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breast cancer

Higher Fruit and Vegetable Consumption Associated with Reduced Risk of ER-negative Breast Cancer 

An analysis of a large pooled data set from the Pooling Project of Prospective Studies of Diet and Cancer reported by Seungyoun Jung, ScD, Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, and colleagues in Journal of the National Cancer...

hematologic malignancies
leukemia

Postinduction Dexamethasone and Individualized Dosing of Asparaginase Improve Outcome in Pediatric ALL 

Findings from the Dana-Farber Cancer Institute ALL Consortium Protocol 00-01, recently reported by Lynda M. Vrooman, MD, Dana-Farber Cancer Institute, and colleagues in Journal of Clinical Oncology, indicate that postinduction dexamethasone and individualized dosing of Escherichia coli–derived...

SIDEBAR: Notes from a Death with Dignity Program 

Participation in the Seattle Cancer Care Alliance Death with Dignity program reflects concerns about autonomy, dignity, and functional status rather than disease-related symptoms or depression. The Death with Dignity program “both allows patients with cancer who wish to consider this option to do...

palliative care

Death with Dignity Program at Seattle Cancer Care Alliance 

After passage of the Washington Death with Dignity Act in November 2008, the Seattle Cancer Care Alliance—the site of outpatient care for patients with cancer from Fred Hutchinson–University of Washington Cancer Consortium—developed a Death with Dignity program. The program is adapted from existing ...

leukemia

New Susceptibility Variants for Childhood ALL in Ethnically Diverse Populations 

Acute lymphoblastic leukemia (ALL) is the most common cancer in children, and the incidence of the disease varies by ethnicity. Available evidence indicates an inherited predisposition to ALL, but the genetic basis of ALL susceptibility in diverse ancestry has not been examined in detail. Xu and...

breast cancer

Epigenome-wide Study of DNA Methylation in Breast Cancer Using Prospectively Collected Samples 

Available data suggest that DNA methylation in blood is a potential epigenetic marker of cancer risk, but this has not been evaluated on a genome-wide scale in prospective studies of breast cancer. Xu and colleagues measured DNA methylation at 27,578 CpG sites (ie, DNA regions where cytosine and...

lung cancer

Synergy of Metformin and Gefitinib in LKB1 Wild-type NSCLC Cell Lines 

Clinical resistance to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor treatment has been observed in lung cancer. The antidiabetic drug metformin has shown significant inhibitory and proapoptotic effects in several cancer models alone and in combination with chemotherapeutic...

colorectal cancer

Serum miR-21 as Diagnostic and Prognostic Biomarker in Colorectal Cancer 

The oncogenic microRNAs miR-21and miR-31 negatively regulate tumor-suppressor genes. Toiyama and colleagues conducted a series of studies to assess their potential as serum biomarkers in colorectal cancer. Screening in medium from two colorectal cancer cell lines and serum analysis in 12 patients...

pancreatic cancer

Elevated Serum miR-1290 May Distinguish Early Pancreatic Cancer  

In studies to identify circulating microRNA levels that could distinguish low-stage pancreatic cancer from healthy and disease controls, Li and colleagues, measured 735 microRNAs in pancreatic cancer case and control sera and selected 18 microRNA candidates for validation in an independent set of...

lung cancer

Circulating Tumor Cells with ALK Rearrangement in ALK-positive NSCLC 

The diagnostic test for ALK rearrangement in non–small cell lung cancer (NSCLC) for crizotinib (Xalkori) treatment currently uses biopsy or fine-needle aspiration. Pailler and colleagues assessed whether ALK rearrangement could be detected using circulating tumor cells. They analyzed circulating...

skin cancer

Dabrafenib for Unresectable or Metastatic Melanoma with BRAF V600E Mutation 

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.  Indication On May 29, 2013, dabrafenib (Tafinlar) was approved for ...

leukemia

Identification of Oncogenic Mutations in Chronic Neutrophilic Leukemia and Atypical Chronic Myeloid Leukemia 

Among the hematologic cancers for which molecular causes remain unclear are chronic neutrophilic leukemia and atypical (BCR-ABL1–negative) chronic myeloid leukemia. Both disorders currently are diagnosed on the basis of neoplastic expansion of granulocytic cells and exclusion of genetic factors...

colorectal cancer

Similar Short-term Outcomes with Laparoscopic vs Open Surgery for Rectal Cancer 

As recently reported in Lancet Oncology by Martijn H.G.M. van der Pas, MD, of VU University Medical Center, Amsterdam, and colleagues, the phase III COLOR II trial has shown that laparoscopic surgery can produce similar safety outcomes, resection margins, and completeness of resection compared with ...

