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cns cancers

A Brain Tumor Diagnosis Has Taken My Life in New Directions

The first sign that I could have a life-threatening illness was a bout of severe dizziness, which sent me first to a general practitioner for a physical examination and then to an ear specialist for more tests. At just 24 and in excellent health, the sudden onset of dizziness didn’t initially set...

Certainty

The following essay by William N. Harwin, MD, is adapted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was coedited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and thebigcasino.org.   My wife...

myelodysplastic syndromes

Selected Abstracts From 2015 ASH Annual Meeting: Part 2

Here are several more abstracts selected from the proceedings of the 2015 American Society of Hematology (ASH) Annual Meeting and Exposition, highlighting therapeutics in acute leukemias and myelodysplastic syndromes. For five other top abstracts on therapies for acute leukemias and myelodysplastic ...

skin cancer

Expanded Approval of Pembrolizumab in 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 18, 2015, approval of the programmed cell death...

A Famous French Oncologist’s Gastronomic Advice for Reducing Cancer Risk

BookmarkTitle: The Anti-cancer Diet: Reduce Cancer Risk Through the Foods You EatAuthors:  David Khayat, MDPublisher: W.W. Norton & CompanyPublication date: April 2015Price: $26.95; hardcover, 288 pages   In 2002, David Khayat, MD, was in Turkey on holiday with friends when he received a call...

Fear’s Many Deleterious Consequences

Bookmark Title: The Fear Cure: Cultivating Courage as Medicine for the Body, Mind, and Soul Author: Lissa Rankin, MD Publisher: Hay House, Inc Publication date: February 23, 2015 Price: $25.99; hardcover, 336 pages   Fear is a healthy survival mechanism, a fight-or-flight response designed to put...

A Pioneering Oncologist’s Roadmap Forward

Bookmark Title: The Death of Cancer: After Fifty Years on the Front Lines of Medicine, a Pioneering Oncologist Reveals Why the War on Cancer Is Winnable—and How We Can Get There Authors: Vincent T. DeVita, Jr, MD, and Elizabeth DeVita-Raeburn Publisher: Farrar, Straus and Giroux Publication date:...

leukemia

FDA Approves Ofatumumab for Patients With Chronic Lymphocytic Leukemia in Complete or Partial Response

The U.S. Food and Drug Administration (FDA) has approved ofatumumab (Arzerra), a CD20-directed cytolytic monoclonal antibody, for extended treatment of patients who are in complete or partial response after at least two lines of therapy for recurrent or progressive chronic lymphocytic leukemia...

breast cancer

Looking at the Real-World Effects of Genetic Testing

According to the most recent estimates, 55% to 65% of women who inherit the BRCA1 mutation and about 45% of women who inherit the BRCA2 mutation will develop breast cancer by the time they are 70 years old. There is also a substantial increase in the probability of developing ovarian cancers in...

Defibrotide Under Review for Transplant-Related Complication

A potentially fatal complication of hematopoietic stem cell transplantation may be reversed with the use of a novel drug currently under priority review at the U.S. Food and Drug Administration (FDA). Hepatic veno-occlusive disease/sinusoidal obstruction syndrome is usually a serious complication...

symptom management

How Cancer and Its Treatments Affect Cognitive Function

Although chemotherapy is often cited as the main culprit for diminishing cognitive function in patients with cancer, ushering the term “chemobrain” into the vernacular, research by Tim A. Ahles, PhD, and his colleagues is showing that multiple factors may contribute to the condition.1 Using breast...

skin cancer

Increased Incidence of in Situ and Invasive Melanoma in Denmark

In a study reported in JAMA Dermatology,1 Neel Maria Helvind, MD, of the University Hospital Rigshospitalet, Copenhagen, Denmark, and colleagues analyzed the increases in melanoma incidence seen in Denmark between 1985 and 2012. Over that time, the incidence of malignant melanoma doubled to rates...

solid tumors
prostate cancer

Increased Survival and Toxicity With Docetaxel, No Apparent Benefit of Zoledronic Acid in Prostate Cancer

As reported in The Lancet by James et al, results of the STAMPEDE trial, which used a multiarm, multistage seamless phase II/III design, showed increased survival and toxicity with docetaxel and little benefit of zoledronic acid when added to first-line long-term hormone therapy in patients with...

