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kidney cancer

ODAC Backs Axitinib for Kidney Cancer

The FDA’s Oncologic Drugs Advisory Committee voted 13-0 that Pfizer’s drug axitinib (Inlyta) had a favorable benefit-risk profile for patients with advanced renal cell carcinoma after initial treatment has failed. The FDA is due to make a final decision in the first half of 2012. Panelists said the ...

lymphoma

Expert Point of View: Improved Survival with Chemotherapy Alone in Limited-stage Hodgkin Lymphoma

A criticism of the HD.6 trial is that current radiation techniques are probably less toxic than subtotal nodal radiation therapy, which was used in this investigation. Responding to this in an accompanying editorial in The New England Journal of Medicine,1 David J. Straus, MD, of the lymphoma...

lymphoma

Improved Survival with Chemotherapy Alone in Limited-stage Hodgkin Lymphoma

An important study suggests that radiotherapy may not be a necessary addition to chemotherapy in previously untreated patients with limited-stage Hodgkin lymphoma, sparing patients the risks of late radiation-induced cardiac effects and second cancers. These data were based on 12 years of follow-up ...

issues in oncology

Oncologists Examine Promise vs Reality of Personalized Medicine

Personalized medicine: It’s a phrase that reverberates across all cancer meetings. “Matching the right drug to the right patient” will be accomplished, in the not too distant future, through genomic sequencing of the tumor and targeted, less toxic therapy. This much has been established—or has it?...

kidney cancer

Tyrosine Kinase Inhibitor Therapy Yields Complete Remission in Patients with Metastatic Renal Cell Carcinoma

Targeted therapies have markedly improved outcomes in patients with advanced renal cell carcinoma, with median overall survival of greater than 2 years having been observed with sunitinib (Sutent) treatment. Objective responses, consisting mostly of partial responses, are observed in approximately...

lung cancer

Lung Cancer Advocates Seek to Raise Awareness (and Research Funding)

Although lung cancer is the leading cause of cancer death in the United States for both men and women—nearly 157,000 deaths from lung cancer occurred in 2011, according to the American Cancer Society—survey results from the Lung Cancer Research Foundation (LCRF) show that 60% of Americans are...

breast cancer

Ablation of Small Primary Breast Tumors: The Next Step in Local Therapy?

Local treatment of breast cancer is trending toward less invasive procedures that achieve comparable outcomes to standard interventions. What will the next step along this continuum be? According to Michael S. Sabel, MD, a surgical oncologist at the University of Michigan Comprehensive Cancer...

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...

pain management

Shared REMS Approved for all Transmucosal Immediate-release Fentanyl Products

The FDA has approved a new transmucosal immediate-release fentanyl Risk Evaluation and Mitigation Strategy (REMS) access program. The REMS is a single shared system for all transmucosal immediate-release fentanyl products. Among the goals of the REMS access program are to mitigate the risk of...

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...

issues in oncology
health-care policy

Drug Shortages Hit Oncology Hard: Experts Weigh in on Challenges and Solutions

Periodic drug shortages are an unavoidable reality in our complicated pharmaceutical supply chain; however, over the past several years, drug shortages have expanded to crisis levels, putting vulnerable patients at risk. In 2010, there were 178 drug shortages reported to the FDA, 132 of which were...

lymphoma

Expert Point of View: Maintenance Rituximab vs Retreatment Rituximab in Patients with Low–Tumor-Burden Follicular Lymphoma

The findings of RESORT1 have tremendous implications, both clinically and economically, commented Andrew D. Zelenetz, MD, Chief of the Lymphoma Service at Memorial Sloan-Kettering Cancer Center, New York, in an interview. “The maintenance arm received rituximab [Rituxan] every 3 months...

leukemia

A Second Chance for Gemtuzumab in Acute Myeloid Leukemia

Gemtuzumab ozogamicin (Mylotarg) may have a second chance for regulatory acceptance, as studies presented at ASH 2011 demonstrated that gemtuzumab can be safely and effectively given by adjusting the dosing and treatment schedule. Gemtuzumab ozogamicin was approved for the treatment of acute...

leukemia

Expert Point of View: Ponatinib Continues to Impress in Patients with Leukemia

At the 2011 ASH Annual Meeting, Pierre Laneuville, MD, Director of Hematology at McGill University in Montreal, predicted that ponatinib may be “the drug that will replace them all” in the treatment of chronic myeloid leukemia. Dr. Laneuville explained his rationale, recalling that in the pivotal...

breast cancer

Expert Point of View: Can Molecular Profiling Identify ER-positive Patients Destined for Relapse?

