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Expert Point of View: Sandra Swain, MD, FACP

Sandra Swain, MD, FACP, Medical Director of the Washington Cancer Institute, MedStar Washington Hospital Center, Washington, DC, moderated the San Antonio session where the dose-dense chemotherapy studies were presented, and commented on the findings of the two studies. iddETC Trial With regard...

breast cancer

Dose-dense Chemotherapy in Breast Cancer: Epirubicin-based Regimens Studied in German and UK Trials

In the treatment of early breast cancer, dose-dense regimens (given every 2 weeks) have proven superior to conventionally dosed chemotherapy (given every 3 weeks), but data on long-term survival are lacking. Two studies presented at the San Antonio Breast Cancer Symposium evaluated the benefit of...

breast cancer

Final 'Joint Analysis' Confirms Life-saving Benefit of Trastuzumab in Patients with HER2-positive Early Breast Cancer

In the final planned joint analysis of overall survival from the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-31 and North Central Cancer Treatment Group (NCCTG) N9831 trials, the addition of trastuzumab (Herceptin) to paclitaxel following doxorubicin/cyclophosphamide (AC) reduced...

colorectal cancer

Outcomes Comparable for Panitumumab and Bevacizumab in Metastatic Colorectal Cancer 

In patients with KRAS wild-type metastatic colorectal cancer, outcomes were comparable whether patients received the epidermal growth factor receptor (EGFR) inhibitor panitumumab (Vectibix) or the vascular endothelial growth factor (VEGF) inhibitor bevacizumab (Avastin). This was shown both in the...

colorectal cancer

FOLFOXIRI Plus Bevacizumab Is Superior to FOLFIRI Plus Bevacizumab in Metastatic Colorectal Cancer 

For the treatment of metastatic colorectal cancer, better outcomes were achieved when bevacizumab (Avastin) was added to FOLFOXIRI (leucovorin, fluorouracil [5-FU], oxaliplatin, irinotecan), rather than FOLFIRI (leucovorin, 5-FU, irinotecan), in the phase III TRIBE trial conducted at 35 Italian...

head and neck cancer
lung cancer
issues in oncology

Patients with Cancer Need to Know That It Is Never Too Late to Quit Smoking 

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. Patients with head and neck or lung...

breast cancer

FOXP3 Expression Linked to Better Survival with Adjuvant Anthracycline Not Followed by Taxane in Breast Cancer 

The French UNICANCER-PACS 01 trial compared six cycles of anthracycline-based adjuvant therapy with FEC (epirubicin, cyclophosphamide, fluorouracil; FEC6) vs three cycles of FEC followed by three cycles of docetaxel (FEC/docetaxel) in patients with node-positive primary breast cancer. After...

lymphoma

Cytarabine in Conditioning Regimen for Younger Patients with MCL 

High-dose cytarabine should be incorporated into the induction regimen of younger patients with mantle cell lymphoma (MCL) before autologous stem cell transplantation, according to final results of the MCL Younger Trial of the European Mantle Cell Lymphoma Network, presented at the ASH Annual...

hematologic malignancies
lymphoma

Bendamustine/Rituximab Noninferior to Standard Chemotherapy for Advanced Indolent Non-Hodgkin and Mantle Cell Lymphomas 

The combination of bendamustine (Treanda) and rituximab (Rituxan), or BR, was found to be noninferior to commonly used chemotherapy with R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone) or R-CVP (rituximab plus cyclophosphamide, vincristine, and prednisone) in...

hematologic malignancies

Ibrutinib Receives Two Oncology Breakthrough Therapy Designations from FDA

Janssen Research & Development, LLC, and Pharmacyclics, LLC, announced that the FDA has granted Breakthrough Therapy Designations for the investigational oral agent ibrutinib as a monotherapy for two B-cell malignancies: in patients with relapsed or refractory mantle cell lymphoma who have...

solid tumors
colorectal cancer

Colorectal Cancer: A Decade of Progress 

The 2013 Gastrointestinal Cancers Symposium marked the 10th anniversary of the meeting. Richard M. Goldberg, MD, the Klotz Family Chair in Cancer Research, Professor of Medicine, and James Cancer Hospital Physician-in-Chief at The Ohio State University, looked back over the decade to highlight the...

solid tumors
gastroesophageal cancer

Second-line Docetaxel Improves Esophageal and Gastric Cancer Survival 

A phase III study from the United Kingdom has shown that second-line treatment with docetaxel improves overall survival of patients with advanced esophagogastric cancer.1 The strategy has already been widely adopted, but COUGAR-02 is the first study to provide definitive evidence of a survival...

