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breast cancer
symptom management

Estrogen for Vulvovaginal Atrophy in Breast Cancer: Debate Continues

Vulvovaginal atrophy is a concern for the majority of patients with breast cancer, not only because of its physical and psychosexual consequences, but because the optimal treatment—estrogen replacement—is controversial. Patients and physicians alike remain concerned that external estradiol may...

prostate cancer

Sipuleucel-T Should Be Used Early in Metastatic Castrate-resistant Prostate Cancer, before Chemotherapy

When sipuleucel-T (Provenge) was approved by FDA in April 2010, it was the first vaccine to be approved as a treatment for prostate cancer and was hailed as a major advance. Although sipuleucel-T is now reimbursable by Medicare, some physicians are not clear about when to use it, and patients who...

prostate cancer

Data on Watchful Waiting for Low-risk Prostate Cancer May Swing Focus to Higher-risk Tumors and Quality of Life

Surgery did not increase survival rates compared to watchful waiting in men with clinically localized prostate cancer. Results were particularly strong for men with prostate-specific antigen (PSA) levels of 10 ng/dL and under, and those who have low-risk disease, according to data from the Prostate ...

hematologic malignancies

JAK2 and MPL Mutation Screening: What Are the Indications and How to Interpret the Results

The World Health Organization system organizes myeloid malignancies into five major categories, which are subsequently further subclassified using a combination of bone marrow morphology and cytogenetic/molecular information (Table 1).1 JAK2 and MPL mutations are not disease-specific and occur...

lung cancer

Epigenetic Therapy Shows Positive Results in Late-stage Lung Cancer

A small phase I/II clinical study from Johns Hopkins University in Baltimore found that epigenetic therapy with a combination of azacitidine (Vidaza) and entinostat (an investigational agent) produced responses in some patients with refractory advanced non–small cell lung cancer. The study results, ...

leukemia

Is Gemtuzumab a Therapeutic Option in Older Patients with Acute Myeloid Leukemia?

Previous studies of gemtuzumab ozogamicin (Mylotarg) had variable results in acute myeloid leukemia (AML). Before trials reported at the 2011 ASH Annual Meeting, two major studies had compared chemotherapy with or without gemtuzumab in patients with AML, said Martin Tallman, MD, Chief of the...

symptom management

Glucarpidase Approved to Treat Methotrexate Toxicity

The FDA has approved intravenous glucarpidase (Voraxaze) to treat patients with toxic levels of methotrexate in their blood due to kidney failure. Glucarpidase is an enzyme that rapidly reduces methotrexate levels by breaking down the chemotherapy drug to a form that can be eliminated from the...

multiple myeloma

Expert Point of View: Next-generation Proteasome Inhibitors Will Improve Outcomes in Bortezomib-refractory Myeloma Patients

Myeloma experts agree that the new proteosome inhibitors are particularly welcome because they are at least as effective as bortezomib (Velcade) but produce much less neuropathy. Dramatic Results “The activity of MLN 9708 is very encouraging,” said Paul G. Richardson, MD, of Dana-Farber Cancer...

leukemia

Three Novel Agents Show Promise in Acute Lymphoblastic Leukemia

Susan O’Brien, MD, Professor in the Department of Leukemia at The University of Texas MD Anderson Cancer Center, Houston, has a special interest in novel developments in the treatment of acute lymphoblastic leukemia (ALL). At the 2011 ASH Annual Meeting, she discussed her picks of top newsmakers in ...

breast cancer

Facing the Future without Fear of Breast Cancer Recurrence

A year ago, I was living my dream. Married to a wonderful man, Danny, and with two young children to raise, Karl, 7, and Marcus, 4, I had given up a career in accounting to be a stay-at-home mom. At age 34, I was enjoying life, helping my children with their homework and going to their soccer and...

multiple myeloma

Carfilzomib May Offer Advantages in Patients with Relapsed/Refractory Multiple Myeloma

Carfilzomib is an oral second-generation proteasome inhibitor with a mechanism of action that may increase efficacy and reduce adverse effects currently associated with proteasome inhibitor therapy. It is being investigated for use in multiple myeloma and select solid tumors, and the FDA has...

Expert Point of View: Peripheral Blood or Bone Marrow as Unrelated Donor Stem Cell Source

This large randomized, controlled trial took a lot of time and extensive resources, and yet survival was the same between the two types of unrelated donor transplant sources, noted Stephanie J. Lee, MD, Professor of Medicine at Washington University and the Fred Hutchinson Cancer Center in Seattle. ...

issues in oncology

Which Is Better: Peripheral Blood or Bone Marrow as Unrelated Donor Stem Cell Source?

