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issues in oncology

Smoking Prevalence Declines Among Health-Care Professionals

In a study reported as a research letter in JAMA, Sarna et al found that the prevalence of smoking among U.S. health-care professionals was 8.3% in 2010/2011, representing decreases of 23.4% since 2003 and 19.3% since 2006/2007. A previous study had shown no marked reduction in smoking rates among...

lung cancer

Dabrafenib Receives FDA Breakthrough Therapy Designation for BRAF-Mutated NSCLC

The U.S. Food and Drug Administration (FDA) has granted Breakthrough Therapy designation for dabrafenib (Tafinlar) for the treatment of patients with metastatic BRAF V600E mutation–positive non–small cell lung cancer (NSCLC) who have received at least one prior line of...

colorectal cancer
issues in oncology

Known Lung Cancer Oncogenes ALK and ROS1 May Also Drive Certain Colorectal Tumors

ALK and ROS1 gene rearrangements, which are known to drive subsets of lung cancer, appear to be present in some colorectal cancers as well, according to the results of a study published in Molecular Cancer Research. The findings by Aisner et al suggest that therapies used to target these two...

gynecologic cancers
issues in oncology

Quadrivalent HPV Vaccine Provides Poorer Protection in Women 18 and Older or With Abnormal Cytology

In a study reported in the Journal of Clinical Oncology, Mahmud et al evaluated the effectiveness of the quadrivalent human papillomavirus (HPV) vaccine against cervical dysplasia using population-based individual level data routinely collected in Manitoba. They found that a high proportion of...

leukemia

Ibrutinib Promising as Initial Therapy for Elderly Patients With CLL in Phase IB/II Trial

Chemoimmunotherapy has produced improved response and survival in young patients with chronic lymphocytic leukemia (CLL), but its use in elderly patients has been limited by myelosuppression and infection. In a phase IB/II study reported in The Lancet Oncology, O’Brien et al assessed the use...

supportive care

Short-Term Follow-up Reveals Suboptimal Pain Relief and Marked Pain Worsening in Ambulatory Cancer Patients

In an analysis reported in the Journal of Clinical Oncology, Zhao et al assessed factors associated with pain severity changes in ambulatory patients with solid tumors in the Eastern Cooperative Oncology Group E2Z02 (Symptom Outcomes and Practice Patterns) trial. They found that approximately...

supportive care

Nurse- and Gastroenterologist-Led Algorithm-Based Management Improve GI Symptoms After Pelvic Radiotherapy

In the ORBIT trial, reported in The Lancet, Andreyev et al compared outcomes with usual care, gastroenterologist-led algorithm-based management, and nurse-led algorithm-based management for patients with chronic gastrointestinal symptoms following pelvic radiotherapy for cancer. The findings...

breast cancer
issues in oncology

Meta-Analysis Indicates No Reduction in Risk of Local or Distant Breast Cancer Recurrence With Preoperative Staging MRI

In an individual patient data meta-analysis reported in the Journal of Clinical Oncology, Houssami et al found that preoperative magnetic resonance imaging (MRI) was not associated with differences in local recurrence or distant recurrence compared with conventional imaging in women with breast...

issues in oncology

Chemotherapy Drug Shortages Threaten Quality of Treatment

Over the past several years, there have been recurring shortages of widely used generic chemotherapy agents in the United States. In a letter to The New England Journal of Medicine, Gogineni et al described a survey of U.S. oncologists regarding types and frequency of chemotherapy shortages and...

gynecologic cancers

Half of Patients With Stage I Pediatric Malignant Ovarian Germ Cell Tumors Can Be Spared Chemotherapy After Initial Surgery With Surveillance Strategy

In a Children’s Oncology Group study (AGCT0132) reported in the Journal of Clinical Oncology, Billmire et al found that overall survival can be preserved in patients with stage I pediatric malignant ovarian germ cell tumor with a strategy of initial surveillance after surgical resection....

