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...
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....
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...
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...
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...
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...
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 ...
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...
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...
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...
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 ...
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...
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...
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...
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...
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...
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...
Over 1,300 breast surgeons attended the 13th Annual Meeting of the American Society of Breast Surgeons, held May 2–6 in Phoenix. Presentations included investigations on recurrence after lumpectomy, gender differences in breast cancer, and the potential role of infrared thermography in diagnosing...
A study presented at the 13th Annual Meeting of the American Society of Breast Surgeons suggested that accelerated partial-breast irradiation (APBI) using brachytherapy might control the tumor bed better than whole-breast irradiation (WBI), while another study suggested that radiofrequency ablation ...
Commenting on the trial of combined BRAF and MEK inhibition in advanced melanoma, Michael K.K. Wong, MD, PhD, Professor of Medicine at Keck School of Medicine, University of Southern California, Los Angeles, called the findings “nothing short of extraordinary” and a potential “game changer.”...
In advanced melanoma, combination therapy with two investigational drugs—one targeting BRAF and the other the MEK pathway—achieved a median progression-free survival of 7.4 months, which rose to 10.8 months in patients who were optimally dosed, reported Jeffrey S. Weber, MD, PhD, Director of the...
Michael P. Link, MD, 2011–2012 President of ASCO and a pediatric oncologist himself (at Stanford University School of Medicine and the Lucile Salter Packard Children’s Hospital at Stanford), said the crizotinib study by Mosse and colleagues has far-ranging implications. “The molecular driver (ALK)...
The value of the targeted agent crizotinib (Xalkori) may not be restricted to the 5% of patients with non–small cell lung cancer who have abnormalities in the ALK gene. In a phase I study conducted by the Children’s Oncology Group consortium, crizotinib halted tumor growth and, in some cases,...
“Stated simply, T-DM1 really works in this patient population,” said Louis Weiner, MD, Director of the Georgetown-Lombardi Cancer Center in Washington, DC, and the invited discussant of the presentation. “It is an important new weapon in the therapeutic armamentarium for breast cancer.” While...
Positive results continue to be reported for trastuzumab emtansine (T‑DM1), the antibody-drug conjugate linking trastuzumab (Herceptin) to a cytotoxic agent. Early results of the international phase III EMILIA study, presented at the 2012 ASCO Annual Meeting, showed a 35% reduction in risk of...
“Our old friends are sometimes worth keeping, and that is certainly true for weekly paclitaxel,” said the invited discussant of CALGB 40502, Kathy Miller, MD, of Indiana University School of Medicine, Indianapolis, at the ASCO Annual Meeting. She noted that Dr. Rugo must “remain strict to the...
In the treatment of metastatic breast cancer, established older agents outperformed newer, more expensive drugs in two studies that made news at the 2012 ASCO Annual Meeting. Microtubule Inhibitors In the phase III open-label CALBG 40502/NCCTG N063H trial of 799 chemotherapy-naive patients with...
Michael Williams, MD, the Byrd S. Leavell Professor of Medicine and Chief of Hematologic Malignancies at the University of Virginia Cancer Center, Charlottesville, commented, “Bendamustine/rituximab provides equivalent or better responses vs R-CHOP [rituximab, cyclophosphamide, doxorubicin,...
Richard I. Fisher, MD, the Samuel E. Durand Professor of Medicine at the University of Rochester Medical Center in Rochester, New York, cautioned that it is too early to embrace the bendamustine/rituximab regimen. Caution Advised “Bendamustine is a very active agent with moderate toxicity that...
Updated results of the StiL NHL1 study, presented at the 2012 ASCO Annual Meeting Plenary Session, showed that bendamustine plus rituximab (Rituxan) more than doubled the median progression-free survival, compared with the standard R-CHOP regimen (rituximab, cyclophosphamide, doxorubicin,...
Oncologists can expect to hear more about immune checkpoint blockade, according to two discussants of these abstracts. In fact, five PD-1 immune checkpoint compounds are already in the pipeline (Table 1), according to Giuseppe Giaccone, MD, PhD, of the National Cancer Institute, Bethesda, Maryland. ...
In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. The MEK inhibitor trametinib...
With three available tyrosine kinase inhibitors for the treatment of chronic myeloid leukemia (CML), attention has turned from the ability to achieve a sustained response to the possibility of “curing” patients. Updates of pivotal trials presented at ASCO may help define the role of the tyrosine...
