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lung cancer

NCCN Marks 20 Years of Evidence-Based Decision-Making in Small Cell Lung Cancer

The National Comprehensive Cancer Network (NCCN) recently announced publication of the 20th annual edition of the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Small Cell Lung Cancer (SCLC). One of the eight original NCCN Guidelines, the NCCN Guidelines for SCLC was initially...

breast cancer

PALB2 Study: Researchers and Patients Must 'Pal' for Progress

The recent publication by Antoniou et al on risk of breast cancer in PALB2 carriers,1 reviewed in this issue of The ASCO Post (page 47), is a contribution to the interesting history of the PALB2 gene, and an important milestone in the expansion of hereditary cancer susceptibility testing in the...

breast cancer

Study Quantifies Risk of Hereditary Breast Cancer in Carriers of PALB2 Mutations

In a study reported in The New England Journal of Medicine, Antonis C. Antoniou, PhD, Reader in Cancer Risk Prediction and Cancer Research UK Senior Cancer Research Fellow at the University of Cambridge, and colleagues identified lifetime risk of breast cancer in families with germline...

issues in oncology

Patient-Reported Outcomes in Hematology and Oncology Product Development

INSIDE THE BLACK BOX is an occasional column providing insight into the U.S. Food and Drug Administration (FDA) and its policies and procedures. In this installment, Virginia Kwitkowski, MS, RN, ACNP-BC, and Elektra Papadopoulos, MD, MPH, discuss FDA’s current approach to the review of study...

Researchers at University of Michigan Receive $2.3 Million Grant to Promote Safety, Reduce Exposure Risk, at Chemotherapy Infusion Sites

Researchers at the University of Michigan School of Nursing and Comprehensive Cancer Center have received a $2.3 million grant to study oncology nurses’ exposure to hazardous drugs, including identifying ways to reduce exposure. “There are significant acute and long-term side effects from hazardous ...

lung cancer

Lung Cancer Webinar Highlights Brain Metastases and Thoracic Radiotherapy

Postoperative radiation therapy, given after adjuvant chemotherapy, significantly increased overall survival in non–small cell lung cancer (NSCLC) compared to chemotherapy alone, according to a study reported at ASCO’s 2014 Annual Meeting.1 That study, an analysis of records in the National Cancer...

lung cancer

Optimal Chemoradiotherapy Dosing and Recurrence After Stereotactic Body Radiotherapy Explored in Lung Cancer Webinar

Cetuximab (Erbitux) added no survival benefit to chemoradiation in stage III non–small cell lung cancer (NSCLC), according to results reported in a Plenary Session of the 2013 World Conference on Lung Cancer in Sydney, Australia.1 It was the second surprise result from the Radiation Therapy...

2014 Lasker Award

The Albert and Mary Lasker Foundation has announced Mary-Claire King, PhD, of the University of Washington, Seattle, will receive the 2014 Lasker~Koshland Special Achievement Award for her contributions to medical science and human rights.  Dr. King’s demonstration of the existence of familial...

gynecologic cancers

Angiogenesis in Ovarian Cancer: Are We Missing the Clinical Target?

Production of vascular endothelial growth factor (VEGF) is increased during normal ovulation, and can account for much of the reversible toxicity associated with ovarian hyperstimulation.1,2 We also have compelling data from multiple clinical trials to validate the importance of tumor-associated...

gynecologic cancers

Adding Antiangiopoietin Agent Trebananib to Paclitaxel Improves Progression-Free Survival in Recurrent Epithelial Ovarian Cancer

Trebananib inhibits angiogenesis by blocking the binding of angiopoietins 1 and 2 to the Tie2 receptor expressed on endothelial cells, a mechanism that differs from vascular endothelial growth factor (VEGF) inhibitors and that involves a different signaling pathway. In the phase III TRINOVA-1 trial ...

gynecologic cancers

Early Study Finds Olaparib Tablet Safe in Pretreated Ovarian Cancer Patients; More Effective in Those With BRCA Mutations

An oral tablet form of a poly-ADP ribose polymerase (PARP) inhibitor, olaparib, given in combination with chemotherapy, was safe in heavily pretreated patients with ovarian cancer, and patients with BRCA mutations may have a better response compared with those without a BRCA mutation, according to...

prostate cancer

PSA—It Just Keeps Getting Better, So Why Should It Stand Alone?

