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leukemia

Ibrutinib in Previously Treated CLL and CLL With 17p Deletion

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 July 28, 2014, the approved use of ibrutinib (Imbruvica) in...

leukemia
lymphoma

Idelalisib for Relapsed CLL in Combination With Rituximab and for Relapsed Follicular Lymphoma or Small Lymphocytic Lymphoma

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 July 23, 2014, idelalisib (Zydelig) was approved for  use in...

breast cancer

Circulating Tumor Cells in Metastatic Breast Cancer: Are We Afraid of the Truth?

All truths are easy to understand once they are discovered; the point is to discover them.” —Galileo Galilei   There are several “truths” in breast oncology that have been discovered over the years, become widely understood, and changed the way we practice. Prospective randomized studies have...

ASCO Celebrates Oncology Luminaries for 50th Anniversary

In the 50 years since the American Society of Clinical Oncology was founded, the treatment of cancer has advanced dramatically, due to the work of researchers making important scientific breakthroughs, physicians responsible for delivering those advances to patients, and countless others who...

breast cancer

Patience Remains a Virtue: The Ongoing Quest to Optimize Adjuvant Endocrine Therapy in Breast Cancer

The most recent ASCO Clinical Practice Guideline update—summarized in this issue of The ASCO Post—represents the latest chapter in the ongoing evolution of adjuvant endocrine therapy for hormone-sensitive breast cancer.1 Rather than including a comprehensive review of the 2010 guidelines, this...

breast cancer

Adjuvant Endocrine Therapy for Hormone Receptor–Positive Breast Cancer: ASCO Clinical Practice Guideline Focused Update

ASCO has released a focused update of its clinical practice guideline on adjuvant endocrine therapy in women with hormone receptor–positive breast cancer.1 The focused update, formulated by Harold J. Burstein, MD, PhD, of Dana-Farber Cancer Institute, Boston, and colleagues in the ASCO Update...

pancreatic cancer

Study Finds New Genetic Risk Markers in Pancreatic Cancer

A large DNA analysis of people with and without pancreatic cancer has identified several new genetic markers that signal increased risk of developing the disease, report scientists from ­Dana-Farber Cancer Institute and other institutions worldwide. The markers are variations in the inherited DNA...

gastroesophageal cancer

EGFR as a Therapeutic Target for Gastroesophageal Cancer—or Is It Really?

The epidermal growth factor receptor (EGFR) gene is often amplified and its protein overexpressed in upper gastrointestinal cancers—and overexpression has prognostic value. With the advent of monoclonal antibodies and tyrosine kinase inhibitors against EGFR, we have witnessed a rash of randomized...

supportive care

Supportive Care in Pediatric Patients With Cancer: Recent Developments in Treating Febrile Neutropenia

Recent developments in supportive care for children with cancer can be broken down into three categories: doing the simple things well, applying evidence-based medicine to daily practice, and extending the benefits to everyone, according to Scott C. Howard, MD, of St. Jude Children’s Research...

supportive care

NEPA for Chemotherapy-Induced Nausea and Vomiting: Key Endpoints and Additional Analyses Show Strong Efficacy

For the prevention of chemotherapy-induced nausea and vomiting, NEPA, a novel combination of a neurokinin-1 (NK1) receptor antagonist and the 5-HT3 receptor antagonist palonosetron (Aloxi), has been studied in three pivotal trials that were recently published in the Annals of Oncology.1-3 Further...

head and neck cancer
supportive care

Mucositis Remains a Challenge in Head and Neck Cancer

Chemoradiotherapy for head and neck cancer requires intensive supportive care by a knowledgeable and proactive multidisciplinary team, according to Avraham Eisbruch, MD, Professor of Radiation Oncology at the University of Michigan, Ann Arbor. “Aggressive chemoradiotherapy has improved the cure...

triple-negative

Studies Assess Response to Platinum Therapy in Triple-Negative Breast Cancer

Studies in triple-negative breast cancer presented at the 2014 ASCO Annual Meeting sought to determine predictors of response to platinum agents. One identified a subset of responders to neoadjuvant chemotherapy, but prediction proved more elusive in metastatic disease. Neoadjuvant Carboplatin The...

issues in oncology

Who Will Care for Patients With Cancer?

The workforce numbers show a disturbing trend. According to a recent study by ASCO, by 2025, overall demand for oncology services is projected to grow by 40%, but physician supply is predicted to increase by only 25%, generating a shortage of 2,258 oncologists providing full-time equivalent...

health-care policy

Does the United States Have the Best Health-Care System in the World?

