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Expert Point of View: Sarah B. Goldberg, MD, MPH

In a commentary accompanying reporting of the phase II study of the MEK inhibitor selumetinib by Dr. Pasi A. Jänne, MD, PhD, and colleagues, Sarah B. Goldberg, MD, MPH, Assistant Professor of Medicine, and colleagues at Yale Cancer Center, New Haven, Connecticut, noted that KRAS, a member of the...

lung cancer

Selumetinib/Docetaxel Shows Promising Activity in Previously Treated KRAS-mutant Non-Small Cell Lung Cancer

Currently, there are no approved therapies for KRAS-mutant non–small cell lung cancer (NSCLC), and few clinical trials have been performed specifically in this setting. In a recent article in Lancet Oncology, Pasi A. Jänne, MD, PhD, Scientific Director, Belfer Institute for Applied Cancer Science,...

Expert Point of View: Michel Ducreux, MD, PhD

Michel Ducreux, MD, PhD, of the Institut Gustave Roussy in Villejuif, France, discussed the findings at the ESMO meeting. He said that TH-302 represents a “new drug and new concept, the microenvironment.” He noted, “Pancreatic cancers are frequently hypovascularized, at least the primary tumor, and ...

leukemia

Expert Point of View: Farhad Ravandi, MD 

Over the past 2 decades, we have witnessed remarkable progress in the treatment of patients with acute promyelocytic leukemia (APL). The introduction of all-trans retinoic acid (ATRA) in the front-line therapy setting and arsenic trioxide in the relapse setting had already led to a significant...

leukemia

Chemotherapy-free Regimen Successful in Acute Promyelocytic Leukemia 

For the first time, a chemotherapy-free regimen was superior to conventional cytotoxic chemotherapy for the treatment of acute promyelocytic leukemia (APL). The combination of all-trans retinoic acid (ATRA) plus arsenic trioxide (Trisenox) achieved significantly superior overall survival compared...

issues in oncology
cost of care

Integration across the Spectrum: Community Perspective on the Medical Oncology Home Model 

The term “patient-centered cancer care” has become ingrained in today’s health-care vernacular. However, no matter what modifications occur in clinical oncology practice, the terms value and cost-effectiveness are now a solid part of the equation. At ASCO’s Quality Care Symposium, Linda D....

Expert Point of View: Philip Agop Philip, MD and Alan P. Venook, MD

Philip Agop Philip, MD, Head of the Multidisciplinary Team for Gastrointestinal and Neuroendocrine Oncology and Neuroendocrine at Karmanos Cancer Institute at Wayne State University, Detroit, was the formal discussant of the paper at the Gastrointestinal Cancers Symposium. He said the positive...

colorectal cancer

Genetic and Epigenetic Alterations in Colorectal Cancer and Metastases

Treatment of colorectal cancer is complicated by the potential difference in molecular profiles between the primary tumor and metastases. Miranda and colleagues from the Humanitas Clinical and Research Center in Milan, Italy, recently assessed the presence of molecular heterogeneity during...

lymphoma

Solving a 30-year Mystery

When I began experiencing severe neck and back pain about 9 years ago, I had no idea it could be a late side effect from the radiation therapy I had received 31 years ago to treat my Hodgkin lymphoma. And none of the doctors I’ve seen over the past decade have been able to make the connection...

lung cancer

Use of Beta-blockers Associated with Improved Survival in Patients with NSCLC Receiving Definitive Radiation Therapy 

As reported recently in Annals of Oncology, a retrospective study by Wang and colleagues showed that use of beta-adrenergic receptor antagonists (beta-blockers), typically used in treatment of hypertension and heart disease, was associated with significantly improved distant metastasis–free...

leukemia
lymphoma
multiple myeloma

More Brief Reports from ASH, Including New Data in Leukemia, Lymphoma, and Myelodysplastic Syndrome

At the 54th Annual Meeting of the American Society of Hematology (ASH), held in Atlanta, nearly 5,000 abstracts were presented in oral sessions and posters. As part of our ongoing comprehensive coverage from the meeting, here are several more studies of note. New Targets in Acute Myeloid Leukemia...

hematologic malignancies

No Rationale for Eliminating Prophylactic Platelet Transfusions in Patients with Hematologic Malignancies 

Prophylactic platelet transfusions should remain the standard of care for many patients with hematologic malignancies who are thrombocytopenic during intensive treatment or stem cell transplant, investigators of the TOPPS trial (noninferiority Trial Of Prophylactic Platelet transfusionS)...

