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Showing 4201 - 4250In Managing Ovarian Cancer, Precision Medicine Is a Work in Progress
Precision medicine in the management of ovarian cancer “is a work in progress, to be sure,” Steven B. Newman, MD, noted in wrapping up the session on gynecologic cancer at the recent Best of ASCO meeting in Chicago. “A list of different histologic types of ovarian cancer and potential targets are...
Enhanced Benefit Shown With FOLFIRI/Ziv-Aflibercept in Subset of Patients With Metastatic Colorectal Cancer
The survival benefit demonstrated in the VELOUR study for FOLFIRI (irinotecan, fluorouracil [5-FU], leucovorin) plus ziv-aflibercept (Zaltrap) vs FOLFIRI plus placebo in metastatic colorectal cancer patients who progressed on oxaliplatin-based chemotherapy persisted beyond median survival times for ...
First Photographs of Breast Surgery, New York City, 1886
Antiseptic principles delivered the promise of safe surgery, while asepsis allowed safe major dissections and invasion of body cavities. The physicians who were using these techniques recognized the amazing difference in their surgical results and corresponding mortality rates and proselytized to...
Improving Treatment of Depression in Patients With Cancer: The SMaRT Oncology-2 Trial
Clinical depression is highly prevalent, associated with significant morbidity, often underrecognized, and inadequately treated in cancer patients. Professor Michael Sharpe and Jane Walker, PhD, and their colleagues’ seminal work on enhancing treatment of depression in cancer patients using a...
Failure of Cilengitide in Newly Diagnosed Glioblastoma With Methylated MGMT Promoter
Temozolomide in combination with radiation for newly diagnosed glioblastoma was approved by the U.S. Food and Drug Administration in 2005—almost 10 years ago—but we have unfortunately made little progress in improving survival for this incurable brain tumor. Despite recent completion of three...
ECOG E4402/RESORT Trial: When ‘Black and White’ Results Are Actually Gray
The results of the ECOG E4402/RESORT trial recently reported by Kahl and colleagues,1 and reviewed in this issue of The ASCO Post, provide interesting new information on the use of maintenance rituximab (Rituxan) vs retreatment with rituximab at progression in patients with low–tumor burden...
Attaining the Goal of Preventing Ovarian Cancer
Fifteen years ago, David Fishman, MD, launched the National Ovarian Cancer Early Detection Program as part of the National Cancer Institute’s Early Detection Research Network. The goal of the research effort was to develop methods to accurately detect ovarian cancer while it was still confined to...
Significant Improvement in Overall Survival With Second-Line Addition of Ramucirumab to Docetaxel in Stage IV NSCLC
In the phase III REVEL trial reported in Lancet, Edward B. Garon, MD, of the David Geffen School of Medicine at UCLA/Translational Research in Oncology–US Network, Los Angeles, and colleagues found that the addition of the antiangiogenic vascular endothelial growth factor receptor (VEGFR)-2...
Fertility Preservation Suggested With Triptorelin in Long-Term Study
Young women with early breast cancer may be more likely to resume menses and become pregnant when treated with a luteinizing hormone–releasing hormone (LH-RH) analog (also known as a gonadotropin-releasing hormone [GnRH] analog) along with chemotherapy, according to the final follow-up of...
Managing Resistance to Targeted Agents: The Future of NSCLC Therapy
The bane of treating non–small cell lung cancer (NSCLC) patients with druggable mutations has been the development of resistance to targeted agents. New compounds are meeting the challenge of treating resistant disease, according to Fadlo R. Khuri, MD, FACP, Professor and Chair of Hematology and...
Hypofractionated Radiation Much Less Toxic Than Conventionally Fractionated Radiation in Early Breast Cancer
Hypofractionated whole-breast irradiation was associated with much less acute toxicity during radiation therapy compared with conventionally fractionated whole-breast irradiation and also led to improved physical well-being and less physician-reported and patient-reported fatigue 6 months later,...
Chest Radiation Improves Survival and Intrathoracic Recurrence Rates in Extended-Stage Small Cell Lung Cancer
Thoracic radiotherapy extended progression-free survival, reduced intrathoracic recurrences, and improved overall survival at 2 years when added to prophylactic cranial irradiation in patients with extended-stage small cell lung cancer in an international randomized controlled trial.1 “Thoracic...
Updated GEM2005 Trial Confirms Benefit of Melphalan/Bortezomib Combination in Elderly Multiple Myeloma Patients
Melphalan in combination with bortezomib (Velcade) should be maintained as one of the standards of care for the treatment of elderly patients with multiple myeloma, concluded Spanish trialists reporting updated results from the GEM2005 study comparing bortezomib/melphalan/prednisone with...
