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skin cancer

Phase II Study Shows Improved Survival With Addition of Sargramostim to Ipilimumab in Metastatic Melanoma

Use of the granulocyte-macrophage colony-stimulating factor (GM-CSF) sargramostim (Leukine) together with the cytotoxic T-lymphocyte–associated antigen 4 (CTLA-4) inhibitor ipilimumab (Yervoy) prolonged overall survival but not progression-free survival in patients with metastatic melanoma,...

lung cancer

Crizotinib Is Highly Active in ROS1-Rearranged NSCLC

Crizotinib (Xalkori) produced a high response rate and durable responses in patients with ROS1-rearranged non–small cell lung cancer (NSCLC), according to a study reported in The New England Journal of Medicine.1 Lead authors Alice T. Shaw, MD, PhD, of Massachusetts General Hospital Cancer Center,...

lung cancer

Lung Cancer: Next Frontier for Immunotherapy

Immune checkpoint inhibitors, particularly PD-1 (programmed cell death-1) and PD-L1 (programmed death-ligand 1) inhibitors, are being studied extensively in lung cancer. These agents, alone and in combination, appear to have the potential to change the management of non–small cell lung cancer...

pancreatic cancer

Choice for Metastatic Pancreatic Cancer: FOLFIRINOX or Gemcitabine/Nab-Paclitaxel?

The choice between FOLFIRINOX (fluorouracil [5-FU], leucovorin, irinotecan, oxaliplatin) vs the combination of gemcitabine and nanoparticle albumin-bound (nab)-paclitaxel (Abraxane) for first-line treatment of metastatic pancreatic cancer is not much of a contest, judging by a discussion of...

skin cancer

New Serologic Assay May Help Predict Recurrences in Merkel Cell Carcinoma

A new and inexpensive serologic assay may help to predict recurrences of Merkel cell carcinoma, according to Paul Nghiem, MD, PhD, the Michael Piepkorn Endowed Chair in Dermatology Research at the University of Washington, Seattle, who helped develop the test.1 Dr. Nghiem and other experts in...

skin cancer

Hedgehog Inhibitors Can Be Life-Altering in Patients With Advanced Basal Cell Carcinoma

What advanced basal cell carcinomas lack in frequency, they make up for in morbidity, and for these challenging patients, the hedgehog inhibitors have changed lives, according to experts at the 3rd Annual World Cutaneous Malignancies Congress, held recently in San Francisco. “The majority of basal...

Expert Point of View: Ethan Basch, MD

Formal discussant of the patient-reported outcomes study by Smith et al presented at the Quality Care Symposium in Boston, Ethan Basch, MD, Director of the Cancer Outcomes Research Program at the University of North Carolina School of Medicine in Chapel Hill, praised the research for its important...

palliative care

Private Payer and Academic Center Data Capture Inappropriate Use of End-of-Life Care

Data sharing between a comprehensive cancer center and a private insurer appears to be a novel way to capture practice patterns that can point to potential quality improvements. A study that combined data from Dana-Farber Cancer Institute and Blue Cross Blue Shield of Massachusetts showed that some ...

lung cancer

Revisiting Successes in Advanced NSCLC to Test Value in Earlier-Stage Disease

Some pretty good evidence suggests that chemotherapy that works in advanced disease probably works even better in early-stage disease,” said Fadlo R. Khuri, MD, Chair, Department of Hematology and Medical Oncology at Winship Cancer Institute in Atlanta, in summarizing results from ­trials of...

lung cancer

Lung Cancer Expert Offers Recommendations for Treating Toxicities Associated With Targeted Therapies

Clearly life as a thoracic oncologist has changed. Our paradigm for giving one-size-fits-all chemotherapy seems a bit dated, as we now are learning that there are multiple targets that we can treat effectively with the right drugs,” Jyoti D. Patel, MD, Associate Professor of Medicine at...

leukemia

Transplants for AML in First Remission: A Great Leap Forward, Sideways, or Backward?

