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Showing 2501 - 2550The 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...
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...
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 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...
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...
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...
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...
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...
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 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...
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 ...
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 ...
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...
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...
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...
Expect Questions About Physical Activity and Reduced Mortality Risks
A study finding that just doing some leisure time physical activity reduces overall and cancer-specific mortality by 20% and that more activity can provide even greater survival benefits concludes that health-care professionals should encourage inactive patients to perform more leisure time...
Just Engaging in ‘Some’ Leisure Time Physical Activity Reduces Overall and Cancer-Specific Mortality
There’s good news for those who recognize the benefits of exercise but feel they have neither the time nor energy for frequent workouts: A recent study reported in JAMA Internal Medicine1 has found that just performing “some” leisure time physical activity, even below the recommended minimum level, ...
IGF2 May Be Target in Colorectal Cancer With Stable Disease As Response to Anti-EGFR Therapy
In a study exploring the mechanisms of stabilized disease vs tumor regression with targeted anti–epidermal growth factor receptor (EGFR) therapy in colorectal cancer reported in Science Translational Medicine, Zanella and colleagues found that stable disease as response was characterized by...
The Paradox of Positive Thinking
The ASCO Post is pleased to reproduce installments of the “Art of Oncology” as published previously in the Journal of Clinical Oncology (JCO). These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...
Unexpectedly Huge Survival Benefit With Pertuzumab and Trastuzumab in HER2-Positive Metastatic Breast Cancer
In my opinion, the combination of pertuzumab (Perjeta) and trastuzumab (Herceptin) is one of the most important advances in the field of metastatic breast cancer in the past 10 years. As recently reported by Swain, my other colleagues, and me and reviewed in this issue of The ASCO Post, the...
CLEOPATRA Overall Survival Analysis: Significant Benefit for Pertuzumab Plus Trastuzumab/Docetaxel in HER2-Positive Metastatic Breast Cancer
As reported in The New England Journal of Medicine by Sandra M. Swain, MD, of Washington Cancer Institute, MedStar Washington Hospital Center, and colleagues, the final prespecified overall survival analysis in the phase III CLEOPATRA study showed a significant 15.7-month increase in median overall ...
Pembrolizumab vs Ipilimumab: Good vs Better
The treatment landscape for metastatic melanoma has recently undergone a remarkable transformation. Prior to 2011, clinicians and patients were presented with difficult decisions between therapies without proven survival benefit. Now, similarly difficult but much more hopeful choices are posed...
Anti–PD-1 Antibody Pembrolizumab Improves Progression-Free and Overall Survival vs Ipilimumab in Advanced Melanoma
In the phase III KEYNOTE-006 trial reported in The New England Journal of Medicine,1 Caroline Robert, MD, PhD, Head of the Dermatology Unit at the Institut Gustave Roussy, Paris, and colleagues found that the anti–programmed cell death protein 1 (PD-1) antibody pembrolizumab (Keytruda) increased...
Welcome to Multikinase Inhibitors in Radioiodine-Refractory Thyroid Cancer
In the past 2 decades, the incidence of thyroid cancer has risen steeply, with rates now growing by 5.5% annually.1 In 2014, 62,980 new cases of thyroid cancer were diagnosed in the United States. The good news is that, overall, the prognosis of thyroid cancer remains excellent; 97.8% of patients...
Large Improvement in Progression-Free Survival With Lenvatinib in Radioiodine-Refractory Thyroid Cancer
In a phase III trial reported in The New England Journal of Medicine, Martin Schlumberger, MD, of Institut Gustave Roussy, and colleagues found that the multikinase inhibitor lenvatinib (Lenvima) produced a large improvement in progression-free survival vs placebo in patients with advanced...
Optimizing Treatment for Small, Lymph Node–Negative, HER2-Overexpressing Breast Cancers
Large, randomized phase III clinical trials showed that the addition of HER2-targeted therapy to chemotherapy for patients with early-stage, HER2-overexpressing breast cancers substantially decreased the risk of recurrence and improved survival. The chemotherapy given in these trials varied, but it ...
