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cns cancers

ASTRO 2016: Reduced Radiation Boost Volume Recommended for Average-Risk Pediatric Medulloblastoma, but Craniospinal Axis Dose Remains Unchanged

In the largest trial conducted for average-risk medulloblastoma, survival rates following reduced radiation therapy boost volumes were comparable to standard treatment volumes for the primary tumor site, but lower doses of craniospinal axis irradiation were associated with higher event rates and...

cns cancers

ASTRO 2016: Postoperative Stereotactic Radiosurgery: New Standard of Care for Patients With Resected Brain Metastases?

For patients who have cancer that has metastasized to the brain, stereotactic radiosurgery (SRS) results in statistically comparable survival rates, reduced cognitive decline, and better quality of life, compared to whole-brain radiotherapy (WBRT), according to research presented at the 58th Annual ...

cns cancers
lung cancer

Little Benefit Reported With WBRT in NSCLC Patients With Brain Metastases Unsuitable for Resection or Stereotactic Radiotherapy

In a UK-based phase III noninferiority trial (QUARTZ) reported in The Lancet, Mulvenna et al found that use of whole-brain radiotherapy in addition to optimal supportive care including dexamethasone was associated with little additional benefit in non–small cell lung cancer (NSCLC) patients...

cns cancers

Is Weekly Vinblastine Active in Chemotherapy-Naive Children With Progressive Low-Grade Glioma?

In a phase II Canadian Pediatric Brain Tumor Consortium Study reported in the Journal of Clinical Oncology, Lassaletta et al found that vinblastine monotherapy was associated with response or stable disease in most children with chemotherapy-naive low-grade glioma. Vinblastine monotherapy has shown ...

hematologic malignancies
leukemia

Is Extramedullary Disease at Diagnosis Prognostic in Adult Acute Myeloid Leukemia?

The presence of extramedullary disease at acute myeloid leukemia (AML) diagnosis was not an independent prognostic factor for worse survival, based on an analysis of data from the Eastern Cooperative Oncology Group–American College of Radiology Imaging Network (ECOG-ACRIN) reported by Ganzel...

cns cancers

Effect of Radiosurgery Alone vs With Whole-Brain Radiotherapy on Cognitive Function in Patients With Brain Metastases

Physicians from Carolinas HealthCare System’s Neurosciences Institute and Levine Cancer Institute are among the authors of a recent study published by Brown et al in JAMA.1 The study showed how among patients with one to three brain metastases, the use of stereotactic radiosurgery alone, compared...

lymphoma

For High-Grade and Aggressive Non-Hodgkin Lymphomas, Treat Adults Like Children

Outcomes for adults with high-grade and aggressive non-Hodgkin lymphomas (NHLs) appear to be better when these patients are treated with pediatric-inspired protocols, according to Mitchell S. Cairo, MD, Chief of the Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Maria...

lung cancer

Ceritinib Shows Overall and Intracranial Activity in Advanced NSCLC Previously Treated With Crizotinib and Chemotherapy

Lucio Crinò, MD, of the University Medical School of Perugia, Italy, and colleagues found that ceritinib (Zykadia) was active overall and in central nervous system (CNS) metastases in patients with ALK-rearranged advanced non–small cell lung cancer (NSCLC) previously treated with crizotinib...

lymphoma

Understanding Double-Hit Lymphomas and Optimizing Management

Double-hit lymphomas are a challenging subset of high-grade B-cell lymphomas, previously characterized histologically as diffuse large B-cell lymphoma or B-cell lymphoma unclassifiable with intermediate features between diffuse large B-cell lymphoma and Burkitt lymphoma. Expert guidance in their...

lung cancer

Phase III Trial Finds No Survival Benefit of Adding Ipilimumab to Etoposide/Platinum in Extensive-Stage SCLC

The addition of the anti–CTLA-4 (cytotoxic T-lymphocyte–associated protein 4) checkpoint inhibitor ipilimumab (Yervoy) to etoposide/platinum did not improve overall survival in the first-line treatment of patients with extensive-stage small cell lung cancer (SCLC), according to a phase...

