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gynecologic cancers
issues in oncology

Greater Progression-Free Survival Benefit of Maintenance Olaparib in BRCA-Mutant Platinum-Sensitive Recurrent Serous Ovarian Cancer

A recently reported phase II trial indicated that maintenance therapy with the PARP inhibitor olaparib significantly improved progression-free survival vs placebo in patients with platinum-sensitive serous ovarian cancer. As reported in The Lancet Oncology by Ledermann et al, a preplanned...

leukemia

First-Line Lenalidomide Plus Rituximab Is Safe and Effective in Older and Younger CLL Patients, Phase II Study Shows

The combination of lenalidomide (Revlimid) and rituximab (Rituxan) has shown synergistic activity in chronic lymphocytic leukemia (CLL) preclinical models. In a CLL Research Consortium phase II study of the combination in treatment-naive patients reported in the Journal of Clinical Oncology, James...

skin cancer

ASCO 2014: Ipilimumab/Nivolumab Combination Achieves Long-Term Survival for Patients With Advanced Melanoma

Concurrent treatment with ipilimumab (Yervoy) and nivolumab resulted in a 2-year survival rate of 79% for patients with advanced melanoma. “While this is a small trial, that is very impressive 2-year survival data,” noted Mario Sznol, MD, at a press briefing on progress in immunotherapy ...

breast cancer

Early Change in Chemotherapy Based on Elevated Circulating Tumor Cells Does Not Improve Outcome in Metastatic Breast Cancer

Elevated circulating tumor cells are associated with poor prognosis in metastatic breast cancer. In the phase III Southwest Oncology Group (SWOG) S0500 trial reported in the Journal of Clinical Oncology, Smerage et al assessed whether changing chemotherapy after one cycle of first-line treatment in ...

skin cancer

ASCO 2014: Adjuvant Ipilimumab Significantly Improves Recurrence-Free Survival in Patients With High-Risk Stage III Melanoma

Adjuvant therapy with ipilimumab (Yervoy) for patients with high-risk stage III melanoma significantly improved recurrence-free survival, the primary endpoint of the phase III EORTC 18071/CA 184-029 study. Patients randomly assigned to receive ipilimumab had a 9-month absolute improvement in...

gynecologic cancers

ASCO 2014: Cediranib Plus Olaparib Significantly Increases Progression-Free Survival in Women With Recurrent Ovarian Cancer

The combination of two investigational oral drugs, the PARP inhibitor olaparib and the antiangiogenic drug cediranib, significantly extended progression-free survival and increased the overall response rate compared to olaparib alone in a phase II study among women with recurrent,...

head and neck cancer

ASCO 2014: Lenvatinib Yields High Response Rates, Delays Progression in Patients With Radioiodine-Resistant Differentiated Thyroid Cancer

A phase III, multicenter, double-blind, placebo-controlled study found that the oral targeted drug lenvatinib is highly effective among patients with differentiated thyroid cancer resistant to standard radioiodine therapy. “The main result is an extraordinary improvement in progression-free...

prostate cancer

ASCO 2014: Adding Docetaxel to Androgen-Deprivation Therapy Significantly Improves Survival in Hormone-Sensitive Prostate Cancer

The addition of docetaxel to androgen-deprivation therapy extended survival for men with newly diagnosed hormone-sensitive prostate cancer by more than 13 months in the National Cancer Institute–led phase III E3805 study. The survival benefit was even greater for men with high-volume disease. ...

breast cancer

ASCO 2014: Adjuvant Exemestane With Ovarian Function Suppression Better at Preventing Breast Cancer Recurrence Than Tamoxifen

A joint analysis of two phase III trials demonstrated that the aromatase inhibitor exemestane more effectively prevents breast cancer recurrences than tamoxifen when either was given with ovarian function suppression to premenopausal women with hormone-sensitive cancers. Exemestane plus ovarian...

lung cancer

ASCO 2014: Second-Line Treatment With Ramucirumab Plus Standard Docetaxel Extends Overall Survival in Advanced Lung Cancer

Patients with stage IV non–small cell lung cancer (NSCLC) who relapsed after initial platinum-based therapy experienced extended overall survival with a combination of the antiangiogenic agent ramucirumab (Cyramza) and standard chemotherapy with docetaxel, compared to patients receiving...

