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lymphoma

Multicenter Phase II Trial Supporting Approval of Brentuximab Vedotin in Anaplastic Large-cell Lymphoma

Systemic anaplastic large-cell lymphoma (ALCL) is an aggressive T-cell lymphoma subtype characterized by uniform expression of CD30. Apart from low- to intermediate-risk patients with ALK-positive disease, patients with ALCL have a poor prognosis when treated with conventional, anthracycline-based...

hematologic malignancies
lymphoma

German Study Finds Bendamustine Improves Progression-free Survival in Patients with Non-Hodgkin Lymphoma

Updated results of the StiL NHL1 study, presented at the 2012 ASCO Annual Meeting Plenary Session, showed that bendamustine plus rituximab (Rituxan) more than doubled the median progression-free survival, compared with the standard R-CHOP regimen (rituximab, cyclophosphamide, doxorubicin,...

breast cancer
global cancer care

Breast Cancer and Noncommunicable Diseases: Where in the World Do We Start?

As the world’s most common cancer among women, and the most likely reason around the globe that a woman will die of cancer, breast cancer affects countries at all economic levels. Despite the common misconception that breast cancer is primarily a problem of high-income countries, the majority of...

prostate cancer
issues in oncology

New PSA Recommendations: The Debate over Prostate Cancer Screening Continues

The U.S. Preventive Services Task Force (USPSTF) recently issued a recommendation statement advising against the use of prostate-specific antigen (PSA)-based testing for prostate cancer,1 leaving many in the oncology community concerned that decades of clinical progress will be stalled, and setting ...

colorectal cancer

Adjuvant Chemotherapy May Confer Survival Benefit in Patients Older than 75 with Stage III Disease

Because few people over 75 participate in clinical trials, it is unknown whether adjuvant chemotherapy could benefit this population. Faced with this gap in clinical trial evidence, researchers reviewed data from 5,489 patients ≥ 75 years with stage III colon cancer. The review suggests that...

solid tumors

Screening Should Begin Early for Survivors of Childhood Cancer

Survivors of childhood cancer, particularly those treated for childhood Hodgkin lymphoma or Wilms tumor with abdominal radiation, procarbazine (Matulane), and platinum chemotherapy, are at an increased risk of developing gastrointestinal subsequent malignant neoplasms, according to a retrospective...

sarcoma

Pazopanib: New Drug for Advanced Soft-tissue Sarcoma

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 April 2012, pazopanib (Votrient) was approved for the ...

supportive care
pain management
palliative care

Early Access to Palliative/Supportive Care vs Usual Care Improves Pain Management

Many cancer patients remain undertreated for pain despite availability of guidelines and educational efforts to improve pain treatment. In a recent Annals of Oncology article, Bandieri and colleagues from the Italian Epidemiologia Clinico-Assistenziale del Dolore in Ospedale (ECAD-O) group report a ...

breast cancer
integrative oncology

Soy Phytoestrogens and Breast Cancer: An Enduring Dilemma

The impact of soy consumption on breast cancer diagnosis and outcome has remained of concern to clinicians and researchers for the past 20 years. Although studied extensively in epidemiologic studies as well as lab and animal research, no medical consensus on soy’s effects has emerged. Many studies ...

thyroid cancer

Cabozantinib Prolongs Progression-free Survival in Advanced Medullary Thyroid Cancer

Cabozantinib prolonged progression-free survival in patients with unresectable, locally advanced, or metastatic medullary thyroid cancer with documented disease progression in the phase III EXAM trial. Based on these results, Exelixis submitted a New Drug Application to the FDA in May 2012. The...

solid tumors

Two Single Nucleotide Polymorphisms Associated with Risk for Paclitaxel-related Peripheral Neuropathy

Peripheral neuropathy is the most common severe toxicity in patients receiving paclitaxel, and mutations in genes affecting drug metabolism, distribution, and elimination are likely to modulate risk for such neurotoxicity. In a recent study, Daniel Hertz, PharmD, and colleagues from the University...

leukemia

Prognostic Value of Integrated Cytogenetic and Mutational Risk Classification in Acute Myeloid Leukemia

Jay P. Patel, BS, and colleagues from Memorial Sloan-Kettering Cancer Center in New York recently performed mutational analysis of 18 genes in a subgroup of newly diagnosed acute myeloid leukemia (AML) patients who had been randomized to receive cytarabine plus high-dose or standard-dose...

colorectal cancer

Increased Adjuvant Therapy Use and Improved Survival in Dutch Elderly Patients with Stage III Colon Cancer: A Direct Correlation?

