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Showing 601 - 650Increased Risk of Severe Neurocognitive Impairment in Adult Survivors of Pediatric CNS Tumors
As reported in the Journal of Clinical Oncology by Brinkman et al, a study in the St. Jude Lifetime Cohort showed that adult survivors of pediatric central nervous system (CNS) tumors are at increased risk of severe neurocognitive impairment. Study Details The study involved 224 survivors of CNS...
Alectinib in ALK-Positive Metastatic NSCLC After Crizotinib
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 December 11, 2015, alectinib (Alecensa) was granted...
A Brain Tumor Diagnosis Has Taken My Life in New Directions
The first sign that I could have a life-threatening illness was a bout of severe dizziness, which sent me first to a general practitioner for a physical examination and then to an ear specialist for more tests. At just 24 and in excellent health, the sudden onset of dizziness didn’t initially set...
Abnormal Fused Gene Is a Triple Threat in Driving Pediatric Brain Tumors
Oncology researchers have discovered that an abnormal fused gene that drives pediatric brain tumors poses a triple threat, operating simultaneously through three distinct biologic mechanisms—the first such example in cancer biology. The study was published by Bandopadhayay et al in Nature...
French Trial Shows Addition of First-Line Bevacizumab to Cisplatin/Pemetrexed Improves Survival in Malignant Pleural Mesothelioma
In the French phase III MAPS trial reported in The Lancet, Zalcman et al found that the addition of bevacizumab (Avastin) to standard cisplatin/pemetrexed (Alimta) treatment increased overall and progression-free survival in patients with newly diagnosed pleural mesothelioma. Vascular endothelial...
Gregory T. Armstrong, MD, MSCE, on Late Mortality in Childhood Cancer Survivors
Gregory T. Armstrong, MD, MSCE, of St. Jude Children's Research Hospital, discusses the findings of a landmark survivorship study (Abstract LBA2).
Jan C. Buckner, MD, on Whole-Brain Radiation and Radiosurgery in Patients With Brain Metastases
Jan C. Buckner, MD, of the Mayo Clinic discusses adjuvant whole-brain radiotherapy and the need for initial treatment with radiosurgery and close monitoring to preserve cognitive function in patients with brain metastases (Abstract LBA4).
Alice T. Shaw, MD, PhD, on ALK, Crizotinib, and Alectinib
Alice T. Shaw, MD, PhD, of Massachusetts General Hospital, summarizes efficacy and safety data from studies on crizotinib, brigatinib, and alectinib for ALK-positive non–small cell lung cancer (ORAL 33.03, 33.06, 33.07).
Priscilla K. Brastianos, MD, on Genetic Screening of Brain Metastases
Priscilla K. Brastianos, MD, of Massachusetts General Hospital, discusses genomic characterization of brain metastases and paired primary tumors, which could reveal potential therapeutic targets (Abstract 2905).
Tony Mok, MD, and Alice Shaw, MD, PhD: Expert Perspectives on ALK Inhibition and Brigatinib
Tony Mok, MD, of The Chinese University of Hong Kong, and Alice Shaw, MD, PhD, of Massachusetts General Hospital, discuss the current status and future outlook of ALK inhibition, and an assessment of brigatinib CNS activity in patients with ALK-positive non-small cell lung cancer and intracranial...
Anita Mahajan, MD, on Radiotherapy Advances in the CNS and Aerodigestive Tract
Anita Mahajan, MD, of MD Anderson Cancer Center, summarizes results from three clinical trials on radiation therapy for ependymoma, locally advanced thoracic esophageal squamous cell carcinoma, and meningioma (Abstracts 31, 1, 7).
The Evolving Treatment Landscape of ALK-Positive NSCLC
Since the initial discovery of ALK rearrangement in non–small cell lung cancer (NSCLC) in 2007,1 small molecule tyrosine kinase inhibitors of ALK have transformed the course of disease for those patients with ALK-rearranged (ie, ALK-positive) NSCLC. Crizotinib (Xalkori), a multitargeted tyrosine...
