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issues in oncology
issues in oncology

Medicare Part D Low-Income Subsidy Program Improves Adherence to Hormone Therapy After Breast Cancer Surgery

Findings from a study of more than 23,000 women suggest that the Medicare Part D Extra Help program, which provides low-income subsidies for medications, improves adherence to hormone therapy after breast cancer surgery in all racial/ethnic groups and reduces racial/ethnic disparities. The study,...

gastroesophageal cancer

Substantial Benefit of Intensive Surveillance Following Bimodality Therapy for Esophageal Cancer

In a study reported in the Journal of Clinical Oncology, Sudo et al found that many patients undergoing definitive chemoradiotherapy (bimodality therapy) for esophageal cancer can derive substantial survival benefit  from subsequent salvage surgery, supporting a practice of intensive...

lung cancer

ASCO Endorses Guideline for Molecular Testing to Select Lung Cancer Patients for EGFR and ALK Inhibitor Treatment

ASCO has endorsed the recently developed joint College of American Pathologists (CAP), International Association for the Study of Lung Cancer (IASLC), and Association of Molecular Pathologists (AMP) guideline on molecular testing for selection of patients with lung cancer for EGFR and ALK inhibitor ...

lung cancer
issues in oncology

Researchers Reveal Genomic Diversity of Individual Lung Tumors

Known cancer-driving genomic aberrations in localized lung cancer appear to be so consistently present across tumors that a single biopsy of one region of the tumor is likely to identify most of them, according to a paper published by Zhang et al in Science. The study led by scientists at The...

colorectal cancer

Hormone Loss Could Be Involved in Colon Cancer

Some cancers, like breast and prostate cancer, are driven by hormones such as estrogen and testosterone, but to date, there are none that are understood to be driven by the lack of a hormone. New evidence reported by researchers at Thomas Jefferson University, Philadelphia, suggests that human...

supportive care
issues in oncology

Adding Aprepitant to Granisetron/Dexamethasone Reduces Chemotherapy-Induced Nausea and Vomiting After High-Dose Melphalan Conditioning in Myeloma

In a phase III trial reported in the Journal of Clinical Oncology, Schmitt et al found that adding aprepitant to granisetron and dexamethasone significantly reduced chemotherapy-induced nausea and vomiting in myeloma patients undergoing high-dose melphalan conditioning and autologous stem cell...

breast cancer

Second-Line Bevacizumab/Chemotherapy Improves Progression-Free Survival in Advanced HER2-Negative Breast Cancer

In the phase III TANIA trial reported in The Lancet Oncology, von Minckwitz et al found that adding bevacizumab (Avastin) to chemotherapy in second-line treatment improved progression-free survival after first-line bevacizumab plus chemotherapy in patients with HER2-negative locally recurrent or...

leukemia

New Findings in Acute Promyelocytic Leukemia

Three studies reported in the Journal of Clinical Oncology provide information on maintenance treatment with the synthetic retinoid tamibarotene in acute promyelocytic leukemia, potential implications of QT interval prolongation related to arsenic trioxide (Trisenox), and potential health-related...

lymphoma

FDA Approves Bortezomib Injection for Previously Untreated Patients With Mantle Cell Lymphoma

The U.S. Food and Drug Administration (FDA) has approved bortezomib (Velcade) injection for previously untreated patients with mantle cell lymphoma. This is the first treatment in the United States to be approved for use in previously untreated patients with mantle cell lymphoma. Bortezomib was...

breast cancer

Improved Survival With Maintenance Capecitabine/Bevacizumab vs Bevacizumab Alone in HER2-Negative Metastatic Breast Cancer

Regulatory approval of bevacizumab (Avastin) plus docetaxel in metastatic breast cancer was withdrawn in Europe in February 2011 and in the United States in November 2011. The phase III IMELDA trial comparing maintenance capecitabine/bevacizumab vs bevacizumab after first-line bevacizumab/docetaxel ...

multiple myeloma

Updated GEM2005 Trial Confirms Benefit of Melphalan/Bortezomib Combination in Elderly Multiple Myeloma Patients