colorectal cancer

A New Donor Shines with Conquer Cancer Foundation

To support all of our valuable programs for patients and physicians, the Conquer Cancer Foundation of the American Society of Clinical Oncology partners with organizations of every size and scale, and every partnership has a lasting impact. Recently, the Foundation began working with a new...

breast cancer

Pathologic Complete Response Yields Long-term Benefits in Meta-analysis  

Breast cancer patients who achieve a pathologic complete response to neoadjuvant therapy have more favorable outcomes than those who do not, according to a meta-analysis of neoadjuvant trials presented at the 2012 San Antonio Breast Cancer Symposium.1 Patients who achieved a pathologic complete...

breast cancer

Dose-dense Chemotherapy in Breast Cancer: Epirubicin-based Regimens Studied in German and UK Trials

In the treatment of early breast cancer, dose-dense regimens (given every 2 weeks) have proven superior to conventionally dosed chemotherapy (given every 3 weeks), but data on long-term survival are lacking. Two studies presented at the San Antonio Breast Cancer Symposium evaluated the benefit of...

breast cancer

Final 'Joint Analysis' Confirms Life-saving Benefit of Trastuzumab in Patients with HER2-positive Early Breast Cancer

In the final planned joint analysis of overall survival from the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-31 and North Central Cancer Treatment Group (NCCTG) N9831 trials, the addition of trastuzumab (Herceptin) to paclitaxel following doxorubicin/cyclophosphamide (AC) reduced...

colorectal cancer

Outcomes Comparable for Panitumumab and Bevacizumab in Metastatic Colorectal Cancer 

In patients with KRAS wild-type metastatic colorectal cancer, outcomes were comparable whether patients received the epidermal growth factor receptor (EGFR) inhibitor panitumumab (Vectibix) or the vascular endothelial growth factor (VEGF) inhibitor bevacizumab (Avastin). This was shown both in the...

issues in oncology

On Radiation and Cancer Risk

We owe our life to radiation. The universe was created in a thermonuclear explosion, and continued existence of life on Earth depends on plants using chlorophyll to capture light energy emitted by the sun (and exploding supernovas) and converting it into chemical energy, with the subsequent...

cost of care
survivorship

Study Finds Young Cancer Survivors Often Skip Checkups

Athough the majority of the more than 69,000 adolescents and young adults (AYAs) diagnosed with cancer each year will survive their disease, many of them will experience interruptions in their education and a derailment in their career tract, curtailing their lifetime earning potential and reducing ...

colorectal cancer

FOLFOXIRI Plus Bevacizumab Is Superior to FOLFIRI Plus Bevacizumab in Metastatic Colorectal Cancer 

For the treatment of metastatic colorectal cancer, better outcomes were achieved when bevacizumab (Avastin) was added to FOLFOXIRI (leucovorin, fluorouracil [5-FU], oxaliplatin, irinotecan), rather than FOLFIRI (leucovorin, 5-FU, irinotecan), in the phase III TRIBE trial conducted at 35 Italian...

issues in oncology

Large Epidemiologic Studies Re-examine Hazards of Smoking

“Smokers lose at least one decade of life expectancy, as compared with those who have never smoked,” and the increased risk of death from cigarettes smoking “are now nearly identical for men and women,” according to two separate studies published online by TheNew England Journal of Medicine. One...

hematologic malignancies
leukemia

Short Wait for Lab Results Is Reasonable Strategy to Better Characterize AML and Design Therapy

Waiting a short period of time for laboratory results to better characterize acute myeloid leukemia (AML) and design therapeutic approaches is a reasonable strategy, researchers in Toulouse, France, found after a retrospective review of 599 newly diagnosed AML patients treated by induction...

gynecologic cancers

Short-term Survival Advantage of Carrying BRCA Mutation Does Not Extend to Long Term

While carrying a BRCA 1 or BRCA 2 mutation was associated with a better prognosis in the 3-year period after diagnosis of invasive ovarian cancer, this short-term survival advantage did not lead to long-term survival benefit, according to a study published in the Journal of the National Cancer...

skin cancer

Trametinib Shows Activity in Previously Treated but BRAF Inhibitor–naive BRAF-mutant Melanoma

In a multicenter phase II study, trametinib showed “significant clinical activity” in a cohort of BRAF inhibitor–naive patients with BRAF-mutant cutaneous melanoma previously treated with chemotherapy and/or immunotherapy. Only minimal clinical activity, however, was observed among a cohort of...

