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breast cancer

Single-agent Lapatinib Arm Discontinued in ALTTO

The Adjuvant Lapatinib and/or Trastuzumab Treatment Optimization (ALTTO) study, which is evaluating various anti-HER2 therapy approaches in breast cancer, has discontinued the single-agent lapatinib (Tykerb) arm, according to study sponsor GlaxoSmithKline. Following a preplanned interim analysis...

JOP Content Now Available Online before Print

Journal of Oncology Practice (JOP) recently began publishing the majority of its articles online ahead of print. This exciting initiative benefits both JOP’s authors and readers by making practice-changing content readily available online in a timely manner. With the launch of the...

Give Your Patients the Latest GI Research News

On January 19, direct your patients to www.cancer.net/gisymposium, where they can get up-to-the-minute research highlights from the 3-day 2012 Gastrointestinal Cancers Symposium. Also, your patients can listen to a podcast of the symposium highlights online or download it free of charge at...

Renewing Our Commitment to Conquering Cancer

Congress passed a resolution in December recognizing the 40th anniversary of the National Cancer Act of 1971 and the more than 12 million cancer survivors who are alive as a result of the nation’s commitment to cancer research and advances in cancer prevention, detection, diagnosis, and treatment....

Joining ASCO’s ACT Network Offers Variety of Advocacy Opportunities

Are you looking for ways to discuss the issues that impact the oncology community with members of Congress? Doing so is easier than you think. ASCO’s ACT Network provides many different opportunities to contact your policymakers, including the ability to draft your own message to your member of...

ASCO Launches FASCO Designation

ASCO has announced the designation of Fellow of the American Society of Clinical Oncology, otherwise known as FASCO. Formerly called the ASCO Statesman Award and launched in 2007, the distinction is designed to honor ASCO’s most active volunteer members. “The FASCO status represents recognition for ...

integrative oncology

Acupuncture Continues to Secure Position within Integrative Oncology

More than 14 years after an NIH Consensus Panel finding of “efficacy of acupuncture in adult postoperative and chemotherapy nausea and vomiting,” an informal show-of-hands poll at the Eighth International Society for Integrative Oncology (SIO) Conference indicated acupuncture was not yet fully...

integrative oncology

NIH Director Calls for Rigorous Evaluation of Integrative Medicine to Provide Evidence of Efficacy

“Many new frontiers exist in integrative medicine,” NIH Director Francis Collins, MD, PhD, stated in his keynote address at the Eighth International Conference of the Society for Integrative Oncology (SIO) in Cleveland. “The evidence is overwhelming that these approaches are being used by many...

integrative oncology

‘New Science, New Solutions’ Explored at Society for Integrative Oncology Conference

“Innovating Integrative Oncology: New Science, New Solutions” was the title of the Society for Integrative Oncology (SIO) Eighth International Conference. Topics ranged from molecular biology to mitigation of treatment toxicity to mind-body medicine. A total of 505 people attended the conference,...

breast cancer
symptom management

Estrogen for Vulvovaginal Atrophy in Breast Cancer: Debate Continues

Vulvovaginal atrophy is a concern for the majority of patients with breast cancer, not only because of its physical and psychosexual consequences, but because the optimal treatment—estrogen replacement—is controversial. Patients and physicians alike remain concerned that external estradiol may...

Expert Point of View: Sipuleucel-T Should Be Used Early in Metastatic Castrate-resistant Prostate Cancer, before Chemotherapy

“The main message [from Dr. Hall’s presentation at the 2011 Chemotherapy Foundation Symposium] is that we need to think about using sipuleucel-T early in men with prostate cancer who are asymptomatic but are castration-resistant and metastatic. “If there is going to be a benefit [of the vaccine],...

prostate cancer

Sipuleucel-T Should Be Used Early in Metastatic Castrate-resistant Prostate Cancer, before Chemotherapy

When sipuleucel-T (Provenge) was approved by FDA in April 2010, it was the first vaccine to be approved as a treatment for prostate cancer and was hailed as a major advance. Although sipuleucel-T is now reimbursable by Medicare, some physicians are not clear about when to use it, and patients who...

prostate cancer

Data on Watchful Waiting for Low-risk Prostate Cancer May Swing Focus to Higher-risk Tumors and Quality of Life

