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pancreatic cancer

Addition of Nab-Paclitaxel to Gemcitabine Improves Survival in Previously Untreated Metastatic Pancreas Cancer 

In a phase III trial reported in The New England Journal of Medicine, Daniel D. Von Hoff, MD, of Translational Genomics Research Institute in Phoenix, and colleagues assessed the addition of albumin-bound paclitaxel (nab-paclitaxel [Abraxane]) to gemcitabine in patients with previously untreated...

pancreatic cancer

Adjuvant Gemcitabine Improves Long-Term Survival in Patients With Resected Pancreatic Cancer

An initial report from the phase III Charité Onkologie (CONKO) 001 trial of adjuvant gemcitabine vs observation in patients with completely resected pancreas cancer showed that gemcitabine treatment was associated with a significant prolongation of disease-free survival.1 As reported in JAMA by...

palliative care
cost of care

Two Studies Highlight Communication Challenges Facing Medical Oncology

In one study presented at ASCO’s second annual Quality Care Symposium in San Diego, patients receiving chemotherapy with palliative care intent were at high risk of side-effect–related hospitalization, which defeats the clinical purpose and adds preventable costs to health care.1 “There is an...

issues in oncology
survivorship

Oncologists Need to Inform Primary Care Physicians About Late and Long-Term Effects of Chemotherapy

A nationally representative survey of 1,130 oncologists and 1,072 primary care physicians found that primary care physicians had limited awareness of late or long-term effects of chemotherapy agents. This was attributed to primary care physicians not typically encountering chemotherapy agents...

Dr. Weisenthal Replies

Dr. Mason states that I implied that Dr. Telli supports the routine application of chemosensitivity assays. I have no knowledge regarding Dr. Telli’s views on this subject, nor did I in any way attempt to represent her views, much less imply that she was supportive of anything relating to...

Oncology Meetings

January 2014 AACR-IASLC Joint Conference on the Molecular Origins of Lung CancerJanuary 6-9 • San Diego, CaliforniaFor more information: www.aacr.org 2014 Gastrointestinal Cancers SymposiumJanuary 16-18 • San Francisco, CaliforniaFor more information: www.gicasym.org 10th Annual Clinical...

lymphoma

Ibrutinib in Previously Treated Mantle Cell Lymphoma

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. Indication On November 13, 2013, ibrutinib (Imbruvica) was granted...

breast cancer

Similar High Complete Response Rate With Neoadjuvant Trastuzumab, Lapatinib, and Combined Therapy in HER2-Positive Breast Cancer

In a phase III trial (NSABP B-41) performed to assess the potential benefit of neoadjuvant dual HER2 blockade in HER2-positive breast cancer, André Robidoux, MD, of Centre Hospitalier de l’Université de Montréal, and colleagues in the National Surgical Adjuvant Breast and Bowel Project (NSABP)...

breast cancer

Long-Term Follow-up of the HERA Trial Shows No Benefit of 2 Years vs 1 Year of Trastuzumab in Early Breast Cancer 

As reported in The Lancet by Aron Goldhirsch, MD, of the European Institute of Oncology in Milan, Italy, and colleagues from the Breast International Group (BIG), the comparison of 1 vs 2 years of trastuzumab (Herceptin) in patients with HER2-positive early breast cancer in the phase III HERA trial ...

neuroendocrine tumors

Extended-Release Lanreotide Significantly Delays Disease Progression in Patients With Neuroendocrine Tumors in Large Phase III CLARINET Trial

A strong antiproliferative response was shown for the somatostatin analog lanreotide (subcutaneous, extended-release formulation, Somatuline Autogel [Somatuline Depot in the United States]) in patients with gastroenteropancreatic neuroendocrine tumors, in the large multinational prospective phase...

gynecologic cancers

Using Hyperthermia for Cancer Treatment: Proofs, Promises, and Uncertainties

With the headline, “Rare Cancer Treatments, Cleared by F.D.A. but Not Subject to Scrutiny,” a recent article in The New York Times reported that several medical centers were treating patients with cancer using a hyperthermia system that had received a Humanitarian Use Device approval from the U.S....

