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From Small-town House Calls to Bone Marrow Transplants, Nobel Laureate Continues Father’s Legacy

“I echo the sentiments of many previous Nobel laureates when I say that the success we celebrate today was made possible by the work of many others in this and in related fields.” So ended the Nobel Lecture by E. Donnall Thomas, MD, the famed investigator and 1990 Nobel Laureate in Physiology or...

Special Anniversary Issue: Narratives in Oncology

The ASCO Post is pleased to present this special anniversary edition in recognition of the publication's 3rd year serving the oncology community. We hope you enjoy this special commemorative issue profiling several of the many leaders in the oncology community. In coming issues ofThe ASCO Post and...

prostate cancer

Supplemental New Drug Application Submitted for Abiraterone

Janssen Research & Development, LLC, has submitted a supplemental New Drug Application (sNDA) to the FDA to extend the use of abiraterone acetate (Zytiga) administered with prednisone for the treatment of patients with metastatic castration-resistant prostate cancer who are asymptomatic or...

breast cancer

FDA Approves Pertuzumab for HER2-positive Metastatic Breast Cancer

The FDA has approved pertuzumab (Perjeta), a new anti-HER2 therapy, to treat patients with HER2-positive late-stage breast cancer. Intended for patients who have not received prior treatment for metastatic breast cancer with an anti-HER2 therapy or chemotherapy, pertuzumab is combined with...

thyroid cancer

Obese Patients at Higher Risk of Aggressive Thyroid Tumors

Obese patients present with more advanced and more aggressive forms of papillary thyroid cancer and should be screened for thyroid cancer with sonography, which is more sensitive in detecting thyroid cancer than physical examination alone, according to a study published online in the Archives of...

Everolimus: New Indication in Renal Angiomyolipoma Associated with Tuberous Sclerosis Complex

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 In April 2012, the kinase inhibitor everolimus...

breast cancer

Too Soon to Know How Circulating Tumor Cells Might Be Used to Guide Treatment of Breast Cancer

In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. “A simple blood test.” These were...

lymphoma

Multicenter Phase II Trial Supporting Approval of Brentuximab Vedotin in Anaplastic Large-cell Lymphoma

Systemic anaplastic large-cell lymphoma (ALCL) is an aggressive T-cell lymphoma subtype characterized by uniform expression of CD30. Apart from low- to intermediate-risk patients with ALK-positive disease, patients with ALCL have a poor prognosis when treated with conventional, anthracycline-based...

multiple myeloma

Novel Agent Carfilzomib Receives Positive Vote from Oncologic Drugs Advisory Committee for Use in Multiple Myeloma

Onyx Pharmaceuticals recently announced that the FDA’s Oncologic Drugs Advisory Committee (ODAC) determined by a vote of 11–0 (with 1 abstention) that, in patients with relapsed and refractory multiple myeloma who have received at least two prior lines of therapy that included a proteasome...

issues in oncology

Medical Ethicists Reflect on Their Personal Cancer Experiences

The recently published book, Malignant: Medical Ethicists Confront Cancer, takes a personal look at the cancer experience from the perspective of seven medical ethicists who were also patients with cancer or cared for spouses with cancer.1 The book’s editor, Rebecca Dresser, JD, MS, who teaches law ...

Expert Point of View: Kathy Miller, MD

“Our old friends are sometimes worth keeping, and that is certainly true for weekly paclitaxel,” said the invited discussant of CALGB 40502, Kathy Miller, MD, of Indiana University School of Medicine, Indianapolis, at the ASCO Annual Meeting. She noted that Dr. Rugo must “remain strict to the...

breast cancer

Older Breast Cancer Drugs Prove Superior to Newer Ones

In the treatment of metastatic breast cancer, established older agents outperformed newer, more expensive drugs in two studies that made news at the 2012 ASCO Annual Meeting. Microtubule Inhibitors In the phase III open-label CALBG 40502/NCCTG N063H trial of 799 chemotherapy-naive patients with...

