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Conquering Cancer With 2013 Career Development Award Recipient Rebecca A. Gardner, MD

Rebecca A. Gardner, MD is an Assistant Professor at the University of Washington and Attending Physician at Seattle Children’s Hospital. She received a 2013 Conquer Cancer Foundation of ASCO Career Development Award (CDA) for her project “Autologous T cells genetically modified to express a CD19...

hematologic malignancies

FDA Approval of Siltuximab for Multicentric Castleman’s Disease

INSIDE THE BLACK BOX is an occasional column providing insight into the FDA and its policies and procedures. In this installment, FDA hematologist/oncologist Albert Deisseroth, MD, PhD, discusses the recent approval of siltuximab for patients with multicentric Castleman’s disease who are human...

colorectal cancer

Many Patients With Colorectal Cancer Fail to Receive Adjuvant Chemotherapy

Data from the National Cancer Data Bank (2010–2011) suggest that 30% of patients with colorectal cancer who are eligible for adjuvant chemotherapy fail to receive it, but their odds increase by 30% when surgery is performed by laparoscopy, rather than laparotomy.1 “In this large national database...

colorectal cancer

Colorectal Cancer Screening Poised for Change

New screening modalities and the customization of the screening population could soon change the way that screening for colorectal cancer is done. At Digestive Disease Week 2014, the largest gathering of gastrointestinal disease specialists in the world, researchers presented data suggesting that...

breast cancer

Preoperative Breast MRI: Does Higher Sensitivity Equal Better Outcomes?

Breast magnetic resonance imaging (MRI) is superior to more commonly used imaging modalities in preoperative breast cancer staging and should be a key element in routine workup. But despite its high sensitivity for catching cancers, breast MRI still does not deliver maximum value for the patient....

pancreatic cancer

Research Insights From the AACR Special Conference on Pancreatic Cancer

Pancreatic cancer still kills 40,000 Americans a year out of approximately 44,000 diagnosed. While advances in diagnosis and treatment are extending the lives of patients with other cancers, pancreatic ductal adenocarcinoma remains the second most lethal tumor (behind lung cancer). While a magic...

Expert Point of View: Gregory A. Masters, MD, FASCO

This combination shows good activity in the difficult-to-treat second-line setting of NSCLC,” said Gregory A. Masters, MD, FASCO, about the results of the REVEL study reported at the ASCO Annual Meeting. Dr. Masters, who is Attending Physician at the Helen F. Graham Cancer Center and Research...

Expert Point of View: Sherene Loi, MD PhD

Sherene Loi, MD PhD, Head of the Translational Breast Cancer Genomics Lab at the Peter McCallum Cancer Centre, Victoria, Australia, commented on the N9831 study presentation and referred to her group’s own work on tumor-infiltrating lymphocytes. These investigators have shown a positive association ...

breast cancer

Immune-Related Genes Predictive of Trastuzumab Benefit

Improved relapse-free survival following treatment with adjuvant trastuzumab (Herceptin) appears to be associated with a heightened state of immunologic function, according to genomic analysis that resulted in a 14-gene profile predictive of outcomes in the landmark NCCTG (Alliance) N9831 trial.1...

Expert Point of View: Sharon H. Giordano, MD, MPH

Formal discussant Sharon H. Giordano, MD, MPH, Professor of Medicine and Chair of Health Services Research at The University of Texas MD Anderson Cancer Center, Houston, emphasized how important it is to preserve fertility in these younger patients with breast cancer. “The main downside is an...

breast cancer

Goserelin With Chemotherapy Prevents Early Menopause, Helps Preserve Fertility in Younger Women With Hormone Receptor–Negative Breast Cancer

The good news for younger women with hormone receptor–negative early breast cancer is that adding goserelin (Zoladex), a luteinizing hormone–releasing hormone (LHRH) agonist, to chemotherapy can prevent sudden menopause, better preserve ovarian function and fertility, and lead to successful...

Expert Point of View: Gregory A. Masters, MD, FASCO

At an ASCO press conference held during the Annual Meeting, moderator Gregory A. Masters, MD, FASCO, who is Attending Physician at the Helen F. Graham Cancer Center and Research Institute, Newark, Delaware, commented on the study presented by Liu et al. “This new combination demonstrates how...

gynecologic cancers

Oral Two-Drug Regimen Appears Promising in Phase II Trial of Recurrent Platinum-Sensitive Ovarian Cancer

An all-oral combination of the investigational agents olaparib and cediranib nearly doubled progression-free survival in platinum-sensitive recurrent ovarian cancer in a National Cancer Institute (NCI)-sponsored randomized phase II trial reported at the 2014 ASCO Annual Meeting.1 The toxicity...

