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skin cancer

Novel Drugs Ipilimumab and Vemurafenib for Advanced Melanoma

In this introductory installment of In the Clinic, The ASCO Post provides an overview of two new melanoma agents recently approved by FDA, with discussion on pivotal data leading to approval, dosage and administration, and managing drug-related toxicities. Watch for more on clinical use of novel...

prostate cancer

Short-term Androgen Deprivation plus Radiotherapy Improves Outcomes in Intermediate-risk Prostate Cancer

The addition of short-term androgen-deprivation therapy to external-beam radiation therapy improved overall and disease-specific survival in men with nonbulky localized prostate cancer and prostate-specific antigen (PSA) levels up to 20 ng/mL, as reported recently in The New England Journal of...

gynecologic cancers

New Biomarker Test Cleared to Evaluate Ovarian Cancer Likelihood

Fujirebio Diagnostics announced that it has received 510(k) clearance from the FDA to market the company’s HE4 Test in an algorithm called ROMA to aid in assessing whether a premenopausal or postmenopausal woman who presents with an ovarian adnexal mass is at high or low likelihood of finding...

head and neck cancer

New Therapies and Prognostic Techniques Highlighted in Head and Neck Cancer

D. Neil Hayes, MD, MPH, of the University of North Carolina at Chapel Hill, described efforts to position the epidermal growth factor receptor (EGFR) inhibitor cetuximab (Erbitux) in head and neck cancer treatment. Surprisingly negative results came from the phase III Radiation Therapy Oncology...

sarcoma

Novel Approaches and Agents Making Headway against Sarcoma

Novel approaches and agents reported at the ASCO 2011 Annual Meeting are improving outcomes in sarcoma, a heterogeneous disease with historically poor outcomes, according to William D. Tap, MD, Section Chief of Sarcoma Oncology at Memorial Sloan-Kettering Cancer Center in New York. Dr. Tap...

kidney cancer
prostate cancer

Novel Management Strategies Assessed in Renal Cell and Prostate Cancers

At the Best of ASCO Miami meeting, William Oh, MD, of the Tisch Cancer Institute, Mount Sinai School of Medicine, New York, described new trends and remaining questions in the management of renal cell and prostate cancers. Axitinib vs Sorafenib in Second-line RCC Axitinib, a potent and selective...

multiple myeloma

Multiple Myeloma Research Spotlights Treatment Concerns and Advances

Myeloma data reported at this year’s ASCO meeting raise concern about the safety of a mainstay class of drugs in this disease, while also hinting at good efficacy of some novel drugs and approaches, according to William I. Bensinger, MD, of the Fred Hutchinson Cancer Research Center, Seattle....

SIDEBAR: Risk-based Approach Needed for Stage II Colorectal Cancer

Management of stage II colorectal cancer remains a considerable gray area where an individualized risk-based approach and more molecular research are needed, according to Axel Grothey, MD, of the Mayo Clinic in Rochester, Minnesota. “Stage II is a little bit more complicated than stage III,” he...

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...

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...

breast cancer

Important Briefs from the 2011 Breast Cancer Symposium

The 2011 Breast Cancer Symposium was recently held in San Francisco, bringing together a multidisciplinary group of specialists and sponsored by ASCO, the American Society for Radiation Oncology, the Society of Surgical Oncology, the American Society of Breast Disease, the American Society of...

integrative oncology

Integrative Medicine Offers Added Value for Patients with Cancer

Addressing a patient’s physical, emotional, and spiritual needs during the cancer journey, integrative medicine combines such time-honored therapies as nutrition, exercise, and meditation alongside allopathic approaches to cancer care, with the ultimate goal of improving survival rates and reducing ...

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 ...

breast cancer

Low-level Expression of ESR1 Tied to Tamoxifen Resistance

Data from a retrospective analysis of two pivotal breast cancer studies suggest that the low-level expression of the estrogen receptor (ER) gene ESR1 “is a determinant of tamoxifen resistance in ER-positive breast cancer,” reported researchers in the Journal of Clinical Oncology. “We performed...

prostate cancer

Hypofractionated Radiotherapy Effectively Controls High-risk Prostate Cancer

The use of hypofractionated intensity-modulated radiotherapy (IMRT) appears to be a reasonable option for men with intermediate- to high-risk prostate cancer,1 reported Alan Pollack, MD, Chairman of Radiation Oncology at the University of Miami Miller School of Medicine in Miami and lead...

