francisco, and colleagues in The New England Journal of Medicine, the multiarm adaptive randomization phase II I-SPY 2 trial has shown that the addition of veliparib/carboplatin and the ad...
Large Study Finds No Link Between Vasectomy and Prostate Cancer Risk
The ASCO Post
In a new study, men who underwent vasectomy did not have an increased risk of prostate cancer, nor were they more likely to die from prostate cancer than men who did not receive this procedure. According to the researchers, this is the largest prospective study of vasectomy and fatal ...
European Studies Compare Conventional vs Hypofractionated Radiotherapy for Localized Prostate Cancer
Matthew Stenger
Two recent European phase III trials with different study designs focused on hypofractionated vs conventional radiotherapy in localized prostate cancer. Investigators in the CHHiP trial1 showed that the hypofractionated approach is noninferior to standard fractionation, with no increa...
Immune Analysis of On-Treatment Longitudinal Biopsies Predicts Response to Melanoma Immunotherapy
The ASCO Post
Immune response measured in tumor biopsies during the course of early treatment predicts which melanoma patients will benefit from specific immune checkpoint blockade drugs, researchers at The University of Texas MD Anderson Cancer Center found in a report published by Chen et al in Cancer Discovery...
Continued ABVD vs Omission of Bleomycin (AVD) After Negative Imaging Findings in Advanced Hodgkin Lymphoma
Matthew Stenger
In a phase III trial reported in The New England Journal of Medicine, Peter Johnson, MD, of the Cancer Research UK Centre, University of Southampton, and colleagues found similar efficacy with continued ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) vs omission of bleomycin (...
Global Curriculum in Surgical Oncology Outlined by Society of Surgical Oncology and European Society of Surgical Oncology
Matthew Stenger
As reported by Chandrakanth Are, MBBS, MBA, FRCS, FACS, of the University of Nebraska Medical Center, Omaha, and colleagues at the Society of Surgical Oncology (SSO) and European Society of Surgical Oncology (ESSO), the rising global burden of cancer and inequalities in surgical oncol...
Effect of Radiosurgery Alone vs With Whole-Brain Radiotherapy on Cognitive Function in Patients With Brain Metastases
The ASCO Post
Physicians from Carolinas HealthCare System’s Neurosciences Institute and Levine Cancer Institute are among the authors of a recent study published by Brown et al in JAMA.1 The study showed how among patients with one to three brain metastases, the use of stereotactic radiosurgery alone, compared wi...
Nivolumab Achieves Response in Most Patients With Classical Hodgkin Lymphoma After ASCT and Brentuximab Vedotin
Matthew Stenger
In a phase II trial reported in The Lancet Oncology by Anas Younes, MD, of Memorial Sloan Kettering Cancer Center, and colleagues, treatment with the anti–PD-1 (programmed cell death protein 1) immune checkpoint inhibitor nivolumab (Opdivo) produced response in two-thirds of patients ...
Venetoclax Produces High Response Rate in Relapsed or Refractory CLL With 17p Deletion
Matthew Stenger
In a pivotal phase II study reported in The Lancet Oncology, Stephan Stilgenbauer, MD, of Ulm University, Germany, and colleagues found that the BCL2 inhibitor venetoclax (ABT-199) produced a high response rate in patients with relapsed or refractory chronic lymphocytic leukemia (CLL)...
New SSO, ASTRO, ASCO Joint Ductal Carcinoma in Situ Consensus Guideline Could Curb Unnecessary Breast Surgery and Reduce Health-System Costs
Matthew Stenger
Three leading national cancer organizations have issued a consensus guideline for physicians treating women who have ductal carcinoma in situ treated with breast-conserving surgery with whole-breast irradiation. The new guideline has the potential to save many women from unnecessary surgeries, while...
ASCO Adapts CCO Guideline on Selection of Optimal Adjuvant Therapies for HER2-Negative and HER2-Positive Breast Cancers
Matthew Stenger
As reported in the Journal of Clinical Oncology by Neelima Denduluri, MD, and colleagues, ASCO has adapted a Cancer Care Ontario (CCO) clinical practice guideline on selection of optimal adjuvant chemotherapy for HER2-negative and adjuvant targeted therapy for HER2-positive breast can...
Hypofractionated Radiotherapy Not Inferior to Conventional Radiotherapy in Low-Risk Prostate Cancer
Matthew Stenger
In a phase III noninferiority trial (NRG Oncology RTOG 0415) reported in the Journal of Clinical Oncology, W. Robert Lee, MD, MS, Med, of Duke University Medical Center, and colleagues found that hypofractionated radiotherapy was not inferior to conventional radiotherapy in disease-fr...
ASCO Endorses Cancer Care Ontario Recommendations on Role of Patient and Disease Factors in Adjuvant Systemic Therapy Decisions in Early-Stage, Operable Breast Cancer
Matthew Stenger
As reported in the Journal of Clinical Oncology (JCO) by N. Lynn Henry, MD, PhD, of University of Michigan Comprehensive Cancer Center, Ann Arbor, and colleagues,1 ASCO has endorsed Cancer Care Ontario guideline recommendations on the role of patient and disease factors in decisions o...
ESMO Releases New Consensus Guidelines on the Management of Metastatic Colorectal Cancer
The ASCO Post
The European Society for Medical Oncology (ESMO) has released new consensus guidelines for the management of metastatic colorectal cancer that reflect an increasingly personalized approach to treatment. These guidelines were published by Van Cutsem et al in Annals of Oncology.1 “Management of ...
Study Shows Women Who Received Cancer Screening Invitation Letters Are More Likely to Have a Pap Test
The ASCO Post
Receiving an invitation to undergo screening for cervical cancer is associated with a greater likelihood of getting screened, according to a study published by Tavasoli et al in Preventive Medicine.1 The study explored the impact of invitation and reminder letters on cervical cancer screening parti...
Adding Bevacizumab to Letrozole Improves Progression-Free Survival but Increases Toxicity in Hormone Receptor–Positive Metastatic Breast Cancer
Matthew Stenger
In a phase III trial (CALGB 40503/Alliance) reported in the Journal of Clinical Oncology, Maura N. Dickler, MD, of Memorial Sloan Kettering Cancer Center, and colleagues found that the addition of bevacizumab (Avastin) to first-line endocrine therapy with letrozole improved progressi...
Prevalence of Estrogen Receptor Mutations in Patients With Metastatic Breast Cancer
The ASCO Post
A new study published online by JAMA Oncology examined the prevalence and significance of estrogen receptor mutations in patients with metastatic breast cancer.1 The activation of the estrogen receptor is a feature of most breast cancers in which estrogen receptor expression is detected. An aromata...
Inotuzumab Ozogamicin Improves Outcomes vs Standard Therapy in Relapsed/Refractory Acute Lymphoblastic Leukemia
Matthew Stenger
In a phase III trial reported in The New England Journal of Medicine, Hagop M. Kantarjian, MD, of The University of Texas MD Anderson Cancer Center, and colleagues found that treatment with the antibody-drug conjugate inotuzumab ozogamicin resulted in a greater complete remission rate...
Phase III Trial Shows Adding Obinutuzumab to Bendamustine Improves Progression-Free Survival in Rituximab-Refractory NHL
Matthew Stenger
In the phase III GADOLIN trial reported in The Lancet Oncology, Laurie H. Sehn, MD, Chair, British Columbia Cancer Agency Lymphoma Tumor Group, and Clinical Associate Professor at the University of British Columbia, Vancouver, and colleagues, found that adding the anti-CD20 antibody obinutuzumab (Ga...
Economic Crisis Associated With Increased Cancer Mortality
Matthew Stenger
The global economic crisis has been associated with increased unemployment and reduced public-sector expenditure on health care. In a study reported in The Lancet, Mahiben Maruthappu, MA, of Imperial College London, and colleagues found that the global economic crisis beginning in 200...
Reduced-Intensity Related-Donor Haploidentical vs HLA-Matched Sibling-Donor Hematopoietic Cell Transplantation in Lymphoma
Matthew Stenger
In an analysis of the observational database of the Center for International Blood and Marrow Transplant Research reported in the Journal of Clinical Oncology, Nilanjan Ghosh, MD, PhD, of Levine Cancer Institute, Carolinas Healthcare System, Charlotte, North Carolina, and colleagues f...
New Analysis Shows Advertising by U.S. Cancer Centers Has Soared Over Past Decade
The ASCO Post
American cancer centers promoting their services dramatically increased their advertising spending from 2005 to 2014, with the bulk of the spending by for-profit organizations, according to the results of a study published by Vater et al in JAMA Internal Medicine.1 Small Percentage Responsible for ...
ASCO Guideline on Endocrine Therapy for Hormone Receptor–Positive Metastatic Breast Cancer
Matthew Stenger
As reported by Hope S. Rugo, MD, of the University of California San Francisco Comprehensive Cancer Center, and colleagues in the Journal of Clinical Oncology, ASCO has released a clinical practice guideline on endocrine therapy for hormone receptor–positive metastatic breast cancer.1 The recom...
ASCO Guideline on Potentially Curable Pancreatic Cancer
Matthew Stenger
As reported in the Journal of Clinical Oncology by Alok A. Khorana, MD, of Cleveland Clinic, and colleagues, ASCO has released a clinical practice guideline on the treatment of potentially curable pancreatic cancer.1 The recommendations are based on an expert panel systematic review o...
ASCO Guideline on Treatment of Locally Advanced, Unresectable Pancreatic Cancer
Matthew Stenger
As reported by Edward P. Balaban, DO, FASCO, of Penn State Hershey Cancer Institute, and colleagues in the Journal of Clinical Oncology, ASCO has released a clinical practice guideline on the treatment of locally advanced, unresectable pancreatic cancer.1 The recommendations are based...
ASCO Guideline on Metastatic Pancreatic Cancer
Matthew Stenger
As reported in the Journal of Clinical Oncology by Davendra P.S. Sohal, MD, MPH, of Cleveland Clinic, and colleagues, ASCO has released a clinical practice guideline on the treatment of patients with metastatic pancreatic cancer.1 Recommendations are based on an expert panel systemati...
Greatest Benefit of Adjuvant Exemestane in Premenopausal Women at Higher Risk of Breast Cancer Recurrence
Matthew Stenger
In an analysis of the SOFT and TEXT trials reported in the Journal of Clinical Oncology, Meredith M. Regan, ScD, of Dana-Farber Cancer Institute, and colleagues found that the greatest benefit of adjuvant exemestane in reducing breast cancer recurrence was among women with the greates...
Detection of Breast Cancer With Ultrasound vs Tomosynthesis in Women With Mammography-Negative Dense Breasts
Matthew Stenger
As reported in the Journal of Clinical Oncology by Alberto S. Tagliafico, MD, of the University of Genoa, and colleagues, interim findings in the Italian prospective ASTOUND study indicate that ultrasound is associated with improved incremental detection of breast cancer at screening ...
Addition of Ixazomib to Lenalidomide/Dexamethasone Improves Progression-Free Survival in Relapsed/Refractory Multiple Myeloma
Matthew Stenger
In the phase III TOURMALINE-MM-1 trial reported in The New England Journal of Medicine, Philippe Moreau, MD, of the University Hospital Hôtel Dieu, Nantes, France, and colleagues found that adding the oral proteasome inhibitor ixazomib (Ninlaro) to lenalidomide (Revlimid) and dexamethasone si...
European Demand for Radiotherapy Expected to Rise Approximately 16% Over Next Decade
The demand for radiotherapy across all European countries will increase by an average of 16% between 2012 and 2025, with the highest expected increase being for prostate cancer cases (24%), according to a new study published by Borras et al in Radiotherapy and Oncology.1 These projections came fro...
Pembrolizumab Active in PD-L1–Positive Advanced Gastric Cancer and Triple-Negative Breast Cancer
Matthew Stenger
The KEYNOTE-012 phase Ib trial assessed single-agent pembrolizumab (Keytruda) in patients with advanced programmed cell death ligand 1 (PD-L1)–positive gastric cancer, triple-negative breast cancer, urothelial cancer, and head and neck cancer. The activity of pembrolizumab in study patients w...
ASCO Clinical Practice Guideline Update on Ovarian Suppression/Adjuvant Endocrine Therapy in Hormone Receptor–Positive Breast Cancer
Matthew Stenger
As reported in the Journal of Clinical Oncology by Harold J. Burstein, MD, PhD, of Dana-Farber Cancer Institute, Boston, and colleagues, ASCO has released a clinical practice guideline update on ovarian suppression as part of the extant guideline on adjuvant endocrine therapy in hormone recep...
Cancer and Fertility Program Improves Patient Satisfaction With Information on Fertility Risks and Preservation
Matthew Stenger
As reported by Joanne F. Kelvin, MSN, RN, CNS, AOCN, of Memorial Sloan Kettering Cancer Center (MSK), and colleagues in the Journal of Clinical Oncology, a cancer and fertility program established at MSK improved patient satisfaction with information received regarding fertility risks and pre...
Prolonged Progression-Free Survival With Addition of Palbociclib to Fulvestrant in HER2-Negative Metastatic Breast Cancer
Matthew Stenger
As reported in The Lancet Oncology by Massimo Cristofanilli, MD, of the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, and colleagues, the final results of the phase III PALOMA-3 trial showed that the addition of the CDK4/CDK6 inhibitor palbociclib (Ibrance) to fulvestr...
Daratumumab Shows High Activity in Heavily Pretreated and Refractory Multiple Myeloma
Matthew Stenger
In the phase II SIRIUS trial reported in The Lancet, Sagar Lonial, MD, of Winship Cancer Institute, Emory University, and colleagues found that the CD38-targeted monoclonal antibody daratumumab (Darzalex) produced durable responses in patients with multiple myeloma who had received at least t...
Pembrolizumab Improves Survival vs Docetaxel in Previously Treated PD-L1–Positive Advanced Non–Small Cell Lung Cancer
Matthew Stenger
As reported in The Lancet by Roy S. Herbst, MD, PhD, of Yale School of Medicine, and colleagues,1 the phase II/III KEYNOTE-010 trial showed that pembrolizumab (Keytruda) significantly improved overall survival vs docetaxel in patients with previously treated programmed cell death ligand 1 (PD-L1)-po...
ASCO Statement on Human Papillomavirus Vaccination for Cancer Prevention
Matthew Stenger
As reported in the Journal of Clinical Oncology by Howard H. Bailey, MD, of the University of Wisconsin Carbone Cancer Center, and colleagues, ASCO has released a statement on increasing human papillomavirus (HPV) vaccination to prevent HPV-related cancers in the United States.1 In the United Stat...
Improvement in Overall Survival With Addition of Chemotherapy to Radiotherapy in Low-Grade Glioma
Matthew Stenger
Final results of the RTOG 9802 phase III trial reported in The New England Journal of Medicine by Jan C. Buckner, MD, of Mayo Clinic, Rochester, and colleagues, showed that the addition of chemotherapy with procarbazine, lomustine, and vincristine to radiotherapy significantly prolonged overall...
Increased Survival and Toxicity With Docetaxel, No Benefit of Zoledronic Acid, When Added to First-Line Hormone Therapy in Prostate Cancer
Matthew Stenger
As reported in The Lancet by Nicholas D. James, BSc, MBBS, PhD, of the University of Warwick, and colleagues, survival results of the STAMPEDE trial, which used a multiarm, multistage seamless phase II/III design, provide little evidence of benefit of zoledronic acid and showed increased surv...
Neratinib Improves Invasive Disease–Free Survival in HER2-Positive Breast Cancer
Matthew Stenger
In the phase III ExteNET trial reported in The Lancet Oncology, Arlene Chan, MD, of the Breast Cancer Research Centre-Western Australia, Perth, and colleagues found that 1 year of treatment with the HER1, HER2, and HER4 tyrosine kinase inhibitor neratinib improved invasive disease–free surviv...
No Survival Benefit Reported With Chemoradiotherapy vs Continued Chemotherapy in Controlled Locally Advanced Pancreatic Cancer
Matthew Stenger
In the phase III GERCOR LAP07 trial reported by Pascal Hammel, MD, of Beaujon Hospital, Clichy, France, and colleagues in JAMA, there was no survival benefit of chemoradiotherapy vs continued chemotherapy in patients with locally advanced pancreatic cancer controlled after 4 months of gemcitabine wi...
ASCO Endorses European Association of Urology Guideline on Muscle-Invasive and Metastatic Bladder Cancers
Matthew Stenger
As reported in the Journal of Clinical Oncology by Matthew I. Milowsky, MD, of the University of North Carolina Lineberger Comprehensive Cancer Center, and colleagues,1 ASCO has endorsed the European Association of Urology clinical practice guideline on muscle-invasive and metastatic bladd...
No Disease-Free Survival Benefit of Adjuvant Sunitinib or Sorafenib in High-Risk Nonmetastatic Renal Cell Carcinoma
Matthew Stenger
In the phase III ECOG-ACRIN E2805 trial reported in The Lancet by Naomi B. Haas, MD, of Abramson Cancer Center, University of Pennsylvania, and colleagues, no benefit of adjuvant vascular endothelial growth factor receptor (VEGFR) inhibitor treatment with sunitinib or sorafenib (Nexavar) was ...
Anti–PD-L1 Antibody Atezolizumab Active in Previously Treated Advanced Urothelial Carcinoma
Matthew Stenger
In a phase II trial reported in The Lancet, Jonathan E. Rosenberg, MD, of Memorial Sloan Kettering Cancer Center, and colleagues found that the anti–PD-L1 (programmed cell death ligand 1) antibody atezolizumab produced durable responses in a marked proportion of patients with previously treat...
Increased Physical Activity Associated With Lower Risk of 13 Types of Cancer
A new study of the relationship between physical activity and cancer has shown that greater levels of leisure-time physical activity were associated with a lower risk of developing 13 different types of cancer. The risk of developing seven cancer types was 20%, or more, lower among the most-a...
Eribulin Improves Overall Survival vs Dacarbazine in Previously Treated Advanced Liposarcoma or Leiomyosarcoma
Matthew Stenger
In a phase III trial reported in The Lancet, Patrick Schöffski, MD, of University Hospitals Leuven, Leuven Cancer Institute, Belgium, and colleagues found that eribulin (Halaven) improved overall survival vs dacarbazine in patients with advanced or metastatic soft-tissue sarcoma who had recei...
Enzalutamide Produces Large Progression-Free Survival Benefit vs Bicalutamide in Two Trials in Castration-Resistant Prostate Cancer
Matthew Stenger
In the randomized phase II TERRAIN trial reported in The Lancet Oncology, Neal D. Shore, MD, of Carolina Urologic Research Center, Myrtle Beach, and colleagues found that use of the androgen receptor inhibitor enzalutamide (Xtandi) more than doubled median progression-free survival vs bicalutamide i...
ASCO Guideline on Use of Biomarkers to Guide Decisions on Adjuvant Systemic Therapy in Early-Stage Invasive Breast Cancer
Matthew Stenger
As reported in the Journal of Clinical Oncology by Lyndsay N. Harris, MD, and colleagues,1 ASCO has released a clinical practice guideline on the use of biomarkers in addition to estrogen receptor/progesterone receptor and HER2 status to guide decisions on adjuvant systemic therapy in women with ear...
Transcription Factor CDX2 May Be a Prognostic Biomarker in Stage II and III Colon Cancer
Matthew Stenger
In a study reported in The New England Journal of Medicine, Piero Dalerba, MD, of Columbia University, and colleagues found that absence of the transcription factor CDX2 was prognostic for poor outcome in patients with stage II and III colon cancer vs cancers with CDX2 expression.1 However, adjuvant...
ASCO Endorses Cancer Care Ontario Guideline on Active Surveillance for Management of Localized Prostate Cancer
Matthew Stenger
As reported by Ronald C. Chen, MD, MPH, of the University of North Carolina at Chapel Hill, and colleagues in the Journal of Clinical Oncology, ASCO has endorsed, with qualifications, the 2015 Cancer Care Ontario (CCO) guideline on active surveillance for management of localized prostate cancer. ASC...
ACS/ASCO Breast Cancer Survivorship Care Guideline
Matthew Stenger
The American Cancer Society (ACS) and ASCO have issued a Breast Cancer Survivorship Care guideline, published jointly in the Journal of Clinical Oncology and CA: A Cancer Journal for Clinicians.1,2 The guideline recommendations were formulated by a multidisciplinary expert work group and are based o...
Atezolizumab Improves Survival vs Docetaxel in Previously Treated NSCLC: Increased Benefit With Increased PD-L1 Expression
Matthew Stenger
In the phase II POPLAR trial reported in The Lancet, Louis Fehrenbacher, MD, of Kaiser Permanente Medical Center, and colleagues found that the investigational anti–programmed cell death ligand 1 (PD-L1) antibody atezolizumab improved overall survival vs docetaxel in patients with non–small cel...
Update of ASCEND-1 Trial Shows Ceritinib Highly Active in ALK-Rearranged NSCLC, Including Intracranial Disease
Matthew Stenger
Updated results of the phase I ASCEND-1 trial, reported by Kim et al in The Lancet Oncology, indicate that the ALK inhibitor ceritinib (Zykadia) produced high response rates in advanced ALK-rearranged non–small cell lung cancer (NSCLC), including intracranial disease, in both patients with and with...
Decreased PSA Screening and Decreased Diagnosis of Early-Stage Prostate Cancer
Matthew Stenger
Recent data indicate that the rate of prostate-specific antigen (PSA) screening and the rate of diagnosis of early-stage prostate cancer have decreased since a 2012 U.S. Preventive Services Task Force (USPSTF) statement (released in October 2011) gave a grade D recommendation against PSA scre...
Everolimus Improves Progression-Free Survival in Advanced Neuroendocrine Tumors of the Lung or Gastrointestinal Tract
Matthew Stenger
In a phase III trial (RADIANT-4) reported in The Lancet, James C. Yao, MD, of the University of Texas MD Anderson Cancer Center, and colleagues found that everolimus (Afinitor) and supportive care significantly prolonged progression-free survival vs placebo and supportive care in patients with advan...
First-Line Ibrutinib Improves Progression-Free and Overall Survival vs Chlorambucil in Older Patients With Chronic Lymphocytic Leukemia
Matthew Stenger
As reported in The New England Journal of Medicine and at the 2015 American Society of Hematology Annual Meeting, Jan A. Burger, MD, PhD, and colleagues found that first-line treatment with the oral Bruton’s tyrosine kinase inhibitor ibrutinib (Imbruvica) improved progression-free and overall surviv...
Reduction in Late Mortality in Childhood Cancer Survivors
Matthew Stenger
In a study reported in The New England Journal of Medicine, Gregory T. Armstrong, MD, MSCE, of St. Jude Children’s Research Hospital, Memphis, and colleagues found that late mortality has decreased over time among 5-year survivors of childhood cancer in the Childhood Cancer Survivor Study cohort.1 T...
No Apparent Benefit of Long-Term Mifepristone in the Treatment of Unresectable Meningioma
Matthew Stenger
In a phase III trial (SWOG S9005) reported in the Journal of Clinical Oncology,1 YongLi Ji, MD, PhD, and Claire Verschraegen, MD, of the University of Vermont Cancer Center; and colleagues found no benefit of treatment with the antiprogestin agent mifepristone vs placebo in patients with unresectabl...
Scandinavian Sarcoma Group Trial Shows Continued Benefit With 3 Years vs 1 Year of Adjuvant Imatinib in High-Risk GIST
Matthew Stenger
As reported in the Journal of Clinical Oncology by Heikki Joensuu, MD, PhD, of the Comprehensive Cancer Center Helsinki, Finland, and colleagues, the second planned analysis in the Scandinavian Sarcoma Group XVIII/AIO trial showed a recurrence-free survival benefit and a continued overall survi...
Two Types of Asparaginase Compared in Newly Diagnosed Childhood Acute Lymphoblastic Leukemia
Matthew Stenger
Intravenous pegylated (PEG) Escherichia coli (E coli) asparaginase was associated with similar toxicity and efficacy compared with intramuscular native E coli L-asparaginase in children with newly diagnosed acute lymphoblastic leukemia, according to the results of a phase III trial (DFCI 05-001...
Potential Overdiagnosis of Contralateral Breast Cancer With Preoperative Breast MRI in Older Women With Breast Cancer
Matthew Stenger
In an analysis of the Surveillance, Epidemiology, and End Results (SEER)-Medicare database reported in the Journal of Clinical Oncology, Shi-Yi Wang, MD, PhD, of Yale School of Public Health, and colleagues found that the use of preoperative magnetic resonance imaging (MRI) was associated with overd...
Minimal Residual Disease Identified by NPM1 Mutation Is a Powerful Marker for Poorer Outcome in Standard-Risk AML
Matthew Stenger
In a study reported in The New England Journal of Medicine, Adam Ivey, MSc, from Guy’s Hospital, London, and colleagues found that a leukemia-specific marker consisting of mutation in the gene encoding nucleophosmin (NPM1) can be used to identify minimal residual disease in peripheral blood in stand...
PARP Inhibitor Olaparib Produces High Response Rate in Metastatic Prostate Cancer With DNA-Repair Defects
Matthew Stenger
In the TOPARP-A phase II trial reported in The New England Journal of Medicine, Joaquin Mateo, MD, of the Institute of Cancer Research and The Royal Marsden in London, and colleagues, found that the PARP inhibitor olaparib (Lynparza) produced a high response rate in patients with previously treated ...
Pediatric Oncology Groups Endorse Ethical Framework for Rationing Scarce Drugs
Kirsten Boyd Goldberg
The Children’s Oncology Group (COG) and the American Society of Pediatric Hematology/Oncology (ASPHO) have endorsed formal clinical recommendations for rationing chemotherapy and supportive care agents during times of shortage. The guidance is needed because persistent shortages of many standard the...
Adding Ibrutinib to Bendamustine/Rituximab Improves Outcome in Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma
Matthew Stenger
In the phase III HELIOS trial reported in The Lancet Oncology, Asher Chanan-Khan, MD, of the Mayo Clinic Cancer Center, Jacksonville, Florida, and colleagues found that addition of the Bruton’s tyrosine kinase (BTK) inhibitor ibrutinib (Imbruvica) to bendamustine (Treanda)/rituximab (Rituxan) increa...
Rolapitant Reduces Chemotherapy-Induced Nausea and Vomiting in Patients Receiving Moderately and Highly Emetogenic Chemotherapy
Matthew Stenger
In three phase III studies reported in The Lancet Oncology, the addition of the neurokinin-1 (NK-1) receptor antagonist rolapitant to serotonin (5-HT3) receptor antagonist and dexamethasone treatment significantly improved complete response rates in the prevention of chemotherapy-induced nausea and ...
Dose-Intensified vs Standard Salvage Radiation for Biochemically Recurrent Prostate Cancer After Prostatectomy
Matthew Stenger
Initial results of a European phase III trial (SAKK 09/10), reported in the Journal of Clinical Oncology by Ghadjar et al of the Swiss Group for Clinical Cancer Research, showed little difference in acute toxicity with salvage radiotherapy of 70 vs 64 Gy in patients with biochemical recurrence of pr...
Comparing Recurrence Risk With Anastrozole vs Tamoxifen in Postmenopausal Women With Ductal Carcinoma in Situ
Matthew Stenger
Two recently reported phase III trials compared adjuvant anastrozole vs tamoxifen in postmenopausal women with hormone receptor–positive ductal carcinoma in situ. As reported in The Lancet by Margolese et al,1 the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-35 trial, performed in w...
New AJCC Precision Medicine Guidelines Aimed at Improving Personalized Cancer Treatment Plans for Patients
The ASCO Post
A committee of national experts, led by a Cleveland Clinic researcher, has established first-of-its-kind guidelines to promote more accurate and individualized cancer predictions, guiding more precise treatment and leading to improved patient survival rates and outcomes. These guidelines were publis...
Study Finds Colorectal Cancer More Likely to Affect Minorities at Younger Age
The ASCO Post
Researchers at the University of Missouri School of Medicine reported that minority and ethnic groups are being diagnosed with colorectal cancer at younger ages and more advanced stages than non-Hispanic whites. The study was recently published in Cancer Medicine.1 “While we know the risk of develo...
Pancreas Cancer Liquid Biopsy: Proof-of-Principle Study
The ASCO Post
Pancreatic cancer tumors are ripe for analysis with a liquid biopsy, according to researchers at The University of Texas MD Anderson Cancer Center. In a proof-of-principle study published recently in Annals of Oncology,1 the investigators reported on research in which they conducted whole-genome, wh...
Computerized Cognitive Training Promising for Reducing Cognitive Late Effects in Childhood Cancer Survivors
The ASCO Post
In a study reported in the Journal of Clinical Oncology, Heather M. Conklin, PhD, of St. Jude Children’s Research Hospital, and colleagues found that computerized cognitive training showed promise in reducing cognitive late effects in survivors of childhood cancer.1 Study Details In the study, con...
Global and North American Phase II Studies Show Alectinib Is Highly Active in Crizotinib-Resistant/Refractory ALK-Rearranged NSCLC
Matthew Stenger
In two phase II trials, reported in the Journal of Clinical Oncology and The Lancet Oncology, the ALK inhibitor alectinib (Alecensa), which is active against acquired crizotinib resistance mutations and exhibits high central nervous system (CNS) penetration, was associated with considerable activity...
Lenalidomide Plus Rituximab Highly Active in Initial Treatment of Mantle Cell Lymphoma
Matthew Stenger
In a phase II trial reported in The New England Journal of Medicine by Jia Ruan, MD, PhD, and colleagues, first-line treatment with the immunomodulatory agent lenalidomide (Revlimid) and the anti-CD20 antibody rituximab (Rituxan) followed by maintenance lenalidomide and rituximab produced a high res...
Study Reveals Potential Therapy Targets for Triple-Negative Breast Cancer
The ASCO Post
A multi-institutional international investigation led by scientists at The University of Texas MD Anderson Cancer Center, Houston, has revealed new information about how molecules called long noncoding RNAs (lncRNA) interact with HIF-1, a signaling pathway that is overexpressed in many cancers. HIF-...
Evolution
John V. Cox, DO, MBA, FACP, FASCO and James O. Armitage, MD, FASCO
Ten years ago, ASCO created the Journal of Oncology Practice to address a gap in the literature; there were no peer-reviewed journals dedicated to the practical issues of delivering quality oncology care. The original research and editorials published in JOP focus on care delivery topics such as pra...
