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Friends of Cancer Research Holds Annual Conference on Clinical Cancer Research

Friends of Cancer Research, in conjunction with the Engelberg Center for Health Care Reform at Brookings, recently held the seventh annual Conference on Clinical Cancer Research in Washington, DC. The panels that comprised the daylong meeting discussed a future that has already begun. The most...

bladder cancer

Treating Bladder Cancer in 2015

Treatment of advanced bladder cancer continues to prove challenging, and therapies that offer long-term survival remain elusive. The ASCO Post recently spoke with Derek Raghavan, MD, PhD, FACP, FRACP, FASCO, President of the Levine Cancer Center, Charlotte, North Carolina, about the current state...

breast cancer
issues in oncology

Dr. Mary-Claire King Proposes Population Screening in All Young Women for BRCA Mutations

It is not enough for Mary-Claire King, PhD, to have identified the germline BRCA1 mutation associated with hereditary breast and ovarian cancers. Her clinically applicable discovery is one of the world’s greatest in genetics and one for which she has been highly lauded. But not one to rest on her...

breast cancer

E1199 Update: It’s Weekly Paclitaxel for Triple‑Negative Breast Cancer

An update of clinical trial E1199 showed that weekly paclitaxel and every-3-week docetaxel were both more effective than every-3-week paclitaxel in preventing deaths and tumor recurrences, according to Joseph Sparano, MD, Professor of Medicine and Women’s Health at the Albert Einstein College of...

pancreatic cancer

Modified Nab-Paclitaxel/Gemcitabine in Pancreatic Cancer: Efficacious, Less Toxic, Less Costly

A less intensive regimen of nab-paclitaxel (Abraxane) plus gemcitabine appears to be as efficacious as the standard regimen in first-line treatment for metastatic pancreatic cancer, but less toxic and far less expensive, according to a study that earned a Merit Award at the 2015 Gastrointestinal...

Expect Questions About Atypical Hyperplasia as an Important Risk Factor for Breast Cancer

A special report in The New England Journal of Medicine concluded that atypical hyperplasia of the breast “confers an absolute risk of later breast cancer of 30% at 25 years of follow-up.1” This is higher than previously recognized, and the report’s authors urged “more intensive screening and...

breast cancer

Atypical Hyperplasia as a Predictor of Future Breast Cancer: Focus on Chemoprevention and Screening

Atypical hyperplasia of the breast has “special importance as a predictor of future breast cancer,” according to a special report in The New England Journal of Medicine.1 That special importance is based on the high incidence of atypical hyperplasia—found in around 10% of the 1 million breast...

lung cancer

First-Line Crizotinib Superior to Pemetrexed‑Plus‑Platinum Chemotherapy in Patients With ALK‑Positive NSCLC

Crizotinib (Xalkori) treatment “was superior to pemetrexed-plus-platinum chemotherapy with respect to progression-free survival, objective response rate, reduction in lung-cancer symptoms, and improvement in quality of life” in patients with previously untreated advanced anaplastic lymphoma kinase...

integrative oncology

Capsaicin

Scientific name: 8-methyl-N-vanillyl-6-nonenamide Brand names: Zostrix cream 0.025% or 0.075%, Salonpas Gel-Patch Hot, Sinus Buster (homeopathic intranasal spray). The use of dietary supplements by patients with cancer has increased significantly over the past 20 years despite insufficient evidence ...

breast cancer

Iniparib: The Fairy Tale Dream Comes to an End

The first poly ADP ribose polymerase (PARP) inhibitor was developed in the early 1990s. Since then, the activity of PARP inhibitors has been explored in a variety of settings, including and perhaps most enthusiastically in the treatment of cancer. The greater dependence of several cancers on PARP,...

colorectal cancer

ASCO Endorsement of ESMO Guidelines on Hereditary Colorectal Cancer Syndromes

In a recent issue of the Journal of Clinical Oncology,1 and as reviewed in this issue of The ASCO Post, an ASCO expert endorsement panel reviewed and endorsed, with minor qualifications, the European Society for Medical Oncology (ESMO) clinical practice guidelines for management of familial/genetic ...

colorectal cancer

Racial Disparities in Survival Related More to Health Differences at Diagnosis Than to Subsequent Treatment

The persistent disparity in colon cancer survival by race seemed to be related more to differences in health at diagnosis than to differences in subsequent treatment, according to an analysis of data from the Survey, Epidemiology, and End Results (SEER)–Medicare database. “Our study suggests that...

