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Showing 11951 - 12000Novel BRAF Inhibitor Receives FDA Approval in Metastatic Melanoma
Vemurafenib (Zelboraf) received FDA approval on August 17, 2011, for treatment of metastatic or unresectable melanoma, based on the results of the phase III BRIM3 trial.1 BRIM3 compared vemurafenib to dacarbazine in 675 untreated patients with the BRAF V600E mutation. Vemurafenib targets the...
Palliative Care, Quality of Life, and Cost
More than half of our nation’s patients with cancer are Medicare beneficiaries, making the entitlement program ground zero in the heated debate on health-care spending. Total Medicare expenditures attributable to beneficiaries in their last year of life runs upward of 30%; this statistic serves as...
FDA Approves Brentuximab Vedotin in Two Lymphoma Indications
The antibody-drug conjugate brentuximab vedotin (Adcetris) was granted accelerated approval on August 19 for the treatment of relapsed or refractory Hodgkin lymphoma and systemic anaplastic large cell lymphoma. Brentuximab vedotin is the first new drug to be approved in Hodgkin lymphoma in more...
LETTER TO THE EDITOR: Treating Cancer or Fear?
I read the article by Deb Stewart, “Acting on Fear” (The ASCO Post, August 15, 2011, page 1) with interest, disappointment, and empathy. “Acting on fear” in cancer treatment generally, and particularly in breast cancer, is not uncommon. Hence, I was most interested in the article’s major thrust, as ...
‘Hot Chemotherapy’ Generates Heated Debate about Its Use with Cytoreductive Surgery to Manage Peritoneal Metastases
"Hot chemotherapy” has become the common term for hyperthermic intraperitoneal chemotherapy (HIPEC), which together with cytoreductive surgery is being used by some surgeons to treat patients with carcinomatosis from colorectal cancer. While HIPEC is not considered the most important component of...
SIDEBAR: Letter to President Obama
Excerpt from a letter signed by ASCO and other leading cancer organizations to President Barack Obama (July 13, 2011) urging him to resist proposed cuts to Medicare reimbursement for oncology drugs: “Due to financial and administrative burdens that currently exist, community oncology practices...
Oncology Community Faces Complex Challenges in Evolving Policy Arena
As the political environment heats up in advance of the upcoming presidential campaign season, many issues crucial to the oncology community are being placed on the political chopping block as policymakers seek ways to reduce the mounting debt and soaring health-care spending. To help clarify some...
Yoga, Geriatric Assessment, and Nausea/Vomiting Addressed in Session on Supportive Care and Survivorship Issues
Marie E. Wood, MD, of the Familial Cancer Program at the University of Vermont, Burlington, addressed clinically relevant issues in supportive care and survivorship at the Best of ASCO® Annual Meeting ‘11 in Miami. Delayed Nausea and Vomiting Two studies addressed the problem of...
SIDEBAR: Novel Agents Are Still Needed to Address Cytopenias in Myelofibrosis
Despite improving splenomegaly and symptoms in patients with myelofibrosis, ruxolitinib has not been helpful for managing cytopenias in this population, according to Wendy Stock, MD, of the University of Chicago. “Additional trials are underway with novel [JAK] inhibitors, with some hints about...
Improvements Highlighted in Treatment of Leukemias and Preleukemias
Certain preleukemic conditions and leukemia in high-risk patients have remained challenging to treat despite advances in hematology, according to Wendy Stock, MD, of the University of Chicago. But studies reported at the Best of ASCO® Annual Meeting ‘11 in Seattle show progress even in these ...
Novel Drugs Ipilimumab and Vemurafenib for Advanced Melanoma
In this introductory installment of In the Clinic, The ASCO Post provides an overview of two new melanoma agents recently approved by FDA, with discussion on pivotal data leading to approval, dosage and administration, and managing drug-related toxicities. Watch for more on clinical use of novel...
Short-term Androgen Deprivation plus Radiotherapy Improves Outcomes in Intermediate-risk Prostate Cancer
The addition of short-term androgen-deprivation therapy to external-beam radiation therapy improved overall and disease-specific survival in men with nonbulky localized prostate cancer and prostate-specific antigen (PSA) levels up to 20 ng/mL, as reported recently in The New England Journal of...
FDA Approves Denosumab to Increase Bone Mass in Patients with Cancer
Denosumab (Prolia) recently received FDA approval as a treatment to increase bone mass in patients at high risk for fracture receiving androgen deprivation therapy for nonmetastatic prostate cancer or adjuvant aromatase inhibitor therapy for breast cancer. Pivotal Trials The approvals were based...
