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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...

palliative care

How Effective Communication Can Improve Patient Care—and Reduce Physician Burnout

Surveys conducted between 1950 and 1970 show that most physicians considered it inhumane to give patients with a poor cancer prognosis the bad news.1,2 Since then, it has been well established that open communication between physician and patient is an essential part of effective cancer care and...

lung cancer

The Evolving Treatment Landscape of ALK-Positive NSCLC

Since the initial discovery of ALK rearrangement in non–small cell lung cancer (NSCLC) in 2007,1 small molecule tyrosine kinase inhibitors of ALK have transformed the course of disease for those patients with ALK-rearranged (ie, ALK-positive) NSCLC. Crizotinib (Xalkori), a multitargeted tyrosine...

lung cancer

Global and North American Phase II Studies Show Alectinib Is Highly Active in Crizotinib-Resistant/Refractory ALK-Rearranged NSCLC

In two phase II trials, reported in the Journal of Clinical Oncology and The Lancet Oncology, the ALK inhibitor alectinib (Alecensa), which is active against acquired crizotinib resistance mutations and exhibits high central nervous system (CNS) penetration, was associated with considerable...

issues in oncology
hematologic malignancies

Blood Test Can Predict High-Risk Cancers in Patients Treated With CAR-T

Dramatic advances have been made in using genetically engineered chimeric antigen receptor–modified T cells (CAR-T) with anti-CD19 specificity to treat highly refractory hematologic malignancies. The highest complete remission rates have been achieved in patients with relapsed or refractory acute...

multiple myeloma
palliative care

Study Confirms Benefit of Triplet vs Doublet in Newly Diagnosed Multiple Myeloma

Triplets should be the standard of care in most newly diagnosed multiple myeloma patients, according to a study that validated a practice that has become common in the United States, though not necessarily elsewhere. The use of three drugs led to significant reductions in disease progression and...

colorectal cancer

I Am Not Afraid of Cancer

At age 73, I’m no shrinking violet and I don’t run to the doctor at the first sign of a problem. I practice naturopathy and can usually ward off potential health issues by maintaining a healthy diet and lifestyle. When I began experiencing some mild discomfort in my rectum 2½ years ago, I was...

issues in oncology
supportive care
geriatric oncology

Deconditioning in Older Adults With Cancer: A Cascade to Dependency

It is estimated that nearly half of adults over age 80 living in the community are frail despite apparent functional well-being.1 Frailty is recognized as a clinical syndrome in which three or more of the following criteria are present: unintentional weight loss, self-reported exhaustion, weakness, ...

breast cancer

Exploratory Analysis of ExteNET Trial Shows Consistency of Benefit With Neratinib

An exploratory analysis of the ­ExteNET study of neratinib in early HER2-positive breast cancer after treatment with trastuzumab (Herceptin) upheld the findings previously reported for the 2-year analysis, according to the study’s principal investigator Arlene Chan, MD, of the Breast Cancer...

Expert Point of View: George Sledge, MD

George Sledge, MD, Professor, and Chief, Division of Oncology, Stanford University Medical Center, told The ASCO Post that he found the data from the pooled analysis “very exciting.” “One of the big questions in triple-negative breast cancer is how to select which drugs work best for which...

breast cancer

Homologous Recombination Deficiency Score Correlated With Response to Platinum in Breast Cancer

The homologous recombination deficiency (HRD) score may be a predictive biomarker of response to neoadjuvant platinum-based therapy in patients with triple-negative breast cancer, according to studies presented at the 2015 San Antonio Breast Cancer Symposium. “We found, in our adjusted analysis,...

pancreatic cancer

Pancreas Cancer Liquid Biopsy: Proof-of-Principle Study

Pancreatic cancer tumors are ripe for analysis with a liquid biopsy, according to researchers at The University of Texas MD Anderson Cancer Center. In a proof-of-principle study published recently in Annals of Oncology,1 the investigators reported on research in which they conducted whole-genome,...

supportive care

Uridine Triacetate Granules for Fluorouracil or Capecitabine Overdose or Early Severe Toxicity

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 11, 2015, uridine triacetate (Vistogard) was approved...

breast cancer

Role of Carboplatin in Triple-Negative Breast Cancer Still Unclear

Studies presented at the 2015 San Antonio Breast Cancer Symposium built upon an increasing body of data in support of the neoadjuvant use of carboplatin in patients with triple-negative breast cancer. Overall, however, the studies fell short of establishing carboplatin’s role in this malignancy and ...

breast cancer

Immunotherapy for Breast Cancer: Early Lackluster Study Results yet Promise Remains

Immunotherapy is at the forefront of exciting new approaches to cancer, with excellent and long-lasting responses in metastatic melanoma and non–small cell lung cancer (NSCLC) and several immunotherapy agents now approved for those malignancies by the U.S. Food and Drug Administration (FDA). The...

