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gynecologic cancers
global cancer care

Simple Rapid Vinegar Test Cuts Cervical Cancer Death Rates by One-third in Rural India 

In the era of personalized medicine for cancer care, it was both surprising and encouraging to hear about a simple low-tech intervention delivered by women in the community that cut the rate of death from cervical cancer in India by about one-third. The intervention, a simple visual inspection...

Expert Point of View: Gottfried Konecny, MD

Formal discussant Gottfried Konecny, MD, Associate Professor of Medicine, David Geffen School of Medicine at UCLA, also viewed the study as a game changer. He cited the strengths of the study, including its design, randomization with stratification, P values adjusted for multiple testing, and the...

lymphoma

It’s Déjà Vu All Over Again

Yogi Berra offered the comment “It’s déjà vu all over again” when he witnessed Mickey Mantle and Roger Maris repeatedly hitting back-to-back home runs in the early 1960s. His pithy remark neatly summarizes my reaction when I read the article, “Dose-Adjusted EPOCH-Rituximab Therapy in Primary...

skin cancer

GM-CSF Boosts Survival Benefit of Ipilimumab in Metastatic Melanoma 

For metastatic melanoma, the activity of ipilimumab can be boosted by the addition of granulocyte-macrophage colony-stimulating factor (GM-CSF, Leukine), according to a phase II study that found the combination improved overall survival, vs ipilimumab alone. The results were presented at the 2013...

lymphoma

Plasma Epstein-Barr Virus DNA a Potential Marker for Treatment Response in Advanced Hodgkin Lymphoma 

Plasma Epstein-Barr Virus (EBV) DNA has prognostic significance in Hodgkin lymphoma, both prior to therapy and at 6 months of follow-up, according to results of a study published in Blood. “Plasma EBV-DNA positivity at month 6 is associated with particularly poor outcomes and may serve as an...

prostate cancer

Replacing Animal Fat with Vegetable Fat May Reduce Mortality Risk in Men with Nonmetastatic Disease

“Among men with nonmetastatic prostate cancer, replacing carbohydrates and animal fat with vegetable fat may reduce the risk of all-cause mortality,” according to a prospective study of 4,577 men with nonmetastatic prostate cancer in the Health Professionals Follow-up Study. Vegetable fat intake...

breast cancer

Cognitive Complaints after Breast Cancer Treatment and Neuropsychological Testing

About one in five patients who had completed primary breast cancer treatments but had not started endocrine therapy “had elevated memory and/or executive function complaints that were statistically significantly associated with domain-specific” neuropsychological test performances and depressive...

gynecologic cancers

Driven by the Past 

When I was 9 years old, a bout of nausea, vomiting, and abdominal pain sent me to the emergency room. The physicians diagnosed appendicitis and rushed me to the operating room. But what the surgeon found instead was a 10-cm-wide, grade 2, immature teratoma. In 1968, treatment for malignant ovarian...

skin cancer

'Spectacular' Results with Immunotherapies in Melanoma Galvanize the Oncology Community 

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. Much of the news about immunotherapy ...

cns cancers

Molecular Imaging Improves Care in Pediatric Glioma

The amino acid imaging agent, O-(2-[18F]-fluoroethyl)-L-tyrosine (F-18 FET), may improve upon standard magnetic resonance imaging (MRI) and its diagnostic benefit for imaging pediatric gliomas when conventional MRI is not sufficient, said researchers at the Society of Nuclear Medicine and Molecular ...

kidney cancer

Results of AXIS Trial Indicate a Significant Improvement over Historical Survival Data in Renal Cell Carcinoma 

The phase III open-label AXIS trial comparing axitinib (Inlyta) vs sorafenib (Nexavar) as second-line treatment for metastatic renal cell carcinoma has shown a significant difference in median progression-free survival (8.3 months in the axitinib group vs 5.7 months in the sorafenib group; hazard...

gastrointestinal cancer

SEER Analysis Shows Increased Survival with Surgery and Radiation Therapy in Metastatic Gastric Cancer 

A Surveillance, Epidemiology, and End Results (SEER) database analysis reported by Ravi Shridhar, MD, PhD, and colleagues in Cancer indicates that patients receiving surgery and radiation therapy for metastatic gastric cancer have prolonged survival compared with those receiving either alone or...

gynecologic cancers

Integrated Genomic Characterization of Endometrial Carcinomas Suggests New Classification Scheme 

