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breast cancer

Ado-Trastuzumab Emtansine in Metastatic Breast 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 On February 22, 2013, ado-trastuzumab emtansine...

colorectal cancer

BRAF Mutations in Colorectal Cancer: The Next Frontier 

Some 5% to 10% of patients with colorectal cancer harbor the BRAF mutation, placing them at risk for poor treatment response and worse outcomes. The ASCO Post interviewed S. Gail Eckhardt, MD, an expert in this area who is Professor and Head of the Division of Medical Oncology at the University of...

hepatobiliary cancer
pancreatic cancer
gastrointestinal cancer

Important Data and Treatment Advances Reported in GIST and in Pancreatic and Liver Cancers 

The 10th annual Gastrointestinal Cancers Symposium, held recently in San Francisco, was jointly sponsored by ASCO, the AGA (American Gastroenterological Association), ASTRO (American Society for Radiation Oncology), and the SSO (Society of Surgical Oncology). “We seek to present the newest...

bladder cancer

Clinical-Pathologic Stage Discrepancy High in Patients with Bladder Cancer Undergoing Surgery 

About 48% of all patients with bladder cancer undergoing radical cystectomy have a discrepancy between their clinical stage and pathologic stage, according to the largest study to date to examine this issue. Upstaging after surgery is associated with reduced survival, while downstaging after...

kidney cancer
prostate cancer

New Findings in Prostate and Kidney Cancers Clarify the Roles of Abiraterone, Finasteride, Bevacizumab, and Surveillance 

Attendees at the 2013 Genitourinary Cancers Symposium in Orlando, Florida, were brought up to date with the latest news on cancers of the prostate, testes, bladder, and kidney. Below are selected highlights from the meeting describing findings of noteworthy abstracts to extend our regular news...

leukemia

Homoharringtonine/Omacetaxine: The Little Drug that Could

First, a clarification: Homoharringtonine is a natural plant alkaloid derived from Cephalotaxus fortunei; from the 1970s until the present, it was the subject of intensive research efforts by Chinese investigators to clarify its role as an antileukemic agent.1-3 Omacetaxine mepesuccinate (Synribo)...

colorectal cancer

Is Aspirin Protective against Colorectal Cancer? 

A growing body of evidence provides biologic and clinical evidence that nonsteroidal anti-inflammatory agents are protective against colorectal cancer. “It is fascinating for me as a medical oncologist and epidemiologist to see how the worlds of colorectal cancer treatment and epidemiology are...

pain management

Duloxetine Reduced Painful Chemotherapy-induced Peripheral Neuropathy  

The use of duloxetine (Cymbalta) for 5 weeks “was associated with a statistically and clinically significant improvement” in painful chemotherapy-induced peripheral neuropathy when compared with placebo in a phase III randomized, double-blind crossover trial reported in the Journal of the American...

leukemia

Bortezomib Added to Standard Induction Therapy Produced Encouraging AML Remission Rate  

Adding bortezomib (Velcade) to standard daunorubicin and cytarabine induction chemotherapy for acute myeloid leukemia (AML) “resulted in an encouraging remission rate” in previously untreated older adults, according to results of Cancer and Leukemia Group B (CALGB/Alliance) study 10502. The...

breast cancer

Progression-free Survival in HER2-positive Metastatic Breast Cancer Improved with T-DM1 

First-line treatment with ado-trastuzumab emtansine (T-DM1) “provided a significant improvement” in progression-free survival when compared to trastuzumab (Herceptin) plus docetaxel in a randomized phase II study among patients with HER2-positive metastatic or recurrent locally advanced breast...

survivorship

Fred Hutchinson Cancer Research Center Survivorship Program to Lead New Study on Cancer In Young Adults

The Fred Hutchinson Cancer Research Center Survivorship Program and its Directors, K. Scott Baker, MD, and Karen Syrjala, PhD, have been selected to lead a nationwide study that aims to improve long-term health outcomes for cancer survivors between the ages of 18 and 39 years. Underway this spring, ...

breast cancer

Increase in Advanced Breast Cancer among Younger Women Is Small but Significant, and Trend Is Likely to Continue 

The incidence of advanced breast cancer among women aged 25 to 39 years increased by an average of 2.07% per year from 1976 to 2009 and the trend seems likely to continue, according to an analysis of data for 936,497 women diagnosed with malignant breast cancer. The small but statistically...

