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SIDEBAR: Photodynamic Therapy for Cancer

Photodynamic therapy is a two-step treatment that includes a photosensitizing agent and a light source. In the first step, the photosensitizing agent (porfimer sodium) is injected into the bloodstream and absorbed by all cells. Over 24 to 48 hours, the drug is concentrated in cancer cells. In the...

hematologic malignancies
multiple myeloma

Multiple Myeloma Research Foundation Initiatives Are Leading to More Effective Targeted Treatment

In 1996, at just 37, the last thing Kathy Giusti expected to hear was that she had the fatal blood cancer multiple myeloma. An executive at Searle Pharmaceuticals and the mother of an 18-month-old daughter, Giusti was told she probably had 3 years to live. At the time, treatments for the disease...

survivorship

Risk Stratification and Targeted Therapy, Abetted by Collaboration, Improve Outcomes for Children with Cancer

Outcomes for children with cancer have “improved over the course of the years incrementally, mostly not from the development of new drugs, because virtually all the drugs that we use now in leukemia were available in the 1970s. It is really through better understanding of the heterogeneity of the...

On the Early Days of Breast-conserving Therapy and the Unique Relationship between Oncologists and Their Patients

Jay R. Harris, MD, Chair of the Department of Radiation Oncology at the Dana-Farber Cancer Institute and the Brigham and Women’s Hospital, Boston, helped pioneer the use of breast-conserving therapy in women with early-stage breast cancer. When asked why he chose to pursue a career in radiation...

From Small-town House Calls to Bone Marrow Transplants, Nobel Laureate Continues Father’s Legacy

“I echo the sentiments of many previous Nobel laureates when I say that the success we celebrate today was made possible by the work of many others in this and in related fields.” So ended the Nobel Lecture by E. Donnall Thomas, MD, the famed investigator and 1990 Nobel Laureate in Physiology or...

Everolimus: New Indication in Renal Angiomyolipoma Associated with Tuberous Sclerosis Complex

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 In April 2012, the kinase inhibitor everolimus...

SIDEBAR: Expect Questions from Your Patients

“We have already received several calls and requests from patients who desire to participate in our research or get the test done,” Anthony Lucci, MD, said about the response to a study published in The Lancet Oncology and media coverage of the findings. Dr. Lucci is lead author of the study, which ...

breast cancer

Too Soon to Know How Circulating Tumor Cells Might Be Used to Guide Treatment of Breast Cancer

In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. “A simple blood test.” These were...

sarcoma

Pazopanib: New Drug for Advanced Soft-tissue Sarcoma

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 In April 2012, pazopanib (Votrient) was approved for the ...

thyroid cancer

Cabozantinib Prolongs Progression-free Survival in Advanced Medullary Thyroid Cancer

Cabozantinib prolonged progression-free survival in patients with unresectable, locally advanced, or metastatic medullary thyroid cancer with documented disease progression in the phase III EXAM trial. Based on these results, Exelixis submitted a New Drug Application to the FDA in May 2012. The...

solid tumors

Two Single Nucleotide Polymorphisms Associated with Risk for Paclitaxel-related Peripheral Neuropathy

Peripheral neuropathy is the most common severe toxicity in patients receiving paclitaxel, and mutations in genes affecting drug metabolism, distribution, and elimination are likely to modulate risk for such neurotoxicity. In a recent study, Daniel Hertz, PharmD, and colleagues from the University...

prostate cancer

Blood Test to Improve Prostate Cancer Detection

Beckman Coulter, Inc, recently announced Premarket Approval from the FDA for the Prostate Health Index, a simple, noninvasive blood test that is 2.5 times more specific in detecting prostate cancer than prostate-specific antigen (PSA) in patients with PSA values in the 4 to 10 ng/mL range and has...

leukemia

Prognostic Value of Integrated Cytogenetic and Mutational Risk Classification in Acute Myeloid Leukemia

Jay P. Patel, BS, and colleagues from Memorial Sloan-Kettering Cancer Center in New York recently performed mutational analysis of 18 genes in a subgroup of newly diagnosed acute myeloid leukemia (AML) patients who had been randomized to receive cytarabine plus high-dose or standard-dose...

integrative oncology

Astragalus

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...

