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colorectal cancer

‘Watch-and-Wait’ Strategy Does Not Compromise Survival in Selected Patients With Rectal Cancer

A “watch-and-wait” approach to treating rectal cancer patients with complete responses to chemoradiotherapy resulted in a 3-year survival rate of 91%, which is similar to historic survival rates after surgical resection, according to an analysis of the International Watch & Wait Database.1 For ...

lung cancer

Clinical Trials Study the Role of Immunotherapy in the First-Line Setting of Non–Small Cell Lung Cancer

In 2016, the KEYNOTE-024 trial set the bar for first-line immunotherapy in non–small cell lung cancer (NSCLC). Trial results showed that pembrolizumab (Keytruda), an antibody to programmed cell death protein 1 (PD-1), reduced the risk of disease progression or death by 50% and the risk of death by...

survivorship
health-care policy

Timing Is Everything

In 1959, my 5-year-old cousin, Kim, was diagnosed with acute lymphocytic leukemia (ALL). As an 8-year-old, I didn’t really understand what was happening to him, except that he had to go to the Riley Hospital for Children in Indianapolis, Indiana, for treatment. The haunting vision of his looking...

lung cancer

Understanding the Role of Immunotherapy for Lung Cancer: A Paradigm Shift for the Better

“Immunotherapy for lung cancer is a paradigm shift. I would never have thought when I started my career taking care of lung cancer patients in the mid 1990s that we’d now be substituting chemotherapy with an antibody immunotherapy in 2017. It’s incredible,” commented Roy S. Herbst, MD, PhD, Chief...

pain management

Combating Untreated Cancer-Related Pain

The problem of pain management facing clinicians today is twofold: how to ensure safe and effective treatment for patients with cancer in chronic pain, while avoiding the overuse of opioid medications and the potential for substance use disorder and diversion. According to the American Cancer...

colorectal cancer

Expert Point of View: Frank Sinicrope, MD

Frank Sinicrope, MD, Professor of Medicine and Oncology at the Mayo Clinic, Rochester, Minnesota, told The ASCO Post that anti–programmed cell death protein 1 (anti–PD-1) agents “have already changed the landscape” of metastatic colorectal cancer. “We are currently treating microsatellite...

colorectal cancer

CheckMate 142 Update: Prolonged Disease Control With Nivolumab in Deficient Mismatch Repair Colorectal Cancer

With 6 additional months of follow-up since the initial presentation of results, in the phase II CheckMate 142 trial, 74% of heavily pretreated patients with metastatic colorectal microsatellite instability–high (MSI-H) cancers are alive after single-agent treatment with nivolumab (Opdivo).1...

hematologic malignancies

Study Finds Mutations in Myelodysplastic Syndrome Linked to Poorer Outcome After Stem Cell Transplantation

In a study reported in The New England Journal of Medicine, Lindsley et al found that a number of mutations present in patients with myelodysplastic syndrome (MDS) were associated with poorer clinical outcome after allogeneic hematopoietic stem cell transplantation (HSCT). Study Details The study ...

skin cancer

Disease Symptoms Are the Most Frequent Indicators of Recurrence in Patients With Stage II Melanoma

Recurrences of early-stage (stage II) melanoma are more often detected by patients and their physicians than by routine imaging tests, according to study results published by Berger et al in the Journal of the American College of Surgeons. “We are most concerned about patients who have stage ...

skin cancer

Intermittent Vismodegib Regimens in Patients With Multiple Basal Cell Carcinomas

In a phase II trial reported in The Lancet Oncology, Dréno et al found that two long-term intermittent vismodegib (Erivedge) dosing regimens provided a similar reduction in the number of clinically significant basal cell carcinomas among patients with multiple lesions. Study Details In the ...

gastroesophageal cancer

Adding Bevacizumab to Perioperative Chemotherapy in Esophagogastric Adenocarcinoma

In the UK Medical Research Council ST03 phase II/III trial reported in The Lancet Oncology, Cunningham et al found that adding bevacizumab (Avastin) to perioperative chemotherapy did not improve survival in patients with operable esophagogastric cancer and may have been associated with impaired...

gynecologic cancers

Comparison of Sentinel Lymph Node Biopsy vs Lymphadenectomy in Endometrial Cancer Staging

In the FIRES prospective cohort study reported in The Lancet Oncology, Rossi et al found that sentinel lymph node mapping was highly accurate in detecting metastases compared with complete lymphadenectomy in women with endometrial cancer. Study Details The study included women with clinical stage ...

