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Showing 1701 - 1750Routine 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: Hisham Mehanna, PhD
Formal discussant Hisham Mehanna, PhD, Chief of Head and Neck Surgery and Director of Head and Neck Studies and Education at the University of Birmingham, United Kingdom, congratulated Dr. D’Cruz on conducting an ambitious and difficult trial. “Like all studies, it has flaws, but the study has...
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 ...
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...
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...
Expert Point of View: Anees B. Chagpar, MD
“This is an important study. We’ve known for some time that the aromatase inhibitors tend to be better than tamoxifen for postmenopausal women with hormonally sensitive invasive breast cancer. The NSABP B-35 trial asked the same question in ductal carcinoma in situ. These data, which now follow...
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...
Expert Point of View: Wendy Stock, MD
Wendy Stock, MD, of the University of Chicago, was the formal discussant of these three studies presented at the 2015 ASCO Annual Meeting. Commenting on the first study on acute myeloid leukemia (AML) by Dr. Gerber and colleagues, she said, “This work can improve understanding of the leukemia stem...
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...
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...
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: 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...
Obinutuzumab Moves Into Lymphoma Treatment
The addition of obinutuzumab (Gazyva) to standard bendamustine (Treanda) chemotherapy followed by obinutuzumab maintenance therapy delays the progression of indolent non-Hodgkin lymphoma (NHL), almost doubling progression-free survival in rituximab (Rituxan)-refractory patients, according to the...
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...
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...
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...
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 ...
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...
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,...
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...
Expert Point of View: Michael F. Greene, MD, and Dan L. Longo, MD
In an accompanying editorial in The New England Journal of Medicine, Michael F. Greene, MD, Chief of Obstetrics at Massachusetts General Hospital, and Dan L. Longo, MD, Professor of Medicine at Harvard Medical School and Dana-Farber Cancer Institute, mentioned the low odds for both oncologists and...
Chemotherapy/Radiotherapy Safe in Second and Third Trimesters of Pregnancy
Children with in utero exposure to chemotherapy and/or radiation therapy during maternal treatment for cancer had no impairment in cognition, cardiac function, and general early childhood development, according to a study reported at the European Cancer Congress in Vienna, Austria, and published...
Expert Point of View: Luis Paz-Ares, MD
This is the first time we have seen data from the BIRCH trial in these three different cohorts using biomarker expression on tumor cells and immune cells,” said formal discussant Luis Paz-Ares, MD, Professor Medicine at the Hospital Universitario 12 de Octubre, Madrid, Spain. “BIRCH confirms the...
Atezolizumab Makes Inroads in Non–Small Cell Lung Cancer
The anti–PD-L1 (programmed cell death-ligand 1) antibody atezolizumab (formerly known as MPDL3280A) achieved encouraging outcomes in patients with non–small lung cancer (NSCLC) in two different trials: POPLAR1 and BIRCH.2 PD-L1 has emerged as a predictive biomarker for atezolizumab response in both ...
Expert Point of View: Cora N. Sternberg, MD, FACP
Cora N. Sternberg, MD, FACP, Chief of Medical Oncology at San Camillo Forlanini Hospital, Rome, Italy, discussed the implications of the METEOR trial. Everolimus (Afinitor) is considered standard second-line therapy, with a benchmark progression-free survival of 4.9 months in the RECORD-1 trial,...
Phase III METEOR Trial Finds Cabozantinib Improves Progression-Free Survival vs Everolimus in Advanced Renal Cell Carcinoma
Cabozantinib (Cometriq) nearly doubled progression-free survival compared with standard everolimus (Afinitor) therapy in patients with advanced renal cell carcinoma, according to the phase III METEOR trial.1 Additionally, a preplanned interim analysis found an encouraging trend toward overall...
Expert Point of View: Frederic Amant, MD, PhD
Frederic Amant, MD, PhD, Assistant Professor, Staff Gynecologic Oncologist, and Head of the Scientific Section of Gynecologic Oncology at University Hospitals Leuven in Leuven, Belgium, stressed that the study by Lambertini et al is a meta-analysis, not a randomized controlled trial. Nevertheless,...
Ovarian Suppression During Chemotherapy Preserves Fertility in Young Women With Breast Cancer
Several studies have addressed the risks and benefits of ovarian suppression during chemotherapy for breast cancer in women of childbearing age. A new meta-analysis of randomized trials found that it prevented premature ovarian failure and was associated with a higher number of pregnancies post...
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 ...
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 ...
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...
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...