Expert Point of View: Nasser H. Hanna, MD

Formal discussant of the study by Park et al, Nasser H. Hanna, MD, Associate Professor of Medicine at the Indiana University Simon Cancer Center, Indianapolis, said that the trial confirms the difficulty of giving consolidation therapy, since less than two-thirds of patients were able to get the...

lung cancer

Pieces of the Puzzle in Treating Early Non–Small Cell Lung Cancer

Separate studies in early-stage non–small cell lung cancer (NSCLC) found that the addition of consolidation chemotherapy to concurrent chemoradiotherapy did not improve survival and that adjuvant erlotinib (Tarceva) did not improve survival. There was a suggestion of benefit for adjuvant erlotinib...

leukemia

Ibrutinib Surpasses Ofatumumab as Second-Line Treatment of Chronic Lymphocytic Leukemia

Ibrutinib (Imbruvica) significantly improved progression-free survival, overall survival, and response when compared with ofatumumab (Arzerra) as second-line treatment of chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) in the phase III RESONATE study. The study results were...

Expert Point of View: Steven J. O’Day, MD, Don S. Dizon, MD, Michael Birrer, MD, PhD

Steven J. O’Day, MD, Director, Clinical Research, Beverly Hills Cancer Center and Director, Los Angeles Skin Cancer Institute, Beverly Hills, California, commented on cervical cancer study by Hinrichs et al from the National Cancer Institute (NCI) during a press briefing at the ASCO Annual Meeting. ...

gynecologic cancers

Early Study Explores New Approach to Treating Advanced Cervical Cancer

A small, federally funded study of nine patients treated with human papillomavirus (HPV)-targeted adoptive T-cell therapy gives reason to hope that this type of therapy may be a new effective approach for patients with metastatic cervical cancer and possibly other solid tumors.1 In the study, two...

Expert Point of View: Cora N. Sternberg, MD, FACP

Despite the availability of hormonal therapy for the treatment of metastatic prostate cancer and the high response rates for these agents, most patients eventually experience progression to castration-resistant disease. “Multidisciplinary team approaches have contributed to the enormous progress...

prostate cancer

Updated Information on Prostate Cancer Drugs: Enzalutamide, Orteronel, and Cixutumumab

Three separate studies of treatments for prostate cancer reported at the 2014 ASCO Annual Meeting in Chicago showed excellent, intermediate, and disappointing results. An update of the previously reported PREVAIL trial (see March 1 issue of The ASCO Post, page 1) was overwhelmingly positive for the ...

Expert Point of View: Josep Tabernero, MD, PhD

Josep Tabernero, MD, PhD, Head of Medical Oncology and the Institute of Oncology at Vall d’Hebron University Hospital in Barcelona, Spain, discussed the results of CALGB/SWOG 80405 at the ASCO Plenary Session. “CALGB/SWOG 80405 did not meet the primary endpoint of superiority [for cetuximab] in a...

colorectal cancer

Combined With Chemotherapy, Cetuximab and Bevacizumab Found Comparable for First-Line Metastatic Colorectal Cancer Treatment

Call it a draw: Cetuximab (Erbitux), an EGFR inhibitor,  and bevacizumab (Avastin), a VEGF inhibitor, confer comparable benefits as first-line treatment with chemotherapy for metastatic colorectal cancer, according to the phase III Cancer and Leukemia Group B (CALGB)/Southwest Oncology Group (SWOG) ...

Advancing Immune Checkpoint Targeting in Cancer Treatment

James P. Allison, PhD, Professor and Chair of the Department of Immunology, Executive Director of the Moon Shots Immunotherapy Platform, and Deputy Directory of the David H. Koch Center for Applied Research of Genitourinary Cancers at The University of Texas MD Anderson Cancer Center, Houston, is...

lung cancer
issues in oncology

Time to Move Forward With Lung Screening

Start with the most lethal cancer globally—lung cancer—for which standard approaches result in a modest 5-year survival. Then consider the results from the National Lung Screening Trial (NLST), suggesting in a well done randomized study that significant mortality reduction does occur with low-dose...

