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leukemia

Bosutinib Shows 'Acceptable Safety' in Philadelphia Chromosome–Positive Leukemia

Bosutinib (Bosulif) demonstrated “acceptable safety with manageable toxicities” in a phase I/II study among patients with chronic-phase chronic myeloid leukemia (CML) or advanced Philadelphia chromosome–positive leukemia (accelerated-phase/blast-phase CML or acute lymphoblastic leukemia). Patients...

lung cancer

Some Lung Cancers Detected by Low-Dose CT in National Lung Screening Trial May Be Indolent

More than 18% of all lung cancers detected by low-dose computed tomography in the National Lung Screening Trial (NLST) may be clinically insignificant. Overdiagnosis should be considered when describing the risks of [low-dose computed tomography] screening for lung cancer, according to a review of...

cns cancers

An Overview of the REGAL Trial and Anti-VEGF Therapies in Recurrent Glioblastoma

As published in the Journal of Clinical Oncology by Batchelor and colleagues1 and reviewed in a recent issue of The ASCO Post (November 15, 2013, page 106), the REGAL trial was a randomized, phase III, placebo-controlled, partially blinded trial evaluating the efficacy of cediranib, an...

leukemia
lymphoma

Expanded Options for Age and Donor Sources for Transplant

Although many oncologists consider matched sibling donors as the best source of grafts for hematopoietic cell transplantation, two separate studies presented at the recent American Society of Hematology Annual Meeting support the use of alternative donor grafts for patients with lymphoma and acute...

global cancer care

ASCO Member Helps to Strengthen Cancer Care Internationally Through Philanthropy and Volunteer Service

Ian F. Tannock, MD, PhD, DSc, FASCO, Professor of Medical Oncology at Princess Margaret Hospital and University of Toronto, has long been an advocate for ASCO as a truly global society and a leader in cancer care worldwide. It’s something he encouraged during his time on ASCO’s Board of Directors,...

colorectal cancer
gynecologic cancers
issues in oncology
survivorship

Nothing Prepared Me for Cancer

Fourteen years ago, when I was just 29, I was feeling weak and fatigued and had severe pain in my abdomen. I’d had these symptoms for about a year, but none of the several doctors I saw or any of the tests they performed could find the source of my problems. I even had one nurse practitioner tell...

hematologic malignancies
issues in oncology

Focus on the Michigan Society of Hematology and Oncology

Founded nearly 3 decades ago in response to unfavorable changes in Medicare reimbursement regulations and growing coverage issues with Michigan’s private payers that threatened oncologists’ ability to provide quality cancer care to patients, the Michigan Society of Hematology and Oncology (MSHO)...

issues in oncology

FDA Programs to Expedite Drug and Biologic Product Development

With the advent of Breakthrough Therapy designation, there are now four FDA programs to expedite the development of promising new agents: Fast Track, Breakthrough Therapy, Priority Review, and Accelerated Approval (Table 1). These programs complement one another and serve a common goal: to speed...

skin cancer

Trametinib and Dabrafenib in Combination for Unresectable or Metastatic Melanoma With BRAF V600E or V600K Mutations

On January 9, 2014, the combination of trametinib (Mekinist) and dabrafenib (Tafinlar) was granted accelerated approval for the treatment of patients with unresectable or metastatic melanoma with BRAF V600E or V600K mutations as detected by a U.S. Food and Drug Administration (FDA)-approved...

palliative care

NIH Makes Palliative Care More Attainable for Pediatric Patients and Their Families

A campaign “Palliative Care: Conversations Matter” recently launched by the National Institute of Nursing Research (NINR) aims to increase the use of palliative care for children with serious illness. Palliative care can reduce a child’s pain, help manage other distressing symptoms, and provide...

issues in oncology

ASCO Turns Attention to Community Researchers With Community Research Forum

The implementation of clinical trials and quality research programs by community-based investigators and research staff is one of the most effective weapons available in the fight against cancer. The ASCO Community Research Forum was designed in support of this mission and to aid these...

breast cancer

HER2 Testing: The Next Chapter

Late last year, the American Society of Clinical Oncology and College of American Pathologists published a comprehensive update of guidelines for HER2 testing,1 the first such update since their initial landmark publication in 2007.2 This new report, summarized in this issue of The ASCO Post,...

breast cancer

ASCO and College of American Pathologists Guideline Update: Recommendations for HER2 Testing in Breast Cancer

The American Society of Clinical Oncology (ASCO) and College of American Pathologists (CAP) recently convened an Update Committee to conduct a systematic literature review and update recommendations for optimal HER2 testing. In particular, the Committee identified criteria and areas requiring...

