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integrative oncology

Shiitake Mushroom 

The use of dietary supplements by patients with cancer has increased significantly over the past 2 decades despite insufficient evidence of safety and effectiveness. Finding reliable sources of information about dietary supplements can be daunting. Patients typically rely on family, friends, and...

cns cancers

Molecular Imaging Improves Care in Pediatric Glioma

The amino acid imaging agent, O-(2-[18F]-fluoroethyl)-L-tyrosine (F-18 FET), may improve upon standard magnetic resonance imaging (MRI) and its diagnostic benefit for imaging pediatric gliomas when conventional MRI is not sufficient, said researchers at the Society of Nuclear Medicine and Molecular ...

prostate cancer

Radium-223 Dichloride for Castration-resistant Prostate Cancer with Symptomatic Bone Metastases 

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 15, 2013, radium Ra 223 dichloride (Xofigo) was...

supportive care

Venous Thromboembolism in Patients with Cancer: Real-world Challenges for the Practicing Oncologist 

The close association between cancer and thrombosis has been recognized now for more than 150 years.1 Not only is it now known that patients with cancer are at substantially increased risk of developing venous thromboembolism, even prior to the diagnosis of cancer, but the association between...

supportive care

Updated ASCO Clinical Practice Guideline for Venous Thromboembolism Prophylaxis and Treatment 

ASCO has released a new evidence-based clinical practice guideline for venous thromboembolism prophylaxis and treatment, updating the 2007 practice guideline.1 The update is based on a systematic review of literature published from December 2007 to December 2012. An Update Committee reviewed...

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...

Expert Point of View: Christine M. Lovly, MD, PhD

“The definition of molecular subsets of lung cancer [in terms of] driver mutations has revolutionized the care of patients with non–small cell lung cancer [NSCLC],” said formal discussant Christine M. Lovly, MD, PhD, Instructor in Medicine at Vanderbilt-Ingram Cancer Center, Nashville. ALK...

lung cancer

Second-generation ALK Inhibitor Breakthrough Drug Promising in Early Study for Non–Small Cell Lung Cancer 

Encouraging results were seen in a preliminary study of a second-generation ALK inhibitor in advanced ALK-positive non–small cell lung cancer (NSCLC). The drug—dubbed LDK378—achieved tumor shrinkage in almost all patients enrolled in the study, in all mutational subsets, in crizotinib...

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 ...

Some Excess Cancer Risk in Men May Be Related to Greater Height  

More than one-third of the excess risk for cancers among men may be due to factors associated with height, according to data from the Vitamins and Lifestyle (VITAL) study. As reported in the Journal of the National Cancer Institute, these factors include the “number of susceptible cells in a...

leukemia
geriatric oncology

Lenalidomide Induces Long-lasting Responses in Elderly Patients

Treatment with lenalidomide (Revlimid) as initial therapy induced long-lasting responses in a phase II study of 60 patients with chronic lymphocytic leukemia (CLL). “Overall, 35 patients (58%) patients had responses lasting more than 36 months and were considered long-term responders,” the...

breast cancer

Two Studies Indicate Potential Predictors of Survival Benefit from Endocrine Therapy 

Two studies published in Journal of Clinical Oncology indicate that treatment-related symptoms and mammographic density reduction may predict whether a woman with hormone receptor–positive breast cancer will benefit from adjuvant endocrine therapy. In one study, women who had specific adverse...

global cancer care

Clinical Trials for Patients in Africa

Thank you very much for The ASCO Post Evening News,* which ensures I don’t miss anything that happened at the ASCO 2013 meeting. Due to financial constraints I could not attend the ASCO Annual Meeting in Chicago. My comment is that pharmaceutical companies should extend their oncology drug trials...

issues in oncology

Co-discoverer of DNA Double Helix, James Watson, PhD, Offers a New Theory on Cancer Progression 

Despite his fame as co-discoverer—along with Francis Crick, PhD—of the double-helix structure of deoxyribonucleic acid (DNA) in 1953, that accomplishment is not what James Dewey Watson, PhD, came to talk about during a recent presentation he gave at the World Science Festival in New York. Instead,...

colorectal cancer

Looking for Drivers in the Rearview Mirror 

The latest clinical trial looking at combining vascular endothelial growth factor (VEGF) and epidermal growth factor receptor (EGFR) inhibition in metastatic colorectal cancer adds little to our overall understanding of the mechanisms for optimizing selection of patients to receive such therapies....