Global and North American Phase II Studies Show Alectinib Is Highly Active in Crizotinib-Resistant/Refractory ALK-Rearranged NSCLC
In two phase II trials, reported in the Journal of Clinical Oncology and The Lancet Oncology, the ALK inhibitor alectinib (Alecensa), which is active against acquired crizotinib resistance mutations and exhibits high central nervous system (CNS) penetration, was associated with considerable...
Uridine Triacetate Granules for Fluorouracil or Capecitabine Overdose or Early Severe Toxicity
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 December 11, 2015, uridine triacetate (Vistogard) was approved...
Rituximab Adds Benefit to Chemotherapy in Adult B-Cell Precursor ALL
The addition of rituximab (Rituxan) to the pediatric-inspired chemotherapy protocol for B-cell precursor acute lymphoblastic leukemia (ALL) significantly improved event-free survival in a large European study presented at the 2015 ASH Annual Meeting.1 The GRAALL-R 2005 phase III study is the first...
Study Finds Alectinib Highly Active in ALK-Positive, Crizotinib-Resistant NSCLC
In a North American phase II trial reported in The Lancet Oncology, Shaw et al found that alectinib (Alecensa), which is active against acquired crizotinib (Xalkori) resistance mutations and exhibits high central nervous system (CNS) penetration, was associated with considerable activity in...
2016 GI Symposium: Everolimus Slows Growth of Neuroendocrine Tumors
Researchers report the results of a new analysis from a phase III trial of patients with neuroendocrine tumors that begin in the gastrointestinal (GI) tract or have an unknown origin. Compared to placebo, everolimus (Afinitor) was associated with a 6- to 8-month longer time period before the cancer ...
2016 GI Symposium: New Targeted Hormone-Radiation Treatment Slows Growth of Midgut Neuroendocrine Tumors
Early results from the NETTER-1 phase III study of patients with previously treated, advanced midgut neuroendocrine tumors show that a novel therapy, lutetium Lu-177 dotatate (Lutathera), may substantially slow tumor growth. Patients treated with the experimental drug had a 79% lower risk ...
Understanding Crizotinib, 1 Year after High-profile Presentation
The findings from a phase I study of crizotinib in non–small cell lung cancer (NSCLC) were presented in a Plenary Session at the 2010 ASCO Annual Meeting—an unusual event, since such early-phase data are not generally the topic of plenary sessions. The study showed that a majority of mostly...
Plenary Report: Busulfan/Melphalan Improves Survival in High-risk Neuroblastoma Patients, Phase III Study Results Show
Myeloablative therapy with a busulfan (Busulfex, Myleran)/melphalan combination (BuMel) was superior to a regimen of carboplatin/etoposide/melphalan (CEM) in pediatric patients with high-risk neuroblastoma, according to results of the large, phase III HR-NBL1/SIOPEN trial presented at the 2011 ASCO ...
Expert Point of View: High-dose Methotrexate Improves Outcome for High-risk Acute Lymphoblastic Leukemia in Younger Patients
The acute lymphoblastic leukemia study presented by Eric Larsen, MD, during the 2011 ASCO Plenary Session “was designed to test intensified CNS-directed therapy during the interim maintenance phase of treatment. CNS control is an important issue. Although CNS involvement occurs in less than 10% of...
Combined Therapy Produces Good Outcomes in Primary Testicular Diffuse Large B-cell Lymphoma
Final results of an international phase II trial of first-line treatment for primary testicular diffuse large B-cell lymphoma show that using a combined treatment strategy including chemotherapy and central nervous system and testicular prophlaxis “was associated with a good outcome.” The results...
Don’t Take Away Our Hope
After experiencing the loss of my wife Dina’s first pregnancy during her second trimester, we naturally worried that something would go wrong when she became pregnant again. But when our son Will was delivered at full term, we thought we could finally relax. Born at a whopping 10 lb, Will seemed...
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...
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 ...
Combination of Oncolytic Virus and Chemotherapy Holds Promise in Glioblastoma
Glioblastoma remains a uniformly lethal disease. Both the alkylating agent temozolomide and oncolytic viruses (engineered to preferentially infect and kill cancer cells) hold promise in treatment of glioblastoma. The effects of combining the two and the mechanisms of their interaction on cancer...
