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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...

Expect Questions About Preventing Melanoma

A recent report from the Centers for Disease Control and Prevention (CDC) stated that the incidence of melanoma “doubled between 1982 and 2011, but comprehensive skin cancer prevention programs could prevent 20% of new cases between 2020 and 2030.”1,2 That report should serve to increase interest...

skin cancer

Capitalizing on Increased Interest in Skin Cancer During Summer to Reeducate People About Sunscreens and ‘Smart Sun Strategies’

Amid the encouraging studies reported at the 2015 ASCO Annual Meeting about advances in the treatment of melanoma was a troubling finding about the incidence of melanoma increasing. An analysis of data from nine Surveillance, Epidemiology, and End Results (SEER) registries found that the incidence...

skin cancer

Adjuvant Ipilimumab Increases Recurrence-Free Survival After Complete Resection of High-Risk Stage III Melanoma

In the phase III European Organisation for Research and Treatment of Cancer (EORTC) 18071 trial reported in The Lancet Oncology, Alexander M.M. Eggermont, MD, PhD, Director General of the Gustave Roussy Cancer Center in Villejuif, France, and colleagues found that adjuvant therapy with the immune...

integrative oncology

American Ginseng

The use of dietary supplements by patients with cancer has increased significantly over the past 20 years despite insufficient evidence of safety and effectiveness. Finding reliable sources of information about dietary supplements can be daunting. Patients typically rely on family, friends, and the ...

hematologic malignancies

Microangiopathic Hemolytic Anemia and Thrombocytopenia

Question 1: In this case, what is the most appropriate next best test? Correct Answer: B. Peripheral blood smear examination. Expert Perspective In the appropriate clinical setting, information obtained from a carefully examined peripheral blood smear film is indispensable. The peripheral blood...

hematologic malignancies

Microangiopathic Hemolytic Anemia and Thrombocytopenia

The ASCO Post is pleased to present Hematology Expert Review, an occasional feature that includes a case report detailing a particular hematologic condition followed by questions. Answers to each question with expert commentary can be found in the sidebar. In this installment, we present the case...

gynecologic cancers
geriatric oncology

Gynecologic Cancer in the Older Patient: The Activities of the Elderly Working Group of NRG Oncology

Geriatrics for the Oncologist is guest edited by Stuart Lichtman, MD, FACP, FASCO, and developed in collaboration with the International Society of Geriatric Oncology (SIOG). Visit SIOG.org for more on geriatric oncology.   The elderly population in the United States is growing, and by the year...

lung cancer

Progress in the Treatment of Patients With EGFR-Mutated NSCLC

Approximately 10% to 15% of patients with advanced non–small cell lung (NSCLC) cancer have mutations in the epidermal growth factor receptor (EGFR) in tumor cells. Specific therapies to inhibit the activity of EGFR-mutated NSCLC have now been clearly shown to improve response rate and...

lung cancer

Early-Phase Studies Show Activity of Novel EGFR Inhibitors Rociletinib and AZD9291 in T790M-Positive NSCLC

Two early-phase studies have shown that the novel epidermal growth factor receptor (EGFR) inhibitors rociletinib and AZD9291 exhibit high activity in non–small cell lung cancer (NSCLC) patients with the EGFR T790M mutation who had progressed on prior EGFR inhibitor therapy.1,2 The T790M mutation...

issues in oncology

Precision Medicine Trials Bring Targeted Treatments to More Patients

At the 2015 ASCO Annual Meeting, both ASCO and the National Cancer Institute (NCI) unveiled details of new precision medicine trials that will greatly expand the number of patients with cancer who are benefiting from targeted agents. The trials will match a patient’s tumor molecular profile with an ...

Expert Point of View: Daniel G. Coit, MD

Daniel G. Coit, MD, of Memorial Sloan Kettering Cancer Center, New York, and Chair of the National Comprehensive Cancer Network (NCCN) Melanoma Guidelines Panel, discussed the findings reported by Lewin et al at the ASCO Annual Meeting. “This is a small retrospective study examining a prospective...

skin cancer

PET/CT Detects Asymptomatic Melanoma Recurrences

In monitoring patients with melanoma at high risk for relapse, surveillance imaging with 18F-fluorodeoxyglucose–positron-emission tomography (FDG-PET)/computed tomography (CT) can detect asymptomatic metastases and thus facilitate early treatment, according to Australian investigators who presented ...

