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With the Goal of Curing Cancer, Ezra M. Greenspan, MD, Helped Usher in the Modern Era of Chemotherapy

Two events in Ezra M. Greenspan’s early adult life convinced him to pursue a career in medicine: the death of a college friend from pneumonia when the two were students at Cornell University College of Arts and Sciences and his own bout with the disease soon after. Saved by a local physician who...

survivorship

Making Progress in Survivorship Care Planning

The recommendation that a survivorship care plan be provided to patients and their primary care providers was first presented in the 2006 Institute of Medicine (IOM) report, From Cancer Patient to Cancer Survivor: Lost in Transition. The IOM committee proposed that this document include two parts—a ...

hematologic malignancies

Donor KIRDL1-R245 Allele Predicts Improved Survival and Reduced Progression in Pediatric Allogeneic Stem Cell Transplant

Killer-cell immunoglobulin-like receptors (KIRs) that regulate natural-killer cells are highly polymorphic, and some KIR2DL1 alleles (ie, KIR2DL1-R245) encode receptors characterized by stronger signaling function than others (ie, KIR2DL1-C245). In a study reported in the Journal of Clinical...

breast cancer
gynecologic cancers
issues in oncology

Cancer Is in My Soul

The threat of getting cancer began for me before I was born. In 1950, when my mother was pregnant with me, she was diagnosed with breast cancer and refused treatment until after she gave birth, so I have always felt that cancer was woven into my soul. For the first year of my life, I was raised by...

issues in oncology

Developing Intermediate Endpoints in Immunotherapy

“The immune system holds tremendous potential for long-term sustained antitumor activity,” said James P. Allison, PhD, Immunology Chair, The University of Texas MD Anderson Cancer Center, Houston, as he opened a panel discussion at a meeting cosponsored by the Friends of Cancer Research and the...

thyroid cancer

Sorafenib in Differentiated Thyroid Carcinoma

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. New Indication On November 22, 2013, sorafenib (Nexavar) was...

prostate cancer

L-Type Amino Acid Transporters (LAT) Inhibition May Be a New Therapeutic Option for Metastatic Castration-Resistant Prostate Cancer

L-type amino acid transporters (LATs) uptake neutral amino acids including L-leucine into cells, stimulating mTOR complex 1 (mTORC1) signaling and protein synthesis. LAT1 and LAT3 are overexpressed at different stages of prostate cancer and are involved in increasing nutrients and stimulating cell...

breast cancer

Targeted Intraoperative Radiotherapy Plus Lumpectomy Noninferior to External-Beam Radiotherapy in Preventing Breast Cancer Recurrence

In the randomized noninferiority TARGIT-A trial reported in The Lancet, Jayant S. Vaidya, PhD, FRCS, and Michael Baum, MD, FRCS, of University College London, and colleagues compared risk-adapted radiotherapy using single-dose targeted intraoperative radiotherapy vs fractionated external-beam...

multiple myeloma

IFM 2005-02 Update Differs From CALGB 100104: Why? 

The updated analysis of the Intergroupe Francophone du Myelome (IFM) 2005-02 trial in newly diagnosed multiple myeloma patients showed that lenalidomide (Revlimid) maintenance prolongs progression-free survival after stem cell transplantation, but does not improve overall survival, according to...

multiple myeloma

Surprising Findings for Lenalidomide Maintenance in Updated IFM 2005-02 Analysis 

A new analysis of the multiple myeloma Intergroupe Francophone du Myelome (IFM) 2005-02 trial showed that lenalidomide (Revlimid) maintenance prolongs progression-free survival after stem cell transplantation, but does not improve overall survival.1 This is possibly attributed to the shorter...

colorectal cancer

Overall Survival Improved by Adding Panitumumab to FOLFOX4 but Only in Metastatic Colorectal Cancer Without RAS Mutation

Patients with metastatic colorectal cancer that harbors KRAS mutations in exon 2 and patients with  other activating RAS mutations do not benefit from anti–epidermal growth factor receptor (EGFR) therapy and may in fact be harmed by it. In an analysis reported in The New England Journal of Medicine ...

kidney cancer

Tivozanib Improves Progression-Free but Not Overall Survival vs Sorafenib in Metastatic Renal Cell Carcinoma

The investigational agent tivozanib is a selective tyrosine kinase inhibitor of vascular endothelial growth factor receptor (VEGFR)-1, -2, and -3. In a phase III trial reported in the Journal of Clinical Oncology by Robert J. Motzer, MD, of Memorial Sloan-Kettering Cancer Center (MSKCC), and...

