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Expert Point of View: Roy S. Herbst, MD, PhD

Results of CheckMate 057 represent excellent progress, but they are not truly ‘checkmate,’” said Roy S. Herbst, MD, PhD, Chief of Medical Oncology, Director of the Thoracic Oncology Research Program, Associate Director for Translational Research at Yale Cancer Center in New Haven, Connecticut....

colorectal cancer

Mismatch Repair Deficiency Predicts Benefit With Pembrolizumab in Colorectal Cancer

A genetic marker to predict response to anti–PD-1 (anti-programmed cell death protein 1) antibodies may have emerged in colorectal cancer, a tumor type that is a newcomer to the anti–PD-1 ballgame. In a phase II study of colorectal cancer patients treated with pembrolizumab (Keytruda), the presence ...

cost of care

Clinical Trials, Drug Costs, and Restoring the Primacy of the Patient Volunteer

“What’s past is prologue.” —William Shakespeare Today, a cancer drug under study in a clinical trial is commonly provided for a finite period of time after the study closes to accrual. If that drug were not yet U.S. Food and Drug Administration (FDA)-approved when the study began, the complimentary ...

skin cancer

CheckMate 067: Dual Checkpoint Blockade Proves Effective in Advanced Melanoma

In advanced melanoma, combination treatment with nivolumab (Opdivo) and ipilimumab (Yervoy) more than doubled the median progression-free survival time over ipilimumab alone in the CheckMate 067 trial. That said, single-agent nivolumab proved almost as powerful in patients expressing the programmed ...

skin cancer

Patients’ Desire for Rapid Notification of Skin Biopsy Results Leads to Preference for Phone Call Over Face-to-Face Visit

Patients’ preference for how they receive biopsy results “has shifted from face-to-face visit to discussion over the telephone because of a desire for rapid notification,” according to a survey of 301 patients recruited at three different melanoma clinics. Although 67.1% of the patients preferred...

leukemia

Patients With Relapsed/Refractory CLL That Progresses Early on Ibrutinib Have Poor Outcomes

Most patients with relapsed/refractory chronic lymphocytic leukemia (CLL) who discontinued ibrutinib (Imbruvica) early “were difficult to treat and had poor outcomes,” according to a study of patients enrolled in four different clinical trials of ibrutinib, with or without rituximab (Rituxan), at...

lymphoma

Carpe Diem

My life as a cancer survivor and an oncologist has taught me the importance of living every day to the fullest. Sometimes we all need a little reminding to appreciate life to the fullest. When I think of my former patient, Marc, that is what comes to mind. When I was a senior in high school, I was...

issues in oncology

Redefining Cancer

The ability to interrogate cancer cells at the genomic, proteomic, immunologic, and metabolomic levels will transform oncology care from one that relies mainly on trial-and-error treatment strategies based on the anatomy of the tumor to one that is more precisely based on the tumor’s molecular...

head and neck cancer

Clinical Trials Actively Recruiting Patients With Oral Cavity and Oropharyngeal Cancers

The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies for patients with oral cavity and oropharyngeal cancers. The trials are investigating combination therapies, treatment toxicity, specialized adjuvant therapies, and proton therapy. All of ...

gynecologic cancers

Hormonal Therapy and Risk of Ovarian Cancer

Ovarian cancer is the second most common gynecologic malignancy in the United States, with an estimated 21,290 new cases expected this year. Ovarian cancer causes 5% of all cancer deaths in women, making it responsible for the highest number of gynecologic cancer deaths.1 Age, family history, and...

gynecologic cancers

Meta-analysis Shows Increased Risk of Ovarian Cancer With Menopausal Hormone Therapy

In a study reported in The Lancet, the Collaborative Group on Epidemiological Studies of Ovarian Cancer found that use of menopausal hormone therapy was associated with increased risk of ovarian cancer, with risk being highest among current users.1 The study consisted of meta-analyses of...

prostate cancer

National Cancer Institute Pulls PSA Data From SEER

In a move that reverberated through much of the cancer research community, the National Cancer Institute (NCI) recently announced that it had removed all prostate-specific antigen (PSA) data from its current Surveillance, Epidemiology, and End Results (SEER) data submission and associated...

