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integrative oncology

Milk Thistle

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...

issues in oncology

On Being A Mentee and the Value of the Conquer Cancer Foundation’s Career Development Award

At the ASCO Annual Meeting in June, the Conquer Cancer Foundation presented the 2014 recipients of prestigious grants and awards, including the Young Investigator Award, Career Development Award, and the Advanced Clinical Research Award in Breast Cancer. In announcing the awards, Charles W. Penley, ...

issues in oncology

The Value of Lifelong Mentorship in Career Development

While the development of mentorship relationships is critical in launching and nurturing the academic careers of young investigators, it is also an essential component for continued success throughout their careers, according to Jennifer R. Brown, MD, PhD. Dr. Brown, Director of the CLL Center at...

supportive care

Improving Treatment of Depression in Patients With Cancer: The SMaRT Oncology-2 Trial

Clinical depression is highly prevalent, associated with significant morbidity, often underrecognized, and inadequately treated in cancer patients.  Professor Michael Sharpe and Jane Walker, PhD, and their colleagues’ seminal work on enhancing treatment of depression in cancer patients using a...

cns cancers

Failure of Cilengitide in Newly Diagnosed Glioblastoma With Methylated MGMT Promoter

Temozolomide in combination with radiation for newly diagnosed glioblastoma was approved by the U.S. Food and Drug Administration in 2005—almost 10 years ago—but we have unfortunately made little progress in improving survival for this incurable brain tumor. Despite recent completion of three...

lymphoma

Time to Treatment Failure Similar With Rituximab Retreatment vs Maintenance in Low–Tumor Burden Follicular Lymphoma

Maintenance rituximab (Rituxan) has been shown to improve progression-free survival vs observation in low–tumor burden follicular lymphoma. In the Eastern Cooperative Oncology Group (ECOG) E4402 Trial ­(RESORT), reported in the Journal of Clinical Oncology, Brad S. Kahl, MD, of the University of...

pain management

Despite Growing Awareness, the Global Crisis of Untreated Cancer Pain Persists

Each day, millions of patients with cancer around the world suffer unrelieved pain because they are denied morphine, the gold standard of cancer pain control. The World Health Organization has called access to morphine a human rights issue. Not surprisingly, the crisis in unrelieved cancer pain is...

supportive care

Life-Threatening Dermatologic Toxicity

A variety of life-threatening dermatologic adverse events may occur in association with cancer drug therapies. Here, we discuss the recognition and management of three types of such toxicities: type I hypersensitivity/anaphylaxis, Stevens-Johnson syndrome/toxic epidermal necrolysis, and drug rash...

Society Announces Candidates for 2015 ASCO Election

Fourteen distinguished ASCO members have been selected by the ASCO Nominating Committee as candidates for open leadership positions within the Society for the 2015 ASCO Election. Biographical information and interviews with each candidate, as well as instructions for casting a proxy ballot, will be ...

cns cancers

FDA Grants Orphan Drug Designation to Bivalent Vaccine for Neuroblastoma

The U.S. Food and Drug Administration (FDA) has granted orphan drug designation to MabVax Therapeutics’ vaccine for the treatment of relapsed or recurrent high-risk neuroblastoma in remission or with limited residual disease after best available treatment. The bivalent vaccine is intended to elicit ...

breast cancer

Fertility Preservation Suggested With Triptorelin in Long-Term Study

Young women with early breast cancer may be more likely to resume menses and become pregnant when treated with a luteinizing hormone–releasing hormone (LH-RH) analog (also known as a gonadotropin-releasing hormone [GnRH] analog) along with chemotherapy, according to the final follow-up of...

breast cancer

Pathologic Complete Response: Understanding the Subtleties

In the neoadjuvant treatment of breast cancer, the importance of achieving a pathologic complete response (pCR) varies substantially by breast cancer subtype. Patients are increasingly interested in this outcome, but it means different things to different patients, according to two breast cancer...