Melphalan in combination with bortezomib (Velcade) should be maintained as one of the standards of care for the treatment of elderly patients with multiple myeloma, concluded Spanish trialists reporting updated results from the GEM2005 study comparing bortezomib/melphalan/prednisone with...

skin cancer

Anti–PD-1 Antibody Pembrolizumab Is Active in Ipilimumab-Refractory Advanced Melanoma

As reported in The Lancet by Robert et al, the anti–programmed-death receptor-1 (PD-1) antibody pembrolizumab (Keytruda) produced durable responses in a phase I trial in patients with ipilimumab (Yervoy)-refractory melanoma. The study provided the basis for the recent accelerated approval of...

gynecologic cancers

HPV 16/18 Vaccine Shows Protective Efficacy in Women Aged > 25 Years in 4-Year Interim Follow-up of VIVIANE Study

In the 4-year interim follow-up of the VIVIANE study reported in The Lancet by Skinner et al, the human papillomavirus (HPV) 16/18 AS04-adjuvanted vaccine was found to be protective against 6-month persistent infection or cervical intraepithelial neoplasia grade 1 or higher (CIN1+) associated with...

prostate cancer

Abiraterone Acetate/Prednisone in Metastatic Castration-Resistant Prostate Cancer: Final Analysis of Early-Access Protocol Study

Abiraterone acetate (Zytiga) is approved for use in combination with prednisone in the treatment of metastatic castration-resistant prostate cancer. As reported by Sternberg et al in The Lancet Oncology, results of an open-label, early-access protocol trial initiated prior to approval indicated no...

2014 Nobel Prize in Physiology or Medicine Awarded to John O’Keefe, FRS, May-Britt Moser, PhD, and Edvard I. Moser, PhD

The Nobel Assembly at Karolinska Institutet has awarded the 2014 Nobel Prize in Physiology or Medicine to John O’Keefe, FRS, and to May-Britt Moser, PhD, and Edvard I. Moser, PhD, for their discoveries of cells that constitute a positioning system in the brain. This “inner GPS”...

colorectal cancer
issues in oncology

Study Finds Increase in Colonoscopy Rates Has Lead to Overuse

A retrospective study led by researchers at Brigham and Women's Hospital has found an overuse of colonoscopies for colorectal cancer screening and surveillance. The study demonstrated that endoscopists commonly recommended shorter follow-up intervals than established guidelines support, and these...

breast cancer

Swedish Study Indicates No Increased Risk of Breast Cancer With 5 Years of Continuous Exposure to Calcium Channel Blockers

A recently reported U.S. population-based case-control study in women aged 55 to 74 years indicated that current use of calcium channel blockers for ≥ 10 years was associated with increased risk of ductal breast cancer (odds ratio [OR] = 2.4) and lobular breast cancer. In a Swedish case-control...

breast cancer

Comorbidity Associated With Shorter Overall Survival but Not With Time to Relapse or Toxicity in Older Women on Adjuvant Chemotherapy

In the Cancer and Leukemia Group B (CALGB) 70103 study, comorbidity was associated with shorter overall survival among older women with early-stage breast cancer and good functional status receiving adjuvant chemotherapy. “The presence of four or more conditions appeared to be a threshold for ...

lung cancer

FDA Grants Breakthrough Therapy Designation to AP26113 for ALK-Positive NSCLC

The U.S. Food and Drug Administration (FDA) has granted Breakthrough Therapy designation to Ariad Pharmaceutical’s investigational agent AP26113 for patients with anaplastic lymphoma kinase (ALK)-positive metastatic non–small cell lung cancer (NSCLC) who are resistant to crizotinib...

lymphoma

PET-CT as Standard for Response Assessment After First-Line Therapy in Follicular Lymphoma

In a pooled analysis reported in The Lancet Haematology, Trotman et al found that 18F-fluorodeoxyglucose (FDG) positron-emission tomography/low-dose computed tomography (PET-CT) provides improved prognostic information over conventional contrast-enhanced CT in assessment of response to first-line...

