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Showing 1851 - 1900Cabozantinib 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 ...
How Rehabilitation Services Provide Benefit for Patients With Spinal Metastases
The benefits of rehabilitation in traumatic spinal injuries are well established. Recently, studies have shown similarly positive results in cancer-related spinal injuries, indicating that rehabilitation can play a complementary role in the care management of this patient population....
Closing the Clinical Trial Gap for Adolescents and Young Adults With Cancer
Although overall survival rates for patients with cancer continue to soar—with 14.5 million cancer survivors today1—most of that gain is among pediatric and older adult patients. For adolescents and young adults with cancer—defined by the National Cancer Institute (NCI) as those in the 15- to...
Geriatric Assessment of Transplant-Ineligible Older Adults With Multiple Myeloma: A Novel Approach in the Era of Novel Agents
Myeloma is a disease of aging, with a median age at diagnosis in the United States of 69 years.1 As the population ages, forecasts estimate that, within 20 years, 3 of every 4 people diagnosed with multiple myeloma in the United States will be between the ages of 64 and 84 years.2 In anticipation...
Palbociclib Combined With Fulvestrant in Advanced Breast Cancer Progressing After Endocrine Therapy
On February 19, 2016, palbociclib (Ibrance) was approved for use in combination with fulvestrant (Faslodex) for treatment of hormone receptor–positive, HER2-negative advanced or metastatic breast cancer with disease progression following endocrine therapy.1,2 In February 2015, palbociclib in...
Cancer Survivorship Research: Learning From the Past to Improve Future Outcomes
Soon after effective therapies for some childhood malignancies were first identified, early leaders in our field had concerns about what would happen to surviving patients as they aged. In 1975, Giulio D’Angio, MD, one of the founders of modern pediatric radiation oncology, presciently called for...
Reduction in Late Mortality in Childhood Cancer Survivors
In a study reported in The New England Journal of Medicine, Gregory T. Armstrong, MD, MSCE, of St. Jude Children’s Research Hospital, Memphis, and colleagues found that late mortality has decreased over time among 5-year survivors of childhood cancer in the Childhood Cancer Survivor Study cohort.1...
FDA Approves Crizotinib for ROS1-Positive Metastatic Non–Small Cell Lung Cancer
The U.S. Food and Drug Administration has approved the tyrosine kinase inhibitor crizotinib (Xalkori) for the treatment of patients with metastatic non–small cell lung cancer (NSCLC) whose tumors are ROS1-positive. Crizotinib was first approved in 2011 for the treatment of patients whose tumors are ...
Anticoagulation in Patients With Cancer: Understanding the Complexities of Prophylaxis and Management
Venous thromboembolic events are more prevalent in patients with cancer than in persons without it. Cancer is associated with a high rate of venous thromboembolism recurrence, bleeding, requirement for long-term anticoagulation, and reduced quality of life. Moreover, thrombosis is the second most...
Chronic Lymphocytic Leukemia: The Golden Drug Only for Golden Agers?
As reviewed in this issue of The ASCO Post, Burger and colleagues recently reported findings of the RESONATE-2 trial of ibrutinib (Imbruvica) vs chlorambucil (Leukeran) as initial therapy for elderly patients with chronic lymphocytic leukemia (CLL).1 The study met its primary endpoint of...
First-Line Ibrutinib Improves Progression-Free and Overall Survival vs Chlorambucil in Older Patients With Chronic Lymphocytic Leukemia
As reported in The New England Journal of Medicine and at the 2015 American Society of Hematology Annual Meeting, Jan A. Burger, MD, PhD, and colleagues found that first-line treatment with the oral Bruton’s tyrosine kinase inhibitor ibrutinib (Imbruvica) improved progression-free and overall...
Selected Abstracts From 2015 ASH Annual Meeting: Part 3
Here are several more abstracts selected from the proceedings of the 2015 American Society of Hematology (ASH) Annual Meeting and Exposition, focusing on the topic of anticoagulation and the cancer patient. For other selected abstracts from this conference, see the December 25, 2015, and the...
