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SIDEBAR: Ibrutinib in Other Hematologic Tumors

At the 2012 ASH Annual Meeting, researchers also reported preliminary results for ibrutinib in diffuse large B-cell lymphoma, follicular lymphoma, and multiple myeloma. A multicenter phase II study in 70 heavily pretreated patients with relapsed or refractory diffuse large B-cell lymphoma in two...

lymphoma

Ibrutinib in Mantle Cell Lymphoma Yields 'Unprecedented' Response Rates 

The investigational agent ibrutinib demonstrated “unprecedented” single-agent activity in relapsed or refractory mantle cell lymphoma, according to the lead author of an international phase II study reported at the Annual Meeting of the American Society of Hematology (ASH).1 Durable Responses “The...

Expert Point of View: Sandra M. Swain, MD, FACP, and Lisa Carey, MD

Sandra M. Swain, MD, FACP, Medical Director, Washington Cancer Institute, MedStar Washington Hospital Center, Washington, DC, who moderated the session, said these interesting observations must now be validated in preclinical models of triple-negative tumors, and then tested in patients. “Residual...

breast cancer

Key Pathways Identified in Triple-negative Breast Cancer 

Five key biologic pathways have become evident in triple-negative breast cancer tumors, and these pathways may be targetable with agents that are currently available or in development, results from an international genetic analysis revealed at the 2012 San Antonio Breast Cancer Symposium. Justin M. ...

Expert Point of View: Sagar Lonial, MD

Commenting on Dr. Palumbo’s presentation at the ASH meeting, Sagar Lonial, MD, Professor of Hematology and Medical Oncology at the Winship Cancer Center at Emory University, Atlanta, noted that while a survival benefit has been associated with maintenance lenalidomide (Revlimid) after transplant,...

multiple myeloma

Survival Benefit Achieved with Four Drugs plus Maintenance in Myeloma

An overall survival benefit in newly diagnosed multiple myeloma was attained with a four-drug induction regimen followed by a duet for maintenance in a study from the Italian GIMEMA network. Antonio Palumbo, MD, Chief of the Myeloma Unit at the University of Torino in Italy, reported the findings...

breast cancer

Treatment of HER2-positive Disease in 2013 

From the initial discovery of the HER2 family of receptors in the mid-1980s to the present, a “wealth of riches” has been uncovered in terms of agents that can target pathways relevant to this aggressive breast cancer type, notes Hope S. Rugo, MD, Director of Breast Oncology and Clinical Trials...

breast cancer

Research Roundup from San Antonio: New Data on Triple-negative, HER2-positive, Local, and Advanced Breast Cancer 

The 2012 San Antonio Breast Cancer Symposium featured more than 2,500 abstracts and lectures, including timely research in the field and discussions for scientists and clinicians alike. In addition to nearly two dozen in-depth reports from the meeting, The ASCO Post brings readers the following...

leukemia
lymphoma
multiple myeloma

ASH Highlights Included New Data in Myeloma, Lymphoma, and Leukemia, plus Studies of Mucositis and Graft-vs-Host Disease

The 54th Annual Meeting of the American Society of Hematology (ASH) featured about 5,000 abstracts, including oral sessions and posters, as well as named lectures and symposia. In addition to our regular news coverage from the meeting, below are capsule summaries of a few news highlights that we...

Expert Point of View: C. Kent Osborne, MD

C. Kent Osborne, MD, Professor of Medicine and Molecular and Cellular Biology at Baylor College of Medicine and Director of the Lester and Sue Smith Breast Center at Baylor told The ASCO Post that this is “brand new” data that “looks very interesting.” He noted that groups for whom letrozole is the ...

breast cancer

For Lobular Carcinoma, Letrozole Works Better Than Tamoxifen  

In the treatment of postmenopausal estrogen receptor–positive women with lobular carcinoma, letrozole appears to have a greater benefit than tamoxifen, according to an analysis of this subset of patients in the Breast International Group (BIG) 1-98 trial reported at the 35th Annual San Antonio...

Expert Point of View: Sandra M. Swain, MD, FACP and Eric P. Winer, MD

Commenting on the study presented by Dr. Wolff at the 2012 San Antonio Breast Cancer Symposium, ASCO President Sandra M. Swain, MD, FACP, Medical Director, Washington Cancer Institute, MedStar Washington Hospital Center, Washington, DC, said she found it “disturbing” that about half the population...

breast cancer
leukemia

Chemotherapy for Breast Cancer Carries a Small, but Concerning, Risk for Leukemia 

The risk for developing a secondary malignancy after chemotherapy for breast cancer is very small, but it is statistically significantly higher than for the general population, a review of the National Comprehensive Cancer Network (NCCN) database revealed in a study presented at the 2012 San...