Expert Point of View: Michael Seiden, MD

“We are approaching the 15th year of exploring molecularly targeted therapies in ovarian cancer,” said Michael Seiden, MD, of Fox Chase Cancer Center, Philadelphia, and formal discussant of the papers presented during an oral abstract session on gynecologic cancer at the 2012 ASCO Annual Meeting....

gynecologic cancers

Bevacizumab and Olaparib Boost Progression-free Survival in Ovarian Cancer

A trio of randomized, controlled trials of different molecularly targeted therapies showed variable results in ovarian cancer, as reported at the 2012 ASCO Annual Meeting in Chicago. The phase III AURELIA trial demonstrated that the addition of the vascular endothelial growth factor (VEGF)...

cns cancers

New Standard of Care for Anaplastic Oligodendroglial Tumors with 1p/19q Codeletions

Adjuvant chemotherapy with PCV (procarbazine [Matulane], lomustine [CeeNU], and vincristine) following standard radiation therapy delayed disease progression and increased survival in patients with a relatively rare type of brain tumor called anaplastic oligodendroglioma. A subgroup analysis found...

Expert Point of View: William K. Oh, MD

Formal discussant of the SWOG 9346 trial, William K. Oh, MD, Tisch Cancer Institute at the Mount Sinai School of Medicine, New York, said that at least 23 phase II trials have suggested that intermittent androgen deprivation therapy was safe and effective and that this practice has been broadly...

prostate cancer

SIDEBAR: SWOG 9346 Conclusions Debated in Special Post-plenary Discussion

Based on the controversial nature of the SWOG 9346 findings, presented at the 2012 Annual Meeting Plenary Session, ASCO intiated a pilot program at the meeting for a “town hall” type of discussion, where attendees could voice their concerns and questions, and where presenter Maha Hussain, MD,...

prostate cancer

Continuous Androgen Deprivation Therapy Continues to Be Standard of Care for Newly Diagnosed Metastatic Prostate Cancer

Based on a prespecified definition of survival comparability, intermittent androgen deprivation proved to be inferior to continuous androgen deprivation for men with newly diagnosed hormone-sensitive metastatic prostate cancer in the phase III SWOG 9346 intergroup trial. The data were presented at...

Expert Point of View: Michael Williams, MD

Michael Williams, MD, the Byrd S. Leavell Professor of Medicine and Chief of Hematologic Malignancies at the University of Virginia Cancer Center, Charlottesville, commented, “Bendamustine/rituximab provides equivalent or better responses vs R-CHOP [rituximab, cyclophosphamide, doxorubicin,...

prostate cancer
issues in oncology

New PSA Recommendations: The Debate over Prostate Cancer Screening Continues

The U.S. Preventive Services Task Force (USPSTF) recently issued a recommendation statement advising against the use of prostate-specific antigen (PSA)-based testing for prostate cancer,1 leaving many in the oncology community concerned that decades of clinical progress will be stalled, and setting ...

colorectal cancer

Adjuvant Chemotherapy May Confer Survival Benefit in Patients Older than 75 with Stage III Disease

Because few people over 75 participate in clinical trials, it is unknown whether adjuvant chemotherapy could benefit this population. Faced with this gap in clinical trial evidence, researchers reviewed data from 5,489 patients ≥ 75 years with stage III colon cancer. The review suggests that...

solid tumors

Screening Should Begin Early for Survivors of Childhood Cancer

Survivors of childhood cancer, particularly those treated for childhood Hodgkin lymphoma or Wilms tumor with abdominal radiation, procarbazine (Matulane), and platinum chemotherapy, are at an increased risk of developing gastrointestinal subsequent malignant neoplasms, according to a retrospective...

prostate cancer

Pretreatment Tumor Hypoxia Predicts Biochemical Failure after Radiotherapy for Prostate Cancer

Hypoxia often occurs early in solid tumor development as a result of imbalances between oxygen supply and consumption and may lead to genetic and molecular signaling that influences the biology and clinical behavior of tumors and response to treatment. Milosevic and colleagues from Princess...