Expert Point of View: William K. Oh, MD

Formal discussant William K. Oh, MD, Chief of the Division of Hematology and Medical Oncology, Professor of Medicine and Urology, and the Ezra M. Greenspan, MD, Professor in Clinical Cancer Therapeutics at Icahn School of Medicine at Mount Sinai, New York, was not convinced that corticosteroids...

solid tumors
prostate cancer

Did Corticosteroids Worsen Survival in Patients with Metastatic Prostate Cancer Enrolled in the AFFIRM Trial? 

A post hoc analysis of the AFFIRM trial found that on-study use of corticosteroids led to worse outcomes in metastatic castration-resistant prostate cancer regardless of whether patients were randomly assigned to enzalutamide (Xtandi) or placebo.1 On-study corticosteroid use was associated with...

Expert Point of View: Anthony D’Amico, MD

Now there are mature data from three trials comparing adjuvant radiotherapy vs a wait-and see approach in men following radical prostatectomy, said formal discussant Anthony D’Amico, MD, Dana-Farber Cancer Center and Harvard Medical School, Boston, at the Genitourinary Cancers Symposium. Despite...

solid tumors
prostate cancer

Reduced Risk of PSA Failure with Adjuvant Radiotherapy vs Wait-and-see Approach in Stage T3 Prostate Cancer

Extended follow-up of the German ARO 96-02 trial shows that adjuvant radiotherapy reduces the risk of biochemical failure in men whose prostate cancer extends through the prostate capsule (stage T3), compared with a wait-and-see approach, after radical prostatectomy. Adjuvant radiotherapy reduced...

Expert Point of View: Robert A. Wolff, MD and Jordan Berlin, MD

Robert A. Wolff, MD, Professor in the Department of Gastrointestinal Oncology at The University of Texas MD Anderson Cancer Center, Houston, observed, “The bevacizumab seemed to leverage the capecitabine with a magnitude of benefit that is very reminiscent of the initial trials with...

colorectal cancer

Bevacizumab plus Capecitabine Has Robust Effect in Elderly Patients with Colorectal Cancer

In elderly patients with treatment-naive metastatic colorectal cancer, a trend toward a survival benefit was observed for bevacizumab (Avastin) plus capecitabine (Xeloda) in the international phase III AVEX trial, which was presented at the 2013 Gastrointestinal Cancers Symposium by David...

multiple myeloma

Thalidomide/Prednisone Maintenance after Stem Cell Transplant Improves Progression-free but Not Overall Survival

Maintenance therapy with thalidomide (Thalomid) and prednisone after autologous stem cell transplantation in patients with multiple myeloma improved progression-free survival but not overall survival, according to results of a phase III trial reported in Blood. Patients receiving maintenance...

head and neck cancer

Two Studies Focus on Treatment Strategies for Preserving the Larynx While Increasing Survival

Two recent studies in the Journal of Clinical Oncology focused on treatment strategies to preserve the larynx while increasing survival of patients with cancer of larynx. RTOG 91-11 Ten-year results from the Radiation Therapy Oncology Group (RTOG) 91-11 trial found that both chemotherapy regimens...

integrative oncology

Barrie R. Cassileth, MS, PhD, Champion of Integrative Oncology, Continues to Nurture Growth of the Field 

Over the past decade, integrative oncology has gained wide acceptance as an evidenced-based way to improve the lives of patients with cancer throughout the continuum of their care. The ASCO Post recently spoke with Barrie R. Cassileth, MS, PhD, Chief of the Integrative Medicine Service and Laurance ...

leukemia

SIDEBAR: Further Reflections on a Successful Trial

The authors are to be congratulated for successfully conducting a randomized study of FLAG (fludarabine, cytarabine, and granulocyte colony-stimulating factor [Neupogen]) vs FLAG plus liposomal daunorubicin (DaunoXome) in relapsed pediatric acute myeloid leukemia (AML). The difficulty in conducting ...