lymphoma

ASCO 2014: Bortezomib Combination Significantly Improves Progression-Free Survival in Newly Diagnosed Mantle Cell Lymphoma

An international, randomized phase III study found that replacing vincristine with bortezomib (Velcade) in R-CHOP (rituximab [Rituxan] plus cyclophosphamide, doxorubicin, vincristine, and prednisone) significantly improved outcomes in newly diagnosed patients with mantle cell lymphoma who were...

breast cancer

Study Identifies Risk of Chemotherapy-Related Hospitalization for Early-Stage Breast Cancer Patients

Oncologists now have a new understanding of the toxicity levels of specific chemotherapy regimens used for women with early-stage breast cancer, according to research from The University of Texas MD Anderson Cancer Center. The retrospective study, reported in the Journal of Clinical Oncology by...

pancreatic cancer

Central Pancreatectomy for Low-Grade Neoplasms Results in 'Excellent' Pancreatic Function but Substantial Morbidity

The availability of cross-sectional imaging has resulted in increased diagnosis of low-grade pancreatic neoplasms and use of central pancreatectomy as an alternative to standard resection for such lesions. In a French single-center experience reported in JAMA Surgery, Goudard et al found that...

colorectal cancer

No Differences in Surgical Outcomes With Four Different Chemotherapy Regimens Plus Preoperative Radiotherapy in Rectal Cancer

As reported in the Journal of Clinical Oncology by O’Connell et al, the National Surgical Adjuvant Breast and Bowel Project (NSABP) Trial R-04 is assessing four chemotherapy regimens given concurrently with preoperative radiotherapy in order to help identify optimal treatment in patients with ...

colorectal cancer

Korean Trial Shows Similar Disease-Free Survival With Laparoscopic vs Open Surgery in Mid- or Low-Rectal Cancer After Neoadjuvant Chemoradiotherapy

In the noninferiority COREAN trial reported in The Lancet Oncology, Jeong et al found that laparoscopic surgery was associated with disease-free survival similar to that with open surgery for mid- or low-rectal cancer. Study Details In this open-label trial, 340 patients with cT3N0–2M0...

head and neck cancer

Physicians and Patients/Caregivers Frequently Disagree on Medicare Resource Allocations for Patients With Advanced Head and Neck Cancer

In a study reported in JAMA Otolaryngology–Head & Neck Surgery, Rocke et al compared hypothetical resource allocation by otolaryngology–head and neck surgery physicians and patients with that by advanced cancer patients or their caregivers. They found significant differences in...

breast cancer

ASCO Guideline Update Recommends Tamoxifen for Up to 10 Years for Women With Nonmetastatic Hormone Receptor–Positive Breast Cancer

The American Society of Clinical Oncology (ASCO) has issued an update to its clinical practice guideline on the use of adjuvant endocrine therapy for women with stage I to III hormone receptor–positive breast cancer. The guideline was published in the Journal of Clinical Oncology. Duration...

hepatobiliary cancer

No Apparent Benefit of Adding Cetuximab to Gemcitabine Plus Oxaliplatin in Advanced Biliary Tract Cancer

Gemcitabine plus a platinum agent is standard treatment in advanced biliary cancer. In the phase II open-label noncomparative BINGO trial, reported in The Lancet Oncology, Malka et al found no apparent benefit of adding the EGFR inhibitor cetuximab (Erbitux) to gemcitabine/oxaliplatin in first-line ...

lymphoma

No Apparent Benefit of Rituximab After Lymphoma-Directed Conditioning and Allogeneic Stem Cell Transplantation for Relapsed/Refractory Aggressive NHL

In an open-label phase II trial reported in The Lancet Oncology, Glass et al examined the strategy of adding rituximab (Rituxan) to standard prophylaxis for graft-vs-host disease after allogeneic stem cell transplantation in relapsed or refractory aggressive non-Hodgkin lymphoma. Rituximab did not...

breast cancer
supportive care

Proactive Patient-Centered Program May Reduce the Risk of Lymphedema in Survivors of Breast Cancer

