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New Precision Medicine Guidelines Aimed at Improving Personalized Cancer Treatment Plans for Patients

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...

breast cancer
supportive care

No Association Seen Between New or Worsening Aromatase Inhibitor–Related Musculoskeletal or Vasomotor Symptoms and Relapse-Free Survival

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. However, in a study reported in the Journal of Clinical Oncology, Stearns et al...

leukemia

Increased Response Rate With Higher Dose of Obinutuzumab Monotherapy for Patients With Chronic Lymphocytic Leukemia

A randomized phase II study in symptomatic, untreated patients with chronic lymphocytic leukemia (CLL) found an increased overall response rate with obinutuzumab (Gazyva) at a dose of 2,000 mg vs 1,000. In addition, the “data demonstrate that obinutuzumab produces a higher response rate in...

gynecologic cancers
issues in oncology

UK Study Suggests Potential Mortality Benefit of Ovarian Cancer Screening in Postmenopausal Women

As reported in The Lancet by Jacobs et al, the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) suggests there may be a mortality benefit of ovarian cancer screening in postmenopausal women. Study Details In the trial, 202,546 postmenopausal women aged 50 to 74 years from 13 centers...

breast cancer

High Risk on Breast Cancer Risk Prediction Tools Associated With More Favorable Disease Characteristics

In a Swedish study reported in the Journal of Clinical Oncology, Holm et al found that high risk on the Tyrer–Cuzick predicted 10-year breast cancer risk score (TCRS) and a 77-single nucleotide polymorphism polygenic risk score (PRS) tended to be associated with favorable prognostic features...

hematologic malignancies
leukemia

Use of Antilymphocyte Globulin Appears to Reduce Chronic Graft-vs-Host Disease After Allogeneic Stem Cell Transplantation in Acute Leukemia

In a European phase III study reported in The New England Journal of Medicine, Kröger et al found that inclusion of antihuman T-lymphocyte immune globulin (ATG) in the myeloablative conditioning regimen in patients with acute myeloid or lymphoid leukemia resulted in a significant reduction in...

breast cancer

Japanese Study Shows Oral Fluoropyrimidine S-1 Is Noninferior to Taxanes as First-Line Treatment of HER2-Negative Metastatic Breast Cancer

In a Japanese phase III trial (SELECT BC) reported in The Lancet Oncology, Takashima et al found that first-line treatment with the oral fluoropyrimidine S-1 was associated with noninferior overall survival vs taxane regimens in women with HER2-negative metastatic breast cancer resistant to...

breast cancer

Nonsignificant Improvement in Disease-Free Survival With Adjuvant Lapatinib/Trastuzumab vs Trastuzumab in Early HER2-Positive Breast Cancer

Results of a phase III trial, reported in the Journal of Clinical Oncology by Piccart-Gebhart et al, showed a modest and statistically nonsignificant increase in disease-free survival with concurrent adjuvant lapatinib (Tykerb) and trastuzumab (Herceptin) vs trastuzumab alone in patients with...

palliative care
skin cancer
issues in oncology

Blood Test That Monitors ctDNA Better Than the Standard in Tracking Metastatic Melanoma

Physicians treating patients with metastatic melanoma may soon have a superior tool in their efforts to closely track the disease. A new study shows that a blood test that monitors blood levels of DNA fragments from dead cancer cells does a better job than the current standard test at tracking the...

lung cancer

Pembrolizumab Improves Survival vs Docetaxel in Previously Treated PD-L1–Positive Advanced NSCLC

As reported in The Lancet by Herbst et al, the phase II/III KEYNOTE-010 trial showed that pembrolizumab (Keytruda) significantly improved overall survival vs docetaxel in patients with previously treated programmed death ligand 1 (PD-L1)–positive advanced non–small cell lung cancer...

health-care policy
issues in oncology

ASCO Calls for Improvements to Clinical Pathway Programs in Oncology

ASCO released a new policy statement with recommendations to ensure that clinical pathways in oncology promote—not hinder—the care of patients with cancer. Published by Zon et al in the Journal of Oncology Practice, the statement asserts that the way in which these treatment management...

breast cancer

AACR, Triple Negative Breast Cancer Foundation, and Carol’s Crusade for a Cure Foundation Partner to Offer Grant Opportunity

The American Association for Cancer Research (AACR), Triple Negative Breast Cancer Foundation, and Carol’s Crusade for a Cure Foundation have announced a new partnership and grant opportunity in metastatic triple-negative breast cancer research. The AACR–Triple Negative Breast Cancer...

