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multiple myeloma

Treating Earlier to Avoid Progression to Multiple Myeloma 

With an expanded list of drugs to treat multiple myeloma, experts are interested in whether treating precursor diseases to multiple myeloma can prevent progression to full-blown myeloma. In addition, new drugs are entering the armamentarium for treating multiple myeloma, noted Ruben Niesvizky, MD,...

neuroendocrine tumors

Extended-Release Lanreotide Significantly Delays Disease Progression in Patients With Neuroendocrine Tumors in Large Phase III CLARINET Trial

A strong antiproliferative response was shown for the somatostatin analog lanreotide (subcutaneous, extended-release formulation, Somatuline Autogel [Somatuline Depot in the United States]) in patients with gastroenteropancreatic neuroendocrine tumors, in the large multinational prospective phase...

breast cancer

Radiotherapy Benefit in Young Women With Node-Positive Breast Cancer May Vary by Intrinsic Subtypes

Radiation therapy appears to significantly decrease local recurrence in premenopausal women with node-positive and luminal A tumors, based on an analysis of two small but independent randomized series reported at the 2013 European Cancer Congress in Amsterdam.1 “Though not definitive, our study...

lymphoma

Autologous Transplantation as Consolidation Improves Progression-Free Survival in Aggressive Non-Hodgkin Lymphoma

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...

issues in oncology

Consent Is Informed and Shared, But Is It Compassionate?

A 72-year-old, obese male patient and a poor operative candidate is diagnosed with esophageal carcinoma. He has multiple comorbidities and a past history of colon carcinoma. His staging workup, which included a colonoscopy, revealed recurrent colon carcinoma. Thus, we have a patient who we...

SIDEBAR: Shared Decisions: What Should We Expect?

There is growing interest by patients, policymakers, and clinicians in shared decision-making as a means to include patients in health decisions and translate patient evidence into clinical practice. Conceptually, sharing of information seems like a natural interplay between doctors and their...

Expert Point of View: Howard Hochster, MD

Addressing a presentation by Scott Kopetz, MD, PhD, at the 2013 Chemotherapy Foundation, Howard Hochster, MD, Yale University Cancer Center, New Haven, Connecticut, said he agrees with Dr. Kopetz about the need for expanded RAS testing. “Now we have two studies suggesting that tumors with all the...

Janet L. Rowley, MD, Matriarch of Modern Cancer Genetics, Dies at Age 88

Dr. Janet L. Rowley’s groundbreaking research in the translocation of genetic material bucked scientific convention and heralded a new understanding that cancer is indeed a genetic disease. Her research was largely responsible for the discoveries that led to the development of the targeted cancer...

breast cancer
supportive care

No Significant Improvement With Decongestive Therapy vs More Conservative Approach to Treating Arm Lymphedema 

Daily manual lymphatic drainage and bandaging followed by compression garments did not result in significant improvement in lymphedema compared to a more conservative approach with compression garments only, according to a study evaluating 95 women previously treated for breast cancer with...

With the Goal of Curing Cancer, Ezra M. Greenspan, MD, Helped Usher in the Modern Era of Chemotherapy

Two events in Ezra M. Greenspan’s early adult life convinced him to pursue a career in medicine: the death of a college friend from pneumonia when the two were students at Cornell University College of Arts and Sciences and his own bout with the disease soon after. Saved by a local physician who...

survivorship

Making Progress in Survivorship Care Planning

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 ...

Science Magazine Names Cancer Immunotherapy as Scientific Breakthrough of the Year

While acknowledging that the full potential of cancer immunotherapy remains unclear, the editors of the journal Science said that the approach of using the immune system to attack tumors marks a turning point in the treatment of cancer.1 The successes of cancer immunotherapy in clinical trials in...

palliative care

Assessing Patients for Palliative Care

In 2012, ASCO issued a provisional clinical opinion addressing the integration of palliative care services into standard oncology practice at the time a patient is diagnosed with metastatic or advanced cancer and for patients with uncontrolled symptoms.1 However, despite ASCO’s provisional clinical ...

