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gynecologic cancers

Pazopanib Maintenance Therapy Extends Progression‑free Survival in Patients with Ovarian Cancer 

Maintenance therapy with the targeted therapy pazopanib (Votrient) extended progression-free survival in women with ovarian cancer who were disease-free following initial treatment with surgery and chemotherapy, according to results of a phase III trial presented at the 49th Annual Meeting of...

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...

Expert Point of View: Gottfried Konecny, MD

Formal discussant Gottfried Konecny, MD, Associate Professor of Medicine, David Geffen School of Medicine at UCLA, also viewed the study as a game changer. He cited the strengths of the study, including its design, randomization with stratification, P values adjusted for multiple testing, and the...

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...

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...

lymphoma

Plasma Epstein-Barr Virus DNA a Potential Marker for Treatment Response in Advanced Hodgkin Lymphoma 

Plasma Epstein-Barr Virus (EBV) DNA has prognostic significance in Hodgkin lymphoma, both prior to therapy and at 6 months of follow-up, according to results of a study published in Blood. “Plasma EBV-DNA positivity at month 6 is associated with particularly poor outcomes and may serve as an...

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...

gynecologic cancers

Learning to Negotiate the Genomic Complexities of Cancer

The Cancer Genome Atlas (TCGA) Research Network recently reported the results of an integrated analysis of the genomic features of 373 endometrial carcinomas.1 This report joins previously published results of similar analyses in ovarian, breast, and colorectal cancers, squamous cell carcinoma of...

lung cancer

Erlotinib in First-line Treatment of Metastatic NSCLC with EGFR Exon 19 Deletion or Exon 21 (L858R) Substitution 

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 14, 2013, erlotinib (Tarceva) was approved for...

breast cancer

Outcomes with Adjuvant Trastuzumab in HER2-positive Breast Cancer Not Affected by PTEN Status 

PTEN is a negative regulator of PI3K/AKT signaling. PI3K/AKT signaling can be activated by HER2, and it has been hypothesized that alteration in this pathway may affect sensitivity to trastuzumab (Herceptin). Preclinical data and some of the limited available clinical data suggest that loss or...

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...

Expert Point of View: Priya Rastogi, MD

Priya Rastogi, MD, Associate Professor of Medicine at the University of Pittsburgh Medical Center, discussed the findings at the session. She noted that previous studies have also shown higher pathologic complete response rates among HER2-enriched patients who were hormone receptor–negative, and...

breast cancer

Benefit for Dual HER2 Targeting in Neoadjuvant Breast Cancer Regimen Restricted to Subset of Patients 

As a neoadjuvant regimen for HER2-positive early breast cancer, the use of two HER2-directed agents was no more effective than trastuzumab (Herceptin) alone in producing pathologic complete responses, although one subset of patients did benefit from this approach, according to the results of the...

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...

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....

cns cancers

Management of Anaplastic Oligodendroglial Tumors 

Pearls in Neuro-oncology is guest edited by Tracy Batchelor, MD, Director, Division of Neuro-Oncology, Massachusetts General Hospital Cancer Center, and Professor of Neurology, Harvard Medical School, Boston. The series is intended to provide the practicing oncologist with guidance in managing...

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...

solid tumors

Denosumab in Adults and Skeletally Mature Adolescents with Giant Cell Tumor of Bone 

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 June 13, 2013, denosumab (Xgeva) was approved for the ...

colorectal cancer

Addition of Brivanib to Cetuximab in Chemotherapy-refractory Metastatic Wild-type KRAS Colorectal Cancer: Key Results 

The addition of a combination of epidermal growth factor receptor (EGFR) and vascular endothelial growth factor (VEGF) inhibitors to chemotherapy has not improved outcome in first-line treatment of advanced colorectal cancer. However, in early-phase evaluation, the addition of the investigational...

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...

lymphoma

Lenalidomide in Relapsed/Progressed Mantle Cell Lymphoma after Two Prior Therapies Including Bortezomib 

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 June 5, 2013, lenalidomide (Revlimid) was approved...

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...

leukemia
lymphoma

New Drug Application Submitted for Ibrutinib in the Treatment of Two B-cell Malignancies

Pharmacyclics, Inc, recently announced that it has submitted a New Drug Application (NDA) to the U.S. Food and Drug Administration (FDA) for the investigational oral Bruton’s tyrosine kinase inhibitor ibrutinib, for two relapsed/refractory B-cell malignancy indications: mantle cell lymphoma (MCL)...