SIDEBAR: Expect Questions from Your Patients

Promising results announced at the recent ASCO Annual Meeting from studies with BRAF and MEK inhibitors have made headlines, but only one of these agents—the BRAF inhibitor vemurafenib (Zelboraf)—has been approved by the FDA. The others are still investigational. Patients interested in gaining...

skin cancer

MEK Inhibitor Reduces Progression of BRAF-mutated Melanoma and Might also Benefit Others

In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. The MEK inhibitor trametinib...

sarcoma

Pazopanib: New Drug for Advanced Soft-tissue Sarcoma

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 In April 2012, pazopanib (Votrient) was approved for the ...

breast cancer

My Breast Cancer Had Been Coming for Years

I’ve never had a normal mammogram screening. There was always something suspicious the test picked up: macrocalcifications in one breast 1 year and a cyst in the other breast the next year. Over a period of 3 years, I had six tissue biopsies, all benign for cancer. So when I flunked another...

supportive care
pain management
palliative care

Early Access to Palliative/Supportive Care vs Usual Care Improves Pain Management

Many cancer patients remain undertreated for pain despite availability of guidelines and educational efforts to improve pain treatment. In a recent Annals of Oncology article, Bandieri and colleagues from the Italian Epidemiologia Clinico-Assistenziale del Dolore in Ospedale (ECAD-O) group report a ...

Expert Point of View: Samuel A. Wells, MD

This study follows earlier phase I and II trials showing remarkable responses in patients with advanced medullary thyroid carcinoma, some of whom had progressed on prior tyrosine kinase inhibitor therapy, explained formal discussant of this trial, Samuel A. Wells, MD, of the Center for Cancer...

thyroid cancer

Cabozantinib Prolongs Progression-free Survival in Advanced Medullary Thyroid Cancer

Cabozantinib prolonged progression-free survival in patients with unresectable, locally advanced, or metastatic medullary thyroid cancer with documented disease progression in the phase III EXAM trial. Based on these results, Exelixis submitted a New Drug Application to the FDA in May 2012. The...

solid tumors

p53 Mutation in Advanced Solid Tumors Linked to Aggressive Course

Mutations in the tumor-suppressor protein p53, among the most common mutations in cancers, affect apoptosis, genomic stability, and angiogenesis. To determine the effect of p53 mutation on clinical characteristics and disease and treatment outcomes, Rabih Said, MD, MPH, and colleagues from The...

solid tumors

Two Single Nucleotide Polymorphisms Associated with Risk for Paclitaxel-related Peripheral Neuropathy

Peripheral neuropathy is the most common severe toxicity in patients receiving paclitaxel, and mutations in genes affecting drug metabolism, distribution, and elimination are likely to modulate risk for such neurotoxicity. In a recent study, Daniel Hertz, PharmD, and colleagues from the University...

solid tumors

Alterations in PTEN Insufficient to Predict Sensitivity to Drugs Targeting PI3K/mTOR Pathway

PTEN acts as a tumor-suppressor gene through the action of its phosphatase protein product, which participates in regulation of the cell cycle to prevent too-rapid cell growth and division. Loss of PTEN function has been shown to increase PI3K/mTOR signaling, and preclinical data suggest that PTEN...

Mitotane-containing Regimens Explored for a Rare Tumor

Response rates and progression-free survival rates were significantly better among patients with advanced adrenocortical carcinoma receiving mitotane (Lysodren) plus EDP (etoposide, doxorubicin, and cisplatin) than in patients receiving mitotane with streptozocin (Zanosar), according to results of...

global cancer care
health-care policy

Cancer Care in Rwanda: A Model of Creative Partnerships

While disparities in cancer care remain problematic in wealthy industrial nations like the United States, the challenges faced in poorer regions of the world are, by comparison, inestimable. Nationally regarded health-care expert Lawrence N. Shulman, MD, of Dana-Farber Cancer Institute, is part of...

Sarcoma Foundation of America Teams with Conquer Cancer Foundation to Fund Potentially Life-saving Research

When Matthew Alsante signed on to serve as Executive Director of the Sarcoma Foundation of America (SFA) 6 years ago, he had a visceral understanding of the importance of the organization’s work. Mr. Alsante had lost his father to lung cancer in 1999. “Right up until the last day of his life, if...