Robert S. Miller, MD, FACP, FASCO, Joins ASCO as Medical Director of Society’s Institute for Quality

Robert S. Miller, MD, FACP, ­FASCO, Assistant Professor of Oncology and Oncology Medical Information Officer at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, has been named Medical Director of the Institute for Quality (iQ) of the American Society of Clinical Oncology (ASCO). Dr....

lung cancer

Managing Resistance to Targeted Agents: The Future of NSCLC Therapy

The bane of treating non–small cell lung cancer (NSCLC) patients with druggable mutations has been the development of resistance to targeted agents. New compounds are meeting the challenge of treating resistant disease, according to Fadlo R. Khuri, MD, FACP, Professor and Chair of Hematology and...

lymphoma

Exciting Highlights in Several Types of Lymphoma Presented at Best of ASCO

Antibody-drug conjugates are being tested against several types of lymphomas and for some of these agents, “activity is quite impressive,” Andrew M. Evens, DO, MSc, reported at the recent Best of ASCO meeting in Chicago. Dr. Evens, Professor of Medicine, Chief, Division of Hematology/Oncology, and...

breast cancer

Hypofractionated Radiation Much Less Toxic Than Conventionally Fractionated Radiation in Early Breast Cancer

Hypofractionated whole-breast irradiation was associated with much less acute toxicity during radiation therapy compared with conventionally fractionated whole-breast irradiation and also led to improved physical well-being and less physician-reported and patient-reported fatigue 6 months later,...

Expert Point of View: Benjamin Movsas, MD

Benjamin Movsas, MD, Chair of Radiation Oncology at Henry Ford Hospital in Detroit, served as moderator at a press conference where the two SBRT studies by Timmerman et al and Ashworth et al were reported.1,2 Dr. Movsas said that SBRT is a promising approach, noting that the therapy facilitates...

lung cancer

Stereotactic Body Radiation Therapy Benefits Patients With Early-Stage Inoperable or Advanced Oligometastatic Lung Cancer

The door is open for expanded use of stereotactic body radiation therapy (SBRT) in patients with inoperable early-stage lung cancer and for patients with oligometastatic stage IV non-small cell lung cancer (NSCLC), according to results of two studies presented at the 56th Annual Meeting of the...

issues in oncology

Relevance of the Hippocratic Oath in the 21st Century

On the face of it, the idea that a code of professional conduct dating to the ancient Iron Age could possibly retain any relevance in the current era of “Big Data,” religious and cultural pluralism, trillion-dollar government budgets, and nanotechnology seems preposterous. Yet the well-publicized...

Expert Point of View: Benjamin Movsas, MD

Benjamin Movsas, MD, Chair of Radiation Oncology at Henry Ford Hospital in Detroit, served as moderator at a press conference where the two SBRT studies by Timmerman et al and Ashworth et al were reported.1,2 Dr. Movsas said that SBRT is a promising approach, noting that the therapy facilitates...

bladder cancer

EGFR a Potential Target in Muscle-Invasive Bladder Cancer With Basal-Like Phenotype

As reported by Rebouissou and colleagues in Science Translational Medicine, a subset of muscle-invasive bladder cancers that present with a basal-like phenotype is associated with poorer survival, EGFR pathway activation, and sensitivity to EGFR inhibition. Assessment of data from 383 tumors...

lung cancer

Clinical Trials Actively Recruiting Patients With Lung Cancer

The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies of people with lung neoplasms, including stage I and II small cell and non–small cell lung cancers. The studies include phase Ib, II, III, observational, and interventional trials...

head and neck cancer

No Benefit Seen for Cetuximab Added to Cisplatin and Accelerated Radiotherapy in Advanced Head and Neck Carcinoma

Use of cisplatin or cetuximab (Erbitux) with radiotherapy improves overall survival in stage III or IV head and neck carcinoma, and adding cetuximab to platinum therapy improves overall survival in metastatic disease. In the phase III Radiation Therapy Oncology Group (RTOG) 0522 trial reported in...

lymphoma

Beyond R-CHOP for Lymphoma

The R-CHOP regimen (rituximab [Rituxan] plus cyclophosphamide, doxorubicin, vincristine, and prednisone) was a major advance in treating diffuse large B-cell lymphoma, but experts are seeking to up the ante and identify ways to continue to improve outcomes beyond that achieved with R-CHOP. “We are...

multiple myeloma

Experts Debate the Need for Upfront vs Late Stem Cell Transplant in Multiple Myeloma

With powerful new drugs capable of achieving sustained and deep remissions in multiple myeloma, the role of upfront stem cell transplantation is being questioned by experts, who debated the pros and cons at the National Comprehensive Cancer Network (NCCN) 9th Annual Congress on Hematologic...

breast cancer

Variety of Adjuvant Strategies Explored in HER2‑Positive and Other Breast Cancer Types

Adjuvant trastuzumab (Herceptin) was shown to be effective in patients with breast cancers ≤ 2 cm, regardless of estrogen receptor status, in a meta-analysis1 of five chemotherapy trials, but a “pressing question” remaining is whether T1a/b, N0 tumors warrant the use of adjuvant trastuzumab, Andrew ...

breast cancer

For Triple-Negative Breast Cancer, Adding Carboplatin to Anthracycline/Taxane Produces Benefit, but How Much?

