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Ziv-aflibercept with FOLFIRI in Metastatic Colorectal Cancer

In August 2012, the antiangiogenic agent ziv-aflibercept (Zaltrap) was approved for use in combination with FOLFIRI (fluorouracil, leucovorin, irinotecan) for the treatment of metastatic colorectal cancer resistant to or progressing after an oxaliplatin-containing regimen.1,2 Approval was based on...

Kidney Cancer Association Works with Conquer Cancer Foundation to Stimulate Breakthrough Research

For any nonprofit cancer organization, a key challenge is how to balance the enormous task of supporting cancer patients with the latest information about current treatments while helping to advance the search for new breakthroughs in therapeutic options. For the past 6 years, the Kidney Cancer...

supportive care
palliative care

Dying Patients with Cancer Who Avoid Aggressive Care but Stay Connected with an Oncologist Have Better Quality of Life

Dying patients with cancer who avoided hospitalizations and life-prolonging measures, who worried less, prayed or meditated, were visited by a pastor, and maintained a therapeutic alliance with their oncologist had the highest quality of life at the end of life, according to a study recently...

breast cancer
supportive care

Sexual Dysfunction in Female Cancer Survivors Is Prevalent

Although medical experts put the proportion of female survivors facing some form of sexual dysfunction following a cancer diagnosis and treatment at nearly 100%, very few women raise sexual health concerns with their oncologist. In a study of 261 patients with gynecologic or breast cancer published ...

leukemia

FDA Approves New Orphan Drug for Chronic Myelogenous Leukemia

The FDA has approved bosutinib (Bosulif) to treat chronic myelogenous leukemia (CML). The drug is intended for patients with chronic, accelerated, or blast phase Philadelphia chromosome–positive CML who are resistant to or who cannot tolerate other therapies, including imatinib (Gleevec). The...

Expert Point of View: Timothy Wilt, MD, MPH

PIVOT is the largest and longest randomized trial conducted in men with early-stage prostate cancer detected during the era of widespread PSA testing. The trial enrolled 731 men and followed them for up to 15 years after randomization. PIVOT results demonstrate that compared to observation, radical ...

prostate cancer
issues in oncology

No Survival Benefit of Radical Prostatectomy vs Observation for Localized Prostate Cancer Detected by PSA Testing

The relative benefits of surgery or observation in men with prostate cancer detected by prostate-specific antigen (PSA) testing have not been defined. Randomized trials comparing radical prostatectomy with observation were conducted before widespread use of PSA testing and an observational study...

Predictors and Treatment for Transformed Lymphoma: Current Paradigms

At the recent Pan Pacific Lymphoma Conference, held in Maui, Hawaii, Richard I. Fisher, MD, Chairman of the SWOG Lymphoma Committee and Vice-President for Strategic and Program Development at the University of Rochester Medical Center in New York, gave a presentation on the characteristics and...

skin cancer

Importance of Dermatologic Care for Patients with Cancer

I first became interested in treating skin issues associated with cancer about 10 years ago, during my dermatology residency training at the University of Chicago. Many of the agents under clinical development at the time, such as cetuximab (Erbitux) or sorafenib (Nexavar), were causing...

Contagious Cancer and an Unexplained Phenomenon Might Inspire Future Therapies

A deadly contagious cancer known as devil facial tumor disease is pushing the world’s largest carnivorous marsupial, the Tasmanian devil (Sarcophilius harrisii), to the brink of extinction. The loss of an interesting creature aside, the plight of the Tasmanian devil raises provocative questions...

Faculty Q&A Discussion: Anaplastic Large-cell Lymphoma

 Dr. Armitage: For ALK-negative anaplastic large cell lymphoma, brentuximab vedotin is the best thing we have to deal with patients with recurrent disease, and who knows where it will end up in primary therapy. But if the patient is ALK-positive, there is a potential for crizotinib (Xalkori) to...

lymphoma

Management of a Patient with Relapsed and Refractory Hodgkin Lymphoma

Case Summary presented by Andreas Engert, MD, Chairman, German Hodgkin Study Group, University Hospital of Cologne, Cologne, Germany This is a case report of a 23-year-old female patient who was diagnosed with Hodgkin lymphoma in January 2009. She received two cycles of ABVD (doxorubicin,...

