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Showing 1751 - 1800Expert Point of View: Chemotherapy Generally Safe in Pregnancy
Chemotherapy delivered in the first trimester is associated with a 10% to 30% risk of abortion and 10% to 25% risk of malformations. Therefore, it should be postponed until the second or third trimester, when most regimens appear to be safe, according to Nicholas Pavlidis, MD, of the University of...
Chemotherapy Generally Safe in Pregnancy
The diagnosis of cancer in a pregnant woman causes concerns for both the mother and her unborn child. But studies suggest that most chemotherapy regimens can be delivered with reasonable safety after the first trimester. Cancer is diagnosed in about 1 per 1,000 to 2,000 pregnancies, mostly breast...
Biosimilars in Cancer Treatment: What Should the Oncology Community Expect?
Alternative versions of biologic agents, ie, “biosimilars,” will presumably be getting the green light by the FDA, giving oncologists more choices for treatments that come at lower costs to patients and society. The FDA plans to issue its guidance on biosimilars by the end of this year, paving the...
Global Trials: Do Benefits Outweigh Pitfalls?
Global clinical trials have many advantages and are essential in many disease settings, but there are also challenges that confront global industry-sponsored research, said Sandra Horning, MD, Senior Vice President and Global Head of Clinical Development in Hematology/Oncology for Genentech (Table...
Predictive Biomarker for Bevacizumab: Are We Getting Closer?
The need to identify a biomarker to guide treatment with bevacizumab (Avastin) is abundantly clear, and studies presented at the 2011 European Multidisciplinary Cancer Congress suggest this goal may be in sight. “Finding predictive biomarkers is a challenge, but there are candidates,” said Eric Van ...
Expert Point of View: Novel HDAC Inhibitor May Restore Estrogen Sensitivity in Breast Cancer
Joyce O’Shaughnessy, MD, of Baylor Sammons Cancer Center in Dallas, who moderated the symposium where the results were presented, called the use of entinostat in advanced estrogen receptor–positive breast cancer “very, very promising.” She added, “I agree that it’s time for a phase III trial of...
Novel HDAC Inhibitor May Restore Estrogen Sensitivity in Breast Cancer
The addition of the investigational histone deacetylase (HDAC) inhibitor entinostat significantly delayed breast cancer progression and showed a trend for a survival benefit in the phase II ENCORE 301 study. The study was conducted in women with advanced estrogen receptor–positive breast cancer...
Expert Point of View: Aflibercept Improves Overall Survival in Patients with Metastatic Colorectal Cancer
David Kerr, MD, of the University of Oxford, United Kingdom, who is also President of the European Society of Medical Oncology, formally discussed the study, which he called “well designed and well conducted.” He applauded the investigators for performing a preplanned subgroup analysis with a...
Aflibercept Improves Overall Survival in Patients with Metastatic Colorectal Cancer
The novel fusion protein aflibercept added to standard chemotherapy led to an overall survival benefit in a global phase III trial of second-line metastatic colorectal cancer, reported at the 2011 European Multidisciplinary Cancer Congress in Stockholm.1 “Adding aflibercept to FOLFIRI [leucovorin,...
SIDEBAR: Patient Advocates Form Huge Presence at EMCC 2011
Patient advocate and two-time breast cancer survivor Kathi Apostolidis from Greece spoke at a session on patients’ and physicians’ use of social media. “Social media is not a fad. It has real value,” she said. She uses social media to connect with oncologists and policymakers across the globe, and...
Twitter Dominates Social Media Buzz at Stockholm Meeting
There was a time when clinical trial results were disseminated mainly through peer-reviewed journals that appeared in your mailbox. Computers and prompt reporting from medical conferences changed that, and same-day postings on medical websites brought “breaking news” a step closer. But the...
Neutrophil/Lymphocyte Ratio Can Upstage Patients with Bladder Cancer
A sizable proportion of bladder cancer patients who would benefit from neoadjuvant chemotherapy are not receiving it, researchers from the University of Wisconsin School of Medicine and Public Health, Madison, concluded. Their conclusion was based on their assessment of the neutrophil/lymphocyte...
Expert Point of View: Benefit of Panitumumab Seen Primarily in Patients with Recurrent or Metastatic Head and Neck Cancer and HPV-negative Tumors
Discussing the presentation, Jean Bourhis, MD, PhD, of the Institut Gustave Roussy in Villejuif, France, said that while HPV has become a major prognostic factor in locally advanced head and neck cancer, its prognostic value in recurrent and metastatic disease is less clear. “The role of HPV in...