sarcoma

Reduced Local Recurrence With Intensity-Modulated vs External-Beam Radiation Therapy in Primary Soft-Tissue Sarcomas of the Extremity

There are no large-scale direct comparisons of outcomes with intensity-modulated radiation therapy vs conventional external-beam radiation therapy in patients with soft-tissue sarcoma of the extremity. In a single-institution experience reported in the Journal of Clinical Oncology, Folkert et al at ...

prostate cancer

PSA Bounce After Radiotherapy May Be Associated With Outcomes in Patients With Prostate Cancer

A temporary rise in prostate-specific antigen (PSA) scores after radiotherapy may have an association with outcomes in patients with prostate cancer, according to the study findings presented by Naghavi et al in the International Journal of Clinical Oncology. Experiencing a PSA bounce was...

Proposed Comorbidity-Age Index in Prognostic Model for Allogeneic Hematopoietic Cell Transplantation

In a study reported in the Journal of Clinical Oncology, Sorror et al found that a composite comorbidity-age index was better than age alone in predicting nonrelapse mortality and survival in patients undergoing allogeneic hematopoietic cell transplantation. Study Details The study included data...

cns cancers
pancreatic cancer

ESMO 2014: Everolimus Improves Overall Survival in Patients With Advanced Pancreatic Neuroendocrine Tumors

In a phase III trial, treatment with everolimus (Afinitor) resulted in a median overall survival of over 3 and a half years in patients with well-differentiated and progressive pancreatic neuroendocrine tumors, representing what the study authors called a "clinically important" although not...

gynecologic cancers

Next-Generation HPV Vaccine May Prevent 90% of Cervical Cancer Cases Worldwide

A study of a nine-valent human papillomavirus (HPV) vaccine that provides protection against HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58, has found it to be highly safe and efficacious. If vaccination programs with this new-generation vaccine are effectively implemented, approximately 90% of...

prostate cancer

Cabozantinib Active in Pretreated Metastatic Castration-Resistant Prostate Cancer

In a phase II expansion study reported in the Journal of Clinical Oncology, Smith et al found that the multikinase inhibitor cabozantinib (Cometriq) showed activity in previously treated metastatic castration-resistant prostate cancer. Cabozantinib targets include VEGFR2 and MET kinases. Study...

sarcoma

Phase II Study Shows Activity of Hypoxia-Activated Alkylating Prodrug in Combination With Doxorubicin in Advanced Soft-Tissue Sarcoma

In a phase II study reported in the Journal of Clinical Oncology, Chawla et al found that the combination of a hypoxia-activated alkylating prodrug (TH-302) and doxorubicin was active in first-line treatment of advanced soft-tissue sarcoma. TH-302 is a prodrug of the cytotoxic alkylating agent...

skin cancer

ESMO 2014: Nivolumab Shows Signs of Superior Response Rate Compared to Standard Chemotherapy in Advanced Melanoma

The monoclonal antibody nivolumab achieved superior response rates and a longer duration of response than standard chemotherapy in patients whose melanoma has progressed after treatment with ipilimumab (Yervoy), according to preliminary data from a phase III trial presented at the ESMO 2014...

lung cancer

ESMO 2014: Lung Cancer Vaccine Fails to Improve Survival in Surgically Resected Non–Small Cell Lung Cancer

The MAGRIT trial showed disappointing results for a developmental vaccine called MAGE-3 in patients with non–small cell lung cancer (NSCLC) who had undergone surgical resection. This is the largest vaccine trial conducted in lung cancer, and investigators hoped that an immunotherapy approach...

