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colorectal cancer

Patients Diagnosed With Stage I to III Rectal Cancer at Younger Age Have Increased Risk for Positive Lymph Nodes

Patients diagnosed with stage I to III rectal cancer at a younger age are at increased risk of having positive lymph nodes, according to an analysis of data published in the Journal of the National Cancer Institute. “This finding merits further investigation and may ultimately impact treatment...

breast cancer
solid tumors

Neoadjuvant Nab-Paclitaxel Improves Pathologic Complete Response Rate vs Solvent-Based Paclitaxel in Early-Stage Breast Cancer

In the phase III GeparSepto-GBG 69 trial, reported in The Lancet Oncology by Untch et al, neoadjuvant nab-paclitaxel (Abraxane) improved pathologic complete response rate vs conventional solvent-based paclitaxel in women with early-stage breast cancer. Study Details In the open-label trial, 1,206 ...

solid tumors
prostate cancer

Survival Differs With Metastatic Site in Castration-Resistant Prostate Cancer

Overall survival differed according to the site of metastases in men with castration-resistant prostate cancer, according to a meta-analysis reported in the Journal of Clinical Oncology by Halabi et al. Study Details The study involved data from 8,820 men who received docetaxel chemotherapy in...

breast cancer

I Never Forget I Have Cancer

I have a history of fibrocystic breasts, which required biopsies to make certain the cysts were benign, and for years they were. But in 2009, my mammogram screening picked up a suspicious lump in my right breast, which turned out to be stage III estrogen receptor–positive/progesterone...

breast cancer

The Perplexing Increase in Bilateral Mastectomies

The increased rate of bilateral mastectomies, as shown in recently released data from the Agency for Healthcare Research and Quality (AHRQ), is “perplexing,” Ismail Jatoi, MD, PhD, told The ASCO Post. “We are seeing more and more women with unilateral breast cancer opt for bilateral mastectomy,...

prostate cancer

Biomarkers in Prostate Cancer: PARP Inhibitors and Defects in DNA Repair

New data on molecular biomarkers in advanced prostate cancer are accumulating at a fast pace. The studies in this area can now be broadly grouped in two distinct areas—those that broadly relate to androgen signaling and those that relate to DNA-repair pathways. The Androgen-Signaling Pathway With...

colorectal cancer

Increased Travel Burden Decreases Likelihood of Receiving Radiation Therapy for Rectal Cancer Treatment

Increased travel distance to a cancer treatment facility negatively impacts the likelihood that patients with stage II/III rectal cancer will receive radiation therapy to treat their disease, according to a study analyzing 26,845 patient records from the National Cancer Data Base (NCDB) published...

breast cancer
solid tumors

Neratinib Improves Invasive Disease–Free Survival After Trastuzumab-Based Therapy in HER2-Positive Breast Cancer

Chan et al found that 1 year of treatment with the HER1, 2, and 4 tyrosine kinase inhibitor neratinib improved invasive disease–free survival vs placebo after trastuzumab (Herceptin)-based adjuvant therapy in patients with early-stage HER2-positive breast cancer, in the phase III ExteNET...

prostate cancer

Hypofractionated Radiotherapy Not Noninferior to Standard Radiotherapy in Late Genitourinary and Gastrointestinal Toxicity in Prostate Cancer

Hypofractionated radiotherapy was not noninferior to conventionally fractionated radiotherapy in late genitourinary and gastrointestinal toxicity in patients with prostate cancer in the Dutch phase III HYPRO trial. These findings were reported by Aluwini et al in The Lancet Oncology. An earlier...

geriatric oncology

Geriatric Assessment of Transplant-Ineligible Older Adults With Multiple Myeloma: A Novel Approach in the Era of Novel Agents

Myeloma is a disease of aging, with a median age at diagnosis in the United States of 69 years.1 As the population ages, forecasts estimate that, within 20 years, 3 of every 4 people diagnosed with multiple myeloma in the United States will be between the ages of 64 and 84 years.2 In anticipation...

