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supportive care

Uridine Triacetate Granules for Fluorouracil or Capecitabine Overdose or Early Severe Toxicity

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 11, 2015, uridine triacetate (Vistogard) was approved...

Expert Point of View: Angela DeMichele, MD, and Melinda L. Telli, MD

The formal discussant for the CALGB 40603 and GeparSixto studies at the San Antonio Breast Cancer Symposium was Angela DeMichele, MD, Professor of Medicine and Miller Chair in Breast Cancer Excellence at the Perelman School of Medicine, University of Pennyslvania. “The key questions raised by these ...

breast cancer

Role of Carboplatin in Triple-Negative Breast Cancer Still Unclear

Studies presented at the 2015 San Antonio Breast Cancer Symposium built upon an increasing body of data in support of the neoadjuvant use of carboplatin in patients with triple-negative breast cancer. Overall, however, the studies fell short of establishing carboplatin’s role in this malignancy and ...

breast cancer

Immunotherapy for Breast Cancer: Early Lackluster Study Results yet Promise Remains

Immunotherapy is at the forefront of exciting new approaches to cancer, with excellent and long-lasting responses in metastatic melanoma and non–small cell lung cancer (NSCLC) and several immunotherapy agents now approved for those malignancies by the U.S. Food and Drug Administration (FDA). The...

Expert Point of View: Lisa Carey, MD

For the most part, the cardiotoxicity with trastuzumab appears to be largely reversible, unlike anthracyclines, which cause permanent cardiac damage,” said Lisa Carey, MD, Distinguished Professor at the UNC Lineberger Breast Center, Chapel Hill, North Carolina. “In this small study, they saw no...

breast cancer

Prophylactic Beta-Blocker Preserves Left-Ventricular Function in Patients Receiving Trastuzumab

The beta-blocker bisoprolol was able to prevent trastuzumab (Herceptin)-associated declines in left-ventricular ejection fraction, whereas the effect of the angiotensin-converting–enzyme (ACE) inhibitor perindopril was less robust. Use of bisoprolol reduced dose interruptions for trastuzumab due to ...

Sally Vernon, PhD, Appointed to National Cancer Institute Board

Sally Vernon, PhD, Chair of the Department of Health Promotion and Behavioral Sciences at The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, has been appointed to the Board of Scientific Counselors for Clinical Sciences and Epidemiology at the National...

Karmanos Cancer Institute Announces New Leadership Roles for Elisabeth Heath, MD, FACP, and Ulka Vaishampayan, MD

The Barbara Ann Karmanos Cancer Institute recently announced the promotion of two physician scientists: Elisabeth Heath, MD, FACP, and Ulka Vaishampayan, MD. Elisabeth Heath, MD, FACP Dr. Heath will lead the Genitourinary Oncology Multidisciplinary Team at Karmanos Cancer Institute. She will also...

Expert Point of View: Kevin S. Hughes, MD

This study confirms that what is important is a negative margin, not the margin size,” said Kevin S. Hughes, MD, a breast surgeon who is Co-Director of the Avon Comprehensive Breast Evaluation Center at Massachusetts General Hospital, Boston. “This is a confirmatory study of the consensus...

breast cancer

Surgical Margin Width Not Related to Breast Cancer Recurrence

The width of the surgical margin doesn’t matter, as long as the margin is negative, according to a large study of breast-conserving surgery in patients with invasive breast cancer. The risk of ipsilateral breast tumor recurrence was similar for wide negative margins (2–4 mm) or narrow negative...

Expert Point of View: Carlos L. Arteaga, MD

Carlos L. Arteaga, MD, the Donna S. Hall Chair in Breast Cancer Research and Director of the Center for Cancer Targeted Therapies at Vanderbilt University School of Medicine, Nashville, commented on the BELLE-2 trial for The ASCO Post. “We have learned that there is a subgroup of patients, who are...

breast cancer
issues in oncology

PI3K Inhibitor Buparlisib Extends Progression-Free Survival  in Advanced Breast Cancer

Addition of the oral investigational pan-PI3K inhibitor buparlisib to the endocrine agent fulvestrant (Faslodex) improved progression-free survival among postmenopausal women with advanced hormone receptor–positive/HER2-negative advanced breast cancer. “We are happy to announce that the phase III...