Role of Ado-Trastuzumab Emtansine in Metastatic Breast Cancer Solidified
Ado-trastuzumab emtansine (formerly T-DM1; Kadcyla) improved overall survival compared with treatment of physician’s choice of therapy for patients with pretreated HER2-positive metastatic breast cancer, according to the phase III TH3RESA trial.1 Patients enrolled in the trial had previously been...
Survivorship Care in Manitoba: Transition Appointments and Follow-up Care Plans
Working with specialized oncology teams, a provincial agency in Manitoba, Canada, has developed standardized care plans and guidelines for cancer survivors that are implemented in a transition appointment.1 This appointment, which follows the end of active treatment, marks the transfer of medical...
Study Finds No Progression-Free Survival Benefit for Weekly Dose-Dense vs Every-3-Week Paclitaxel Plus Carboplatin in Ovarian Cancer
Weekly dose-dense paclitaxel did not provide a progression-free survival benefit over every-3-week paclitaxel in combination with carboplatin and with or without elective bevacizumab (Avastin) in patients with previously untreated ovarian cancer, according to the results of the phase III GOG-0262...
Mistletoe
The use of dietary supplements by patients with cancer has increased significantly over the past 20 years despite insufficient evidence of safety and effectiveness. Finding reliable sources of information about dietary supplements can be daunting. Patients typically rely on family, friends, and...
Nivolumab Plus Ipilimumab in Unresectable or Metastatic Melanoma Regardless of BRAF Mutation Status
On January 23, 2016, the indication for nivolumab (Opdivo) plus ipilimumab (Yervoy) in unresectable or metastatic melanoma was expanded through accelerated approval to include patients regardless of BRAF V600 mutation status.1 The combination was previously approved for treatment of patients with...
Management of Advanced Lung Cancer in the Elderly: A Reason to Rejoice or a Cause for Concern?
There is ample evidence to suggest that older adults with a good performance status (0 or 1) with advanced non–small cell lung cancer (NSCLC) should be treated with combination chemotherapy akin to younger patients.1,2 However, older adults comprise a heterogeneous group that has been...
New Technology to Characterize Circulating Tumor Cells Suggests Better Treatment Decision-Making in Prostate Cancer
An early study showed that an experimental blood test (ie, “liquid biopsy”) that characterizes the phenotype and genomic characteristics of circulating tumor cells appears to have utility in personalizing treatment decisions for individual men with advanced prostate cancer.1 The assay—developed and ...
Clinic-Based Weight-Loss Intervention Successful in Cancer Survivors
A randomized clinical trial examining the effect of a 15-week healthy living program on weight loss in cancer survivors showed a 5.3% decrease in baseline body weight in those participating in the program.1 “Cancer survivors randomized to a 15-week clinic-based weight-loss intervention lost an...
Bridging the Medical Gap in Long-Term Cancer Survivorship Care
Although more people than ever before are surviving cancer—there are currently 14.5 million cancer survivors, and that number is expected to climb to 19 million by 20241—they often experience long-lasting physical, emotional, and financial concerns related to the disease. To address the unmet...
Surveillance for Recurrence and Second Cancers: Guidelines and Caveats
Striking the right balance between under- and oversurveillance of cancer survivors is challenging, and oncology providers are best served by knowing and following guidelines—though they can change often. Cancer recurrence and second cancers are two of the major threats to the health of cancer...
Fecal Immunochemical Test Sensitive and Effective for Annual Colorectal Cancer Screening
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 the fecal immunochemical...
Dutch Study Shows Increased Risk of Second Cancer for Survivors of Hodgkin Lymphoma During Long-Term Follow-up
In a Dutch study reported in The New England Journal of Medicine, Schaapveld et al found that survivors of Hodgkin lymphoma treated between 1965 and 2000 were at a 4.6-fold greater risk of second cancer vs the general population during long-term follow-up. There was no significant difference in the ...
Reduction in Late Mortality in Childhood Cancer Survivors in the Childhood Cancer Survivor Study Cohort
In a study reported in The New England Journal of Medicine, Armstrong et al found that late mortality decreased over time among 5-year survivors of childhood cancer in the Childhood Cancer Survivor Study cohort. The reduction is consistent with efforts during recent decades to modify treatment with ...
