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lung cancer

Nivolumab in Metastatic NSCLC After Platinum Therapy

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 October 9, 2015, the anti–programmed cell death protein 1...

neuroendocrine tumors

Telotristat Etiprate Added to Standard Therapy for Carcinoid Syndrome Shows Clinical Benefit in Patients With Metastatic Neuroendocrine Tumors

The investigational drug telotristat etiprate was shown to have clinical benefit when added to somatostatin analog therapy for carcinoid syndrome not adequately controlled by long-acting somatostatin analog therapy, the current standard of care, in patients with metastatic neuroendocrine tumors....

skin cancer

Why Melanoma Rates Are Increasing in Adolescents and Young Adults, Especially Among Females

The incidence of melanoma among children, adolescents, and young adults has reached epidemic proportions, increasing more than 250% over the past 4 decades, with young females at highest risk for the deadly cancer, according to a study1 by researchers at Roswell Park Cancer Institute in Buffalo,...

breast cancer

Survival and Bevacizumab in Early Breast Cancer: Time to Reconsider?

In metastatic HER2-negative breast cancer, several trials have shown that the addition of the anti–vascular endothelial growth factor (VEGF) monoclonal antibody bevacizumab (Avastin) to different chemotherapy regimens significantly improved response rates and progression-free survival by various...

palliative care

End-of-Life Clinical Decisions Still Need Conversations About Improving Care

In 2014, the Institute of Medicine report Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life called for more conversations about improving care for those who are dying. Improving the care of the imminently dying is an important issue in the oncology...

issues in oncology

Study Finds Quality of Physician Recommendation to Parents Key to Encourage/Discourage HPV Vaccination of Adolescents

A nationwide online survey of 776 pediatricians and family physicians assessing the quality of their human papillomavirus (HPV) vaccine recommendations to parents has found that approximately 27% of respondents said they do not strongly endorse HPV vaccination; further, 26% and 39% of respondents...

breast cancer

Functional Subtyping With 80-Gene Assay Identifies Distinct Triple-Positive Subtypes in Breast Cancer Patients

Molecular categorization of tumors with immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) has become a critical component in the diagnosis and treatment of breast cancer, improving outcomes by assigning the most appropriate therapy to specific tumor pathways. According to a...

lung cancer

Antibody-Drug Conjugate Makes Strong Showing in Small Cell Lung Cancer

The antibody-drug conjugate rovalpituzumab tesirine has shown strong clinical activity as second- and third-line treatment for small cell lung cancer in a phase I/Ib multicenter study,1 especially in the subset with high expression of the delta-like protein 3 (DLL3), which the drug targets. This...

lung cancer

Combined EGFR and VEGF Inhibition Ameliorates the Impact of  the EGFR T790M Mutation in NSCLC

Treatment with erlotinib and bevacizumab (Avastin) may help overcome the poor prognosis associated with T790M mutations present at diagnosis in advanced non–small cell lung cancer (NSCLC), according to the results of the phase II BELIEF trial.1 At the 2015 European Cancer Congress, Rolf A. Stahel,...

solid tumors
bladder cancer
skin cancer

PD-1/PD-L1 Inhibitors Show Promise in Additional Tumor Types

While inhibitors of programmed cell death protein 1 (PD-1) or its ligand (PD-L1) are becoming established in melanoma, non–small cell lung cancer, and renal cell carcinoma, their efficacy is also being evaluated in numerous other tumor types, with promising results, according to studies presented...

skin cancer

Survival Benefit in Metastatic Melanoma Grows Larger in COMBI-v Update

Combined BRAF and MEK inhibition was superior to BRAF inhibition alone in unresectable metastatic melanoma, according to the updated survival analysis of the large randomized COMBI-v trial.1 These findings were reported at the 2015 European Cancer Congress recently held in Vienna, Austria....

