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Showing 1751 - 1800Telotristat Ethyl: A Novel Therapy for Carcinoid Syndrome—Not a Panacea but a Step in the Right Direction
The multihumoral manifestations of neuroendocrine tumors include diarrhea, cutaneous flushing, wheezing, and right-sided valvular heart disease.1 Serotonin, a biogenic amine and product of tryptophan metabolism,2 mediates several of these symptoms.3,4 Diarrhea is a cardinal and often disabling...
Liquid Biopsies Show Promise in Diffuse Large B-Cell Lymphoma
Technologic advances for detecting and analyzing cell-free circulating tumor DNA (ctDNA) from peripheral blood offer a precision method for monitoring diffuse large B-cell lymphoma (DLBCL). Although most patients with DLBCL are cured with initial therapy, those who are not cured have a poor...
Circulating Tumor DNA Profiling Identifies Clonal Evolution Patterns and Permits Classification of Tumor Subtypes in DLBCL
In a study reported in Science Translational Medicine, Florian Scherer, MD, David M. Kurtz, MD (Conquer Cancer Foundation Young Investigator), Aaron M. Newman, PhD, and colleagues from Stanford University found that analysis of circulating tumor DNA (ctDNA) permits identification of patterns of...
Expert Point of View: Fiona Blackhall, PhD, FRCP
“There has undoubtedly been extremely rapid progress made in establishing effective therapies for anaplastic lymphoma kinase (ALK)-positive non–small cell lung cancer (NSCLC) patients in less than a decade,” said Fiona Blackhall, PhD, FRCP, Chair of Thoracic Oncology and medical oncologist at the...
Adding Antiandrogen Therapy to Radiation Therapy in Recurrent Prostate Cancer
As reported in The New England Journal of Medicine by Shipley et al in the NRG Oncology Radiation Therapy Oncology Group (RTOG), the final analysis of the phase III RTOG 9601 trial showed that the addition of antiandrogen therapy with bicalutamide to radiation therapy significantly improves overall ...
Veliparib Improves Reponse but Not Progression-Free Survival in BRCA-Mutation Carriers
A randomized phase II study in women with metastatic breast cancer who have mutations in BRCA1 or BRCA2 evaluated the addition of the poly (ADP-ribose) polymerase (PARP) inhibitor veliparib to combination chemotherapy. The trial did not meet its primary endpoint.1 Hyo Sook Han, MD, of Moffitt...
Tumor-Infiltrating Lymphocytes Prognostic in the Metastatic and Neoadjuvant Breast Cancer Settings
Studies presented at the 2016 San Antonio Breast Cancer Symposium added to growing evidence that tumor-infiltrating lymphocytes are important prognostic factors in breast cancer. One investigation evaluated their impact in advanced HER2-positive breast cancer, finding a linear relationship between...
What Have We Got to Lose?
Tuesday morning was the regular time for the departmental meeting—an opportunity to discuss cases, troubleshoot, debrief, and expedite the necessary allied health referrals. As usual, patient cases were being discussed in alphabetical order of the attending oncologist. We were already three...
Vitamin D and Cancer: A Uniform Dose Is Unlikely to Fit All Patients
Technically, vitamin D is a secosteroid hormone, not a vitamin. Increasing evidence indicates that vitamin D exerts effects beyond calcium homeostasis. Importantly, for example, higher serum vitamin D levels are associated with better cancer outcomes, including survival.1-3 The protective effects...
Addressing Discrimination and Bias in Medical Education
“As a medical student, I often felt marginalized from my medical community. I have been told that my name is ‘not American,’ fallen prey to being confused for support staff such as a janitor (even while wearing my white coat) and been asked questions like, ‘Where are you really from?’ or ‘How old...
PARP Inhibitor Niraparib Yields ‘Unprecedented’ Results in Ovarian Cancer in Phase III Trial
The first phase III trial of an inhibitor of poly (ADP-ribose) polymerase (PARP) yielded unprecedented results in treating ovarian cancer. The trial was presented at the European Society for Medical Oncology (ESMO) in Copenhagen, Denmark, and electronically reported concurrently in The New England ...
Niraparib Maintenance Improves Progression-Free Survival in Platinum-Sensitive Recurrent Ovarian Cancer
In a phase III trial (ENGOT-OV16/NOVA) reported at the 2016 ESMO (European Society for Medical Oncology) Congress and in The New England Journal of Medicine by Mansoor R. Mirza, MD, of the Rigshospitalet–Copenhagen University Hospital, and colleagues, maintenance therapy with the PARP (poly...