Benefit of Panitumumab Seen Primarily in Patients with Recurrent or Metastatic Head and Neck Cancer and HPV-negative Tumors
The addition of panitumumab (Vectibix) to chemotherapy improved overall and progression-free survival in patients with recurrent or metastatic squamous cell carcinoma of the head and neck, but its benefit was limited to patients whose tumors were negative for the human papillomavirus (HPV).1 The...
Important Briefs from the 2011 European Multidisciplinary Cancer Congress
Nearly 16,000 people from 16 countries attended this year’s European Multidisciplinary Cancer Congress, held recently in Stockholm. The ASCO Post has featured several key reports from the meeting and will offer further coverage in upcoming issues. Additional noteworthy studies presented at the...
Optimizing HER2-directed Therapy in the Clinic
Seminal research in the treatment of HER2-positive breast cancer has been led by Edith A. Perez, MD, the Serene M. and Frances C. Durling Professor of Medicine at the Mayo Clinic, Jacksonville, Florida. The ASCO Post asked Dr. Perez to share her approach to HER2-directed therapy. Testing...
Breast Cancer Experts Voice Opinion and Express ‘Disappointment’ over FDA Decision
Gabriel N. Hortobagyi, MD, Chair of Medical Breast Oncology at The University of Texas MD Anderson Cancer Center, Houston, said he was “disappointed but not surprised” at the FDA decision to withdraw the bevacizumab (Avastin) indication in breast cancer. “Once the FDA put this in the hands of ODAC, ...
The Newly Diagnosed Patient with Cancer and Access to Care
A study presented at the 2011 ASCO Annual Meeting raised concerns that newly diagnosed cancer patients are having trouble seeing an oncologist. Interviews with several cancer centers and community practices, however, suggest that the process runs smoothly, for the most part. Majority of Patients...
Single-agent Lapatinib Arm Discontinued in ALTTO
The Adjuvant Lapatinib and/or Trastuzumab Treatment Optimization (ALTTO) study, which is evaluating various anti-HER2 therapy approaches in breast cancer, has discontinued the single-agent lapatinib (Tykerb) arm, according to study sponsor GlaxoSmithKline. Following a preplanned interim analysis...
Neoadjuvant Chemotherapy or Surgery First: Outcome Not Affected
Chemotherapy can be delivered before breast-conserving therapy or after surgery, without influencing long-term local-regional recurrence, a large study from The University of Texas MD Anderson Cancer Center confirmed. The data were presented at the 2011 Breast Cancer Symposium in San Francisco.1 “A ...
Estrogen for Vulvovaginal Atrophy in Breast Cancer: Debate Continues
Vulvovaginal atrophy is a concern for the majority of patients with breast cancer, not only because of its physical and psychosexual consequences, but because the optimal treatment—estrogen replacement—is controversial. Patients and physicians alike remain concerned that external estradiol may...
Resection of Metastatic Lesions Extends Survival in Multiple Tumor Types
Surgical oncologists urged other cancer providers to appreciate the potentially curative role that surgery can play in the management of many stage IV solid tumors, in a session during the American College of Surgeons 97th Annual Clinical Congress in San Francisco. Pulmonary Metastases Stephen G....
Oncology Research a Strong Presence at the American College of Surgeons Meeting: New Data in Pancreatic, Rectal, Thyroid, and Breast Cancers
Research in cancer staging, surgical procedures, outcomes, and medical treatment was included among the 2,000 abstracts presented at the 97th Annual American College of Surgeons Clinical Congress in San Francisco. The ASCO Post was there to capture the latest findings. Neoadjuvant Chemotherapy in...
Oncologists Examine Promise vs Reality of Personalized Medicine
Personalized medicine: It’s a phrase that reverberates across all cancer meetings. “Matching the right drug to the right patient” will be accomplished, in the not too distant future, through genomic sequencing of the tumor and targeted, less toxic therapy. This much has been established—or has it?...
CancerConnect Offers Online Alternative Networking for Patients
Social networking sites like Facebook and Twitter are rapidly growing, giving patients with cancer a place to connect with others. But an alternative networking website claims to be a more comprehensive, responsible, “commercial-free” alternative. Over 10,000 patients with cancer have registered at ...
Ablation of Small Primary Breast Tumors: The Next Step in Local Therapy?
Local treatment of breast cancer is trending toward less invasive procedures that achieve comparable outcomes to standard interventions. What will the next step along this continuum be? According to Michael S. Sabel, MD, a surgical oncologist at the University of Michigan Comprehensive Cancer...
