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breast cancer

Adding Everolimus to First-Line Trastuzumab/Paclitaxel Does Not Increase Progression-Free Survival in HER2-Positive Metastatic Breast Cancer

In the phase III BOLERO-1 trial, reported in The Lancet Oncology, Sara A. Hurvitz, MD, of the University of California, Los Angeles, and colleagues found that the addition of the mTOR inhibitor everolimus (Afinitor) to trastuzumab (Herceptin)/paclitaxel did not significantly increase...

multiple myeloma

Carfilzomib in Combination With Lenalidomide and Dexamethasone in Relapsed Multiple Myeloma

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 July 24, 2015, carfilzomib (Kyprolis) was approved for use in...

colorectal cancer

Learning to Refine the Use of Regorafenib to Best Advantage in Advanced Colorectal Cancer

In patients with advanced colorectal cancer who have been heavily treated with a sequence of chemotherapy regimens and/or targeted therapies, the goals of treatment on or off a clinical trial are readily definable. These patients and their managing teams are striving to extend the length of lives,...

colorectal cancer

Regorafenib Improves Overall Survival in Asian Patients  With Previously Treated Metastatic Colorectal Cancer

In a phase III trial (CONCUR) reported in The Lancet Oncology, Jin Li, MD, and colleagues found that the multikinase inhibitor regorafenib (Stivarga) improved overall survival vs placebo in Asian patients with previously treated metastatic colorectal cancer.1 Regorafenib is approved in the United...

skin cancer

FDA Approves Sonidegib for Locally Advanced Basal Cell Carcinoma

The U.S. Food and Drug Administration (FDA) approved sonidegib (Odomzo) for the treatment of patients with locally advanced basal cell carcinoma that has recurred following surgery or radiation therapy or those who are not candidates for surgery or radiation therapy. The approval was based on...

cns cancers

Short Course of Radiotherapy May Be Adequate for Elderly and Frail Patients With Glioblastoma Multiforme

No difference in overall survival or progression-free survival was observed between elderly and/or frail patients undergoing short and standard courses of radiotherapy for glioblastoma multiforme, according to data presented by Elena Fidarova, MD, at the 2015 Multinational Association of Supportive ...

kidney cancer

FDA Grants Breakthrough Therapy Designation to Lenvatinib for Metastatic Renal Cell Carcinoma

The U.S. Food and Drug Administration (FDA) granted lenvatinib (Lenvima) Breakthrough Therapy designation for investigational use in patients with advanced or metastatic renal cell carcinoma who were previously treated with a vascular endothelial growth factor (VEGF)-targeted therapy. Lenvatinib...

lung cancer

Gefitinib in EGFR-Mutant Metastatic NSCLC

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 July 13, 2015, gefitinib (Iressa) was approved for first-line ...

lung cancer

Immunotherapy Makes Inroads in Small Cell Lung Cancer

Early data on immunotherapy for small cell lung cancer (SCLC) have been encouraging. SCLC may catch up to non–small cell lung cancer (NSCLC), where immunotherapy is now standard of care, if these early data are borne out in phase III trials. Phase Ib and II studies of immunotherapy in SCLC were...

lung cancer

Moving Forward in Non–Small Cell Lung Cancer: Targeted Combinations and Immunotherapy

The newer targeted therapies and immunotherapies have proven to be a boon to the treatment of lung and other cancers, but how best to deploy those therapies remains a burning question. Another important focus of current research is the identification and validation of biomarkers for these...

health-care policy

‘Right to Try’ Laws: Helpful or Harmful?

Since 2014, “Right to Try” legislation has been sweeping the nation. Created to enable terminally ill patients to gain access to experimental drugs, biologics, and devices by sidestepping the approval process of the U.S. Food and Drug Administration (FDA), at press time, 22 states have enacted...

lung cancer

Immune Checkpoint Inhibitors: The Dawn of a New Era for Lung Cancer Therapy

The therapeutic paradigm for lung cancer has changed rapidly over the past few years toward individualized therapy. For certain subsets of patients, molecularly targeted agents have resulted in robust gains in overall survival and quality of life. However, for the majority of patients with...

breast cancer

Studies Explore New Avenues to Pursue in Metastatic Triple-Negative Breast Cancer

Two agents targeting novel pathways show promise in metastatic triple-negative breast cancer, according to separate studies presented at the 2015 ASCO Annual Meeting and reviewed at the Best of ASCO® meeting by Steven J. Isakoff, MD, PhD, of Massachusetts General Hospital, Boston. The first study...

