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Showing 2551 - 2600Microangiopathic Hemolytic Anemia and Thrombocytopenia
Question 1: In this case, what is the most appropriate next best test? Correct Answer: B. Peripheral blood smear examination. Expert Perspective In the appropriate clinical setting, information obtained from a carefully examined peripheral blood smear film is indispensable. The peripheral blood...
Progress in the Treatment of Patients With EGFR-Mutated NSCLC
Approximately 10% to 15% of patients with advanced non–small cell lung (NSCLC) cancer have mutations in the epidermal growth factor receptor (EGFR) in tumor cells. Specific therapies to inhibit the activity of EGFR-mutated NSCLC have now been clearly shown to improve response rate and...
Early-Phase Studies Show Activity of Novel EGFR Inhibitors Rociletinib and AZD9291 in T790M-Positive NSCLC
Two early-phase studies have shown that the novel epidermal growth factor receptor (EGFR) inhibitors rociletinib and AZD9291 exhibit high activity in non–small cell lung cancer (NSCLC) patients with the EGFR T790M mutation who had progressed on prior EGFR inhibitor therapy.1,2 The T790M mutation...
Cost vs Our Values in Cancer Care
An 80-year-old patient with metastatic prostate cancer asked me to discontinue his treatments, which were costing him more than $1,000 every 3 months. Although he had Medicare, he did not have secondary insurance. I told him that I would seek compassionate-care payment from the pharmaceutical...
A Lasting Legacy
When Emil J Freireich, MD, retires from the University of Texas MD Anderson Cancer Center on September 1, he will have spent 50 years at the institution and a total of 60 years in the pursuit of curing childhood leukemia as well as other cancers and in the educational development of young...
American College of Physicians Releases High Value Care Screening Advice for Five Common Cancers
In a paper published in Annals of Internal Medicine1, the American College of Physicians (ACP) issued advice for screening average risk adults without symptoms for five common cancers: breast, colorectal, ovarian, prostate, and cervical. In a companion piece also published in Annals2, ACP outlined...
Magnetic Resonance Imaging/Ultrasound Fusion: A Promising Technology for Image-Guided Prostate Biopsy
An elegant study by Siddiqui et al1—reviewed in this issue of The ASCO Post—offers compelling evidence for the diagnostic utility of “targeted” prostate biopsy using multiparametric magnetic resonance imaging (MRI) data fused with ultrasound images. The technique involves first performing a...
Microangiopathic Hemolytic Anemia and Thrombocytopenia: Answers From Hematology Expert Review Questions
Question 1: What is the best first step in management of this patient? Correct Answer: C. Start plasma exchange. Expert Perspective Although distinguishing among thrombotic thrombocytopenic purpura, typical hemolytic uremic syndrome, and atypical hemolytic uremic syndrome (see Table 1 in the...
Conquer Cancer Foundation Donor Spotlight: Ludwig Cancer Research
Among the Conquer Cancer Foundation’s newest supporters, Ludwig Cancer Research is an international community of distinguished scientists dedicated to preventing and controlling cancer. Its emphasis on collaboration and long-term support has fostered its role as a leader in immunotherapy and other...
Improved Understanding of Glioma Tumor Biology
The management of patients with lower-grade gliomas is evolving. As evidenced by two recent publications in The New England Journal of Medicine,1,2 reviewed in this issue of The ASCO Post, there has been a substantial increase in our knowledge of the molecular characteristics of these neoplasms....
New Molecular Classifications of Gliomas Established
Two studies reported in The New England Journal of Medicine identified new molecular classifications of glioma that capture biologic and prognostic differences. The Cancer Genome Atlas Research Network identified three prognostically significant subtypes of lower-grade glioma that were identified...
The Conundrum of Estrogen-Receptor Signaling in HER2-Positive Breast Cancer
BOLERO-1—reviewed in this issue of The ASCO Post—is the next installment in a series of randomized trials evaluating the addition of everolimus (Afinitor) to standard therapy in metastatic breast cancer.1 The initial evaluation of everolimus in the HER2-positive metastatic setting looked extremely...
Carfilzomib in Combination With Lenalidomide and Dexamethasone in Relapsed 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 July 24, 2015, carfilzomib (Kyprolis) was approved for use in...