Many concerns were raised and dire speculations predicted during the further implementation of the Affordable Care Act this year. So far, the trickling news is good: An estimated total of 20 million people gained coverage under the new law as of May 1,1 about 6 million enrolled in the law’s...

leukemia
lymphoma

Recent FDA Drug Approvals Foster Growing Treatment Armamentarium for Chronic Lymphocytic Leukemia and Rare B-Cell Lymphomas

Recent approvals announced by the U.S. Food and Drug Administration (FDA) have led to increased treatment options for managing several difficult-to-treat hematologic B-cell cancers. The newly approved drugs and/or their indications include the oral PI3K delta inhibitor idelalisib (Zydelig) for the...

kidney cancer

Ongoing Clinical Trials Actively Recruiting Patients With Kidney Cancer

The information in this Clinical Trials Resource Guide includes actively recruiting clinical studies for patients with kidney cancer. The list includes a pilot study and observational, randomized, and nonrandomized phase II and phase III studies evaluating new therapies, combination therapies,...

lung cancer

Failure of IGF-1R Inhibitor Figitumumab in Advanced Nonadenocarcinoma Non–Small Cell Lung Cancer

The vast majority of non–small cell lung cancer (NSCLC) patients present with advanced disease, and many will develop metastases after primary curative therapy. Until recently, despite its low efficacy, chemotherapy remained the only treatment modality in metastatic NSCLC. Within the past decade,...

lung cancer

Phase III Trial of Figitumumab Plus Chemotherapy in Advanced NSCLC Stopped Early for Futility and Increased Harm

In the first phase III trial assessing the combination of an insulin-like growth factor 1 receptor (IGF-1R) inhibitor with chemotherapy as first-line treatment for advanced nonadenocarcinoma non–small cell lung cancer (NSCLC), the addition of the fully human immunoglobulin G2 monoclonal antibody...

Expert Point of View: Wyndham H. Wilson, MD, PhD

Since the presentation on mediastinal lymphoma at the Pan Pacific Lymphoma Conference, Wyndham H. Wilson, MD, PhD, Chief of the Hematological Malignancies Therapeutics Section, Metabolism Branch, Cancer Research Center, of the National Cancer Institute in Bethesda, Maryland, offered The ASCO Post...

lymphoma

Best Way to Treat Mediastinal Lymphomas Is Still Unclear

A variety of treatment options used today can achieve good outcomes in patients with mediastinal lymphomas, according to James O. ­Armitage, MD, the Joe Shapiro Professor of Medicine at the University of Nebraska Medical Center in Omaha. He discussed some of the current evidence helping to refine...

colorectal cancer

Understanding the Impact of Results From CALGB/ SWOG 80405 and Other New Data in Colorectal Cancer

The Cancer and Leukemia Group B (CALGB)/Southwest Oncology Group (SWOG) 80405 trial, presented during the Plenary Session at this year’s ASCO Annual Meeting, demonstrated that cetuximab (Erbitux) and bevacizumab (Avastin) confer similar benefits as first-line treatment with chemotherapy for KRAS...

multiple myeloma

Treating Multiple Myeloma in 2014

The field of multiple myeloma is rapidly changing, and the shifts that are occurring impact the management of these patients, from initial diagnosis through multiple relapses. At the 9th Annual New Orleans Summer Cancer Meeting, Sergio A. Giralt, MD, Chief of the Adult Bone Marrow Transplant...

lymphoma

Jury Still Out on Interim PET for Response-Adapted Therapy in Hodgkin Lymphoma

Interim positron-emission tomography (PET) scans provide good prognostic information in patients with Hodgkin lymphoma, but more research is needed to determine whether patients benefit when the findings are used to alter treatment, according to Oliver Press, MD, PhD, Professor at the University of ...

solid tumors

How Evolutionary Game Theory Is Offering Clues to Disrupt Cancer Cell Metabolism

Kenneth J. Pienta, MD, and his colleagues at Johns Hopkins Medicine in Baltimore are using the principles of evolutionary game theory to learn how cancer cells cooperate within a tumor to gather energy and metastasize. Game theory, the mathematic study of strategic decision-making that is commonly...

supportive care

Memorial Sloan Kettering Cancer Center Launches Meaning-Centered Psychotherapy Programs for Terminally Ill Patients, Cancer Survivors, and Caregivers

Although most major cancer centers in the United States offer support groups and individual counseling sessions to help patients with cancer cope with their disease and treatment, over the past decade Memorial Sloan Kettering Cancer Center in New York has broadened its psycho-oncology programs to...

