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lung cancer

Understanding Crizotinib, 1 Year after High-profile Presentation

The findings from a phase I study of crizotinib in non–small cell lung cancer (NSCLC) were presented in a Plenary Session at the 2010 ASCO Annual Meeting—an unusual event, since such early-phase data are not generally the topic of plenary sessions. The study showed that a majority of mostly...

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...

breast cancer

Stalked by Cancer: One Woman’s Story

Cancer has been stalking me all my life. My mother’s mother had died of breast cancer at a relatively young age. My mother was diagnosed with breast cancer in the early 1960s, when she was 35 and I was just 5 years old. Although she was told that she probably wouldn’t live more than 2 years, she...

lung cancer

Maintenance Therapy Prolongs Progression-free Survival in Advanced NSCLC but Produces No Overall Survival Benefit

Maintenance therapy with either pemetrexed (Alimta) or gefitinib (Iressa) achieved modest improvements in progression-free survival in patients with advanced non–small cell lung cancer (NSCLC). The magnitude of improved progression-free survival was 1.3 months and 2.2 months, respectively, in the...

lung cancer

Emerging Targeted Therapies Offer Glimmer of Hope for NSCLC but Biomarkers for Response Needed

Among the newer approaches to treatment of non–small cell lung cancer (NSCLC) are heat-shock protein 90 (Hsp90) inhibitors, toll-like receptor 2 (TLR2) agonists, and vascular-disrupting agents. So far, none appears to be a “home run,” but Hsp90 inhibition may be the most promising of the three...

lung cancer

Identifying Genetic Factors That Predict Response to Chemotherapy in NSCLC

A genetic variation in the chemokine-like receptor 1 (CMKLR1) gene was statistically significantly associated with poor overall survival in patients with non–small cell lung cancer (NSCLC) who were treated with platinum-based chemotherapy with or without radiation. The variation was identified by a ...

breast cancer

Genomic Researchers Identify Weak Points in Breast Cancer Cells

A large-scale project in genetic profiling has identified weak points in breast tumor cells that not only represent potentially new “druggable” targets but could lead to an entirely new classification of all cancers. The findings were recently reported in Cancer Discovery, a journal of the American ...

issues in oncology

A Conversation with Samuel Silver, MD, PhD

Over the past 2 decades, significant therapeutic advances have led to greater survival rates and quality of life for patients with cancer. During the same period there has been a transformation in the way oncology services are both perceived and delivered. In a recent conversation with The ASCO...

lung cancer

World Conference on Lung Cancer: Personalized Approaches to Treatment

The 14th World Conference on Lung Cancer hosted more than 7,000 attendees in Amsterdam recently, with the theme “Better Care through Personalized Medical Approaches.” The following are brief summaries of key data presented at the conference, with perspective provided by Roy S. Herbst, MD, PhD, of...

lung cancer

Crizotinib plus Companion Diagnostic Test Approved in NSCLC

On August 26, 2011, the FDA granted accelerated approval to Pfizer’s crizotinib (Xalkori) for the treatment of patients with locally advanced or metastatic non–small cell lung cancer (NSCLC) that is anaplastic lymphoma kinase (ALK)-positive as detected by an FDA-approved test. The FDA approved the...

cost of care
palliative care
health-care policy

Palliative Care, Quality of Life, and Cost

More than half of our nation’s patients with cancer are Medicare beneficiaries, making the entitlement program ground zero in the heated debate on health-care spending. Total Medicare expenditures attributable to beneficiaries in their last year of life runs upward of 30%; this statistic serves as...

lymphoma

FDA Approves Brentuximab Vedotin in Two Lymphoma Indications

The antibody-drug conjugate brentuximab vedotin (Adcetris) was granted accelerated approval on August 19 for the treatment of relapsed or refractory Hodgkin lymphoma and systemic anaplastic large cell lymphoma. Brentuximab vedotin is the first new drug to be approved in Hodgkin lymphoma in more...