head and neck cancer
lung cancer
issues in oncology

Patients with Cancer Need to Know That It Is Never Too Late to Quit Smoking 

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. Patients with head and neck or lung...

breast cancer

My Life Will Never Be Normal 

After being diagnosed with stage II invasive ductal carcinoma in my right breast in 2004, I did an Internet search to learn more about my treatment options so I could be prepared when I met with my oncologist to discuss my treatment plan. I was especially interested in therapies that would be...

colorectal cancer
lung cancer
prostate cancer
lymphoma
multiple myeloma
issues in oncology
palliative care

Study Shows Little Association of Multidisciplinary Tumor Boards with Measures of Care 

A survey of Veterans Affairs (VA) medical centers recently reported by Nancy L. Keating, MD, MPH, and colleagues at Harvard Medical School in the Journal of the National Cancer Institute showed that the presence of multidisciplinary tumor boards had little association with rates of recommended...

issues in oncology
health-care policy

Focus on the Medical Oncology Association of Southern California 

For more than 2 decades, the guiding principle of the Medical Oncology Association of Southern California (MOASC) has been to ensure the continuation of the private practice of medical oncology and to provide the highest quality care to cancer patients. Founded in 1990, MOASC is the largest...

global cancer care

Survey Shows Public's Knowledge of Cancer Progress Is Rising, But Myths Persist 

People are more optimistic today about their chances of surviving cancer, according to findings from a new international survey commissioned by Lilly Oncology. The phone survey of 4,341 individuals (including people in the general population, cancer survivors, and caregivers) in six countries (the...

Jane Cooke Wright, MD, ASCO Cofounder, Dies at 93 

The practice of oncology advances incrementally; each step forward, no matter how painfully small at times, leads to the next. The oncology community readily offers tribute to predecessors in the field who took those first steps into the uncharted regions of cancer care, without which today’s...

gynecologic cancers

Analysis Shows No 10-year Survival Advantage in Patients with Ovarian Cancer and BRCA1 or BRCA2 Mutations 

Several studies have suggested that short-term overall survival for women with ovarian cancer and BRCA1 or BRCA2 mutations is better than that in patients without such mutations. Indeed, a recent report by Kelly L. Bolton, PhD, and colleagues indicated that 5-year overall survival was 36% for...

issues in oncology

Enhanced Electronic Module Aims to Prevent Errors in Oral Chemotherapy Prescribing

An oral chemotherapy prescription-writing module grafted to a shared electronic medical record is part of a series of quality improvement efforts undertaken at Dana-Farber Cancer Institute in Boston to prevent errors in prescribing oral chemotherapy agents. While oncologists have readily accepted...

hematologic malignancies
multiple myeloma

High Infection Rates Found in Multiple Myeloma Patients, With High Mortality  

A large Swedish study using population-based data to estimate the risk of bacterial and viral infections among 9,610 patients with multiple myeloma (9,253 eligible for analysis) found that the myeloma patients had a 7-fold risk of developing any infection compared to 34,931 matched controls from...

issues in oncology

Preparing for the Next Superstorm: Protecting Patients during Natural Disasters 

When Hurricane Sandy slammed into the East Coast last October, the magnitude of devastation it left in its wake exceeded even the most dire predictions. Eighty mile per hour winds and record storm surges destroyed antiquated electrical grids and flooded subway stations, leaving much of New York...

solid tumors

FDA Approves Regorafenib for Advanced Gastrointestinal Stromal Tumors

The FDA has expanded the approved use of regorafenib (Stivarga) to treat patients with metastatic or unresectable gastrointestinal stromal tumors (GIST) that no longer respond to treatment with imatinib (Gleevec) or sunitinib (Sutent). Regorafenib, a multikinase inhibitor, blocks several enzymes...

breast cancer

FOXP3 Expression Linked to Better Survival with Adjuvant Anthracycline Not Followed by Taxane in Breast Cancer 

The French UNICANCER-PACS 01 trial compared six cycles of anthracycline-based adjuvant therapy with FEC (epirubicin, cyclophosphamide, fluorouracil; FEC6) vs three cycles of FEC followed by three cycles of docetaxel (FEC/docetaxel) in patients with node-positive primary breast cancer. After...

Expert Point of View: Elizabeth Mittendorf, MD

“This study confirms previously published racial disparities in access to care, but factors that drive these disparities have not been elucidated,” stated Elizabeth Mittendorf, MD, Department of Surgical Oncology at The University of Texas MD Anderson Cancer Center, Houston. The study was...

breast cancer

Black Women Less Likely to Get Sentinel Lymph Node Biopsy and More Likely to Have Lymphedema on Axillary Lymph Node Dissection 

Although sentinel lymph node biopsy is the recommended method for axillary staging of node-negative breast cancer, racial disparities in access to care were found in a study presented at the 2012 San Antonio Breast Cancer Symposium. Black women were 12% less likely than white women with breast...

