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solid tumors

PI3K Inhibitors May Improve Response to Cancer Immunotherapy

The induction of antitumor immunity by vaccines or immunotherapies is inhibited by the immunosuppressive microenvironment of tumors. Toll-like receptor (TLR) agonists have the potential to increase inflammatory antitumor effects in the microenvironment, but these ligands can exert a mixture of both ...

issues in oncology

A Patient with Cancer Saw a Need and Left a Living Legacy

It is well documented that the rigors of delivering cancer care can unintentionally supersede valuable doctor-patient communication. Before he died in 1995, Kenneth B. Schwartz, a patient with cancer at Massachusetts General Hospital, recognized this phenomenon and founded the Kenneth B. Schwartz...

breast cancer

Reexcision Rates Following Breast-conservation Surgery Vary Widely

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. Reexcision rates for women with...

multiple myeloma

Carfilzomib May Offer Advantages in Patients with Relapsed/Refractory Multiple Myeloma

Carfilzomib is an oral second-generation proteasome inhibitor with a mechanism of action that may increase efficacy and reduce adverse effects currently associated with proteasome inhibitor therapy. It is being investigated for use in multiple myeloma and select solid tumors, and the FDA has...

issues in oncology

Which Is Better: Peripheral Blood or Bone Marrow as Unrelated Donor Stem Cell Source?

Over the past decade, the use of peripheral blood stem cells has increased, and now about 75% of unrelated living donor transplants are performed using peripheral blood stem cells without supportive data in the unrelated donor setting. This trend is called into question by results of a large phase...

multiple myeloma

Long-term Survival Benefit and Safety Confirmed for VMP Regimen in Multiple Myeloma in Patients Who Were Not Transplant Candidates

Five-year analysis of the VISTA trial confirms a survival advantage with VMP (bortezomib [Velcade], melphalan, and prednisone) for upfront treatment of multiple myeloma in patients who were not transplant candidates. At a median follow-up of 60.1 months, a 13-month improvement in overall survival...

skin cancer

What You Should Know about Peginterferon Alfa-2b for Adjuvant Treatment of Melanoma

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 Peginterferon alfa-2b (PegIntron, Sylatron) was recently ...

head and neck cancer

Challenges, Progress, and Future Directions in Head and Neck Cancer

Although head and neck cancer remains a major therapeutic challenge, significant advances have been made over the past few decades. The ASCO Post recently spoke with Marshall R. Posner, MD, Medical Director of the Head and Neck Oncology Program, Mount Sinai Medical Center, New York, about the...

lung cancer

Adding Thalidomide to Chemoradiation Increases Toxicities but Not Survival for Stage III Non–Small Cell Lung Cancer

Adding thalidomide (Thalomid) to the third-generation chemotherapy doublet of paclitaxel and carboplatin and radiation for patients with stage III non–small cell lung cancer (NSCLC) increased toxicities but did not improve survival. These results from the Eastern Cooperative Oncology Group (ECOG)...

issues in oncology

Starting Down the Path toward Electronic QOPI®: ASCO and US Oncology Collaborate in Quality Measurement

The Quality Oncology Practice Initiative (QOPI®), ASCO’s quality measurement program, is entering its 6th successful year and continuing to grow, both in number of participants and in quality measures evaluated. In the truest spirit of quality improvement, ASCO’s oncologist leaders have determined...

SIDEBAR: Career Development Award

The Career Development Award (CDA) is a 3-year grant totaling $200,000 to provide funding to clinical investigators who have received their initial faculty appointment, to establish an independent clinical cancer research program. This research must have a patient-oriented focus, including a...

breast cancer

SWOG S0226 Findings Revive Interest in Combination Hormonal Therapy

Two hormonal therapies combined are more efficacious than one when used as first-line treatment for hormone receptor–positive metastatic breast cancer in postmenopausal women, finds Southwest Oncology Group trial S0226. Results of the phase III trial, reported at the 2011 CTRC-AACR San Antonio...

Important News Briefs: New Data Reported in Gastric, Colorectal, and Hepatocellular Cancers

Findings presented at the 2012 Gastrointestinal Cancers Symposium will impact the future care of patients with these malignancies. The ASCO Post has summarized some of the most newsworthy data in the following briefs. In the phase III GRANITE-1 trial (n = 656), single-agent treatment with...

gastrointestinal cancer

What Were the Take-home Messages from the 2012 Gastrointestinal Cancers Symposium?

