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skin cancer

Studies Suggest Bright Future for Combination Immunotherapy in Advanced Melanoma, but Questions Remain

Two studies presented at the 2016 ASCO Annual Meeting focused on the use of combination immunotherapy in the treatment of patients with advanced melanoma. Updated results from the phase III CheckMate 067 trial centered on the combination of nivolumab (Opdivo) plus ipilimu­mab (Yervoy) compared...

health-care policy
legislation

CMS Proposal for Part B Drug Payment: A Poorly Conceived Experiment

On March 11, 2016, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule in the Federal Register to test a change in reimbursement for Part B drugs.1 The first phase involves changing the 6% add-on to the average sales price (ASP) used to make drug payments under Part B to...

hematologic malignancies
lymphoma

CNS-IPI for CNS Relapse in Diffuse Large B-Cell Lymphoma

As reported in the Journal of Clinical Oncology, Schmitz et al have developed and validated a risk score for CNS relapse—the Central Nervous System International Prognostic Index (CNS-IPI)—in patients with diffuse large B-cell lymphoma (DLBCL) treated with R-CHOP (rituximab [Rituxan]...

solid tumors
prostate cancer

No Survival Benefit for Cabozantinib Reported in Previously Treated Metastatic Castration-Resistant Prostate Cancer

Smith et al found no improvement in overall survival with cabozantinib (Cometriq) vs prednisone in patients with previously treated metastatic castration-resistant prostate cancer, in the phase III COMET-1 trial reported in the Journal of Clinical Oncology. Cabozantinib, which inhibits MET, VEGF...

breast cancer

Results of Two Practice-Changing Breast Cancer Trials Upheld

Results of two pivotal breast cancer trials reported at the 2016 ASCO Annual Meeting confirmed the practice-changing findings that resulted from earlier findings. PALOMA-2 The phase III PALOMA-2 trial confirmed results from the smaller, open-label phase II PALOMA-1 trial that led to the U.S. Food...

issues in oncology

Patient-Oncologist Difference of Opinion About Advanced Cancer Prognosis Is Common, Study Shows

Misunderstandings about prognosis between patients with advanced cancer and their doctors was common, according to a study by Gramling et al in JAMA Oncology—and the vast majority of patients didn't know that their doctors held different opinions about how long they might live. “We've...

hematologic malignancies
multiple myeloma

Long-Term Benefit of Lenalidomide/Dexamethasone Reported in High-Risk Smoldering Multiple Myeloma

As reported by Mateos et al in The Lancet Oncology, long-term follow-up in the phase III QuiRedex trial indicates continued benefit of lenalidomide (Revlimid)/dexamethasone vs observation in preventing disease progression in patients with high-risk smoldering multiple myeloma. Study Details In...

colorectal cancer

World GI 2016: Anti–Interleukin-1 Alpha Antibody MABp1 Improves Outcomes Significantly Over Placebo in Advanced Colorectal Cancer

A novel anti–interleukin-1 alpha antibody has shown a significant impact on symptoms and a high level of safety and tolerability in patients with advanced colorectal cancer, according to phase III data presented by Hickish et al at ESMO’s 18th World Congress on Gastrointestinal Cancer...

gastrointestinal cancer

World GI 2016: Chemoradiotherapy After Surgery for Gastric Cancer Shows Similar Outcomes to Postoperative Chemotherapy

Postoperative treatment intensification with chemoradiotherapy does not achieve better outcomes compared to postoperative chemotherapy in patients with gastric cancer who have already undergone preoperative chemotherapy, according to phase III data presented by Verheij et al at the ESMO 18th World...

colorectal cancer

World GI 2016: Anti–PD-L1 Immunotherapy Combined With MEK Inhibition Shows Response in Microsatellite-Stable Metastatic Colorectal Cancer

Anti–PD-L1 (programmed cell death ligand 1) immunotherapy may achieve a response in patients with microsatellite-stable metastatic colorectal cancer if combined with a MEK inhibitor, according to phase I data presented at the European Society for Medical Oncology (ESMO) 18th World Congress on ...