lung cancer
issues in oncology
issues in oncology

Rates of New Lung Cancer Cases Drop in U.S. Men and Women

Tobacco control efforts are having a major impact on Americans’ health, a new analysis of lung cancer data suggests. The rate of new lung cancer cases decreased among men and women in the United States from 2005 to 2009, according to a report in this week’s Morbidity and Mortality...

skin cancer

Sentinel Lymph Node Biopsy Associated With Survival Advantage in Merkel Cell Carcinoma

In patients with Merkel cell carcinoma, sentinel lymph node biopsy was shown to be associated with improved survival, according to the results of a retrospective study reported by Kachare et al in the Annals of Surgical Oncology. Thus, sentinel lymph node biopsy offers prognostic information that...

leukemia

Good Results Using Loss of Major Molecular Response as Criterion for Restarting Tyrosine Kinase Inhibitor Therapy in CML

Many patients with chronic-phase chronic myelogenous leukemia (CML) in complete molecular response have molecular relapse after discontinuation of imatinib (Gleevec) treatment. In a French multicenter observational study reported in the Journal of Clinical Oncology, Rousselot et al assessed the...

gynecologic cancers
gynecologic cancers

No Benefit of Adding Tirapazamine to Cisplatin Chemoradiation in Locally Advanced Cervical Cancer

In a phase III intergroup trial (Gynecologic Oncology Group Protocol 219) reported in the Journal of Clinical Oncology, DiSilvestro et al in the Gynecologic Oncology Group and National Cancer Institute of Canada Clinical Trials Group evaluated the addition of the hypoxic cell sensitizer...

leukemia
issues in oncology

Higher Copayment Associated With Greater Discontinuation of and Nonadherence to Tyrosine Kinase Inhibitor Treatment in CML

The availability of the tyrosine kinase inhibitor imatinib (Gleevec) has dramatically increased survival in chronic myeloid leukemia (CML). Nonadherence to therapy with imatinib and other tyrosine kinase inhibitors is associated with disease progression and treatment resistance. In a study reported ...

gynecologic cancers

No Survival Benefit of Erlotinib in EGFR-Unselected Patients With Nonprogressing Ovarian Cancer After Platinum Therapy

EGFR is overexpressed in the majority of advanced epithelial ovarian carcinomas, and there is evidence indicating that overexpression is associated with poorer prognosis. In a phase III European Organisation for Research and Treatment of Cancer (EORTC)-Gynaecological Cancer Group and Gynecologic...

survivorship

Survey Finds Many General Internists Are Uncomfortable Caring for Adult Survivors of Childhood Cancer

A National Cancer Institute–funded survey of general internists asking about their attitudes and knowledge about the care of adult childhood cancer survivors has found that few internists are comfortable caring for these patients. Moreover, many are unfamiliar with the Children’s...

supportive care
issues in oncology

Most Physicians Would Enroll in Hospice If They Were Terminally Ill With Cancer, Study Finds

In a research letter published in JAMA Internal Medicine, Chinn et al surveyed physicians’ attitudes towards hospice treatment if they were terminally ill with cancer and assessed how physician preferences might affect timing of hospice discussions with their terminally ill patients. They...

lung cancer

Preclinical Study Suggests E-Cigarettes May Contribute to Lung Cancer in High-Risk Individuals

A study of human bronchial epithelial cells carrying mutations in the TP53 and KRAS genes has found that e-cigarette vapors enhanced the cells’ cancerous behaviors. The study suggests that e-cigarette exposure may contribute to lung cancer in individuals at high risk for the disease. The...

leukemia

Matched-Pairs Analysis Shows Better Survival With Allogeneic Transplantation vs Conventional Chemotherapy in Postremission Therapy for AML

In a prospective matched-pairs analysis reported in the Journal of Clinical Oncology, Stelljes et al in the German AML Cooperative Group compared outcomes with allogeneic stem cell transplantation vs conventional postremission chemotherapy in patients aged < 60 years with acute myeloid leukemia...

supportive care

Single Fractions of Radiation for Painful Bone Metastases May Be Noninferior to Multiple Fractions