Diamonds Are Forever, Tyrosine Kinase Inhibitors Are Not?
Sir Donald Munger: “You have been on holiday, I understand. Relaxing, I hope?” James Bond: “Oh, hardly relaxing, but most satisfying.” (Diamonds Are Forever) As tyrosine kinase inhibitors became the mainstay of therapy for patients with chronic myeloid leukemia (CML), our assumption has been that...
Falls in Older Patients With Cancer: Recognizing and Reducing the Risk
In older patients, a current or previous cancer diagnosis confers a 15% to 20% greater risk of suffering a fall.1 Defined as an “unexpected event in which the participant comes to rest on the ground, floor, or lower level,” a fall occurs in 30% to 50% of cancer patients 65 years of age or...
Nivolumab in Squamous Cell Carcinoma of the Head and Neck in CheckMate 141: Game Not Over
Most patients with squamous cell carcinoma of the head and neck present with locally advanced disease. With combined-modality approaches, the chance of cure ranges from < 50% to up to 80%, depending on the site, stage, and other risk factors, such as human papillomavirus (HPV) status. When...
Nivolumab Improves Overall Survival in Recurrent Platinum-Refractory Squamous Cell Carcinoma of the Head and Neck
In the phase III CheckMate 141 trial reported in The New England Journal of Medicine, Robert L. Ferris, MD, PhD, of the University of Pittsburgh Medical Center and Cancer Institute, and colleagues found that nivolumab (Opdivo) increased overall survival vs standard therapies in patients with...
Optimizing Access to Fertility Preservation Options
Ensuring that people with cancer understand how cancer treatment could affect their fertility and what options are available for preserving fertility were widely recognized as top priorities by attendees of the 2016 Oncofertility Conference in Chicago. As detailed at the conference, means of...
Expert Point of View: Philip McCarthy, MD
The ASCO Post asked Philip McCarthy, MD, Professor of Oncology and Internal Medicine at Roswell Park Cancer, Buffalo, and Director of the Blood and Marrow Transplant Center there, to comment on these study findings. He first addressed the need to study earlier intervention for smoldering ...
High Response Rates to Triplet Therapy in Smoldering Myeloma
High-risk patients with smoldering multiple myeloma responded to a regimen of elotuzumab (Empliciti), lenalidomide (Revlimid), and dexamethasone, in a multicenter phase II study led by Irene Ghobrial, MD, of Dana-Farber Cancer Institute, Boston.1 “The high response rates among this patient...
Pertuzumab, Trastuzumab, Plus Aromatase Inhibitor Beneficial in Metastatic Breast Cancer
In the phase II PERTAIN study of locally advanced or metastatic hormone receptor–positive, HER2-positive breast cancer patients, the addition of pertuzumab (Perjeta) to a regimen of trastuzumab (Herceptin) and an aromatase inhibitor in the first-line setting significantly improved progression-free ...
Osimertinib Significantly Improves Survival for Patients With Non–Small Cell Lung Cancer
For patients with epidermal growth factor receptor (EGFR) T790M–positive non–small cell lung cancer (NSCLC), osimertinib (Tagrisso) demonstrated clinically superior efficacy over pemetrexed (Alimta) plus a platinum agent, with a 70% reduction in the risk of disease progression, according to the...
What Precisely Is Precision Oncology—and Will It Work?
We know from chaos theory that even if you had a perfect model of the world, you’d need infinite precision in order to predict future events. —Nassim Nicholas Taleb The term “precision oncology” is used to describe diverse strategies in cancer medicine ranging from the use of targeted therapies...
Lu-177 Dotatate Improves Progression-Free Survival in Midgut Neuroendocrine Tumors
In a phase III trial (NETTER-1) reported in The New England Journal of Medicine, Strosberg et al found that the addition of the targeted radiotherapeutic agent lutetium Lu-177 dotatate to octreotide long-acting repeatable (LAR) (Sandostatin LAR) significantly improved progression-free...
Fear of Diagnostic Low-Dose Radiation Exposure May Be Overstated, Experts Assert
In an article published by Siegel et al in The Journal of Nuclear Medicine, researchers assert that exposure to medical radiation does not increase a person’s risk of getting cancer. The long-held belief that even low doses of radiation, such as those received in diagnostic imaging, increase...
