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Showing 1851 - 1900Treatment Update in Gastric, Pancreatic, and Colorectal Cancers
Although new gastrointestinal cancers are on the rise, advancements in their treatment, as well as the upcoming results of perioperative trials, could prove to be “clinical practice game-changers,” declared Thomas J. George, Jr, MD, FACP, at the 2016 Community Oncology Conference in Orlando,...
Expert Point of View: Peter C. Enzinger, MD
Not so FAST? The study discussant Peter C. Enzinger, MD, Director of the Center for Esophageal and Gastric Cancer at Dana-Farber/Brigham and Women’s Cancer Center, Boston, viewed the findings of the FAST trial as promising but voiced several considerations, as did Gulam A. Manji, MD, PhD,...
Increased Risk for Cardiovascular Events Seen in Patients With CML Taking Tyrosine Kinase Inhibitors
Although tyrosine kinase inhibitors have dramatically increased survival for patients with chronic myeloid leukemia (CML), continuous administration of these drugs may elicit long-term toxicity, including cardiovascular adverse events. To investigate the incidence of vascular events in patients...
SIRIUS Trial Heralds a New Era of Promise in Treating Resistant Myeloma
Multiple myeloma cells uniformly overexpress CD38.1 Daratumumab (Darzalex), a CD38-targeting human IgG1 kappa monoclonal antibody, has been evaluated in a series of phase I/II trials involving patients with relapsed or relapsed and refractory myeloma who have received at least two or more prior...
PALOMA-3 Trial in HER2-Negative Metastatic Breast Cancer: Challenge of Moving Beyond Estrogen Receptor Positivity
Hormone receptor–positive breast cancer represents the largest therapeutic subgroup of the disease. The development of endocrine therapies has shaped the treatment paradigm for both advanced- and early-stage disease for decades.1 Still, despite their significant impact, advanced breast cancer...
Prolonged Progression-Free Survival With Addition of Palbociclib to Fulvestrant in HER2-Negative Metastatic Breast Cancer
As reported in The Lancet Oncology by Massimo Cristofanilli, MD, of the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, and colleagues, the final results of the phase III PALOMA-3 trial showed that the addition of the CDK4/CDK6 inhibitor palbociclib (Ibrance) to fulvestrant...
Anti–PD-1 Inhibitor Gains Foothold in Merkel Cell Carcinoma
Immunotherapy marches on! One of the latest frontiers for checkpoint inhibitors is the treatment of Merkel cell carcinoma, a rare but aggressive type of cancer. First-line therapy with pembrolizumab (Keytruda)—an anti–PD-1 (programmed cell death protein 1) inhibitor—achieved an objective response...
Combined-Modality Therapy for Low-Grade Gliomas: Balancing Toxicity, Delivery Logistics, and Survival Benefit
Low-grade gliomas account for 15% of all primary brain tumors and represent a heterogeneous group of glial neoplasms. Although these tumors have been termed low-grade, this is a misnomer, especially for some grade II gliomas, which may exhibit a more aggressive behavior and variable natural...
Ovarian Suppression in Premenopausal Women With Estrogen Receptor–Positive Breast Cancer
Oophorectomy was the first proposed form of endocrine therapy for women with breast cancer. Over 100 years ago, Thomas Nunn reported a relationship between menopause and regression of breast cancer.1 This incited interest in the induction of menopause as an anticancer therapy, and in 1986, a...
Improvement in Overall Survival With Addition of Chemotherapy to Radiotherapy in Low-Grade Glioma
Final results of the RTOG 9802 phase III trial reported in The New England Journal of Medicine by Jan C. Buckner, MD, of Mayo Clinic, Rochester, and colleagues, showed that the addition of chemotherapy with procarbazine, lomustine, and vincristine to radiotherapy significantly prolonged overall...
Providing Inpatient Physical Rehabilitation for Patients With Advanced Cancer
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, ...
Moving the Needle on HPV Vaccination
In 2012–2013, members of the President’s Cancer Panel (prescancerpanel.cancer.gov) focused their efforts on accelerating widespread acceptance of and use of approved human papillomavirus (HPV) vaccines to prevent cancer. The topic is important, because HPVs cause most cases of cervical cancer and...