hepatobiliary cancer

World GI 2016: Phase III RESORCE Study Data Show Regorafenib Improves Overall Survival in Previously Treated Patients With Unresectable Liver Cancer

Results from the phase III RESORCE trial show that regorafenib (Stivarga) tablets achieved a median overall survival improvement in patients with unresectable hepatocellular carcinoma (HCC) that progressed after treatment with sorafenib (Nexavar) tablets. The study, presented by Bruix et al during...

multiple myeloma

Updated Outcomes and Impact of Age in FIRST Trial in Multiple Myeloma

As reported by Hulin et al in the Journal of Clinical Oncology, the updated findings in the phase III FIRST trial continue to show improved progression-free and overall survival with continuous lenalidomide (Revlimid) plus low-dose dexamethasone (Rd) vs melphalan, prednisone, and thalidomide (MPT)...

prostate cancer

Mixed Results With Hypofractionated vs Conventional Radiotherapy for Localized Prostate Cancer

Investigators of two European phase III trials have reached different conclusions on whether hypofractionated radiotherapy should replace conventional radiotherapy as a new standard of treatment in localized prostate cancer. The CHHiP trial findings favoring hypofractionation were reported by David ...

gynecologic cancers

Neoadjuvant Chemotherapy May Render Advanced Ovarian Cancers Responsive to Immunotherapy

Although most patients with advanced ovarian cancer initially respond to platinum-based chemotherapy, they usually relapse. According to a study by Frances R. Balkwill, PhD, Professor of Cancer Biology at Barts Cancer Institute, Queen Mary University of London, United Kingdom, and colleagues...

Erika P. Hamilton, MD, Named Director of Breast and Gynecologic Cancer Research

Sarah Cannon has announced the promotion of Erika P. Hamilton, MD, to Director of the institution’s Breast and Gynecologic Cancer Research Program. Over the past 3 years, Dr. Hamilton has been instrumental in the growth and success of the program. “Erika has quickly become a recognized thought...

hematologic malignancies

Complexities in the Diagnosis and Management of Amyloidosis

Question 1: What is the next best step for this patient? Correct Answer: C. Determination of amyloid subtype. Expert Perspective Amyloidosis encompasses a heterogeneous group of diseases bound by the characteristic deposition of amyloid fibrils in soft tissues and bone marrow, and it could be...

lung cancer

Routine Prophylactic vs Deferred Radiotherapy for Procedure-Tract Metastases in Malignant Pleural Mesothelioma

Prophylactic radiotherapy after surgery and large-bore pleural procedures did not result in significant reduction in the incidence of procedure-tract metastases in malignant pleural mesothelioma, according to the UK phase III SMART trial reported by Clive et al in The Lancet Oncology. Study...

lymphoma

Comparison of Chemotherapy Regimens After Negative Interim PET-CT in Advanced Hodgkin Lymphoma

In a phase III trial reported in The New England Journal of Medicine, Johnson et al found similar efficacy with continued ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) chemotherapy vs omission of bleomycin (AVD) after negative interim PET-CT (positron-emission tomography–computed...

issues in oncology
symptom management

Clinical Trials Actively Recruiting Patients With Cardiotoxicity Resulting From Treatment

Observational Study Title: Assessment for Long-Term Cardiovascular Impairment Associated With Trastuzumab Cardiotoxicity in HER2-Positive Breast Cancer Survivors Study Type: Observational Study Sponsor and Collaborators: Memorial Sloan Kettering Cancer Center Purpose: To study whether strain and...

cns cancers

New Standard of Care Emerges for Anaplastic Glioma Without 1p/19q Codeletion

Adjuvant temozolomide, after radiotherapy, improves overall survival in patients with grade 3 anaplastic glioma without 1p/19q codeletion, according to a phase III EORTC (European Organization for Research and Treatment of Cancer) study presented at the 2016 ASCO Annual Meeting.1 “We were...