leukemia
myelodysplastic syndromes

Advancing Classification and Risk Stratification for Leukemia and Myelodysplastic Syndromes

Refinements in the classification and risk stratification for leukemia and myelodysplastic syndromes were reported by three different investigators at the 2015 ASCO Annual Meeting. The first study showed that leukemia stem cell phenotypes are associated with outcomes in acute myeloid leukemia...

colorectal cancer

Triple Inhibition May Cripple BRAF-Mutated Colorectal Cancer

Triplet therapy that inhibits the BRAF, MEK, and EGFR pathways appears promising in BRAF-mutated colorectal cancer, a malignancy that typically does not respond to BRAF inhibition alone.1 At the 2015 ASCO Annual Meeting, Chloe Evelyn Atreya, MD, of the University of California, San Francisco,...

pancreatic cancer

Novel Enzyme Improves Outcomes in Subset of Patients With Pancreatic Cancer

Patients with stage IV pancreatic cancer who received a novel enzyme along with standard chemotherapy experienced a doubling in progression-free survival, compared to those given chemotherapy alone, in a study presented at the 2015 ASCO Annual Meeting.1 Response rates and median duration of...

Expert Point of View: Noah Hahn, MD

Commenting on the pembrolizumab (Keytruda) phase Ib study, Noah Hahn, MD, of Johns Hopkins Sidney Kimmel Cancer Center, Baltimore, called the overall response rate of 28% with pembrolizumab “pretty impressive. Nearly two-thirds of patients had some response or tumor reduction, and overall survival...

bladder cancer

Immunotherapy Marches On, Making Headway in Advanced Urothelial Bladder Cancer

Two immunotherapy agents show promise in preliminary studies of advanced urothelial bladder cancer: the anti–PD-1 (programmed cell death protein 1) antibody pembrolizumab (Keytruda) and the anti–PD-L1 (programmed cell death ligand 1) antibody atezolizumab. Separate phase I studies of each drug...

Expert Point of View: Jeffrey L. Wolf, MD

Jeffrey L. Wolf, MD, Director of the Myeloma Program at the University of California, San Francisco, formally discussed the ENDEAVOR study at the ASCO Annual Meeting. He commented that the “doubling” in progression-free survival is “impressive” and said that “time will tell if this difference...

multiple myeloma

Carfilzomib/Dexamethasone Doubles Progression-Free Survival vs Bortezomib/Dexamethasone in Patients With Relapsed Multiple Myeloma

In the first head-to-head study comparing two proteasome inhibitors in relapsed multiple myeloma, carfilzomib (Kyprolis)/dexamethasone provided a doubling in progression-free survival, compared with bortezomib (Velcade)/dexamethasone.1 Results of the phase III ENDEAVOR trial of the two regimens in...

Expert Point of View: Jeremy Abramson, MD

Jeremy Abramson, MD, Clinical Director of the Center for Lymphoma at Massachusetts General Hospital, Boston, agrees that obinutuzumab is an advance over rituximab. Like rituximab, obinutuzumab targets CD-20, but rituximab does not directly induce cell death. Obinutuzumab is a type 2 antibody and...

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...

health-care policy

Medicare to Reimburse Doctors for End-of-Life Counseling

In a breakthrough proposal announced on July 8, the Centers for Medicare & Medicaid Services (CMS) plans to reimburse physicians for end-of-life counseling, a move that the oncology community has long been lobbying for. Arriving just as the presidential election cycle begins to heat up, the CMS ...

Mount Sinai Honors James F. Holland, MD, FASCO, on the Occasion of His 90th Birthday

On May 14, 2015, over 160 colleagues, family members, friends, and patients of James F. ­Holland, MD, FASCO, gathered in the Goldwurm Auditorium in the Icahn School of Medicine at Mount Sinai Hospital in New York to honor Dr. Holland for the contributions he has made during his remarkable career in ...

multiple myeloma

Daratumumab Expanded Access Program Open to Eligible U.S. Patients With Heavily Pretreated Multiple Myeloma

Janssen Biotech, Inc, announced the opening of a daratumumab expanded access program for eligible patients in the United States. Daratumumab is an investigational human anti-CD38 monoclonal antibody being evaluated in clinical trials as a treatment for patients with multiple myeloma. The...

issues in oncology

Cost vs Our Values in Cancer Care

An 80-year-old patient with metastatic prostate cancer asked me to discontinue his treatments, which were costing him more than $1,000 every 3 months. Although he had Medicare, he did not have secondary insurance. I told him that I would seek compassionate-care payment from the pharmaceutical...

palliative care

The Importance of Including Adolescents and Young Adults With Cancer in Their Advance Care Planning

Three years ago, a study of adolescents and young adults aged 16 to 28 with metastatic or recurrent cancer or HIV/AIDS compared the usefulness of two previously developed advance care planning guides—one prepared specifically for adolescents and young adults and one specifically for adults. The...