lymphoma

Longer-Term Follow-up of Breast Implant–Associated Anaplastic Large Cell Lymphoma: More Certainty About Certain Uncertainties

When what is now called breast implant–associated anaplastic large cell lymphoma was first recognized and initially described, a number of uncertainties prevailed—mainly, was the association with breast implants real, and was this a true lymphoma? Through the significant efforts of those who...

lymphoma

ASH Studies Confirm Benefit of Rituximab Maintenance in Follicular Lymphoma

Findings from two major studies presented at the 2013 American Society of Hematology Annual Meeting not only confirm the benefit of rituximab (Rituxan) maintenance in follicular lymphoma, but also indicate that the longer the maintenance period, the greater the impact on progression-free survival....

breast cancer

Addition of Novel Antiangiogenic Agent of No Benefit in Metastatic Breast Cancer

Ramucirumab added to first-line docetaxel failed to improve progression-free survival in patients with metastatic breast cancer in the large, randomized, placebo-controlled ROSE/TRIO-12 trial.1 An interim analysis of overall survival showed no advantage for the addition of ramucirumab. This study,...

breast cancer
pain management

Postmastectomy Pain Effectively Treated With a Simple Injection

For postmastectomy neuropathic pain, perineural infiltration with a combination of bupivacaine and dexamethasone is a “simple, effective, practice-changing treatment that any surgeon can do,” according to Laura J. Esserman, MD, MBA, Professor of Surgery and Radiology at the University of...

breast cancer

SABCS Highlights Include Findings in Triple-Negative Disease, Protective Effects of Exercise, and the Adherence-Copay Link

The San Antonio Breast Cancer Symposium brings together specialists from all over the world who focus on management of breast cancer. We have covered many of the important presentations in the pages of The ASCO Post and in our online Evening News. Below are summaries of additional noteworthy...

colorectal cancer

Maintenance Treatment With Capecitabine and Bevacizumab Is Effective in Metastatic Colorectal Cancer

In patients with metastatic colorectal cancer, maintenance treatment with capecitabine plus bevacizumab (Avastin) after induction treatment with capecitabine, oxaliplatin, and bevacizumab (CAPOX-B) significantly delayed disease progression, compared to observation, according to the final results of ...

issues in oncology
health-care policy

The Surgeon General’s Report on Tobacco Turns 50: Much Success, Much Work Ahead

On January 11, 2014, the nation commemorated the 50th anniversary of a document that transformed our public health landscape and has saved millions of lives: Smoking and Health: Report of the Advisory Committee to the Surgeon General of the Public Health Service. This groundbreaking report, which...

lung cancer

Nintedanib Combined With Docetaxel Is Effective Second-Line Option for Advanced NSCLC

The combination of nintedanib and docetaxel “is an effective second-line option” for patients with advanced non–small cell lung cancer (NSCLC) who have received previous treatment with one line of platinum-based therapy, according to results from the phase III LUME-Lung 1 study published in The...

breast cancer

Overdiagnosis of Breast Cancer: New Research Directions

Currently, one of the most challenging problems in oncology is to accurately predict whether neoplastic lesions detected by screening tests will progress. The focus on developing ever-more sensitive cancer screening tests has produced the clinical dilemma of overdiagnosis. Overdiagnosis occurs when ...

breast cancer

The Canadian National Breast Screening Trial Had So Many Flaws That Its Results Should Not Be Used to Guide Screening Recommendations

If a randomized, controlled trial of therapy for breast cancer was submitted for publication in which 1. The drug being tested was old and ineffective, and 2. prior to randomization, the women underwent a clinical breast examination and the study coordinators knew who had the largest cancers, and...

breast cancer

Flaws in CNBSS Are Vast, Impact on Screening Recommendations Is Nil

The recent report from the Canadian National Breast Screening Study (CNBSS)—published in BMJ and reviewed in The ASCO Post, early release online—concluded that annual mammography in women aged 40 to 59 does not result in a reduction in mortality from breast cancer beyond that of physical...

issues in oncology

Leaders of ASCO, ASH, ASTRO, and NCCN Embrace Collaboration With Advanced Practitioners

Nearly 250 advanced practitioners assembled at the first annual JADPRO Live educational symposium in St. Petersburg, Florida, hosted by the Journal of the Advanced Practitioner in Oncology (JADPRO). Leaders from four prominent oncology organizations championed collaborative practice as not only...