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...

kidney cancer

First-line Sunitinib Followed by Everolimus Remains Standard Sequence in Metastatic Renal Cell Carcinoma 

With the approval of a number of different drugs for the treatment of metastatic renal cell carcinoma, a major issue is how to sequence these drugs to optimize outcome. A large, randomized phase II study called RECORD-3 shows that the standard sequence of the multitargeted tyrosine kinase inhibitor ...

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

Shorter Duration of Hormone Therapy Feasible in Localized High-risk Prostate Cancer 

Men with localized high-risk prostate cancer treated with adjuvant radiotherapy had similar overall and disease-free survival when treated with 18 months of androgen deprivation therapy vs 36 months of androgen deprivation therapy, the current standard of care in this setting. These results were...

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...

Expert Point of View: Hedy Lee Kindler, MD

Hedy Lee Kindler, MD, Associate Professor of Medicine at the University of Chicago, the invited discussant of three of these presentations, emphasized the persistent lethality of advanced pancreatic cancer. She predicted that within this decade, pancreatic cancer will become the second leading...

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...

lymphoma

Déjà Vu Redux: Lessons from the SWOG-8516 Study in Aggressive Lymphomas

Joseph M. Connors, MD, authored a commentary in the June 25 issue of The ASCO Post inspired by a recent New England Journal of Medicine publication on dose-adjusted EPOCH-R chemotherapy (etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab) for primary mediastinal B-cell ...

sarcoma

Ridaforolimus Delayed Tumor Progression in Patients with Previously Treated Metastatic Sarcoma  

“Ridaforolimus delayed tumor progression to a small statistically significant degree in patients with metastatic sarcoma who experienced benefit with prior chemotherapy,” according to results of an international phase III trial. The large randomized placebo-controlled phase III trial evaluated the...

breast cancer

For Women ≥ 70 Years with Early Breast Cancer, Adding Radiotherapy to Lumpectomy and Tamoxifen Does Not Increase Survival 

Long-term follow-up of Cancer and Leukemia Group B (CALGB) trial 9343 confirmed and extended 5-year results that in women age ≥ 70 years with clinical stage I, estrogen receptor (ER)-positive breast cancer treated with lumpectomy followed by tamoxifen, “irradiation adds no significant benefit in...

breast cancer

Cisplatin plus Cetuximab vs Cisplatin Alone in Patients with Metastatic Triple-negative Breast Cancer

Adding cetuximab (Erbitux) to cisplatin doubled the overall response rate and appeared to prolong progression-free and overall survival in a randomized phase II study among patients with metastatic triple-negative breast cancer. Although the trial did not meet its primary endpoint of overall...

integrative oncology

Western Science Catching Up with Traditional Chinese Medicine 

Since the National Institutes of Health Consensus Statement in 1997 concluded that the evidence to date suggests acupuncture is effective in the treatment of chemotherapy-induced nausea and vomiting,1 numerous additional indications for its use in relieving symptoms related to cancer or its...

integrative oncology

Acupuncture May Reduce Arm Lymphedema in Patients with Breast Cancer 

Integrative Oncology is guest edited by Barrie R. Cassileth, MS, PhD, Chief of the Integrative Medicine Service and Laurance S. Rockefeller Chair in Integrative Medicine at Memorial Sloan-Kettering Cancer Center, New York. The Integrative Medicine Service at Memorial Sloan-Kettering Cancer Center...

breast cancer

Is Age Truly Relative in HER2-Positive Breast Cancer? 

Breast cancer arising in younger women has increasingly become the subject of intense study, and often debate, over the past decade. Retrospective studies have illustrated that breast cancer in young women is more commonly an aggressive subtype (ie, triple-negative/basal-like, HER2-enriched),...

lung cancer

Further Support for Front-line Targeted EGFR Therapy 

LUX-Lung 3 is the sixth, and largest, prospective, randomized trial to evaluate targeted EGFR inhibition vs front-line platinum doublet chemotherapy for patients with EGFR mutations. LUX-Lung 3 distinguishes itself from the previous trials (see Table 1) by using afatinib (Gilotrif), a...

breast cancer
colorectal cancer
lymphoma

ASCO Studies Support Limited Use of 'Routine' Imaging 

The overuse of imaging in oncology workup and surveillance is a timely concern, as health-care dollars shrink and the risk for second malignancies becomes clearer. At this year’s ASCO Annual Meeting, several studies showed that although many routine imaging studies may be unnecessary, physicians...

lung cancer

Where Are We With ALK Inhibition in Lung Cancer? 