Moving Forward in Non–Small Cell Lung Cancer: Targeted Combinations and Immunotherapy
The newer targeted therapies and immunotherapies have proven to be a boon to the treatment of lung and other cancers, but how best to deploy those therapies remains a burning question. Another important focus of current research is the identification and validation of biomarkers for these...
‘Right to Try’ Laws: Helpful or Harmful?
Since 2014, “Right to Try” legislation has been sweeping the nation. Created to enable terminally ill patients to gain access to experimental drugs, biologics, and devices by sidestepping the approval process of the U.S. Food and Drug Administration (FDA), at press time, 22 states have enacted...
Immune Checkpoint Inhibitors: The Dawn of a New Era for Lung Cancer Therapy
The therapeutic paradigm for lung cancer has changed rapidly over the past few years toward individualized therapy. For certain subsets of patients, molecularly targeted agents have resulted in robust gains in overall survival and quality of life. However, for the majority of patients with...
Increased Lifetime Risk of Cardiovascular Disease for Patients Treated for Hodgkin Lymphoma
Survivors of Hodgkin lymphoma treated as adolescents or adults are at increased risk of cardiovascular diseases throughout their lives, according to results of a retrospective cohort study of 2,524 Dutch patients followed for a median of 20 years. “Treating physicians and patients should be aware...
Coriolus versicolor
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 ...
The Flipped Classroom: Swapping the Traditional Lecture Hall for an Online Version
Despite enormous advances in modern medicine and the explosion of biomedical information over the past century, the way medical education is taught in the United States is stuck in a format that does not optimize learning, according to Charles Prober, MD, Senior Associate Dean for Medical Education ...
Dabrafenib Plus Trametinib Improves Overall Survival vs Dabrafenib in BRAF V600–Mutant Melanoma
Overall survival results of the phase III COMBI-d trial reported in The Lancet by Georgina V. Long, MD, and colleagues showed that the combination of the BRAF inhibitor dabrafenib (Tafinlar) with the MEK inhibitor trametinib (Mekinist) resulted in significantly prolonged overall survival vs...
Emerging Technology Will Help Tackle Tumor Complexity
Emerging laboratory technology will be “moving the bar forward” in terms of molecular markers, genomics, and gene-expression profiling, with the potential for huge payoffs to oncologists and patients, according to Mark Pegram, MD, the Susy Yuan-Huey Hung Professor of Medicine at Stanford School of...
Positioning Targeted and Immunotherapy-Based Approaches in Lung Cancer
With immunotherapy changing the face of lung cancer, is there still a place for targeted therapy? Two experts from Emory University debated this issue at the 2015 Debates and Didactics in Hematology and Oncology Conference held in Sea Island, Georgia. Fadlo Khuri, MD, was recently named President...
Elotuzumab Ushers in a New Era in Myeloma Therapy
The long wait for monoclonal antibodies for the treatment of multiple myeloma is over. In the landmark ELOQUENT-2 study, reviewed in this issue of The ASCO Post, Lonial and colleagues convincingly demonstrate the effectiveness of elotuzumab, a monoclonal antibody directed against SLAMF7, in the...
Adding Elotuzumab to Lenalidomide Plus Dexamethasone Improves Progression-Free Survival in Refractory Multiple Myeloma
In an interim analysis of the phase III ELOQUENT-2 trial reported in The New England Journal of Medicine, Sagar Lonial, MD, of Emory University School of Medicine, Meletios Dimopoulos, MD, of National and Kapodistrian University of Athens, and colleagues found that the addition of elotuzumab to...
‘Encouraging Results’ With Newer EGFR TKIs in Patients With NSCLC Who Progressed After Prior EGFR TKI Therapy
Two studies of third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors among patients with non–small cell lung cancer (NSCLC) who had progressive disease following treatment with a first-generation EGFR tyrosine kinase inhibitor “show encouraging results,” according to...
HPV-Positive Head and Neck Cancer: When Can Chemotherapy Be Omitted?
Are there patients with locally advanced squamous cell carcinoma of the head and neck associated with human papillomavirus (HPV) for whom chemotherapy can be omitted? Experts debated this question at the 2015 Debates and Didactics in Hematology and Oncology Conference in Sea Island, Georgia,...