Additional 5 Years of Letrozole May Benefit Some Postmenopausal Women With Early-Stage Breast Cancer
Five years of aromatase inhibitor as upfront therapy or after tamoxifen is the current standard of care for postmenopausal women with early hormone receptor–positive breast cancer. A new trial suggests that extending aromatase inhibitor therapy with letrozole for an additional 5 years may improve...
The ENDEAVOR Trial: A Case Study in the Interpretation of Modern Cancer Trials
It can be easy to miss the forest for the trees in the interpretation of clinical trials. In particular, trials for the treatment of cancer are exceedingly complex, with long lists of inclusion and exclusion criteria, designs with hidden biases, drugs with unpronounceable names (if not cumbersome...
Pembrolizumab Improves Survival vs Docetaxel in Previously Treated PD-L1–Positive Advanced Non–Small Cell Lung Cancer
As reported in The Lancet by Roy S. Herbst, MD, PhD, of Yale School of Medicine, and colleagues,1 the phase II/III KEYNOTE-010 trial showed that pembrolizumab (Keytruda) significantly improved overall survival vs docetaxel in patients with previously treated programmed cell death ligand 1...
Leisure-Time Physical Activity Reduces Risk of Multiple Cancer Types
In a study reported in JAMA Internal Medicine, Moore et al found that greater leisure-time physical activity was associated with a reduced risk for many types of cancer. Study Details The study used pooled data on 1.44 million adults from 12 prospective U.S. and European cohorts with...
Surgical Oncologist Suzanne L. Topalian, MD, Shines at the Forefront of Groundbreaking Research in Cancer Immunotherapy
Nationally recognized surgical oncologist and researcher Suzanne L. Topalian, MD, had an early interest in the arts as well as science and decided to major in English upon entering Wellesley College in Wellesley, Massachusetts. “I wanted to keep all my options open, so I also enrolled in a pre-med...
With an Illustrious Career in Breast Oncology, Daniel F. Hayes, MD, FASCO, Follows in the Footsteps of Giants as ASCO President-Elect
ASCO President-Elect Daniel F. Hayes, MD, FASCO, was born in Shelbyville, Indiana, a small city in the center of the state. “My dream was to become a high school basketball and track and field coach; my older brother wanted to be a doctor, and his ambitions also began in first grade,” revealed Dr....
Monitoring Survivors of Childhood Cancers for Late Effects of Treatment
This past January, ASCO held its inaugural Cancer Survivorship Symposium, which brought together the fields of medical oncology and primary care to address the critical need for coordinated care for cancer survivors. Among the presenters at the symposium was Smita Bhatia, MD, MPH, who gave the...
The Role of Occupational and Physical Therapy in Geriatric Oncology
With individuals aged 65 and older accounting for more than 50% of the U.S. population diagnosed with cancer,1 the demand for occupational and physical therapists to treat this population will increase in the years to come. Thus, it is essential for primary care providers to know that the...
A Perilous Time for Refugees With Cancer
The numbers are difficult to fathom. According to a report by the United Nations High Commissioner for Refugees (UNHCR), in 2015, over 60 million people worldwide were forcibly displaced as a result of conflict, persecution, generalized violence, or human rights violations.1 Over 9 million of those ...
Increased Physical Activity Associated With Lower Risk of 13 Types of Cancer
A new study of the relationship between physical activity and cancer has shown that greater levels of leisure-time physical activity were associated with a lower risk of developing 13 different types of cancer. The risk of developing seven cancer types was 20%, or more, lower among the...
ExteNET Trial of Neratinib: One Size Does Not Fit All in HER2-Positive Breast Cancer
Neratinib is an oral anti-HER2 tyrosine kinase inhibitor that has shown promising activity in the treatment of HER2-positive metastatic breast cancer.1 It differs from monoclonal antibodies such as trastuzumab (Herceptin) because, as a small molecule, neratinib blocks the ATP binding site on the...
New FDA Rule Prohibits Sale of E-Cigarettes to Anyone Under Age 18 and Requires Warning Labels
A new rule extending U.S. Food and Drug Administration (FDA) oversight to all tobacco products, including electronic cigarettes (e-cigarettes), and banning the sale of these products to anyone under the age of 181 was hailed as a major advanced by many leaders of medical and health organizations....
Cabozantinib in Advanced Renal Cell Carcinoma
In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On April 25, 2016, a tablet formulation of cabozantinib...
Fitness: Can Exercise Lengthen Survival in Patients With Cancer?