Robert S. Miller, MD, FACP, FASCO, Joins ASCO as Medical Director for Society's Institute for Quality

Robert S. Miller, MD, FACP, FASCO, Assistant Professor of Oncology and Oncology Medical Information Officer at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, has been named Medical Director of the Institute for Quality (iQ) of the American Society of Clinical Oncology (ASCO). ...

skin cancer

ESMO 2014: BRAF/MEK Inhibitor Combinations Impressive in Melanoma Trials

For advanced/metastatic melanoma patients with BRAF mutations, two pathway inhibitors are much better than one, according to studies presented at the ESMO 2014 Congress that demonstrated improved progression-free and overall survival for regimens combining a BRAF inhibitor with an inhibitor of the...

head and neck cancer

ESMO 2014: Afatinib Improves Progression-Free Survival in Advanced Head and Neck Cancer

The tyrosine kinase inhibitor afatinib (Gilotrif) was significantly superior to methotrexate as second-line therapy in patients with advanced squamous cell carcinoma of the head and neck who progressed after platinum-based chemotherapy, according to results of the LUX-Head & Neck 1 trial. The...

lung cancer

ESMO 2014: Novel Oral Agent Treats Cancer-Related Cachexia in Non–Small Cell Lung Cancer

For the first time, studies show that a drug is effective in treating cancer-related cachexia. Oral anamorelin hydrochloride increased lean body mass, achieved weight gain, and improved quality of life in patients with cancer-related cachexia in two pivotal phase III studies presented at the ESMO...

breast cancer

ESMO 2014: CLEOPATRA Study Shows ‘Unprecedented’ Survival With Dual HER2 Blockade in Metastatic Breast Cancer

In the final overall survival analysis of the phase III CLEOPATRA trial, patients with HER2-positive metastatic breast cancer patients lived 15.7 months longer if they received pertuzumab (Perjeta) in addition to trastuzumab (Herceptin) and docetaxel, investigators reported at the ESMO 2014...

lung cancer
issues in oncology

Screening for and Treating Early-Stage Lung Cancer Is Less Costly Than Treating Late-Stage Disease

A new study found that the average cost to screen high-risk individuals for lung cancer with low-dose computed tomography (CT) plus the average cost of curative-intent treatment is lower than the average cost to treat advanced-stage lung cancer, which quite rarely results in a cure. The findings by ...

lung cancer

New ALK Inhibitor Alectinib Shows Activity vs Crizotinib-Resistant NSCLC

In the phase I portion of a phase I/II study reported in The Lancet Oncology, Gadgeel et al found that the novel ALK inhibitor alectinib showed activity against systemic disease and brain metastases in patients with non–small cell lung cancer (NSCLC) resistant to the ALK inhibitor crizotinib...

lung cancer

European Phase III Trial Suggests Benefit of Thoracic Radiotherapy in Extensive-Stage Small Cell Lung Cancer

In a European phase III trial reported in The Lancet, Slotman et al found benefits of thoracic radiotherapy in patients with extensive-stage small cell lung cancer who had responded to chemotherapy and had received prophylactic cranial radiotherapy. Although thoracic radiotherapy did not...

lung cancer

Meta-Analysis Shows No Overall Survival Benefit of Six vs Fewer Planned Cycles of First-Line Platinum-Based Chemotherapy in Advanced NSCLC

In a systematic review and meta-analysis of individual patient data reported in The Lancet Oncology, Rossi et al found no overall survival benefit with six vs fewer than six planned cycles of first-line platinum-based treatment in patients with advanced non–small cell lung cancer (NSCLC). A...

multiple myeloma

Continuous Lenalidomide/Dexamethasone Improves Progression-Free Survival in Transplant-Ineligible Patients With Myeloma

In the phase III FIRST trial reported in The New England Journal of Medicine, Benboubker et al found that continuous lenalidomide (Revlimid) plus dexamethasone significantly improved progression-free survival vs melphalan/prednisone/thalidomide (Thalomid) in transplant-ineligible myeloma patients....

gynecologic cancers
gynecologic cancers

Pazopanib Maintenance Improves Progression-Free Survival in Ovarian Cancer, but Benefit Limited to Non–East Asian Patients

In a phase III trial reported in the Journal of Clinical Oncology, du Bois et al found that maintenance therapy with the VEGFR and PDGFR inhibitor pazopanib (Votrient) significantly prolonged progression-free survival vs placebo in women with ovarian cancer without progression after first-line...