Journal of Oncology Practice Expands Research Coverage and Debuts a New Look
Jo Cavallo
Launched by ASCO in 2005 to provide oncologists with original research on the delivery of high-quality cancer care, the Journal of Oncology Practice (JOP) enters its 11th year with a new look and feel. Beginning in January 2016, JOP will be copublished by ASCO and Harborside Press, the publisher of ...
Phase III Trials Fail to Show Noninferiority of Surgical Outcome for Laparoscopic vs Open Resection in Rectal Cancer
Matthew Stenger
Two phase III trials, reported in JAMA by James Fleshman, MD, of Baylor University Medical Center, Dallas, and colleagues1 and Andrew R. Stevenson, MBBS, FRACS, of the University of Queensland, Brisbane, Australia, and colleagues,2 failed to show noninferiority of surgical outcome for laparoscopic v...
Surgical Excision Without Radiation Therapy in Women With Low-Risk Ductal Carcinoma in Situ
Matthew Stenger
Lawrence J. Solin, MD, of Albert Einstein Healthcare Network, Philadelphia, and colleagues reported the 12-year results from the ECOG-ACRIN E5194 trial in the Journal of Clinical Oncology. Among women with ductal carcinoma in situ with low-risk clinical and pathologic characteristics, they found tha...
ASCO Endorses ACCP Guideline on Treatment of Small Cell Lung Cancer
Matthew Stenger
As reported in the Journal of Clinical Oncology,1 ASCO has endorsed the current American College of Chest Physicians (ACCP) guideline on treatment of small cell lung cancer (SCLC), released in 2013.2 After review of evidence from an updated literature search covering 2011 to March 2015, an ASCO endo...
BRAF Inhibition Successful in Relapsed/Refractory Hairy Cell Leukemia
Matthew Stenger
In two phase II studies reported in The New England Journal of Medicine, Enrico Tiacci, MD, of the University of Perugia, Italy, and colleagues found that the BRAF inhibitor vemurafenib (Zelboraf) produced responses in nearly all patients with BRAF V600E–positive hairy cell leukemia that relapsed a...
Improved Progression-Free Survival With Trabectedin vs Dacarbazine After Chemotherapy Failure in Liposarcoma or Leiomyosarcoma
Matthew Stenger
In a phase III trial reported in the Journal of Clinical Oncology, George D. Demetri, MD, of Harvard Medical School and Dana-Farber Cancer Institute, Boston, and colleagues found that treatment with trabectedin (Yondelis) significantly improved progression-free survival vs dacarbazine in patients wi...
Convergence of Breast Cancer Incidence but Continued Divergence of Mortality in Black Women and White Women
Matthew Stenger
In an article published in CA: A Cancer Journal for Clinicians, Carol E. DeSantis, MPH, and colleagues from the American Cancer Society reported that the incidence of breast cancer in black women has caught up to that in white women, whereas the risk of mortality continues to be higher in black wom...
Nivolumab Improves Overall Survival vs Docetaxel in Advanced Previously Treated Squamous Cell NSCLC
Matthew Stenger
In a phase III trial reported in The New England Journal of Medicine, Julie Brahmer, MD, of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, and colleagues found that treatment with the programmed cell death protein 1 (PD-1) immune checkpoint inhibitor antibody nivolumab (...
ASCO Clinical Practice Guideline: Use of Biomarkers to Guide Systemic Therapy for Women With Metastatic Breast Cancer
Matthew Stenger
As reported in the Journal of Clinical Oncology by Catherine Van Poznak, MD, and colleagues, ASCO has issued a clinical practice guideline on the use of biomarkers to guide decisions on systemic therapy in women with metastatic breast cancer.1 The statement is based on an ASCO expert panel review of...
Regional Nodal Irradiation in Early Breast Cancer Yields Significant Disease-Free Survival Benefit in Two Trials
Matthew Stenger
Two phase III trials recently reported in The New England Journal of Medicine indicated that the addition of regional nodal irradiation was associated with no or marginal overall survival benefit but significantly improved disease-free survival in patients with early-stage breast cancer.1,2 NCIC MA...
Gut Bacteria May Facilitate Efficacy of Anti–PD-L1 Agents
Caroline Helwick
Could the manipulation of bacteria in the gut pack the same punch in melanoma as antibodies targeting the programmed cell death protein and its ligand (PD-1/PD-L1)? It’s possible, at least in mice, according to research from the University of Chicago, recently published in Science.1 The researchers ...
Accelerated Partial-Breast vs Whole-Breast Irradiation After Surgery for Early Breast Cancer
Matthew Stenger
As reported in The Lancet by Vratislav Strnad, MD, of University Hospital Erlangen, Germany, and colleagues, 5-year results of a phase III noninferiority trial showed no difference in local relapse, disease-free survival, or overall survival with adjuvant accelerated partial breast irradiation using...
ACS Guideline Update on Breast Cancer Screening for Women at Average Risk
Matthew Stenger
As reported in JAMA by Kevin C. Oeffinger, MD, of Memorial Sloan Kettering Cancer Center, New York, and colleagues, the American Cancer Society (ACS) has issued an update to its 2003 guideline on breast cancer screening for women at average risk of breast cancer.1 Robert A. Smith, PhD, of the Cancer...
ASCO Clinical Practice Guideline Update: Systemic Therapy for Stage IV NSCLC
Matthew Stenger
As reported in the Journal of Clinical Oncology by Gregory A. Masters, MD, and colleagues, ASCO has issued a clinical practice guideline update on systemic therapy for stage IV non–small cell lung cancer (NSCLC).1 Recommendations are based on an update committee systematic review of randomized contr...
Checkmate 057: Nivolumab Improves Survival vs Docetaxel in Advanced Nonsquamous Non–Small Cell Lung Cancer
Matthew Stenger
In the phase III CheckMate 057 trial, reported in The New England Journal of Medicine by Hossein Borghaei, DO, of Fox Chase Cancer Center, and colleagues, the programmed cell death protein 1 (PD-1) inhibitor nivolumab (Opdivo) improved overall survival vs docetaxel in patients with advanced nonsquam...
Mediterranean Diet Supplemented With Extra-Virgin Olive Oil Reduces Risk for Invasive Breast Cancer
Matthew Stenger
As reported in JAMA Internal Medicine by Estefania Toledo, MD, MPH, PhD, and colleagues, a large Spanish primary prevention nutrition intervention trial in patients at high cardiovascular risk (PREDIMED) showed a large reduction in the risk for invasive breast cancer among women 60 to 80 years of ag...
Study Finds Quality of Physician Recommendation to Parents Key to Encourage/Discourage HPV Vaccination of Adolescents
Jo Cavallo
A nationwide online survey of 776 pediatricians and family physicians assessing the quality of their human papillomavirus (HPV) vaccine recommendations to parents has found that approximately 27% of respondents said they do not strongly endorse HPV vaccination; further, 26% and 39% of respondents re...
ASCO Clinical Practice Guideline Update: Recommendations for the Use of White Blood Cell Growth Factors
Matthew Stenger
ASCO has issued a clinical practice guideline update on use of hematopoietic colony-stimulating factors, as reported in the Journal of Clinical Oncology by Thomas J. Smith, MD, FACP, FASCO, FAAHMP, and colleagues.1 This update to the ASCO 2006 guideline was based on a systematic review of randomized...
Improved Overall Survival With Neoadjuvant Plus Adjuvant Bevacizumab in Early HER2-Negative Breast Cancer
Matthew Stenger
The phase III National Surgical Adjuvant Breast and Bowel Project (NSABP) B-40 (NRG Oncology) trial showed that the addition of bevacizumab (Avastin) to docetaxel + anthracycline-based neoadjuvant chemotherapy improved pathologic complete response rate, the primary endpoint, in patients with early H...
A Cancer Diagnosis Can Lead to Significant Loss of Working Hours, Income
The ASCO Post
A new analysis indicates that when American adults are diagnosed with cancer, they experience significant decreases in the probability of working, in the number of hours they work, and correspondingly, in their incomes. Such negative impacts of a cancer diagnosis are particularly pronounced among wo...
ASCO Endorses ASTRO Guideline on Postoperative Radiation Therapy for Endometrial Cancer
Matthew Stenger
As reported in the Journal of Clinical Oncology by Larissa A. Meyer, MD, MPH, and colleagues, ASCO has endorsed the recently published American Society for Radiation Oncology (ASTRO) guideline on postoperative radiation therapy for endometrial cancer.1 The ASCO clinical practice guideline endorsemen...
Endocrine Therapy Alone Linked to Low Risk of Breast Cancer Recurrence in Women With a Low-Risk Score on 21-Gene Assay
Matthew Stenger
A prospective validation study of a 21-gene expression assay showed that treatment with endocrine therapy alone in women with hormone receptor–positive, HER2-negative breast cancer who had a low recurrence risk score resulted in low risk of recurrence. All patients included in the study were eligibl...
Nivolumab and Cabozantinib Improve Outcomes vs Everolimus in Previously Treated Advanced Renal Cell Carcinoma
Matthew Stenger
The CheckMate 025 trial, reported in The New England Journal of Medicine by Robert J. Motzer, MD, and colleagues, showed that treatment with the programmed cell death protein (PD-1) checkpoint inhibitor nivolumab (Opdivo) increased overall survival vs the mTOR inhibitor everolimus (Afinitor) in pati...
Maternal Cancer During Pregnancy Does Not Appear to Affect Cognitive or General Development in Early Childhood
Matthew Stenger
In a study reported in The New England Journal of Medicine, Frederic Amant, MD, PhD, of University Hospitals Leuven, Belgium, and colleagues in the International Network on Cancer, Infertility, and Pregnancy found that cancer diagnosed during pregnancy did not appear to affect cognitive, cardiac, or...
Addition of Necitumumab to First-Line Gemcitabine/Cisplatin Improves Overall Survival in Stage IV Squamous NSCLC
Matthew Stenger
In the phase III SQUIRE trial reported in The Lancet Oncology, Nick Thatcher, PhD, FRCP, of The Christie Hospital NHS Trust, Manchester, UK, and colleagues found that the addition of the second-generation epidermal growth factor receptor (EGFR) antibody necitumumab to first-line gemcitabine/cisplati...
Addition of Bevacizumab to Standard Chemotherapy Improves Overall Survival Only in High-Risk Ovarian Cancer
Matthew Stenger
Final overall survival results of the phase III ICON7 trial reported in The Lancet Oncology by Amit M. Oza, MD, and colleagues indicate no significant improvement with the addition of bevacizumab (Avastin) to standard chemotherapy in women with newly diagnosed ovarian cancer.1 However, an overall su...
EBCTCG Meta-analyses Show Improved Outcomes With Aromatase Inhibitors vs Tamoxifen and a Potential Benefit of Adjuvant Bisphosphonates Limited to Postmenopausal Women
Matthew Stenger
The Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) patient-level meta-analyses, concurrently reported in The Lancet, sought to clarify the effects of adjuvant aromatase inhibitor vs tamoxifen treatment and adjuvant bisphosphonate treatment in early breast cancer.1,2 The endocrine treat...
Adding Docetaxel to Androgen-Deprivation Therapy Prolongs Overall Survival in Metastatic Prostate Cancer
Matthew Stenger
In a phase III trial (E3805) reported in The New England Journal of Medicine, Christopher J. Sweeney, MBBS, of Dana-Farber Cancer Institute, Boston, and colleagues found that chemohormonal therapy with docetaxel plus androgen-deprivation therapy produced a significant 13.6-month increase in median o...
ASCO Statement: Improving the Evidence Base for Treating Older Adults With Cancer
Matthew Stenger
Older persons are the fastest-growing segment of the U.S. population and account for the majority of cancer diagnoses and deaths and the majority of cancer survivors. However, since this population is underrepresented in clinical trials, the evidence base for treating older patients is poor. As repo...
Increased Risk of Death From Breast Cancer for Women With Ductal Carcinoma in Situ vs General Population
Matthew Stenger
In a study reported in JAMA Oncology, Steven A. Narod, MD, FRCPC, of Women’s College Research Institute, Women’s College Hospital, and the University of Toronto, and colleagues found that the risk of breast cancer mortality was elevated in patients with ductal carcinoma in situ compared with the gen...
Pembrolizumab Increases Progression-Free Survival in Ipilimumab-Refractory Advanced Melanoma
Matthew Stenger
In a randomized phase II trial (KEYNOTE-002) reported in The Lancet Oncology, Antoni Ribas, MD, of UCLA Jonsson Comprehensive Cancer Center, Los Angeles, and colleagues found that treatment with the anti–PD-1 (programmed cell death protein 1) antibody pembrolizumab (Keytruda) prolonged progression-f...
ASCO Statement Addresses Recommendations for Obesity Clinical Trials in Cancer Survivors
Matthew Stenger
As reported in the Journal of Clinical Oncology by Jennifer A. Ligibel, MD, of Dana-Farber Cancer Institute, and colleagues, ASCO has issued a statement providing recommendations for obesity clinical trials in cancer survivors.1 ASCO convened the Research Summit on Advancing Obesity Clinical Trials...
Immune Checkpoint Inhibitor Nivolumab Is Active in Patients With Heavily Pretreated Advanced Non–Small Cell Lung Cancer
Matthew Stenger
In a phase I cohort expansion trial reported in the Journal of Clinical Oncology, Scott N. Gettinger, MD, of Yale Cancer Center, New Haven, Connecticut, and colleagues found that monotherapy with the anti–programmed cell death protein 1 (PD-1) checkpoint inhibitor antibody nivolumab (Opdivo) produce...
Differing Patterns of Breast Cancer Risk After Hormone Therapy With Estrogen Plus Progestin or Estrogen Alone
Matthew Stenger
In an analysis of Women’s Health Initiative trials reported in JAMA Oncology, Rowan T. Chlebowski, MD, PhD, of Harbor-UCLA Medical Center, and colleagues found differing patterns of breast cancer risk among women receiving menopausal hormone therapy with estrogen plus progestin or estrogen alone.1 W...
Statin Use at Start of Androgen-Deprivation Therapy Increases Time to Progression During Treatment of Prostate Cancer
Matthew Stenger
Statin use has been associated with improved outcomes in prostate cancer. In a study reported in JAMA Oncology, Lauren C. Harshman, MD, of Dana-Farber Cancer Institute, Boston, and colleagues found that statin use at the time of the initiation of androgen-deprivation therapy was associated with prol...
ASCO Policy Statement Update: Genetic and Genomic Testing for Cancer Susceptibility
Matthew Stenger
As reported in the Journal of Clinical Oncology by Mark E. Robson, MD, of Memorial Sloan Kettering Cancer Center, and colleagues, ASCO has issued a policy statement update on genetic and genomic testing for cancer susceptibility.1 The statement, commissioned by ASCO’s Cancer Prevention and Ethics Co...
Adding Elotuzumab to Lenalidomide Plus Dexamethasone Improves Progression-Free Survival in Refractory Multiple Myeloma
Matthew Stenger
In an interim analysis of the phase III ELOQUENT-2 trial reported in The New England Journal of Medicine, Sagar Lonial, MD, of Emory University School of Medicine, Meletios Dimopoulos, MD, of National and Kapodistrian University of Athens, and colleagues found that the addition of elotuzumab to lena...
Novel Combination Increases Progression-Free Survival in CLL Patients Who Are Not Candidates for Fludarabine
Matthew Stenger
In the phase III COMPLEMENT 1 trial reported in The Lancet, Peter Hillmen, MB, ChB, of St. James’s University Hospital, Leeds, and colleagues found that the addition of the anti-CD20 antibody ofatumumab (Arzerra) to chlorambucil (Leukeran) increased progression-free survival among patients with chr...
Dabrafenib Plus Trametinib Improves Overall Survival vs Dabrafenib in BRAF V600–Mutant Melanoma
Matthew Stenger
Overall survival results of the phase III COMBI-d trial reported in The Lancet by Georgina V. Long, MD, and colleagues showed that the combination of the BRAF inhibitor dabrafenib (Tafinlar) with the MEK inhibitor trametinib (Mekinist) resulted in significantly prolonged overall survival vs dabrafe...
Regorafenib Improves Overall Survival in Asian Patients With Previously Treated Metastatic Colorectal Cancer
Matthew Stenger
In a phase III trial (CONCUR) reported in The Lancet Oncology, Jin Li, MD, and colleagues found that the multikinase inhibitor regorafenib (Stivarga) improved overall survival vs placebo in Asian patients with previously treated metastatic colorectal cancer.1 Regorafenib is approved in the United S...
Adding Everolimus to First-Line Trastuzumab/Paclitaxel Does Not Increase Progression-Free Survival in HER2-Positive Metastatic Breast Cancer
Matthew Stenger
In the phase III BOLERO-1 trial, reported in The Lancet Oncology, Sara A. Hurvitz, MD, of the University of California, Los Angeles, and colleagues found that the addition of the mTOR inhibitor everolimus (Afinitor) to trastuzumab (Herceptin)/paclitaxel did not significantly increase progression-fre...
New Molecular Classifications of Gliomas Established
Matthew Stenger
Two studies reported in The New England Journal of Medicine identified new molecular classifications of glioma that capture biologic and prognostic differences. The Cancer Genome Atlas Research Network identified three prognostically significant subtypes of lower-grade glioma that were identified by...
Magnetic Resonance Imaging/Ultrasound Fusion–Guided Biopsy Improves Detection of High-Risk Prostate Cancer
Matthew Stenger
In a study reported in JAMA, M. Minhaj Siddiqui, MD, currently of the University of Maryland School of Medicine, and colleagues found that targeted magnetic resonance imaging (MRI)/ultrasound fusion–guided prostate biopsy increased diagnosis of high-risk prostate cancer and reduced detection of low-...
No Survival Benefit for Eribulin vs Capecitabine in Advanced Breast Cancer
Matthew Stenger
Eribulin (Halaven) currently is indicated in the United States for treatment of patients with metastatic breast cancer who previously received at least two chemotherapy regimens for metastatic disease and an anthracycline and a taxane in either the adjuvant or metastatic setting. Its approval was ba...
Early-Phase Studies Show Activity of Novel EGFR Inhibitors Rociletinib and AZD9291 in T790M-Positive NSCLC
Matthew Stenger
Two early-phase studies have shown that the novel epidermal growth factor receptor (EGFR) inhibitors rociletinib and AZD9291 exhibit high activity in non–small cell lung cancer (NSCLC) patients with the EGFR T790M mutation who had progressed on prior EGFR inhibitor therapy.1,2 The T790M mutation con...
ASCO Endorses ASTRO Guideline on Definitive and Adjuvant Radiotherapy in Locally Advanced NSCLC
Matthew Stenger
As reported in the Journal of Clinical Oncology by Andrea Bezjak, MD, of Princess Margaret Cancer Center, Toronto, and colleagues,1 ASCO has recently endorsed the American Society for Radiation Oncology (ASTRO) evidence-based guideline on external-beam radiotherapy for patients with locally advanced...
Adjuvant Ipilimumab Increases Recurrence-Free Survival After Complete Resection of High-Risk Stage III Melanoma
Matthew Stenger
In the phase III European Organisation for Research and Treatment of Cancer (EORTC) 18071 trial reported in The Lancet Oncology, Alexander M.M. Eggermont, MD, PhD, Director General of the Gustave Roussy Cancer Center in Villejuif, France, and colleagues found that adjuvant therapy with the immune ch...
16-Gene Assay Recurrence Score Predicts Recurrence After Surgery for Localized Renal Cell Carcinoma
Matthew Stenger
In a study reported in The Lancet Oncology, Brian Rini, MD, of the Cleveland Clinic Taussig Cancer Institute, and colleagues developed a 16-gene assay and recurrence score that predicted postoperative outcome in patients with stage I to III clear cell renal cell carcinoma.1 Development Phase In th...
PD-1 Inhibitor Pembrolizumab Active in Advanced NSCLC: Outcomes Better With Higher PD-L1 Expression
Matthew Stenger
In the phase I KEYNOTE-001 trial reported in The New England Journal of Medicine,1 Edward B. Garon, MD, of the David Geffen School of Medicine at the University of California, Los Angeles, and colleagues found that the programmed cell death protein 1 (PD-1) inhibitor pembrolizumab (Keytruda) produce...
Meta-analysis Shows Increased Risk of Ovarian Cancer With Menopausal Hormone Therapy
Matthew Stenger
In a study reported in The Lancet, the Collaborative Group on Epidemiological Studies of Ovarian Cancer found that use of menopausal hormone therapy was associated with increased risk of ovarian cancer, with risk being highest among current users.1 The study consisted of meta-analyses of individual...
Long-Term Survival Advantage Seen With Intraperitoneal vs Intravenous Chemotherapy in Advanced Ovarian Cancer
Matthew Stenger
In an analysis of Gynecologic Oncology Group (GOG) studies reported in the Journal of Clinical Oncology, Devansu Tewari, MD, of Kaiser Permanente Irvine Medical Center, and colleagues found that intraperitoneal chemotherapy was associated with a survival advantage compared with intravenous chemother...
Outcomes of the CUSTOM ‘Basket’ Trial of Molecular Profiling and Targeted Therapy in Advanced Thoracic Malignancies
Matthew Stenger
In the phase II CUSTOM trial reported in the Journal of Clinical Oncology, Ariel Lopez-Chavez, MD, Anish Thomas, MD, and colleagues performed molecular profiling of tumors in patients with advanced non–small cell lung cancer (NSCLC), small cell lung cancer (SCLC), or thymic malignancies and assigned...
Nivolumab Increases Response Rate vs Chemotherapy in Advanced Melanoma Progressing After Anti–CTLA-4 Treatment
Matthew Stenger
In a phase III trial (CheckMate 037) reported in The Lancet Oncology, Jeffrey S. Weber, MD, PhD, of the Moffitt Cancer Center, and colleagues found that treatment with the PD-1 (programmed cell death protein 1) inhibitor nivolumab (Opdivo) resulted in a significantly greater response rate vs chemoth...
Addition of Ramucirumab to Second-Line FOLFIRI Improves Overall Survival in Metastatic Colorectal Cancer
Matthew Stenger
In the phase III RAISE trial reported in The Lancet Oncology, Josep Tabernero, MD, PhD, Head of Medical Oncology at Vall d’Hebron Institute of Oncology, Barcelona, and colleagues found that the addition of the antiangiogenic anti–vascular endothelial growth factor receptor 2 (VEGFR2) antibody ramuci...
ASCO Endorses American Cancer Society Prostate Cancer Survivorship Care Guidelines
Matthew Stenger
As reported in the Journal of Clinical Oncology by Matthew J. Resnick, MD, of Vanderbilt University Medical Center, and colleagues, ASCO has endorsed the 2014 American Cancer Society Prostate Cancer Survivorship Care Guidelines.1,2 The ASCO endorsement panel was co-chaired by Dr. Resnick and David F...
Addition of Lenalidomide to Docetaxel-Prednisone Worsens Survival in Chemotherapy-Naive Metastatic Castration-Resistant Prostate Cancer
Matthew Stenger
In the phase III MAINSAIL trial reported in The Lancet Oncology, Daniel P. Petrylak, MD, of Yale Cancer Center, New Haven, Connecticut, and colleagues found that the addition of lenalidomide (Revlimid) to docetaxel-prednisone in chemotherapy-naive men with metastatic castration-resistant prostate ca...
Higher-Than-Expected Incidence of Marrow Neoplasms After Adjuvant Therapy for Breast Cancer
Matthew Stenger
In a study reported in the Journal of Clinical Oncology, Antonio C. Wolff, MD, of Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, and colleagues found a low but higher-than-expected incidence of marrow neoplasms in patients receiving adjuvant radiation therapy or chemotherapy for...
High Invasive Disease-Free Survival With Adjuvant Paclitaxel and Trastuzumab in Small, Node‑Negative, HER2-Positive Breast Cancers
Matthew Stenger
In a phase II study reported in The New England Journal of Medicine, Sara M. Tolaney, MD, MPH, of Dana-Farber Cancer Institute, and colleagues found that adjuvant paclitaxel and trastuzumab (Herceptin) was associated with high invasive disease-free survival in women with small, node-negative, HER2-p...
Racial/Ethnic Differences in Diagnosis of Breast Cancer at Stage I and Subsequent Survival Reflect Biologic Differences
Matthew Stenger
In a study reported in JAMA, Javaid Iqbal, MD, of Women’s College Research Institute, Toronto, and colleagues found racial/ethnic differences in the likelihood of breast cancer diagnosis at stage I and subsequent survival in U.S. breast cancer patients.1 These differences seemed largely to reflect i...
Large Improvement in Progression-Free Survival With Lenvatinib in Radioiodine-Refractory Thyroid Cancer
Matthew Stenger
In a phase III trial reported in The New England Journal of Medicine, Martin Schlumberger, MD, of Institut Gustave Roussy, and colleagues found that the multikinase inhibitor lenvatinib (Lenvima) produced a large improvement in progression-free survival vs placebo in patients with advanced radioiodi...
Meaning-Centered Group Psychotherapy Improves Psychological Well-Being in Patients With Advanced Cancer
Matthew Stenger
In a randomized trial reported in the Journal of Clinical Oncology, William Breitbart, MD, of Memorial Sloan Kettering Cancer Center, and colleagues found that meaning-centered group psychotherapy significantly improved psychological well-being compared with supportive group psychotherapy in patient...
Anti–PD-1 Antibody Pembrolizumab Improves Progression-Free and Overall Survival vs Ipilimumab in Advanced Melanoma
Matthew Stenger
In the phase III KEYNOTE-006 trial reported in The New England Journal of Medicine,1 Caroline Robert, MD, PhD, Head of the Dermatology Unit at the Institut Gustave Roussy, Paris, and colleagues found that the anti–programmed cell death protein 1 (PD-1) antibody pembrolizumab (Keytruda) increased pro...
CLEOPATRA Overall Survival Analysis: Significant Benefit for Pertuzumab Plus Trastuzumab/Docetaxel in HER2-Positive Metastatic Breast Cancer
Matthew Stenger
As reported in The New England Journal of Medicine by Sandra M. Swain, MD, of Washington Cancer Institute, MedStar Washington Hospital Center, and colleagues, the final prespecified overall survival analysis in the phase III CLEOPATRA study showed a significant 15.7-month increase in median overall ...
ASCO Releases 2015 Report on The State of Cancer Care in America
In March, ASCO published its second annual report, The State of Cancer Care in America: 2015.1 Its findings show a mixed landscape, on the one hand, spotlighting advances in therapy and improving survival rates, but on the other, describing a cancer care system under stress from increasing demand fo...
Improved Progression-Free Survival With Brentuximab Vedotin After Transplantation in Hodgkin Lymphoma Patients
Matthew Stenger
In the phase III AETHERA trial reported in The Lancet, Craig H. Moskowitz, MD, of Memorial Sloan Kettering Cancer Center, and colleagues found that brentuximab vedotin (Adcetris) consolidation therapy after autologous stem cell transplantation prolonged progression-free survival by 18 months vs plac...
Impact of Informed Decision-Making on Breast Cancer Screening
Matthew Stenger
In a study reported in Lancet, Jolyn Hersch, MApplSc, of the University of Sydney, and colleagues found that use of a decision aid containing information on overdetection in breast cancer screening was associated with an increased rate of informed choice regarding screening, a reduced rate of positi...
Radiotherapy or Not in Older Women Receiving Breast-Conserving Surgery and Endocrine Treatment?
Matthew Stenger
In the phase III PRIME II trial, designed to assess whether whole-breast irradiation could be omitted in women aged ≥ 65 years with early-stage breast cancer undergoing breast-conserving surgery and receiving adjuvant endocrine treatment, Ian H. Kunkler, MB BChir, FRCR, of Western General Hospital, ...
Analysis Shows No Link Between Aromatase Inhibitor–Related Musculoskeletal/Vasomotor Symptoms and Relapse-Free Survival
Matthew Stenger
Retrospective analyses of the ATAC, TEAM, and BIG 1-98 adjuvant endocrine therapy trials in breast cancer have suggested that treatment-emergent endocrine symptoms may be associated with superior survival outcomes. In a study reported in the Journal of Clinical Oncology, Vered Stearns, MD, Professor...
Evidence of Recurrence-Free, Disease-Free, and Overall Survival Benefit of Aspirin and COX‑2 Inhibitor Use in Stage III Colon Cancer
Matthew Stenger
In an analysis from the Cancer and Leukemia Group B (CALGB) 89803 adjuvant trial reported in the Journal of the National Cancer Institute, Kimmie Ng, MD, MPH, of Dana-Farber Cancer Institute, Boston, and colleagues found consistent trends suggesting benefit of aspirin use and cyclo-oxygenase-2 (COX-...
Immune Gene Profile Strongly Associated With Benefit of Adjuvant Trastuzumab in HER2-Positive Breast Cancer
Matthew Stenger
In a study reported in the Journal of Clinical Oncology, Edith A. Perez, MD, of the Mayo Clinic, Jacksonville, and colleagues found that an immune function gene profile was associated with significantly improved relapse-free survival among patients with early-stage HER2-positive breast cancer who ha...
No Benefit of High- vs Standard-Dose Radiotherapy or Addition of Cetuximab to Chemoradiation in Stage IIIA/IIIB NSCLC
Matthew Stenger
As reported in The Lancet Oncology by Jeffrey D. Bradley, MD, of Washington University, and colleagues, the phase III Radiation Therapy Oncology Group 0617 trial showed no survival benefit of high- vs standard-dose radiotherapy or addition of cetuximab (Erbitux) to concurrent paclitaxel/carboplatin...
No Overall Survival Difference for Immediate vs Deferred Chemotherapy After Radical Cystectomy in Muscle-Invasive Bladder Cancer
Matthew Stenger
In the European Organisation for Research and Treatment of Cancer (EORTC) 30994 trial, a phase III intergroup study reported in The Lancet Oncology,1 Cora N. Sternberg, MD, FACP, Chief of Medical Oncology at San Camillo and Forlanini Hospitals, Rome, and colleagues found no overall survival differen...
Increased Progression-Free Survival With Addition of Carfilzomib to Lenalidomide/Dexamethasone in Relapsed Multiple Myeloma
Matthew Stenger
In a planned interim analysis of the phase III ASPIRE trial reported in The New England Journal of Medicine, A. Keith Stewart, MB, ChB, of the Mayo Clinic, Scottsdale, Arizona, and colleagues found that the addition of the proteasome inhibitor carfilzomib (Kyprolis) to lenalidomide (Revlimid)/dexame...