Expert Point of View: Jennifer R. Brown, MD, PhD

Commenting on the CLL 11 trial in chronic lymphocytic leukemia (CLL), Jennifer R. Brown, MD, PhD, Director of the CLL Center at Dana-Farber Cancer Institute, Boston, said she agreed with first author Valentin Goede, MD, that in this study, replacing rituximab (Rituxan) with obinutuzumab (Gazyva) in ...

Expert Point of View: C. Kent Osborne, MD

At the San Antonio Breast Cancer Symposium, press briefing moderator C. Kent Osborne, MD, Director of the Dan Duncan Cancer Center at Baylor College of Medicine, Houston, predicted the findings of the study by Badwe et al could be practice-changing. “This is not to say that we shouldn’t perform...

breast cancer

In Stage IV Breast Cancer, the Primary May Not Need to Be Removed

Mastectomy is unnecessary in many women with stage IV breast cancer, according to a study from Indian investigators, reported at the 2013 San Antonio Breast Cancer Symposium.1 The study randomly assigned 350 patients with metastatic breast cancer to mastectomy, complete axillary dissection, plus...

issues in oncology

ASCO Applauds CVS Caremark’s Move to Stop Selling Tobacco

CVS Caremark recently announced that it will stop selling cigarettes and other tobacco products at its more than 7,600 CVS/pharmacy stores across the United States by October 1, 2014, making CVS/pharmacy the first national pharmacy chain to take this step in support of the health and well-being of...

colorectal cancer

Irinotecan Drug-Eluting Beads Improve Outcomes in Colorectal Cancer Patients With Liver Metastases

Irinotecan drug-eluting beads (DEBIRI) given simultaneously with FOLFOX (leucovorin, fluorouracil, oxaliplatin) and bevacizumab (Avastin) in patients with unresectable colorectal liver metastasis improved response rates, increased resectability, and prolonged hepatic progression–free survival in a...

kidney cancer

Sequencing Sorafenib and Sunitinib in Either Order Does Not Affect Survival in Metastatic Renal Cell Carcinoma

The explosion of new therapies for metastatic renal cell carcinoma is a welcome advance, but studies have not yet defined optimal sequencing of the newer therapies. According to the phase III SWITCH trial, it matters little whether therapy for metastatic renal cell carcinoma begins with sorafenib...

prostate cancer

PREVAIL Trial Shows Enzalutamide to Be a Promising Option for Metastatic Castration-Resistant Prostate Cancer

Encouraging results of the large phase III PREVAIL trial represent another positive milestone for men with metastatic castration-resistant prostate cancer. Enzalutamide (Xtandi) improved overall survival by 29% and reduced the risk of radiographic progression of disease by 81% in men who had not...

gynecologic cancers

Cancer Has Allowed Me to Put My Goals First

Despite my family history of cancer—my father had colorectal cancer, his father had gallbladder cancer, and my father’s mother died of what was believed to be uterine cancer—when I complained to my gynecologist about postmenopausal bleeding in the spring of 2011, I was told not to worry about it....

palliative care

St. Jude Children’s Research Hospital Committee Identifies Eight Palliative Care Priorities in Pediatric Oncology

About 2½ years ago, St. Jude Children’s Research Hospital in Memphis conducted a series of focus groups to better understand the palliative care priorities of bereaved parents. Their findings were never intended to be generalized, but rather to be used to formulate a strategic plan for an...

breast cancer
health-care policy

Affordable Care Act to Cover Chemoprevention for Women at High Risk for Breast Cancer

On January 9, 2014, Kathleen Sebelius, Secretary of the Department of Health and Human Services, announced that under the Patient Protection and Affordable Care Act, women at increased risk of breast cancer will be entitled to preventive medications without incurring out-of-pocket costs (with the...

health-care policy

ASCO Addresses Changes in Medicare for 2014

Medicare patients make up 61% of new cancer cases in the United States, and as the population ages, that proportion is expected to rise to 70% by 2030. Over the past decade, the oncology community has been financially challenged by alterations in the Medicare payment system. To address the changes...

leukemia

Ibrutinib for Previously Treated Chronic Lymphocytic Leukemia

On February 12, 2014, ibrutinib (Imbruvica) was granted accelerated approval for the treatment of patients with chronic lymphocytic leukemia (CLL) who have received at least one prior therapy.1,2 Ibrutinib previously received accelerated approval for the treatment of patients with mantle cell...

breast cancer

Impact of Delayed Initiation of Adjuvant Chemotherapy for Breast Cancer Varies by Tumor Subtype

The optimal time interval between surgery and initiation of adjuvant chemotherapy for early-stage breast cancer is not well established. Although most physicians aim to initiate adjuvant chemotherapy within a few weeks of surgery, clinical factors may cause delay. The influence of delay on relapse...