Eastern Cooperative Oncology Group (ECOG) trials have demonstrated that recurrence patterns are different for estrogen receptor (ER)-positive vs ER-negative breast cancer. While ER-negative disease carries a high risk for early recurrence—peaking around year 1.5 from diagnosis—risk steadily...

breast cancer

Benefits of Some Bisphosphonates Confirmed in Breast Cancer Outcomes, but Questions Remain

The story of bisphosphonates, and their disease-modifying potential in breast cancer, is still evolving. While some studies presented at the 2011 San Antonio Breast Cancer Symposium failed to show gains, others found benefits. The theme that is emerging is that bisphosphonates may be most...

SIDEBAR: Expect Questions from Your Patients

The possibility of reexcision after breast-conservation surgery should be discussed with patients before the initial surgery, advised Laurence E. McCahill, MD, lead investigator of the JAMA study on reexcision following breast-conservation surgery, which showed wide variability in reexcision...

breast cancer

Reexcision Rates Following Breast-conservation Surgery Vary Widely

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. Reexcision rates for women with...

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...

skin cancer

What You Should Know about Peginterferon Alfa-2b for Adjuvant Treatment of Melanoma

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 Peginterferon alfa-2b (PegIntron, Sylatron) was recently ...

head and neck cancer

Challenges, Progress, and Future Directions in Head and Neck Cancer

Although head and neck cancer remains a major therapeutic challenge, significant advances have been made over the past few decades. The ASCO Post recently spoke with Marshall R. Posner, MD, Medical Director of the Head and Neck Oncology Program, Mount Sinai Medical Center, New York, about the...

breast cancer

SWOG S0226 Findings Revive Interest in Combination Hormonal Therapy

Two hormonal therapies combined are more efficacious than one when used as first-line treatment for hormone receptor–positive metastatic breast cancer in postmenopausal women, finds Southwest Oncology Group trial S0226. Results of the phase III trial, reported at the 2011 CTRC-AACR San Antonio...

prostate cancer

Two Novel Agents Prolong Survival in Advanced Prostate Cancer

Two novel agents with distinct mechanisms of action join ranks of treatments that extend survival for patients with castration-resistant prostate cancer: MDV3100 and radium-223. Both drugs achieved a survival advantage compared with placebo, with relatively benign side-effect profiles, according to ...

health-care policy

AACR Urges Congress to Maintain, Preferably Increase, Cancer Research Funding

December 23, 2011, marked the 40th anniversary of the National Cancer Act. To mark that occasion, on February 2, the American Association for Cancer Research (AACR) held a Congressional briefing, attended by about 100 legislative aides, to remind Congress that the war on cancer is far from over....

health-care policy

Research Funding Key to Continued Progress in Cancer Care

American Association for Cancer Research (AACR) President and ASCO member Judy Garber, MD, MPH, recently spoke with The ASCO Post about the findings of AACR’s landmark Cancer Progress Report,1 In addition, she offered her perspective on the current and future state of cancer research. Project...

breast cancer

Context May Affect Benefit of Adjuvant Clodronate in Breast Cancer

A benefit of the oral bisphosphonate clodronate when used as adjuvant therapy for early breast cancer may depend on factors such as the endpoint assessed and patient age, suggests the randomized B-34 trial conducted by the National Surgical Adjuvant Breast and Bowel Project (NSABP). The trial,...

FDA Drug Approvals, January–March 2012

Imatinib mesylate tablets (Gleevec) approved for the adjuvant treatment of adult patients following complete gross resection of Kit (CD117) positive gastrointestinal stromal tumors (GIST). Accelerated approval for this indication was granted in December 2008. Vismodegib (Erivedge) capsules...

kidney cancer

What You Need to Know About Axitinib, New Agent for Treating Advanced Renal Cell Carcinoma

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 January 2012, the second-generation vascular...

head and neck cancer
survivorship

Eating Problems and Pain Prevalent in Survivors of Head/Neck Cancer

“Eating problems due to poor oropharyngeal functioning and persistent pain are the most prevalent problems” faced by patients 5 years after being treated for head and neck cancer, according to a study published online by the Archives of Otolaryngology–Head & Neck Surgery.1 More than 50% of...

SIDEBAR: Genotype and Treatment Outcomes

At the 2011 San Antonio Breast Cancer Symposium, Joyce O’Shaughnessy, MD, described how the genetic profiles of 12 patients with metastatic triple-negative breast were used to guide treatment for metastatic disease Patient #10 was a 59-year-old African-American woman with primary...