Optimal dose fractionation for radiation therapy of painful bone metastases from multiple primary sites remains undefined. In a phase III noninferiority trial reported in The Lancet Oncology, Chow et al compared 8 Gy in a single fraction vs 20 Gy in multiple fractions in patients with painful bone...

lung cancer

Imprime PGG Added to Chemoimmunotherapy Shows Improved Outcomes in Advanced Lung Cancer Patients

The addition of Imprime PGG, a type of immunotherapy, to chemoimmunotherapy with carboplatin, paclitaxel, and cetuximab (Erbitux) resulted in improved response rates and overall survival rates in patients with late-stage, non–small cell lung cancer (NSCLC), according to the results of a phase ...

lymphoma

No Survival Difference for Autologous vs Reduced-Intensity Conditioning Allogeneic Stem Cell Transplant in Chemotherapy-Sensitive Mantle Cell Lymphoma

In an analysis reported in the Journal of Clinical Oncology, Fenske et al compared outcomes with early or late autologous vs reduced-intensity conditioning allogeneic hematopoietic stem cell transplantation in a population of patients with chemotherapy-sensitive mantle cell lymphoma. They found no...

gynecologic cancers
gynecologic cancers

Recurrent Ovarian Cancers Respond to Cancer Vaccine After ‘Reprogramming’ With Decitabine

Treatment with the drug decitabine prior to administration of chemotherapy and a cancer vaccine yielded clinical benefit for women with recurrent ovarian cancer, suggesting that this combinatorial chemoimmunotherapy may provide a new treatment option for patients with the disease, according to a...

skin cancer

Phase II Pilot Study Does Not Support Phase III Investigation of IV High-Dose Interferon Without Maintenance in Resected Melanoma

There is evidence that high-dose interferon alfa-2b consisting of 4 weeks of daily intravenous interferon alfa-2b followed by 48 weeks of subcutaneous maintenance interferon alfa-2b three times per week reduces risk of recurrence of resected melanoma and that response may depend on the early...

lung cancer

Study Evaluates Risk of Depression by Race and Sex Among Patients With Newly Diagnosed Lung Cancer

In a study reported in the Journal of Clinical Oncology, Traeger et al evaluated risk of depression symptoms and psychosocial service use by race and sex among patients with newly diagnosed lung cancer. The investigators found that black men have the highest prevalence of depressive symptoms, white ...

breast cancer
supportive care

No Difference for Aprepitant vs Dexamethasone for Chemotherapy-Induced Delayed Emesis in Patients With Breast Cancer

In a phase III study reported in the Journal of Clinical Oncology, Roila et al compared aprepitant vs dexamethasone in prevention of delayed emesis in breast cancer patients treated with anthracycline/cyclophosphamide who had received palonosetron/aprepitant/dexamethasone prophylaxis for acute...

Oral Insulin Sensitizers Associated With Decreased Cancer Risk in Women With Type 2 Diabetes

According to the findings of a meta-analysis by Sun et al published in Diabetes, Obesity, and Metabolism, patients with type 2 diabetes mellitus who are on certain therapies, such as insulin secretagogues, may be at higher risk for cancer. This increased risk was seen more frequently in women, and...

leukemia

‘Faster and Deeper Responses’ With Dasatinib vs Imatinib in Chronic-Phase CML Patients

Dasatinib (Sprycel) resulted in “faster and deeper responses” compared to imatinib (Gleevec) among patients with newly diagnosed chronic-phase chronic myeloid leukemia (CML), according to a 3-year follow-up of the randomized phase III DASISION (Dasatinib vs Imatinib Safety In...

skin cancer

Imiquimod 5% Cream Inferior to Surgical Excision in Nodular and Superficial Basal Cell Carcinoma

In a noninferiority trial (SINS) reported in The Lancet Oncology, Bath-Hextall et al compared imiquimod 5% cream vs surgical excision for nodular and superficial basal cell carcinomas. Imiquimod cream was found to be inferior to surgical excision, but it may have a role in treatment of low-risk...

