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breast cancer

Drugging PI3K in Breast Cancer: Findings From SABCS 2013

Components of the phosphatidylinositide 3-kinase/mammalian target of rapamycin (PI3K/mTOR) pathway are deregulated in many human cancers, with about 30% of breast cancers harboring PIK3CA gene mutations. Emerging research shows that these mutations may render estrogen receptor alpha-positive tumors ...

breast cancer

Common Mutations May Impact Neoadjuvant Treatment Outcomes in Breast Cancer

Emerging research is suggesting that outcomes from neoadjuvant chemotherapy may be correlated with two genetic mutations that are common in breast cancer—PIK3CA and TP53. Their presence may affect response to treatment, and mutational shift after treatment may affect survival, according to studies...

Expert Point of View: Andrew D. Zelenetz, MD, PhD

Andrew D. Zelenetz, MD, PhD, Chair of the Non-Hodgkin Lymphoma Guideline Panel of the National Comprehensive Cancer Network (NCCN) and former Chief of the Lymphoma Service at Memorial Sloan-Kettering Cancer Center, New York, commented on the study by Yamshon et al for The ASCO Post. He said the...

lymphoma

‘R-Squared’ Lymphoma Treatment: Possible Markers of Response Identified

A correlative analysis of a study evaluating lenalidomide (Revlimid) plus rituximab (Rituxan) in patients with indolent non-Hodgkin lymphoma found that increases in the levels of several cytokines correlated with response to treatment. The study by investigators from the University of California...

Expert Point of View: Nathan Fowler, MD

“The future is increasingly bright for patients as we move into an era of effective nonchemotherapy treatment options,” commented Nathan Fowler, MD, Associate Professor in the Department of Lymphoma/Myeloma at The University of Texas MD Anderson Cancer Center, Houston. “Over the past several years, ...

lymphoma

Lenalidomide/Rituximab Doublet a Potential Front-Line Treatment in Some Lymphomas

The biologic doublet of lenalidomide (Revlimid) plus rituximab (Rituxan) can achieve high response rates and durable remissions in lymphoma, according to a parade of phase II studies presented at the 2013 American Society of Hematology (ASH) Annual Meeting in New Orleans. The immunomodulatory agent ...

Expert Point of View: Lajos Pusztai, MD, DPhil

Lajos Pusztai, MD, DPhil, Professor of Medicine and Director of Breast Medical Oncology at Yale University, New Haven, Connecticut, who was the formal discussant of the papers by Sikov et al and Rugo et al, said there is mounting evidence for using carboplatin. He and his own research team have...

breast cancer

Addition of Carboplatin to Standard Neoadjuvant Chemotherapy in Triple-Negative Breast Cancer Supported by SABCS Studies

The achievement of a pathologic complete response in patients with triple-negative breast cancer was boosted by the addition of carboplatin to a standard neoadjuvant chemotherapy regimen, and by the addition of veliparib, an investigational oral PARP inhibitor, plus carboplatin to a standard...

Expert Point of View: Bruce Cheson, MD

Ibrutininb appears to be the most promising drug we have seen in Waldenstrom’s macroglobulinemia and will likely significantly change the therapeutic landscape,” according to Bruce Cheson, MD, Deputy Chief, Hematology-Oncology and Head of Hematology Research at Georgetown Lombardi Cancer Center in...

lymphoma

Ibrutinib Induces Prompt and Durable Responses in Some Lymphomas

The Bruton’s tyrosine kinase inhibitor ibrutinib (Imbruvica) is changing the landscape of treatment in chronic lymphocytic leukemia. New research with the drug in lymphoma, presented at the 2013 American Society of Hematology (ASH) Annual Meeting in New Orleans, indicates it may be of benefit in...

Expert Point of View: Andrew D. Zelenetz, MD, PhD

Andrew D. Zelenetz, MD, PhD, Chair of the Non-Hodgkin Lymphoma Guideline Panel of the National Comprehensive Cancer Network (NCCN) and former Chief of the Lymphoma Service at Memorial Sloan-Kettering Cancer Center, New York, put the latest maintenance trials into perspective for The ASCO Post....

lymphoma

ASH Studies Confirm Benefit of Rituximab Maintenance in Follicular Lymphoma

Findings from two major studies presented at the 2013 American Society of Hematology Annual Meeting not only confirm the benefit of rituximab (Rituxan) maintenance in follicular lymphoma, but also indicate that the longer the maintenance period, the greater the impact on progression-free survival....

