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lung cancer
issues in oncology

Ceritinib Highly Active in Patients With ALK-Rearranged Advanced NSCLC, Including Those With Prior Crizotinib Treatment

Non–small cell lung cancer (NSCLC) harboring ALK rearrangement is sensitive to the ALK inhibitor crizotinib (Xalkori), but resistance ultimately occurs. In a phase I study reported in The New England Journal of Medicine, Shaw et al found that the more-potent ALK inhibitor ceritinib was...

cns cancers

Metastatic Neuroblastoma Confined to Distant Lymph Nodes Associated With Better Survival Compared With Other Stage IV Disease

The pattern of metastatic spread is not incorporated into current risk-stratification systems for neuroblastoma. In a retrospective study reported in the Journal of Clinical Oncology, Morgenstern et al found that patients with neuroblastoma with metastatic disease limited to distant lymph nodes...

leukemia
myelodysplastic syndromes

Prolonged Administration of Azacitidine Improves Response in Myelodysplasia, Less So in Combination With Entinostat

In the phase II US Leukemia Intergroup Trial E1905 reported in the Journal of Clinical Oncology, Prebet et al found that prolonged administration of lower-dose azacitidine produced a high response rate in patients with myelodysplastic syndrome or acute myeloid leukemia (AML) with myelodysplastic...

solid tumors
issues in oncology

Tumor Size, Location, and Mitotic Rate, but Not Genotype, Associated With Recurrence-Free Survival in Trial of Adjuvant Imatinib vs Placebo in GIST

The ACOSOG Z9001 (Alliance) study showed that 1 year of adjuvant imatinib (Gleevec) prolonged recurrence-free survival after resection of primary gastrointestinal stromal tumors (GIST). As reported by Corless et al in the Journal of Clinical Oncology, a study evaluating correlation of pathologic...

breast cancer

Continued Event-Free Survival Benefit of Neoadjuvant/Adjuvant Trastuzumab in HER2-Positive Locally Advanced Breast Cancer

As reported by Gianni et al in The Lancet Oncology, long-term follow-up of women with HER2-positive locally advanced breast cancer receiving neoadjuvant chemotherapy alone vs with neoadjuvant and adjuvant trastuzumab (Herceptin) in the phase III NOAH trial has shown continued event-free survival...

lymphoma

Omitting Radiotherapy in Early PET-Negative Stage I/II Hodgkin Lymphoma Is Associated With Increased Risk of Early Relapse

The EORTC/LYSA/FIL Intergroup H10 trial assessed whether omitting involved-node radiotherapy would affect progression-free survival in patients with negative early positron-emission tomography (PET) scans after two cycles of ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) compared with...

gynecologic cancers

Locoregional Progression of Cervical Cancer Follows Reverse Ontogenetic Sequence

In a study reported in The Lancet Oncology, Höckel et al demonstrated that locoregional progression of cervical cancer follows the reverse sequence of establishment of adult tissues in ontogeny. Ontogenetic staging was a better predictor of survival than pathologic staging. Previous work by...

leukemia

Phase II Study Suggests Benefit of Adding Rituximab to Chlorambucil in First-Line Treatment for Chronic Lymphocytic Leukemia

In a UK phase II study reported in the Journal of Clinical Oncology, Hillmen et al assessed the safety and activity of adding rituximab (Rituxan) to chlorambucil (Leukeran) in first-line treatment of chronic lymphocytic leukemia (CLL). Such a regimen may be an alternative to fludarabine-based...

colorectal cancer
issues in oncology

Stool Multitarget DNA Test More Sensitive, But Less Specific Than Fecal Immunochemical Test for Colorectal Cancer Screening in Persons at Average Risk

In a study reported in The New England Journal of Medicine, Imperiale et al found that a noninvasive, multitarget stool DNA test—including assays for KRAS mutations, aberrant NDRG4 and BMP3 methylation, β-actin, and hemoglobin—was significantly more sensitive but significantly less ...

gynecologic cancers

Risk Factors for Gastrointestinal Adverse Events Studied in Setting of First-Line Bevacizumab/Chemotherapy for Ovarian Cancer