SIDEBAR: The March of Progress in Lung Cancer Treatment

Before the discovery of predictive molecular tests (eg, EGFR mutation and ALK rearrangement), each chemotherapy drug for stage IV non–small cell lung cancer had about the same chance of success. Progress was made as more drugs were discovered. Patients lived longer with second- and third-line...

lung cancer

New ASCO Focused Update Recommendation on Maintenance Treatment of Stage IV Non–Small Cell Lung Cancer

A focused update to the 2009 ASCO Clinical Practice Guideline Update on Chemotherapy for Stage IV Non-Small-Cell Lung Cancer reflects new evidence on maintenance therapy in patients with response or stable disease after four cycles of first-line cytotoxic chemotherapy.1 The 2009 update...

breast cancer

No Value for Axillary Dissection in Patients with Breast Cancer and Occult Nodal Metastases

In a subanalysis of the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-32 study, nearly 16% of clinically node-negative patients were found to have occult metastases upon more detailed assessment of the sentinel lymph nodes. While a slight difference in outcomes was found among this...

lymphoma

Similar Outcomes Confirmed in Variety of Lymphoma Treatment Comparisons

Three abstracts reported at the Best of ASCO® meeting in Seattle provide guidance to hematologists when it comes to long-standing gray areas in lymphoma management, according to Oliver Press, MD, PhD, of the Fred Hutchinson Cancer Research Center and the University of Washington, Seattle....

SIDEBAR: Searching for More Efficacious, Less Toxic Adjuvant Chemotherapy for NSCLC

Accumulating data are helping to better define the risk-benefit profile of various adjuvant chemotherapy regimens for non–small cell lung cancer (NSCLC) and the impact of adding biologic agents to the mix, according to H. Jack West, MD, of the Swedish Cancer Institute in Seattle. In the randomized ...

lung cancer

Incremental Advances Demonstrated in Management of Locoregional Lung Cancer

Data presented at the ASCO Annual Meeting this year on the management of locoregional lung cancer present a mixed picture, with some advances and some disappointments, according to H. Jack West, MD, of the Swedish Cancer Institute in Seattle, who reviewed studies in this area at the Best of ASCO...

SIDEBAR: Molecular Heterogeneity Complicates Management of Resistance

The molecular heterogeneity of lung cancers will make it a challenge to manage resistance in this era of targeted therapy, according to D. Ross Camidge, MD, PhD, of the University of Colorado, Denver. A case in point: the anaplastic lymphoma kinase (ALK) story. Recently updated data for crizotinib ...

lung cancer

Research Increasingly Points to the Role of Molecular Diversity in Metastatic Lung Cancer

Molecular diversity—its existence, extent, and implications for therapy—was a central theme of key metastatic lung cancer studies presented at this year’s ASCO meeting, according to D. Ross Camidge, MD, PhD, of the University of Colorado, Denver, who addressed major findings in advanced lung cancer ...

global cancer care
health-care policy

Tobacco Remains the Dominant Global Risk Factor Underlying Cancer

Despite clear evidence that tobacco causes at least 18 types of cancer, as well as many other diseases, many people all over the world smoke or chew tobacco, or are exposed to secondhand smoke. Although smoking among Americans has declined slowly but steadily over the past 40 years, it remains the...

lung cancer

Time to Reconsider Treatment Paradigm for Elderly Patients with Advanced Non–Small Cell Lung Cancer?

Significantly longer median overall survival among elderly patients with advanced non–small cell lung cancer (NSCLC) receiving doublet chemotherapy rather than monotherapy yielded a 36% reduction in mortality risk in a phase III randomized trial. “We saw a survival benefit with doublet chemotherapy ...

lung cancer

Crizotinib: New Drug for ALK-positive Advanced Non–Small Cell Lung Cancer

Indication Crizotinib (Xalkori) is an oral inhibitor of receptor tyrosine kinases including anaplastic lymphoma kinase (ALK), hepatocyte growth factor receptor (HGFR, c-Met), and recepteur d’origine nantais (RON). In August 2011, the FDA granted the drug accelerated approval for the treatment of...

lung cancer

No Improvement in Survival with High-dose over Standard-dose Radiation for Stage III Non–Small Cell Lung Cancer

Surprisingly, less may be more when it comes to radiation therapy with concurrent chemotherapy for patients with stage III non–small cell lung cancer (NSCLC), according to an interim analysis of the randomized phase III Radiation Therapy Oncology Group (RTOG) 0617 trial presented at the 53rd Annual ...

issues in oncology

Do We Need the USPSTF?