colorectal cancer

ASCP/CAP/AMP/ASCO Guideline on Molecular Biomarkers for Evaluation of Colorectal Cancer

As reported in the Journal of Clinical Oncology by Antonia 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 Clinical Pathology...

head and neck cancer

Adding Buparlisib to Paclitaxel in Platinum-Pretreated Squamous Cell Carcinoma of the Head and Neck

In the phase II BERIL-1 trial reported in The Lancet Oncology, Soulières et al found that adding the pan-PI3K (phosphatidylinositol 3-kinase) inhibitor buparlisib to paclitaxel improved outcomes in patients with platinum-pretreated recurrent metastatic squamous cell carcinoma of the head and ...

breast cancer

Zoledronic Acid Every 12 Weeks vs Every 4 Weeks in Women With Breast Cancer and Bone Metastases

In the phase III OPTIMIZE-2 trial reported in JAMA Oncology, Hortobagyi et al found that an every-12-week schedule of zoledronic acid was noninferior to an every-4-week schedule in terms of skeletal-related event rate in women with bone metastases from breast cancer who were currently receiving...

breast cancer

Residual Cancer Burden, Breast Cancer Phenotype, and Long-Term Prognosis After Neoadjuvant Chemotherapy

In a study reported in the Journal of Clinical Oncology, Symmans et al found that residual cancer burden (RCB) after neoadjuvant chemotherapy was significantly prognostic for long-term outcome across breast cancer subtypes. Study Details The study included 5 patient cohorts from The University of ...

lung cancer

Italian Trial Adds Bevacizumab to Cisplatin/Etoposide in Extensive-Disease Small Cell Lung Cancer

In an Italian phase III trial reported in the Journal of Clinical Oncology, Tiseo et al found that adding first-line bevacizumab (Avastin) to cisplatin/etoposide did not prolong overall survival in patients with extensive-disease small cell lung cancer. Study Details In the open-label trial, 204...

leukemia

Adding Idelalisib to Bendamustine/Rituximab in Relapsed or Refractory Chronic Lymphocytic Leukemia

As reported by Zelenetz et al in The Lancet Oncology, an 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 patients with relapsed or refractory chronic lymphocytic...

Justin F. Klamerus, MD, MMM, Appointed President of Karmanos Cancer Hospital

Justin F. Klamerus, MD, MMM, has been appointed President of the Barbara Ann Karmanos Cancer Hospital, the clinical operation of Karmanos Cancer Institute in Detroit. The appointment was effective as of January 2017. Dr. Klamerus will report directly to Gerold Bepler, MD, PhD, President and Chief...

skin cancer

Link Between Alcohol Intake and Increased Risk for Melanoma

Although alcohol consumption is associated with increasing the risk of many cancers, including liver, pancreatic, colon, rectal, and breast, the link between alcohol and higher risk of melanoma is equivocal. Now, a large prospective study by Andrew Rivera, MD, of Harvard Medical School, Boston, and ...

leukemia

Postinduction MRD Predicts Outcome From Transplantation in NPM1-Mutant AML

In an analysis of a French trial reported in the Journal of Clinical Oncology, Balsat et al found that postinduction minimal residual disease was predictive of outcome and benefit from allogeneic stem cell transplantation (ASCT) in patients with NPM1-mutant acute myeloid leukemia (AML). Nicolas...

2017 Oncology Meetings

FEBRUARY ASCO-SITC Clinical Immuno-Oncology SymposiumFebruary 23-25 • Orlando, Florida For more information: http://immunosym.org FACTOR (Funding, Awareness, Collaboration, Trials, Osteosarcoma Research) Miami Conference 2017February 24-25 • Coral Gables, Florida For more information:...

issues in oncology

NCCN Working Group on Value Tools Presents Preliminary Findings and Recommendations

Over the past several years, the introduction of decision-making tools for patients from major cancer organizations, including ASCO and the National Comprehensive Cancer Network® (NCCN®), has been news, applauded as a step toward more patient-centered care and featured at many meetings. Next steps, ...

neuroendocrine tumors

Telotristat Ethyl: A Novel Therapy for Carcinoid Syndrome—Not a Panacea but a Step in the Right Direction

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 disabling...

neuroendocrine tumors

Telotristat Ethyl Reduces Frequency of Bowel Movements in Patients With Metastatic Neuroendocrine Tumors and Carcinoid Syndrome

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 patients with...

lymphoma

Liquid Biopsies Show Promise in Diffuse Large B-Cell Lymphoma

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 poor...