The updated results of the European Randomised Study of Screening for Prostate Cancer (ERSPC)—reported in The Lancet by Fritz H. Schröder, MD, of Erasmus University Medical Center, and colleagues1 and reviewed in this issue of The ASCO Post—show a continued decline, as predicted,2 in the number...

prostate cancer

European Researchers at 13-Year Follow-up: Increased Absolute Benefit of PSA Screening in Prostate Cancer Mortality, but Time for Population-Based Screening Has Not Arrived

The 13-year follow-up of the European Randomized Study of Screening for Prostate Cancer ­(ERSPC), reported by Fritz H. Schröder, MD, PhD, Professor Emeritus of Urology at Erasmus University Medical Center, Rotterdam, the Netherlands, and colleagues in The Lancet, showed that prostate-specific...

pancreatic cancer

FDA Grants Fast Tract Designation to Investigational Combination Therapy In Metastatic Pancreatic Cancer

The U.S. Food and Drug Administration (FDA) has granted Fast Track designation for Halozyme Therapeutics’ program investigating pegylated recombinant human hyaluronidase (PEGPH20) in combination with gemcitabine and albumin-bound paclitaxel (nab-paclitaxel [Abraxane]) for the treatment of patients...

gynecologic cancers

Novel Immunotherapy for Ovarian Cancer Receives Fast Track Designation

The U.S. Food and Drug Administration (FDA) has granted fast track designation to the investigation of motolimod (VTX-2337) when administered in combination with pegylated liposomal doxorubicin for the treatment of women with ovarian cancer whose disease has progressed on or recurred after...

skin cancer

FDA Approves Pembrolizumab for Advanced Melanoma

The U.S. Food and Drug Administration (FDA) today granted accelerated approval to the anti–PD-1 antibody pembrolizumab (Keytruda) for the treatment of patients with advanced or unresectable melanoma who are no longer responding to other drugs. Pembrolizumab is intended for use following treatment...

hematologic malignancies

‘Paradigm-Shifting’ Results in Treatment of Hematologic Disorders

The three leukemia/lymphoma studies selected from the many 2014 ASCO Annual Meeting abstracts for presentation at the recent Best of ASCO meeting in Chicago “are really paradigm-shifting,” noted Lucy A. Godley, MD, PhD, of the University of Chicago. These studies, she said, “give great promise for...

Pros and Cons of Early Chemohormonal Therapy

There is considerable debate about moving chemohormonal therapy to an earlier point in the treatment of prostate cancer, at the time of initial diagnosis of metastases, according to Dr. Yu. In the pro column, “You might hit those de novo testosterone-independent clones if they exist.” Additionally, ...

When Should Chemotherapy Be Used in Metastatic Prostate Cancer?

Questions abound when it comes to the optimal timing and sequencing of chemotherapy in metastatic prostate cancer, according to Dr. Yu. For example, arguments could be made both for using it earlier, while disease is still hormone-sensitive, or later, after hormonal resistance emerges. “For...

prostate cancer

Studies Help Refine Management of Prostate Cancer

Several studies reported at this year’s ASCO Annual Meeting address gray areas in the management of prostate cancer, according to Evan Y. Yu, MD, Associate Professor at the University of Washington and the Seattle Cancer Care Alliance. “In prostate cancer, probably the most excitement has happened...

gynecologic cancers

In Managing Ovarian Cancer, Precision Medicine Is a Work in Progress

Precision medicine in the management of ovarian cancer “is a work in progress, to be sure,” Steven B. Newman, MD, noted in wrapping up the session on gynecologic cancer at the recent Best of ASCO meeting in Chicago. “A list of different histologic types of ovarian cancer and potential targets are...

breast cancer

Disparities Persist in Early-Stage Breast Cancer Treatment, MD Anderson Study Finds

Despite its acceptance as standard of care for early-stage breast cancer almost 25 years ago, barriers still exist that preclude patients from receiving breast-conserving therapy, with some patients still opting for a mastectomy, according to research from The University of Texas MD Anderson Cancer ...

lung cancer

Hsp90 Inhibitors May Soon Transition Into Clinic

Inhibitors of heat shock protein 90 (Hsp90) look promising for the treatment of advanced non–small cell lung cancer (NSCLC) and have the advantage of not needing a specific mutation to target, said Suresh S. Ramalingam, MD, Professor and Chief of Medical Oncology at the Winship Cancer Institute of...

lung cancer

In Advanced Lung Cancer, Targeted Combinations Are Still Works in Progress

For the treatment of advanced non–small cell lung cancer (NSCLC), combinations of targeted agents are of great research interest but have not yet been shown to improve outcomes. Single-agent treatment with tyrosine kinase inhibitors, therefore, remains the standard of care for patients with...