breast cancer
integrative oncology

Qigong Practice Associated with Quality-of-life Benefits in Women Undergoing Radiation Therapy for Breast Cancer 

Qigong (“qi” or “chi” = energy flow, “gong” = skill or achievement) is an integrated mind-body exercise and meditative practice that involves rhythmic breathing coordinated with repetition of fluid movements and calm focus on the body. A study reported in Cancer by Zhen Chen, MD, and colleagues...

prostate cancer

Similar Outcomes for 18 vs 36 Months of Androgen Blockade in High-risk Prostate Cancer Treated with Radiation 

Eighteen months of hormone therapy appears to be as safe and effective as 36 months when combined with radiation for patients with high-risk prostate cancer.1 Patients who received the shorter course of hormone therapy plus radiation had survival rates similar to those who received 36 months of...

hepatobiliary cancer
pancreatic cancer
gastrointestinal cancer

Important Data and Treatment Advances Reported in GIST and in Pancreatic and Liver Cancers 

The 10th annual Gastrointestinal Cancers Symposium, held recently in San Francisco, was jointly sponsored by ASCO, the AGA (American Gastroenterological Association), ASTRO (American Society for Radiation Oncology), and the SSO (Society of Surgical Oncology). “We seek to present the newest...

kidney cancer
prostate cancer

New Findings in Prostate and Kidney Cancers Clarify the Roles of Abiraterone, Finasteride, Bevacizumab, and Surveillance 

Attendees at the 2013 Genitourinary Cancers Symposium in Orlando, Florida, were brought up to date with the latest news on cancers of the prostate, testes, bladder, and kidney. Below are selected highlights from the meeting describing findings of noteworthy abstracts to extend our regular news...

breast cancer

Progression-free Survival in HER2-positive Metastatic Breast Cancer Improved with T-DM1 

First-line treatment with ado-trastuzumab emtansine (T-DM1) “provided a significant improvement” in progression-free survival when compared to trastuzumab (Herceptin) plus docetaxel in a randomized phase II study among patients with HER2-positive metastatic or recurrent locally advanced breast...

SIDEBAR: Three Breakthrough Therapy Designations for Ibrutinib from the FDA

In February 2013, FDA granted Breakthrough Therapy Designations for ibrutinib as a monotherapy for the treatment of patients with relapsed or refractory mantle cell lymphoma and as a monotherapy for the treatment of patients with Waldenström’s macroglobulinemia, both of which are also B-cell...

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...

SIDEBAR: The Ethical Imperative of Clinical Equipoise 

In her editorial about the RESONATE trial (page 1), Dr. O’Brien raises the issue of equipoise in this phase III clinical trial that compares the efficacy of ibrutinib and ofatumumab (Arzerra) in patients with relapsed or refractory chronic lymphocytic leukemia (CLL) who are not appropriate...

leukemia

Ibrutinib CLL Trial: Where Is the Equipoise?

The RESONATE trial is randomly assigning patients with refractory or relapsed CLL to either ofatumumab (Arzerra) or the investigational oral agent ibrutinib. Ofatumumab is an anti-CD20 monoclonal antibody like rituximab (Rituxan), but is more potent as a single agent. It was approved for refractory ...

breast cancer

Higher HER2 Expression Linked to Best Results with T-DM1 in Patients with HER2-positive Metastatic Breast Cancer

A biomarker analysis of the pivotal EMILIA trial suggests that women with metastatic HER2-positive breast cancer with tumors that have high expression of HER2 derive the most robust benefit from treatment with the antibody-drug conjugate T-DM1 (also now known as ado-trastuzumab emtansine...

leukemia

Drug Approvals in Acute Myeloid Leukemia: Can We Do Better? 