gynecologic cancers

Genetic Flaw That Drives Some Ovarian Cancers Identified

Researchers at Dana-Farber Cancer Institute, Boston, have identified an overactive gene that drives about one-third of high-grade serous ovarian tumors—the most common and malignant type of ovarian cancer. The gene, GAB2, isn’t mutated or abnormal, but triggers cancerous cell growth because the...

breast cancer

Younger Women With Younger Children Less Likely to Receive Radiation Therapy After Breast-Conserving Surgery for Breast Cancer

In a study reported in the Journal of the National Cancer Institute, Pan et al assessed factors associated with noncompliance with recommended radiation therapy following breast-conserving surgery for breast cancer.1 A primary factor in underuse of radiation therapy was younger patients having...

breast cancer

Can Postoperative Radiotherapy Be Avoided in Older Women With Early Breast Cancer and High Estrogen Receptor Expression?

A more conservative approach that avoids radiation therapy seems to be a reasonable option for a subgroup of older women with hormone receptor–positive breast cancer at low risk of recurrence. Overall outcomes were similar with or without radiation in older women with hormone receptor–positive...

breast cancer

HER2-Positive Breast Cancer Patients With Small Tumors Benefit From Low-Toxicity Regimen 

There may be a benefit for treating small HER2-positive tumors—a breast cancer subset for whom treatment recommendations have not been established but for whom there is still risk of recurrence—and this can be done with little toxicity, according to a multicenter study presented at the 2013 San...

breast cancer

Seven Studies at SABCS Make Dr. Jame Abraham's List of 'Practice-Changing' Talks

From December 10 to 14, the American Association for Cancer Research, the Cancer Therapy & Research Center at The University of Texas Health Sciences Center at San Antonio, and Baylor College of Medicine once again hosted the San Antonio Breast Cancer Symposium (SABCS), presenting...

geriatric oncology

International Society of Geriatric Oncology Meeting Explores Multidisciplinary, Tailored Treatment of Older Patients With Cancer

The annual meeting of the International Society of Geriatric Oncology (SIOG, www.siog.org) was held in Copenhagen from October 24 to 26. The theme of the meeting was the “Multidisciplinary Approach Towards Personalized Treatments.” The Society, which was founded in 2000, is a multidisciplinary...

Expert Point of View: Carlos L. Arteaga, MD and David Cameron, MD, MRCP

After the IBIS-II presentation at the San Antonio Breast Cancer Symposium, Carlos L. Arteaga, MD, of Vanderbilt Ingram Cancer Center, Nashville, noted that women at high risk are afraid of developing breast cancer and that pharmacologic intervention may allay their anxiety. “Dr. Cuzick’s study...

breast cancer

Anastrozole Halves Risk of First Breast Cancer in High-Risk Postmenopausal Women 

Five years of treatment with anastrozole reduced the risk of breast cancer by 53% in postmenopausal women at high risk for developing the disease, according to an analysis of the International Breast Cancer Intervention Study (IBIS)-II trial. Anastrozole reduced the risk of estrogen...

leukemia
lymphoma

Mounting Success in Trials of Genetically Engineered T Cells to Treat Leukemias and Lymphomas

Reports have been trickling in from centers conducting research on the use of chimeric antigen receptor–modified T cells (CAR-T) in hematologic cancer, and the news is encouraging. When directed against CD19, such personalized therapeutic T cells are known as CTL019, and small pilot trials of this...

ASCO's 50th Anniversary and the Road Ahead

As the American Society of Clinical Oncology celebrates its 50th anniversary, ASCO’s Chief Executive Officer Allen S. Lichter, MD, FASCO, recently talked with The ASCO Post about the Society’s past, present, and future. Important Milestone What are your thoughts about ASCO’s origins and its 50th...

Expert Point of View: Joseph R. Mikhael, MD

These are exciting data from the head-to-head phase III comparison of MPT [melphalan, prednisone, and thalidomide (Thalomid)], a globally accepted standard of care, to the novel combination of lenalidomide/low-dose dexamethasone in newly diagnosed multiple myeloma patients ineligible for...

multiple myeloma

Continuous Lenalidomide/Low-Dose Dexamethasone: A New Option for Older Patients With Newly Diagnosed Myeloma 

First-line treatment of newly diagnosed multiple myeloma using the Rd regimen (continuous lenalidomide [Revlimid] plus low-dose dexamethasone) was superior to standard triplet treatment with MPT (melphalan, prednisone, and thalidomide [Thalomid]) for 72 weeks, according to initial results of the...