Adding Cetuximab to First-Line FOLFIRI Does Not Benefit Metastatic Colorectal Cancer Patients With RAS Mutations
Matthew Stenger
The phase III CRYSTAL trial showed that the addition of cetuximab (Erbitux) to first-line FOLFIRI (fluorouracil, leucovorin, and irinotecan) significantly improved overall survival, progression-free survival, and objective response rates in patients with KRAS codon 12/13 (exon 2) wild-type metastati...
Hypofractionated Whole-Breast Irradiation After Breast-Conserving Surgery Used in Up to One-Third of Eligible Patients
Matthew Stenger
In a study reported in JAMA, Justin E. Bekelman, MD, of the University of Pennsylvania Perelman School of Medicine, and colleagues found that approximately two-thirds of patients with early-stage breast cancer for whom hypofractionated whole-breast irradiation (for 3–5 weeks) was endorsed received c...
New Analysis Reports Increased Risk of Thyroid Cancer After Breast Cancer Diagnosis
The ASCO Post
Breast cancer survivors are at increased risk of developing thyroid cancer, especially within 5 years of their breast cancer diagnosis, according to a new analysis of a large national database. The study results were presented at the Endocrine Society’s 97th Annual Meeting.1 “Recognition of this as...
Adjuvant Ovarian Suppression May Benefit Women With Premenopausal Breast Cancer Who Received Prior Chemotherapy
Matthew Stenger
In a phase III trial (SOFT) reported in The New England Journal of Medicine, Prudence A. Francis, MD, of Peter MacCallum Cancer Centre, Melbourne, Australia, Meredith M. Regan, ScD, of IBCSG Statistical Centre at Dana-Farber Cancer Institute, Boston, and colleagues found that the addition of ovarian...
Physician-Controlled Decisions in Cancer Care Linked to Lower Quality Rating
The ASCO Post
Patients who described physician-controlled decisions about their cancer care vs shared decision-making were less likely to report receiving excellent quality of care, according to a study published by JAMA Oncology.1 The Institute of Medicine has called for shared decision-making and accommodation...
Gastric, Breast Cancer Risk in Carriers of CDH1 Gene Mutations
The ASCO Post
In a new study,1 more precise estimates of age-associated risks of gastric and breast cancer were derived for carriers of the CDH1 gene mutation, a cancer-predisposing gene that is abnormal in families meeting criteria for clinically defined hereditary diffuse gastric cancer (HDGC). David G. Huntsm...
Study Finds Websites That Market Personalized Cancer Care Services Overemphasize Benefits
A recent analysis of 55 Internet websites marketing a broad range of tests and services that promise the ability to personalize cancer treatment has found that the websites often overemphasize their purported benefits and downplay their limitations. In addition, the study results show that the major...
Nivolumab Shows Activity in Previously Treated Metastatic Renal Cell Carcinoma
Matthew Stenger
In a randomized phase II trial reported in the Journal of Clinical Oncology, Robert J. Motzer, MD, of Memorial Sloan Kettering Cancer Center, New York, and colleagues found that the programmed cell death protein-1 (PD-1) immune checkpoint inhibitor antibody nivolumab (Opdivo) was associated with an...
First-Line Crizotinib Improves Progression-Free Survival vs Chemotherapy in ALK-Positive NSCLC
Matthew Stenger
In a phase III trial (PROFILE 1014) reported in The New England Journal of Medicine, Benjamin J. Solomon, MB, BS, PhD, of Peter MacCallum Cancer Centre, Melbourne, and colleagues found that the ALK inhibitor crizotinib (Xalkori) improved progression-free survival vs standard chemotherapy in first-li...
Clonal Hematopoiesis With Somatic Mutations Increases Risk of Hematologic Cancer, Mortality, and Cardiovascular Disease
Matthew Stenger
In two studies recently reported in The New England Journal of Medicine,1,2 whole-exome sequencing of DNA from peripheral blood cells of individuals unselected for hematologic phenotype showed that clonal hematopoiesis with somatic mutations is increasingly common with increasing age and is associat...
Combination Treatment Every 2 Weeks May Benefit Some Women With High-Risk Early-Stage Breast Cancer
Matthew Stenger
In a phase III trial (SWOG S0221) reported in the Journal of Clinical Oncology, George T. Budd, MD, of Taussig Cancer Center, Cleveland Clinic, and colleagues found no difference in disease-free survival among four different combinations of continuous or every-other-week doxorubicin/cyclophosphamide...
PD-1 Blockade With Nivolumab Produces High Response Rate in Relapsed/Refractory Hodgkin Lymphoma
Matthew Stenger
Anti–PD-1 antibodies have been shown to be effective in solid tumors. There is evidence that the malignant Reed-Sternberg cells in Hodgkin lymphomas use the programmed cell death protein 1 (PD-1) pathway to evade immune detection, with alterations in chromosome 9p24.1 increasing levels of the PD-1 l...
Clinically Inappropriate Patient Demands of Oncologists Happen More Infrequently Than Expected
The ASCO Post
A new study1 conducted at outpatient oncology centers found that only 1% of 5,050 patient-clinician encounters resulted in a clinically inappropriate request, of which very few were complied with by physicians. Ezekiel J. Emanuel, MD, PhD, of the University of Pennsylvania, and colleagues analyzed ...
ASCO Endorses ESMO Guideline on Hereditary Colorectal Cancer Syndromes
Matthew Stenger
Approximately 5% to 6% of cases of colorectal cancer are associated with germline mutations conferring an inherited predisposition for disease. As reported by Stoffel and colleagues in the Journal of Clinical Oncology,1 ASCO has endorsed, with qualifying statements, the European Society for Medical ...
No Benefit of Adding Iniparib to Gemcitabine/Carboplatin in Metastatic Triple‑Negative Breast Cancer
Matthew Stenger
In a phase III trial reported in Journal of Clinical Oncology, Joyce O’Shaughnessy, MD, of Baylor Charles A. Sammons Cancer Center, Dallas, and colleagues found that the addition of iniparib to gemcitabine and carboplatin did not improve overall survival or progression-free survival in patients with...
Novel Genomic Signature Predicts Postcystectomy Recurrence in High-Risk Bladder Cancer
Matthew Stenger
As reported in the Journal of the National Cancer Institute, Anirban P. Mitra, MD, PhD, of the University of Southern California, and colleagues identified a novel genome-based signature that improves prediction of postcystectomy recurrence in patients with high-risk bladder cancer.1 Use of the sign...
Moffitt Cancer Center Reports on Faculty Participants in International Discovery of Genetic Risk Factors for Ovarian Cancer
The ASCO Post
Researchers from Moffitt Cancer Center in Tampa, Florida have participated in a global effort that has identified six new regions of the genome that increase risk of epithelial ovarian cancer, according to a news release from Moffitt. The collaborative study was published recently in Nature Genetics...
Vitamin D Protects Against Colorectal Cancer by Boosting the Immune System
The ASCO Post
A study by investigators at Dana-Farber Cancer Institute has demonstrated that vitamin D can protect some people with colorectal cancer by heightening the immune system’s vigilance against tumor cells. The research, released earlier this month by the journal Gut, shows a link between vitamin D and ...
Nivolumab Improves Outcomes vs Dacarbazine in Previously Untreated Advanced Melanoma Without a BRAF Mutation
Matthew Stenger
In a phase III trial reported in The New England Journal of Medicine, Robert and colleagues found that the programmed cell death protein-1 (PD-1) immune-checkpoint–inhibitor antibody nivolumab (Opdivo) significantly increased overall survival, progression-free survival, and objective response rate c...
Coupling Head and Neck Cancer Screening and Lung Cancer Scans Could Improve Early Detection, Survival
The ASCO Post
Adding head and neck cancer screenings to recommended lung cancer screenings would likely improve early detection and survival, according to a multidisciplinary team led by scientists affiliated with the University of Pittsburgh Cancer Institute (UPCI), a partner with the University of Pittsburgh Me...
No Benefit of Adding Lapatinib to Fulvestrant in Hormone Receptor–Positive Advanced Breast Cancer
Matthew Stenger
In a phase III trial (Cancer and Leukemia Group B [CALGB] 40302/Alliance) reported in the Journal of Clinical Oncology, Harold J. Burstein, MD, PhD, of Dana-Farber Cancer Institute, Boston, and colleagues found that the addition of the dual EGFR-HER2 inhibitor lapatinib (Tykerb) to endocrine therapy...
Physical Activity Improves Survival for Men With Localized Prostate Cancer
The ASCO Post
Among a large group of men with localized prostate cancer, those who engaged in higher levels of physical activity had lower rates of overall mortality and lower rates of prostate cancer-specific mortality, according to a study published in Cancer Epidemiology, Biomarkers & Prevention.1 “Our re...
Study Finds Whole-Genome Sequencing Is Successful in Identifying Patients’ Risk for Inherited Cancers
A study by researchers at The University of Texas Southwestern Medical Center in Dallas and The Ohio State University in Columbus of whole-genome sequencing on patients found to have BRCA1 or BRCA2 mutations as well as on those who were not carriers of a BRCA1/2 mutation has found cancer risk of pot...
SIO Clinical Practice Guidelines on the Use of Integrative Therapies as Supportive Care in Patients Treated for Breast Cancer
Matthew Stenger
The Society for Integrative Oncology (SIO) Guidelines Working Group has recently released clinical practice guidelines on the use of integrative therapies as supportive care in patients receiving treatment for breast cancer. The guidelines, reported by Heather Greenlee, ND, PhD, MPH, of Mailman Scho...
ASCO Clinical Expert Statement on Cancer Survivorship Care Planning
Matthew Stenger
Efforts at implementing survivorship care plans have met with limited success in oncology practice, in part due to the time required to complete them, the lack of role clarity, and the lack of reimbursement for time to complete the documents. In response, ASCO convened a Survivorship Care Planning W...
Crizotinib Is Highly Active in ROS1-Rearranged NSCLC
Matthew Stenger
Crizotinib (Xalkori) produced a high response rate and durable responses in patients with ROS1-rearranged non–small cell lung cancer (NSCLC), according to a study reported in The New England Journal of Medicine.1 Lead authors Alice T. Shaw, MD, PhD, of Massachusetts General Hospital Cancer Center, a...
Phase II Study Shows Improved Survival With Addition of Sargramostim to Ipilimumab in Metastatic Melanoma
Matthew Stenger
Use of the granulocyte-macrophage colony-stimulating factor (GM-CSF) sargramostim (Leukine) together with the cytotoxic T-lymphocyte–associated antigen 4 (CTLA-4) inhibitor ipilimumab (Yervoy) prolonged overall survival but not progression-free survival in patients with metastatic melanoma, accordin...
Immune-Suppressing Protein in Noncancerous Cells of Cancer Patients Offers Clue to Drug Response
The ASCO Post
A multicenter phase I study using an investigational immune therapy drug has found that the presence of the immune-suppressing protein PD-L1 in noncancerous immune cells can predict how patients with different types of advanced cancer will respond to treatment. The study, led by a Yale Cancer Cente...
Antacids Linked to Better Survival in Patients With Head and Neck Cancer
The ASCO Post
Patients with head and neck cancer who used antacid medicines to control acid reflux had better overall survival, according to a study from the University of Michigan Comprehensive Cancer Center. Results of the study were published in Cancer Prevention Research.1 Reflux can be a common side effect ...
CD19-Directed CAR T Cells Produce Sustained Remission in Relapsed/Refractory Acute Lymphoblastic Leukemia
Matthew Stenger
In a study reported in The New England Journal of Medicine, Shannon L. Maude, MD, PhD, of Children’s Hospital of Philadelphia, and Noelle Frey, MD, of the Perelman School of Medicine, University of Pennsylvania, and colleagues reported achieving sustained remissions in children and adults with relap...
Power Behind ‘Master’ Gene for Cancer Discovered
The ASCO Post
A study at The University of Texas MD Anderson Cancer Center, Houston, led by Mong-Hong Lee, PhD, Professor of Molecular and Cellular Oncology, has demonstrated the significance of CSN6 in regulating Myc which may well open up a new pathway for treating and killing tumors. The study results are publ...
New Imaging Technique Identifies Receptors for Targeted Cancer Therapy
The ASCO Post
Dartmouth researchers have developed a fluorescence imaging technique that can more accurately identify receptors for targeted cancer therapies without a tissue biopsy. They report on their findings in a recently published article in Cancer Research.1 “Protein overexpression is a hallmark of certai...
NORCCAP Trial Shows Reduced Colorectal Cancer Incidence and Mortality With Flexible Sigmoidoscopy Screening at 11 Years
Matthew Stenger
The Norwegian Colorectal Cancer Prevention (NORCCAP) trial comparing colorectal cancer screening with flexible sigmoidoscopy vs no screening showed no reduction in colorectal cancer incidence or mortality after 7 years of follow-up. As reported by Øyvind Holme, MD, of Sorlandet Hospital Kristiansand...
Systemic Therapy in Men With Metastatic Castration-Resistant Prostate Cancer: ASCO/CCO Clinical Practice Guideline
Matthew Stenger
The ASCO Clinical Practice Guidelines Committee and the Cancer Care Ontario (CCO) program in evidence-based care have released a clinical practice guideline on systemic therapy in men with metastatic castration-resistant prostate cancer. The guideline was published in the Journal of Clinical Oncolog...
Cancer-Killing Virus Plus Chemotherapy Studied in Recurrent Ovarian Cancer
The ASCO Post
In 6 out of 10 cases, ovarian cancer is diagnosed when the disease is advanced and 5-year survival is only 27%. A new study suggests that a cancer-killing virus combined with a chemotherapy drug might safely and effectively treat advanced or recurrent forms of the disease. Researchers at The Ohio S...
Adding Pan-Deacetylase Inhibitor Panobinostat to Bortezomib and Dexamethasone Improves Progression-Free Survival in Relapsed Myeloma
Matthew Stenger
In the phase III PANORAMA 1 trial reported in The Lancet Oncology, Jesus F. San-Miguel, MD, of Clinica Universidad de Navarra-CIMA, Pamplona, Spain, and colleagues found that adding the pan-deacetylase inhibitor panobinostat to bortezomib (Velcade) and dexamethasone improved progression-free surviva...
Study Finds Wide Variation in Quality, Content of Clinical Cancer Guidelines
The ASCO Post
What’s the best way to treat rectal cancer? Consult any of five top clinical guidelines for rectal cancer and you will get a different answer, according to a new study by researchers at the University of Michigan Comprehensive Cancer Center. Their findings were published online in the journal Cancer...
Proteome-Scale Map of the Human Interactome Network Created
The ASCO Post
Researchers have produced a new largest-scale map of human protein interactions that will better enable scientists to trace how genetic changes lead to diseases ranging from cancer to Huntington’s disease. The expanded map, published in the journal Cell,1 is about 30% larger than the combination of ...
Use of Hospice Care by Medicare Patients Associated With Lower Rate of Hospitalization, ICU Admission, Invasive Procedures, and Costs
The ASCO Post
Medicare patients with poorprognosis cancers who received hospice care had significantly lower rates of hospitalization, intensive care unit (ICU) admissions and invasive procedures at the end of life, along with significantly lower health care expenditures during the last year of life, according t...
Memorial Sloan Kettering Team Discovery Advances Understanding of Immunotherapy’s Successes—and Its Failures
The ASCO Post
A collaborative team of leaders in the field of cancer immunology from Memorial Sloan Kettering Cancer Center has made a key discovery that advances the understanding of why some patients respond to the CTLA-4 blocking antibody ipilimumab (Yervoy), an immunotherapy drug, while others do not. A rep...
ASCO Endorses AUA/ASTRO Guideline on Adjuvant and Salvage Radiotherapy After Prostatectomy
The ASCO Post
ASCO has issued an endorsement of the American Urological Association (AUA)/American Society for Radiation Oncology (ASTRO) guideline on the use of adjuvant and salvage radiotherapy after prostatectomy, which was based on a systematic review of medical literature. The ASCO endorsement was published ...
Oral Rivaroxaban Has Efficacy Similar to Enoxaparin Plus Vitamin K Antagonist in Preventing Recurrent Venous Thromboembolism
Matthew Stenger
In a subgroup analysis of the pooled results of the EINSTEIN-DVT and EINSTEIN-PE trials reported at the 2014 European Society for Medical Oncology (ESMO) 2014 Congress and published recently in The Lancet Haematology, Martin H. Prins, MD, of Maastricht University Medical Centre, Maastricht, Netherla...
Incidence of Colorectal Cancer in Young Adults Expected to Rise
The ASCO Post
While the incidence of colorectal cancer in people 50 years or older has declined, the incidence among people 20 to 49 years has increased, according to a report published online recently by JAMA Surgery.1 From 1998 through 2006, the incidence of colorectal cancer declined 3% per year in men and 2.4...
Continuous Lenalidomide/Dexamethasone Improves Progression-Free Survival in Transplant-Ineligible Patients With Myeloma
Matthew Stenger
In the phase III FIRST trial reported in The New England Journal of Medicine, Lotfi Benboubker, MD, Service d’Hématologie et Thérapie Cellulaire, Hôpital Bretonneau, Centre Hospitalier Régional Universitaire (CHRU), Tours, France, and colleagues found that continuous lenalidomide (Revlimid) plus dex...
Study Finds Significant Increase in Bilateral Mastectomy for Unilateral Breast Cancer Despite Lack of Survival Benefit
Matthew Stenger
In an observational cohort study reported in JAMA, Allison W. Kurian, MD, MSc, Assistant Professor of Medicine and of Health Research and Policy at Stanford University School of Medicine, and colleagues assessed use of and mortality after bilateral mastectomy, breast-conserving surgery plus radiatio...
Pazopanib Maintenance Improves Progression-Free Survival in Ovarian Cancer
Matthew Stenger
In a phase III trial reported in the Journal of Clinical Oncology, Andreas du Bois, MD, PhD, Professor of Gynecologic Oncology at Kliniken Essen-Mitte in Essen, Germany, and colleagues found that maintenance therapy with the vascular endothelial growth factor receptor (VEGFR) and platelet-derived g...
U.S. Skin Cancer Costs Rise From 2002 Through 2011
The ASCO Post
The costs associated with skin cancer increased five times as fast as treatments for other cancers between 2002 and 2011, according to a Centers for Disease Control and Prevention (CDC) study published online in the American Journal of Preventive Medicine.1 The average annual cost for skin cancer t...
Study Sheds Light on Factors That May Contribute to Pancreatic Cancer
The ASCO Post
New research that provides a better understanding of pancreatic cancer may help identify individuals at increased risk. The findings were recently published early online in Cancer.1 Pancreatic cancer is usually detected at a very late stage and has a 5-year survival rate of less than 5%. Strategies...
Ipilimumab/Sargramostim Improves Overall Survival vs Ipilimumab Alone in Patients With Advanced Metastatic Melanoma
Jo Cavallo
A randomized clinical trial of patients with advanced metastatic melanoma treated with ipilimumab (Yervoy), an immune checkpoint inhibitor, in combination with sargramostim (Leukine), an immune stimulant, vs ipilimumab alone, has found a 1-year survival rate of 68.9% vs 52.9% in the ipilimumab-only ...
Vigorous Exercise Lowers Risk of Cardiovascular Events in Adult Survivors of Childhood Hodgkin Lymphoma
Matthew Stenger
In a report from the Childhood Cancer Survivor Study published in the Journal of Clinical Oncology,1 Lee W. Jones, PhD, of Memorial Sloan Kettering Cancer Center, and colleagues found that vigorous exercise reduces the risk of major cardiovascular events in adult survivors of childhood Hodgkin lymph...
Impact of High-Dose Melphalan/Autologous Stem Cell Transplant and Lenalidomide Maintenance in Myeloma Patients ≤ Age 65
Matthew Stenger
In a phase III trial reported in The New England Journal of Medicine, Antonio Palumbo, MD, Chief of the Myeloma Unit at the University of Turin, Italy, and colleagues found that high-dose melphalan plus autologous stem cell transplantation improved progression-free survival and overall survival comp...
Long-Term Overall Survival Benefit Seen With Trastuzumab Added to Adjuvant Chemotherapy in Early-Stage HER2-Positive Breast Cancer
Matthew Stenger
Earlier planned joint analyses of outcomes in the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-31 trial and the North Central Cancer Treatment Group (NCCTG) N9831 trial showed that adding trastuzumab (Herceptin) to adjuvant chemotherapy improved disease-free survival and overall sur...
Joint Analysis Further Confirms Well-Established Standard of Care in Early Breast Cancer
Edith A. Perez, MD
This analysis demonstrates excellent news related to the long-term benefit of adding 1 year of trastuzumab (Herceptin) starting with the paclitaxel portion of adjuvant chemotherapy for patients with resected HER2-positive breast cancer. The study reflects the fact that excellent science in collabora...
Dartmouth Study Finds Lung Cancer Screening With Low-Dose CT Could Be Cost-Effective
The ASCO Post
Dartmouth researchers say lung cancer computed tomographic (CT) screening in the National Lung Screening Trial (NLST) meets a commonly accepted standard for cost-effectiveness as reported recently in The New England Journal of Medicine.1 The screening test uses annual low-dose CT scans to spot lung ...
Two Phase III Trials Show Benefit With BRAF/MEK Inhibitor Combination vs BRAF Inhibitor Alone in Advanced Melanoma
Matthew Stenger
Two phase III trials have shown that the strategy of adding MEK inhibitor therapy to BRAF inhibitor therapy significantly improves progression-free survival in previously untreated patients with advanced BRAF-mutant melanoma.1,2 Overall survival benefit is also suggested by interim analysis in both ...
Study Shows Integrative Medicine Can Relieve Pain and Anxiety for Cancer Inpatients
The ASCO Post
Researchers at The Penny George Institute for Health and Healing in Minneapolis have found that integrative medicine therapies can decrease pain and anxiety for hospitalized cancer patients. Their findings were published recently in the Journal of the National Cancer Institute Monographs.1 “Followi...
Adding VEGFR2 Inhibitor Ramucirumab to Paclitaxel Increases Overall Survival as Second-Line Treatment for Advanced Gastric Cancer
Matthew Stenger
In the phase III RAINBOW trial reported in The Lancet Oncology, Hansjochen Wilke, MD, Director of Medical Oncology/Hematology at Kliniken Essen-Mitte, Essen, Germany, and colleagues found that adding the vascular endothelial growth factor receptor 2 (VEGFR2) inhibitor ramucirumab (Cyramza) to paclit...
Half of Premature Colorectal Cancer Deaths Due to Socioeconomic Inequality
The ASCO Post
Half of all premature deaths from colorectal cancer (described as deaths in people ages 25 to 64) in the United States are linked to ethnic, socioeconomic, and geographic inequalities, and therefore could be prevented according to a new study by American Cancer Society researchers. The report, which...
Kinase-Activating Alterations Identified in Most Cases of Philadelphia Chromosome–Like Acute Lymphoblastic Leukemia May Be Targetable With Available Tyrosine Kinase Inhibitors
Matthew Stenger
In a study reported in The New England Journal of Medicine, Kathryn G. Roberts, PhD, of St. Jude Children’s Research Hospital, and colleagues performed detailed genomic analysis of patients with Philadelphia chromosome–like acute lymphoblastic leukemia (ALL) and identified kinase-activating alterati...
ASCO Endorses Guideline for Molecular Testing for Selecting Lung Cancer Patients for EGFR and ALK Inhibitor Treatment
Matthew Stenger
ASCO has endorsed the recently developed joint College of American Pathologists (CAP), International Association for the Study of Lung Cancer (IASLC), and Association for Molecular Pathology (AMP) guideline on molecular testing for selection of patients with lung cancer for EGFR and ALK inhibitor tr...
Whole-Brain Radiation Therapy Plus Stereotactic Radiosurgery Improves Survival in Better-Prognosis Patients With Brain Metastases
Joseph Cupolo
In a secondary analysis utilizing the graded prognostic assessment—an improved diagnosis-specific index—patients with one to three brain metastases had no survival advantage when treated with whole-brain radiation therapy and stereotactic radiosurgery, compared with whole-brain radiotherapy alone, a...
E-Cigarettes Unhelpful in Smoking Cessation Among Patients With Cancer
The ASCO Post
In a new study of patients with cancer who smoke, those using e-cigarettes in addition to traditional cigarettes were more nicotine-dependent and equally or less likely to have quit smoking traditional cigarettes than nonusers.1 The rising use of e-cigarettes has raised many questions among patient...
No Benefit Seen for Cetuximab Added to Cisplatin and Accelerated Radiotherapy in Advanced Head and Neck Carcinoma
Matthew Stenger
Use of cisplatin or cetuximab (Erbitux) with radiotherapy improves overall survival in stage III or IV head and neck carcinoma, and adding cetuximab to platinum therapy improves overall survival in metastatic disease. In the phase III Radiation Therapy Oncology Group (RTOG) 0522 trial reported in th...
Significant Improvement in Overall Survival With Second-Line Addition of Ramucirumab to Docetaxel in Stage IV NSCLC
Matthew Stenger
In the phase III REVEL trial reported in Lancet, Edward B. Garon, MD, of the David Geffen School of Medicine at UCLA/Translational Research in Oncology–US Network, Los Angeles, and colleagues found that the addition of the antiangiogenic vascular endothelial growth factor receptor (VEGFR)-2 inhibito...
ASCO Clinical Practice Guideline: Chemotherapy and Targeted Therapy in Advanced HER2-Negative or HER2 Status–Unknown Breast Cancer
Matthew Stenger
The American Society of Clinical Oncology has released a new clinical practice guideline on chemotherapy and targeted therapy for women with advanced HER2-negative or HER2 status–unknown breast cancer. The guideline is published in the Journal of Clinical Oncology.1 In formulating the consensus gui...
Lower- vs Higher-Than-Expected Long-Term Colorectal Cancer Mortality After Removal of Lower- vs Higher-Risk Adenomas
Matthew Stenger
Few data are available on long-term risk of colorectal cancer mortality after adenoma removal. In a Norwegian study reported in The New England Journal of Medicine, Magnus Løberg, MD, of the Department of Health Management and Health Economics, University of Oslo, and colleagues found that patients ...
Early Study Reports Modified Vitamin D Has Potential in Treatment for Pancreatic Cancer
The ASCO Post
Researchers at the Salk Institute have reported on a synthetic derivative of vitamin D able to collapse the barrier of cells shielding pancreatic tumors, making this challenging cancer more susceptible to therapeutic drugs. The discovery has led to human trials for pancreatic cancer, even in advance...
Time to Treatment Failure Similar With Rituximab Retreatment vs Maintenance in Low–Tumor Burden Follicular Lymphoma
Matthew Stenger
Maintenance rituximab (Rituxan) has been shown to improve progression-free survival vs observation in low–tumor burden follicular lymphoma. In the Eastern Cooperative Oncology Group (ECOG) E4402 Trial (RESORT), reported in the Journal of Clinical Oncology, Brad S. Kahl, MD, of the University of Wis...
CENTRIC Trial Shows No Benefit of Adding Cilengitide to Therapy in Glioblastoma With Methylated MGMT Promoter
Matthew Stenger
In the phase III CENTRIC/European Organisation for Research and Treatment of Cancer (EORTC) 26071-22072 trial reported in The Lancet Oncology, Roger Stupp, MD, of University Hospital Zurich, and colleagues found that adding the selective αvβ3 and αvβ5 integrin inhibitor cilengitide to standard temo...
Integrated Collaborative Care Program Highly Successful in Treating Major Depression in Patients With Cancer
Matthew Stenger
In the Scottish SMaRT Oncology-2 study reported in The Lancet, Michael Sharpe, MD, and Jane Walker, PhD, of University of Oxford, United Kingdom, and colleagues found that an integrated collaborative treatment program for depression (“depression care for people with cancer”) was associated with sign...
One in Three People With Cancer Has Anxiety or Other Mental Health Challenges
The ASCO Post
Researchers in Germany report that nearly a third of more than 2,100 patients with cancer interviewed at inpatient and outpatient care centers experienced a clinically meaningful level of mental or emotional distress that meets the strict diagnostic criteria for mental disorders including anxiety an...
Genetic ‘Hotspot’ Linked to Endometrial Cancer Aggressiveness
The ASCO Post
Parents of twins often tell them apart through subtle differences such as facial expression, moles, voice tone, and gait. Similarly, physicians treating women with endometrial cancer must be able to distinguish between different versions of this disease form that, on the surface, appear the same. W...
Primary Androgen Deprivation Does Not Improve Long-Term Survival in Older Patients With Localized Prostate Cancer
Matthew Stenger
Primary androgen-deprivation therapy has been widely used in localized prostate cancer, despite the absence of definitive evidence of benefit in early-stage disease. In a large population-based cohort study reported in JAMA Internal Medicine, Grace L. Lu-Yao, MPH, PhD, of Rutgers Cancer Institute of...
Nine-Valent HPV Vaccine May Prevent Nearly 90% of Cervical Cancers
The ASCO Post
Because nine human papillomavirus (HPV) subtypes were found to cause the majority of cervical precancers, a nine-valent HPV vaccine currently being investigated may be able to prevent more cervical cancers than current vaccines, according to research published in Cancer Epidemiology, Biomarkers &...
Expert Consensus Recommends Echocardiograph as Cornerstone to Protecting Cancer Patients’ Heart Health
The ASCO Post
Patients with cancer and survivors of cancer are living longer than ever before as a result of significant advances made over the past decade. Importantly, however, cardiovascular complications of their cancer treatment may present a life-threatening issue after their cancer treatment has ended. Sig...
European Researchers at 13-Year Follow-up: Increased Absolute Benefit of PSA Screening in Prostate Cancer Mortality, but Time for Population-Based Screening Has Not Arrived
Matthew Stenger
The 13-year follow-up of the European Randomized Study of Screening for Prostate Cancer (ERSPC), reported by Fritz H. Schröder, MD, PhD, Professor Emeritus of Urology at Erasmus University Medical Center, Rotterdam, the Netherlands, and colleagues in The Lancet, showed that prostate-specific antige...
Adding Antiangiopoietin Agent Trebananib to Paclitaxel Improves Progression-Free Survival in Recurrent Epithelial Ovarian Cancer
Matthew Stenger
Trebananib inhibits angiogenesis by blocking the binding of angiopoietins 1 and 2 to the Tie2 receptor expressed on endothelial cells, a mechanism that differs from vascular endothelial growth factor (VEGF) inhibitors and that involves a different signaling pathway. In the phase III TRINOVA-1 trial ...
