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lymphoma

Important Briefs: Lymphoma Research on Improved Chemotherapy, Biomarker Associations, and Stem Cell Transplant Approaches

The 11th International Conference on Malignant Lymphoma was held June 15–18 in Lugano, Switzerland. More than 3,000 hematologists, clinical oncologists, pathologists, and researchers attended the meeting, which was first convened in 1981. Topics of discussion included lymphoma staging in the new...

Expert Point of View: Smoking and Lack of Exercise Increase Risk of Some Cancers, but Moderate Alcohol Consumption Reduces Colon Cancer Risk

At a press conference where results of the study by Land and colleagues were released, George W. Sledge, Jr, MD, said, “This study highlights the importance of lifestyle factors. We need to think about encouraging women who engage in unhealthy behaviors that place them at risk for cancer to change...

colorectal cancer

Smoking and Lack of Exercise Increase Risk of Some Cancers, but Moderate Alcohol Consumption Reduces Colon Cancer Risk

A substudy of the large prospective National Surgical Adjuvant Breast and Bowel Project (NSABP) Breast Cancer Prevention Trial revealed both expected and surprising findings related to the association between lifestyle factors (cigarette smoking, alcohol, and exercise) and cancer risk. As might be...

Expert Point of View: Novel Agents Prolong Disease-free Survival in Ovarian Cancer

Stanley B. Kaye, MD, of Royal Marsden Hospital in London, the invited discussant, commented, “The trial of olaparib was important, showing clear superiority of olaparib with an impressive hazard ratio that was not restricted to BRCA-mutated patients.…There is a role for taking this drug forward as...

gynecologic cancers

Novel Agents Prolong Disease-free Survival in Ovarian Cancer

Novel agents produced high response rates and prolonged remissions in patients with platinum-sensitive recurrent ovarian cancer, in studies reported at the 2011 ASCO Annual Meeting. In an international randomized phase II trial, maintenance therapy with the oral poly [ADP-ribose] polymerase (PARP)...

Expert Point of View: Iniparib Fails to Improve Outcomes in Triple-negative Breast Cancer

The discussant of the iniparib data (abstract 1007), Lisa A. Carey, MD, Medical Director of the University of North Carolina Breast Center, noted that the phase II results provoked “great enthusiasm and high expectations from doctors and patients” but the primary statistical endpoint was not met....

breast cancer

Iniparib Fails to Improve Outcomes in Triple-negative Breast Cancer

As reported in the March 15 issue of The ASCO Post, a phase III trial of the novel agent iniparib failed to demonstrate a significant improvement in survival for women with metastatic triple-negative breast cancer. The “top-line” results were communicated in the spring via press releases from...

SIDEBAR: Lessons for Today

Many of Osler’s precepts and teachings are as applicable today as they were a century ago. Their universality and timeless relevance are guideposts. Some of his frequently cited aphorisms include: “In the physician or surgeon no quality takes rank with imperturbability.” “Care more particularly ...

hematologic malignancies

On William Osler: The Old Art and the New Science

William Osler (1849–1919) is one of the most revered physicians in the history of medicine. He was an outstanding clinician who emphasized bedside teaching, hard work, medical history, and lifelong learning.1 As Professor of Medicine at four institutions in three countries, he exerted a profound...

Expert Point of View: Longer Imatinib Treatment Is Better in High-risk GIST

Charles D. Blanke, MD, Chief of Medical Oncology at the University of British Columbia in Vancouver, critiqued the SSGXVIII study, noting its “goals were reasonable and the methodologies for primary and secondary objectives were sound. The conclusion regarding recurrence-free survival is valid, as...

solid tumors

Longer Imatinib Treatment Is Better in High-risk GIST

A phase III trial presented at the ASCO 2011 Plenary Session could change the duration of adjuvant therapy for some patients with resected gastrointestinal stromal tumors (GIST). When imatinib treatment was extended to 3 years, compared with the standard 1 year, patients with high-risk GIST were...

Expert Point of View: Novel Agents Improve Survival in Patients with Metastatic Melanoma

Discussing the melanoma studies at the Plenary Session, Kim Margolin, MD, of the University of Washington Fred Hutchinson Cancer Research Center in Seattle, noted that while the new therapies are welcomed, they are not without their challenges. “Ipilimumab now shows a survival benefit in...

skin cancer

Novel Agents Improve Survival in Patients with Metastatic Melanoma

Novel treatments for metastatic melanoma dominated the buzz at the 2011 ASCO Annual Meeting and across the major news outlets, with reports that two agents with entirely different mechanisms of action could extend survival. The studies’ inclusion in the ASCO Plenary Session attested to the...

breast cancer

Stalked by Cancer: One Woman’s Story

Cancer has been stalking me all my life. My mother’s mother had died of breast cancer at a relatively young age. My mother was diagnosed with breast cancer in the early 1960s, when she was 35 and I was just 5 years old. Although she was told that she probably wouldn’t live more than 2 years, she...