Important Resources

Persons whose illnesses are related to exposure to the World Trade Center disaster may be eligible for medical services or monetary compensation under two Federal programs. The World Trade Center (WTC) Health Program provides medical monitoring and treatment for responders at the World Trade...

issues in oncology
health-care policy

9/11 and Cancer: What Do We Know?

On September 11, 2001, the devastating terrorist attack that destroyed the World Trade Center left in its wake a unique toxic site in both mass and quantity of hazardous materials. It took 9 months to remove approximately 2 million tons of wreckage from Ground Zero, during which thousands of...

issues in oncology

Will Oncologists Be the First to Cure Heart Disease?

Oncologists love jargon—a language peculiar to a particular trade, profession, or group that facilitates communication among members. Our day-to-day communications, medical notes, and journal reports are filled with this type of jargon. Other definitions of jargon are less flattering, including...

lung cancer

Can Metastatic Lung Cancer Be Cured?

Don’t expect metastatic lung cancer to be cured any time soon, says Paul A. Bunn, Jr, MD, Professor and James Dudley Chair in Cancer Research at the University of Colorado School of Medicine, Denver. “You have to be disease-free for some length of time in order to be cured, which is our goal,” he...

Top 5 Advances in Modern Oncology

1. Chemotherapy Cures Advanced Hodgkin Lymphoma In the first chemotherapy breakthrough for advanced cancer in adults, a four-drug combination chemotherapy regimen, called MOPP (mustargen/­oncovin/procarbazine/prednisone), induced long-term remissions in over half of patients with aggressive Hodgkin ...

issues in oncology

ASCO 50th Anniversary Poll Names the Top 5 Advances From the Past 50 Years

ASCO has announced the “Top 5 Advances in 50 Years of Modern Oncology,” based on results of worldwide voting on CancerProgress.Net—ASCO’s interactive website documenting the history of progress against cancer. The “Top 5 in 50” results identify pivotal discoveries in chemotherapy, prevention,...

health-care policy

AACR 2014 Cancer Progress Report Call to Action: Prioritize Federal Funding for Biomedical Research

Last month, the American Association for Cancer Research (AACR) released its 2014 Cancer Progress Report: Transforming Lives Through Research, which highlights the quickening pace of drug development and approval, especially in molecularly targeted agents, that are leading to increased numbers of...

lung cancer

FDG-PET Is Less Specific in Diagnosing Lung Cancer in Areas With Endemic Infectious Lung Disease

Although positron-emission tomography (PET) combined with 18F–fluorodeoxyglucose (FDG) is recommended for the noninvasive diagnosis of pulmonary nodules suspicious for lung cancer, in populations with endemic infectious lung disease, FDG-PET may not accurately identify malignant lesions. An...

breast cancer

Patients With DCIS Have Decreased Risk of Cardiovascular Death, Independent of Treatment

Recent concerns about potential overdiagnosis and overtreatment of ductal carcinoma in situ of the breast (DCIS) led researchers in the Netherlands to study late effects of treatment, such as cardiovascular disease, morbidity, and mortality in a large population-based cohort of DCIS patients....

breast cancer

Comorbidity Associated With Shorter Overall Survival but Not With Time to Relapse or Toxicity in Older Women on Adjuvant Chemotherapy

In the Cancer and Leukemia Group B (CALGB) 70103 study, comorbidity was associated with shorter overall survival among older women with early-stage breast cancer and good functional status receiving adjuvant chemotherapy. “The presence of four or more conditions appeared to be a threshold for...

colorectal cancer

Enhanced Benefit Shown With FOLFIRI/Ziv-Aflibercept in Subset of Patients With Metastatic Colorectal Cancer

The survival benefit demonstrated in the VELOUR study for FOLFIRI (irinotecan, fluorouracil [5-FU], leucovorin) plus ziv-aflibercept (Zaltrap) vs FOLFIRI plus placebo in metastatic colorectal cancer patients who progressed on oxaliplatin-based chemotherapy persisted beyond median survival times for ...

breast cancer
colorectal cancer
gynecologic cancers
prostate cancer

Overscreening for Prostate, Breast, Colorectal, and Cervical Cancer Can Raise Costs and Harm Patients

Analyses of data from 27,404 people aged 65 and older participating in the National Health Interview Survey (NHIS) from 2000 through 2010 suggest that overscreening for prostate, breast, cervical, and colorectal cancer screening “is common in both men and women, which not only increases health care ...

cns cancers

MSH6 Mutations May Influence Temozolomide Resistance in Treatment-Naive Gliomas Independent of MGMT Methylation

