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issues in oncology

Chemotherapy Drug Shortages Threaten Quality of Treatment

Over the past several years, there have been recurring shortages of widely used generic chemotherapy agents in the United States. In a letter to The New England Journal of Medicine, Gogineni et al described a survey of U.S. oncologists regarding types and frequency of chemotherapy shortages and...

gynecologic cancers

Half of Patients With Stage I Pediatric Malignant Ovarian Germ Cell Tumors Can Be Spared Chemotherapy After Initial Surgery With Surveillance Strategy

In a Children’s Oncology Group study (AGCT0132) reported in the Journal of Clinical Oncology, Billmire et al found that overall survival can be preserved in patients with stage I pediatric malignant ovarian germ cell tumor with a strategy of initial surveillance after surgical resection....

skin cancer

Sentinel Lymph Node Biopsy Associated With Survival Advantage in Merkel Cell Carcinoma

In patients with Merkel cell carcinoma, sentinel lymph node biopsy was shown to be associated with improved survival, according to the results of a retrospective study reported by Kachare et al in the Annals of Surgical Oncology. Thus, sentinel lymph node biopsy offers prognostic information that...

leukemia

Good Results Using Loss of Major Molecular Response as Criterion for Restarting Tyrosine Kinase Inhibitor Therapy in CML

Many patients with chronic-phase chronic myelogenous leukemia (CML) in complete molecular response have molecular relapse after discontinuation of imatinib (Gleevec) treatment. In a French multicenter observational study reported in the Journal of Clinical Oncology, Rousselot et al assessed the...

leukemia
issues in oncology

Higher Copayment Associated With Greater Discontinuation of and Nonadherence to Tyrosine Kinase Inhibitor Treatment in CML

The availability of the tyrosine kinase inhibitor imatinib (Gleevec) has dramatically increased survival in chronic myeloid leukemia (CML). Nonadherence to therapy with imatinib and other tyrosine kinase inhibitors is associated with disease progression and treatment resistance. In a study reported ...

survivorship

Survey Finds Many General Internists Are Uncomfortable Caring for Adult Survivors of Childhood Cancer

A National Cancer Institute–funded survey of general internists asking about their attitudes and knowledge about the care of adult childhood cancer survivors has found that few internists are comfortable caring for these patients. Moreover, many are unfamiliar with the Children’s...

supportive care
issues in oncology

Most Physicians Would Enroll in Hospice If They Were Terminally Ill With Cancer, Study Finds

In a research letter published in JAMA Internal Medicine, Chinn et al surveyed physicians’ attitudes towards hospice treatment if they were terminally ill with cancer and assessed how physician preferences might affect timing of hospice discussions with their terminally ill patients. They...

lung cancer

Preclinical Study Suggests E-Cigarettes May Contribute to Lung Cancer in High-Risk Individuals

A study of human bronchial epithelial cells carrying mutations in the TP53 and KRAS genes has found that e-cigarette vapors enhanced the cells’ cancerous behaviors. The study suggests that e-cigarette exposure may contribute to lung cancer in individuals at high risk for the disease. The...

leukemia

Matched-Pairs Analysis Shows Better Survival With Allogeneic Transplantation vs Conventional Chemotherapy in Postremission Therapy for AML

In a prospective matched-pairs analysis reported in the Journal of Clinical Oncology, Stelljes et al in the German AML Cooperative Group compared outcomes with allogeneic stem cell transplantation vs conventional postremission chemotherapy in patients aged < 60 years with acute myeloid leukemia...

supportive care

Single Fractions of Radiation for Painful Bone Metastases May Be Noninferior to Multiple Fractions

Optimal dose fractionation for radiation therapy of painful bone metastases from multiple primary sites remains undefined. In a phase III noninferiority trial reported in The Lancet Oncology, Chow et al compared 8 Gy in a single fraction vs 20 Gy in multiple fractions in patients with painful bone...

lung cancer

Imprime PGG Added to Chemoimmunotherapy Shows Improved Outcomes in Advanced Lung Cancer Patients