Bringing the History of Cancer to Film

Ken Burns Presents Cancer: The Emperor of All Maladies, A Film by Barak Goodman will be broadcast on PBS on March 30, March 31, and April 1. Check local listings for broadcast times.   Like the book it’s based on, the television documentary Ken Burns Presents Cancer: The Emperor of All Maladies, A...

lymphoma

For Hodgkin Lymphoma Patients, It Ain’t Over

With less than 10,000 patients diagnosed with Hodgkin lymphoma each year and a cure rate of approximately 75% to 80%, drug development for this disease was never a priority for pharmaceutical companies. So when the antibody-drug conjugate brentuximab vedotin (Adcetris) was approved by the U.S. Food ...

lymphoma

PD-1 Blockade With Nivolumab Produces High Response Rate in Relapsed/Refractory Hodgkin Lymphoma

Anti–PD-1 antibodies have been shown to be effective in solid tumors. There is evidence that the malignant Reed-Sternberg cells in Hodgkin lymphomas use the programmed cell death protein 1 (PD-1) pathway to evade immune detection, with alterations in chromosome 9p24.1 increasing levels of the PD-1...

breast cancer

The Search for Optimal Adjuvant Breast Cancer Chemotherapy: The End of an Era?

Using a complex and innovative study design, Budd and colleagues from the Southwest Oncology Group (SWOG) addressed, in a randomized multicenter trial,1 an issue that has been under evaluation for over 40 years—namely, what are the optimal dose and schedule for adjuvant breast cancer chemotherapy?...

hematologic malignancies

Aged to (Im)Perfection: Age-Related Clonal Hematopoiesis?

Five decades ago, the analysis of metaphase chromosomes in the hematologic malignancies provided our first broad glimpse into the genetic anatomy of a malignant cell. Today, the advent of high-throughput methods such as next-generation sequencing, capable of surveying the entire genome, provides an ...

hematologic malignancies

Clonal Hematopoiesis With Somatic Mutations Increases Risk of Hematologic Cancer, Mortality, and Cardiovascular Disease

In two studies recently reported in The New England Journal of Medicine,1,2 whole-exome sequencing of DNA from peripheral blood cells of individuals unselected for hematologic phenotype showed that clonal hematopoiesis with somatic mutations is increasingly common with increasing age and is...

lung cancer

Crizotinib Crosses Another Finish Line in Lung Cancer

Treatment of anaplastic lymphoma kinase (ALK)–positive lung cancer has been one of the great success stories in oncology in the past decade. First discovered in lung cancer in 2007, ALK rearrangements are found in 3% to 5% of patients and define a distinct molecular subgroup of the disease with...

lung cancer

First-Line Crizotinib Improves Progression-Free Survival vs Chemotherapy in ALK-Positive NSCLC

In a phase III trial (PROFILE 1014) reported in The New England Journal of Medicine, Benjamin J. Solomon, MB, BS, PhD, of Peter MacCallum Cancer Centre, Melbourne, and colleagues found that the ALK inhibitor crizotinib (Xalkori) improved progression-free survival vs standard chemotherapy in...

thyroid cancer

Lenvatinib in Advanced Radioiodine-Refractory Differentiated Thyroid Cancer

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 February 13, 2015, lenvatinib (Lenvima) was approved for the...

neuroendocrine tumors

Lanreotide Evaluated in Pancreatic Neuroendocrine Subgroup

The somatostatin analog lanreotide (Somatuline) depot extended the time to disease progression in patients with pancreatic neuroendocrine tumors, in a planned subgroup analysis of the CLARINET trial, Alexandria T. Phan, MD, of The Houston Methodist Hospital in Texas, reported at the 2015...

pain management

Key Evidence Gaps and Research Priorities Should Be Addressed So Physicians Can Identify Patients Most Likely to Benefit From Opioids

Key evidence gaps and research priorities must be addressed “so that physicians can recognize patients for whom opioids are most appropriate and use optimal regimens for these patients,” according to the National Institutes of Health (NIH) Pathways to Prevention Workshop final report on the role of ...

integrative oncology

Herbal Supplements: Increasing Problems

In Don Quixote, the 1605 Spanish literary masterpiece by Miguel Cervantes, “Balsam of Fierabras” is mentioned often as a therapeutic panacea. It calls for mixing rosemary, wine, oil, and salt. As the story goes, the knight relied heavily on this herbal preparation to relieve him of pain from the...

multiple myeloma

Five Questions Can Guide the Treatment of Relapsed Myeloma

Joseph Mikhael, MD, MEd, myeloma expert at the Mayo Clinic in Arizona, Scottsdale, and Associate Dean of the Mayo School of Graduate Medical Education, considers five questions when selecting treatment for patients with multiple myeloma who relapse. “With prolonged survival, which approaches 10...