As reported in the Journal of Clinical Oncology, Burger et al assessed risk factors for gastrointestinal adverse events in women with advanced ovarian cancer receiving first-line bevacizumab (Avastin)/chemotherapy with or without bevacizumab maintenance or chemotherapy alone in the phase III...

issues in oncology
issues in oncology

Socioeconomic Disparities in Mortality After Cancer Surgery Reflect Higher Failure-to-Rescue Rates in Hospitals Treating More Low-Income Patients

Although it has been found that lower socioeconomic status is associated with higher operative mortality, the factors explaining this disparity have not been clearly defined. In a study of major cancer surgery reported in JAMA Surgery, Reames et al found that hospitals with the highest proportion...

prostate cancer

Preclinical Study Suggests Benefits of Increased Tumor Perfusion and Reduced Tumor Hypoxia With Exercise in Prostate Cancer

In a study reported in the Journal of the National Cancer Institute, McCullough et al used an orthotopic rat model of prostate cancer to assess the effects of exercise on tumor hemodynamics and tissue hypoxia. Their findings of enhanced tumor perfusion and diminished tumor hypoxia suggest that...

Analysis of SWOG Trials Indicates No Survival Difference After 1 Year in Cancer Patients Treated In vs Out of Clinical Trials

In a study reported in the Journal of the National Cancer Institute, Unger et al evaluated whether cancer patients from SWOG clinical trials were similar to nontrial patients in baseline characteristics and survival. They found that, overall, trial participation in standard treatment arms did not...

prostate cancer
issues in oncology

Swedish Study Shows Lower Prostate Cancer Mortality in High-Incidence Areas

In a study reported in the Journal of the National Cancer Institute, Stattin et al found that rates of prostate cancer mortality, excess mortality in men with prostate cancer, and metastatic prostate cancer were lower in counties in Sweden with higher vs lower incidence of prostate cancer that...

skin cancer
head and neck cancer

Cutaneous Melanoma and Papillary Thyroid Carcinoma: Mutual Increased Risk

In a study reported in JAMA Otolaryngology-Head & Neck Surgery, Oakley et al found that papillary thyroid cancer increases the risk of cutaneous malignant melanoma and vice versa. In addition, the investigators found that patients with both cancers have a high frequency of BRAF V600E mutation. ...

issues in oncology
breast cancer

High Circulating Tumor Cell Count at Baseline and Increases in Count During Treatment Linked to Reduced Survival in Metastatic Breast Cancer

In a pooled analysis of individual patient data reported in The Lancet Oncology, Bidard et al found that baseline circulating tumor cell counts and increases in counts during treatment were highly prognostic in patients with metastatic breast cancer beginning new treatment and that addition of...

issues in oncology
breast cancer

Shortening of Leukocyte Telomeres Associated With Increased All-Cause and Breast Cancer–Specific Mortality in Breast Cancer Patients

Short telomeres are associated with increased risk of cancer, but data on telomere length and mortality in breast cancer survivors are inconsistent. In a study reported in the Journal of the National Cancer Institute, Duggan et al found that decreases in telomere length between baseline and 30...

breast cancer

No Difference in Bone Mineral Density Changes With Adjuvant Exemestane vs Anastrozole in Women With Early Breast Cancer

In a companion study (MA.27B) to the open-label phase III National Cancer Institute of Canada Clinical Trials Group (NCIC CTG) MA.27 trial in women with early breast cancer reported in The Lancet Oncology, Goss et al found that adjuvant aromatase inhibitor treatment with exemestane, a mildly...

issues in oncology
prostate cancer

Circulating Tumor Cell Count and Early Change in Count Are Prognostic for Survival in First-Line Docetaxel Treatment of Prostate Cancer

As reported in the Journal of Clinical Oncology, Goldkorn et al assessed the prognostic value of circulating tumor cell counts in patients with metastatic castration-resistant prostate cancer receiving standard first-line docetaxel plus prednisone with or without atrasentan in the SWOG S0421 trial. ...

sarcoma

No Overall Survival Benefit of First-Line Doxorubicin Plus Ifosfamide vs Doxorubicin Alone in Advanced Soft-Tissue Sarcoma