Over the past decade, the use of peripheral blood stem cells has increased, and now about 75% of unrelated living donor transplants are performed using peripheral blood stem cells without supportive data in the unrelated donor setting. This trend is called into question by results of a large phase...

gastrointestinal cancer

What Were the Take-home Messages from the 2012 Gastrointestinal Cancers Symposium?

Richard M. Goldberg, MD, of The Ohio State University Medical Center, chaired the steering committee of the 2012 Gastrointestinal Cancers Symposium in San Francisco, which attracted approximately 4,000 registrants who viewed data from some 700 scientific abstracts. The ASCO Post asked Dr. Goldberg...

hematologic malignancies

How I Work up the Patient with Thrombocytosis

Thrombocytosis is defined as a platelet count greater than 400 × 109/L. In routine clinical practice, thrombocytosis is much more likely to be reactive (> 80% of cases) than primary. Reactive thrombocytosis is usually associated with infections, inflammation, trauma, hemolysis, metastatic...

leukemia

Autologous Transplant vs Consolidation Chemotherapy in Acute Myeloid Leukemia: A Recent European Trial

Investigators in the Dutch-Belgian Hemato-Oncology Cooperative Group and the Swiss Group for Clinical Cancer Research Collaborative Group recently reported in the journal Blood that autologous peripheral blood stem cell transplantation significantly reduced relapse rate compared with intensive...

leukemia

Autologous Hematopoietic Cell Transplantation for Adult Acute Myeloid Leukemia: A Question That Doesn’t Go Away

More than 3 decades ago, the first trials of autologous hematopoietic cell transplantation as consolidation therapy for acute myeloid leukemia (AML) in first remission were conducted. The initial results were inconclusive; most patients survived the procedure, but post-transplant relapse was common ...

gastrointestinal cancer

New Assays, Surveillance Techniques Reported for GI Malignancies

Two studies highlighted in press conferences and one presented during an invited lecture at the 2012 Gastrointestinal Cancers Symposium, held recently in San Francisco, suggest that early detection of pancreatic, esophageal, and colorectal cancers could soon improve. Enzyme Immunoassay Spots...

prostate cancer
bladder cancer
kidney cancer

Important News Briefs: New Data Reported in Prostate, Bladder, and Kidney Cancers

The recent 2012 Genitourinary Cancers Symposium featured a wealth of presentations on prostate, bladder, kidney, and other genitourinary cancers. Brief summaries of some of the oral and poster sessions are presented. Exercise and Recurrence Vigorous exercise has been shown to reduce cancer...

pancreatic cancer

Radiation Therapy Lowers Risk of Cancer Recurrence in Patients Undergoing Pancreatic Surgery

Radiation therapy was associated with a lower risk of cancer recurrence in pancreatic cancer surgery patients, making it, like chemotherapy, an important addition to treatment, Mayo Clinic research found. Whether radiotherapy helps patients after pancreatic cancer surgery has been a long-standing...

prostate cancer

GU Symposium 2016: New Blood Test Technology Shows Promise for Guiding Prostate Cancer Treatment Decisions

An early study suggests that an experimental blood test may help guide individualized decisions on the most appropriate treatments for patients with prostate cancer. The new noninvasive “liquid biopsy” scans the entire landscape of different kinds of cancer cells in blood and analyzes...

kidney cancer
kidney cancer

GU Symposium 2016: Cabozantinib Improves Upon the Standard of Care for Advanced Kidney Cancer

New analyses from a phase III clinical trial of patients with previously treated advanced kidney cancer demonstrated that patients of all risk levels experience more benefit from cabozantinib (Cometriq) than from the current standard of care, everolimus (Afinitor). The greater activity of...

colorectal cancer

Cancer Does Not Have to Be a Death Sentence

When I found a large amount of blood on my toilet tissue just before Thanksgiving in 2010, I wasn’t too concerned. At just 45 years old, I was in excellent health, and other than the bloody stool I had no other symptoms signaling that something was seriously wrong. My primary care physician thought ...

leukemia

Liposomal Vincristine Receives Positive Vote from ODAC

Talon Therapeutics, Inc, announced the Oncologic Drugs Advisory Committee voted 7 yes, 4 no, and 2 abstain that evidence from clinical studies supports a favorable benefit-risk assessment for use of vincristine sulfate liposomes injection (Marqibo). The manufacturer is seeking an indication for the ...