Expert Point of View: Ian Tannock, MD, PhD, DSc

Formal discussant of this trial Ian Tannock, MD, PhD, DSc, of Princess Margaret Cancer Centre and University of Toronto, Canada, took issue with the design of RTOG 0521. He questioned the use of one-sided P values instead of conventional two-sided P values, noting that overall survival would have...

prostate cancer

Adjuvant Chemotherapy Proves Effective in Localized, High-Risk Prostate Cancer

For the first time, a large randomized trial has suggested that overall survival is improved by the addition of adjuvant chemotherapy to androgen suppression and radiotherapy in men with localized, high-risk, hormone-sensitive prostate cancer. Docetaxel has been used to treat metastatic...

leukemia

Ibrutinib Plus Bendamustine/Rituximab Called a New Standard in Patients With Previously Treated CLL

The addition of ibrutinib (Imbruvica) to standard therapy with bendamustine (Treanda)/rituximab (Rituxan) significantly reduced the risk of disease progression or death and overall response rates compared with bendamustine/rituximab alone in previously treated chronic lymphocytic leukemia...

supportive care

Two Factors Predict for Recurrent Venous Thromboembolism in Patients With Cancer

Patients with cancer who develop venous thromboembolism are at high risk of such obstructive disease recurring despite adequate anticoagulation. A prespecified analysis of the CATCH trial identified two major predictors of recurrence: venous compression by the tumor and a diagnosis of hepatobiliary ...

sarcoma

Eribulin Improves Overall Survival in Difficult-to-Treat Sarcoma Types

Eribulin (Halaven), a cytotoxic agent approved for advanced/metastatic breast cancer, may improve overall survival for patients with two common and difficult-to-treat forms of advanced/metastatic sarcoma, investigators reported at the 2015 ASCO Annual Meeting.1 Eribulin is a microtubule inhibitor...

skin cancer

Not All Stage III Melanoma Patients Need Complete Nodal Dissection

Complete lymph node dissection did not improve survival in melanoma patients randomized to this practice, vs sentinel lymph node biopsy alone, German investigators reported at the 2015 ASCO Annual Meeting.1 “This is the first study that tested the typical recommendation of complete lymph node...

Expert Point of View: George Somlo, MD, FACP

This is a significant study. About 30% of patients who undergo breast-conserving surgery or partial mastectomy are likely to have positive margins. Optimal treatment is to remove the entire tumor surgically and then follow with radiation. Standard practice requires reexcision for positive margins,” ...

breast cancer

Routine Resection of Cavity Shave Margins Halved Reexcision Rates in Breast Cancer

Taking additional tissue circumferentially around the cavity left by partial mastectomy (“cavity shave margins”) cut the rate of positive margins by nearly 50% and the rate of reexcision for margin clearance by more than 50% compared with standard partial mastectomy with or without the surgeon...

Expert Point of View: Joseph A. Sparano, MD, and Don Dizon, MD

Joseph A. Sparano, MD, Professor of Medicine and Women’s Health at the Albert Einstein College of Medicine, New York, was the formal discussant of the study and commented, “These findings confirm the strong signal observed in the phase II PALOMA1 trial, and there were no subgroups that did not...

multiple myeloma

Single-Agent Daratumumab Activity Deemed ‘Remarkable’ in Refractory Multiple Myeloma

Heavily pretreated patients with multiple myeloma achieved rapid, durable, and deepening responses to the anti-CD38 monoclonal antibody daratumumab, in a phase II study presented at the 2015 ASCO Annual Meeting.1 “Daratumumab showed remarkable single-agent activity in heavily pretreated and...

issues in oncology

Considering Clonality in Precision Medicine

Precision cancer medicine entails treating patients based upon the molecular characteristics of their tumor. One could argue that we have been tailoring therapeutic regimens based upon tumor characteristics for years, whether it be treating patients based upon disease subtypes determined by...

head and neck cancer

Elective Neck Dissection Beats Watch and Wait Approach in Early Oral Cancer

Elective neck dissection of node-negative early-stage oral cancer at the time of primary surgery improves overall survival and disease-free survival compared with therapeutic neck dissection (ie, therapeutic neck dissection at the time of nodal relapse, or “watch and wait” approach), according to a ...