High Invasive Disease-Free Survival With Adjuvant Paclitaxel and Trastuzumab in Small, Node‑Negative, HER2-Positive Breast Cancers
In a phase II study reported in The New England Journal of Medicine, Sara M. Tolaney, MD, MPH, of Dana-Farber Cancer Institute, and colleagues found that adjuvant paclitaxel and trastuzumab (Herceptin) was associated with high invasive disease-free survival in women with small, node-negative,...
Increased Risk of Secondary Bone Marrow Neoplasia After Adjuvant Breast Cancer Treatment: Risk/Benefit Analysis and Biologic Insights
Ever since the early application of adjuvant chemotherapy for breast cancer decades ago, it has been recognized that there is always a price to pay for its success in reducing breast cancer mortality. Most of that “cost” is commonly considered in terms of the potential morbid short- and long-term...
Maitake
The use of dietary supplements by patients with cancer has increased significantly over the past 2 decades despite insufficient evidence of safety and effectiveness. Finding reliable sources of information about dietary supplements can be daunting. Patients typically rely on family, friends, and...
MAINSAIL Trial: Worse Outcomes With Addition of Lenalidomide to Docetaxel-Prednisone in Prostate Cancer
The combination of docetaxel plus prednisone has been a standard therapy in advanced prostate cancer since 2004.1 Since then, there have been multiple randomized phase III trials comparing this standard of care with additional drug therapy. None has demonstrated improvement in outcome. Lenalidomide ...
Answers: Case Report on Chronic Myelogenous Leukemia
Question 1: In the current era of tyrosine kinase inhibitor therapy, which prognostic model is best to assess the prognosis of a person with a new diagnosis of CML? Correct Answer: D. All of the above Expert Perspective Despite not being perfect, all of these scores are reasonably effective at...
PARP Inhibitors: The First Potential Treatment of Hereditary Ovarian Cancers
Poly(ADP-ribose) polymerase (PARP) inhibitors are one of the most exciting new classes of agents in development for the treatment of ovarian cancer. Olaparib (Lynparza), the lead oral PARP inhibitor, received accelerated approval by the U.S. Food and Drug Administration (FDA) for the treatment of...
American College of Physicians Releases Best Practice Advice for Cervical Cancer Screening in Average-Risk Women
In April 2015, the American College of Physicians (ACP) released its clinical advice guideline, Cervical Cancer Screening in Average-Risk Women: Best Practice Advice From the Clinical Guidelines Committee of the American College of Physicians.1 The guideline aims to reduce the overuse of cervical...
Pembrolizumab Safe and Effective in Patients With NSCLC, Especially in Those With Tumors Showing High Levels of PD-L1 Expression
Add lung cancer to the growing list of cancers that may derive benefit from immunotherapy. The KEYNOTE-001 trial found that pembrolizumab (Keytruda) achieved durable responses in a proportion of patients with non–small cell lung cancer (NSCLC) and high levels of expression of the protein PD-L1...
Expert Point of View: Philip L. McCarthy, MD
Another exciting multiple myeloma treatment will be presented at the 2015 ASCO Annual Meeting,” Philip L. McCarthy, MD, Professor of Oncology and Director of the Blood and Marrow Transplant Center at Roswell Park Cancer Institute, Buffalo, New York, commented in an interview with The ASCO Post....
After a Long and Distinguished Career, Robert C. Young, MD, Shows No Sign of Slowing Down
Robert C. Young, MD, ASCO Past President, longtime leader of Fox Chase Cancer Center, and an internationally recognized expert in lymphoma and ovarian cancer, is a forward-looking doctor who is confident about something not in his future: retirement. “I’ll never quit working; I’m just not wired...
Andrew C. von Eschenbach, MD, Went From the Front Lines of Cancer Care to a Bird’s-Eye View of the Changing Oncology Landscape
At the end of the day, I’m still a kid from South Philly,” Andrew C. von Eschenbach, MD, former Director of the National Cancer Institute (NCI) and Commissioner of the U.S. Food and Drug Administration (FDA), told The ASCO Post. Dr. von Eschenbach is the product of a closely knit yet culturally...