New ASCO Focused Update Recommendation on Maintenance Treatment of Stage IV Non–Small Cell Lung Cancer
A focused update to the 2009 ASCO Clinical Practice Guideline Update on Chemotherapy for Stage IV Non-Small-Cell Lung Cancer reflects new evidence on maintenance therapy in patients with response or stable disease after four cycles of first-line cytotoxic chemotherapy.1 The 2009 update...
No Value for Axillary Dissection in Patients with Breast Cancer and Occult Nodal Metastases
In a subanalysis of the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-32 study, nearly 16% of clinically node-negative patients were found to have occult metastases upon more detailed assessment of the sentinel lymph nodes. While a slight difference in outcomes was found among this...
Can Bayesian Design Streamline Our Sluggish Clinical Trial System?
The randomized controlled clinical trial has long been the gold standard for new cancer drugs to demonstrate worthiness of FDA approval; however, many experts contend that that our method of bringing drugs to the market is plagued by undue costs, long delays, and overregulation. According to Donald ...
International Prostate Cancer Studies Report Inroads in Managing Bone Metastases
Treatment and prevention of bone metastases in patients with prostate cancer is coming of age, according to several studies presented at the European Multidisciplinary Cancer Congress (ECCO/ESMO/ESTRO). Among the most impressive studies reported was an international phase III trial of radium-223,...
SIDEBAR: Expert Q and A
D. Neil Hayes, MD, MPH, of the University of North Carolina, Chapel Hill, discusses the role of HPV status in head and neck cancer. Are you convinced human papillomavirus (HPV) positivity is associated with better prognosis? Dr. D. Neil Hayes: The HPV story influences almost everything we do in...
New Therapies and Prognostic Techniques Highlighted in Head and Neck Cancer
D. Neil Hayes, MD, MPH, of the University of North Carolina at Chapel Hill, described efforts to position the epidermal growth factor receptor (EGFR) inhibitor cetuximab (Erbitux) in head and neck cancer treatment. Surprisingly negative results came from the phase III Radiation Therapy Oncology...
SIDEBAR: Questions and Answers about Adjuvant Imatinib in GIST
"As clinicians, we really need to ask who should receive adjuvant [imatinib], and we have several ways to risk-stratify patients, including tumor characteristics (size, location, mitotic index), mutational analyses, and a recently published nomogram for patient-specific survival,” said William D....
Novel Approaches and Agents Making Headway against Sarcoma
Novel approaches and agents reported at the ASCO 2011 Annual Meeting are improving outcomes in sarcoma, a heterogeneous disease with historically poor outcomes, according to William D. Tap, MD, Section Chief of Sarcoma Oncology at Memorial Sloan-Kettering Cancer Center in New York. Dr. Tap...
Adjuvant Treatment Still Standard in Melanoma, but New Drugs Prolong Life in Metastatic Setting
At the Best of ASCO® Miami meeting, Omid Hamid, MD, The Angeles Clinic and Research Institute (www.theangelesclinic.org), Los Angeles, California, reviewed abstracts that received a great deal of attention at this year’s Annual Meeting—the new treatments for metastatic melanoma. He also described...
Screening for Ovarian Cancer May Do More Harm Than Good, but New Therapies for the Disease Are Improving Outcomes
At the Best of ASCO Miami meeting, Daniela Matei, MD, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, described how new approaches are significantly prolonging remission in ovarian cancer. Ovarian Screening Provides No Benefit The Prostate, Lung, Colorectal, and Ovarian (PLCO) ...
Novel Management Strategies Assessed in Renal Cell and Prostate Cancers
At the Best of ASCO Miami meeting, William Oh, MD, of the Tisch Cancer Institute, Mount Sinai School of Medicine, New York, described new trends and remaining questions in the management of renal cell and prostate cancers. Axitinib vs Sorafenib in Second-line RCC Axitinib, a potent and selective...
Multiple Myeloma Research Spotlights Treatment Concerns and Advances
Myeloma data reported at this year’s ASCO meeting raise concern about the safety of a mainstay class of drugs in this disease, while also hinting at good efficacy of some novel drugs and approaches, according to William I. Bensinger, MD, of the Fred Hutchinson Cancer Research Center, Seattle....
