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cns cancers

Glioblastoma: Novel Immunotherapy Approaches Generate Responses and Excitement

Checkpoint inhibitors were major attention grabbers at the 2015 ASCO Annual Meeting, but studies suggested there are other encouraging means of harnessing the immune system in the treatment of glioblastoma. EGFRvIII-Targeted Vaccine David A. Reardon, MD, Clinical Director of the Center for...

issues in oncology

Value: What Do We Mean, Who Should Decide?

Oscar Wilde famously defined a cynic as “a man who knows the price of everything and the value of nothing.” I do not think that oncologists need to be as cynical as this, but it was very appropriate that a major theme of this year’s ASCO Annual Meeting was the concept of “value.” It is clear that...

colorectal cancer

Statin Use Not Associated With Reduced Mortality Among Patients With Primary Colorectal Cancer

Statin use was not associated with reduced mortality among patients diagnosed with primary colorectal cancer between 2003 and 2009 and followed for a median of 3.4 years in the Darmkrebs: Chancen der Verhütung durch Screening (DACHS) study, an ongoing population-based study of colorectal cancer in...

skin cancer

Expect Questions About Increased Risk of Melanoma From Consuming Grapefruits and Orange Juice

Could too much citrus cause skin cancer?” was the lead-in of an NBC News item about a study linking consumption of grapefruits and oranges to an increased risk of melanoma.1 “Citrus consumption and skin cancer: How real is the link?” was the question posed by a headline in The Washington Post.2...

skin cancer

Public Urged Not to Overreact to Study Finding Link Between Citrus Fruits and Melanoma Risk

A study finding a link between citrus consumption and increased risk of melanoma1 may provide food for thought about the findings and implications as well as whet the appetite for more evidence, but according to several experts commenting on the study, it does not mean you should stop eating citrus ...

hematologic malignancies

Microangiopathic Hemolytic Anemia and Thrombocytopenia: Answers From Hematology Expert Review Questions

Question 1: What is the best first step in management of this patient? Correct Answer: C. Start plasma exchange. Expert Perspective Although distinguishing among thrombotic thrombocytopenic purpura, typical hemolytic uremic syndrome, and atypical hemolytic uremic syndrome (see Table 1 in the...

hematologic malignancies

Microangiopathic Hemolytic Anemia and Thrombocytopenia: Questions

Hematology Expert Review is an occasional feature that includes a case report followed by questions, answers, and expert commentary. In the July 25 issue of The ASCO Post, part 1 of a case report was published and focused on diagnosis (see summary below). Here, in part 2, the management of this...

skin cancer

Sonidegib in Basal Cell Carcinoma

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, sonidegib (Odomzo) was approved for treatment...

issues in oncology

Johnson & Johnson Creates Independent Bioethics Panel to Evaluate Compassionate Drug Use Requests

In May 2015, Johnson & Johnson announced its partnership with New York University (NYU) School of Medicine in New York to create a first-of-its kind independent bioethics panel to review requests made to the company for compassionate use of an investigational drug and determine how the company...

geriatric oncology

Geriatric Oncology: A Geriatrician’s Perspective

“The management of older individuals, including older cancer patients, involves a wisdom developed over a lifetime, thanks to time-consuming listening and painstaking collection and interpretation of clinical details.” —Lodovico Balducci, MD It is not simple to be a geriatrician in a world of...

cns cancers

Improved Understanding of Glioma Tumor Biology

The management of patients with lower-grade gliomas is evolving. As evidenced by two recent publications in The New England Journal of Medicine,1,2 reviewed in this issue of The ASCO Post, there has been a substantial increase in our knowledge of the molecular characteristics of these neoplasms....

cns cancers

New Molecular Classifications of Gliomas Established

Two studies reported in The New England Journal of Medicine identified new molecular classifications of glioma that capture biologic and prognostic differences. The Cancer Genome Atlas Research Network identified three prognostically significant subtypes of lower-grade glioma that were identified...

breast cancer

The Conundrum of Estrogen-Receptor Signaling in HER2-Positive Breast Cancer

BOLERO-1—reviewed in this issue of The ASCO Post—is the next installment in a series of randomized trials evaluating the addition of everolimus (Afinitor) to standard therapy in metastatic breast cancer.1 The initial evaluation of everolimus in the HER2-positive metastatic setting looked extremely...

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,...

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