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issues in oncology

Smarter Trial Design Saves Money and Produces Better Drugs

The process of identifying a promising molecule and moving it from the laboratory through the highly complex series of clinical trials necessary to garner U.S. Food and Drug Administration (FDA) approval is a costly scientific gauntlet during which many new agents fail. New trial design,...

gynecologic cancers

Gardasil 9 Adds Protection Against Cancer Caused by Additional Human Papillomavirus Types

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.   On December 10, 2014, Gardasil 9 (human papillomavirus 9-valent...

issues in oncology
cost of care

Panelists Lambast, Explore the High Cost of Cancer Drugs

At the 2014 American Society of Hematology Annual Meeting, a symposium on the high cost of cancer drugs proved provocative and a bit testy as panelists presented their various points of view. ‘Medical Darwinian System’ Already known for his outspoken views on the topic is Hagop M. Kantarjian, MD,...

hematologic malignancies

Will Checkpoint Inhibitors Be Winners in Hematologic Cancers, Too?

A  “Featured Topic” session during the 56th American Society of Hematology (ASH) Annual Meeting and Exposition drew a standing-room-only crowd to hear two experts weigh in on checkpoint blockade in hematologic malignancies. While new to hematology, these drugs—the cytotoxic T-lymphocyte–associated...

multiple myeloma

Cleveland Clinic Piloting ‘Adaptive Therapy’ Approach in Multiple Myeloma

For newly diagnosed multiple myeloma patients, Cleveland Clinic specialists believe two drugs may suffice for most patients, bucking the trend toward using triplets for all patients and reserving them for patients with insufficient response to two. They described a pilot study of their “carepath”...

leukemia

Blinatumomab Achieves Complete Molecular Responses in Majority of B-Cell Leukemia Patients

Results from the international phase II BLAST study show that one cycle of blinatumomab (Blincyto) immunotherapy achieved complete minimal residual disease response in 78% of patients with acute lymphoblastic leukemia.1 Complete minimal residual disease response was achieved in 80% of patients...

leukemia

Venetoclax Gaining Ground in Two Types of Leukemia

Venetoclax, formerly known as ABT-199, is moving forward into phase III development in acute myelogenous leukemia (AML) and chronic lymphocytic leukemia (CLL), based on encouraging data from separate phase Ib and II trials presented at the 56th Annual Meeting and Exposition of the American Society...

breast cancer
global cancer care

Breast Health Global Initiative Tackles Third-World Health Care

Benjamin O. Anderson, MD, is the Director of the Breast Health Global Initiative (BHGI) and surgical oncologist and Director of the Breast Health Clinic at the University of Washington in Seattle. The ASCO Post recently spoke with Dr. Anderson about the conceptual framework of the...

gynecologic cancers

FDA Approves Companion Diagnostic for the Detection of BRCA1/2 Mutations in Ovarian Cancer

The recent U.S. Food and Drug Administration (FDA) of olaparib (Lynparza) occurred concurrently with that of a companion diagnostic, BRACAnalysis CDx. This genetic test is designed to detect the presence of mutations in the BRCA genes in blood samples from patients with ovarian cancer. The BRCA...

prostate cancer

Physical Activity Improves Survival for Men With Localized Prostate Cancer

Among a large group of men with localized prostate cancer, those who engaged in higher levels of physical activity had lower rates of overall mortality and lower rates of prostate cancer-specific mortality, according to a study published in Cancer Epidemiology, Biomarkers & Prevention.1 “Our...

head and neck cancer
lung cancer

Coupling Head and Neck Cancer Screening and Lung Cancer Scans Could Improve Early Detection, Survival

Adding head and neck cancer screenings to recommended lung cancer screenings would likely improve early detection and survival, according to a multidisciplinary team led by scientists affiliated with the University of Pittsburgh Cancer Institute (UPCI), a partner with the University of Pittsburgh...

neuroendocrine tumors

Lanreotide in Gastroenteropancreatic Neuroendocrine Tumors

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.   On December 16, 2014, lanreotide (Somatuline depot injection) was ...

skin cancer

Survival Benefits of Front-Line Treatment With Nivolumab for Advanced Melanoma Confirmed, Yet Questions Remain

As reported in this issue of The ASCO Post, Robert and colleagues recently published a phase III study comparing the anti–programmed death 1 (PD-1) antibody nivolumab with the standard melanoma chemotherapy dacarbazine in the front-line treatment of patients with advanced BRAF wild-type melanoma.1...

breast cancer

Ultrasonography Detects Mammographically Occult Invasive Cancers

Mammograms often miss occult breast cancers concealed in dense breasts. Women with dense breasts represent about 40% to 50% of women who undergo mammography screening. In some states and centers in the United States, women with dense breasts are routinely offered ultrasonography following a...