skin cancer

Patient Exhibits Involution of Eruptive Melanocytic Nevi on Combination BRAF and MEK Inhibitor Therapy

Eruptive melanocytic nevi are observed in patients receiving the multikinase inhibitor sorafenib (Nexavar) and the selective BRAF inhibitor vemurafenib (Zelboraf). In a case reported in JAMA Dermatology, Shen et al found that the addition of the MEK inhibitor cobimetinib to vemurafenib in a woman...

cns cancers

Pilot Study Evaluates Concurrent Use of Sunitinib and Radiation Therapy in Recurrent High-Grade Glioma

The combination of continuous daily-dosed sunitinib (Sutent) and hypofractionated stereotactic radiation therapy produced acceptable toxicity and “encouraging” 6-month progression-free survival in previously irradiated patients with recurrent high-grade glioma, according to the results...

hematologic malignancies

Preclinical Study Identifies Potential Drug Combination for Mantle Cell Lymphoma and Chronic Lymphocytic Leukemia

Combining the molecular targeted drug ibrutinib (Imbruvica) with the investigational anticancer agent ABT-199 may improve outcomes for patients with mantle cell lymphoma and chronic lymphocytic leukemia (CLL), according to preclinical data presented at the American Association for Cancer Research...

multiple myeloma

Adding Pan-Deacetylase Inhibitor Panobinostat to Bortezomib and Dexamethasone Improves Progression-Free Survival in Relapsed Myeloma

In the phase III PANORAMA1 trial reported in The Lancet Oncology, San-Miguel and colleagues found that adding the pan-deacetylase inhibitor panobinostat to bortezomib (Velcade) and dexamethasone improved progression-free survival in patients with relapsed or relapsed and refractory multiple...

lymphoma

Search for Effective Regimens in Elderly Patients With Hodgkin Lymphoma

As the U.S. population continues to age, oncologists will be faced with a growing number of elderly patients with Hodgkin lymphoma, but there is currently no consensus on how to treat this population. Regimens used to treat younger patients have too much toxicity for most older patients, and thus...

Major Depression Is Undertreated in Patients With Cancer

In a Scottish study reported in The Lancet Psychiatry, Walker et al assessed the prevalence and adequacy of treatment of major depression in patients with cancer of different primary sites. The prevalence of major depression ranged from 5.6% in patients with genitourinary cancers to 13.1% in those...

lung cancer

SMaRT Oncology-3 Trial Reports Collaborative Care Program Reduces Major Depression in Patients With Lung Cancer

In the SMaRT Oncology-3 study reported in The Lancet Oncology, Walker et al found that an integrated collaborative treatment program for depression (‘depression care for people with cancer’) was associated with significantly reduced severity of depression compared with usual care in...

solid tumors

Second-Line Ramucirumab Plus Paclitaxel Improves Overall Survival in Patients With Advanced Gastric Cancer

The addition of the monoclonal antibody VEGFR-2 antagonist ramucirumab (Cyramza) to paclitaxel led to a statistically significant improvement in median overall survival in patients with advanced gastric cancer or gastroesophageal junction adenocarcinoma in a phase III trial, reported Wilke et al in ...

Primary Site of Neuroblastoma Tied to Differences in Biologic, Clinical Characteristics, Including Survival

In a study reported in Journal of Clinical Oncology, Vo et al in the International Neuroblastoma Risk Group Project found significant differences in clinical and biologic features of neuroblastoma according to primary tumor site, including poorer survival for adrenal sites of primary disease and...

gynecologic cancers

mTOR Inhibitor Ridaforolimus Shows Activity in Advanced Endometrial Cancer

The oral mTOR inhibitor ridaforolimus was modestly active and reasonably tolerated in women with recurrent or metastatic endometrial cancer, according to the results of a phase II study reported in Gynecologic Oncology. Tsoref et al suggested that it may prove to be an effective therapeutic...

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