skin cancer

Brigham and Women’s Hospital Tumor Staging for Cutaneous Squamous Cell Carcinoma Outperforms AJCC and UICC Staging

In a study reported in the Journal of Clinical Oncology, Pritesh S. Karia, MPH, and Chrysalyne D. Schmults, MD, MSCE, of Brigham and Women’s Hospital, Boston, and colleagues compared Brigham and Women’s Hospital, American Joint Committee on Cancer (AJCC), and International Union Against Cancer...

leukemia
cost of care

Higher Copayment Associated With Greater Discontinuation of and Nonadherence to Tyrosine Kinase Inhibitor Treatment in CML

The availability of the tyrosine kinase inhibitor imatinib (Gleevec) has dramatically increased survival in chronic myeloid leukemia (CML). Nonadherence to therapy with imatinib and other tyrosine kinase inhibitors is associated with disease progression and treatment resistance. In a study reported ...

issues in oncology
health-care policy

FDA Orders Cessation of Sale, Distribution of Four Tobacco Products

FDA has issued orders to stop the further sale and distribution of four tobacco products currently on the market. The action marks the first time the FDA has used its authority under the Family Smoking Prevention and Tobacco Control Act to order a manufacturer of currently available tobacco...

leukemia

Idelalisib Plus Rituximab in Heavily Pretreated Relapsed CLL: ‘Dawn of a New Age’?

Idelalisib plus rituximab (Rituxan) improved progression-free survival, overall response rates, and overall survival compared with rituximab alone in heavily pretreated patients with relapsed chronic lymphocytic leukemia (CLL). Moreover, the combination provided effective, durable disease control...

breast cancer

Adding Bevacizumab to Adjuvant Chemotherapy/Trastuzumab Fails to Improve Survival in HER2-Positive Breast Cancer

The addition of bevacizumab (Avastin) to adjuvant chemotherapy did not improve invasive disease-free survival or overall survival in patients with high-risk HER2-positive breast cancer in the large randomized phase III BETH trial. Although not specifically designed to answer this question, BETH...

leukemia

Minimal Residual Disease Before and After Transplant: What Does It Mean?

In patients with acute leukemia, outcomes after hematopoietic stem cell transplantation are negatively impacted by the presence of minimal residual disease. However, transplant can prolong survival in patients with minimal residual disease after consolidation, according to two studies presented at...

colorectal cancer
survivorship

Colorectal Cancer Survivors Face Challenges With Bowel Regulation

The fight against colorectal cancer leaves many survivors with battle wounds, according to studies that show a high incidence of assorted morbidities that can affect quality of life. Clinicians, in fact, may be unaware of the struggles with bowel function that occur during survivorship, researchers ...

Expert Point of View: Neal J. Meropol, MD

Neal J. Meropol, MD, Chief of Hematology and Oncology at University Hospitals Case Medical Center at Case Western Reserve University, Cleveland, discussed the various findings in RAS mutations at the Gastrointestinal Cancers Symposium. “RAS mutations beyond exon 2 are common, occurring in about 15% ...

colorectal cancer

More Support for ‘All-RAS’ Testing in Metastatic Colorectal Cancer

Multiple studies reported at the 2014 Gastrointestinal Cancers Symposium add further support for widening the genetic analysis of colorectal cancer tumors. In fact, experts predict that more extensive genetic testing for RAS gene mutations (in KRAS and NRAS) beyond the routine analysis of KRAS exon ...

kidney cancer
prostate cancer

Five Key Studies in Prostate Cancer and Renal Cell Carcinoma

The 10th Genitourinary Cancers Symposium, sponsored by ASCO, the American Society for Radiation Oncology, and the Society of Urologic Oncology, was held January 29–February 1, 2014, in San Francisco. The more than 630 abstracts presented addressed essential research in genitourinary malignancies,...

prostate cancer

Role of Immunotherapy Explored in Metastatic Castration-Resistant Prostate Cancer

Ipilimumab (Yervoy) failed to meet the primary endpoint of improving overall survival in the randomized, phase III CA184-043 trial. However, the immunotherapy did improve progression-free survival and prostate-specific antigen (PSA) response compared with placebo in postdocetaxel metastatic...

lung cancer

I Refuse to Capitulate to Cancer

Early last year, just as I returned to my residency in neurologic surgery at Stanford University after completing 2 years of my postdoctoral fellowship in a laboratory developing optogenetic techniques, I started losing weight—dropping from 180 lb to 160 lb in just 6 months—and I was having fairly...

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