leukemia

Bone Loss Associated With Leukemia Therapy Occurs Sooner Than Previously Thought

Investigators at Children’s Hospital Los Angeles (CHLA) have found that significant bone loss occurs during the first month of chemotherapy for acute lymphoblastic leukemia (ALL), which is far earlier than previously assumed. Results of the study were published by Orgel et al in the...

breast cancer

Superior Long-Term Outcomes Linked to Axillary Pathologic Complete Response After Chemotherapy for Breast Cancer

In an analysis of experience at MD Anderson Cancer Center reported in JAMA Oncology, Mougalian et al found that 10-year overall and relapse-free survival rates in patients with stage II or III breast cancer and axillary metastases receiving primary systemic chemotherapy were higher in those with vs ...

supportive care
issues in oncology

UK Trial Shows Little Benefit of Pregabalin Combined With Palliative Radiotherapy for Cancer-Induced Bone Pain

In a UK study reported in the Journal of Clinical Oncology, Fallon et al found no improvement with pregabalin vs placebo combined with concurrent palliative radiotherapy in relieving cancer-induced bone pain. Study Details In the double-blind trial, 233 patients with bone metastases who were...

breast cancer

Comparing Recurrence Risk With Anastrozole vs Tamoxifen in Postmenopausal Women With Ductal Carcinoma in Situ

Two recently reported phase III trials compared adjuvant anastrozole vs tamoxifen in postmenopausal women with hormone receptor–positive ductal carcinoma in situ. As reported in The Lancet by Margolese et al,1 the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-35 trial, performed in...

prostate cancer

Dose-Intensified vs Standard Salvage Radiation for Biochemically Recurrent Prostate Cancer After Prostatectomy

Initial results of a European phase III trial (SAKK 09/10), reported in the Journal of Clinical Oncology by Ghadjar et al of the Swiss Group for Clinical Cancer Research, showed little difference in acute toxicity with salvage radiotherapy of 70 vs 64 Gy in patients with biochemical recurrence of...

colorectal cancer

Dutch Trial Indicates 6-Year Surveillance Interval Is Sufficient for Many Individuals With Familial Colorectal Cancer

In a Dutch trial reported in the Journal of Clinical Oncology, Simone D. ­Hennink, MD, of Leiden University Medical Center in Leiden, the Netherlands, and colleagues found that a 6-year colonoscopic surveillance interval is sufficient for many individuals with familial colorectal cancer.1 However,...

hepatobiliary cancer

High Rate of Local Control Reported With High-Dose Hypofractionated Proton Beam Therapy in Liver Cancers

High-dose hypofractionated proton beam therapy produced a high rate of local control in patients with localized unresectable hepatocellular carcinoma or intrahepatic cholangiocarcinoma, according to a phase II study reported in the Journal of Clinical Oncology by Hong et al. Study Details In the...

Expert Point of View: C. Kent Osborne, MD

These data will help us personalize treatment for our patients. We still don’t know which women with a favorable cancer like ductal carcinoma in situ are most likely to progress. This is an unmet need,” said C. Kent Osborne, MD, Director of the Dan L. Duncan Cancer Center at Baylor College of...

breast cancer

Tamoxifen or Anastrozole for Ductal Carcinoma in Situ?

Ductal carcinoma in situ is a relatively benign form of breast cancer (stage 0), yet up to 10% of women with ductal carcinoma in situ will have a recurrence within 10 years. At present, there is no way to identify which women will recur, so standard treatment is lumpectomy plus radiation therapy....

breast cancer

Synthetic 2D Mammography May Hold Advantages Over 2D/3D Mammography

In screening for breast cancer, results from a study in the United Kingdom suggest that the use of “synthetic” two-dimensional (2D) mammography, rather than 2D/three-dimensional (3D) combinations, could save radiologists’ time and patients’ exposure to radiation as well as result in many fewer...

breast cancer

Selected Abstracts From 2015 San Antonio Breast Cancer Symposium

The 2015 San Antonio Breast Cancer Symposium (SABCS), hosted by the American Association for Cancer Research, the Cancer Therapy & Research Center at The University of Texas Health Sciences Center at San Antonio, and Baylor College of Medicine, was held in December 2015. As has been true for...

multiple myeloma

Studies Confirm and Extend the Benefits of Ixazomib in Multiple Myeloma

Patients with multiple myeloma now have access to an all-oral regimen, with the recent approval of the oral proteasome inhibitor ixazomib (Ninlaro) in previously treated patients. New pairings for the drug in relapsed/refractory and newly diagnosed patients are being studied, with investigators...

skin cancer

Pembrolizumab Label Updated With New Clinical Trial Information

Late in 2015, the U. S. Food and Drug Administration (FDA) expanded the label for pembrolizumab ­(Keytruda), a humanized antibody, to include the initial treatment of patients with unresectable or metastatic melanoma.  Previously, pembrolizumab had received accelerated approval in patients with...