Oncology Meetings

January 2014 2014 Gastrointestinal Cancers SymposiumJanuary 16-18 • San Francisco, CaliforniaFor more information: www.gicasym.org 10th Annual Clinical Breakthroughs and Challenges in Hematologic MalignanciesJanuary 18 • Orlando, FloridaFor more information:...

solid tumors
integrative oncology

Stress and Tumor Biology: Insights Into Managing Stress to Help Improve Cancer Care

Stress is ubiquitous in our society, especially for people diagnosed with a life-threatening illness. There is a common misconception that stress is derived from a particular negative event. However, the event itself (the stressors, such as cancer diagnoses and treatment) does not causes stress....

hematologic malignancies

Donor KIRDL1-R245 Allele Predicts Improved Survival and Reduced Progression in Pediatric Allogeneic Stem Cell Transplant

Killer-cell immunoglobulin-like receptors (KIRs) that regulate natural-killer cells are highly polymorphic, and some KIR2DL1 alleles (ie, KIR2DL1-R245) encode receptors characterized by stronger signaling function than others (ie, KIR2DL1-C245). In a study reported in the Journal of Clinical...

thyroid cancer

Sorafenib in Differentiated Thyroid Carcinoma

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. New Indication On November 22, 2013, sorafenib (Nexavar) was...

kidney cancer

Tivozanib Improves Progression-Free but Not Overall Survival vs Sorafenib in Metastatic Renal Cell Carcinoma

The investigational agent tivozanib is a selective tyrosine kinase inhibitor of vascular endothelial growth factor receptor (VEGFR)-1, -2, and -3. In a phase III trial reported in the Journal of Clinical Oncology by Robert J. Motzer, MD, of Memorial Sloan-Kettering Cancer Center (MSKCC), and...

Oncology Meetings

FEBRUARY 25th International Congress on Anti-Cancer TreatmentFebruary 4-6 • Paris, FranceFor more information: www.icact.fr APOS 11th Annual ConferenceFebruary 13-15 • Tampa, FloridaFor more information:www.apos-society.org/apos2014/ European Society for Medical Oncology Sarcoma and GIST...

breast cancer

Final Overall Survival Data Show Better Results With Higher Dose of Fulvestrant

Among patients with locally advanced or metastatic estrogen receptor–positive breast cancer, fulvestrant (Faslodex) given at 500 mg “is associated with a 19% reduction in risk of death and a 4.1-month difference in median overall survival compared with fulvestrant 250 mg,” according to final...

cns cancers

An Overview of the REGAL Trial and Anti-VEGF Therapies in Recurrent Glioblastoma

As published in the Journal of Clinical Oncology by Batchelor and colleagues1 and reviewed in a recent issue of The ASCO Post (November 15, 2013, page 106), the REGAL trial was a randomized, phase III, placebo-controlled, partially blinded trial evaluating the efficacy of cediranib, an...

skin cancer

FDA Approves Combination Therapy for Unresectable or Metastatic Melanoma With BRAF V600E/K Mutations

The U.S. Food and Drug Administration (FDA) has approved trametinib (Mekinist) for use in combination with dabrafenib (Tafinlar) for the treatment of patients with unresectable melanoma or metastatic melanoma with BRAF V600E or V600K mutations. These mutations must be detected by an FDA-approved...

multiple myeloma

Pomalidomide Plus Low-Dose Dexamethasone: Important New Option in Relapsed/Refractory Multiple Myeloma

Pomalidomide (Pomalyst) plus low-dose dexamethasone significantly improved progression-free survival compared to pomalidomide alone in patients with relapsed and refractory multiple myeloma enrolled in a multicenter, open-label study, the phase II part of the MM-002 trial. The study confirmed the...

leukemia

In CLL With Coexisting Conditions, Chlorambucil Produces Better Outcomes With Obinutuzumab Than With Rituximab

A randomized phase III trial conducted in 26 countries found that combining chlorambucil (Leukeran) with an anti-CD20 antibody—either obinutuzumab (Gazya) or rituximab (Rituxan)—produced better outcomes among patients with previously untreated chronic lymphocytic leukemia (CLL) and coexisting...

pancreatic cancer

High Expression of hENT1 Can Predict Better Survival Among Patients on Postsurgical Gemcitabine

High levels of expression of the human equilibrative nucleoside transporter 1 (hENT1) were associated with longer median survival of patients with pancreatic adenocarcinoma receiving gemcitabine, according to an analysis of clinical data and cancer tissue collected from the European Study Group for ...

2014 Oncology Meetings

FEBRUARY European Society for Medical Oncology Sarcoma and GIST 2014February 18-19 • Milan, ItalyFor more information: www.esmo.org 2014 BMT Tandem MeetingAmerican Society for Blood and Marrow TransplantationFebruary 19 - 23 • Orlando, FloridaFor more information: www.asbmt.org Multidisciplinary...

integrative oncology

Kava

Kava Scientific Name: Piper methysticum Common Names: Kava-kava, kawa, kavain, rauschpfeffer, intoxicating long pepper, tonga, yagona, and yaqona. Overview Kava, a perennial shrub indigenous to the Hawaiian Islands and the Pacific Rim, is known for its relaxant effects and used for social and...