issues in oncology
supportive care

New Assessment Tools in Development to Guide Care for Older Patients

More than 1,400 people from 62 countries attended the 2012 Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) International Symposium on Supportive Care in Cancer, held in New York last June. One of the featured sessions, which was jointly...

supportive care

Supportive Care Experts Explore 30 Years of Progress in the Field

Thirty years ago, when the first supportive care meeting as a forerunner of the Multinational Association of Supportive Care in Cancer (MASCC) Symposium was held in New York, supportive care was largely ignored, with little discussion at major cancer meetings, which focused primarily on...

multiple myeloma

FDA Grants Accelerated Approval to Carfilzomib for Multiple Myeloma

Onyx Pharmaceuticals announced that the FDA has granted accelerated approval to carfilzomib (Kyprolis) for the treatment of patients with multiple myeloma who have received at least two prior therapies, including treatment with bortezomib (Velcade) and an immunomodulatory therapy, and have...

supportive care
palliative care

Supportive Care Research Runs the Gamut from Genetic Markers of Treatment Side Effects to Neuropathic Pain Therapies

Attendees from around the world gathered for the Multinational Association for Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) International Symposium on Supportive Care in Cancer, held June 28–30 in New York. Below are highlights from the meeting, representing...

Expert Point of View: Constantine S. Tam, MBBS, MD

The findings in chronic lymphocytic leukemia (CLL) were discussed by Constantine S. Tam, MBBS, MD, of St. Vincent’s Hospital in Melbourne, Australia, who observed, “There is a long list of novel agents in CLL. I think some of the most promising are those targeting the B-cell receptor pathway. This...

leukemia

Novel Agents Should Have Impact in Lymphocytic Leukemias

Agents with novel mechanisms of action may strongly impact outcomes in chronic lymphocytic leukemia (CLL) and acute lymphocytic leukemia (ALL), if data from early-phase studies presented at this year’s ASCO Annual Meeting are any indication. There is a clear unmet need for more effective therapies...

hematologic malignancies

Biokine Therapeutics Awarded FDA Orphan Drug Designation for Mobilization of Stem Cells in Patients with Cancer

Biokine Therapeutics Ltd announced that it has received Orphan Drug designation from the FDA for BKT140, a highly selective chemokine receptor antagonist that induces mobilization of hematopoietic stem cells from bone marrow into peripheral blood for collection and subsequent transplantation in...

colorectal cancer

FDA Approves Ziv-aflibercept for Metastatic Colorectal Cancer

The FDA has approved ziv-aflibercept (Zaltrap) for use in combination with a FOLFIRI (leucovorin, fluorouracil, irinotecan) chemotherapy regimen to treat adults with colorectal cancer. Ziv-aflibercept is an angiogenesis inhibitor that inhibits the blood supply to tumors. It is intended for patients ...

global cancer care

Despite Challenges, Initiatives Bring Gradual Improvements to Cancer Care in Lebanon

Nagi S. El Saghir, MD, FACP, Professor of Clinical Medicine and Hematology-Oncology at the American University of Beirut, is the founding President of the Lebanese Society of Medical Oncology (LSMO). Dr. El Saghir has focused much of his research on the early detection, prevention, and treatment of ...

multiple myeloma

Carfilzomib: New Drug with Accelerated Approval for 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. Indication In July 2012, carfilzomib (Kyprolis) was granted...

leukemia

Liposomal Vincristine Approved in Acute Lymphoblastic Leukemia

The FDA has approved vincristine sulfate liposome injection (Marqibo) to treat adults with Philadelphia chromosome–negative acute lymphoblastic leukemia (ALL). Administered once a week, liposomal vincristine is approved for patients whose leukemia has relapsed two or more times, or whose leukemia...

The Problem of Monitoring Remission

How wonderful it is that we now have to concern ourselves with survivorship issues! The ever-increasing success of cancer therapy means that more and more patients can look to a life beyond cancer diagnosis and treatment. But living with cancer creates its own problems. While treatment often may be ...

prostate cancer

Letter to the Editor: More Thoughts on PSA

An article that appeared in the August 15 issue of The ASCO Post (“Rethinking the Role of PSA Screening in Public Health”) contains false statements about the discovery of prostate-specific antigen (PSA) and its effectiveness as a test for early detection of prostate cancer. Contrary to what’s...

