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breast cancer

Expect Questions and Perhaps Unrealistic Expectations

A recent study reporting the absolute 20-year survival benefit from contralateral prophylactic mastectomy was less than 1% for women with stage I and II breast cancer without BRCA mutations runs counter to common perceptions about the risk of contralateral breast cancer among these women and the...

breast cancer

Survival Benefit of Contralateral Prophylactic Mastectomy Less Than 1% at 20 Years, but Numbers of Procedures Have Increased

For women with stage I and II breast cancer without BRCA mutations, the absolute 20-year survival benefit from contralateral prophylactic mastectomy was less than 1%, regardless of age, estrogen receptor status, and cancer stage, according to a decision analysis study using a Markov model to...

leukemia

Protocol Modifications Decrease Toxicity, Increase Event-Free Survival in Children With Down Syndrome Treated for ALL

Protocol modifications to address increased risk of toxicity and excess early mortality among children with Down syndrome being treated for B-cell acute lymphoblastic leukemia (ALL) proved safe for patients with Down syndrome, and these patients had event-free survival similar to those without Down ...

leukemia

Advances in Hematopoietic Cell Transplant for Pediatric AML Reduce Toxicity and Expand Access, but Relapse Remains a Problem

Advances in allogeneic hematopoietic cell transplantation for children with acute myeloid leukemia (AML) have resulted in less toxic pretransplant conditioning regimens and expanded access to transplantation, but post-treatment leukemic relapse remains a big problem. The progress and continuing...

lymphoma

Para-Aortic Lymph Node Radiation Raises Risk of Developing Diabetes Mellitus in Hodgkin Lymphoma Survivors

Radiation to the para-aortic lymph nodes, “leading to radiation exposure of the pancreas, is associated with a dose-dependent increased risk” of developing diabetes mellitus among long-term survivors of Hodgkin lymphoma (HL), according to a study by Frederika A. van Nimwegen, MSc, of the...

leukemia
lymphoma

Allogeneic Conditioning Regimen Reduces Myelosuppression, Graft-vs-Host Disease in Lymphocytic Leukemia/Lymphoma

The combination of bendamustine (Treanda), fludarabine, and rituximab (Rituxan), or BFR, was shown to be safe and effective conditioning for patients with relapsed chronic lymphocytic leukemia/lymphoma receiving allogeneic stem cell transplantation from related or unrelated donors. “Remarkably,...

colorectal cancer

Substantial Reductions in Surgical Site Infections After Colorectal Surgery With Bundling Approach

Use of a preventive surgical site infection bundle that spanned the phases or perioperative care “was associated with a substantial reduction in [surgical site infections] after colorectal surgery,” according to results of a retrospective study of 559 patients who underwent major elective...

lung cancer

No Survival Benefits With Erlotinib and Whole-Brain Radiotherapy for NSCLC With Multiple Brain Metastases

“To exploit the potential radiosensitizing properties, the direct effect on brain metastases, and systemic activity of erlotinib,” researchers from the United Kingdom tested concurrent erlotinib and whole-brain radiotherapy followed by maintenance erlotinib in patients with of non–small cell lung...

breast cancer

Most Women Who Choose Breast Reconstruction Are Satisfied With Decision-Making Process

Most patients who choose to have breast reconstruction following mastectomy are satisfied with the decision-making process. Reasons for not choosing reconstruction vary by race and include the desire to avoid additional surgery and fear of implants. These and other conclusions of an analysis of...

lymphoma

Pro-oxidant Molecule Imexon Shows Clinical Activity in Relapsed/Refractory B-Cell NHL

The pro-oxidant molecule imexon (Amplimexon/NSC-714597) produced an overall response rate of 30% in patients with relapsed/refractory B-cell non-Hodgkin lymphoma (NHL) participating in a phase II study. Noting that “lymphoma cells are subject to higher levels of oxidative stress than their normal...

‘Everybody Has a Mutation or More’

While genome sequencing is not currently recommended or widely used because of its high cost and paucity of meaningful, actionable results, some patients wouldn’t want it even if it were free and useful, ­Theodora Ross, MD, PhD, Director of the Cancer Genetics Program at the University of Texas...