Bill & Melinda Gates Foundation Names Susan Desmond-Hellman New CEO

The Bill & Melinda Gates Foundation has selected Susan Desmond-­Hellmann, MD, MPH, as its next Chief Executive Officer. Currently the Chancellor of the University of California, San Francisco (UCSF), Dr. Desmond-Hellmann will assume her role on May 1, 2014. “We chose Sue because of her...

lung cancer

Activation of Innovative Lung Cancer Master Protocol Officially Announced, Enrollment to Begin in March

At a recent meeting in Washington, DC, Friends of Cancer Research and the Engelberg Center for Health Care Reform at the Brookings Institution officially announced activation of the Lung Cancer Master Protocol, a new research strategy that has the potential to hurdle or bypass known clinical trial...

supportive care

Diagnosing and Treating Chronic Mucocutaneous Graft-vs-Host Disease

Chronic graft-vs-host disease is a major cause of late, nonrelapse death following allogeneic hematopoietic stem cell transplantation. In addition, chronic graft-vs-host disease results in significant functional impairment and decreased quality of life for long-term survivors of stem cell...

ASCO Announces Election Results for Terms Beginning June 2014

In addition to the election of Julie M. Vose, MD, MBA, FASCO, as President of the American Society of Clinical Oncology (ASCO) for a 1-year term beginning in June 2015 (see page 85), ASCO has announced four new members who were recently elected to the ASCO Board of Directors and two new members...

lung cancer

Adjuvant Gefitinib in Patients With NSCLC: Bad Idea or Wrong Patient Selection?

Despite optimal surgical resection and adjuvant chemotherapy with cisplatin-based doublets, the 5-year overall survival for patients with early-stage non–small cell lung cancer (NSCLC) remains suboptimal. In the International Association for the Study of Lung Cancer (IASLC) staging project, the...

multiple myeloma

Meta-Analysis Upholds Benefit in Progression-Free Survival, but Not Overall Survival, With Lenalidomide Maintenance

Multiple myeloma patients derived a benefit from maintenance lenalidomide (Revlimid) treatment in terms of progression-free but not overall survival, according to a meta-analysis of four key trials presented at the 2013 American Society of Hematology (ASH) Annual Meeting.1 The study does little to...

issues in oncology

Overcoming Drug Development Challenges in the New Era of Cancer Care

While the last 15 years have brought unprecedented advances in oncology drug development, the next 10 years promise to usher in even greater opportunities to realize the goal of precision medicine in the treatment of cancer, providing patients with more effective care and better outcomes. Reaching...

thyroid cancer

Sorafenib in Differentiated Thyroid Carcinoma

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. New Indication On November 22, 2013, sorafenib (Nexavar) was...

Julie M. Vose, MD, MBA, FASCO, Elected ASCO President for 2015–2016 Term

Julie M. Vose, MD, MBA, FASCO, has been elected President of ASCO for a 1-year term beginning in June 2015. She will take office as President-Elect during the ASCO Annual Meeting in Chicago in June 2014. “ASCO is a very diverse and multifaceted organization with so much to offer its membership. The ...

breast cancer

Targeted Intraoperative Radiotherapy Plus Lumpectomy Noninferior to External-Beam Radiotherapy in Preventing Breast Cancer Recurrence

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...

lung cancer

Molecularly Targeted Therapy for Lung Cancer

INSIDE THE BLACK BOX is an occasional column offering insight into the FDA and its policies and procedures. This installment addresses a changing paradigm in the treatment of lung cancer, exemplified by concurrent approval of a companion diagnostic with each of several new targeted agents or new...

multiple myeloma

Surprising Findings for Lenalidomide Maintenance in Updated IFM 2005-02 Analysis 

A new analysis of the multiple myeloma Intergroupe Francophone du Myelome (IFM) 2005-02 trial showed that lenalidomide (Revlimid) maintenance prolongs progression-free survival after stem cell transplantation, but does not improve overall survival.1 This is possibly attributed to the shorter...

