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integrative oncology

Bromelain

Scientific Names: Sulfydryl proteolytic enzyme, cysteine proteinase Common Names: Ananase, Dayto Anase, Traumanase Overview Derived from the fruits and stems of pineapples, bromelain is a proteolytic enzyme that is used to treat burns and skin conditions, and as an anti-inflammatory agent....

gastrointestinal cancer

New NCCN Patient Resources Assist Decision-Making for Patients With Stomach Cancer

According to the American Cancer Society, it is estimated that more than 26,000 people will be diagnosed with stomach cancer in the United States this year, with nearly 1 million new cases diagnosed worldwide each year, according to the World Health Organization. Because there are no early symptoms ...

colorectal cancer

ESMO 2016: Longer Interval Between Preoperative Chemoradiotherapy and Surgery Urged in Locally Advanced Rectal Cancer

A longer waiting interval from the end of preoperative chemoradiotherapy to surgery increases the rate of pathologic complete response and yields a higher proportion of patients achieving tumor downstaging in patients with locally advanced rectal cancer, according to new findings from a...

Sanford Research in South Dakota Receives NIH Grant in Head and Neck, Pediatric Cancers

The Cancer Biology Research Center at Sanford Research in Sioux Falls, South Dakota, is the recipient of a 5-year, nearly $11.7 million grant from the National Institutes of Health (NIH) to translate laboratory research into clinical trials for head and neck and pediatric cancers. The grant was...

head and neck cancer

Rise in Oropharyngeal Cancer Incidence in the UK Not Solely Driven by HPV

The rise in the incidence of oropharyngeal squamous cell carcinoma in the United Kingdom from 2002 to 2011 was not solely attributable to a rise in the incidence of human papillomavirus (HPV)-positive disease, according to a study published in Cancer Research,1 which reported that the proportion of ...

colorectal cancer

ESMO 2016: Dabrafenib/Trametinib/Panitumumab Improves Efficacy in BRAF Mutation–Positive Metastatic Colorectal Cancer

Patients with metastatic colorectal cancer and tumors harboring the BRAF V600E mutation who received triple therapy with dabrafenib (Tafinlar), trametinib (Mekinist), and panitumumab (Vectibix) showed an improved best overall response and prolonged progression-free survival compared to...

issues in oncology

Barriers and Opportunities Reported in the Study of Human Papillomavirus Education and Immunization Efforts

Human papillomavirus (HPV) vaccination rates remain low across the United States, with fewer than 40% of girls and just over 21% of boys receiving the recommended vaccine series. Research from Roswell Park Cancer Institute has identified barriers that need to be overcome to improve vaccination...

solid tumors
hematologic malignancies

ESMO 2016: Vemurafenib Shows Clinical Benefit in Diverse BRAF V600–Mutated Tumors

Findings from a phase II trial of vemurafenib in previously treated patients with advanced disease and BRAF-mutated tumors indicate that the drug is effective in patients with diverse BRAF V600­–mutated tumors but not in patients with BRAF non-V600 mutations. After a mean treatment...

skin cancer

Personalized Vaccines May Protect Patients With High-Risk Melanoma

The field of cancer vaccines may be reinvigorated by a new understanding, and the therapeutic leveraging, of neoantigens. Researchers from Dana-Farber Cancer Institute in Boston are exploring this novel approach as a means of protecting patients with high-risk melanoma from recurrence. Early...

When Breath Becomes Air: Dr. Lucy Kalanithi Reflects on Dr. Paul Kalanithi’s Life and Writing

Perhaps more than any other book in recent memory, When Breath Becomes Air has struck a chord among readers, both inside the medical community and among the public, desiring an honest and philosophical consideration of death. The autobiographical account of Paul Kalanithi, MD, a physician diagnosed ...

skin cancer

Association of PD-L1 Expression and Response to Pembrolizumab in Advanced Melanoma

In an analysis from the phase IB KEYNOTE-001 trial, Daud et al found that the level of programmed cell death ligand 1 (PD-L1) expression was associated with outcomes of pembrolizumab (Keytruda) treatment in patients with advanced melanoma. These findings were reported in the Journal of Clinical...

head and neck cancer

Study Finds Nivolumab Improves Survival vs Standard Therapy in Recurrent Squamous Cell Carcinoma of the Head and Neck

In the phase III CheckMate 141 trial reported in The New England Journal of Medicine, Ferris et al found that nivolumab (Opdivo) increased overall survival vs standard therapies in patients with recurrent platinum-refractory squamous cell carcinoma of the head and neck. Study Details In this...

Arti Hurria, MD: From Leadership Development Program to Board of Directors

Arti Hurria, MD, a geriatric oncologist at City of Hope in Duarte, California, is the first graduate of ASCO’s Leadership Development Program to be elected to ASCO’s Board of Directors. Within 5 years of completing the program, Dr. Hurria went from learning leadership skills to applying them to...

