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lung cancer

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...

cns cancers

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 ...

cns cancers

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 ...

lung cancer

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...

cns cancers

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...

lymphoma

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...

cns cancers

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...

cns cancers

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...

cns cancers

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 ...

cns cancers

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...

prostate 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...

cns cancers

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...

breast cancer

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...

solid tumors
lung cancer
cns cancers

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. ...

survivorship

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...

cns cancers

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...

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...

cns cancers

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...

cns cancers

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,...

cns cancers

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...

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...

cns cancers

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...

cns cancers

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 ...

cns cancers

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...

cns cancers

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...

cns cancers

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...

cns cancers

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...

cns cancers
supportive care

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...

cns cancers
supportive care

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...

cns cancers

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...

cns cancers

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...

colorectal cancer

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...

cns cancers

The Challenges and Rewards of Neuro-oncology 

Despite the extremely difficult clinical challenges posed by brain tumors, mortality rates in this disease have decreased somewhat over the past several decades due, in part, to advances in surgical techniques and therapies. The ASCO Post recently discussed contemporary issues in neuro-oncology...

leukemia

Homoharringtonine/Omacetaxine: The Little Drug that Could

First, a clarification: Homoharringtonine is a natural plant alkaloid derived from Cephalotaxus fortunei; from the 1970s until the present, it was the subject of intensive research efforts by Chinese investigators to clarify its role as an antileukemic agent.1-3 Omacetaxine mepesuccinate (Synribo)...

cns cancers

Neurosurgeon Eric Holland, MD, PhD, joins Fred Hutchinson and University of Washington Medicine; Plans to Develop Brain Cancer Program

Neurosurgeon and brain cancer researcher Eric Holland, MD, PhD, will be joining Fred Hutchinson Cancer Research Center and the University of Washington in summer 2013.  Dr. Holland will be Senior Vice President and Director of the Human Biology Division at Fred Hutchinson Cancer Research Center,...

cns cancers

Improving Treatment and Care for Patients with Primary Brain Cancers 

Despite advances in neuroimaging, the development of focused radiation therapy, and more effective chemotherapy, life expectancy for patients with primary malignant tumors of the brain and spinal cord remains stubbornly low at between 15 and 18 months. However, there are significant advances on the ...

cns cancers

Molecular Imaging Improves Care in Pediatric Glioma

The amino acid imaging agent, O-(2-[18F]-fluoroethyl)-L-tyrosine (F-18 FET), may improve upon standard magnetic resonance imaging (MRI) and its diagnostic benefit for imaging pediatric gliomas when conventional MRI is not sufficient, said researchers at the Society of Nuclear Medicine and Molecular ...

lung cancer

Second-generation ALK Inhibitor Breakthrough Drug Promising in Early Study for Non–Small Cell Lung Cancer 

Encouraging results were seen in a preliminary study of a second-generation ALK inhibitor in advanced ALK-positive non–small cell lung cancer (NSCLC). The drug—dubbed LDK378—achieved tumor shrinkage in almost all patients enrolled in the study, in all mutational subsets, in crizotinib...

cns cancers

Bevacizumab in Glioblastoma: Another Perspective 

Given the results of the AVAglio trial, we feel that a more balanced discussion about the role of bevacizumab (Avastin) in patients with newly diagnosed glioblastoma is in order. The accompanying article in The ASCO Post suggests that bevacizumab has no benefit in newly diagnosed glioblastoma; data ...

cns cancers

Studies Explore Role of Bevacizumab in Combination Therapies for Glioblastoma

At the 2013 ASCO Annual Meeting, studies evaluating the addition of bevacizumab (Avastin) to standard therapy in newly diagnosed glioblastoma multiforme patients did not meet their primary endpoints. When paired with irinotecan, however, bevacizumab showed activity in MGMT-unmethylated tumors....

cns cancers

Management of Anaplastic Oligodendroglial Tumors 

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...

cns cancers

Ongoing Progress in Treatment of Medulloblastoma 

Brain tumors are the second most frequent pediatric malignancy. Medulloblastoma, a primitive cerebellar tumor of neuroectodermal origin, is the second most common brain tumor, accounting for 20% of childhood tumors of the central nervous system. Craniospinal radiotherapy has been the main curative...

cns cancers

No Event-Free Survival Difference With Chemotherapy Before vs After Radiotherapy in Children With High-Risk Medulloblastoma 

A number of different strategies for combining chemotherapy and radiation therapy have been evaluated in the effort to improve survival in patients with high-risk medulloblastoma. In a trial (POG 9031) reported in Journal of Clinical Oncology, Nancy J. Tarbell, MD, of Massachusetts General...

cns cancers

Sitimagene Ceradenovec/IV Ganciclovir in Glioblastoma: Legitimizing the Gene Therapy Approach for Brain Tumors 

The ASPECT study,1 a randomized, open-label, phase III trial examining adenovirus-mediated gene therapy with sitimagene ceradenovec followed by IV ganciclovir for patients with operable high-grade glioma, is an important achievement for both neuro-oncology and gene therapy. As vector engineering...

cns cancers

Postresection Adenovirus-Mediated Gene Therapy Improves Time to Death/Reintervention but Not Survival in Adult Glioblastoma 

In an open-label phase III trial (ASPECT) reported in Lancet Oncology, Manfred Westphal, MD, of University Hospital Eppendorf in Hamburg, and colleagues assessed the effects of locally applied adenovirus-mediated gene therapy with sitimagene ceradenovec followed by IV ganciclovir after surgical...

cns cancers

Resistance to Anti-VEGF Drugs in Glioblastoma Is Linked to Mesenchymal Transition 

Antiangiogenic therapy reduces tumor vascular permeability and delays tumor progression but may ultimately promote an aggressive treatment-resistant phenotype. In a study reported in Clinical Cancer Research, Piao and colleagues attempted to identify factors responsible for glioblastoma resistance...

cns cancers

Protecting Hippocampus During Whole-Brain Radiation Substantially Reduces Rate of Cognitive Decline 

Protecting the stem cells that reside in and around the hippocampus substantially reduces the rate of cognitive decline in patients during whole-brain radiotherapy without a significant risk of recurrence in that area of the brain, a new study shows. Results of the phase II clinical trial of...

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