Expert Point of View: Stephen K.L. Chia, MD

Stephen K.L. Chia, MD, of the British Columbia Cancer Agency, Vancouver, discussed two of these neoadjuvant breast cancer studies at the ASCO Annual Meeting. In the current landscape for neoadjuvant therapy in HER2-positive disease, said Dr. Chia, the NeoSphere, ­TRYPHAENA, KRISTINE, and I-SPY 2...

breast cancer

Pertuzumab-Containing Regimens Compared for Neoadjuvant Treatment in Early Breast Cancer

In patients with HER2-positive early breast cancer, pathologic complete response rates after neoadjuvant therapy were higher with docetaxel plus carboplatin plus trastuzumab (Herceptin) plus pertuzumab (Perjeta), or TCH+P, than with ado-trastuzumab emtansine (Kadcyla) plus pertuzumab, or T-DM1+P,...

geriatric oncology
supportive care
leukemia

Assessment of Fitness, Function, and Quality of Life Essential in Treatment of Older Patients With CLL

Significant progress has been made in the past 2 decades in the care of patients with chronic lymphocytic leukemia (CLL). Recently, the therapeutic armamentarium has expanded for such patients with the introduction of new targeted agents. CLL is predominantly a disease of the elderly, with a...

symptom management

Factors Associated With Chemotherapy-Induced Peripheral Neuropathy in Older Patients

In an analysis of the linked Southwest Oncology Group–Medicare databases reported by Hershman et al in the Journal of Clinical Oncology, an increased risk of peripheral neuropathy in older patients receiving taxane therapy was associated with increasing age and a history of diabetes in...

gastrointestinal cancer

Study Finds Regorafenib Increases Progression-Free Survival in Advanced Gastric Cancer

The multikinase inhibitor regorafenib (Stivarga) prolonged progression-free survival vs placebo in patients with previously treated advanced gastric carcinoma, in a phase II trial reported in the Journal of Clinical Oncology by Pavlakis et al. A regional difference in treatment effect was observed. ...

Expert Point of View: David R. Spigel, MD

“These are outstanding results,” commented formal discussant of this trial David R. Spigel, MD, of the Sarah Cannon Research Institute, Nashville, Tennessee. In melanoma, the combination of nivolumab (Opdivo) plus ipilimumab (Yervoy) vs nivolumab alone vs ipilimumab alone found superior...

lung cancer

Combination of Nivolumab and Ipilimumab Moves Forward in NSCLC

How best to combine new immunotherapies is a burning question in oncology. A new study in the CheckMate series suggests that nivolumab (Opdivo) and ipilimumab (Yervoy) can be safely and effectively combined as first-line treatment of advanced non–small cell lung cancer (NSCLC),1 but further study...

breast cancer

Approximately 20% of Older Women With Early Breast Cancer Experience Some Form of Functional Decline After Treatment

In a study of older women with newly diagnosed stage I to III breast cancer, approximately 1 in 5 lost the ability to complete some of the basic tasks necessary for independent living within 1 year of initiating treatment. The study also found that a simple survey can help identify which women are...

breast cancer

No Advantage With Cyclophosphamide/Methotrexate Maintenance in Hormone Receptor–Negative Early Breast Cancer, but Subgroup May Benefit

Low-dose oral cyclophosphamide plus methotrexate maintenance therapy yielded no disease-free survival benefit in women with hormone receptor–negative early breast cancer, according to the phase III International Breast Cancer Study Group (IBCSG) 22-00 trial. Some evidence of benefit was...

prostate cancer

Tasquinimod Improves Radiographic PFS but Not OS in Metastatic Castration-Resistant Prostate Cancer

In a phase III trial reported in the Journal of Clinical Oncology, Sternberg et al found that tasquinimod, an oral therapy targeting components of the tumor microenvironment, increased radiographic progression-free survival but not overall survival vs placebo in men with chemotherapy-naive...

solid tumors
sarcoma

French Phase III Trial Shows No Benefit of Adding Zoledronate to Chemotherapy and Surgery in Osteosarcoma

