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solid tumors

Improved Outcomes in Patients With Germ Cell Testicular Tumors in the Modern Era

Although patients with poor-risk metastatic testicular germ cell tumors continue to have less favorable outcomes, the bar has been raised by contemporary treatment. There is still room for improvement in managing metastatic testicular germ cell tumors, especially in poor-risk patients, but if...

issues in oncology

Cancer Registries and the Evolving Role of Big Data in Cancer Care

In 1956, the American College of Surgeons encouraged the development of hospital-based registries, but for the most part, these efforts were clumsy, inaccessible card files of data. Today, advanced microcomputer technology has increased the ability to not only collect and cull cancer data but also...

issues in oncology

'Doctor, We Prayed for You'

A 70-year-old female patient underwent a cardiac procedure to repair her mitral valve, and at the same time, she also underwent a coronary artery bypass grafting. She had an uneventful course for the first four postoperative days. On the sixth postoperative day, she started complaining of abdominal ...

prostate cancer

Study Finds Association Between Androgen-Deprivation Therapy in Prostate Cancer and Risk of Alzheimer’s Disease

In a retrospective analysis reported in the Journal of Clinical Oncology, Nead et al found that use of androgen-deprivation therapy in the treatment of prostate cancer was associated with an increased risk of subsequent Alzheimer’s disease. Study Details In the study, a text-processing...

survivorship
issues in oncology

Material and Psychological Financial Hardship for U.S. Cancer Patients

In a population-based study reported in the Journal of Clinical Oncology, Yabroff et al found that cancer and its treatment were associated with material financial hardship for 29% and psychological financial hardship for 32% of patients aged 18 to 64 years in the United States. Financial hardship...

gynecologic cancers
issues in oncology

Could a Screening Test That Would Reduce Deaths From Ovarian Cancer Be on the Way?

"A solid triple but not a home run” is how Karen H. Lu, MD, characterized a study in The Lancet reporting a reduction in deaths from ovarian cancer with the use of multimodal ovarian cancer screening.1 Dr. Lu’s remark was one of several, mostly but not universally, favorable and optimistic comments ...

lung cancer

Stage Increase in Lung Cancer More Frequent After Open vs Closed Thoracic Surgery

An increase in the stage of non–small cell lung cancer (NSCLC) due to cancer-positive lymph node discovery was more common following open chest surgery for lung lobe removal of early-stage lung cancer compared to the closed-chest procedure known as video-assisted thoracic surgery (VATS). The...

lymphoma

Ibrutinib in Relapsed Mantle Cell Lymphoma

Treatment of mantle cell lymphoma continues to evolve, both in the front-line and relapsed settings. Key advances include better use of established agents, such as the incorporation of high-dose cytarabine into initial induction regimens and application of rituximab (Rituxan)...

lymphoma

Winning the Battle at the Front Lines: Lenalidomide Plus Rituximab— A Promising Initial Treatment for Mantle Cell Lymphoma

Mantle cell lymphoma is a pernicious, incurable disease. Front-line therapies for this disease are not currently standardized; however, novel therapies for relapsed or refractory mantle cell lymphoma can ideally be translated into beneficial treatments for newly diagnosed patients, as clearly...

hematologic malignancies
lymphoma

Lenalidomide Plus Rituximab Highly Active in  Initial Treatment of Mantle Cell Lymphoma

In a phase II trial reported in The New England Journal of Medicine by Jia Ruan, MD, PhD, and colleagues, first-line treatment with the immunomodulatory agent lenalidomide (Revlimid) and the anti-CD20 antibody rituximab (Rituxan) followed by maintenance lenalidomide and rituximab produced a high...

lung cancer

The Evolving Treatment Landscape of ALK-Positive NSCLC

Since the initial discovery of ALK rearrangement in non–small cell lung cancer (NSCLC) in 2007,1 small molecule tyrosine kinase inhibitors of ALK have transformed the course of disease for those patients with ALK-rearranged (ie, ALK-positive) NSCLC. Crizotinib (Xalkori), a multitargeted tyrosine...

breast cancer

International Innovation Grant Supports Novel Breast Cancer Health Education Program in Mexico

The International Innovation Grant, funded by the Conquer Cancer Foundation (CCF) of ASCO, provides research funding in support of novel and innovative projects that can have a significant impact on cancer control in low- and middle-income countries. The grant is intended to support research that...

lung cancer

Global and North American Phase II Studies Show Alectinib Is Highly Active in Crizotinib-Resistant/Refractory ALK-Rearranged NSCLC

In two phase II trials, reported in the Journal of Clinical Oncology and The Lancet Oncology, the ALK inhibitor alectinib (Alecensa), which is active against acquired crizotinib resistance mutations and exhibits high central nervous system (CNS) penetration, was associated with considerable...

breast cancer

Exploratory Analysis of ExteNET Trial Shows Consistency of Benefit With Neratinib

An exploratory analysis of the ­ExteNET study of neratinib in early HER2-positive breast cancer after treatment with trastuzumab (Herceptin) upheld the findings previously reported for the 2-year analysis, according to the study’s principal investigator Arlene Chan, MD, of the Breast Cancer...

supportive care

Uridine Triacetate Granules for Fluorouracil or Capecitabine Overdose or Early Severe Toxicity

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. On December 11, 2015, uridine triacetate (Vistogard) was approved...

