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colorectal cancer

No Disease-Free Survival Benefit of Adding Cetuximab to FOLFOX4 in KRAS Exon 2 Wild-Type Resected Stage III Colon Cancer

In an interim analysis of the European phase III PETACC-8 trial reported in The Lancet Oncology, Taieb et al found no disease-free survival or overall survival benefit with the addition of cetuximab (Erbitux) to standard adjuvant FOLFOX4 (oxaliplatin, fluorouracil, leucovorin) therapy in patients...

issues in oncology

High Neutrophil-to-Lymphocyte Ratio Is Associated With Poorer Survival in Solid Tumors Overall and in Individual Cancer Types

In a systematic review and meta-analysis reported in Journal of the National Cancer Institute, Templeton et al found that high neutrophil-to-lymphocyte ratio, a marker of inflammation, is associated with significantly poorer overall survival in solid tumors overall and by individual category. High...

leukemia

Event-Free Survival Benefit, Greater Toxicity of Augmented Postremission Therapy for Children/Young Adults With High-Risk Acute Lymphoblastic Leukemia

In a UK phase III trial (UKALL 2003) reported in The Lancet Oncology, Vora et al found that augmented postremission therapy provided an event-free survival benefit at the cost of increased toxicity in children and young adults with clinical standard- or intermediate-risk but minimal residual...

solid tumors

Phase III Trial Indicates That S-1 Monotherapy Should Remain Standard Treatment of Locally Advanced Gastric Cancer in Japan

The oral fluoropyrimidine S-1 is standard treatment for locally advanced gastric cancer in Japan. In a Japanese phase III trial (SAMIT) in locally advanced disease reported in The Lancet Oncology, Tsuburaya et al found that sequential paclitaxel plus tegafur and uracil or S-1 did not improve...

gastroesophageal cancer

No Overall Survival Improvement but Some Palliative Benefit With Gefitinib vs Placebo in Esophageal Cancer Progressing After Chemotherapy

In what may be the first randomized trial of systemic therapy in this setting, Dutton and colleagues evaluated gefitinib (Iressa) vs placebo in patients with esophageal cancer progressing after chemotherapy. As reported in The Lancet Oncology, the COG trial showed no survival benefit with gefitinib ...

issues in oncology

Oncologist Communication Skills Training Program Effective for Both Oncologists and Patients

In a Japanese study reported in the Journal of Clinical Oncology, Fujimori et al found that an oncologist communication skills training program based on patient preferences in receiving bad news was of benefit to both oncologists and patients. Study Details In the study, 30 oncologists were...

breast cancer

Tumor Microenvironment of Metastasis Score Independently Predicts Distant Metastasis in Estrogen Receptor–Positive/HER2-Negative Breast Cancer

Tumor microenvironment of metastasis (TMEM) consists of direct contact between a macrophage, an endothelial cell, and a tumor cell. In a case-control study reported in the Journal of the National Cancer Institute, Rohan et al found that TMEM score was an independent predictor of distant metastasis...

gynecologic cancers

Adding Antiangiopoietin Agent Trebananib to Paclitaxel Improves Progression-Free Survival in Recurrent Epithelial Ovarian Cancer

Trebananib inhibits angiogenesis by blocking the binding of angiopoietins 1 and 2 to the Tie2 receptor expressed on endothelial cells, a mechanism that differs from VEGF inhibitors and that involves a different signaling pathway. In the phase III TRINOVA-1 trial reported in The Lancet Oncology,...

breast cancer
supportive care

HERA Trial 8-Year Follow-up Shows Low Rate of Trastuzumab-Associated Cardiac Dysfunction

In a study reported in Journal of Clinical Oncology, Azambuja et al found low rates of trastuzumab (Herceptin)-related cardiac dysfunction over a median of 8 years of follow-up in the HERceptin Adjuvant (HERA) trial. The majority of patients with cardiac dysfunction achieved acute recovery. Study...

issues in oncology
head and neck cancer

EPIC Cohort Study: High Thyroglobulin and Low TSH Precede Differentiated Thyroid Cancer, but Neither Can Be Used in Screening

