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FDA Approves EGFR Mutation–Detecting Blood Test for NSCLC

The U.S. Food and Drug Administration (FDA) recently approved the cobas EGFR Mutation Test v2, a blood-based companion diagnostic for the epidermal growth factor receptor (EGFR) inhibitor erlotinib (Tarceva). This is the first FDA-approved, blood-based genetic test that can detect EGFR gene...

Early Lapatinib-Related Rash in Breast Cancer

An analysis of the phase III adjuvant ALTTO trial showed that early rash was associated with better clinical outcome with lapatinib (Tykerb) treatment of HER2-positive breast cancer, as reported by Sonnenblick et al. It had been previously found that early rash was associated with improved...

neuroendocrine tumors

FDA Approves New Diagnostic Imaging Agent to Detect Rare Neuroendocrine Tumors

The U.S. Food and Drug Administration (FDA) has approved Netspot, the first kit for the preparation of Ga-68 dotatate injection, a radioactive diagnostic agent for positron-emission tomography (PET) imaging. This radioactive probe will help locate tumors in adult and pediatric patients with...

Breast Density Legislation: An Opportunity for Better Risk Assessment

Dense breasts are not an automatic indication for additional imaging. Instead, breast density generally provides an opportunity for improved risk assessment, according to Kevin Hughes, MD, of Massachusetts General Hospital, Boston. “More than 20 states have mandated that women be informed of...

The Importance of Listening to Patients

My experience with cancer, or more accurately, cancers, is complicated. In 2002, after returning from a medical mission to Honduras, I noticed a bean-sized lymph node above my left clavicle. As an oncology-certified nurse, I knew not to ignore any unusual nodules that pop up on the body and asked...

Rising

There were once two patients with leukemia. Other than their diagnoses and their ages, these two men had nothing in common. Meet Michael Michael was an artist—a sculptor. He had large, sensitive, blue eyes and a quiet, pensive manner. His acute observational power led him to ponder deep questions...

An Unusual Memoir of Cancer

“A book about the future must be written in advance. Later I won’t have the energy. So I will do it now.” So begins The Iceberg, a memoir set in Britain of a woman, Marion Coutts, whose husband was diagnosed with a brain tumor, which eventually killed him. Unfortunately, cancer memoirs flood the...

University of Maryland Greenebaum Cancer Center Designated as NCI Comprehensive Cancer Center

The University of Maryland Marlene and Stewart Greenebaum Cancer Center has been awarded the National Cancer Institute’s (NCI’s) highest designation as a Comprehensive Cancer Center. The prestigious distinction recognizes the cancer center’s high caliber of scientific leadership and robust programs ...

The Best HCAHPS Score: A Rodeo Invitation

An otherwise healthy, actively working, independent 60-year-old patient came to us with a several months’ history of abdominal pain. He had been seen by other physicians prior to coming to us for a second opinion. Our workup revealed a large cystic lesion emanating from the pancreas but involving ...

issues in oncology

Low-Dose Chemical Exposure and Cancer

According to estimates from the World Health Organization (WHO) and the International Agency for Research on Cancer (IARC), environmental toxic exposures are responsible for between 7% and 19% of human cancers. However, the 2008–2009 President’s Cancer Panel Annual Report estimated that the “true...

hepatobiliary cancer

Clinical Trials Actively Recruiting Patients With Liver Cancer

Pilot Study Title: Pilot Study of Hepatic Arterial Infusion Therapy in Patients With Unresectable or Borderline Resectable Intrahepatic Cholangio­carcinoma Study Type: Interventional/nonrandomized/parallel assignment Study Sponsor and Collaborators: Washington University School of Medicine Purpose: ...

multiple myeloma

SIRIUS Trial Heralds a New Era of Promise in Treating Resistant Myeloma

Multiple myeloma cells uniformly overexpress CD38.1 Daratumumab (Darzalex), a CD38-targeting human IgG1 kappa monoclonal antibody, has been evaluated in a series of phase I/II trials involving patients with relapsed or relapsed and refractory myeloma who have received at least two or more prior...

issues in oncology

American Cancer Society Report Assesses Progress Against Goals Set for Nation 25 Years Ago

A new report assesses how the nation fared against the ambitious goal set by the American Cancer Society (ACS) to reduce cancer death rates by 50% over 25 years ending in 2015. The report finds areas where progress was substantial, and others where it was not. Published by Byers et al,1 the report ...