Like most of the folks reading this commentary, I’m a taxpayer. Although I sometimes become impatient with the strategic games on Capitol Hill, I basically appreciate that government helps many things to work, and some of them even work well. However, there are aspects of government function that...

lung cancer

NSCLC Studies: Bevacizumab/Pemetrexed Maintenance Improves Survival, KRAS Status Has No Impact on Outcomes with Sorafenib

Maintenance therapy with bevacizumab (Avastin) plus pemetrexed (Alimta) showed a modest improvement in progression-free survival vs bevacizumab alone in patients with advanced non–small cell lung cancer (NSCLC), according to the final analysis of the AVAPERL study. In a separate study, selecting...

health-care policy

ASCO Supports the United Nations Political Declaration on Noncommunicable Diseases

In September, government leaders from around the world as well as representatives from civil society, the private sector and academia gathered at the United Nations in New York for the first-ever summit on the growing economic and human crisis posed by noncommunicable diseases (NCDs), especially in ...

gynecologic cancers

Alternative Treatment for Advanced Ovarian Cancer Reduces Neurotoxicity and Alopecia

A randomized phase III clinical trial found that carboplatin/pegylated liposomal doxorubicin (Doxil) was not superior in prolonging progression compared to the standard carboplatin/paclitaxel as first-line therapy of patients with advanced ovarian cancer. The carboplatin/liposomal doxorubicin...

breast cancer

Fewer False-positives, Small Increased Risk of Late Diagnosis with Biennial Mammography

Screening mammography every other year reduced false-positive recalls by about one-third compared to annual screening, but was associated with a small increase in the probability of late-stage cancer diagnosis, according to a study funded by the NCI and published in Annals of Internal Medicine. To...

lung cancer

Improved Survival with Concurrent Chemotherapy plus Radiotherapy for Patients with Stage III Non–Small Cell Lung Cancer

Five-year survival was statistically significantly higher for patients with stage III non–small cell lung cancer (NSCLC) who received concurrent rather than sequential cisplatin-based chemotherapy combined with thoracic radiotherapy, according to the phase III Radiation Therapy Oncology Group...

lung cancer

NCCN Guidelines® for Lung Cancer Screening Now Available

The new NCCN Guidelines for Lung Cancer Screening primarily refer to non–small cell lung cancer, the most common type of lung cancer, and recommend helical low-dose computed tomography (LDCT) screening for select patients at high risk for the disease. In addition to outlining the appropriate use of ...

issues in oncology

Predictive Biomarker for Bevacizumab: Are We Getting Closer?

The need to identify a biomarker to guide treatment with bevacizumab (Avastin) is abundantly clear, and studies presented at the 2011 European Multidisciplinary Cancer Congress suggest this goal may be in sight. “Finding predictive biomarkers is a challenge, but there are candidates,” said Eric Van ...

issues in oncology

Important Lessons for Oncology from the Front Lines of the AIDS Pandemic

On June 5, 1981, the CDC issued a warning about a rare type of pneumonia discovered among a small group of young gay men in Los Angeles, later determined to be AIDS-related, ushering in the HIV/AIDS epidemic. Early on, AIDS-related malignancies brought the oncology community into this formidable...

SIDEBAR: Expect Questions from Your Patients

Patients concerned about an increased risk of cancer among recipients of organ transplantation need to know that “in the great majority of cases, patients don’t get cancer,” according to Eric Engels, MD, MPH, lead author of the Transplant Cancer Match Study report and Senior Investigator, Division...

issues in oncology
solid tumors
hematologic malignancies

Solid Organ Transplant Recipients Have Increased Risk for Broad Range of Malignancies

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. The Transplant Cancer Match Study, a ...

lung cancer

Evidence of Improved Survival for Lobectomy vs Limited Resection in Early-stage Lung Cancer

“Evidence is statistically inconclusive but suggestive that lobectomy, compared with limited resection, is associated with increased long-term survival for early-stage lung cancer,” according to a study reported in the Journal of the National Cancer Institute. The study analyzed data from 679...

ASCO Helps Survivors Transition into Life after Treatment with New Booklet

Progress against cancer has helped save or extend the lives of millions of patients. Thanks to advances in medical research, there are about 12 million cancer survivors today in the United States. For patients transitioning back into everyday life after surgery, chemotherapy, radiation therapy, or...

bladder cancer

Neutrophil/Lymphocyte Ratio Can Upstage Patients with Bladder Cancer

A sizable proportion of bladder cancer patients who would benefit from neoadjuvant chemotherapy are not receiving it, researchers from the University of Wisconsin School of Medicine and Public Health, Madison, concluded. Their conclusion was based on their assessment of the neutrophil/lymphocyte...