Combination chemotherapy for triple-negative breast cancer is anthracycline- and taxane-based and has not really changed much in the past 10 years, but “we are starting to see emerging data with selective activity of platinum agents,” Priyanka ­Sharma, MD, told participants at the Best of ASCO...

Despite Potential to Overwhelm, Surveys Still Essential Research Tool

The age of the Internet and worldwide connectivity has made it easier than ever to send out surveys to a wide audience quickly and easily. This ease of access can make surveys an affordable and readily available research tool for independent investigators, but it can also make surveys an...

lung cancer

Local Treatments Fail to Improve Survival in Mesothelioma

The prognosis for malignant pleural mesothelioma remains dim, despite attempts to intensify treatment in the phase II SAKK 17/04 trial and other studies. The results of SAKK 17/04, presented at the 2014 European Society for Medical Oncology (ESMO) Congress in Madrid, showed that the addition of...

lung cancer
palliative care

Novel Oral Agent Treats Cachexia in Patients With Non–Small Cell Lung Cancer

For the first time, studies show that a drug is effective in treating several domains of cancer-related cachexia. Oral anamorelin increased lean body mass, achieved weight gain, and improved quality of life in patients with cancer-related cachexia in two pivotal phase III studies presented together ...

global cancer care

Women Underrepresented in Oncology Leadership Positions, Greek Survey Shows

A growing number of oncologists in Greece are female, but women continue to be underrepresented in leadership positions, according to a survey reported at the ESMO 2014 Congress. “In Greece, and across Europe, women oncologists still find it hard to access leadership or academic positions,” said...

skin cancer

Nivolumab Yields ‘Impressive’ Duration of Response as Late-Line Melanoma Treatment

Nivolumab yielded an “impressive” duration of response when used as second- or third-line treatment for patients with advanced melanoma, according to Jeffrey S. Weber, MD, of the Moffitt Cancer Center in Tampa, Florida, who presented preliminary results of a phase III trial at the European Society...

Expert Point of View: Christian Blank, MD, PhD

Oncologists are now “in the luxury position of having two highly potent agents to treat BRAF V600–mutated melanoma,” noted Christian Blank, MD, PhD, Group Leader of Immunology at The Netherlands Cancer Institute, Amsterdam, who discussed the two papers at the ESMO 2014 Presidential Symposium....

skin cancer

BRAF/MEK Inhibitor Combinations Impressive in Melanoma Trials

For advanced/metastatic melanoma patients with BRAF mutations, two pathway inhibitors are better than one, according to studies presented at the European Society for Medical Oncology (ESMO) 2014 Congress that demonstrated improved progression-free and overall survival for regimens combining a BRAF...

gynecologic cancers

Encouraging Early Signals for Cediranib in Recurrent Cervical Cancer

Cediranib (a potent tyrosine kinase inhibitor of vascular endothelial growth factor receptor (VEGFR)-1, -2, and -3) produced a modest improvement in progression-free survival and a robust improvement in response rates compared with placebo when added to chemotherapy in patients with recurrent...

breast cancer

BRCA Mutations Found in Many Breast Tumors Called ‘ER-Positive’

BRCA mutations may occur in nearly one-third of breast cancer patients who would have been described as having triple-negative cancer except that their tumors express low levels of estrogen receptor, so the tumors are described as ER–low positive, according to researchers from The University of...

breast cancer

High-Risk Benign Breast Lesions: Some Patients Can Avoid Surgery

High-risk atypical benign breast lesions are upgraded to cancer in more than 15% of patients, but the routine excision of such lesions is probably unnecessary. At the 2014 Breast Cancer Symposium in San Francisco, researchers presented information that could guide the selection of patients who...

breast cancer

Novel Agents May Address Endocrine Therapy Resistance

Progress has recently been swift in the development of new drugs to improve the response to hormone therapy in breast cancer, according to Hope S. Rugo, MD, Professor of Medicine and Director of Breast Oncology and Clinical Trials Education at the University of California, San Francisco, Helen...

breast cancer

CLEOPATRA: Survival With Dual HER2 Blockade ‘Unprecedented’