In the open-label, phase III EORTC 62012 trial reported in The Lancet Oncology, Judson et al found that doxorubicin plus ifosfamide was not associated with any overall survival advantage compared with doxorubicin alone in patients with advanced or metastatic soft-tissue sarcoma. Progression-free...

issues in oncology

Children With Cancer, Parents, and Providers Value Patient-Reported Outcomes Feedback

In a pilot trial (PediQUEST) reported in the Journal of Clinical Oncology, Wolfe et al assessed the effects of use of the PediQUEST electronic patient-reported feedback survey on health-related quality of life in children with advanced cancer. Although few significant improvements were observed,...

prostate cancer

Stereotactic Body Radiation Costs Less but Is Associated With More Genitourinary Toxicity vs Intensity-Modulated Radiation Therapy for Prostate Cancer

In a retrospective Medicare-based study reported in the Journal of Clinical Oncology, Yu et al found that although stereotactic body radiation therapy is associated with lower treatment costs than intensity-modulated radiation therapy in treatment of prostate cancer, it is also associated with...

issues in oncology
colorectal cancer
issues in oncology

Only Small Number of Genetic Markers Show Association With Capecitabine Toxicity in Colorectal Cancer

In a study reported in the Journal of Clinical Oncology, Rosmarin et al assessed the association of reported fluorouracil (5-FU) toxicity genetic markers with occurrence of capecitabine toxicity of grade ≥ 3 in the QUASAR2 trial in colorectal cancer and with occurrence of capecitabine and 5-FU...

issues in oncology
issues in oncology
issues in oncology

Satisfaction With Work-Life Balance Among U.S. Oncologists Lower Than Other Medical Specialties, Survey Says

The American Society of Clinical Oncology (ASCO) conducted a survey of U.S. oncologists between October 2012 and March 2013, evaluating satisfaction with work-life balance and career plans. The findings, reported in the Journal of Clinical Oncology by Shanafelt et al, indicate that most are...

lymphoma

Rituximab Maintenance Delays Need for Subsequent Treatment vs Watchful Waiting in Asymptomatic Nonbulky Follicular Lymphoma

In an open-label phase III trial reported by Ardeshna et al in The Lancet Oncology, rituximab (Rituxan) induction plus maintenance was found to delay the need for subsequent therapy and improve elements of quality of life vs watchful waiting in patients with advanced asymptomatic nonbulky...

breast cancer
issues in oncology

Greater Interpretive Volume Leads to Greater Accuracy in Quebec Breast Cancer Screening Program

In a study reported in the Journal of the National Cancer Institute, Théberge et al evaluated the association between radiologist interpretive volume and breast cancer screening accuracy in the Quebec Breast Cancer Screening Program. They found that accuracy increased with increasing volume, ...

breast cancer
issues in oncology

Pilot Study Shows Decision Aid Helps in Decision-Making Regarding Mammography Screening in Women Aged ≥ 75 Years

Although it is recommended that women aged ≥ 75 years be informed of the benefits and risks of mammography before being screened, it appears that this is not common practice. As reported in JAMA Internal Medicine by Schonberg et al, a decision aid developed by the investigators helped improved...

prostate cancer
myelodysplastic syndromes

No Apparent Increased Risk of Myelodysplastic Syndrome With Definitive Radiotherapy in Prostate Cancer

Exposure to ionizing radiation has been associated with increased risk of myelodysplastic syndrome, and it remains unclear whether radiation doses used in prostate cancer treatment result in increased risk. In a retrospective cohort study reported in the Journal of the National Cancer Institute,...

colorectal cancer

Higher Macrophage Inhibitory Cytokine-1 Levels Associated With Increased Risk of Colorectal Cancer

It is known that chronic inflammation plays a role in the development of colorectal cancer. In a study reported in the Journal of the National Cancer Institute, Mehta et al evaluated the association of the novel plasma inflammatory biomarker macrophage inhibitory cytokine-1 (MIC-1; growth...

prostate cancer

Continued Survival Benefits With Radical Prostatectomy in Longer-Term Follow-up in Scandinavian Prostate Cancer Group-4 Trial

As reported in The New England Journal of Medicine by Bill-Axelson et al, additional long-term follow-up in the Scandinavian Prostate Cancer Group-4 trial (SPCG-4) continues to show significant benefits of radical prostatectomy vs watchful waiting in early prostate cancer, including reduced risk of ...