Expert Point of View: Michel Ducreux, MD, PhD

Michel Ducreux, MD, PhD, of the Institut Gustave Roussy in Villejuif, France, discussed the findings at the ESMO meeting. He said that TH-302 represents a “new drug and new concept, the microenvironment.” He noted, “Pancreatic cancers are frequently hypovascularized, at least the primary tumor, and ...

pancreatic cancer

TH-302 plus Gemcitabine Delays Progression in Untreated Advanced Pancreatic Adenocarcinoma 

A novel drug that is activated under conditions of hypoxia significantly delayed progression in locally advanced or metastatic pancreatic adenocarcinoma when combined with gemcitabine in untreated patients. The findings of the randomized phase II TH-CR-04 trial were presented at the 2012 ESMO...

Expert Point of View: Philip Agop Philip, MD and Alan P. Venook, MD

Philip Agop Philip, MD, Head of the Multidisciplinary Team for Gastrointestinal and Neuroendocrine Oncology and Neuroendocrine at Karmanos Cancer Institute at Wayne State University, Detroit, was the formal discussant of the paper at the Gastrointestinal Cancers Symposium. He said the positive...

pancreatic cancer

Nab-paclitaxel/Gemcitabine Combination Improves Overall Survival in Pancreatic Cancer 

In patients with treatment-naive metastatic pancreatic cancer, the addition of nanoparticle albumin-bound (nab)-paclitaxel (Abraxane) to gemcitabine improved overall survival vs gemcitabine alone, in an international study presented at the 2013 Gastrointestinal Cancers Symposium.1 New Standard “We...

Expert Point of View: David J. Kuter, MD, PhD

David J. Kuter, MD, PhD, Professor of Medicine, Harvard Medical School, and Director of the Center for Hematology at Massachusetts General Hospital, Boston, commented on the findings for The ASCO Post. “TOPPS is a good attempt to address whether transfusions are helpful as prophylaxis in patients...

hematologic malignancies

No Rationale for Eliminating Prophylactic Platelet Transfusions in Patients with Hematologic Malignancies 

Prophylactic platelet transfusions should remain the standard of care for many patients with hematologic malignancies who are thrombocytopenic during intensive treatment or stem cell transplant, investigators of the TOPPS trial (noninferiority Trial Of Prophylactic Platelet transfusionS)...

Expert Point of View: Laura van't Veer, PhD

Laura van’t Veer, PhD, Director of the Specialized Programs of Research Excellence (SPORE) of the University of California, San Francisco, commented on the meta-analysis. She said the study confirms that a pathologic complete response in the neoadjuvant setting is generally meaningful as it clearly ...

breast cancer

Pathologic Complete Response Yields Long-term Benefits in Meta-analysis  

Breast cancer patients who achieve a pathologic complete response to neoadjuvant therapy have more favorable outcomes than those who do not, according to a meta-analysis of neoadjuvant trials presented at the 2012 San Antonio Breast Cancer Symposium.1 Patients who achieved a pathologic complete...

Expert Point of View: Sandra Swain, MD, FACP

Sandra Swain, MD, FACP, Medical Director of the Washington Cancer Institute, MedStar Washington Hospital Center, Washington, DC, moderated the San Antonio session where the dose-dense chemotherapy studies were presented, and commented on the findings of the two studies. iddETC Trial With regard...

breast cancer

Dose-dense Chemotherapy in Breast Cancer: Epirubicin-based Regimens Studied in German and UK Trials

In the treatment of early breast cancer, dose-dense regimens (given every 2 weeks) have proven superior to conventionally dosed chemotherapy (given every 3 weeks), but data on long-term survival are lacking. Two studies presented at the San Antonio Breast Cancer Symposium evaluated the benefit of...

breast cancer

Final 'Joint Analysis' Confirms Life-saving Benefit of Trastuzumab in Patients with HER2-positive Early Breast Cancer

In the final planned joint analysis of overall survival from the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-31 and North Central Cancer Treatment Group (NCCTG) N9831 trials, the addition of trastuzumab (Herceptin) to paclitaxel following doxorubicin/cyclophosphamide (AC) reduced...

Expert Point of View: Axel Grothey, MD and Eric Van Cutsem, MD, PhD

Two gastrointestinal cancer experts commented on the findings in interviews with The ASCO Post. Axel Grothey, MD, Professor of Oncology at the Mayo Clinic, Rochester, Minnesota, noted, “The PEAK and SPIRITT trial were decently designed, decently powered randomized phase II trials, and the results...

colorectal cancer

Outcomes Comparable for Panitumumab and Bevacizumab in Metastatic Colorectal Cancer 

In patients with KRAS wild-type metastatic colorectal cancer, outcomes were comparable whether patients received the epidermal growth factor receptor (EGFR) inhibitor panitumumab (Vectibix) or the vascular endothelial growth factor (VEGF) inhibitor bevacizumab (Avastin). This was shown both in the...