Oncology Meetings

May 2013 Annual Paris Melanoma ConferenceMay 2-3 • Paris, FranceFor more information: www.primeoncology.org/parismelanoma2013 5th IMPAKT Breast Cancer ConferenceMay 2-4 • Brussels, BelgiumFor more information: www.esmo.org Florida Society of Clinical Oncology Third Annual AVBCC ConferenceMay 2-5 •...

issues in oncology
palliative care

New ASCO/AAHPM Project Will Harness Technology to Foster Improved Palliative Care in Oncology

ASCO and the American Academy of Hospice and Palliative Care Medicine (AAHPM) recently announced a joint initiative to support delivery of high-quality palliative care in medical oncology. The initiative is funded by ASCO’s first-ever grant from the Agency for Health Care Research Quality. The...

hematologic malignancies
leukemia

A Promising New Agent's Road to Approval in CLL Raises Questions, Stirs Controversy 

Early trial results in single-agent therapy with the oral Bruton’s tyrosine kinase (BTK) inhibitor ibrutinib have produced excellent responses in patients with chronic lymphocytic leukemia (CLL). Moreover, ibrutinib is extremely well tolerated, allowing patients to remain on trial and receive the...

issues in oncology

Access to Care: Who Gets Referred to a Medical Oncologist and/or Another Cancer Specialist and Who Receives Treatment for Advanced Cancer? 

What factors determine who is referred to a medical oncologist and receives treatment for advanced cancers? Several articles in the Journal of Oncology Practice suggest that factors influencing referral and treatment go beyond the patient’s medical condition and preference and include such details...

solid tumors
colorectal cancer

More Recreational Physical Activity Associated with Reduced All-cause Mortality in Patients with Colorectal Cancer 

In a study recently reported in Journal of Clinical Oncology, Peter T. Campbell, PhD, and colleagues from the Epidemiology Research Program of the American Cancer Society, Atlanta, found that more recreational physical activity before and after a diagnosis of colorectal cancer was associated with...

solid tumors
colorectal cancer

Benefit of Continued Antiangiogenic Treatment with Bevacizumab after Progression in Metastatic Colorectal Cancer 

As reported recently in Lancet Oncology by Jaafar Bennouna, MD, of Institut de Cancérologie de l’Ouest, Nantes, France, and colleagues, the phase III ML18147 trial showed a survival benefit with continued bevacizumab (Avastin) treatment after first progression in metastatic colorectal cancer.1 The...

skin cancer

Sentinel Node Biopsy in Melanoma: Essential or Optional? 

Is sentinel node biopsy in melanoma an essential component of care? Despite a large multinational trial and recently published or updated guidelines, the question is still a thorny one according to experts who debated the issue at the recent meeting of the Society of Surgical Oncology in...

solid tumors
hepatobiliary cancer

Medical Oncologists Underestimate Resectability of Liver Metastases 

Medical oncologists are apt to underestimate the resectability of liver metastases in patients with colorectal cancer and therefore often fail to refer potential surgical candidates for surgical consultation, according to a study presented at the 18th Annual Conference of the National Comprehensive ...

SIDEBAR: The Ethical Imperative of Clinical Equipoise 

In her editorial about the RESONATE trial (page 1), Dr. O’Brien raises the issue of equipoise in this phase III clinical trial that compares the efficacy of ibrutinib and ofatumumab (Arzerra) in patients with relapsed or refractory chronic lymphocytic leukemia (CLL) who are not appropriate...

leukemia

Ibrutinib CLL Trial: Where Is the Equipoise?

The RESONATE trial is randomly assigning patients with refractory or relapsed CLL to either ofatumumab (Arzerra) or the investigational oral agent ibrutinib. Ofatumumab is an anti-CD20 monoclonal antibody like rituximab (Rituxan), but is more potent as a single agent. It was approved for refractory ...

SIDEBAR: First Report of Antibody-Drug Conjugate in Advanced Ovarian Cancer

In a related presentation at the AACR Annual Meeting,1 the antibody-drug conjugate DMUC5754A showed encouraging activity in women with ovarian cancer, particularly those with platinum-resistant disease, which currently lacks effective treatment options. The first-in-human phase I study included 44...