Expert Point of View: Bertrand Tombal, MD, PhD

We have made major progress by moving docetaxel forward, and now the largest pool of patients who become hormone resistant have received local therapy and then progressed. We have a lot of drugs for castration-resistant prostate cancer, and we are studying them earlier in the course of disease, but ...

prostate cancer

Update on Clinical Trials in Metastatic Prostate Cancer

Despite the proliferation of new drugs to treat prostate cancer, further progress is proving somewhat elusive, according to three trials presented at the 2015 European Cancer Congress. One study had positive results with orteronel maintenance therapy in patients with metastatic castration-resistant ...

prostate cancer

Meta-analysis Evaluates Benefit of Docetaxel and Bisphosphonates in Hormone-Sensitive Prostate Cancer

The results of a meta-analysis conducted in the United Kingdom may guide clinicians in the use of docetaxel and bisphosphonates in patients with hormone-sensitive prostate cancer.1 Claire L. Vale, PhD, Senior Research Scientist at the Medical Research Council Clinical Trials Unit at University...

pancreatic cancer

FDA Approves Liposomal Irinotecan for Advanced Pancreatic Cancer

The U.S. Food and Drug Administration has approved irinotecan liposome injection (Onivyde), in combination with fluorouracil (5-FU) and leucovorin, to treat patients with metastatic pancreatic cancer who have been previously treated with gemcitabine-based chemotherapy. The effectiveness of...

Expert Point of View: Anita Mahajan, MD

Anita Mahajan, MD, a radiation oncologist at the University of Texas MD Anderson Cancer Center, Houston, moderated the press conference where these findings were discussed. “Use of radiation for atypical meningiomas has been controversial. It has been difficult to put a study together, because we...

cns cancers

Cooperative Group Study Finds Radiation May Benefit Patients With Atypical Meningiomas

Management of the vast majority of meningiomas is straightforward, but treatment of atypical meningiomas has been controversial. Should radiation be part of therapy or not has been the question. The first analysis of Radiation Therapy Oncology Group (RTOG) 0539 suggested that patients will have...

pain management

Dexamethasone to Preempt Radiation-Induced Pain

Bone is a common site of metastasis for prostate, breast, and lung cancers, and palliative radiotherapy is often used to treat these metastases. Although it is an effective therapy, severe pain flare following radiation occurs in about one-third of patients. It usually resolves within 10 days, but...

issues in oncology
legislation

Debate Over Physician-Assisted Suicide Continues, State by State

In 1997, after surviving a storm of high-court legal challenges, Oregon’s Death With Dignity Act went into effect, making Oregon the first American state to legalize physician-assisted suicide. The Supreme Court ruled that there was no right to assisted suicide in the Constitution but implied that...

issues in oncology

Is Health Care in the United States a Basic Human Right or an Entitlement?

Mercy Killers is a one-man show that details the consequences of a medical health-care catastrophe (breast cancer) in a family.1 This disturbing fictional account is actually a daily event in cancer centers: losing insurance for technicalities, losing a home because of an inability to pay the...

Expert Point of View: Brian D. Kavanagh, MD, MPH, FASTRO

At a press conference held during the ASTRO Annual Meeting, ASTRO President-Elect Brian D. Kavanagh, MD, MPH, FASTRO, interim Chair of Radiation Oncology at the University of Colorado, Anschutz Medical Campus, Denver, said, “This study provides an important lesson for the field. We are lucky to...

lung cancer

Intensity-Modulated Radiotherapy Gains Ground for Treatment of Stage III Non–Small Cell Lung Cancer

Intensity-modulated radiation therapy appears to be preferable to three-dimensional (3D) conformal radiation therapy as part of treatment for patients with locally advanced (stage III) non–small cell lung cancer (NSCLC). Compared with 3D conformal radiotherapy, intensity-modulated radiotherapy...

hematologic malignancies

William Dameshek, MD, Helped Take Hematology From a Minor Medical Discipline to a Major Scientific Field

Although William Dameshek, MD, is renowned for his work in hematology, especially in advancing the understanding of myeloproliferative disorders and their interrelatedness, his early interest in medicine was instead focused on such diverse diseases as hyperthyroidism and typhus fever. Born on May...