Expert Point of View: Lajos Pusztai, MD

Commenting on the GeparSepto study presented at the San Antonio Breast Cancer Symposium, Lajos Pusztai, MD, Yale University School of Medicine, New Haven, Connecticut, said, “This study, along with a smaller SWOG study, establishes nab-paclitaxel as a legitimate treatment option for triple-negative ...

breast cancer

Nab-Paclitaxel Boosts Pathologic Complete Response in High-Risk Breast Cancer

Nab-paclitaxel (Abraxane) achieved superior results compared with conventional solvent-based paclitaxel in patients with early-stage high-risk breast cancer in the large phase III GeparSepto trial from the German Breast Group (GBG).1 The study, presented at the 2014 San Antonio Breast Cancer...

Expert Point of View: Benjamin O. Anderson, MD

Commenting on this study, Benjamin O. Anderson, MD, Director of the Breast Health Clinic, Seattle Cancer Care Alliance, Washington, said: “This new analysis of the Oncotype DX DCIS assay strengthens the findings of earlier studies performed in more limited subgroups, validating that the assay...

breast cancer

Oncotype DX Ductal Carcinoma in Situ Score Reliably Predicts Tumor Recurrence

Ductal carcinoma in situ, which accounts for 30% of all newly diagnosed breast cancers, does not always evolve into a lesion with metastatic potential. Only a proportion of these cases will progress to invasive breast cancer, but up until recently, it has not been possible to identify reliably...

breast cancer

No Benefit for Adjuvant Capecitabine Monotherapy in Elderly Patients With Early-Stage Breast Cancer

Adjuvant therapy with capecitabine plus ibandronate failed to improve outcomes vs ibandronate alone in elderly patients with moderate-to-high-risk early-stage breast cancer in the ICE study—the largest study to date conducted in elderly women with breast cancer.1 “Capecitabine is frequently used in ...

Expert Point of View: Amy H. Comander, MD

Amy H. Comander, MD, a medical oncologist at the Massachusetts General Hospital Cancer Center and Instructor in Medicine at Harvard Medical School, Boston, told The ASCO Post that the findings will clearly help her in counseling patients. “I am excited to be able to discuss the study with my...

Highlights From the 2015 Gastrointestinal Cancers Symposium

The 2015 Gastrointestinal Cancers Symposium was held January 15 to 17. Direct your patients to www.cancer.net/blog to read the latest research on the treatment of colorectal cancer, including what it means for patient care. On the Cancer.Net blog, your patients can also listen to a podcast...

global cancer care

Save the Date: World Cancer Day 2015

Have you marked your calendar for World Cancer Day? Each year on February 4, World Cancer Day unites people from across the globe in the fight against cancer. The initiative is organized by the Union for International Cancer Control (UICC) to raise cancer awareness and encourage governments and...

palliative care

Palliative Care in the Middle East

While some seek peace in the Middle East through political means, others are looking to help patients with cancer find peace through palliative care. This endeavor is bringing oncology professionals together across the region’s national borders and cultural boundaries to implement solutions and...

Cancer.Net Launches PRE-ACT Patient Clinical Trial Education Program

Clinical trials are the key to driving advances in the prevention, diagnosis, and treatment of cancer, yet, it is estimated that only about 5% of patients with cancer participate in clinical trials. That is why Cancer.Net, ASCO’s patient-facing educational website, has teamed up with Neal Meropol,...

issues in oncology

Top 10 Myths About FDA’s Office of Hematology and Oncology Products

INSIDE THE BLACK BOX is an occasional column providing insight into the U.S. Food and Drug Administration (FDA) and its policies and procedures. In this installment, FDA oncologists Gideon Blumenthal, MD, and Tatiana Prowell, MD, discuss 10 common myths about FDA’s Office of Hematology and Oncology ...

skin cancer

Anti–PD-1 Antibody Nivolumab in Previously Treated Unresectable or Metastatic 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.   On December 22, 2014, the anti–PD-1 (programmed cell death...

