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Showing 1901 - 1950Expanded Approval of Pembrolizumab in Unresectable or Metastatic Melanoma
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 December 18, 2015, approval of the programmed cell death...
Transcription Factor CDX2 May Be Prognostic Biomarker in Stage II and III Colon Cancer
In a study reported in The New England Journal of Medicine, Dalerba et al found that absence of the transcription factor CDX2, although prognostic for poor outcome in stage II and III colon cancer vs cancers with CDX2 expression, identified a subgroup of high-risk patients who appeared to benefit...
Dr. Abraham’s Top-10 Picks for the Most Clinically Relevant Breast Cancer Studies of 2015
Sparano JA, Gray RJ, Makower DF, et al: Prospective validation of a 21-gene expression assay in breast cancer. N Engl J Med 373:2005-2014, 2015. Chagpar AB, Killelea BK, Tsangaris TN, et al: A randomized, controlled trial of cavity shave margins in breast cancer. N Engl J Med 373:503-510, 2015....
Selected Abstracts From 2015 San Antonio Breast Cancer Symposium
The 2015 San Antonio Breast Cancer Symposium (SABCS), hosted by the American Association for Cancer Research, the Cancer Therapy & Research Center at The University of Texas Health Sciences Center at San Antonio, and Baylor College of Medicine, was held in December 2015. As has been true for...
Pembrolizumab Label Updated With New Clinical Trial Information
Late in 2015, the U. S. Food and Drug Administration (FDA) expanded the label for pembrolizumab (Keytruda), a humanized antibody, to include the initial treatment of patients with unresectable or metastatic melanoma. Previously, pembrolizumab had received accelerated approval in patients with...
Pieces of Grief
The ASCO Post is pleased to reproduce installments of the “Art of Oncology” as published previously in the Journal of Clinical Oncology (JCO). These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...
Acupuncture for Cancer Symptom Clusters
Acupuncture has been practiced for thousands of years in Eastern Asian cultures as a component of traditional Chinese medicine.1 In the United States, acupuncture became known to the public as a complementary and alternative medicine technique in the 1970s, but it took many years before it was...
Winning the Battle at the Front Lines: Lenalidomide Plus Rituximab— A Promising Initial Treatment for Mantle Cell Lymphoma
Mantle cell lymphoma is a pernicious, incurable disease. Front-line therapies for this disease are not currently standardized; however, novel therapies for relapsed or refractory mantle cell lymphoma can ideally be translated into beneficial treatments for newly diagnosed patients, as clearly...
Lenalidomide Plus Rituximab Highly Active in Initial Treatment of Mantle Cell Lymphoma
In a phase II trial reported in The New England Journal of Medicine by Jia Ruan, MD, PhD, and colleagues, first-line treatment with the immunomodulatory agent lenalidomide (Revlimid) and the anti-CD20 antibody rituximab (Rituxan) followed by maintenance lenalidomide and rituximab produced a high...
How Effective Communication Can Improve Patient Care—and Reduce Physician Burnout
Surveys conducted between 1950 and 1970 show that most physicians considered it inhumane to give patients with a poor cancer prognosis the bad news.1,2 Since then, it has been well established that open communication between physician and patient is an essential part of effective cancer care and...
The Evolving Treatment Landscape of ALK-Positive NSCLC
Since the initial discovery of ALK rearrangement in non–small cell lung cancer (NSCLC) in 2007,1 small molecule tyrosine kinase inhibitors of ALK have transformed the course of disease for those patients with ALK-rearranged (ie, ALK-positive) NSCLC. Crizotinib (Xalkori), a multitargeted tyrosine...
Homologous Recombination Deficiency Score Correlated With Response to Platinum in Breast Cancer
The homologous recombination deficiency (HRD) score may be a predictive biomarker of response to neoadjuvant platinum-based therapy in patients with triple-negative breast cancer, according to studies presented at the 2015 San Antonio Breast Cancer Symposium. “We found, in our adjusted analysis,...