colorectal cancer

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...

myelodysplastic syndromes
leukemia
hematologic malignancies

Myeloablative Conditioning for Stem Cell Transplantation Remains Standard of Care in Patients With MDS and AML

A randomized trial from the Bone and Marrow Transplant Clinical Trials Network was halted early after concluding that allogeneic stem cell transplantation after a reduced-intensity conditioning regimen resulted in higher relapse rates compared to myeloablative conditioning. The phase III randomized ...

leukemia

Self-Reports Overestimate Mercaptopurine Intake in Childhood Acute Lymphoblastic Leukemia

Mercaptopurine is critical for maintaining remission in childhood acute lymphoblastic leukemia (ALL). However, a study has shown that overreporting of intake is common, and self-reports of intake are not as reliable as electronic reporting.1 About 86% of parents and children overreported the number ...

Expert Point of View: George Daley, MD, PhD, and David Williams, MD

Press briefing moderator George Daley, MD, PhD, of Boston Children’s Hospital, was enthusiastic about these results, despite the small number of patients treated in studies of CAR-T cells thus far. Most of the results have been in a positive direction, he noted. “It is remarkably exciting to see...

hematologic malignancies

New Use for CAR-T Cells Post Transplantation

The approach of using genetically engineered chimeric antigen receptor (CAR)-T cells has received much attention for treating leukemias, where it has achieved spectacular long-lasting complete remissions in some patients with no other treatment options. CAR-T cells are also being studied in...

Expert Point of View: Kanti Rai, MD

In a separate interview, Kanti Rai, MD, of the Northwell Health System in New Hyde Park, New York, noted that venetoclax is one of several “exciting recent developments in this disease.” There is the Bruton tyrosine kinase inhibitor ibrutinib (Imbruvica), the PI3K inhibitor idelalisib (Zydelig),...

leukemia

Venetoclax May Prove to Be Strong Weapon Against Poor-Prognosis Chronic Lymphocytic Leukemia

Venetoclax, the latest entry into the field of treatment of chronic lymphocytic leukemia (CLL), is a powerful investigational therapy that promises to fill an important niche: treatment of high-risk relapsed/refractory patients with deletions of 17p. Nearly 80% of patients with relapsed/refractory...

leukemia

Severe Toxicities Seen in Younger Patients Receiving  Front-Line Idelalisib for Chronic Lymphocytic Leukemia

Hematologists and patients with chronic lymphocytic leukemia (CLL) are excited about new drugs that have dramatically improved outcomes. But all drugs have side effects, and it is important to be aware of potential consequences. Hepatotoxicity turns out to be a major concern in younger CLL patients ...

Expert Point of View: Susan O’Brien, MD

Clearly idelalisib improved overall survival when added to bendamustine (Bendetta/Treanda)/rituximab (Rituxan). These results are similar to those from the HELIOS trial reported at last year’s ASCO meeting,” said Susan O’Brien, MD, Associate Director for Clinical Science for the Chao Family...

leukemia
issues in oncology

Idelalisib Improves Progression-Free Survival Over Bendamustine Plus Rituximab in Chronic Lymphocytic Leukemia

Idelalisib (Zydelig) combined with bendamustine (Bendeka, Treanda) plus rituximab (Rituxan) was superior to chemotherapy with bendamustine/rituximab plus placebo, reducing the risk of progressive disease and death while improving progression-free survival and overall survival in patients with...

Expert Point of View: Robert Hromas, MD, and Timothy A. Graubert, MD

Robert Hromas, MD, of the University of Florida College of Medicine, Gainesville, who moderated a press briefing, commented that the finding of benefit with rituximab “resolves a long-standing controversy” with this cancer. “These results are exciting for those of us who treat leukemia,” he...

leukemia

Rituximab Adds Benefit to Chemotherapy in Adult B-Cell Precursor ALL

The addition of rituximab (Rituxan) to the pediatric-inspired chemotherapy protocol for B-cell precursor acute lymphoblastic leukemia (ALL) significantly improved event-free survival in a large European study presented at the 2015 ASH Annual Meeting.1 The GRAALL-R 2005 phase III study is the first...