lung cancer

ASCEND-4 Study Shows 45% Reduction in Risk of Disease Progression for NSCLC Patients on First-Line Ceritinib

Compared to chemotherapy, the use of first-line ceritinib (Zykadia) resulted in a statistically significant and clinically meaningful improvement in median progression-free survival, with an estimated 45% reduction in disease progression risk, as well as significant improvements in quality of...

bladder cancer

Nivolumab in Metastatic Urothelial Carcinoma After Platinum Therapy

As reported in The Lancet Oncology by Sharma et al, the phase II CheckMate 275 trial has shown nivolumab (Opdivo) to produce durable responses in patients with metastatic urothelial cancer who had received at least one prior platinum-based regimen. The study supported the recent accelerated...

gynecologic cancers

Intentional Weight Loss in Postmenopausal Women May Be Linked to Reduced Endometrial Cancer Risk

Although many studies have linked obesity with an increased risk for endometrial cancer, information about the influence of weight loss on the cancer in postmenopausal women has been limited. Now, a study by Luo et al evaluating the association of weight change and endometrial cancer risk among...

bladder cancer

FDA Accepts Two sBLAs for Pembrolizumab in Locally Advanced or Metastatic Urothelial Cancer

On February 3, the U.S. Food and Drug Administration (FDA) accepted for review two supplemental Biologics License Applications (sBLAs) for pembrolizumab (Keytruda) in patients with locally advanced or metastatic urothelial cancer. Specifically, the application for first-line use was accepted and...

lung cancer

Increased Risk of Cardiac Events With High Heart Dose in High-Dose Thoracic Radiotherapy

In a single-center pooled analysis reported in the Journal of Clinical Oncology, Wang et al found that a higher dose of radiation to the heart was associated with an increased risk of cardiac events in patients receiving high-dose radiation therapy for stage III non–small cell lung cancer...

breast cancer

Accelerated Partial-Breast vs Whole-Breast Irradiation After Breast-Conserving Surgery

As reported in The Lancet Oncology by Polgár et al, 5-year late side effects and cosmetic results were similar with accelerated partial-breast irradiation (APBI) with interstitial brachytherapy vs whole-breast irradiation (WBI) after breast-conserving surgery for low-risk invasive and in...

prostate cancer

Adding Antiandrogen Therapy to Radiation Therapy in Recurrent Prostate Cancer

As reported in The New England Journal of Medicine by Shipley et al in the NRG Oncology Radiation Therapy Oncology Group (RTOG), the final analysis of the phase III RTOG 9601 trial showed that the addition of antiandrogen therapy with bicalutamide to radiation therapy significantly improves overall ...

lung cancer

Expert Point of View: Michael Boyer, MBBS, PhD

“This drug [durvalumab] clearly shows activity in the third-line and beyond setting, and the higher the programmed cell death ligand 1 (PD-L1) expression, the higher the response rate,” noted Michael Boyer, MBBS, PhD, Chief Clinical Officer and Conjoint Chair of Medical Oncology (Thoracic...

lung cancer

Study Finds Durvalumab of Benefit in Advanced and Metastatic Non–Small Cell Lung Cancer

Durvalumab was active and led to long-lasting response in a cohort of heavily pretreated patients with epidermal growth factor receptor/anaplastic lymphoma kinase (EGFR/ALK) wild-type locally advanced and metastatic non–small cell lung cancer (NSCLC), particularly among patients whose tumors...

myelodysplastic syndromes

Early Success Reported With Two New Agents for High-Risk Myelodysplastic Syndromes

At the 2016 American Society for Hematology (ASH) Annual Meeting & Exposition, researchers reported early success with two new experimental agents for high-risk myelodysplastic syndromes—enasidenib (also known as AG-221), a potent oral inhibitor of the isocitrate dehydrogenase 2 (IDH2) enzyme,...

Selected Abstracts From the 2016 ASH Annual Meeting

Here are several abstracts selected from the proceedings of this year’s American Society of Hematology (ASH) Annual Meeting & Exposition, highlighting newer therapeutics in several different types of non-Hodgkin lymphomas (NHLs), including mantle cell lymphoma and marginal zone lymphoma. For...

lymphoma

Studies Advance the Use of PD-1 Blockade in Classical Hodgkin Lymphoma

Classical Hodgkin lymphoma is one of the malignancies most susceptible to treatment with monoclonal antibodies targeting the programmed cell death protein (PD-1). Nivolumab (Opdivo) has been approved by the U.S. Food and Drug Administration (FDA) for use in patients with relapsed/refractory...