lymphoma

New Data Guide Treatment for Rare Form of Hodgkin Lymphoma

Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) accounts for approximately 5% of Hodgkin lymphoma cases. It is distinguished from classic Hodgkin lymphoma by a variety of clinical and pathologic features, including expression of B-cell associated antigens such as CD20. Given that the...

leukemia

Erwinia chrysanthemi Asparaginase for Acute Lymphoblastic Leukemia in Patients with Hypersensitivity to E coli–derived Asparaginase

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 Erwinia chrysanthemi asparaginase (Erwinaze) was...

supportive care

Update on Novel Anticoagulants: Dabigatran Etexilate

Efficacy and safety of traditional anticoagulants (eg, vitamin K antagonists) are well recognized, given their long-standing use in clinical practice. However, the novel anticoagulants have several potential advantages over the vitamin K antagonists. Even so, in light of their recent introduction...

leukemia

Treating Acute Promyelocytic Leukemia without Chemotherapy

Throughout the course of medical history, we have witnessed innovations that have initially been met with skepticism but have later revolutionized our management of patients with specific disorders. The recent history of oncology drug development is full of instances where a drug that was...

AACR Inducts Frank McCormick, PhD, FRS, DSc (hon) as President; Elects Charles L. Sawyers, MD, as President-elect, 2012-2013

Leadership of the American Association for Cancer Research (AACR) inducted Frank McCormick, PhD, FRS, DSc (hon), as President of the society during the AACR Annual Meeting held earlier this month Dr. McCormick is the Director of the University of California, San Francisco (UCSF) Helen Diller Family ...

issues in oncology

Cancer Informatics: A Future Necessity, but Challenges Abound

The National Cancer Policy Forum of the Institute of Medicine (IOM) recently convened a workshop on cancer informatics to examine and discuss needs and challenges facing biomedical researchers, which will in turn affect the way oncology is practiced in the future. “This is a time of huge scientific ...

prostate cancer

SELECT Trial Update: Vitamin E Fails to Prevent Prostate Cancer in Healthy Men, Appears to Increase Risk

Supplements touted as preventing prostate cancer may turn out to be dangerous, as is evident from updated results of the largest long-term prevention trial, called the Selenium and Vitamin E Cancer Prevention Trial (SELECT). Final analysis of SELECT showed that, compared to placebo, vitamin E alone ...

Expert Point of View: Controlled Study Links ‘Chemobrain’ to Longitudinal Changes in Brain

Commenting on the study by Deprez et al, Patricia Ganz, MD, noted the importance of the finding for clinicians. “This study tells us that self-reported complaints mapped onto the neuropsychologic tasks; this has not been shown very often,” said Dr. Ganz, who is Director of the Division of Cancer...

colorectal cancer

Quality of Life Is What’s Most Important to Me

For me, getting a cancer diagnosis has been more annoying than frightening. Mainly, I’m annoyed at myself for not taking care of an anal skin tag sooner. (I’d had it since birth.) The growth hadn’t been a problem until I got pregnant with my first child and it became temporarily engorged with...

issues in oncology

Changing the Course of Human Health through Bold Pursuits in Science

The synergy between industry, academic research, and regulatory bodies will play an increasingly important role in ensuring the future of a robust cancer drug pipeline. To gain insight on oncologic development trends, The ASCO Post recently spoke with Jean Pierre Bizzari, MD, Head of Global...

breast cancer

PEDF Has Cytotoxic Effect on Breast Cancer Cells and Neuron-protective Effect

The cytokine pigment epithelium–derived factor (PEDF) is downregulated in brain metastases of breast cancer by approximately 14-fold compared with primary breast tumors, suggesting that promoting its expression might inhibit metastatic spread. Normal breast epithelial cells express high levels of...

Constructing a Top Five List in Oncology

The American Society of Clinical Oncology has joined the American Board of Internal Medicine (ABIM) Foundation and eight other medical specialty societies to take a collective stand in improving patient care and addressing rising health-care costs. As part of the ABIM Foundation’s Choosing Wisely®...

multiple myeloma

Novel Agents and Genomic Sequencing Show Promise in Improving Multiple Myeloma Management

For over 30 years, Kenneth C. Anderson, MD, Kraft Family Professor of Medicine at Harvard Medical School and Director of the Jerome Lipper Multiple Myeloma Center and LeBow Institute for Myeloma Therapeutics at Dana-Farber Cancer Institute in Boston, has focused his translational research on B-cell ...