“All great truths begin as blasphemies.” —George Bernard Shaw (Annajanksa, 1918)   Until about 15 years ago, persons with acute myelogenous leukemia (AML) were considered candidates to receive a blood cell or bone marrow allotransplant in first remission only if they had had an HLA-identical...

lymphoma

PD-1 Blockade Moves Into Hematology

The promise of the programmed death receptor-1 (PD-1) inhibitors seen in solid tumors, especially melanoma, may hold true for at least one hematologic malignancy, according to studies presented at the 56th American Society of Hematology (ASH) Annual Meeting and Exposition. At a press briefing, data ...

breast cancer

Mammographic Density Is Highly Heritable, Possibly Explaining the Familial Aggregation of Breast Cancer

Using a fully automated method to ascertain volumetric mammographic density, a study conducted by the Karolinska Mammography (KARMA) project for risk prediction of breast cancer in Sweden confirmed the high heritability of mammographic density, although estimates were weaker for absolute than for...

breast cancer

About 25% of Patients Who Undergo Breast-Conservation Surgery for Stage 0 to II Carcinoma Have Subsequent Surgery

“Approximately one-fourth of all patients who undergo initial breast-conservation surgery for breast cancer will have a subsequent operative intervention,” concluded a study published online by JAMA Surgery. “The rate of repeat surgeries varies by patient, tumor, and facility factors,” reported Lee ...

leukemia

Patients With Chronic Lymphocytic Leukemia Who Progress After Front-line Treatment May Be Candidates for Novel Noncytotoxic Therapies

Although patients who relapse within 3 years of front-line fludarabine, cyclophosphamide, and rituximab (Rituxan; FCR) therapy have poor survival when treated with conventional salvage regimens, these patients may be candidates for novel noncytotoxic therapies, according to an analysis of extended...

colorectal cancer

AJCC Cancer Staging System Is Most Accurate Measuring Response to Chemoradiation in Locally Advanced Rectal Cancer

When classifying response to chemoradiation among patients with locally advanced rectal cancer, the American Joint Committee on Cancer (AJCC) Cancer Staging Manual (7th edition) system “is most accurate and should be adopted as the standard,” Attaphorn Trakarnsanga, MD, and colleagues at Memorial...

issues in oncology

Physicians Need to Maintain Flexibility to Deviate From Treatment Guidelines Without Financial Penalties

With the provocative headline, “How Medical Care Is Being Corrupted,” an op-ed piece in The New York Times argued that “financial forces largely hidden from the public are beginning to corrupt care and undermine the bond of trust between doctors and patients.”1 The article warned that insurers,...

gynecologic cancers

Electro-Gynecology, Philadelphia, 1883

Through the Lens of Oncology History A Century of Progress The text and photographs on these pages represent the establishment of oncology as a viable medical specialty during the mid-1800s. The images and captions are excerpted from a four-volume series of books titled Oncology Tumors &...

breast cancer

Man With Tumor of the Breast, Albumen Print, Paris, 1873

Through the Lens of Oncology History A Century of Progress The text and photographs on these pages represent the establishment of oncology as a viable medical specialty during the mid-1800s. The images and captions are excerpted from a four-volume series of books titled Oncology Tumors &...

gynecologic cancers

Ovarian Cancer Has Taught Me to Be Fearless

In 2013, I was at the top of my professional game. I was a lead performer in the hit Broadway show Motown: The Musical, playing singing legend Diana Ross, which earned me a Tony Award nomination. Performing eight shows a week is exhausting, but I had no problem meeting the physical demands of the...

lymphoma

Life Is Like Riding a Bicycle

The following essay by Bruce D. Cheson, MD, is adapted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was coedited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and thebigcasino.org.   The ride...

integrative oncology

The Long and Winding Road to Modern Integrative Oncology

It has been a long road from the blind acceptance of unproven “alternative” remedies for the treatment of cancer to the development of rigorous guidelines for integrative care, which address symptom control. The recently released Society for Integrative Oncology (SIO) guidelines applicable to...

integrative oncology

The Best of SIO

The following five abstracts, which include four clinical studies and one basic research study, were named the top abstracts at the 2014 International Conference of the Society for Integrative Oncology. Therapeutic Effects of Lyophilized Leech Saliva Extract Hassona MDH, Ammar AE, Gao TY, et al: In ...

integrative oncology

Personalized Integrative Cancer Care: Focus of the 11th International Conference of the Society for Integrative Oncology

There were several aspects of the 11th International Conference of the Society for Integrative Oncology (SIO), held October 26-28, 2014, in Houston, that distinguished it from past years. One major change was that this year’s conference was held in collaboration with The University of Texas MD...

gynecologic cancers

Olaparib for BRCA-Mutated Previously Treated Advanced Ovarian Cancer

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. On December 19, 2014, olaparib (Lynparza) was granted accelerated...

palliative care

Incorporating Physical Medicine and Rehabilitation Into Palliative Care

Although cancer rehabilitation has been a part of oncology clinical practice for several decades, it has largely gone unrecognized as an integral part of palliative medicine and survivorship care. Now, the role of physical medicine and rehabilitation in oncology care may increase as patients with...

