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issues in oncology

Access to Care: Who Gets Referred to a Medical Oncologist and/or Another Cancer Specialist and Who Receives Treatment for Advanced Cancer? 

What factors determine who is referred to a medical oncologist and receives treatment for advanced cancers? Several articles in the Journal of Oncology Practice suggest that factors influencing referral and treatment go beyond the patient’s medical condition and preference and include such details...

skin cancer

Sentinel Node Biopsy in Melanoma: Essential or Optional? 

Is sentinel node biopsy in melanoma an essential component of care? Despite a large multinational trial and recently published or updated guidelines, the question is still a thorny one according to experts who debated the issue at the recent meeting of the Society of Surgical Oncology in...

gynecologic cancers

Most Women with Ovarian Cancer Do Not Get Guideline-specified Treatment Linked to Survival Benefits 

Most women with ovarian cancer are not receiving adequate treatment, as specified in National Comprehensive Cancer Network (NCCN) Guidelines,1 and as a result are being deprived of the survival benefits correlated with guideline-recommended treatment, according to a study presented at the Society...

solid tumors
breast cancer
survivorship

Dr. Bernard Fisher's Breast Cancer Research Left a Lasting Legacy of Improved Therapeutic Efficacy and Survival 

Bernard Fisher, MD, is recognized today for his groundbreaking research in breast cancer, which ultimately ended the standard practice of performing the Halsted radical mastectomy, a treatment that had been in place for more than 75 years. His laboratory and clinical investigations led to more...

colorectal cancer

Emerging Prognostic Markers in Colon Cancer 

Patients with stage II colon cancer generally have a favorable prognosis, with about 80% of patients surviving 5 years after surgery and the majority of these long-term survivors presumed to be cured. Clearly though, some patients are destined to recur after surgery, and there is an urgent need to...

gynecologic cancers
lymphoma
issues in oncology

Guideline Adherence and Geriatric Assessment Studies among NCCN Scientific Posters of Interest 

For the first time at the National Comprehensive Cancer Network (NCCN) Annual Conference, scientific posters were included as part of the program. The ASCO Post captured some of the most interesting findings for our readers, including the following news briefs. The findings of these studies support ...

issues in oncology
supportive care
symptom management

Automated Telephone Monitoring Reduces Chemotherapy-related Symptoms 

The use of an automated computer-based telephone monitoring system to assess symptoms during outpatient chemotherapy—and provide intervention where appropriate by a nurse practitioner—substantially reduced the number of days with symptoms in a study reported at the 18th Annual Conference of the...

Cancer Treatment Pioneers to Share Prize in Medicine and Biomedical Research

Peter C. Nowell, MD, Janet D. Rowley, MD, and Brian J. Druker, MD, have been named as the recipients of the 2013 Albany Medical Center Prize in Medicine and Biomedical Research, to be officially awarded May 17. The $500,000 award, given to those who have altered the course of medical research, is...

breast cancer

Reducing Incidental Cardiac Irradiation during Breast Radiotherapy  

In the treatment of breast cancer, a wealth of data from prospective clinical trials and meta-analyses has documented the benefits of radiation to prevent local-regional recurrence and improve survival. Accordingly, important quality indicators in breast cancer care include: (1) receipt of...

NCCN Clinical Practice Guidelines in Oncology: 2013 Updates 

At the 18th Annual Conference of the National Comprehensive Cancer Network (NCCN), representatives of NCCN Guidelines panels presented two new sets of guidelines along with updates for several tumor types, summarized in this issue of The ASCO Post. New NCCN Guidelines for Survivorship “The...

integrative oncology

Ginger

The use of dietary supplements by cancer patients has risen 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 the...

American Association for Cancer Research CEO Recognized with Prestigious Award from Fox Chase Cancer Center

Margaret Foti, PhD, MD (hc), Chief Executive Officer of the American Association for Cancer Research (AACR), was honored with the 2013 Stanley P. Reimann Honor Award for her deep and far-reaching contributions to cancer science and medicine at a celebration hosted by Fox Chase Cancer Center, held...

solid tumors

HIV Infection Does Not Adversely Affect Outcomes of Liver Transplantation for Hepatocellular Carcinoma

Liver transplantation for hepatocellular carcinoma is feasible for HIV-infected patients, with no differences in post-transplant survival or hepatocellular carcinoma recurrence rates compared with liver transplantation for hepatocellular carcinoma in HIV-uninfected patients. The study, published in ...

lung cancer

Meta-analysis Slightly Favors Platinum-based First-line Treatment in Patients with Advanced NSCLC