A patient-centered educational and behavioral program focusing on self-care strategies appears to be an effective way to reduce the risk of lymphedema in survivors of breast cancer, according to the results of a prospective study by Fu et al at New York University. These findings, reported in the...

lung cancer

No Progression-Free or Overall Survival Benefit With Second- or Third-Line Erlotinib vs Docetaxel in EGFR-Unselected Japanese NSCLC Patients

In a Japanese phase III trial (DELTA) reported in the Journal of Clinical Oncology, Kawaguchi et al found that erlotinib (Tarceva) was associated with no progression-free survival or overall survival advantage as second- or third-line therapy in EGFR-unselected patients with non–small cell...

breast cancer

Circulating Tumor Cells Predict Disease-Free Survival and Overall Survival in Patients With Early Average- to High-Risk Breast Cancer

Although presence of circulating tumor cells has been shown to predict reduced survival in metastatic breast cancer, data on their predictive performance in earlier breast cancer are lacking. In a study reported in the Journal of the National Cancer Institute, Rack et al found that presence of...

hepatobiliary cancer

More Toxicity Associated With Addition of Sorafenib to Yttrium-90 Radioembolization Prior to Liver Transplantation

The addition of sorafenib (Nexavar) to yttrium-90 radioembolization was associated with higher rates of biliary complications and potentially more acute rejections prior to transplantation in patients with hepatocellular carcinoma, according to the results of a prospective randomized pilot study....

lymphoma

Lenalidomide Plus R-CHOP21 Highly Active in Elderly Patients With Untreated Diffuse Large B-Cell Lymphoma

Lenalidomide (Revlimid) is active in relapsed or refractory aggressive B-cell lymphomas. In a European phase II trial (REAL07) reported in The Lancet Oncology, Vitolo et al examined the addition of lenalidomide to rituximab (Rituxan), cyclophosphamide, doxorubicin, vincristine, and prednisolone...

leukemia
issues in oncology

Mutations Associated With Arsenic Resistance in Acute Promyelocytic Leukemia

In a letter to The New England Journal of Medicine, Zhu et al described identification of resistance mutations in acute promyelocytic leukemia patients receiving arsenic trioxide (Trisenox) and all-trans retinoic acid (ATRA) therapy. The direct-binding targets of arsenic trioxide in the...

lung cancer

Proteomic Signature for EGFR Inhibitor Therapy Predicts Survival Benefit of Second-Line Chemotherapy vs Erlotinib in NSCLC

There are conflicting data on whether epidermal growth factor receptor (EGFR) inhibitor therapy is beneficial in second-line treatment of lung cancer patients with unknown or wild-type EGFR status. In a phase III trial (PROSE) reported in The Lancet Oncology, Gregorc et al assessed the predictive...

hepatobiliary cancer

Insulin-Like Growth Factor-1 Score Improves Assessment of Prognosis in Hepatocellular Carcinoma

In a study reported in the Journal of the National Cancer Institute, Kaseb et al developed a plasma insulin-like growth factor 1 (IGF-1)–based score for hepatic reserve in hepatocellular carcinoma and compared its predictive ability with that of the Child-Turcotte-Pugh (CTP) score in two...

prostate cancer

No Overall Survival Improvement With Ipilimumab After Radiotherapy in Metastatic Castration-Resistant Prostate Cancer Progressing After Docetaxel

In a phase III trial (CA184-043) reported in The Lancet Oncology, Kwon et al assessed the effects of adding ipilimumab (Yervoy) after radiotherapy in patients with metastatic castration-resistant prostate cancer progressing after docetaxel chemotherapy. The investigators found no improvement...

pancreatic cancer

Early Study Shows Improved Survival With Radioimmunotherapy/Gemcitabine Combination in Patients With Advanced Pancreatic Ductal Cancer

A randomized phase Ib study of a combination of low radiosensitizing doses of gemcitabine and fractionated doses of 90Y-clivatuzumab tetraxetan in patients with metastatic pancreatic ductal cancer who had received at least two prior systemic therapies, has found a significant survival advantage in...

solid tumors
solid tumors

Studies Evaluate Racial Variations, Cost, and Influence of Access to Care in the Management and Treatment of Testicular Cancer