Adding Cetuximab to Chemoradiation Did Not Benefit Patients With Advanced Head and Neck Cancer: What Were the Reasons?
Two landmark randomized studies demonstrated improved survival of patients with head and neck cancer receiving the epidermal growth factor receptor (EGFR) antibody cetuximab (Erbitux) concurrent with radiotherapy compared with radiotherapy alone,1 and similar improvement in patients with...
Variety of Adjuvant Strategies Explored in HER2‑Positive and Other Breast Cancer Types
Adjuvant trastuzumab (Herceptin) was shown to be effective in patients with breast cancers ≤ 2 cm, regardless of estrogen receptor status, in a meta-analysis1 of five chemotherapy trials, but a “pressing question” remaining is whether T1a/b, N0 tumors warrant the use of adjuvant trastuzumab, Andrew ...
For Triple-Negative Breast Cancer, Adding Carboplatin to Anthracycline/Taxane Produces Benefit, but How Much?
Combination chemotherapy for triple-negative breast cancer is anthracycline- and taxane-based and has not really changed much in the past 10 years, but “we are starting to see emerging data with selective activity of platinum agents,” Priyanka Sharma, MD, told participants at the Best of ASCO...
Radiotherapy Should Be Added to Hormone Therapy in Node-Positive Prostate Cancer
Node-positive prostate cancer has typically been excluded from clinical trials, leaving oncologists with little evidence to guide management for this group of patients. A study presented at the European Society for Medical Oncology (ESMO) 2014 Congress sheds light on this issue, providing the...
Long-Term Results of COU-AA-302 Confirm Abiraterone Benefit
Final results of the COU-AA-302 trial continue to support the survival benefit of abiraterone acetate (Zytiga) in men with chemotherapy-naive metastatic castration-resistant prostate cancer, often referred to as the “predocetaxel space.” “The study met the overall survival endpoint and all...
FDA Approves Bortezomib Injection for Previously Untreated Patients With Mantle Cell Lymphoma
The U.S. Food and Drug Administration (FDA) has approved bortezomib (Velcade) injection for previously untreated patients with mantle cell lymphoma. This is the first treatment in the United States to be approved for use in previously untreated patients with mantle cell lymphoma. Bortezomib was...
Novel Oral Agent Treats Cachexia in Patients With Non–Small Cell Lung Cancer
For the first time, studies show that a drug is effective in treating several domains of cancer-related cachexia. Oral anamorelin increased lean body mass, achieved weight gain, and improved quality of life in patients with cancer-related cachexia in two pivotal phase III studies presented together ...
Nivolumab Yields ‘Impressive’ Duration of Response as Late-Line Melanoma Treatment
Nivolumab yielded an “impressive” duration of response when used as second- or third-line treatment for patients with advanced melanoma, according to Jeffrey S. Weber, MD, of the Moffitt Cancer Center in Tampa, Florida, who presented preliminary results of a phase III trial at the European Society...
BRAF/MEK Inhibitor Combinations Impressive in Melanoma Trials
For advanced/metastatic melanoma patients with BRAF mutations, two pathway inhibitors are better than one, according to studies presented at the European Society for Medical Oncology (ESMO) 2014 Congress that demonstrated improved progression-free and overall survival for regimens combining a BRAF...
Encouraging Early Signals for Cediranib in Recurrent Cervical Cancer
Cediranib (a potent tyrosine kinase inhibitor of vascular endothelial growth factor receptor (VEGFR)-1, -2, and -3) produced a modest improvement in progression-free survival and a robust improvement in response rates compared with placebo when added to chemotherapy in patients with recurrent...
Novel Agents May Address Endocrine Therapy Resistance
Progress has recently been swift in the development of new drugs to improve the response to hormone therapy in breast cancer, according to Hope S. Rugo, MD, Professor of Medicine and Director of Breast Oncology and Clinical Trials Education at the University of California, San Francisco, Helen...
CLEOPATRA: Survival With Dual HER2 Blockade ‘Unprecedented’
In the final overall survival analysis of the phase III CLEOPATRA trial, HER2-positive metastatic breast cancer patients lived 15.7 months longer if they received pertuzumab (Perjeta) in addition to trastuzumab (Herceptin) and docetaxel, investigators reported at the European Society for Medical...