In the French phase III OS2006 trial reported by Piperno-Neumann et al in The Lancet Oncology, the addition of zoledronate to chemotherapy and surgery provided no event-free survival benefit in the treatment of patients with newly diagnosed high-grade osteosarcoma. Study Details In the open-label ...

hematologic malignancies
lymphoma

Adding Obinutuzumab to Bendamustine Improves Progression-Free Survival in Rituximab-Refractory NHL

In the phase III GADOLIN trial reported in The Lancet Oncology, Sehn et al found that adding the anti-CD20 antibody obinutuzumab (Gazyva) to bendamustine (Bendeka, Treanda) increased progression-free survival in patients with rituximab-refractory indolent non-Hodgkin lymphoma (NHL). Outcomes in...

hepatobiliary cancer

FDA Approves Sofosbuvir/Velpatasvir for Treatment of Chronic Hepatitis C Virus Infection

On June 28, the U.S. Food and Drug Administration (FDA) approved a fixed-dose combination of sofosbuvir, 400 mg, plus velpatasvir, 100 mg (Epclusa) to treat adult patients with chronic hepatitis C virus (HCV) either with or without cirrhosis. For patients with moderate to severe cirrhosis...

lymphoma

Study Finds Addition of High-Dose Cytarabine to Immunochemotherapy Before Transplant Improves Outcomes in Younger Patients With MCL

The phase III European MCL Younger trial has shown that adding high-dose cytarabine to immunochemotherapy prior to autologous stem cell transplantation (ASCT) increased the time to treatment failure among patients with mantle cell lymphoma (MCL) aged ≤ 65 years. The results were reported by...

gynecologic cancers

No Overall Advantage to Adding Pertuzumab to Chemotherapy in Platinum-Resistant Ovarian Cancer, but Subgroup May Benefit

According to the European phase III PENELOPE trial reported in the Journal of Clinical Oncology, Kurzeder et al found that adding pertuzumab (Perjeta) to investigator’s choice of chemotherapy did not improve progression-free survival in women with low-HER3 mRNA–expressing...

colorectal cancer

Adding Adjuvant Oxaliplatin to Fluoropyrimidine May Be of Benefit in Deficient Mismatch Repair Colon Cancer

In a French retrospective study reported by David Tougeron, MD, PhD, of Poitiers University Hospital, Poitiers, France, and colleagues in the Journal of the National Cancer Institute, the addition of adjuvant oxaliplatin to fluoropyrimidine treatment improved disease-free survival in patients with...

cns cancers

Retroviral Replicating Vector That Delivers Cytosine Deaminase to Cancer Cells Active in Recurrent Glioblastoma

A phase I study by Timothy F. Cloughesy, MD, Director of the Neuro-Oncology Program at the UCLA Jonsson Comprehensive Cancer Center, and colleagues published in Science Translational Medicine investigated the effectiveness of vocimagene amiretrorepvec (Toca 511), an experimental nonlytic,...

AMA Announces Board of Trustees for 2016–2017

The American Medical Association (AMA) has introduced the 21 members of its Board of Trustees for the coming year, following elections held during the Annual Meeting of the AMA House of Delegates. Andrew W. Gurman, MD, an orthopedic hand surgeon, was sworn in as the 171st President of the AMA. In...

Ohio State Names Timothy Pawlik, MD, MPH, PhD, Chair of Surgery and Chair for Cancer Research

The Ohio State University Wexner Medical Center has appointed a nationally recognized surgeon and liver cancer expert to lead its surgical and surgical oncology programs. Timothy Pawlik, MD, MPH, PhD, will be the Chair of the Medical Center’s Department of Surgery, as well as The Urban Meyer III...

integrative oncology

Black Cohosh

Scientific Name: Cimicifuga racemosa Common Names: Black snakeroot, rattlesnake root, squawroot, bugbane, bugwort Brand Names: Remifemin, Menofem, Klimadynon Overview A perennial plant native to the eastern United States and Canada, black cohosh root was used by Native Americans to treat colds,...