breast cancer

Neoadjuvant Paclitaxel Before Anthracycline Improves Response in High-Risk Early Breast Cancer

In a phase III 2×2 factorial trial (Neo-tAnGo) reported in The Lancet Oncology, Earl et al compared neoadjuvant therapy with epirubicin/cyclophosphamide followed by paclitaxel with or without gemcitabine vs paclitaxel with or without gemcitabine followed by epirubicin/cyclophosphamide in ...

breast cancer

Wider Surgical Margins Do Not Appear To Reduce Local Recurrence Rates in Triple-Negative Breast Cancer

Wider surgical margins did not reduce the rate of local recurrence in women with triple-negative breast cancer treated with breast-conserving therapy, according to the results of a study published in the Annals of Surgical Oncology. Pilewskie et al reported that their data support the definition of ...

breast cancer

Oral Ibandronic Acid Is Not Noninferior to IV Zoledronic Acid in Preventing Skeletal-Related Events in Patients With Breast Cancer

In a phase III noninferiority trial (ZICE) reported in The Lancet Oncology, Barrett-Lee et al compared oral ibandronic acid vs intravenous zoledronic acid in treatment of bone metastases from breast cancer. The study showed that ibandronic acid was not noninferior to zoledronic acid in preventing...

lymphoma

Sustained Complete Responses With Novel Immunotherapy in Lymphoma

Approximately 40% of patients with Hodgkin or non-Hodgkin lymphoma have tumor cells that express the type II latency Epstein-Barr virus (EBV) antigens latent membrane protein 1 (LMP1) and LMP2. T cells specific for these antigens are present in low levels and may be rendered nonreactive by the...

lymphoma

Anti–PD-1 Antibody Pidilizumab Plus Rituximab Shows High Activity in Relapsed Follicular Lymphoma

Antitumor immune responses may be inhibited by immune checkpoints in the tumor microenvironment including effects of PD-1 (programmed cell death 1), a co-inhibitory receptor on tumor T cells that impairs T-cell function. In a phase II study reported in The Lancet Oncology, Westin et al assessed the ...

lung cancer

No Survival Benefit for Tecemotide After Chemoradiotherapy in Stage III NSCLC

In the phase III START trial reported in The Lancet Oncology, Butts et al assessed whether maintenance treatment with the MUC1 antigen–specific immunotherapy tecemotide could prolong overall survival in patients with unresectable stage III non–small cell lung cancer (NSCLC) who had...

EUROCARE-5: Trends in Survival for Childhood Cancers

As reported in The Lancet Oncology by Gatta et al, the population-based EUROCARE-5 study has shown improved survival for all childhood cancers combined in Europe between 1999–2001 and 2005–2007 and persistence of regional survival disparities. Study Details The study involved analysis ...

breast cancer

Younger Women With Younger Children Less Likely to Receive Radiation Therapy After Breast-Conserving Surgery for Breast Cancer

In a study reported in the Journal of the National Cancer Institute, Pan et al assessed factors associated with noncompliance with recommended radiation therapy following breast-conserving surgery for breast cancer. A primary factor in underuse of radiation therapy was younger patients having...

Suboptimal Adverse Event Reporting in Cancer Clinical Trial Publications

In a study reported in the Journal of Clinical Oncology, Sivendran et al assessed the degree to which publication of phase III trials in oncology conformed with CONSORT (Consolidated Standards of Reporting Trials) recommendations for reporting adverse events. They found that adverse event...

breast cancer

Dasatinib/Letrozole Drug Combination Delays Disease Progression in Hormone Receptor–Positive, HER2-Negative Metastatic Breast Cancer

Adding dasatinib (Sprycel) to a standard antihormone therapy, letrozole, doubled the time before disease progressed for women with hormone receptor–positive, HER2-negative metastatic breast cancer, according to results of a phase II clinical trial presented at the 2013 San Antonio Breast...

colorectal cancer
issues in oncology

Protective Effect of Aspirin for Colorectal Cancer Is Associated With rs6983267 T Allele