Faculty Q&A Discussion: Communicating with Patients

 Dr. Armitage: As oncologists, we face many challenges. I think the most difficult is when you say to a patient with a disease everybody expects will be cured, and every patient expects to be cured, “It is not worth trying to do that. It is time to worry about keeping you as well as possible for as ...

SIDEBAR: Melanoma Treatment Options Exploding, but Old Standbys Should Remain

New drugs are rapidly changing the treatment paradigm for stage IV melanoma, but there is still validity to some of the old standbys, according to Michael Sabel, MD, of the University of Michigan, Ann Arbor, who described the shifting landscape of melanoma treatment at the Best of ASCO Boston...

SIDEBAR: How Should SWOG 9346 Be Interpreted?

The findings of Southwest Oncology Group (SWOG) 9346 sparked controversy at the ASCO Annual Meeting, and the interpretations were debated at an official postpresentation discussion. At the Best of ASCO Boston meeting, William K. Oh, MD, of Mount Sinai School of Medicine, New York—who also served as ...

SIDEBAR: Progression-free Survival Curve for Regorafenib Hints at Subgroup Effect

In all likelihood, only a subset of patients given regorafenib derive benefit, as suggested by the progression-free survival curve seen in the CORRECT trial, according to Dr. Overman. “This is a very interesting curve. The medians don’t really capture the difference.… If you look more at the area...

colorectal cancer

Evidence Is Changing Colorectal Cancer Treatment Landscape

Key colorectal cancer studies presented at this year’s ASCO Annual Meeting are changing the treatment landscape in this disease, according to Michael Overman, MD, of The University of Texas MD Anderson Cancer Center, who reviewed the data at the Best of ASCO San Diego meeting. The mix included...

SIDEBAR: A Tough Call: The T1a HER2-positive Tumor

The optimal adjuvant management of T1a HER2-positive breast cancers is uncertain and requires an individualized approach, according to Hope S. Rugo, MD, Professor of Medicine and Director, Breast Oncology and Clinical Trials Education at the UCSF Helen Diller Family Comprehensive Cancer Center....

breast cancer

Cytotoxic Chemotherapy for Breast Cancer: Are We Done Tweaking It?

While novel targeted agents may grab the headlines in the treatment of breast cancer, oncologists still debate the optimal delivery of conventional cytotoxic chemotherapy, still a vital component of treatment. At the Best of ASCO Boston meeting, Steven J. Isakoff, MD, PhD, of Massachusetts General...

SIDEBAR: Molecular Testing Requires Planning at Time of Biopsy

The molecular analysis of lung cancer patients is becoming more and more complex,” and clinicians therefore need to consider any additional tissue requirements upfront, Dr. Horn commented. At Vanderbilt University, testing for EGFR, KRAS, and eight other mutations is done using the Lung SnaPshot...

supportive care

2012 Is ‘Banner Year’ for Research on Symptom Management

The year 2012 was “a banner year for symptom management,” according to Debra L. Barton, RN, PhD, of the Mayo Clinic, Rochester, Minnesota, who presented data on patient and survivor care at the Best of ASCO San Diego meeting. “I have been doing symptom management for about 20 years, and it seems...

issues in oncology

Tweeting at ASCO Annual Meetings Can Enhance the Experience

Tweeting at concerts or plays may earn you scornful looks or even stern warnings from ushers, but tweeting at the ASCO Annual Meeting may enhance the meeting experience for you and others. In a study comparing trends in Twitter use by physicians during the 2010 and 2011 ASCO Annual Meetings, some...

prostate cancer
issues in oncology

FDA Approves Production of Imaging Agent to Detect Prostate Cancer

The FDA approved the production and use of Choline C 11 Injection, a positron-emission tomography (PET) imaging agent used to help detect recurrent prostate cancer. Choline C 11 Injection is administered intravenously to produce an image that helps to locate specific body sites for follow-up tissue ...

prostate cancer

Hormonal Therapy with Enzalutamide Increases Survival in Castrate-resistant Prostate Cancer after Chemotherapy

The androgen receptor–signaling inhibitor enzalutamide (Xtandi) is reported to differ from conventional antiandrogen agents in that it inhibits androgen receptor nuclear translocation, DNA binding, and coactivator recruitment, has a greater affinity for the androgen receptor, and induces tumor...

New ASCO Tobacco Cessation Practice Resources Will Offer Help for Providers as Well as Patients

It is well recognized that tobacco use increases the risk of several kinds of cancer. However, it is less well recognized that quitting tobacco remains important once an individual has been diagnosed with cancer, a common misconception held by oncologists and patients alike. Patients with cancer...

