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leukemia

Ofatumumab Plus Chlorambucil for Previously Untreated CLL in Patients Not Treatable With Fludarabine-Based Regimens

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. On April 17, 2014, ofatumumab (Arzerra) received regular approval...

issues in oncology

Creating a Comprehensive Catalog of Cancer Genes to Improve Patient Outcomes

In January, Eric S. Lander, PhD, Director of the Broad Institute of MIT and Harvard in Cambridge, Massachusetts, and his colleagues published the results from their landmark study,1 which explored the feasibility of creating a comprehensive catalog of cancer genes. The researchers collected and...

thyroid cancer

Increased Incidence of Thyroid Cancer: An Epidemic of Diagnosis?

In a study reported in JAMA Otolaryngology Head & Neck Surgery,1 Davies and Welch found that the incidence of thyroid cancer has nearly tripled since 1975. However, the increase appears to represent an “epidemic of diagnosis” and to almost exclusively represent increased diagnosis of papillary...

cns cancers

Surgical Resection of Newly Diagnosed Glioblastoma: What Is the Standard of Care?

The neurosurgeon is often the gateway provider when patients present with what on magnetic resonance imaging (MRI) appears to be a new glioblastoma. Because histology-based diagnosis is a prerequisite for initiating standard therapy with radiation and chemotherapy, the first question that the...

breast cancer
colorectal cancer
lung cancer
pancreatic cancer

ASCO Committee Defines Clinically Meaningful Goals for Clinical Trials in Pancreas, Breast, Lung, and Colorectal Cancers

The ASCO Cancer Research Committee recently convened four disease-specific working groups—in pancreas, breast, lung, and colon cancers—to “consider the design of future clinical trials that would produce results that are clinically meaningful to patients.” An ASCO perspective statement, reported in ...

Setting a ‘Moon Shots’ Goal to Drastically Reduce Cancer Mortality Over the Next Decade

In 2012, just 1 year after taking the reins as President of The University of Texas MD Anderson Cancer Center, Ronald A. DePinho, MD, announced his plans to launch the Moon Shots Program, the most ambitious endeavor undertaken by the cancer center to dramatically accelerate the pace of reducing...

ASCO Launches New Resources for Providers and Patients to Address Link Between Obesity and Cancer

As the obesity epidemic takes its toll on the nation’s health, ASCO is making strides to address this growing concern as it relates to cancer. ASCO has developed a suite of educational resources designed to help oncology providers educate their patients about the negative effects of obesity on...

colorectal cancer

Getting It Right in the End: Individualization of Care for Patients With Rectal Cancer

Data from trials conducted mostly in the 1970s and 1980s established the paradigm that optimal treatment of rectal cancer requires a combination of radiation therapy, chemotherapy, and surgery.1 Virtually all of these trials, however, demonstrated that radiotherapy added only to the local control...

colorectal cancer

Neoadjuvant Chemotherapy Without Routine Radiotherapy Shows Promise in Patients With Locally Advanced Rectal Cancer

In a pilot study reported in the Journal of Clinical Oncology, Deborah Schrag, MD, MPH, and colleagues from Memorial Sloan Kettering Cancer Center, New York, assessed outcomes with neoadjuvant FOLFOX (fluorouracil, leucovorin, oxaliplatin)/bevacizumab (Avastin) with selective use of...

prostate cancer

Continued Survival Benefits Seen With Radical Prostatectomy vs Watchful Waiting in Long-Term Follow-up of the SPCG-4 Trial

The long-term benefits of radical prostatectomy vs watchful waiting in men with localized prostate cancer has remained a debated issue. As reported in The New England Journal of Medicine by Anna Bill-Axelson, MD, of Uppsala University Hospital, and colleagues, additional long-term follow-up in the...

lung cancer

Phase III Study Explores Addition of Nintedanib to Docetaxel in Second-Line Treatment of Non–Small Cell Lung Cancer

In a phase III trial (LUME-Lung 1) reported in The Lancet Oncology, Reck et al assessed the addition of nintedanib to docetaxel in second-line treatment of non–small cell lung cancer (NSCLC).1 The combination significantly improved progression-free survival in all patients and improved overall...

issues in oncology

Cancer Chemotherapy Use During Pregnancy

INSIDE THE BLACK BOX is an occasional column providing insight into the FDA and its policies and procedures. In this installment, National Toxicology Program scientists Kembra L. Howdeshell, PhD, and Michael D. Shelby, PhD, discuss a recently completed monograph that reviews the published data on...