2015 Recipients of the Susan G. Komen Brinker Awards for Scientific Distinction to Present Lectures at San Antonio Breast Cancer Symposium

Susan G. Komen has announced the recipients of the 2015 Brinker Awards for Scientific Distinction, which honors leading scientists who have made the most significant advances in breast cancer research and medicine.  The 2015 recipients of the Brinker Awards for Scientific Distinction are Myles A....

issues in oncology

Increased Lifetime Risk of Developing Cancer in Patients With HIV

The effectiveness of antiretroviral therapy has enabled patients with HIV to live long enough to have high lifetime risks for several types of cancer. The finding has important clinical implications for cancer screening, as well as primary prevention, according to the results of a study funded by...

issues in oncology

Falls Experienced by Older Patients Are Often Not Recorded or Responded to by Oncology Providers

A study comparing self-reported falls by older patients with cancer with the history and physical and/or clinic notes completed by their oncology providers “found that oncology providers rarely recorded or responded to falls in their older patients.” There was minimal evidence of documentation of...

prostate cancer
palliative care

Aggressive End-of-Life Care More Frequent Among Black Men With End-Stage Prostate Cancer

A study to examine end-of-life care among black and white patients dying of prostate cancer found that “significant racial disparities in end-of-life care” do exist. “Although diagnostic and therapeutic interventions are less frequent in black patients with end-stage prostate cancer, the rate of...

pancreatic cancer

Irinotecan Liposome Injection Plus Fluorouracil/Leucovorin to Treat Patients With Metastatic Pancreatic Cancer

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 October 22, 2015, irinotecan liposome injection (Onivyde)...

breast cancer
issues in oncology

Updated ACS Breast Cancer Screening Guideline Recognizes Greater Role for Individual’s Values and Preferences

The reactions to the updated breast cancer screening guideline from the American Cancer Society (ACS) have been many, varied, and not consistently favorable but not surprising to Kevin C. Oeffinger, MD, who chaired the ACS panel that issued the guideline. Breast cancer screening “is an area that...

Stepping Back in Medical History: A Groundbreaking Surgeon’s Battle With the Establishment

Bookmark Title: Dr. Mütter’s Marvels: A True Tale of Intrigue and Innovation at the Dawn of Modern MedicineAuthor:  Cristin O’Keefe AptowiczPublisher: Gotham BooksPublication date: September 8, 2015Price: $17.00, paperback; 384 pages In the late 1740s, John Wesley—a British evangelist and...

multiple myeloma

CAR T-Cell Immunotherapy Saved My Life

I have always prided myself on being healthy and fit, so when I started experiencing a chronic cough, difficulty breathing, and pain in my ribs and back, I thought they were the inevitable symptoms of a severe cold. At 42 and the mother of three children, it was inconceivable to me that I could...

multiple myeloma

Daratumumab Approved in Multiple Myeloma

The U.S. Food and Drug Administration has granted accelerated approval for daratumumab (Darzalex) to treat patients with multiple myeloma who have received at least three prior treatments, including a proteasome inhibitor and an immunomodulatory agent, or who are double-refractory to a proteasome...

issues in oncology

A Selfless Act

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,...

Cancer Cured My Life

The following essay by Richard M. Levine, MD, is adapted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which is coedited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and the bigcasino.org. I’m a...

solid tumors

Engaging Clinicians in the Collection of Cancer Registry Data to Improve Clinical Research

In June, the Commission on Cancer of the American College of Surgeons published a revision of its Facility Oncology Registry Data Standards (FORDS) manual, which contains all the data items, codes, and rules to abstract data into cancer registries at the more than 1,500 Commission on...

sarcoma

Trabectedin in Unresectable or Metastatic Liposarcoma or Leiomyosarcoma

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 October 23, 2015, trabectedin (Yondelis) was approved for the...

breast cancer
issues in oncology

Diet and Cancer: How Will We Make Progress?

Not only is breast cancer among the most common cancers in women, but it is also one of the most common causes of premature death. Rates of death from the disease vary widely around the world, reflecting variations in risk, screening, and access to highest quality treatment. Although female gender...

breast cancer

Mediterranean Diet Supplemented With Extra-Virgin Olive Oil Reduces Risk for Invasive Breast Cancer

As reported in JAMA Internal Medicine by Estefania Toledo, MD, MPH, PhD, and colleagues, a large Spanish primary prevention nutrition intervention trial in patients at high cardiovascular risk (PREDIMED) showed a large reduction in the risk for invasive breast cancer among women 60 to 80 years of...