Frederick Pei Li, MD, Pioneer of Cancer Genetics, Dies at 75

Frederick Pei Li, MD, who helped inaugurate the era of cancer genetics by demonstrating that people can inherit a genetic susceptibility to develop certain malignancies, died on June 12 at the age of 75. A Professor at Dana-Farber Cancer Institute, Harvard Medical School, and Harvard T.H. Chan...

lung cancer

Date of Last Chemotherapy Is Not a Proxy for Deciding When to Stop Treating Metastatic NSCLC

“Patients, their families, and oncologists recognize the administration of chemotherapy near death as aggressive and poor-quality care,” William F. Pirl, MD, MPH, and colleagues from Massachusetts General Hospital, Boston, wrote in the Journal of Oncology Practice. “However, rates have been slowly...

breast cancer

Building and Adjusting to My Life After Cancer

I had been watching a lump in my left breast for signs of cancer for 10 years, from around the time I was 21. Screening tests had failed to find any tissue abnormality, and my doctor said I was too young to have cancer, so I wasn’t overly concerned. But when I noticed the lump getting bigger in...

Expect and Encourage Questions About the Benefits and Harms of Cancer Screening

Issuing advice for high-value care in screening for five common cancers, the High Value Care Task Force of the American College of Physicians (ACP) stated: “The target audience for this paper is all clinicians. The target patient population is average-risk, asymptomatic patients.” “What we tried...

issues in oncology

Agreement on High-Value Screening for Five Common Cancers

Finding agreement on high-value cancer screening among organizations publishing screening guidelines, the American College of Physicians (ACP) issued advice listing the least-intensive screening strategies that all the organizations recommend—as well as strategies not recommended—for five common...

Clara D. Bloomfield, MD, FASCO: Never One to Back Down From a Challenge

Clara D. Bloomfield, MD, FASCO, always sat in the front row at school. She grew up during a rigidly paternalist period in American society, and her early feminist leanings were brushed aside as grade-school adventures. The medical school lecture room of the 1960s was a male-dominated culture, and...

The Mind-Body Program in Action

Here are several real-life examples of the positive effects of the mind-body program, shared by Robin Hardbattle, MS, LAc, and the parents of children who benefited from it. Breathing Practices and Guided Imagery: Prior to learning breathing practices and guided meditation, Matt, a 12-year-old...

integrative oncology

The Pediatric Fitness Program: A Mind-Body Approach

The fundamental challenge in treating children with cancer centers on how to help relieve their suffering while they undergo difficult care. Typically, they do not yet have adult coping skills, and even if they had some ability to cope, many of the issues they face during treatment are...

lung cancer

Pembrolizumab in Advanced NSCLC: The Promise of Immune Checkpoint Inhibitors

Drugs targeting the immune-checkpoint pathways have shown promising activity in non–small cell lung cancer (NSCLC). In a recent article in The New England Journal of Medicine, Garon and colleagues reported the results of the KEYNOTE-001 clinical trial evaluating single-agent pembrolizumab...

lung cancer

PD-1 Inhibitor Pembrolizumab Active in Advanced NSCLC: Outcomes Better With Higher PD-L1 Expression

In the phase I KEYNOTE-001 trial reported in The New England Journal of Medicine,1 Edward B. Garon, MD, of the David Geffen School of Medicine at the University of California, Los Angeles, and colleagues found that the programmed cell death protein 1 (PD-1) inhibitor pembrolizumab (Keytruda)...

kidney cancer

16-Gene Assay Recurrence Score Predicts Recurrence After Surgery for Localized Renal Cell Carcinoma

In a study reported in The Lancet Oncology, Brian Rini, MD, of the Cleveland Clinic Taussig Cancer Institute, and colleagues developed a 16-gene assay and recurrence score that predicted postoperative outcome in patients with stage I to III clear cell renal cell carcinoma.1 Development Phase In the ...

breast cancer
issues in oncology

Assessing and Improving Imaging Interpretation in Breast Cancer Screening

The quality of mammography images has markedly improved over the past few decades. However, the quality of the interpretation of mammograms remains variable. That said, more than 38 million mammograms are performed annually in the United States. So said Diana Buist, PhD, Senior Scientific...

skin cancer

Oncolytic Immunotherapy in Melanoma: It’s Not All About PD-1

The benefit from immune-directed therapies in patients with advanced melanoma is not limited to the exploding field of checkpoint inhibitors. According to Robert Andtbacka, MD, Associate Professor of Surgical Oncology, at the Huntsman Cancer Institute at the University of Utah, Salt Lake City,...

cns cancers

Poliovirus for Glioblastoma Grabs National Attention

Researchers at The Preston Robert Tisch Brain Tumor Center at Duke University are being barraged by patients wishing to enroll in their clinical trial of an engineered poliovirus for recurrent glioblastoma. This comes as a result of a CBS 60 Minutes interview with lead researcher Matthias...

