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issues in oncology

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...

breast cancer

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...

breast cancer

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 ...

breast cancer
symptom management

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...

solid tumors

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....

thyroid cancer
pancreatic cancer
colorectal cancer
breast cancer

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...

issues in oncology

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?...

issues in oncology

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 ...

breast cancer

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...

lymphoma

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...

lymphoma

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...

multiple myeloma

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...

multiple myeloma

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...

multiple myeloma

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...

multiple myeloma

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, ...

multiple myeloma

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...

leukemia

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,...

lymphoma

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...

lymphoma

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...

breast cancer

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...

breast cancer

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...

breast cancer

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 ...

breast cancer

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...

breast cancer

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...

breast cancer

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 ...

breast cancer

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...

breast cancer

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 ...

breast cancer

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: ...

breast cancer

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,...

breast cancer

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...

breast cancer

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...

Expert Point of View: Maintenance with Lenalidomide or Bortezomib Prolongs Remission in Elderly Patients with Multiple Myeloma

David S. Siegel, MD, PhD, of the John Theurer Cancer Center at Hackensack University Medical Center in New Jersey, commented to The ASCO Post that essentially all patients with multiple myeloma could be candidates for maintenance therapy. “But I don’t know that we have established that maintenance...

multiple myeloma

Maintenance with Lenalidomide or Bortezomib Prolongs Remission in Elderly Patients with Multiple Myeloma

The benefit of maintenance therapy in newly diagnosed multiple myeloma patients ineligible for stem cell transplant, such as the elderly, is still debated, though value appears to be emerging, according to studies presented at the 2011 American Society of Hematology (ASH) Annual Meeting....

breast cancer

Expert Point of View: Next-generation Sequencing in Metastatic Triple-negative Breast Cancer Yields Rewards

Hope Rugo, MD, of the University of California, San Francisco, commented on Dr. O’Shaughnessy’s presentation on molecular pathways in triple-negative breast cancer at the 2011 San Antonio Breast Cancer Symposium. “The really exciting thing is that we have moved from intrinsic subtyping of breast...

SIDEBAR: Genotype and Treatment Outcomes

At the 2011 San Antonio Breast Cancer Symposium, Joyce O’Shaughnessy, MD, described how the genetic profiles of 12 patients with metastatic triple-negative breast were used to guide treatment for metastatic disease Patient #10 was a 59-year-old African-American woman with primary...

breast cancer

Next-generation Sequencing in Metastatic Triple-negative Breast Cancer Yields Rewards

The startling molecular heterogeneity of metastatic triple-negative breast cancer is now obvious and helps to explain the poor outcomes observed in this patient subset. Comprehensive genomic and transcriptomic interrogation of metastatic triple-negative breast cancer is elucidating the molecular...

gastrointestinal cancer

New Assays, Surveillance Techniques Reported for GI Malignancies

Two studies highlighted in press conferences and one presented during an invited lecture at the 2012 Gastrointestinal Cancers Symposium, held recently in San Francisco, suggest that early detection of pancreatic, esophageal, and colorectal cancers could soon improve. Enzyme Immunoassay Spots...

gastrointestinal cancer

Expert Point of View: Re-analysis of RADIANT-2 Finds Benefit for Everolimus in Patients with Carcinoid Tumors

Timothy J. Hobday, MD, of the Mayo Clinic in Rochester, Minnesota, discussed the findings of the RADIANT-2 re-analysis at the 2012 Gastrointestinal Cancers Symposium. Speaking from the perspective of a clinical researcher, he said, “the conclusions of the study are reasonable” and provide “valuable ...

cns cancers

Re-analysis of RADIANT-2 Finds Benefit for Everolimus in Patients with Carcinoid Tumors

A re-analysis of the RADIANT-2 trial, which evaluated everolimus (Afinitor) in patients with advanced nonpancreatic neuroendocrine tumors, has yielded prognostic factors that identify a group of patients who are not only at high risk for recurrence but who may derive benefit from treatment with...

breast cancer

SIDEBAR: International Study Confirms ACOSOG Z0011

Preliminary findings of the International Breast Cancer Study Group (IBCSG) 23-01 trial1 show no benefit for axillary lymph node dissection in patients with only minimally involved sentinel nodes, thereby supporting the results of the American College of Surgeons Oncology Group (ACOSOG) Z0011...

breast cancer

Advances in Axillary Surgery for Patients with Breast Cancer

Results from the American College of Surgeons Oncology Group (ACOSOG) Z0011 trial, which found no benefit for completion axillary nodal dissection in patients with breast cancer involving one to two positive sentinel nodes,1 have led to changes in breast cancer management, though points of...

gastrointestinal cancer

Survival Analysis by Gastric Cancer Subtypes in AVAGAST Phase III Trial

Subset analysis of the AVAGAST trial, which evaluated the benefit of bevacizumab (Avastin) in advanced gastric cancer, has demonstrated distinct differences in outcomes according to disease subtype, reported Manish A. Shah, MD, of Weill Cornell Medical College and New York Presbyterian Hospital, at ...

gastrointestinal cancer

Targeting KRAS in GI Cancers: The Hunt for the Holy Grail in Cancer Research

The RAS oncogenes are the most frequently mutated class of oncogenes in human cancers, and this has prompted a search for Ras inhibitors to effectively treat tumors with these mutations. Despite intensive efforts, however, none has materialized clinically because K-Ras is proving to be a very...

colorectal cancer

Expert Point of View: ColoPrint Gene Assay Can Guide Treatment Decisions in Stage II Colon Cancer

Axel Grothey, MD, of the Mayo Clinic, Rochester, Minnesota, told The ASCO Post that he finds the data “intriguing” and that the study exemplifies the value of developing molecular signatures for use in colon cancer. “It identifies patients with an excellent prognosis, who perhaps should not be...

colorectal cancer

ColoPrint Gene Assay Can Guide Treatment Decisions in Stage II Colon Cancer

ColoPrint, an 18-gene expression profile assay for patients with early-stage colon cancer, accurately stratifies patients by recurrence risk and identifies a subset who can be adequately treated by surgery alone, investigators reported at the 2012 Gastrointestinal Cancers Symposium.1 According to...

breast cancer
kidney cancer
lung cancer
skin cancer
leukemia
lymphoma
issues in oncology

NCCN Clinical Practice Guidelines: Important Updates for 2012

The National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology have become the most widely used guidelines in oncology practice. The Guidelines cover 97% of all patients with cancer and are continually updated by expert panels. The 2012 Guidelines include some completely...

colorectal cancer

Expert Point of View: Novel Multikinase Inhibitor Improves Survival in Metastatic Colorectal Cancer

The results of the CORRECT trial created some degree of “buzz” at the 2012 Gastrointestinal Cancers Symposium, with experts predicting that regorafenib will become FDA-approved and have strong clinical utility. While numerically, the benefit appeared small, “There is a real difference with this...

colorectal cancer

Novel Multikinase Inhibitor Improves Survival in Metastatic Colorectal Cancer

The novel tyrosine kinase inhibitor regorafenib, given as a single agent to patients with treatment-refractory metastatic colorectal cancer, significantly improved overall survival and delayed disease progression in an international phase III trial presented at the 2012 Gastrointestinal Cancers...

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