lymphoma

Obinutuzumab in Relapsed or Refractory Follicular Lymphoma

On February 26, 2016, obinutuzumab (Gazyva) was approved for use in combination with bendamustine (Bendeka, Treanda) followed by obinutuzumab monotherapy for treatment of patients with follicular lymphoma who have relapsed after or are refractory to a rituximab (Rituxan)-containing regimen.1,2...

leukemia

Two Types of Asparaginase Compared in Newly Diagnosed Childhood Acute Lymphoblastic Leukemia

Intravenous pegylated (PEG) Escherichia coli (E coli) asparaginase was associated with similar toxicity and efficacy compared with intramuscular native E coli L-asparaginase in children with newly diagnosed acute lymphoblastic leukemia, according to the results of a phase III trial (DFCI 05-001).1 ...

cns cancers

No Apparent Benefit of Long-Term Mifepristone in the Treatment of Unresectable Meningioma

In a phase III trial (SWOG S9005) reported in the Journal of Clinical Oncology,1 YongLi Ji, MD, PhD, and Claire Verschraegen, MD, of the University of Vermont Cancer Center; and colleagues found no benefit of treatment with the antiprogestin agent mifepristone vs placebo in patients with...

breast cancer

Palbociclib Combined With Fulvestrant in Advanced Breast Cancer Progressing After Endocrine Therapy

On February 19, 2016, palbociclib (Ibrance) was approved for use in combination with fulvestrant (Faslodex) for treatment of hormone receptor–positive, HER2-negative advanced or metastatic breast cancer with disease progression following endocrine therapy.1,2 In February 2015, palbociclib in...

solid tumors

Everolimus in Advanced Neuroendocrine Tumors

On February 26, 2016, everolimus (Afinitor) was approved for treatment of adult patients with progressive, well-differentiated, nonfunctional neuroendocrine tumors of gastrointestinal or lung origin that are unresectable, locally advanced, or metastatic.1,2 The drug was previously approved for...

lymphoma

FDA Approves Obinutuzumab in Follicular Lymphoma

The U.S. Food and Drug Administration (FDA) has approved obinutuzumab (Gazyva), an anti-CD-20 monoclonal antibody, for use in combination with bendamustine (Bendeka, Treanda) followed by obinutuzumab monotherapy for the treatment of patients with follicular lymphoma who relapsed after, or are...

leukemia
lymphoma

First-Line Ibrutinib Improves Progression-Free and Overall Survival vs Chlorambucil in Older Patients With Chronic Lymphocytic Leukemia

As reported in The New England Journal of Medicine and at the 2015 American Society of Hematology Annual Meeting, Jan A. Burger, MD, PhD, and colleagues found that first-line treatment with the oral Bruton’s tyrosine kinase inhibitor ibrutinib (Imbruvica) improved progression-free and overall...

gynecologic cancers

SGO 2016: Advanced Ovarian Cancer Caused by Genetic Mutations Linked to Better PFS and OS Following Treatment Including Bevacizumab

Women with advanced ovarian cancer caused by genetic mutations—including in BRCA1 and BRCA2—lived significantly longer than those who did not have a mutation following treatment with a chemotherapy regimen that included bevacizumab (Avastin). According to a study, those with BRCA1 and a ...

breast cancer

Little Effect of Pretreatment Renal Function on Outcomes in Older Women Receiving Chemotherapy for Early-Stage Breast Cancer

As reported by Lichtman et al in the Journal of Clinical Oncology, an ancillary study (Alliance A171201) of the CALGB 49907 trial showed no significant association of pretreatment creatinine clearance with grade ≥ 3 hematologic toxicity, dose modification, therapy completion, relapse-free...

gynecologic cancers

Adding Cediranib to Platinum Therapy Increases Progression-Free Survival in Relapsed Platinum-Sensitive Ovarian Cancer

The phase III ICON6 trial showed that adding cediranib to platinum-based therapy increased progression-free survival and toxicity in women with first relapse of platinum-sensitive ovarian cancer, reported Ledermann et al in The Lancet. Study Details In the double-blind trial, 456 women with...

kidney cancer

No Disease-Free Survival Benefit of Adjuvant Sunitinib or Sorafenib in High-Risk Nonmetastatic Renal Cell Carcinoma