Expert Point of View: Nancy E. Davidson, MD, and Claudine Isaacs, MD

This study provides key insights into the longstanding and vexing debate about optimal systemic therapy for these young women. We wonder about the role of tamoxifen, aromatase inhibitors, chemotherapy, and ancillary therapies like bisphosphonates,” said Nancy E. Davidson, MD, Director of the...

breast cancer

Exemestane/Ovarian Suppression Reduces Recurrence vs Tamoxifen/Ovarian Suppression in Premenopausal Breast Cancer

A joint analysis of two important phase III clinical trials—TEXT (Tamoxifen and Exemestane Trial) and SOFT (Suppression of Ovarian Function Trial)—showed that exemestane plus ovarian function suppression was superior to tamoxifen plus ovarian suppression in preventing recurrence in premenopausal...

breast cancer
survivorship

Coping With the Aftermath of Cancer

Even now, 3 years after I was diagnosed with breast cancer, I’m still struggling with how it is possible to have a normal mammogram and 6 months later be confronted with stage II estrogen/progesterone–positive, HER2-positive breast cancer. The news was especially devastating to hear because it...

skin cancer

Modest Improvement in Progression-Free but Not Overall Survival With Selumetinib vs Chemotherapy

Patients with uveal melanoma treated with selumetinib had modestly improved progression-free survival and response rate compared to patients treated with chemotherapy, but no improvement in overall survival, according to results of a randomized, open-label, phase II trial. “Improvement in clinical...

head and neck cancer
issues in oncology

Limited Public Awareness of Head and Neck Cancers Raises Concerns About Prevention and Detection

Public awareness of head and neck cancer is limited, with the lack of awareness including the term head and neck cancer and common symptoms and risk factors, such as tobacco use and human papillomavirus (HPV), according to results of a cross-sectional online survey reported in JAMA...

breast cancer

Underuse of Trimodality Treatment for Patients With Inflammatory Breast Cancer Negatively Impacts Survival

Analysis of data for 10,197 women treated for nonmetastatic inflammatory breast cancer treated over a 12-year-period found that the use of trimodality treatment (chemotherapy, surgery, and radiation therapy) fluctuated annually between 58.4% and 73%. “Underutilization of trimodality therapy...

Expect Questions but Not a Lot of Resistance

Stopping statin therapy is safe for patients with cancer who have a life expectancy of no more than a year, according to a randomized study reported at the 2014 ASCO Annual Meeting. Discontinuing statins did not shorten survival, reduced symptom burden, improved overall quality of life, and led...

palliative care

Discontinuing Statins Near the End of Life Is Safe, Can Reduce Symptom Burden, and Is Generally Acceptable to Patients

Discontinuing statins for patients near the end of life is safe, saves money, spares patients from swallowing yet another pill and from the symptoms associated with statins, and is generally welcomed by patients. That last bit might come as a surprise to some physicians who worry that discontinuing ...

hematologic malignancies

Siltuximab for Multicentric Castleman’s Disease

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 23, 2014, the anti–interleukin (IL)-6 monoclonal antibody...

FDA Launches 'OpenFDA' Initiative to Ease Access to Public Health Data

The U.S. Food and Drug Administration (FDA) has launched openFDA, a new initiative designed to make it easier for web developers, researchers, and the public to access large, important public health datasets collected by the Agency. In alignment with the recent Presidential Executive Order on Open...

issues in oncology

UC Davis Comprehensive Cancer Center Tailors Pilot Program to Help Patients Adhere to Oral Chemotherapy

A University of California, Davis, Comprehensive Cancer Center program designed to better manage cancer patients taking oral chemotherapy drugs has demonstrated that one-on-one counseling, education, and monitoring can improve adherence to therapy. Issues in Adherence The rise in oral chemotherapy...

issues in oncology

'Physician Education Is Key' to Continued Advances in Geriatric Oncology

Several times during his lecture at the 2014 ASCO Annual Meeting, Stuart M. Lichtman, MD, FACP, FASCO, the recipient of the B.J. Kennedy Award for Scientific Excellence in Geriatric Oncology, emphasized, “Physician education is the key” to continued advances in geriatric oncology. He specified that ...

issues in oncology

ASCO Convenes Think Tank to Tackle Disparities in Cancer Care

Despite advances in cancer screening and in more effective therapies to treat the disease, which have led to improved outcomes and increased survival rates for millions of people with cancer, not every American is reaping the benefits of these advances. Disparities in health-care access, quality of ...

leukemia

Nonadherence With Maintenance Medication an Issue in Children With Leukemia

An estimated 25% of children in remission from acute lymphocytic leukemia (ALL) are missing too many doses of the oral agent mercaptopurine, a maintenance medication that minimizes their risk of relapse when taken every day for 2 years, according to a study recently published online in Blood.1 The...