Expert Point of View: Jordan D. Berlin, MD

Jordan D. Berlin, MD, Ingram Professor of Cancer Research and Clinical Director of the GI Oncology Program at Vanderbilt-Ingram Cancer Center, Nashville, commented on the findings of TRIBE.  “This study is outstanding, and while we don’t have overall survival data yet the findings suggest that we...

colorectal cancer

FOLFOXIRI Plus Bevacizumab Is Superior to FOLFIRI Plus Bevacizumab in Metastatic Colorectal Cancer 

For the treatment of metastatic colorectal cancer, better outcomes were achieved when bevacizumab (Avastin) was added to FOLFOXIRI (leucovorin, fluorouracil [5-FU], oxaliplatin, irinotecan), rather than FOLFIRI (leucovorin, 5-FU, irinotecan), in the phase III TRIBE trial conducted at 35 Italian...

Expert Point of View: Seema A. Khan, MD

Responding to the results of the ACOSOG Z1071 study, Seema A. Khan, MD, Professor of Surgery at Northwestern University Feinberg School of Medicine, Chicago, urged caution in adopting the practice of sentinel lymph node surgery after chemotherapy for some patients with breast cancer at this time....

breast cancer

Role of Sentinel Node Surgery Explored in Node-positive Breast Cancer 

Sentinel lymph node surgery performed after neoadjuvant chemotherapy in women presenting with node-positive disease could spare many patients with breast cancer needless axillary lymph node dissection, according to a study of the American College of Surgeons Oncology Group presented at the 2012 San ...

Expert Point of View: Clifford A. Hudis, MD and Daniel F. Hayes, MD

Clifford A. Hudis, MD, Chief of the Breast Cancer Medicine Service at Memorial Sloan-Kettering Cancer Center, New York, commented after the presentation, “It strikes me that these findings are parallel to those shown with PAM50 by Liu et al at this meeting.” In that study,1 based on the Cancer and...

breast cancer

21-gene Recurrence Score Does Not Predict Paclitaxel Benefit  

The 21-gene recurrence score significantly predicted the risk of recurrence and death in node-positive, estrogen receptor–positive patients treated with adjuvant chemoendocrine therapy, but it did not predict benefit from the addition of paclitaxel to the regimen in a subset of patients from the...

Expert Point of View: Laura J. van ’t Veer, PhD and Andrew Seidman, MD

Laura J. van ’t Veer, PhD, Leader of the Breast Oncology Program at the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, commented on the findings. “These investigators confirm in a robust meta-analysis that neoadjuvant chemotherapy response is different...

Subsets of Young Patients Have Higher Pathologic Complete Response Rates

In achieving a pathologic complete response to neoadjuvant chemotherapy, it seems that age matters, according to a study reported at the 2012 San Antonio Breast Cancer Symposium.1 Patients with breast cancer aged 35 and younger were more likely to achieve a pathologic complete response than their...

Expert Point of View: William M. Grady, MD and Jordan Berlin, MD

William M. Grady, MD, of the Fred Hutchinson Cancer Research Center, Seattle, a member of the news planning team for the symposium, commented, “There has been considerable interest in determining whether molecular alterations in primary colorectal cancer are more accurate prognostic indicators than ...

solid tumors
colorectal cancer

Oncogenic Pathway Signatures May Guide Treatment after Colorectal Cancer Resection 

Deregulation of oncogenic signaling pathways was used to molecularly subclassify colorectal cancers into clinically relevant subgroups with both prognostic and predictive implications, in a study from the Duke Institute for Genome Sciences and Policy in Durham, North Carolina.1 “There is a need to...

Expert Point of View: J. Randolph Hecht, MD

J. Randolph Hecht, MD, Professor of Clinical Medicine and Director of the Gastrointestinal Oncology Program at the University of California, Los Angeles, commented to The ASCO Post that it is premature to accept this algorithm in the absence of its correlation with clinical outcomes. The one...

solid tumors
breast cancer

Evaluating HER2 Status in Esophageal Cancers: FISH vs Immunohistochemistry 

In screening patients with esophageal cancers for HER2 status, the relative efficiency of immunohistochemistry (IHC) vs fluorescence in situ hybridization (FISH) has been debated. Researchers from the Mayo Clinic compared the testing strategies and have proposed an algorithm that puts IHC up front, ...

solid tumors
colorectal cancer

Colorectal Cancer: A Decade of Progress 

The 2013 Gastrointestinal Cancers Symposium marked the 10th anniversary of the meeting. Richard M. Goldberg, MD, the Klotz Family Chair in Cancer Research, Professor of Medicine, and James Cancer Hospital Physician-in-Chief at The Ohio State University, looked back over the decade to highlight the...