Study Quantifies Risk of Hereditary Breast Cancer in Carriers of PALB2 Mutations
Matthew Stenger
In a study reported in The New England Journal of Medicine, Antonis C. Antoniou, PhD, Reader in Cancer Risk Prediction and Cancer Research UK Senior Cancer Research Fellow at the University of Cambridge, and colleagues identified lifetime risk of breast cancer in families with germline loss-of-funct...
No Difference in Complication Rates or Hospital Stay With Robot-Assisted vs Open-Surgery Cystectomy in Bladder Cancer
Matthew Stenger
Retrospective analyses indicate that robot-assisted laparoscopic surgery for radical cystectomy in patients with bladder cancer is associated with reduced risk of complications and shorter hospital stay compared with open surgery. In a small single-institution randomized trial reported in a letter t...
Adding Tomosynthesis to Digital Mammography Decreased Recall Rate, Increased Cancer Detection Rate in Breast Cancer Screening
Matthew Stenger
In a large multicenter study reported in JAMA, Sarah M. Friedewald, MD, of the Advocate Lutheran General Hospital, Center for Advanced Care, Park Ridge, Illinois, and colleagues found that use of tomosynthesis plus digital mammography reduced the recall rate and increased the cancer detection rate i...
Study Finds Increased Breast Cancer Screening Costs in Medicare Population but No Increase in Cancer Detection
Matthew Stenger
In a study of the use of breast cancer screening modalities in the Medicare population reported in Journal of the National Cancer Institute, Brigid K. Killelea, MD, MPH, FACS, and colleagues at Yale University School of Medicine, Yale Cancer Center, and Yale–New Haven Hospital, New Haven, Connecticu...
Using Electronic Health Records to Improve Communication With Patients
Charlotte Bath
Clinicians may argue that electronic health records (EHRs) interfere with the patient-physician relationship, and patients may complain about “distracted doctors,” too busy with computer screens to make eye contact, but according to Thomas W. LeBlanc, MD, MA, of Duke University School of Medicine an...
Oncology Practice: What Are the Factors Driving Change?
Caroline McNeil
Clinical practice changes in response to new medical evidence, but not always immediately or all at once. So what else determines whether and how quickly practice changes in response to evidence, for instance, that a widely used drug is effective only in patients with a certain biomarker? In a new ...
Study Estimates Risk of Premature Menopause After Treatment for Hodgkin Lymphoma
The ASCO Post
Previous research has suggested that women with Hodgkin lymphoma who receive certain types of chemotherapy or radiotherapy are at increased risk of future infertility, but there was insufficient information to provide patients with detailed advice. In a study published in the Journal of the National...
Systematic Model Identifies Factors Associated With Adherence in Prostate Cancer Prevention Trial
The ASCO Post
Healthy men participating in the Prostate Cancer Prevention Trial who actively participate in all steps of the clinical trial are most likely to undergo an end-of-study biopsy, according to a study published in Cancer Epidemiology, Biomarkers and Prevention.1 The Prostate Cancer Prevention Trial was...
Lung Screening–Detected Abnormalities Other Than Cancer Result in Smoking Cessation: National Lung Screening Trial Analysis
Matthew Stenger
In a study reported in the Journal of the National Cancer Institute, Martin C. Tammemägi, PhD, of Brock University, Ontario, and colleagues assessed smoking cessation rates among participants undergoing chest x-ray or computed tomography (CT) screening for lung cancer in the National Lung Screening ...
Phase III Trial of Figitumumab Plus Chemotherapy in Advanced NSCLC Stopped Early for Futility and Increased Harm
Matthew Stenger
In the first phase III trial assessing the combination of an insulin-like growth factor 1 receptor (IGF-1R) inhibitor with chemotherapy as first-line treatment for advanced nonadenocarcinoma non–small cell lung cancer (NSCLC), the addition of the fully human immunoglobulin G2 monoclonal antibody fig...
No Overall Survival Improvement but Some Palliative Benefit With Gefitinib in Esophageal Cancer Progressing Postchemotherapy
Matthew Stenger
In what may be the first randomized trial of systemic therapy in this setting, Susan J. Dutton, MSc, of University of Oxford, United Kingdom, and colleagues evaluated the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor gefitinib vs placebo in patients with esophageal cancer progres...
PREVAIL Trial: Enzalutamide Before Chemotherapy Prolongs Survival in Metastatic Prostate Cancer
Matthew Stenger
The androgen-receptor inhibitor enzalutamide (Xtandi) has been shown to prolong survival in men with metastatic castration-resistant prostate cancer with progressive disease after chemotherapy. In the phase III PREVAIL trial reported in The New England Journal of Medicine, Tomasz M. Beer, MD, of OHS...
Study Finds New Genetic Risk Markers in Pancreatic Cancer
The ASCO Post
A large DNA analysis of people with and without pancreatic cancer has identified several new genetic markers that signal increased risk of developing the disease, report scientists from Dana-Farber Cancer Institute and other institutions worldwide. The markers are variations in the inherited DNA co...
Adjuvant Endocrine Therapy for Hormone Receptor–Positive Breast Cancer: ASCO Clinical Practice Guideline Focused Update
Matthew Stenger
ASCO has released a focused update of its clinical practice guideline on adjuvant endocrine therapy in women with hormone receptor–positive breast cancer.1 The focused update, formulated by Harold J. Burstein, MD, PhD, of Dana-Farber Cancer Institute, Boston, and colleagues in the ASCO Update Commit...
Early Change in Chemotherapy Based on Elevated Circulating Tumor Cells Does Not Improve Outcome in Metastatic Breast Cancer
Matthew Stenger
Elevated circulating tumor cells are associated with poor prognosis in metastatic breast cancer. In a phase III trial (Southwest Oncology Group [SWOG] S0500) reported in Journal of Clinical Oncology, Jeffrey B. Smerage, MD, PhD, Clinical Associate Professor in Medical Oncology at the University of M...
Minority of Older Patients With Low-Risk Prostate Cancer Managed by Observation, Rates Vary Widely Among Urologists and Radiation Oncologists
Matthew Stenger
Most older men with low-risk prostate cancer receive upfront treatment, despite the absence of a clear survival benefit and potential for morbidity. In a retrospective cohort study reported in JAMA Internal Medicine, Karen E. Hoffman, MD, MHSc, MPH, of The University of Texas MD Anderson Cancer Cent...
Childhood Cancer Survivors Hospitalized Frequently Years After Cancer Treatment
The ASCO Post
Survivors of childhood cancers were hospitalized more often and for longer durations because of blood disorders and other problems, many years after cancer treatment was completed, compared with the general population, according to a study published in Cancer Epidemiology, Biomarkers & Preventio...
Sorafenib Improves Progression-Free Survival in Progressive Radioactive Iodine–Refractory Differentiated Thyroid Cancer
Matthew Stenger
Patients with radioactive iodine–refractory locally advanced or metastatic differentiated thyroid cancer have a poor prognosis. In the double-blind phase III DECISION trial reported in The Lancet, Marcia S. Brose, MD, PhD, of Abramson Cancer Center of the University of Pennsylvania, and colleagues ...
Rilotumumab Added to First-Line Chemotherapy May Benefit Patients With Advanced Gastric or Esophagogastric Junction Adenocarcinoma
Matthew Stenger
Hepatocyte growth factor (HGF) and its receptor MET have been found to promote the proliferation, migration, and survival of tumor cells and to play a role in gastric cancer. In a phase II study reported in The Lancet Oncology, Timothy Iveson, MD, of the University Hospital Southampton NHS Foundatio...
Swiss Medical Board Members Discuss Recommendation to Phase Out Mammography Screening
Matthew Stenger
In a New England Journal of Medicine “Perspective” article, Nikola Biller-Andorno, MD, PhD, of the University of Zurich and Harvard Medical School, and Peter Jüni, MD, of the University of Bern, provide the rationale for a recent report by the Swiss Medical Board advocating the phasing out of mammog...
HIV-Infected People With Early-Stage Cancers Are Up to Four Times More Likely to Go Untreated for Cancer
Human immunodeficiency virus (HIV)-infected people diagnosed with cancer are two to four times more likely to go untreated for their cancer compared to uninfected cancer patients, according to a large retrospective study from researchers in Penn Medicine’s Abramson Cancer Center and the National Can...
Surgical Biopsy Proves Safe for Selected Patients With Late-Stage Lung Cancer
Researchers at the University of California Davis have determined that surgical biopsies can be safely performed on select patients with late-stage non-small cell lung cancer, which should enhance their access to drugs that target specific genetic mutations such as epidermal growth factor receptor (...
Ado-Trastuzumab Emtansine Improves Progression-Free Survival vs Physician’s Choice in Advanced HER2-Positive Breast Cancer
Matthew Stenger
There are few treatment options for breast cancer patients with progressive disease after two or more HER2-directed regimens for recurrent or metastatic disease. In the open-label phase III TH3RESA trial reported in The Lancet Oncology by Ian E. Krop, MD, PhD, of the Dana-Farber Cancer Institute, Bo...
ASCO Clinical Practice Guideline: Disease Management in Advanced HER2-Positive Breast Cancer With Brain Metastases
Matthew Stenger
As many as half of all patients with metastatic HER2-positive breast cancer develop brain metastases over time. The American Society of Clinical Oncology recently released a clinical practice guideline on disease management for patients with advanced HER2-positive breast cancer and brain metastases,...
Lung Cancer Mutation Consortium Finds Oncogenic Drivers in Majority of Metastatic Lung Adenocarcinomas
Matthew Stenger
The Lung Cancer Mutation Consortium (LCMC) was formed to test adenocarcinomas of the lung for 10 oncogenic drivers in order to enable clinicians to select targeted treatments and enroll patients into suitable clinical trials. As recently reported in JAMA by Mark G. Kris, MD, William and Joy Ruane Ch...
Nonadherence With Maintenance Medication an Issue in Children With Leukemia
An estimated 25% of children in remission from acute lymphocytic leukemia (ALL) are missing too many doses of the oral agent mercaptopurine, a maintenance medication that minimizes their risk of relapse when taken every day for 2 years, according to a study recently published online in Blood.1 The s...
Stronger Nicotine Dependency Associated With Higher Lung Cancer Risk
A study by investigators at the National Cancer Institute (NCI) has indicated that people who are highly addicted to nicotine, ie, those who smoke their first cigarette within 5 minutes after awakening, are at higher risk of developing lung cancer than those who wait for 1 hour or more to smoke. The...
ASCO Clinical Practice Guideline: Systemic Therapy for Patients With Advanced HER2-Positive Breast Cancer
Matthew Stenger
Approximately 15% of patients with breast cancer have tumors that overexpress the HER2 protein and these patients can benefit from HER2-targeted therapies. The American Society of Clinical Oncology recently released a clinical practice guideline on systemic therapy for patients with advanced HER2-po...
Colonoscopy Adenoma Detection Rate Inversely Proportional to Risk of Interval Colorectal Cancer and Colorectal Cancer Mortality
Matthew Stenger
In a study of health-care organization data reported in The New England Journal of Medicine, Douglas A. Corley, MD, PhD, of Kaiser Permanente, and colleagues assessed the relationship between proportion of colonoscopies performed by a gastroenterologist that detect an adenoma and risk of subsequent ...
Physician Attitudes About Multiplex Tumor Genomic Testing: Variation in Projected Use and Confidence
Matthew Stenger
It is a widely expressed belief that predictive multiplex somatic genomic testing represents the ability to transform cancer care by identifying targetable alterations in multiple cancer genes. Do oncologists share this belief? How do they intend to use such tests in practice? In a study reported i...
Study Calls for Revisiting Guidelines for Screening Childhood Cancer Survivors at Risk of Congestive Heart Failure
One of the first studies to analyze the effectiveness of screening survivors of childhood cancer for early signs of impending congestive heart failure found improved health outcomes but suggests that less frequent screening than currently recommended may yield similar clinical benefit. The researche...
ASCO Clinical Practice Guideline Update: Sentinel Lymph Node Biopsy for Patients With Early-Stage Breast Cancer
Matthew Stenger
ASCO recently convened an update committee of experts in medical oncology, pathology, radiation oncology, surgical oncology, guideline implementation, and advocacy to develop evidence-based recommendations that update the ASCO 2005 clinical practice guideline on use of sentinel node biopsy in patien...
Postmastectomy Radiotherapy Reduces Breast Cancer Recurrence and Mortality in Women With One to Three Positive Nodes
Matthew Stenger
Meta-analyses have shown that postmastectomy radiotherapy reduces risks of recurrence and breast cancer mortality in the population of all women with node-positive disease, but outcomes in those with only one to three positive nodes have not been specifically examined. As reported by Paul McGale, Ph...
Hookah Tobacco Smoking Among Students
Educational campaigns meant to dissuade college students from initiating hookah tobacco smoking may be more successful if they combat positive perceptions of hookah use as attractive and romantic, rather than focusing solely on the harmful components of hookah tobacco smoke, a new University of Pitt...
ASCO Endorses SSO/ASTRO Guideline on Margins for Breast-Conserving Surgery With Whole-Breast Irradiation in Stage I/II Breast Cancer
Matthew Stenger
As reported in the Journal of Clinical Oncology,1 ASCO has endorsed the recently published Society of Surgical Oncology (SSO) and American Society for Radiation Oncology (ASTRO) consensus guideline on margins for breast-conserving surgery with whole-breast irradiation in stage I and II invasive brea...
Water Pipe Smoking May Increase Risk for Cancer
Young adults who smoked water pipes in hookah bars had elevated levels of nicotine, cotinine, tobacco-related cancer-causing agents, and volatile organic compounds in their urine, and this may increase their risk for cancer and other chronic diseases, according to a study published in Cancer Epidem...
ASCO Releases Guideline on Prevention and Management of Chemotherapy-Induced Peripheral Neuropathy in Survivors of Adult Cancers
Matthew Stenger
ASCO has released a clinical practice guideline on prevention and treatment of chemotherapy-induced peripheral neuropathy in adult cancer patients, published in the Journal of Clinical Oncology.1 The guidelines resulted from the efforts of an expert panel, with representation from the fields of med...
ASCO Releases Adapted Guideline on Screening, Assessment, and Care of Anxiety and Depressive Symptoms in Adults With Cancer
Matthew Stenger
Detection of depression is suboptimal, and its severity is underestimated in the general population, but it is known psychiatric disorders are more common in patients with cancer than in those with any other chronic illness. Although studies in cancer patients have yielded varying figures, it is est...
ASCO Releases Adapted Guideline on Screening, Assessment, and Management of Fatigue in Adult Survivors of Cancer
Matthew Stenger
A majority of cancer patients experience some level of fatigue during the course of their treatment, and approximately 30% contend with persistent fatigue for years after treatment. Fatigue is among the most common and distressing long-term effects of cancer treatment and significantly affects patie...
Ceritinib Highly Active in Patients With ALK-Rearranged Advanced NSCLC
Matthew Stenger
Non-small cell lung cancer (NSCLC) harboring ALK rearrangement is sensitive to the ALK inhibitor crizotinib (Xalkori), but resistance ultimately occurs. In a phase I study reported in The New England Journal of Medicine, Alice T. Shaw, MD, PhD, of Dana-Farber/Harvard Cancer Center, Boston, and colle...
Phase III Study Explores Addition of Nintedanib to Docetaxel in Second-Line Treatment of Non–Small Cell Lung Cancer
Matthew Stenger
In a phase III trial (LUME-Lung 1) reported in The Lancet Oncology, Reck et al assessed the addition of nintedanib to docetaxel in second-line treatment of non–small cell lung cancer (NSCLC).1 The combination significantly improved progression-free survival in all patients and improved overall survi...
Continued Survival Benefits Seen With Radical Prostatectomy vs Watchful Waiting in Long-Term Follow-up of the SPCG-4 Trial
Matthew Stenger
The long-term benefits of radical prostatectomy vs watchful waiting in men with localized prostate cancer has remained a debated issue. As reported in The New England Journal of Medicine by Anna Bill-Axelson, MD, of Uppsala University Hospital, and colleagues, additional long-term follow-up in the S...
Neoadjuvant Chemotherapy Without Routine Radiotherapy Shows Promise in Patients With Locally Advanced Rectal Cancer
Matthew Stenger
In a pilot study reported in the Journal of Clinical Oncology, Deborah Schrag, MD, MPH, and colleagues from Memorial Sloan Kettering Cancer Center, New York, assessed outcomes with neoadjuvant FOLFOX (fluorouracil, leucovorin, oxaliplatin)/bevacizumab (Avastin) with selective use of chemoradiotherap...
Phase III Trial Reports Focused Ultrasound Reduces Cancer Pain
A phase III clinical trial has shown that noninvasive magnetic resonance-guided focused ultrasound treatment that heats the cancer within the bone, relieves pain and improves function for most patients when other treatment options are limited. The results were published recently in the Journal of th...
ASCO Committee Defines Clinically Meaningful Goals for Clinical Trials in Pancreas, Breast, Lung, and Colorectal Cancers
Matthew Stenger
The ASCO Cancer Research Committee recently convened four disease-specific working groups—in pancreas, breast, lung, and colon cancers—to “consider the design of future clinical trials that would produce results that are clinically meaningful to patients.” An ASCO perspective statement, reported in ...
Increased Incidence of Thyroid Cancer: An Epidemic of Diagnosis?
Matthew Stenger
In a study reported in JAMA Otolaryngology Head & Neck Surgery,1 Davies and Welch found that the incidence of thyroid cancer has nearly tripled since 1975. However, the increase appears to represent an “epidemic of diagnosis” and to almost exclusively represent increased diagnosis of papillary t...
Elevated Morbidity/Mortality Risks for Childhood Cancer Survivors Further Increase After Fourth Decade
An analysis of the first generation of childhood cancer survivors, who are now aging into their fourth and fifth decades, shows further increases in the survivors’ morbidity and mortality risks. “By age 50 years, more than half of survivors have experienced a severe, disabling, or life-threatening e...
AURELIA Trial: Adding Bevacizumab to Chemotherapy Improves Outcomes in Platinum-Resistant Recurrent Ovarian Cancer
Single-agent chemotherapy is standard in platinum-resistant ovarian cancer. In the open-label phase III AURELIA trial reported in the Journal of Clinical Oncology, Eric Pujade-Lauraine, MD, PhD, of Université Paris Descartes, and colleagues found that the addition of bevacizumab (Avastin) to chemoth...
Lack of Insurance Coverage a Barrier to Lung Cancer Screening
The majority of current and former smokers would welcome screenings for lung cancer if their insurance covered the spiral computed tomography (CT) scans, according to research from Roswell Park Cancer Institute and the Medical University of South Carolina. The study by Jennifer Delmerico, MPH, and c...
SSO-ASTRO Consensus Guideline on Margins for Breast-Conserving Surgery in Stage I/II Invasive Breast Cancer
Matthew Stenger
The Society of Surgical Oncology (SSO) and American Society for Radiation Oncology (ASTRO) formed a multidisciplinary expert panel in 2013 to examine the relationship between surgical margin width and ipsilateral breast tumor recurrence and develop guidelines on margins for breast-conserving surgery...
Bladder Cancer Patient With Rare Genetic Mutations Shows Exceptional Response to Everolimus/Pazopanib Combination
The ASCO Post
A patient with advanced bladder cancer experienced a complete response for 14 months to the drug combination everolimus (Afinitor) and pazopanib (Votrient) in a phase I trial, and genomic profiling of his tumor revealed two alterations that may have caused this exceptional response, according to a s...
No Mortality Benefit of Mammography Screening in 25-Year Follow-up of Canadian National Breast Screening Study
Matthew Stenger
As reported in BMJ by Anthony B. Miller, MD, Professor Emeritus at the Dalla Lana School of Public Health, University of Toronto, and colleagues, the 25-year follow-up of the Canadian National Breast Screening Study has shown no mortality benefit of annual mammography screening for breast cancer com...
FACS Trial: Intensive Follow-up Increases Surgical Treatment of Recurrence With Curative Intent in Colorectal Cancer
Matthew Stenger
In the FACS trial, reported in JAMA, John N. Primrose, MD, FRCS, of University of Southampton, England, and colleagues compared outcomes with intensive follow-up with carcinoembryonic antigen (CEA) measurement, computed tomography (CT), both, or minimum follow-up after curative surgery for primary c...
Complications Other Than Incontinence or Erectile Dysfunction After Prostatectomy or Radiotherapy for Prostate Cancer
Matthew Stenger
Studies of complications of surgery or radiotherapy for prostate cancer generally focus on incontinence and erectile dysfunction. In a population-based cohort study reported in The Lancet Oncology, Robert Nam, MD, MSc, FRCS(C), Professor of Surgery, Sunnybrook Health Sciences Centre, University of T...
Electronic Cigarette Use and Smoking Among Adolescents
The ASCO Post
Use of e-cigarettes does not discourage, and may encourage, conventional cigarette use among U.S. adolescents.” This was the conclusion of a cross-sectional analysis of survey data from a representative sample of middle and high school students who completed the National Youth Tobacco Survey (NYTS) ...
Study Shows Pathologic Complete Response to Neoadjuvant Therapy for Breast Cancer of Prognostic Value but Not for Use as Surrogate for Survival
Matthew Stenger
Pathologic complete response to neoadjuvant therapy has been proposed as a surrogate endpoint for long-term clinical benefit in breast cancer. The U.S. Food and Drug Administration (FDA) established the international Collaborative Trials in Neoadjuvant Breast Cancer (CTNeoBC) working group to perfor...
Does ‘Specialist Bias’ Contribute to Overtreatment of Prostate Cancer?
Charlotte Bath
Specialist bias, in which specialists recommend the therapy that they are capable of delivering, is thought to influence the treatment of patients with localized prostate cancer and to contribute to overtreatment of men with limited life expectancy,” Ayal A. Aizer, MD, MPH, and colleagues, from the ...
Two Behavioral Interventions Help Cancer Patients Struggling With Sleep Issues, Penn Medicine Study Finds
The ASCO Post
Patients with cancer who are struggling with sleep troubles, due in part to pain or side effects of treatment, can count on two behavioral interventions for relief—cognitive behavioral therapy for insomnia and mindfulness-based stress reduction—Penn Medicine researchers reported in a recent study pu...
Colorectal Cancer Screening: Quality Measures Should Focus on Patient Benefit Over Age Alone, Study Reports
The ASCO Post
Screening for colorectal cancer based on age alone may contribute to both underuse and overuse of colonoscopy, sigmoidoscopy, and fecal occult blood testing among older people, according to a study by investigators at the University of Michigan and the Veterans Affairs Center for Clinical Management...
History of Prostate Cancer Increases Risk of Melanoma in White Men
Matthew Stenger
History of severe acne, which is a surrogate for high androgen activity, has been associated with increased risk of prostate cancer, and recent data suggest that severe teenage acne is a risk factor for melanoma. Such findings suggest a role of androgens in etiology for both prostate cancer and mela...
Higher Copayment Associated With Greater Discontinuation of and Nonadherence to Tyrosine Kinase Inhibitor Treatment in CML
Matthew Stenger
The availability of the tyrosine kinase inhibitor imatinib (Gleevec) has dramatically increased survival in chronic myeloid leukemia (CML). Nonadherence to therapy with imatinib and other tyrosine kinase inhibitors is associated with disease progression and treatment resistance. In a study reported ...
Brigham and Women’s Hospital Tumor Staging for Cutaneous Squamous Cell Carcinoma Outperforms AJCC and UICC Staging
Matthew Stenger
In a study reported in the Journal of Clinical Oncology, Pritesh S. Karia, MPH, and Chrysalyne D. Schmults, MD, MSCE, of Brigham and Women’s Hospital, Boston, and colleagues compared Brigham and Women’s Hospital, American Joint Committee on Cancer (AJCC), and International Union Against Cancer (UICC...
Delayed Adjuvant Chemotherapy Associated With Poorer Overall Survival in Breast Cancer
Matthew Stenger
In a study reported in the Journal of Clinical Oncology, de Melo Gagliato et al from The University of Texas MD Anderson Cancer Center, Houston, assessed the association between time to adjuvant chemotherapy and survival in breast cancer patients.1 They found that delay of therapy is associated with...
Telephone Education and Counseling Effective in Programs Targeting Familial/Genetic Cancer Risk Screening
Matthew Stenger
Two studies recently reported in the Journal of Clinical Oncology indicate that telephone-based education or counseling initiatives can be successful in educating individuals at familial or genetic risk of cancer and in inducing these at-risk individuals to undergo recommended screening. In the Fam...
Long-Term Decline in Neuropsychological Function Seen After Cranial Radiotherapy for Pediatric Lymphoid Malignancy
Matthew Stenger
Central nervous system–directed chemotherapy and cranial radiotherapy for childhood acute lymphoblastic leukemia or lymphoma have neurotoxic effects. In a study reported in Journal of Clinical Oncology, Ilse Schuitema, MSc, of Leiden University, and colleagues evaluated white matter changes and neur...
Cognitive-Behavioral Therapy Plus Hypnosis Controls Fatigue in Breast Cancer Patients Receiving Radiotherapy
Matthew Stenger
In a study reported in the Journal of Clinical Oncology,1 Guy H. Montgomery, PhD, Icahn School of Medicine at Mount Sinai, New York, and colleagues found that an intervention consisting of cognitive-behavioral therapy plus hypnosis produced better control of fatigue than supportive meetings with tr...
No Mortality Benefit of Breast Cancer Mammography Screening in 25-Year Follow-up of Canadian National Breast Screening Study
Matthew Stenger
As reported in BMJ by Anthony B. Miller, MD, Professor Emeritus at the Dalla Lana School of Public Health, University of Toronto, and colleagues, the 25-year follow-up of the Canadian National Breast Screening Study has shown no mortality benefit of annual mammography screening for breast cancer com...
Short-Term Follow-Up Reveals Suboptimal Pain Relief and Marked Pain Worsening in Ambulatory Patients With Cancer
Matthew Stenger
In an analysis reported in the Journal of Clinical Oncology, Fengmin Zhao, MS, PhD, Dana-Farber Cancer Institute, Boston, and colleagues assessed factors associated with pain severity changes in ambulatory patients with invasive solid tumors (breast, prostate, colon/rectum, or lung) in the Eastern C...
Breast Implant–Associated Anaplastic Large Cell Lymphoma Shows Better Outcome in Cases With No Distinct Tumor Mass
Matthew Stenger
Only recently described, breast implant–associated anaplastic large cell lymphoma usually presents as an effusion-associated fibrous capsule surrounding the implant and less frequently as a mass. Little is known about the natural history and long-term outcomes of such disease. In a study reported in...
ASCO and College of American Pathologists Guideline Update: Recommendations for HER2 Testing in Breast Cancer
Matthew Stenger
The American Society of Clinical Oncology (ASCO) and College of American Pathologists (CAP) recently convened an Update Committee to conduct a systematic literature review and update recommendations for optimal HER2 testing. In particular, the Committee identified criteria and areas requiring clarif...
Long-Term Follow-up Indicates Increased Telomere Length With Lifestyle Change in Men With Low-Risk Prostate Cancer
Matthew Stenger
Short telomere length in peripheral blood mononuclear cells is associated with aging and age-related diseases such as cancer, stroke, vascular dementia, cardiovascular disease, obesity, osteoporosis, and diabetes. Telomere attrition is considered a potential mechanism in triggering the chromosomal r...
An Overview of the REGAL Trial and Anti-VEGF Therapies in Recurrent Glioblastoma
Annick Desjardins, MD, FRCPC
As published in the Journal of Clinical Oncology by Batchelor and colleagues1 and reviewed in a recent issue of The ASCO Post (November 15, 2013, page 106), the REGAL trial was a randomized, phase III, placebo-controlled, partially blinded trial evaluating the efficacy of cediranib, an investigation...
Novel BRAF Fusions Identified in 'Pan-Negative' Melanomas Subset May Be Sensitive to MEK Inhibition
A study by Sosman et al has identified two novel BRAF fusions in melanomas previously considered to be negative for molecular targets. In addition, these “pan-negative” melanomas were found to be sensitive to MEK inhibitors. According to the study, BRAF fusions define a new molecular subset of melan...
Younger Women With Younger Children Less Likely to Receive Radiation Therapy After Breast-Conserving Surgery for Breast Cancer
Matthew Stenger
In a study reported in the Journal of the National Cancer Institute, Pan et al assessed factors associated with noncompliance with recommended radiation therapy following breast-conserving surgery for breast cancer.1 A primary factor in underuse of radiation therapy was younger patients having child...
Genetic Flaw That Drives Some Ovarian Cancers Identified
The ASCO Post
Researchers at Dana-Farber Cancer Institute, Boston, have identified an overactive gene that drives about one-third of high-grade serous ovarian tumors—the most common and malignant type of ovarian cancer. The gene, GAB2, isn’t mutated or abnormal, but triggers cancerous cell growth because the gene...
Tivozanib Improves Progression-Free but Not Overall Survival vs Sorafenib in Metastatic Renal Cell Carcinoma
Matthew Stenger
The investigational agent tivozanib is a selective tyrosine kinase inhibitor of vascular endothelial growth factor receptor (VEGFR)-1, -2, and -3. In a phase III trial reported in the Journal of Clinical Oncology by Robert J. Motzer, MD, of Memorial Sloan-Kettering Cancer Center (MSKCC), and colleag...
Study Explores Protective Effect of Aspirin Against Colorectal Cancer
Matthew Stenger
It has been posited that aspirin treatment may reduce risk for colorectal cancer through inhibition of WNT/cadherin-associated protein β1 (CTNNB1, or β-catenin) signaling. In a study reported recently in the Journal of the National Cancer Institute, Nan et al investigated the potential role of the s...
Overall Survival Improved by Adding Panitumumab to FOLFOX4 but Only in Metastatic Colorectal Cancer Without RAS Mutation
Matthew Stenger
Patients with metastatic colorectal cancer that harbors KRAS mutations in exon 2 and patients with other activating RAS mutations do not benefit from anti–epidermal growth factor receptor (EGFR) therapy and may in fact be harmed by it. In an analysis reported in The New England Journal of Medicine ...
