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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...

survivorship
cns cancers
issues in oncology

Increased 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...

lung cancer

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...

cns cancers

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...

cns cancers
issues in oncology

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...

lung cancer
solid tumors

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...

survivorship
cns cancers

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).

cns cancers

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).

lung cancer

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).

solid tumors
cns cancers

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).

lung cancer

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...

cns cancers
gastroesophageal cancer

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).

lung cancer

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...

lung cancer

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...

supportive care

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...

leukemia

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...

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