Several meta-analyses conducted in the past have suggested that survival of patients with advanced non–small cell lung cancer (NSCLC) is improved if first-line chemotherapy includes platinum derivatives. Results from a new meta-analysis of randomized clinical trials show that platinum-based...

lung cancer
issues in oncology

Simultaneous EGFR Mutations and HER2 Gene Amplifications in Large Series of Patients with Non–Small Cell Lung Cancer 

In a molecular profile analysis of 2,271 cases of non–small cell lung cancer (NSCLC), EGFR was mutated in 12% and KRAS in 32% of cases. HER2 gene amplification was confirmed as a rare event in NSCLC (4%). Coexistence of HER2 gene amplification and EGFR mutation was identified in three cases, while...

lymphoma

John P. Leonard, MD, Leads NCI's Alliance for Clinical Trials in Oncology Lymphoma Committee

John P. Leonard, MD, a hematology and oncology expert specializing in the treatment of lymphomas at Weill Cornell Medical College, has been named Chair of the Lymphoma Committee for the National Cancer Institute (NCI)-sponsored group, the Alliance for Clinical Trials in Oncology. Dr. Leonard is the ...

breast cancer

Double the Mastectomy, Double the Complications 

A retrospective analysis of a large surgical database has documented that bilateral mastectomy is associated with a doubling in complication rates, compared with unilateral mastectomy. Researchers reported the findings at the 14th Annual Meeting of the American Society of Breast Surgeons in...

colorectal cancer
lung cancer

Pulmonary Metastasectomy in Patients with Colorectal Cancer 

The largest-to-date and only prospective Spanish series of 549 patients who underwent surgical resection of lung metastases from colorectal carcinoma demonstrated a good postoperative recovery from the procedure. A further analysis on morbidity, the correlation between imaging studies and...

supportive care

Once-daily Moxifloxacin for Low-risk Patients with Febrile Neutropenia 

Once-daily oral moxifloxacin works at least as well as twice-daily oral ciprofloxacin plus amoxicillin–clavulanic acid when it comes to treating febrile neutropenia in patients who are at low risk for complications, according to a randomized, double-blind trial reported in the Journal of Clinical...

prostate cancer

Radium-223 Dichloride Approved for Patients with Castration-resistant Prostate Cancer

On May 15, 2013, the U.S. Food and Drug Administration approved radium Ra 223 dichloride (Xofigo) for the treatment of patients with castration-resistant prostate cancer, symptomatic bone metastases, and no known visceral metastatic disease.  Radium-223 dichloride is an alpha-particle–emitting...

lung cancer

FDA Approves Expanded Use for Erlotinib, Companion Diagnostic to Detect Genetic Mutations in NSCLC

The FDA has approved erlotinib (Tarceva) for the first-line treatment of patients with metastatic non–small cell lung cancer (NSCLC) whose tumors have epidermal growth factor receptor (EGFR) exon 19 deletions or exon 21 (L858R) substitution mutations. This indication for erlotinib was approved...

hematologic malignancies
leukemia

Potent Activity Shown for First-in-class PI3K-delta Inhibitor in Chronic Lymphocytic Leukemia 

Heavily pretreated patients with chronic lymphocytic leukemia (CLL) responded robustly to the first-in-class small-molecule inhibitor idelalisib (formerly GS1101), in a phase I dose-finding study reported in a press briefing prior to the 2013 ASCO Annual Meeting.1 Idelalisib, a specific inhibitor...

lung cancer

'Less Is More' with Regard to Adjuvant Radiation in Stage III Non–Small Cell Lung Cancer

Standard-dose conformal radiotherapy (60 Gy) is more effective and safer than high-dose radiotherapy (74 Gy) in patients with locally advanced stage III non–small cell lung cancer (NSCLC) undergoing chemotherapy, according to results of the phase III randomized, controlled Radiation Therapy...

skin cancer

Trametinib in Unresectable or Metastatic Melanoma with BRAF V600E or BRAF V600K Mutation

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 May 29, 2013, trametinib (Mekinist) was approved by...

breast cancer

Axillary Radiotherapy: New Standard of Care in Node-positive Breast Cancer? 