Expert Point of View: William Y. Kim, MD

Formal discussant of this trial William Y. Kim, MD, of the University of North Carolina’s Lineberger Comprehensive Cancer Center, Chapel Hill, commented on the fact that the IMvigor study had a substantial number of patients compared with other phase II trials in bladder cancer. “This trial was not ...

solid tumors

Atezolizumab in Urothelial Cancer: Ushering in a New Standard of Care

Atezolizumab achieved excellent results in a cohort of patients with platinum-resistant urothelial cancer enrolled in a large phase II trial known as IMvigor 210.1 Overall response rates were greatly improved over those with historical controls, and responses were durable. Although expression of...

solid tumors

Improved Outcomes in Patients With Germ Cell Testicular Tumors in the Modern Era

Although patients with poor-risk metastatic testicular germ cell tumors continue to have less favorable outcomes, the bar has been raised by contemporary treatment. There is still room for improvement in managing metastatic testicular germ cell tumors, especially in poor-risk patients, but if...

issues in oncology

'Doctor, We Prayed for You'

A 70-year-old female patient underwent a cardiac procedure to repair her mitral valve, and at the same time, she also underwent a coronary artery bypass grafting. She had an uneventful course for the first four postoperative days. On the sixth postoperative day, she started complaining of abdominal ...

kidney cancer

Two Contenders for Second-Line Treatment of Advanced Renal Cell Carcinoma

Options for second-line therapy of advanced/metastatic renal cell carcinoma are expanding. Updates from the CheckMate 025 and METEOR ­trials presented at the 2016 Genitourinary Cancers Symposium solidify the value of both nivolumab (Opdivo, an immune checkpoint inhibitor) and cabozantinib...

issues in oncology

Higher Risk of Cancer Mortality in Solid-Organ Transplant Recipients

In a study reported in JAMA Oncology, Acuna et al found a nearly threefold increased risk of cancer mortality in solid-organ transplant recipients compared with the general population in Ontario, Canada. Study Details The population-based cohort study included data from 11,061 patients who...

cns cancers
issues in oncology

Abnormal Fused Gene Is a Triple Threat in Driving Pediatric Brain Tumors

Oncology researchers have discovered that an abnormal fused gene that drives pediatric brain tumors poses a triple threat, operating simultaneously through three distinct biologic mechanisms—the first such example in cancer biology. The study was published by Bandopadhayay et al in Nature...

lung cancer
solid tumors

French Trial Shows Addition of First-Line Bevacizumab to Cisplatin/Pemetrexed Improves Survival in Malignant Pleural Mesothelioma

In the French phase III MAPS trial reported in The Lancet, Zalcman et al found that the addition of bevacizumab (Avastin) to standard cisplatin/pemetrexed (Alimta) treatment increased overall and progression-free survival in patients with newly diagnosed pleural mesothelioma. Vascular endothelial...

palliative care
lung cancer
issues in oncology

Afatinib Shows Clinical Benefit for Non–Small Cell Lung Cancer Patients With Brain Metastases

Non­–small cell lung cancer (NSCLC) patients with common epidermal growth factor (EGFR) mutations and brain metastases showed improved progression-free survival and response from the EGFR tyrosine kinase inhibitor afatinib (Gilotrif) compared to standard platinum doublet chemotherapy....

palliative care

Study Finds Need for Improved End-of-Life Care for Parents With Terminal Cancer

Care for mothers with terminal cancer could be improved to help resolve their psychological distress and to help surviving family members cope, a study by University of North Carolina at Chapel Hill researchers have found. Based on the study findings published by Park et al in the journal BMJ...

Famed Cancer Biostatistician, Norman Breslow, PhD, Dies

A longitudinal case-controlled analysis of the probability of attaining normality after achieving 60: A perspective from the social sciences based on expert ethnographic insights.” So begins a long and charmingly erudite birthday card to internationally regarded biostatistician Norman Breslow, PhD, ...

solid tumors
colorectal cancer

Pilot Study Indicates Little Activity of Vemurafenib in Metastatic BRAF-Mutated Colorectal Cancer

In a phase II pilot study reported in the Journal of Clinical Oncology, Scott Kopetz, MD, PhD, of The University of Texas MD Anderson Cancer Center, and colleagues found little clinical activity of vemurafenib (Zelboraf) in patients with metastatic BRAF-mutated colorectal cancer.1 The BRAF V600E...