In a phase III trial (ECOG-ACRIN E2805) reported in The Lancet by Haas et al, no benefit of adjuvant VEGFR (vascular endothelial growth factor receptor) inhibitor treatment with sunitinib or sorafenib (Nexavar) was observed vs placebo in patients with completely resected high-risk nonmetastatic...

myelodysplastic syndromes

No Significant Survival Advantage for Rigosertib in High-Risk Myelodysplastic Syndromes, but Subgroups May Benefit

As reported in The Lancet Oncology by Garcia-Manero et al, the phase III ONTIME trial showed that treatment with the Ras mimetic rigosertib did not significantly improve overall survival vs best supportive care in patients with high-risk myelodysplastic syndromes after failure of hypomethylating...

gynecologic cancers
supportive care
symptom management

Fosaprepitant Combination Reduces Risk of Emesis During Chemoradiotherapy for Cervical Cancer

The addition of fosaprepitant (Emend) to palonosetron and dexamethasone reduced the risk of emesis during 5 weeks of chemoradiotherapy for cervical cancer, according to the phase III GAND-emesis trial reported in The Lancet Oncology by Ruhlmann et al. Study Details In the double-blind trial, 234...

head and neck cancer

Retrospective Analysis Suggests Benefit of Adding Cetuximab to Radiotherapy Irrespective of p16 Status in Oropharyngeal Carcinoma

A retrospective analysis of the phase III registration trial IMCL-9815 of cetuximab (Erbitux) reported in the Journal of Clinical Oncology by Rosenthal et al suggests that the addition of cetuximab to radiotherapy was of benefit irrespective of p16 expression in patients with locoregionally...

breast cancer

Adding Palbociclib to Fulvestrant Prolongs Progression-Free Survival in Hormone Receptor–Positive, HER2-Negative Metastatic Breast Cancer

As reported in The Lancet Oncology by Cristofanilli et al, the final results of the phase III PALOMA-3 trial show that the addition of the CDK4/CDK6 inhibitor palbociclib (Ibrance) to fulvestrant (Faslodex) improved progression-free survival in women with hormone receptor–positive,...

bladder cancer

Atezolizumab Active in Previously Treated Locally Advanced or Metastatic Urothelial Carcinoma

The anti–PD-L1 (programmed cell death ligand 1) antibody atezolizumab produced durable responses in a marked proportion of patients with previously treated locally advanced or metastatic urothelial carcinoma, according to a phase II trial reported in The Lancet by Rosenberg et al. The...

colorectal cancer

High Expression of Epiregulin or Amphiregulin Predicts Benefit of Panitumumab in RAS Wild-Type Advanced Colorectal Cancer

In the UK phase III PICCOLO trial reported in JAMA Oncology, Seligmann et al found that high expression of either of the epidermal growth factor receptor (EGFR) ligands epiregulin or amphiregulin was associated with a progression-free survival benefit with panitumumab (Vectibix)/irinotecan vs...

leukemia

Adding Targeted Therapy to Chemoimmunotherapy in Patients With Chronic Lymphocytic Leukemia: Questions as to Optimal Strategy Remain

The HELIOS study is an international phase III trial of bendamustine (Treanda) plus rituximab (Rituxan) in combination with ibrutinib (Imbruvica) vs placebo in patients with previously treated chronic lymphocytic leukemia. As reported by Chanan-Khan in The Lancet Oncology1 and reviewed in this...

hematologic malignancies

Adding Ibrutinib to Bendamustine/Rituximab Improves Outcome in Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma

In the phase III HELIOS trial reported in The Lancet Oncology, Asher Chanan-Khan, MD, of the Mayo Clinic Cancer Center, Jacksonville, Florida, and colleagues found that addition of the Bruton’s tyrosine kinase (BTK) inhibitor ibrutinib (Imbruvica) to bendamustine (Treanda)/rituximab (Rituxan)...

breast cancer

Role of Ado-Trastuzumab Emtansine in Metastatic Breast Cancer Solidified

Ado-trastuzumab emtansine (formerly T-DM1; Kadcyla) improved overall survival compared with treatment of physician’s choice of therapy for patients with pretreated HER2-positive metastatic breast cancer, according to the phase III TH3RESA trial.1 Patients enrolled in the trial had previously been...

hematologic malignancies
multiple myeloma

Carfilzomib Plus Dexamethasone in Previously Treated 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. On January 21, 2016, carfilzomib (Kyprolis) was approved for use in ...

prostate cancer

Hypofractionation Is Ready for Prime Time in Prostate Cancer, but Will It Be Adopted?