The third-generation tyrosine kinase inhibitor ponatinib showed robust efficacy in the 10-month follow-up of the phase II PACE trial (Ponatinib Ph+ALL and CML Evaluation), which is evaluating ponatinib in treatment-refractory chronic myeloid leukemia (CML)1 At the 2012 ASCO Annual Meeting, Jorge E. ...
Additional noteworthy gastrointestinal cancer studies presented during oral abstract sessions at the 2012 ASCO Annual Meeting included the following trials in metastatic colorectal cancer. Perifosine/Capecitabine Fails in Phase III Trial Adding perifosine, an oral alkylphospholipid inhibitor that...
Invited discussant Alan Venook, MD, of the University of California, San Francisco, pointed out that the hazard ratio of 0.81 and the 1.4-month improvement in overall survival in the TML trial did not reach the target hazard ratio of 0.77 in the statistical design of the study. However, “it is...
In a study highlighted at a press briefing during the 2012 ASCO Annual Meeting, German investigators reported that prolonging treatment with bevacizumab (Avastin) beyond disease progression extends overall survival in patients with metastatic colorectal cancer.1 Patients received bevacizumab plus...
Risks associated with being a young cancer survivor were emphasized by two studies highlighted in press briefings at the 2012 ASCO Annual Meeting. Investigators from the Children’s Oncology Group (COG) reported that adolescents and young adults treated for high-risk B-precursor acute lymphoblastic ...
Results of several long-running chemotherapy trials were reported at the 2012 ASCO Annual Meeting breast cancer oral session, reported in brief here. NSABP B-38 The final analysis of the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-38 trial showed that the addition of gemcitabine...
Eun-Sil Shelley Hwang, MD, MPH, of Duke University Medical Center, Durham, North Carolina, who discussed both papers on ductal carcinoma in situ at the ASCO Annual Meeting, noted that better risk stratification and treatments are substantially changing the outlook for DCIS. “We are getting close to ...
Risk stratification and outcomes can be improved for women with ductal carcinoma in situ (DCIS), according to two studies presented at the 2012 ASCO Annual Meeting. RTOG 9804 Findings from the Radiation Therapy Oncology Group (RTOG) 9804 trial suggested that even for DCIS patients whose prognosis...
Gunter von Minckwitz, MD, PhD, of the German Breast Group and the University of Frankfurt, discussed the findings of the NSABP B-41 trial. He observed that lapatinib was not more effective than trastuzumab, which is in line with increasing evidence in various breast cancer settings showing greater...
Lapatinib (Tykerb) proved valuable as a component of neoadjuvant chemotherapy for HER2-positive operable breast cancer in the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-41 trial presented at the 2012 ASCO Annual Meeting by Andre Robidoux, MD, of the NSABP and the University of...
Grant McArthur, MB, BS, PhD, Head of the Cancer Therapeutics Program at the Peter MacCallum Cancer Centre in Melbourne, Australia, congratulated the investigators on a rapidly accrued, well-conducted, and ethical study that encouraged crossover to the active arm. He noted that regorafenib is an...
Regorafenib, an orally administered investigational tyrosine kinase inhibitor that has shown activity in chemorefractory metastatic colorectal cancer, markedly delayed disease progression in patients with treatment-refractory metastatic gastrointestinal stromal tumor (GIST) in the phase III GRID...
Recent advances in understanding the pathogenesis and altered signaling pathways in thyroid cancer are improving treatment options for this malignancy, especially for the subset of patients with medullary thyroid cancer and those with differentiated thyroid cancer that has metastasized, according...
Differentiated thyroid cancer—papillary, follicular, and Hürthle cell carcinomas—has historically been managed by endocrinologists, surgeons, and radiation oncologists, but recent progress in the field has led to greater involvement by medical oncologists, especially in the care of patients with...
Bruno C. Medeiros, MD, of Stanford University School of Medicine, Palo Alto, commented, “It’s clear to say that new treatment strategies are needed for adults with [acute lymphocytic leukemia (ALL)] to improve outcomes of relapsed disease and to prevent relapses to begin with.” He noted that while ...
The findings in chronic lymphocytic leukemia (CLL) were discussed by Constantine S. Tam, MBBS, MD, of St. Vincent’s Hospital in Melbourne, Australia, who observed, “There is a long list of novel agents in CLL. I think some of the most promising are those targeting the B-cell receptor pathway. This...
Agents with novel mechanisms of action may strongly impact outcomes in chronic lymphocytic leukemia (CLL) and acute lymphocytic leukemia (ALL), if data from early-phase studies presented at this year’s ASCO Annual Meeting are any indication. There is a clear unmet need for more effective therapies...