Giving Effective Feedback
Charlene M. Dewey, MD, MEd, FACP, Assistant Dean of Educator Development; Associate Professor of Medical Education and Administration; and Associate Professor of Medicine at Vanderbilt University School of Medicine in Nashville, offers these suggestions for effectively communicating feedback to...
How and When to Give Professional Feedback
Providing students and residents with feedback on their medical performance is a key element in their learning and development and ensures that high standards are met, according to Charlene M. Dewey, MD, MEd, FACP, Assistant Dean of Educator Development; Associate Professor of Medical Education and ...
The Promise of Immune Checkpoint Inhibition: Changing the Therapeutic Landscape for Melanoma and Other Malignancies
The past 3 years have witnessed transformative changes in the way that solid tumors and hematologic malignancies are approached, in almost every instance now including consideration of some form of immunomodulation in the first- or later-line therapeutic setting. The greatest success has occurred...
The Basket Trial: An Evolving Clinical Trial Design
The recently published results of the CUSTOM (Molecular Profiling and Targeted Therapies in Advanced Thoracic Malignancies) trial, reviewed in this issue of The ASCO Post, describe a basket trial focused on identifying molecular biomarkers in advanced non–small cell lung cancer (NSCLC), small...
What Is the Future of Intraperitoneal Treatment in Advanced Ovarian Cancer?
An analysis of Gynecologic Oncology Group (GOG) studies recently reported in the Journal of Clinical Oncology by Tewari and colleagues and reviewed in this issue of The ASCO Post showed a survival benefit of intraperitoneal chemotherapy vs intravenous chemotherapy over long-term follow-up in women...
Routine Resection of Cavity Shave Margins Halved Reexcision Rates in Breast Cancer
Taking additional tissue circumferentially around the cavity left by partial mastectomy (“cavity shave margins”) cut the rate of positive margins by nearly 50% and the rate of reexcision for margin clearance by more than 50% compared with standard partial mastectomy with or without the surgeon...
Elective Neck Dissection Beats Watch and Wait Approach in Early Oral Cancer
Elective neck dissection of node-negative early-stage oral cancer at the time of primary surgery improves overall survival and disease-free survival compared with therapeutic neck dissection (ie, therapeutic neck dissection at the time of nodal relapse, or “watch and wait” approach), according to a ...
Agreement on High-Value Screening for Five Common Cancers
Finding agreement on high-value cancer screening among organizations publishing screening guidelines, the American College of Physicians (ACP) issued advice listing the least-intensive screening strategies that all the organizations recommend—as well as strategies not recommended—for five common...
The Pediatric Fitness Program: A Mind-Body Approach
The fundamental challenge in treating children with cancer centers on how to help relieve their suffering while they undergo difficult care. Typically, they do not yet have adult coping skills, and even if they had some ability to cope, many of the issues they face during treatment are...
Pembrolizumab in Advanced NSCLC: The Promise of Immune Checkpoint Inhibitors
Drugs targeting the immune-checkpoint pathways have shown promising activity in non–small cell lung cancer (NSCLC). In a recent article in The New England Journal of Medicine, Garon and colleagues reported the results of the KEYNOTE-001 clinical trial evaluating single-agent pembrolizumab...
PD-1 Inhibitor Pembrolizumab Active in Advanced NSCLC: Outcomes Better With Higher PD-L1 Expression
In the phase I KEYNOTE-001 trial reported in The New England Journal of Medicine,1 Edward B. Garon, MD, of the David Geffen School of Medicine at the University of California, Los Angeles, and colleagues found that the programmed cell death protein 1 (PD-1) inhibitor pembrolizumab (Keytruda)...
Adjuvant Ipilimumab in High-Risk Stage III Melanoma: Encouraging Study Results Yet Questions Remain
Ipilimumab (Yervoy) is a fully human monoclonal antibody that blocks the negative T-cell regulator cytotoxic T-lymphocyte antigen 4 (CTLA-4) and has improved overall survival for patients with unresectable or metastatic melanoma in two phase III studies.1,2 Based upon these results, ipilimumab was...
American Ginseng
The use of dietary supplements by patients with cancer has increased significantly over the past 20 years despite insufficient evidence of safety and effectiveness. Finding reliable sources of information about dietary supplements can be daunting. Patients typically rely on family, friends, and the ...
