The ASCO Post is pleased to reproduce installments of the “Art of Oncology” as published previously in the Journal of Clinical Oncology (JCO). These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...
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 November 13, 2015, osimertinib (Tagrisso) was granted...
The following essay by Paul A. Bunn, Jr, MD, is adapted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was coedited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and thebigcasino.org. I grew up...
In a phase III trial reported in The New England Journal of Medicine, Julie Brahmer, MD, of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, and colleagues found that treatment with the programmed cell death protein 1 (PD-1) immune checkpoint inhibitor antibody nivolumab...
A recent report by DeSantis and colleagues from the American Cancer Society, summarized in this issue of The ASCO Post, presented breast cancer incidence and mortality data from an extensive analysis of the U.S. system of state-based tumor registries.1 The data showed that the incidence of breast...
The FDA approved necitumumab (Portrazza) in combination with gemcitabine and cisplatin for first-line treatment of patients with metastatic squamous non–small cell lung cancer (NSCLC). Necitumumab is not indicated for treatment of nonsquamous NSCLC. Necitumumab is a recombinant human IgG1...
Over the past year or so, a host of new agents were approved for the treatment of patients with various types of cancer (see related article on page 1). Patrick Medina, PharmD, of the University of Oklahoma College of Pharmacy, Oklahoma City, and Monique Giordana, PharmD, BCOP, of Regions...
The investigational agent anamorelin significantly increased lean body mass, body weight, total body mass, and fat mass in patients with advanced non–small cell lung cancer (NSCLC) and cachexia, according to Jennifer S. Temel, MD, who presented the results of two phase III studies at the 2015...
We have a responsibility to develop better treatment for inflammatory breast cancer,” Massimo Cristofanilli, MD, FACP, told participants at the 17th Annual Lynn Sage Breast Cancer Symposium in Chicago. As recently appointed Associate Director of Translational Research and Precision Medicine at the ...
In 2014, the U.S. Food and Drug Administration (FDA) approved 9 new drugs and biologics in the treatment of cancer and added 10 notable new indications or formulations to existing drug labels, marking a year of significant progress in improving the quality of cancer care in the United States. So...
The following new hematology/oncology agents and expanded indications were approved by the U.S. Food and Drug Administration (FDA) Center for Drug Evaluation and Research in 2015: Alectinib (Alecensa), an ALK inhibitor, for the treatment of patients with anaplastic lymphoma kinase (ALK)-positive...
An analysis of data from 46,803 patients with stage IV non–small cell lung cancer (NSCLC) who received palliative chest radiation therapy found that 49% received radiotherapy for longer than 15 fractions, and 28% received more than 25 fractions. This treatment pattern “is inconsistent with the...
Foundation Medicine, Inc. recently announced that it has signed a national agreement for the company’s comprehensive genomic profiling assay for solid tumors, called FoundationOne, with UnitedHealthcare. The agreement, which became effective December 15, 2015, covers the assay for patients with...
The 15th Annual Conference of the International Society of Geriatric Oncology (SIOG) took place in Prague, Czech Republic, over 3 days (November 12–14, 2015). At the heart of the meeting were presentations on supportive care, comprehensive geriatric assessment and treatment—so that we fully...
Question 1: Based on the rationale for the current “standard of care” for primary diffuse large B-cell lymphoma of the CNS, what is the optimal induction therapy? Correct Answer: C. A high-dose methotrexate–based regimen. Expert Perspective Untreated primary diffuse large B-cell lymphoma of the CNS ...
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 November 24, 2015, necitumumab (Portrazza) was approved for use ...
The optimal management strategy for ductal carcinoma in situ has become increasingly controversial with respect to potential overdiagnosis and overtreatment. Much of the controversy for ductal carcinoma in situ stems from its exceptional breast cancer–specific survival, which approaches close to...
Over 10 years ago, we welcomed a new approach to cancer surgery when the 2004 COST trial demonstrated the benefits of laparoscopic compared with open surgery for colon cancer. This randomized trial of 872 patients showed improved perioperative recovery with laparoscopic colectomy without...