Case Report of Regression of Glioblastoma After Chimeric Antigen Receptor T-Cell Therapy
In a brief report in The New England Journal of Medicine, Brown et al described regression of glioblastoma after chimeric antigen receptor (CAR) T-cell therapy. A 50-year-old patient with recurrent multifocal glioblastoma after tumor resection, radiation therapy, and temozolomide was treated with...
Colonoscopy Screening in Older Adults
A large population-based observational study by Xabier García-Albéniz, MD, PhD, of the Harvard T.H. Chan School of Public Health, and colleagues evaluating the effectiveness and safety of screening colonoscopy for the prevention of colorectal cancer in people aged 70 to 74 and 75 to 79 has found...
Study Suggests No Evidence for Screening Mammography Cutoff Age
An analysis of data from nearly 6 million screening mammograms found no evidence for a clear cutoff age to stop breast cancer screening. Screening mammography among women aged 75 years was associated with higher cancer detection and lower recall rates than among younger women in the study. These...
Co-occurrence of Cancer and Cognitive Impairment in Older Adults
The prevalence of both cancer and cognitive impairment increases with age.1-3 Based upon Surveillance, Epidemiology, and End Results (SEER)-Medicare studies, it is estimated that 3% to 7% of patients with cancer aged ≥ 65 also suffer from dementia, although the true prevalence of dementia in this...
Mutational Characteristics of Chemotherapy-Treated Bladder Urothelial Neoplasms
Radical cystectomy with urinary diversion is the standard of care for muscle invasive bladder cancer.1 Meta-analyses of prospective data have shown a 5% overall survival benefit at 5 years for those receiving neoadjuvant systemic chemotherapy prior to cystectomy.2,3 We currently know of two...
Confirmation or Transformation? The Case of Palbociclib in Hormone Receptor–Positive Metastatic Breast Cancer
Women with hormone receptor–positive metastatic breast cancer are witnessing an unprecedented time of success in the battle against their disease. Just in the past 12 months, a number of prospective, randomized, phase III studies were reported, with positive results indicating the value of...
Addition of Palbociclib to Letrozole in Previously Untreated Advanced Estrogen Receptor–Positive, HER2-Negative Breast Cancer
In the phase III PALOMA-2 trial reported in The New England Journal of Medicine, Richard S. Finn, MD, of the David Geffen School of Medicine at the University of California, Los Angeles, and colleagues found that the addition of palbociclib (Ibrance) to letrozole significantly improved...
Expert Point of View: Sergio A. Giralt, MD
Sergio A. Giralt, MD, Chief of the Adult Bone Marrow Transplant Service at Memorial Sloan Kettering Cancer Center, New York, and the Melvin Berlin Family Chair in Multiple Myeloma, commented on the findings of the StaMINA trial for The ASCO Post. He said the results of the largest randomized U.S....
Women in Oncology: Breaking Down Barriers and Looking to the Future
There has been no better time than the present for women in the field of oncology: Women at all stages of their careers are finding more opportunities and avenues to excel. At the time of the last ASCO workforce survey, women made up 28.4% of the oncologist workforce, and that proportion is rising...
T-Cell Transfer Therapy Targets Mutant KRAS in Metastatic Colorectal Cancer
In a case report in The New England Journal of Medicine, Tran et al at the National Cancer Institute describe response to adoptive transfer of ex vivo expanded tumor-infiltrating lymphocytes containing T cells targeting personalized cancer neoepitopes in a patient with lung metastases from...
Osimertinib Improves Progression-Free Survival vs Platinum/Pemetrexed in EGFR T790M–Positive NSCLC
In the phase III AURA3 trial reported in The New England Journal of Medicineby Mok et al, osimertinib (Tagrisso) significantly improved progression-free survival (PFS) vs platinum/pemetrexed (Alimta) among patients with epidermal growth factor receptor (EGFR) T790M–positive non–small...
Expect Questions About Cardiovascular Risk Factors Among Cancer Survivors
Reports of rare, but in some cases fatal, cardiac complications when the checkpoint inhibitors ipilimumab (Yervoy) and nivolumab (Opdivo) are used in combination should be taken seriously but should not scare patients away from potentially life-saving drugs, according to Javid J. Moslehi, MD. Dr....
Cardiac Complications in Patients Receiving Combination Checkpoint Inhibitors Are Rare but Can Be Fatal
Cardiovascular toxicities associated with cancer treatments are not new. What is new, and what has prompted recent articles in The New England Journal of Medicine,1,2 is the explosion of cancer therapies, which has dramatically changed the natural course of many cancers but can lead to cardiac,...
