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integrative oncology

Kava

Kava Scientific Name: Piper methysticum Common Names: Kava-kava, kawa, kavain, rauschpfeffer, intoxicating long pepper, tonga, yagona, and yaqona. Overview Kava, a perennial shrub indigenous to the Hawaiian Islands and the Pacific Rim, is known for its relaxant effects and used for social and...

multiple myeloma

Ongoing NCI-Funded Clinical Trials Actively Recruiting Patients With Hematologic Cancers: Multiple Myeloma

Study Type: Non-Randomized Phase I/Interventional Study Title: Multicenter Phase I Study of Th1/Tc1 Immunotherapy Following Autologous Hematopoietic Progenitor Cell Transplantation in High-Risk Multiple Myeloma Study Sponsor and Collaborators: National Cancer Institute; Hackensack University...

issues in oncology

FDA Programs to Expedite Drug and Biologic Product Development

With the advent of Breakthrough Therapy designation, there are now four FDA programs to expedite the development of promising new agents: Fast Track, Breakthrough Therapy, Priority Review, and Accelerated Approval (Table 1). These programs complement one another and serve a common goal: to speed...

Radiation Oncology Institute Awards $200,000 Grant to Christopher Slatore, MD

The Radiation Oncology Institute (ROI) has named Christopher G. Slatore, MD, recipient of a $200,000 award, distributed over 2 years, for a project to examine the comparative value of radiation therapy and patient outcomes among patients with lung cancer. Dr. Slatore is Assistant Professor in the...

Expert Point of View: Bruce Cheson, MD

Ibrutininb appears to be the most promising drug we have seen in Waldenstrom’s macroglobulinemia and will likely significantly change the therapeutic landscape,” according to Bruce Cheson, MD, Deputy Chief, Hematology-Oncology and Head of Hematology Research at Georgetown Lombardi Cancer Center in...

lymphoma

Ibrutinib Induces Prompt and Durable Responses in Some Lymphomas

The Bruton’s tyrosine kinase inhibitor ibrutinib (Imbruvica) is changing the landscape of treatment in chronic lymphocytic leukemia. New research with the drug in lymphoma, presented at the 2013 American Society of Hematology (ASH) Annual Meeting in New Orleans, indicates it may be of benefit in...

Expert Point of View: Andrew D. Zelenetz, MD, PhD

Andrew D. Zelenetz, MD, PhD, Chair of the Non-Hodgkin Lymphoma Guideline Panel of the National Comprehensive Cancer Network (NCCN) and former Chief of the Lymphoma Service at Memorial Sloan-Kettering Cancer Center, New York, put the latest maintenance trials into perspective for The ASCO Post....

lymphoma

Novel Agents Show Activity in Non-Hodgkin Lymphoma

PI3K-mediated activation of downstream effectors allows tumors to escape from negative growth control, and this action may be checked with PI3K inhibitors. At the 2013 American Society of Hematology (ASH) Annual Meeting, researchers reported results in patients with relapsed or refractory lymphoma...

lymphoma

FDA Accepts New Drug Application for Idelalisib in Refractory Indolent Non-Hodgkin Lymphoma

The U.S. Food and Drug Administration (FDA) has accepted the New Drug Application (NDA) for idelalisib, a targeted, oral inhibitor of PI3K-delta, for the treatment of refractory indolent non-Hodgkin lymphoma (NHL). The FDA has granted a standard review for the NDA, with a target review date of...

lung cancer

Nintedanib Combined With Docetaxel Is Effective Second-Line Option for Advanced NSCLC

The combination of nintedanib and docetaxel “is an effective second-line option” for patients with advanced non–small cell lung cancer (NSCLC) who have received previous treatment with one line of platinum-based therapy, according to results from the phase III LUME-Lung 1 study published in The...

breast cancer

No Mortality Benefit of Breast Cancer Mammography Screening in 25-Year Follow-up of Canadian National Breast Screening Study

As reported in BMJ by Anthony B. Miller, MD, Professor Emeritus at the Dalla Lana School of Public Health, University of Toronto, and colleagues, the 25-year follow-up of the Canadian National Breast Screening Study has shown no mortality benefit of annual mammography screening for breast cancer...