A series of studies evaluating the cost-effectiveness, risks, and outcomes associated with detecting, diagnosing, and treating testicular cancer were presented at a press conference during the 2014 Annual Scientific Meeting of the American Urological Association in Orlando, Florida. Although...

prostate cancer

Results of Three Studies Indicate 17-Gene Assay Is a Significant Predictor of Prostate Cancer Aggressiveness at the Time of Diagnosis

According to the results from three studies published in European Urology, the 17-gene Oncotype DX Genomic Prostate Score is a significant predictor of disease aggressiveness at the time of diagnosis before intervention with radiation or surgery. The test provides more precise and individualized...

solid tumors
bladder cancer

Accelerated Methotrexate, Vinblastine, Doxorubicin, Cisplatin With Pegfilgrastim Is Effective, Well-Tolerated Neoadjuvant Therapy for Bladder Cancer

Although neoadjuvant cisplatin-based chemotherapy is standard of care for muscle-invasive bladder cancer, it is not widely used due to concerns over toxicity and delayed cystectomy. In a phase II trial reported in the Journal of Clinical Oncology, Plimack et al evaluated whether a neoadjuvant...

solid tumors
bladder cancer

Neoadjuvant Dose-Dense Methotrexate, Vinblastine, Doxorubicin, Cisplatin With Pegfilgrastim: Safe and Effective in Muscle-Invasive Urothelial Cancer

In a phase II trial reported in the Journal of Clinical Oncology, Choueiri et al found that a neoadjuvant four-cycle/8-week regimen of dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin was well tolerated and effective in patients with muscle-invasive urothelial cancer. Study Details ...

issues in oncology

Carcinogens Found in Water Pipe Smoking May Increase Risk for Cancer

Researchers investigating the effects of water pipe smoking on the health of young adults have found elevated levels of nicotine, cotinine, tobacco-related cancer-causing agents, and volatile organic compounds, including benzene and acrolein, in the urine of users. Given the significant intake of...

lung cancer

Necitumumab Plus Chemotherapy Shows Overall Survival Benefit in Patients With Squamous NSCLC

In the large phase III SQUIRE trial of necitumumab (IMC-11F8) in combination with gemcitabine and cisplatin in the first-line treatment of advanced squamous non–small cell lung cancer (NSCLC), patients with stage IV metastatic disease showed a statistically significant improvement in overall...

prostate cancer

Delaying Androgen Deprivation Therapy May Be Safe for Men With Prostate Cancer Relapse Detected by PSA Testing

According to a large, population-based observational study of men who had a prostate-specific antigen (PSA)-only based relapse after prostate surgery or radiation therapy, delaying androgen deprivation therapy until the onset of symptoms or appearance of cancer on a scan does not substantially...

lymphoma

Diffuse Erythema Predicts Complete Remission of Skin Disease With Alemtuzumab in Leukemic Cutaneous T-Cell Lymphoma

As reported in a research letter in JAMA Dermatology, Watanabe et al found that diffuse erythema at presentation in patients with leukemic T-cell lymphoma was associated with better response to low-dose alemtuzumab (Campath) compared with patients presenting with preexisting plaques or tumors....

issues in oncology
colorectal cancer

Phase II Feasibility Study Tests Four Molecular-Based Hypotheses in Advanced Colorectal Cancer

In a phase II feasibility study (MRC FOCUS3) reported in British Journal of Cancer, Maughan et al used KRAS and BRAF mutation status and topoisomerase-1 expression status to randomly assign patients with advanced colorectal cancer to molecular hypothesis–driven treatment or control treatment. ...

skin cancer

Squamous Cell Carcinoma Within Advanced Basal Cell Carcinoma During Vismodegib Treatment: Importance of Serial Biopsy

In a report in JAMA Dermatology, Zhu et al discuss two cases in which clinically significant squamous cell carcinoma was found within the tumor bed of locally advanced basal cell carcinoma during vismodegib (Erivedge) treatment for basal cell carcinoma. In one, basal cell carcinoma tumor shrinkage...

prostate cancer
issues in oncology

Tools for Identifying Pathologically Insignificant Prostate Cancer Are Inaccurate In Unscreened Men

