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Expert Point of View: Melanie B. Thomas, MD

Melanie B. Thomas, MD, Associate Director of Clinical Investigations and the Grace E. DeWolff Chair of Medical Oncology at the Medical University of South Carolina in Charleston, commented on the findings by Martin et al for The ASCO Post. “I think this study is exciting,” she said. “They were...

prostate cancer

Long-Term Safety Data on Radium-223 in Prostate Cancer Reassuring

Long-term follow-up of the ALSYMPCA trial showed that radium Ra 223 dichloride (Xofigo) is extremely safe and active in men with castration-resistant prostate cancer and bone metastases. A snapshot of safety data from about 1.5 years after patients’ final radium-223 injection shows minimal...

kidney cancer

Sequencing Sorafenib and Sunitinib in Either Order Does Not Affect Survival in Metastatic Renal Cell Carcinoma

The explosion of new therapies for metastatic renal cell carcinoma is a welcome advance, but studies have not yet defined optimal sequencing of the newer therapies. According to the phase III SWITCH trial, it matters little whether therapy for metastatic renal cell carcinoma begins with sorafenib...

kidney cancer

Cytoreductive Nephrectomy Improves Survival in Metastatic Renal Cell Carcinoma Patients With Longer Life Expectancy

Prior to the advent of targeted therapy, cytoreductive nephrectomy was associated with a 6-month improvement in overall survival in patients with metastatic renal cell carcinoma. With new and better targeted therapies for the disease, the appropriate use of cytoreductive nephrectomy has been...

legislation

Congress Agrees on Repeal of Sustainable Growth Rate

The U.S. Congress recently did something rarely seen on Capitol Hill: Leaders from both sides of the aisle agreed on a piece of legislation. On February 6, 2014, the House Energy and Commerce and Ways and Means Committees and the Senate Finance Committee announced its agreement on a bill—the SGR...

issues in oncology

The Future of Biomedical Research

In January, Congress approved a $1 trillion appropriations bill for the rest of fiscal year 2014. While the new bill includes $29.9 billion for the National Institutes of Health (NIH)—$1 billion above FY2013 levels after sequestration—including $4.9 billion for the National Cancer Institute (NCI),...

Expert Point of View: Charles Ryan, MD

Charles Ryan, MD, moderator of the press conference at the Genitourinary Cancers Symposium where the PREVAIL trial data were discussed, emphasized that this study breaks new ground for enzalutamide (Xtandi) in chemotherapy-naive patients with metastatic castration-resistant prostate cancer. “The...

prostate cancer

PREVAIL Trial Shows Enzalutamide to Be a Promising Option for Metastatic Castration-Resistant Prostate Cancer

Encouraging results of the large phase III PREVAIL trial represent another positive milestone for men with metastatic castration-resistant prostate cancer. Enzalutamide (Xtandi) improved overall survival by 29% and reduced the risk of radiographic progression of disease by 81% in men who had not...

issues in oncology

The Author Replies

I read with interest the note from Jeff Boyd, PhD, Senior Vice-President for Molecular Medicine at Fox Chase Cancer Center, calling into question my recent commentary about the high costs of partly validated testing in the domain of molecular medicine. One of the oldest tricks in the book is to...

thyroid cancer

‘Epidemic of Diagnosis’ of Thyroid Cancer Is Most Acute for Women

The epidemiology of the increased incidence of thyroid cancer, which has nearly tripled since 1975, “suggests that it is not an epidemic of disease but rather an epidemic of diagnosis,” Louise Davies, MD, MS, and H. Gilbert Welch, MD, MPH, concluded after analyzing trends in patients diagnosed with ...

prostate cancer

Dietary Lycopene Linked to Reduced Risk of Lethal Prostate Cancer, Less Tumor Angiogenesis

“Dietary intake of lycopene was associated with reduced risk of lethal prostate cancer and with a lesser degree of angiogenesis in the tumor,” Ke Zu, MD, of Harvard School of Public Health, Boston, and colleagues concluded after reviewing dietary information and total and lethal prostate cancer...

colorectal cancer

For Metastatic Colorectal Cancer, Bevacizumab Is More Commonly Included Than Anti-EGFR Antibody Therapies

Analysis of a large cohort of patients with metastatic colorectal cancer who received chemotherapy at academic, private, and community-based oncology practices using the same chemotherapy order entry system showed that “bevacizumab has been more consistently integrated into treatment regimens than...

gynecologic cancers

Cancer Has Allowed Me to Put My Goals First

Despite my family history of cancer—my father had colorectal cancer, his father had gallbladder cancer, and my father’s mother died of what was believed to be uterine cancer—when I complained to my gynecologist about postmenopausal bleeding in the spring of 2011, I was told not to worry about it....