Forty years ago, President Richard Nixon announced a “war on cancer.” Some of that war’s first battles were won in the field of acute myeloid leukemia (AML) with two agents, cytarabine and daunorubicin, receiving U.S. Food and Drug Administration (FDA) approval based on their ability to produce...

breast cancer

Novel Regimen Produces High Pathologic Complete Response Rates in Triple-negative Breast Cancer 

Interim results from a small neoadjuvant study of patients with triple-negative breast cancer has found high rates of pathologic complete response with the combination of nab-paclitaxel (Abraxane), carboplatin, and bevacizumab (Avastin).1 The study was presented at the 18th Annual Conference of the ...

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...

skin cancer

Breakthrough Therapy Designation for Lambrolizumab for the Treatment of Advanced Melanoma

Merck has announced that the U.S. Food and Drug Administration (FDA) has designated lambrolizumab (MK-3475) as a Breakthrough Therapy for the treatment of patients with advanced melanoma. Lambrolizumab is Merck’s investigational antibody therapy targeting the programmed death receptor (PD-1) that...

leukemia

Ibrutinib Receives Third Breakthrough Therapy Designation from the FDA

Pharmacyclics, Inc, announced that the FDA has granted an additional Breakthrough Therapy Designation for the investigational oral agent ibrutinib as monotherapy for the treatment of patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma with deletion of the short arm of...

hepatobiliary cancer

Early Data Promising for Concurrent Sorafenib Plus Embolization in Metastatic Liver Cancer 

If sorafenib (Nexavar) and local ablation techniques are both effective in the treatment of metastatic hepatocellular carcinoma, could they deliver an even greater punch when combined? The concurrent use of interventional radiology approaches and sorafenib for metastatic hepatocellular carcinoma is ...

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...

solid tumors
colorectal cancer

Smoking Linked to Shorter Disease-free Survival in Stage III Colon Cancer 

According to an analysis reported by Amanda Phipps, PhD, MPH, Assistant Professor of Epidemiology at the University of Washington and Assistant Member at Fred Hutchinson Cancer Research Center, Seattle, and colleagues in the Journal of Clinical Oncology, patients with stage III colon cancer who...

lung cancer
issues in oncology

Low-dose CT Detects Twice as Many Early-stage Lung Cancers as Chest X-ray, According to Additional NLST Results

Results of the first of three planned annual screening examinations from the National Lung Screening Trial (NLST) were recently published and physicians may now have more information to share with their patients about the benefits and risks of low-dose computed tomography lung cancer screening.1...

geriatric oncology
issues in oncology

Improving the Care and Study of Older Patients with Cancer 

Predicting toxicity in older patients receiving chemotherapy is an important clinical problem. It has been shown that standard oncology measures such as performance status are not adequate to predict outcomes in the elderly. Clinical measures that are important in geriatric oncology are not...

hematologic malignancies
leukemia

Postinduction Dexamethasone and Individualized Dosing of Asparaginase Improve Outcome in Pediatric ALL 

Findings from the Dana-Farber Cancer Institute ALL Consortium Protocol 00-01, recently reported by Lynda M. Vrooman, MD, Dana-Farber Cancer Institute, and colleagues in Journal of Clinical Oncology, indicate that postinduction dexamethasone and individualized dosing of Escherichia coli–derived...

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...

Expert Point of View: Andrew D. Zelenetz, MD, PhD

In a separate interview, Andrew D. Zelenetz, MD, PhD, Chief of the Lymphoma Service at Memorial Sloan-Kettering Cancer Center in New York, said that he found the relapse rate of 20% observed in this study to be quite low, and he wanted to know the characteristics of the 537 patients included in the ...

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...

lymphoma

FDA Approves Lenalidomide for Relapsed/Refractory Mantle Cell Lymphoma

The U.S. Food and Drug Administration has approved lenalidomide (Revlimid) for the treatment of patients with mantle cell lymphoma whose disease has relapsed or progressed after two prior therapies, one of which included bortezomib (Velcade). Clinical Trial The approval was based on the results of...

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...

lung cancer

No Survival Benefit of ERCC1 and RRM1 Expression-based Chemotherapy in Patients with Advanced NSCLC 

A trial reported by Gerold Bepler, MD, PhD, of Karmanos Cancer Institute, Detroit, and colleagues in Journal of Clinical Oncology assessed whether chemotherapy selected on the basis of in situ ERCC1 and RRM1 protein levels could improve outcomes in patients with advanced non–small cell lung cancer...

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