Resistance to temozolomide in glioblastoma has been thought to be largely mediated by expression of the DNA repair enzyme MGMT, although there are data suggesting a role for inactivation of MSH6 and other mismatch repair proteins. In a study reported in Clinical Cancer Research, Nguyen and...

issues in oncology

Potential for Improved Effectiveness and Reduced Toxicity of Radiotherapy With Ultrahigh Dose-Rate FLASH Irradiation

Studies in vitro have suggested that sub-millisecond pulses of radiation produce less genomic instability than continuous prolonged irradiation at the same total dose. In a study reported in Science Translational Medicine, Favaudon and colleagues assessed the effects of ultrahigh dose-rate...

gastrointestinal cancer

CD44 Expression a Marker for Chemotherapy Resistance in Gastric Cancer, Overcome by Hedgehog Inhibition

CD44 is a gastric cancer stem cell marker, and the hedgehog signaling pathway can be dysregulated by cancer stem cells during tumorigenesis. In a study reported in Clinical Cancer Research, Yoon and colleagues found that high CD44 expression was associated with chemotherapy resistance and poorer...

supportive care
survivorship

Expert Consensus Recommends Echocardiograph as Cornerstone to Protecting Cancer Patients’ Heart Health

Patients with cancer and survivors of cancer are living longer than ever before as a result of significant advances made over the past decade. Importantly, however, cardiovascular complications of their cancer treatment may present a life-threatening issue after their cancer treatment has ended....

LIVESTRONG Narrows Finalists in ‘Big C’ Competition: Winner to Be Announced This Month

Newly launched in 2014 by LIVESTRONG, “The Big C” is a one-of-a-kind global competition to generate innovations that improve the daily quality of life for the 32.5 million people around the world living with cancer now. The competition was open to entrepreneurs, trailblazers, technology whizzes,...

Expect Questions From Patients

The study finding1 that men with moderate pattern baldness on the front and the crown of the head at age 45 had a 40% increased risk, compared to men with no baldness at that age, of developing prostate cancer later in life has received coverage by diverse media, from USA Today2 to TIME3 to the...

prostate cancer

Moderate Form of Male Pattern Baldness Associated With Increased Risk of Aggressive Prostate Cancer

Men with moderate pattern baldness on the front and the crown of the head at age 45 had a 40% increased risk, compared to men with no baldness at that age, of developing prostate cancer later in life, according to a study led by researchers from the National Cancer Institute (NCI) and published in...

gynecologic cancers

Nine-Valent HPV Vaccine May Prevent Nearly 90% of Cervical Cancers

Because nine human papillomavirus (HPV) subtypes were found to cause the majority of cervical precancers, a nine-valent HPV vaccine currently being investigated may be able to prevent more cervical cancers than current vaccines, according to research published in Cancer Epidemiology, Biomarkers...

Patient Guides Available Through ASCO University Bookstore

ASCO Answers: Managing the Cost of Cancer Care explains the various costs associated with cancer treatment, including health-care coverage through the Affordable Care Act. It also provides a list of financial resources available to help offset expenses related to care and tips for organizing...

sarcoma

Social Media Is Helping Me Cope With Cancer

Despite a diagnosis in August 2013 of stage III high-grade spindle cell sarcoma and subsequent disease recurrence, I’m mindful of how fortunate I am that my cancer was found before widespread metastases could take hold, making treatment futile. It was just happenstance, 2 months before, on a long...

issues in oncology

Fear

The following essay by Michael Feinstein, MD, is excerpted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was co-edited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and thebigcasino.org....

Roswell Park Researchers Awarded Nearly $5 Million to Support Research Projects

Several faculty members at Roswell Park Cancer Institute have been awarded nearly $5 million in grant funding from public and private organizations to further their efforts to find new and better ways to detect and treat cancer and improve patients’ quality of life. The 13 awards, including two for ...

2014 Oncology Meetings

OCTOBER 18th SIS World Congress on Breast HealthcareOctober 16-19 • Orlando, Florida For more information: www2.kenes.com/sis/Pages/Home.aspx 2014 Quality Care SymposiumOctober 17-18 • Boston, MassachusettsFor more information: quality.asco.org Atlanta Lung Cancer SymposiumOctober 18 • Atlanta,...

The Audacity of Courage

We have toolsWe have ghoulsBut nowhere are there more foolsThan in the rulesfrom those who govern the tools!        In the bias       That climbs on the shoulders       To bring plausibility       Through implied causality,Where is ignorance?Where is reality?Where are all the tools of Reason?       ...

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