Targeted Intraoperative Radiotherapy Plus Lumpectomy Noninferior to External-Beam Radiotherapy in Preventing Breast Cancer Recurrence
Matthew Stenger
In the randomized noninferiority TARGIT-A trial reported in The Lancet, Jayant S. Vaidya, PhD, FRCS, and Michael Baum, MD, FRCS, of University College London, and colleagues compared risk-adapted radiotherapy using single-dose targeted intraoperative radiotherapy vs fractionated external-beam radiot...
Cautious Comments on the TARGIT-A Trial
Thomas A. Buchholz, MD, and Benjamin D. Smith, MD
Numerous randomized trials have demonstrated that whole-breast irradiation plays an important role after breast-conserving surgery for invasive breast cancer. A recent meta-analysis of these trials indicated that whole-breast irradiation decreased the risk of total breast cancer relapse events and i...
L-Type Amino Acid Transporters (LAT) Inhibition May Be a New Therapeutic Option for Metastatic Castration-Resistant Prostate Cancer
Matthew Stenger
L-type amino acid transporters (LATs) uptake neutral amino acids including L-leucine into cells, stimulating mTOR complex 1 (mTORC1) signaling and protein synthesis. LAT1 and LAT3 are overexpressed at different stages of prostate cancer and are involved in increasing nutrients and stimulating cell g...
Inhibition of LAT Transporters and Leucine Uptake: A Step Forward for Therapeutic Strategies in Prostate Cancer
Elizabeth R. Kessler, MD, and E. David Crawford, MD
The seminal study by Wang and colleagues reported in the Journal of the National Cancer Institute1 and reviewed in this issue of The ASCO Post suggests a potential new therapeutic option in the treatment of advanced prostate cancer. The authors draw attention to the reliance of cancer cells on amino...
Donor KIRDL1-R245 Allele Predicts Improved Survival and Reduced Progression in Pediatric Allogeneic Stem Cell Transplant
Matthew Stenger
Killer-cell immunoglobulin-like receptors (KIRs) that regulate natural-killer cells are highly polymorphic, and some KIR2DL1 alleles (ie, KIR2DL1-R245) encode receptors characterized by stronger signaling function than others (ie, KIR2DL1-C245). In a study reported in the Journal of Clinical Oncolog...
Improvements Needed in Use of Survivorship Care Plans
Matthew Stenger
Survivorship care plans, consisting of treatment summaries and follow-up plans, are intended to promote coordination of post-treatment cancer care, but little is known about how survivorship care plans are being used in routine oncology practice. In a study reported in the Journal of the National Ca...
Making Progress in Survivorship Care Planning
Mary McCabe, RN, MS
The recommendation that a survivorship care plan be provided to patients and their primary care providers was first presented in the 2006 Institute of Medicine (IOM) report, From Cancer Patient to Cancer Survivor: Lost in Transition. The IOM committee proposed that this document include two parts—a ...
Sharing Treatment Decision-Making With Patients: Where’s the Evidence of Value?
Caroline Helwick
Though certainly not new to oncologists, “shared decision-making” between doctors and patients is receiving increased attention in the medical community today. While it’s an idea with merit, Steven J. Katz, MD, MPH, a specialist in quality care issues, maintains that expectations about the potential...
Autologous Transplantation as Consolidation Improves Progression-Free Survival in Aggressive Non-Hodgkin Lymphoma
Matthew Stenger
The strategy of autologous stem-cell transplantation as consolidation in high-intermediate– or high-risk diffuse aggressive non-Hodgkin lymphoma (NHL) has not been specifically examined in the rituximab (Rituxan) era. In the phase III Southwest Oncology Group (SWOG)-led intergroup 9704 trial reporte...
Long-Term Follow-up of the HERA Trial Shows No Benefit of 2 Years vs 1 Year of Trastuzumab in Early Breast Cancer
Matthew Stenger
As reported in The Lancet by Aron Goldhirsch, MD, of the European Institute of Oncology in Milan, Italy, and colleagues from the Breast International Group (BIG), the comparison of 1 vs 2 years of trastuzumab (Herceptin) in patients with HER2-positive early breast cancer in the phase III HERA trial ...
Similar High Complete Response Rate With Neoadjuvant Trastuzumab, Lapatinib, and Combined Therapy in HER2-Positive Breast Cancer
Matthew Stenger
In a phase III trial (NSABP B-41) performed to assess the potential benefit of neoadjuvant dual HER2 blockade in HER2-positive breast cancer, André Robidoux, MD, of Centre Hospitalier de l’Université de Montréal, and colleagues in the National Surgical Adjuvant Breast and Bowel Project (NSABP) evalu...
Adding Abiraterone to Prednisone Significantly Prolongs Time to Pain Progression in Chemotherapy-Naive Men With Metastatic Castration-Resistant Prostate Cancer
Matthew Stenger
An interim analysis of the COU-AA-302 phase III trial in asymptomatic or mildly symptomatic chemotherapy-naive men with metastatic castration-resistant prostate cancer showed that the addition of abiraterone (Zytiga) to prednisone significantly delayed radiographic progression and improved overall s...
No Apparent Benefit of Adjuvant Gefitinib in Resected NSCLC in Prematurely Closed Trial
Matthew Stenger
As reported in Journal of Clinical Oncology by Glenwood D. Goss, MD, of the Ottawa Hospital Cancer Center, and colleagues, the prematurely closed NCIC CTG BR19 study showed no apparent survival benefit of adjuvant gefitinib (Iressa, withdrawn from U.S. market) vs placebo in patients with completely ...
Investigators Report Valganciclovir May Increase Survival in Glioblastoma
Matthew Stenger
In a letter to The New England Journal of Medicine, Cecilia Söderberg-Nauclér, MD, PhD, and colleagues from the Karolinska Institutet, Stockholm, described experience with the anti-cytomegalovirus (CMV) agent valganciclovir (Valcyte) in the treatment of glioblastoma, citing dramatically improved ov...
NCI-Led Scientists Develop Criteria for 'Omics' Tests Used in Clinical Investigations
Caroline Helwick
High-throughput “omics” technologies that generate molecular profiles on tumor specimens are increasingly being incorporated into clinical trials, but some of these assays have not been well validated, leading many in the research community to question their fitness for use in patient-care decisions...
Patient-Reported Outcomes, a Central Component to Value and Rapid-Learning Systems
Ronald Piana
With the passage of the Patient Protection and Affordable Care Act in 2010, value became the operative word in assessing the success of health care, from outcomes to cost. To drive more value, the Affordable Care Act seeks to implement initiatives such as comparative effectiveness research that will...
GeparTrio Long-Term Data Show Response-Guided Neoadjuvant Therapy for Breast Cancer Improves Survival
Matthew Stenger
In an exploratory analysis of long-term survival data from the GeparTrio trial reported in the Journal of Clinical Oncology, Gunter von Minckwitz, MD, PhD, of the German Breast Group in Neu-Isenburg and the University of Frankfurt, Germany, and colleagues found that response-guided neoadjuvant chemo...
Adjuvant Gemcitabine Improves Long-Term Survival in Patients With Resected Pancreatic Cancer
Matthew Stenger
An initial report from the phase III Charité Onkologie (CONKO) 001 trial of adjuvant gemcitabine vs observation in patients with completely resected pancreas cancer showed that gemcitabine treatment was associated with a significant prolongation of disease-free survival.1 As reported in JAMA by Helm...
Addition of Nab-Paclitaxel to Gemcitabine Improves Survival in Previously Untreated Metastatic Pancreas Cancer
Matthew Stenger
In a phase III trial reported in The New England Journal of Medicine, Daniel D. Von Hoff, MD, of Translational Genomics Research Institute in Phoenix, and colleagues assessed the addition of albumin-bound paclitaxel (nab-paclitaxel [Abraxane]) to gemcitabine in patients with previously untreated met...
Anti–VEGFR-2 Antibody Ramucirumab Prolongs Survival in Previously Treated Advanced Gastric or Gastroesophageal Cancer
Matthew Stenger
Vascular endothelial growth factor (VEGF)– and VEGF receptor-2 (VEGFR-2)–mediated signaling and angiogenesis seem to have an important role in the pathogenesis of gastric cancer. In the phase III REGARD trial reported in Lancet, Charles S. Fuchs, MD, MPH, of Dana-Farber Cancer Institute, Boston, and...
Rituximab Does Not Improve Outcome in B-Cell Lymphoma With Skeletal Involvement, but Radiotherapy Benefit Found
Matthew Stenger
In a retrospective analysis of German High-Grade Non-Hodgkin Lymphoma Study Group trials reported in the Journal of Clinical Oncology, Gerhard Held, MD, of Saarland University Medical School in Homburg, and colleagues assessed the impact of rituximab (Rituxan) and radiotherapy on outcome in patients...
No Survival Benefit of Adjuvant Ibandronate in High-Risk Early Breast Cancer: Potential Activity in Low-Estrogen Patients
Matthew Stenger
The effect of bisphosphonate treatment in early breast cancer is controversial, with some data indicating survival benefit in the adjuvant setting. In a study reported in the Journal of Clinical Oncology (German Adjuvant Intergroup Node-Positive Study, GAIN), Gunter von Minckwitz, MD, PhD, Chairman ...
Alliance Trial Evaluates Sentinel Node Surgery After Neoadjuvant Chemotherapy for Node-Positive cN1 Breast Cancer
Matthew Stenger
Sentinel lymph node surgery provides reliable nodal staging information and is associated with less morbidity than axillary lymph node dissection in patients with clinically node-negative (cN0) breast cancer. The American College of Surgeons Oncology Group (ACOSOG) Z1071 (Alliance) trial examined th...
Spanning a Spectrum of Issues Related to Head and Neck Cancers
Charlotte Bath
Five recent articles in JAMA Otolaryngology–Head & Neck Surgery1-5 span a spectrum of issues related to head and neck cancers. These include risk factors, concentration of care to teaching hospitals, avoiding venous thromboembolism, and encouraging patients to eat and do swallowing exercises to ...
Cost-Effectiveness of MRI Screening for Women With Familial Risk of Breast Cancer in the Netherlands
Matthew Stenger
Annual screening for breast cancer with magnetic resonance imaging (MRI) has been found to be cost-effective in women aged 30 to 60 years who are BRCA1 or BRCA2 carriers or who have a 50% chance of being a carrier, and such screening is recommended in these women by many authorities. It is unclear w...
Impact of Deficient DNA Mismatch Repair on Disease-Free Survival in Stage III Colon Cancer
Matthew Stenger
In an analysis reported in the Journal of Clinical Oncology, Frank A. Sinicrope, MD, of the Mayo Clinic and North Central Cancer Treatment Group (NCCTG), and colleagues investigated the association of deficient DNA mismatch repair with prognosis in patients with stage III colon cancer treated with a...
In Mismatch Repair–Deficient Colon Cancer, Side Matters
Leonard B. Saltz, MD
In general, we have come to think of mismatch repair–deficient colon cancer as having a more favorable prognosis, being less likely to metastasize to regional nodes or distant sites, and being resistant to fluoropyrimidines. Much of our data, however, come from trials combining stage II and III pati...
One Dose of HPV 16/18 Vaccine Produces Durable Response, Study Finds
Jo Cavallo
Results from the Costa Rica HPV 16/18 Vaccine Trial indicate that 4-year efficacy against 12-month HPV 16/18 persistent infection was similarly high among women who received one, two, or the recommended three doses of the bivalent HPV16/18 L1 virus-like particle vaccine (Cervarix). The findings sugg...
Long-Term Colorectal Cancer Incidence and Mortality After Lower Endoscopy
Matthew Stenger
Colonoscopy and sigmoidoscopy have been shown to provide protection against colorectal cancer, but the magnitude and duration of protection, particularly against proximal colon cancer, remain undefined. A study of long-term colorectal cancer incidence and mortality after lower endoscopy reported in ...
Brivanib Studied in First- and Second-Line Therapy for Advanced Hepatocellular Carcinoma
Matthew Stenger
The investigational drug brivanib is a dual inhibitor of vascular endothelial growth factor and fibroblast growth factor signaling, both implicated in hepatocellular carcinoma. The agent was recently evaluated in two phase III trials, one comparing first-line brivanib with sorafenib (Nexavar) in adv...
Brivanib Fails to Live Up to the Promise of Early Studies
Laura Williams Goff, MD, MS
Hepatocellular carcinoma is a devastating disease worldwide. Although advances in liver transplantation, surgery, and locoregional therapies have made tumor control or even cure possible for a minority of patients, the majority of patients diagnosed with hepatocellular carcinoma will develop advance...
No Difference in Long-Term Survival With Finasteride or Placebo in the Prostate Cancer Prevention Trial
Matthew Stenger
In the Prostate Cancer Prevention Trial (PCPT), initially reported in 2003, finasteride significantly reduced the risk of prostate cancer by 24.8% but was associated with a relative 26.9% increase in risk of high-grade disease compared with placebo. In a study reported in The New England Journal of ...
Finasteride for Prostate Cancer Prevention: Long-Term Results Disappointing but Reassuring
Michael L. LeFevre, MD, MSPH
All medical care should seek to achieve one or more of three goals: to relieve suffering, to prevent future suffering, or to prolong life. Care for cancer is no exception, and minimizing suffering from cancer and prolonging life has primarily resulted from advances in treatment. Although there are a...
Breast Cancer Index Assay Prognostic for Distant Recurrence in Estrogen Receptor–Positive, Node-Negative Breast Cancer
Matthew Stenger
In a study reported in The Lancet Oncology, Dennis C. Sgroi, MD, of Massachusetts General Hospital, and colleagues compared the ability of the breast-cancer index (BCI) assay, 21-gene recurrence score (Oncotype DX), and an immunohistochemical prognostic model (IHC4) to predict early and late distant...
Multicenter Analysis of Outcomes of Lymphoma in Pregnancy
Matthew Stenger
Lymphoma is the fourth most frequent cancer to occur in pregnant women. In a multicenter retrospective analysis reported in Journal of Clinical Oncology, Andrew M. Evens, DO, MSc, Chief of Hematology/Oncology at Tufts University Medical Center, Boston, and colleagues examined treatment, complication...
Two Patients in One, Mom and Baby: Managing Coincident Pregnancy and Lymphoma
Joseph M. Connors, MD
The news that she is both pregnant and has been found to have a potentially lethal malignancy is one of the most emotionally wrenching events any young woman ever faces. Understandably, the patient, her partner, their families, and even their caregivers find this experience fraught with anxiety and ...
Vertebral Compression Fracture Risk Increased After Spinal Stereotactic Body Radiotherapy
Matthew Stenger
In a study reported in Journal of Clinical Oncology, Arjun Sahgal, MD, of Princess Margaret Cancer Centre in Toronto, and colleagues evaluated the occurrence of vertebral compression fractures in patients undergoing spinal stereotactic body radiotherapy.1 Vertebral compression fractures occurred in ...
High-Dose Spinal Stereotactic Body Radiotherapy Associated With Increased Risk of Vertebral Compression Fracture
Eric Lis, MD
As reviewed in this issue of The ASCO Post, Sahgal et al reported a multi-institutional analysis aimed at clarifying the risk of developing either new or progressive vertebral body compression fractures following high-dose spinal stereotactic body radiation therapy. In the period studied, they encou...
Circulating Estrogens and Androgens Associated With Breast Cancer Risk in Premenopausal Women
Matthew Stenger
In a study reported in The Lancet Oncology, Timothy Key, DPhil, of Oxford University, and colleagues in the Endogenous Hormones and Breast Cancer Collaborative Group analyzed data from seven prospective studies to determine associations between sex hormones and risk of breast cancer in premenopausal...
Evidence-Based Opportunity to Personalize Breast Cancer Risk: The Data Are Building
Victor G. Vogel, MD, MHS
The worldwide data from prospective studies of the relationship between levels of endogenous sex hormones and breast cancer risk in postmenopausal women show multiple and complex relationships.1 Nine prospective studies (different from those reported here) of women not taking exogenous sex hormones ...
In International Study, Patients Prefer Subcutaneous Over Intravenous Trastuzumab for Breast Cancer
Matthew Stenger
Subcutaneous trastuzumab (not available in the United States) has been shown to have noninferior efficacy and similar pharmacokinetic and safety profiles compared with intravenous trastuzumab (Herceptin) in patients with early-stage HER2-positive breast cancer. In the PrefHer trial reported in Lance...
No Progression-Free Survival Difference for Cediranib or Cediranib/Lomustine vs Lomustine in Recurrent Glioblastoma
Matthew Stenger
In a phase III study (REGAL trial) reported in the Journal of Clinical Oncology, Tracy T. Batchelor, MD, MPH, of the Massachusetts General Hospital Cancer Center, and colleagues compared oral monotherapy with the investigational pan–vascular endothelial growth factor (VEGF) receptor tyrosine kinase ...
Yoga Improves Sleep Quality in Patients With Cancer Suffering From Sleep Disruption
Matthew Stenger
It is estimated that 30% to 90% of patients with cancer experience impairment of sleep quality post-treatment, and such impairment can be severe enough to increase morbidity and mortality. Preliminary evidence indicates that yoga may improve sleep in cancer patients. In a study reported in the Jour...
Bevacizumab/Capecitabine Improves Progression-Free Survival in Older Patients With Treatment-Naive Metastatic Colorectal Cancer
Matthew Stenger
Elderly patients are often underrepresented in clinical trials of metastatic colorectal cancer. In the phase III AVEX trial reported in The Lancet Oncology,1 David Cunningham, MD, of Royal Marsden Hospital in London and colleagues assessed the addition of bevacizumab (Avastin) to capecitabine in pa...
The AVEX Trial
Stuart M. Lichtman, MD, FACP
As reported in The Lancet Oncology by Cunningham and colleagues and reviewed in this issue of The ASCO Post, the AVEX trial was an open-label randomized phase III trial limited to patients over the age of 70 years with previously untreated, unresectable metastatic colorectal cancer who were not deem...
Modifiable Risk Factors Potentiate Therapy-Associated Risk for Major Cardiac Events in Adult Survivors of Childhood Cancer
Matthew Stenger
In a study reported in the Journal of Clinical Oncology, Gregory T. Armstrong, MD, of St. Jude Children’s Research Hospital in Memphis, and colleagues assessed the frequency of major cardiac events and cardiovascular risk factors among adult survivors of childhood cancer and their siblings.1 They fo...
Cardiovascular Risk Factors in Cancer Survivors
Smita Bhatia, MD, MPH
Armstrong et al evaluated the prevalence of self-reported hypertension, diabetes mellitus, dyslipidemia, and obesity and the incidence of self-reported major cardiac events such as coronary artery disease, heart failure, valvular disease, and arrhythmias in adult survivors of childhood cancer in the...
Cabozantinib Improves Disease-Free Survival in Progressive Medullary Thyroid Cancer
Matthew Stenger
Cabozantinib (Cometriq) is an inhibitor of hepatocyte growth factor receptor (MET), vascular endothelial growth factor receptor 2 (VEGFR2), and rearranged during transfection (RET) tyrosine kinases. In a phase III trial reported in Journal of Clinical Oncology, Rossella Elisei, MD, of University of ...
Cabozantinib in Medullary Thyroid Cancer: A Landscape-Shaping New Treatment
Mingzhao Xing, MD, PhD
Medullary thyroid cancer is derived from parafollicular C cells in the thyroid gland. The disease is sporadic in about 75% of cases and hereditary in the remaining 25%.1 Oncogenic mutations in the gene for tyrosine kinase receptor rearranged during transfection (RET) are driver genetic alterations o...
Low-Dose CT Screening Identifies More Early Lung Cancer but Has Lower Positive Predictive Value vs Radiography
Matthew Stenger
Results of the two rounds of annual incidence screening with low-dose computed tomography (CT) vs radiography in the National Lung Screening Trial (NLST) were recently reported by Denise R. Aberle, MD, Professor of Radiology and Bioengineering at the University of California at Los Angeles and nati...
Lung Cancer Screening: Actionable Evidence
James L. Mulshine, MD
This recent paper in The New England Journal of Medicine outlines the details of the clinical outcomes with two incidence screens that were conducted as part of the National Lung Screening Trial (NLST).1 In the wake of the positive review of the U.S. Preventive Services Task Force (USPSTF) draft rec...
Telomere Length May Be a Prognostic Marker for Prostate Cancer
The ASCO Post
Cancer cells are known to have short telomeres, but just how short they are from cancer cell to cancer cell may be a determining factor in a prostate cancer patient’s prognosis, according to a study1 led by scientists at Johns Hopkins. “Doctors are looking for new ways to accurately predict prostat...
Study Shows Increased Risk of Mental Disorders in Childhood Cancer Survivors and Potential Increased Risk in Young Siblings
Matthew Stenger
Survivors of childhood cancer are at risk for long-term adverse physical and mental effects, but little is known about the effects of illness in siblings of these patients. In a study reported in The Lancet Oncology, Lasse Wegener Lund, MD, of the Danish Cancer Society Research Centre and Paediatric...
Psychosocial Health in Long-Term Survivors of Childhood Cancer
Kevin R. Krull, PhD
The study by Lund and colleagues discussed in this issue of The ASCO Post reinforces concerns about psychosocial health in long-term survivors of childhood cancer. Taking advantage of national registries, these investigators demonstrated that, when compared to the general population, survivors are a...
More Active Physician Intervention Needed to Keep Patients From Smoking
Charlotte Bath
More active support and interventions by physicians are required to get patients who still smoke to stop, according to two articles published online by the Journal of Oncology Practice (JOP),1,2 and to prevent school-aged children and adolescents from starting to use tobacco, according to a U.S. Pre...
10-Year Breast Cancer Survival Similar Regardless of BRCA1 Mutation Status
Matthew Stenger
In a study reported in Journal of Clinical Oncology, Tomasz Huzarski, MD, PhD, of Pomeranian Medical University, Szczecin, Poland, and colleagues from the Polish Hereditary Breast Cancer Consortium assessed survival among women with early-onset breast cancer with and without BRCA1 mutation and ident...
Progression-Free Survival With Pazopanib Not Inferior to Sunitinib Benefit in Metastatic Renal Cell Carcinoma
Matthew Stenger
Pazopanib (Votrient) and sunitinib (Sutent) have been shown to provide progression-free survival benefit compared with placebo or interferon in phase III trials in metastatic renal cell carcinoma. In a noninferiority trial reported in The New England Journal of Medicine by Robert J. Motzer, MD, of M...
Pazopanib vs Sunitinib in Metastatic Renal Cell Carcinoma: How Do We Choose?
Brian I. Rini, MD
Over the past decade, the field of metastatic renal cell carcinoma therapy has witnessed the development of multiple drugs targeting the vascular endothelial growth factor (VEGF) pathway, based on the underlying biology of renal cell carcinoma that leads to reliance on angiogenic signaling. The init...
Accelerated Partial-Breast Irradiation Using 3D Conformal Radiation Therapy Causes More Adverse Events Compared With Whole-Breast Irradiation
Matthew Stenger
The RAPID trial compared accelerated partial-breast irradiation using three-dimensional (3D) conformal external-beam radiation therapy vs whole-breast irradiation in women with invasive or in situ breast cancer ≤ 3 cm. As reported by Ivo A. Olivotto, MD, FRCPC, of the British Columbia Cancer Agency...
Increased Alcohol Consumption Between Menarche and Pregnancy Increases Breast Cancer Risk
Matthew Stenger
Adult alcohol consumption during the previous year is related to breast cancer risk, and breast tissue is particularly susceptible to carcinogens between menarche and first full-term pregnancy. In a study reported in Journal of the National Cancer Institute, Ying Liu, MD, PhD, of Washington Universi...
Alcohol Consumption Between Menarche and Pregnancy and Breast Cancer Risk: Factors in Risk Accumulation
Graham A. Colditz, MD, DrPH
In a study recently published in the Journal of the National Cancer Institute and summarized in this issue of The ASCO Post, we found a relationship between alcohol intake between menarche and first pregnancy and risk for breast cancer. Placing this study in context can help us interpret the data an...
ALSYMPCA Trial: Updated Analysis of Survival With Radium-223 Treatment in Metastatic Prostate Cancer
Matthew Stenger
In a trial (ALSYMPCA trial) reported in The New England Journal of Medicine, Chris Parker, MD, from Royal Marsden Hospital in Surrey, UK, and colleagues compared the alpha emitter radium-223 dichloride (Xofigo) with best standard of care in men with castration-resistant prostate cancer and bone meta...
Radium-223 and Beyond in Metastatic Castration-Resistant Prostate Cancer
Maha Hussain, MD, FACP, FASCO
Metastasis to bone is the hallmark of prostate cancer and a major source of disease-related morbidity and mortality. In addition to prostate cancer cells, other major players in the vicious interactive cycle of prostate cancer bone metastasis are osteoblasts, osteoclasts, and mineralized bone matrix...
No Benefit/Detriment of Donor Change in Second Stem Cell Transplant for Leukemia Relapse
Matthew Stenger
Minimal data are available on outcomes of second allogeneic hematopoietic stem cell transplantation from unrelated donors after a first transplant in patients with hematologic relapse of acute leukemia. In a study reported in Journal of Clinical Oncology, Maximilian Christopeit, MD, of University Ho...
Treatment of Relapse of Acute Leukemia Post-Transplant: Still Hope for Patients With Chemosensitive Disease
Richard Champlin, MD
Disease recurrence is a devastating event after allogeneic hematopoietic stem cell transplantation as treatment for acute myeloid leukemia (AML). Median time to relapse is approximately 4 months and the majority of relapses occur within 2 years after transplant. The prognosis is usually poor. Overal...
Cohort Analysis: Adjuvant Tamoxifen Reduces Risk of Contralateral Breast Cancer in BRCA1/2 Mutation Carriers
Matthew Stenger
In a study reported in the Journal of Clinical Oncology, Kelly-Anne Phillips, MBBS, MD, of the University of Melbourne, and colleagues analyzed the association of adjuvant tamoxifen use and risk of contralateral breast cancer among women carrying BRCA1 and BRCA2 mutations in the International BRCA1 ...
Tamoxifen in Women With BRCA1 and BRCA2 Mutations: Another Option?
Rowan T. Chlebowski, MD, PhD
In analyses of pooled information from cohorts of women with BRCA1 and BRCA2 mutations who have had a prior breast cancer diagnosis, Phillips and colleagues examined the association between tamoxifen use compared to nonuse on contralateral breast cancer risk.1 Tamoxifen use was associated with lower...
What Para-Aortic Nodal Involvement Predicts About Survival in PET-CT–Negative Locally Advanced Cervical Cancer
Matthew Stenger
In a study reported in the Journal of Clinical Oncology, Sebastien Gouy, MD, of Institut Gustave Roussy and colleagues evaluated survival outcomes in patients with locally advanced cervical cancer and negative positron-emission tomography/computed tomography (PET-CT) imaging results who underwent la...
Pretreatment Lymph Node Dissection May Improve Survival in Advanced Cervical Cancer, But for Too Few?
Kathleen Moore, MD
Women with cervical cancer metastasized to para-aortic lymph nodes have historically had a poor prognosis, with 3-year overall survival rates of 25% to 40%.1-3 This has been attributed to the presence of occult systemic disease at the time of presentation and a high rate of distant recurrences follo...
Progesterone and Estrogen Receptor Expression Are Prognostic Markers for Endometrioid and High-Grade Serous Ovarian Cancer
Matthew Stenger
Few markers of ovarian cancer prognosis have been established, perhaps because potential subtype associations are missed in studies including patients with all histopathologic subtypes. In a study reported in The Lancet Oncology, Weiva Sieh, MD, PhD, Assistant Professor of Health Research and Policy...
Timely Findings From the Ovarian Tumor Tissue Analysis Consortium
Krishnansu S. Tewari, MD
In the Ovarian Tumor Tissue Analysis Consortium Study recently published by Sieh et al,1 tissue microarrays from 2,933 cases of epithelial ovarian carcinoma demonstrated that progesterone receptor (PR) expression and estrogen receptor (ER) expression were associated with significantly improved dise...
No Invasive Disease–Free Survival Benefit for Bevacizumab Added to Adjuvant Chemotherapy in Triple-Negative Breast Cancer
Matthew Stenger
In a study (BEATRICE trial) reported in Lancet Oncology, David Cameron, MD, Professor of Oncology and Director of Cancer Services, NHS Lothian at the University of Edinburgh, and colleagues evaluated the strategy of adding the antiangiogenic agent bevacizumab (Avastin) to adjuvant chemotherapy in wo...
The BEATRICE Study: Where Does Targeting Breast Cancer Vasculature Stand in 2013?
Lisa A. Carey, MD
Antiangiogenic strategies using the anti–vascular endothelial growth factor (VEGF) monoclonal antibody bevacizumab (Avastin) gained traction in breast cancer with the publication of the Eastern Cooperative Oncology Group (ECOG) 2100 trial in 2007. That study demonstrated a progression-free survival ...
Postresection Adenovirus-Mediated Gene Therapy Improves Time to Death/Reintervention but Not Survival in Adult Glioblastoma
Matthew Stenger
In an open-label phase III trial (ASPECT) reported in Lancet Oncology, Manfred Westphal, MD, of University Hospital Eppendorf in Hamburg, and colleagues assessed the effects of locally applied adenovirus-mediated gene therapy with sitimagene ceradenovec followed by IV ganciclovir after surgical rese...
Sitimagene Ceradenovec/IV Ganciclovir in Glioblastoma: Legitimizing the Gene Therapy Approach for Brain Tumors
William T. Curry, MD
The ASPECT study,1 a randomized, open-label, phase III trial examining adenovirus-mediated gene therapy with sitimagene ceradenovec followed by IV ganciclovir for patients with operable high-grade glioma, is an important achievement for both neuro-oncology and gene therapy. As vector engineering bec...
Potential Prognostic Significance Shown for Interaction of Follicular Lymphoma Cells with Immune Microenvironment
Matthew Stenger
It has been shown that CD4 and CD8 tumor-infiltrating lymphocytes in follicular lymphoma have impaired function and suppressed recruitment of critical signaling proteins to the immunologic synapse, and a number of studies have indicated the prognostic importance of the immune microenvironment in fol...
Researchers Identify Gene Variations in Lung Cancer Patients That May Help Predict an Individual's Treatment Response
The ASCO Post
Researchers at the Moffitt Cancer Center have identified four inherited genetic variants in patients with non–small cell lung cancer that can help predict survival and treatment response. Their findings, published in Carcinogenesis,1 could help lead to more personalized treatment options and improve...