skin cancer

Treatment Paradigm in Advanced Melanoma Poised for Change… Again

In the treatment of advanced/metastatic melanoma, recent debate has focused on the choice of initial therapy: ipilimumab (Yervoy) or, for patients with BRAF-mutant cancer, a BRAF/MEK inhibitor. This issue is now taking a back seat to the emerging conversation about the positioning of antibodies...

colorectal cancer

Colorectal Cancer 2015

Despite advances in detection and treatment, colorectal cancer remains the third deadliest cancer among men and women in the United States. To get a better understanding of the current state of this disease and what lies ahead, The ASCO Post recently spoke with colorectal cancer expert John L....

health-care policy

Molecular Pathologists vs the FDA: Proposed Regulation of Laboratory-Developed Tests Sparks Debate

The packed ballroom looked like a plenary session at any big medical research meeting. But on the dais were representatives of the Food and Drug Administration (FDA), the subject was the Agency’s proposed regulation of laboratory-developed tests, and the attendees who lined up to ask questions for...

lung cancer
issues in oncology

Overdiagnosis May Be Overblown in Lung Cancer Screening

“Overdiagnosis has been overblown” in concerns voiced about lung cancer screening with low-dose computed tomography, ­Andrea B. McKee, MD, told participants at the opening session of the 2014 Chicago Multidisciplinary Symposium in Thoracic Oncology. Dr. McKee is Chair of the Department of Radiation ...

lung cancer

Top 10 Lessons Learned So Far About Treating Lung Cancer With Immunotherapy

Immunotherapy agents “really work” in treating lung cancer, but they have unique toxicities, are challenging to combine with other therapies, and questions remain about dose and duration, Roy S. Herbst, MD, PhD, stated at the 2014 Chicago Multidisciplinary Symposium in Thoracic Oncology. “There are ...

issues in oncology

More Than 1.5 Million Cancer Deaths Averted During 2 Decades of Dropping Mortality

The American Cancer Society’s annual cancer statistics report found that a 22% drop in cancer mortality over 2 ­decades led to the avoidance of more than 1.5 million cancer deaths that would have occurred if peak rates had persisted. And while cancer death rates have declined in every state, the...

lung cancer

Significant Improvement in Progression-Free Survival Using Sunitinib as Switch Maintenance in Advanced NSCLC

Progression-free survival was significantly improved among patients with advanced non–small cell lung cancer (NSCLC) receiving sunitinib (Sutent) as switch maintenance compared to placebo, according to results of an Alliance phase III trial (Cancer and Leukemia Group B [CALGB] 3067). The effect of...

breast cancer

Contralateral Prophylactic Mastectomy: Know the Data When Discussing the Option With Patients

Oncologists need a better understanding of why women choose contralateral prophylactic mastectomies without indication, and they need data to counter their patients’ misperceptions about this treatment choice. “Many women who choose [contralateral prophylactic mastectomy] are not at increased risk...

breast cancer

Fulvestrant Surpasses Anastrozole in First-Line Treatment of Metastatic Breast Cancer

Fulvestrant (Faslodex) at a 500-mg dose was superior to anastrozole as first-line therapy for advanced hormone receptor–positive breast cancer in the phase II FIRST study.1 Overall survival and time to disease progression were significantly better with fulvestrant than with the current standard of...

Expert Point of View: Erin Hofstatter, MD

These data do not change what we already know: Chemoprevention is slam-dunk, hands-down effective in preventing breast cancer. The effects of 5 years of chemoprevention persist for 20 years. This is great because it [could potentially] reduce the numbers of women we need to treat,” said Erin...

breast cancer

Tamoxifen Prevention of Breast Cancer Extends More Than 16 Years

The benefits of tamoxifen as primary prevention of breast cancer are well established. The good news is that the benefits live on, with a protective effect that extends up to 22 years. At a median follow-up of 16 years, women treated with 5 years of tamoxifen enjoyed a 29% reduction in the risk of...

breast cancer

BOLERO-1: Everolimus Plus Trastuzumab/Paclitaxel Misses the Mark in First‑Line HER2-Positive Advanced Breast Cancer

The addition of everolimus (Afinitor) to weekly trastuzumab (Herceptin) plus paclitaxel in the first-line metastatic breast cancer setting did not improve outcomes in the phase III BOLERO-1/TRIO-019 but did provide a “signal” in the hormone receptor–negative subset. The study was reported at the...

breast cancer

Pembrolizumab Holds Promise in Breast Cancer, Early Studies Suggest

Single-agent treatment with the immunotherapy drug pembrolizumab produced a “signal of activity” and led to some durable responses in patients with metastatic triple-negative breast cancer, Rita Nanda, MD, of the University of Chicago, reported at the 2014 San Antonio Breast Cancer Symposium.1...

breast cancer

Neoadjuvant Therapy in Triple-Negative Breast Cancer: Impact of Subtype

Among women with triple-negative breast cancer, overall, basal-like and non–basal-like tumors were equally likely to demonstrate a pathologic complete response to neoadjuvant chemotherapy, but they responded differently to the addition of carboplatin and bevacizumab (Avastin) to a standard...