colorectal cancer

Overall Survival Improved by Adding Panitumumab to FOLFOX4 but Only in Metastatic Colorectal Cancer Without RAS Mutation

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 ...

colorectal cancer

Study Explores Protective Effect of Aspirin Against Colorectal Cancer

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...

breast cancer

HER2-Positive Breast Cancer Patients With Small Tumors Benefit From Low-Toxicity Regimen 

There may be a benefit for treating small HER2-positive tumors—a breast cancer subset for whom treatment recommendations have not been established but for whom there is still risk of recurrence—and this can be done with little toxicity, according to a multicenter study presented at the 2013 San...

breast cancer

Seven Studies at SABCS Make Dr. Jame Abraham's List of 'Practice-Changing' Talks

From December 10 to 14, the American Association for Cancer Research, the Cancer Therapy & Research Center at The University of Texas Health Sciences Center at San Antonio, and Baylor College of Medicine once again hosted the San Antonio Breast Cancer Symposium (SABCS), presenting...

skin cancer

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...

geriatric oncology

Addressing the Challenges of an Aging Population

We have an aging population, which is a good thing since people are living longer. [But] cancer is a disease that tends to occur most frequently in older people, so the combination of those two events will lead to many more older people with cancer, a larger cancer population in general, and a...

geriatric oncology

Evaluating and Screening Geriatric Patients for Treatment

One of the key questions in geriatric oncology is: How can we use all of the work geriatricians have done over the years in general geriatrics and apply that to the field of oncology? One-quarter to one-third of us are going to develop cancer throughout our lifetime, and half of the time it is...

breast cancer

Who Opts for Chemoprevention? 

Based on age and risk, an estimated 10 million women in the United States may be eligible for an agent aimed at preventing breast cancer, but chemoprevention is underutilized. Fewer than 5% of women at high risk who are offered tamoxifen for chemoprevention agree to take the drug, partly due to...

breast cancer

Anastrozole Halves Risk of First Breast Cancer in High-Risk Postmenopausal Women 

Five years of treatment with anastrozole reduced the risk of breast cancer by 53% in postmenopausal women at high risk for developing the disease, according to an analysis of the International Breast Cancer Intervention Study (IBIS)-II trial. Anastrozole reduced the risk of estrogen...

leukemia
lymphoma

Mounting Success in Trials of Genetically Engineered T Cells to Treat Leukemias and Lymphomas

Reports have been trickling in from centers conducting research on the use of chimeric antigen receptor–modified T cells (CAR-T) in hematologic cancer, and the news is encouraging. When directed against CD19, such personalized therapeutic T cells are known as CTL019, and small pilot trials of this...

breast cancer

Adjuvant Bisphosphonates in Early Breast Cancer: Practice-Changing Findings?

Adjuvant use of bisphosphonates reduced the risk of bone recurrence by 34% and the risk of breast cancer death by 17% in postmenopausal women with early breast cancer in a large meta-analysis conducted by the Early Breast Cancer Trialists’ Collaborative Group (EBCTCG). The potentially...

multiple myeloma

Continuous Lenalidomide/Low-Dose Dexamethasone: A New Option for Older Patients With Newly Diagnosed Myeloma 

First-line treatment of newly diagnosed multiple myeloma using the Rd regimen (continuous lenalidomide [Revlimid] plus low-dose dexamethasone) was superior to standard triplet treatment with MPT (melphalan, prednisone, and thalidomide [Thalomid]) for 72 weeks, according to initial results of the...

leukemia

Leukemia Pioneer John M. Goldman, DM, Dies at 75

“He gave his honours to the world again,his blessed part to heaven, and slept in peace.” —William Shakespeare, Henry VIII In 1971, John M. Goldman, DM, FRCP, FRCPath, FMedSci, began research in chronic myeloid leukemia (CML), a uniformly fatal disease at the time. Over the ensuing decades, Dr....

breast cancer

Final Overall Survival Data Show Better Results With Higher Dose of Fulvestrant

Among patients with locally advanced or metastatic estrogen receptor–positive breast cancer, fulvestrant (Faslodex) given at 500 mg “is associated with a 19% reduction in risk of death and a 4.1-month difference in median overall survival compared with fulvestrant 250 mg,” according to final...