As recently reported in Nature, investigators in The Cancer Genome Atlas Research Network performed an integrated genomic, transcriptomic, and proteomic characterization of 373 endometrial carcinomas, including 307 endometrioid and 66 serous or mixed histology cases, using array- and...

issues in oncology

Study Shows HPV Vaccine Reduced Rate of Infection in Teenage Girls by 56% 

A new government study investigating the prevalence of human papillomavirus (HPV) infections in females aged 14 to 59 before and after the introduction in 2006 of the HPV vaccine found that the rate of the HPV infection dropped by 56%, decreasing from 11.5% in 2006 to 5.1% in 2010 among female...

lung cancer

Erlotinib in First-line Treatment of Metastatic NSCLC with EGFR Exon 19 Deletion or Exon 21 (L858R) Substitution 

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 May 14, 2013, erlotinib (Tarceva) was approved for...

solid tumors

FDA Approves Denosumab to Treat Giant Cell Tumor of the Bone

The U.S. Food and Drug Administration (FDA) has expanded the approved use of denosumab (Xgeva) to treat adults and some adolescents with giant cell tumor of the bone, a rare and usually noncancerous tumor. Denosumab, which was granted orphan product designation, was reviewed under the FDA’s...

SIDEBAR: Notes from the Lead Investigator 

We conducted this study to clarify a hypothesis that had been generated from preclinical work and small clinical datasets. One additional background point that should be made is that although not all previously reported small datasets had demonstrated a relationship between PTEN expression and...

breast cancer

Outcomes with Adjuvant Trastuzumab in HER2-positive Breast Cancer Not Affected by PTEN Status 

PTEN is a negative regulator of PI3K/AKT signaling. PI3K/AKT signaling can be activated by HER2, and it has been hypothesized that alteration in this pathway may affect sensitivity to trastuzumab (Herceptin). Preclinical data and some of the limited available clinical data suggest that loss or...

breast cancer

Measurement of Circulating Tumor DNA Shows Promise in Monitoring Metastatic Breast Cancer 

Management of metastatic breast cancer requires monitoring of tumor burden to assess response to treatment, and there is a need for biomarkers that can measure tumor burden with high sensitivity and specificity. Assays measuring serum cancer antigen (CA) 15-3 and circulating tumor cells have been...

prostate cancer

Radium-223 Dichloride for Castration-resistant Prostate Cancer with Symptomatic Bone Metastases 

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 May 15, 2013, radium Ra 223 dichloride (Xofigo) was...

leukemia

Molecular Landscaping of Acute Myeloid Leukemia: Are We Relearning the Past or Informing the Future?

Acute myeloid leukemia (AML) is a clinically and molecularly heterogeneous disease.1 This concept has been supported by more than 4 decades of studies showing distinct outcomes of subsets of patients that differ in age, disease type (primary vs secondary vs therapy-related), and cytogenetic and...

leukemia

Genomic and Epigenomic Characterization of Acute Myeloid Leukemia 

In a study by the Cancer Genome Atlas Research Network reported in The New England Journal of Medicine, genomes of 200 adult cases of de novo acute myeloid leukemia (AML) were analyzed by whole-genome sequencing (n = 50) or whole-exome sequencing (n = 150) to identify mutations and relationships...

colorectal cancer

Best First-line Treatment for Advanced Colorectal Cancer Remains Unclear 

In patients with advanced colorectal cancer, it remains unclear which biologic agent added to standard chemotherapy is best, even after a head-to-head comparison of two commonly used agents. In the phase III FIRE-3 trial, conducted by the German AIO CRC Study Group, the addition of cetuximab...

prostate cancer

Two New Genetic Tests Offer Progress in Personalized Medicine for Newly Diagnosed Prostate Cancer 

At least 12 different genetic tests for prostate cancer are under development. The two tests currently available are Oncotype DX (Genomic Health, Redwood City, California) and Prolaris (Myriad Genetic Laboratories, Salt Lake City). Both tests can identify which low-risk patients are “truly” at low...

breast cancer

Benefit for Dual HER2 Targeting in Neoadjuvant Breast Cancer Regimen Restricted to Subset of Patients 

As a neoadjuvant regimen for HER2-positive early breast cancer, the use of two HER2-directed agents was no more effective than trastuzumab (Herceptin) alone in producing pathologic complete responses, although one subset of patients did benefit from this approach, according to the results of the...

breast cancer

Search for Biomarkers of mTOR Inhibitor Benefit in Breast Cancer Fails to Pan Out 

The search for a biomarker of benefit from mTOR inhibitors in breast cancer fell flat in an exploratory genetic analysis of the ­BOLERO-2 trial, presented at the 2013 ASCO Annual Meeting by Gabriel N. Hortobagyi, MD, FACP, Professor of Breast Medical Oncology at The University of Texas MD Anderson...

issues in oncology

ASCO Will Change with the Times 

At the 2013 ASCO Annual Meeting, The ASCO Post caught up with new President Clifford A. Hudis, MD, Chief of the Breast Cancer Medicine Service at Memorial Sloan-Kettering Cancer Center, New York, for a glimpse of his plans for ASCO in the coming year, and his thoughts on being elected ASCO...