breast cancer
kidney cancer
lung cancer
skin cancer
leukemia
lymphoma
issues in oncology

NCCN Clinical Practice Guidelines: Important Updates for 2012

The National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology have become the most widely used guidelines in oncology practice. The Guidelines cover 97% of all patients with cancer and are continually updated by expert panels. The 2012 Guidelines include some completely...

bladder cancer

Chemoradiation with Fluorouracil and Mitomycin Reduces Recurrence of Muscle-invasive Bladder Cancer

Radiotherapy is an alternative to surgery in muscle-invasive bladder cancer, particularly in less-fit patients. However, it is associated with high rates of incomplete response or recurrence, with salvage surgery often being required. Although synchronous chemoradiotherapy has improved local...

supportive care

New Research Shows Promise in Cachexia, a Persistent Clinical Challenge

In the late 1980s, researchers led by Alfred L. Goldberg, PhD, first isolated the large protein complexes now called 26S proteasomes, which are the sites where most cellular proteins are degraded back to amino acids. Protein degradation by the proteasome pathway is critical in regulating many...

leukemia

Study Shows Steady Increases in Survival for Children with ALL

A study by the Children’s Oncology Group (COG) reported that 5-year survival for acute lymphoblastic leukemia (ALL) among children treated through COG clinical trials increased from 83.7% during the period 1990-1994 to 90.4% in the period 2000-2005. The improvements in survival were observed among...

leukemia

Progress in Treating Chronic Lymphocytic Leukemia Has Led to Across-the-board Improvements in Survival

Four decades ago, Kanti R. Rai, MD, was determined to figure out why some of his patients with chronic lymphocytic leukemia (CLL) died within 2 years after their diagnosis, while others lived for 20 or even 30 years. At the time, Dr. Rai was a young scientist doing research in leukemia at...

prostate cancer

Expert Point of View: Study Shows Continued Benefit of PSA Screening in Reducing Prostate Cancer Mortality

Many of the almost 100 reports in various journals and newspapers refer to the lack of effect on overall mortality with screening in ERSPC in a very critical fashion. Clarification is necessary. Our trial did not intend to and is not powered to study the effect of screening on overall mortality....

Immunotherapy Clinical Trials Show Benefits for Patients with Advanced Cancers

Immunotherapeutic approaches, including vaccines, a monoclonal antibody, and a combination of low-dose interleukin (IL)-2 (Proleukin) and retinoic acid, are showing some success in clinical trials investigating the prevention of breast cancer recurrence in women at high risk, the treatment of...

supportive care
symptom management

Managing Febrile Neutropenia: What Are the Best Antibiotic Regimens?

Management of patients with cancer who have fever and a low neutrophil count is one of the most common scenarios oncologists face today. “Physicians have to be keenly aware of the infection risks, diagnostic methods, and microbial therapies required for managing febrile neutropenic patients because ...

sarcoma

FDA Approves Pazopanib for Advanced Soft-tissue Sarcoma

The FDA has approved pazopanib (Votrient) to treat patients with advanced soft-tissue sarcoma who have previously received chemotherapy. Pazopanib is an oral agent that works by interfering with angiogenesis. Soft-tissue sarcoma occurs in about 10,000 cases annually in the United States. More than ...

leukemia

Pediatric ALL with Induction Failure Is Highly Heterogeneous with Varying Outcomes

While failure of remission-induction therapy is rare in children and adolescents with acute lymphoblastic leukemia (ALL), when it does occur it is highly adverse and heterogeneous, according to a study in The New England Journal of Medicine. “Patients who have T-cell leukemia appear to have a...

palliative care

The Semantics of Palliative Care

The interview with Thomas J. Smith, MD (The ASCO Post, April 15, 2012), the lead author of the ASCO Palliative Care Provisional Clinical Opinion, was timely. However, it left many clinical terms and issues unclear. A significant percentage of modern medicine, including cancer care, is palliative....

pain management

Screening for Distress and Unmet Needs in Patients with Cancer

In the past decade, “screening for distress has been positioned as the sixth vital sign in cancer care, in addition to the first five, which are measurements of pulse, respiration, blood pressure, temperature, and pain,” according to a review article in the Journal of Clinical Oncology. Although...

Choosing Wisely® Campaign

ASCO recently published a detailed review of the “Top Five” opportunities to improve the quality and value of cancer care by curbing use of common tests and treatments that are not supported by clinical evidence. Published in the Journal of Clinical Oncology,1 the article coincided with the...

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