skin cancer

LETTER TO THE EDITOR: Adjuvant Therapy in Cutaneous Melanoma: The Need for a New Approach

Melanoma of the skin remains a fatal disease, and its incidence continues to rise, mostly in young adults during their prime. Surgery remains the most effective therapeutic modality, but patients’ survival depends on the stage of the disease at the time of diagnosis. Various therapeutic agents have ...

kidney cancer

Sunitinib-induced Hypertension May Be Efficacy Biomarker in Patients with Metastatic Renal Cell Carcinoma

A retrospective exploratory analysis of pooled efficacy data from more than 500 patients with metastatic renal cell carcinoma treated with sunitinib (Sutent) “support the hypothesis that hypertension may be a viable biomarker of antitumor efficacy in this patient population,” according to a report...

gynecologic cancers

Adding Gemcitabine to Chemoradiation Improves Survival Outcomes for Locally Advanced Cervical Cancer

A phase III, open-label, randomized trial found that adding gemcitabine to concurrent cisplatin chemoradiotherapy and using gemcitabine as adjuvant chemotherapy with cisplatin improved survival outcomes in women with locally advanced cervical cancer. Toxicity was increased compared to standard...

multiple myeloma

Subcutaneous Bortezomib Offers Improved Safety Profile for Treating Patients with Relapsed Multiple Myeloma

Subcutaneous administration of bortezomib (Velcade) was comparably efficacious to intravenous administration in a phase III trial in patients with relapsed multiple myeloma, but the SC route “seemed to have an improved systemic safety profile compared with intravenous delivery,’’ investigators...

Expert Point of View: More Evidence Links Vitamin D Deficiency to Breast Cancer

Julie R. Gralow, MD, Professor of Oncology at the University of Washington, Seattle, said the data reported by Rickles et al at the American Society of Breast Surgeons Annual Meeting support the Goodwin study presented at the 2008 ASCO Annual Meeeting.1 In that earlier Canadian cohort of 512 women, ...

breast cancer

Radiotherapy in DCIS: Recurrence Patterns Are Different

For women with ductal carcinoma in situ (DCIS), radiation therapy after excision is not a slam-dunk in terms of benefits, according to a study presented at the American Society of Breast Surgeons 12th Annual Meeting.1 In a study that focused on the pattern of breast cancer recurrence in women with...

breast cancer

‘Paradoxical’ Result Tying Estrogen to Reduced Risk of Breast Cancer Is Consistent with Laboratory Data

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,...

gynecologic cancers

Important Briefs from the ACOG 59th Annual Clinical Meeting

Several presentations at the 59th Annual Clinical Meeting of the American College of Obstetricians and Gynecologists (ACOG), held April 30–May 4 in Washington, DC, focused on cancers associated with the reproductive tract and issues important to women’s health. Four noteworthy studies presented at...

health-care policy

Opinion: The FDA–Pharmaceutical Industry Complex

On January 17, 1961, President Dwight D. Eisenhower, in his farewell address to the nation, coined the term “the military-industrial complex.” His purpose was to warn of the inefficiencies that could result from such a relationship, which would imperil the strength of our military and the safety of ...

Expert Point of View: 3-Year Screening Interval Safe for Women with HPV-negative and Normal Pap Tests, Data Show

This is a wonderful population-based study… that makes us comfortable with the current recommendations. The issue of how frequently one or the other test should be used is an evolving area,” said George W. Sledge, Jr, MD. Dr. Sledge is ASCO Immediate Past President. Dr. Sledge pointed out that...

gynecologic cancers

2011 ASCO Annual Meeting: 3-Year Screening Interval Safe for Women with HPV-negative and Normal Pap Tests, Data Show

A large, “real-world” study has validated current recommendations from the American Congress of Obstetricians and Gynecologists (ACOG), American Cancer Society (ACS), and American Society for Colposcopy and Cervical Pathology (ASCCP) endorsing a 3-year cervical cancer screening interval for women...

lymphoma
survivorship

Survivorship Symposium 2016: Study Finds That Less Than Half of Survivors of Hodgkin Lymphoma Received All Recommended Follow-up Care

According to the American Cancer Society’s 2014 Cancer Facts & Figures, Hodgkin lymphoma is diagnosed in about 800 adolescents and young adults each year. And while standard treatments for the cancer, including chemotherapy and radiation, are very effective in improving survival,...