The addition of Imprime PGG, a type of immunotherapy, to chemoimmunotherapy with carboplatin, paclitaxel, and cetuximab (Erbitux) resulted in improved response rates and overall survival rates in patients with late-stage, non–small cell lung cancer (NSCLC), according to the results of a phase ...

lymphoma

No Survival Difference for Autologous vs Reduced-Intensity Conditioning Allogeneic Stem Cell Transplant in Chemotherapy-Sensitive Mantle Cell Lymphoma

In an analysis reported in the Journal of Clinical Oncology, Fenske et al compared outcomes with early or late autologous vs reduced-intensity conditioning allogeneic hematopoietic stem cell transplantation in a population of patients with chemotherapy-sensitive mantle cell lymphoma. They found no...

gynecologic cancers
gynecologic cancers

Recurrent Ovarian Cancers Respond to Cancer Vaccine After ‘Reprogramming’ With Decitabine

Treatment with the drug decitabine prior to administration of chemotherapy and a cancer vaccine yielded clinical benefit for women with recurrent ovarian cancer, suggesting that this combinatorial chemoimmunotherapy may provide a new treatment option for patients with the disease, according to a...

skin cancer

Phase II Pilot Study Does Not Support Phase III Investigation of IV High-Dose Interferon Without Maintenance in Resected Melanoma

There is evidence that high-dose interferon alfa-2b consisting of 4 weeks of daily intravenous interferon alfa-2b followed by 48 weeks of subcutaneous maintenance interferon alfa-2b three times per week reduces risk of recurrence of resected melanoma and that response may depend on the early...

lung cancer

Study Evaluates Risk of Depression by Race and Sex Among Patients With Newly Diagnosed Lung Cancer

In a study reported in the Journal of Clinical Oncology, Traeger et al evaluated risk of depression symptoms and psychosocial service use by race and sex among patients with newly diagnosed lung cancer. The investigators found that black men have the highest prevalence of depressive symptoms, white ...

breast cancer
supportive care

No Difference for Aprepitant vs Dexamethasone for Chemotherapy-Induced Delayed Emesis in Patients With Breast Cancer

In a phase III study reported in the Journal of Clinical Oncology, Roila et al compared aprepitant vs dexamethasone in prevention of delayed emesis in breast cancer patients treated with anthracycline/cyclophosphamide who had received palonosetron/aprepitant/dexamethasone prophylaxis for acute...

Oral Insulin Sensitizers Associated With Decreased Cancer Risk in Women With Type 2 Diabetes

According to the findings of a meta-analysis by Sun et al published in Diabetes, Obesity, and Metabolism, patients with type 2 diabetes mellitus who are on certain therapies, such as insulin secretagogues, may be at higher risk for cancer. This increased risk was seen more frequently in women, and...

leukemia

‘Faster and Deeper Responses’ With Dasatinib vs Imatinib in Chronic-Phase CML Patients

Dasatinib (Sprycel) resulted in “faster and deeper responses” compared to imatinib (Gleevec) among patients with newly diagnosed chronic-phase chronic myeloid leukemia (CML), according to a 3-year follow-up of the randomized phase III DASISION (Dasatinib vs Imatinib Safety In...

skin cancer

Imiquimod 5% Cream Inferior to Surgical Excision in Nodular and Superficial Basal Cell Carcinoma

In a noninferiority trial (SINS) reported in The Lancet Oncology, Bath-Hextall et al compared imiquimod 5% cream vs surgical excision for nodular and superficial basal cell carcinomas. Imiquimod cream was found to be inferior to surgical excision, but it may have a role in treatment of low-risk...

breast cancer

Wider Surgical Margins Do Not Appear To Reduce Local Recurrence Rates in Triple-Negative Breast Cancer

Wider surgical margins did not reduce the rate of local recurrence in women with triple-negative breast cancer treated with breast-conserving therapy, according to the results of a study published in the Annals of Surgical Oncology. Pilewskie et al reported that their data support the definition of ...