Neoadjuvant Chemotherapy Plus Two Anti-HER2 Agents Optimal for HER2-Positive Breast Cancer
For women with human epidermal growth factor receptor 2 (HER2)-positive breast cancer, combining two anti-HER2 agents with chemotherapy is the most effective treatment modality in the neoadjuvant setting, according to a meta-analysis published in the Journal of the National Cancer Institute. The...
FDA Approves Ramucirumab in Combination With Paclitaxel for Advanced Gastric or Gastroesophageal Junction Adenocarcinoma
The U.S. Food and Drug Administration (FDA) has approved ramucirumab (Cyramza) for use in combination with paclitaxel for the treatment of patients with advanced gastric or gastroesophageal junction adenocarcinoma. Ramucirumab was approved in April 2014 as a single agent for the treatment of...
Top 10 Myths About FDA’s Office of Hematology and Oncology Products
INSIDE THE BLACK BOX is an occasional column providing insight into the U.S. Food and Drug Administration (FDA) and its policies and procedures. In this installment, FDA oncologists Gideon Blumenthal, MD, and Tatiana Prowell, MD, discuss 10 common myths about FDA’s Office of Hematology and Oncology ...
Maintenance Therapy in Ovarian Cancer: What’s at Stake?
Maintenance therapy in ovarian cancer refers to a cohort of women achieving response to initial adjuvant chemotherapy who then go on to additional therapy in the hopes of extending time to recurrence or inducing a lasting remission. The concept is not new and retains its scientific and clinical...
Treatment of Newly Diagnosed Multiple Myeloma With Lenalidomide Plus Low-Dose Dexamethasone
The FIRST trial—reported by Benboubker and colleagues in The New England Journal of Medicine and summarized in this issue of The ASCO Post (page 93)—is a landmark study.1 It is one of the largest randomized trials in multiple myeloma ever conducted. More importantly, it is a well-designed trial...
Patient-Reported Data Indicate that Radiation Therapy Does Not Increase Risk of Lymphedema in Patients With Node-Negative Breast Cancer
A secondary analysis of the National Surgical Adjuvant Breast and Bowel Project B-32 trial1 indicates that radiation therapy does not increase the incidence of lymphedema in patients with node-negative breast cancer, according to research presented at the American Society for Radiation Oncology’s...
Expert Point of View: Hope S. Rugo, MD
Hope S. Rugo, MD, Professor of Medicine and Director of Breast Oncology and Clinical Trials Education at the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, discussed the results of the RESILIENCE trial presented at the European Society for Medical Oncology ...
Adding Sorafenib to Capecitabine Fails to Improve Progression-Free Survival in Advanced Breast Cancer
In patients with locally advanced or metastatic breast cancer, the addition of sorafenib (Nexavar), a broad-spectrum tyrosine kinase inhibitor, to capecitabine did not improve progression-free or overall survival in the phase III RESILIENCE trial. The findings were presented at the European Society ...
Studies Evaluate Maintenance Bevacizumab in Metastatic Breast Cancer
Although bevacizumab (Avastin) may no longer be an active player in metastatic breast cancer, phase III studies presented at this year’s European Society for Medical Oncology (ESMO) Congress reignited interest in the drug as part of maintenance therapy. The TANIA trial met its primary endpoint,...
Moving Forward With Biomarkers in Non–Small Cell Lung Cancer
The effort to identify new biomarkers for response and outcomes in lung cancer is advancing, according to studies presented at the European Society for Medical Oncology (ESMO) 2014 Congress in Madrid. Immunohistochemical expression of folate receptor for vintafolide and thymidylate synthase for...
Emerging Drugs Effectively Tackle Non–Small Cell Lung Cancer Mutations
For advanced nonsquamous non–small cell lung cancer (NSCLC), targeting of the epidermal growth factor receptor (EGFR) mutation and the ALK abnormality has become an established strategy. Later-generation drugs in these categories are now showing efficacy in trials, including for the treatment of...
Single-Agent Carfilzomib, Compared to Corticosteroids Plus Cyclophosphamide, Fails to Improve Survival in Myeloma
Carfilzomib (Kyprolis), as a single agent, failed to improve survival in relapsed and refractory myeloma patients, as compared with a corticosteroid and optional cyclophosphamide, in the phase III FOCUS trial, presented at the European Society for Medical Oncology (ESMO) 2014 Congress in Madrid.1...
Expert Point of View: Stefan Sleijfer, MD, PhD
Formal discussant of the PAZOGIST trial at the European Society for Medical Oncology (ESMO) 2014 Congress, Stefan Sleijfer, MD, PhD, of Erasmus MC Cancer Institute, Rotterdam, the Netherlands, said “The title of my talk is ‘Small Molecules: Greater Success,’ and we are not yet there.” He agreed...