In a study reported in British Journal of Cancer, Shaw et al assessed the accuracy of several reported criteria for identifying insignificant prostate cancer for active surveillance in a population of unscreened men. None of the examined tools provided sufficient discrimination of insignificant...

cns cancers

Phase I Study Finds Novel Antibody Shows Promise in Children With Advanced Neuroblastoma

Researchers from St. Jude Children’s Research Hospital conducted a phase I study of hu14.18K322A, an experimental monoclonal antibody genetically engineered at the hospital, in 38 children with refractory or recurrent neuroblastoma. The patients received escalating doses of hu14.18K322A...

hepatobiliary cancer

Tumor Factors Associated With Poorer Overall Survival in Patients With Intrahepatic Cholangiocarcinoma Undergoing Curative Intent Surgery

There are limited data on outcomes after surgery for intrahepatic cholangiocarcinoma. In a systematic review and meta-analysis reported in JAMA Surgery, Mavros et al found that tumor characteristics are the primary predictors of survival after curative intent surgery, indicating the need for...

supportive care

Magnetic Resonance–Guided Focused Ultrasound Reduces Pain From Bone Metastases

Few options are available to treat pain from bone metastases in patients refractory to drug and radiation therapy. In a phase III study reported in the Journal of the National Cancer Institute, Hurwitz et al found significant pain relief using magnetic resonance–guided focused ultrasound...

breast cancer

Adding Neoadjuvant Carboplatin to Taxane, Anthracycline, and Targeted Therapy Increases Pathologic Complete Response in Triple-Negative Breast Cancer

Preclinical data suggest that triple-negative breast cancer is sensitive to interstrand crosslinking agents and that the combination of a taxane, trastuzumab (Herceptin), and a platinum may have synergistic effects in HER2-positive breast cancer. In a randomized phase II trial (GeparSixto, German...

gynecologic cancers

Glutamine Ratio Is Key Indicator of Tumor Aggression in Ovarian Cancer, Study Finds

An analysis of the metabolic profiles of hundreds of ovarian tumors has revealed a new test to determine whether ovarian cancer cells have the potential to metastasize. The study, which was published in Molecular Systems Biology, also suggests how ovarian cancer treatments can be tailored based on...

leukemia

Good Prognosis for High-Risk Ph-Negative ALL With Chemotherapy After Early Cytologic Response and Low Minimal Residual Disease Level on Flow Cytometry

In a Spanish trial (PETHEMA ALL-AR-03) reported in the Journal of Clinical Oncology, Ribera et al found high disease-free and overall survival rates with delayed consolidation and maintenance chemotherapy in high-risk Philadelphia chromosome–negative acute lymphoblastic leukemia (ALL)...

breast cancer

Ado-Trastuzumab Emtansine Improves Progression-Free Survival vs Physician’s Choice in Previously Treated Advanced HER2-Positive Breast Cancer

There are few treatment options for breast cancer patients with progressive disease after two or more HER2-directed regimens for recurrent or metastatic disease. In the open-label phase III TH3RESA trial reported in The Lancet Oncology by Krop and et al, ado-trastuzumab emtansine (Kadcyla)...

breast cancer

ASCO Releases Companion Guideline on Disease Management for Patients With Advanced HER2-Positive Breast Cancer and Brain Metastases

As many as half of patients with metastatic HER2-positive breast cancer develop brain metastases over time. The American Society of Clinical Oncology recently released a clinical practice guideline on disease management for patients with advanced HER2-positive breast cancer and brain metastases. A...

lung cancer
supportive care

Modafinil Not Better Than Placebo for Fatigue in Lung Cancer Patients

In a trial reported in the Journal of Clinical Oncology, Spathis et al found that that the central nervous system (CNS) stimulant modafinil had no effect on fatigue compared with placebo in patients with advanced non–small cell lung cancer (NSCLC). Fatigue improved in both groups during the...

head and neck cancer

Increased Incidence of Thyroid Cancer: An Epidemic of Diagnosis?

In a study reported in JAMA Otolaryngology Head & Neck Surgery, Davies and Gilbert found that the incidence of thyroid cancer has nearly tripled since 1975. However, the increase appears to represent an “epidemic of diagnosis” and to almost exclusively represent increased diagnosis...

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