Expert Point of View: Lisa Carey, MD

For the most part, the cardiotoxicity with trastuzumab appears to be largely reversible, unlike anthracyclines, which cause permanent cardiac damage,” said Lisa Carey, MD, Distinguished Professor at the UNC Lineberger Breast Center, Chapel Hill, North Carolina. “In this small study, they saw no...

breast cancer

Prophylactic Beta-Blocker Preserves Left-Ventricular Function in Patients Receiving Trastuzumab

The beta-blocker bisoprolol was able to prevent trastuzumab (Herceptin)-associated declines in left-ventricular ejection fraction, whereas the effect of the angiotensin-converting–enzyme (ACE) inhibitor perindopril was less robust. Use of bisoprolol reduced dose interruptions for trastuzumab due to ...

breast cancer

Surgical Margin Width Not Related to Breast Cancer Recurrence

The width of the surgical margin doesn’t matter, as long as the margin is negative, according to a large study of breast-conserving surgery in patients with invasive breast cancer. The risk of ipsilateral breast tumor recurrence was similar for wide negative margins (2–4 mm) or narrow negative...

breast cancer
issues in oncology

PI3K Inhibitor Buparlisib Extends Progression-Free Survival  in Advanced Breast Cancer

Addition of the oral investigational pan-PI3K inhibitor buparlisib to the endocrine agent fulvestrant (Faslodex) improved progression-free survival among postmenopausal women with advanced hormone receptor–positive/HER2-negative advanced breast cancer. “We are happy to announce that the phase III...

colorectal cancer

Study Finds Colorectal Cancer More Likely to Affect Minorities at Younger Age

Researchers at the University of Missouri School of Medicine reported that minority and ethnic groups are being diagnosed with colorectal cancer at younger ages and more advanced stages than non-Hispanic whites. The study was recently published in Cancer Medicine.1 “While we know the risk of...

myelodysplastic syndromes
leukemia
hematologic malignancies

Myeloablative Conditioning for Stem Cell Transplantation Remains Standard of Care in Patients With MDS and AML

A randomized trial from the Bone and Marrow Transplant Clinical Trials Network was halted early after concluding that allogeneic stem cell transplantation after a reduced-intensity conditioning regimen resulted in higher relapse rates compared to myeloablative conditioning. The phase III randomized ...

leukemia

Self-Reports Overestimate Mercaptopurine Intake in Childhood Acute Lymphoblastic Leukemia

Mercaptopurine is critical for maintaining remission in childhood acute lymphoblastic leukemia (ALL). However, a study has shown that overreporting of intake is common, and self-reports of intake are not as reliable as electronic reporting.1 About 86% of parents and children overreported the number ...

hematologic malignancies

New Use for CAR-T Cells Post Transplantation

The approach of using genetically engineered chimeric antigen receptor (CAR)-T cells has received much attention for treating leukemias, where it has achieved spectacular long-lasting complete remissions in some patients with no other treatment options. CAR-T cells are also being studied in...

leukemia

Venetoclax May Prove to Be Strong Weapon Against Poor-Prognosis Chronic Lymphocytic Leukemia

Venetoclax, the latest entry into the field of treatment of chronic lymphocytic leukemia (CLL), is a powerful investigational therapy that promises to fill an important niche: treatment of high-risk relapsed/refractory patients with deletions of 17p. Nearly 80% of patients with relapsed/refractory...

leukemia

Severe Toxicities Seen in Younger Patients Receiving  Front-Line Idelalisib for Chronic Lymphocytic Leukemia

Hematologists and patients with chronic lymphocytic leukemia (CLL) are excited about new drugs that have dramatically improved outcomes. But all drugs have side effects, and it is important to be aware of potential consequences. Hepatotoxicity turns out to be a major concern in younger CLL patients ...

Expert Point of View: Susan O’Brien, MD

Clearly idelalisib improved overall survival when added to bendamustine (Bendetta/Treanda)/rituximab (Rituxan). These results are similar to those from the HELIOS trial reported at last year’s ASCO meeting,” said Susan O’Brien, MD, Associate Director for Clinical Science for the Chao Family...

leukemia
issues in oncology

Idelalisib Improves Progression-Free Survival Over Bendamustine Plus Rituximab in Chronic Lymphocytic Leukemia

Idelalisib (Zydelig) combined with bendamustine (Bendeka, Treanda) plus rituximab (Rituxan) was superior to chemotherapy with bendamustine/rituximab plus placebo, reducing the risk of progressive disease and death while improving progression-free survival and overall survival in patients with...

Expert Point of View: Robert Hromas, MD, and Timothy A. Graubert, MD

Robert Hromas, MD, of the University of Florida College of Medicine, Gainesville, who moderated a press briefing, commented that the finding of benefit with rituximab “resolves a long-standing controversy” with this cancer. “These results are exciting for those of us who treat leukemia,” he...

leukemia

Rituximab Adds Benefit to Chemotherapy in Adult B-Cell Precursor ALL

The addition of rituximab (Rituxan) to the pediatric-inspired chemotherapy protocol for B-cell precursor acute lymphoblastic leukemia (ALL) significantly improved event-free survival in a large European study presented at the 2015 ASH Annual Meeting.1 The GRAALL-R 2005 phase III study is the first...

lung cancer

ALK Rearrangements Common in Young Patients With Lung Cancer

Two investigative groups have reported interesting observations about genomic alterations in the tumors of young patients with lung cancer. Notably, ALK rearrangement was the most common driver mutation found, in studies reported at the 16th World Conference on Lung Cancer.1,2 “To our knowledge,...

prostate cancer

Even After Antiandrogen Therapy, Docetaxel Remains Useful in Prostate Cancer

A study presented at the 2016 Genitourinary Cancers Symposium showed that 40% of patients with metastatic castration-resistant prostate cancer treated with docetaxel following abiraterone (Zytiga) had at least a 50% reduction in prostate-specific antigen (PSA), demonstrating the activity of this...

issues in oncology

Patient-Centric Care: Translating Research to Results

The 2016 Genitourinary Cancers Symposium was held earlier this month in San Francisco. Abstracts and presentations included data and discussion on the latest strategies in the prevention, screening, diagnosis, and treatment of prostate, kidney, testicular, and urothelial cancers. Snapshots of data...

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