2011 in Review: Oncology Drugs/Indications Newly Approved by FDA

At press time, the FDA had granted approval for the following new agents and indications for cancer treatment in 2011. Asparaginase Erwinia chrysanthemi (Erwinaze) as a component of a multiagent chemotherapeutic regimen for the treatment of acute lymphoblastic leukemia in patients who have...

breast cancer

Optimizing HER2-directed Therapy in the Clinic

Seminal research in the treatment of HER2-positive breast cancer has been led by Edith A. Perez, MD, the Serene M. and Frances C. Durling Professor of Medicine at the Mayo Clinic, Jacksonville, Florida. The ASCO Post asked Dr. Perez to share her approach to HER2-directed therapy. Testing...

lymphoma

Update on Novel Treatments for Peripheral T-cell Lymphoma

At the recent Pan-Pacific Lymphoma Conference in Kauai, Hawaii, Julie M. Vose, MD, from the University of Nebraska Medical Center, Omaha, discussed novel treatments for peripheral T-cell lymphoma (PTCL). PTCL is a heterogeneous group of aggressive T-cell/natural killer (NK) cell non-Hodgkin...

lung cancer

Advances in Lung Cancer Treatment Show Incremental Benefits, but Room for Improvement Remains

Newer therapies for the treatment of non–small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) were discussed at the Chemotherapy Foundation Symposium. More inroads have been made in improving outcomes for patients with NSCLC than for those with SCLC, but there is still room for...

lung cancer

Presurgical Gemcitabine/Cisplatin Improves Survival in Lung Cancer

Preoperative gemcitabine plus cisplatin had a statistically significant impact on outcomes among patients with stage IIB/IIIA non–small-cell lung cancer in a phase III randomized study comparing surgery alone or surgery plus preoperative chemotherapy. The 3-year progression-free survival rates were ...

lymphoma
geriatric oncology

Expert Point of View: Therapy for Hodgkin Lymphoma in the Elderly Remains Undefined

Elderly Hodgkin lymphoma, typically defined as affecting individuals ≥ 60 years of age, remains a disease for which no standard treatment recommendation exists. This population is underrepresented in clinical studies, and survival rates in older patients with Hodgkin lymphoma are significantly and ...

integrative oncology

NIH Director Calls for Rigorous Evaluation of Integrative Medicine to Provide Evidence of Efficacy

“Many new frontiers exist in integrative medicine,” NIH Director Francis Collins, MD, PhD, stated in his keynote address at the Eighth International Conference of the Society for Integrative Oncology (SIO) in Cleveland. “The evidence is overwhelming that these approaches are being used by many...

solid tumors

Resection of Metastatic Lesions Extends Survival in Multiple Tumor Types

Surgical oncologists urged other cancer providers to appreciate the potentially curative role that surgery can play in the management of many stage IV solid tumors, in a session during the American College of Surgeons 97th Annual Clinical Congress in San Francisco. Pulmonary Metastases Stephen G....

lung cancer

High EGFR Expression Can Predict Survival Benefit from Cetuximab plus First-line Chemotherapy in NSCLC

High expression of epidermal growth factor receptor (EGFR) can predict survival benefit from cetuximab (Erbitux) added to first-line chemotherapy in patients with advanced non–small cell lung cancer (NSCLC). The identification of high EGFR expression as a tumor biomarker follows findings from the...

solid tumors

Targeting AKT/mTOR May Improve Response to Monoclonal Antibodies in Some Cancers

The insulin-like growth factor (IGF) network plays a central role in regulating tumor cell growth and differentiation, tumor angiogenesis, metastasis, apoptosis, and multidrug resistance. Increased IGF-1 receptor (IGF-1R) expression and circulating IGF-1 are associated with increased risk for...

ASCO Membership Categories Offer a Place for Everyone

If your work touches those who have cancer, you have a place within ASCO. That’s the message that the organization, during its 48 years, has gotten across in many ways, not the least of which is its membership categories, which have expanded right along with the field of cancer care. “ASCO is...

lung cancer

Epigenetic Therapy Shows Positive Results in Late-stage Lung Cancer

A small phase I/II clinical study from Johns Hopkins University in Baltimore found that epigenetic therapy with a combination of azacitidine (Vidaza) and entinostat (an investigational agent) produced responses in some patients with refractory advanced non–small cell lung cancer. The study results, ...

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