The X-Ray Era: 1901–1915

A Century of Progress The text and photographs on this page are excerpted from a four-volume series of books titled Oncology Tumors & Treatment: A Photographic History, by Stanley B. Burns, MD, FACS. The photos below are from the volume titled “The X-ray Era: 1901–1915.” To view additional...

lung cancer

Checkmate 057: Nivolumab Improves Survival vs Docetaxel  in Advanced Nonsquamous Non–Small Cell Lung Cancer

In the phase III CheckMate 057 trial, reported in The New England Journal of Medicine by Hossein Borghaei, DO, of Fox Chase Cancer Center, and colleagues, the programmed cell death protein 1 (PD-1) inhibitor nivolumab (Opdivo) improved overall survival vs docetaxel in patients with advanced...

A Shrink Tells the Inside Story of Psychiatry

Bookmark Title: Shrinks: The Untold Story of PsychiatryAuthor:   Jeffrey A. Lieberman, MD, with Ogi OgasPublisher: Little, Brown and CompanyPublication date: March 10, 2015Price: $28.00, hardcover; 352 pages Jeffrey A. Lieberman, MD, is the Lawrence C. Kolb Professor and Chairman of Psychiatry at...

solid tumors
kidney cancer

Changing Landscape in the Treatment of Metastatic Renal Cell Carcinoma: Findings With Nivolumab and Cabozantinib

In the October 25 issue of The ASCO Post, we presented two important studies in previously treated advanced renal cell carcinoma, including the paper by Motzer et al “Nivolumab versus everolimus in advanced renal-cell carcinoma” (CheckMate 025), published in The New England Journal of Medicine,...

lung cancer

Updated Guidelines for Treating Stage IV NSCLC: Trying to Keep Up

In late August 2015, Gregory A. Masters, MD, and colleagues published an update to the ASCO guidelines for systemic therapy for stage IV non–small cell lung cancer (NSCLC), summarized in this issue of The ASCO Post.1 This builds on the full guidelines published in 20092 and the additional switch...

How QOPI® Is Improving Oncology Care

Launched in 2002 as a pilot program to promote excellence in oncology care, the origins of ASCO’s Quality Oncology Practice Initiative (QOPI®) date as far back as 1997, when the Institute of Medicine (IOM) created a National Cancer Policy Board to assess the state of cancer care in the United...

breast cancer

Accelerated Partial-Breast vs Whole-Breast Irradiation After Surgery for Early Breast Cancer

As reported in The Lancet by Vratislav Strnad, MD, of University Hospital Erlangen, Germany, and colleagues, 5-year results of a phase III noninferiority trial showed no difference in local relapse, disease-free survival, or overall survival with adjuvant accelerated partial breast irradiation...

skin cancer

Talimogene Laherparepvec for Treatment of Unresectable Cutaneous, Subcutaneous, and Nodal Melanoma Lesions

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 October 27, 2015, talimogene laherparepvec (Imlygic) was...

skin cancer

Ipilimumab in Adjuvant Treatment of Cutaneous Melanoma With Nodal Involvement

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 October 28, 2015, ipilimumab (Yervoy) was approved for adjuvant ...

hematologic malignancies

The State of Progress in Hematologic Malignancies

The number of targeted therapies approved by the U.S. Food and Drug Administration (FDA) in the treatment of a variety of cancers, especially hematologic malignancies, continues to rise. In 2014 alone, 4 of the 10 new agents directed at discrete molecular targets approved by the FDA were for blood...

solid tumors
colorectal cancer

Oncologists Encouraged to Learn More About Lesser-Known Heritable Gastrointestinal Cancers

The genetic basis for inherited colorectal cancer is proving to be a much bigger and more complicated “pie” than was appreciated just a few years ago, according to Michael Hall, MD, Director of Gastrointestinal Risk Assessment at Fox Chase Cancer Center, Philadelphia. “With next-generation...

cns cancers

Actionable Targets Identified in Brain Metastases

New research shows that paired primary tumor and brain metastases share a common ancestor, but as the metastases develop in the brain, they exhibit novel genetic alterations that can activate a number of signaling pathways. More than half of the mutations represent potential therapeutic targets....

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