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Showing 1301 - 1350Expert Point of View: Benjamin J. Solomon, MBBS, PhD
“The LUX-Lung 3 study has been much awaited. It is the first study to use cisplatin/pemetrexed [Alimta], which we now recognize as the best comparator arm. The study was positive for afatinib. While the use of maintenance pemetrexed may have dented the hazard ratio, I doubt this would have impacted ...
First-line Afatinib Superior to Standard Chemotherapy in Advanced EGFR-mutated Non–Small Cell Lung Cancer
First-line therapy with the investigational oral agent afatinib improved progression-free survival compared with standard chemotherapy (pemetrexed (Alimta)/cisplatin) in patients with advanced non–small cell lung cancer (NSCLC) harboring an EGFR mutation. Afatinib improved progression-free survival ...
Expert Point of View: Landscape for Treatment of Metastatic Melanoma Is Expanding
At an Annual Meeting press conference, ASCO spokesperson Sylvia Adams, MD, said, “BREAK-3 confirms that BRAF targeting is effective in metastatic melanoma. The tumor shrinkage seen with dabrafenib is similar to results observed for the FDA-approved drug vemurafenib, with fewer side effects. We will ...
Landscape for Treatment of Metastatic Melanoma Is Expanding
Metastatic melanoma was long considered untreatable and incurable. The FDA approval of ipilimumab (Yervoy) and vemurafenib (Zelboraf) ushered in a new era for this disease, and now additional treatment options are in late stages of clinical development. Dabrafenib, a novel oral BRAF inhibitor, and...
Expert Point of View: TAILOR
Formal discussant of the TAILOR trial, Benjamin J. Solomon, MBBS, PhD, of the Peter MacCallum Cancer Centre, East Melbourne, Australia, noted that the study asks an important question about the benefit of an EGFR inhibitor in patients with wild-type EGFR. The progression-free survival reported in...
Expert Point of View: PARAMOUNT
Formal discussant Gregory Peter Kalemkerian, MD, of the University of Michigan Comprehensive Cancer Center, Ann Arbor, questioned whether all patients need maintenance therapy, since some patients on placebo lived as long as those on pemetrexed maintenance, and quality of life, as reported...
Second-line Treatments Tested in Patients with Non-Small Cell Lung Cancer
Results of two late-breaking phase III trials presented at 2012 ASCO Annual Meeting add to the evolving understanding of how best to treat non–small cell lung cancer (NSCLC). The TAILOR trial suggested the benefit of chemotherapy over EGFR-targeted therapy as second-line treatment of patients with...
Supportive Care Experts Explore 30 Years of Progress in the Field
Thirty years ago, when the first supportive care meeting as a forerunner of the Multinational Association of Supportive Care in Cancer (MASCC) Symposium was held in New York, supportive care was largely ignored, with little discussion at major cancer meetings, which focused primarily on...
Taking Family History and Referral to Genetic Counseling Could Be Improved, Survey Finds
Obtaining a thorough family history of cancer should be a key component in evaluating patients and deciding whether to refer those at increased risk of either primary or second cancers for genetic counseling and testing. Many community oncology practices comply with this practice, but there is room ...
Antidepressant Drug Has ‘Clinically Meaningful’ Effect on Chemotherapy-induced Painful Neuropathy
The oral antidepressant duloxetine (Cymbalta) at 60 mg/d improved chemotherapy-induced painful neuropathy in a randomized, double-blind, placebo-controlled, phase III trial.1 Overall, 59% of patients treated with duloxetine experienced some pain relief, 33% reported at least a 30% decrease in pain, ...
FDG-PET Falls Short for Diagnosis of Non–Small Cell Lung Cancer
The ability to make a diagnosis of non–small cell lung cancer (NSCLC) with FDG-PET varies widely among centers, and this imaging modality performed more poorly in community and academic centers than in published studies.1 A secondary analysis of the prospective American College of Surgeons Oncology ...
Patient Preference Studied in Treatment Selection for Renal Cell Carcinoma
More attention is being paid to the importance of patient preference as a factor in treatment selection. An innovative randomized, double-blind study in patients with metastatic kidney cancer demonstrates that quality of life and side effects drive patient preference.1 Results also suggest that...