cns cancers

Effect of Radiosurgery Alone vs Radiosurgery Plus WBRT on Cognitive Function in Patients With Brain Metastases

Physicians from Carolinas HealthCare System's Neurosciences Institute and Levine Cancer Institute are among the authors of a study published by Brown et al in JAMA. The study showed how among patients with one to three brain metastases, the use of stereotactic radiosurgery (SRS) alone, compared...

solid tumors
lung cancer

Ceritinib Shows Overall and Intracranial Activity in Advanced NSCLC Previously Treated With Crizotinib and Chemotherapy

Crinò et al found that ceritinib (Zykadia) was active overall and in central nervous system (CNS) metastases in patients with ALK-rearranged advanced non–small cell lung cancer (NSCLC) previously treated with crizotinib (Xalkori) and chemotherapy, according to the ASCEND-2 phase II...

hematologic malignancies
leukemia
lymphoma
multiple myeloma

Selected Hematology Abstracts From the 2016 ASCO Annual Meeting

Here are several abstracts selected from the proceedings of the 2016 ASCO Annual Meeting, focusing on clinical trials on therapeutics in different types of leukemia, multiple myeloma, follicular lymphoma, and central nervous system (CNS) lymphoma. For full details of these study abstracts, visit...

hematologic malignancies
lymphoma

CNS-IPI for CNS Relapse in Diffuse Large B-Cell Lymphoma

As reported in the Journal of Clinical Oncology, Schmitz et al have developed and validated a risk score for CNS relapse—the Central Nervous System International Prognostic Index (CNS-IPI)—in patients with diffuse large B-cell lymphoma (DLBCL) treated with R-CHOP (rituximab [Rituxan]...

cns cancers

New Standard of Care Emerges for Anaplastic Glioma Without 1p/19q Codeletion

Adjuvant temozolomide, after radiotherapy, improves overall survival in patients with grade 3 anaplastic glioma without 1p/19q codeletion, according to a phase III EORTC (European Organization for Research and Treatment of Cancer) study presented at the 2016 ASCO Annual Meeting.1 “We were...

cns cancers

Analysis of Cerebrospinal Fluid for D-2-Hydroxyglutarate May Detect Malignant Brain Tumors Nonsurgically

When a brain tumor is suspected, its presence is usually confirmed by anatomic imaging such as computed tomography (CT) or magnetic resonance imaging (MRI). But through imaging, not much about the tumor molecularly can be learned. Surgery and a biopsy are necessary to get a glimpse of the cancer...

cns cancers

Retroviral Replicating Vector That Delivers Cytosine Deaminase to Cancer Cells Active in Recurrent Glioblastoma

A phase I study by Timothy F. Cloughesy, MD, Director of the Neuro-Oncology Program at the UCLA Jonsson Comprehensive Cancer Center, and colleagues published in Science Translational Medicine investigated the effectiveness of vocimagene amiretrorepvec (Toca 511), an experimental nonlytic,...

cns cancers

For High-Risk Neuroblastoma, Two Transplants May Be Better Than One

In children with high-risk neuroblastoma, tandem autologous stem cell transplant (ASCT) improved event-free survival rates in the ANBL0532 trial from the Children’s Oncology Group. The study was presented at the plenary session of the 2016 ASCO Annual Meeting by Julie R. Park, MD, of Seattle...

supportive care

Cancer and Fertility Program Improves Patient Satisfaction With Information on Fertility Risks and Preservation

As reported by Joanne F. Kelvin, MSN, RN, CNS, AOCN, of Memorial Sloan Kettering Cancer Center (MSK), and colleagues in the Journal of Clinical Oncology, a cancer and fertility program established at MSK improved patient satisfaction with information received regarding fertility risks and...

cns cancers

Combined-Modality Therapy for Low-Grade Gliomas: Balancing Toxicity, Delivery Logistics, and Survival Benefit