lung cancer

ALK Rearrangements Common in Young Patients With Lung Cancer

Two investigative groups have reported interesting observations about genomic alterations in the tumors of young patients with lung cancer. Notably, ALK rearrangement was the most common driver mutation found, in studies reported at the 16th World Conference on Lung Cancer.1,2 “To our knowledge,...

prostate cancer

Even After Antiandrogen Therapy, Docetaxel Remains Useful in Prostate Cancer

A study presented at the 2016 Genitourinary Cancers Symposium showed that 40% of patients with metastatic castration-resistant prostate cancer treated with docetaxel following abiraterone (Zytiga) had at least a 50% reduction in prostate-specific antigen (PSA), demonstrating the activity of this...

issues in oncology

Patient-Centric Care: Translating Research to Results

The 2016 Genitourinary Cancers Symposium was held earlier this month in San Francisco. Abstracts and presentations included data and discussion on the latest strategies in the prevention, screening, diagnosis, and treatment of prostate, kidney, testicular, and urothelial cancers. Snapshots of data...

multiple myeloma

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...

breast cancer

Ado-Trastuzumab Emtansine Improved Overall Survival for Heavily Pretreated Patients With HER2-Positive Breast Cancer

Among patients with HER2-positive, metastatic breast cancer that had progressed despite treatment with two or more forms of HER2-targeted therapy (trastuzumab [Herceptin] and lapatinib [Tykerb]), median overall survival was increased for those treated with ado-trastuzumab emtansine (aka T-DM1...

Expert Point of View: Daniel Hayes, MD

In an interview with The ASCO Post, 2016 President-Elect of ASCO Daniel Hayes, MD, explained his interest in what he labeled “very exciting technology.” “Most of the DNA in plasma is normal, coming from white cells. Within that, there’s a small amount of tumor DNA. I have been told that you either...

breast cancer

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...

breast cancer

Neoadjuvant Palbociclib Enhances Effect of Anastrozole on Complete Cell-Cycle Arrest

The cyclin-dependent kinase (CDK) 4/6  inhibitor palbociclib (Ibrance) enhanced cell-cycle control over that achieved with anastrozole alone in a study that evaluated the drugs’ ability to induce complete cell-cycle arrest in tumor cells and to produce clinical responses, as neoadjuvant therapy for ...

Expert Point of View: Virginia Kaklamani, MD, and William Sikov, MD

This study was started in 1977. In this subgroup of premenopausal women with high-risk breast cancer but luminal A subtype, data suggest that there is no benefit from chemotherapy,” said Virginia Kaklamani, MD, leader of the Breast Cancer Program at the Cancer Therapy and Research Center and...

breast cancer

Study Suggests Luminal A Breast Cancer Patients May Not Need Chemotherapy

The ability to classify breast cancer according to biologic subtype has enabled researchers to dig deeper and determine which therapies benefit specific subgroups. Encouraging evidence from an analysis of a Danish trial presented at the 2015 San Antonio Breast Cancer Symposium suggests that...

Expert Point of View: Marcela Maus, MD

Commenting on the study presented by ­Schuster et al at the 2015 ASH Annual Meeting and Exposition, Marcela Maus, MD, Director of the Cellular Immunity Program at Massachusetts General Hospital in Boston, said: “These are amazing results. The study shows that [chimeric antigen receptor...

hematologic malignancies
lymphoma

Could CAR-T Therapy Be Moving Into Lymphoma?

The use of T cells that are genetically engineered to express chimeric antigen receptor (CAR-T) has made headway as an approach to hematologic malignancies, with the best results achieved in leukemia. At the 2015 American Society of Hematology (ASH) Annual Meeting and Exposition, a preliminary...