Expert Point of View: Prostate Cancer Studies Compare Outcomes, Toxicities, and Costs
Nicholas B. Vogelzang, MD, moderator of the press briefing where these findings were presented, agreed that the first study supports intensity-modulated radiotherapy (IMRT) as the current standard of care. With costs of health care increasing exponentially, it is important to establish the...
Re-analysis of RADIANT-2 Finds Benefit for Everolimus in Patients with Carcinoid Tumors
A re-analysis of the RADIANT-2 trial, which evaluated everolimus (Afinitor) in patients with advanced nonpancreatic neuroendocrine tumors, has yielded prognostic factors that identify a group of patients who are not only at high risk for recurrence but who may derive benefit from treatment with...
No Benefit Shown With Afatinib in HER2-Positive Breast Cancer With Progressive Brain Metastases
In the phase II LUX-Breast 3 trial reported in The Lancet Oncology, Cortés et al found that afatinib (Gilotrif) alone or combined with vinorelbine did not increase patient benefit vs investigator choice of treatment in patients with HER2-positive breast cancer and progressive brain...
Everolimus Improves Progression-Free Survival in Advanced Neuroendocrine Tumors of the Lung or Gastrointestinal Tract
In a phase III RADIANT-4 trial reported in The Lancet, Yao et al found that everolimus (Afinitor) and supportive care significantly prolonged progression-free survival vs placebo and supportive care in patients with advanced nonfunctional neuroendocrine tumors of the lung or gastrointestinal tract. ...
Risk Stratification and Targeted Therapy, Abetted by Collaboration, Improve Outcomes for Children with Cancer
Outcomes for children with cancer have “improved over the course of the years incrementally, mostly not from the development of new drugs, because virtually all the drugs that we use now in leukemia were available in the 1970s. It is really through better understanding of the heterogeneity of the...
New Standard of Care for Anaplastic Oligodendroglial Tumors with 1p/19q Codeletions
Adjuvant chemotherapy with PCV (procarbazine [Matulane], lomustine [CeeNU], and vincristine) following standard radiation therapy delayed disease progression and increased survival in patients with a relatively rare type of brain tumor called anaplastic oligodendroglioma. A subgroup analysis found...
Bevacizumab/Temozolomide Combination Safe and Active against Advanced Neuroendocrine Tumors
The combination of bevacizumab (Avastin) and temozolomide can be safely administered together in patients with advanced neuroendocrine tumors, and “the combination regimen appears promising for patients with pancreatic [neuroendocrine tumors],” according to results of a phase II study reported in...
Understanding and Managing Pseudoprogression in Glioblastoma Patients
Pearls in Neuro-oncology is guest edited by Tracy Batchelor, MD, Director, Division of Neuro-Oncology, Massachusetts General Hospital Cancer Center, and Professor of Neurology, Harvard Medical School, Boston. The series is intended to provide the practicing oncologist with guidance in managing...
Chemotherapy plus Radiation Improved Progression-free Survival in Adults with Low-grade Glioma
Adult patients with supratentorial low-grade glioma who received chemotherapy with PCV (procarbazine [Matulane], lomustine [CeeNu], and vincristine) in addition to radiation therapy had improved progression-free survival but not overall survival compared to patients receiving radiotherapy alone,...
First Drug for Children with Rare Brain Tumor Approved
The FDA approved a new pediatric dosage form of everolimus (Afinitor Disperz) to treat the rare brain tumor called subependymal giant cell astrocytoma (SEGA). This is the first approved pediatric-specific dosage form developed for the treatment of a pediatric tumor. Afinitor Disperz is recommended...
SIDEBAR: Does Lapatinib Prevent CNS Metastases in HER2-positive Breast Cancer?
Lapatinib has shown some efficacy against existing brain metastases in patients with HER2-positive breast cancer but not in preventing them in the first place, according to Hope S. Rugo, MD, Professor of Medicine and Director, Breast Oncology and Clinical Trials Education at the UCSF Helen Diller...
Long-term Survivors of Hodgkin Lymphoma May Have Increased Risk of Neurocognitive Impairment
A “new finding” that long-term survivors of childhood Hodgkin lymphoma may be at risk for neurocognitive impairment and central nervous system (CNS) pathology arose from a study among 62 patients treated with either high-dose (≥ 30 Gy) thoracic radiation or lower-dose (< 30 Gy) thoracic...