Low-grade gliomas account for 15% of all primary brain tumors and represent a heterogeneous group of glial neoplasms. Although these tumors have been termed low-grade, this is a misnomer, especially for some grade II gliomas, which may exhibit a more aggressive behavior and variable natural...

cns cancers

Improvement in Overall Survival With Addition of Chemotherapy to Radiotherapy in Low-Grade Glioma

Final results of the RTOG 9802 phase III trial reported in The New England Journal of Medicine by Jan C. Buckner, MD, of Mayo Clinic, Rochester, and colleagues, showed that the addition of chemotherapy with procarbazine, lomustine, and vincristine to radiotherapy significantly prolonged overall...

cns cancers

Chemoradiotherapy Improves Survival in Patients Over Age 65 With Glioblastoma: A New Standard Option?

The combination of short-course radiotherapy and temozolomide followed by maintenance with temozolomide significantly improved survival compared with short-course radiotherapy alone in newly diagnosed elderly patients with glioblastoma, according to the results of a global cooperative group trial...

cns cancers

Julie R. Park, MD, on Neuroblastoma: Results of a Children’s Oncology Group Study

Julie R. Park, MD, of Seattle Children’s Hospital, discusses findings from this phase III trial of tandem myeloablative autologous stem cell transplant using peripheral blood stem cell as consolidation therapy for high-risk neuroblastoma (Abstract LBA3).

cns cancers

James R. Perry, MD, on Glioblastoma: Study Results on Treating Elderly Patients

James R. Perry, MD, of Sunnybrook Health Sciences Centre, discusses findings of a phase III trial of short-course radiotherapy with or without concomitant and adjuvant temozolomide in older patients with this tumor (Abstract LBA2).

cns cancers

ASCO 2016: Tandem Autologous Stem-Cell Transplant Improves Outcomes for Children With High-Risk Neuroblastoma

Historically, less than 50% of children with high-risk neuroblastoma live 5 or more years after diagnosis. A National Cancer Institute (NCI)-funded phase III trial performed by the Children’s Oncology Group found that adding a second autologous stem-cell transplant to standard therapy...

cns cancers

ASCO 2016: Temozolomide Chemotherapy Plus Short-Course Radiotherapy Improves Survival in Elderly Patients With Glioblastoma

A Canadian-led randomized phase III trial found that adding temozolomide chemotherapy during short-course radiation therapy, followed by monthly maintenance doses of temozolomide, significantly improved survival of elderly patients with glioblastoma, reducing the risk of death by 33%. These data...

cns cancers

Martin J. Van Den Bent, MD, PhD, on Anaplastic Glioma: Results from the CATNON Trial

Martin J. Van Den Bent, MD, PhD, of the Daniel den Hoed Cancer Center, discusses the interim analysis of the EORTC phase III study on concurrent and adjuvant temozolomide in anaplastic glioma without 1p/19q co-deletion (Abstract LBA2000).

cns cancers
solid tumors

Retroviral Replicating Vector That Delivers Cytosine Deaminase to Cancer Cells Active in Recurrent Glioblastoma

A phase I study by Cloughesy et al published in Science Translational Medicine investigating the effectiveness of vocimagene amiretrorepvec (Toca 511), an experimental nonlytic, retroviral replicating vector that delivers cytosine deaminase to cancer cells, and an investigational...

cns cancers

Play-Based Procedural Preparation May Aid Children Undergoing Cranial Radiation Therapy

Play-based procedural preparation not only helps children cope with the stress and anxiety of radiation therapy, but can also help reduce the amount of sedation used and cut costs, according to a study from the Child Life Program at St. Jude Children’s Research Hospital. The study was...

cns cancers

Clinically Relevant Mutations Identified Through Sequencing of Cerebrospinal Fluid of Patients With CNS Cancers