Surgery did not increase survival rates compared to watchful waiting in men with clinically localized prostate cancer. Results were particularly strong for men with prostate-specific antigen (PSA) levels of 10 ng/dL and under, and those who have low-risk disease, according to data from the Prostate ...

prostate cancer

NIH Panel Endorses Active Surveillance in Low-risk Prostate Cancer

Active surveillance of localized prostate cancer is a viable management option that should be offered to low-risk patients in place of immediate treatment, said a panel of experts convened by the National Institutes of Health. A fairly new concept, active surveillance takes a more proactive...

kidney cancer

ODAC Backs Axitinib for Kidney Cancer

The FDA’s Oncologic Drugs Advisory Committee voted 13-0 that Pfizer’s drug axitinib (Inlyta) had a favorable benefit-risk profile for patients with advanced renal cell carcinoma after initial treatment has failed. The FDA is due to make a final decision in the first half of 2012. Panelists said the ...

colorectal cancer

Further Individualizing Staging Offers Benefits in Patients with Colon Cancer

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...

solid tumors

Resection of Metastatic Lesions Extends Survival in Multiple Tumor Types

Surgical oncologists urged other cancer providers to appreciate the potentially curative role that surgery can play in the management of many stage IV solid tumors, in a session during the American College of Surgeons 97th Annual Clinical Congress in San Francisco. Pulmonary Metastases Stephen G....

skin cancer

Sentinel Lymph Node Biopsy for Thin Melanomas?

When sentinel lymph node biopsy for the regional staging of melanoma was first introduced, it was recommended for any patient with a melanoma 1.0 mm in Breslow thickness or greater. Patients with thin melanomas were not thought to have a sufficiently high risk to warrant the additional cost and...

SIDEBAR: Bevacizumab in Breast Cancer: Additional Perspective

A recent poll by MDoutlook1 concluded that payer coverage would have a significant role in bevacizumab’s use in metastatic breast cancer. Usage of the drug could be cut by two-thirds in the United States and by one-third outside the United States. The NCCN has kept its recommendation of bevacizumab ...

breast cancer

Bevacizumab Breast Cancer Indication Rescinded: What Are the Downstream Implications?

Leading up to FDA’s resolution to revoke the breast cancer indication for bevacizumab (Avastin), the debate over the drug’s clinical value was imbued with contentious ideologic overtones, which culminated in a 2-day public hearing that exposed deep divisions not only in the scientific community,...

lymphoma

Favorable Early-stage Hodgkin Lymphoma and HD.6: The Take-Home and Don’t–Take-Home Messages

The Canadian HD.6 randomized study in patients with nonbulky early-stage Hodgkin lymphoma is mostly of historic interest.1,2 It has little relevance to current treatment standards or questions, and the risk for its inappropriate interpretation is of great concern. Radical Radiation Approach Long...

lymphoma

Expert Point of View: Improved Survival with Chemotherapy Alone in Limited-stage Hodgkin Lymphoma

A criticism of the HD.6 trial is that current radiation techniques are probably less toxic than subtotal nodal radiation therapy, which was used in this investigation. Responding to this in an accompanying editorial in The New England Journal of Medicine,1 David J. Straus, MD, of the lymphoma...

thyroid cancer

Vandetanib Demonstrates Therapeutic Efficacy in Patients with Advanced Medullary Thyroid Cancer

A phase III trial among patients with locally advanced or metastatic medullary thyroid cancer met its primary objective of progression-free survival prolongation among patients receiving vandetanib compared to placebo. The secondary efficacy endpoints of objective response rate, disease control...

supportive care

Depression Is Dangerous among Patients with Cancer, but Talking and Pharmacologic Treatments Can Be Effective

In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. “Depression is a very dangerous...

issues in oncology

Oncologists Examine Promise vs Reality of Personalized Medicine

Personalized medicine: It’s a phrase that reverberates across all cancer meetings. “Matching the right drug to the right patient” will be accomplished, in the not too distant future, through genomic sequencing of the tumor and targeted, less toxic therapy. This much has been established—or has it?...

hematologic malignancies

JAK2 and MPL Mutation Screening: What Are the Indications and How to Interpret the Results

The World Health Organization system organizes myeloid malignancies into five major categories, which are subsequently further subclassified using a combination of bone marrow morphology and cytogenetic/molecular information (Table 1).1 JAK2 and MPL mutations are not disease-specific and occur...

