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Showing 7351 - 7400Hypofractionation 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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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 ...
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...
Ofatumumab for Extended Treatment of Patients With Recurrent or Progressive Chronic Lymphocytic Leukemia
On January 19, 2016, ofatumumab (Arzerra) was approved for extended treatment of patients in complete or partial response after at least two lines of therapy for recurrent or progressive chronic lymphocytic leukemia (CLL).1,2 Ofatumumab was previously approved for treatment of untreated patients...
2016 Head and Neck Cancer Symposium: Uninsured and Medicaid Patients More Likely to Present With Advanced Tumors, Experience Cancer-Specific Mortality
Compared to patients with non-Medicaid insurance, uninsured patients and patients with Medicaid are more likely to present with advanced stages of head and neck cancer and have higher overall and cancer-specific mortality rates, according to research presented by Churilla et al at the 2016...
Expert Point of View: Oliver Sartor, MD
“This platform has no selection bias. Phlebotomy samples are drawn at key decision points. We begin to see that heterogeneity of circulating tumor cells predicted for shorter progression and survival times with selected androgen receptor–directed therapies. We need to study this prospectively,”...
Carboplatin/Paclitaxel Tops Oxaliplatin/Capecitabine as Neoadjuvant Regimen for Esophageal Cancer
The United Kingdom’s phase II NEOSCOPE trial compared the toxicity and efficacy of two preoperative chemoradiation regimens—carboplatin/paclitaxel and oxaliplatin/capecitabine—and judged one to be the winner. “CarPacRT passed the prespecified efficacy criteria for taking forward to phase III, but...
Expert Point of View: Claus Rödel, MD
Claus Rödel, MD, of the Department of Radiotherapy, University of Frankfurt, Germany, discussed the study at the 2016 Gastrointestinal Cancers Symposium. “The main strength of the Polish II study is clearly its innovative design,” he said. “It sequentially combines effective local radiotherapy and...
Shorter Radiation Course May Benefit Patients With Locally Advanced Rectal Cancer
As neoadjuvant treatment for locally advanced rectal cancer, a shorter course of radiation therapy followed by chemotherapy may be as good as, or better than, standard chemoradiotherapy, according to a study from the Polish Colorectal Study Group presented at the 2016 Gastrointestinal Cancers...
Expert Point of View: Bertram Wiedenmann, MD, PhD and Markus Moehler, MD, PhD
Commenting on the programmed cell death protein 1 (PD-1)/PD-1 ligand (PD-L1) antibodies in tumors with mismatch repair deficiency, Bertram Wiedenmann, MD, PhD, Professor of Internal Medicine and Gastroenterology, Universitätsmedizin Berlin, Germany, suggested, “The efficacy of pembrolizumab...
Antithymocyte Globulin Reduces Need for Immunosuppressants After Hematopoietic Cell Transplantation From Unrelated Donors
In a phase III trial reported in The Lancet Oncology, Walker et al found that treatment with antithymocyte globulin reduced the need for immunosuppressive therapy in patients with hematologic malignancies receiving hematopoietic cell transplantation from unrelated donors. Study Details In this...
Eribulin Improves Overall Survival vs Dacarbazine in Advanced Liposarcoma or Leiomyosarcoma
In a phase III trial reported in The Lancet, Schöffski et al found that eribulin improved overall survival vs dacarbazine in patients with advanced or metastatic soft-tissue sarcoma who had received at least two prior systemic treatments for advanced disease. Outcome in the subgroup with...
Addition of TG4010 Vaccine to First-Line Chemotherapy Appears to Improve Progression-Free Survival in Advanced NSCLC
As reported in The Lancet Oncology by Quoix et al, the addition of immunotherapy with TG4010—the modified vaccinia Ankara expressing MUC1 and interleukin 2—to first-line chemotherapy improved progression-free survival in patients with advanced non–small cell lung cancer (NSCLC) in ...
No Benefit of Adding Adjuvant and Maintenance Lapatinib to Chemoradiation in High-Risk Patients With Resected Squamous Cell Carcinoma of the Head and Neck
In a phase III trial reported in the Journal of Clinical Oncology, Harrington et al found that the addition of concurrent adjuvant lapatinib (Tykerb) to chemoradiation therapy and the use of maintenance lapatinib did not improve disease-free or overall survival in high-risk patients with resected...
Similar Low Incidence of Bowel Symptoms With Hypofractionated vs Conventionally Fractionated Radiotherapy in Localized Prostate Cancer
As reported by Wilkins et al in The Lancet Oncology, 2-year patient-reported outcomes in a UK phase III trial (CHHiP) substudy have shown a similar low incidence of bowel problems among patients with intermediate-risk localized prostate cancer receiving hypofractionated vs conventionally...
Removal of Complex Renal Tumors Performed Safely by Robotic Surgery in Selected Patients
Renal cell carcinoma can sometimes spread to the inferior vena cava, posing a threat to the heart and brain. Robotic nephrectomy for inferior vena cava tumor thrombus has favorable outcomes in selected patients compared with open surgery, which can have a high rate of complications, reported Abaza...
A Brain Tumor Diagnosis Has Taken My Life in New Directions
The first sign that I could have a life-threatening illness was a bout of severe dizziness, which sent me first to a general practitioner for a physical examination and then to an ear specialist for more tests. At just 24 and in excellent health, the sudden onset of dizziness didn’t initially set...
New AJCC Precision Medicine Guidelines Aimed at Improving Personalized Cancer Treatment Plans for Patients
A committee of national experts, led by a Cleveland Clinic researcher, has established first-of-its-kind guidelines to promote more accurate and individualized cancer predictions, guiding more precise treatment and leading to improved patient survival rates and outcomes. These guidelines were...