leukemia

Encouraging Early Results With Novel Agents in CLL

Two novel agents have shown promising activity in chronic lymphocytic leukemia (CLL), including poor-risk patients: the Bcl-2 inhibitor ABT-199 and the small-molecule PI3K inhibitor IPI-145. Both drugs achieved excellent response rates in heavily pretreated relapsed/refractory patients including...

colorectal cancer
pancreatic cancer

GI Symposium Presentations Include Important Updates in Treatment and Prognosis of Pancreatic and Colorectal Cancers

More than 650 studies were presented at the 2014 Gastrointestinal Cancers Symposium, which attracted a multidisciplinary group of more than 3,500 medical, surgical, and radiation oncologists and gastroenterologists. The following briefs highlight a handful of noteworthy studies from the meeting....

issues in oncology

Cancer Genes and Molecular Medicine: More Education Needed

I read with interest and concern the Perspective piece, “Cancer Genes, Promiscuity, and the National Debt,” which appeared on page 1 of the February 1st issue of The ASCO Post. The underlying premise of this wide-ranging and provocative article would appear to be that in a rush to implement...

lung cancer

Protein Expression–Based Risk Model for Recurrence in Resected NSCLC

In a study reported in Clinical Cancer Research, Gold and colleagues developed a risk model for recurrence of resected non–small cell lung cancer (NSCLC) based on protein expression and clinical variables. The study involved analysis of samples from 370 patients with NSCLC resected between 2002 and ...

skin cancer

Staging of Cutaneous Squamous Cell Carcinoma

Neoplasms originating from skin keratinocytes are increasing in frequency in the United States and include a spectrum of diseases culminating in the development of invasive cutaneous squamous cell carcinoma. Although most cases of cutaneous squamous cell carcinoma can be treated conservatively with ...

lymphoma

Crizotinib Proves Effective in ALK-Positive Lymphoma

Crizotinib (Xalkori) produced promising results in patients with ALK-positive lymphoma in two small studies presented at the 2013 American Society of Hematology (ASH) Annual Meeting. Crizotinib exerted potent antitumor activity in advanced ALK-positive lymphoma and achieved durable responses in...

lymphoma

Idelalisib Achieves High Response Rates in ‘Double-Refractory’ Indolent NHL

In patients with indolent B-cell non-Hodgkin lymphoma (NHL) refractory to both rituximab (Rituxan) and an alkylating agent, monotherapy with the selective oral PI3K-delta inhibitor idelalisib produced a high response rate, with responses persisting for 1 year in the average patient, according to...

breast cancer

Adding Bevacizumab to Adjuvant Chemotherapy/Trastuzumab Fails to Improve Survival in HER2-Positive Breast Cancer

The addition of bevacizumab (Avastin) to adjuvant chemotherapy did not improve invasive disease-free survival or overall survival in patients with high-risk HER2-positive breast cancer in the large randomized phase III BETH trial. Although not specifically designed to answer this question, BETH...

breast cancer

Immune Modulation May Aid Some Breast Cancer Subtypes

There may be an immunogenic phenotype in breast cancer that could benefit from immune modulation as part of treatment, according to results from studies that correlated high levels of tumor-infiltrating lymphocytes with both pathologic complete responses and long-term outcomes. Studies presented at ...

kidney cancer
prostate cancer

Five Key Studies in Prostate Cancer and Renal Cell Carcinoma

The 10th Genitourinary Cancers Symposium, sponsored by ASCO, the American Society for Radiation Oncology, and the Society of Urologic Oncology, was held January 29–February 1, 2014, in San Francisco. The more than 630 abstracts presented addressed essential research in genitourinary malignancies,...

SIDEBAR: Examples of Advances Attributed to Cooperative Group Trials

Produced long-term survival and cures in the majority of pediatric cancer cases Showed that breast-conserving lumpectomy is often a better surgical option than radical mastectomy, developed optimal adjuvant chemotherapy regimens, and demonstrated the preventive benefits of tamoxifen...

lung cancer

I Refuse to Capitulate to Cancer

Early last year, just as I returned to my residency in neurologic surgery at Stanford University after completing 2 years of my postdoctoral fellowship in a laboratory developing optogenetic techniques, I started losing weight—dropping from 180 lb to 160 lb in just 6 months—and I was having fairly...

lymphoma

Bendamustine/Rituximab May Be Important Alternative for Indolent NHL or MCL

Results from the BRIGHT study combined with long-term safety data from other studies suggest that bendamustine (Treanda) plus rituximab (Rituxan) “may be an important alternative treatment option” for the initial treatment of patients with low-grade non-Hodgkin lymphoma (NHL) and mantle cell...

issues in oncology

Have You Heard?