ASCO 2016: CancerLinQ Extends Its Reach, Announces New Partnerships

ASCO announced that a total of 58 practices in 39 states and the District of Columbia have joined ­CancerLinQ™, ASCO’s big data initiative to rapidly improve the quality of care for people with cancer. ­CancerLinQ is already up and running in a number of practices and drawing on approximately...

kidney cancer

Lenvatinib in Combination With Everolimus in Advanced Renal Cell 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. On May 13, 2016, lenvatinib (Lenvima) was approved for use in...

prostate cancer

Prostate Cancer: Opinions Vary on Gleason Scores and Surgery

Diagnosis and treatment of prostate cancer have been the source of heated debate for decades, most of which has centered on the clinical value of the prostate-specific antigen (PSA) test. In 2012, the U.S Preventive Services Task Force (USPSTF) gave the PSA test a D grade, which discourages many...

ASCO Submits Comments to ONC on Enhanced Oversight of the HIT Certification Program

On Monday, May 2, ASCO submitted comments to the Office of the National Coordinator (ONC) regarding the proposed Enhanced Oversight of the ONC Health Information Technology (HIT) Certification Program rule. The rule would increase ONC oversight of certified health IT, define a process for...

Lung Cancer Alliance Supports Two Young Investigator Awards

The Conquer Cancer Foundation of ASCO (CCF) has received generous support from Lung Cancer Alliance to fund a 2016 and 2017 Young Investigator Award (YIA) in lung cancer. Lung Cancer Alliance has a more than 20-year history of working to save lives and advance research by empowering those living...

breast cancer

PALOMA-3 Trial in HER2-Negative Metastatic Breast Cancer: Challenge of Moving Beyond Estrogen Receptor Positivity

Hormone receptor–positive breast cancer represents the largest therapeutic subgroup of the disease. The development of endocrine therapies has shaped the treatment paradigm for both advanced- and early-stage disease for decades.1 Still, despite their significant impact, advanced breast cancer...

Expert Point of View: Winald Gerritsen, MD, PhD

“This is a really great study with excellent translational research,” said formal discussant Winald Gerritsen, MD, PhD, Professor of Immunotherapy at Radboud University Medical Center, Nijmegen, The Netherlands. “I consider it practice-changing for Merkel cell carcinoma. The company is going for...

skin cancer

Anti–PD-1 Inhibitor Gains Foothold in Merkel Cell Carcinoma

Immunotherapy marches on! One of the latest frontiers for checkpoint inhibitors is the treatment of Merkel cell carcinoma, a rare but aggressive type of cancer. First-line therapy with pembrolizumab (Keytruda)—an anti–PD-1 (programmed cell death protein 1) inhibitor—achieved an objective response...

supportive care

Learning About Fertility Is Important to Young Patients With Cancer

It is more and more common for people to wait until their 30s or 40s to have children. Consequently, many young adults have not completed their desired childbearing when they are diagnosed with cancer. Cancer treatments can impair fertility directly (usually via gonadotoxicity from chemotherapy,...

AACR CEO Margaret Foti, PhD, MD (hc), Honored With Ovarcome Excellence Award

Margaret Foti, PhD, MD (hc), Chief Executive Officer (CEO) of the American Association for Cancer Research (AACR), has received the Ovarcome Excellence 2016 Award in recognition of her accomplishments in the field of cancer research, and her commitment to increasing public awareness about cancer...

cns cancers

Combined-Modality Therapy for Low-Grade Gliomas: Balancing Toxicity, Delivery Logistics, and Survival Benefit

Low-grade gliomas account for 15% of all primary brain tumors and represent a heterogeneous group of glial neoplasms. Although these tumors have been termed low-grade, this is a misnomer, especially for some grade II gliomas, which may exhibit a more aggressive behavior and variable natural...

breast cancer

Ovarian Suppression in Premenopausal Women With Estrogen Receptor–Positive Breast Cancer

Oophorectomy was the first proposed form of endocrine therapy for women with breast cancer. Over 100 years ago, Thomas Nunn reported a relationship between menopause and regression of breast cancer.1 This incited interest in the induction of menopause as an anticancer therapy, and in 1986, a...