leukemia
lymphoma

FDA Approves Revised Prescribing Information for Ponatinib, Authorizes Resumption of Drug Sales and Distribution

The U.S. Food and Drug Administration (FDA) has approved revised prescribing information and a Risk Evaluation and Mitigation Strategy (REMS) for ponatinib (Iclusig) that allows immediate resumption of its marketing and commercial distribution. The prescribing information includes a revised...

breast cancer

Oral Ibandronic Acid Is Not Noninferior to IV Zoledronic Acid in Preventing Skeletal-Related Events in Patients With Breast Cancer

In a phase III noninferiority trial (ZICE) reported in The Lancet Oncology, Barrett-Lee et al compared oral ibandronic acid vs intravenous zoledronic acid in treatment of bone metastases from breast cancer. The study showed that ibandronic acid was not noninferior to zoledronic acid in preventing...

lymphoma

Sustained Complete Responses With Novel Immunotherapy in Lymphoma

Approximately 40% of patients with Hodgkin or non-Hodgkin lymphoma have tumor cells that express the type II latency Epstein-Barr virus (EBV) antigens latent membrane protein 1 (LMP1) and LMP2. T cells specific for these antigens are present in low levels and may be rendered nonreactive by the...

Julie M. Vose, MD, MBA, FASCO, Elected ASCO President for 2015-2016 Term

Julie M. Vose, MD, MBA, FASCO, has been elected President of the American Society of Clinical Oncology (ASCO) for a 1-year term beginning in June 2015. She will take office as President-Elect during the ASCO Annual Meeting in Chicago in June 2014. Additionally, four new members were elected to the...

lung cancer

No Survival Benefit for Tecemotide After Chemoradiotherapy in Stage III NSCLC

In the phase III START trial reported in The Lancet Oncology, Butts et al assessed whether maintenance treatment with the MUC1 antigen–specific immunotherapy tecemotide could prolong overall survival in patients with unresectable stage III non–small cell lung cancer (NSCLC) who had...

issues in oncology

U.S. Cancer Death Rates Continue Decline, Annual Report Shows

Maintaining a 2 decade–long trend, the cancer death rate in the United States continues to decline, according to the Annual Report to the Nation on the Status of Cancer, published online this week in Cancer. The report, which covers the years 2001 to 2010, shows drops in death rates for a...

breast cancer

Younger Women With Younger Children Less Likely to Receive Radiation Therapy After Breast-Conserving Surgery for Breast Cancer

In a study reported in the Journal of the National Cancer Institute, Pan et al assessed factors associated with noncompliance with recommended radiation therapy following breast-conserving surgery for breast cancer. A primary factor in underuse of radiation therapy was younger patients having...

issues in oncology
pancreatic cancer

Low hENT1 Is Associated With Poorer Survival in Patients With Pancreatic Cancer Receiving Adjuvant Gemcitabine

In a study reported in the Journal of the National Cancer Institute, Greenhalf et al analyzed the association between human equilibrative nucleoside transporter 1 (hENT1) levels and survival in patients with pancreas cancer receiving adjuvant gemcitabine or fluorouracil (5-FU)/leucovorin after ...

breast cancer

Dasatinib/Letrozole Drug Combination Delays Disease Progression in Hormone Receptor–Positive, HER2-Negative Metastatic Breast Cancer

Adding dasatinib (Sprycel) to a standard antihormone therapy, letrozole, doubled the time before disease progressed for women with hormone receptor–positive, HER2-negative metastatic breast cancer, according to results of a phase II clinical trial presented at the 2013 San Antonio Breast...

prostate cancer

Second-Line Therapies May Benefit Patients With Castration-Resistant Prostate Cancer and Poor Performance Status

Patients with castration-resistant prostate cancer and a poor performance status who were previously treated with docetaxel may benefit from currently available second-line therapies, according to the findings of a meta-analysis by Iacovelli et al published in Prostate Cancer and Prostatic...