Mantle Cell Lymphoma: Is Transplantation Still Necessary?
Autologous stem cell transplantation has played a critical role in the treatment of mantle cell lymphoma, but in the age of novel treatments, is it always warranted? Two experts in the field explored the question at the 2015 Debates and Didactics in Hematology and Oncology Conference sponsored by...
Diagnosis of Additional Small Cancers Suggests Screening Mammography Leads to Overdiagnosis
A study of screening mammography across U.S. counties found that “the clearest result of mammography screening is the diagnosis of additional small cancers” but without a “concomitant decline in the detection of larger cancers, which might explain the absence of any significant difference in the...
Anti–PD-1 Superior to Chemotherapy in the KEYNOTE-002 Trial
Immunotherapy, once considered a niche treatment for a few specific cancers, has rapidly emerged as an additional pillar of cancer therapeutics. With the proliferation of promising results, clinical trials, and new drug approvals, one cannot help but be amazed that only 3 years have elapsed since...
Docetaxel Chemohormonal Therapy in Metastatic Hormone-Sensitive Prostate Cancer
Sweeney et al reported on the results of a seminal phase III trial (E3805) of chemohormonal therapy vs androgen-deprivation therapy in metastatic hormone-sensitive prostate cancer in a recent issue of The New England Journal of Medicine,1 and the study is summarized in this issue of The ASCO Post....
Adding Docetaxel to Androgen-Deprivation Therapy Prolongs Overall Survival in Metastatic Prostate Cancer
In a phase III trial (E3805) reported in The New England Journal of Medicine, Christopher J. Sweeney, MBBS, of Dana-Farber Cancer Institute, Boston, and colleagues found that chemohormonal therapy with docetaxel plus androgen-deprivation therapy produced a significant 13.6-month increase in median...
Adjuvant Treatment of Early-Stage Breast Cancer: Meta-analyses Provide More Clarity
The Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) continues its practice of being a lighthouse, shedding its beacon of light on the vast ocean of breast cancer research through the publication of two large, individual patient level–data meta-analyses on the management of women with...
Nivolumab in Lung Cancer Supported by Updated Trial Data
For the treatment of advanced squamous non–small cell lung cancer (NSCLC), the programmed cell death protein 1 (PD-1) antibody nivolumab (Opdivo) continues to show results in key trials that now report 18-month data. The updates were reported at the 16th World Conference on Lung Cancer in Denver,...
Important Caveats to Consider Concerning Low-Dose Daily Aspirin for the Primary Prevention of Colorectal Cancer
The use of low-dose aspirin by most adults aged 50 to 59 for the primary prevention of colorectal cancer is now included in the U.S. Preventive Services Task Force (USPSTF) updated draft recommendation statement, “Aspirin to Prevent Cardiovascular Disease and Cancer.”1 The release of the statement...
Trifluridine/Tipiracil in Previously Treated Metastatic Colorectal 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 September 22, 2015, trifluridine/tipiracil (Lonsurf) was...
Bevacizumab in Ovarian Cancer: Results of ICON7
Based on preclinical (in vitro and in vivo) data, there is a strong biologic rationale for the addition of an antiangiogenic drug strategy in the treatment of epithelial ovarian cancer.1 Single-agent trials have confirmed both the biologic and clinical activity of bevacizumab (Avastin) in the...
Addition of Bevacizumab to Standard Chemotherapy Improves Overall Survival Only in High-Risk Ovarian Cancer
Final overall survival results of the phase III ICON7 trial reported in The Lancet Oncology by Amit M. Oza, MD, and colleagues indicate no significant improvement with the addition of bevacizumab (Avastin) to standard chemotherapy in women with newly diagnosed ovarian cancer.1 However, an overall...
Anti-EGFR Therapy in Squamous Cell Lung Carcinoma: Swimming With or Against the Tide?
Lung cancer is the most common, lethal, and costly cancer worldwide, accounting for at least 1.8 million new cases per year (12.9% of the total).1 Over the past decade, there has been a major shift in the treatment of non–small cell lung cancer (NSCLC), especially in adenocarcinoma, accompanied by...