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...

breast cancer

Examining the Role Genetics Plays in Breast Cancer Onset 

Internationally known for her research in the molecular genetics of cancer, Olufunmilayo I. Olopade, MD, FACP, first became interested in oncology during medical school in Nigeria, where she cared for patients with Burkitt’s lymphoma. After moving to Chicago in 1983 to continue her medical...

issues in oncology

Genomic Heterogeneity Can Lead to the Selection of 'Incorrect' Targeted Inhibitors 

Genomic heterogeneity within tumors and among lesions varies widely, and “discordance among lesions could lead to the selection of the ‘incorrect’ targeted inhibitor,” according to David B. Solit, MD, of Memorial Sloan-Kettering Cancer Center, who spoke at the ASCO/American Association for Cancer...

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...

skin cancer

Anti-PD-1 Antibody Lambrolizumab Produces Durable Responses with Low Toxicity in Patients with Advanced Melanoma  

Lambrolizumab produced a high rate of sustained tumor regression when tested among 135 patients with advanced melanoma in a multi-institutional, international, phase I expansion study reported in The New England Journal of Medicine. At a median follow-up of 11 months, responses were durable in the...

lymphoma

Dr. Joseph Bertino's Breakthrough Work in Methotrexate Resistance Led to Understanding Why Cancer Drugs Work or Fail 

Looking over his 5 decades in clinical oncology and research, ­Joseph R. Bertino, MD, says his greatest professional satisfaction comes from seeing his former students and oncology fellows go on to achieve great success in their own medical and research careers. It is a fitting sentiment since Dr....

Cedars-Sinai Medical Physicist Honored by American Association of Physicists in Medicine

Benedick Fraass, PhD, FAAPM, FASTRO, FACR, has received the William D. Coolidge Award from the American Association of Physicists in Medicine for his distinguished career achievements in medical physics, including his pioneering work in radiation oncology.    “The William D. Coolidge Award credits...

issues in oncology

NIH Commits $24 Million Annually for Big Data Centers of Excellence

The National Institutes of Health will fund up to $24 million per year for 4 years to establish six to eight investigator-initiated Big Data to Knowledge Centers of Excellence. The centers will improve the ability of the research community to use increasingly large and complex datasets through the...

issues in oncology

Adolescents, Young Adults with Cancer Often Challenged By Unmet Needs Following Treatment 

About 70,000 adolescents and young adults (AYAs) between the ages of 15 and 39 are diagnosed with cancer each year, and in the past 30 years, there has been little or no improvement in survival in this population. In addition to the disease itself, they face many other challenges: reentry into...

health-care policy
legislation

The Sunshine Act Calls for Greater Transparency in Industry-Doctor Relationships 

Signed into law on March 23, 2010, the Patient Protection and Affordable Care Act represents the most significant overhaul of the U.S. health-care system since the passage of Medicare and Medicaid in 1965. Because of the law’s sheer scope, parts of it still remain obfuscated by its 2,400 or so...

Focus on the West Virginia Oncology Society 

Now in its fifth year, the West Virginia Oncology Society (WVOS) is already having a major impact on cancer care in the state. In 2010, a joint initiative to develop a statewide cancer clinical trials network was launched by WVOS and the West Virginia University Cancer Center. With funding support...

lung cancer

Significant Improvement in Overall Survival Seen with Pemetrexed Maintenance after Pemetrexed/Cisplatin Induction in Patients with Advanced NSCLC 

In the phase III PARAMOUNT trial, pemetrexed (Alimta) continuation maintenance therapy significantly reduced the risk of disease progression by 38% compared with placebo after pemetrexed/cisplatin induction in patients with advanced nonsquamous non–small cell lung cancer (NSCLC). Final overall...

colorectal cancer

Link between Red Meat Consumption and Mortality Clarified in Patients with Nonmetastatic Colorectal Cancer  

Evidence shows that diets high in red and processed meat are associated with an increased risk of colorectal cancer. In a study reported in the Journal of Clinical Oncology, Marjorie L. McCullough, ScD, Strategic Director of Nutritional Epidemiology, and colleagues from the Epidemiology Research...

lung cancer

First-line Carboplatin/Pemetrexed Improves Survival vs Pemetrexed Alone in Advanced Lung Cancer 

A significant proportion of patients with advanced non–small cell lung cancer (NSCLC) have poor performance status, and optimal clinical management of these patients has not been established. In an attempt to help define optimal chemotherapy in such patients, Mauro Zukin, MD, of Instituto Nacional...