SIDEBAR: Research Is Taking the Guesswork Out of Lymphoma Management
The selected studies answer some critical questions in lymphoma that hematologists face daily and that have been the source of intense debate in the field, according to Oliver Press, MD, PhD, of the Fred Hutchinson Cancer Research Center and the University of Washington, Seattle. “I think the...
Similar Outcomes Confirmed in Variety of Lymphoma Treatment Comparisons
Three abstracts reported at the Best of ASCO® meeting in Seattle provide guidance to hematologists when it comes to long-standing gray areas in lymphoma management, according to Oliver Press, MD, PhD, of the Fred Hutchinson Cancer Research Center and the University of Washington, Seattle....
Practice-changing Evidence in Treatment of Noncolorectal GI Cancers
Studies presented at the ASCO Annual Meeting in the field of noncolorectal gastrointestinal cancer both reaffirmed certain standards of care and introduced some practice-changing data, according to A. Craig Lockhart, MD, of Washington University in St. Louis. Perioperative Therapy for Gastric...
SIDEBAR: Will Aflibercept Break Dry Spell in New Agents for Colorectal Cancer?
Promising results were recently presented from VELOUR, a second-line phase III trial comparing FOLFIRI (leucovorin, fluorouracil, irinotecan) with vs without aflibercept, a fusion protein that binds placental growth factor, VEGFA, and VEGFB.1 “This is an important trial because it might lead to the ...
Standards of Care Confirmed in Latest Group of Colorectal Cancer Trials
Colorectal cancer studies reported at this year’s ASCO meeting offered little in the way of practice-changing information, according to Axel Grothey, MD, of the Mayo Clinic in Rochester, Minnesota. But they did confirm existing standards of care, he noted at the Best of ASCO® meeting in Seattle....
Other Breast Cancer Studies of Note
At this year’s Best of ASCO® Miami meeting, Harold Burstein, MD, PhD, discussed several studies he found interesting and relevant to clinical practice. Genomic Assays One study examined two genomic assays for ER-positive breast cancer, Oncotype DX and PAM50, and found considerable overlap among the ...
SIDEBAR: Studies Sparked Questions to Breast Cancer Specialists
Based on the MAP.3 findings, should we be using exemestane to prevent breast cancer in high-risk patients? Dr. Harold Burstein: The risk of developing breast cancer was 2.5% in the placebo arm, vs 1% to 1.5% risk with exemestane. Also, the cancers that were avoided were probably ones with good...
Breast Cancer Studies Explore Wide Variety of Prevention and Treatment Strategies, Offering New Insights
At the Best of ASCO® meeting in Miami, Harold Burstein, MD, PhD, Dana-Farber Cancer Institute, Boston, and Carey K. Anders, MD, University of North Carolina at Chapel Hill, presented high-impact breast cancer abstracts that will enable clinicians to optimize their use of radiotherapy and biologics. ...
SIDEBAR: Searching for More Efficacious, Less Toxic Adjuvant Chemotherapy for NSCLC
Accumulating data are helping to better define the risk-benefit profile of various adjuvant chemotherapy regimens for non–small cell lung cancer (NSCLC) and the impact of adding biologic agents to the mix, according to H. Jack West, MD, of the Swedish Cancer Institute in Seattle. In the randomized ...
Incremental Advances Demonstrated in Management of Locoregional Lung Cancer
Data presented at the ASCO Annual Meeting this year on the management of locoregional lung cancer present a mixed picture, with some advances and some disappointments, according to H. Jack West, MD, of the Swedish Cancer Institute in Seattle, who reviewed studies in this area at the Best of ASCO...
SIDEBAR: Molecular Heterogeneity Complicates Management of Resistance
The molecular heterogeneity of lung cancers will make it a challenge to manage resistance in this era of targeted therapy, according to D. Ross Camidge, MD, PhD, of the University of Colorado, Denver. A case in point: the anaplastic lymphoma kinase (ALK) story. Recently updated data for crizotinib ...
Research Increasingly Points to the Role of Molecular Diversity in Metastatic Lung Cancer
Molecular diversity—its existence, extent, and implications for therapy—was a central theme of key metastatic lung cancer studies presented at this year’s ASCO meeting, according to D. Ross Camidge, MD, PhD, of the University of Colorado, Denver, who addressed major findings in advanced lung cancer ...
SIDEBAR: Expect More Answers in the Future
“We are still following patients from the initial cohort,” reported Martin G. Sanda, MD, principal investigator of the study published in JAMA, “Prediction of Erectile Function Following Treatment for Prostate Cancer.” At a median follow-up now of about 6 years, “there is evidence that there might...