lymphoma

Nivolumab in Classical Hodgkin Lymphoma

On May 17, 2016, nivolumab (Opdivo) was granted accelerated approval for treatment of patients with classical Hodgkin lymphoma that has relapsed or progressed after autologous hematopoietic stem cell transplantation and post-transplantation brentuximab vedotin (Adcetris).1,2 Continued approval for ...

bladder cancer

PD-L1 Inhibitor Atezolizumab for Locally Advanced or Metastatic Urothelial 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.On May 18, 2016, the PD-L1 (programmed cell death ligand 1)...

health-care policy

Statement From FDA Commissioner Robert Califf, MD, on the Release of the Final Individual Patient Expanded Access Form

On June 2, 2016, U.S. Food and Drug Administration (FDA) Commissioner Robert Califf, MD, issued the following statement on the release of the final individual patient expanded access form.  “Today, the FDA finalized its efforts to streamline the process used by physicians to request expanded...

Expert Point of View: Michael O. Koch, MD

Session moderator, Michael O. Koch, MD, Professor of Urology and Chairman of the Department of Urology at Indiana University School of Medicine, Indianapolis, described the drug as a “game-changer for metastatic disease.” “The last [development] that was even similar to this was when the MVAC...

leukemia

Seattle Children’s Reports Promising Early Results With Immunotherapy in Relapsed ALL

Seattle Children’s announced that 39 of 42 patients treated in a phase I clinical trial using genetically reprogrammed T cells to treat relapsed or refractory acute lymphoblastic leukemia (ALL) have achieved complete remission, showing no detectable leukemia cells. Phase II of this trial, known as...

prostate cancer

Chemotherapy After Radical Prostatectomy May Benefit African Americans and High-Risk Patients

A new U.S. Department of Veterans Affairs (VA) study suggests that African American men and men with a higher tumor stage may benefit from adjuvant chemotherapy following radical prostatectomy.1 According to prespecified analysis of these two “high–risk” subgroups, patients with ≥ T3b disease had a ...

health-care policy

Moving the Needle on HPV Vaccination

In 2012–2013, members of the President’s Cancer Panel (prescancerpanel.cancer.gov) focused their efforts on accelerating widespread acceptance of and use of approved human papillomavirus (HPV) vaccines to prevent cancer. The topic is important, because HPVs cause most cases of cervical cancer and...

University of Catania Presents Margaret Foti Scholar-in-Training Award to Saverio Candido, PhD

The American Association for Cancer Research (AACR) congratulates Saverio Candido, PhD, on receiving the fourth Margaret Foti Scholar-in-Training Award from the University of Catania in Italy. Dr. Candido is being recognized for his research on biomarkers of bladder cancer development and...

It Started With Twitter: ASBrS Immediate Past-President, Deanna Attai, MD, Spearheads Patient-Centered Care

Breast surgeon Deanna Attai, MD, is a virtual mighty mouse as a spokesperson for her professional organization, the American Society of Breast Surgeons (ASBrS). She is as big on ideas as she is petite in stature and for actively tweeting on medical topics (@DrAttai). Assistant Clinical Professor...

Comparing Treatments by Efficacy, Toxicity, and Cost

Last year, five organizations introduced new methods to compare cancer treatments. For more on ASCO’s Value Framework, see page 120. The NCCN Evidence Blocks™ use a simple graphic to show experts’ ratings of systemic therapies in five areas: efficacy, safety, quality and quantity of evidence,...

issues in oncology

How Will Value Framework Tools Be Used in Everyday Practice?

Value framework tools made a splash in 2015, with five different groups unveiling methods to help physicians and patients compare therapies based on efficacy, toxicity, and/or cost. Now these potential users are beginning to examine and debate the tools, including how and whether they will work in...

pancreatic cancer

Adjuvant Chemotherapy Improves Survival in Pancreatic Cancer

An adjuvant chemotherapy regimen improved overall survival in early-stage pancreatic cancer patients, in the large phase III European ESPAC-4 study reported at the 2016 ASCO Annual Meeting.1 The combination of gemcitabine and capecitabine almost doubled the 5-year survival rate, compared to...

Expert Point of View: Stuart A. Grossman, MD, and Deborah Schrag, MD

Formal discussant of this trial Stuart A. Grossman, MD, of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, commented that the trial did not include a best standard-of-care arm. The pivotal trial defined optimal radiotherapy as 60 Gy over 6 weeks, but this...

cns cancers

Chemoradiotherapy Improves Survival in Patients Over Age 65 With Glioblastoma: A New Standard Option?