ASCO Presents First-Ever ASCO Congressional Leadership Award to Representative Michael Burgess, MD

ASCO presented Representative Michael Burgess, MD (TX-26) with the Society’s first-ever ASCO Congressional Leadership Award to recognize his steadfast work to advance policies that support cancer research and treatment. This new, annual award honors a Member of Congress who is a dedicated champion ...

gynecologic cancers

What We Know and What We Need to Know About Neoadjuvant Chemotherapy in Advanced Ovarian Cancer

Ever since the landmark studies of Griffiths and colleagues in the 1970s,1 primary cytoreductive surgery followed by chemotherapy with the objective of achieving minimal residual disease has been the standard approach for women with advanced-stage epithelial ovarian cancer. However, what is...

gynecologic cancers

SGO and ASCO Clinical Practice Guideline on Neoadjuvant Chemotherapy for Newly Diagnosed Advanced Ovarian Cancer

As reported by Alexi A. Wright, MD, MPH, of Dana-Farber Cancer Institute, and colleagues in the Journal of Clinical Oncology, ASCO and the Society of Gynecologic Oncology (SGO) have released a clinical practice guideline on neoadjuvant therapy for patients with newly diagnosed stage IIIC or IV...

Expert Point of View: Olivier Michielin, MS, MD, PhD

The paper’s invited discussant was Olivier Michielin, MS, MD, PhD, Head of Personalized Analytical Oncology and the Melanoma Clinic at Lausanne University Hospital in Switzerland. He called the findings of the European Organisation for Research and Treatment (EORTC) 18071 trial a “new landmark in...

skin cancer

Adjuvant Ipilimumab Improves Survival in High-Risk Melanoma

Patients with stage III melanoma who were considered to be at high risk for recurrence derived an overall survival benefit from adjuvant treatment with ipilimumab (Yervoy), although it came at the price of considerable toxicity, according to updated survival results from the phase III European...

Quality Science at ESMO 2016

Andrés Cervantes, MD, PhD, Scientific Chair of the 2016 European Society for Medical Oncology (ESMO) Congress, concluded the meeting earlier this month by recognizing a number of important take-home messages. At a closing press conference, Dr. Cervantes noted that the “ESMO 2016 Congress has...

Huntsman Cancer Institute Names Ben Tanner Executive Director

University of Utah Health Care (UUHC) has named Ben ­Tanner, Huntsman Cancer Institute’s current Director of Clinical Operations and Chief Operating Officer (COO), as the Institute’s Executive Director, replacing Ray Lynch, who is retiring after 13 years of service. Mr. Tanner has been COO of the...

breast cancer
supportive care

Consensus on Defining and Measuring Lymphedema Is Needed to Advance Efforts to Intervene Early and Prevent Progression

“Early intervention might prevent lymphedema progression,” Alphonse Taghian, MD, PhD, said at the 18th Annual Lynn Sage Breast Cancer Symposium in Chicago, but the lack of a universal definition of lymphedema and agreement on how to optimally measure it impedes phase III studies to test that...

breast cancer

Mammography-Detected Small Breast Cancers May Represent Overdiagnosis, With Survival Gains Reflecting Improved Systemic Therapy

In a study using SEER (Surveillance, Epidemiology, and End Results) data reported in The New England Journal of Medicine, Welch et al found that screening mammography has resulted in a substantial increase in detection of small breast tumors, many of which represent overdiagnosis, accompanied by...

kidney cancer

Study Finds Adjuvant Sunitinib Improves Disease-Free Survival in High-Risk Renal Cell Carcinoma After Nephrectomy

In the phase III S-TRAC trial reported at the 2016 European Society for Medical Oncology Congress and in The New England Journal of Medicine by Ravaud et al, adjuvant sunitinib (Sutent) significantly prolonged disease-free survival vs placebo in patients with high-risk renal cell carcinoma after...

breast cancer

Breast Cancer Study Finds Higher Mortality Rate in Black Women Than White Women, and the Disparity Is Growing

The Avon Foundation for Women recently released a new study on the racial disparities in breast cancer mortality in the 50 largest cities in the United States between 2005 and 2014. Published in Cancer Epidemiology,1 the study was conducted by Sinai Urban Health Institute in collaboration with the...

sarcoma

FDA Grants Accelerated Approval to Olaratumab for Treatment of Advanced Soft-Tissue Sarcoma

Today, the U.S. Food and Drug Administration (FDA) granted accelerated approval to olaratumab (Lartruvo) in combination with doxorubicin to treat adults with certain types of soft-tissue sarcoma. Olaratumab is approved for use with the FDA-approved chemotherapy drug doxorubicin for the treatment of ...