Important Briefs from the 2011 Breast Cancer Symposium
The 2011 Breast Cancer Symposium was recently held in San Francisco, bringing together a multidisciplinary group of specialists and sponsored by ASCO, the American Society for Radiation Oncology, the Society of Surgical Oncology, the American Society of Breast Disease, the American Society of...
Integrative Medicine Offers Added Value for Patients with Cancer
Addressing a patient’s physical, emotional, and spiritual needs during the cancer journey, integrative medicine combines such time-honored therapies as nutrition, exercise, and meditation alongside allopathic approaches to cancer care, with the ultimate goal of improving survival rates and reducing ...
Expert Point of View: Panitumumab Is Not Beneficial in KRAS Mutations: No Exceptions
Axel Grothey, MD, of the Mayo Clinic, Rochester, Minnesota, found the findings presented by Marc Peeters, MD, PhD,1 at the 2011 European Multidisciplinary Cancer Congress to be of great interest, from both clinical and research perspectives. “We have two discrepant analyses now for G13D. When we...
Panitumumab Is Not Beneficial in KRAS Mutations: No Exceptions
The need to restrict treatment with panitumumab (Vectibix) to metastatic colorectal cancer patients with wild-type (normal) KRAS tumors was upheld in a study presented at the 2011 European Multidisciplinary Cancer Congress (EMCC). The investigation found a consistent lack of benefit for the drug...
Time to Reconsider Treatment Paradigm for Elderly Patients with Advanced Non–Small Cell Lung Cancer?
Significantly longer median overall survival among elderly patients with advanced non–small cell lung cancer (NSCLC) receiving doublet chemotherapy rather than monotherapy yielded a 36% reduction in mortality risk in a phase III randomized trial. “We saw a survival benefit with doublet chemotherapy ...
Crizotinib: New Drug for ALK-positive Advanced Non–Small Cell Lung Cancer
Indication Crizotinib (Xalkori) is an oral inhibitor of receptor tyrosine kinases including anaplastic lymphoma kinase (ALK), hepatocyte growth factor receptor (HGFR, c-Met), and recepteur d’origine nantais (RON). In August 2011, the FDA granted the drug accelerated approval for the treatment of...
ASCO Symposium Helps Practices Leverage Health IT, Understand EHR Policy Changes
To help community oncology practices and large institutions navigate recent health-care policy changes and leverage health information technology (HIT) to improve the quality of care, ASCO will hold the 2011 HIT/EHR Symposium at the Westin Peachtree Plaza in Atlanta on November 4–5. “This symposium ...
GI Symposium Helps Oncologists Stay Abreast of Fast-moving Research
Gastrointestinal cancers are a key therapeutic area in research, and science is moving forward in that arena at a fast clip. But how are those who focus on gastrointestinal malignancies in the clinic supposed to stay on top of it all? One great way is to attend the annual Gastrointestinal Cancers...
T-DM1: Antibody Drug Conjugate Outperforms Standard Anti‑HER2 Therapy in Metastatic HER2-positive Breast Cancer
The investigational antibody-drug conjugate T-DM1 improved progression-free survival over standard chemotherapy with docetaxel plus trastuzumab (Herceptin) when given as first-line treatment of HER2-positive metastatic breast cancer, according to an open-label phase II study reported at the 2011...
No Improvement in Survival with High-dose over Standard-dose Radiation for Stage III Non–Small Cell Lung Cancer
Surprisingly, less may be more when it comes to radiation therapy with concurrent chemotherapy for patients with stage III non–small cell lung cancer (NSCLC), according to an interim analysis of the randomized phase III Radiation Therapy Oncology Group (RTOG) 0617 trial presented at the 53rd Annual ...
Do We Need the USPSTF?
Like most of the folks reading this commentary, I’m a taxpayer. Although I sometimes become impatient with the strategic games on Capitol Hill, I basically appreciate that government helps many things to work, and some of them even work well. However, there are aspects of government function that...
Everolimus Overcomes Resistance to Hormonal Therapy in Advanced Breast Cancer
Adding everolimus (Afinitor) to exemestane in postmenopausal women with advanced breast cancer resistant to aromatase inhibitors significantly improved outcomes, according to the phase III BOLERO-2 trial reported at the 2011 European Multidisciplinary Cancer Congress, held September 23–27 in...