Expert Point of View: Paul Bunn, Jr, MD

Although the results for E1505 were negative, “overall survival and disease-free survival are not the only things we can learn from this trial,” said Paul Bunn, Jr, MD, Distinguished Professor in the Division of Medical Oncology at the University of Colorado, Denver, who formally discussed the...

lung cancer

Bevacizumab Plus Chemotherapy Fails to Prolong Survival in Early-Stage Lung Cancer

Overall survival in patients with surgically resected early-stage non–small cell lung cancer (NSCLC) did not improve with the addition of bevacizumab (Avastin) to chemotherapy, according to the findings of a study researchers have called a “top abstract” from the 16th World Conference on Lung...

cost of care

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...

multiple myeloma

Multiple Myeloma in 2015: A Year for the Record Books

Few malignancies have received as much attention, in the way of newly approved drugs, as multiple myeloma did in 2015. In November alone, 3 new agents were approved, bringing the total to 4 for the year as part of a record 7 approvals and to 16 regulatory approvals over the past 12 years. Speakers...

lung cancer

Study Finds Alectinib Highly Active in ALK-Positive, Crizotinib-Resistant NSCLC

In a North American phase II trial reported in The Lancet Oncology, Shaw et al found that alectinib (Alecensa), which is active against acquired crizotinib (Xalkori) resistance mutations and exhibits high central nervous system (CNS) penetration, was associated with considerable activity in...

hematologic malignancies
lymphoma

Swedish Study Indicates No Pregnancy-Related Increase in Risk of Relapse in Hodgkin Lymphoma

In a Swedish study reported in the Journal of Clinical Oncology, Weibull et al found that pregnancy did not appear to increase the risk of subsequent relapse in women with Hodgkin lymphoma in remission. Study Details The study included data from Swedish health-care registers and medical records...

lymphoma
survivorship
issues in oncology

Study Shows Inferior Outcomes for African American Pediatric Lymphoma Patients

Researchers from Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine have published a study showing that African American pediatric patients with Hodgkin lymphoma have inferior overall survival compared with their white and Hispanic peers. The study, published ...

sarcoma

FDA Approves Eribulin Mesylate in Unresectable or Metastatic Liposarcoma

The U.S. Food and Drug Administration today approved eribulin mesylate (Halaven), an antimicrotubular antineoplastic agent, for the treatment of unresectable or metastatic liposarcoma. This treatment is approved for patients who received prior chemotherapy that contained an anthracycline drug....

gynecologic cancers
colorectal cancer
head and neck cancer
issues in oncology
issues in oncology

100% of NCI-Designated Cancer Centers Endorse the Promotion of the HPV Vaccination for Cancer Prevention

All National Cancer Institute (NCI)-designated cancer centers have united to support human papillomavirus (HPV) vaccination. A team of HPV experts drafted a consensus statement that advises widespread use of HPV vaccines to prevent cancer. HPV causes cancer of the cervix, anus, and throat. The HPV ...

palliative care
colorectal cancer

One in Seven Colorectal Cancer Patients Diagnosed Before Recommended Screening Age

Nearly 15% of patients diagnosed with colorectal cancer were younger than 50, the age at which screening recommendations begin. The study by researchers at the University of Michigan Comprehensive Cancer Center also found that younger patients were more likely to have advanced disease. The authors ...

breast cancer
supportive care
survivorship

Risk Factors for Lymphedema in Patients Treated for Breast Cancer

In a study reported in the Journal of Clinical Oncology, Ferguson et al found that cellulitis in the affected arm, but not blood draws, injections, trauma to the affected arm, or air travel, was associated with an increased risk of lymphedema in women treated for breast cancer. Study Details In...

prostate cancer

DNA Damage and Repair Pathway Signature May Be Associated With Prognosis After Prostatectomy in High-Risk Prostate Cancer

In a study reported in JAMA Oncology, Evans et al identified a DNA damage and repair pathway gene signature that was significantly associated with outcomes after prostatectomy for high-risk prostate cancer independent of standard clinicopathologic factors. Study Details The study involved 1,090...

gastroesophageal cancer
issues in oncology
issues in oncology

STS 2016: Race, Lower Socioeconomic Status Linked With Worse Survival Following Esophageal Cancer Surgery

Poor black patients undergoing surgery for esophageal cancer are at higher risk for death than white patients and patients with higher socioeconomic status, according to a scientific presentation by Erhunmwunsee et al at the 52nd Annual Meeting of The Society of Thoracic Surgeons. The abstract,...

lung cancer

STS 2016: Body Mass Index Linked With Complications After Lung Cancer Surgery

Body mass index affects outcomes following lung resection for lung cancer. Patients with very high or very low body mass index measurements have the highest risks for complications, according to a scientific presentation at the 52nd Annual Meeting of The Society of Thoracic Surgeons. The abstract...

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