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breast cancer

First National Data on Breast Cancer Subtypes Mark New Era in Biomarker Epidemiology

This year’s Report to the Nation on the Status of Cancer contains the first national combined data set on the incidence of four major breast cancer subtypes by race/ethnicity, poverty level, geography, and other factors. The findings show that “there are unique racial/ethnic-specific incidence...

lung cancer

Outcomes of the CUSTOM ‘Basket’ Trial of Molecular Profiling and Targeted Therapy in Advanced Thoracic Malignancies

In the phase II CUSTOM trial reported in the Journal of Clinical Oncology, Ariel Lopez-Chavez, MD, Anish Thomas, MD, and colleagues performed molecular profiling of tumors in patients with advanced non–small cell lung cancer (NSCLC), small cell lung cancer (SCLC), or thymic malignancies and...

gynecologic cancers

What Is the Future of Intraperitoneal Treatment in Advanced Ovarian Cancer?

An analysis of Gynecologic Oncology Group (GOG) studies recently reported in the Journal of Clinical Oncology by Tewari and colleagues and reviewed in this issue of The ASCO Post showed a survival benefit of intraperitoneal chemotherapy vs intravenous chemotherapy over long-term follow-up in women...

gynecologic cancers

Long-Term Survival Advantage Seen With Intraperitoneal vs Intravenous Chemotherapy in Advanced Ovarian Cancer

In an analysis of Gynecologic Oncology Group (GOG) studies reported in the Journal of Clinical Oncology, Devansu Tewari, MD, of Kaiser Permanente Irvine Medical Center, and colleagues found that intraperitoneal chemotherapy was associated with a survival advantage compared with intravenous...

Expert Point of View: Aditya Bardia, MD

These results are promising. The fact that there were two patients with a complete response caught my eye. This is very exciting in metastatic triple-negative breast cancer. These were heavily pretreated patients; 85% had more than four lines of prior therapy,” said Aditya Bardia, MD, a breast...

breast cancer

Anti–PD-L1 Agent Shows Activity in Early Study of Triple-Negative Breast Cancer

An investigational immunotherapy called MPDL3280A showed encouraging and durable clinical activity in heavily pretreated patients with metastatic triple-negative breast cancer, in an early study presented at the 2015 Annual Meeting of the American Association of Cancer Research (AACR).1 Responses...

prostate cancer

Studies Evaluate Effectiveness of Active Surveillance in Prostate Cancer Patients

Active surveillance has become a viable option for many men with low-risk prostate cancer who choose not to undergo active treatment such as surgery or radiotherapy. Four studies evaluating the effectiveness, trends, and other considerations for active surveillance in managing prostate cancer were...

prostate cancer

New Studies Call for Smarter Approach to Prostate Cancer Screening

Prostate cancer is one of the most common cancers in American men, yet controversy over the utilization and frequency of prostate-specific antigen (PSA) screening methods remains, due to the overdiagnosis and overtreatment of men with low-grade, less-aggressive forms of the disease. At the 110th...

breast cancer

Nipple-Sparing Mastectomy Shown to Be Oncologically Safe

Mastectomies that preserve the nipple and an envelope of breast skin are as safe as more radical operations for qualifying early-stage breast cancer patients, according to a meta-analysis and systematic literature review presented at the American Society of Breast Surgeons 16th Annual Meeting.1...

Expert Point of View: Alison M. Friedmann, MD

Commenting on the AREN0532/AREN0533 data, Alison M. Friedmann, MD, of the Department of Hematology/Oncology at Massachusetts General Hospital, Boston, said that this is an important study. “This continues to build on the highly successful risk-adapted treatment approach of the previous National...

kidney cancer

Intensified Therapy Improves Survival in Wilms Tumor Patients With Rare Genetic Abnormality

Data from two phase III studies led by the Children’s Oncology Group show that augmenting or intensifying therapy for children with high-risk Wilms tumor improved relapse-free survival. These children are deemed to be at high risk due to a specific chromosomal abnormality that confers worse...

cns cancers

Whole-Brain Radiation: Risks Outweigh Benefits for Limited Brain Metastases

New data from a phase III ­Alliance trial weighs in on a longstanding debate in the treatment of brain metastases: Should whole-brain radiation therapy be added to stereotactic radiosurgery? The study found that although whole-brain radiation therapy improved local tumor control in patients with...

head and neck cancer

Clinically Meaningful Preliminary Results With Pembrolizumab in Recurrent Head and Neck Cancer

Pembrolizumab (Keytruda) is making inroads into head and neck cancer, with encouraging results in heavily pre-treated patients with recurrent or metastatic squamous cell carcinoma of the head and neck, according to a report on the expansion-cohort ­KEYNOTE-012 study presented at the 2015 ASCO...

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,...

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