Expect Questions From Patients

Conscientious doctors are unlikely to say yes to a patient’s request for full genome sequencing,” Theodora Ross, MD, PhD, wrote in The New York Times.1 Dr. Ross, Director of the Cancer Genetics Program at the University of Texas Southwestern Medical Center in Dallas, was writing about the current...

breast cancer

News of Mutations in PALB2 Gene Raising Risk of Breast Cancer Offers Opportunity to Explain Limits of Genetic Testing

The response among patients to news reports about mutations in a gene known as PALB2 raising the risk of breast cancer “has been predictable,” Theodora Ross, MD, PhD, wrote in The New York Times.1 As an example, Dr. Ross, Director of the Cancer Genetics Program at The University of Texas...

issues in oncology

Using Electronic Health Records to Improve Communication With Patients

Clinicians may argue that electronic health records (EHRs) interfere with the patient-physician relationship, and patients may complain about “distracted doctors,” too busy with computer screens to make eye contact, but according to Thomas W. LeBlanc, MD, MA, of Duke University School of Medicine...

hematologic malignancies

‘Paradigm-Shifting’ Results in Treatment of Hematologic Disorders

The three leukemia/lymphoma studies selected from the many 2014 ASCO Annual Meeting abstracts for presentation at the recent Best of ASCO meeting in Chicago “are really paradigm-shifting,” noted Lucy A. Godley, MD, PhD, of the University of Chicago. These studies, she said, “give great promise for...

gynecologic cancers

In Managing Ovarian Cancer, Precision Medicine Is a Work in Progress

Precision medicine in the management of ovarian cancer “is a work in progress, to be sure,” Steven B. Newman, MD, noted in wrapping up the session on gynecologic cancer at the recent Best of ASCO meeting in Chicago. “A list of different histologic types of ovarian cancer and potential targets are...

lung cancer

FDG-PET Is Less Specific in Diagnosing Lung Cancer in Areas With Endemic Infectious Lung Disease

Although positron-emission tomography (PET) combined with 18F–fluorodeoxyglucose (FDG) is recommended for the noninvasive diagnosis of pulmonary nodules suspicious for lung cancer, in populations with endemic infectious lung disease, FDG-PET may not accurately identify malignant lesions. An...

breast cancer

Patients With DCIS Have Decreased Risk of Cardiovascular Death, Independent of Treatment

Recent concerns about potential overdiagnosis and overtreatment of ductal carcinoma in situ of the breast (DCIS) led researchers in the Netherlands to study late effects of treatment, such as cardiovascular disease, morbidity, and mortality in a large population-based cohort of DCIS patients....

breast cancer

Comorbidity Associated With Shorter Overall Survival but Not With Time to Relapse or Toxicity in Older Women on Adjuvant Chemotherapy

In the Cancer and Leukemia Group B (CALGB) 70103 study, comorbidity was associated with shorter overall survival among older women with early-stage breast cancer and good functional status receiving adjuvant chemotherapy. “The presence of four or more conditions appeared to be a threshold for...

colorectal cancer

Enhanced Benefit Shown With FOLFIRI/Ziv-Aflibercept in Subset of Patients With Metastatic Colorectal Cancer

The survival benefit demonstrated in the VELOUR study for FOLFIRI (irinotecan, fluorouracil [5-FU], leucovorin) plus ziv-aflibercept (Zaltrap) vs FOLFIRI plus placebo in metastatic colorectal cancer patients who progressed on oxaliplatin-based chemotherapy persisted beyond median survival times for ...

breast cancer
colorectal cancer
gynecologic cancers
prostate cancer

Overscreening for Prostate, Breast, Colorectal, and Cervical Cancer Can Raise Costs and Harm Patients

Analyses of data from 27,404 people aged 65 and older participating in the National Health Interview Survey (NHIS) from 2000 through 2010 suggest that overscreening for prostate, breast, cervical, and colorectal cancer screening “is common in both men and women, which not only increases health care ...

Expect Questions From Patients

The study finding1 that men with moderate pattern baldness on the front and the crown of the head at age 45 had a 40% increased risk, compared to men with no baldness at that age, of developing prostate cancer later in life has received coverage by diverse media, from USA Today2 to TIME3 to the...

prostate cancer

Moderate Form of Male Pattern Baldness Associated With Increased Risk of Aggressive Prostate Cancer

Men with moderate pattern baldness on the front and the crown of the head at age 45 had a 40% increased risk, compared to men with no baldness at that age, of developing prostate cancer later in life, according to a study led by researchers from the National Cancer Institute (NCI) and published in...

lymphoma

Exciting Highlights in Several Types of Lymphoma Presented at Best of ASCO

Antibody-drug conjugates are being tested against several types of lymphomas and for some of these agents, “activity is quite impressive,” Andrew M. Evens, DO, MSc, reported at the recent Best of ASCO meeting in Chicago. Dr. Evens, Professor of Medicine, Chief, Division of Hematology/Oncology, and...

leukemia

Obinutuzumab Could Have Synergistic Action With New Tyrosine Kinase Inhibitors

Final results from the phase I/II GAUGUIN study showed that obinutuzumab (Gazyva) monotherapy was active in patients with heavily pretreated relapsed or refractory chronic lymphocytic leukemia, European researchers reported in Blood. In phase II, median progression-free survival was 10.7 months and ...

multiple myeloma
geriatric oncology

Updated GEM2005 Trial Confirms Benefit of Melphalan/Bortezomib Combination in Elderly Multiple Myeloma Patients