Residents Association Recognizes 57 Mentors and Teachers With 2014 Educator of the Year Award

The Association of Residents in Radiation Oncology (ARRO) has honored 57 educators with the 2014 Educator of the Year Award. The award, presented annually, recognizes outstanding teachers and mentors of radiation oncology residents. Each radiation oncology residency program may nominate one faculty ...

Expect Questions From Patients

Conscientious doctors are unlikely to say yes to a patient’s request for full genome sequencing,” Theodora Ross, MD, PhD, wrote in The New York Times.1 Dr. Ross, Director of the Cancer Genetics Program at the University of Texas Southwestern Medical Center in Dallas, was writing about the current...

breast cancer

News of Mutations in PALB2 Gene Raising Risk of Breast Cancer Offers Opportunity to Explain Limits of Genetic Testing

The response among patients to news reports about mutations in a gene known as PALB2 raising the risk of breast cancer “has been predictable,” Theodora Ross, MD, PhD, wrote in The New York Times.1 As an example, Dr. Ross, Director of the Cancer Genetics Program at The University of Texas...

integrative oncology

The Role of Music Therapy in Cancer Care

Music therapy, an established adjuvant to standard cancer care, is offered in a growing number of cancer centers throughout the United States and internationally. Defined by the American Music Therapy Association (AMTA) as “the evidence-based use of music interventions to accomplish individual...

issues in oncology

Sequencing Analysis of Tumor DNA: Is It All in the Plasma?

Massively parallel sequencing analyses have demonstrated that most of the common malignancies display relatively complex repertoires of somatic genetic alterations, that the number of highly recurrent mutations is limited, and that a large number of genes is mutated in a small minority of tumors...

head and neck cancer

Ongoing Clinical Trials Actively Recruiting Patients With Intraocular Cancer

The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies of children and adults with intraocular cancers. The studies include pilot, phase 0, phase I, phase II, and observational trials evaluating new combination therapies, vaccines, optical...

breast cancer

Breast Cancer Screening Using Tomosynthesis in Combination With Digital Mammography

In a study reported in JAMA and reviewed in this issue of The ASCO Post, Friedewald and colleagues1 showed that the addition of tomosynthesis to digital mammography2 resulted in a decrease in the screening recall rate3 and an increase in the cancer detection rate.4,5 This retrospective analysis of...

National Cancer Institute Launches the National Clinical Trials Network to Expedite Scientific Advances

In March, the National Cancer Institute (NCI) transformed its Cooperative Group Program into the National Clinical Trials Network (NCTN). Spurred by recommendations in the Institute of Medicine (IOM) 2010 report, A National Cancer Clinical Trials System for the 21st Century: Reinvigorating the NCI...

NIH Launches Human Safety Study of Ebola Vaccine Candidate

The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, has launched initial human testing of an investigational vaccine to prevent Ebola virus disease, according to a news release issued by NIH. The early-stage trial has begun initial human...

Kenneth S. Ramos, MD, PhD, PharmB, Named New MD-PhD Head  at University of Arizona College of Medicine, Tucson

Kenneth S. Ramos, MD, PhD, PharmB, has been named the new MD-PhD Program Director at the University of Arizona College of Medicine, Tucson. The Program was established in 1990 to provide dual training in medicine and research to students interested in careers as research-intensive physicians...

issues in oncology

ASCO Launches New Publication for Oncology Trainees and Early-Career Professionals

In February 2014, ASCO launched a new member publication, ASCO Connection: Trainee & Early-Career Oncologists. This quarterly magazine-style publication is dedicated to topics of interest to medical students, interns, residents, fellows, and junior faculty. All ASCO Student/Non-Oncology...

bladder cancer

Complications No Different Between Open and Robot-Assisted Radical Cystectomy When Open Urinary Diversion Performed

We read the letter to the editor in the July 24, 2014, issue of The New England Journal of Medicine entitled, “A Randomized Trial of Robot-Assisted Laparoscopic Radical Cystectomy,” with great interest.1 Provocative Results In the letter, reviewed in this issue of The ASCO Post, Bochner and...

breast cancer

PALB2 Study: Researchers and Patients Must 'Pal' for Progress

The recent publication by Antoniou et al on risk of breast cancer in PALB2 carriers,1 reviewed in this issue of The ASCO Post (page 47), is a contribution to the interesting history of the PALB2 gene, and an important milestone in the expansion of hereditary cancer susceptibility testing in the...

breast cancer

Study Quantifies Risk of Hereditary Breast Cancer in Carriers of PALB2 Mutations

In a study reported in The New England Journal of Medicine, Antonis C. Antoniou, PhD, Reader in Cancer Risk Prediction and Cancer Research UK Senior Cancer Research Fellow at the University of Cambridge, and colleagues identified lifetime risk of breast cancer in families with germline...