gynecologic cancers

Cancer Diagnosis Can Spark Worry over Numerous Health Concerns

The early discovery of my endometrial cancer is a prime example of the health rewards you can reap if you are lucky enough to have good medical care and a dogged physician. Long past menopause, I wasn’t experiencing any of the typical warning signs of the disease—vaginal bleeding or pelvic...

colorectal cancer

Capecitabine Noninferior to 5-FU with Improved Toxicity Profile in Rectal Cancer, Two Studies Demonstrate

Two separate trials presented during an oral session at the 2011 ASCO Annual Meeting suggest that capecitabine (Xeloda) can replace fluorouracil (5-FU) as part of chemoradiotherapy for rectal cancer. Patients randomly assigned to either treatment had comparable outcomes but with less toxicity from...

prostate cancer

Sunitinib/Prednisone Improves Progression-free Survival but not Overall Survival in Metastatic Castrate-resistant Prostate Cancer

According to M. Dror Michaelson, MD, PhD, second-line therapy with sunitinib (Sutent) and prednisone improves progression-free survival but not overall survival in men with metastatic castrate-resistant prostate cancer previously treated with docetaxel-based chemotherapy. Dr. Michaelson, of the...

lung cancer

Understanding Crizotinib, 1 Year after High-profile Presentation

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...

symptom management

Vanderbilt Oncologists Partner with Cardiologists to Research Chemotherapy-related Cardiac Toxicity

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...

Expert Point of View: Busulfan/Melphalan Improves Survival in High-risk Neuroblastoma Patients, Phase III Study Results Show

At the ASCO Plenary Session where the HR-NBL1/SIOPEN trial was presented, formal discussant Julie R. Park, MD, of the University of Washington, Seattle, said, “Large randomized trials have previously shown that myeloablative therapy improves outcomes in high-risk neuroblastoma, and it is now...

cns cancers

Plenary Report: Busulfan/Melphalan Improves Survival in High-risk Neuroblastoma Patients, Phase III Study Results Show

Myeloablative therapy with a busulfan (Busulfex, Myleran)/melphalan combination (BuMel) was superior to a regimen of carboplatin/etoposide/melphalan (CEM) in pediatric patients with high-risk neuroblastoma, according to results of the large, phase III HR-NBL1/SIOPEN trial presented at the 2011 ASCO ...

leukemia

Plenary Report: High-dose Methotrexate Improves Outcome for High-risk Acute Lymphoblastic Leukemia in Younger Patients

High-dose methotrexate achieved superior event-free survival rates compared with standard Capizzi (escalating) methotrexate treatment in children and young adults with high-risk acute lymphoblastic leukemia (ALL), according to a practice-changing study reported during the Plenary Session of the...

lymphoma

Important Briefs: Lymphoma Research on Improved Chemotherapy, Biomarker Associations, and Stem Cell Transplant Approaches

The 11th International Conference on Malignant Lymphoma was held June 15–18 in Lugano, Switzerland. More than 3,000 hematologists, clinical oncologists, pathologists, and researchers attended the meeting, which was first convened in 1981. Topics of discussion included lymphoma staging in the new...

gynecologic cancers

Novel Agents Prolong Disease-free Survival in Ovarian Cancer

Novel agents produced high response rates and prolonged remissions in patients with platinum-sensitive recurrent ovarian cancer, in studies reported at the 2011 ASCO Annual Meeting. In an international randomized phase II trial, maintenance therapy with the oral poly [ADP-ribose] polymerase (PARP)...

hematologic malignancies

On William Osler: The Old Art and the New Science

William Osler (1849–1919) is one of the most revered physicians in the history of medicine. He was an outstanding clinician who emphasized bedside teaching, hard work, medical history, and lifelong learning.1 As Professor of Medicine at four institutions in three countries, he exerted a profound...

Expert Point of View: Longer Imatinib Treatment Is Better in High-risk GIST

Charles D. Blanke, MD, Chief of Medical Oncology at the University of British Columbia in Vancouver, critiqued the SSGXVIII study, noting its “goals were reasonable and the methodologies for primary and secondary objectives were sound. The conclusion regarding recurrence-free survival is valid, as...

solid tumors

Longer Imatinib Treatment Is Better in High-risk GIST

A phase III trial presented at the ASCO 2011 Plenary Session could change the duration of adjuvant therapy for some patients with resected gastrointestinal stromal tumors (GIST). When imatinib treatment was extended to 3 years, compared with the standard 1 year, patients with high-risk GIST were...