Grant to Develop Website and Mobile App to Track Radiation Therapy Toxicity Awarded to Radiation Oncology Resident

The Radiation Oncology Institute has selected Malolan S. Rajagopalan, MD, a radiation oncology resident at the University of Pittsburgh Cancer Institute, to receive a $20,000 grant for a project to compile best practices regarding the management of radiation therapy toxicity. Dr. Rajagopalan’s...

Major Cancer Milestones in History, From ASCO’s CancerProgress.Net

To help tell the story of progress against cancer, ASCO launched CancerProgress.Net in 2011. The site is intended as a resource for media, policymakers, oncologists, advocates, and the public. One central feature of the site is an interactive timeline of major milestones in cancer treatment,...

global cancer care

Reports From the IPOS/AORTIC Travel Scholars

Eight individuals were awarded travel scholarships allowing them to attend the IPOS/AORTIC Program (International Psycho-Oncology Society/African Organization for Research and Training in Cancer) and share their experiences and efforts toward improving the psychosocial care of patients with cancer...

leukemia
lymphoma

Expanded Options for Age and Donor Sources for Transplant

Although many oncologists consider matched sibling donors as the best source of grafts for hematopoietic cell transplantation, two separate studies presented at the recent American Society of Hematology Annual Meeting support the use of alternative donor grafts for patients with lymphoma and acute...

global cancer care

Conquer Cancer Foundation Funds Research in Low- and Middle-Income Countries for the First Time

The Conquer Cancer Foundation of the American Society of Clinical Oncology has announced the four recipients of the inaugural 2014 International Innovation Grant, which is a new program that underscores the Foundation’s continued commitment to improving the care of patients worldwide. The 1-year...

breast cancer

Common Mutations May Impact Neoadjuvant Treatment Outcomes in Breast Cancer

Emerging research is suggesting that outcomes from neoadjuvant chemotherapy may be correlated with two genetic mutations that are common in breast cancer—PIK3CA and TP53. Their presence may affect response to treatment, and mutational shift after treatment may affect survival, according to studies...

lymphoma

Lenalidomide/Rituximab Doublet a Potential Front-Line Treatment in Some Lymphomas

The biologic doublet of lenalidomide (Revlimid) plus rituximab (Rituxan) can achieve high response rates and durable remissions in lymphoma, according to a parade of phase II studies presented at the 2013 American Society of Hematology (ASH) Annual Meeting in New Orleans. The immunomodulatory agent ...

issues in oncology

Cancer Genes, Promiscuity, and the National Debt

There is no doubt that this is a halcyon period in oncology. The unraveling of the genome has been tremendously important, and finally has helped us to move treatment selection from an era of rational empiricism to one of refined, molecular prognostication. In the care of breast cancer, the impact...

health-care policy

Major Cancer Advances in 2013 Highlight Importance of Federal Funding

About one-third of the most important clinical advances in cancer last year were made possible at least in part through federal funding, according to ASCO’s annual report on progress in cancer, published in the Journal of Clinical Oncology.1 Significant Declines in Funding The report, “Clinical...

breast cancer

Addition of Carboplatin to Standard Neoadjuvant Chemotherapy in Triple-Negative Breast Cancer Supported by SABCS Studies

The achievement of a pathologic complete response in patients with triple-negative breast cancer was boosted by the addition of carboplatin to a standard neoadjuvant chemotherapy regimen, and by the addition of veliparib, an investigational oral PARP inhibitor, plus carboplatin to a standard...

multiple myeloma

Pomalidomide Plus Low-Dose Dexamethasone: Important New Option in Relapsed/Refractory Multiple Myeloma

Pomalidomide (Pomalyst) plus low-dose dexamethasone significantly improved progression-free survival compared to pomalidomide alone in patients with relapsed and refractory multiple myeloma enrolled in a multicenter, open-label study, the phase II part of the MM-002 trial. The study confirmed the...

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