“It’s not a matter of if a child will be seriously poisoned or killed. It’s a matter of when.” Lee Cantrell, PharmD, Director of the San Diego Division of the California Poison Control System and Professor of Clinical Pharmacy at the University of California, San Francisco, commenting on the...

integrative oncology

Reishi Mushroom

Scientific name: Ganoderma lucidum Common names: Ling zhi, lin zi, mushroom of immortality Overview A fungus, reishi mushroom is an important component of the traditional medical systems of China, Japan, Korea, and other Asian countries. It is used to increase energy, stimulate the immune system,...

survivorship

Ongoing Clinical Trials Actively Recruiting Adolescent and Young Adult Survivors of Childhood Cancer

ADOLESCENT AND YOUNG ADULT CHILDHOOD CANCER SURVIVORS Study Type: Randomized/interventional Study Title: A Randomized Web-Based Physical Activity Intervention in Adolescent Survivors of Childhood Cancer Study Sponsor and Collaborators: St. Jude Children’s Research Hospital Purpose: Five-year...

hematologic malignancies

ASBMT Honors Mary Horowitz, MD, MS, With Lifetime Achievement Award for Blood and Marrow Transplant Research

Mary Horowitz, MD, MS, the Robert A. Uihlein, Jr. Chair in Hematologic Research, Professor of Medicine and Chief of Hematology and Oncology at the Medical College of Wisconsin (MCW), was presented with the 2014 Lifetime Achievement Award by the American Society for Blood and Marrow Transplantation...

breast cancer

Determining Why Younger Women With Breast Cancer Are Less Likely to Survive Than Their Older Counterparts

Although cancer survival rates among pediatric and older adult patients continue to rise, survival rates for adolescents and young adults (AYAs), defined by the National Cancer Institute as those between the ages of 15 and 39, have remained stagnant for decades. In breast cancer especially, AYAs...

NCI Awards for Extramural/Intramural Research

Three of the 10 projects recently awarded grants by the National Institutes of Health (see page 73) focused on cancer research. These include the following: Grant No. 1 U01 CA18303001 Title: Therapeutic Elimination of Stem Cells for Relapsed Pediatric AML Extramural Investigators: Drs. Yang Liu,...

issues in oncology

Informed Consent: Not Just About Blood Tests and Procedures Anymore

On February 24, the Institute of Medicine National Cancer Policy Forum convened a workshop, “Contemporary Issues in Human Subjects Protection in Cancer Research,” in Washington, DC. In his introduction to the workshop, Steven Piantadosi, MD, PhD, Director, Samuel Oschin Cancer Institute,...

NIH Opens Its Doors to Research for Extramural/Intramural Collaboration

Ten projects that will enable nongovernment researchers to conduct clinical research at the National Institutes of Health (NIH) Clinical Center in Bethesda, Maryland, were announced recently. Through these 3-year, renewable awards of up to $500,000 per year, scientists from institutions across the...

palliative care

Overcoming Physician Bias in Recommending Palliative Care

In 2010, Jennifer S. Temel, MD, published her landmark study in The New England Journal of Medicine showing that the introduction of palliative care early after a diagnosis of metastatic non–small cell lung cancer, along with cancer therapy, not only provided patients with a better quality of life...

prostate cancer

Long-Term Complications of Prostate Cancer Treatment May Have Been Underappreciated

The recent study by Nam et al in The Lancet Oncology—reviewed in this issue of The ASCO Post—provides a fresh perspective on complications other than incontinence or erectile dysfunction that commonly arise after primary treatment of localized prostate cancer.1 The authors conducted a...

breast cancer

No Mortality Benefit of Mammography Screening in 25-Year Follow-up of Canadian National Breast Screening Study

As reported in BMJ by Anthony B. Miller, MD, Professor Emeritus at the Dalla Lana School of Public Health, University of Toronto, and colleagues, the 25-year follow-up of the Canadian National Breast Screening Study has shown no mortality benefit of annual mammography screening for breast cancer...

kidney cancer

A Conversation With Arie Belldegrun, MD, FACS, and Allan Pantuck, MD, MS, FACS

Cancer Immunotherapy What is the role of immunotherapy in the treatment of metastatic renal cell carcinoma? The harnessing of the immune system as an effective treatment for cancer was recently selected by the journal Science as the top scientific Breakthrough of the Year for 2013.1 With this...