Study Finds Colorectal Cancer More Likely to Affect Minorities at Younger Age
Researchers at the University of Missouri School of Medicine reported that minority and ethnic groups are being diagnosed with colorectal cancer at younger ages and more advanced stages than non-Hispanic whites. The study was recently published in Cancer Medicine.1 “While we know the risk of...
Elotuzumab in Previously Treated Multiple Myeloma
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 November 30, 2015, elotuzumab (Empliciti) was approved for...
Plasma-Based Test Identifies Impactful Mutations in BOLERO-2 Population
A plasma-based cell-free DNA test identified mutations in the estrogen receptor 1 gene (ESR1) in 30% of patients from the BOLERO-2 trial of everolimus (Afinitor) plus exemestane, and these mutations were correlated with survival. The results, which support the use of plasma as a source of...
The 340B Drug Pricing Program: Background, Concerns, and Solutions
The 340B Drug Pricing Program was created by Congress through the Veterans Health Care Act of 1992 to allow some health-care entities—including safety-net providers with large shares of uninsured and low-income patients and other “covered entities”—to obtain drugs at discounted prices.1,2 Congress...
Study Finds Fecal Immunochemical Test Effective for Annual Colon Cancer Screening
Although the fecal immunochemical test is a common method for colorectal cancer screening, its acceptability and performance over several rounds of annual testing are largely unknown. Now, a large retrospective cohort study by Jensen et al assessing the fecal immunochemical...
American College of Physicians Issues Advice for Evaluating Hematuria as a Marker of Urinary Tract Cancer
Although little controversy exists regarding the indication for urologic evaluation for patients with gross hematuria, the evaluation of patients with the much more common finding of microscopic hematuria is complicated by a lack of clarity regarding indications for clinical referral, according to...
Hormone Replacement and Ovarian Cancer: Competing Risks in Decisions about Bilateral Salpingo-oophorectomy
Recently reported findings that bilateral salpingo-oophorectomy and hysterectomy decreased the risk of ovarian cancer compared to ovarian conservation and hysterectomy, without increasing cardiovascular, fracture, and other cancer risks, should “challenge” current thinking about bilateral...
Death Rates Significantly Reduced for Men Having Radical Prostatectomy vs Watchful Waiting
Estimated 15-year results from the Scandinavian Prostate Cancer Group Study (SPCG-4) show that men diagnosed with early prostate cancer and randomly assigned to radical prostatectomy continued to have significantly reduced rates of death from prostate cancer, death from any cause, and risk of...
Understanding Crizotinib, 1 Year after High-profile Presentation
The findings from a phase I study of crizotinib in non–small cell lung cancer (NSCLC) were presented in a Plenary Session at the 2010 ASCO Annual Meeting—an unusual event, since such early-phase data are not generally the topic of plenary sessions. The study showed that a majority of mostly...
Iniparib Fails to Improve Outcomes in Triple-negative Breast Cancer
As reported in the March 15 issue of The ASCO Post, a phase III trial of the novel agent iniparib failed to demonstrate a significant improvement in survival for women with metastatic triple-negative breast cancer. The “top-line” results were communicated in the spring via press releases from...
Novel Agents Improve Survival in Patients with Metastatic Melanoma
Novel treatments for metastatic melanoma dominated the buzz at the 2011 ASCO Annual Meeting and across the major news outlets, with reports that two agents with entirely different mechanisms of action could extend survival. The studies’ inclusion in the ASCO Plenary Session attested to the...
Conflicts of Interest in Health-care Reform?
Last year’s health-care reform legislation, the Patient Protection and Affordable Care Act, was designed to incrementally roll out major new bureaucratic entities, oversight, and mandates for the practice of medicine between its enactment and 2013, after the next presidential election. A new...
Exemestane Prevents Invasive and Preinvasive Breast Cancers in MAP.3 Trial
The aromatase inhibitor exemestane, taken for 5 years, significantly reduced invasive and preinvasive breast cancers in postmenopausal women at increased risk for the disease, in the large Canadian NCIC CTG MAP.3 randomized trial. Results of the trial were presented at the recent ASCO Annual...
