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breast cancer

Adjuvant Trastuzumab Duration: When Is Enough, Enough?

The duration of adjuvant systemic chemotherapy for breast cancer has been a subject of investigation, scrutiny, and meta-analysis.1,2 With the appreciation that prolonged regimens of cytotoxic chemotherapy of, for example, 1 to 2 years in duration were not superior in reducing breast cancer...

breast cancer

Breast Cancer Vaccines for Primary Prevention Move Toward Clinical Use

The first candidate vaccine to prevent recurrence of breast cancer entered clinical trials about 8 years ago, and since then, the idea of a vaccine for secondary prevention has gained traction; more such vaccines are now in development. But this fall, it was vaccines for primary prevention that had ...

gynecologic cancers

Continuous, Combined Hormone Replacement Therapy Protects Against Endometrial Cancer

According to an analysis of the Women’s Health Initiative, continuous combined use of estrogen plus progestin reduces the risk of endometrial cancer among postmenopausal women. The study was reported at the 2013 European Cancer Congress by Rowan T. Chlebowski, MD, PhD, Professor and Chief of...

neuroendocrine tumors

Extended-Release Lanreotide Significantly Delays Disease Progression in Patients With Neuroendocrine Tumors in Large Phase III CLARINET Trial

A strong antiproliferative response was shown for the somatostatin analog lanreotide (subcutaneous, extended-release formulation, Somatuline Autogel [Somatuline Depot in the United States]) in patients with gastroenteropancreatic neuroendocrine tumors, in the large multinational prospective phase...

Expert Point of View: Sibylle Loibl, MD

Sibylle Loibl, MD, of the German Breast Group and the Klinikum Offenbach in Germany, discussed the NeoALTTO findings at the European Cancer Congress, noting that this trial is one of several studies that all point to one conclusion: Pathologic complete response rates are lower in HER2-positive...

breast cancer

PIK3CA-Mutant Tumors Not Likely to Respond to Neoadjuvant HER2 Blockade

In early breast cancer patients receiving anti-HER2 therapy in the NeoALTTO trial, mutations in PIK3CA were associated with lower rates of pathologic complete response, according to a study reported at the 2013 European Cancer Congress by José Baselga, MD, Physician-in-Chief at Memorial...

breast cancer

Radiotherapy Benefit in Young Women With Node-Positive Breast Cancer May Vary by Intrinsic Subtypes

Radiation therapy appears to significantly decrease local recurrence in premenopausal women with node-positive and luminal A tumors, based on an analysis of two small but independent randomized series reported at the 2013 European Cancer Congress in Amsterdam.1 “Though not definitive, our study...

lymphoma

S9704 Trial: Autologous Transplantation as Consolidation in Aggressive Lymphoma

Autologous bone marrow or stem cell transplantation has had an important role in the treatment of aggressive lymphoma for several decades. The important results of the PARMA study1 demonstrated that patients in first relapse who remained chemosensitive had improved progression-free and overall...

lymphoma

Autologous Transplantation as Consolidation Improves Progression-Free Survival in Aggressive Non-Hodgkin Lymphoma

The strategy of autologous stem-cell transplantation as consolidation in high-intermediate– or high-risk diffuse aggressive non-Hodgkin lymphoma (NHL) has not been specifically examined in the rituximab (Rituxan) era. In the phase III Southwest Oncology Group (SWOG)-led intergroup 9704 trial...

issues in oncology

Consent Is Informed and Shared, But Is It Compassionate?

A 72-year-old, obese male patient and a poor operative candidate is diagnosed with esophageal carcinoma. He has multiple comorbidities and a past history of colon carcinoma. His staging workup, which included a colonoscopy, revealed recurrent colon carcinoma. Thus, we have a patient who we...

colorectal cancer

Call for Expanded Genetic Profiling in Colorectal Cancer

Testing for codons 12 and 13 on the KRAS gene and BRAF testing can predict whether patients with colorectal cancer will respond to anti–epidermal growth factor receptor (EGFR) therapies. However, genetic alterations not captured by testing for KRAS codon 12 and 13 mutations may play an important...

Janet L. Rowley, MD, Matriarch of Modern Cancer Genetics, Dies at Age 88

Dr. Janet L. Rowley’s groundbreaking research in the translocation of genetic material bucked scientific convention and heralded a new understanding that cancer is indeed a genetic disease. Her research was largely responsible for the discoveries that led to the development of the targeted cancer...

issues in oncology

African Americans Report Receiving Few Positive Recommendations by Physicians About Joining Clinical Trial 

A study among African American patients with cancer who had declined to participate in a therapeutic clinical trial found that few patients reported receiving a positive recommendation from their physician to participate in the trial. “Patients gave multiple refusal reasons,” researchers led by...

breast cancer
supportive care

No Significant Improvement With Decongestive Therapy vs More Conservative Approach to Treating Arm Lymphedema 

Daily manual lymphatic drainage and bandaging followed by compression garments did not result in significant improvement in lymphedema compared to a more conservative approach with compression garments only, according to a study evaluating 95 women previously treated for breast cancer with...

SIDEBAR: Expect Questions From Your Patients About Hyperthermia

Most but not all cancer treatment with hyperthermia is still being done in clinical trials. The exception is using hyperthermia for superficial cancers, most commonly chest wall recurrences in the breast. Using hyperthermia for superficial cancer “is approved and reimbursable by Medicare,” Mark W....

gynecologic cancers

Using Hyperthermia for Cancer Treatment: Proofs, Promises, and Uncertainties

With the headline, “Rare Cancer Treatments, Cleared by F.D.A. but Not Subject to Scrutiny,” a recent article in The New York Times reported that several medical centers were treating patients with cancer using a hyperthermia system that had received a Humanitarian Use Device approval from the U.S....

Ludwig Cancer Research Contributes One-Half Billion in New Funding to Six U.S. Research Institutions 

On behalf of its founder, Daniel K. Ludwig, Ludwig Cancer Research has awarded $540 million across six Ludwig Centers, including those at Johns Hopkins University, Harvard University, the Massachusetts Institute of Technology, Memorial Sloan-Kettering Cancer Center, Stanford University, and the...

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,...

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