lymphoma

Novel Agents Show Activity in Non-Hodgkin Lymphoma

PI3K-mediated activation of downstream effectors allows tumors to escape from negative growth control, and this action may be checked with PI3K inhibitors. At the 2013 American Society of Hematology (ASH) Annual Meeting, researchers reported results in patients with relapsed or refractory lymphoma...

multiple myeloma

ASH Studies Refine Myeloma Treatment and Show Promise for New Agents

Multiple myeloma researchers moved the field forward at the 2013 American Society of Hematology (ASH) Annual Meeting, presenting evaluations of treatment schedules and reports of encouraging activity with compounds in development. Alternating vs Sequential Regimens In 231 newly diagnosed elderly...

breast cancer
pain management

Postmastectomy Pain Effectively Treated With a Simple Injection

For postmastectomy neuropathic pain, perineural infiltration with a combination of bupivacaine and dexamethasone is a “simple, effective, practice-changing treatment that any surgeon can do,” according to Laura J. Esserman, MD, MBA, Professor of Surgery and Radiology at the University of...

breast cancer

SABCS Highlights Include Findings in Triple-Negative Disease, Protective Effects of Exercise, and the Adherence-Copay Link

The San Antonio Breast Cancer Symposium brings together specialists from all over the world who focus on management of breast cancer. We have covered many of the important presentations in the pages of The ASCO Post and in our online Evening News. Below are summaries of additional noteworthy...

Expert Point of View: Neal J. Meropol, MD

Neal J. Meropol, MD, Chief of Hematology and Oncology at University Hospitals ­Seidman Cancer Center and Case Western Reserve University, discussed the CAIRO3 results at the Gastrointestinal Cancers Symposium. He said there are three main lessons from ­CAIRO3: (1) It is feasible yet challenging to...

colorectal cancer

Maintenance Treatment With Capecitabine and Bevacizumab Is Effective in Metastatic Colorectal Cancer

In patients with metastatic colorectal cancer, maintenance treatment with capecitabine plus bevacizumab (Avastin) after induction treatment with capecitabine, oxaliplatin, and bevacizumab (CAPOX-B) significantly delayed disease progression, compared to observation, according to the final results of ...

Expert Point of View: Manish Shah, MD

Manish Shah, MD, Director of Gastrointestinal Oncology and Associate Professor of Medicine at New York–Presbyterian/Weill Cornell Medical Center in New York, discussed the findings of the RAINBOW trial at the 2014 Gastrointestinal Cancers Symposium. Dr. Shah noted that in this “well sized” study,...

gastrointestinal cancer

Ramucirumab Plus Paclitaxel Improves Overall Survival After First Progression in Metastatic Gastric Cancer

In the global phase III RAINBOW trial in patients with metastatic gastric cancer, the investigational monoclonal antibody ramucirumab significantly improved both progression-free and overall survival, when added to paclitaxel in second-line therapy, as reported at the 2014 Gastrointestinal Cancers...

Expert Point of View: Rebecca Miksad, MD, MPH

Rebecca Miksad, MD, MPH, Assistant Professor of Medicine at Harvard Medical School and Attending Physician, Gastrointestinal Medical Oncology, Beth Israel Deaconess Medical Center, Boston, discussed the findings at the symposium and the potential for immunotherapy in pancreatic cancer....

pancreatic cancer

Immunotherapy Duo Improves Survival in Metastatic Pancreatic Cancer

Overall survival was improved in metastatic pancreatic cancer patients through an innovative immunotherapy strategy in a multicenter study reported at the 2014 Gastrointestinal Cancers Symposium.1 “This is the first time a randomized study has shown that immunotherapy is effective in pancreatic...

Expert Point of View: Jeffrey Miller, MD

Jeffrey Miller, MD, Professor of Medicine at the University of Minnesota and Deputy Director of the Masonic Cancer Clinic in Minneapolis, commented on the haploidentical hematopoietic stem cell transplantation studies presented at the American Society of Hematology meeting for The ASCO Post “The...

hematologic malignancies

Haploidentical Stem Cell Transplantation Producing Good Outcomes, Expanding Transplant Pool

HLA-haploidentical hematopoietic stem cell transplantation can be performed safely, yield good outcomes, and greatly expand the number of patients with hematologic malignancies who can be treated with stem cell transplant, studies presented at the 2013 American Society of Hematology (ASH) Annual...