Inside Knowledge From a Cancer Survivor

Curtis Pesmen is a well-regarded writer who has authored six books of nonfiction as well as numerous articles for publications such as Esquire and The New York Times. He also has served as founding editor of LIVESTRONG Quarterly and often speaks and writes on patient advocacy. Shortly after...

breast cancer

Pembrolizumab in Triple-Negative Breast Cancer: Emerging New Treatment Modality

Lajos Pusztai, MD, DPhil, Professor of Medicine, Chief of Breast Medical Oncology and Co-Director of Cancer Genetics Research Program at Yale Cancer Center, New Haven, Connecticut, commented on ­KEYNOTE-012. He remarked that the overall response rate of 18.5% to the single agent is similar to...

breast cancer
gastroesophageal cancer
gastrointestinal cancer

Pembrolizumab Active in PD-L1–Positive Advanced Gastric Cancer and Triple-Negative Breast Cancer

The KEYNOTE-012 phase Ib trial assessed single-agent pembrolizumab (Keytruda) in patients with advanced programmed cell death ligand 1 (PD-L1)–positive gastric cancer, triple-negative breast cancer, urothelial cancer, and head and neck cancer. The activity of pembrolizumab in study patients with...

skin cancer

Sequential Nivolumab/Ipilimumab Appears More Active Than Reverse Sequence in Advanced Melanoma

In the phase II CheckMate 064 trial reported in The Lancet Oncology, Weber et al found that sequential nivolumab (Opdivo)/ipilimumab (Yervoy) was more active than the reverse sequence (ipilimumab/nivolumab) in patients with advanced melanoma. Study Details In the open-label study, 138 patients...

multiple myeloma

Ixazomib: A Relevant Addition to Myeloma Therapy

In 2015, four new drugs were approved for the treatment of multiple myeloma by the U.S. Food and Drug Administration: panobinostat (Farydak), daratumumab (Darzalex), elotuzumab (Empliciti), and ixazomib (Ninlaro). Of them, the first three are drugs with unique new targets, whereas ixazomib is the...

multiple myeloma

Addition of Ixazomib to Lenalidomide/Dexamethasone Improves Progression-Free Survival in Relapsed/Refractory Multiple Myeloma

In the phase III TOURMALINE-MM-1 trial reported in The New England Journal of Medicine, Philippe Moreau, MD, of the University Hospital Hôtel Dieu, Nantes, France, and colleagues found that adding the oral proteasome inhibitor ixazomib (Ninlaro) to lenalidomide (Revlimid) and dexamethasone...

David Spigel, MD, Appointed as Sarah Cannon Chief Scientific Officer

Sarah Cannon announced the promotion of David Spigel, MD, as Chief Scientific Officer. The new appointment supports the continuous expansion of clinical research and drug development programs, which provides patients with access to novel therapies at the earliest stages. As Chief Scientific...

gastrointestinal cancer
pancreatic cancer
colorectal cancer

Treatment Update in Gastric, Pancreatic, and Colorectal Cancers

Although new gastrointestinal cancers are on the rise, advancements in their treatment, as well as the upcoming results of perioperative trials, could prove to be “clinical practice game-changers,” declared Thomas J. George, Jr, MD, FACP, at the 2016 Community Oncology Conference in Orlando,...

Expert Point of View: Peter C. Enzinger, MD

Not so FAST? The study discussant Peter C. Enzinger, MD, Director of the Center for Esophageal and Gastric Cancer at Dana-Farber/Brigham and Women’s Cancer Center, Boston, viewed the findings of the FAST trial as promising but voiced several considerations, as did Gulam A. Manji, MD, PhD,...

gastrointestinal cancer
gastroesophageal cancer

First-in-Class Antibody Reduces Gastric Cancer Recurrence

A novel immunotherapy agent, the first in its class, reduced disease progression by more than 50% when added to standard chemotherapy for patients with advanced gastric cancer, according to results from an international phase II trial presented at the 2016 ASCO Annual Meeting.1 The drug, IMAB362,...

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