Richard M. Goldberg, MD, of The Ohio State University Medical Center, chaired the steering committee of the 2012 Gastrointestinal Cancers Symposium in San Francisco, which attracted approximately 4,000 registrants who viewed data from some 700 scientific abstracts. The ASCO Post asked Dr. Goldberg...

Expert Point of View: Two Novel Agents Prolong Survival in Advanced Prostate Cancer

“My comment on the AFFIRM trial is ‘wow, very impressive.’ The median survival and the declines in PSA levels are impressive, and this is going to change the way we care for patients in our practices,” said Nicholas Vogelzang, MD, medical oncologist with Comprehensive Cancer Centers of Nevada and...

prostate cancer

Two Novel Agents Prolong Survival in Advanced Prostate Cancer

Two novel agents with distinct mechanisms of action join ranks of treatments that extend survival for patients with castration-resistant prostate cancer: MDV3100 and radium-223. Both drugs achieved a survival advantage compared with placebo, with relatively benign side-effect profiles, according to ...

2012 Oncology Meetings

MARCH Hematology/Oncology Pharmacy Association 8th Annual Meeting March 21-24 • Orlando, Florida For more information: www.hoparx.org 65th Society of Surgical Oncology Annual Meeting March 21-24 • Orlando, Florida For more information: www.surgonc.org Society of Interventional Radiology 37th...

VEGFR Tyrosine Kinase Inhibitors Linked to Increased Risk of Fatal Adverse Events

A meta-analysis of 10 randomized controlled trials involving 4,679 patients showed that the use of vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitors was associated with an increased risk of fatal adverse events. “The crude incidence of [fatal adverse events] in patients ...

colorectal cancer

Survival Advantage of Oxaliplatin Extends to Diverse Group of Patients

The survival advantage conferred by adding oxaliplatin to adjuvant chemotherapy with fluorouracil (5-FU), as previously shown in randomized controlled trials, extends to patients in the general population, including older and minority group patients and those with higher comorbidity. These results, ...

hematologic malignancies
leukemia
lymphoma

ASH 2011 Presentations Include Novel Agents and New Strategies in Leukemia, Lymphoma, and Myeloma

Attendees at the 53rd Annual Meeting of the American Society of Hematology (ASH), held recently in in San Diego, were able to choose from a wide range of interesting and important sessions exploring hematologic malignancies. In addition to The ASCO Post’s regular news coverage from the meeting,...

integrative oncology

Some Patients Using Complementary and Alternative Therapies May Be Receiving ‘Parallel’ Rather Than Integrative Care

Most patients with cancer receiving complementary and alternative medicine do so not as part of integrative care, but rather as “parallel care,” according to Lynda Balneaves, RN, PhD, Associate Professor, University of British Columbia, School of Nursing in Vancouver. Dr. Balneaves is lead...

health-care policy

AACR Urges Congress to Maintain, Preferably Increase, Cancer Research Funding

December 23, 2011, marked the 40th anniversary of the National Cancer Act. To mark that occasion, on February 2, the American Association for Cancer Research (AACR) held a Congressional briefing, attended by about 100 legislative aides, to remind Congress that the war on cancer is far from over....

breast cancer

Context May Affect Benefit of Adjuvant Clodronate in Breast Cancer

A benefit of the oral bisphosphonate clodronate when used as adjuvant therapy for early breast cancer may depend on factors such as the endpoint assessed and patient age, suggests the randomized B-34 trial conducted by the National Surgical Adjuvant Breast and Bowel Project (NSABP). The trial,...

multiple myeloma

Maintenance with Lenalidomide or Bortezomib Prolongs Remission in Elderly Patients with Multiple Myeloma

The benefit of maintenance therapy in newly diagnosed multiple myeloma patients ineligible for stem cell transplant, such as the elderly, is still debated, though value appears to be emerging, according to studies presented at the 2011 American Society of Hematology (ASH) Annual Meeting....

hematologic malignancies

How I Work up the Patient with Thrombocytosis

Thrombocytosis is defined as a platelet count greater than 400 × 109/L. In routine clinical practice, thrombocytosis is much more likely to be reactive (> 80% of cases) than primary. Reactive thrombocytosis is usually associated with infections, inflammation, trauma, hemolysis, metastatic...