leukemia

Volasertib Granted Orphan Drug Designation for Acute Myeloid Leukemia

The U.S. Food and Drug Administration (FDA) has granted Orphan Drug Designation to volasertib for acute myeloid leukemia. Volasertib is currently being evaluated in a phase III clinical trial for the treatment of patients aged 65 or older, with previously untreated AML, who are ineligible for...

lung cancer

Ceritinib Highly Active in Patients With ALK-Rearranged Advanced NSCLC

Non-small cell lung cancer (NSCLC) harboring ALK rearrangement is sensitive to the ALK inhibitor crizotinib (Xalkori), but resistance ultimately occurs. In a phase I study reported in The New England Journal of Medicine, Alice T. Shaw, MD, PhD, of Dana-Farber/Harvard Cancer Center, Boston, and...

health-care policy

The Affordable Care Act: NCCN Panelists Rate It ‘Average’

Oncologists and third-party payers are already experiencing changes as a result of the Affordable Care Act, which earned an “average” rating by a panel of providers, payers, and patients assembled at the 19th Annual Conference of the National Comprehensive Cancer Network (NCCN) in Hollywood,...

lung cancer
lymphoma

Belinostat Moves Forward in Trials for Two Aggressive Cancers

In February, the U.S. Food and Drug Administration (FDA) granted belinostat (Beleodaq), a targeted histone deacetylase (HDAC) inhibitor, priority review status based on a pivotal phase II trial in peripheral T-cell lymphoma. Just 1 month later, researchers at the National Cancer Institute (NCI) in...

lung cancer
bladder cancer

FGFR Inhibitors of Interest in Bladder and Lung Cancer

Fibroblast growth factor receptor (FGFR) inhibitors are an emerging area of interest in cancer therapeutics. Studies presented at the 2014 American Association for Cancer Research (AACR) Annual Meeting in San Diego provided early encouraging data for two investigational pan-FGFR inhibitors for the...

leukemia
myelodysplastic syndromes

Early Data for AG-221 Show Unprecedented Activity in Acute Myeloid Leukemia and Myelodysplastic Syndrome

Although the data are preliminary, experts were impressed with responses to a novel IDH2 inhibitor called AG-221 in patients with hematologic malignancies. In the first clinical trial of AG-221, there were three complete remissions, two complete remissions with incomplete platelet count recovery...

breast cancer
colorectal cancer
lung cancer
prostate cancer
skin cancer
leukemia
lymphoma
multiple myeloma
survivorship

NCCN Clinical Practice Guidelines in Oncology: 2014 Updates

At the 19th Annual Conference of the National Comprehensive Cancer Network (NCCN), held recently in Hollywood, Florida, NCCN Panel members presented updates for several tumor types, briefly summarized here. For a more complete description of all updates, visit www.nccn.org. Breast Cancer Guidelines ...

symptom management

Guidelines for Chemotherapy-Induced Neuropathy: The Known Unknowns

It is a tribute to the advances in supportive care that peripheral neuropathy, along with fatigue, has become the most vexing management challenge in cancer patients receiving chemotherapy. The successes of modern antiemetic regimens and white blood cell growth factor support have radically altered ...

survivorship
symptom management

ASCO Releases Guideline on Prevention and Management of Chemotherapy-Induced Peripheral Neuropathy in Survivors of Adult Cancers

ASCO has released a clinical practice guideline on prevention and treatment of chemotherapy-induced peripheral neuropathy in adult cancer patients, published in the Journal of Clinical Oncology.1 The guidelines resulted from the efforts of an expert panel, with representation from the fields of...

Enthusiasm and Vision Guide the Head of FDA’s Oncology Office

In  2005, Richard Pazdur, MD, was named the FDA’s Director of the Office of Hematology and Oncology Products. By any measure, being arbiter of the nation’s oncology drug pipeline is a daunting prospect, but Dr. Pazdur sees it as an opportunity to encourage his talented staff to work for the greater ...