issues in oncology

Cancer Diagnosis Among Patients With Diabetes Reduced Adherence to Evidence-Based Medications

“A cancer diagnosis among patients with diabetes reduced adherence with evidence-based medications, particularly if patients’ life expectancy was short,” according to a study among Medicare beneficiaries reported in the Journal of Oncology Practice. “These findings emphasize the vulnerability of...

hepatobiliary cancer

More Than One-Third of Those Diagnosed With Hepatocellular Carcinoma as Outpatients Have Diagnostic Delays of 3 or More Months

Nearly 20% of patients with hepatocellular carcinoma “wait more than 3 months from presentation to diagnosis, which can contribute to interval tumor growth,” Nishant Patel, MD, and colleagues concluded in the Journal of the National Comprehensive Cancer Network. They based their conclusions on a...

issues in oncology

Determining Why Patients With HIV Infection and Non–AIDS-Defining Cancers Are Less Likely to Receive Cancer Treatment

A survey sent to medical and radiation oncologists to identify factors contributing to observed disparities in cancer treatment between patients infected with HIV and those not infected “found that a substantial proportion of physicians (21%) would alter their treatment recommendations based on HIV ...

lymphoma

Increased Lifetime Risk of Cardiovascular Disease for Patients Treated for Hodgkin Lymphoma

Survivors of Hodgkin lymphoma treated as adolescents or adults are at increased risk of cardiovascular diseases throughout their lives, according to results of a retrospective cohort study of 2,524 Dutch patients followed for a median of 20 years. “Treating physicians and patients should be aware...

colorectal cancer

Long-Term Use of Thyroid Hormone Replacement Linked to Decreased Risk of Colorectal Cancer

Long-term thyroid hormone replacement was associated with a decreased risk of colorectal cancer, but hyperthyroidism and untreated hypothyroidism were associated with a modestly elevated risk, according to a study using a large population-based medical records database from the United Kingdom. A...

breast cancer
pain management

Increased Interest in Simple Injection to Treat Women With Postmastectomy Pain

After presenting results of a study showing that injecting a standard analgesic combination into trigger points of pain along the inframammary fold relieved postmastectomy pain, Laura J. Esserman, MD, MBA, Director of the Carol Franc Buck Breast Care Center and Co-Leader of the Breast Oncology...

From Small-Town Mexico to Big Pharma, a Look at Opiates for Good and Bad

Bookmark Title: Dreamland: The True Tale of America’s Opiate Epidemic Author: Sam Quinones Publisher: Bloomsbury Press Publication date:  April 21, 2015 Price: $28.00; hardcover, 384 pages Despite growing awareness within the oncology community and the emergence of the palliative care...

Breast Surgeon Carolyn Mary Kaelin, MD, MPH, FACS, Dies at 54

Carolyn Mary Kaelin, MD, MPH, FACS, died on July 28 at the age of 54. A gifted and compassionate breast cancer surgeon, Dr. Kaelin was a surgical oncologist in the Women’s Cancers Program at Dana-Farber Cancer Center and Director of the Breast Clinic at Brigham and Women’s Hospital. Dr. Kaelin...

breast cancer

I’m Living a Full and Happy Life With Stage IV Breast Cancer

After coping with breast cancer for more than a decade, it is difficult for me to put into words exactly how grateful I am to all the doctors, nurses, and researchers whose efforts have kept me alive for all these years. And not just alive, but thriving. A routine mammogram had discovered two...

A Cancer Handbook for Inquisitive Laypersons and Health-Care Professionals

Bookmark Title: The Cancer Solution: Taking Charge of Your Life With CancerAuthor: Jack C. Westman, MD, MSPublisher: Archway PublishingPublication date:  January 15, 2015Price: $20.00; paperback, 310 pages I was at a meeting in San Francisco in 1978 and received a call from my wife, Nancy:...

Never Say Never

The following essay by Grace Wang, 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. D.K. came to me ...

gynecologic cancers

How Carolyn D. Runowicz, MD, FASCO, Is Shaping the Future of Gynecologic Cancers

Carolyn D. Runowicz, MD, ­FASCO, has worn just about every hat in the field of oncology—clinician, professor, researcher, administrator, and even cancer survivor.  Currently the Executive Associate Dean for Academic Affairs and Professor in the Department of Obstetrics and Gynecology at the Herbert ...