SIDEBAR: Expect Questions from Your Patients

The study of concurrent HPV and Pap testing for cervical cancer was widely reported even before the recent ASCO Annual Meeting. In an interview with The ASCO Post, Barnett Kramer, MD, was asked how physicians can respond to questions about the study from patients. “You can tell a woman over the...

gynecologic cancers

Cervical Cancer Screening Study Should Reassure Physicians and Patients that a 3-Year Screening Interval Is Safe and Effective

Results of a large-scale cervical cancer screening study using concurrent human papillomavirus (HPV) and Pap testing should “reassure” women over 30 who test negative for HPV and have normal Pap tests that “it is extremely safe to go 3 years” before being tested again, Barnett S. Kramer, MD, MPH,...

issues in oncology

A Conversation with David Henry, MD

Given the intricate nature of oncology workflow, terminology, cancer staging, and the high risk associated with chemotherapy administration, an oncology electronic medical record (EMR) system needs to be much more than a storehouse of patient information. According to David Henry, MD, Clinical...

My First of Many ASCO Meetings

In June, I attended my first ASCO Annual Meeting. Although I have been practicing and teaching urology for 35 years with a specific interest in genitourinary oncology and I have attended dozens of national meetings, the ASCO Annual Meetings were not on my radar. Focus on the Patient The...

prostate cancer

Cabozantinib Shows Encouraging Activity in Metastatic Castrate‑resistant Prostate Cancer

Cabozantinib, a dual inhibitor of MET kinase and the vascular endothelial growth factor (VEGF) receptor, exhibits high, early single-agent activity in men with metastatic castrate-resistant prostate cancer, according to Maha Hussain, MD, FACP, who presented these findings at the 2011 ASCO Annual...

issues in oncology

Is Subspecialization an Option or a Necessity in Community Practices?

Should oncologists in community practices subspecialize? What would that mean for them and for their patients? These are some of the issues tackled in a Journal of Oncology Practice (JOP) Strategies for Career Success article entitled “Subspecialization in Community Oncology: Option or Necessity?”...

FDA Issues Updated Safety Data on Silicone Gel–filled Breast Implants

The FDA has released a report updating the clinical and scientific information for silicone gel–filled breast implants, including preliminary safety data from studies conducted by the manufacturers (Allergan and ­Mentor) as a condition of their November 2006 approval. While the report confirms...

pain management

First Fentanyl Nasal Spray Approved for Cancer Breakthrough Pain

The FDA has approved fentanyl nasal spray (Lazanda) for the management of breakthrough pain in cancer patients 18 years of age and older who are already receiving and who are tolerant to opioid therapy for their underlying persistent cancer pain. This marks the first FDA product approval for...

global cancer care

A Prominent Oncologist Retraces Her Steps from Baghdad

Maha Hussain, MD, FACP, Professor of Medicine and Urology, is the Associate Director for Clinical Research at the University of Michigan Comprehensive Cancer Center (UMCCC) and Co-leader of its Prostate Cancer/GU Oncology program. Dr. Hussain recently spoke with The ASCO Post about becoming a...

kidney cancer

Studies Explore Potential Benefits of Sunitinib before Nephrectomy in Metastatic Clear Cell Renal Cancer

The multitargeted tyrosine kinase inhibitor sunitinib (Sutent) is established as first-line therapy in metastatic clear cell renal cancer. Data supporting use of cytoreductive nephrectomy in metastatic clear cell renal cancer come from the pre–targeted therapy era, when less-effective immune...

lymphoma

Intergroup Study Evaluates Outcomes of Elderly vs Younger Patients Treated for Advanced Hodgkin Lymphoma

The 11th International Conference on Malignant Lymphoma was held June 15–18 in Lugano, Switzerland. Topics of discussion included lymphoma staging in the new millennium, lymphoma and its microenvironment, and lymphoma cure vs control. The ASCO Post summarized several key presentations in the July...

Cancer.Net Mobile App for Patients

Described as “a gem of a freebie,” Cancer.Net’s new app is the mobile companion for patients to stay informed about cancer and to organize important personal data often needed for doctor visits. It includes interactive tools to help patients get answers to important questions, track side effects,...