breast cancer

Partial Breast Irradiation with Brachytherapy in Early Breast Cancer: Retrospective Analysis Looks at Trends and Guidelines

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...

breast cancer

Surgical Oncology: Advances and Challenges in Breast Cancer Surgery

Mortality rates for breast cancer have declined steadily in the United States since 1990, resulting in an improvement in survival. Multiple factors have contributed to this positive trend, one of which is the combination of earlier detection and more sophisticated surgical techniques. The ASCO Post ...

prostate cancer

Abiraterone: New Drug in the Treatment of Metastatic Castration-resistant Prostate Cancer

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. Indication Abiraterone acetate (Zytiga) (an oral agent that...

lung cancer

Epigenetic Therapy Shows Positive Results in Late-stage Lung Cancer

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, ...

lung cancer

Lung Cancer Advocates Seek to Raise Awareness (and Research Funding)

Although lung cancer is the leading cause of cancer death in the United States for both men and women—nearly 157,000 deaths from lung cancer occurred in 2011, according to the American Cancer Society—survey results from the Lung Cancer Research Foundation (LCRF) show that 60% of Americans are...

lung cancer

I Never Expected to Get Lung Cancer

When intermittent chest pains sent me to the emergency room nearly a decade ago, I worried that I was having some kind of cardiac event. The ER doctor wanted to make sure that I didn’t have a pulmonary embolism, so in addition to ordering a complete cardiac workup, she also ordered a chest x-ray to ...

breast cancer

Ablation of Small Primary Breast Tumors: The Next Step in Local Therapy?

Local treatment of breast cancer is trending toward less invasive procedures that achieve comparable outcomes to standard interventions. What will the next step along this continuum be? According to Michael S. Sabel, MD, a surgical oncologist at the University of Michigan Comprehensive Cancer...

leukemia

Is Gemtuzumab a Therapeutic Option in Older Patients with Acute Myeloid Leukemia?

Previous studies of gemtuzumab ozogamicin (Mylotarg) had variable results in acute myeloid leukemia (AML). Before trials reported at the 2011 ASH Annual Meeting, two major studies had compared chemotherapy with or without gemtuzumab in patients with AML, said Martin Tallman, MD, Chief of the...

lymphoma

New Anti-CD20 Monoclonal Antibody Studied in B-cell Non-Hodgkin Lymphoma

The new anti-CD20 monocolonal antibody obinutuzumab is being studied in the treatment of patients with relapsed CD20-positive indolent B-cell non-Hodgkin lymphoma. GAUSS is the first clinical trial to compare obinutuzumab head-to-head against rituximab (Rituxan) induction therapy. “In this first...

breast cancer

Study Questions Use of Partial Breast Brachytherapy in Older Women

Partial breast brachytherapy is less effective and more toxic than whole-breast irradiation when used after lumpectomy, suggests an analysis of Medicare claims data. In the 2000–2007 study of more than 130,000 older women with breast cancer—the largest of its kind to date—the rate of mastectomy in...

breast cancer

AVEREL Trial Shows Benefit of Bevacizumab in HER2-positive Locally Recurrent or Metastatic Breast Cancer

In findings likely to intensify the debate about the role of bevacizumab (Avastin) in advanced breast cancer, the AVEREL trial concludes that adding this antiangiogenic antibody to standard therapy prolongs progression-free survival by about 3 months in women with HER2-positive locally recurrent...

symptom management

Glucarpidase Approved to Treat Methotrexate Toxicity

The FDA has approved intravenous glucarpidase (Voraxaze) to treat patients with toxic levels of methotrexate in their blood due to kidney failure. Glucarpidase is an enzyme that rapidly reduces methotrexate levels by breaking down the chemotherapy drug to a form that can be eliminated from the...

cost of care

Cost of Care: A Multidisciplinary Responsibility

I read the interview with Dr. Ezekiel Emanuel (The ASCO Post, December 15, 2011) with much interest, as the health-care policy problems that America is currently experiencing have plagued other countries for some time. Despite proactive measures and attempts to amend those situations elsewhere,...

issues in oncology
health-care policy

Drug Shortages Hit Oncology Hard: Experts Weigh in on Challenges and Solutions

Periodic drug shortages are an unavoidable reality in our complicated pharmaceutical supply chain; however, over the past several years, drug shortages have expanded to crisis levels, putting vulnerable patients at risk. In 2010, there were 178 drug shortages reported to the FDA, 132 of which were...