Conventional Induction Chemotherapy Beneficial in Only a Subset of Older Adults with AML
Over the past several decades, progress in the treatment of acute myeloid leukemia (AML) in the older population (generally considered to be older than 60 years) has been limited (Fig. 1). In particular, the outcome of patients over age 70 has been poor, with few long-term survivors. Although AML...
Despite Advances, Little Overall Improvement Seen in Treatment of Older Adults with AML
The outcome of treatment of older adults with acute myeloid leukemia (AML) remains unsatisfactory, although certainly not a totally futile exercise. Patients satisfying the entry criteria for cooperative group clinical trials can be expected to have complete remission rates of 50% to 55%, with...
A Conversation with Barrie R. Cassileth, PhD
Barrie R. Cassileth, PhD, Chief, Integrative Medicine Service at Memorial Sloan-Kettering Cancer Center (MSKCC) in New York, recently spoke with The ASCO Post about her quest to stamp out the illegitimate use of alternative medicine in cancer care and the results from her latest research. A...
Evaluating Risk for Suicide in People Diagnosed or Living with Cancer
The challenges of life-threatening physical illness can sometimes lead to suicide. In fact, given the critical stressors that a person with cancer faces, we might expect suicide to be a more common reaction. Patients with cancer are at increased risk of completed suicide, though the prevalence of...
A Landmark Lung Screening Trial: What Does It Mean for Clinicians and Their Patients?
The NCI-funded National Lung Screening Trial (NLST), published recently in The New England Journal of Medicine,1 was heralded as a landmark study in lung cancer detection. This study is the first comprehensive clinical trial to find that screening high-risk individuals with low-dose CT reduces lung ...
Androgen Deprivation Therapy plus Radiotherapy Increases Survival in Men with Localized Prostate Cancer
The addition of short-term androgen deprivation therapy to radiotherapy for men with stage T1b, T1c, T2a, or T2b prostate adenocarcinoma and a prostate-specific antigen (PSA) level of 20 ng/mL or less “conferred a modest but significant increase in the 10-year rate of overall survival, from 57 to...
Expert Point of View: World Conference on Lung Cancer
The EURTAC study provides additional evidence of the efficacy of the oral EGFR inhibitors in the first-line treatment of patients with mutated EGFR—and, importantly, in Western patients, rather than Asians, for whom data are more abundant. “The findings speak to the fact that all patients with...
Androgen Deprivation plus Radiotherapy Increases Survival in Men with Localized Prostate Cancer
Adding short-term androgen-deprivation therapy to radiotherapy “conferred a modest but significant increase in the 10-year rate of overall survival, from 57% to 62%,” in men with localized prostate cancer enrolled in Radiation Therapy Oncology Group (RTOG) trial 94-08. “This increase was...
Many Women Treated for High-risk Breast Cancer Do Not Receive Recommended Postmastectomy Radiation Therapy
Despite major studies showing that postmastectomy radiation therapy improves survival for women with high-risk breast cancer and evidence-based guidelines supporting the use of postmastectomy radiotherapy, 45% of these patients do not receive such treatment, according to an analysis of data from...
Using the New Melanoma Drugs in the Clinic
With two effective new treatments for advanced melanoma, the question has become how to best use them and how to manage their toxicities. Vemurafenib (Zelboraf) and ipilimumab (Yervoy)1 have different pharmacokinetics, which lend themselves to different patient types. Omid Hamid, MD, of The...
Novel Drugs Ipilimumab and Vemurafenib for Advanced Melanoma
In this introductory installment of In the Clinic, The ASCO Post provides an overview of two new melanoma agents recently approved by FDA, with discussion on pivotal data leading to approval, dosage and administration, and managing drug-related toxicities. Watch for more on clinical use of novel...
Short-term Androgen Deprivation plus Radiotherapy Improves Outcomes in Intermediate-risk Prostate Cancer
The addition of short-term androgen-deprivation therapy to external-beam radiation therapy improved overall and disease-specific survival in men with nonbulky localized prostate cancer and prostate-specific antigen (PSA) levels up to 20 ng/mL, as reported recently in The New England Journal of...
No Value for Axillary Dissection in Patients with Breast Cancer and Occult Nodal Metastases
In a subanalysis of the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-32 study, nearly 16% of clinically node-negative patients were found to have occult metastases upon more detailed assessment of the sentinel lymph nodes. While a slight difference in outcomes was found among this...