Cancer clinical trials in three distinct phases, as they have been conducted for decades, are probably no longer the best way to bring a drug or biologic agent to market. This was the consensus of three panels at the 8th Annual Conference on Clinical Cancer Research convened by Friends of Cancer...
Non-Hodgkin lymphoma (NHL) associated with human immunodeficiency virus (HIV) infection generally can be treated the same as lymphoma in non–HIV-infected patients, with a few caveats, according to Lawrence D. Kaplan, MD, of the Helen Diller Family Comprehensive Cancer Center of the University of...
An intervention called the Serious Illness Care Program helps clinicians to conduct more, earlier, and better conversations about goals of care with their seriously ill patients, according to Rachelle E. Bernacki, MD, MS, who presented the preliminary results of a study using this approach at the...
This is a group of patients who have not done very well over the years. The cure rate for children with acute lymphoblastic leukemia (ALL) is over 90%, whereas this group of patients (ie, aged 18–50) typically has a 5-year survival of 40% to 50%. Use of pediatric regimens has boosted that survival, ...
Treatment with capecitabine increased disease-free and overall survival in breast cancer patients with residual disease after neoadjuvant chemotherapy, according to a study reported by researchers from Japan and Korea at the 2015 San Antonio Breast Cancer Symposium.1 “It has been unclear whether...
Breast cancer afflicts 1 in 8 women in their lifetime, and 1 in 25 die from this disease. Although a number of randomized trials have demonstrated the clear benefits of mammography screening in women up to age 74 on reducing mortality, data are sparse in women over age 74, especially among...
The requirement for tumor tissue specimens and associated analyses in order to participate in clinical trials appears to be a significant barrier to clinical trial enrollment and may delay treatment. Potential solutions to reducing or eliminating these barriers include routine tissue banking at...
A new analysis indicated that many patients continue working after being diagnosed with metastatic cancer, but a heavy burden of symptoms may prevent them from doing so. Published by Tevaarwerk et al in Cancer, the study illustrates the need to treat difficult symptoms so that patients can maintain ...
Lori J. Pierce, MD, of the University of Michigan Health System, discusses findings on second cancer incidence and non-breast cancer mortality among 40,000 women in 75 clinical trials. (Abstract S5-08)
Julie Vose, MD, MBA, of the University of Nebraska Medical Center, and John F. Gerecitano, MD, PhD, of Memorial Sloan Kettering Cancer Center, discuss a phase I study of venetoclax monotherapy in patients with relapsed/refractory non-Hodgkin lymphoma, including updated safety and efficacy data...
James Foran, MD, of the Mayo Clinic Cancer Center, discusses two key studies on clofarabine: as a single agent for induction and postremission therapy in newly diagnosed AML, and as the basis for consolidation in nonfavorable AML (Abstracts 217 and 218).
Craig H. Moskowitz, MD, of Memorial Sloan Kettering Cancer Center, discusses a phase I study of an anti-CD19 monoclonal antibody used in relapsed/refactory B-lineage non-Hodgkin lymphoma (Abstract 182).
John Leonard, MD, of Weill Cornell Medical College, discusses this phase II study of R-CHOP with or without bortezomib in patients with untreated non-germinal center B-cell-like subtype diffuse large cell lymphoma (Abstract 811).
Julie Vose, MD, MBA, of the University of Nebraska Medical Center, and David Straus, MD, of Memorial Sloan Kettering Cancer Center, discuss the initial results of the U.S. Intergroup Trial of response-adapted chemotherapy or chemotherapy/radiation therapy based on PET for nonbulky stage I and II...
Julie Vose, MD, MBA, of the University of Nebraska Medical Center, and Cameron J. Turtle, MBBS, PhD, of the Fred Hutchinson Cancer Research Center, discuss anti-CD19 chimeric antigen receptor-modified T-cell therapy and clinical outcome (Abstract 184).
More patients with advanced non–small cell lung cancer (NSCLC) could benefit from pembrolizumab (Keytruda), said Roy Herbst, MD, PhD, Chief of Medical Oncology at Yale Cancer Center and Smilow Cancer Hospital at Yale-New Haven. Dr. Herbst presented promising results from the pivotal phase...