breast cancer

Veliparib Improves Reponse but Not Progression-Free Survival in BRCA-Mutation Carriers

A randomized phase II study in women with metastatic breast cancer who have mutations in BRCA1 or BRCA2 evaluated the addition of the poly (ADP-ribose) polymerase (PARP) inhibitor veliparib to combination chemotherapy. The trial did not meet its primary endpoint.1 Hyo Sook Han, MD, of Moffitt...

skin cancer

ECCO 2017: Pembrolizumab Shows Activity in Mucosal Melanoma in Multiple KEYNOTE Studies

Three clinical trials of the immunotherapy pembrolizumab (Keytruda) have shown that it is active against a rare subtype of skin cancer, mucosal melanoma. The findings were presented by Butler et al at the 2017 European Cancer Congress (ECCO) (Abstract 1142). Until now, mucosal melanoma has often...

breast cancer

Adjuvant Letrozole vs Anastrozole in Hormone Receptor–Positive Node-Positive Early Breast Cancer

As reported in the Journal of Clinical Oncology by Smith et al, the final results of the phase III FACE trial showed no difference in disease-free or overall survival for adjuvant letrozole vs anastrozole in postmenopausal women with hormone receptor–positive node-positive early breast...

bladder cancer

FDA Approves Nivolumab in Locally Advanced or Metastatic Bladder Cancer

On February 2, 2017, the U.S. Food and Drug Administration (FDA) granted accelerated approval to nivolumab (Opdivo) for the treatment of patients with locally advanced or metastatic urothelial carcinoma who have disease progression during or following platinum-containing chemotherapy or have...

breast cancer

Tumor-Infiltrating Lymphocytes Prognostic in the Metastatic and Neoadjuvant Breast Cancer Settings

Studies presented at the 2016 San Antonio Breast Cancer Symposium added to growing evidence that tumor-infiltrating lymphocytes are important prognostic factors in breast cancer. One investigation evaluated their impact in advanced HER2-positive breast cancer, finding a linear relationship between...

gastrointestinal cancer

Nivolumab, as Salvage, Improves Overall Survival in Gastric Cancer

Gastric cancer can apparently be added to the growing list of malignancies for which drugs targeting the programmed cell death protein 1 (PD‑1) receptor are effective, according to the results of the phase III ONO-4538 investigation conducted in Asia and presented at the 2017 Gastrointestinal...

cost of care

The Cost of a Patient’s Last Ride

It was a call from a referring physician who wanted the patient to be transferred to our major academic center. The patient had a history of a lethal malignancy in a very advanced stage. The patient was already outside the bell curve, for she had survived far longer than expected for a malignancy...

colorectal cancer

Dual Inhibition Proves Effective for BRAF-Mutated Colorectal Tumors

In patients with metastatic colorectal cancer who have mutations in BRAF V600, the addition of the BRAF inhibitor vemurafenib (Zelboraf) to cetuximab ­(Erbitux) and irinotecan significantly improved progression-free survival, results of the phase II Southwest Oncology Group (SWOG) 1406 trial have...

skin cancer

ECCO 2017: Melanoma Death Rates Will Fall by 2050, but Number of Deaths Will Increase

By 2050, the death rates from malignant melanoma will have decreased from their current levels, but the numbers of people dying from the disease will have increased due to the aging of populations. However, if new treatments for the deadly skin cancer prove to be effective, the numbers of deaths...

gastroesophageal cancer

ECCO 2017: Breath Test Might Help Detect Stomach and Esophageal Cancers

A test that measures the levels of five chemicals in the breath has shown promising results for the detection of cancers of the esophagus and stomach in a large patient trial presented by Markar et al at the 2017 European Cancer Congress (Abstract 6LBA). Together, stomach and esophageal...

kidney cancer

Intermittent Sunitinib Appears Feasible in Previously Untreated Metastatic Renal Cell Carcinoma

In a phase II study reported in the Journal of Clinical Oncology, Ornstein et al found that an intermittent schedule of sunitinib (Sutent) may be feasible in patients with previously untreated metastatic renal cell carcinoma. Study Details In the study, 37 patients with clear cell metastatic...

lung cancer

Phase III Trial Finds First-Line Ceritinib Improves PFS vs Platinum-Based Chemotherapy in ALK-Rearranged NSCLC

In a phase III trial (ASCEND-4) reported in The Lancet, Soria et al found that ceritinib (Zykadia) improved progression-free survival vs platinum-based chemotherapy in first-line treatment of advanced ALK-rearranged non–small cell lung cancer (NSCLC). Ceritinib is a next-generation selective...

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