Expert Point of View: Kanti R. Rai, MD

“These three excellent, encouraging, tantalizing studies show that we really are making progress in the treatment of chronic CLL, whereas 10 to 12 years ago, we had no real progress to report,” stated Kanti R. Rai, MD, Chief, CLL Research Program, North Shore-LIJ Medical Center, New Hyde Park, NY. ...

leukemia

Idelalisib, Obinutuzumab Show Encouraging Results in CLL Studies 

A trio of presentations at the ASCO Annual Meeting focused on two promising investigational drugs for the treatment of chronic lymphocytic leukemia (CLL). These two drugs—idelalisib and obinutuzumab—join a list of new approaches showing potential. Idelalisib Alone A phase I dose-ranging study of...

Expert Point of View: Marjorie G. Zauderer, MD and Andrew D. Seidman, MD

Commenting on the ganetespib study, Marjorie G. Zauderer, MD, a medical oncologist at Memorial Sloan-Kettering Cancer Center in New York, said that this first-in-class study suggests efficacy and represents a potential advance in lung cancer treatment. “We haven’t had any advances in a long time....

lung cancer

First Positive Trial of Heat Shock Protein 90 Inhibitor in Lung Cancer That Has Progressed after First-line Therapy 

The investigational heat shock protein (Hsp)90 inhibitor ganetespib plus docetaxel extended overall survival compared with docetaxel alone as second-line therapy in patients with advanced non–small cell adenocarcinoma of the lung that had progressed on first-line therapy in the randomized phase II...

lung cancer

Second-generation ALK Inhibitor Breakthrough Drug Promising in Early Study for Non–Small Cell Lung Cancer 

Encouraging results were seen in a preliminary study of a second-generation ALK inhibitor in advanced ALK-positive non–small cell lung cancer (NSCLC). The drug—dubbed LDK378—achieved tumor shrinkage in almost all patients enrolled in the study, in all mutational subsets, in crizotinib...

breast cancer
gynecologic cancers

Despite a Recurrence, I'm Not Surrendering My Life to Cancer

This is the first time I’m going public with the fact that I have advanced ovarian cancer. I thought I could avoid the fate of my mother and her mother, both of whom died of ovarian cancer in their 50s, and live well past my 60s and even 70s. But at 58, I’ve had to accept that that is not likely. I ...

issues in oncology
legislation

Supreme Court Rules Human Genes May Not Be Patented 

On June 13, the U.S. Supreme Court ruled unanimously that isolated human genes may not be patented. However, the creation of synthetic forms of DNA, known as complementary DNA (cDNA), is eligible for patent protection. The decision resolves the question brought before the Supreme Court justices in...

cns cancers

Bevacizumab in Glioblastoma: Another Perspective 

Given the results of the AVAglio trial, we feel that a more balanced discussion about the role of bevacizumab (Avastin) in patients with newly diagnosed glioblastoma is in order. The accompanying article in The ASCO Post suggests that bevacizumab has no benefit in newly diagnosed glioblastoma; data ...

cns cancers

Studies Explore Role of Bevacizumab in Combination Therapies for Glioblastoma

At the 2013 ASCO Annual Meeting, studies evaluating the addition of bevacizumab (Avastin) to standard therapy in newly diagnosed glioblastoma multiforme patients did not meet their primary endpoints. When paired with irinotecan, however, bevacizumab showed activity in MGMT-unmethylated tumors....