It has been posited that aspirin treatment may reduce risk for colorectal cancer through inhibition of WNT/cadherin-associated protein β1 (CTNNB1, or β-catenin) signaling. In a study reported in the Journal of the National Cancer Institute, Nan et al investigated the potential role of the ...

prostate cancer

Second-Line Therapies May Benefit Patients With Castration-Resistant Prostate Cancer and Poor Performance Status

Patients with castration-resistant prostate cancer and a poor performance status who were previously treated with docetaxel may benefit from currently available second-line therapies, according to the findings of a meta-analysis by Iacovelli et al published in Prostate Cancer and Prostatic...

breast cancer

Final Overall Survival Analysis of CONFIRM Trial Shows Advantage of Higher Dose of Fulvestrant in Advanced Breast Cancer

As reported in the Journal of the National Cancer Institute by Di Leo et al, the final overall survival analysis of the CONFIRM trial has shown a significant benefit of fulvestrant (Faslodex) at 500 mg vs 250 mg in postmenopausal women with locally advanced or metastatic estrogen...

colorectal cancer
supportive care

No Benefit of Calcium/Magnesium in Preventing Oxaliplatin-Induced Sensory Neurotoxicity in Patients With Colon Cancer

In a phase III N08CB/Alliance trial reported in the Journal of Clinical Oncology, Loprinzi et al assessed whether calcium and magnesium treatment reduced oxaliplatin-related neurotoxicity in patients with colon cancer receiving adjuvant FOLFOX (fluorouracil, leucovorin, and oxaliplatin). They found ...

CALGB 40603 Trial Supports Adding Carboplatin to Neoadjuvant Chemotherapy in Triple-Negative Breast Cancer

The addition of carboplatin to a neoadjuvant regimen significantly increased the rate of pathologic complete response in patients with triple-negative breast cancer. The results from the CALGB/Alliance 40603 study were reported at the 2013 San Antonio Breast Cancer Symposium (Abstract S5-01)....

leukemia

Survival Benefit With High-Dose Cytarabine Induction in AML Patients Aged < 46 Years

In a European Organisation for Research and Treatment of Cancer (EORTC) and Gruppo Italiano Malattie Ematologiche dell’ Adulto (GIMEMA) phase III trial (AML-12) reported in Journal of Clinical Oncology, Willemze et al compared induction regimens containing high-dose or standard-dose...

breast cancer

Adjuvant Paclitaxel/Trastuzumab Tolerable, Benefits Women With Stage I HER2-Positive, Node-Negative Breast Cancer

There may be a benefit for treating small HER2-positive tumors and this can be done with little toxicity, according to a multicenter study presented at the 2013 San Antonio Breast Cancer Symposium (Abstract S1-04). Previous studies of chemotherapy plus anti-HER2 treatment for node-negative...

breast cancer

PIK3CA Mutations Predictive of Resistance to Neoadjuvant Therapy in HER2/HR-Positive Breast Cancers

Women with HER2-positive, hormone receptor-positive breast cancer with mutations in the PI3K/AKT pathway may respond poorly to neoadjuvant therapy, German researchers reported at the 2013 San Antonio Breast Cancer Symposium (Abstract S4-06). “We found that very few women with HER2-positive...

breast cancer

Nonsignificant Reduction in Breast Cancer Risk Seen With Low-Dose Tamoxifen in Postmenopausal Hormone Replacement Therapy Users

In postmenopausal women receiving hormone replacement therapy, low-dose tamoxifen did not significantly reduce the risk of breast cancer but did increase climacteric symptoms, according to the phase III study results presented by DeCensi et al in the Annals of Oncology. However, beneficial trends...

Increased Cardiovascular Risk Despite Healthier Lifestyle Characteristics in Hematopoietic Cell Transplant Survivors

In a study reported in the Journal of Clinical Oncology, Chow et al compared cardiovascular risk and risk factors in hematopoietic cell transplantation recipients with those in a matched general population sample. Hematopoietic cell transplantation survivors were at greater risk for cardiomyopathy, ...

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