Molecular Profiling Improves Classification of Nodal Peripheral T-Cell Lymphomas
Matthew Stenger
The differential diagnosis of the most common peripheral T-cell lymphoma subtypes is difficult. In a diagnostic accuracy study reported in the Journal of Clinical Oncology, Pier Paolo Piccaluga, MD, PhD, of the University of Bologna, and colleagues in the European T-Cell Lymphoma Study Group and Int...
Molecular Profiling Improves Classification of Nodal Peripheral T-Cell Lymphomas
Steven M. Horwitz, MD
One of the primary obstacles we face in caring for patients with peripheral T-cell lymphomas is a too often inadequate response to chemotherapy with low rates of progression-free and overall survival.1 And while more intensive treatment programs and the availability of novel agents give a greater ho...
Obinutuzumab Shows Activity in Relapsed/Refractory Diffuse Large B-cell Lymphoma or Mantle Cell Lymphoma and Indolent Non-Hodgkin Lymphoma
Matthew Stenger
Obinutuzumab is a type II, glycoengineered, humanized anti-CD20 monoclonal antibody. In the phase II GAUGUIN studies reported in the Journal of Clinical Oncology by Franck Andre Morschhauser, MD, PhD, of Centre Hospitalier Régional Universitaire de Lille and Gilles A. Salles, MD, PhD, of Hospices Ci...
Can Obinutuzumab Benefit Patients With Rituximab-Refractory Non-Hodgkin Lymphoma?
Julie M. Vose, MD
Obinutuzumab is a glycoengineered type II antibody that differs from type I anti-CD20 antibodies by being associated with actin reorganization and adhesion followed by direct cell death.1 Obinutuzumab has been glycoengineered by reduction in fucose content of the Fc region, which increases its affin...
No Event-Free Survival Difference With Chemotherapy Before vs After Radiotherapy in Children With High-Risk Medulloblastoma
Matthew Stenger
A number of different strategies for combining chemotherapy and radiation therapy have been evaluated in the effort to improve survival in patients with high-risk medulloblastoma. In a trial (POG 9031) reported in Journal of Clinical Oncology, Nancy J. Tarbell, MD, of Massachusetts General Hospital,...
Ongoing Progress in Treatment of Medulloblastoma
Karen J. Marcus, MD
Brain tumors are the second most frequent pediatric malignancy. Medulloblastoma, a primitive cerebellar tumor of neuroectodermal origin, is the second most common brain tumor, accounting for 20% of childhood tumors of the central nervous system. Craniospinal radiotherapy has been the main curative m...
Significant Improvement in Overall Survival Seen With Pemetrexed Maintenance After Pemetrexed/Cisplatin Induction in Patients With Advanced Nonsquamous NSCLC
Matthew Stenger
In the phase III PARAMOUNT trial, pemetrexed (Alimta) continuation maintenance therapy significantly reduced the risk of disease progression by 38% compared with placebo after pemetrexed/cisplatin induction in patients with advanced nonsquamous non–small cell lung cancer (NSCLC). Final overall survi...
Pemetrexed Maintenance in PARAMOUNT: Continuation Proves to Be a Strong Option for Advanced NSCLC, Although Not a Mandate
H. Jack West, MD
The PARAMOUNT trial1 represents an important landmark study of continuation maintenance therapy with pemetrexed (Alimta). While maintenance therapy gained a toehold in routine management of advanced non–small cell lung cancer (NSCLC) several years ago, the first trials that demonstrated a significan...
Pattern in Lung Cancer Pathology May Predict Recurrence After Surgery
The ASCO Post
A new study by thoracic surgeons and pathologists at Memorial Sloan-Kettering Cancer Center shows that a specific pattern found in the tumor pathology of some lung cancer patients is a strong predictor of recurrence. Knowing that this feature exists in a tumor’s pathology could be an important facto...
Bevacizumab/Pemetrexed Maintenance Increases Progression-Free Survival vs Bevacizumab Alone in Advanced Nonsquamous NSCLC
Matthew Stenger
Maintenance therapy is associated with improved survival in non–small cell lung cancer (NSCLC), but few studies have compared active agents in this setting. In a phase III trial (AVAPERL trial) reported in the Journal of Clinical Oncology by Fabrice Barlesi, MD, PhD, of Aix Marseille University–Assi...
Non–Small Cell Lung Cancer Maintenance Therapy: None, Single Agent, Multiple Agents?
Philip D. Bonomi, MD
Barlesi et al have reported results of a randomized trial comparing bevacizumab (Avastin) vs pemetrexed (Alimta)/bevacizumab as maintenance therapy in patients with stage IV nonsquamous cell non–small cell lung cancer (NSCLC). It is important to consider their observations in relation to data from o...
Fertility Rates in Childhood Cancer Survivors Suggest Strategies for Follow-up Care
Caroline McNeil
Childhood cancer survivors with clinical infertility have a good chance of achieving pregnancy, according to new findings from the Childhood Cancer Survivor Study (CCSS). Study Background As a group, women who survive childhood cancer are known to have lower fertility rates. This study, however, f...
Enhanced Treatment, Surveillance Needed for Patients With BRAF-Mutant Melanoma to Prevent Secondary Cancers
The ASCO Post
Researchers at Moffitt Cancer Center suggest secondary cancers seen in melanoma patients who are being treated for a BRAF gene mutation may require new strategies, such as enhanced surveillance and combining BRAF inhibitor therapy with other inhibitors, especially as they become more widely used. Th...
Study Suggests Low-Grade Prostate Cancers May Not Progress Over Time
Jo Cavallo
Data analyzed from a large cohort study of men diagnosed with prostate cancer found that prostate cancer aggressiveness may be established when the tumor is formed and not changed over time. The researchers of the study, Kathryn L. Penney, ScD, Instructor in the Department of Medicine at Harvard Med...
Meta-Analysis: Addition of Taxane to Cisplatin/5-FU Induction Improves Outcome in Locally Advanced Head and Neck Cancers
Matthew Stenger
Cisplatin plus fluorouracil (5-FU) induction chemotherapy has been compared with taxane (docetaxel or paclitaxel), cisplatin, and 5-FU in randomized trials in locoregionally advanced head and neck cancers. An updated individual patient data meta-analysis reported in the Journal of Clinical Oncology ...
American Ginseng Improves Cancer-Related Fatigue
Matthew Stenger
In a collaborative phase III trial of the North Central Cancer Treatment Group and Mayo Clinic (N07C2) reported in Journal of the National Cancer Institute by Debra L. Barton, RN, PhD, AOCN, FAAN, of the Mayo Clinic and colleagues, patients with cancer-related fatigue were treated with Wisconsin gin...
Ginseng in the Spotlight
Ollie Minton, MB, BS, PhD, FRCP
I read the study by Barton and colleagues in Journal of the National Cancer Institute with great interest. Ginseng seems potentially to be one treatment for cancer-related fatigue, a poorly understood but debilitating symptom that patients experience during and after treatment.1 I am impressed that...
Family Members of Children With Cancer Are Also at Risk for the Disease
Jo Cavallo
Parents and siblings of children with cancer have between a two- and four-times increased risk of developing cancer than first-degree relatives with no childhood cancer patients, according to a study published in the International Journal of Cancer.1 The study, led by Joshua Schiffman, MD, Medical D...
Role of Epithelial-to-Mesenchymal Transition in Ovarian Cancer
Jo Cavallo
In a study of ovarian cancer cells taken from patients, scientists from Georgia Institute of Technology have confirmed that metastasizing cancer cells have a different molecular structure from primary tumor cells and display genetic signatures consistent with epithelial-to-mesenchymal transition. Al...
Acquired Resistance to Crizotinib from ROS1 G2032R Mutation
Matthew Stenger
The ALK inhibitor crizotinib (Xalkori) has also shown activity in lung cancers with ROS1 translocations. As recently reported by Mark M. Awad, MD, PhD, of Massachusetts General Hospital, Boston, and colleagues in The New England Journal of Medicine, a mutation conferring resistance to crizotinib was...
High Rate of Durable Remissions with Ibrutinib in Patients with Relapsed Chronic Lymphocytic Leukemia
Matthew Stenger
Durable remissions are uncommon with current treatments for relapsed chronic lymphocytic leukemia (CLL). Bruton’s tyrosine kinase is an essential component of B cell–receptor signaling that mediates interactions with the tumor microenvironment and promotes survival and proliferation of CLL cells. Ib...
Ibrutinib Produces High Response Rate in Patients with Refractory Mantle Cell Lymphoma
Matthew Stenger
Ibrutinib is a first-in-class oral covalent inhibitor of Bruton’s tyrosine kinase, a mediator of the B cell-receptor signaling pathway implicated in the pathogenesis of B-cell cancers. As reported in The New England Journal of Medicine, Michael L. Wang, MD, of The University of Texas MD Anderson Can...
PET/CT Superior to Bone Marrow Biopsy for Diagnosis, Prognosis in Lymphoma
The ASCO Post
A more precise method for determining bone marrow involvement in patients with diffuse large B-cell lymphoma has been identified by researchers in a study published recently in The Journal of Nuclear Medicine.1 Imaging with 18F–fluorodeoxyglucose positron-emission tomography/computed tomography (FDG...
New Guidelines Issued in the Treatment of Multiple Myeloma-Related Bone Disease
The International Myeloma Working Group (IMWG) has developed clinical practice recommendations for the management of multiple myeloma-related bone disease based on published study data through August 2012. Consensus of the interdisciplinary panel of clinical experts on the plasma cell cancer was use...
Crizotinib Improves Progression-free Survival vs Pemetrexed or Docetaxel in Advanced ALK-positive NSCLC
Matthew Stenger
In a phase III trial reported by Alice T. Shaw, MD, PhD, a thoracic oncologist at Massachusetts General Hospital, Boston, and colleagues in The New England Journal of Medicine, crizotinib (Xalkori) improved progression-free survival compared with standard chemotherapy in previously treated patients ...
Where Are We With ALK Inhibition in Lung Cancer?
Fred R. Hirsch, MD, PhD
The prospective phase III PROFILE 1007 study compared the ALK inhibitor crizotinib (Xalkori) to chemotherapy in patients with advanced non–small cell lung cancer (NSCLC) with ALK gene–rearranged tumors refractory to previous chemotherapy. The study showed a clear superiority for crizotinib in terms ...
Low-dose CT Screening for Lung Cancer: Details of First Round of Screening in National Lung Screening Trial
Matthew Stenger
The National Lung Screening Trial found that 3 years of annual screening with low-dose helical computed tomography (CT) reduced lung cancer mortality compared with chest radiography in older persons who were heavy smokers.1 The Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial also rece...
Evolving Issues in Low-dose CT Lung Cancer Screening
James L. Mulshine, MD, and Jeffrey Schneider, MD
Over a decade has passed since the start of the National Lung Cancer Screening Trial and more than 2 years since the first report indicating that this randomized study had demonstrated a significant reduction in lung cancer mortality with low-dose computed tomography (CT) screening.1 That favorable ...
Oncofetal Protein SALL4 Is a Marker of Aggressive Hepatocellular Carcinoma and a Potential Therapeutic Target
Matthew Stenger
Hepatocellular carcinomas with characteristics of embryonic stem cell and progenitor cell gene expression are associated with particularly poor prognosis. SALL4 is an oncofetal protein that is expressed in the human fetal liver and normally silenced in the adult liver, but re-expressed in a subgroup...
Targeted Suppression of a Reactivated Developmental Pathway in Hepatocellular Cancer
James L. Abbruzzese, MD
This issue of The ASCO Post summarizes the results of an important study recently published in The New England Journal of Medicine by Yong and colleagues. As outlined, investigators from the National University of Singapore Yong Loo Lin School of Medicine have identified re-expression of SALL4 as a ...
LUX-Lung 3: Afatinib Prolongs Progression-free Survival vs Cisplatin/Pemetrexed in Advanced Lung Adenocarcinoma
Matthew Stenger
Afatinib (Gilotrif) is an oral selective ErbB family inhibitor that irreversibly blocks signaling from EGFR/ErbB1, HER2/ErbB2, and ErbB4 and has exhibited broad-spectrum activity against EGFR mutations in preclinical studies. A phase II study of afatinib in EGFR-mutation positive lung adenocarcinoma...
Further Support for Front-line Targeted EGFR Therapy
Melissa L. Johnson, MD
LUX-Lung 3 is the sixth, and largest, prospective, randomized trial to evaluate targeted EGFR inhibition vs front-line platinum doublet chemotherapy for patients with EGFR mutations. LUX-Lung 3 distinguishes itself from the previous trials (see Table 1) by using afatinib (Gilotrif), a second-generat...
Age Not Linked to Recurrence in Observation or Trastuzumab Groups with HER2-positive Breast Cancer
Matthew Stenger
Available data suggest that younger age is an independent risk factor for disease recurrence and death in women with breast cancer. However, there has not been adequate study of the interaction of age with human epidermal growth factor receptor 2 (HER2) status or anti-HER2 treatment. In an analysis ...
Is Age Truly Relative in HER2-Positive Breast Cancer?
Carey K. Anders, MD
Breast cancer arising in younger women has increasingly become the subject of intense study, and often debate, over the past decade. Retrospective studies have illustrated that breast cancer in young women is more commonly an aggressive subtype (ie, triple-negative/basal-like, HER2-enriched), higher...
Whole-exome Sequencing of NCI-60 Cell Line Panel Provides Genomic Resource for Cancer Biology and Pharmacology
Matthew Stenger
The NCI-60 cell lines, which represent cancers of the lung, colon, brain, ovary, breast, prostate, and kidney, as well as leukemia and melanoma, are the most frequently studied human tumor cell lines in cancer research and have generated the most extensive cancer pharmacology database worldwide. As ...
Infertility in Men Raises Their Risk for Cancer
A cohort study of 2,238 men who were evaluated for infertility at a clinic in Texas from 1989 to 2009 found that those men who had azoospermia, a condition in which no measurable sperm is present, had a 2.2-fold higher cancer risk compared with those who were nonazoospermic. The study was published ...
First-line Carboplatin/Pemetrexed Improves Survival vs Pemetrexed Alone in Advanced Lung Cancer
Matthew Stenger
A significant proportion of patients with advanced non–small cell lung cancer (NSCLC) have poor performance status, and optimal clinical management of these patients has not been established. In an attempt to help define optimal chemotherapy in such patients, Mauro Zukin, MD, of Instituto Nacional d...
Docetaxel Superior to Erlotinib in Second-line Treatment of Advanced Non–Small Cell Lung Cancer with Wild-type EGFR
Matthew Stenger
There is ongoing debate about the efficacy of erlotinib (Tarceva) in patients with advanced non-small cell lung cancer (NSCLC) whose tumors have wild-type EGFR. In the TAILOR trial, reported in Lancet Oncology by Garassino and colleagues,1 erlotinib was compared with standard docetaxel as second-lin...
Link between Red Meat Consumption and Mortality Clarified in Patients with Nonmetastatic Colorectal Cancer
Matthew Stenger
Evidence shows that diets high in red and processed meat are associated with an increased risk of colorectal cancer. In a study reported in the Journal of Clinical Oncology, Marjorie L. McCullough, ScD, Strategic Director of Nutritional Epidemiology, and colleagues from the Epidemiology Research Pro...
Intercalated Chemotherapy/Erlotinib Improves Progression-free Survival in Advanced NSCLC
Matthew Stenger
EGFR mutation status may not be known at the time treatment is started in patients with advanced non–small cell lung cancer (NSCLC). Further, some data suggest that the efficacy of concurrent treatment with an EGFR tyrosine kinase inhibitor and chemotherapy is reduced because the G1 cell-cycle arres...
Significant Improvement in Overall Survival Seen with Pemetrexed Maintenance after Pemetrexed/Cisplatin Induction in Patients with Advanced NSCLC
Matthew Stenger
In the phase III PARAMOUNT trial, pemetrexed (Alimta) continuation maintenance therapy significantly reduced the risk of disease progression by 38% compared with placebo after pemetrexed/cisplatin induction in patients with advanced nonsquamous non–small cell lung cancer (NSCLC). Final overall survi...
Addition of Brivanib to Cetuximab in Chemotherapy-refractory Metastatic Wild-type KRAS Colorectal Cancer: Key Results
Matthew Stenger
The addition of a combination of epidermal growth factor receptor (EGFR) and vascular endothelial growth factor (VEGF) inhibitors to chemotherapy has not improved outcome in first-line treatment of advanced colorectal cancer. However, in early-phase evaluation, the addition of the investigational VE...
Looking for Drivers in the Rearview Mirror
John L. Marshall, MD
The latest clinical trial looking at combining vascular endothelial growth factor (VEGF) and epidermal growth factor receptor (EGFR) inhibition in metastatic colorectal cancer adds little to our overall understanding of the mechanisms for optimizing selection of patients to receive such therapies. W...
Nearly Half of Sarcoma Surgeries Performed by Non-oncology Surgeons
Caroline Helwick
Nearly half the surgical procedures for sarcoma done at 85 academic medical centers were performed by surgeons untrained in oncology, according to national data analyzed by researchers from the University of California Davis Medical Center, Sacramento. Orthopedic oncologists and surgical oncologist...
Critically Ill Hematology Patients Admitted to ICU Have Good Survival, Disease Control, and Quality of Life
Matthew Stenger
A large prospective multicenter cohort study in France and Belgium, reported by Elie Azoulay, MD, of Saint-Louis Hospital, Paris, and colleagues from the Groupe de Recherche Respiratoire en Réanimation Onco-Hématologique,1 has shown that critically ill patients with hematologic malignancies admitted...
Just Say 'Know'
Jeffrey S. Groeger, MD, and Kathleen N. Cathcart, MD
In 1989, Denardo and associates reported the results of intensive care unit (ICU) therapy in a series of patients who developed acute respiratory failure and required mechanical ventilation after bone marrow transplantation. Of those on mechanical ventilatory support longer than 4 days, not one surv...
Updated ASCO Clinical Practice Guideline for Venous Thromboembolism Prophylaxis and Treatment
Matthew Stenger
ASCO has released a new evidence-based clinical practice guideline for venous thromboembolism prophylaxis and treatment, updating the 2007 practice guideline.1 The update is based on a systematic review of literature published from December 2007 to December 2012. An Update Committee reviewed evidenc...
Study Reports 25% of Women Don't Complete Recommended Breast Cancer Treatment
One-quarter of women who should take hormone-blocking therapies as part of their breast cancer treatment either do not start or do not complete the 5-year course, according to a new study led by University of Michigan Comprehensive Cancer Center researchers. For many women with hormone receptor--po...
Genomic and Epigenomic Characterization of Acute Myeloid Leukemia
Matthew Stenger
In a study by the Cancer Genome Atlas Research Network reported in The New England Journal of Medicine, genomes of 200 adult cases of de novo acute myeloid leukemia (AML) were analyzed by whole-genome sequencing (n = 50) or whole-exome sequencing (n = 150) to identify mutations and relationships bet...
Measurement of Circulating Tumor DNA Shows Promise in Monitoring Metastatic Breast Cancer
Matthew Stenger
Management of metastatic breast cancer requires monitoring of tumor burden to assess response to treatment, and there is a need for biomarkers that can measure tumor burden with high sensitivity and specificity. Assays measuring serum cancer antigen (CA) 15-3 and circulating tumor cells have been re...
Immunohistochemistry Effectively Detects ALK Rearrangement in Non-small Cell Lung Cancer Study
ALK rearrangement has been demonstrated to be a potent oncogenic driver and a promising therapeutic target in non-small cell lung cancer. It defines a distinct molecular subset of NSCLC, in particular adenocarcinoma that can benefit by the treatment of ALK-inhibitors. Development of robust and relia...
Outcomes with Adjuvant Trastuzumab in HER2-positive Breast Cancer Not Affected by PTEN Status
Matthew Stenger
PTEN is a negative regulator of PI3K/AKT signaling. PI3K/AKT signaling can be activated by HER2, and it has been hypothesized that alteration in this pathway may affect sensitivity to trastuzumab (Herceptin). Preclinical data and some of the limited available clinical data suggest that loss or inact...
Integrated Genomic Characterization of Endometrial Carcinomas Suggests New Classification Scheme
Matthew Stenger
As recently reported in Nature, investigators in The Cancer Genome Atlas Research Network performed an integrated genomic, transcriptomic, and proteomic characterization of 373 endometrial carcinomas, including 307 endometrioid and 66 serous or mixed histology cases, using array- and sequencing-base...
Learning to Negotiate the Genomic Complexities of Cancer
Joyce F. Liu, MD, MPH
The Cancer Genome Atlas (TCGA) Research Network recently reported the results of an integrated analysis of the genomic features of 373 endometrial carcinomas.1 This report joins previously published results of similar analyses in ovarian, breast, and colorectal cancers, squamous cell carcinoma of th...
SEER Analysis Shows Increased Survival with Surgery and Radiation Therapy in Metastatic Gastric Cancer
Matthew Stenger
A Surveillance, Epidemiology, and End Results (SEER) database analysis reported by Ravi Shridhar, MD, PhD, and colleagues in Cancer indicates that patients receiving surgery and radiation therapy for metastatic gastric cancer have prolonged survival compared with those receiving either alone or neit...
Accountable Care Organizations May Be at Risk for New Medical Liabilities
The promotion of accountable care organizations, a crucial element in the Affordable Care Act, may result in liability risks, said H. Benjamin Harvey, MD, JD, a radiologist in the Department of Radiology at Massachusetts General Hospital, and I. Glenn Cohen, JD, Assistant Professor of Law at Harvard...
Radiation-sparing Dose-adjusted EPOCH-Rituximab for Primary Mediastinal B-cell Lymphoma
Matthew Stenger
Tumor control is frequently not achieved with standard immunochemotherapy in patients with primary mediastinal B-cell lymphoma, requiring consolidation with mediastinal radiotherapy. However, radiotherapy is associated with serious late adverse effects and is still associated with disease progressio...
KRAS Status Not Associated with Survival in Pooled Adjuvant Therapy Trials in Early-stage Lung Cancer
Matthew Stenger
KRAS mutations have been reported in approximately 30% of lung adenocarcinomas. They occur most frequently in codons 12 and 13 in non–small cell lung cancer (NSCLC), and are most common in cancer in smokers and in nonsquamous NSCLC. Some data suggest that KRAS mutation is associated with poorer outc...
Study Shows High Concordance of Recurrent Somatic Alterations in Primary and Matched Metastatic NSCLC
Matthew Stenger
In a study reported in Journal of Clinical Oncology, Stéphane Vignot, MD, of Institut National de la Santé et de la Recherche Medicale (INSERM) Unit 981, Paris, and Gustave Roussy Institute, Villejuif, France, and colleagues used next-generation sequencing to identify somatic alterations in archived...
Mitigating the Anxiety over Tumor Heterogeneity
Jean-Charles Soria, MD, PhD
This collaborative study with Foundation Medicine (Cambridge, Massachusetts), using very sensitive deep sequencing, partially mitigates some of the anxiety generated by the identification of tumor heterogeneity. While our data in lung cancer confirm that such heterogeneity exists, they also indicate...
Reducing Unnecessary and High-dose Pediatric CT Scans Could Cut Future Cancers by More than Half
A study examining trends in x-ray computed tomography (CT) use in children in the United States has found that reducing unnecessary scans and lowering the doses for the highest-dose scans could lower the overall lifetime risk of future imaging-related cancers by 62%. The research was published onlin...
No Survival Benefit of ERCC1 and RRM1 Expression-based Chemotherapy in Patients with Advanced NSCLC
Matthew Stenger
A trial reported by Gerold Bepler, MD, PhD, of Karmanos Cancer Institute, Detroit, and colleagues in Journal of Clinical Oncology assessed whether chemotherapy selected on the basis of in situ ERCC1 and RRM1 protein levels could improve outcomes in patients with advanced non–small cell lung cancer (...
Similar Short-term Outcomes with Laparoscopic vs Open Surgery for Rectal Cancer
Matthew Stenger
As recently reported in Lancet Oncology by Martijn H.G.M. van der Pas, MD, of VU University Medical Center, Amsterdam, and colleagues, the phase III COLOR II trial has shown that laparoscopic surgery can produce similar safety outcomes, resection margins, and completeness of resection compared with ...
Identification of Oncogenic Mutations in Chronic Neutrophilic Leukemia and Atypical Chronic Myeloid Leukemia
Matthew Stenger
Among the hematologic cancers for which molecular causes remain unclear are chronic neutrophilic leukemia and atypical (BCR-ABL1–negative) chronic myeloid leukemia. Both disorders currently are diagnosed on the basis of neoplastic expansion of granulocytic cells and exclusion of genetic factors know...
One Cancer Center's Approach to Death with Dignity
Frederick R. Appelbaum, MD
In November 2008, the Washington State legislature passed the Washington Death with Dignity Act allowing patients with a terminal diagnosis and less than 6 months to live to request and self-administer lethal medication. After considerable internal debate, our cancer center elected to develop a Deat...
Death with Dignity Program at Seattle Cancer Care Alliance
Matthew Stenger
After passage of the Washington Death with Dignity Act in November 2008, the Seattle Cancer Care Alliance—the site of outpatient care for patients with cancer from Fred Hutchinson–University of Washington Cancer Consortium—developed a Death with Dignity program. The program is adapted from existing ...
Once-daily Moxifloxacin for Low-risk Patients with Febrile Neutropenia
Once-daily oral moxifloxacin works at least as well as twice-daily oral ciprofloxacin plus amoxicillin–clavulanic acid when it comes to treating febrile neutropenia in patients who are at low risk for complications, according to a randomized, double-blind trial reported in the Journal of Clinical On...
Postinduction Dexamethasone and Individualized Dosing of Asparaginase Improve Outcome in Pediatric ALL
Matthew Stenger
Findings from the Dana-Farber Cancer Institute ALL Consortium Protocol 00-01, recently reported by Lynda M. Vrooman, MD, Dana-Farber Cancer Institute, and colleagues in Journal of Clinical Oncology, indicate that postinduction dexamethasone and individualized dosing of Escherichia coli–derived L-asp...
Intensified Liposomal Daunorubicin May Offer High Survival Rates without Added Cardiotoxicity for Children with Leukemia
Treating pediatric leukemia patients with a liposomal formulation of anthracycline-based chemotherapy at an intensified dose during initial treatment may result in high survival rates without causing any added heart toxicity, according to the results of a study published online in Blood.1 Acute mye...
Higher Fruit and Vegetable Consumption Associated with Reduced Risk of ER-negative Breast Cancer
Matthew Stenger
An analysis of a large pooled data set from the Pooling Project of Prospective Studies of Diet and Cancer reported by Seungyoun Jung, ScD, Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, and colleagues in Journal of the National Cancer Institut...
Determining the Best Diet for Patients with Cancer
How much does diet and body weight influence the effectiveness of cancer treatment and reduce the risk of cancer recurrence? What is the optimal diet for patients with cancer and survivors to follow? There are currently no hard and fast rules, but some dietary clues are starting to emerge. Search f...
Geriatric Factors Predict Severe Toxicity in Elderly Patients on First-line Treatment for Metastatic Colorectal Cancer
Matthew Stenger
Elderly patients differ with respect to tolerance of therapy for colorectal cancer. In a study reported in Journal of Clinical Oncology, Thomas Aparicio, MD, PhD, of the University of Paris, and colleagues analyzed geriatric factors for potential association with severe toxicity, dose-intensity redu...
No Difference in Overall Survival with Axitinib or Sorafenib in Second-line Treatment for Advanced Renal Cell Carcinoma
Matthew Stenger
The phase III open-label AXIS trial comparing axitinib (Inlyta) vs sorafenib (Nexavar) as second-line treatment for metastatic renal cell carcinoma showed significantly prolonged independent radiology committee–assessed progression-free survival with axitinib treatment (hazard ratio [HR] = 0.665, P ...
HIV Infection Does Not Adversely Affect Outcomes of Liver Transplantation for Hepatocellular Carcinoma
Liver transplantation for hepatocellular carcinoma is feasible for HIV-infected patients, with no differences in post-transplant survival or hepatocellular carcinoma recurrence rates compared with liver transplantation for hepatocellular carcinoma in HIV-uninfected patients. The study, published in ...
Genetic Diversity May Predict Outcomes in Head and Neck Cancer
A new measure of cell heterogeneity within a tumor may predict treatment outcomes of patients with squamous cell carcinoma of the head and neck. In a recent report,1 investigators at Massachusetts General Hospital and Massachusetts Eye and Ear Infirmary reported how the mutant allele tumor heterog...
EGFR Prevents Maturation of microRNAs under Hypoxic Conditions
The epidermal growth factor receptor (EGFR) sends signals that thwart the development of tumor-suppressing microRNAs under conditions of hypoxia, an international team led by scientists at The University of Texas MD Anderson Cancer Center discovered. The results were reported in an early online publ...
Smoking Linked to Shorter Disease-free Survival in Stage III Colon Cancer
Matthew Stenger
According to an analysis reported by Amanda Phipps, PhD, MPH, Assistant Professor of Epidemiology at the University of Washington and Assistant Member at Fred Hutchinson Cancer Research Center, Seattle, and colleagues in the Journal of Clinical Oncology, patients with stage III colon cancer who ever...
Mayo Clinic Genomic Analysis Lends Insight to Prostate Cancer
Mayo Clinic researchers have used next-generation genomic analysis to determine that some of the more aggressive prostate cancer tumors have similar genetic origins, which may help in predicting cancer progression. The findings appeared online recently in the journal Cancer Research.1 Gleason Patte...
Gold Nanoparticles Can Help Fight Ovarian Cancer
Positively charged gold nanoparticles are usually toxic to cells, but cancer cells somehow manage to avoid nanoparticle toxicity. Mayo Clinic researchers found out why and determined how to make the nanoparticles effective against ovarian cancer cells. The discovery is detailed in the current online...
Innovative State Program Reduces Colorectal Cancer Disparities, Mortality Rates Among African American Patients
A study analyzing the impact of the Delaware Cancer Consortium, the state’s cancer control program, reports a 41% reduction in colorectal mortality rates for African Americans.1 The recently published study provided analysis on a novel design and approach used to eliminate colorectal cancer disparit...
Profound and Rapid Molecular Remission with CD19-targeted T Cells in Relapsed B-cell ALL
Matthew Stenger
As was recently reported in Science Translational Medicine, Renier J. Brentjens, MD, and colleagues at Memorial Sloan-Kettering Cancer Center, New York, found that profound molecular remission was rapidly induced in patients with relapsed B-cell acute lymphoblastic leukemia (ALL) using autologous T ...