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 ...

prostate cancer

Fewer Rectal Side Effects with IMRT than with 3D-CRT for Prostate Cancer

The use of intensity-modulated radiation therapy (IMRT) is associated with fewer acute and late toxic effects than is three-dimensional conformal radiation therapy (3D-CRT) in men with localized prostate cancer, according to preliminary analysis of the Radiation Therapy Oncology Group (RTOG) 0126...

hematologic malignancies
leukemia
lymphoma
multiple myeloma

NCCN Meeting Addresses Issues in Hematologic Malignancies

The National Comprehensive Cancer Network (NCCN) 6th Annual Congress on Hematologic Malignancies, held recently in New York, included reviews of the management of hematologic diseases as well as discussions of outstanding issues in the field. The following is a synopsis of some of the important...

skin cancer

Gathering Data Point to Potential Advantages of Vismodegib in Basal Cell Carcinoma and Other Advanced Cancers

Vismodegib is a small-molecule, orally active hedgehog pathway inhibitor that has shown considerable promise in treating basal cell carcinoma and is currently being evaluated alone and in combination in early-phase trials in medulloblastoma and a long list of other cancers.1 Owing to its...

prostate cancer

Prostate Cancer Screening Reconsidered

Prostate cancer is the most prevalent nonskin cancer in men. An estimated 16% of men are diagnosed with prostate cancer, yet only 3% of men die from it.1 Unlike other cancers, prostate cancer is associated with a prolonged lead-time, meaning it can take anywhere from 5 to 12 years to become...

SIDEBAR: Expect Questions from Your Patients

“The message” of a meta-analysis of 17 randomized trials of breast-conserving surgery with or without radiation, “should be that the benefits of radiation are not temporary, that it provides an increased chance of cure,” Thomas A. Buchholz, MD, told The ASCO Post. The meta-analysis was conducted by ...

issues in oncology

The Newly Diagnosed Patient with Cancer and Access to Care

A study presented at the 2011 ASCO Annual Meeting raised concerns that newly diagnosed cancer patients are having trouble seeing an oncologist. Interviews with several cancer centers and community practices, however, suggest that the process runs smoothly, for the most part. Majority of Patients...

lymphoma

Intensified Chemotherapy with R-ACVBP Improves Survival in Younger Patients with Diffuse B-cell Lymphoma

Compared with standard R-CHOP (rituximab [Rituxan], doxorubicin, cyclophosphamide, vincristine, and prednisone), intensified immunochemotherapy with R-ACVBP (dose-intensive rituximab, doxorubicin, cyclophosphamide, vindesine [not available in U.S.], bleomycin, and prednisone) significantly improves ...

head and neck cancer

New Indication for Cetuximab in Squamous Cell Carcinoma of the Head and Neck

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. Cetuximab (Erbitux) was recently approved by the FDA for use in...

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...

bladder cancer

Highlights of Bladder Cancer Research Include Novel Agents and New Approach to Identifying Biomarkers

It is an exciting time for researchers involved in developing new therapies for bladder cancer. More agents are in clinical development, drugs with novel mechanisms and novel trial designs are being implemented, and functional collaboration is occurring in the field, according to Noah Hahn, MD,...

hematologic malignancies

Ruxolitinib for Myelofibrosis Therapy: A Good Start but a Long Road Ahead

Following a priority review process for orphan diseases, ruxolitinb (Jakafi) recently became the first drug to receive FDA approval for the treatment of intermediate- and high-risk myelofibrosis. Discovery in 2004 of the JAK2V617F mutation in a significant proportion of patients with...

breast cancer

BOLERO-2: Everolimus Thwarts Resistance to Hormonal Therapy in Advanced Breast Cancer

Adding an inhibitor of the mammalian target of rapamycin (mTOR) to hormonal therapy for advanced breast cancer effectively circumvents resistance, suggest updated results of the randomized BOLERO-2 trial. With a median follow-up of 12.5 months, the likelihood of disease progression or death among...

cns cancers

Everolimus for Tumors Associated with Carcinoid Syndrome

The combination of everolimus (Afinitor) plus octreotide (Sandostatin) long-acting repeatable (LAR) formulation improved progression-free survival by 23% over placebo plus octreotide LAR in a randomized phase III study of patients with advanced neuroendocrine tumors associated with carcinoid...

Conquer Cancer Foundation Awards Oncology Fellows for GI Cancer Research

The Conquer Cancer Foundation of ASCO Merit Awards will be presented to 20 leading oncology trainees for their important contributions to gastrointestinal cancer research. This year’s recipients will be recognized at the 2012 Gastrointestinal Cancers Symposium, which takes place January 19-21 in...

SIDEBAR: Expect Questions from Your Patients

The current lack of awareness about the high risk of venous thromboembolism (VTE) among people being treated for cancer as outpatients means “there’s a great role for provider education,” Alok Khorana, MD, told The ASCO Post. Here are Dr. Khorana’s answers to some likely questions from patients....