Expert Point of View: Maintenance Rituximab vs Retreatment Rituximab in Patients with Low–Tumor-Burden Follicular Lymphoma
The findings of RESORT1 have tremendous implications, both clinically and economically, commented Andrew D. Zelenetz, MD, Chief of the Lymphoma Service at Memorial Sloan-Kettering Cancer Center, New York, in an interview. “The maintenance arm received rituximab [Rituxan] every 3 months...
Maintenance Rituximab vs Retreatment Rituximab in Patients with Low–Tumor-Burden Follicular Lymphoma
For patients with low–tumor-burden follicular lymphoma treated upfront with rituximab (Rituxan), retreating upon disease progression was as effective as extended dosing, or maintenance therapy, in a randomized phase III study that compared the approaches.1 Given the excellent outcomes, lack of a...
New Immunomodulatory Drug Produces Impressive Phase II Results in Multiple Myeloma
Data on pomalidomide, the novel oral immunomodulatory drug for multiple myeloma, was a major highlight of the 2011 ASH Annual Meeting, according to Kenneth D. Anderson, MD, of Dana-Farber Cancer Institute, Boston, who called the drug “very, very exciting.” Paul Richardson, MD, also of Dana-Farber...
Expert Point of View: Next-generation Proteasome Inhibitors Will Improve Outcomes in Bortezomib-refractory Myeloma Patients
Myeloma experts agree that the new proteosome inhibitors are particularly welcome because they are at least as effective as bortezomib (Velcade) but produce much less neuropathy. Dramatic Results “The activity of MLN 9708 is very encouraging,” said Paul G. Richardson, MD, of Dana-Farber Cancer...
Next-generation Proteasome Inhibitors Will Improve Outcomes in Bortezomib-refractory Myeloma Patients
The next-generation proteasome inhibitor carfilzomib is expected to gain FDA approval in the near future, offering a treatment option that may be as effective as and less neurotoxic than bortezomib (Velcade). Studies presented at the ASH Annual Meeting upheld benefits of the drug observed in...
Expert Point of View: Monoclonal Antibody Promising in Multiple Myeloma
With a wealth of new agents of various classes in the pipeline, “myeloma is going to become a chronic illness, with sustained complete responses achieved in a significant fraction of patients,” according to Kenneth C. Anderson, MD, of Dana-Farber Cancer Institute and Harvard Medical School, ...
Monoclonal Antibody Promising in Multiple Myeloma
Elotuzumab, a humanized IgG1 monoclonal antibody targeting human CS1, a cell-surface glycoprotein expressed on 95% of myeloma cells, elicited responses in 82% of relapsed/refractory myeloma patients in a phase II study reported at the ASH Annual Meeting.1 Objective response rates exceeded 90% in...
Novel Agent Efficacious in Chronic Lymphocytic Leukemia
A novel inhibitor of B-cell receptor signaling produced high rates of remission and was well tolerated in patients with chronic lymphocytic leukemia (CLL) who were refractory to at least two previous treatments, reported Susan O’Brien, MD, of The University of Texas MD Anderson Cancer Center,...
Expert Point of View: Post-CHOP Radioimmunotherapy Comparable to Rituximab Given along with CHOP in Previously Untreated Follicular Lymphoma
SWOG S0016, which compared treatment with CHOP-R (cyclophosphamide, doxorubicin, vincristine, prednisone, plus rituximab [Rituxan]) and CHOP-RIT (CHOP plus tositumomab/iodine-131 tositumomab [Bexxar]) in patients with follicular lymphoma, was one of the most important studies at the 2011 ASH...
Post-CHOP Radioimmunotherapy Comparable to Rituximab Given along with CHOP in Previously Untreated Follicular Lymphoma
In patients with previously untreated follicular lymphoma, similar outcomes were achieved with CHOP-R (cyclophosphamide, doxorubicin, vincristine, prednisone, plus six doses of rituximab [Rituxan]) and CHOP-RIT (CHOP plus one dose of tositumomab/iodine-131 tositumomab [Bexxar]) in a phase III...
Expert Point of View: Everolimus plus Exemestane Significantly Prolongs Remission in BOLERO-2
Signaling of mammalian target of rapamycin (mTOR) is required for estrogen-induced breast tumor cell proliferation, and hyperactivation of the mTOR pathway is observed in endocrine-resistant breast cancer cells. Clinically, this makes for a rational one-two punch in endocrine-resistant breast...