breast cancer

Fertility Concerns Affect Treatment Choices in Young Women With Breast Cancer, but Few Use Preservation Options

Little is known about how fertility concerns affect treatment decisions or fertility preservation strategies at the time of initial diagnosis of breast cancer. In an ongoing multicohort study reported in the Journal of Clinical Oncology, Ruddy et al found that most young women with breast cancer...

prostate cancer

High Bone Biomarker Levels Linked to Preferential Survival Benefit of Atrasentan in Castration-Resistant Prostate Cancer With Skeletal Metastases

Although elevated markers of bone turnover are associated with poor survival in castration-resistant prostate cancer, the association of these markers with outcome in the setting of bone-targeted therapy is uncertain. In a study reported in the Journal of the National Cancer Institute, Lara et al...

prostate cancer

No Benefit of Early Zoledronic Acid in Reducing Skeletal-Related Events in Castration-Sensitive Prostate Cancer With Bone Metastases

As reported in the Journal of Clinical Oncology by Smith et al, the double-blind phase III Cancer and Leukemia Group B (CALGB) 9020/Alliance trial assessed the effect of early initiation of zoledronic acid in reducing risk of skeletal-related events in men with castration-sensitive prostate cancer. ...

issues in oncology
breast cancer
issues in oncology

Correlation of PIK3CA Mutation and Neoadjuvant Lapatinib/Letrozole Response in Hormone Receptor–Positive, HER2-Negative Breast Cancer

In a phase IIB study reported in the Journal of Clinical Oncology, Guarneri et al compared neoadjuvant letrozole plus lapatinib (Tykerb) or placebo in postmenopausal women with hormone receptor–positive, HER2-negative breast cancer. Response rates were similar in the two groups, but a...

skin cancer

Durable Tumor Responses With Nivolumab in Long-Term Follow-up of Patients With Advanced Melanoma

In a dose-escalation, cohort expansion study reported in the Journal of Clinical Oncology, Topalian et al found that treatment with the PD-1 immune checkpoint inhibitor nivolumab produced durable responses in patients with advanced melanoma. Long-term follow-up also showed promising survival rates...

lung cancer

Trends in Phase III Trials in Advanced NSCLC: Decline in Use of Overall Survival as Primary Endpoint, More ‘Positive’ Outcomes

In a study published in the Journal of Clinical Oncology, Sacher et al identified trends in reporting of phase III trials in advanced non–small cell lung cancer (NSCLC) that include reduced use of overall survival as the primary endpoint and an increase in claims of positive outcomes despite...

gynecologic cancers
gynecologic cancers

Same Progression-Free Survival, Better Quality of Life With Lower-Dose Weekly vs Every-3-Week Carboplatin/Paclitaxel in Advanced Ovarian Cancer

In an open-label phase III trial (MITO-7) reported in The Lancet Oncology, Pignata et al found that while a lower-dose weekly carboplatin/paclitaxel regimen did not improve progression-free survival compared with standard every-3-week carboplatin/paclitaxel as first-line treatment of advanced...

survivorship

Childhood Cancer Survivors at Very High Risk of Later Endocrine Disorders in Scandinavian Study

In a population-based cohort study (Adult Life after Childhood Cancer in Scandinavia, or ALiCCS) reported in The Lancet, Licht et al assessed the lifetime risk of endocrine disorders in Scandinavian long-term survivors of childhood cancer. They found a nearly fivefold increased risk of hospital...

gynecologic cancers
issues in oncology

Screening With Visual Inspection of Cervix After 4% Acetic Acid Could Reduce Cervical Cancer Mortality by 22,000 per Year in India

Cervical cancer is the leading cause of cancer death in women in India, a nation where large-scale Pap smear screening is not feasible. As reported in the Journal of the National Cancer Institute, Shastri et al have performed a large cluster-randomized study of education and screening of Indian...

skin cancer

‘Real World’ Safety Study of Vemurafenib in BRAF V600–Mutated Metastatic Melanoma Shows Similar Safety Profile as Pivotal Trials