A Coast-to-Coast Road to an Illustrious Career in Radiation Oncology

Nationally regarded radiation oncologist and lymphoma expert Richard Hoppe, MD, was reared in Seaford, a small town hugging the South Shore of Long Island, New York. “I grew up in the early part of Long Island’s suburban sprawl, and my childhood was a fairly typical experience for that time,”...

cost of care

Speaking Up Against High Cancer Drug Prices

Physicians have a duty to speak up against high cancer drug prices,” Hagop M. Kantarjian, MD, resolutely stated in an interview with The ASCO Post. “We should speak up because high drug prices are harming patients.” A leader in the effort to drive down the cost of drugs needed to treat patients...

breast cancer

Cancer Has Robbed Me of My Physical Beauty but Not My Inner Strength

I’ve been plagued with various ailments all my life. Physically and emotionally abused by my stepfather as a child, over the years I’ve developed severe psychological issues including depression and anxiety disorder. I am also in constant physical pain from cervical degenerative disc disease,...

issues in oncology

A Proposal for Patient-Selected Controlled Trials: Good Science and Good Medicine

The Clinical Trials and Translational Research Advisory Committee (CTAC) of the National Cancer Institute (NCI) met for the 22nd time on March 12, 2014, in their ongoing effort to improve efficiency and effectiveness of cancer clinical trials. A significant portion of the meeting addressed lagging...

integrative oncology

St. John's Wort

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...

palliative care

Explore Cancer Care That Best Supports Patients and Families at the Palliative Care in Oncology Symposium

Palliative care is essential to good cancer care, but it is a topic that can raise red flags because of the common misperception that it is reserved for those in the terminal stage of the disease. In truth, palliative care is highly necessary for all patients with cancer, and when it is integrated...

breast cancer

Should Breast Cancer Patients With One to Three Positive Nodes Routinely Receive Postmastectomy Radiation?

The Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) continues to provide valuable clinically relevant and practice-influencing information garnered from individual patient-level data from numerous randomized trials in breast cancer. The large numbers of patients and long-term follow-up...

breast cancer

ASCO Clinical Practice Guideline Update: Sentinel Lymph Node Biopsy for Patients With Early-Stage Breast Cancer

ASCO recently convened an update committee of experts in medical oncology, pathology, radiation oncology, surgical oncology, guideline implementation, and advocacy to develop evidence-based recommendations that update the ASCO 2005 clinical practice guideline on use of sentinel node biopsy in...

leukemia

Looking Ahead in Treating Chronic Lymphocytic Leukemia

It’s the dawn of a new era in the treatment of chronic lymphocytic leukemia (CLL), largely due to the development of agents targeting the BCR signaling pathway, according to John C. Byrd, MD, of The Ohio State University Comprehensive Cancer Center, Columbus. At the 19th Annual Conference of the...

issues in oncology
supportive care

NCCN Roundtable: When a Parent Has Cancer

Attendees at this year’s annual conference of the National Comprehensive Cancer Network (NCCN) not only got up to date on the Guidelines but left with a better understanding of how children deal with a parent’s cancer, and how oncology providers can best help. Panelists for the NCCN roundtable...

leukemia

Mercaptopurine Oral Suspension for Acute Lymphoblastic Leukemia

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.   On April 28, 2014, an oral suspension of mercaptopurine (Purixan) ...

prostate cancer

Delaying Androgen Deprivation Therapy May Not Compromise Survival in Men With Prostate Cancer and PSA-Only Relapse

In men with prostate cancer and a prostate-specific antigen (PSA)-only recurrence after curative surgery or radiation, delaying androgen deprivation therapy for at least 2 years or until clinical progression (ie, new symptoms, metastasis by imaging techniques or short PSA doubling time) did not...

lung cancer

Phase I Study of Novel Third-Generation EGFR Inhibitor Holds Promise Against Resistance Mutation in Patients With Non–Small Cell Lung Cancer

Preliminary evidence suggests that AZD9291, a novel mutant-selective epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, may become a treatment option for patients with advanced, EGFR-mutant, non–small cell lung cancer (NSCLC) that has progressed on standard EGFR inhibitors....

breast cancer

ALTTO Trial Finds Dual Anti-HER2 Therapy No Better Than Trastuzumab Alone

The highly anticipated results from the phase III ALTTO trial show no additional benefit for adding lapatinib (Tykerb) to trastuzumab (Herceptin) in the adjuvant treatment of HER2-positive breast cancer.1 The results were presented at the 2014 ASCO Annual Meeting’s Plenary Session by Martine J....

prostate cancer

‘Unprecedented’ Survival Benefit in Prostate Cancer With Addition of Docetaxel to Hormone Therapy

Adding docetaxel to standard androgen ablation therapy (ie, testosterone suppression) extended survival by more than 1 year in men with newly diagnosed metastatic hormone-sensitive prostate cancer in the phase III E3805 trial, funded by the National Institutes of Health. As reported at the ASCO...