Supportive Care Research Runs the Gamut from Genetic Markers of Treatment Side Effects to Neuropathic Pain Therapies
Attendees from around the world gathered for the Multinational Association for Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) International Symposium on Supportive Care in Cancer, held June 28–30 in New York. Below are highlights from the meeting, representing...
Developments in Hematologic Cancers Include New Considerations in Treating Challenging Leukemias and Multiple Myelomas
Speakers at the National Comprehensive Cancer Network (NCCN) 7th Annual Congress on Hematologic Malignancies reviewed the current standard of care for various hematologic cancers and explored new concepts in treatment. Below are highlights from presentations on chronic myelogenous leukemia (CML),...
Pazopanib Noninferior to Sunitinib as Front-line Therapy for Metastatic Renal Cell Carcinoma
Pazopanib (Votrient) is poised to become another option for first-line therapy of metastatic renal cell carcinoma based on results of the phase III COMPARZ trial reported at the 2012 ESMO Congress in Vienna.1 The study met its primary endpoint by demonstrating that pazopanib was noninferior to...
Role of Crizotinib in Previously Treated ALK-positive Advanced NSCLC
In yet another success story for personalized medicine, a targeted therapy extended survival in patients whose cancers expressed the target. Crizotinib (Xalkori), the first-in-class ALK inhibitor, extended progression-free survival and improved response rates compared with single-agent chemotherapy ...
Challenges Persist in Treatment of Elderly Patients with CLL, but Novel Agents Hold Promise for Future Strategies
Chronic lymphocytic leukemia (CLL) is mainly a disease of the elderly, and the lack of a standard regimen for elderly patients has been a major challenge. The myelosuppressive regimens used to treat younger patients are not well tolerated by the elderly. However, some newer approaches currently...
Study Reveals Global Picture of Obstacles to Pain Control in Patients with Cancer
Hundreds of millions of patients with cancer around the world are suffering from unrelieved cancer pain, despite the availability of morphine and other drugs that could alleviate that suffering. The major barriers are twofold: governments failing to ensure an adequate supply of morphine and other...
Expert Point of View: Reinhard Dummer, MD
Although the effects of BRAF inhibition were initially unprecedented in patients with BRAF-mutated metastatic melanoma, “the problem is that the effect is not durable,” said formal discussant of this trial, Reinhard Dummer, MD, University Hospital of Zurich, Switzerland. The development of...
Combination of BRAF and MEK Inhibitors Paves Way for Phase III Studies in BRAF-mutated Metastatic Melanoma
Two late-breaking studies presented at the 2012 European Society for Medical Oncology (ESMO) Congress highlight the promising potential of combining dual BRAF and MEK inhibitors for the treatment of BRAF-mutated metastatic melanoma. A phase II study showed that combining full doses of the BRAF...
Expert Point of View: Jean-Yves Pierga, MD
Formal discussant of the MISSION trial, Jean-Yves Pierga, MD, Institut Curie, Paris, said that it is one of several studies to show no clear benefit in overall survival for the addition of a tyrosine kinase inhibitor targeting angiogenesis in advanced non–small cell lung cancer. Dr. Pierga noted...
Sorafenib Fails to Improve Survival as Third- or Fourth-line Treatment of Advanced Non–Small Cell Lung Cancer
Third- or fourth-line therapy with sorafenib (Nexavar) failed to extend overall survival in patients with advanced non–small cell lung cancer (NSCLC), according to the main results of the phase III MISSION trial. However, a post hoc biomarker analysis of MISSION suggested that patients with...
Expert Point of View: Nicholas Turner, MD, PhD
Commenting on the studies evaluating novel agents in breast cancer, Nicholas Turner, MD, PhD, of the Royal Marsden Hospital in London, observed that for BKM120 plus trastuzumab (Herceptin), the “benefit appears to be in only a relatively small proportion of patients, but in those patients there is...
Novel Agents for Breast Cancer and Prostate Cancer Impressive in Early Trials
Several sessions at the 2012 European Society for Medical Oncology (ESMO) Congress in Vienna focused on novel targeted therapies in various stages of development. Summarized here are data on two promising drugs for breast cancer and two for prostate cancer. E-3810 in Breast Cancer Two experimental...
Updated Results from T-DM1 and Regorafenib Trials, plus Other Highlights from ESMO 2012
The 35th European Society for Medical Oncology (ESMO) Congress in Vienna broke all records for attendance, with about 16,000 attendees from all over the world. Some sessions were standing room only, including the Presidential Symposia, the ESMO-ASCO Joint Symposium on genomics in breast cancer, and ...