ASCO Launches Oncology Practice Census

How many oncologists are in private practice and how many are employed by hospitals and academic medical centers in the United States? No one knows the answer for sure, but ASCO is undertaking an ambitious national effort to determine where oncologists are practicing these days. Online Survey...

issues in oncology

Gene Profiling–guided Therapy May Improve Survival in Patients with Carcinoma of Unknown Primary

Molecular gene-expression profiling is an emerging technique to determine tissue of origin in patients with carcinoma of unknown primary, although the value of predictions from such profiling in improving treatment outcomes is unclear. In a prospective trial using tumor profiling results to direct...

lung cancer
issues in oncology

After a Decade of Decline in Smoking Rates, Progress Has Stalled

Approximately 20% of all Americans smoke, and 443,000 of them will die each year as a result. Tobacco use is the leading cause of preventable death in the United States and the greatest behavioral determinant of morbidity and mortality (6%–10% of U.S. health-care costs). Nearly 30% of all cancer...

leukemia

Prognostic Value of Integrated Cytogenetic and Mutational Risk Classification in Acute Myeloid Leukemia

Jay P. Patel, BS, and colleagues from Memorial Sloan-Kettering Cancer Center in New York recently performed mutational analysis of 18 genes in a subgroup of newly diagnosed acute myeloid leukemia (AML) patients who had been randomized to receive cytarabine plus high-dose or standard-dose...

leukemia

Updated Findings Further Define Role of Tyrosine Kinase Inhibitors in CML

With three available tyrosine kinase inhibitors for the treatment of chronic myeloid leukemia (CML), attention has turned from the ability to achieve a sustained response to the possibility of “curing” patients. Updates of pivotal trials presented at ASCO may help define the role of the tyrosine...

leukemia

PACE Trial Update: Ponatinib Produces High Response Rates in CML

The third-generation tyrosine kinase inhibitor ponatinib showed robust efficacy in the 10-month follow-up of the phase II PACE trial (Ponatinib Ph+ALL and CML Evaluation), which is evaluating ponatinib in treatment-refractory chronic myeloid leukemia (CML)1 At the 2012 ASCO Annual Meeting, Jorge E. ...

issues in oncology

New Study on Communicating Bad News, from the Patient’s Perspective

There is limited evidence in the literature about how oncologists should discuss bad or serious news with their patients. A recent study sought to understand what patients with cancer value when their doctors communicate news of recurrence.1 The ASCO Post spoke with the study’s lead author, Anthony ...

colorectal cancer

Increased Adjuvant Therapy Use and Improved Survival in Dutch Elderly Patients with Stage III Colon Cancer: A Direct Correlation?

A survival benefit of adjuvant chemotherapy has been reported for select elderly patients with stage III colon cancer, but many elderly patients are not candidates for or are not given adjuvant therapy due to comorbidities and fear of toxicity. In a recent Annals of Oncology article, van...

gastrointestinal cancer

SIDEBAR: Other Colorectal Cancer News from ASCO

Additional noteworthy gastrointestinal cancer studies presented during oral abstract sessions at the 2012 ASCO Annual Meeting included the following trials in metastatic colorectal cancer. Perifosine/Capecitabine Fails in Phase III Trial Adding perifosine, an oral alkylphospholipid inhibitor that...

colorectal cancer

Bevacizumab beyond Progression Prolongs Survival in Metastatic Colorectal Cancer

In a study highlighted at a press briefing during the 2012 ASCO Annual Meeting, German investigators reported that prolonging treatment with bevacizumab (Avastin) beyond disease progression extends overall survival in patients with metastatic colorectal cancer.1 Patients received bevacizumab plus...

breast cancer
lymphoma
survivorship

ASCO Studies Point to Risks Associated with Treating Childhood Cancers

Risks associated with being a young cancer survivor were emphasized by two studies highlighted in press briefings at the 2012 ASCO Annual Meeting. Investigators from the Children’s Oncology Group (COG) reported that adolescents and young adults  treated for high-risk B-precursor acute lymphoblastic ...

Expert 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 ...

lung cancer

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 ...

skin cancer

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...

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