Radiotherapy to the axilla may replace axillary lymph node dissection for local tumor control in selected patients with sentinel node–positive breast cancer, sparing many patients lymphedema, according to the final results of the European Organisation for Research and Treatment of Cancer (EORTC)...

breast cancer

Study Confirms 10 Years of Adjuvant Tamoxifen Is Superior to 5 Years 

The landmark aTTom study showed that 10 years of adjuvant tamoxifen is superior to 5 years of tamoxifen in reducing the risk of breast cancer recurrence or death but that the full survival benefits of extended treatment do not emerge until after the 10 years of treatment. These findings, which were ...

skin cancer

MEK Inhibitor Improves Outcomes in Metastatic Uveal Melanoma 

For the first time, a drug has proven effective in the treatment of uveal (ocular) melanoma that has metastasized, according to a randomized multicenter phase II study presented at the 2013 ASCO Annual Meeting.1 “This study is the first to demonstrate an improved clinical outcome with any systemic...

thyroid cancer

Sorafenib Halts Disease Progression in Metastatic Differentiated Thyroid Cancer  

For the first time in decades, a drug has halted disease progression in treatment-resistant differentiated thyroid cancer, according to the results of a phase III study presented at the 2013 ASCO Annual Meeting.1 No new drugs have been approved for differentiated thyroid cancer in 40 years, but...

gynecologic cancers
global cancer care

Simple Rapid Vinegar Test Cuts Cervical Cancer Death Rates by One-third in Rural India 

In the era of personalized medicine for cancer care, it was both surprising and encouraging to hear about a simple low-tech intervention delivered by women in the community that cut the rate of death from cervical cancer in India by about one-third. The intervention, a simple visual inspection...

gynecologic cancers

Practice-changing Study Shows Survival Benefit for Antiangiogenesis in Advanced Cervical Cancer 

The addition of bevacizumab (Avastin) to chemotherapy prolongs overall survival in women with metastatic cervical cancer compared with chemotherapy alone, according to the results of a randomized phase III study presented at the Plenary Session of the ASCO Annual Meeting.1 Women on the...

lymphoma

It’s Déjà Vu All Over Again

Yogi Berra offered the comment “It’s déjà vu all over again” when he witnessed Mickey Mantle and Roger Maris repeatedly hitting back-to-back home runs in the early 1960s. His pithy remark neatly summarizes my reaction when I read the article, “Dose-Adjusted EPOCH-Rituximab Therapy in Primary...

skin cancer

GM-CSF Boosts Survival Benefit of Ipilimumab in Metastatic Melanoma 

For metastatic melanoma, the activity of ipilimumab can be boosted by the addition of granulocyte-macrophage colony-stimulating factor (GM-CSF, Leukine), according to a phase II study that found the combination improved overall survival, vs ipilimumab alone. The results were presented at the 2013...

kidney cancer

Results of AXIS Trial Indicate a Significant Improvement over Historical Survival Data in Renal Cell Carcinoma 

The phase III open-label AXIS trial comparing axitinib (Inlyta) vs sorafenib (Nexavar) as second-line treatment for metastatic renal cell carcinoma has shown a significant difference in median progression-free survival (8.3 months in the axitinib group vs 5.7 months in the sorafenib group; hazard...

supportive care

Venous Thromboembolism in Patients with Cancer: Real-world Challenges for the Practicing Oncologist 

The close association between cancer and thrombosis has been recognized now for more than 150 years.1 Not only is it now known that patients with cancer are at substantially increased risk of developing venous thromboembolism, even prior to the diagnosis of cancer, but the association between...

colorectal cancer

Best First-line Treatment for Advanced Colorectal Cancer Remains Unclear 

In patients with advanced colorectal cancer, it remains unclear which biologic agent added to standard chemotherapy is best, even after a head-to-head comparison of two commonly used agents. In the phase III FIRE-3 trial, conducted by the German AIO CRC Study Group, the addition of cetuximab...

prostate cancer

Two New Genetic Tests Offer Progress in Personalized Medicine for Newly Diagnosed Prostate Cancer 

At least 12 different genetic tests for prostate cancer are under development. The two tests currently available are Oncotype DX (Genomic Health, Redwood City, California) and Prolaris (Myriad Genetic Laboratories, Salt Lake City). Both tests can identify which low-risk patients are “truly” at low...

leukemia

Idelalisib, Obinutuzumab Show Encouraging Results in CLL Studies 

A trio of presentations at the ASCO Annual Meeting focused on two promising investigational drugs for the treatment of chronic lymphocytic leukemia (CLL). These two drugs—idelalisib and obinutuzumab—join a list of new approaches showing potential. Idelalisib Alone A phase I dose-ranging study of...

lung cancer

First Positive Trial of Heat Shock Protein 90 Inhibitor in Lung Cancer That Has Progressed after First-line Therapy 

The investigational heat shock protein (Hsp)90 inhibitor ganetespib plus docetaxel extended overall survival compared with docetaxel alone as second-line therapy in patients with advanced non–small cell adenocarcinoma of the lung that had progressed on first-line therapy in the randomized phase II...