Expert Point of View: Colleen A. Lawton, MD

“This is very exciting work and is exactly what we need in prostate cancer,” said Colleen A. Lawton, MD, Vice-Chair of the Medical College of Wisconsin, Milwaukee, and moderator of a press conference where the study by Spratt et al was discussed. “The prognostic measures we use are rough and...

prostate cancer

Prognostic and Predictive Molecular Subtypes of Prostate Cancer Identified

Members of the oncology community have long complained that prostate cancer lags behind breast cancer regarding biomarkers for prognosis and treatment, but the good news is that this gap is narrowing. In the largest study of its kind to date, presented at the 58th Annual Meeting of the American...

skin cancer

ESMO 2016: Pooled Analysis Shows PD-L1 Expression as a Biomarker for Nivolumab Plus Ipilimumab Response in Advanced Melanoma

A pooled analysis from three clinical trials in advanced melanoma shows that although patients treated with nivolumab and nivolumab plus ipilimumab with ≥ 5% programmed death-ligand 1 (PD-L1) tumor expression have similar progression-free survival, durable response rates were higher for the...

head and neck cancer

ESMO 2016: Meta-analysis Confirms Superiority of Concomitant Over Induction Chemotherapy in Nonmetastatic Head and Neck Cancer

Patients with head and neck squamous cell carcinoma achieved prolonged overall survival when concomitant chemotherapy was administered with locoregional treatment or radiotherapy, according to findings from a large meta-analysis reported by Blanchard et al at the European Society for Medical...

Expert Point of View: Vinai Gondi, MD

Formal discussant of both trials, Vinai Gondi, MD, Director of CNS Radiation Oncology at Northwestern Medicine Cancer Center in Warrenville, Illinois, offered a somewhat more nuanced take on the data from these studies. To begin, he commended the authors of both studies. “These were both...

lung cancer

ESMO 2016: Clinical Benefit Demonstrated With Everolimus and Pasireotide LAR Alone or in Combination in Advanced Lung and Thymic Carcinoids

In patients with advanced lung or thymus carcinoid receiving everolimus, pasireotide LAR, or the combination of the two drugs, statistically significant positive impact was seen on proportion of patients’ progression-free rate at 9 months (primary endpoint) in all three arms, more relevant in ...

cns cancers

Stereotactic Radiosurgery Achieves Better Quality of Life and Improved Cognition Than Whole-Brain Radiotherapy

Two separate randomized trials presented at the 58th Annual Meeting of the American Society of Radiation Oncology (ASTRO) affirmed the value of stereotactic radiosurgery as an option for postoperative treatment of the surgical cavity of resected brain metastases, potentially avoiding the cognitive...

issues in oncology
cost of care

COA Releases 2016 Community Oncology Practice Impact Report

On October 4, the Community Oncology Alliance (COA) released the 2016 Community Oncology Practice Impact Report, which tracks the changing landscape of cancer care in the United States. It documents a 121% increase in community cancer clinic closings and a 172% increase in consolidation into...

prostate cancer

Safety of Extreme Hypofractionation Reassuring in Intermediate-Risk Prostate Cancer

Giving patients larger fractions of radiation over shorter periods (ie, hypofractionation) is gaining ground in several types of cancers. This approach is attractive for patients’ convenience, shortening treatment and travel times, and also for resource utilization. Several studies have shown that ...

lung cancer
skin cancer
kidney cancer

Modification of Dosage Regimen for Nivolumab in Renal Cell Carcinoma, Melanoma, and NSCLC

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 September 13, 2016, the U.S. Food and Drug Administration...

Expert Point of View: Brian Kavanagh, MD

“Lung cancer patients are living longer with stereotactic body radiation therapy. Patients should have access to this care. It would be tragic if we couldn’t give this treatment to patients who need it,” said Brian Kavanagh, MD, President of the American Society for Radiation Oncology (ASTRO) and...

skin cancer

Investigational Immunotherapy Appears Safe and Somewhat Active in Advanced Melanoma

The investigational immunotherapeutic IMC-20D7S was found to be well tolerated and somewhat active in patients with advanced melanoma, including one complete response, according to the results of a phase I/Ib trial reported by Khalil et al in Clinical Cancer Research.  IMD-20D7S is a...

lung cancer

Retrospective Studies Confirm Survival Benefit of Stereotactic Body Radiotherapy in Early-Stage NSCLC

Stereotactic body radiation therapy is becoming more widely adopted for the treatment of early-stage non–small cell lung cancer (NSCLC). Along with its increasing uptake, survival has significantly increased over the past decade, according to two large retrospective studies presented at the 58th...

lung cancer

Atezolizumab Approved for the Treatment of Metastatic NSCLC That Has Progressed During or After Platinum-Containing Therapy