High Levels of Psychological Distress Are Common among Parents of Children with Advanced Cancer 

High to severe levels of psychological distress are common among parents of children with advanced cancer, according to a study conducted at three children’s hospitals—Boston Children’s Hospital, Children’s Hospital of Philadelphia, and Seattle Children’s Hospital. The cohort study was embedded in...

integrative oncology

Symptom Management with Complementary Therapies for Patients Receiving Radiation Therapy

The supportive care of patients with cancer receiving radiotherapy is an important responsibility for the radiation oncologist, and complementary therapies are an integral component of many patients’ treatment strategy.A recent prospective study suggests that 54% of patients with breast cancer...

breast cancer

Living with the Fear of Cancer 

After a friend was diagnosed with breast cancer, I became so worried it would happen to me, I decided to perform regular breast self-exams so I could familiarize myself with the normal feel of my breasts, and quickly spot any changes. My friend’s diagnosis scared me, and that fear probably saved my ...

solid tumors
breast cancer
survivorship

Dr. Bernard Fisher's Breast Cancer Research Left a Lasting Legacy of Improved Therapeutic Efficacy and Survival 

Bernard Fisher, MD, is recognized today for his groundbreaking research in breast cancer, which ultimately ended the standard practice of performing the Halsted radical mastectomy, a treatment that had been in place for more than 75 years. His laboratory and clinical investigations led to more...

leukemia

Drug Approvals in Acute Myeloid Leukemia: Can We Do Better? 

Forty years ago, President Richard Nixon announced a “war on cancer.” Some of that war’s first battles were won in the field of acute myeloid leukemia (AML) with two agents, cytarabine and daunorubicin, receiving U.S. Food and Drug Administration (FDA) approval based on their ability to produce...

Memorial Sloan-Kettering Cancer Center Announces New Appointments

Memorial Sloan-Kettering Cancer Center in New York recently announced the following appointments: Chief of Lymphoma Anas Younes, MD, has been named Chief of the Lymphoma Service in the Division of Hematologic Oncology, Department of Medicine. An internationally recognized medical oncologist with...

Oncology Meetings

May Northern New England Clinical Oncology Society Spring MeetingMay 17 • Manchester, New HampshireFor more information: www.nnecos.org Iowa Oncology Society Spring Membership ConferenceMay 17-18 • West Des Moines, IowaFor more information: www.ios-iowa.com California Breast Cancer Research...

solid tumors
pancreatic cancer
global cancer care

Oral S-1 Noninferior to Gemcitabine in Advanced Pancreatic Cancer in Japan and Taiwan 

As reported by Hideki Ueno, MD, PhD, of National Cancer Center Hospital, Tokyo, and colleagues in Journal of Clinical Oncology, treatment with the oral fluoropyrimidine derivative S-1 was associated with noninferior overall survival and reduced hematologic toxicity compared with gemcitabine...

gynecologic cancers

Lynch Syndrome: A Multitude of Predispositions 

The current uncertainty regarding the relative frequencies of cancers of various anatomic sites in Lynch syndrome poses a difficulty in commenting on the syndrome’s overall cancer spectrum. It is even more vexing to address the order in which these cancers are prone to occur. What we do know is...

gynecologic cancers

Women with Lynch Syndrome and Endometrial Cancer Are at Increased Risk of Other Cancers 

Lynch syndrome is an autosomal dominantly inherited disorder due to germline mutations in DNA mismatch repair genes. Mismatch repair mutation carriers are at increased risk of several cancers, with endometrial cancer being one of the most commonly diagnosed cancers in women with Lynch syndrome. In...

gynecologic cancers

Combinatorial Immunologic Approach Yields Benefit in Preliminary Study of Recurrent Ovarian Cancer

A two-step immunologic approach that includes a personalized dendritic cell vaccine for each patient followed by adoptive T-cell therapy holds promise for the treatment of recurrent ovarian cancer, according to results of two consecutive phase I studies presented at the American Association for...

colorectal cancer

Emerging Prognostic Markers in Colon Cancer 

Patients with stage II colon cancer generally have a favorable prognosis, with about 80% of patients surviving 5 years after surgery and the majority of these long-term survivors presumed to be cured. Clearly though, some patients are destined to recur after surgery, and there is an urgent need to...

solid tumors
colorectal cancer

12-Gene Recurrence Score Predicts Recurrence in Stage II Colon Cancer in CALGB 9851 Population 

As reported by Alan P. Venook, MD, Professor of Medicine (Hematology/Oncology) at the University of California, San Francisco, and colleagues in Journal of Clinical Oncology, a 12-gene recurrence score (Oncotype DX Colon Cancer Assay) was shown to predict recurrence in stage II colon cancer in a...

gynecologic cancers
lymphoma
issues in oncology

Guideline Adherence and Geriatric Assessment Studies among NCCN Scientific Posters of Interest 

For the first time at the National Comprehensive Cancer Network (NCCN) Annual Conference, scientific posters were included as part of the program. The ASCO Post captured some of the most interesting findings for our readers, including the following news briefs. The findings of these studies support ...