prostate cancer

First Urine-based Molecular Test to Gauge Need for Repeat Prostate Biopsies

Gen-Probe announced the FDA has approved its PROGENSA PCA3 (prostate cancer gene 3) assay, the first molecular test to help determine the need for repeat prostate biopsies in men who have had a previous negative biopsy. “Overexpression of the PCA3 gene is highly specific to cancerous prostate...

kidney cancer

What You Need to Know About Axitinib, New Agent for Treating 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. Indication In January 2012, the second-generation vascular...

skin cancer

Answer to Secondary Cancers with RAF Inhibitors May Be Concomitant MEK Inhibition

Keratoacanthomas and cutaneous squamous cell carcinomas are frequently observed in patients receiving the RAF inhibitor vemurafenib (Zelboraf) for treatment of BRAF-mutated melanoma. As discussed by Lacouture and colleagues in a recent Journal of Clinical Oncology article, these effects appear to...

leukemia

Autologous Transplant vs Consolidation Chemotherapy in Acute Myeloid Leukemia: A Recent European Trial

Investigators in the Dutch-Belgian Hemato-Oncology Cooperative Group and the Swiss Group for Clinical Cancer Research Collaborative Group recently reported in the journal Blood that autologous peripheral blood stem cell transplantation significantly reduced relapse rate compared with intensive...

leukemia

Autologous Hematopoietic Cell Transplantation for Adult Acute Myeloid Leukemia: A Question That Doesn’t Go Away

More than 3 decades ago, the first trials of autologous hematopoietic cell transplantation as consolidation therapy for acute myeloid leukemia (AML) in first remission were conducted. The initial results were inconclusive; most patients survived the procedure, but post-transplant relapse was common ...

colorectal cancer

Adjuvant Therapy for Stage III Colon Cancer: Survival Advantage of Oxaliplatin Reported in Clinical Trials Extends to Diverse Group of Patients

The survival advantage conferred by adding oxaliplatin to adjuvant chemotherapy with fluorouracil (5-FU) in stage III colon cancer, as previously shown in patients in randomized controlled trials, extends to patients in the general population, including older and minority group patients and those...

prostate cancer

Immune Changes Reported with Early Use of Sipuleucel-T in Neoadjuvant Setting for Prostate Cancer

Sipuleucel-T (Provenge) can generate a circulating immune response to treat men with metastatic castrate-resistant prostate cancer, as per its FDA-approved indication.1 A neoadjuvant trial was performed to investigate whether earlier use of sipuleucel-T can generate an immune response in the...

gastrointestinal cancer

New Assays, Surveillance Techniques Reported for GI Malignancies

Two studies highlighted in press conferences and one presented during an invited lecture at the 2012 Gastrointestinal Cancers Symposium, held recently in San Francisco, suggest that early detection of pancreatic, esophageal, and colorectal cancers could soon improve. Enzyme Immunoassay Spots...

prostate cancer
bladder cancer
kidney cancer

Important News Briefs: New Data Reported in Prostate, Bladder, and Kidney Cancers

The recent 2012 Genitourinary Cancers Symposium featured a wealth of presentations on prostate, bladder, kidney, and other genitourinary cancers. Brief summaries of some of the oral and poster sessions are presented. Exercise and Recurrence Vigorous exercise has been shown to reduce cancer...

prostate cancer

Prostate Cancer Studies Compare Outcomes, Toxicities, and Costs

Patients with prostate cancer are treated with various forms of radiotherapy and/or radical prostatectomy with little comparative data to inform treatment selection. Two studies presented at the 2012 Genitourinary Cancers Symposium attempt to address that gap. In one study of men with localized...

geriatric oncology

Moving the Field of Geriatric Oncology Forward

With the aging of the population, virtually all of the subspecialties of oncology will soon be concerned primarily with the care of older patients. While there is not one precise definition of the age of “geriatric” patients, it is clear that the aging of our society has necessitated a focus on the ...

cns cancers

Re-analysis of RADIANT-2 Finds Benefit for Everolimus in Patients with Carcinoid Tumors

A re-analysis of the RADIANT-2 trial, which evaluated everolimus (Afinitor) in patients with advanced nonpancreatic neuroendocrine tumors, has yielded prognostic factors that identify a group of patients who are not only at high risk for recurrence but who may derive benefit from treatment with...