lung cancer

No Survival Benefit of ERCC1 and RRM1 Expression-based Chemotherapy in Patients with Advanced NSCLC 

A trial reported by Gerold Bepler, MD, PhD, of Karmanos Cancer Institute, Detroit, and colleagues in Journal of Clinical Oncology assessed whether chemotherapy selected on the basis of in situ ERCC1 and RRM1 protein levels could improve outcomes in patients with advanced non–small cell lung cancer...

lung cancer

Study Shows High Concordance of Recurrent Somatic Alterations in Primary and Matched Metastatic NSCLC

In a study reported in Journal of Clinical Oncology, Stéphane Vignot, MD, of Institut National de la Santé et de la Recherche Medicale (INSERM) Unit 981, Paris, and Gustave Roussy Institute, Villejuif, France, and colleagues used next-generation sequencing to identify somatic alterations in...

lung cancer

KRAS Status Not Associated with Survival in Pooled Adjuvant Therapy Trials in Early-stage Lung Cancer 

KRAS mutations have been reported in approximately 30% of lung adenocarcinomas. They occur most frequently in codons 12 and 13 in non–small cell lung cancer (NSCLC), and are most common in cancer in smokers and in nonsquamous NSCLC. Some data suggest that KRAS mutation is associated with poorer...

lymphoma

Radiation-sparing Dose-adjusted EPOCH-Rituximab for Primary Mediastinal B-cell Lymphoma 

Tumor control is frequently not achieved with standard immunochemotherapy in patients with primary mediastinal B-cell lymphoma, requiring consolidation with mediastinal radiotherapy. However, radiotherapy is associated with serious late adverse effects and is still associated with disease...

breast cancer

Effect of Radium-223 Dichloride in Breast Cancer Bone Metastasis Model 

Radium-223 dichloride (Xofigo) is an alpha particle–emitting radiotherapeutic drug that mimics calcium and localizes to areas of high bone turnover, providing targeted therapy for skeletal metastasis. The drug was recently approved for treatment of patients with castration-resistant prostate...

colorectal cancer

Treating BRAF V600E Colorectal Cancer May Require Concomitant BRAF and PI3K/mTOR Inhibition 

BRAF V600E mutations are associated with poor prognosis in colorectal cancer. A study by Coffee and colleagues examined PI3K/mTOR signaling in BRAF V600E colorectal cancer cell lines after BRAF inhibition as well as cell viability and apoptosis after combined BRAF and PI3K/mTOR inhibition.  Western ...

gastrointestinal cancer

SEER Analysis Shows Increased Survival with Surgery and Radiation Therapy in Metastatic Gastric Cancer 

A Surveillance, Epidemiology, and End Results (SEER) database analysis reported by Ravi Shridhar, MD, PhD, and colleagues in Cancer indicates that patients receiving surgery and radiation therapy for metastatic gastric cancer have prolonged survival compared with those receiving either alone or...

gynecologic cancers

Integrated Genomic Characterization of Endometrial Carcinomas Suggests New Classification Scheme 

As recently reported in Nature, investigators in The Cancer Genome Atlas Research Network performed an integrated genomic, transcriptomic, and proteomic characterization of 373 endometrial carcinomas, including 307 endometrioid and 66 serous or mixed histology cases, using array- and...

lung cancer

Erlotinib in First-line Treatment of Metastatic NSCLC with EGFR Exon 19 Deletion or Exon 21 (L858R) Substitution 

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.   Indication On May 14, 2013, erlotinib (Tarceva) was approved for...

breast cancer

Outcomes with Adjuvant Trastuzumab in HER2-positive Breast Cancer Not Affected by PTEN Status 

PTEN is a negative regulator of PI3K/AKT signaling. PI3K/AKT signaling can be activated by HER2, and it has been hypothesized that alteration in this pathway may affect sensitivity to trastuzumab (Herceptin). Preclinical data and some of the limited available clinical data suggest that loss or...

Expert Point of View: Marc Lippman, MD and C. Kent Osborne, MD

An editorial by Marc Lippman, MD, Leonard M. Miller School of Medicine, University of Miami, and C. Kent Osborne, MD, Breast Center, Baylor College of Medicine, Houston,1 accompanied the study by Dawson and colleagues. These authors commented that the study’s key findings—that variation in the...

breast cancer

Measurement of Circulating Tumor DNA Shows Promise in Monitoring Metastatic Breast Cancer 

Management of metastatic breast cancer requires monitoring of tumor burden to assess response to treatment, and there is a need for biomarkers that can measure tumor burden with high sensitivity and specificity. Assays measuring serum cancer antigen (CA) 15-3 and circulating tumor cells have been...

prostate cancer

Radium-223 Dichloride for Castration-resistant Prostate Cancer with Symptomatic Bone Metastases 

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. Indication On May 15, 2013, radium Ra 223 dichloride (Xofigo) was...

leukemia

Genomic and Epigenomic Characterization of Acute Myeloid Leukemia 

In a study by the Cancer Genome Atlas Research Network reported in The New England Journal of Medicine, genomes of 200 adult cases of de novo acute myeloid leukemia (AML) were analyzed by whole-genome sequencing (n = 50) or whole-exome sequencing (n = 150) to identify mutations and relationships...