As reported in The Lancet Oncology by Larkin et al, interim results of a safety study designed to reflect the spectrum of patients encountered in routine practice suggest that vemurafenib (Zelboraf) has a safety profile in patients with BRAF V600–mutated metastatic melanoma similar to that...

head and neck cancer

Intensity-Modulated Radiation Therapy Reduces PEG Tube Dependence and Severe Skin and Mucous Membrane Toxicity in Oropharyngeal Cancer

In a single-center experience reported in JAMA Otolaryngology-Head & Neck Surgery, Lohia et al found that intensity-modulated radiation therapy for oropharyngeal cancer reduces percutaneous endoscopic gastrostomy (PEG) tube dependence and severe skin and mucous membrane toxicity compared with...

lung cancer

Meta-Analysis Shows Survival Benefit of Preoperative Chemotherapy in NSCLC

In a systematic review and individual patient meta-analysis reported in The Lancet, the NSCLC Meta-analysis Collaborative Group found that neoadjuvant therapy for non–small cell lung cancer (NSCLC) was associated with a significant 13% reduction in risk of death. Significant benefits in...

prostate cancer

No Overall Survival Advantage for Escalated-Dose vs Control-Dose Conformal Radiotherapy for Prostate Cancer at 10 Years

As reported in The Lancet Oncology by Dearnaley et al, the 10-year follow-up of the phase III open-label MRC RT01 trial showed continued benefit of escalated-dose vs control-dose conformal radiotherapy in biochemical progression-free survival in patients with prostate cancer but no overall survival ...

supportive care

Early Palliative Care Benefits Patients With Advanced Cancer

In a study published in The Lancet, Zimmermann et al compared quality of life, symptom severity, and care satisfaction with early initiation of palliative care vs standard cancer care in patients with advanced cancer. Although early palliative care was not associated with improved quality of life...

lymphoma

Standard 24 Gy More Effective Than 4 Gy in Radiotherapy for Indolent Lymphoma

Follicular lymphoma has been found to respond to radiotherapy doses as low as 4 Gy. In the phase III FORT trial reported in The Lancet Oncology, Hoskin et al compared radiotherapy with 4 Gy in two fractions vs 24 Gy in 12 fractions in patients with indolent lymphoma, finding that the 24-Gy regimen...

colorectal cancer
issues in oncology

Lower Adenoma Miss Rate With Full-Spectrum vs Standard Forward-Viewing Colonoscopy

In a study reported in The Lancet Oncology, Gralnek et al found that full-spectrum endoscopic colonoscopy had a lower adenoma miss rate compared with standard forward-viewing colonoscopy. Study Details In the study, performed at three sites in Israel, one in the Netherlands, and two in the United ...

breast cancer

Anthropometric and Hormonal Factors Increase Risk for Male Breast Cancer

In a study reported in the Journal of the National Cancer Institute, Brinton et al assessed the role of anthropometric, medical history, and hormone-related factors in male breast cancer in the Male Breast Cancer Pooling Project. Factors found to be associated with risk included height,...

gynecologic cancers
issues in oncology

Reduced Risk of Cervical Lesions Among Girls and Women 6 Years After Licensure of HPV Vaccine in Denmark

In a cohort study reported in the Journal of the National Cancer Institute, Baldur-Felskov et al found that there has been a significant reduction in cervical lesions among Danish girls and women receiving the quadrivalent human papillomavirus (HPV) vaccine during the first 6 years of its...

lymphoma

Event-Free Survival at 24 Months Can Serve as Endpoint for Disease-Related Outcome in Diffuse Large B-Cell Lymphoma Treated With Immunochemotherapy

In a study reported in the Journal of Clinical Oncology, Maurer et al found that patients with diffuse large B-cell lymphoma (DLBCL) treated with immunochemotherapy who achieve event-free survival at 24 months have overall survival that does not differ significantly from that in the general...

gynecologic cancers

Adding Bevacizumab to Chemotherapy Improves Survival in Advanced Cervical Cancer

Retreatment with cisplatin has reduced effectiveness in patients with recurrent cervical cancer who have received cisplatin with radiation therapy. In a 2×2 factorial phase III trial reported in The New England Journal of Medicine, Tewari et al compared cisplatin/paclitaxel vs nonplatinum...

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