Separate phase III trials presented at the 2016 Genitourinary Cancers Symposium demonstrated that modest hypofractionated radiotherapy is noninferior to conventional radiotherapy for men with intermediate- and low-risk prostate cancer and should be considered a new standard of care.1,2 However, it...

gastrointestinal cancer

Radiolabeled Somatostatin Analog May Represent A Paradigm Change in the Treatment of Neuroendocrine Tumors

A radiolabeled somatostatin analog compound, 177Lu-DOTA0-Tyr3-Octreotate (Lu-177 dotatate), reduced the risk of disease progression or death by 79% in the international phase III NETTER-1 population of previously treated, advanced neuroendocrine tumors of midgut origin.1 Lu-177 dotatate belongs to...

lung cancer

Anamorelin Increases Lean Body Mass in NSCLC Patients With Cachexia

Anamorelin (a ghrelin-receptor agonist) increased lean body mass but had no beneficial effect on handgrip strength vs placebo in patients with advanced non–small cell lung cancer (NSCLC) and cachexia, according to two international phase III trials (ROMANA 1 and 2) reported in The Lancet...

colorectal cancer

Selective Internal Radiotherapy Does Not Improve Any-Site but Prolongs Liver-Specific Progression-Free Survival in Metastatic Colorectal Cancer

In the phase III SIRFLOX trial reported in the Journal of Clinical Oncology, van Hazel et al found that adding selective internal radiation therapy with yttrium-90 resin microspheres to FOLFOX (fluorouracil, leucovorin, oxaliplatin) with or without bevacizumab (Avastin) did not improve any-site...

head and neck cancer

New Staging System for Human Papillomavirus–Related Oropharyngeal Cancer

As reported in The Lancet Oncology by O’Sullivan et al, a new staging system for human papillomavirus–related oropharyngeal cancer has been developed based on findings from the International Collaboration on Oropharyngeal Cancer Network for Staging (ICON-S) study. Study Details The...

neuroendocrine tumors

Everolimus Effective in Neuroendocrine Tumors of Gastrointestinal Origin

In a subgroup analysis of the phase III RADIANT-4 trial, focusing on neuroendocrine tumors of gastrointestinal origin, the mTOR inhibitor everolimus (Afinitor) essentially doubled the median progression-free survival time, compared with placebo, researchers reported at the 2016 Gastrointestinal...

gynecologic cancers

Study Finds No Progression-Free Survival Benefit for Weekly Dose-Dense vs Every-3-Week Paclitaxel Plus Carboplatin in Ovarian Cancer

Weekly dose-dense paclitaxel did not provide a progression-free survival benefit over every-3-week paclitaxel in combination with carboplatin and with or without elective bevacizumab (Avastin) in patients with previously untreated ovarian cancer, according to the results of the phase III GOG-0262...

gastrointestinal cancer

Asian Trial Finds No Survival Benefit of Adding Gastrectomy to Chemotherapy in Incurable Advanced Gastric Cancer

In the Asian phase III REGATTA trial reported in The Lancet Oncology, Fujitani et al found that the addition of gastrectomy to chemotherapy did not improve overall survival in patients with advanced gastric cancer with a single noncurable factor. Study Details In this open-label trial conducted...

gynecologic cancers

Study Finds No Adverse Impact of Minimally Invasive Hysterectomy on Long-Term Survival in Endometrial Cancer

Use of minimally invasive hysterectomy did not seem to have an adverse impact on long-term survival in women with endometrial cancer, according to an analysis reported in the Journal of Clinical Oncology by Wright et al. Study Details The study involved Surveillance, Epidemiology, and End Result...