Nationally Regarded Cancer Advocate Ellen Stovall Dies

Passion is a much-needed virtue in one who seeks to change the world for the better. When you combine intelligence, stamina, iron-willed determination, the grace of an ambassador, and simple human likability with passion, you get that rare person who can turn words and ideas into reality. Such a...

gynecologic cancers
issues in oncology

Could a Screening Test That Would Reduce Deaths From Ovarian Cancer Be on the Way?

"A solid triple but not a home run” is how Karen H. Lu, MD, characterized a study in The Lancet reporting a reduction in deaths from ovarian cancer with the use of multimodal ovarian cancer screening.1 Dr. Lu’s remark was one of several, mostly but not universally, favorable and optimistic comments ...

breast cancer

Mastectomy Healed by Earth Dressing

Through the Lens of Oncology History A Century of Progress The text and photographs on this page are excerpted from a four-volume series of books titled Oncology Tumors & Treatment: A Photographic History, by Stanley B. Burns, MD, FACS. The photos below are from the volume titled “The...

issues in oncology

Pieces of Grief

The ASCO Post is pleased to reproduce installments of the “Art of Oncology” as published previously in the Journal of Clinical Oncology (JCO). These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

breast cancer

A Noted Breast Surgeon’s Book of Solid Advice

Bookmark Title: The New Generation Breast Cancer Book: How to Navigate Your Diagnosis and Treatment Options—and Remain Optimistic—in an Age of Information Overload Author: Elisa Port, MD Publisher: Ballantine Books Publication date: September 2015 Price: $20.00; paperback, 320 pages When a new...

Saving Children Orphaned by AIDS in South Africa

Bookmark Title: Empty Hands, A Memoir: One Woman’s Journey to Save Children Orphaned by AIDS in South Africa Author:  Sister Abegail Ntleko Publisher: North Atlantic Books Publication date: September 1, 2015 Price: $12.95; paperback, 176 pages With the development of the multidrug highly active...

integrative oncology
symptom management

Acupuncture for Cancer Symptom Clusters

Acupuncture has been practiced for thousands of years in Eastern Asian cultures as a component of traditional Chinese medicine.1 In the United States, acupuncture became known to the public as a complementary and alternative medicine technique in the 1970s, but it took many years before it was...

lymphoma

Ibrutinib in Relapsed Mantle Cell Lymphoma

Treatment of mantle cell lymphoma continues to evolve, both in the front-line and relapsed settings. Key advances include better use of established agents, such as the incorporation of high-dose cytarabine into initial induction regimens and application of rituximab (Rituxan)...

lymphoma

Phase III Trial Shows Improved Progression-Free Survival With Ibrutinib vs Temsirolimus in Relapsed/Refractory Mantle Cell Lymphoma

In aphase III trial reported in The Lancet and at the recent American Society of Hematology Annual Meeting and Exposition, Martin Dreyling, MD, of the European Mantle Cell Lymphoma Network, and colleagues found that ibrutinib (Imbruvica) was associated with improved progression-free survival vs...

lymphoma

Winning the Battle at the Front Lines: Lenalidomide Plus Rituximab— A Promising Initial Treatment for Mantle Cell Lymphoma

Mantle cell lymphoma is a pernicious, incurable disease. Front-line therapies for this disease are not currently standardized; however, novel therapies for relapsed or refractory mantle cell lymphoma can ideally be translated into beneficial treatments for newly diagnosed patients, as clearly...

hematologic malignancies
lymphoma

Lenalidomide Plus Rituximab Highly Active in  Initial Treatment of Mantle Cell Lymphoma

In a phase II trial reported in The New England Journal of Medicine by Jia Ruan, MD, PhD, and colleagues, first-line treatment with the immunomodulatory agent lenalidomide (Revlimid) and the anti-CD20 antibody rituximab (Rituxan) followed by maintenance lenalidomide and rituximab produced a high...

breast cancer
issues in oncology

The New Frontiers of Breast Cancer

A seismic shift is underway in screening and treatment approaches for breast cancer. These changes are being fueled by studies showing that mammography in younger women may do more harm than good and that advances in genomic testing and a better understanding of the biology of breast cancers may...

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