Expert Point of View: Angela DeMichele, MD, and Melinda L. Telli, MD

The formal discussant for the CALGB 40603 and GeparSixto studies at the San Antonio Breast Cancer Symposium was Angela DeMichele, MD, Professor of Medicine and Miller Chair in Breast Cancer Excellence at the Perelman School of Medicine, University of Pennyslvania. “The key questions raised by these ...

breast cancer

Prophylactic Beta-Blocker Preserves Left-Ventricular Function in Patients Receiving Trastuzumab

The beta-blocker bisoprolol was able to prevent trastuzumab (Herceptin)-associated declines in left-ventricular ejection fraction, whereas the effect of the angiotensin-converting–enzyme (ACE) inhibitor perindopril was less robust. Use of bisoprolol reduced dose interruptions for trastuzumab due to ...

breast cancer
issues in oncology

PI3K Inhibitor Buparlisib Extends Progression-Free Survival  in Advanced Breast Cancer

Addition of the oral investigational pan-PI3K inhibitor buparlisib to the endocrine agent fulvestrant (Faslodex) improved progression-free survival among postmenopausal women with advanced hormone receptor–positive/HER2-negative advanced breast cancer. “We are happy to announce that the phase III...

leukemia

Venetoclax May Prove to Be Strong Weapon Against Poor-Prognosis Chronic Lymphocytic Leukemia

Venetoclax, the latest entry into the field of treatment of chronic lymphocytic leukemia (CLL), is a powerful investigational therapy that promises to fill an important niche: treatment of high-risk relapsed/refractory patients with deletions of 17p. Nearly 80% of patients with relapsed/refractory...

lung cancer

Bevacizumab Plus Chemotherapy Fails to Prolong Survival in Early-Stage Lung Cancer

Overall survival in patients with surgically resected early-stage non–small cell lung cancer (NSCLC) did not improve with the addition of bevacizumab (Avastin) to chemotherapy, according to the findings of a study researchers have called a “top abstract” from the 16th World Conference on Lung...

cost of care

The 340B Drug Pricing Program: Background, Concerns, and Solutions

The 340B Drug Pricing Program was created by Congress through the Veterans Health Care Act of 1992 to allow some health-care entities—including safety-net providers with large shares of uninsured and low-income patients and other “covered entities”—to obtain drugs at discounted prices.1,2 Congress...

lung cancer

Study Finds Alectinib Highly Active in ALK-Positive, Crizotinib-Resistant NSCLC

In a North American phase II trial reported in The Lancet Oncology, Shaw et al found that alectinib (Alecensa), which is active against acquired crizotinib (Xalkori) resistance mutations and exhibits high central nervous system (CNS) penetration, was associated with considerable activity in...

palliative care
colorectal cancer

One in Seven Colorectal Cancer Patients Diagnosed Before Recommended Screening Age

Nearly 15% of patients diagnosed with colorectal cancer were younger than 50, the age at which screening recommendations begin. The study by researchers at the University of Michigan Comprehensive Cancer Center also found that younger patients were more likely to have advanced disease. The authors ...

multiple myeloma

FDA Approves Carfilzomib as Single Agent or in Combination in Relapsed/Refractory Multiple Myeloma

Amgen announced on January 21 that the U.S. Food and Drug Administration (FDA) approved the supplemental New Drug Application of carfilzomib (Kyprolis) for injection in combination with dexamethasone or with lenalidomide (Revlimid) plus dexamethasone for the treatment of patients with relapsed or...

colorectal cancer
issues in oncology

Study Finds Fecal Immunochemical Test Effective for Annual Colon Cancer Screening

Although the fecal immunochemical test is a common method for colorectal cancer screening, its acceptability and performance over several rounds of annual testing are largely unknown. Now, a large retrospective cohort study by Jensen et al assessing the fecal immunochemical...

breast cancer

Study Finds Adjuvant Anastrozole Reduces Recurrence Risk vs Tamoxifen in Postmenopausal Women With Ductal Carcinoma in Situ

