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issues in oncology

Oncology Advances Included in Cleveland Clinic's Top 10 Medical Innovations List for 2015

Antibody-drug conjugates, checkpoint inhibitors, and single-dose intraoperative radiation therapy for breast cancer were included in the Cleveland Clinic's Ninth Annual Top 10 Medical Innovations List released earlier today. The list identifies those advances likely to have a major impact on...

prostate cancer

ALSYMPCA Subgroup Analysis: Radium-223 Survival Benefit Irrespective of Prior Docetaxel in Castration-Resistant Prostate Cancer With Bone Metastases

The phase III ALSYMPCA trial showed that radium-223 (Xofigo) increased overall survival vs placebo patients with castration-resistant prostate cancer and symptomatic bone metastases.  In a prespecified subgroup analysis reported in The Lancet Oncology, Hoskin et al found that overall survival...

gynecologic cancers

Topical Cidofovir and Imiquimod Active in Treating Vulval Intraepithelial Neoplasia

In a UK phase II trial reported in The Lancet Oncology, Tristram et al found that topical cidofovir and topical imiquimod were active in the treatment of vulval intraepithelial neoplasia, suggesting that such treatment may constitute an alternative to surgery. Study Details In the open-label...

breast cancer

Long-Term Overall Survival Benefit of Adding Trastuzumab to Adjuvant Chemotherapy in Early-Stage HER2-Positive Breast Cancer

Earlier planned joint analyses of outcomes in the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-31 trial and North Central Cancer Treatment Group (NCCTG) N9831 trial showed that adding trastuzumab (Herceptin) to adjuvant chemotherapy improved disease-free survival and overall...

Single Nucleotide Polymorphisms in Thrombomodulin Gene Predict Mortality in Patients With Graft-vs-Host Disease

The pathophysiology of steroid refractoriness in graft-vs-host disease in allogeneic stem cell transplantation is not completely understood, although there is evidence that endothelial cell stress, which involves endothelial thrombomodulin, plays a role. In a study reported in the Journal of...

gynecologic cancers
sarcoma

Low Mitotic Count Is an Independent Predictor of Survival in Women With Recurrent Uterine Leiomyosarcoma

Although low mitotic count, surgery, and disease-free interval of more than 6 months were associated with improved survival in women with recurrent or persistent uterine leiomyosarcoma, only low number of mitoses was identified as an independent predictor of survival post relapse, according to...

lung cancer

No Progression-Free Survival Benefit of Dacomitinib vs Erlotinib Overall or in KRAS Wild-Type Disease in Pretreated Advanced NSCLC

In a phase III ARCHER 1009 trial reported in The Lancet Oncology, Ramalingam et al found no progression-free survival benefit of the irreversible pan-HER tyrosine kinase inhibitor dacomitinib vs erlotinib among all patients with pretreated non–small cell lung cancer (NSCLC) or among those...

lung cancer

No Survival Benefit With Pan-HER Tyrosine Kinase Inhibitor Dacomitinib vs Placebo in Pretreated Advanced NSCLC

In the phase III NCIC CTG BR.26 Trial reported in The Lancet Oncology, Ellis et al found that treatment with the irreversible pan-HER tyrosine kinase inhibitor dacomitinib was not associated with an overall survival benefit compared with placebo in patients with pretreated advanced or...

hepatobiliary cancer
pancreatic cancer

Regional Hepatopancreaticobiliary Surgical Program Improves Care in VA System

In a retrospective cohort study reported in JAMA Surgery, Lau et al found that implementation of a multidisciplinary hepatopancreaticobiliary surgical program in a Veterans Affairs (VA) health-care region resulted in improved care and outcomes. The study involved analysis of practices and outcomes ...

supportive care

Oral Rivaroxaban Has Efficacy Similar to Enoxaparin Plus Vitamin K Antagonist in Preventing Recurrent Venous Thromboembolism

In a subgroup analysis of the pooled results of the EINSTEIN-DVT and EINSTEIN-PE trials reported in The Lancet Haematology, Prins et al found that the recurrence rate for venous thromboembolism in cancer patients receiving anticoagulant therapy with oral rivaroxaban (Xarelto) was similar to that in ...

supportive care

Partnership Between Medical Oncologists and Palliative Care Specialists Improves Outcomes at an Inpatient Oncology Unit

First evaluation of a pioneering “co-rounding” partnership between medical oncologists and palliative care specialists at Duke University Medical Center shows improvements in both health system–related and patient-related outcomes. The first year of the new partnership—set...

solid tumors

First-Line FOLFIRI Improves Time to Treatment Failure and Is Better Tolerated vs ECX in Advanced Gastric Cancer

In a phase III French Intergroup trial reported in the Journal of Clinical Oncology, Guimbaud et al found that FOLFIRI (fluorouracil [5-FU], leucovorin, and irinotecan) significantly prolonged time to treatment failure compared with ECX (epirubicin, cisplatin, and capecitabine) in first-line...

breast cancer

Newly Discovered Molecular-Level Mechanism May Increase the Growth of Breast Cancer Cells

Researchers at VTT Technical Research Centre of Finland, the University of Turku, Finland, and the University of Oslo, Norway, have discovered a previously unknown molecular-level mechanism that may partly explain the increased growth of cancer cells. The study, published in the British Journal of...

survivorship

ASCO Issues Clinical Expert Statement on Cancer Survivorship Care Planning

Efforts at implementing survivorship care plans have met with limited success in oncology practice, in part due to the time required to complete survivorship care plans, lack of role clarity, and lack of reimbursement for time to complete the documents. In response, ASCO convened a Survivorship...

leukemia

CD19-Directed CAR T Cells Produce Sustained Remission in Relapsed/Refractory ALL

In a study reported in The New England Journal of Medicine, Maude et al reported achieving sustained remissions in children and adults with relapsed/refractory acute lymphoblastic leukemia (ALL) using autologous CD19-targeted chimeric antigen receptor (CAR)-modified T cells. Study Details In the...

breast cancer

Neratinib Plus Capecitabine Shows Activity in HER2-Positive Metastatic Breast Cancer

Neratinib is an irreversible pan-tyrosine kinase inhibitor with activity against HER1, HER2, and HER4. In a phase I/II trial reported in the Journal of Clinical Oncology, Saura et al found that the combination of neratinib and capecitabine exhibited high activity in patients with trastuzumab...

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...

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