Paclitaxel Poliglumex Gets Orphan Drug Designation for Glioblastoma Multiforme
Cell Therapeutics, Inc, recently announced that paclitaxel poliglumex (OPAXIO) has been granted orphan drug designation by the FDA for the treatment of glioblastoma multiforme. Orphan designation was granted based on preliminary activity seen from phase II results of paclitaxel poliglumex when...
Investigators’ Perseverance Pays Off in Treating Anaplastic Oligodendroglioma
The theme of this year’s key abstracts on central nervous system tumors is that “perseverance and analysis of long-term outcomes lead to practice-changing results and important insights,” according to Eric L. Chang, MD, of the USC Norris Cancer Hospital and Keck School of Medicine, Los Angeles, who ...
Cognitive Impairment in Patients with Cancer
Cancer therapy, including radiation and chemotherapy, can be harmful to multiple organ systems. The central nervous system (CNS) has generally been considered less vulnerable to the toxic effects of cancer therapy. However, the use of more aggressive treatment modalities combined with prolonged...
Trastuzumab Emtansine Improves Survival vs Capecitabine plus Lapatinib in Second-line HER2-positive Breast Cancer
Trastuzumab emtansine (T-DM1) is an antibody-drug conjugate composed of trastuzumab bound to the cytotoxic microtubule inhibitor emtansine (DM1, derivative of maytansine) by a stable linker. Trastuzumab targets the conjugate to HER2 receptors, and the linker releases the cytotoxic agent when the...
Early Surgical Treatment of Low-grade Glioma Improves Survival vs Watchful Waiting
In a comparison of surgical treatment strategies for low-grade gliomas, patients in Norway treated at a hospital that generally favored early surgical resection had better overall survival than patients treated at a hospital that favored diagnostic biopsy and watchful waiting, according to a study...
Revised Everolimus Dosing and New Safety/Efficacy Data for Approval in Subependymal Giant Cell Astrocytoma
On August 29, 2012, everolimus in a tablet for oral suspension form (Afinitor Disperz) was given accelerated approval for the treatment of pediatric and adult patients with tuberous sclerosis complex who have subependymal giant cell astrocytoma (SEGA) that requires therapeutic intervention but...
Bevacizumab Added to Radiation and Chemotherapy Improved Progression-free Survival in Newly Diagnosed Glioblastoma
Recently announced results of the phase III AVAglio study showed that bevacizumab (Avastin) in combination with radiation and temozolomide chemotherapy increased progression-free survival (a co-primary endpoint) by 36% compared to radiation and temozolomide chemotherapy plus placebo (hazard ratio...
Expert Point of View: Vinai Gondi, MD
This memantine study is a critical first step in understanding and delaying cognitive deterioration in brain metastasis patients, noted formal discussant Vinai Gondi, MD, Associate Director of Research at the CDH Proton Center in Warrenville, Illinois, and Clinical Associate Professor at the...
Memantine Provides Modest Improvement in Cognition after Cranial Irradiation
Memantine, a drug used to treat Alzheimer’s disease, slowed cognitive decline in patients with brain cancer treated with whole-brain radiation therapy in a phase III trial reported at the 54th Annual Meeting of the American Society for Radiation Oncology (ASTRO), held recently in Boston. Cognitive...
Management of Brain Metastases
Pearls in Neuro-oncology is guest edited by Tracy Batchelor, MD, Director, Division of Neuro-Oncology, Massachusetts General Hospital Cancer Center, and Professor of Neurology, Harvard Medical School, Boston. The series is intended to provide the practicing oncologist with guidance in managing...
Surgery of Primary Tumor Site Has No Impact on Local Control and Outcome in Patients ≥ 18 Months with Stage IV Disease
“In intensively treated patients with stage IV neuroblastoma age 18 months or older at diagnosis, surgery of the primary tumor site has no impact on local control rate and outcome,” according to findings from the German prospective clinical trial NB97. “The results of the study,” the researchers...
Bevacizumab plus Chemotherapy after Progression of Metastatic Colorectal Cancer on First-line Therapy Including Bevacizumab
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 January 23, 2013, bevacizumab (Avastin) was approved...