Expert Point of View: Brian D. Kavanagh, MD, MPH, FASTRO, and Zain A. Husain, MD
You don’t need high-tech interventions to prove value. Sometimes we can use a medication that has been around a long time,” declared press conference moderator Brian D. Kavanagh, MD, MPH, FASTRO, of the University of Colorado, Anschutz Medical Campus, Denver. “It is better to prevent the problem of ...
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...
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...
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...
Expert Point of View: Peter Naredi, MD, and Michael Brada, MD
Peter Naredi, MD, European CanCer Organization (ECCO) Scientific Co-Chair of the Congress, stated in a press release: “In my view, Dr. Brastianos and colleagues very elegantly show what we mean with precision medicine, how genetic profiling can support our understanding of the metastatic process,...
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....
Expert Point of View: Vincent Grégoire, MD, PhD
I am actually not comfortable discussing this analysis,” said formal discussant Vincent Grégoire, MD, PhD, of the Department of Radiation Oncology, St-Luc University Hospital, Brussels, Belgium. “Instead of me you need a biostatistician. Nevertheless, I will try to address the study.” “The study...
Lenvatinib in Refractory Thyroid Cancer: Survival Benefit or Not?
In the original phase III SELECT trial, no overall survival benefit was observed for lenvatinib (Lenvima) vs placebo in progressive radioactive iodine–refractory differentiated thyroid cancer. Overall survival was a secondary endpoint in that trial. However, in an updated analysis of SELECT, which...
Quick Takes From ECC 2015 Include New Data in Melanoma, Prostate and Breast Cancers, and Renal Cell Carcinoma
The 2015 European Cancer Congress (ECC), held recently in Vienna, represented the combined efforts of the European Cancer Organisation (ECCO), the European Society for Medical Oncology (ESMO), and other partner organisations, constituting the largest European platform for oncology education. At...
Expert Point of View: Paul M. Busse, MD, PhD
HPV-associated oropharyngeal cancer is becoming more and more prevalent. This is a ‘different beast’—distinct from the squamous cell carcinomas of the tonsil and tongue that arise from standard risk factors of tobacco and alcohol. Patients without a smoking history have an 85% to 90% cure rate,...
Evidence Mounts for Less-Intense Chemoradiation Therapy for Low-Risk Oropharyngeal Cancer
A new study shows that deintensification of chemoradiation therapy translates to excellent pathologic complete response rates in low-risk human papillomavirus (HPV)-associated oropharyngeal cancer.1 Patient-reported outcomes showed that side effects declined after 8 weeks. The hope is that these...
Expert Point of View: Anita Mahajan, MD
This study pushes the envelope of how to use our therapies to give the most benefit to patients we otherwise wouldn’t be treating: in this case, children under the age of 3. This age group has historically been a ‘no man’s land.’ Now we see we can treat children as young as 1 year,” said Anita...
Study Lowers the Age Bar for Radiation in Children With Ependymoma
The good news is that children as young as 1 year old with the aggressive brain tumor ependymoma can be treated safely and effectively with immediate postoperative radiation therapy, according to the results of a trial presented at the 2015 ASTRO Annual Meeting.1 “Ependymoma is the third most...
Expert Point of View: David Beyer, MD
In an interview with The ASCO Post, incoming ASTRO President David Beyer, MD, provided his perspective on the use of hypofractionation in prostate cancer. Dr. Beyer is Medical Director of the Cancer Centers of Northern Arizona in Sedona. “Fractionation has been an important topic over the past few...
Hypofractionated Radiotherapy Makes Inroads as Primary Treatment of Prostate Cancer
Several studies presented at the 2015 ASTRO Annual Meeting explored the use of hypofractionation (delivering higher doses of radiation in fewer fractions) in the treatment of patients with prostate cancer. These studies found comparable outcomes in terms of efficacy and adverse events. Although...
Genomic Test Identifies Patients With Prostate Cancer in Need of Intensified Salvage Therapy
Prostate cancer has been slow to catch up with breast cancer in terms of using biomarkers, but a new study represents progress in this regard. A genomic classifier called Decipher® provides important information that can be used to make treatment decisions for men with prostate cancer and a rising...
Expert Point of View: Martine Piccart, MD, PhD
Martine Piccart, MD, PhD, Professor of Oncology at the Université Libre de Bruxelles, Belgium, and President of the European Cancer Organisation, said she found it “distressing” to see such large variations in 5-year survival across European countries. “I would like to stress the fact that these...
Cancer Survival Improves in Europe, With Wide Regional Variations
EUROCARE-5, the latest in a series of comprehensive reports on the state of cancer survival in Europe, shows an improvement in 5-year survival from 1998 to 2007, with large variations among regions of Europe, according to a presentation at the European Cancer Congress.1 Furthermore, although 5-year ...