Conquer Cancer Foundation Grant Recipient 'Pays It Forward' Through Philanthropic Support, Volunteer Service

Dr. Dawn Hershman, Associate Professor of Medicine and Epidemiology at Columbia University Medical Center and leader of the Breast Cancer Program at Herbert Irving Comprehensive Cancer Center, is committed to doing what she can to develop, encourage, and support the next generation of oncology...

health-care policy

AACR Cautions Diminished NIH Funding Jeopardizes Ability to Eradicate Cancer Health Disparities

Recently the American Association for Cancer Research (AACR) hosted a congressional briefing to highlight the significance of federally funded biomedical research in improving our understanding of cancer health disparities and developing targeted interventions to eliminate them. Disproportionate...

breast cancer

Age Not Linked to Recurrence in Observation or Trastuzumab Groups with HER2-positive Breast Cancer  

Available data suggest that younger age is an independent risk factor for disease recurrence and death in women with breast cancer. However, there has not been adequate study of the interaction of age with human epidermal growth factor receptor 2 (HER2) status or anti-HER2 treatment. In an analysis ...

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...

lung cancer

LUX-Lung 3: Afatinib Prolongs Progression-free Survival vs Cisplatin/Pemetrexed in Advanced Lung Adenocarcinoma 

Afatinib (Gilotrif) is an oral selective ErbB family inhibitor that irreversibly blocks signaling from EGFR/ErbB1, HER2/ErbB2, and ErbB4 and has exhibited broad-spectrum activity against EGFR mutations in preclinical studies. A phase II study of afatinib in EGFR-mutation positive lung...

hepatobiliary cancer

Targeted Suppression of a Reactivated Developmental Pathway in Hepatocellular Cancer 

This issue of The ASCO Post summarizes the results of an important study recently published in The New England Journal of Medicine by Yong and colleagues. As outlined, investigators from the National University of Singapore Yong Loo Lin School of Medicine have identified re-expression of SALL4 as a ...

palliative care

Diane E. Meier, MD: From Early Lessons in Critical Thinking to 'Palliative Care Everywhere' 

Although the world is full of suffering, it is full also of the overcoming of it.  —Helen Keller, Optimism, 1903 Shortly past 8:00 AM on July 1977, Diane E. Meier, MD, FACP, began the first day of her medical internship. Within minutes she would experience another first: the death of a patient...

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 ...

lymphoma

Ibrutinib Produces High Response Rate in Patients with Refractory Mantle Cell Lymphoma

Ibrutinib is a first-in-class oral covalent inhibitor of Bruton’s tyrosine kinase, a mediator of the B cell-receptor signaling pathway implicated in the pathogenesis of B-cell cancers. As reported in The New England Journal of Medicine, Michael L. Wang, MD, of The University of Texas MD Anderson...

leukemia

High Rate of Durable Remissions with Ibrutinib in Patients with Relapsed Chronic Lymphocytic Leukemia 

Durable remissions are uncommon with current treatments for relapsed chronic lymphocytic leukemia (CLL). Bruton’s tyrosine kinase is an essential component of B cell–receptor signaling that mediates interactions with the tumor microenvironment and promotes survival and proliferation of CLL cells....

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...

breast cancer

GeparSixto Study Finds Benefit for Neoadjuvant Carboplatin in Triple-negative Breast Cancer 

In patients with triple-negative breast cancer, the addition of carboplatin significantly improved the rate of pathologic complete response after neoadjuvant chemotherapy in a study by the German Breast Group (GBG)/Gynecologic Oncology Working Group–Breast (AGO-B) reported at the 2013 ASCO Annual...

Expert Point of View: Tim Maughan, MD

Maintenance treatment with capecitabine plus bevacizumab can be considered in clinical practice, according to Tim Maughan, MD, Professor of Clinical Oncology at Oxford University in the United Kingdom, who discussed CAIRO3 at the session. He said that approximately 60% of patients with metastatic...

colorectal cancer

Maintenance Treatment Delays Progression in Metastatic Colorectal Cancer 

For patients with unresectable metastatic colorectal cancer, maintenance treatment with capecitabine (Xeloda) and bevacizumab (Avastin) significantly delayed disease progression and improved overall survival in the phase III CAIRO3 study by the Dutch Colorectal Cancer Group. Miriam Koopman, MD,...

lung cancer

Significant Improvement in Overall Survival Seen With Pemetrexed Maintenance After Pemetrexed/Cisplatin Induction in Patients With Advanced Nonsquamous NSCLC 

In the phase III PARAMOUNT trial, pemetrexed (Alimta) continuation maintenance therapy significantly reduced the risk of disease progression by 38% compared with placebo after pemetrexed/cisplatin induction in patients with advanced nonsquamous non–small cell lung cancer (NSCLC). Final overall...

lymphoma

Can Obinutuzumab Benefit Patients With Rituximab-Refractory Non-Hodgkin Lymphoma? 

Obinutuzumab is a glycoengineered type II antibody that differs from type I anti-CD20 antibodies by being associated with actin reorganization and adhesion followed by direct cell death.1 Obinutuzumab has been glycoengineered by reduction in fucose content of the Fc region, which increases its...

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