SIDEBAR: Clinical Trials of VTE Prophylaxis for Outpatients

Several studies are investigating low-molecular-weight heparins to reduce the risk of venous thromboembolism (VTE) among patients with cancer. “I enrolled patients in SAVE-ONCO,” Alok Khorana, MD, said, “but that trial used drug called semuloparin, which is not currently available in the United...

supportive care

Outpatients Need to Be Aware of High Risk of Developing Venous Thromboembolism

Most patients who develop venous thromboembolisms (VTE) while being treated for cancer, do so as outpatients, according to results of a retrospective, observational study comparing the incidence of VTE among inpatients and outpatients with cancer. Yet many outpatients do not even realize that they...

cns cancers

First Genomic-based Pediatric Trials Launched in Neuroblastoma

Last November, Dell announced it was donating an initial $4 million including cloud-computing technology to speed up development of personalized medicine trials for children with neuroblastoma and other pediatric cancers. According to the American Cancer Society, about 650 children under the age of ...

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 ...

lymphoma
geriatric oncology

Therapy for Hodgkin Lymphoma in the Elderly Remains Undefined

At the 2011 Pan-Pacific Lymphoma Conference held recently in Kauai, Hawaii, Andrew M. Evens, DO, MSc, Director of the Lymphoma Program at the University of Massachusetts Medical School in Worcester, discussed Hodgkin lymphoma in elderly patients. Event-free survival and overall survival rates in...

gynecologic cancers

Advances in Gynecologic Cancer Surgery Continue to Improve Outcomes

Over the past several decades, advances in chemotherapy and surgery have begun to translate into improved survival in gynecologic malignancies. The ASCO Post recently spoke with Ginger Gardner, MD, a surgical oncologist at Memorial Sloan-Kettering Cancer Center, who specializes in the management...

breast cancer
symptom management

Estrogen for Vulvovaginal Atrophy in Breast Cancer: Debate Continues

Vulvovaginal atrophy is a concern for the majority of patients with breast cancer, not only because of its physical and psychosexual consequences, but because the optimal treatment—estrogen replacement—is controversial. Patients and physicians alike remain concerned that external estradiol may...

prostate cancer

Data on Watchful Waiting for Low-risk Prostate Cancer May Swing Focus to Higher-risk Tumors and Quality of Life

Surgery did not increase survival rates compared to watchful waiting in men with clinically localized prostate cancer. Results were particularly strong for men with prostate-specific antigen (PSA) levels of 10 ng/dL and under, and those who have low-risk disease, according to data from the Prostate ...

prostate cancer

NIH Panel Endorses Active Surveillance in Low-risk Prostate Cancer

Active surveillance of localized prostate cancer is a viable management option that should be offered to low-risk patients in place of immediate treatment, said a panel of experts convened by the National Institutes of Health. A fairly new concept, active surveillance takes a more proactive...

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....

thyroid cancer
pancreatic cancer
colorectal cancer
breast cancer

Oncology Research a Strong Presence at the American College of Surgeons Meeting: New Data in Pancreatic, Rectal, Thyroid, and Breast Cancers

Research in cancer staging, surgical procedures, outcomes, and medical treatment was included among the 2,000 abstracts presented at the 97th Annual American College of Surgeons Clinical Congress in San Francisco. The ASCO Post was there to capture the latest findings. Neoadjuvant Chemotherapy in...

lymphoma

Improved Survival with Chemotherapy Alone in Limited-stage Hodgkin Lymphoma

An important study suggests that radiotherapy may not be a necessary addition to chemotherapy in previously untreated patients with limited-stage Hodgkin lymphoma, sparing patients the risks of late radiation-induced cardiac effects and second cancers. These data were based on 12 years of follow-up ...

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...

SIDEBAR: Expect Questions from Your Patients

When patients and family members have concerns about depression, they often bring them up with the staff, not with the treating oncologist. “I think that people with cancer don’t want to distract their medical oncologist or their surgeon by talking about their mood,” Dr. Massie noted. “Some people ...

issues in oncology

Oncologists Examine Promise vs Reality of Personalized Medicine

Personalized medicine: It’s a phrase that reverberates across all cancer meetings. “Matching the right drug to the right patient” will be accomplished, in the not too distant future, through genomic sequencing of the tumor and targeted, less toxic therapy. This much has been established—or has it?...

hematologic malignancies

JAK2 and MPL Mutation Screening: What Are the Indications and How to Interpret the Results

The World Health Organization system organizes myeloid malignancies into five major categories, which are subsequently further subclassified using a combination of bone marrow morphology and cytogenetic/molecular information (Table 1).1 JAK2 and MPL mutations are not disease-specific and occur...

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