Charles Rubin, MD, Pediatric Cancer Specialist, Dies at 62

Charles M. Rubin, MD, Associate Professor of Pediatrics at the University of Chicago Medicine, a highly respected specialist in the care of children with cancer, died on July 17. He was 62. An authority on all aspects of pediatric cancers, Dr. Rubin had a particular interest in brain tumors and...

leukemia

A Lasting Legacy

When Emil J Freireich, MD, retires from the University of Texas MD Anderson Cancer Center on September 1, he will have spent 50 years at the institution and a total of 60 years in the pursuit of curing childhood leukemia as well as other cancers and in the educational development of young...

Blame

The following essay by Karen J. Krag, 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. It is easier ...

The Human Heart: Tales of Science and Mystery

BOOKMARK Title: The Man Who Touched His Own Heart: True Tales of Science, Surgery, and Mystery Author: Rob Dunn Publisher: Little, Brown and Company Publication date: February 3, 2015 Price: $27.00; hardcover, 384 pages No part of the human anatomy has been as mythologized, analogized, and...

issues in oncology

Past President of ASCO Takes on New Role at Memorial Sloan Kettering Cancer Center to Improve Patient Care and Public Health

In June, Memorial Sloan Kettering Cancer Center (Memorial) in New York announced it had appointed ­Clifford A. Hudis, MD, FACP, Chief of Breast Medicine Service, to a newly created position of Vice President for Government Relations and Chief Advocacy Officer. In addition to his new role, Dr. Hudis ...

breast cancer

Comparing Regimens Guides Therapeutic Decisions in Previously Treated Advanced Breast Cancer

Kaufman and colleagues recently reported findings of a phase III trial comparing eribulin ­(Halaven) vs capecitabine in patients with advanced breast cancer who had previously received anthracycline and taxane therapy,1 and a review of their study appears in this issue of The ASCO Post. Although...

breast cancer

No Survival Benefit for Eribulin vs Capecitabine in Advanced Breast Cancer

Eribulin (Halaven) currently is indicated in the United States for treatment of patients with metastatic breast cancer who previously received at least two chemotherapy regimens for metastatic disease and an anthracycline and a taxane in either the adjuvant or metastatic setting. Its approval was...

lung cancer

ODAC Discussion ‘Constructive’ About Necitumumab for Squamous NSCLC

The U.S. Food and Drug Administration’s (FDA) Oncologic Drugs Advisory Committee (ODAC) favored the approval of necitumumab in combination with gemcitabine and cisplatin for use in first-line treatment of patients with locally advanced or metastatic squamous non–small cell lung cancer (NSCLC). In...

prostate cancer

Magnetic Resonance Imaging/Ultrasound Fusion: A Promising Technology for Image-Guided Prostate Biopsy

An elegant study by Siddiqui et al1—reviewed in this issue of The ASCO Post—offers compelling evidence for the diagnostic utility of “targeted” prostate biopsy using multiparametric magnetic resonance imaging (MRI) data fused with ultrasound images. The technique involves first performing a...

prostate cancer

Magnetic Resonance Imaging/Ultrasound Fusion–Guided Biopsy Improves Detection of High-Risk Prostate Cancer

In a study reported in JAMA, M. Minhaj Siddiqui, MD, currently of the University of Maryland School of Medicine, and colleagues found that targeted magnetic resonance imaging (MRI)/ultrasound fusion–guided prostate biopsy increased diagnosis of high-risk prostate cancer and reduced detection of...

cost of care
hematologic malignancies

Study Shows Current Blood Cancer Drug Prices Are Not Justified

The costs associated with cancer drug prices have risen dramatically over the past 15 years, a trend concerning to many oncologists. In a new analysis, researchers at The University of Texas MD Anderson Cancer Center concluded the majority of existing treatments for hematologic cancers are...

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