Melphalan in combination with bortezomib (Velcade) should be maintained as one of the standards of care for the treatment of elderly patients with multiple myeloma, concluded Spanish trialists reporting updated results from the GEM2005 study comparing bortezomib/melphalan/prednisone with...

pancreatic cancer

Vitamin D Deficiency Is Prevalent Among Patients With Advanced Pancreatic Cancer

Vitamin D deficiency was highly prevalent among patients newly diagnosed with advanced pancreatic cancer, and black patients had statistically significantly lower levels than white patients, according to a recent study reported by Katherine Van Loon, MD, MPH, of the UCSF Helen Diller Family...

gynecologic cancers

Cervical Cancer Risks After Negative HPV Test Lower at 3 Years Than After Negative Pap Result

Three-year risks for cervical cancer and cervical intraepithelial neoplasia grade 3 or worse (CIN3+) were lower following a negative test for human papillomavirus (HPV) than following a negative Pap test, according to a large study comparing three cervical cancer screening strategies, HPV or Pap...

breast cancer

Variety of Adjuvant Strategies Explored in HER2‑Positive and Other Breast Cancer Types

Adjuvant trastuzumab (Herceptin) was shown to be effective in patients with breast cancers ≤ 2 cm, regardless of estrogen receptor status, in a meta-analysis1 of five chemotherapy trials, but a “pressing question” remaining is whether T1a/b, N0 tumors warrant the use of adjuvant trastuzumab, Andrew ...

breast cancer

50 Years of Advancements in Treating Breast Cancer Have Led to Tumor-Centered Treatment Algorithm

Transformations in the treatment of early-stage breast cancer have shifted the therapeutic approach from a “stage-centered treatment algorithm” to a “tumor biology-centered treatment algorithm,” Priyanka Sharma, MD, Associate Professor of Medicine, University of Kansas School of Medicine, Kansas...

breast cancer

For Triple-Negative Breast Cancer, Adding Carboplatin to Anthracycline/Taxane Produces Benefit, but How Much?

Combination chemotherapy for triple-negative breast cancer is anthracycline- and taxane-based and has not really changed much in the past 10 years, but “we are starting to see emerging data with selective activity of platinum agents,” Priyanka ­Sharma, MD, told participants at the Best of ASCO...

breast cancer

Neoadjuvant Chemotherapy Plus Two Anti-HER2 Agents Optimal for HER2-Positive Breast Cancer

For women with human epidermal growth factor receptor 2 (HER2)-positive breast cancer, combining two anti-HER2 agents with chemotherapy is the most effective treatment modality in the neoadjuvant setting, according to a meta-analysis published in the Journal of the National Cancer Institute. The...

Expect Questions About Pertuzumab for HER2-Positive Breast Cancer

The 56.5-month overall survival for women with HER2-positive metastatic breast cancer receiving first-line treatment with pertuzumab (Perjeta) in combination with trastuzumab (Herceptin) and docetaxel in the CLEOPATRA trial represents a 15.7-month survival advantage for those receiving pertuzumab...

breast cancer

Impressive Survival Data for Women With HER2-Positive Breast Cancer Increase First-Line Use of Pertuzumab/Trastuzumab

"Impressive,” “outstanding,” and “unprecedented” are among the terms used to describe the 56.5-month overall survival for women with HER2-positive metastatic breast cancer receiving first-line treatment with pertuzumab (Perjeta) in combination with trastuzumab (Herceptin) and docetaxel in the...

colorectal cancer

‘Incredible Changes’ in the Field of Colorectal Cancer

Over the past 50 years, there have been incredible changes in the field of colorectal cancer,” Emily K. Bergsland, MD, noted in opening the colorectal cancer session at the Best of ASCO meeting in Chicago. Dr. Bergsland is a gastrointestinal oncologist at the Helen Diller Family Comprehensive...

colorectal cancer

For Selected Patients With Metastatic Colorectal Cancer, Taking a Break From Combination Chemotherapy Might Be Appropriate and Appreciated

Two phase III studies presented at the Best of ASCO meeting in Chicago shed more light on the role of maintenance therapy in patients with metastatic colorectal cancer undergoing first-line treatment with oxaliplatin-based chemotherapy. The two studies compared maintenance therapy with bevacizumab...

sarcoma

Advances in Sarcoma Owe Much to Children’s Oncology Group

Improvements over the past 3 decades in 5-year survival rates for patients with osteosarcoma and Ewing’s sarcoma owe a lot to chemotherapy clinical trials conducted by the Children’s Oncology Group (COG), Mark Agulnik, MD, acknowledged at the Best of ASCO meeting in Chicago. Dr. Agulnik is...