Researchers Awarded NCI Grants to Address ‘Provocative Questions’

Two scientists are among the first recipients of grants geared to answer “Provocative Questions” in cancer research, a new project funded by the National Cancer Institute (NCI), part of the National Institutes of Health (NIH).  Cynthia Sears, MD, and Peter Searson, PhD, both of Johns Hopkins, will...

Ziv-aflibercept with FOLFIRI in Metastatic Colorectal Cancer

In August 2012, the antiangiogenic agent ziv-aflibercept (Zaltrap) was approved for use in combination with FOLFIRI (fluorouracil, leucovorin, irinotecan) for the treatment of metastatic colorectal cancer resistant to or progressing after an oxaliplatin-containing regimen.1,2 Approval was based on...

Metastasis Promoted by Cleaving and Inhibiting Proapoptotic Effect of von Willebrand Factor

Mochizuki and colleagues from Keio University in Tokyo, the Chemo-Sero-Therapeutic Research Institute in Kumamoto, and RIKEN in Saitama have shown that von Willebrand factor has proapoptotic effects and that a disintegrin and metalloproteinase 28 (ADAM28) promotes metastasis by cleaving and...

breast cancer

Physical Activity Benefits Breast Cancer Survivors, but Role in Reducing Breast Cancer Risk Is Less Clear

Breast cancer survivors who engage in moderate to high levels of physical activity have reduced mortality and improved quality of life, according to recent studies. In addition, exercise may play a role in lowering the risk of breast cancer. “Physical activity can hasten recovery from the immediate ...

breast cancer
supportive care

Sexual Dysfunction in Female Cancer Survivors Is Prevalent

Although medical experts put the proportion of female survivors facing some form of sexual dysfunction following a cancer diagnosis and treatment at nearly 100%, very few women raise sexual health concerns with their oncologist. In a study of 261 patients with gynecologic or breast cancer published ...

leukemia

FDA Approves New Orphan Drug for Chronic Myelogenous Leukemia

The FDA has approved bosutinib (Bosulif) to treat chronic myelogenous leukemia (CML). The drug is intended for patients with chronic, accelerated, or blast phase Philadelphia chromosome–positive CML who are resistant to or who cannot tolerate other therapies, including imatinib (Gleevec). The...

Expert Point of View: Dan L. Longo, MD

The term “abscopal” is from Greek roots that mean “away from the target.” Coined by R.H. Mole in 1953, it was used to label observed effects of radiation at a distance from the volume irradiated. Mounting evidence suggests an immunologic basis for the effect, but it should also be remembered that...

lymphoma

Management of a Patient  with Systemic Anaplastic Large Cell Lymphoma following Failure of One or More Combination Regimens

Case Summary presented by Steven M. Horwitz, MD, Assistant Attending, Lymphoma Service, Memorial Sloan-Kettering Cancer Center, New York. This is a case of a 49-year-old woman who developed an enlarged right axillary lymph node. The woman had noticed some discomfort under her right arm, which she...

lymphoma

Management of a Patient with Relapsed and Refractory Hodgkin Lymphoma

Case Summary presented by Andreas Engert, MD, Chairman, German Hodgkin Study Group, University Hospital of Cologne, Cologne, Germany This is a case report of a 23-year-old female patient who was diagnosed with Hodgkin lymphoma in January 2009. She received two cycles of ABVD (doxorubicin,...

lymphoma

Management of a Patient with Hodgkin Lymphoma following Failure of Autologous Stem Cell Transplant

Case Summaries presented by Joseph M. Connors, MD, Clinical Director, Centre for Lymphoid Cancer, British Columbia Cancer Agency, University of British Columbia, Vancouver, British Columbia, Canada When considering the management of a patient whose Hodgkin lymphoma has relapsed despite high dose...

multiple myeloma

Will Carfilzomib Add Value to Multiple Myeloma Treatment?

Carfilzomib (Kyprolis), the next-generation proteasome inhibitor recently approved by the FDA for relapsed/refractory multiple myeloma, showed strong activity in the front-line setting when paired with lenalidomide (Revlimid) and low-dose dexamethasone (CRd).1 The study evaluated stringent complete ...