Everolimus plus Exemestane Significantly Prolongs Remission in BOLERO-2
Adding an inhibitor of mammalian target of rapamycin (mTOR) to an aromatase inhibitor more than doubled the time to disease progression in patients with advanced, treatment-refractory breast cancer in the phase III BOLERO-2 trial, whose updated results were presented at the San Antonio Breast...
Expert Point of View #2: Can Molecular Profiling Identify ER-positive Patients Destined for Relapse?
Understanding the different relapse patterns within estrogen receptor (ER)-positive breast cancer is important for guiding treatment decisions, said Laura Esserman, MD, of the University of California, San Francisco, Medical Center. Women who fall into the two separate categories may have different ...
Expert Point of View: Can Molecular Profiling Identify ER-positive Patients Destined for Relapse?
Eastern Cooperative Oncology Group (ECOG) trials have demonstrated that recurrence patterns are different for estrogen receptor (ER)-positive vs ER-negative breast cancer. While ER-negative disease carries a high risk for early recurrence—peaking around year 1.5 from diagnosis—risk steadily...
Can Molecular Profiling Identify ER-positive Patients Destined for Relapse?
Estrogen receptor (ER)-positive breast cancer often recurs years after the initial diagnosis, and understanding the patterns of timing regarding relapse could identify patients needing more aggressive treatment. At the 2011 San Antonio Breast Cancer Symposium, several investigative teams reported...
Expert Point of View: Benefits of Some Bisphosphonates Confirmed in Breast Cancer Outcomes, but Questions Remain
James Ingle, MD, of the Mayo Clinic, Rochester, Minnesota, formally discussed the ABCSG-12 and ZO-FAST bisphosphonate studies presented at the 2011 San Antonio Breast Cancer Symposium, noting, “There is a lot of interest in the effect of bisphosphonates on the tumor microenvironment and the impact ...
Benefits of Some Bisphosphonates Confirmed in Breast Cancer Outcomes, but Questions Remain
The story of bisphosphonates, and their disease-modifying potential in breast cancer, is still evolving. While some studies presented at the 2011 San Antonio Breast Cancer Symposium failed to show gains, others found benefits. The theme that is emerging is that bisphosphonates may be most...
Expert Point of View: Bevacizumab Progression-free Survival Benefit Upheld in AVEREL Trial
Modest benefit reported from AVEREL1 triggered comments among trialists about the future of bevacizumab (Avastin) in breast cancer. “Although there’s controversy about the recent revoking of FDA approval of bevacizumab for metastatic breast cancer, I think there is a consensus in our disappointment ...
Bevacizumab Progression-free Survival Benefit Upheld in AVEREL Trial
Bevacizumamb (Avastin) added to trastuzumab (Herceptin) and docetaxel as first-line therapy for HER2-positive advanced breast cancer moderately improved progression-free survival in the phase III AVEREL trial, presented at the 2011 San Antonio Breast Cancer Symposium by Luca Gianni, MD, of the San ...
SIDEBAR: Lessons Learned from Other HER2 trials
From studies presented at the San Antonio Breast Cancer Symposium and elsewhere, important observations have emerged that will eventually advance our understanding of HER2-positive disease. According to C. Kent Osborne, MD, of Baylor College of Medicine, Houston, key findings include the following: ...
Expert Point of View: Dual HER2 Blockade Substantially Delays Disease Progression
The availability of effective therapies for HER2-positive tumors has made breast cancer a better managed disease, but outcomes could be further enhanced through the targeting of other players in this pathway, emerging data suggest. C. Kent Osborne, MD, of Baylor College of Medicine, Houston,...
Dual HER2 Blockade Substantially Delays Disease Progression
There is an emerging theme in HER2-positive breast cancer: The greater the pathway inhibition, the better the outcome. The latest evidence comes from the phase III Clinical Evaluation of Pertuzumab and Trastuzumab (CLEOPATRA) trial of 808 patients with previously untreated metastatic disease. The...
Atypical Breast Lesions: How High Is the Cancer Risk?
Women with atypical breast lesions have approximately a 5% to 11% risk of developing breast cancer within 5 years, depending on histology, and this risk can be reduced with chemoprevention, according to a presentation at the 2011 San Antonio Breast Cancer Symposium.1 Investigators tracked the...
Important News Briefs: New Data Reported in Gastric, Colorectal, and Hepatocellular Cancers
Findings presented at the 2012 Gastrointestinal Cancers Symposium will impact the future care of patients with these malignancies. The ASCO Post has summarized some of the most newsworthy data in the following briefs. In the phase III GRANITE-1 trial (n = 656), single-agent treatment with...