In a phase III trial (National Surgical Adjuvant Breast and Bowel Project [NSABP] B-35) reported in The Lancet, Margolese et al found that adjuvant anastrozole significantly improved the breast cancer–free interval vs tamoxifen in postmenopausal women with hormone receptor–positive...

breast cancer
supportive care

No Association Seen Between New or Worsening Aromatase Inhibitor–Related Musculoskeletal or Vasomotor Symptoms and Relapse-Free Survival

Retrospective analyses of the ATAC, TEAM, and BIG 1-98 adjuvant endocrine therapy trials in breast cancer have suggested that treatment-emergent endocrine symptoms may be associated with superior survival outcomes. However, in a study reported in the Journal of Clinical Oncology, Stearns et al...

palliative care

New Target Identified for Reducing Metastasis

A protein that is constantly expressed by cancer cells and quiescent in healthy cells appears to be a solid target for reducing cancer's ability to spread, scientists reported. The WASF3 protein enables cancer cell invasion, and by interrupting its relationship with another protein, CYFIP1, which...

colorectal cancer
hepatobiliary cancer
lung cancer
lymphoma

Increased Cancer Mortality Rate Among Recipients of Solid-Organ Transplants

Solid-organ transplant recipients have a higher rate of cancer mortality than what is expected in the general population, according to a Canadian study by Acuna et al published in JAMA Oncology. Cancer mortality among transplant recipients was significantly elevated compared with data for the...

leukemia

Increased Response Rate With Higher Dose of Obinutuzumab Monotherapy for Patients With Chronic Lymphocytic Leukemia

A randomized phase II study in symptomatic, untreated patients with chronic lymphocytic leukemia (CLL) found an increased overall response rate with obinutuzumab (Gazyva) at a dose of 2,000 mg vs 1,000. In addition, the “data demonstrate that obinutuzumab produces a higher response rate in...

gynecologic cancers
issues in oncology

UK Study Suggests Potential Mortality Benefit of Ovarian Cancer Screening in Postmenopausal Women

As reported in The Lancet by Jacobs et al, the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) suggests there may be a mortality benefit of ovarian cancer screening in postmenopausal women. Study Details In the trial, 202,546 postmenopausal women aged 50 to 74 years from 13 centers...

palliative care
issues in oncology
palliative care

Palliative Care Initiated in the Emergency Department Associated With Improved Quality of Life

A palliative care consultation initiated in the emergency department for patients with advanced cancer was associated with improved quality of life and did not seem to shorten survival, according to an article published by Grudzen et al in JAMA Oncology. Visits to the emergency department are...

breast cancer

Ultrasound Guidance Lowers Risks of Thoracic Nerve Block Technique for Mastectomy

A regional anesthesia technique called thoracic paravertebral nerve block is highly effective in controlling pain after breast cancer surgery, but concern about potential complications may limit its use. A new study provides evidence that using ultrasound to guide the nerve blocking procedure...

breast cancer

Nonsignificant Improvement in Disease-Free Survival With Adjuvant Lapatinib/Trastuzumab vs Trastuzumab in Early HER2-Positive Breast Cancer

Results of a phase III trial, reported in the Journal of Clinical Oncology by Piccart-Gebhart et al, showed a modest and statistically nonsignificant increase in disease-free survival with concurrent adjuvant lapatinib (Tykerb) and trastuzumab (Herceptin) vs trastuzumab alone in patients with...

skin cancer

LETTER TO THE EDITOR: Adjuvant Therapy in Cutaneous Melanoma: The Need for a New Approach

Melanoma of the skin remains a fatal disease, and its incidence continues to rise, mostly in young adults during their prime. Surgery remains the most effective therapeutic modality, but patients’ survival depends on the stage of the disease at the time of diagnosis. Various therapeutic agents have ...

prostate cancer

Death Rates Significantly Reduced for Men Having Radical Prostatectomy vs Watchful Waiting

Estimated 15-year results from the Scandinavian Prostate Cancer Group Study (SPCG-4) show that men diagnosed with early prostate cancer and randomly assigned to radical prostatectomy continued to have significantly reduced rates of death from prostate cancer, death from any cause, and risk of...

multiple myeloma

Subcutaneous Bortezomib Offers Improved Safety Profile for Treating Patients with Relapsed Multiple Myeloma

Subcutaneous administration of bortezomib (Velcade) was comparably efficacious to intravenous administration in a phase III trial in patients with relapsed multiple myeloma, but the SC route “seemed to have an improved systemic safety profile compared with intravenous delivery,’’ investigators...

solid tumors

2011 ASCO Annual Meeting: Cabozantinib Broadly Active in Multiple Tumor Types

Cabozantinib (XL184), an oral inhibitor of MET kinase and the vascular endothelial growth factor receptor (VEGFR2), produced high rates of disease control in several solid tumor types and controlled bone metastases in many patients, according to a phase II study presented at the 2011 ASCO Annual...