sarcoma

Targeted Agents Making Inroads Against Sarcoma

Targeted agents have started to make inroads in sarcoma therapies, and gastrointestinal stromal tumor (GIST) is the poster child for this success,” Mark Agulnik, MD, stated in summarizing progress in GIST and other sarcomas at the Best of ASCO meeting in Chicago. Dr. Agulnik is Associate Professor, ...

lymphoma

Risk of Premature Menopause Raised by Some but Not All Hodgkin Lymphoma Therapies

An analysis of nonsurgical menopause risk among 2,127 women treated for Hodgkin lymphoma found that “risk of premature menopause increased more than 20-fold” after ovarian radiotherapy, alkylating chemotherapy other than dacarbazine, or BEAM (carmustine [BiCNU], etoposide, cytarabine, melphalan)...

lymphoma

Second-Line Gemcitabine the Preferred Option for Relapsed or Refractory Lymphoma

For patients with relapsed or refractory aggressive lymphoma in a National Cancer Institute of Canada clinical trial, second-line treatment with GDP (gemcitabine, dexamethasone, and cisplatin) was as effective as DHAP (dexamethasone, cytarabine, and cisplatin). Treatment with GDP “can be considered ...

gastroesophageal cancer

Customizing Surveillance Strategy in Patients With Esophageal Adenocarcinoma

A surveillance strategy for patients with esophageal adenocarcinoma treated with chemoradiation and surgery (trimodality therapy) can potentially be customized based on surgical pathology stage, according to an analysis of 518 patients with esophageal adenocarcinoma who underwent trimodality...

issues in oncology

Over 14 Million Major Medical Conditions in U.S. Adults Linked to Cigarette Smoking

At least 14 million major medical conditions among U.S. adults aged 35 years and older were attributed to cigarette smoking by a study estimating the disease burden of cigarette smoking, which, according to the study’s authors, “remains immense.” Among current and former smokers, prevalence ratios...

Expect Questions From Patients

Screening for thyroid cancer should be discouraged to prevent an “epidemic of diagnosis”—like the one occurring in South Korea—from happening in the United States and other countries, according to the authors of an analysis of the South Korean screening program. That study was published in The New...

issues in oncology
thyroid cancer

South Korean Study Sparks Warnings About the Hazards of Overscreening

An “epidemic of diagnosis” of thyroid cancer is occurring in South Korea and “absolutely could happen here,” according to H. Gilbert Welch, MD, MPH, Professor of Medicine at the Dartmouth Institute for Health Policy and Clinical Practice, Hanover, New Hampshire. Dr. Welch is coauthor of an article...

lung cancer

Top 5 Breakthroughs in the Treatment of Advanced Lung Cancer

A countdown of the top 5 breakthrough therapies in the treatment of advanced lung cancer was presented by D. Ross Camidge, MD, PhD, at the 2014 Chicago Multidisciplinary Symposium in Thoracic Oncology.1 Dr. Camidge is Director, Thoracic Oncology Clinical and Clinical Research Programs, and...

colorectal cancer

Personalized Genetic and Environmental Risk Assessment Does Not Increase Use of Colorectal Cancer Screening

Individualized genetic and environmental risk assessment of susceptibility to colorectal cancer does not influence adherence to screening in average-risk persons, according to results from a two-group, randomized, controlled trial. Among patients who received genetic and environmental risk...

colorectal cancer

Small Risk-Adjusted Variation in Hospital Readmissions Following Colorectal Cancer Surgery

“Little risk-adjusted variation exists in hospital readmission rates after colorectal surgery,” according to an analysis of data from 44,822 patients who underwent colorectal resection for cancer at 1,401 U.S. hospitals between 1997 and 2002. “The use of readmission rates as a high-stakes quality...

colorectal cancer

Patients With Metastatic Colorectal Cancer Have Improved Outcome With FOLFOXIRI and Bevacizumab

Patients with untreated metastatic colorectal cancer who received ­FOLFOXIRI (folinic acid, fluorouracil, oxaliplatin, irintotecan) plus bevacizumab (Avastin) had improved survival compared with patients who received FOLFIRI (folinic acid, fluorouracil, irintotecan) plus bevacizumab in a phase III...

leukemia

Obinutuzumab May Have Synergistic Action With New Tyrosine Kinase Inhibitors

Final results from the phase I/II GAUGUIN study showed that obinutuzumab (Gazyva) monotherapy was active in patients with heavily pretreated relapsed or refractory chronic lymphocytic leukemia, European researchers reported in Blood. In phase II, median progression-free survival was 10.7 months,...

Expect Questions About Cancer Cachexia From Patients and Family Members

Cachexia is estimated to be the immediate cause of death in 20% to 40% of cancer patients,” and by the time of diagnosis, “60% of patients with lung cancer have already experienced a significant weight loss, according to the National Cancer Institute.1 “All of us who have treated these patients...

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