issues in oncology

FDA Programs to Expedite Drug and Biologic Product Development

With the advent of Breakthrough Therapy designation, there are now four FDA programs to expedite the development of promising new agents: Fast Track, Breakthrough Therapy, Priority Review, and Accelerated Approval (Table 1). These programs complement one another and serve a common goal: to speed...

lymphoma

Novel Agents Show Activity in Non-Hodgkin Lymphoma

PI3K-mediated activation of downstream effectors allows tumors to escape from negative growth control, and this action may be checked with PI3K inhibitors. At the 2013 American Society of Hematology (ASH) Annual Meeting, researchers reported results in patients with relapsed or refractory lymphoma...

multiple myeloma

ASH Studies Refine Myeloma Treatment and Show Promise for New Agents

Multiple myeloma researchers moved the field forward at the 2013 American Society of Hematology (ASH) Annual Meeting, presenting evaluations of treatment schedules and reports of encouraging activity with compounds in development. Alternating vs Sequential Regimens In 231 newly diagnosed elderly...

lymphoma

R-GCVP Regimen for Patients With Diffuse Large B-Cell Lymphoma and Cardiac Comorbidity

For patients with diffuse large B-cell lymphoma (DLBCL) who are unable to receive anthracycline-containing chemoimmunotherapy because of cardiac comorbidity, a regimen of rituximab (Rituxan), gemcitabine, cyclophosphamide, vincristine, and prednisolone (R-GCVP) “is an active, reasonably...

lung cancer

Nintedanib Combined With Docetaxel Is Effective Second-Line Option for Advanced NSCLC

The combination of nintedanib and docetaxel “is an effective second-line option” for patients with advanced non–small cell lung cancer (NSCLC) who have received previous treatment with one line of platinum-based therapy, according to results from the phase III LUME-Lung 1 study published in The...

breast cancer

No Mortality Benefit of Breast Cancer Mammography Screening in 25-Year Follow-up of Canadian National Breast Screening Study

As reported in BMJ by Anthony B. Miller, MD, Professor Emeritus at the Dalla Lana School of Public Health, University of Toronto, and colleagues, the 25-year follow-up of the Canadian National Breast Screening Study has shown no mortality benefit of annual mammography screening for breast cancer...

leukemia

Encouraging Early Results With Novel Agents in CLL

Two novel agents have shown promising activity in chronic lymphocytic leukemia (CLL), including poor-risk patients: the Bcl-2 inhibitor ABT-199 and the small-molecule PI3K inhibitor IPI-145. Both drugs achieved excellent response rates in heavily pretreated relapsed/refractory patients including...

hematologic malignancies

Haploidentical Stem Cell Transplantation Producing Good Outcomes, Expanding Transplant Pool

HLA-haploidentical hematopoietic stem cell transplantation can be performed safely, yield good outcomes, and greatly expand the number of patients with hematologic malignancies who can be treated with stem cell transplant, studies presented at the 2013 American Society of Hematology (ASH) Annual...

colorectal cancer

Irinotecan Drug-Eluting Beads Improve Outcomes in Colorectal Cancer Patients With Liver Metastases

Irinotecan drug-eluting beads (DEBIRI) given simultaneously with FOLFOX (leucovorin, fluorouracil, oxaliplatin) and bevacizumab (Avastin) in patients with unresectable colorectal liver metastasis improved response rates, increased resectability, and prolonged hepatic progression–free survival in a...

prostate cancer

PREVAIL Trial Shows Enzalutamide to Be a Promising Option for Metastatic Castration-Resistant Prostate Cancer

Encouraging results of the large phase III PREVAIL trial represent another positive milestone for men with metastatic castration-resistant prostate cancer. Enzalutamide (Xtandi) improved overall survival by 29% and reduced the risk of radiographic progression of disease by 81% in men who had not...

supportive care

Music Therapy Yields Positive Effects on Coping Skills, Social Integration, and Family Environment for Young Patients With Cancer

A collaborative multisite study has found that teens and young adults undergoing stem cell transplantation as part of cancer treatment gain coping skills and resilience-related outcomes when participating with a board-certified music therapist in a therapeutic music protocol that includes writing...

issues in oncology

Telephone Education and Counseling Effective in Programs Targeting Familial/Genetic Cancer Risk Screening

Two studies recently reported in the Journal of Clinical Oncology indicate that telephone-based education or counseling initiatives can be successful in educating individuals at familial or genetic risk of cancer and in inducing these at-risk individuals to undergo recommended screening. In the...