In the final overall survival analysis of the phase III CLEOPATRA trial, HER2-positive metastatic breast cancer patients lived 15.7 months longer if they received pertuzumab (Perjeta) in addition to trastuzumab ­(Herceptin) and docetaxel, investigators reported at the European Society for Medical...

cns cancers

Effect of Micro-RNA on M2 Macrophages and Murine Glioblastoma

Monocyte-derived glioma-associated macrophages are the largest infiltrating immune cell population in glioblastomas and act to facilitate gliomagenesis. In a study reported in the Journal of the National Cancer Institute, Xu and colleagues assessed the effect of microRNA (miR)-142-3p on...

breast cancer

DNA Double-Strand Break Repair Genes and Oxidative Damage in Brain Metastasis of Breast Cancer

In a study reported in the Journal of the National Cancer Institute, Woditschka and colleagues identified a role for the DNA repair genes BARD1 and RAD51 and oxidative damage in brain metastases in breast cancer. The two genes were implicated in expression profiling of 23 matched resected brain...

Expect Questions About Pertuzumab for HER2-Positive Breast Cancer

The 56.5-month overall survival for women with HER2-positive metastatic breast cancer receiving first-line treatment with pertuzumab (Perjeta) in combination with trastuzumab (Herceptin) and docetaxel in the CLEOPATRA trial represents a 15.7-month survival advantage for those receiving pertuzumab...

breast cancer

Impressive Survival Data for Women With HER2-Positive Breast Cancer Increase First-Line Use of Pertuzumab/Trastuzumab

"Impressive,” “outstanding,” and “unprecedented” are among the terms used to describe the 56.5-month overall survival for women with HER2-positive metastatic breast cancer receiving first-line treatment with pertuzumab (Perjeta) in combination with trastuzumab (Herceptin) and docetaxel in the...

integrative oncology
pain management
symptom management

Acupuncture Treatment for Cancer Pain and Chemotherapy-Induced Peripheral Neuropathy

Acupuncture is a traditional Chinese medicine technique that involves inserting and manipulating filiform needles into specific points of the body to achieve a therapeutic effect. According to traditional Chinese medicine, disruptions in the flow of “vital energy” (qi) throughout the body are the...

Institute of Medicine Elects 70 New Members, 10 Foreign Associates

The  Institute of Medicine (IOM) has announced the names of 70 new members and 10 foreign associates during its 44th Annual Meeting held in October.  Election to the IOM is considered one of the highest honors in the fields of health and medicine and recognizes individuals who have demonstrated...

colorectal cancer

Clinical Trials Actively Recruiting Patients With Colon or Rectal Cancer

The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies of people with colon or rectal cancer in the newly diagnosed and metastatic settings. The studies include phase I, Ib, II, observational, and interventional trials investigating new drug...

NIH Awards More Than $30 Million to Enhance Diversity in the Biomedical Research Workforce

The National Institutes of Health (NIH) announced the award of more than $30 million in fiscal year 2014 funds to develop new approaches that engage researchers, including those from backgrounds underrepresented in biomedical sciences, and prepare them to thrive in the NIH-funded workforce. These...

gastrointestinal cancer

The RAINBOW Trial: Dawn of a New Era in Upper Gastrointestinal Malignancies

As reviewed in this issue of The ASCO Post (page 155), the RAINBOW trial is an international phase III study demonstrating improved overall survival with ramucirumab (Cyramza) plus paclitaxel as second-line therapy for patients with advanced gastric/gastroesophageal junction adenocarcinoma over...

skin cancer

Ipilimumab/Sargramostim Improves Overall Survival vs Ipilimumab Alone in Patients With Advanced Metastatic Melanoma

A randomized clinical trial of patients with advanced metastatic melanoma treated with ipilimumab (Yervoy), an immune checkpoint inhibitor, in combination with sargramostim (Leukine), an immune stimulant, vs ipilimumab alone, has found a 1-year survival rate of 68.9% vs 52.9% in the ipilimumab-only ...

hematologic malignancies
solid tumors
issues in oncology

Top 10 Myths About FDA’s Office of Hematology and Oncology Products

INSIDE THE BLACK BOX is an occasional column providing insight into the U.S. Food and Drug Administration (FDA) and its policies and procedures. In this installment, FDA oncologists Gideon Blumenthal, MD, and Tatiana Prowell, MD, discuss 10 common myths about FDA’s Office of Hematology and Oncology ...

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