SIDEBAR: Expert Q and A
D. Neil Hayes, MD, MPH, of the University of North Carolina, Chapel Hill, discusses the role of HPV status in head and neck cancer. Are you convinced human papillomavirus (HPV) positivity is associated with better prognosis? Dr. D. Neil Hayes: The HPV story influences almost everything we do in...
Crizotinib: New Drug for ALK-positive Advanced Non–Small Cell Lung Cancer
Indication Crizotinib (Xalkori) is an oral inhibitor of receptor tyrosine kinases including anaplastic lymphoma kinase (ALK), hepatocyte growth factor receptor (HGFR, c-Met), and recepteur d’origine nantais (RON). In August 2011, the FDA granted the drug accelerated approval for the treatment of...
Do We Need the USPSTF?
Like most of the folks reading this commentary, I’m a taxpayer. Although I sometimes become impatient with the strategic games on Capitol Hill, I basically appreciate that government helps many things to work, and some of them even work well. However, there are aspects of government function that...
Fewer False-positives, Small Increased Risk of Late Diagnosis with Biennial Mammography
Screening mammography every other year reduced false-positive recalls by about one-third compared to annual screening, but was associated with a small increase in the probability of late-stage cancer diagnosis, according to a study funded by the NCI and published in Annals of Internal Medicine. To...
Adjuvant Trastuzumab in Nonanthracycline Regimen Studied
One of four large, randomized trials to evaluate adjuvant trastuzumab (Herceptin) in early-stage HER2-positive breast cancer—and the only study to include a nonanthracycline chemotherapy regimen—found that regimen had similar efficacy to anthracycline-containing regimens, but with lower rates of...
Biosimilars in Cancer Treatment: What Should the Oncology Community Expect?
Alternative versions of biologic agents, ie, “biosimilars,” will presumably be getting the green light by the FDA, giving oncologists more choices for treatments that come at lower costs to patients and society. The FDA plans to issue its guidance on biosimilars by the end of this year, paving the...
Sunitinib and Everolimus: New Indications in Pancreatic Neuroendocrine Tumors
With In the Clinic, The ASCO Post 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. Sunitinib Indication—The oral kinase inhibitor...
Preoperative Chemoradiotherapy May Extend Survival for Patients with Esophagogastric Junction Adenocarcinoma
Several American and European clinical trials have yielded mixed results on the survival advantage of preoperative chemoradiotherapy for patients with locally advanced esophagogastric junction adenonocarcinoma. However, a distinguished panel at the 2011 ASTRO Annual Meeting did agree that surgery...
Medical Students Can Now Be ASCO Members, Thanks to an Intern Who Pressed
ASCO has just added a membership category for medical students, spurred on by—you guessed it—a medical student. Daniel G. Stover, MD, knew he wanted to go into oncology from very early on. But when he contacted ASCO to join as an intern, having just graduated from Vanderbilt School of Medicine, he...
Gathering Data Point to Potential Advantages of Vismodegib in Basal Cell Carcinoma and Other Advanced Cancers
Vismodegib is a small-molecule, orally active hedgehog pathway inhibitor that has shown considerable promise in treating basal cell carcinoma and is currently being evaluated alone and in combination in early-phase trials in medulloblastoma and a long list of other cancers.1 Owing to its...
How Should We Treat Nodular Lymphocyte-predominant Hodgkin Lymphoma?
At the 2011 Pan-Pacific Lymphoma Conference in Kauai, Hawaii, Andreas Engert, MD, Chairman of the German Hodgkin Lymphoma Study Group (GHSG) and Professor of Medicine at the University Hospital of Cologne, Germany, discussed the treatment of nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL),...
Prostate Cancer Screening Reconsidered
Prostate cancer is the most prevalent nonskin cancer in men. An estimated 16% of men are diagnosed with prostate cancer, yet only 3% of men die from it.1 Unlike other cancers, prostate cancer is associated with a prolonged lead-time, meaning it can take anywhere from 5 to 12 years to become...