Expert Point of View: Seema A. Khan, MD

Responding to the results of the ACOSOG Z1071 study, Seema A. Khan, MD, Professor of Surgery at Northwestern University Feinberg School of Medicine, Chicago, urged caution in adopting the practice of sentinel lymph node surgery after chemotherapy for some patients with breast cancer at this time....

breast cancer

Role of Sentinel Node Surgery Explored in Node-positive Breast Cancer 

Sentinel lymph node surgery performed after neoadjuvant chemotherapy in women presenting with node-positive disease could spare many patients with breast cancer needless axillary lymph node dissection, according to a study of the American College of Surgeons Oncology Group presented at the 2012 San ...

breast cancer

21-gene Recurrence Score Does Not Predict Paclitaxel Benefit  

The 21-gene recurrence score significantly predicted the risk of recurrence and death in node-positive, estrogen receptor–positive patients treated with adjuvant chemoendocrine therapy, but it did not predict benefit from the addition of paclitaxel to the regimen in a subset of patients from the...

Expert Point of View: Laura J. van ’t Veer, PhD and Andrew Seidman, MD

Laura J. van ’t Veer, PhD, Leader of the Breast Oncology Program at the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, commented on the findings. “These investigators confirm in a robust meta-analysis that neoadjuvant chemotherapy response is different...

Subsets of Young Patients Have Higher Pathologic Complete Response Rates

In achieving a pathologic complete response to neoadjuvant chemotherapy, it seems that age matters, according to a study reported at the 2012 San Antonio Breast Cancer Symposium.1 Patients with breast cancer aged 35 and younger were more likely to achieve a pathologic complete response than their...

lung cancer

No Benefit of Adding Carboplatin to Pemetrexed in Second-line Treatment of Patients With Advanced Non–Small Cell Lung Cancer 

An Italian randomized phase II study (GOIRC 02-2006 study) recently reported in Journal of Clinical Oncology by Andrea Ardizzoni, MD, of Azienda Ospedaliero-Universitaria in Parma, Italy, and colleagues showed no progression-free survival benefit of adding carboplatin to pemetrexed (Alimta) in...

lung cancer
palliative care

Patients Receiving Palliative Radiation Therapy for Metastatic Non–Small Cell Lung Cancer May Be Overtreated 

Many patients receiving palliative radiation therapy to the bone or chest for metastatic non–small cell lung cancer (NSCLC) may be receiving a greater number of treatments and higher doses than are supported by current evidence, according to a Cancer Care and Outcomes Research and Surveillance...

lymphoma

Cytarabine in Conditioning Regimen for Younger Patients with MCL 

High-dose cytarabine should be incorporated into the induction regimen of younger patients with mantle cell lymphoma (MCL) before autologous stem cell transplantation, according to final results of the MCL Younger Trial of the European Mantle Cell Lymphoma Network, presented at the ASH Annual...

hematologic malignancies
leukemia
issues in oncology

Quizartinib Data Encouraging in Phase II Investigations of FLT3 Mutation–positive Acute Myeloid Leukemia

The investigational oral FLT3 inhibitor quizartinib appears to be a safe and effective treatment for patients with relapsed or refractory acute myeloid leukemia (AML), according to results of a phase II trial presented at the 54th Annual Meeting of the American Society of Hematology (ASH) in...

Expert Point of View: Martin Dreyling, MD

“The BRIGHT study had a noninferiority design, but I question why BR was not found superior, because the StiL trial showed a huge difference in progression-free survival favoring BR,” said Martin Dreyling, MD, Professor at the University of Munich in Germany. “In BRIGHT, BR achieved higher...

hematologic malignancies
lymphoma

Bendamustine/Rituximab Noninferior to Standard Chemotherapy for Advanced Indolent Non-Hodgkin and Mantle Cell Lymphomas 

The combination of bendamustine (Treanda) and rituximab (Rituxan), or BR, was found to be noninferior to commonly used chemotherapy with R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone) or R-CVP (rituximab plus cyclophosphamide, vincristine, and prednisone) in...

hematologic malignancies
issues in oncology

Pomalidomide in Previously Treated Multiple Myeloma 

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 On February 8, 2013, the immunomodulatory agent...

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