lung cancer

Importance of Using Multiplex Testing for Oncogenic Drivers to Select Targeted Drugs in Lung Cancer

Lung cancer is the leading cause of cancer death in the world as well as in the United States, where it is the leading cancer killer in both men and women. The majority of lung cancer patients present with metastatic (stage IV) disease that cannot be cured with current therapies. Standard cytotoxic ...

lung cancer

Lung Cancer Mutation Consortium Finds Oncogenic Drivers in Majority of Metastatic Lung Adenocarcinomas

The Lung Cancer Mutation Consortium (LCMC) was formed to test adenocarcinomas of the lung for 10 oncogenic drivers in order to enable clinicians to select targeted treatments and enroll patients into suitable clinical trials. As recently reported in JAMA by Mark G. Kris, MD, William and Joy Ruane...

Following ‘Fruitful’ Year of Collaboration, Advocacy, and Growth, Pediatric Hematology/Oncology Moves to Next Level

Finishing up a 2-year term as President of the American Society of Pediatric Hematology/Oncology (ASPHO), A. Kim Ritchey, MD, summarized ASPHO’s achievements in advocacy, education, and professional development in his State of the Society address at the ASPHO 27th Annual Meeting in Chicago. He also ...

Be Counted in 2014 ASCO National Oncology Census— No Login Information Required

Please be counted in this year’s ASCO National Oncology Census—the only annual survey of the entire oncology community that aims to capture and describe changes in cancer care over time. Through the 2013 census, more than 8,000 oncologists in community practices, hospitals, and academic medical...

colorectal cancer

Panitumumab Plus FOLFOX for KRAS Wild-Type Metastatic Colorectal Cancer

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. Panitumumab (Vectibix) was recently approved by the U.S. Food and...

breast cancer

ASCO Clinical Practice Guideline: Disease Management in Advanced HER2-Positive Breast Cancer With Brain Metastases

As many as half of all patients with metastatic HER2-positive breast cancer develop brain metastases over time. The American Society of Clinical Oncology recently released a clinical practice guideline on disease management for patients with advanced HER2-positive breast cancer and brain...

breast cancer

Ado-Trastuzumab Emtansine as a Late Treatment for HER2-Positive Metastatic Breast Cancer—Better and Less Toxic Than Physician’s Choice

TH3RESA is a randomized phase III open-label study, reported in The Lancet Oncology and summarized in this issue of The ASCO Post, which examined the activity of ado-trastuzumab emtansine (Kadcyla) in heavily pretreated HER2-positive metastatic breast cancer.1 Formerly known as T-DM1,...

breast cancer

Ado-Trastuzumab Emtansine Improves Progression-Free Survival vs Physician’s Choice in Advanced HER2-Positive Breast Cancer

There are few treatment options for breast cancer patients with progressive disease after two or more HER2-directed regimens for recurrent or metastatic disease. In the open-label phase III TH3RESA trial reported in The Lancet Oncology by Ian E. Krop, MD, PhD, of the Dana-Farber Cancer Institute,...

National Institutes of Health Names New Council Members

The National Institutes of Health has announced the appointment of nine individuals to the NIH Council of Councils. The Council was established to advise the NIH Director on policies and activities of the Division of Program Coordination, Planning, and Strategic Initiatives (­DPCPSI), including...

issues in oncology

Navigating Cancer in the Era of Personalized Medicine: Rev 2014 Explores Emerging Issues, Ideas for Action

Diagnosed with stage IV non–small cell lung cancer in 2011, Stephen Wright turned to patient support groups where he learned about the anaplastic lymphoma kinase (ALK) mutation and a new drug that targeted it, crizotinib (Xalkori). He asked—then insisted—that he be tested for the mutation. He found ...

gynecologic cancers

FDA Advisory Committee Votes Against Accelerated Approval for Olaparib in Ovarian Cancer

The U.S. Food and Drug Administration (FDA) Oncologic Drugs Advisory Committee (ODAC) voted 11 to 2 that current evidence from clinical studies does not support an accelerated approval for use of olaparib as a maintenance treatment for women with platinum-sensitive relapsed ovarian cancer who have...

Expert Point of View: Jeffrey S. Weber, MD, PhD

Jeffrey S. Weber, MD, PhD, Director of the Donald A. Adam Comprehensive Melanoma Research Center at the Moffitt Cancer Center and Research Institute, Tampa, Florida, was very impressed by the response rate and survival outcomes. “Responses were outstanding. Eight of nine patients in cohort 2...

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