SIDEBAR: Trials Establish New Standard of Care for Anaplastic Oligodendroglioma

Long-term results of two cooperative group phase III trials have determined radiation therapy and chemotherapy is the new standard of care for newly diagnosed anaplastic oligodendroglioma with 1p19q loss,” commented Eric L. Chang, MD, of the USC Norris Cancer Hospital and Keck School of Medicine,...

leukemia

Bosutinib in Chronic Myelogenous Leukemia Patients with Resistance or Intolerance of Prior Therapy

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 In September 4, 2012, bosutinib (Bosulif) was approved...

leukemia

Kinase Inhibitors Compared in First-line Treatment of CML

Bosutinib (Bosulif) is an oral dual Src/Abl kinase inhibitor that is active against many Bcr-Abl mutations associated with imatinib (Gleevec) resistance and that has reduced activity against nonspecific molecular targets associated with toxicities reported for other second-generation kinase...

Pediatric Pathologist Sidney Farber, MD: The ‘Father of Modern Chemotherapy’ and Cofounder of the Jimmy Fund

In June 3, 1948, The New England Journal of Medicine published a study by Sidney Farber, MD, showing that a synthetic compound, 4-aminopteroylglutamic acid (aminopterin), could induce remissions in seriously ill children with acute leukemia.1 Although the study was small—just 16 children—10 showed...

Neuropathy Not Predictive of Outcomes with Adjuvant Taxane Therapy in Breast Cancer

Neuropathy is a common and potentially disabling adverse effect of taxane therapy, particularly weekly paclitaxel. A number of recent studies have identified single nucleotide polymorphisms that appear to increase risk of grade 2 to 4 neuropathy in patients with breast cancer who receive taxanes....

Successful Use of Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy May Hinge on Prior Experience

A review of 60 consecutive patients with peritoneal carcinomatosis who underwent cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (HIPEC)—sometimes called “hot chemotherapy”—found 0% mortality and 33% morbidity, with “a significant reduction of grade III/IV morbidity,...

21-gene Recurrence Score Predicts Outcomes of Node-positive, ER-positive Patients after Adjuvant Chemoendocrine Therapy

The 21-gene recurrence score (obtained with Oncotype DX) can help identify patients with estrogen receptor (ER)-positive, node-positive breast cancer who do not respond well to adjuvant chemoendocrine therapy, according to a retrospective analysis of the National Surgical Adjuvant Breast and Bowel...

Novel Device May Eliminate Need for Re-excision after Lumpectomy

A novel device employed during breast surgery reduces the need for re-excision due to positive margins. This lessens patient anxiety, lowers treatment costs, and helps preserve the cosmetic appearance of the breast, according to a large prospective study reported at the 2012 Breast Cancer...

solid tumors

Noncolorectal GI Cancer Evidence Incorporated into Guidelines

The noncolorectal gastrointestinal cancer studies selected for this year’s Best of ASCO meetings include some whose results are being folded into practice guidelines or are good candidates for incorporation, according to Alexandria T. Phan, MD, Associate Professor at The University of Texas MD...

leukemia
lymphoma

Developments in Hematologic Cancers Include New Considerations in Treating Challenging Leukemias and Multiple Myelomas

Speakers at the National Comprehensive Cancer Network (NCCN) 7th Annual Congress on Hematologic Malignancies reviewed the current standard of care for various hematologic cancers and explored new concepts in treatment. Below are highlights from presentations on chronic myelogenous leukemia (CML),...

supportive care
pain management

Pain Remains Prevalent among Oncology Outpatients, with Odds of Undertreatment Twice as High among Minority Patients

In 1994, a landmark study of pain among oncology outpatients prompted a host of pain management initiatives.1 More than 18 years later, a recent study among more than 2,000 cancer outpatients has found that “one-third of the patients who had pain or used analgesics received inadequate treatment for ...

pancreatic cancer

A Series of Medical Missteps

Since the beginning of my symptoms—occasional pain on the upper left side of my abdomen, accompanied at times by nausea—which started nearly 20 years ago, my condition, pancreatic neuroendocrine tumor, either remained undetected or was completely misdiagnosed until just recently. A series of...

Despite the Rhetoric, Cancer Care Costs Keep Skyrocketing: Is There a Solution?