Valerian
Scientific Names: Valeriana officinalis, Valeriana radix Common Names: Garden valerian, Indian valerian, Pacific valerian, garden heliotrope Overview A perennial flowering plant prevalent in Europe, Asia, and North America, valerian has a long medicinal history as a relaxant. Its potential as a...
Approval of Dinutuximab for High-Risk Neuroblastoma: Lessons Learned in Expediting the Development of Pediatric Cancer Drugs
On March 10, 2015, the U.S. Food and Drug Administration (FDA) granted regular approval to dinutuximab (formerly known as chimeric 14.18 antibody; Unituxin) for use in combination with granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin-2 (IL-2), and 13-cis-retinoic acid...
Faculty Development in Oncology: Advancing the Field by Optimizing Opportunities for Educators to Learn and Grow
In 2015, Janet Riddle, MD, and her colleagues published an article1 outlining 12 key themes for delineating how fellowship programs in medical education should be developed (See “12 Tips for Developing Successful Fellowship Programs for Medical Educators,” below.) The ASCO Post talked with Dr....
Precautions in Cancer Rehabilitation Services: Imperative or Impediment in Patient Care?
GUEST EDITOR Physiatry in Oncology explores the benefits of cancer rehabilitation in oncology practice to screen survivors for physical and cognitive impairments along the care continuum to minimize survivors’ disability and maximize their quality of life. The column is guest edited by Sean Smith, ...
What’s New in Antiemesis Therapy
The optimal use of new antiemetics was the subject of a presentation at the 14th Annual School of Breast Oncology, Emory University, Atlanta, by Frankie Ann Holmes, MD, Associate Director of Breast Oncology Research at Texas Oncology, Houston. “The science of nausea and vomiting is so compelling,...
Treatment of Early HER2-Positive Breast Cancer: One Size Does Not Fit All
Despite the routine use of HER2 blockade in early HER2-positive breast cancer, clinicians can always benefit from a refresher on key treatment considerations. Clinical pearls and controversial issues were the topic of a presentation at the 14th Annual School of Breast Oncology at Emory University, ...
Daratumumab in Previously Treated Multiple Myeloma
On November 21, 2016, daratumumab (Darzalex) was approved for use in combination with lenalidomide (Revlimid) and dexamethasone or with bortezomib (Velcade) and dexamethasone for the treatment of patients with multiple myeloma who have received at least one prior therapy.1,2 The drug was initially ...
New Treatments for Lung Cancer in 2016
With drug approvals for immunotherapy in the first- and second-line settings, breakthroughs in targeting epidermal growth factor receptor (EGFR) mutations, and the rapid evolution of therapies that target anaplastic lymphoma kinase (ALK) rearrangements, 2016 has been an extraordinary year for lung...
NCI Study Affirms There Is No Safe Level of Smoking
People who consistently smoked an average of less than 1 cigarette per day over their lifetime had a 64% higher risk of earlier death than never-smokers, and those who smoked between 1 and 10 cigarettes a day had an 87% higher risk of earlier death than never-smokers, according to a new study from...
Nivolumab in Recurrent or Metastatic Squamous Cell Carcinoma of the Head and Neck
On November 10, 2016, nivolumab (Opdivo) was approved for treatment of recurrent or metastatic squamous cell carcinoma of the head and neck with disease progression on or after platinum-based therapy.1,2 Supporting Efficacy Data Approval was based on the finding of an overall survival advantage...
Mutanome-Directed Immunotherapy: Finding the Best Treatment Match
Oncologists may be accustomed to looking for commonalities in patients, but highly personalized therapies are now being developed based on mutational analysis of tumors. According to data presented at the Cedars-Sinai annual symposium on New Therapeutics in Oncology: The Road to Personalized...
FDA Approves Daratumumab in Combination Therapy for Patients With Multiple Myeloma Receiving at Least One Prior Treatment
On November 21, 2016, the U.S. Food and Drug Administration (FDA) approved daratumumab (Darzalex) in combination with lenalidomide (Revlimid) and dexamethasone or bortezomib (Velcade) and dexamethasone for the treatment of patients with multiple myeloma who have received at least one prior...
Sleep Disruption in Cancer Survivors: Yoga Offers a Low-Risk Intervention With High Potential for Benefit
Impaired sleep quality is a concerning problem for many patients with cancer, and pharmacologic treatments come with many negative effects. Several small studies indicate that yoga improves persistent fatigue, sleep disturbance, anxiety, and quality of life, in addition to reducing the need for ...