breast cancer
supportive care

Cognitive-Behavioral Therapy Plus Hypnosis Controls Fatigue in Breast Cancer Patients Receiving Radiotherapy

In a study reported in the Journal of Clinical Oncology,1 Guy H. ­Montgomery, PhD, Icahn School of Medicine at Mount Sinai, New York, and colleagues found that an intervention consisting of cognitive-behavioral therapy plus hypnosis produced better control of fatigue than supportive meetings with...

breast cancer
cns cancers

How to Approach the Problem of CNS Metastasis in HER2-Positive Patients

Central nervous system (CNS) metastasis is a pervasive problem in the setting of HER2-positive breast cancer. While some patients can be managed easily, others are challenging, said Eric P. Winer, MD, Chief of the Division of Women’s Cancers and the Thompson Senior Investigator for Breast Cancer...

survivorship
leukemia
lymphoma

Long-Term Decline in Neuropsychological Function Seen After Cranial Radiotherapy for Pediatric Lymphoid Malignancy

Central nervous system–directed chemotherapy and cranial radiotherapy for childhood acute lymphoblastic leukemia or lymphoma have neurotoxic effects. In a study reported in Journal of Clinical Oncology, Ilse Schuitema, MSc, of Leiden University, and colleagues evaluated white matter changes and...

integrative oncology

The Ketogenic Diet in Cancer Control

Ketogenic (or very-low-carbohydrate) diets have been employed since the 1920s as nonpharmacologic therapies for epilepsy and, in some instances, have obviated the need for medication for that disease. Since the 1960s, the ketogenic diet has become better known as a means of managing obesity. This...

issues in oncology

Telemedicine: Efficiency in Cancer Screening and Outreach

As defined by the U.S. Health Resources and Services Administration teleheath is “the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health, and health administration.” It has ...

issues in oncology

Telephone Education and Counseling Effective in Programs Targeting Familial/Genetic Cancer Risk Screening

Two studies recently reported in the Journal of Clinical Oncology indicate that telephone-based education or counseling initiatives can be successful in educating individuals at familial or genetic risk of cancer and in inducing these at-risk individuals to undergo recommended screening. In the...

solid tumors
issues in oncology

How Decoding the Genomes of Exceptional Responders Is Leading to More Effective Treatment for All Patients With Cancer

In 2012, David B. Solit, MD, Geoffrey Beene Chair and Director of the Center for Molecular Oncology at Memorial Sloan Kettering Cancer Center (MSKCC) in New York, and his colleagues published the results of a phase II study1 of 45 patients with advanced bladder cancer. The purpose of the clinical...

palliative care

St. Jude Children’s Research Hospital Committee Identifies Eight Palliative Care Priorities in Pediatric Oncology

About 2½ years ago, St. Jude Children’s Research Hospital in Memphis conducted a series of focus groups to better understand the palliative care priorities of bereaved parents. Their findings were never intended to be generalized, but rather to be used to formulate a strategic plan for an...

breast cancer
health-care policy

Affordable Care Act to Cover Chemoprevention for Women at High Risk for Breast Cancer

On January 9, 2014, Kathleen Sebelius, Secretary of the Department of Health and Human Services, announced that under the Patient Protection and Affordable Care Act, women at increased risk of breast cancer will be entitled to preventive medications without incurring out-of-pocket costs (with the...

leukemia

Ibrutinib for Previously Treated Chronic Lymphocytic Leukemia

On February 12, 2014, ibrutinib (Imbruvica) was granted accelerated approval for the treatment of patients with chronic lymphocytic leukemia (CLL) who have received at least one prior therapy.1,2 Ibrutinib previously received accelerated approval for the treatment of patients with mantle cell...

breast cancer

Delayed Adjuvant Chemotherapy Associated With Poorer Overall Survival in Breast Cancer

In a study reported in the Journal of Clinical Oncology, de Melo Gagliato et al from The University of Texas MD Anderson Cancer Center, Houston, assessed the association between time to adjuvant chemotherapy and survival in breast cancer patients.1 They found that delay of therapy is associated...

lung cancer

Protein Expression–Based Risk Model for Recurrence in Resected NSCLC

In a study reported in Clinical Cancer Research, Gold and colleagues developed a risk model for recurrence of resected non–small cell lung cancer (NSCLC) based on protein expression and clinical variables. The study involved analysis of samples from 370 patients with NSCLC resected between 2002 and ...