Although health-care experts routinely agree that the rising costs of oncology services are untenable, there is disagreement about how to reduce expenditures without harming access and quality of care. At this year’s ASCO Annual Meeting, Thomas J. Smith, MD, FACP, offered some interesting ideas...

gynecologic cancers

Major Strides Seen in Treatment of Gynecologic Cancers

Research reported at this year’s ASCO Annual Meeting shows major strides in treating ovarian and cervical cancers, suggesting the potential of new agents and adding evidence in areas where optimal management is unclear, according to Jonathan S. Berek, MD, of the Stanford Women’s Cancer Center,...

multiple myeloma

Novel Drug Combinations Present New Hope for Effective Treatments in Multiple Myeloma

Developing early-phase clinical trials that incorporate combinations of novel agents targeting different pathways in the hematologic cancer multiple myeloma is a leading focus of the work of Sagar Lonial, MD, Professor of Hematology and Vice Chair of Clinical Affairs in the Department of Hematology ...

Karnofsky Award Winner Honors Mentors through Gift to Conquer Cancer Foundation

Kanti R. Rai, MD, and his wife Susan have been loyal donors to the Conquer Cancer Foundation for the past 9 years, but in 2012, a momentous occasion in his career inspired Dr. Rai to make a unique gift. A Moment of Reflection In the spring of 2012, Dr. Rai, an internationally recognized expert on ...

skin cancer

Vismodegib: Novel Agent for Treating Advanced Basal Cell Carcinoma

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 In January 2012, vismodegib (Erivedge) was approved...

issues in oncology

Whole-blood RNA Expression Profiles as Prognostic Models for Castration-resistant Prostate Cancer

Survival among patients with castration-resistant prostate cancer is highly variable, and there is a scarcity of prognostic markers that could be used to stratify patients in clinical trials, improve treatment, and accelerate drug development. Two recent studies reported in Lancet Oncology have...

breast cancer

SIDEBAR: Dealing with the Toxicity of Everolimus/Exemestane

While packing a punch in terms of clinical benefit, everolimus plus exemestane can also be a tough pill to swallow for many patients. The management of the potential toxicities associated with this new regimen was addressed at the 2012 Breast Cancer Symposium by Matthew J. Ellis, MB, PhD, of...

lung cancer
issues in oncology

SIDEBAR: Dacomitinib: Better in Whom? Better in What?

Drug development is a highly competitive business. A new drug must be proven to be better than the standard one before it can be registered for public use. Starting with preclinical data, there should be evidence of lower 50% inhibitory concentrations in selective cell lines or a broader spectrum...

lung cancer
issues in oncology

Phase II Study Suggests Advantage of Irreversible Pan-HER Inhibition in Advanced NSCLC

Dacomitinib is a new tyrosine kinase inhibitor that forms irreversible covalent bonds with the ATP domain of each of the three kinase-active members of the HER family—EGFR/HER1, HER2, and HER4. Agents such as erlotinib (Tarceva) and gefitinib (Iressa), which are of proven benefit in advanced...

leukemia

Challenges Persist in Treatment of Elderly Patients with CLL, but Novel Agents Hold Promise for Future Strategies

Chronic lymphocytic leukemia (CLL) is mainly a disease of the elderly, and the lack of a standard regimen for elderly patients has been a major challenge. The myelosuppressive regimens used to treat younger patients are not well tolerated by the elderly. However, some newer approaches currently...

issues in oncology

Challenging Times: A Day in the Life of a Community Oncologist

Community oncologists man the front line of cancer care, treating upward of 85% of our nation’s patients. Over the past 2 decades, regulatory and economic changes have left many practices in a state of flux and uncertainty, some struggling to keep their doors open. To shed light on the community...

skin cancer

Combination of BRAF and MEK Inhibitors Paves Way for Phase III Studies in BRAF-mutated Metastatic Melanoma

Two late-breaking studies presented at the 2012 European Society for Medical Oncology (ESMO) Congress highlight the promising potential of combining dual BRAF and MEK inhibitors for the treatment of BRAF-mutated metastatic melanoma. A phase II study showed that combining full doses of the BRAF...

Nobel Laureate E. Donnall Thomas, MD, Dies at 92

In his 1990 Nobel Prize Lecture, Eduard Donnall Thomas, MD, with characteristic humility, acknowledged that the success he celebrated “was made possible by the work of many others in this and related fields.” Dr. Thomas, whose groundbreaking work in bone marrow transplantation marked a new era in...

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