cns cancers

Investigators Update PVS-RIPO Data in Glioblastoma

At the 2015 ASCO Annual Meeting, Annick Desjardins, MD, Associate Professor of Neurology at Duke University Medical Center, presented a brief update on the ongoing study of oncolytic PVS-RIPO in glioblastoma, which now includes 24 patients.1 The median age of enrolled patients is 57, most have a...

hematologic malignancies

Pacritinib for Myelofibrosis: Effective in Patients With Thrombocytopenia

An emerging JAK inhibitor, pacritinib, appears not only effective in a broad population of patients with myelofibrosis but also among a subset with very low platelet counts, investigators from the global phase III PERSIST-1 trial reported at the 2015 ASCO Annual Meeting.1 “There is a huge unmet...

Expert Point of View: Sumanta K. Pal, MD

This combination [lenvatinib and everolimus] is a potential game-changer in metastatic renal cell carcinoma. We’ve studied other combinations to no avail; for example, bevacizumab [Avastin] plus everolimus had no advantage over everolimus alone. Other combinations are too toxic, such as sunitinib...

kidney cancer

Lenvatinib/Everolimus: Robust Combination in Metastatic Renal Cell Carcinoma

The combination of lenvatinib (Lenvima) plus everolimus (Afinitor) significantly extended progression-free survival compared with everolimus alone in metastatic renal cell carcinoma, according to a randomized phase II trial.1 Median progression-free survival for patients who received the...

breast cancer

Anastrozole and Tamoxifen: Both Options for Ductal Carcinoma in Situ

Anastrozole was found to be at least as safe and effective as tamoxifen in preventing breast cancer recurrence in women with ductal carcinoma in situ, in the large NSABP B-35/SWOG-35 study.1 Among all women in the trial, however, the 10-year breast cancer–free interval rates were higher in women...

breast cancer

Ado-Trastuzumab Emtansine Fails to Replace Standard of Care in First-Line Metastatic Breast Cancer

Results are now in for the phase III MARIANNE trial. Although ado-trastuzumab emtansine (formerly known as T-DM1, Kadcyla) proved noninferior to trastuzumab (Herceptin) plus a taxane in the first-line metastatic breast cancer setting, it performed no better than the standard of care.1 “T-DM1 and...

Expert Point of View: Michael P. Link, MD

“We have had remarkable success in treating patients with cancer. Millions of survivors are a testament to this success. But the ‘cost of cure’ borne by our patients is substantial in terms of diminished quality and quantity of life,” commented the formal discussant of the study ­Michael P. Link,...

thyroid cancer

Thyroid Cancer Rarely Diagnosed in Those With Asymptomatic, Benign Nodules

A prospective, multicenter, observational study involving 992 consecutive patients with one to four asymptomatic, sonographically or cytologically benign thyroid nodules found that “the majority of nodules exhibited no significant size change during 5 years of follow-up or actually decreased in...

leukemia

Durable Responses at 3-Year Follow-up for CLL Patients Receiving Single-Agent Ibrutinib

At a median follow-up of 3 years, ibrutinib (Imbruvica) demonstrated continued activity with durable responses that improved in quality with extended treatment of patients with chronic lymphocytic leukemia (CLL). In addition, grade 3 toxicity and adverse events leading to treatment discontinuation...

Irwin Rose, PhD, Nobel Laureate and Biochemist, Dies at 88

Scientist and Nobel Laureate ­Irwin “Ernie” Rose, PhD, passed away June 2, 2015, after a long illness. He was 88. Dr. Rose shared the 2004 Nobel Prize for chemistry with Aaron Ciechanover, MD, DSc, and Avram Hershko, MD, PhD, of the Israel Institute of Technology for their pioneering work in...

Preeminent Cancer Researcher Brian E. Henderson, MD, Dies

Brian E. Henderson, MD, began his medical path as a researcher in virology, and as a young scientist, he ventured to Africa as part of a Centers for Disease Control team to study yellow fever. The better part of his esteemed medical career, however, was as one of the world’s most respected...

breast cancer

My Faith Helped Me Choose a Way Forward With Cancer

I've been fortunate to be strong and healthy for most of my life. In fact, there is no history of any serious illness in my family, which is why I was so unprepared to hear the words “You have breast cancer” 5 years ago. Not only was the diagnosis foreign to me, I had no idea what chemotherapy and...

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