cost of care
health-care policy

Cancer Care Under the Affordable Care Act

The problematic rollout of the Affordable Care Act’s website, HealthCare.gov, made good political theater, but while much of the heated discussion centered on the plan’s need to enroll “young invincibles,” America’s cancer care system and the older patients it serves were also affected by parts of...

breast cancer

Issues in the Management of the Axilla in Patients With Breast Cancer

For the past 40 years the story of breast cancer surgery in general, and for the past 20 years the management of the axilla in particular, has been one of increasing conservatism. To give our readers insight into the current and future direction of axillary management, The ASCO Post spoke with...

hematologic malignancies

FDA Approval of Siltuximab for Multicentric Castleman’s Disease

INSIDE THE BLACK BOX is an occasional column providing insight into the FDA and its policies and procedures. In this installment, FDA hematologist/oncologist Albert Deisseroth, MD, PhD, discusses the recent approval of siltuximab for patients with multicentric Castleman’s disease who are human...

colorectal cancer

Colorectal Cancer Screening Poised for Change

New screening modalities and the customization of the screening population could soon change the way that screening for colorectal cancer is done. At Digestive Disease Week 2014, the largest gathering of gastrointestinal disease specialists in the world, researchers presented data suggesting that...

breast cancer

Goserelin With Chemotherapy Prevents Early Menopause, Helps Preserve Fertility in Younger Women With Hormone Receptor–Negative Breast Cancer

The good news for younger women with hormone receptor–negative early breast cancer is that adding goserelin (Zoladex), a luteinizing hormone–releasing hormone (LHRH) agonist, to chemotherapy can prevent sudden menopause, better preserve ovarian function and fertility, and lead to successful...

lung cancer

Pieces of the Puzzle in Treating Early Non–Small Cell Lung Cancer

Separate studies in early-stage non–small cell lung cancer (NSCLC) found that the addition of consolidation chemotherapy to concurrent chemoradiotherapy did not improve survival and that adjuvant erlotinib (Tarceva) did not improve survival. There was a suggestion of benefit for adjuvant erlotinib...

prostate cancer

Updated Information on Prostate Cancer Drugs: Enzalutamide, Orteronel, and Cixutumumab

Three separate studies of treatments for prostate cancer reported at the 2014 ASCO Annual Meeting in Chicago showed excellent, intermediate, and disappointing results. An update of the previously reported PREVAIL trial (see March 1 issue of The ASCO Post, page 1) was overwhelmingly positive for the ...

Expert Point of View: Nancy E. Davidson, MD, and Claudine Isaacs, MD

This study provides key insights into the longstanding and vexing debate about optimal systemic therapy for these young women. We wonder about the role of tamoxifen, aromatase inhibitors, chemotherapy, and ancillary therapies like bisphosphonates,” said Nancy E. Davidson, MD, Director of the...

head and neck cancer
issues in oncology

Limited Public Awareness of Head and Neck Cancers Raises Concerns About Prevention and Detection

Public awareness of head and neck cancer is limited, with the lack of awareness including the term head and neck cancer and common symptoms and risk factors, such as tobacco use and human papillomavirus (HPV), according to results of a cross-sectional online survey reported in JAMA...

palliative care

Discontinuing Statins Near the End of Life Is Safe, Can Reduce Symptom Burden, and Is Generally Acceptable to Patients

Discontinuing statins for patients near the end of life is safe, saves money, spares patients from swallowing yet another pill and from the symptoms associated with statins, and is generally welcomed by patients. That last bit might come as a surprise to some physicians who worry that discontinuing ...

hematologic malignancies

Siltuximab for Multicentric Castleman’s Disease

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. On April 23, 2014, the anti–interleukin (IL)-6 monoclonal antibody...

issues in oncology

'Physician Education Is Key' to Continued Advances in Geriatric Oncology

Several times during his lecture at the 2014 ASCO Annual Meeting, Stuart M. Lichtman, MD, FACP, FASCO, the recipient of the B.J. Kennedy Award for Scientific Excellence in Geriatric Oncology, emphasized, “Physician education is the key” to continued advances in geriatric oncology. He specified that ...

breast cancer

ASCO Guideline for Management of Brain Metastases From  HER2-Positive Breast Cancer: An Important Framework

Brain metastases are a devastating complication of cancer, and occur in up to 50% of patients with advanced human epidermal growth factor 2 (HER2)-positive breast cancer. Management of brain metastases requires individualized coordination between the traditional treatment modalities for...

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