leukemia

Ibrutinib for Previously Treated Chronic Lymphocytic Leukemia

On February 12, 2014, ibrutinib (Imbruvica) was granted accelerated approval for the treatment of patients with chronic lymphocytic leukemia (CLL) who have received at least one prior therapy.1,2 Ibrutinib previously received accelerated approval for the treatment of patients with mantle cell...

breast cancer

Impact of Delayed Initiation of Adjuvant Chemotherapy for Breast Cancer Varies by Tumor Subtype

The optimal time interval between surgery and initiation of adjuvant chemotherapy for early-stage breast cancer is not well established. Although most physicians aim to initiate adjuvant chemotherapy within a few weeks of surgery, clinical factors may cause delay. The influence of delay on relapse...

breast cancer

Delayed Adjuvant Chemotherapy Associated With Poorer Overall Survival in Breast Cancer

In a study reported in the Journal of Clinical Oncology, de Melo Gagliato et al from The University of Texas MD Anderson Cancer Center, Houston, assessed the association between time to adjuvant chemotherapy and survival in breast cancer patients.1 They found that delay of therapy is associated...

skin cancer

Brigham and Women’s Hospital Tumor Staging for Cutaneous Squamous Cell Carcinoma Outperforms AJCC and UICC Staging

In a study reported in the Journal of Clinical Oncology, Pritesh S. Karia, MPH, and Chrysalyne D. Schmults, MD, MSCE, of Brigham and Women’s Hospital, Boston, and colleagues compared Brigham and Women’s Hospital, American Joint Committee on Cancer (AJCC), and International Union Against Cancer...

prostate cancer
skin cancer

History of Prostate Cancer Increases Risk of Melanoma in White Men

History of severe acne, which is a surrogate for high androgen activity, has been associated with increased risk of prostate cancer, and recent data suggest that severe teenage acne is a risk factor for melanoma. Such findings suggest a role of androgens in etiology for both prostate cancer and...

lymphoma

Crizotinib Proves Effective in ALK-Positive Lymphoma

Crizotinib (Xalkori) produced promising results in patients with ALK-positive lymphoma in two small studies presented at the 2013 American Society of Hematology (ASH) Annual Meeting. Crizotinib exerted potent antitumor activity in advanced ALK-positive lymphoma and achieved durable responses in...

leukemia

Gemtuzumab Ozogamicin Reduces Relapse, Improves Event-Free Survival in Pediatric AML

The monoclonal antibody gemtuzumab ozogamicin (Mylotarg) improved event-free survival and reduced the risk of relapse in children with acute myeloid leukemia (AML) in a study from the Children’s Oncology Group, presented at the 55th American Society of Hematology (ASH) Annual Meeting and Exposition ...

lymphoma

Idelalisib Achieves High Response Rates in ‘Double-Refractory’ Indolent NHL

In patients with indolent B-cell non-Hodgkin lymphoma (NHL) refractory to both rituximab (Rituxan) and an alkylating agent, monotherapy with the selective oral PI3K-delta inhibitor idelalisib produced a high response rate, with responses persisting for 1 year in the average patient, according to...

lymphoma

Promising Results Demonstrated for Brentuximab Vedotin in Cutaneous T-Cell Lymphoma

Phase II results suggest that brentuximab vedotin (Adcetris) has encouraging activity in CD30-positive cutaneous T-cell lymphomas and lymphoproliferative disorders, including mycosis fungoides, the most common type of cutaneous T-cell lymphoma. High levels of responses were achieved in a 48-patient ...

breast cancer

Immune Modulation May Aid Some Breast Cancer Subtypes

There may be an immunogenic phenotype in breast cancer that could benefit from immune modulation as part of treatment, according to results from studies that correlated high levels of tumor-infiltrating lymphocytes with both pathologic complete responses and long-term outcomes. Studies presented at ...

kidney cancer
prostate cancer

Five Key Studies in Prostate Cancer and Renal Cell Carcinoma

The 10th Genitourinary Cancers Symposium, sponsored by ASCO, the American Society for Radiation Oncology, and the Society of Urologic Oncology, was held January 29–February 1, 2014, in San Francisco. The more than 630 abstracts presented addressed essential research in genitourinary malignancies,...

issues in oncology

Transition From Busy Oncologist to Retiree: Challenges and Opportunities

Oncology is a demanding field that requires special qualities to care for very sick patients, many of whom will die prematurely of their disease. Research indicates that years of facing life-and-death decisions in the clinic can be associated with oncology burnout syndrome, which effects physician...

integrative oncology

Reishi Mushroom

Scientific name: Ganoderma lucidum Common names: Ling zhi, lin zi, mushroom of immortality Overview A fungus, reishi mushroom is an important component of the traditional medical systems of China, Japan, Korea, and other Asian countries. It is used to increase energy, stimulate the immune system,...

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