cns cancers

Bevacizumab in Glioblastoma: Another Perspective 

Given the results of the AVAglio trial, we feel that a more balanced discussion about the role of bevacizumab (Avastin) in patients with newly diagnosed glioblastoma is in order. The accompanying article in The ASCO Post suggests that bevacizumab has no benefit in newly diagnosed glioblastoma; data ...

cns cancers

Studies Explore Role of Bevacizumab in Combination Therapies for Glioblastoma

At the 2013 ASCO Annual Meeting, studies evaluating the addition of bevacizumab (Avastin) to standard therapy in newly diagnosed glioblastoma multiforme patients did not meet their primary endpoints. When paired with irinotecan, however, bevacizumab showed activity in MGMT-unmethylated tumors....

lung cancer

FDA Approves Afatinib for Late-stage Lung Cancer

On July 12, 2013, the FDA approved the tyrosine kinase inhibitor afatinib (Gilotrif) for the first-line treatment of patients with metastatic non–small cell lung cancer (NSCLC) whose tumors express epidermal growth factor receptor (EGFR) exon 19 deletions or exon 21 (L858R) substitution mutations...

breast cancer
leukemia

FDA Grants Priority Review to Obinutuzumab in CLL and Pertuzumab in Neoadjuvant Therapy for HER2-positive Early-stage Breast Cancer

Two drugs were recently given Priority Review designation by FDA. Obinutuzumab (GA101) was granted Priority Review for the treatment of chronic lymphocytic leukemia, based on final stage 1 data from the pivotal CLL11 trial. The FDA confirmed the action date is December 20, 2013. FDA also granted...

breast cancer
skin cancer
multiple myeloma
supportive care
gastroesophageal cancer

New Research Presented in Breast, Gastric, Esophageal Cancers, Melanoma, and Multiple Myeloma, plus Supportive Care 

Attendees at the ASCO Annual Meeting are faced with a major challenge of trying to attend as many important sessions as they can over a 4-day period. Our challenge is to feature the major news in The ASCO Post. In addition to our regular comprehensive coverage of key presentations, the following...

breast cancer

ASCO Releases Updated Guideline on Interventions for Women at Increased Risk for Breast Cancer

The American Society of Clinical Oncology (ASCO) recently issued a newly updated clinical practice guideline on pharmacologic prevention interventions for premenopausal and postmenopausal women who are at increased risk for breast cancer. Compared to the previous version of the guideline, this...

hematologic malignancies
leukemia
lymphoma

New Research on Combination Chemotherapy, Prognostic Biomarkers, and PET-guided Radiation Therapy in B-cell Malignancies 

The 12th International Conference on Malignant Lymphoma was held June 19-22, 2013, in Lugano, Switzerland. Over 3,000 hematologists, clinical oncologists, pathologists, and leading researchers attended the meeting, which featured new research on B-cell malignancies, follicular lymphoma, as well as...

breast cancer

Head-to-Head Matchup Shows Adjuvant Taxane Schedules Equally Effective  

In the treatment of early breast cancer, outcomes are equivalent whether paclitaxel is delivered weekly or every 2 weeks, though the weekly schedule may be better tolerated, according to the results of a phase III trial presented at the 2013 ASCO Annual Meeting.1 “The progression-free survival...

solid tumors

Dose-dense Chemotherapy Improves Outcomes in Poor-prognosis Germ Cell Tumors 

For poor-prognosis patients with germ-cell tumors, dose intensification of chemotherapy based on slow decline of tumor markers can increase progression-free survival, according to the first randomized trial of a “personalized” treatment strategy for this tumor.1 At the 2013 ASCO Annual Meeting,...

prostate cancer

Enzalutamide Monotherapy Highly Active in Patients with Prostate Cancer Who Have Had No Prior Hormone Therapy 

Enzalutamide (Xtandi) monotherapy induced striking declines in prostate-specific antigen (PSA) in a majority of patients with hormone-naive prostate cancer in a phase II trial, and this oral agent appears to have little effect on bone mineral density. If these findings are confirmed in a phase III...

lymphoma

Why Is Stem Cell Transplant So Underused in Follicular Lymphoma?

Follicular lymphoma is the second most common subtype of non-Hodgkin lymphoma (NHL) in the United States. Of the nearly 70,000 new cases of NHL anticipated in 2013,1 approximately 7,000 to 13,000 (10%–19%) will be follicular lymphoma, by recent estimates.2-5 For many years, the median overall...

pancreatic cancer

Some Successes, Some Failures Reported in Research and Treatment of Pancreatic Cancer 

The challenge of treating pancreatic cancer inched forward with studies reported at the 2013 ASCO Annual Meeting, though some important studies proved disappointing. Nab-paclitaxel Improves Overall Survival In treatment-naive metastatic patients, the addition of nanoparticle albumin-bound...

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