On October 18, 2016, the U.S. Food and Drug Administration (FDA) approved atezolizumab (Tecentriq) for the treatment of patients with metastatic non–small cell lung cancer (NSCLC) whose disease progressed during or following platinum-containing chemotherapy. Patients with EGFR or ALK genomic...

breast cancer

New SSO-ASTRO-ASCO Clinical Practice Guideline Clarifies the Question of Margins for Breast-Conserving Surgery in Ductal Carcinoma in Situ

In 2014, the Society of Surgical Oncology (SSO) and the American Society for Radiation Oncology (ASTRO) published a “Consensus Guideline on Margins for Breast-Conserving Surgery With Whole-Breast Irradiation in Stages I and II Invasive Breast Cancer.”1 A multidisciplinary expert guideline used a...

lung cancer

FDA Modifies the Indication of Erlotinib in Non–Small Cell Lung Cancer to Patients With Specific EGFR Mutations

On October 18, 2016, the U.S. Food and Drug Administration (FDA) modified the indication for erlotinib (Tarceva) in the treatment of non–small cell lung cancer (NSCLC) to limit its use to patients whose tumors have specific epidermal growth factor receptor (EGFR) mutations. The labeling...

breast cancer

Margins for Breast-Conserving Surgery With Whole-Breast Irradiation in Ductal Carcinoma in Situ

A clinical practice guideline on margins for breast-conserving surgery with whole-breast irradiation in ductal carcinoma in situ has been jointly developed by the Society of Surgical Oncology (SSO), the American Society for Radiation Oncology (ASTRO), and ASCO.1-3 The recommendations were...

issues in oncology

‘Dear Presidential Candidates’: A Letter From an Oncologist

Dear Presidential Candidates: Wouldn’t it be great if history’s Alexander the Great was actually Dr. Alexander Fleming, the doctor-scientist who saved millions of lives by discovering penicillin, rather than the other Alexander, who conquered and killed thousands of innocent people? Wouldn’t it be...

breast cancer

Study Shows Strong Evidence Supporting Radiation Boost to Tumor Bed in Ductal Carcinoma in Situ

A radiation boost to the local tumor bed following treatment with breast-conserving therapy (ie, local excision followed by whole-breast radiation therapy) improves local control for patients with ductal carcinoma in situ, according to a study of pooled data from 10 academic centers,1 presented at...

cns cancers

Dutch Study Shows High Prevalence of Early Endocrine Disorders in Survivors of Childhood Brain Tumors

Clement et al found that 25% of survivors of childhood brain tumors were diagnosed with endocrine disorders over 6.6 years of follow-up, based on a Dutch nationwide study reported in the Journal of Clinical Oncology. The study involved data from 718 survivors diagnosed at age ≤ 18 years with a...

prostate cancer

Study Finds PFS Benefit, but No Overall Survival Benefit, for Ipilimumab in Metastatic Castration-Resistant Prostate Cancer

Ipilimumab (Yervoy) was associated with prolonged progression-free survival—but not overall survival—compared with placebo in men with asymptomatic or minimally symptomatic chemotherapy-naive metastatic castration-resistant prostate cancer without visceral metastases, according to a...

lung cancer

Adding Pembrolizumab to Carboplatin/Pemetrexed Seems to Improve Response in Advanced Nonsquamous NSCLC

As reported by Langer et al in The Lancet Oncology, findings in a phase II cohort of the multicohort KEYNOTE-021 study showed that the addition of first-line pembrolizumab (Keytruda) to carboplatin/pemetrexed (Alimta) significantly increased the response rate in patients with advanced nonsquamous...

multiple myeloma

Does Adding Daratumumab to Lenalidomide/Dexamethasone Improve Outcomes in Previously Treated Multiple Myeloma?

The addition of the CD38-targeted antibody daratumumab (Darzalex) to lenalidomide (Revlimid)/dexamethasone improved progression-free survival in patients with previously treated multiple myeloma, according to the results of the phase III POLLUX trial reported by Dimopoulos et al in The New England...

Expert Point of View: Stephen R.D. Johnston, MD

“These results apply to about two-thirds of women with advanced breast cancer, ie, those with hormone receptor–positive metastatic breast cancer,” noted the formal discussant of this paper, Stephen R.D. Johnston, MD, of the Royal Marsden Hospital, London. “At present with first-line endocrine...

breast cancer

Combination of Ribociclib and Letrozole Improved Progression-Free Survival in Hormone Receptor–Positive Advanced Breast Cancer

The combination of the selective CDK4/6 inhibitor ribociclib plus letrozole significantly improved progression-free survival in hormone receptor–positive advanced breast cancer. When ribociclib was added to letrozole, progression-free survival improved by 44% compared with letrozole alone,...

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