Integrative Oncology is guest edited by Barrie R. Cassileth, MS, PhD, of Memorial Sloan Kettering Cancer Center, New York. Regular physical activity has long been associated with decreased risk of disease, including many types of cancer. Such benefits may translate into increased life expectancy...
Ushering in a New Era in Personalized Medicine
When Waun Ki Hong, MD, and his pregnant wife, Mihwa, made the journey from Korea to Manhattan in 1970, he had just $451 in his wallet, and the only job he could get was as an intern in Bronx-Lebanon Hospital Center, a community hospital in the Bronx. The work was grueling—24-hour shifts every 2...
Recent Reports on Treatment for Leukemias, Sinusoidal Obstruction Syndrome, and Graft-vs-Host Disease
In this installment of Hematology Expert Review, I will summarize five studies from the recent literature addressing important questions about leukemias and their treatment, anticoagulant therapy with the new agent defibrotide (Defitelio), and the use of antilymphocyte globulin to prevent chronic...
Some Diagnostic Variability in Interpreting Breast Biopsy Slides
Pathologists disagree about 8% of the time when interpreting a single breast biopsy slide, with more overinterpretation than underinterpretation in discordant cases, according to an analysis combining results from the B-Path (Breast Pathology) study with data on the prevalence of breast cancer...
Moving Forward in Castration-Resistant Prostate Cancer: The TERRAIN and STRIVE Studies
It was over 2 decades ago that my colleagues and I reported in The New England Journal of Medicine that a first-generation oral antiandrogen, flutamide, when added to a luteinizing hormone–releasing hormone (LHRH) agonist, improved survival by nearly 6 months compared to an LHRH agonist alone in...
Boswellia
The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies commonly used by patients with cancer. We chose Boswellia for this issue because of its increasing use by patients with cancer....
Active Surveillance Has Become Standard Care for Men With Low-Risk Localized Prostate Cancer
Active surveillance has been increasingly adopted as a standard approach for men with Gleason score ≤ 6 localized prostate cancer, with major guidelines and consensus statements encouraging this approach,1 including a recently published guideline from Cancer Care Ontario (CCO),2 and endorsement of...
CDX2 in Stage II Colon Cancer: Ready for Prime Time?
In a recent issue of The New England Journal of Medicine, Dalerba et al published an impressive article describing a novel bioinformatics approach to identifying new prognostic and predictive biomarkers in patients with stage II and III colon cancer (see summary in this issue of The ASCO Post).1...
Transcription Factor CDX2 May Be a Prognostic Biomarker in Stage II and III Colon Cancer
In a study reported in The New England Journal of Medicine, Piero Dalerba, MD, of Columbia University, and colleagues found that absence of the transcription factor CDX2 was prognostic for poor outcome in patients with stage II and III colon cancer vs cancers with CDX2 expression.1 However,...
Study Supports Initial Attempt at Debulking Surgery in Stage IIIC Ovarian, Fallopian Tube, and Peritoneal Carcinoma
In a study exploring the effect of primary debulking surgery in women with bulky stage IIIC ovarian, fallopian tube, and primary peritoneal cancers, cytoreduction to no gross residual disease was associated with the best survival outcomes.1 Cytoreduction to 1 to 10 mm of residual disease was also...
Hypofractionated Radiotherapy Not Inferior to Conventional Radiotherapy in Low-Risk Prostate Cancer
Hypofractionated radiotherapy was not inferior to conventional radiotherapy in terms of disease-free survival among men with low-risk prostate cancer, according to the results of the phase III NRG Oncology RTOG 0415 trial reported in the Journal of Clinical Oncology by Lee et al. However, it was...
Some Diagnostic Variability in Interpreting Breast Biopsy Slides
Pathologists would disagree about 8% of the time when interpreting a single breast biopsy slide, with more overinterpretation than underinterpretation in discordant cases, according to an analysis combining results from the B-Path (Breast Pathology) study with data on the prevalence of breast...
Crizotinib in ROS1-Positive Metastatic Non–Small Cell Lung Cancer
On March 11, 2016, crizotinib (Xalkori) was approved for treatment of patients with metastatic non–small cell lung cancer (NSCLC) with ROS1 rearrangement–positive tumors.1,2 A U.S. Food and Drug Administration–approved test for the detection of ROS1 rearrangements in NSCLC is not currently...