NCCN Receives $2 Million in Research Funding to Study Nintedanib in Colorectal and Lung Cancers

The National Comprehensive Cancer Network® (NCCN®) Oncology Research Program (ORP) has announced it has been awarded a $2 million grant from Boehringer Ingelheim Pharmaceuticals, Inc. to develop a program to scientifically evaluate and define the safety and clinical effectiveness of the...

Expert Point of View: Mario Sznol, MD

Mario Sznol, MD, of Yale Cancer Center, New Haven, Connecticut, was formal discussant of the MK-3475 presentations at the American Association for Cancer Research (AACR) Annual Meeting. He alluded to all the factors that complicate assays of PD-L1: the disparate nature of the assays themselves, the ...

skin cancer

PD-L1 Studied as Biomarker for Anti–PD-1 Immunotherapy

The anti–PD-1 inhibitor MK-3475 (formerly lambrolizumab) is in late-stage trials for advanced melanoma and is also being studied in other malignancies, including non–small cell lung cancer (NSCLC). An important aspect of Merck’s development program for MK-3475, as well as for other anti–PD-1 agents ...

issues in oncology

Breaking Bad News Badly Can Add to Upset

When the prognosis is poor, breaking the bad news badly can exacerbate the distress experienced by cancer patients and their families. A lack of sensitivity to patient and family emotions and not being attuned to how individual patients would prefer to be informed about their prognoses can result...

solid tumors

DNA Repair Pathway Recombination Proficiency Score Correlates With Tumor Sensitivity to Chemotherapy

As reported in Science Translational Medicine, Pitroda and colleagues developed a recombination proficiency score that measures the efficiency of DNA repair pathways in the context of cancer therapy aimed at generating DNA damage. The score is based on expression levels of four genes involved in...

SIDEBAR: FDA-Approved Drugs to Use as Single Agents or in Combination Chemotherapy

2014 Ceritinib for the treatment of patients with anaplastic lymphoma kinase (ALK)-positive, metastatic NSCLC with disease progression on or who are intolerant to crizotinib; mercaptopurine as a 20 mg/mL oral suspension for the treatment of acute lymphoblastic leukemia as part of a combination...

issues in oncology
global cancer care

Personalizing Outreach to Address Asian Cancer Health Disparities

In an effort to reduce cancer health disparities among Asian Americans, UC Davis Comprehensive Cancer Center now offers individual, in-language education and culturally sensitive materials for every Asian American cancer patient. New brochures and 5-minute videos were debuted during the National...

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 ...

The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Announces Faculty Appointments, Grants

Noah M. Hahn, MD, has been selected as Associate Professor of Oncology and Urology at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins in Baltimore. Before joining Johns Hopkins, Dr. Hahn was the Director of the Genitourinary Medical Oncology Program at Indiana University. He is an...

Researchers Cornelia Ulrich, PhD, and Bruce A. Edgar, PhD, Join Huntsman Cancer Institute

Cornelia Ulrich, PhD, and Bruce A. Edgar, PhD, scholars in the fields of cancer prevention and molecular biology, respectively, will join Huntsman Cancer Institute at the University of Utah as early as September 1, 2014. Dr. Ulrich is currently serving as a Director of the National Center for...

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...

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...

lung cancer

FDA Approves Ceritinib for Late-Stage Lung Cancer

The U.S. Food and Drug Administration (FDA) has granted accelerated approval to ceritinib (Zykadia) for patients with a metastatic anaplastic lymphoma kinase (ALK)-positive non–small cell lung cancer (NSCLC) who were previously treated with crizotinib (Xalkori). Ceritinib is an ALK tyrosine kinase...

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...

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