multiple myeloma

Lenalidomide in Combination With Dexamethasone in Newly Diagnosed 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 February 18, 2015, the indication for lenalidomide (Revlimid)...

breast cancer

SOFT Trial Results Inconclusive: Further Study Needed

The results of the SOFT trial—presented at the 2014 San Antonio Breast Cancer Symposium, reported recently by Francis et al in The New England Journal of Medicine,1 and reviewed in this issue of The ASCO Post—were not as conclusive as we had hoped. In essence, the study enrolled women with resected ...

breast cancer

Adjuvant Ovarian Suppression May Benefit Women With Premenopausal Breast Cancer Who Received Prior Chemotherapy

In a phase III trial (SOFT) reported in The New England Journal of Medicine, Prudence A. Francis, MD, of Peter MacCallum Cancer Centre, Melbourne, Australia, Meredith M. Regan, ScD, of IBCSG Statistical Centre at Dana-Farber Cancer Institute, Boston, and colleagues found that the addition of...

breast cancer

Increasing the Use of Hypofractionated Radiation in Early-Stage Breast Cancer: The Way Forward

Bekelman and colleagues are to be congratulated on the publication of an important paper—reviewed in this issue of The ASCO Post—alerting us all to the underutilization of hypofractionated whole-breast irradiation in the treatment of early-stage breast cancer.1 As background, recent randomized...

supportive care

Many Cancer Patients at Risk for Hepatitis B Virus Reactivation

In 2015, no cancer patients should be cured of their malignancy only to die of reactivation of hepatitis B virus (HBV),” according to Anna S. Lok, MD, the Alice Lohrman Andrews Research Professor in Hepatology and Director of Clinical Hepatology at the University of Michigan, Ann Arbor. “I...

issues in oncology
health-care policy

Health-Care Fraud and Abuse: Implications for Oncology

Health-care fraud is a long-standing problem in the United States, accounting for $75 billion in government expenses per year,1 while total spending on government health-care programs is over $1 trillion. Two decades ago, the Department of Justice increased its efforts to combat health-care fraud....

skin cancer
cost of care

Health and Economic Burden of Skin Cancer Substantial and Increasing, Highlighting the Value of Prevention Efforts

The average annual number of adults treated for skin cancer, both melanoma and nonmelanoma, in the United States increased from 3.4 million in 2002 to 2006 to 4.9 million in 2007 to 2011 (P < .001), according to a study published in the American Journal of Preventive Medicine. “During this...

colorectal cancer

Refining the ‘Right Patient, Right Drug’ Pairing in Cancer Care: RAS Profiling in Metastatic Colorectal Cancer

In an important post hoc analysis (reviewed in this issue of The ASCO Post), Van Cutsem and colleagues have further refined our knowledge of who are the “right” patients with metastatic colorectal cancer to receive treatment with cetuximab (Erbitux).1 This refinement was accomplished through the...

colorectal cancer

Adding Cetuximab to First-Line FOLFIRI Does Not Benefit Metastatic Colorectal Cancer Patients With RAS Mutations

The phase III CRYSTAL trial showed that the addition of cetuximab (Erbitux) to first-line FOLFIRI (fluorouracil, leucovorin, and irinotecan) significantly improved overall survival, progression-free survival, and objective response rates in patients with KRAS codon 12/13 (exon 2) wild-type...

issues in oncology
palliative care

Why Just Having ‘Good’ Communication Skills Is Not Enough for Talking With Seriously Ill Patients

In the Institute of Medicine’s 2014 report Dying in America,1 the report’s authors found that while frequent clinician-patient conversations about end-of-life care, goals, and preferences are necessary to avoid unwanted treatment, most patients do not have those conversations with their physicians. ...

multiple myeloma

The ASPIRE Trial of Carfilzomib in Relapsed Myeloma: A Major Step Forward

Currently in myeloma, there are at least five new agents that are either approved or in the late-stage of development with impending approval. Major questions in the field relate to how we, as clinicians, will use these new agents and where they will fit in the overall treatment schema. The phase...

multiple myeloma

Increased Progression-Free Survival With Addition of Carfilzomib to Lenalidomide/Dexamethasone in Relapsed Multiple Myeloma

In a planned interim analysis of the phase III ASPIRE trial reported in The New England Journal of Medicine, A. Keith Stewart, MB, ChB, of the Mayo Clinic, Scottsdale, Arizona, and colleagues found that the addition of the proteasome inhibitor carfilzomib (Kyprolis) to lenalidomide...