Einstein-Montefiore Scientists Awarded NCI Grants to Study ‘Provocative Questions’ in Cancer Research

Two research teams at Albert Einstein College of Medicine of Yeshiva University and Montefiore Medical Center, the University Hospital for Einstein, have each been awarded grants from the National Cancer Institute (NCI) as part of their “Provocative Questions” program. The innovative effort is...

prostate cancer
issues in oncology

FDA Approves Production of Imaging Agent to Detect Prostate Cancer

The FDA approved the production and use of Choline C 11 Injection, a positron-emission tomography (PET) imaging agent used to help detect recurrent prostate cancer. Choline C 11 Injection is administered intravenously to produce an image that helps to locate specific body sites for follow-up tissue ...

leukemia

Kinase Inhibitors Compared in First-line Treatment of CML

Bosutinib (Bosulif) is an oral dual Src/Abl kinase inhibitor that is active against many Bcr-Abl mutations associated with imatinib (Gleevec) resistance and that has reduced activity against nonspecific molecular targets associated with toxicities reported for other second-generation kinase...

Pediatric Pathologist Sidney Farber, MD: The ‘Father of Modern Chemotherapy’ and Cofounder of the Jimmy Fund

In June 3, 1948, The New England Journal of Medicine published a study by Sidney Farber, MD, showing that a synthetic compound, 4-aminopteroylglutamic acid (aminopterin), could induce remissions in seriously ill children with acute leukemia.1 Although the study was small—just 16 children—10 showed...

Successful Use of Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy May Hinge on Prior Experience

A review of 60 consecutive patients with peritoneal carcinomatosis who underwent cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (HIPEC)—sometimes called “hot chemotherapy”—found 0% mortality and 33% morbidity, with “a significant reduction of grade III/IV morbidity,...

colorectal cancer

Regorafenib Approved for Advanced Colorectal Cancer

The FDA recently approved regorafenib (Stivarga) to treat patients with metastatic colorectal cancer that has progressed after treatment. Regorafenib is a multikinase inhibitor that blocks several enzymes that promote cancer growth. The drug was reviewed under the FDA’s priority review program that ...

Karnofsky Award Winner Honors Mentors through Gift to Conquer Cancer Foundation

Kanti R. Rai, MD, and his wife Susan have been loyal donors to the Conquer Cancer Foundation for the past 9 years, but in 2012, a momentous occasion in his career inspired Dr. Rai to make a unique gift. A Moment of Reflection In the spring of 2012, Dr. Rai, an internationally recognized expert on ...

issues in oncology

Genome-wide Analysis Reveals Molecular Pathway Aberrations in Uterine Serous Cancer

The molecular pathogenesis of uterine serous carcinoma, the most aggressive form of uterine cancer, remains largely undefined. Kuhn and colleagues from Johns Hopkins Medical Institutions recently identified prominent genetic alterations in uterine serous carcinoma using whole-exome sequencing....

issues in oncology

Whole-blood RNA Expression Profiles as Prognostic Models for Castration-resistant Prostate Cancer

Survival among patients with castration-resistant prostate cancer is highly variable, and there is a scarcity of prognostic markers that could be used to stratify patients in clinical trials, improve treatment, and accelerate drug development. Two recent studies reported in Lancet Oncology have...

lung cancer
issues in oncology

Phase II Study Suggests Advantage of Irreversible Pan-HER Inhibition in Advanced NSCLC

Dacomitinib is a new tyrosine kinase inhibitor that forms irreversible covalent bonds with the ATP domain of each of the three kinase-active members of the HER family—EGFR/HER1, HER2, and HER4. Agents such as erlotinib (Tarceva) and gefitinib (Iressa), which are of proven benefit in advanced...

leukemia

Challenges Persist in Treatment of Elderly Patients with CLL, but Novel Agents Hold Promise for Future Strategies

Chronic lymphocytic leukemia (CLL) is mainly a disease of the elderly, and the lack of a standard regimen for elderly patients has been a major challenge. The myelosuppressive regimens used to treat younger patients are not well tolerated by the elderly. However, some newer approaches currently...

Nobel Laureate E. Donnall Thomas, MD, Dies at 92

In his 1990 Nobel Prize Lecture, Eduard Donnall Thomas, MD, with characteristic humility, acknowledged that the success he celebrated “was made possible by the work of many others in this and related fields.” Dr. Thomas, whose groundbreaking work in bone marrow transplantation marked a new era in...

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