colorectal cancer

Decreased Diversity of Gut Bacteria Associated With  Risk of Colorectal Cancer

In a study reported in the Journal of the National Cancer Institute, Ahn and colleagues found that decreased diversity of gut bacteria and differences in levels of specific bacteria were associated with significantly increased risk of colorectal cancer. The study involved measurement of 16S...

breast cancer

National Program to Screen Ashkenazi Women in Israel for BRCA Mutations Is Being Explored

Citing a World Health Organization report that lists Israel as having one of the highest rates of breast cancer in the world, The New York Times reported on a proposed screening program to identify women with BRCA1 and BRCA2 mutations.1 “A number of influential geneticists and cancer doctors from...

issues in oncology

Charting the Successes: CancerProgress.Net Chronicles More Than 50 Years of ASCO and Progress Against Cancer

On this historic year, as ASCO proudly commemorates its 50th anniversary and decades of evolutionary change and growth, it also celebrates the significant progress that has been made against cancer throughout history. ASCO’s anniversary website, CancerProgress.Net, chronicles these achievements and ...

skin cancer

Brigham and Women’s Hospital Tumor Staging for Cutaneous Squamous Cell Carcinoma Outperforms AJCC and UICC Staging

In a study reported in the Journal of Clinical Oncology, Pritesh S. Karia, MPH, and Chrysalyne D. Schmults, MD, MSCE, of Brigham and Women’s Hospital, Boston, and colleagues compared Brigham and Women’s Hospital, American Joint Committee on Cancer (AJCC), and International Union Against Cancer...

cost of care

Who Pays for Noncompliance? The Hidden Costs of Our Current System

The development of novel targeted therapies that capitalize on our growing understanding of the molecular underpinnings and vulnerabilities of specific malignancies has to rank among the most important advances we have seen in the 50 years since the American Society of Clinical Oncology was...

leukemia
cost of care

Higher Copayment Associated With Greater Discontinuation of and Nonadherence to Tyrosine Kinase Inhibitor Treatment in CML

The availability of the tyrosine kinase inhibitor imatinib (Gleevec) has dramatically increased survival in chronic myeloid leukemia (CML). Nonadherence to therapy with imatinib and other tyrosine kinase inhibitors is associated with disease progression and treatment resistance. In a study reported ...

prostate cancer
skin cancer

Melanoma and Prostate Cancer: Two Sides of One Coin?

In a recent study, reviewed in this issue of The ASCO Post, Li et al present data from two long- term prospective studies—the Physicians Health Study (PHS, from 1982 to 1998), and the Health Professionals’ Follow-up Study (HPFS, from 1986 to 2010)—both of which suggest a strong association between...

prostate cancer
skin cancer

History of Prostate Cancer Increases Risk of Melanoma in White Men

History of severe acne, which is a surrogate for high androgen activity, has been associated with increased risk of prostate cancer, and recent data suggest that severe teenage acne is a risk factor for melanoma. Such findings suggest a role of androgens in etiology for both prostate cancer and...

leukemia

Omacetaxine Mepesuccinate Receives Full FDA Approval for CML

The U.S. Food and Drug Administration (FDA) has granted full approval to omacetaxine mepesuccinate (Synribo) for injection. The full approval was based on the final analysis of two phase II trials that evaluated the efficacy and tolerability data of omacetaxine. The agent received an accelerated...

lymphoma

Crizotinib Proves Effective in ALK-Positive Lymphoma

Crizotinib (Xalkori) produced promising results in patients with ALK-positive lymphoma in two small studies presented at the 2013 American Society of Hematology (ASH) Annual Meeting. Crizotinib exerted potent antitumor activity in advanced ALK-positive lymphoma and achieved durable responses in...

leukemia

Gemtuzumab Ozogamicin Reduces Relapse, Improves Event-Free Survival in Pediatric AML

The monoclonal antibody gemtuzumab ozogamicin (Mylotarg) improved event-free survival and reduced the risk of relapse in children with acute myeloid leukemia (AML) in a study from the Children’s Oncology Group, presented at the 55th American Society of Hematology (ASH) Annual Meeting and Exposition ...

lymphoma

Idelalisib Achieves High Response Rates in ‘Double-Refractory’ Indolent NHL

In patients with indolent B-cell non-Hodgkin lymphoma (NHL) refractory to both rituximab (Rituxan) and an alkylating agent, monotherapy with the selective oral PI3K-delta inhibitor idelalisib produced a high response rate, with responses persisting for 1 year in the average patient, according to...

leukemia

Idelalisib Plus Rituximab in Heavily Pretreated Relapsed CLL: ‘Dawn of a New Age’?