Expert Point of View: C. Kent Osborne, MD

At the San Antonio Breast Cancer Symposium, press briefing moderator C. Kent Osborne, MD, Director of the Dan Duncan Cancer Center at Baylor College of Medicine, Houston, predicted the findings of the study by Badwe et al could be practice-changing. “This is not to say that we shouldn’t perform...

breast cancer

In Stage IV Breast Cancer, the Primary May Not Need to Be Removed

Mastectomy is unnecessary in many women with stage IV breast cancer, according to a study from Indian investigators, reported at the 2013 San Antonio Breast Cancer Symposium.1 The study randomly assigned 350 patients with metastatic breast cancer to mastectomy, complete axillary dissection, plus...

breast cancer

Innovative I-SPY 2 Trial Yields First Results in Triple-Negative Breast Cancer

An innovative approach to streamlining the testing of novel agents in breast cancer has yielded some of its first results, which were reported at the 2013 San Antonio Breast Cancer Symposium.1 Adaptive Trial Design The veliparib/carboplatin plus standard neoadjuvant therapy regimen is currently...

Expert Point of View: Debu Tripathy, MD

Debu Tripathy, MD, Professor of Medicine, Co-Leader of the Women’s Cancer Program, and the Priscilla and Art Ulene Chair in Women’s Cancer at the University of Southern California Norris Cancer Center, Los Angeles, commented on the APT study for The ASCO Post. “In treating early-stage HER2-positive ...

breast cancer

HER2-Positive Breast Cancer Patients With Small Tumors Benefit From Low-Toxicity Regimen

There may be a benefit for treating small HER2-positive tumors—a breast cancer subset for whom treatment recommendations have not been established but for whom there is still risk of recurrence—and this can be done with little toxicity, according to a multicenter study presented at the 2013 San...

colorectal cancer
pancreatic cancer

GI Symposium Presentations Include Important Updates in Treatment and Prognosis of Pancreatic and Colorectal Cancers

More than 650 studies were presented at the 2014 Gastrointestinal Cancers Symposium, which attracted a multidisciplinary group of more than 3,500 medical, surgical, and radiation oncologists and gastroenterologists. The following briefs highlight a handful of noteworthy studies from the meeting....

colorectal cancer

Capecitabine Acceptable in Neoadjuvant Rectal Cancer Setting

As neoadjuvant therapy for rectal cancer, infusional fluorouracil (5-FU) and oral capecitabine achieve similar outcomes, and the addition of oxaliplatin confers no additional benefit, according to the mature results of the National Surgical Adjuvant Breast and Bowel Project (NSABP) R-04 trial,...

Expert Point of View: Josep M. Llovet, MD

Josep M. Llovet, MD, Professor of Medicine at Mount Sinai Hospital, New York, commented on the findings reported by Faivre et al for The ASCO Post. “This is the first time a TGF-β inhibitor has been clinically tested in hepatocellular carcinoma, and the drug has a good safety profile. But this is a ...

hepatobiliary cancer

Biomarker-Defined Subgroup Benefits From Novel Approach to Advanced Hepatocellular Carcinoma

Promising efficacy in advanced hepatocellular carcinoma patients was reported for a novel transforming growth factor–beta receptor type 1 (TGF-β1) kinase inhibitor, LY2157299 monohydrate, at the 2014 Gastrointestinal Cancers Symposium in San Francisco.1 In particular, patients with moderate to...

Expert Point of View: Melanie B. Thomas, MD

Melanie B. Thomas, MD, Associate Director of Clinical Investigations and the Grace E. DeWolff Chair of Medical Oncology at the Medical University of South Carolina in Charleston, commented on the findings by Martin et al for The ASCO Post. “I think this study is exciting,” she said. “They were...

colorectal cancer

Irinotecan Drug-Eluting Beads Improve Outcomes in Colorectal Cancer Patients With Liver Metastases

Irinotecan drug-eluting beads (DEBIRI) given simultaneously with FOLFOX (leucovorin, fluorouracil, oxaliplatin) and bevacizumab (Avastin) in patients with unresectable colorectal liver metastasis improved response rates, increased resectability, and prolonged hepatic progression–free survival in a...

breast cancer
cns cancers

How to Approach the Problem of CNS Metastasis in HER2-Positive Patients

Central nervous system (CNS) metastasis is a pervasive problem in the setting of HER2-positive breast cancer. While some patients can be managed easily, others are challenging, said Eric P. Winer, MD, Chief of the Division of Women’s Cancers and the Thompson Senior Investigator for Breast Cancer...