Misconstrued Review
I’ve been a member of ASCO for longer than I can remember. I read most breast cancer–related articles in The ASCO Post and find them helpful, particularly the reports of as-yet-unpublished papers from meetings. So, it is with great disappointment that, in the November 10, 2015, issue, I read a...
Selected Abstracts From 2015 ASH Annual Meeting: Part 2
Here are several more abstracts selected from the proceedings of the 2015 American Society of Hematology (ASH) Annual Meeting and Exposition, highlighting therapeutics in acute leukemias and myelodysplastic syndromes. For five other top abstracts on therapies for acute leukemias and myelodysplastic ...
Expanded Approval of Pembrolizumab in Unresectable or Metastatic Melanoma
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 December 18, 2015, approval of the programmed cell death...
Transcription Factor CDX2 May Be Prognostic Biomarker in Stage II and III Colon Cancer
In a study reported in The New England Journal of Medicine, Dalerba et al found that absence of the transcription factor CDX2, although prognostic for poor outcome in stage II and III colon cancer vs cancers with CDX2 expression, identified a subgroup of high-risk patients who appeared to benefit...
Increased Survival and Toxicity With Docetaxel, No Apparent Benefit of Zoledronic Acid in Prostate Cancer
As reported in The Lancet by James et al, results of the STAMPEDE trial, which used a multiarm, multistage seamless phase II/III design, showed increased survival and toxicity with docetaxel and little benefit of zoledronic acid when added to first-line long-term hormone therapy in patients with...
Superior Long-Term Outcomes Linked to Axillary Pathologic Complete Response After Chemotherapy for Breast Cancer
In an analysis of experience at MD Anderson Cancer Center reported in JAMA Oncology, Mougalian et al found that 10-year overall and relapse-free survival rates in patients with stage II or III breast cancer and axillary metastases receiving primary systemic chemotherapy were higher in those with vs ...
Comparing Recurrence Risk With Anastrozole vs Tamoxifen in Postmenopausal Women With Ductal Carcinoma in Situ
Two recently reported phase III trials compared adjuvant anastrozole vs tamoxifen in postmenopausal women with hormone receptor–positive ductal carcinoma in situ. As reported in The Lancet by Margolese et al,1 the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-35 trial, performed in...
Dose-Intensified vs Standard Salvage Radiation for Biochemically Recurrent Prostate Cancer After Prostatectomy
Initial results of a European phase III trial (SAKK 09/10), reported in the Journal of Clinical Oncology by Ghadjar et al of the Swiss Group for Clinical Cancer Research, showed little difference in acute toxicity with salvage radiotherapy of 70 vs 64 Gy in patients with biochemical recurrence of...
Neoadjuvant HER2 Inhibitor Therapy and Effect of Molecular Heterogeneity on Response in HER2-Positive Breast Cancer
In the phase III CALGB 40601 trial, reported in the Journal of Clinical Oncology by Lisa A. Carey, MD, of University of North Carolina at Chapel Hill, and colleagues, pathologic complete response rate was not significantly increased by adding neoadjuvant trastuzumab (Herceptin) plus lapatinib...
High Rate of Local Control Reported With High-Dose Hypofractionated Proton Beam Therapy in Liver Cancers
High-dose hypofractionated proton beam therapy produced a high rate of local control in patients with localized unresectable hepatocellular carcinoma or intrahepatic cholangiocarcinoma, according to a phase II study reported in the Journal of Clinical Oncology by Hong et al. Study Details In the...
Dr. Abraham’s Top-10 Picks for the Most Clinically Relevant Breast Cancer Studies of 2015
Sparano JA, Gray RJ, Makower DF, et al: Prospective validation of a 21-gene expression assay in breast cancer. N Engl J Med 373:2005-2014, 2015. Chagpar AB, Killelea BK, Tsangaris TN, et al: A randomized, controlled trial of cavity shave margins in breast cancer. N Engl J Med 373:503-510, 2015....
Selected Abstracts From 2015 San Antonio Breast Cancer Symposium
The 2015 San Antonio Breast Cancer Symposium (SABCS), hosted by the American Association for Cancer Research, the Cancer Therapy & Research Center at The University of Texas Health Sciences Center at San Antonio, and Baylor College of Medicine, was held in December 2015. As has been true for...
Studies Confirm and Extend the Benefits of Ixazomib in Multiple Myeloma
Patients with multiple myeloma now have access to an all-oral regimen, with the recent approval of the oral proteasome inhibitor ixazomib (Ninlaro) in previously treated patients. New pairings for the drug in relapsed/refractory and newly diagnosed patients are being studied, with investigators...
Expert Point of View: William Y. Kim, MD
Formal discussant of this trial William Y. Kim, MD, of the University of North Carolina’s Lineberger Comprehensive Cancer Center, Chapel Hill, commented on the fact that the IMvigor study had a substantial number of patients compared with other phase II trials in bladder cancer. “This trial was not ...
Improved Outcomes in Patients With Germ Cell Testicular Tumors in the Modern Era
Although patients with poor-risk metastatic testicular germ cell tumors continue to have less favorable outcomes, the bar has been raised by contemporary treatment. There is still room for improvement in managing metastatic testicular germ cell tumors, especially in poor-risk patients, but if...
'Doctor, We Prayed for You'
A 70-year-old female patient underwent a cardiac procedure to repair her mitral valve, and at the same time, she also underwent a coronary artery bypass grafting. She had an uneventful course for the first four postoperative days. On the sixth postoperative day, she started complaining of abdominal ...