Expert Point of View: Robert Jones, MD
“The data speak for themselves,” stated Robert Jones, MD, of the Beatson West of Scotland Cancer Center, Glasgow, UK, during discussion of the MAINSAIL trial at the 2012 ESMO Congress. The study raises some important questions, he continued: What are the implications for designing future trials?...
Lenalidomide Trial Negative in Metastatic Castration-resistant Prostate Cancer
Lenalidomide (Revlimid) failed to improve survival and increased toxicity when added to docetaxel and prednisone in men with chemotherapy-naive, progressive, metastatic castration-resistant prostate cancer in the phase III MAINSAIL trial reported at the 2012 ESMO Congress in Vienna. This study...
Expert Point of View: Nicoletta Colombo, MD
Formal discussant of the AURELIA presentation, Nicoletta Colombo, MD, University of Milan Bicocca, European Institute of Oncology, Milan, Italy, said, “This is the only positive trial in patients with platinum-resistant recurrent ovarian cancer.” Dr. Colombo was impressed with the activity of...
Combination Bevacizumab/Chemotherapy Improves Outcomes in Platinum-resistant Ovarian Cancer
The addition of bevacizumab (Avastin) to chemotherapy improved progression-free survival and response rates in patients with platinum-resistant recurrent ovarian cancer, according to an exploratory analysis of the phase III AURELIA trial. The combination of paclitaxel with bevacizumab achieved very ...
Expert Point of View: Jeffrey Bradley, MD
Commenting on both radiotherapy studies and the use of proton-beam therapy in general, Jeffrey Bradley, MD, of Washington University in St Louis, agreed with both presenters that a randomized prospective trial is needed to justify the use of proton-beam therapy in prostate cancer. Washington...
Early Quality of Life Better with Proton-beam Therapy, but Late Effects Similar to Other Treatment Modalities for Prostate Cancer
Differing patterns of patient-reported quality of life for three-dimensional (3D) conformal radiotherapy, intensity-modulated radiation therapy, and proton-beam therapy were reported in a nonrandomized comparison of three modern cohorts of patients with prostate cancer. The study was presented at...
Expert Point of View: Colleen Lawton, MD
“These were two nice presentations evaluating the ability of SBRT to control disease as well as toxicity. This is cutting-edge research. It is very exciting that we could treat prostate cancer patients with radiation inside of 2 to 2.5 weeks, and it is clearly cost-saving. We need longer follow-up...
Stereotactic Body Radiation Therapy Produces Impressive Results in Organ-confined Prostate Cancer
Stereotactic body radiation therapy (SBRT) delivered via the CyberKnife can achieve excellent outcomes with minimal toxicity in patients with prostate cancer. Importantly, this technique delivers therapeutic doses of radiation in four to five fractions, which reduces the number of clinic visits...
Expert Point of View: Thomas Pisansky, MD
Commenting on this paper, Thomas Pisansky, MD, the Mayo Clinic, Rochester, Minnesota, reminded listeners that about 50% of patients treated with external-beam radiation therapy and about 33% of those treated with brachytherapy already have erectile dysfunction prior to treatment. After radiation...
Sildenafil Improves Overall Sexual Function in Men with Prostate Cancer Treated with Radiation
For the first time, a randomized controlled trial reported improved sexual function with 6 months of prophylactic sildenafil citrate before, during, and after radiation therapy in patients with prostate cancer.1 The paper was presented at the Plenary Session during the 54th Annual Meeting of the...
Expert Point of View: Jason A. Efstathiou, MD, DPhil
Although these two trials reported at the ASTRO Annual Meeting are seemingly different, they both establish the value of radiation-based therapy in prostate cancer, demonstrating overall survival benefit and favorable toxicity profiles in high-risk, locally advanced, and castrate-resistant...
Androgen-deprivation Therapy plus Radiation Proven as Standard of Care for High-risk Prostate Cancer
A combined-modality approach of androgen-deprivation therapy plus radiation therapy achieves a substantial survival benefit over androgen-deprivation therapy alone in patients with locally advanced prostate cancer according to final analysis of an intergroup randomized phase III study conducted by...