Phase Ib/II Study Reports High Response Rates Seen With Addition of Cisplatin to Regimen for Advanced Pancreatic Cancer
The oncology research team at HonorHealth Research Institute in Scottsdale, Arizona, is spearheading a phase Ib/II trial that is demonstrating promising results with a novel regimen in patients with advanced pancreatic cancer. “The patients we are treating have advanced adenocarcinoma of the...
Computer-Assisted Decision Support in Medical Oncology: We Need It Now
Today’s medical oncologist is increasingly challenged to stay current with the latest developments in cancer treatment. I have been fortunate to speak with many oncologists over the past quarter-century on how professional life has evolved since the 1990s. These conversations have left me with a...
Throwing Out the Baby With the Bathwater: A Critical Appraisal of the USPSTF Recommendation Against Screening for Prostate Cancer
In 2012, the U.S. Preventive Services Task Force (USPSTF) issued a recommendation against routine screening for prostate cancer.1,2 The grade D recommendation was considered controversial at the time, and remains so now, because many stakeholders have weighed the same body of evidence and come to...
The POPLAR Trial: PD-L1 Blockade With Atezolizumab in Second- or Third-Line Non–Small Cell Lung Cancer
The randomized phase II POPLAR trial—reported by Fehrenbacher and colleagues and reviewed in this issue of The ASCO Post—is another key piece of information for the medical community regarding the value of immune checkpoint blockers in second/third-line treatment of patients with non–small cell...
Minimal Residual Disease in AML: Worth Looking?
As summarized in this issue of The ASCO Post, Ivey and colleagues demonstrated that assessing for NPM1-mutated gene transcripts by reverse-transcriptase quantitative polymerase chain reaction assay is a feasible approach for measuring minimal residual disease after acute myeloid leukemia (AML)...
Fecal Immunochemical Test Highly Sensitive and Effective When Used for Colorectal Cancer Annual Screening Programs
Annual screening with the fecal immunochemical test is highly sensitive for detecting colorectal cancer and “is feasible and effective for population-level colorectal cancer screening,” according to a large-scale retrospective cohort study assessing this test over four rounds of annual screening....
Expert Point of View: Wells Messersmith, MD
Wells Messersmith, MD, Professor and Head of Medical Oncology and Director of the Gastrointestinal Cancer Program, University of Colorado, Denver, discussed the two studies. Closer Look at STEAM Dr. Messersmith said the FOLFOXIRI (fluorouracil [5-FU], leucovorin, oxaliplatin, irinotecan) vs FOLFOX...
Studies Evaluate Bevacizumab-Containing Regimens in Metastatic Colorectal Cancer
Two trials reported at the 2016 Gastrointestinal Cancers Symposium evaluated bevacizumab (Avastin)-containing regimens in the first-line treatment of metastatic colorectal cancer and supported some, but not all, previous findings. The STEAM trial found some numerical differences but no...
Biomarkers in Prostate Cancer: PARP Inhibitors and Defects in DNA Repair
New data on molecular biomarkers in advanced prostate cancer are accumulating at a fast pace. The studies in this area can now be broadly grouped in two distinct areas—those that broadly relate to androgen signaling and those that relate to DNA-repair pathways. The Androgen-Signaling Pathway With...
PARP Inhibitor Olaparib Produces High Response Rate in Metastatic Prostate Cancer With DNA-Repair Defects
In the TOPARP-A phase II trial reported in The New England Journal of Medicine, Joaquin Mateo, MD, of the Institute of Cancer Research and The Royal Marsden in London, and colleagues, found that the PARP inhibitor olaparib (Lynparza) produced a high response rate in patients with previously treated ...
Minimal Residual Disease Identified by NPM1 Mutation Is a Powerful Marker for Poorer Outcome in Standard-Risk AML
In a study reported in The New England Journal of Medicine, Adam Ivey, MSc, from Guy’s Hospital, London, and colleagues found that a leukemia-specific marker consisting of mutation in the gene encoding nucleophosmin (NPM1) can be used to identify minimal residual disease in peripheral blood in...
Introduction of New Diagnostic Devices in Oncology: New Is Not Necessarily Better
“New!” “Improved!” “Throw out that old [fill in the blank] and go buy a new [fill in the blank]!” Sound familiar? The key to marketing is to convince customers that they need a product without which they had previously been quite happy. All too often, this strategy is accompanied by a caveat emptor ...