The prospective phase III PROFILE 1007 study compared the ALK inhibitor crizotinib (Xalkori) to chemotherapy in patients with advanced non–small cell lung cancer (NSCLC) with ALK gene–rearranged tumors refractory to previous chemotherapy. The study showed a clear superiority for crizotinib in terms ...

lung cancer

Crizotinib Improves Progression-free Survival vs Pemetrexed or Docetaxel in Advanced ALK-positive NSCLC  

In a phase III trial reported by Alice T. Shaw, MD, PhD, a thoracic oncologist at Massachusetts General Hospital, Boston, and colleagues in The New England Journal of Medicine, crizotinib (Xalkori) improved progression-free survival compared with standard chemotherapy in previously treated patients ...

Expert Point of View: Ranjana Advani, MD

At the 2013 ASCO Annual Meeting, Ranjana Advani, MD, the Saul A. Rosenberg, MD, Professor of Lymphoma at Stanford University Medical Center, Palo Alto, California, discussed the promise of the B-cell signaling inhibitors idelalisib and ibrutinib in lymphoma. Biggest Question Given the...

lymphoma

B-cell Receptor Signaling Inhibitors Moving Forward in Lymphoma 

Though still in early-phase studies, novel B-cell receptor signaling inhibitors look very promising for the treatment of lymphoma, according to reports from the 2013 ASCO Annual Meeting. Idelalisib in Non-Hodgkin Lymphoma In non-Hodgkin lymphoma (NHL), idelalisib looked impressive as both a single...

Expert Point of View: ­Johan F. Vansteenkiste, MD, PhD

Formal discussant Johan F. Vansteenkiste, MD, PhD, Professor of Internal Medicine at University Hospital KU, Leuven, Belgium, was also enthusiastic about the findings in the concurrent chemoradiotherapy arm, and believes that a confirmatory trial should be done. “Does the promise of immunotherapy...

lung cancer

Tecemotide Vaccine Warrants Further Study in Unresectable Stage III Non–Small Cell Lung Cancer 

Results of the START trial suggest that maintenance therapy with the investigational immunotherapy tecemotide (formerly known as L-BLP25) may have a role in the treatment of patients with unresectable stage III non–small cell lung cancer (NSCLC). Although there was no significant overall survival...

Expert Point of View: ­Jonathan S. Berek, MD 

The CHORUS trial had similar results to the previous European Organisation for Research and Treatment of Cancer (EORTC) 55971 study, showing noninferiority for primary debulking surgery followed by chemotherapy vs neoadjuvant chemotherapy followed by surgery and additional chemotherapy, said formal ...

gynecologic cancers

Neoadjuvant Chemotherapy and Interval Debulking May Be Appropriate for Some Patients With Poor Performance Status Advanced Ovarian Cancer 

Patients with newly diagnosed advanced ovarian cancer—especially patients with poor performance status—appear to derive benefits from neoadjuvant chemotherapy followed by surgery vs primary surgery followed by chemotherapy, according to results of the Medical Research Council (MRC) CHORUS trial. In ...

Expert Point of View: ­Jonathan S. Berek, MD

Weekly vs every-3-week therapy is a somewhat controversial area in ovarian cancer, said formal discussant of the MITO-7 trial, ­Jonathan S. Berek, MD, Director of the Stanford Women’s Cancer Center, Palo Alto, California. “[Japan Clinical Oncology Group (JCOG)]-16 showed a survival advantage for...

gynecologic cancers

Weekly Carboplatin/Paclitaxel Improves Quality of Life, Toxicity vs Every-3-week Regimen in Advanced Ovarian Cancer 

Patients with advanced ovarian cancer have similar survival outcomes thus far with a weekly regimen of carboplatin/paclitaxel vs the standard every-3-week regimen, but the weekly regimen is much better tolerated with improved quality of life, according to final results of the Multicenter Italian...

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