Idelalisib plus rituximab (Rituxan) improved progression-free survival, overall response rates, and overall survival compared with rituximab alone in heavily pretreated patients with relapsed chronic lymphocytic leukemia (CLL). Moreover, the combination provided effective, durable disease control...

lymphoma

Promising Results Demonstrated for Brentuximab Vedotin in Cutaneous T-Cell Lymphoma

Phase II results suggest that brentuximab vedotin (Adcetris) has encouraging activity in CD30-positive cutaneous T-cell lymphomas and lymphoproliferative disorders, including mycosis fungoides, the most common type of cutaneous T-cell lymphoma. High levels of responses were achieved in a 48-patient ...

breast cancer

Zoledronic Acid Fails to Benefit Women With Chemoresistant Breast Cancer

Zoledronic acid does not improve outcomes in patients with early breast cancer who do not have a full response to neoadjuvant anthracycline/taxane–based chemotherapy, according to results of the Neo-Adjuvant Trial Add-On (NATAN) study presented at the 2013 San Antonio Breast Cancer Symposium.1 A...

breast cancer

Adding Bevacizumab to Adjuvant Chemotherapy/Trastuzumab Fails to Improve Survival in HER2-Positive Breast Cancer

The addition of bevacizumab (Avastin) to adjuvant chemotherapy did not improve invasive disease-free survival or overall survival in patients with high-risk HER2-positive breast cancer in the large randomized phase III BETH trial. Although not specifically designed to answer this question, BETH...

breast cancer

Immune Modulation May Aid Some Breast Cancer Subtypes

There may be an immunogenic phenotype in breast cancer that could benefit from immune modulation as part of treatment, according to results from studies that correlated high levels of tumor-infiltrating lymphocytes with both pathologic complete responses and long-term outcomes. Studies presented at ...

leukemia

Novel Therapies May Help Wipe Out Residual Acute Lymphoblastic Leukemia

Minimal residual disease after induction and consolidation for the treatment of acute leukemia might be eradicated by novel therapies, thus obviating the need for stem cell transplantation. That is the prediction of Matthew J. Wieduwilt, MD, PhD, Assistant Clinical Professor of Medicine at the...

leukemia

Minimal Residual Disease Before and After Transplant: What Does It Mean?

In patients with acute leukemia, outcomes after hematopoietic stem cell transplantation are negatively impacted by the presence of minimal residual disease. However, transplant can prolong survival in patients with minimal residual disease after consolidation, according to two studies presented at...

neuroendocrine tumors

For Progressive Neuroendocrine Tumors, Clinical Benefit Is High With Capecitabine Plus Temozolomide

In an interim analysis of a phase II trial, 97% of patients with progressive metastatic neuroendocrine tumors achieved clinical benefit with the combination of capecitabine and temozolomide (CAPTEM). The results were reported at the 2014 Gastrointestinal Cancers Symposium by Robert L. Fine, MD,...

colorectal cancer
survivorship

Colorectal Cancer Survivors Face Challenges With Bowel Regulation

The fight against colorectal cancer leaves many survivors with battle wounds, according to studies that show a high incidence of assorted morbidities that can affect quality of life. Clinicians, in fact, may be unaware of the struggles with bowel function that occur during survivorship, researchers ...

colorectal cancer

Outcomes in Metastatic Colorectal Cancer: Studies Examine Relative Merits, Cost-Effectiveness

Targeted biologic agents have improved long-term outcomes in metastatic colorectal cancer, but debate continues as to their relative efficacy and proper sequencing. At the 2014 Gastrointestinal Cancers Symposium, a number of studies attempted to answer these questions by interrogating the clinical...

colorectal cancer

More Support for ‘All-RAS’ Testing in Metastatic Colorectal Cancer

Multiple studies reported at the 2014 Gastrointestinal Cancers Symposium add further support for widening the genetic analysis of colorectal cancer tumors. In fact, experts predict that more extensive genetic testing for RAS gene mutations (in KRAS and NRAS) beyond the routine analysis of KRAS exon ...

colorectal cancer

Aspirin Use Not Associated With Survival in PIK3CA-Mutant Colorectal Cancer

Contrary to emerging data from other studies, the regular use of aspirin was not associated with improved survival in patients with PIK3CA-mutant metastatic colorectal cancer in a study reported at the 2014 Gastrointestinal Cancers Symposium in San Francisco.1 Large Dataset “We did not validate...

bladder cancer

Fine-Tuning Bladder-Preservation Trimodality Therapy for Patients With Muscle-Invasive Bladder Cancer

Organ preservation is a hallmark of progress in the world of cancer management. For patients with muscle-invasive bladder cancer, the bladder-sparing approach is a well-established alternative to radical cystectomy. Patients undergo cystoscopic evaluation between the induction and consolidation...

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