bladder cancer

Adjuvant Chemotherapy and Overall Survival in Muscle-Invasive Bladder Cancer: Still Climbing the Mountain

Muscle-invasive bladder cancer can be a lethal disease despite curative intent local therapy, with 5-year survival that can be as low as 30% based on the extent of T status and/or lymph node involvement. The use of neoadjuvant chemotherapy with MVAC (methotrexate, vinblastine, doxorubicin, and...

breast cancer

Breast Cancer Management in Review

Anyone who has attended the major oncology meetings knows that research from clinical trials in breast cancer often dominates the stage, with countless abstracts featuring new and updated results. To help the readers of The ASCO Post stay up to date with the latest discoveries and findings...

lung cancer

Results of RTOG 0617 Reconsidered

Radiation Therapy Oncology Group (RTOG) 0617 was a study initially designed to address an important issue in radiation oncology regarding the treatment of stage III non–small cell lung cancer (NSCLC): Are outcomes improved with high-dose as opposed to standard-dose thoracic radiation therapy? The...

prostate cancer

Evidence Mounts for Clinical Utility of AR-V7 in Treatment Selection for Advanced Prostate Cancer

The search is on in prostate cancer to identify predictive and prognostic biologic and genomic markers that go beyond traditional ones. Several groups are working in this area. One marker that has received much attention is a splice abnormality in the androgen receptor (AR) called AR-V7. Two...

breast cancer
issues in oncology

Should Oncologists Be Ordering Breast Cancer Gene Panels?

Two oncologic surgeons squared off at the 32nd Miami Breast Cancer Conference to debate whether breast cancer genetic susceptibility panel testing is ready for routine use in the clinic. J. Michael Dixon, MD, Professor of Surgery and Consultant Surgeon at the Edinburgh Breast Unit in the United...

issues in oncology

Staff Support Sessions in an Oncology Setting

Work-related issues such as coping skills, stress management, burnout, and compassion fatigue are among the challenges faced by clinical and other staff in cancer treatment centers. Given the emotional consequences of professional caregiving, staff support group meetings are valuable resources for...

colorectal cancer

Aspirin as Adjuvant Therapy for Colon Cancer: Is the Time Right?

Aspirin has long proved to be a multipotent drug, with efficacy as a pain reliever, anti-inflammatory agent, antiplatelet agent, and cardioprotective agent. In the cancer world, a large literature has accumulated demonstrating its ability to prevent various epithelial malignancies, most notably...

breast cancer
survivorship

Breast Cancer Management in Review

With the field of breast oncology as complex as ever, a brief update of the latest findings impacting breast cancer treatment seems timely. To that end, I have assembled highlights from a collection of newsworthy studies featured over the past year and into early 2015. Part 1 of this review, which...

issues in oncology
breast cancer

Informing Decision-Making About Mammography Screening

Overdiagnosis associated with breast cancer screening has been the subject of much attention in recent years. The notion that cancer screening—largely believed to be beneficial—could actually be harmful is simultaneously fascinating and difficult to believe. With the publication of multiple studies ...

skin cancer

Combination Immunotherapy Better Than Monotherapy in Advanced Melanoma

As clinical research struggles to keep up with the pace of new immunotherapies, one of the burning questions is how best to combine the new drugs. A new study found that the combination of nivolumab (Opdivo) and ipilimumab (Yervoy) is superior to ipilimumab alone as front-line therapy for untreated ...

lung cancer

Crizotinib Receives Breakthrough Therapy Designation for ROS1-Positive NSCLC

The U.S. Food and Drug Administration (FDA) has granted Breakthrough Therapy designation to crizotinib (Xalkori) for the potential treatment of patients with ROS1-positive non–small cell lung cancer (NSCLC). Crizotinib currently is FDA-approved for the treatment of patients with metastatic NSCLC...

breast cancer

Experts Debate: Can We Cure Metastatic Breast Cancer?

Can metastatic breast cancer ever be cured? This issue was debated at the 32nd Annual Miami Breast Cancer Conference by two experts in the field: George W. Sledge, Jr, MD, Professor of Medicine at Stanford University Medical Center, Palo Alto, California, and Clifford A. Hudis, MD, Chief of the...

skin cancer

Practice-Changing Study: Pembrolizumab Outperforms Ipilimumab in Advanced Melanoma

Pembrolizumab (Keytruda) proved superior to ipilimumab (Yervoy) for the treatment of unresectable advanced melanoma in the global phase III KEYNOTE-006 trial. Pembrolizumab significantly improved overall survival, progression-free survival, and overall response rate compared with ipilimumab, which...

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