breast cancer

Phase III Trial Shows No Benefit of Afatinib vs Trastuzumab Plus Vinorelbine in HER2-Positive Metastatic Breast Cancer

In the phase III LUX-Breast 1 trial reported in The Lancet Oncology, Harbeck et al found no benefit of afatinib (Gilotrif)/vinorelbine vs trastuzumab (Herceptin)/vinorelbine after previous trastuzumab treatment in patients with HER2-positive metastatic breast cancer. Broader inhibition of ErbB...

lung cancer

UK Trial Shows No Survival Benefit of Low–Molecular-Weight Heparin in Patients With Lung Cancer

In the UK phase III FRAGMATIC trial reported in the Journal of Clinical Oncology, Macbeth et al found no survival benefit of adding low–molecular-weight heparin to standard treatment in patients with lung cancer. Previous evidence suggested that low–molecular-weight heparin might...

breast cancer
issues in oncology

ASCO Clinical Practice Guideline Update on Ovarian Suppression/Adjuvant Endocrine Therapy in Hormone Receptor–Positive Breast Cancer

As reported in the Journal of Clinical Oncology by Burstein et al, ASCO has released a clinical practice guideline update on ovarian suppression as part of the extant guideline on adjuvant endocrine therapy in hormone receptor–positive breast cancer. The update is based on an update panel...

colorectal cancer

Patients Diagnosed With Stage I to III Rectal Cancer at Younger Age Have Increased Risk for Positive Lymph Nodes

Patients diagnosed with stage I to III rectal cancer at a younger age are at increased risk of having positive lymph nodes, according to an analysis of data published in the Journal of the National Cancer Institute. “This finding merits further investigation and may ultimately impact treatment...

integrative oncology

Mistletoe

The use of dietary supplements by patients with cancer has increased significantly over the past 20 years despite insufficient evidence of safety and effectiveness. Finding reliable sources of information about dietary supplements can be daunting. Patients typically rely on family, friends, and...

lung cancer

No Survival Benefit of Pemetrexed/Cisplatin Chemoradiation vs Standard Treatment in Nonresectable Stage III NSCLC

As reported by Senan et al in the Journal of Clinical Oncology, the phase III PROCLAIM trial showed no significant improvement in overall survival for chemoradiation with pemetrexed (Alimta)/cisplatin vs etoposide/cisplatin followed by consolidation pemetrexed vs a platinum-based doublet in...

skin cancer

Nivolumab Plus Ipilimumab in Unresectable or Metastatic Melanoma Regardless of BRAF Mutation Status

On January 23, 2016, the indication for nivolumab (Opdivo) plus ipilimumab (Yervoy) in unresectable or metastatic melanoma was expanded through accelerated approval to include patients regardless of BRAF V600 mutation status.1 The combination was previously approved for treatment of patients with...

hematologic malignancies
multiple myeloma

Selected Abstracts From 2015 ASH Annual Meeting: Part 3

Here are several more abstracts selected from the proceedings of the 2015 American Society of Hematology (ASH) Annual Meeting and Exposition, focusing on newly diagnosed multiple myeloma, relapsed/refractory multiple myeloma, and amyloid light-chain (AL) amyloidosis. For other selected abstracts...

supportive care

Rolapitant Reduces Chemotherapy-Induced Nausea and Vomiting in Patients Receiving Moderately and Highly Emetogenic Chemotherapy

In three phase III studies reported in The Lancet Oncology, the addition of the neurokinin-1 (NK-1) receptor antagonist rolapitant to serotonin (5-HT3) receptor antagonist and dexamethasone treatment significantly improved complete response rates in the prevention of chemotherapy-induced nausea and ...

issues in oncology
lung cancer
geriatric oncology

Management of Advanced Lung Cancer in the Elderly: A Reason to Rejoice or a Cause for Concern?

There is ample evidence to suggest that older adults with a good performance status (0 or 1) with advanced non–small cell lung cancer (NSCLC) should be treated with combination chemotherapy akin to younger patients.1,2 However, older adults comprise a heterogeneous group that has been...

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