Proof of Principle for Adoptive T-cell Therapy in Cancer
Matthew Stenger
In a recently published study, Memorial Sloan-Kettering Cancer Center investigators demonstrated the considerable antitumor efficacy of 19-28z chimeric antigen receptor (CAR)-modified T cells in patients with relapsed/refractory B-cell acute lymphoblastic leukemia (ALL). The ASCO Post asked lead aut...
ASCO Announces New Conflict of Interest Policy
In April, ASCO released its updated conflict of interest policy in the development and presentation of scientific research and educational content. The revised policy is designed to increase transparency in financial relationships between individuals and health-care companies and impose new restrict...
New Molecular Testing Guideline for Selection of Lung Cancer Patients for EGFR and ALK Tyrosine Kinase Inhibitor Treatment
Matthew Stenger
A new guideline for molecular testing to select lung cancer patients for treatment with epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors has been jointly developed by the College of American Pathologists, International Association for the Study ...
The Tissue Is the Issue: Choosing Therapy for Lung Cancer
Fred R. Hirsch, MD, PhD
The new guidelines from the College of American Pathologists, International Association for the Study of Lung Cancer, and Association for Molecular Pathology (CAP/IASLC/AMP) are a significant step toward personalized therapy of patients with lung cancer. More than 226,000 new patients per year are d...
Greater Prediagnosis Soy Food Consumption Associated with Improved Survival in Women with Lung Cancer
Matthew Stenger
As recently reported by Gong Yang, MD, MPH, Research Associate Professor at Vanderbilt University School of Medicine, Nashville, and colleagues in the Journal of Clinical Oncology,1 higher prediagnosis consumption of soy food was associated with improved overall survival in Chinese women with lung c...
Risk for Ischemic Heart Disease after Radiotherapy for Breast Cancer
Matthew Stenger
A population-based case-control study reported by Sarah C. Darby, PhD, Professor of Medical Statistics in the Clinical Trial Service Unit and Epidemiologic Studies Unit at the University of Oxford, and colleagues in The New England Journal of Medicine indicates that incidental exposure of the heart ...
Breast Cancer Survivors Not Likely to Maintain Physical Activity Sufficient for Benefits of Exercise
Few breast cancer survivors meet national exercise recommendations during the 10 years after being diagnosed, even though they are among the women who could most benefit from regular physical activity, according to a study by researchers at Fred Hutchinson Cancer Research Center. Prior studies and a...
Autologous Stem Cell Transplant Improves Survival in Transformed Follicular Lymphoma
Matthew Stenger
As reported by the Canadian Blood and Marrow Transplant Group in Journal of Clinical Oncology,1 patients with transformed follicular lymphoma receiving autologous transplantation have improved survival outcomes compared with patients receiving rituximab (Rituxan)-containing chemotherapy alone. Allog...
Role of Stem Cell Transplantation in Follicular Lymphoma
James O. Armitage, MD
The place of either autologous or allogeneic hematopoietic stem cell transplantation in the care of patients with follicular lymphoma has been a point of controversy. However, for patients in whom an effective chemotherapy or chemoimmunotherapy regimen for low-grade follicular lymphoma fails, I beli...
Nonmelanoma Skin Cancer May Be Associated with Modest Increased Risk of Secondary Cancer: Further Study Needed
A prospective study by researchers at Brigham and Women’s Hospital observed an association between risk of second primary cancer and history of nonmelanoma skin cancer in white men and women. The researchers found that people with a history of nonmelanoma skin cancer had a modestly increased risk o...
eHealth: Caregiver Use of Online System Reduces Symptom Distress in Patients with Non–Small Cell Lung Cancer
Matthew Stenger
The results of a study reported by David H. Gustafson, PhD, Research Professor at the University of Wisconsin-Madison, and colleagues in Cancer suggest that informal caregiver (eg, family member) use of a specifically designed online system to support palliative care reduces symptom distress in pati...
Lessons of 2 Decades' Experience with CHESS
David H. Gustafson, PhD
Our work on an Internet-based intervention for lung cancer confirmed what many other studies have shown about technologic interventions for health-care consumers—that such interventions can improve quality of life for caregivers and patients.1 We expected this result in part because of the clinician...
Novel Regimen Produces High Pathologic Complete Response Rates in Triple-negative Breast Cancer
Caroline Helwick
Interim results from a small neoadjuvant study of patients with triple-negative breast cancer has found high rates of pathologic complete response with the combination of nab-paclitaxel (Abraxane), carboplatin, and bevacizumab (Avastin).1 The study was presented at the 18th Annual Conference of the ...
12-Gene Recurrence Score Predicts Recurrence in Stage II Colon Cancer in CALGB 9851 Population
Matthew Stenger
As reported by Alan P. Venook, MD, Professor of Medicine (Hematology/Oncology) at the University of California, San Francisco, and colleagues in Journal of Clinical Oncology, a 12-gene recurrence score (Oncotype DX Colon Cancer Assay) was shown to predict recurrence in stage II colon cancer in a val...
Emerging Prognostic Markers in Colon Cancer
Richard L. Schilsky, MD, FASCO
Patients with stage II colon cancer generally have a favorable prognosis, with about 80% of patients surviving 5 years after surgery and the majority of these long-term survivors presumed to be cured. Clearly though, some patients are destined to recur after surgery, and there is an urgent need to d...
Women with Lynch Syndrome and Endometrial Cancer Are at Increased Risk of Other Cancers
Matthew Stenger
Lynch syndrome is an autosomal dominantly inherited disorder due to germline mutations in DNA mismatch repair genes. Mismatch repair mutation carriers are at increased risk of several cancers, with endometrial cancer being one of the most commonly diagnosed cancers in women with Lynch syndrome. In ...
Lynch Syndrome: A Multitude of Predispositions
Carrie L. Snyder, MSN, and Henry T. Lynch, MD
The current uncertainty regarding the relative frequencies of cancers of various anatomic sites in Lynch syndrome poses a difficulty in commenting on the syndrome’s overall cancer spectrum. It is even more vexing to address the order in which these cancers are prone to occur. What we do know is that...
Oral S-1 Noninferior to Gemcitabine in Advanced Pancreatic Cancer in Japan and Taiwan
Matthew Stenger
As reported by Hideki Ueno, MD, PhD, of National Cancer Center Hospital, Tokyo, and colleagues in Journal of Clinical Oncology, treatment with the oral fluoropyrimidine derivative S-1 was associated with noninferior overall survival and reduced hematologic toxicity compared with gemcitabine treatmen...
The Intriguing Potential of S-1 in Pancreatic Cancer
Eileen M. O’Reilly
The results of the GEST study by Ueno and colleagues add to the intriguing potential role of the oral fluoropyrimidine S-1 in the treatment of pancreas adenocarcinoma. S-1 is a three-component drug consisting of tegafur (a prodrug of fluorouracil), gimeracil (5-chloro-2,4 dihydropyridine, or CDHP, a...
Obese Men with Benign Biopsy at High Risk for Prostate Cancer
Obese men were more likely to have precancerous lesions detected in their benign prostate biopsies compared with nonobese men and were at a greater risk for subsequently developing prostate cancer, according to data published recently in Cancer Epidemiology, Biomarkers & Prevention.1 “Our study...
Benefit of Continued Antiangiogenic Treatment with Bevacizumab after Progression in Metastatic Colorectal Cancer
As reported recently in Lancet Oncology by Jaafar Bennouna, MD, of Institut de Cancérologie de l’Ouest, Nantes, France, and colleagues, the phase III ML18147 trial showed a survival benefit with continued bevacizumab (Avastin) treatment after first progression in metastatic colorectal cancer.1 The t...
More Recreational Physical Activity Associated with Reduced All-cause Mortality in Patients with Colorectal Cancer
In a study recently reported in Journal of Clinical Oncology, Peter T. Campbell, PhD, and colleagues from the Epidemiology Research Program of the American Cancer Society, Atlanta, found that more recreational physical activity before and after a diagnosis of colorectal cancer was associated with lo...
Access to Care: Who Gets Referred to a Medical Oncologist and/or Another Cancer Specialist and Who Receives Treatment for Advanced Cancer?
What factors determine who is referred to a medical oncologist and receives treatment for advanced cancers? Several articles in the Journal of Oncology Practice suggest that factors influencing referral and treatment go beyond the patient’s medical condition and preference and include such details a...
Similar 15-year Functional Outcomes after Prostatectomy or Radiotherapy for Localized Prostate Cancer
Matthew Stenger
Comparative longer-term functional outcomes of radical prostatectomy and external-beam radiation therapy for localized prostate cancer remain undefined. In a study recently reported in The New England Journal of Medicine,1 Matthew J. Resnick, MD, and colleagues at Vanderbilt University, Nashville, c...
Study Shows Lung Cancer CT Screening Could Save 12,000 Lives Annually
Screening all current and former heavy smokers could prevent over 12,000 lung cancer deaths a year, according to a new study published in Cancer.1 The study, funded by the American Cancer Society, arrived at that number based on data from the National Lung Screening Trial (NLST),2 which found that h...
The Risk of Death From Smoking Now Nearly Identical for Men and Women
Researchers from multiple organizations, including the American Cancer Society (ACS), studied the smoking trends among men and women over the last 50 years and found that women’s smoking habits in that time have significantly increased their risk of dying from lung cancer and chronic obstructive pul...
SIGGAR Trials Compare CT Colonography vs Barium Enema and Colonoscopy in Evaluation for Colon Cancer
Matthew Stenger
The companion UK Special Interest Group in Gastrointestinal and Abdominal Radiology (SIGGAR) trials compared computed tomographic (CT) colonography with barium enema and colonoscopy in patients with symptoms suggestive of colon cancer. As recently reported by the SIGGAR investigators in The Lancet,1...
CT Colonography Reconsidered
David H. Kim, MD
The parallel SIGGAR trials recently published in Lancet add to the growing body of literature regarding the utility of computed tomographic (CT) colonography in the detection of colorectal polyps and cancers. These papers reinforce the results seen in other large multicenter trials1-3 and echo the p...
Qigong Practice Associated with Quality-of-life Benefits in Women Undergoing Radiation Therapy for Breast Cancer
Matthew Stenger
Qigong (“qi” or “chi” = energy flow, “gong” = skill or achievement) is an integrated mind-body exercise and meditative practice that involves rhythmic breathing coordinated with repetition of fluid movements and calm focus on the body. A study reported in Cancer by Zhen Chen, MD, and colleagues from...
Addition of Liposomal Daunorubicin Improves Early Outcome in Patients with Pediatric Relapsed AML
Matthew Stenger
Optimal reinduction therapy for patients with relapsed pediatric acute myeloid leukemia (AML) remains undefined. Liposomal daunorubicin (DaunoXome), which offers the potential for reduced cardiotoxicity compared with traditional daunorubicin, is effective in this setting. Gertjan J.L. Kaspers, MD, P...
Effects of Menarche and Menopause on Breast Cancer Risk: Meta-analysis Findings
Matthew Stenger
Menarche and menopause mark the onset and offset of ovarian and endocrine activity associated with reproduction, and early menarche and late menopause are known to increase risk of breast cancer. In a recent Lancet Oncology article, the Collaborative Group on Hormonal Factors in Breast Cancer report...
CDC Reports Racial Disparity in Breast Cancer Mortality
Matthew Stenger
Breast cancer deaths have declined over the past 2 decades, with approximately half of the decrease estimated to be due to advances in early detection and treatment. However, not all racial groups have benefited equally from these advances. A recent report from the Centers for Disease Control and Pr...
Immunoassay Test May Help Identify Early Kidney Cancer
Renal cell carcinoma is the most common form of adult kidney cancer and the third most common urologic malignancy, accounting for about 2% of all malignancies and 2% of cancer-related deaths worldwide. It is also one of the most difficult cancers to detect and treat because it is usually found after...
Obesity, Physical Inactivity Linked with Risk for Subtype of Colorectal Cancer
The ASCO Post
An increasing body mass index (BMI) was associated with a higher risk for colorectal cancer with a specific molecular characteristic, and inversely, physical activity was linked to a decreased risk for that same cancer, according to data published in Cancer Research,1 a journal of the American Assoc...
Patients Receiving Palliative Radiation Therapy for Metastatic Non–Small Cell Lung Cancer May Be Overtreated
Matthew Stenger
Many patients receiving palliative radiation therapy to the bone or chest for metastatic non–small cell lung cancer (NSCLC) may be receiving a greater number of treatments and higher doses than are supported by current evidence, according to a Cancer Care and Outcomes Research and Surveillance Conso...
No Benefit of Adding Carboplatin to Pemetrexed in Second-line Treatment of Patients With Advanced Non–Small Cell Lung Cancer
Matthew Stenger
An Italian randomized phase II study (GOIRC 02-2006 study) recently reported in Journal of Clinical Oncology by Andrea Ardizzoni, MD, of Azienda Ospedaliero-Universitaria in Parma, Italy, and colleagues showed no progression-free survival benefit of adding carboplatin to pemetrexed (Alimta) in secon...
Greater Representation of Older Patients in Phase III Trials Needed
The ASCO Post
The median age of patients diagnosed with advanced non–small cell lung cancer (NSCLC) has steadily increased in recent years and is presently 70 years. Despite this, the elderly are significantly underrepresented in clinical trials. A recent study published in the March 2013 issue of the Internation...
FOXP3 Expression Linked to Better Survival with Adjuvant Anthracycline Not Followed by Taxane in Breast Cancer
Matthew Stenger
The French UNICANCER-PACS 01 trial compared six cycles of anthracycline-based adjuvant therapy with FEC (epirubicin, cyclophosphamide, fluorouracil; FEC6) vs three cycles of FEC followed by three cycles of docetaxel (FEC/docetaxel) in patients with node-positive primary breast cancer. After adjuvant...
Enhanced Electronic Module Aims to Prevent Errors in Oral Chemotherapy Prescribing
Charlotte Bath
An oral chemotherapy prescription-writing module grafted to a shared electronic medical record is part of a series of quality improvement efforts undertaken at Dana-Farber Cancer Institute in Boston to prevent errors in prescribing oral chemotherapy agents. While oncologists have readily accepted th...
Medication Safety at Home
Charlotte Bath
A risk assessment to identify how errors occur when oral chemotherapies are used by pediatric patients at home (and to propose risk-reduction strategies) relied on input from those primarily in charge of oral chemotherapy use at home—the parents. A total of 18 parents were recruited at three pediatr...
Analysis Shows No 10-year Survival Advantage in Patients with Ovarian Cancer and BRCA1 or BRCA2 Mutations
Matthew Stenger
Several studies have suggested that short-term overall survival for women with ovarian cancer and BRCA1 or BRCA2 mutations is better than that in patients without such mutations. Indeed, a recent report by Kelly L. Bolton, PhD, and colleagues indicated that 5-year overall survival was 36% for mutati...
Study Shows New Approach Connecting Smokers to Quit Lines Increases Smoking Cessation Treatment Enrollment
The ASCO Post
Self-identified smokers directly connected to a tobacco cessation quit line are 13 times more likely to enroll in a treatment program as compared to smokers who are handed a quit line referral card and encouraged to call on their own, according to a new study published online in JAMA Internal Medici...
Study Shows Little Association of Multidisciplinary Tumor Boards with Measures of Care
Matthew Stenger
A survey of Veterans Affairs (VA) medical centers recently reported by Nancy L. Keating, MD, MPH, and colleagues at Harvard Medical School in the Journal of the National Cancer Institute showed that the presence of multidisciplinary tumor boards had little association with rates of recommended stage...
Study Finds Young Cancer Survivors Often Skip Checkups
Athough the majority of the more than 69,000 adolescents and young adults (AYAs) diagnosed with cancer each year will survive their disease, many of them will experience interruptions in their education and a derailment in their career tract, curtailing their lifetime earning potential and reducing ...
Use of Beta-blockers Associated with Improved Survival in Patients with NSCLC Receiving Definitive Radiation Therapy
Matthew Stenger
As reported recently in Annals of Oncology, a retrospective study by Wang and colleagues showed that use of beta-adrenergic receptor antagonists (beta-blockers), typically used in treatment of hypertension and heart disease, was associated with significantly improved distant metastasis–free survival...
Genetics, Mathematics, and Colorectal Cancer
Two recent study reports in colorectal cancer explored new data on genetic precursors to the disease and outcome predictors once treatment is initiated. New Genetic Links to Colorectal Cancer Are Identified Investigators from Vanderbilt-Ingram Cancer Center, Nashville, and colleagues in China, Sou...
Selumetinib/Docetaxel Shows Promising Activity in Previously Treated KRAS-mutant Non-Small Cell Lung Cancer
Matthew Stenger
Currently, there are no approved therapies for KRAS-mutant non–small cell lung cancer (NSCLC), and few clinical trials have been performed specifically in this setting. In a recent article in Lancet Oncology, Pasi A. Jänne, MD, PhD, Scientific Director, Belfer Institute for Applied Cancer Science, a...
ASH International Clinical Collaboration Replicates High Cure Rate of APL in Developing Countries
The ASCO Post
The work of an American Society of Hematology (ASH) international clinical network collaborative focused on modernizing treatment protocols for patients in the developing world with acute promyeloctyic leukemia (APL) has drastically improved cure rates in patients in Central and South America. In fa...
Abiraterone Benefits Patients with Metastatic Prostate Cancer Who Have Had No Previous Chemotherapy
Matthew Stenger
The androgen biosynthesis inhibitor abiraterone acetate (Zytiga) has been shown to increase radiographic progression-free survival and delay clinical decline and initiation of chemotherapy in a clinical trial in castration-resistant patients with metastatic prostate cancer who have had no prior chem...
Gene in Eye Melanomas Linked to Good Prognosis
The ASCO Post
Melanomas that develop in the eye often are fatal. Now, researchers at Washington University School of Medicine and the Siteman Cancer Center, St. Louis, Missouri, report they have identified a mutated gene in melanoma tumors of the eye that appears to predict a good outcome. The research was publis...
Subcutaneous Trastuzumab a Potential Alternative to Intravenous Administration in Breast Cancer
Matthew Stenger
Subcutaneous administration of trastuzumab might offer improvements in patient convenience and resource use compared with conventional intravenous administration (Herceptin). A new subcutaneous trastuzumab formulation containing a fixed dose of 600 mg and recombinant human hyaluronidase PH-20 (rHuPH...
Patient Expectations of Benefit in Early-phase Trials: Ethics Issues in Informed Consent
Matthew Stenger
It has been found that many patients in early-phase oncology trials believe their chance of benefit to be much higher than estimates derived from historical data.1-3 In a recently reported study in Journal of Clinical Oncology, Kevin P. Weinfurt, PhD, of Duke Clinical Research Institute, and colleag...
ACS Releases Lung Cancer Screening Guidelines
Ronald Piana
As reported online in CA: A Cancer Journal for Clinicians,1 based on results from the National Lung Screening Trial (NLST) sponsored by the National Cancer Institute (NCI), the American Cancer Society (ACS) has released lung cancer screening guidelines recommending that select clinicians should init...
Postoperative Radiation Therapy Extends Progression-free Survival in Men with High-risk Prostate Cancer
Alice Goodman
Postoperative irradiation significantly improves biochemical progression-free survival and local control compared with a “wait-and-see” approach in men with high-risk prostate cancer, according to more than a decade of long-term follow-up in the European Organisation for Research and Treatment of Ca...
New England Journal of Medicine Article Reports Inferior Outcome in Using Alternative Treatments to Counter Mechlorethamine Shortage
ASCO Immediate Past President Michael P. Link, MD, recently coauthored a perspectives piece in The New England Journal of Medicine on the impact of drug shortages on children with cancer. The paper, “The Impact of Drug Shortages on Children with Cancer — The Example of Mechlorethamine,” describes t...
Cisplatin Linked to Significantly Increased Risk of Venous Thromboembolism
Charlotte Bath
Patients with advanced solid tumors treated with cisplatin-based chemotherapy had a significantly increased risk of venous thromboembolic events, according to a meta-analysis of 38 randomized phase II and III trials evaluating cisplatin-based vs non–cisplatin-based chemotherapy. The trials involved ...
Most Patients Do Not Report that Cure Is Highly Unlikely with Chemotherapy for Advanced Cancer
Matthew Stenger
Chemotherapy for metastatic lung or colorectal cancer can provide palliation and modestly prolong life, but is not curative. In a study recently reported in The New England Journal of Medicine, Jane C. Weeks, MD, of Dana-Farber Cancer Insitute, and colleagues found that the majority of patients with...
Tumor Grade Is Associated with Risk for Venous Thromboembolism
Matthew Stenger
Recent data suggest that risk for venous thromboembolism is associated with biologic aggressiveness of cancer. Findings in the Vienna Cancer and Thrombosis Study, recently reported by Ahlbrecht and colleagues in Journal of Clinical Oncology, indicate that patients with higher-grade tumors are at sig...
Expert Point of View: Agnes Y. Lee, MD
Alice Goodman
Press conferencemoderator Agnes Y. Lee, MD, Medical Director of the Thrombosis Program and Associate Professor of Medicine at the University of British Columbia and Vancouver Coastal Health in Canada, said that apixaban is the third in a new line of anticoagulants for long-term prevention of thrombo...
Gene Profiling Directs Site-specific Therapy for Carcinoma of Unknown Primary Site
Matthew Stenger
Patients with carcinoma of unknown primary site usually receive empiric therapy (eg, with taxane/platinum or gemcitabine/platinum regimens), resulting in a median overall survival of approximately 9 months. As reported recently in Journal of Clinical Oncology, Hainsworth and colleagues have shown th...
Teens and Young Adults with Cancer Want a Voice in End-of-life Care
A top the list of concerns of adolescents and young adults with a life-threatening cancer are these two considerations: being able to choose the kind of medical treatment they want (or do not want) and expressing their wishes to family and friends about how they want to be remembered, according to a...
Bone Marrow Transplants Reduce Risk of Graft-vs-Host Disease Compared to Peripheral Blood
Caroline McNeil
Patients who receive bone marrow transplants are significantly less likely to develop chronic graft-vs-host disease than those who receive peripheral blood stem cell transplants, according to a new, large randomized trial, the first of its kind with unrelated donors. Published recently in The New En...
Statin Use Associated with Reduced Cancer-related Mortality in Danish Study
Matthew Stenger
Cancer-related mortality among patients in the Danish population receiving a diagnosis of cancer at age ≥ 40 years between 1995 and 2007 was significantly reduced in those who were receiving statin therapy at the time of diagnosis, according to an analysis reported by Nielsen and colleagues in The N...
Medical and Behavioral Variables Have More Impact on Physical Functioning Than Finasteride Treatment
Charlotte Bath
Taking finasteride over a 7-year period as part of the Prostate Cancer Prevention Trial (PCPT) “did not affect any of the three primary health-related quality-of-life domains—physical function, mental health, or vitality—either positively or negatively,” according to a study published in the Journal...
Fox Chase Researchers Find Most Medicare Patients Wait Weeks before Breast Cancer Surgery
The ASCO Post
Although patients may feel anxious waiting weeks from the time of their first doctor visit to evaluate their breast until they have breast cancer surgery, new findings from Fox Chase Cancer Center in Philadelphia show that these waits are typical in the United States. Results were published recently...
Significant Reduction in Cancer Risk Seen with Daily Multivitamin Use in Middle-aged and Older Men
Matthew Stenger
Large-scale trials over the past several years have shown a general lack of effect of single vitamins or small numbers of vitamins given at high doses in preventing cancer. However, as recently reported in JAMA by Gaziano and colleagues, the Physicians’ Health Study II has found a modest but signifi...
Finding Lynch Syndrome among Patients with Colorectal Cancer: Routine Tumor Testing Looks Best
Caroline McNeil
Oncologists generally agree that screening patients with colorectal cancer for Lynch syndrome is a good thing. Patients who turn out to have the hereditary syndrome can inform their first-degree relatives, who in turn can undergo genetic testing. Those who have the characteristic mutations can take ...
Study Explores Use of Radiotherapy in Last 30 Days of Life
Charlotte Bath
While few patients receive radiation for cancer treatment in the last 30 days of life, almost 1 in 5 patients who do spend more than 10 of those days in treatment and more than half spend more than 5 days, according to a study published in the Journal of Clinical Oncology.1 The investigators used th...
No Survival Benefit for Oxaliplatin Added to Adjuvant Therapy in Stage II or Elderly Patients with Colon Cancer
Matthew Stenger
Oxaliplatin plus fluorouracil (5-FU)/leucovorin or capecitabine (Xeloda) is a standard of care in adjuvant therapy for stage III colorectal cancer. There is ongoing debate about whether any adjuvant therapy is of benefit in patients with stage II disease, and it is not routinely recommended in this ...
Trastuzumab Emtansine Improves Survival vs Capecitabine plus Lapatinib in Second-line HER2-positive Breast Cancer
Matthew Stenger
Trastuzumab emtansine (T-DM1) is an antibody-drug conjugate composed of trastuzumab bound to the cytotoxic microtubule inhibitor emtansine (DM1, derivative of maytansine) by a stable linker. Trastuzumab targets the conjugate to HER2 receptors, and the linker releases the cytotoxic agent when the com...
Adjuvant Chemotherapy for Breast Cancer Predicted by Disease, Age, and Insurance Type, but Not by Race
Matthew Stenger
Breast cancer mortality has been found to be higher among black and Hispanic women than among white women, with the differences in outcome being attributed in part to more advanced disease stage and greater frequency of unfavorable tumor biology among black and Hispanic women. Studies to date have n...
Nab-paclitaxel vs Solvent-based Paclitaxel in First-line Treatment of Advanced Non–Small Cell Lung Cancer: Final Results
Matthew Stenger
Nanoparticle albumin-bound (nab)-paclitaxel (Abraxane) is a solvent-free paclitaxel formulation intended to reduce solvent-related adverse reactions and improve tumor penetration via the physiologic transport properties of albumin. The final results of a phase III trial comparing nab-paclitaxel and ...
Intermittent Androgen Suppression in Prostate Cancer Noninferior to Continuous Suppression, Associated with Some QOL Benefit
Matthew Stenger
A recently reported National Cancer Institute of Canada (NCIC) Clinical Trials Group study, reported by Crook and colleagues in The New England Journal of Medicine, showed that intermittent androgen suppression was associated with noninferior overall survival when compared with continuous suppressio...
PD-1 Blockade Increases Transferred T-cell Migration to Tumors
Matthew Stenger
One reason that adoptive cell transfer has met with limited clinical success is that approaches based on this strategy have not fully taken into account the role of the tumor microenvironment as a limiting factor in immunotherapy. Recently reported studies by Peng and colleagues1 from The University...
Phase II Study Suggests Advantage of Irreversible Pan-HER Inhibition in Advanced NSCLC
Matthew Stenger
Dacomitinib is a new tyrosine kinase inhibitor that forms irreversible covalent bonds with the ATP domain of each of the three kinase-active members of the HER family—EGFR/HER1, HER2, and HER4. Agents such as erlotinib (Tarceva) and gefitinib (Iressa), which are of proven benefit in advanced non–sma...
Socioeconomic Disparity in Colorectal Cancer Rates Attributed to Obesity and Behavioral Risks
Charlotte Bath
More than one-third of the excess risk of invasive adenocarcinoma of the colon and rectum resulting from low socioeconomic status “could be explained by differences in exposure to behavioral risk factors, particularly a healthy diet,” researchers recently reported in the Journal of the National Canc...
SIDEBAR: Don’t Expect Direct Questions from Patients about Pain
Charlotte Bath
Just asking patients “Is there something else you want to address in the visit,” rather than “Is there anything else you want to address in the visit today,” dramatically reduced patients’ unmet concerns during a primary care visit, according to a 2007 study.1 That learning can be applied to talking...
Successful Use of Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy May Hinge on Prior Experience
Charlotte Bath
A review of 60 consecutive patients with peritoneal carcinomatosis who underwent cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (HIPEC)—sometimes called “hot chemotherapy”—found 0% mortality and 33% morbidity, with “a significant reduction of grade III/IV morbidity, perioperati...
Neuropathy Not Predictive of Outcomes with Adjuvant Taxane Therapy in Breast Cancer
Matthew Stenger
Neuropathy is a common and potentially disabling adverse effect of taxane therapy, particularly weekly paclitaxel. A number of recent studies have identified single nucleotide polymorphisms that appear to increase risk of grade 2 to 4 neuropathy in patients with breast cancer who receive taxanes. It...
Radiation to the Skin and Later Risk of Basal Cell Carcinoma Studied
Charlotte Bath
The likelihood of developing basal cell carcinoma was approximately 40 times higher among participants of the Childhood Cancer Survivor Study (CCSS) who received a dose of 35 Gy or more to the skin from radiation therapy than survivors who were not treated with radiation, according to a study publis...
Kinase Inhibitors Compared in First-line Treatment of CML
Matthew Stenger
Bosutinib (Bosulif) is an oral dual Src/Abl kinase inhibitor that is active against many Bcr-Abl mutations associated with imatinib (Gleevec) resistance and that has reduced activity against nonspecific molecular targets associated with toxicities reported for other second-generation kinase inhibito...
Hormonal Therapy with Enzalutamide Increases Survival in Castrate-resistant Prostate Cancer after Chemotherapy
Matthew Stenger
The androgen receptor–signaling inhibitor enzalutamide (Xtandi) is reported to differ from conventional antiandrogen agents in that it inhibits androgen receptor nuclear translocation, DNA binding, and coactivator recruitment, has a greater affinity for the androgen receptor, and induces tumor shrin...
Prone Position during Radiation Therapy for Breast Cancer Is Associated with Reduced Irradiation to Lung and Heart
Charlotte Bath
Preliminary data on prone positioning during whole-breast radiotherapy following breast-preservation surgery “suggest that radiation exposure to the heart and lung can be reduced compared with supine positioning with similar efficacy,” according to a research letter in the Journal of the American Me...
Tweeting at ASCO Annual Meetings Can Enhance the Experience
Charlotte Bath
Tweeting at concerts or plays may earn you scornful looks or even stern warnings from ushers, but tweeting at the ASCO Annual Meeting may enhance the meeting experience for you and others. In a study comparing trends in Twitter use by physicians during the 2010 and 2011 ASCO Annual Meetings, some Tw...