Expert Point of View: Genes May Predict Taxane-related Peripheral Neuropathy

As an oncologist who frequently avoids taxanes, largely due to concerns about neuropathy, Steven Vogl, MD, of the Bronx, New York, was asked to comment on the study. He observed that while the Indiana University study has no immediate applicability, it is “a good first look.” “I typically don’t...

survivorship

Experts Seek to Explain the Survival Gap in Adolescents and Young Adults with Cancer

While overall cancer survival rates continue to rise-there are nearly 12 million cancer survivors today, according to the latest figures from NCI-most of that improvement is among pediatric and older adult patients. For adolescent and young adult patients with cancer, defined by the NCI as those in ...

prostate cancer

Sunitinib/Prednisone Improves Progression-free Survival but not Overall Survival in Metastatic Castrate-resistant Prostate Cancer

According to M. Dror Michaelson, MD, PhD, second-line therapy with sunitinib (Sutent) and prednisone improves progression-free survival but not overall survival in men with metastatic castrate-resistant prostate cancer previously treated with docetaxel-based chemotherapy. Dr. Michaelson, of the...

lymphoma

Important Briefs: Lymphoma Research on Improved Chemotherapy, Biomarker Associations, and Stem Cell Transplant Approaches

The 11th International Conference on Malignant Lymphoma was held June 15–18 in Lugano, Switzerland. More than 3,000 hematologists, clinical oncologists, pathologists, and researchers attended the meeting, which was first convened in 1981. Topics of discussion included lymphoma staging in the new...

colorectal cancer

Smoking and Lack of Exercise Increase Risk of Some Cancers, but Moderate Alcohol Consumption Reduces Colon Cancer Risk

A substudy of the large prospective National Surgical Adjuvant Breast and Bowel Project (NSABP) Breast Cancer Prevention Trial revealed both expected and surprising findings related to the association between lifestyle factors (cigarette smoking, alcohol, and exercise) and cancer risk. As might be...

breast cancer

Iniparib Fails to Improve Outcomes in Triple-negative Breast Cancer

As reported in the March 15 issue of The ASCO Post, a phase III trial of the novel agent iniparib failed to demonstrate a significant improvement in survival for women with metastatic triple-negative breast cancer. The “top-line” results were communicated in the spring via press releases from...

prostate cancer

Cabozantinib Shows Encouraging Activity in Metastatic Castrate‑resistant Prostate Cancer

Cabozantinib, a dual inhibitor of MET kinase and the vascular endothelial growth factor (VEGF) receptor, exhibits high, early single-agent activity in men with metastatic castrate-resistant prostate cancer, according to Maha Hussain, MD, FACP, who presented these findings at the 2011 ASCO Annual...

kidney cancer

Studies Explore Potential Benefits of Sunitinib before Nephrectomy in Metastatic Clear Cell Renal Cancer

The multitargeted tyrosine kinase inhibitor sunitinib (Sutent) is established as first-line therapy in metastatic clear cell renal cancer. Data supporting use of cytoreductive nephrectomy in metastatic clear cell renal cancer come from the pre–targeted therapy era, when less-effective immune...

lymphoma

Intergroup Study Evaluates Outcomes of Elderly vs Younger Patients Treated for Advanced Hodgkin Lymphoma

The 11th International Conference on Malignant Lymphoma was held June 15–18 in Lugano, Switzerland. Topics of discussion included lymphoma staging in the new millennium, lymphoma and its microenvironment, and lymphoma cure vs control. The ASCO Post summarized several key presentations in the July...

Expert Point of View: Novel JAK Inhibitor May Be an Option for Patients with Myelofibrosis

Ross Levine, MD, of Memorial Sloan-Kettering Cancer Center, New York, was the discussant of the COMFORT-I and COMFORT-II trials.1 He explained that 70% to 90% of patients with myelofibrosis have JAK2 mutations, which appear to be endemic. “This is a driver mutation, although not the only mutation...

kidney cancer

Axitinib Improves Progression-free Survival over Sorafenib in Advanced Renal Cell Carcinoma

A randomized comparative effectiveness phase III trial demonstrated significantly superior efficacy for the tyrosine kinase inhibitor axitinib compared to sorafenib (Nexavar) in patients with advanced renal cell carcinoma (RCC). These data suggest that axitinib may become a new standard of care for ...

health-care policy

Conflicts of Interest in Health-care Reform?

Last year’s health-care reform legislation, the Patient Protection and Affordable Care Act, was designed to incrementally roll out major new bureaucratic entities, oversight, and mandates for the practice of medicine between its enactment and 2013, after the next presidential election. A new...

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