Expert Point of View: Brad S. Kahl, MD

AETHERA is the first study to show a significant effect of a post-transplant strategy in patients at high risk of relapse after transplant,” said Brad S. Kahl, MD, Associate Professor at the University of Wisconsin School of Medicine and Public Health, Madison. “The question remains whether...

lymphoma

Post-Transplant Brentuximab Vedotin Improved Progression-Free Survival in Hodgkin Lymphoma Patients

In patients with Hodgkin lymphoma who are at risk for disease progression following autologous stem cell transplantation, early consolidation with brentuximab vedotin (Adcetris) post-transplant significantly improved progression-free survival compared with placebo in the phase III AETHERA trial.1...

Expert Point of View: Fredrick Hagemeister, MD

As session moderator, Fredrick Hagemeister, MD, Professor of Medicine, University of Texas MD Anderson Cancer Center, Houston, commented during the discussion of Dr. Connors’ study. He first emphasized the need to establish the safety of new drugs in clinical trials before incorporating them...

lymphoma

Brentuximab Vedotin Added to Standard Therapy for Advanced-Stage Hodgkin Lymphoma May Improve Results

Several studies presented at the 2014 ASH Annual Meeting supported the use of brentuximab vedotin (Adcetris) in Hodgkin lymphoma. The Reed-Sternberg cells of classical Hodgkin lymphoma typically express CD30, which is targeted by brentuximab vedotin, an anti-CD30 monoclonal antibody conjugated by a ...

breast cancer

Ovarian Suppression Plus Hormonal Therapy May Be Practice-Changing in Premenopausal Hormone Receptor–Positive Early-Stage Breast Cancer

Results of the large International Breast Cancer Study Group (IBCSG)-coordinated SOFT trial present a convincing argument for the addition of ovarian function suppression to adjuvant hormonal therapy to reduce the risk of tumor recurrence in younger women with hormone receptor–positive early-stage...

issues in oncology

What Is a Physician? Call a Spade a Spade

Anyone who has awoken from a decades-long amnestic spell can be forgiven for thinking that physicians cannot do anything right nowadays. Compared with decades ago, when physicians did mostly right, we now seem to be nowhere close to correctness. Nearly every malady that befalls the health-care...

Expert Point of View: David H. Vesole, MD, PhD, FACP

David H. Vesole, MD, PhD, FACP, Co-Division Chief and Director of Research for the Multiple Myeloma Division at the John Theurer Cancer Center at Hackensack University Medical Center in New Jersey, commented after the presentation of the ASPIRE trial data that the findings were “impressive.” “It’s ...

multiple myeloma

Carfilzomib-Based Triplet Yields ‘Unprecedented’ Duration of Remission in Relapsed Myeloma

The phase III global ASPIRE trial documented an “unprecedented” duration of remission in relapsed multiple myeloma patients receiving carfilzomib (Kyprolis) plus a standard-of-care doublet, according to Keith Stewart, MB, ChB, Professor of Medicine at the Mayo Clinic in Scottsdale, Arizona, who...

supportive care
sarcoma

Growing Support Group for Epithelioid Hemangioendothelioma Spins the ‘Wheel of Hope’

Two years ago, my son was diagnosed with the rare vascular sarcoma epithelioid hemangioendothelioma, on which there is incredibly little reseach and knowledge (see here for more on this rare cancer). PubMed revealed a “characteristic” description: unpredictable behavior, no correlation with...

sarcoma

Unraveling the Mysteries of Epithelioid Hemangioendothelioma

Epithelioid hemangioendothelioma is a rare and devastating vascular sarcoma that affects between 100 and 200 people, mostly young adults, each year in the United States. The cancer may arise as a solitary lesion but more commonly presents with metastatic involvement, usually in the liver and lungs. ...

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