CALGB 40603 Trial Supports Adding Carboplatin to Neoadjuvant Chemotherapy in Triple-Negative Breast Cancer

The addition of carboplatin to a neoadjuvant regimen significantly increased the rate of pathologic complete response in patients with triple-negative breast cancer. The results from the CALGB/Alliance 40603 study were reported at the 2013 San Antonio Breast Cancer Symposium (Abstract S5-01)....

breast cancer

Adjuvant Bisphosphonates Improve Breast Cancer Survival, Reduce Bone Recurrence in Postmenopausal Women With Early Disease

Adjuvant use of bisphosphonates reduced the risk of bone recurrence by 34% and the risk of breast cancer death by 17% in postmenopausal women with early breast cancer in a large meta-analysis conducted by the Early Breast Cancer Trialists’ Collaborative Group (EBCTCG). The potentially...

breast cancer

Adjuvant Paclitaxel/Trastuzumab Tolerable, Benefits Women With Stage I HER2-Positive, Node-Negative Breast Cancer

There may be a benefit for treating small HER2-positive tumors and this can be done with little toxicity, according to a multicenter study presented at the 2013 San Antonio Breast Cancer Symposium (Abstract S1-04). Previous studies of chemotherapy plus anti-HER2 treatment for node-negative...

breast cancer

PIK3CA Mutations Predictive of Resistance to Neoadjuvant Therapy in HER2/HR-Positive Breast Cancers

Women with HER2-positive, hormone receptor-positive breast cancer with mutations in the PI3K/AKT pathway may respond poorly to neoadjuvant therapy, German researchers reported at the 2013 San Antonio Breast Cancer Symposium (Abstract S4-06). “We found that very few women with HER2-positive...

breast cancer

Nonsignificant Reduction in Breast Cancer Risk Seen With Low-Dose Tamoxifen in Postmenopausal Hormone Replacement Therapy Users

In postmenopausal women receiving hormone replacement therapy, low-dose tamoxifen did not significantly reduce the risk of breast cancer but did increase climacteric symptoms, according to the phase III study results presented by DeCensi et al in the Annals of Oncology. However, beneficial trends...

lymphoma

Fractionated 90Y-Ibritumomab Tiuxetan Radioimmunotherapy Produces High Response Rate in Initial Therapy for Follicular Lymphoma

In a phase II trial reported in the Journal of Clinical Oncology, Illidge et al evaluated radioimmunotherapy with fractionated 90Y-ibritumomab tiuxetan (Zevalin) as initial treatment in patients with mostly advanced follicular lymphoma. The treatment was well tolerated, with manageable...

breast cancer

Less Is More: Postoperative Radiation May Be Avoided in Older Women With Estrogen Receptor–Rich Tumors

Among older women with hormone receptor–positive breast cancer, it is reasonable to omit whole-breast radiation therapy after breast-conserving surgery and neoadjuvant hormone therapy if the patient’s tumors have high levels of estrogen receptor expression, but radiation should remain...

breast cancer

NeoALTTO Trial Links Pathologic Complete Response to Clinical Outcomes

Final results of the phase III NeoALTTO trial have confirmed the value of pathologic complete response to dual HER2 blockade in the neoadjuvant setting. The achievement of pathologic complete response was associated with significantly improved event-free survival and overall survival in some women...

breast cancer

Addition of Bevacizumab Fails to Improve Invasive Disease-Free Survival vs Adjuvant Chemotherapy/Trastuzumab Alone in HER2-Positive Breast Cancer

Bevacizumab (Avastin) failed to extend invasive disease–free survival when added to trastuzumab (Herceptin)-directed adjuvant chemotherapy in patients with HER2-positive breast cancer in the phase III BETH trial. Although not specifically designed to answer this question, BETH also...

breast cancer
issues in oncology

Benefit of Breast Cancer Screening More Consistent Across Studies Than Previously Understood

Re-examination of data from four large studies of the benefits and harms of mammography screening shows that the benefits are more consistent across these studies than previously understood and that all the studies indicate a substantial reduction in breast cancer mortality with screening,...