‘Mother of Bone Marrow Transplantation’ Dorothy ‘Dottie’ Thomas Dies at 92

Dorothy “Dottie” Thomas, wife and research partner to 1990 Nobel laureate E. Donnall Thomas, MD, died Friday, January 9, at her home near Seattle. She was 92. Dr. Donnall Thomas, Pioneer of the Bone Marrow Transplant and former Director of the Clinical Research Division at Fred Hutchinson Cancer...

issues in oncology
palliative care

What It Means to Be Mortal

“I learned a lot of things in medical school, but mortality wasn’t one of them,” writes Atul Gawande, MD, MPH, in his new book on the medicalization of aging and dying, Being Mortal: Medicine and What Matters in the End (Metropolitan Books, 2014). In the book, Dr. Gawande critiques the American...

issues in oncology

Smarter Trial Design Saves Money and Produces Better Drugs

The process of identifying a promising molecule and moving it from the laboratory through the highly complex series of clinical trials necessary to garner U.S. Food and Drug Administration (FDA) approval is a costly scientific gauntlet during which many new agents fail. New trial design,...

gynecologic cancers

Gardasil 9 Adds Protection Against Cancer Caused by Additional Human Papillomavirus Types

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.   On December 10, 2014, Gardasil 9 (human papillomavirus 9-valent...

hematologic malignancies

Will Checkpoint Inhibitors Be Winners in Hematologic Cancers, Too?

A  “Featured Topic” session during the 56th American Society of Hematology (ASH) Annual Meeting and Exposition drew a standing-room-only crowd to hear two experts weigh in on checkpoint blockade in hematologic malignancies. While new to hematology, these drugs—the cytotoxic T-lymphocyte–associated...

multiple myeloma

Cleveland Clinic Piloting ‘Adaptive Therapy’ Approach in Multiple Myeloma

For newly diagnosed multiple myeloma patients, Cleveland Clinic specialists believe two drugs may suffice for most patients, bucking the trend toward using triplets for all patients and reserving them for patients with insufficient response to two. They described a pilot study of their “carepath”...

leukemia

Victory for Pediatric Regimens in Adolescents and Young Adults With ALL

Long in the works, early results of the U.S. Intergroup C10403 trial clearly showed that treating acute lymphoblastic leukemia (ALL) in adolescents and young adults using a pediatric-inspired regimen improves event-free survival and overall survival and should be the backbone for future studies in...

leukemia

Blinatumomab Achieves Complete Molecular Responses in Majority of B-Cell Leukemia Patients

Results from the international phase II BLAST study show that one cycle of blinatumomab (Blincyto) immunotherapy achieved complete minimal residual disease response in 78% of patients with acute lymphoblastic leukemia.1 Complete minimal residual disease response was achieved in 80% of patients...

Expert Point of View: Timothy Graubert, MD

These studies are interesting, with provocative and compelling findings,” said Timothy Graubert, MD, the Hagler Family Chair in Oncology and Director of the Hematologic Malignancy Program at Massachusetts General Hospital in Boston. “Bcl-2 proteins regulate cell survival or promote cell death....

leukemia

Venetoclax Gaining Ground in Two Types of Leukemia

Venetoclax, formerly known as ABT-199, is moving forward into phase III development in acute myelogenous leukemia (AML) and chronic lymphocytic leukemia (CLL), based on encouraging data from separate phase Ib and II trials presented at the 56th Annual Meeting and Exposition of the American Society...

gynecologic cancers

FDA Approves Companion Diagnostic for the Detection of BRCA1/2 Mutations in Ovarian Cancer

The recent U.S. Food and Drug Administration (FDA) of olaparib (Lynparza) occurred concurrently with that of a companion diagnostic, BRACAnalysis CDx. This genetic test is designed to detect the presence of mutations in the BRCA genes in blood samples from patients with ovarian cancer. The BRCA...

prostate cancer

Physical Activity Improves Survival for Men With Localized Prostate Cancer

Among a large group of men with localized prostate cancer, those who engaged in higher levels of physical activity had lower rates of overall mortality and lower rates of prostate cancer-specific mortality, according to a study published in Cancer Epidemiology, Biomarkers & Prevention.1 “Our...