The Flipped Classroom: Swapping the Traditional Lecture Hall for an Online Version

Despite enormous advances in modern medicine and the explosion of biomedical information over the past century, the way medical education is taught in the United States is stuck in a format that does not optimize learning, according to Charles Prober, MD, Senior Associate Dean for Medical Education ...

issues in oncology

Access to Cancer Medicines Not Uniform Across Europe

Access to cancer medicines—including some old standbys—is inconsistent across Europe, depriving many patients of treatments that are the standard of care elsewhere,1 according to Alexandru E. Eniu, MD, PhD, Chair of the European Society for Medical Oncology (ESMO) Emerging Countries Committee and...

skin cancer

Dabrafenib Plus Trametinib Improves Overall Survival vs Dabrafenib in BRAF V600–Mutant Melanoma

Overall survival results of the phase III COMBI-d trial reported in The Lancet by Georgina V. Long, MD, and colleagues showed that the combination of the BRAF inhibitor ­dabrafenib (Tafinlar) with the MEK inhibitor trametinib (Mekinist) resulted in significantly prolonged overall survival vs...

lung cancer

Roswell Park Cancer Institute Partners With Cuban Scientists to Develop Lung Cancer Vaccine

Just 4 months after President Barack Obama’s announcement in December 2014 that there would be an easing of the trade embargo between the United States and Cuba, a deal was struck between Roswell Park Cancer Institute in Buffalo, New York, and the Center for Molecular Immunology (CIM) in Havana,...

leukemia

Novel Combination Increases Progression-Free Survival in CLL Patients Who Are Not Candidates for Fludarabine

In the phase III COMPLEMENT 1 trial reported in The Lancet, ­Peter Hillmen, MB, ChB, of St. James’s University Hospital, Leeds, and colleagues found that the addition of the anti-CD20 antibody ofatumumab (Arzerra) to chlorambucil (Leukeran) increased progression-free survival among patients with...

issues in oncology

New Techniques in Oncologic Surgery and Radiology: Some Worth the Expense, Some Not So Much

In recent years, patients with cancer have had the benefit of much high technology: proton-beam radiotherapy, intensity-modulated radiation therapy, various minimally invasive surgery techniques, and robots in the operating room. They all receive hype in the professional and public press, and...

lymphoma

Brentuximab Vedotin for Consolidation Therapy in High-Risk Hodgkin Lymphoma

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 August 17, 2015, brentuximab vedotin (Adcetris) was approved...

geriatric oncology

Coping With Aging and Cancer: Psychosocial Factors and Geriatric-Specific Interventions

You can’t control the wind, but you can adjust your sails,” said Mindy Greenstein, PhD, consulting psychologist and author, to begin her talk at the 2015 World Congress of Psycho-Oncology, held in July in Washington, DC. The sense of this proverb pervaded the entire session on cancer and aging....

supportive care

Suicide After Cancer: Understanding the Challenges Across the Treatment Trajectory

Suicidal thoughts and impulses are among the most challenging symptoms in patients with cancer, and they may occur both during and after treatment. It has long been known that a cancer diagnosis carries an increased risk for suicide, but the problem is not widely addressed. Suicide is one of the...

head and neck cancer

HPV16 DNA in Post-Treatment Oral Rinses Signals Poor Prognosis in Oropharyngeal Cancer

Detectable oral HPV16 DNA in oral rinses post treatment for oropharyngeal cancer appears to be a harbinger of poor prognosis and can predict recurrence. Oral HPV16 DNA rinses are a potential tool for long-term tumor surveillance, according to a study selected for the Best of ASCO® 2015.1 “The goal ...

breast cancer

Role of Surgery and Adjuvant Radiotherapy in the Treatment of Breast Cancer Explored

Two separate retrospective studies have further refined our understanding of the respective contributions of surgery and radiotherapy in the treatment of breast cancer. However, these studies are not definitive, and “gold standard” trials are needed to arrive at definitive recommendations. Both...

prostate cancer

Optimal Timing of Hormonal Therapy for Biochemically Recurrent Prostate Cancer Remains Unclear

There is no consensus as to whether it is better to treat immediately or to delay androgen-deprivation therapy in patients with a rising prostate-specific antigen (PSA) level (“biochemical relapse”) after curative therapy for prostate cancer. A phase III study, selected for the Best of ASCO® 2015,...

colorectal cancer

Secondary Prevention in Metastatic Colorectal Cancer: Benefits of Vitamin D and Aspirin Explored