breast cancer

Novel Regimen Produces High Pathologic Complete Response Rates in Triple-negative Breast Cancer 

Interim results from a small neoadjuvant study of patients with triple-negative breast cancer has found high rates of pathologic complete response with the combination of nab-paclitaxel (Abraxane), carboplatin, and bevacizumab (Avastin).1 The study was presented at the 18th Annual Conference of the ...

issues in oncology
supportive care
symptom management

Automated Telephone Monitoring Reduces Chemotherapy-related Symptoms 

The use of an automated computer-based telephone monitoring system to assess symptoms during outpatient chemotherapy—and provide intervention where appropriate by a nurse practitioner—substantially reduced the number of days with symptoms in a study reported at the 18th Annual Conference of the...

lung cancer

Lessons of 2 Decades' Experience with CHESS

Our work on an Internet-based intervention for lung cancer confirmed what many other studies have shown about technologic interventions for health-care consumers—that such interventions can improve quality of life for caregivers and patients.1 We expected this result in part because of the...

ASCO Completes Prototype for CancerLinQ™, Marking First Demonstration of a 'Learning Health System' to Transform Cancer Care

ASCO has completed a prototype of CancerLinQ™, the Society’s groundbreaking health information technology initiative to achieve higher quality, higher value cancer care with better outcomes for patients. The prototype was shown on March 27 at the National Press Club in Washington, DC, during an...

issues in oncology
health-care policy

Disparities in Cancer Care: How A Deep South Community Overcame Them 

Racial inequities were a daily observation for Edward E. Partridge, MD, growing up in Alabama during the civil rights era. When he became a physician, he saw that these disparities extended into his own field, gynecologic oncology. He decided to do something about it. Dr. Partridge recently...

Personal Testimonial: CAR-modified T Cells in Adults 

Twelve adults with chronic lymphocytic leukemia (CLL) have been treated with CD19-targeted chimeric antigen receptor (CAR) T-cell therapy at the University of Pennsylvania in Philadelphia by Carl June, MD, Richard W. Vague Professor in Immunotherapy, and colleagues. These were all end-stage...

leukemia

Promising Phase II Results Continue to Support Ibrutinib in CLL  

Results from an ongoing phase II study reported at the recent Annual Meeting of the American Association for Cancer Research (AACR) demonstrate impressive activity with the use of ibrutinib in patients with chronic lymphocytic leukemia (CLL) and 17p deletions, which are associated with a poor...

skin cancer

Prevention and Treatment of Acneiform Rash Caused by EGFR Inhibitors 

Dermatologic Events in Oncology is guest edited by Mario E. Lacouture, MD, an Associate Member in the Division of Dermatology, Department of Medicine, at Memorial Sloan-Kettering Cancer Center, New York. He is a board-certified dermatologist with a special interest in dermatologic conditions that...

lymphoma

Role of Stem Cell Transplantation in Follicular Lymphoma 

The place of either autologous or allogeneic hematopoietic stem cell transplantation in the care of patients with follicular lymphoma has been a point of controversy. However, for patients in whom an effective chemotherapy or chemoimmunotherapy regimen for low-grade follicular lymphoma fails, I...

breast cancer
issues in oncology
survivorship

Breakthroughs in Targeted Therapies for Breast Cancer Are Improving Patient Survival Rates 

For more than 20 years, José Baselga, MD, PhD, has devoted his medical and scientific career to caring for breast cancer patients and the development of novel molecular targeted agents to treat the disease. From 1996 to 2010, he was Head of the Oncology Department of Vall d’Hebron University...

breast cancer

Reducing Incidental Cardiac Irradiation during Breast Radiotherapy  

In the treatment of breast cancer, a wealth of data from prospective clinical trials and meta-analyses has documented the benefits of radiation to prevent local-regional recurrence and improve survival. Accordingly, important quality indicators in breast cancer care include: (1) receipt of...

SIDEBAR: Left-sided Adjuvant Breast Radiotherapy: A Change of Heart? 

Darby and colleagues are to be congratulated for an ambitious population-based case-control study that demonstrates the impact of postoperative adjuvant ionizing radiation for early-stage breast cancer on ischemic heart disease.1 The study examined roughly 1,000 cases and 1,000 controls in Sweden...

Factors Increasing Risk of Death from Breast Cancer Identified  

Several studies presented at the Annual Meeting of the American Association for Cancer Research in Washington, DC, focused on factors associated with breast cancer mortality. One study found that older women with longer intervals between mammograms had a higher likelihood of dying of breast cancer. ...

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