A survival benefit of adjuvant chemotherapy has been reported for select elderly patients with stage III colon cancer, but many elderly patients are not candidates for or are not given adjuvant therapy due to comorbidities and fear of toxicity. In a recent Annals of Oncology article, van...

breast cancer
lymphoma
survivorship

ASCO Studies Point to Risks Associated with Treating Childhood Cancers

Risks associated with being a young cancer survivor were emphasized by two studies highlighted in press briefings at the 2012 ASCO Annual Meeting. Investigators from the Children’s Oncology Group (COG) reported that adolescents and young adults  treated for high-risk B-precursor acute lymphoblastic ...

lung cancer

Lung Cancer Death Rates Increase among White Women in Some States

A new study comparing lung cancer death rates among women by year of birth shows dramatic differences in trends between states, likely reflecting the success or failure of tobacco control efforts. The study, published early online in the Journal of Clinical Oncology,1 finds that while lung cancer...

health-care policy

The Affordable Care Act Stands: Now What?

On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act into law—a hotly contested bill that enacted sweeping changes to the U.S. health-care system. The debate over the Affordable Care Act continued all the way to the Supreme Court, spearheaded by the case Florida...

pancreatic cancer

Adjuvant Chemotherapy May Improve Survival for Patients with Periampullary Disease

The European Study Group for Pancreatic Cancer (ESPAC)-3 periampullary cancer trial found that adjuvant chemotherapy following surgical resection of periampullary adenocarcinoma “was not associated with a significant survival benefit in the primary analysis; however, multivariate analysis adjusting ...

cns cancers

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...

lymphoma

Children with Favorable-risk Disease and Complete Response to Chemotherapy Have High Survival Rates without Radiotherapy

Among children with favorable-risk Hodgkin lymphoma, those who achieved a complete response after two cycles of chemotherapy and received no radiotherapy had high rates of survival similar to those who had a less complete response to chemotherapy and received radiotherapy, according to a study in...

breast cancer

Pertuzumab: New Drug for HER2-positive Metastatic Breast Cancer

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 June 2012, pertuzumab (Perjeta) was approved for use...

issues in oncology
supportive care

New Assessment Tools in Development to Guide Care for Older Patients

More than 1,400 people from 62 countries attended the 2012 Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) International Symposium on Supportive Care in Cancer, held in New York last June. One of the featured sessions, which was jointly...

breast cancer

Older Chemotherapy Studies in Breast Cancer Coming of Age

Results of several long-running chemotherapy trials were reported at the 2012 ASCO Annual Meeting breast cancer oral session, reported in brief here. NSABP B-38 The final analysis of the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-38 trial showed that the addition of gemcitabine...

issues in oncology

Taking Family History and Referral to Genetic Counseling Could Be Improved, Survey Finds

Obtaining a thorough family history of cancer should be a key component in evaluating patients and deciding whether to refer those at increased risk of either primary or second cancers for genetic counseling and testing. Many community oncology practices comply with this practice, but there is room ...

breast cancer

Improving Outcomes and Prediction in Ductal Carcinoma in Situ

Risk stratification and outcomes can be improved for women with ductal carcinoma in situ (DCIS), according to two studies presented at the 2012 ASCO Annual Meeting. RTOG 9804 Findings from the Radiation Therapy Oncology Group (RTOG) 9804 trial suggested that even for DCIS patients whose prognosis...

ASCO Responds to Supreme Court Ruling on Health-care Law

When the Supreme Court upheld the Patient Protection and Affordable Care Act on June 28, ASCO released a statement by ASCO President Sandra M. Swain, MD, Medical Director of the Washington Cancer Institute at MedStar Washington Hospital Center. Critically Important Provisions In the statement, Dr....

lung cancer

No Improvement in Overall Survival, Worse Toxicity with Motesanib Added to Chemotherapy in Non–Small Cell Lung Cancer

Two trials (E4599 and AVAiL) have suggested a benefit to adding the anti–vascular endothelial growth factor (VEGF) monoclonal antibody bevacizumab (Avastin) to chemotherapy in patients with advanced nonsquamous non–small cell lung cancer (NSCLC). Bevacizumab acts by binding directly to circulating...

breast cancer

Everolimus Approved for Advanced Breast Cancer

The FDA has approved everolimus tablets (Afinitor) for use in combination with exemestane to treat postmenopausal women with advanced hormone receptor–positive, HER2-negative breast cancer after failure of treatment with letrozole or anastrozole. The approval was based on a randomized,...

issues in oncology
health-care policy

As Conflicting Guidelines Evolve, Experts Continue to Debate the Merits of Cancer Screening

In the 1930s and 1940s, when the American Cancer Society [ACS] first brought forth the message that early cancer detection saves lives, it was a broad brushstroke and an appropriate message. The problem now is that new technology enables us to find [tumors that would never progress to invasive...