Two low-cost, low-tech options may lead to a survival benefit in metastatic colorectal cancer, according to separate retrospective studies selected for the Best of ASCO® 2015. The first study suggested that vitamin D supplementation is worthy of investigation in this regard,1 and the second study...

colorectal cancer
hepatobiliary cancer

Colorectal Liver Metastases: Thumbs Up for Radiofrequency Ablation, Jury Still Out for Selective Internal Radiotherapy

Two “firsts” in studies of colorectal liver metastases were highlighted at the 2015 ASCO Annual Meeting: the first prospective randomized trial to evaluate radiofrequency ablation plus chemotherapy1 and the first large randomized phase III trial to study liver-directed selective internal radiation...

lung cancer
issues in oncology

Positioning Targeted and Immunotherapy-Based Approaches in Lung Cancer

With immunotherapy changing the face of lung cancer, is there still a place for targeted therapy? Two experts from Emory University debated this issue at the 2015 Debates and Didactics in Hematology and Oncology Conference held in Sea Island, Georgia. Fadlo Khuri, MD, was recently named President...

Charting a New Course: From Clinical Investigator to University President

What first intrigued Fadlo R. Khuri, MD, FACP, about the prospect of becoming the 16th President of the American University of Beirut (AUB) in Lebanon was the chance to give back to an institution and a country that had given him so much. Born in Boston, Massachusetts, in 1963, Dr. Khuri was raised ...

multiple myeloma

Elotuzumab Ushers in a New Era in Myeloma Therapy

The long wait for monoclonal antibodies for the treatment of multiple myeloma is over. In the landmark ELOQUENT-2 study, reviewed in this issue of The ASCO Post, Lonial and colleagues convincingly demonstrate the effectiveness of elotuzumab, a monoclonal antibody directed against SLAMF7, in the...

multiple myeloma

Adding Elotuzumab to Lenalidomide Plus Dexamethasone Improves Progression-Free Survival in Refractory Multiple Myeloma

In an interim analysis of the phase III ELOQUENT-2 trial reported in The New England Journal of Medicine, Sagar Lonial, MD, of Emory University School of Medicine, Meletios Dimopoulos, MD, of National and Kapodistrian University of Athens, and colleagues found that the addition of elotuzumab to...

leukemia

Azacitidine Increased Median Overall Survival Among Patients Aged 65 and Older With > 30% Blasts

A multicenter, randomized, open-label, phase III trial among the difficult-to-treat population of patients aged aged 65 and older with acute myeloid leukemia (AML) with > 30% bone marrow blasts “showed that azacitidine was associated with a clinically meaningful improvement” in median overall...

lung cancer

‘Encouraging Results’ With Newer EGFR TKIs in Patients With NSCLC Who Progressed After Prior EGFR TKI Therapy

Two studies of third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors among patients with non–small cell lung cancer (NSCLC) who had progressive disease following treatment with a first-generation EGFR tyrosine kinase inhibitor “show encouraging results,” according to...

kidney cancer

My Positive Attitude Is Keeping Me Alive

Until I was diagnosed with stage III renal cell carcinoma in early 2008, I had no firsthand experience with cancer. To my knowledge, there is no history of cancer in my immediate family, and despite a smoking habit I picked up when I was young, I had been in relatively good health in the 56 years...

Let It Be Hard

The ASCO Post is pleased to reproduce installments of the “Art of Oncology” as published previously in the Journal of Clinical Oncology (JCO). These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

Internationally Acclaimed Cancer Researcher, Gianni Bonadonna, MD, Dies at 81

Gianni Bonadonna, MD, was considered the “Father of Italian Oncology,” but his scientific contributions to the field and his generous collegial spirit extended far beyond the shores of his native land. Dr. Bonadonna was at the forefront in the battle to convince the surgical establishment that...

In Search of a Good Ending for a Life Well Lived

BOOKMARK Title: The Conversation: A Revolutionary Plan for End-of-life CareAuthor: Angelo E. Volandes, MDPublisher: BloomsburyPublication date: January 13, 2015Price: $26.00; hardcover, 240 pages A quick Google search on books about end-of-life care will yield pages of hits on the subject. The...

Microbes by the Trillions

BOOKMARK Title: 10% Human: How Your Body’s Microbes Hold the Key to Health and HappinessAuthor: Alanna CollenPublisher: Harper CollinsPublication date: April 27, 2015Price: $39.99; hardcover, 400 pages "As I walked back through the forest that night in the summer of 2005, with twenty bats in...

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