Pazopanib Improves Progression-Free Survival in Advanced Pretreated GIST
Patients with gastrointestinal stromal tumor (GIST) can achieve remission on tyrosine kinase inhibitors, but almost all of them eventually develop resistance to these agents. The PAZOGIST trial results suggest that pazopanib (Votrient)—a broad-spectrum tyrosine kinase inhibitor—may be an effective ...
Expert Point of View: Alexandria Phan, MD
Formal discussant of the RADIANT-3 trial at the European Society for Medical Oncology (ESMO) Congress, Alexandria Phan, MD, of Houston Methodist Cancer Center, agreed that the crossover to open-label everolimus (Afinitor) by placebo patients probably muddied the waters in the survival estimate....
Clinically Relevant Survival Benefit Seen for Everolimus in Pancreatic Neuroendocrine Tumors
Final results from the RADIANT-3 trial showed a 6-month difference in overall survival favoring everolimus (Afinitor) plus best supportive care over placebo plus best supportive care in patients with well-differentiated advanced and progressive pancreatic neuroendocrine tumors.1 Although the...
Phase III Study Confirms Regorafenib’s Survival Benefit in Metastatic Colorectal Cancer
The phase III CONCUR trial1 of regorafenib (Stivarga) monotherapy in Asian patients with previously treated metastatic colorectal cancer confirmed the overall survival benefit seen in the previous CORRECT trial,2 and in a planned subgroup analysis, suggesting the benefit is substantial in patients ...
Expert Point of View: Axel Grothey, MD
Putting the maintenance trials into context was Axel Grothey, MD, Professor of Oncology at the Mayo Clinic, Rochester, Minnesota, who commented, “These studies inform our clinical practice and have a meaningful impact on how we treat our patients.” DREAM Trial In the DREAM Trial, Dr. Grothey...
All-RAS Testing in Metastatic Colorectal Cancer: Just the First Step
Now that clinicians know to “think beyond KRAS” in metastatic colorectal cancer—and test for all RAS mutations, not just those in exon 2—it seems this is still not sufficient for selecting the best drugs. At the European Society for Medical Oncology (ESMO) 2014 Congress in Madrid, a proffered paper ...
Noteworthy Abstracts From the Breast Cancer Symposium Include Studies of Novel Therapies and of the Impact of Disease Subtypes on Outcomes
More than 150 oral and poster presentations were featured at the 2014 Breast Cancer Symposium, held September 4–6 in San Francisco. The multidisciplinary meeting is sponsored by ASCO, the American Society of Breast Disease, American Society of Breast Surgeons, American Society for Radiation...
Targeted Therapies in Indolent Lymphoma: Challenging the Current Paradigm
The use of targeted therapies in indolent non-Hodgkin lymphoma (NHL) is a burgeoning area. New targeted therapies directed at the cell surface, intracellular pathways, and the microenvironment are being studied for relapsed indolent NHL. These treatments, if validated in large randomized trials,...
For Selected Patients With Metastatic Colorectal Cancer, Taking a Break From Combination Chemotherapy Might Be Appropriate and Appreciated
Two phase III studies presented at the Best of ASCO meeting in Chicago shed more light on the role of maintenance therapy in patients with metastatic colorectal cancer undergoing first-line treatment with oxaliplatin-based chemotherapy. The two studies compared maintenance therapy with bevacizumab...
Expert Point of View: Solange Peters, MD, PhD
The IMPRESS trial asks a simple question: Should you continue an [epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor] while you switch to chemotherapy,” said Solange Peters, MD, PhD, Head of the Thoracic Malignancies Program at the University of Lausanne, Switzerland, at the European ...
IMPRESS Trial: Lung Cancer Progression on First-Line Tyrosine Kinase Inhibitor Indicates the Drug Should Be Stopped
The IMPRESS trial found no benefit for continuing treatment with the epidermal growth factor receptor (EFGR) tyrosine kinase inhibitor gefitinib (Iressa, discontinued in the United States) plus chemotherapy vs chemotherapy alone in patients with EGFR-mutated non–small cell lung cancer (NSCLC) who...
Major Strides Seen This Year in Survivorship Care
"This year was actually a boon for the patient and survivor care section,” Arif H. Kamal, MD, said at the Best of ASCO meeting in Seattle, where he reviewed the leading abstracts and gave some of his own perspective. “What you see is a lot of the limitations of research in the palliative care and...