Stephen Cannistra, MD, Takes Over as Editor-in-Chief of Journal of Clinical Oncology

Since 1989, Stephen Cannistra, MD, has been working to make the Journal of Clinical Oncology (JCO) the most credible, authoritative resource for disseminating significant clinical oncology research while acting as a reviewer, Consultant Editor, Associate Editor, Editorial Board Member, and as of...

Special Award Recipients Honored at 2011 ASCO Annual Meeting

Each year, as a way to recognize enhancements in cancer care, ASCO honors individuals who have made significant contributions to the Society, the practice of oncology, and patients with cancer. At this year’s Annual Meeting, ASCO was pleased to recognize the 2011 Special Award recipients: Kenneth...

ASCO University® Launches New Programs

A couple of convenient new educational opportunities are now available on the ASCO University® website (http://university.asco.org). Cardiac Comorbidity Boards ASCO University® is now offering a pilot series that focuses on cardiovascular disease and cancer treatment–related toxicities. Each module ...

gynecologic cancers

NCI Clinical Investigator Team Leadership Awards: Conversations in Gynecologic Oncology

The National Cancer Institute recognized Cheryl Saenz, MD, and Linda R. Duska, MD, among others, late last year with a Cancer Clinical Investigator Team Leadership Award. The 2-year award includes $50,000 in funding for cancer research programs at NCI-designated cancer centers. The ASCO Post...

breast cancer

Breast Cancer Studies Focus on Tailoring Therapy for Patient Subsets

As part of our ongoing coverage of the 2011 ASCO Annual Meeting, The ASCO Post has provided substantive reports on key breast cancer trials, but others deserve attention. Lapatinib/Capecitabine Controls Brain Metastases Results of the French phase II LANDSCAPE trial found lapatinib (Tykerb) plus...

SIDEBAR: Early Clinical Findings with JAK2 Inhibition

Two small preliminary studies of JAK2 inhibitors CYT387 and SB1518 had encouraging results in patients with myelofibrosis, and these studies were reported in poster presentations at the Annual Meeting.1,2 Both drugs reduced splenomegaly and achieved improvement in constitutional symptoms. SB1518...

Expert Point of View: Novel JAK Inhibitor May Be an Option for Patients with Myelofibrosis

Ross Levine, MD, of Memorial Sloan-Kettering Cancer Center, New York, was the discussant of the COMFORT-I and COMFORT-II trials.1 He explained that 70% to 90% of patients with myelofibrosis have JAK2 mutations, which appear to be endemic. “This is a driver mutation, although not the only mutation...

hematologic malignancies

Novel JAK Inhibitor May Be an Option for Patients with Myelofibrosis

A new approach to treating myelofibrosis appears to be paying off, according to several studies presented at the 2011 ASCO Annual Meeting. Treatment with a novel JAK inhibitor called ruxolitinib demonstrated significant and sustained improvement in splenomegaly and overall quality of life,...

Expert Point of View: Maintenance Therapy Prolongs Progression-free Survival in Advanced NSCLC but Produces No Overall Survival Benefit

Maintenance therapy in NSCLC is an ever-contentious issue,” stated formal discussant of these trials, Martin Edelman, MD, University of Maryland Greenebaum Cancer Center, Baltimore, at the ASCO Annual Meeting. “The maintenance approach is based on two observations: limited benefit from more than...

lung cancer

Maintenance Therapy Prolongs Progression-free Survival in Advanced NSCLC but Produces No Overall Survival Benefit

Maintenance therapy with either pemetrexed (Alimta) or gefitinib (Iressa) achieved modest improvements in progression-free survival in patients with advanced non–small cell lung cancer (NSCLC). The magnitude of improved progression-free survival was 1.3 months and 2.2 months, respectively, in the...

lung cancer

Emerging Targeted Therapies Offer Glimmer of Hope for NSCLC but Biomarkers for Response Needed

Among the newer approaches to treatment of non–small cell lung cancer (NSCLC) are heat-shock protein 90 (Hsp90) inhibitors, toll-like receptor 2 (TLR2) agonists, and vascular-disrupting agents. So far, none appears to be a “home run,” but Hsp90 inhibition may be the most promising of the three...

breast cancer

ODAC Again Recommends FDA Withdraw Its Approval of Bevacizumab for Metastatic Breast Cancer

In June 2011, a public hearing was convened to consider an appeal of the December 2010 recommendation by FDA to remove the breast cancer indication for bevacizumab (Avastin). FDA’s recommendation late last year was in accordance with a July 2010 recommendation by the Oncologic Drugs Advisory...

prostate cancer

Final Decision on Sipuleucel-T

The Centers for Medicare & Mediaid Services (CMS) issued a final decision to cover FDA-approved indications of sipuleucel-T (Provenge) in prostate cancer, calling the treatment “reasonable and necessary.” The CMS final decision assures provider reimbursement of sipuleucel-T for Medicare...