Expert Point of View: Johanna C. Bendell, MD

The study’s formal discussant, Johanna C. Bendell, MD, Director of Gastrointestinal Cancer Research and at the Sarah Cannon Research Institute, Nashville, said COUGAR02 had “good and appropriate stratification factors” and “importantly, included quality-of-life studies.” This is critical, she said, ...

solid tumors
gastroesophageal cancer

Second-line Docetaxel Improves Esophageal and Gastric Cancer Survival 

A phase III study from the United Kingdom has shown that second-line treatment with docetaxel improves overall survival of patients with advanced esophagogastric cancer.1 The strategy has already been widely adopted, but COUGAR-02 is the first study to provide definitive evidence of a survival...

Expert Point of View: Neal J. Meropol, MD and Johanna C. Bendell, MD

Neal J. Meropol, MD, Chief of Hematology and Oncology at University Hospitals Seidman Cancer Center and Case Western Reserve University in Cleveland, commented that the quality of the data on ramucirumab is “very high,” and therefore, “we can believe these results.” The magnitude of the benefit,...

solid tumors
issues in oncology

Targeted Therapy Gaining Ground in the Second-line Treatment of Gastric Cancer 

In gastric cancer, the concept of targeted therapy assumed clinical significance when the addition of trastuzumab (Herceptin) to chemotherapy improved survival by almost 3 months in the ToGA trial.1 Another anti-HER2 agent, lapatinib (Tykerb), now looks promising, as does an agent targeting the...

Expert Point of View: Robert A. Wolff, MD and Jordan Berlin, MD

Robert A. Wolff, MD, Professor in the Department of Gastrointestinal Oncology at The University of Texas MD Anderson Cancer Center, Houston, observed, “The bevacizumab seemed to leverage the capecitabine with a magnitude of benefit that is very reminiscent of the initial trials with...

colorectal cancer

Bevacizumab plus Capecitabine Has Robust Effect in Elderly Patients with Colorectal Cancer

In elderly patients with treatment-naive metastatic colorectal cancer, a trend toward a survival benefit was observed for bevacizumab (Avastin) plus capecitabine (Xeloda) in the international phase III AVEX trial, which was presented at the 2013 Gastrointestinal Cancers Symposium by David...

skin cancer

New Data Reported on Melanoma, Cutaneous T-cell Lymphoma, Basal Cell Carcinoma, and Cancer Treatment Side Effects 

At the recent American Academy of Dermatology 71st Annual Meeting in Miami Beach, researchers presented interesting findings regarding melanoma and other skin cancers. The ASCO Post brings you the following news briefs on these topics. Melanoma Incidence Decreases among Adolescents and Children An...

Expert Point of View: Axel Grothey, MD and Paula R. Pohlmann, MD, PhD

Axel Grothey, MD, Professor of Oncology at the Mayo Clinic, Rochester, Minnesota, said that classifying colorectal cancer by intrinsic subtypes is “the right route forward,” especially if subtypes can be reliably linked to therapeutic response and survival. “We will not be treating all colorectal...

colorectal cancer

Three Molecular Subtypes of Colorectal Cancer Identified 

Intrinsic molecular subtyping in breast cancer has become clinically applicable, and the same could be happening for gastrointestinal tumors, according to an international study reported at the 2013 Gastrointestinal Cancers Symposium in San Francisco.1 While recent efforts have yielded prognostic...

colorectal cancer

BRAF Mutations in Colorectal Cancer: The Next Frontier 

Some 5% to 10% of patients with colorectal cancer harbor the BRAF mutation, placing them at risk for poor treatment response and worse outcomes. The ASCO Post interviewed S. Gail Eckhardt, MD, an expert in this area who is Professor and Head of the Division of Medical Oncology at the University of...

hepatobiliary cancer
pancreatic cancer
gastrointestinal cancer

Important Data and Treatment Advances Reported in GIST and in Pancreatic and Liver Cancers 

The 10th annual Gastrointestinal Cancers Symposium, held recently in San Francisco, was jointly sponsored by ASCO, the AGA (American Gastroenterological Association), ASTRO (American Society for Radiation Oncology), and the SSO (Society of Surgical Oncology). “We seek to present the newest...

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