Expert Point of View: Novel Agents Improve Survival in Patients with Metastatic Melanoma

Discussing the melanoma studies at the Plenary Session, Kim Margolin, MD, of the University of Washington Fred Hutchinson Cancer Research Center in Seattle, noted that while the new therapies are welcomed, they are not without their challenges. “Ipilimumab now shows a survival benefit in...

skin cancer

Novel Agents Improve Survival in Patients with Metastatic Melanoma

Novel treatments for metastatic melanoma dominated the buzz at the 2011 ASCO Annual Meeting and across the major news outlets, with reports that two agents with entirely different mechanisms of action could extend survival. The studies’ inclusion in the ASCO Plenary Session attested to the...

SIDEBAR: Expect Questions from Your Patients

The study of concurrent HPV and Pap testing for cervical cancer was widely reported even before the recent ASCO Annual Meeting. In an interview with The ASCO Post, Barnett Kramer, MD, was asked how physicians can respond to questions about the study from patients. “You can tell a woman over the...

gynecologic cancers

Cervical Cancer Screening Study Should Reassure Physicians and Patients that a 3-Year Screening Interval Is Safe and Effective

Results of a large-scale cervical cancer screening study using concurrent human papillomavirus (HPV) and Pap testing should “reassure” women over 30 who test negative for HPV and have normal Pap tests that “it is extremely safe to go 3 years” before being tested again, Barnett S. Kramer, MD, MPH,...

issues in oncology

A Conversation with David Henry, MD

Given the intricate nature of oncology workflow, terminology, cancer staging, and the high risk associated with chemotherapy administration, an oncology electronic medical record (EMR) system needs to be much more than a storehouse of patient information. According to David Henry, MD, Clinical...

prostate cancer

Cabozantinib Shows Encouraging Activity in Metastatic Castrate‑resistant Prostate Cancer

Cabozantinib, a dual inhibitor of MET kinase and the vascular endothelial growth factor (VEGF) receptor, exhibits high, early single-agent activity in men with metastatic castrate-resistant prostate cancer, according to Maha Hussain, MD, FACP, who presented these findings at the 2011 ASCO Annual...

global cancer care

A Prominent Oncologist Retraces Her Steps from Baghdad

Maha Hussain, MD, FACP, Professor of Medicine and Urology, is the Associate Director for Clinical Research at the University of Michigan Comprehensive Cancer Center (UMCCC) and Co-leader of its Prostate Cancer/GU Oncology program. Dr. Hussain recently spoke with The ASCO Post about becoming a...

kidney cancer

Studies Explore Potential Benefits of Sunitinib before Nephrectomy in Metastatic Clear Cell Renal Cancer

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...

lymphoma

Intergroup Study Evaluates Outcomes of Elderly vs Younger Patients Treated for Advanced Hodgkin Lymphoma

The 11th International Conference on Malignant Lymphoma was held June 15–18 in Lugano, Switzerland. Topics of discussion included lymphoma staging in the new millennium, lymphoma and its microenvironment, and lymphoma cure vs control. The ASCO Post summarized several key presentations in the July...

breast cancer

Breast Cancer Studies Focus on Tailoring Therapy for Patient Subsets

As part of our ongoing coverage of the 2011 ASCO Annual Meeting, The ASCO Post has provided substantive reports on key breast cancer trials, but others deserve attention. Lapatinib/Capecitabine Controls Brain Metastases Results of the French phase II LANDSCAPE trial found lapatinib (Tykerb) plus...

SIDEBAR: Early Clinical Findings with JAK2 Inhibition

Two small preliminary studies of JAK2 inhibitors CYT387 and SB1518 had encouraging results in patients with myelofibrosis, and these studies were reported in poster presentations at the Annual Meeting.1,2 Both drugs reduced splenomegaly and achieved improvement in constitutional symptoms. SB1518...

lung cancer

Maintenance Therapy Prolongs Progression-free Survival in Advanced NSCLC but Produces No Overall Survival Benefit

Maintenance therapy with either pemetrexed (Alimta) or gefitinib (Iressa) achieved modest improvements in progression-free survival in patients with advanced non–small cell lung cancer (NSCLC). The magnitude of improved progression-free survival was 1.3 months and 2.2 months, respectively, in the...

lung cancer

Emerging Targeted Therapies Offer Glimmer of Hope for NSCLC but Biomarkers for Response Needed

Among the newer approaches to treatment of non–small cell lung cancer (NSCLC) are heat-shock protein 90 (Hsp90) inhibitors, toll-like receptor 2 (TLR2) agonists, and vascular-disrupting agents. So far, none appears to be a “home run,” but Hsp90 inhibition may be the most promising of the three...

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