issues in oncology

Two DPYD Variants Join List of Variants Predictive of Fluoropyrimidine Toxicity

In a systematic review and meta-analysis reported in The Lancet Oncology, Meulendijks et al found that the DPYD variants c.1679T>G and c.1236G>A/HapB3 were predictive of severe fluoropyrimidine-associated toxicity, with the variant c.1601G>A not achieving a significant relationship....

breast cancer

No Benefit Shown With Afatinib in HER2-Positive Breast Cancer With Progressive Brain Metastases

In the phase II LUX-Breast 3 trial reported in The Lancet Oncology, Cortés et al found that afatinib (Gilotrif) alone or combined with vinorelbine did not increase patient benefit vs investigator choice of treatment in patients with HER2-positive breast cancer and progressive brain...

solid tumors
lung cancer
cns cancers

Everolimus Improves Progression-Free Survival in Advanced Neuroendocrine Tumors of the Lung or Gastrointestinal Tract

In a phase III RADIANT-4 trial reported in The Lancet, Yao et al found that everolimus (Afinitor) and supportive care significantly prolonged progression-free survival vs placebo and supportive care in patients with advanced nonfunctional neuroendocrine tumors of the lung or gastrointestinal tract. ...

2012 Oncology Meetings

APRIL 3rd European Lung Cancer ConferenceApril 18-21 • Geneva, Switzerland For more information: www.esmo.org Diagnosis and Treatment of Advanced Forms of Prostate Cancer, Bladder Cancer and Kidney CancerApril 20-21 • Kiev, Ukraine For more information: http://nbscience.com Organisation for...

Expect and Encourage Questions from Your Patients

The oncologist has an important role in advising patients about infertility as a potential risk of cancer treatment and answering basic questions about fertility preservation options, according to the ASCO Recommendations on Fertility Preservation in People Treated for Cancer. An ASCO slide set...

issues in oncology

Options for Preserving Fertility Should Be Considered Early to Maximize the Likelihood of Success

Most cancer survivors prefer to have biologic offspring despite concerns about the possible effects of cancer treatment on the child, the child’s lifetime cancer risk, or their own longevity, according to an ASCO panel that developed guidelines on fertility preservation in patients with cancer.1...

gastrointestinal cancer

Salvage Chemotherapy plus Best Supportive Care in Advanced Gastric Cancer

Adding salvage chemotherapy to best supportive care was tolerated and improved overall survival among patients with advanced gastric cancer previously treated with both fluoropyrimidines and platinum, administered simultaneously or concurrently. The authors of the study report, published in the...

Targeted Mutations in ATR Pathway and Implications for Combination Strategies

Many chemotherapy agents work by causing DNA strand breaks or accumulation of DNA replication intermediates. ATR (ataxia-telangiectasia mutated and Rad 3-related protein) is a potential target for combination drug strategies, because signaling of this protein in response to such altered DNA...

SIDEBAR: Marking 40 Years of Cancer Progress

It’s been 40 years since President Richard Nixon declared, “The time has come in America when the same kind of concentrated effort that split the atom and took man to the moon should be turned toward conquering this dread disease,” and later signed into law the National Cancer Act of 1971. Passage...

issues in oncology

ASCO’s Blueprint Sets Goals for Accelerating Cancer Progress

ASCO recently issued a report, Accelerating Progress Against Cancer: ASCO’s Blueprint for Transforming Clinical and Translational Cancer Research, which outlines the Society’s 10-year plan for improving cancer outcomes. Central to achieving that goal are three steps, including (1) therapy...

lymphoma

New Data Guide Treatment for Rare Form of Hodgkin Lymphoma

Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) accounts for approximately 5% of Hodgkin lymphoma cases. It is distinguished from classic Hodgkin lymphoma by a variety of clinical and pathologic features, including expression of B-cell associated antigens such as CD20. Given that the...

leukemia

Erwinia chrysanthemi Asparaginase for Acute Lymphoblastic Leukemia in Patients with Hypersensitivity to E coli–derived Asparaginase

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 Erwinia chrysanthemi asparaginase (Erwinaze) was...

breast cancer

FDA Approves New Silicone Gel–filled Breast Implant

The FDA recently approved a silicone gel-filled breast implant manufactured by Sientra Inc for breast augmentation in women at least 22 years old and breast reconstruction in women of any age. As a condition of approval, Sientra is required to conduct postapproval studies that will assess long-term ...

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