FDA Approves Use of Nivolumab in Metastatic Nonsquamous Lung Cancer
The U.S. Food and Drug Administration (FDA) has approved nivolumab (Opdivo) to treat patients with metastatic nonsquamous non–small cell lung cancer (NSCLC) whose disease progressed during or after platinum-based chemotherapy. Nivolumab is a monoclonal antibody that that blocks the PD-1/PD-L1...
Nivolumab in Combination With Ipilimumab in BRAF V600 Wild-Type Unresectable or Metastatic Melanoma
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 September 30, 2015, the U.S. Food and Drug Administration...
Maternal Malignancy Treated During Pregnancy (125 Mothers)
The majority of women with cancer treated during pregnancy had a diagnosis of breast cancer (69 mothers, including 2 twin pregnancies [55%]) or a hematologic malignancy (20 mothers [16%], including 1 mother with acute lymphoid leukemia, 4 with acute myeloid leukemia, 1 with chronic myeloid...
Maternal Cancer During Pregnancy Does Not Appear to Affect Cognitive or General Development in Early Childhood
In a study reported in The New England Journal of Medicine, Frederic Amant, MD, PhD, of University Hospitals Leuven, Belgium, and colleagues in the International Network on Cancer, Infertility, and Pregnancy found that cancer diagnosed during pregnancy did not appear to affect cognitive, cardiac,...
Nivolumab and Cabozantinib Improve Outcomes vs Everolimus in Previously Treated Advanced Renal Cell Carcinoma
The CheckMate 025 trial, reported in The New England Journal of Medicine by Robert J. Motzer, MD, and colleagues, showed that treatment with the programmed cell death protein (PD-1) checkpoint inhibitor nivolumab (Opdivo) increased overall survival vs the mTOR inhibitor everolimus (Afinitor) in...
Endocrine Therapy Alone Linked to Low Risk of Breast Cancer Recurrence in Women With a Low-Risk Score on 21-Gene Assay
A prospective validation study of a 21-gene expression assay showed that treatment with endocrine therapy alone in women with hormone receptor–positive, HER2-negative breast cancer who had a low recurrence risk score resulted in low risk of recurrence. All patients included in the study were...
Expert Point of View: Clifford Hudis, MD
Clifford Hudis, MD, Chief of the Breast Medicine Service at Memorial Sloan Kettering Cancer Center, New York, said the findings suggest there is essentially no meaningful benefit from chemotherapy in the recurrence score low-risk subset. “It is clinically appropriate to offer endocrine therapy...
TAILORx: Chemotherapy Not Necessary for Women With a Low Recurrence Score
The long-awaited first results are in from the TAILORx study, showing that patients with early breast cancer considered at low risk for recurrence can forgo chemotherapy and be treated with endocrine therapy alone.1 “Women with axillary node-negative, estrogen receptor–positive, HER2-negative...
Expert Point of View: Michael F. Greene, MD, and Dan L. Longo, MD
In an accompanying editorial in The New England Journal of Medicine, Michael F. Greene, MD, Chief of Obstetrics at Massachusetts General Hospital, and Dan L. Longo, MD, Professor of Medicine at Harvard Medical School and Dana-Farber Cancer Institute, mentioned the low odds for both oncologists and...
Chemotherapy/Radiotherapy Safe in Second and Third Trimesters of Pregnancy
Children with in utero exposure to chemotherapy and/or radiation therapy during maternal treatment for cancer had no impairment in cognition, cardiac function, and general early childhood development, according to a study reported at the European Cancer Congress in Vienna, Austria, and published...
Phase III METEOR Trial Finds Cabozantinib Improves Progression-Free Survival vs Everolimus in Advanced Renal Cell Carcinoma
Cabozantinib (Cometriq) nearly doubled progression-free survival compared with standard everolimus (Afinitor) therapy in patients with advanced renal cell carcinoma, according to the phase III METEOR trial.1 Additionally, a preplanned interim analysis found an encouraging trend toward overall...
Ovarian Suppression During Chemotherapy Preserves Fertility in Young Women With Breast Cancer
Several studies have addressed the risks and benefits of ovarian suppression during chemotherapy for breast cancer in women of childbearing age. A new meta-analysis of randomized trials found that it prevented premature ovarian failure and was associated with a higher number of pregnancies post...