Next-generation sequencing identified clinically relevant somatic alterations in cancer-associated genes in the cerebrospinal fluid of patients with central nervous system (CNS) cancers, according to a report by Pentsova et al in the Journal of Clinical Oncology. Somatic Alterations The study...

breast cancer

No Progression-Free Survival Benefit for First-Line Neratinib/Paclitaxel vs Trastuzumab/Paclitaxel in Metastatic HER2-Positive Breast Cancer

In the phase III NEfERT-T trial reported in JAMA Oncology, Awada et al found no progression-free survival benefit of neratinib/paclitaxel vs trastuzumab (Herceptin)/paclitaxel in previously untreated inoperable recurrent or metastatic HER2-positive breast cancer. A potential benefit of...

cns cancers

Study Explores Differential Localization of Glioblastoma Subtypes and Pathogenesis

Researchers at the University of California San Diego School of Medicine have demonstrated that distinct types of glioblastoma tend to develop in different regions of the brain. This finding provides an explanation for how the same cancer-causing mutation can give rise to different types of brain...

cns cancers

KIR3DL1 and HLA-B Allele Combinations May Impact Response to Treatment in Neuroblastoma

In a study reported in the Journal of Clinical Oncology, Forlenza et al found that noninteracting KIR3DL1 and HLA-B subtypes were associated with better response to anti-GD2 antibody treatment in neuroblastoma. Study Details Treatment of neuroblastoma with anti-GD2 monoclonal antibody (eg, the...

lymphoma

Adding Rituximab to Dose-Dense Chemotherapy May Be of Benefit in Burkitt Lymphoma

In a French phase III trial reported in The Lancet, Ribrag et al showed that adding rituximab (Rituxan) to dose-dense chemotherapy improved event-free survival among adults with Burkitt lymphoma. Study Details In the open-label trial, 260 patients were randomized between October 2004 and...

supportive care

Cancer and Fertility Program Improves Patient Satisfaction With Information on Fertility Risks and Preservation

A cancer and fertility program established at Memorial Sloan Kettering Cancer Center (MSKCC) improves patient satisfaction with information received regarding fertility risks and preservation options, according to a report by Kelvin et al in the Journal of Clinical Oncology. Designed to support...

cns cancers

Improved Overall Survival With Addition of Chemotherapy to Radiation in Low-Grade Glioma

The addition of chemotherapy with procarbazine, lomustine, and vincristine to radiotherapy significantly prolonged overall survival in patients with low-grade glioma, according to the final results of the phase III RTOG 9802 trial reported in The New England Journal of Medicine by Buckner et al. A...

cns cancers

Louis Burt Nabors, MD, on Primary and Recurrent Gliomas: Notable Developments in Management

Louis Burt Nabors, MD, of the University of Alabama at Birmingham Comprehensive Cancer Center, discusses improvements in the 2016 NCCN Guidelines for glioma, anaplastic oligodendroglioma, and glioblastoma.

cns cancers

Glioblastoma Multiforme With Mismatch Repair Deficiency May Be Target for Immune Checkpoint Inhibition

Glioblastoma multiforme resulting from germline biallelic mismatch repair deficiency was characterized by hypermutation and elevated neoantigen load—characteristics associated with response to immune checkpoint inhibitors in other settings—according to a study reported in the Journal of ...

A Fight to Remember

In 2006, one of my close friends, Robert O’Connor, won the mayoral race for my hometown of Pittsburgh, Pennsylvania. Everyone loved Robert, affectionately known as “Bob” and often referred to as “The People’s Mayor.” Bob was “Mr. Pittsburgh,” and it was his promise to reverse the city’s...

breast cancer
solid tumors

Neratinib Improves Invasive Disease–Free Survival After Trastuzumab-Based Therapy in HER2-Positive Breast Cancer

Chan et al found that 1 year of treatment with the HER1, 2, and 4 tyrosine kinase inhibitor neratinib improved invasive disease–free survival vs placebo after trastuzumab (Herceptin)-based adjuvant therapy in patients with early-stage HER2-positive breast cancer, in the phase III ExteNET...