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 Exposition ...

lymphoma

Idelalisib Achieves High Response Rates in ‘Double-Refractory’ Indolent NHL

In patients with indolent B-cell non-Hodgkin lymphoma (NHL) refractory to both rituximab (Rituxan) and an alkylating agent, monotherapy with the selective oral PI3K-delta inhibitor idelalisib produced a high response rate, with responses persisting for 1 year in the average patient, according to...

breast cancer

Immune Modulation May Aid Some Breast Cancer Subtypes

There may be an immunogenic phenotype in breast cancer that could benefit from immune modulation as part of treatment, according to results from studies that correlated high levels of tumor-infiltrating lymphocytes with both pathologic complete responses and long-term outcomes. Studies presented at ...

leukemia

Novel Therapies May Help Wipe Out Residual Acute Lymphoblastic Leukemia

Minimal residual disease after induction and consolidation for the treatment of acute leukemia might be eradicated by novel therapies, thus obviating the need for stem cell transplantation. That is the prediction of Matthew J. Wieduwilt, MD, PhD, Assistant Clinical Professor of Medicine at the...

leukemia

Minimal Residual Disease Before and After Transplant: What Does It Mean?

In patients with acute leukemia, outcomes after hematopoietic stem cell transplantation are negatively impacted by the presence of minimal residual disease. However, transplant can prolong survival in patients with minimal residual disease after consolidation, according to two studies presented at...

Expert Point of View: Rebecca A. Miksad, MD, MPH

Rebecca A. Miksad, MD, MPH, Assistant Professor of Medicine at Harvard Medical School and Physician-Investigator at Beth Israel Deaconess Medical Center, Boston, who discussed the paper by Fine et al at the Gastrointestinal Cancers Symposium, said, “the study reports that a range of neuroendocrine...

neuroendocrine tumors

For Progressive Neuroendocrine Tumors, Clinical Benefit Is High With Capecitabine Plus Temozolomide

In an interim analysis of a phase II trial, 97% of patients with progressive metastatic neuroendocrine tumors achieved clinical benefit with the combination of capecitabine and temozolomide (CAPTEM). The results were reported at the 2014 Gastrointestinal Cancers Symposium by Robert L. Fine, MD,...

SIDEBAR: Colorectal Cancer Survivors’ Comments on Strategies to Regulate Bowel Function

Avoiding Foods I don’t eat beans, I don’t eat onions. I’m kind of careful on greens because they just don’t digest well. I don’t eat as many salads. I couldn’t because they went right through. Behavioral Adjustments You learn, over the years, what you can and can’t do. And you can’t overeat....

colorectal cancer
survivorship

Colorectal Cancer Survivors Face Challenges With Bowel Regulation

The fight against colorectal cancer leaves many survivors with battle wounds, according to studies that show a high incidence of assorted morbidities that can affect quality of life. Clinicians, in fact, may be unaware of the struggles with bowel function that occur during survivorship, researchers ...

colorectal cancer

Outcomes in Metastatic Colorectal Cancer: Studies Examine Relative Merits, Cost-Effectiveness

Targeted biologic agents have improved long-term outcomes in metastatic colorectal cancer, but debate continues as to their relative efficacy and proper sequencing. At the 2014 Gastrointestinal Cancers Symposium, a number of studies attempted to answer these questions by interrogating the clinical...

Expert Point of View: Neal J. Meropol, MD

Neal J. Meropol, MD, Chief of Hematology and Oncology at University Hospitals Case Medical Center at Case Western Reserve University, Cleveland, discussed the various findings in RAS mutations at the Gastrointestinal Cancers Symposium. “RAS mutations beyond exon 2 are common, occurring in about 15% ...

colorectal cancer

More Support for ‘All-RAS’ Testing in Metastatic Colorectal Cancer

Multiple studies reported at the 2014 Gastrointestinal Cancers Symposium add further support for widening the genetic analysis of colorectal cancer tumors. In fact, experts predict that more extensive genetic testing for RAS gene mutations (in KRAS and NRAS) beyond the routine analysis of KRAS exon ...

Expert Point of View: Neal J. Meropol, MD

Neal J. Meropol, MD, Chief of Hematology and Oncology at University Hospitals ­Seidman Cancer Center and Case Western Reserve University, Cleveland, discussed the study by Kothari et al presented at the Gastrointestinal Cancers Symposium. He noted that complex interactions exist between PIK3CA and...

colorectal cancer

Aspirin Use Not Associated With Survival in PIK3CA-Mutant Colorectal Cancer

Contrary to emerging data from other studies, the regular use of aspirin was not associated with improved survival in patients with PIK3CA-mutant metastatic colorectal cancer in a study reported at the 2014 Gastrointestinal Cancers Symposium in San Francisco.1 Large Dataset “We did not validate...

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