breast cancer

Complexities of Targeting HER2 in Estrogen Receptor–Positive Breast Cancers

The interactions between the estrogen receptor (ER) and HER2 pathways in breast cancers are clearly complex and remain incompletely understood. Historically, cancers that express both ER and HER2 were thought to be intrinsically resistant to endocrine therapy, likely due to HER2 being the dominant...

breast cancer

No Benefit of Adding Lapatinib to Fulvestrant in Hormone Receptor–Positive Advanced Breast Cancer

In a phase III trial (Cancer and Leukemia Group B [CALGB] 40302/Alliance) reported in the Journal of Clinical Oncology, Harold J. Burstein, MD, PhD, of Dana-Farber Cancer Institute, Boston, and colleagues found that the addition of the dual EGFR-HER2 inhibitor lapatinib (Tykerb) to endocrine...

Daniel F. Hayes, MD, FASCO, Elected ASCO President for 2016–2017 Term

Daniel F. Hayes, MD, FASCO, has been elected President of the American Society of Clinical Oncology (ASCO) for the term beginning in June 2016. He will take office as President-Elect during the ASCO Annual Meeting in Chicago in June 2015. “I’m honored to be elected incoming president of ASCO, which ...

head and neck cancer
lung cancer

Coupling Head and Neck Cancer Screening and Lung Cancer Scans Could Improve Early Detection, Survival

Adding head and neck cancer screenings to recommended lung cancer screenings would likely improve early detection and survival, according to a multidisciplinary team led by scientists affiliated with the University of Pittsburgh Cancer Institute (UPCI), a partner with the University of Pittsburgh...

neuroendocrine tumors

Lanreotide in Gastroenteropancreatic Neuroendocrine Tumors

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.   On December 16, 2014, lanreotide (Somatuline depot injection) was ...

skin cancer

Survival Benefits of Front-Line Treatment With Nivolumab for Advanced Melanoma Confirmed, Yet Questions Remain

As reported in this issue of The ASCO Post, Robert and colleagues recently published a phase III study comparing the anti–programmed death 1 (PD-1) antibody nivolumab with the standard melanoma chemotherapy dacarbazine in the front-line treatment of patients with advanced BRAF wild-type melanoma.1...

skin cancer

Nivolumab Improves Outcomes vs Dacarbazine in Previously Untreated Advanced Melanoma Without a BRAF Mutation

In a phase III trial reported in The New England Journal of Medicine, Robert and colleagues found that the programmed cell death protein-1 (PD-1) immune-checkpoint–inhibitor antibody nivolumab (Opdivo) significantly increased overall survival, progression-free survival, and objective response rate...

breast cancer

Ultrasonography Detects Mammographically Occult Invasive Cancers

Mammograms often miss occult breast cancers concealed in dense breasts. Women with dense breasts represent about 40% to 50% of women who undergo mammography screening. In some states and centers in the United States, women with dense breasts are routinely offered ultrasonography following a...

breast cancer

Nab-Paclitaxel Boosts Pathologic Complete Response in High-Risk Breast Cancer

Nab-paclitaxel (Abraxane) achieved superior results compared with conventional solvent-based paclitaxel in patients with early-stage high-risk breast cancer in the large phase III GeparSepto trial from the German Breast Group (GBG).1 The study, presented at the 2014 San Antonio Breast Cancer...

Expert Point of View: Benjamin O. Anderson, MD

Commenting on this study, Benjamin O. Anderson, MD, Director of the Breast Health Clinic, Seattle Cancer Care Alliance, Washington, said: “This new analysis of the Oncotype DX DCIS assay strengthens the findings of earlier studies performed in more limited subgroups, validating that the assay...

breast cancer

No Benefit for Adjuvant Capecitabine Monotherapy in Elderly Patients With Early-Stage Breast Cancer

Adjuvant therapy with capecitabine plus ibandronate failed to improve outcomes vs ibandronate alone in elderly patients with moderate-to-high-risk early-stage breast cancer in the ICE study—the largest study to date conducted in elderly women with breast cancer.1 “Capecitabine is frequently used in ...

issues in oncology

Top 10 Myths About FDA’s Office of Hematology and Oncology Products

INSIDE THE BLACK BOX is an occasional column providing insight into the U.S. Food and Drug Administration (FDA) and its policies and procedures. In this installment, FDA oncologists Gideon Blumenthal, MD, and Tatiana Prowell, MD, discuss 10 common myths about FDA’s Office of Hematology and Oncology ...

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