Some Excess Cancer Risk in Men May Be Related to Greater Height  

More than one-third of the excess risk for cancers among men may be due to factors associated with height, according to data from the Vitamins and Lifestyle (VITAL) study. As reported in the Journal of the National Cancer Institute, these factors include the “number of susceptible cells in a...

leukemia
geriatric oncology

Lenalidomide Induces Long-lasting Responses in Elderly Patients

Treatment with lenalidomide (Revlimid) as initial therapy induced long-lasting responses in a phase II study of 60 patients with chronic lymphocytic leukemia (CLL). “Overall, 35 patients (58%) patients had responses lasting more than 36 months and were considered long-term responders,” the...

breast cancer

Two Studies Indicate Potential Predictors of Survival Benefit from Endocrine Therapy 

Two studies published in Journal of Clinical Oncology indicate that treatment-related symptoms and mammographic density reduction may predict whether a woman with hormone receptor–positive breast cancer will benefit from adjuvant endocrine therapy. In one study, women who had specific adverse...

prostate cancer

Pain Is More Prevalent and Severe in Men with Metastatic Disease and Use of Docetaxel  

Men who have metastatic castration-resistant prostate cancer and have used docetaxel reported a higher prevalence and greater severity of pain than docetaxel-naive patients, according to results of an anonymous survey conducted at five comprehensive cancer centers in the Prostate Cancer Clinical...

prostate cancer

Use of Advanced Technologies Has Increased in Men at Low Risk of Dying from Prostate Cancer 

The use of advanced treatment technologies, such as intensity-modulated radiotherapy and robotic prostatectomy, has increased among men unlikely to die from prostate cancer, according to a retrospective analysis of data from almost 56,000 men diagnosed with prostate cancer between 2004 and 2009....

lung cancer

Most Patients Receiving Radiotherapy for Incurable Lung Cancer Do Not Realize It Is Unlikely to Cure Them 

Surveying a population-based and health system–based cohort of patients receiving radiation therapy for incurable lung cancer (defined as stage IV or stage IIIB with malignant effusion at diagnosis) revealed that “64% did not understand that [radiotherapy] was not at all likely to cure them.” These ...

Encourage Questions about Late Effects of Treatment   

Melissa Hudson, MD, of St. Jude Children’s Research Hospital in Memphis, and lead author of a study finding that 98.2% of adult survivors of childhood cancer had a chronic health condition, told The ASCO Post that she hoped that survivors’ awareness of the need for ongoing health monitoring was...

survivorship

More Than 98% of Childhood Cancer Survivors Have Chronic Health Conditions 

More than 98% of adult survivors of childhood cancer in a large clinically evaluated cohort had a chronic health condition, including a substantial number of previously undiagnosed problems that are more likely to occur in an older population. “These findings underscore the importance of ongoing...

pancreatic cancer
issues in oncology

Pancreatic Cancer Action Network Names 7-Year Survivor Chair of National Board of Directors 

The Pancreatic Cancer Action Network recently announced the appointment of Laurie MacCaskill to Chair of the National Board of Directors of the organization, effective July 1, 2013. Ms. MacCaskill is the first pancreatic cancer patient to hold this position. Since her diagnosis in 2006, Ms....

pancreatic cancer

I Have No Fear 

I found out that I had stage III pancreatic cancer on Valentine’s Day in 2011, but I think the disease may have been brewing for a long time. For 19 years, I had experienced intermittent pain in the right upper quadrant of my abdomen. I had gallbladder surgery to relieve a bile duct obstruction,...

issues in oncology

Co-discoverer of DNA Double Helix, James Watson, PhD, Offers a New Theory on Cancer Progression 

Despite his fame as co-discoverer—along with Francis Crick, PhD—of the double-helix structure of deoxyribonucleic acid (DNA) in 1953, that accomplishment is not what James Dewey Watson, PhD, came to talk about during a recent presentation he gave at the World Science Festival in New York. Instead,...

cns cancers

Management of Anaplastic Oligodendroglial Tumors 

Pearls in Neuro-oncology is guest edited by Tracy Batchelor, MD, Director, Division of Neuro-Oncology, Massachusetts General Hospital Cancer Center, and Professor of Neurology, Harvard Medical School, Boston. The series is intended to provide the practicing oncologist with guidance in managing...

lung cancer

FDA Approves Afatinib for Late-stage Lung Cancer

On July 12, 2013, the FDA approved the tyrosine kinase inhibitor afatinib (Gilotrif) for the first-line treatment of patients with metastatic non–small cell lung cancer (NSCLC) whose tumors express epidermal growth factor receptor (EGFR) exon 19 deletions or exon 21 (L858R) substitution mutations...

hematologic malignancies

Barriers to Successful Hematopoietic Stem Cell Transplantation 

The Center for International Blood and Marrow Transplant Research is a combined research program of the National Marrow Donor Program and the Medical College of Wisconsin, Milwaukee. At the forefront of research to increase access to hematopoietic stem cell transplantation and improve outcomes, the ...

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