leukemia

Leukemia Pioneer John M. Goldman, DM, Dies at 75

“He gave his honours to the world again,his blessed part to heaven, and slept in peace.” —William Shakespeare, Henry VIII In 1971, John M. Goldman, DM, FRCP, FRCPath, FMedSci, began research in chronic myeloid leukemia (CML), a uniformly fatal disease at the time. Over the ensuing decades, Dr....

leukemia

Bosutinib Shows 'Acceptable Safety' in Philadelphia Chromosome–Positive Leukemia

Bosutinib (Bosulif) demonstrated “acceptable safety with manageable toxicities” in a phase I/II study among patients with chronic-phase chronic myeloid leukemia (CML) or advanced Philadelphia chromosome–positive leukemia (accelerated-phase/blast-phase CML or acute lymphoblastic leukemia). Patients...

lung cancer

Some Lung Cancers Detected by Low-Dose CT in National Lung Screening Trial May Be Indolent

More than 18% of all lung cancers detected by low-dose computed tomography in the National Lung Screening Trial (NLST) may be clinically insignificant. Overdiagnosis should be considered when describing the risks of [low-dose computed tomography] screening for lung cancer, according to a review of...

breast cancer

Final Overall Survival Data Show Better Results With Higher Dose of Fulvestrant

Among patients with locally advanced or metastatic estrogen receptor–positive breast cancer, fulvestrant (Faslodex) given at 500 mg “is associated with a 19% reduction in risk of death and a 4.1-month difference in median overall survival compared with fulvestrant 250 mg,” according to final...

Expect Questions, and Some Reluctance, About Getting a Flu Shot

People with weakened immune systems due to diseases like cancer are at increased risk of severe complications from the flu virus and should get flu shots annually. The Centers for Disease Control and Prevention (CDC) strongly encourages this practice, and most oncologists would recommend that for...

issues in oncology
health-care policy

50th Anniversary of the First U.S. Surgeon General’s Report on Smoking and Health

“When the first Surgeon General’s Report was released in 1964, more than half of American men and over a third of women smoked and lung cancer had gone from an obscure disease to a leading cause of death. In issuing this pioneering report summarizing the known health risks of smoking, our nation’s...

lung cancer

Dabrafenib Receives FDA Breakthrough Therapy Designation for BRAF-Mutated NSCLC

The U.S. Food and Drug Administration (FDA) has granted Breakthrough Therapy designation for dabrafenib (Tafinlar) for the treatment of patients with metastatic BRAF V600E mutation–positive non–small cell lung cancer (NSCLC) who have received at least one prior line of platinum-containing...

leukemia
lymphoma

Expanded Options for Age and Donor Sources for Transplant

Although many oncologists consider matched sibling donors as the best source of grafts for hematopoietic cell transplantation, two separate studies presented at the recent American Society of Hematology Annual Meeting support the use of alternative donor grafts for patients with lymphoma and acute...

global cancer care

ASCO Member Helps to Strengthen Cancer Care Internationally Through Philanthropy and Volunteer Service

Ian F. Tannock, MD, PhD, DSc, FASCO, Professor of Medical Oncology at Princess Margaret Hospital and University of Toronto, has long been an advocate for ASCO as a truly global society and a leader in cancer care worldwide. It’s something he encouraged during his time on ASCO’s Board of Directors,...

breast cancer

Drugging PI3K in Breast Cancer: Findings From SABCS 2013

Components of the phosphatidylinositide 3-kinase/mammalian target of rapamycin (PI3K/mTOR) pathway are deregulated in many human cancers, with about 30% of breast cancers harboring PIK3CA gene mutations. Emerging research shows that these mutations may render estrogen receptor alpha-positive tumors ...

breast cancer

Common Mutations May Impact Neoadjuvant Treatment Outcomes in Breast Cancer

Emerging research is suggesting that outcomes from neoadjuvant chemotherapy may be correlated with two genetic mutations that are common in breast cancer—PIK3CA and TP53. Their presence may affect response to treatment, and mutational shift after treatment may affect survival, according to studies...

lymphoma

‘R-Squared’ Lymphoma Treatment: Possible Markers of Response Identified

A correlative analysis of a study evaluating lenalidomide (Revlimid) plus rituximab (Rituxan) in patients with indolent non-Hodgkin lymphoma found that increases in the levels of several cytokines correlated with response to treatment. The study by investigators from the University of California...

lymphoma

Lenalidomide/Rituximab Doublet a Potential Front-Line Treatment in Some Lymphomas

The biologic doublet of lenalidomide (Revlimid) plus rituximab (Rituxan) can achieve high response rates and durable remissions in lymphoma, according to a parade of phase II studies presented at the 2013 American Society of Hematology (ASH) Annual Meeting in New Orleans. The immunomodulatory agent ...