cns cancers

No Apparent Benefit of Long-Term Mifepristone in the Treatment of Unresectable Meningioma

In a phase III trial (SWOG S9005) reported in the Journal of Clinical Oncology,1 YongLi Ji, MD, PhD, and Claire Verschraegen, MD, of the University of Vermont Cancer Center; and colleagues found no benefit of treatment with the antiprogestin agent mifepristone vs placebo in patients with...

symptom management

Anticoagulation in Patients With Cancer: Understanding the Complexities of Prophylaxis and Management

Venous thromboembolic events are more prevalent in patients with cancer than in persons without it. Cancer is associated with a high rate of venous thromboembolism recurrence, bleeding, requirement for long-term anticoagulation, and reduced quality of life. Moreover, thrombosis is the second most...

cns cancers

Finnish Study Identifies Increased Cancer Risks in Patients With Neurofibromatosis Type 1

In a Finnish study reported in the Journal of Clinical Oncology, Uusitalo et al found that patients with neurofibromatosis type 1 (NF1) were at increased risk of other cancers in addition to nervous system disease. The study included data from a population-based series of patients with...

cns cancers

Alisertib Shows Activity With Irinotecan/Temozolomide in Relapsed or Refractory Neuroblastoma

The oral Aurora A kinase inhibitor alisertib was active in combination with irinotecan/temozolomide in patients with relapsed or refractory neuroblastoma, in a phase I dose-escalation trial reported in the Journal of Clinical Oncology by DuBois et al. The maximum tolerated dose of alisertib was 60...

cns cancers

Combination Therapy May Be Better Than Radiotherapy Alone to Treat Aggressive Brain Cancer, According to Early Study

Radiotherapy effectively damages brain tumors, but the cancer cells can repair themselves in order to live on. Now, researchers at Sidney Kimmel Cancer Center at Thomas Jefferson University have tested a strategy that combines radiotherapy with a drug that shuts down the ability of tumor to mend...

cns cancers

Hyperthermic Laser Surgery Disrupts Blood-Brain-Barrier in Glioblastoma, Opening Path for Chemotherapy

Neurosurgeons at Washington University School of Medicine in St. Louis used hyperthermic laser ablation to shrink tumors in patients with recurrent glioblastoma and noted a temporary disruption of the blood-brain barrier, thereby enabling them to deliver chemotherapy to the peritumoral region....

cns cancers

Two Forms of Radiosurgery for Brain Metastases Are Equally Effective

While two advanced radiosurgery approaches—Gamma Knife and RapidArc—offer different strengths, they are equally effective at eradicating cancer in the brain, say researchers at Sidney Kimmel Cancer Center at Jefferson. Their study, published by Liu et al in Frontiers in Oncology,...

breast cancer

Neratinib Shows Some Activity in Previously Treated HER2-Positive Breast Cancer Brain Metastases

In the phase II Translational Breast Cancer Research Consortium (TBCRC) 022 study, reported by Freedman et al in the Journal of Clinical Oncology, the erbB1, HER2, erbB4 inhibitor neratinib showed some activity in patients with HER2-positive breast cancer brain metastases. Study Details In the...

cns cancers

Malignant Brain Tumors Most Common Cause of Cancer Deaths in Adolescents and Young Adults

A new report published by Ostrom et al in the journal Neuro-Oncology sponsored by the American Brain Tumor Association (ABTA) found that malignant brain tumors are the most common cause of cancer-related deaths in adolescents and young adults aged 15 to 39, and the most common cancer occurring...

cns cancers

Single-Center Study Evaluates Proton Radiotherapy for Pediatric Medulloblastoma

In a phase II study reported in The Lancet Oncology by Yock et al, use of proton radiotherapy for pediatric medulloblastoma was associated with acceptable long-term toxic effects and good survival outcomes. Study Details In the study, 59 patients aged 3 to 21 years were treated at...

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