SIDEBAR: Venous Thromboembolism Expert Panel

Gary H. Lyman, MD, MPH, FRCP (Edin), Co-Chair, Duke University Medical Center Anna Falanga, MD, Co-Chair, Ospedali Riuiniti Bergamo, Italy Daniel Clarke-Pearson, MD, University of North Carolina Christopher Flowers, MD, MS, Winship Cancer Institute Charles W. Francis, MD, University of...

supportive care

Updated ASCO Clinical Practice Guideline for Venous Thromboembolism Prophylaxis and Treatment 

ASCO has released a new evidence-based clinical practice guideline for venous thromboembolism prophylaxis and treatment, updating the 2007 practice guideline.1 The update is based on a systematic review of literature published from December 2007 to December 2012. An Update Committee reviewed...

issues in oncology

‘Medicalizing’ Physician-assisted Suicide

It was with regret that I read the article and commentary on physician-assisted suicide in the June 10 issue of The ASCO Post (“Death with Dignity Program at Seattle Cancer Care Alliance,” by Matthew Stenger, and “One Cancer Center’s Approach to Death with Dignity,” by Frederick R. Appelbaum, MD)....

solid tumors

Denosumab in Adults and Skeletally Mature Adolescents with Giant Cell Tumor of Bone 

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. Indication On June 13, 2013, denosumab (Xgeva) was approved for the ...

hematologic malignancies
issues in oncology

Critically Ill Hematology Patients Admitted to ICU Have Good Survival, Disease Control, and Quality of Life 

A large prospective multicenter cohort study in France and Belgium, reported by Elie Azoulay, MD, of Saint-Louis Hospital, Paris, and colleagues from the Groupe de Recherche Respiratoire en Réanimation Onco-Hématologique,1 has shown that critically ill patients with hematologic malignancies...

colorectal cancer

Addition of Brivanib to Cetuximab in Chemotherapy-refractory Metastatic Wild-type KRAS Colorectal Cancer: Key Results 

The addition of a combination of epidermal growth factor receptor (EGFR) and vascular endothelial growth factor (VEGF) inhibitors to chemotherapy has not improved outcome in first-line treatment of advanced colorectal cancer. However, in early-phase evaluation, the addition of the investigational...

lymphoma

Lenalidomide in Relapsed/Progressed Mantle Cell Lymphoma after Two Prior Therapies Including Bortezomib 

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. Indication On June 5, 2013, lenalidomide (Revlimid) was approved...

hematologic malignancies
leukemia
lymphoma

New Research on Combination Chemotherapy, Prognostic Biomarkers, and PET-guided Radiation Therapy in B-cell Malignancies 

The 12th International Conference on Malignant Lymphoma was held June 19-22, 2013, in Lugano, Switzerland. Over 3,000 hematologists, clinical oncologists, pathologists, and leading researchers attended the meeting, which featured new research on B-cell malignancies, follicular lymphoma, as well as...

integrative oncology

Acupuncture May Reduce Arm Lymphedema in Patients with Breast Cancer 

Integrative Oncology is guest edited by Barrie R. Cassileth, MS, PhD, Chief of the Integrative Medicine Service and Laurance S. Rockefeller Chair in Integrative Medicine at Memorial Sloan-Kettering Cancer Center, New York. The Integrative Medicine Service at Memorial Sloan-Kettering Cancer Center...

lung cancer

Significant Improvement in Overall Survival Seen with Pemetrexed Maintenance after Pemetrexed/Cisplatin Induction in Patients with Advanced NSCLC 

In the phase III PARAMOUNT trial, pemetrexed (Alimta) continuation maintenance therapy significantly reduced the risk of disease progression by 38% compared with placebo after pemetrexed/cisplatin induction in patients with advanced nonsquamous non–small cell lung cancer (NSCLC). Final overall...

lung cancer

Intercalated Chemotherapy/Erlotinib Improves Progression-free Survival in Advanced NSCLC  

EGFR mutation status may not be known at the time treatment is started in patients with advanced non–small cell lung cancer (NSCLC). Further, some data suggest that the efficacy of concurrent treatment with an EGFR tyrosine kinase inhibitor and chemotherapy is reduced because the G1 cell-cycle...