issues in oncology

Cancer Genes, Promiscuity, and the National Debt

There is no doubt that this is a halcyon period in oncology. The unraveling of the genome has been tremendously important, and finally has helped us to move treatment selection from an era of rational empiricism to one of refined, molecular prognostication. In the care of breast cancer, the impact...

breast cancer

Addition of Carboplatin to Standard Neoadjuvant Chemotherapy in Triple-Negative Breast Cancer Supported by SABCS Studies

The achievement of a pathologic complete response in patients with triple-negative breast cancer was boosted by the addition of carboplatin to a standard neoadjuvant chemotherapy regimen, and by the addition of veliparib, an investigational oral PARP inhibitor, plus carboplatin to a standard...

leukemia

Role for Reduced-Intensity Conditioning Regimen in AML After Allogeneic Transplantation

Reduced-intensity conditioning and myeloablative-conditioning regimens following allogeneic hematopoietic cell transplantation in children with acute myeloid leukemia (AML) resulted in comparable survival, according to a study published in Blood. The study evaluated 181 patients, 39 treated with...

Corrections to Note

In the January 15, 2014, issue of The ASCO Post, three errors occurred. These errors have since been corrected and revised versions of the articles may be viewed online at ASCOPost.com or via the QR code here. The errors were as follows below. Trastuzumab Dosing In the article “HER2-Positive...

leukemia
lymphoma

Leukemia/Lymphoma Pioneer Geoffrey P. Herzig, MD, Dies

Many of the advances that have bettered mankind are attributed to those who were driven by a primary passion. Geoffrey P. Herzig, MD, lived the better part of his life with a primary passion: conducting research to increase the cure rate of leukemia and lymphoma patients. His friend and colleague,...

Donald L. Morton, MD, an Icon in Surgical Oncology, Dies

“Tomorrow is the most important thing in life. Comes into us at midnight very clean. It’s perfect when it arrives and it puts itself in our hands. It hopes we’ve learned something from yesterday.” —John Wayne Donald L. Morton, MD, transformed the management of melanoma and breast cancer by...

multiple myeloma

Pomalidomide Plus Low-Dose Dexamethasone: Important New Option in Relapsed/Refractory Multiple Myeloma

Pomalidomide (Pomalyst) plus low-dose dexamethasone significantly improved progression-free survival compared to pomalidomide alone in patients with relapsed and refractory multiple myeloma enrolled in a multicenter, open-label study, the phase II part of the MM-002 trial. The study confirmed the...

leukemia

In CLL With Coexisting Conditions, Chlorambucil Produces Better Outcomes With Obinutuzumab Than With Rituximab

A randomized phase III trial conducted in 26 countries found that combining chlorambucil (Leukeran) with an anti-CD20 antibody—either obinutuzumab (Gazya) or rituximab (Rituxan)—produced better outcomes among patients with previously untreated chronic lymphocytic leukemia (CLL) and coexisting...

pancreatic cancer

High Expression of hENT1 Can Predict Better Survival Among Patients on Postsurgical Gemcitabine

High levels of expression of the human equilibrative nucleoside transporter 1 (hENT1) were associated with longer median survival of patients with pancreatic adenocarcinoma receiving gemcitabine, according to an analysis of clinical data and cancer tissue collected from the European Study Group for ...

pancreatic cancer

CYB5A Induces Autophagy, and Higher Expression Improves Survival in Pancreatic Cancer

Loss of 18q22.3 is a prognostic marker in pancreatic ductal adenocarcinoma. In a study reported in the Journal of the National Cancer Institute, Giovannetti and colleagues assessed the role of 18q22.3-encoded CYB5A in pancreatic cancer prognosis and autophagy modulation. In the study, both resected ...

solid tumors

Intact Gut Microbe Populations Improve Response to Chemotherapy

Gut microflora affect local and systemic inflammatory responses, and inflammation is involved in both pathogenesis and treatment of cancers, but it is unclear whether gut microflora affect inflammation in the sterile tumor microenvironment. In a study reported in Science, Iida and colleagues...

colorectal cancer
gynecologic cancers
issues in oncology
survivorship

Nothing Prepared Me for Cancer

Fourteen years ago, when I was just 29, I was feeling weak and fatigued and had severe pain in my abdomen. I’d had these symptoms for about a year, but none of the several doctors I saw or any of the tests they performed could find the source of my problems. I even had one nurse practitioner tell...

global cancer care

Lessons Learned in Cancer Care Communication

Over the past several decades, outcomes data have traced the success stories in cancer research and therapeutics. However, during those decades of increasingly rapid scientific breakthroughs, certain psychosocial components in the continuum of cancer care were often overlooked. One such element is...

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