Researchers at University of Michigan Receive $2.3 Million Grant to Promote Safety, Reduce Exposure Risk, at Chemotherapy Infusion Sites

Researchers at the University of Michigan School of Nursing and Comprehensive Cancer Center have received a $2.3 million grant to study oncology nurses’ exposure to hazardous drugs, including identifying ways to reduce exposure. “There are significant acute and long-term side effects from hazardous ...

Fox Chase Cancer Center Announces New Staff

Fox Chase Cancer Center has announced the appointment of two staff to the Center’s Department of Radiation Oncology and Surgical Oncology, respectively. Mark A. Hallman, MD, PhD, joins the Department of Radiation Oncology having served there recently as the Department’s Chief Resident. Sanjay S....

lung cancer

Lung Cancer Webinar Highlights Brain Metastases and Thoracic Radiotherapy

Postoperative radiation therapy, given after adjuvant chemotherapy, significantly increased overall survival in non–small cell lung cancer (NSCLC) compared to chemotherapy alone, according to a study reported at ASCO’s 2014 Annual Meeting.1 That study, an analysis of records in the National Cancer...

lung cancer

Optimal Chemoradiotherapy Dosing and Recurrence After Stereotactic Body Radiotherapy Explored in Lung Cancer Webinar

Cetuximab (Erbitux) added no survival benefit to chemoradiation in stage III non–small cell lung cancer (NSCLC), according to results reported in a Plenary Session of the 2013 World Conference on Lung Cancer in Sydney, Australia.1 It was the second surprise result from the Radiation Therapy...

gynecologic cancers

Early Study Finds Olaparib Tablet Safe in Pretreated Ovarian Cancer Patients; More Effective in Those With BRCA Mutations

An oral tablet form of a poly-ADP ribose polymerase (PARP) inhibitor, olaparib, given in combination with chemotherapy, was safe in heavily pretreated patients with ovarian cancer, and patients with BRCA mutations may have a better response compared with those without a BRCA mutation, according to...

prostate cancer

PSA—It Just Keeps Getting Better, So Why Should It Stand Alone?

The updated results of the European Randomised Study of Screening for Prostate Cancer (ERSPC)—reported in The Lancet by Fritz H. Schröder, MD, of Erasmus University Medical Center, and colleagues1 and reviewed in this issue of The ASCO Post—show a continued decline, as predicted,2 in the number...

hematologic malignancies

‘Paradigm-Shifting’ Results in Treatment of Hematologic Disorders

The three leukemia/lymphoma studies selected from the many 2014 ASCO Annual Meeting abstracts for presentation at the recent Best of ASCO meeting in Chicago “are really paradigm-shifting,” noted Lucy A. Godley, MD, PhD, of the University of Chicago. These studies, she said, “give great promise for...

lung cancer

Hsp90 Inhibitors May Soon Transition Into Clinic

Inhibitors of heat shock protein 90 (Hsp90) look promising for the treatment of advanced non–small cell lung cancer (NSCLC) and have the advantage of not needing a specific mutation to target, said Suresh S. Ramalingam, MD, Professor and Chief of Medical Oncology at the Winship Cancer Institute of...

lung cancer

In Advanced Lung Cancer, Targeted Combinations Are Still Works in Progress

For the treatment of advanced non–small cell lung cancer (NSCLC), combinations of targeted agents are of great research interest but have not yet been shown to improve outcomes. Single-agent treatment with tyrosine kinase inhibitors, therefore, remains the standard of care for patients with...

issues in oncology
health-care policy

9/11 and Cancer: What Do We Know?

On September 11, 2001, the devastating terrorist attack that destroyed the World Trade Center left in its wake a unique toxic site in both mass and quantity of hazardous materials. It took 9 months to remove approximately 2 million tons of wreckage from Ground Zero, during which thousands of...

issues in oncology

Potential for Improved Effectiveness and Reduced Toxicity of Radiotherapy With Ultrahigh Dose-Rate FLASH Irradiation

Studies in vitro have suggested that sub-millisecond pulses of radiation produce less genomic instability than continuous prolonged irradiation at the same total dose. In a study reported in Science Translational Medicine, Favaudon and colleagues assessed the effects of ultrahigh dose-rate...

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