issues in oncology
breast cancer

High Levels of Immune Cells in Tumors May Identify Breast Cancer Patients Most Likely to Benefit From Trastuzumab

Women with HER2-positive breast cancer who had the highest levels of immune cells in their tumors gained the most benefit from presurgery treatment with chemotherapy and trastuzumab (Herceptin), according to results presented today at the 2013 San Antonio Breast Cancer Symposium (Abstract S1-05)....

lymphoma

ASH 2013: Brentuximab Vedotin Shows Promising Activity in Non-Hodgkin Lymphoma

The antibody-drug conjugate brentuximab vedotin (Adcetris) has shown “compelling” antitumor activity in patients with non-Hodgkin lymphomas who were no longer responding to treatment, in a study presented at the American Society of Hematology (ASH) Annual Meeting and Exposition...

skin cancer

Study Explores Risk of New Primary Melanomas After Diagnosis of Stage III/IV Melanoma in Patients Not Receiving BRAF Inhibitors

In a study reported in the Journal of Clinical Oncology, Zimmer et al assessed the incidence of spontaneous new primary melanomas in patients with stage III or IV melanoma in order to help clarify risk of BRAF inhibitor–related new melanomas. They found that patients not receiving BRAF...

Elevated Plasma Vitamin B12 Levels Associated With Cancer Risk

High plasma levels of vitamin B12 (cobalamin) have been reported in patients with cancer of different types. In a Danish study reported in the Journal of the National Cancer Institute, Arendt et al assessed cancer risk in subjects presenting with elevated cobalamin. They found that cancer risk...

lymphoma

Biologic Doublet a Potential Front-Line Treatment in Mantle Cell Lymphoma

A high proportion of mantle cell lymphoma patients may achieve an objective and durable response to treatment with an initial chemotherapy-free regimen, according to Jia Ruan, MD, PhD, of Weill Cornell Medical College, New York, who presented the results of a multicenter phase II study at the 55th...

multiple myeloma

Updated Myeloma Trial Shows Lenalidomide Maintenance Post-Transplant Improves Progression-Free But Not Overall Survival

A new analysis of the multiple myeloma IFM 2005-02 trial showed that lenalidomide (Revlimid) maintenance prolongs progression-free survival after stem cell transplantation, but does not improve overall survival. This is possibly attributed to the shorter survival time after first disease...

multiple myeloma

Continuous Lenalidomide/Low-Dose Dexamethasone Improves Survival vs Standard Treatment in Older Patients With Newly Diagnosed Myeloma

First-line treatment of newly diagnosed multiple myeloma using continuous treatment with the doublet of lenalidomide (Revlimid) and low-dose dexamethasone was superior to standard triplet treatment with melphalan, prednisone, and thalidomide (Thalomid) for 72 weeks, according to initial results of...

leukemia

Gemtuzumab Ozogamicin Reduces Relapse, Improves Event-Free Survival in Pediatric AML

The monoclonal antibody gemtuzumab ozogamicin (Mylotarg) improved event-free survival and reduced the risk of relapse in children with acute myeloid leukemia (AML) in a study from the Children’s Oncology Group, presented at the 55th American Society of Hematology (ASH) Annual Meeting and...

prostate cancer
survivorship

Long-Term Symptoms Beyond 10 Years Experienced by Prostate Cancer Survivors

Years after receiving treatment, many patients who survive prostate cancer continue to experience treatment-related symptoms, according to the findings of a study by Darwish-Yassine et al published in the Journal of Cancer Survivorship. These findings highlight the need for improvements in survivor ...

hematologic malignancies

Reduced-Intensity Hematopoietic Stem Cell Transplant Spares Cognition

The intensity of transplant-related chemotherapy and radiation has effects on cognition, according to a study presented at the 55th American Society of Hematology (ASH) Annual Meeting and Exposition (Abstract 913). Full-intensity hematopoietic stem cell transplant was associated with cognitive...

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