The combination of short-course radiotherapy and temozolomide followed by maintenance with temozolomide significantly improved survival compared with short-course radiotherapy alone in newly diagnosed elderly patients with glioblastoma, according to the results of a global cooperative group trial...

Fred Hutchinson Cancer Research Center Hires Steve Stadum as Executive Vice President and Chief Operating Officer

Fred Hutchinson Cancer Research Center has announced the hiring of Steve Stadum as Executive Vice President and Chief Operating Officer. Mr. Stadum, currently the Chief Operating Officer (COO) of the Oregon Health & Science University (OHSU) Knight Cancer Institute, will join Fred Hutchinson as ...

breast cancer
global cancer care

Rising Breast Cancer Incidence in Sub-Saharan Africa: Challenges and Opportunities

The incidence of new cases of breast cancer in low- and middle-income countries, particularly in sub-Saharan ­Africa, is rising, and it will take a concerted effort from the international cancer community to counteract this troubling upward trend. It has been estimated that of the 15 million cancer ...

breast cancer

Additional 5 Years of Letrozole May Benefit Some Postmenopausal Women With Early-Stage Breast Cancer

Five years of aromatase inhibitor as upfront therapy or after tamoxifen is the current standard of care for postmenopausal women with early hormone receptor–positive breast cancer. A new trial suggests that extending aromatase inhibitor therapy with letrozole for an additional 5 years may improve...

multiple myeloma

The ENDEAVOR Trial: A Case Study in the Interpretation of Modern Cancer Trials

It can be easy to miss the forest for the trees in the interpretation of clinical trials. In particular, trials for the treatment of cancer are exceedingly complex, with long lists of inclusion and exclusion criteria, designs with hidden biases, drugs with unpronounceable names (if not cumbersome...

Extending ASCO’s Influence Globally to Improve Patient Care

On June 27, 2016, Clifford A. Hudis, MD, FACP, FASCO, will begin his tenure as Chief Executive Officer of ASCO, succeeding Allen S. Lichter, MD, FASCO, who presided over the Society and the Conquer Cancer Foundation of ASCO since 2006. Dr. Hudis’ dedication to ASCO dates back more than 25 years...

multiple myeloma

Daratumumab Hits the Mark in Early Relapsed Multiple Myeloma

For relapsed or refractory multiple myeloma, daratumumab (Darzalex), combined with bortezomib (Velcade) and dexamethasone, reduced relapses by 61% in the phase III CASTOR study reported at the 2016 ASCO Annual Meeting.1 “The results are unprecedented in a randomized study comparing a novel...

ASCO Announces New Award Honoring Visionary Leader Allen S. Lichter, MD, FASCO

During the 2016 Annual Meeting, ASCO announced the creation of the Allen S. Lichter Visionary Leader Award to recognize ASCO members who have transformed the oncology field or significantly advanced the mission of ASCO, the Conquer Cancer Foundation, or CancerLinQ, LLC, through their leadership,...

issues in oncology
cost of care

Global Economic Crisis May Be Linked to Increased Cancer Mortality

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, Maruthappu et al found that the global economic crisis beginning in 2008 was also associated with a large excess in cancer mortality...

leukemia
cost of care

ASCO 2016: Patients With Cancer With ACA Policies Swiftly Reach Out-of-Pocket Caps

Duke Cancer Institute researchers have found that a hypothetical leukemia patient buying the life-extending drug therapy for his condition would reach his annual out-of-pocket maximum in a month on most of the bronze policies and half of the silver policies offered through the Affordable Care Act...

skin cancer

ASCO 2016: Early Detection, Detection of Smaller Cancers Among Benefits of a Primary Care–Based Skin Cancer Screening Program

Skin cancer screenings performed by primary care physicians during routine office visits improve the detection of potentially deadly melanomas and find them in earlier stages, according to new research from the University of Pittsburgh School of Medicine. The results were presented by Ferris et al...

ASCO 2016: Local Consolidative Therapy Improves Progression-Free Survival in Patients With Oligometastatic NSCLC vs Standard Chemotherapy

Lung cancer patients with oligometastases, defined as three or fewer sites of metastasis, may benefit from aggressive local therapy, surgery, or radiation, after standard chemotherapy, according to research led by The University of Texas MD Anderson Cancer Center. If validated in larger studies,...

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