Patients with epidermal growth factor receptor (EGFR)-activating mutations in advanced lung cancer seem to benefit more from afatinib (Gilotrif) than gefitinib (Iressa) as first-line treatment, Park et al reported in a study (Abstract LBA2) presented at the European Society for Medical Oncology...
In an analysis of the Surveillance, Epidemiology, and End Results (SEER)–Medicare database reported in the Journal of Clinical Oncology, Wang et al found that use of preoperative magnetic resonance imaging (MRI) was associated with overdiagnosis of contralateral breast cancer among older...
Unlike a number of other cancers in which young age at diagnosis is understood to represent distinct disease biology, the genomics and clinical characteristics of non–small cell lung cancer (NSCLC) in young patients are poorly understood. A study by Sacher et al investigating the relationship ...
Findings in an early-terminated German phase III trial (ESPATUE), reported in the Journal of Clinical Oncology by Eberhardt et al, indicate similar outcomes with surgery vs definitive concurrent chemoradiotherapy after induction chemotherapy and chemoradiotherapy in patients with resectable stage...
In a systematic genetic study reported in The Lancet Oncology, Moriyama et al found that germline ETV6 variations identified in a small proportion of children with acute lymphoblastic leukemia (ALL) were associated with a novel syndrome predisposing carriers to disease. Recent data indicated that...
The U.S. Food and Drug Administration (FDA) today granted accelerated approval to alectinib (Alecensa) for the treatment of patients with anaplastic lymphoma kinase (ALK)-positive non–small cell lung cancer (NSCLC) who have had disease progression on or are intolerant to crizotinib (Xalkori). ...
In a phase II trial reported in the Journal of Clinical Oncology, Ou et al found that the investigational ALK inhibitor alectinib, which is active against acquired crizotinib (Xalkori) resistance mutations and exhibits high CNS penetration, was associated with considerable activity in patients with ...
Premenopausal women whose invasive breast cancers were of the luminal A subtype had comparable 10-year disease-free survival rates, regardless of whether or not they received adjuvant chemotherapy, according to data from the phase III Dutch Breast Cancer Cooperative Group (DBCG77B) clinical trial...
Ninety-three percent of pediatric patients (55 of 59) with relapsed/refractory acute lymphoblastic leukemia (ALL) went into remission after receiving an investigational therapy made from their own immune cells, with continuous remissions of over 1 year in 18 patients and over 2 years in nine...
In a European phase III trial (AGO-OVAR 12) reported in The Lancet Oncology, du Bois et al found that adding the antiangiogenic multikinase inhibitor nintedanib (Ofev) to carboplatin/paclitaxel improved progression-free survival in patients with newly diagnosed ovarian cancer. Gastrointestinal...
A study presented by Landier et al at the 57th American Society of Hematology (ASH) Annual Meeting examined the common problem of children in remission from acute lymphocytic leukemia (ALL) not adhering to their maintenance drug regimens, thus putting them at risk of relapse (Abstract 82). ...
Ronald Go, MD, of the Mayo Clinic, discusses a study that used the National Cancer Data Base to determine the extent to which the number of non-Hodgkin lymphoma patients treated annually in a facility affects overall survival (Abstract 266).
Can any cancer cell form another tumor, or is it only select cancer stem cells that give rise to new cancer cells? The answer, a new study finds, is both. Researchers at the University of Michigan Comprehensive Cancer Center looked at human ovarian cancer cells, and found that, for the most part,...
As reported by Tournigand et al in The Lancet Oncology, final analysis of the phase III GERCOR DREAM (OPTIMOX3) trial suggested a benefit of maintenance bevacizumab (Avastin)-erlotinib vs bevacizumab after bevacizumab-based induction therapy in patients with previously untreated metastatic...
The U.S. Food and Drug Administration today approved necitumumab (Portrazza) in combination with gemcitabine and cisplatin for first-line treatment of patients with metastatic squamous non–small cell lung cancer (NSCLC). Necitumumab is not indicated for treatment of nonsquamous NSCLC....
In a study reported in the Journal of the National Cancer Institute, Gentles et al identified a nine-gene molecular prognostic index that improved the overall survival prognostic power of clinical factors in patients with stage I non–small cell lung cancer (NSCLC). Study Details In the...