Expert Point of View: Axitinib Improves Progression-free Survival over Sorafenib in Advanced Renal Cell Carcinoma

According to Eric Jonasch, MD, of The University of Texas MD Anderson Cancer Center, “These data show that treatment with a potent and specific antiangiogenic agent after immunotherapy does provide significant prolongation of progression-free survival, and that axitinib is clearly superior to...

kidney cancer

Axitinib Improves Progression-free Survival over Sorafenib in Advanced Renal Cell Carcinoma

A randomized comparative effectiveness phase III trial demonstrated significantly superior efficacy for the tyrosine kinase inhibitor axitinib compared to sorafenib (Nexavar) in patients with advanced renal cell carcinoma (RCC). These data suggest that axitinib may become a new standard of care for ...

health-care policy

Conflicts of Interest in Health-care Reform?

Last year’s health-care reform legislation, the Patient Protection and Affordable Care Act, was designed to incrementally roll out major new bureaucratic entities, oversight, and mandates for the practice of medicine between its enactment and 2013, after the next presidential election. A new...

health-care policy

Are Clinical Pathways Inevitable in Oncology’s Future?

Our health-care system is undergoing a gradual but inevitable sea change, shifting from traditional fee-for-service to fee-for-value. A session at this year’s Association of Community Cancer Centers meeting in Washington, DC, shed light on how this trend will reshape incentives and the clinical...

Expert Point of View: Exemestane Prevents Invasive and Preinvasive Breast Cancers in MAP.3 Trial

According to Andrea De Censi, MD, of the E.O. Ospedali Galliera in Genoa, Italy, the invited discussant of the paper presented by Paul Goss, MD, PhD, at the 2011 ASCO Annual Meeting, “MAP.3 provides a paradigm shift for breast cancer prevention. Avoiding breast cancer with manageable toxicity is...

breast cancer

Exemestane Prevents Invasive and Preinvasive Breast Cancers in MAP.3 Trial

The aromatase inhibitor exemestane, taken for 5 years, significantly reduced invasive and preinvasive breast cancers in postmenopausal women at increased risk for the disease, in the large Canadian NCIC CTG MAP.3 randomized trial. Results of the trial were presented at the recent ASCO Annual...

breast cancer

Higher Risk of Recurrence for Triple-negative Breast Cancer after Modified Radical Mastectomy without Radiation

“The paucity of therapeutic options” for women with triple-negative breast cancer “emphasizes the urgent need to optimize the current locoregional management of patients with [triple-negative breast cancer] and reduce their risk of locoregional recurrence,” noted the authors of a Canadian study...

colorectal cancer

Endoscopic Excision May Be Viable Alternative to Surgical Resection of Large Colorectal Polyps

A retrospective review of 104 consecutive patients with large colorectal lesions, including 39 with carcinoma, found that “endoscopic excision of large colorectal polyps is a viable alternative to surgical resection in a select group of patients and can be performed safely with a good success...

colorectal cancer

Venous Thromboembolism More Frequent after Open Colorectal Surgery than Post-laparoscopy

The risk of developing venous thromboembolism (VTE) may be nearly twice as high for patients undergoing open colorectal procedures as for those undergoing laparoscopic colorectal resections, according to a report in the Archives of Surgery. The authors also “identified malignancy, obesity, and...

leukemia

Conventional Induction Chemotherapy Beneficial in Only a Subset of Older Adults with AML

Over the past several decades, progress in the treatment of acute myeloid leukemia (AML) in the older population (generally considered to be older than 60 years) has been limited (Fig. 1). In particular, the outcome of patients over age 70 has been poor, with few long-term survivors. Although AML...

leukemia

Despite Advances, Little Overall Improvement Seen in Treatment of Older Adults with AML

The outcome of treatment of older adults with acute myeloid leukemia (AML) remains unsatisfactory, although certainly not a totally futile exercise. Patients satisfying the entry criteria for cooperative group clinical trials can be expected to have complete remission rates of 50% to 55%, with...

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