lymphoma

Expert Point of View: Maintenance Rituximab vs Retreatment Rituximab in Patients with Low–Tumor-Burden Follicular Lymphoma

The findings of RESORT1 have tremendous implications, both clinically and economically, commented Andrew D. Zelenetz, MD, Chief of the Lymphoma Service at Memorial Sloan-Kettering Cancer Center, New York, in an interview. “The maintenance arm received rituximab [Rituxan] every 3 months...

multiple myeloma

Expert Point of View: Next-generation Proteasome Inhibitors Will Improve Outcomes in Bortezomib-refractory Myeloma Patients

Myeloma experts agree that the new proteosome inhibitors are particularly welcome because they are at least as effective as bortezomib (Velcade) but produce much less neuropathy. Dramatic Results “The activity of MLN 9708 is very encouraging,” said Paul G. Richardson, MD, of Dana-Farber Cancer...

multiple myeloma

Next-generation Proteasome Inhibitors Will Improve Outcomes in Bortezomib-refractory Myeloma Patients

The next-generation proteasome inhibitor carfilzomib is expected to gain FDA approval in the near future, offering a treatment option that may be as effective as and less neurotoxic than bortezomib (Velcade). Studies presented at the ASH Annual Meeting upheld benefits of the drug observed in...

multiple myeloma

Expert Point of View: Monoclonal Antibody Promising in Multiple Myeloma

With a wealth of new agents of various classes in the pipeline, “myeloma is going to become a chronic illness, with sustained complete responses achieved in a significant fraction of patients,” according to Kenneth C. Anderson, MD, of Dana-Farber Cancer Institute and Harvard Medical School, ...

leukemia

A Second Chance for Gemtuzumab in Acute Myeloid Leukemia

Gemtuzumab ozogamicin (Mylotarg) may have a second chance for regulatory acceptance, as studies presented at ASH 2011 demonstrated that gemtuzumab can be safely and effectively given by adjusting the dosing and treatment schedule. Gemtuzumab ozogamicin was approved for the treatment of acute...

leukemia

Novel Agent Efficacious in Chronic Lymphocytic Leukemia

A novel inhibitor of B-cell receptor signaling produced high rates of remission and was well tolerated in patients with chronic lymphocytic leukemia (CLL) who were refractory to at least two previous treatments, reported Susan O’Brien, MD, of The University of Texas MD Anderson Cancer Center,...

leukemia

Three Novel Agents Show Promise in Acute Lymphoblastic Leukemia

Susan O’Brien, MD, Professor in the Department of Leukemia at The University of Texas MD Anderson Cancer Center, Houston, has a special interest in novel developments in the treatment of acute lymphoblastic leukemia (ALL). At the 2011 ASH Annual Meeting, she discussed her picks of top newsmakers in ...

leukemia

Expert Point of View: BELA Trial Reborn: Bosutinib Produces Improved Results in Chronic Myeloid Leukemia

Given the results of the BELA trial, with the problems of treatment side-effect management realized and seemingly resolved, Elias Jabbour, MD, Assistant Professor of Medicine at The University of Texas MD Anderson Cancer Center, Houston, assumes bosutinib will be approved in chronic myeloid...

lymphoma

Expert Point of View: Post-CHOP Radioimmunotherapy Comparable to Rituximab Given along with CHOP in Previously Untreated Follicular Lymphoma

SWOG S0016, which compared treatment with CHOP-R (cyclophosphamide, doxorubicin, vincristine, prednisone, plus rituximab [Rituxan]) and CHOP-RIT (CHOP plus tositumomab/iodine-131 tositumomab [Bexxar]) in patients with follicular lymphoma, was one of the most important studies at the 2011 ASH...

lymphoma

Post-CHOP Radioimmunotherapy Comparable to Rituximab Given along with CHOP in Previously Untreated Follicular Lymphoma

In patients with previously untreated follicular lymphoma, similar outcomes were achieved with CHOP-R (cyclophosphamide, doxorubicin, vincristine, prednisone, plus six doses of rituximab [Rituxan]) and CHOP-RIT (CHOP plus one dose of tositumomab/iodine-131 tositumomab [Bexxar]) in a phase III...

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