colorectal cancer

Link between Red Meat Consumption and Mortality Clarified in Patients with Nonmetastatic Colorectal Cancer  

Evidence shows that diets high in red and processed meat are associated with an increased risk of colorectal cancer. In a study reported in the Journal of Clinical Oncology, Marjorie L. McCullough, ScD, Strategic Director of Nutritional Epidemiology, and colleagues from the Epidemiology Research...

lung cancer

Docetaxel Superior to Erlotinib in Second-line Treatment of Advanced Non–Small Cell Lung Cancer with Wild-type EGFR  

There is ongoing debate about the efficacy of erlotinib (Tarceva) in patients with advanced non-small cell lung cancer (NSCLC) whose tumors have wild-type EGFR. In the TAILOR trial, reported in Lancet Oncology by Garassino and colleagues,1 erlotinib was compared with standard docetaxel as...

lung cancer

First-line Carboplatin/Pemetrexed Improves Survival vs Pemetrexed Alone in Advanced Lung Cancer 

A significant proportion of patients with advanced non–small cell lung cancer (NSCLC) have poor performance status, and optimal clinical management of these patients has not been established. In an attempt to help define optimal chemotherapy in such patients, Mauro Zukin, MD, of Instituto Nacional...

issues in oncology

Whole-exome Sequencing of NCI-60 Cell Line Panel Provides Genomic Resource for Cancer Biology and Pharmacology 

The NCI-60 cell lines, which represent cancers of the lung, colon, brain, ovary, breast, prostate, and kidney, as well as leukemia and melanoma, are the most frequently studied human tumor cell lines in cancer research and have generated the most extensive cancer pharmacology database worldwide. As ...

breast cancer

Age Not Linked to Recurrence in Observation or Trastuzumab Groups with HER2-positive Breast Cancer  

Available data suggest that younger age is an independent risk factor for disease recurrence and death in women with breast cancer. However, there has not been adequate study of the interaction of age with human epidermal growth factor receptor 2 (HER2) status or anti-HER2 treatment. In an analysis ...

lung cancer

LUX-Lung 3: Afatinib Prolongs Progression-free Survival vs Cisplatin/Pemetrexed in Advanced Lung Adenocarcinoma 

Afatinib (Gilotrif) is an oral selective ErbB family inhibitor that irreversibly blocks signaling from EGFR/ErbB1, HER2/ErbB2, and ErbB4 and has exhibited broad-spectrum activity against EGFR mutations in preclinical studies. A phase II study of afatinib in EGFR-mutation positive lung...

lung cancer

Afatinib as First-line Treatment for Metastatic NSCLC with EGFR Exon 19 Deletions or Exon 21 (L858R) Substitution Mutations 

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. Indication On July 12, 2013, afatinib (Gilotrif) was approved for...

hepatobiliary cancer

Oncofetal Protein SALL4 Is a Marker of Aggressive Hepatocellular Carcinoma and a Potential Therapeutic Target  

Hepatocellular carcinomas with characteristics of embryonic stem cell and progenitor cell gene expression are associated with particularly poor prognosis. SALL4 is an oncofetal protein that is expressed in the human fetal liver and normally silenced in the adult liver, but re-expressed in a...

lung cancer

Low-dose CT Screening for Lung Cancer: Details of First Round of Screening in National Lung Screening Trial 

The National Lung Screening Trial found that 3 years of annual screening with low-dose helical computed tomography (CT) reduced lung cancer mortality compared with chest radiography in older persons who were heavy smokers.1 The Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial also...

lung cancer

Crizotinib Improves Progression-free Survival vs Pemetrexed or Docetaxel in Advanced ALK-positive NSCLC  

In a phase III trial reported by Alice T. Shaw, MD, PhD, a thoracic oncologist at Massachusetts General Hospital, Boston, and colleagues in The New England Journal of Medicine, crizotinib (Xalkori) improved progression-free survival compared with standard chemotherapy in previously treated patients ...

lymphoma

Ibrutinib Produces High Response Rate in Patients with Refractory Mantle Cell Lymphoma

Ibrutinib is a first-in-class oral covalent inhibitor of Bruton’s tyrosine kinase, a mediator of the B cell-receptor signaling pathway implicated in the pathogenesis of B-cell cancers. As reported in The New England Journal of Medicine, Michael L. Wang, MD, of The University of Texas MD Anderson...

leukemia

High Rate of Durable Remissions with Ibrutinib in Patients with Relapsed Chronic Lymphocytic Leukemia 

Durable remissions are uncommon with current treatments for relapsed chronic lymphocytic leukemia (CLL). Bruton’s tyrosine kinase is an essential component of B cell–receptor signaling that mediates interactions with the tumor microenvironment and promotes survival and proliferation of CLL cells....

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