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...

geriatric oncology

Moving the Field of Geriatric Oncology Forward

With the aging of the population, virtually all of the subspecialties of oncology will soon be concerned primarily with the care of older patients. While there is not one precise definition of the age of “geriatric” patients, it is clear that the aging of our society has necessitated a focus on the ...

palliative care
supportive care
issues in oncology

Italian Study Shows Low-Dose Morphine Better Than Weak Opioids in Relieving Moderate Cancer Pain

In an Italian trial reported in the Journal of Clinical Oncology, Bandieri et al found that low-dose morphine provided better and more rapid pain relief than weak opioids in patients with moderate cancer pain. Study Details In the open-label 28-day trial, 240 adults with moderate cancer pain from ...

solid tumors
lung cancer
cns cancers

Everolimus Improves Progression-Free Survival in Advanced Neuroendocrine Tumors of the Lung or Gastrointestinal Tract

In a phase III RADIANT-4 trial reported in The Lancet, Yao et al found that everolimus (Afinitor) and supportive care significantly prolonged progression-free survival vs placebo and supportive care in patients with advanced nonfunctional neuroendocrine tumors of the lung or gastrointestinal tract. ...

solid tumors
supportive care

FDA Drug Approvals, January–April 2012

Imatinib mesylate tablets (Gleevec) approved for the adjuvant treatment of adult patients following complete gross resection of Kit (CD117) positive gastrointestinal stromal tumors (GIST). Vismodegib capsules (Erivedge) approved for the treatment of metastatic basal cell carcinoma or locally...

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...

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 ...

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 ...

survivorship

Controlled Study Links ‘Chemobrain’ to Longitudinal Changes in Brain

The phenomenon called “chemobrain”—impaired cognitive functioning following chemotherapy—correlates with longitudinal changes in the brain’s white matter, according a recent study in the Journal of Clinical Oncology.1 Structural changes in the white matter, measured by magnetic resonance diffusion...

health-care policy

ACCC Meeting Focuses on Affordable Care Act: Its Future, and What It Might Accomplish

The Association of Community Cancer Centers (ACCC) mid-March Annual Meeting devoted several sessions to the Patient Protection and Affordable Care Act: Will it still be here after the Supreme Court decides its fate? If so, how much of it will survive, and how will it affect oncology practice? In...

issues in oncology

Our Patients, Our Teachers

There is no greater professional satisfaction than the knowledge that you have cared for a patient and the care brought an improvement in the patient's health.  Regardless of the level of appreciation, whether the patient is cured or not, and even if the patient's sense of well-being may be...

lung cancer

Nearly 800,000 Lung Cancer Deaths Averted during 1975–2000 Due to Decline in Smoking Rates

The cumulative impact of changes in smoking behavior that started in the mid-1950s averted approximately 795,851 U.S. lung cancer deaths, 552,574 among men and 243,277 among women from 1975 to 2000, according to a report in the Journal of the National Cancer Institute. The researchers also...

gynecologic cancers
issues in oncology

New Guidelines Recommend Less Frequent Screening for Cervical Cancer, but That Doesn’t Mean Screening Is Less Important

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. In March 2012, the U.S. Preventive...

solid tumors

Using Imatinib for Adjuvant Treatment after Resection of Kit (CD117)-positive Gastrointestinal Stromal Tumors

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 January 2012, imatinib mesylate (Gleevec) was granted ...

colorectal cancer

ColoPrint Gene Assay Can Guide Treatment Decisions in Stage II Colon Cancer

ColoPrint, an 18-gene expression profile assay for patients with early-stage colon cancer, accurately stratifies patients by recurrence risk and identifies a subset who can be adequately treated by surgery alone, investigators reported at the 2012 Gastrointestinal Cancers Symposium.1 According to...

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...

breast cancer

Defining Meaningful Benefit: The Debate Continues in Bevacizumab’s Wake

The events surrounding the labeling of bevacizumab (Avastin) have been well covered since last November when the FDA withdrew the drug’s accelerated approval as a treatment for metastatic breast cancer. However, the controversy initiated a debate over the value of endpoints in clinical trials in...

head and neck cancer

Younger Patients Treated with Systemic Carboplatin at Higher Risk of Ototoxicity

Patients younger than 6 months at the start of systemic carboplatin treatment for retinoblastoma have a significant risk of developing hearing loss, according to a study in the Journal of Clinical Oncology. A review of audiologic test results of 60 patients with retinoblastoma who received...

breast cancer

Concepts about Effects of Menopausal Hormone Therapy on Breast Cancer Continue to Change

In 2002, it was thought that menopausal hormone therapy using estrogen alone increases breast cancer risk, although not as quickly as combined estrogen plus progestin. Current thinking about estrogen alone is that it reduces breast cancer risk. This is just one example of changing concepts about...

thyroid cancer

Vandetanib: New Drug for Unresectable Medullary Thyroid Cancer

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 The oral kinase inhibitor vandetanib (Caprelsa) was...

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