Expert Point of View: Paul Harari, MD
Formal discussant of this trial, Paul Harari, MD, University of Wisconsin School of Medicine and Public Health, Madison, commended the N09C6 investigators for conducting a randomized controlled phase III trial on symptom relief. “Most phase III trials are conducted to evaluate a new cancer...
Oral Rinse Doxepin Relieves Painful Mucositis in Head and Neck Cancer
Doxepin oral rinse significantly improved oral mucositis in patients treated with radiation therapy for head and neck cancer according to results of a phase III trial presented at the 54th Annual Meeting of the American Society for Radiation Oncology (ASTRO) in Boston. However, the improvement was...
Plenary Session Included Findings on Partial- vs Whole-breast Techniques and Patient Beliefs about Radiotherapy
When the dates were picked for the 54th Annual Meeting of the American Society for Radiation Oncology (ASTRO), no one could have anticipated that the meeting would coincide with Hurricane Sandy’s devastation of parts of the northeast. As the storm approached on Monday and Boston shut down its...
Expert Point of View: Meena S. Moran, MD
“Breast cancer in the geriatric population is a major health issue. Of the more than 230,000 new cases diagnosed annually, somewhere between 40% and 50% will occur in women 65 and over. Furthermore, the elderly population has been and will continue to increase exponentially over time,” stated Meena ...
Radiation Therapy Extends Survival in Elderly Women with Early Breast Cancer
Chronologic age alone should not preclude use of radiation in elderly women with early breast cancer, suggest two studies presented at the 54th Annual Meeting of the American Society for Radiation Oncology (ASTRO). Both studies showed a survival improvement in elderly women with early breast cancer ...
Expert Point of View: Vinai Gondi, MD
This memantine study is a critical first step in understanding and delaying cognitive deterioration in brain metastasis patients, noted formal discussant Vinai Gondi, MD, Associate Director of Research at the CDH Proton Center in Warrenville, Illinois, and Clinical Associate Professor at the...
Memantine Provides Modest Improvement in Cognition after Cranial Irradiation
Memantine, a drug used to treat Alzheimer’s disease, slowed cognitive decline in patients with brain cancer treated with whole-brain radiation therapy in a phase III trial reported at the 54th Annual Meeting of the American Society for Radiation Oncology (ASTRO), held recently in Boston. Cognitive...
Expert Point of View: Agnes Y. Lee, MD
Press conferencemoderator Agnes Y. Lee, MD, Medical Director of the Thrombosis Program and Associate Professor of Medicine at the University of British Columbia and Vancouver Coastal Health in Canada, said that apixaban is the third in a new line of anticoagulants for long-term prevention of...
Fixed-dose Apixaban Reduces Risk of Recurrent Venous Thromboembolism
Venous thromboembolism is a frequent problem in cancer patients, and approximately 20% of all patients who develop the disease have a recurrence. Extending treatment with two fixed doses of the investigational agent apixaban, a factor Xa inhibitor without laboratory monitoring, may provide a...
Expert Point of View: Martin Dreyling, MD and Joshua Brody, MD
Martin Dreyling, MD, Professor at the University of Munich in Germany, said the most important lymphoma studies presented at the 2012 ASH Annual Meeting focused on ibrutinib, the first-in-class Bruton’s tyrosine kinase inhibitor. “Basic science has gone mainstream. We will see a revolution during...
Expert Point of View: Claire Dearden, MD
Patients are very excited about this new, well tolerated drug for chronic lymphocytic leukemia (CLL). Ibrutinib is available orally and is not chemotherapy. It produces excellent responses. This is particularly important for elderly [ie, age 65 and older] patients who are not always fit enough to...
Excellent Preliminary Results for Ibrutinib in Chronic Lymphocytic Leukemia
Although still in preliminary testing with no phase III data, ibrutinib is poised to become an important new agent for patients with chronic lymphocytic leukemia (CLL). Two phase II trials reported at the 54th Annual Meeting of the American Society of Hematology (ASH) found that ibrutinib achieved...
Umbilical Cord Blood Transplant: Two Units are No Better Than One in Children with Hematologic Malignancies
Use of two partially HLA-matched units of umbilical cord blood were not superior to a single unit if it contained an adequate number of hematopoietic stem cells, according to a randomized study by the Blood and Marrow Clinical Trials Network. Results were reported at the 54th Annual Meeting of the...