Expert Point of View: Bruno C. Medeiros, MD

Bruno C. Medeiros, MD, of Stanford University School of Medicine, Palo Alto, commented, “It’s clear to say that new treatment strategies are needed for adults with [acute lymphocytic leukemia (ALL)] to improve outcomes of relapsed disease and to prevent relapses to begin with.” He noted that while ...

prostate cancer
issues in oncology

Rethinking the Role of PSA Screening in Public Health

Population screening to identify preclinical disease is considered a central factor in the decades-long decrease in mortality seen in certain cancers. However, hope in the face of deadly disease can sometimes blind us to the scientific evidence. According to the recent U.S. Preventive Services Task ...

SIDEBAR: Don’t Expect Questions: Be Proactive with Younger Patients

It is unrealistic to expect adolescents and young adults with cancer to initiate questions about disease-related or or treatment-related issues that are troubling them, according to Bradley Zebrack, PhD, MSW, MPH, Associate Professor of Social Work at the University of Michigan, Ann Arbor....

supportive care

Adolescent and Young Adult Patients Report Unmet Needs for Cancer Information and Psychosocial Support Services

In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. Psychosocial care needs are not...

breast cancer

Taxane-induced Neuropathy Does Not Correlate with Improved Outcomes in Operable Breast Cancer

An analysis of 4,554 patients who received adjuvant weekly paclitaxel and other taxane-based regimens in the E1199 trial “demonstrated that taxane-induced peripheral neuropathy does not correlate with improved outcomes in patients with operable breast cancer,” investigators reported in the Journal...

multiple myeloma

Carfilzomib: New Drug with Accelerated Approval for Multiple Myeloma

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 July 2012, carfilzomib (Kyprolis) was granted...

The Problem of Monitoring Remission

How wonderful it is that we now have to concern ourselves with survivorship issues! The ever-increasing success of cancer therapy means that more and more patients can look to a life beyond cancer diagnosis and treatment. But living with cancer creates its own problems. While treatment often may be ...

prostate cancer

Letter to the Editor: Dr. Ablin’s Reply

Given my explanation and widely publicized opinion on the improper use of the prostate-specific antigen (PSA) test for screening asymptomatic men for prostate cancer—most recently expressed in a feature article in The ASCO Post (August 15, 2012)—I was pleased to read that Drs. James Mohler and...

prostate cancer

Letter to the Editor: More Thoughts on PSA

An article that appeared in the August 15 issue of The ASCO Post (“Rethinking the Role of PSA Screening in Public Health”) contains false statements about the discovery of prostate-specific antigen (PSA) and its effectiveness as a test for early detection of prostate cancer. Contrary to what’s...

leukemia

CT Scans in Childhood Can Triple Risk of Leukemia and Brain Cancer Later in Life, Study Finds

In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. Computed tomography scans with...

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...

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

Physical Activity Benefits Breast Cancer Survivors, but Role in Reducing Breast Cancer Risk Is Less Clear

Breast cancer survivors who engage in moderate to high levels of physical activity have reduced mortality and improved quality of life, according to recent studies. In addition, exercise may play a role in lowering the risk of breast cancer. “Physical activity can hasten recovery from the immediate ...

Expert Point of View: Michael Krychman, MD

Like female cancer survivors, men experience high rates of sexual dysfunction following a cancer diagnosis and treatment, especially for prostate cancer, with as many as 90% of men reporting erectile dysfunction after radical prostatectomy and nearly as many suffering with the problem following...

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...

lung cancer

Biomarker-driven Adaptive Trial Design Proving Informative in Non–Small Cell Lung Cancer

Biomarker-driven adaptive trial design is an accelerated strategy for targeted drug development that is proving informative in non–small cell lung cancer (NSCLC), according to Roy S. Herbst, MD, PhD, Chief of Medical Oncology and Associate Director of Translational Research at Yale Cancer Center,...

Encouraging Data Presented for Monoclonal Antibodies and Novel Oral Agent in Lymphocytic Leukemias

Novel agents may transform the outcomes of lymphocytic leukemias. In acute lymphocytic leukemia (ALL), encouraging data were presented for two monoclonal antibodies, and in chronic lymphocytic leukemia (CLL), a completely novel class of agents produced surprisingly robust results, said Attaya...

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...

lymphoma
survivorship

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...

breast cancer

Anthracycline/Trastuzumab Treatment Linked to Increased Risk of Heart Failure, Cardiomyopathy

A population-based, retrospective cohort study of 12,500 women diagnosed with incident, invasive breast cancer found that anthracycline and trastuzumab (Herceptin) were associated with increased risk of heart failure and/or cardiomyopathy. “Compared with women who received no chemotherapy, our...

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