Radiotherapy Not Helpful in Early-stage Parotid Acinic Cell Cancer
Charlotte Bath
Adjuvant radiotherapy for patients with parotid acinic cell carcinoma “does not confer a therapeutic advantage in low-grade and early-stage tumors if resection is complete,” but the benefit for patients with higher-grade or higher-stage disease is uncertain because there were few of these patients i...
No Survival Benefit of Radical Prostatectomy vs Observation for Localized Prostate Cancer Detected by PSA Testing
Matthew Stenger
The relative benefits of surgery or observation in men with prostate cancer detected by prostate-specific antigen (PSA) testing have not been defined. Randomized trials comparing radical prostatectomy with observation were conducted before widespread use of PSA testing and an observational study con...
Anticancer Effect of Diabetes Drug Metformin
Matthew Stenger
Retrospective analyses have indicated that the antidiabetic agent metformin may be associated with a quite substantial reduction in risk of cancers. There is evidence that the anticancer effects of metformin are related to inhibition of the growth of certain cancers via activation of AMP kinase with...
Sexual Dysfunction in Female Cancer Survivors Is Prevalent
Jo Cavallo
Although medical experts put the proportion of female survivors facing some form of sexual dysfunction following a cancer diagnosis and treatment at nearly 100%, very few women raise sexual health concerns with their oncologist. In a study of 261 patients with gynecologic or breast cancer published ...
Physical Activity Benefits Breast Cancer Survivors, but Role in Reducing Breast Cancer Risk Is Less Clear
Charlotte Bath
Breast cancer survivors who engage in moderate to high levels of physical activity have reduced mortality and improved quality of life, according to recent studies. In addition, exercise may play a role in lowering the risk of breast cancer. “Physical activity can hasten recovery from the immediate...
Dying Patients with Cancer Who Avoid Aggressive Care but Stay Connected with an Oncologist Have Better Quality of Life
Jo Cavallo
Dying patients with cancer who avoided hospitalizations and life-prolonging measures, who worried less, prayed or meditated, were visited by a pastor, and maintained a therapeutic alliance with their oncologist had the highest quality of life at the end of life, according to a study recently publish...
Lack of Sleep Found to Be Risk Factor for Aggressive Breast Cancers
The ASCO Post
Lack of sleep is linked to more aggressive breast cancers, according to new findings published in the August issue of Breast Cancer Research and Treatment by physician-scientists from University Hospitals Case Medical Center’s Seidman Cancer Center and Case Comprehensive Cancer Center at Case Wester...
No Advantage to Longer Adjuvant Chemotherapy in Women with Early Breast Cancer: CALGB 40101 Trial
Matthew Stenger
The ideal duration of adjuvant therapy for women with lower-risk primary breast cancer remains unknown. The National Surgical Adjuvant Breast and Bowel Project (NSABP) B-15 trial, reported more than 20 years ago, found no difference in outcomes between six cycles of cyclophosphamide, methotrexate, a...
Ipsilateral Radiotherapy for Cervical Lymph Node Metastases
Charlotte Bath
Ipsilateral neck–only radiation therapy “demonstrated excellent locoregional control with no adverse effect on disease-free survival or overall survival” among patients with cervical metastases from an unknown primary site, according to a retrospective review of medical records from 46 patients trea...
Preclinical Research Finds Gene that Permanently Stops Cancer Cell Proliferation
The ASCO Post
Researchers at Case Western Reserve University School of Medicine, Cleveland, have discovered a mutant form of the gene Chk1 that when expressed in cancer cells, permanently stopped their proliferation and caused cell death without the addition of any chemotherapeutic drugs.1 This study illustrates ...
Chemotherapy plus Radiation Improved Progression-free Survival in Adults with Low-grade Glioma
Charlotte Bath
Adult patients with supratentorial low-grade glioma who received chemotherapy with PCV (procarbazine [Matulane], lomustine [CeeNu], and vincristine) in addition to radiation therapy had improved progression-free survival but not overall survival compared to patients receiving radiotherapy alone, acc...
Study Shows Routine CT Surveillance Overused in Pediatric Hodgkin Lymphoma
Matthew Stenger
The value of routine CT surveillance monitoring of pediatric patients for recurrence of Hodgkin lymphoma has been unclear. A study of CT surveillance recently reported by Stephan D. Voss, MD, PhD, and colleagues from the Children’s Oncology Group (COG) in the Journal of Clinical Oncology showed that...
‘Young and Strong’ Program Addresses Multiple Needs of Women in 40s and Younger Diagnosed with Breast Cancer
Charlotte Bath
“Young and Strong” is an exportable model of a program developed at Dana-Farber Cancer Institute and Brigham and Women’s Hospital in Boston to address the significant challenges facing young women with breast cancer. The new model has been designed to “serve young women with breast cancer who are re...
Radiotracer Targeting of Free Prostate-specific Antigen
Matthew Stenger
Serum levels of prostate-specific antigen (PSA) are widely used as a biomarker for prostate cancer, although they often do not distinguish between normal tissue and cancer and do not always accurately reflect clinical outcome. In order to overcome the fact that the small proportion of tumor-associat...
Adding Bevacizumab to Chemotherapy Improves Progression-free Survival in Platinum-sensitive Recurrent Ovarian Cancer
Charlotte Bath
The addition of bevacizumab (Avastin) to gemcitabine and carboplatin, followed by bevacizumab until disease progression, resulted in significantly improved progression-free survival compared to gemcitabine and carboplatin plus placebo among women with platinum-sensitive recurrent ovarian, primary pe...
No Improvement in Overall Survival, Worse Toxicity with Motesanib Added to Chemotherapy in Non–Small Cell Lung Cancer
Matthew Stenger
Two trials (E4599 and AVAiL) have suggested a benefit to adding the anti–vascular endothelial growth factor (VEGF) monoclonal antibody bevacizumab (Avastin) to chemotherapy in patients with advanced nonsquamous non–small cell lung cancer (NSCLC). Bevacizumab acts by binding directly to circulating V...
Lung Cancer Death Rates Increase among White Women in Some States
A new study comparing lung cancer death rates among women by year of birth shows dramatic differences in trends between states, likely reflecting the success or failure of tobacco control efforts. The study, published early online in the Journal of Clinical Oncology,1 finds that while lung cancer de...
Increased Adjuvant Therapy Use and Improved Survival in Dutch Elderly Patients with Stage III Colon Cancer: A Direct Correlation?
Matthew Stenger
A survival benefit of adjuvant chemotherapy has been reported for select elderly patients with stage III colon cancer, but many elderly patients are not candidates for or are not given adjuvant therapy due to comorbidities and fear of toxicity. In a recent Annals of Oncology article, van Steenbergen...
Prognostic Value of Integrated Cytogenetic and Mutational Risk Classification in Acute Myeloid Leukemia
Matthew Stenger
Jay P. Patel, BS, and colleagues from Memorial Sloan-Kettering Cancer Center in New York recently performed mutational analysis of 18 genes in a subgroup of newly diagnosed acute myeloid leukemia (AML) patients who had been randomized to receive cytarabine plus high-dose or standard-dose daunorubici...
Mitotane-containing Regimens Explored for a Rare Tumor
Charlotte Bath
Response rates and progression-free survival rates were significantly better among patients with advanced adrenocortical carcinoma receiving mitotane (Lysodren) plus EDP (etoposide, doxorubicin, and cisplatin) than in patients receiving mitotane with streptozocin (Zanosar), according to results of a...
New Study Examines Racial Disparities in Breast Cancer Mortality
According to the first national study looking at racial disparity in breast cancer mortality rates at the city level in the United States, societal factors—especially poverty and residential segregation—are resulting in the unnecessary deaths of five black women every day—more than 1,700 deaths a ye...
Early Access to Palliative/Supportive Care vs Usual Care Improves Pain Management
Matthew Stenger
Many cancer patients remain undertreated for pain despite availability of guidelines and educational efforts to improve pain treatment. In a recent Annals of Oncology article, Bandieri and colleagues from the Italian Epidemiologia Clinico-Assistenziale del Dolore in Ospedale (ECAD-O) group report a ...
Multicenter Phase II Trial Supporting Approval of Brentuximab Vedotin in Anaplastic Large-cell Lymphoma
Matthew Stenger
Systemic anaplastic large-cell lymphoma (ALCL) is an aggressive T-cell lymphoma subtype characterized by uniform expression of CD30. Apart from low- to intermediate-risk patients with ALK-positive disease, patients with ALCL have a poor prognosis when treated with conventional, anthracycline-based f...
Decoding the Genetic Blueprint of Cancer Cells: Findings in Multiple Myeloma and Breast Cancer
Advances in next-generation DNA sequencing technologies are allowing scientists to decipher the whole genome or whole exome (ie, the coding region of the genome) of cancer specimens more quickly and inexpensively than ever before. And the results are revealing genes that had not previously been asso...
Can Whole-genome Sequencing Predict Cancer Risk and Improve Public Health?
Charlotte Bath
If, as expected, the cost of whole-genome sequencing continues to drop, perhaps down to the $1,000 vicinity, it may become an alluring option for consumers who want to know about their risks for cancer and other diseases. But can genome sequencing really provide practical information about individua...
Maintenance Lenalidomide Improves Progression-free Survival and Time to Progression in Patients with Multiple Myeloma
Charlotte Bath
Three phase III, double-blind, multicenter, randomized studies showed that lenalidomide (Revlimid) maintenance therapy for patients with multiple myeloma significantly improved progression-free survival or time to progression, the primary endpoints of the studies published in The New England Journal...
Study Validates Prognostic Role of Tumor Lymphocytic Infiltration in Resectable Non–Small Cell Lung Cancer
The benefit from platinum-based adjuvant chemotherapy in non–small cell lung cancer (NSCLC) was demonstrated in four randomized trials (International Adjuvant Lung Cancer Trial [IALT], Canadian JBR.10 trial, Cancer and Leukemia Group B [CALGB] 9633 trial, and Adjuvant Navelbine International Triali...
Strong Biomarker Candidates for Predicting Clinical Response to Bevacizumab
Charlotte Bath
Plasma vascular endothelial growth factor A (VEGF-A) and tumor neuropilin-1 “are strong biomarker candidates for predicting clinical outcome in patients with advanced gastric cancer” after treatment with bevacizumab (Avastin). This was the conclusion of a mandatory biomarker program following up on ...
Denosumab Delays Time to First Bone Metastasis in Men with Castration-resistant Prostate Cancer
Charlotte Bath
Denosumab (Xgeva) significantly delayed time to first bone metastases among men with nonmetastatic castration-resistant prostate cancer enrolled in a phase III randomized, placebo-controlled trial. The time to first bone metastasis was 33.2 months among the 716 patients randomly assigned to receive ...
ASCO Issues New Guideline on Chemotherapy Dosing for Obese Patients
In April, ASCO released a new clinical practice guideline on the appropriate dosing of chemotherapy drugs given to obese adult patients with cancer. The result of an analysis by a panel of experts assembled by ASCO, the guideline calls for the use of a patient's actual body weight when calculating c...
Study Shows Continued Benefit of PSA Screening in Reducing Prostate Cancer Mortality
Matthew Stenger
Studies assessing the effect of prostate-specific antigen (PSA) testing on prostate cancer mortality have produced conflicting results, and recommendations regarding PSA screening vary among authorities. The recently published 11-year follow-up of the European Randomized Study of Screening for Prost...
Study Shows Steady Increases in Survival for Children with ALL
A study by the Children’s Oncology Group (COG) reported that 5-year survival for acute lymphoblastic leukemia (ALL) among children treated through COG clinical trials increased from 83.7% during the period 1990-1994 to 90.4% in the period 2000-2005. The improvements in survival were observed among a...
Analysis Suggests CT Screening Could Save Lives at Relatively Low Cost
Results of an actuarial analysis suggest that offering lung cancer screening with low-dose spiral computed tomography (CT) as a commercial insurance benefit to individuals who are 50 to 64 years old and have a smoking history of 30 pack-years or more could save lives at relatively low cost. Cost-be...
JAMA Highlights New Comparative Effectiveness Studies
A recent press briefing moderated by Phil B. Fontanarosa, MD, MBA, Executive Editor, JAMA, presented new findings on comparative effectiveness research, and two of the studies discussed focused on cancer. Dr. Fontanarosa started by defining comparative effectiveness research, which gained prominence...
More New Data Support Use of Daily Aspirin to Prevent Cancers
Caroline McNeil
Three new studies have added data to the growing evidence that low-dose, daily aspirin helps prevent colorectal cancer and other malignancies and may be useful in preventing metastases as well.1-3 Coming on the heels of other recent studies, the results appear to strengthen the case for using aspiri...
American Lung Association Provides Guidance on Lung Cancer Screening
The American Lung Association has released new interim guidelines to assist physicians, patients, and the public in their discussions about lung cancer screening. Developed by the American Lung Association’s Lung Cancer Screening Committee chaired by Jonathan Samet, MD, MS, from the University of So...
Chemoradiation with Fluorouracil and Mitomycin Reduces Recurrence of Muscle-invasive Bladder Cancer
Matthew Stenger
Radiotherapy is an alternative to surgery in muscle-invasive bladder cancer, particularly in less-fit patients. However, it is associated with high rates of incomplete response or recurrence, with salvage surgery often being required. Although synchronous chemoradiotherapy has improved local control...
Before Accepting a ‘Friend’ Request on Social Media, Carefully Consider the Potential Pitfalls and Perils
To friend or not to friend? That is the question many social networkers ponder daily. Oncologists and other health professionals considering “friend” requests from patients would be wise to first consider the potential pitfalls and perils of accepting such requests, according to an article written b...
Canadian Registry Study of Adjuvant Therapy for NSCLC Shows Increased Use in Elderly Patients and Improved Survival
Matthew Stenger
Cisplatin-based adjuvant therapy is recommended for patients with resected stage II–IIIA non–small cell lung cancer (NSCLC). There have been no trials of adjuvant therapy in elderly patients with NSCLC, who constitute a large part of the NSCLC population. A number of analyses indicate that older pat...
Oral Rivaroxaban Is Noninferior to Standard Anticoagulant Therapy in Acute Pulmonary Embolism
Matthew Stenger
Thromboembolic disease is common in patients with cancer and increases risk of mortality. Recent studies showed that the oral factor Xa inhibitor rivaroxaban (Xarelto) was as effective and safe as standard anticoagulant therapy in treating deep-vein thrombosis, with superior efficacy of rivaroxaban ...
Brachytherapy Associated with Increased Complications Compared to Whole-breast Irradiation following Lumpectomy for Breast Cancer
Among older women with invasive breast cancer and treated with lumpectomy, brachytherapy compared with whole-breast irradiation was associated with a decreased likelihood of long-term breast preservation and an increased likelihood of complications, but no difference in overall survival, according t...
Controlled Study Links ‘Chemobrain’ to Longitudinal Changes in Brain
Caroline McNeil
The phenomenon called “chemobrain”—impaired cognitive functioning following chemotherapy—correlates with longitudinal changes in the brain’s white matter, according a recent study in the Journal of Clinical Oncology.1 Structural changes in the white matter, measured by magnetic resonance diffusion t...
Radiation Oncologists Are Discussing Infertility Risks with Young Patients
The ASCO Post
More than 80% of radiation oncologists discuss the impact of cancer treatments on fertility with their patients of childbearing age. This can lead to improved quality of life for young patients with cancer, according to a study in Practical Radiation Oncology.1 In the past, the clinical focus for y...
Surgeon General Releases New Report on Youth Smoking
The ASCO Post
The fight against tobacco use among young people was accelerated recently by Surgeon General Regina M. Benjamin, MD, MBA, with the release of the Surgeon General’s Report, Preventing Tobacco Use Among Youth and Young Adults. This report details the scope, health consequences, and influences that lea...
Not All KRAS Mutations Are Alike in Non–Small Cell Lung Cancer
Matthew Stenger
Mutations in the KRAS oncogene play a critical role in cancer cell growth and resistance to treatment. In colorectal cancer, the presence of any mutant amino acid substitution in the K-Ras protein predicts a poorer response to targeted therapy. In non–small cell lung cancer (NSCLC), however, there i...
Summary of ASCO Provisional Clinical Opinion on Palliative Care
The ASCO provisional clinical opinion on palliative care recently published1 was based largely on data from seven published randomized controlled trials, including a phase III lung cancer trial by Temel and colleagues, which was the trigger for the new recommendations.2 The trial’s principal outcome...
New Biomarker Predicts Survival in Advanced Prostate Cancer
Alice Goodman
Researchers at Memorial Sloan-Kettering Cancer Center have developed the Bone Scan Index (BSI), which is the first quantitative imaging response biomarker that can assess response to treatment and prognosticates for survival in men with metastatic castration-resistant prostate cancer. Based on Bone...
New Data Guide Treatment for Rare Form of Hodgkin Lymphoma
Matthew Stenger
Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) accounts for approximately 5% of Hodgkin lymphoma cases. It is distinguished from classic Hodgkin lymphoma by a variety of clinical and pathologic features, including expression of B-cell associated antigens such as CD20. Given that the overall...
Report to the Nation Finds Continuing Declines in Cancer Death Rates
The ASCO Post
Death rates from all cancers combined for men, women, and children continued to decline in the United States between 2004 and 2008, according to the Annual Report to the Nation on the Status of Cancer, 1975-2008. Overall cancer incidence rates among men decreased by an average of 0.6% per year betwe...
Adjuvant Therapy for Stage III Colon Cancer: Survival Advantage of Oxaliplatin Reported in Clinical Trials Extends to Diverse Group of Patients
Charlotte Bath
The survival advantage conferred by adding oxaliplatin to adjuvant chemotherapy with fluorouracil (5-FU) in stage III colon cancer, as previously shown in patients in randomized controlled trials, extends to patients in the general population, including older and minority group patients and those wi...
Autologous Transplant vs Consolidation Chemotherapy in Acute Myeloid Leukemia: A Recent European Trial
Matthew Stenger
Investigators in the Dutch-Belgian Hemato-Oncology Cooperative Group and the Swiss Group for Clinical Cancer Research Collaborative Group recently reported in the journal Blood that autologous peripheral blood stem cell transplantation significantly reduced relapse rate compared with intensive conso...
Answer to Secondary Cancers with RAF Inhibitors May Be Concomitant MEK Inhibition
Matthew Stenger
Keratoacanthomas and cutaneous squamous cell carcinomas are frequently observed in patients receiving the RAF inhibitor vemurafenib (Zelboraf) for treatment of BRAF-mutated melanoma. As discussed by Lacouture and colleagues in a recent Journal of Clinical Oncology article, these effects appear to re...
Eating Problems and Pain Prevalent in Survivors of Head/Neck Cancer
The ASCO Post
“Eating problems due to poor oropharyngeal functioning and persistent pain are the most prevalent problems” faced by patients 5 years after being treated for head and neck cancer, according to a study published online by the Archives of Otolaryngology–Head & Neck Surgery.1 More than 50% of 5-yea...
Adding Thalidomide to Chemoradiation Increases Toxicities but Not Survival for Stage III Non–Small Cell Lung Cancer
Adding thalidomide (Thalomid) to the third-generation chemotherapy doublet of paclitaxel and carboplatin and radiation for patients with stage III non–small cell lung cancer (NSCLC) increased toxicities but did not improve survival. These results from the Eastern Cooperative Oncology Group (ECOG) 35...
Similar Morbidity, Higher Costs for Robotic vs Laparoscopic Hysterectomy in Women with Endometrial Cancer
A population-based analysis comparing laparoscopic hysterectomy and robotic hysterectomy for endometrial cancer “found similar morbidity but increased cost compared with laparoscopic hysterectomy,” investigators reported in the Journal of Clinical Oncology.1 After adjusting for patient, surgeon, and...
Epigenetic Therapy Shows Positive Results in Late-stage Lung Cancer
Jo Cavallo
A small phase I/II clinical study from Johns Hopkins University in Baltimore found that epigenetic therapy with a combination of azacitidine (Vidaza) and entinostat (an investigational agent) produced responses in some patients with refractory advanced non–small cell lung cancer. The study results, ...
Cancer Survivors at Greater Risk for Cutaneous Melanoma
Charlotte Bath
Patients with a previously diagnosed cancer have an increased risk of developing cutaneous melanoma, with the highest risk among patients who have had a prior diagnosis of melanoma, according to a report published in the Archives of Dermatology.1 Key Findings Using Surveillance, Epidemiology, and ...
Tyrosine Kinase Inhibitor Therapy Yields Complete Remission in Patients with Metastatic Renal Cell Carcinoma
Matthew Stenger
Targeted therapies have markedly improved outcomes in patients with advanced renal cell carcinoma, with median overall survival of greater than 2 years having been observed with sunitinib (Sutent) treatment. Objective responses, consisting mostly of partial responses, are observed in approximately 8...
Laparoscopic Liver Resections Can Be Safe and Oncologically Efficient
Charlotte Bath
Laparoscopic resection of primary and metastatic liver cancers can be safe and oncologically efficient and reduce postoperative length of stay, a single-center study from the United Kingdom found.1 The investigators cautioned, however, that “adequate patient selection and extensive experience in hep...
Partial Breast Irradiation with Brachytherapy in Early Breast Cancer: Retrospective Analysis Looks at Trends and Guidelines
Charlotte Bath
Accelerated partial breast irradiation using brachytherapy (APBIb) as an alternative to whole-breast irradiation (WBI) after breast-conserving surgery has been rapidly adopted in the United States, but the majority of patients receiving APBIb may not be considered suitable for it. A retrospective a...
Further Individualizing Staging Offers Benefits in Patients with Colon Cancer
Charlotte Bath
Supplementing the American Joint Committee on Cancer (AJCC) TNM classification system with additional information available from tumor registries can assist in personalizing treatment and follow-up care for patients with colon cancer, according to a collaborative study by investigators at Memorial S...
Presurgical Gemcitabine/Cisplatin Improves Survival in Lung Cancer
Charlotte Bath
Preoperative gemcitabine plus cisplatin had a statistically significant impact on outcomes among patients with stage IIB/IIIA non–small-cell lung cancer in a phase III randomized study comparing surgery alone or surgery plus preoperative chemotherapy. The 3-year progression-free survival rates were ...
NCCN Guidelines® for Lung Cancer Screening Now Available
The ASCO Post
The new NCCN Guidelines for Lung Cancer Screening primarily refer to non–small cell lung cancer, the most common type of lung cancer, and recommend helical low-dose computed tomography (LDCT) screening for select patients at high risk for the disease. In addition to outlining the appropriate use of...
Tamoxifen vs Surgery Study Shows Older Patients with Breast Cancer Can Achieve a ‘Personal Cure’
Charlotte Bath
A truly final review—when all the patients in the trial have died and the cause of death is known for each—of a randomized trial comparing tamoxifen to surgery in patients over the age of 70 with operable breast cancer found no differences in the survival rates or deaths attributable to breast cance...
Improved Survival with Concurrent Chemotherapy plus Radiotherapy for Patients with Stage III Non–Small Cell Lung Cancer
Charlotte Bath
Five-year survival was statistically significantly higher for patients with stage III non–small cell lung cancer (NSCLC) who received concurrent rather than sequential cisplatin-based chemotherapy combined with thoracic radiotherapy, according to the phase III Radiation Therapy Oncology Group (RTOG)...
Adjuvant Trastuzumab in Nonanthracycline Regimen Studied
The ASCO Post
One of four large, randomized trials to evaluate adjuvant trastuzumab (Herceptin) in early-stage HER2-positive breast cancer—and the only study to include a nonanthracycline chemotherapy regimen—found that regimen had similar efficacy to anthracycline-containing regimens, but with lower rates of car...
Time to Reconsider Treatment Paradigm for Elderly Patients with Advanced Non–Small Cell Lung Cancer?
Charlotte Bath
Significantly longer median overall survival among elderly patients with advanced non–small cell lung cancer (NSCLC) receiving doublet chemotherapy rather than monotherapy yielded a 36% reduction in mortality risk in a phase III randomized trial. “We saw a survival benefit with doublet chemotherapy ...
BRCA Mutation Has Little Effect on Outcome with Neoadjuvant Therapy
The ASCO Post
A retrospective analysis to determine the efficacy of neoadjuvant systemic therapy for breast cancer patients with and without BRCA mutations found the overall prognosis was similar in both groups of patients. “No significant differences were noted in survival outcomes with respect to BRCA status an...
New ASCO Focused Update Recommendation on Maintenance Treatment of Stage IV Non–Small Cell Lung Cancer
Matthew Stenger
A focused update to the 2009 ASCO Clinical Practice Guideline Update on Chemotherapy for Stage IV Non-Small-Cell Lung Cancer reflects new evidence on maintenance therapy in patients with response or stable disease after four cycles of first-line cytotoxic chemotherapy.1 The 2009 update recommendatio...
Short-term Androgen Deprivation plus Radiotherapy Improves Outcomes in Intermediate-risk Prostate Cancer
Alice Goodman
The addition of short-term androgen-deprivation therapy to external-beam radiation therapy improved overall and disease-specific survival in men with nonbulky localized prostate cancer and prostate-specific antigen (PSA) levels up to 20 ng/mL, as reported recently in The New England Journal of Medic...
Tissue of Origin Test Evaluated in Patients with Cancer of Unknown Primary
The ASCO Post
According to results of a study published in the Journal of Molecular Biomarkers and Diagnosis,1 the recently developed Tissue of Origin Test (Pathwork Diagnostics, Inc) aids in the diagnosis of challenging cancer cases such as those that are metastatic or that have a complex clinical history, parti...
Long-term Data Show Benefit of Degarelix Beyond 3 Years in Advanced Hormone-dependent Prostate Cancer
The ASCO Post
Degarelix (Firmagon) is effective and well tolerated beyond 3 years in patients with advanced prostate cancer, according to a recent study published in The Journal of Urology.1 The new study (CS21A) extends the conclusions of the pivotal phase III study (CS21) in which the risk of prostate-specific ...
Genomic Researchers Identify Weak Points in Breast Cancer Cells
Caroline Helwick
A large-scale project in genetic profiling has identified weak points in breast tumor cells that not only represent potentially new “druggable” targets but could lead to an entirely new classification of all cancers. The findings were recently reported in Cancer Discovery, a journal of the American ...
Circulating Tumor Cell Assay Shows Potential for Predicting Prognosis in Head and Neck Carcinoma
Matthew Stenger
According to the NCI, an estimated 49,260 new cases of oral cavity, pharyngeal, and laryngeal cancers occurred in the United States in 2010, and approximately 11,480 deaths were attributed to these cases. It is estimated that 95% or more of these cases are squamous cell carcinomas. Currently, the pr...
Experts Address Cancer-related Distress—the ‘Sixth Vital Sign’
The ASCO Post
More research is needed to investigate the effects of screening and treatment for distress in cancer care, according to a recent issue of the international journal Psycho‑Oncology. This special edition of the journal includes a review of screening for distress and depression over 40 years in cancer ...
At 5 Years, Brachytherapy Shows Quality-of-life Advantages over Radical Prostatectomy for Favorable-risk Prostate Cancer
Charlotte Bath
Five years after treatment for favorable-risk prostate cancer, men who either chose or were randomly assigned to receive brachytherapy reported quality-of-life advantages in urinary and sexual domains and in patient satisfaction compared to men who received radical prostatectomy, according to a stud...
‘Unrealistic Optimism’ Poses Ethical Challenges, May Affect Informed Consent Process
Jo Cavallo
Does a patient’s optimistic expectation of reaping a health benefit from participating in phase I and phase II oncology studies, even when he understands that these early trials are not designed to provide direct therapeutic benefit, compromise the informed consent process? And, does that optimistic...
Combined Therapy Produces Good Outcomes in Primary Testicular Diffuse Large B-cell Lymphoma
Charlotte Bath
Final results of an international phase II trial of first-line treatment for primary testicular diffuse large B-cell lymphoma show that using a combined treatment strategy including chemotherapy and central nervous system and testicular prophlaxis “was associated with a good outcome.” The results we...
Studies Explore Potential Benefits of Sunitinib before Nephrectomy in Metastatic Clear Cell Renal Cancer
Matthew Stenger
The multitargeted tyrosine kinase inhibitor sunitinib (Sutent) is established as first-line therapy in metastatic clear cell renal cancer. Data supporting use of cytoreductive nephrectomy in metastatic clear cell renal cancer come from the pre–targeted therapy era, when less-effective immune therapy...
Is Subspecialization an Option or a Necessity in Community Practices?
Charlotte Bath
Should oncologists in community practices subspecialize? What would that mean for them and for their patients? These are some of the issues tackled in a Journal of Oncology Practice (JOP) Strategies for Career Success article entitled “Subspecialization in Community Oncology: Option or Necessity?” ...
Vanderbilt Oncologists Partner with Cardiologists to Research Chemotherapy-related Cardiac Toxicity
Caroline Helwick
Cardiac toxicity related to chemotherapy is not a new topic but it is an increasingly important one, as concerns are no longer limited to the anthracyclines. Targeted agents unfortunately “target” the cardiovascular system as well, especially bevacizumab (Avastin), trastuzumab (Herceptin) when given...
Understanding Crizotinib, 1 Year after High-profile Presentation
Matthew Stenger
The findings from a phase I study of crizotinib in non–small cell lung cancer (NSCLC) were presented in a Plenary Session at the 2010 ASCO Annual Meeting—an unusual event, since such early-phase data are not generally the topic of plenary sessions. The study showed that a majority of mostly pretreat...
‘Paradoxical’ Result Tying Estrogen to Reduced Risk of Breast Cancer Is Consistent with Laboratory Data
Charlotte Bath
Results from the Women’s Health Initiative1 showing a decreased incidence of breast cancer among postmenopausal hysterectomized women who took estrogen replacement therapy (ERT) may seem paradoxical, but “comply exactly” with laboratory research, according to V. Craig Jordan, OBE, PhD, DSc, Scientif...
Robert A. Figlin, MD, on RCC: Results From the ADAPT Trial
Wells A. Messersmith, MD, on Managing Metastatic Colorectal Cancer: NCCN Guidelines Update
Heinz-Josef Lenz, MD, on Pancreatic Cancer Tumor Profiling and Treatment Response: Results From the COMPASS Trial
Elizabeth A. Mittendorf, MD, PhD, on Breast Cancer Immunotherapy: Building on Recent Successes
Rana R. McKay, MD, on Renal Cell Carcinoma: Results From a Trial on Atezolizumab and Bevacizumab