In a study of the association of thyroid-stimulating hormone (TSH), thyroglobulin, and thyroid hormones with risk of differentiated thyroid cancer reported in Journal of the National Cancer Institute, Rinaldi et al found that high thyroglobulin levels can precede thyroid cancer by many years and...

cns cancers

Glioma-Associated Antigen Peptide Vaccination Produces Antigen-Specific T-Cell Response and Clinical Activity in Children With High-Grade Gliomas

In a study reported in the Journal of Clinical Oncology, Pollack et al found antigen-specific immune responses and evidence of clinical activity with glioma-associated antigen (GAA) peptide vaccination in children with newly diagnosed malignant brainstem and nonbrainstem gliomas. Study Details In ...

multiple myeloma

Combined Index Predicts Early Multiple Myeloma Progression-Related Death in Patients Receiving Front-Line Autologous Stem Cell Transplantation

In a European study reported in the Journal of Clinical Oncology, Moreau et al developed and validated a combined index for prognosis in patients with multiple myeloma treated with front-line autologous stem cell transplantation. The index, consisting of high lactate dehydrogenase (LDH) level,...

breast cancer
issues in oncology

Study Finds Changes in Brain Activity in Breast Cancer Patients Receiving Chemotherapy

A small study of 18 patients with breast cancer treated with chemotherapy has found a significant increase in cognitive complaints and significant correlations between these increases and decreases in multitasking-related brain activation. The study by Deprez et al is published in the Journal of...

head and neck cancer

Stage Migration and Dilution of Higher Stages With PET in Head and Neck Cancer in a Managed Care Setting

A study reported in JAMA Otolaryngology-Head & Neck Surgery by VanderWalde and colleagues suggests that increasing use of positron emission tomography (PET) for diagnosis and staging of head and neck cancer has resulted in considerable stage migration characterized by dilution of higher stages...

colorectal cancer
skin cancer

Study Finds Anorectal Melanoma Is Diagnosed at Later Stages and Is Often Misdiagnosed

Anorectal melanoma is a rare malignant neoplasm that has a variable natural history and nonspecific presentation. A review by Hicks et al of 18 patients treated at Johns Hopkins Hospital between October 1991 and August 2012, finds that the cancer tends to be diagnosed at stage II or later and is...

breast cancer

Higher Distant Invasive Breast Cancer Recurrence Risk for HER2-Positive T1b vs T1a Node-Negative Localized Breast Cancer

In a study of data from an integrated health-care delivery system reported in the Journal of Clinical Oncology, Fehrenbacher et al found that patients with T1b node-negative localized breast cancer have a higher risk of distant invasive recurrence than those with T1a disease. Risk was highest among ...

survivorship

Danish Study Shows Increased Risk of Cardiovascular Disease Throughout Life in Survivors of Adolescent and Young Adult Cancer

In a Danish cohort study reported in the Journal of the National Cancer Institute, Rugbjerg and colleagues found that survivors of adolescent and young adult cancer are at increased risk of cardiovascular disease throughout life, with cardiovascular disease profiles differing according to cancer...

breast cancer

Needle Biopsy Underused in the United States, Adversely Affecting Breast Cancer Treatment

In a study reported in the Journal of Clinical Oncology, Eberth et al found that needle biopsy is underused in diagnosis and treatment of breast cancer, with a number of surgeon factors contributing to underuse. The study involved Medicare data from 89,712 patients with breast cancer seen between...

lung cancer

Phase III Trial of Adding Figitumumab to Chemotherapy in Advanced Nonadenocarcinoma NSCLC Stopped Early for Futility and Increased Harm

In the first phase III trial assessing the combination of an insulin-like growth factor 1 receptor (IGF-1R) inhibitor with chemotherapy as first-line treatment for advanced nonadenocarcinoma non–small cell lung cancer (NSCLC), the addition of the fully human immunoglobulin G2 monoclonal...

lung cancer
issues in oncology

NLST Analysis: Lung Screening–Detected Abnormalities Other Than Cancer Result in Smoking Cessation

In a study reported in the Journal of the National Cancer Institute, Tammemägi et al assessed smoking cessation rates among participants undergoing chest x-ray or computed tomography (CT) screening for lung cancer in the National Lung Screening Trial (NLST). Among patients without a subsequent ...

solid tumors

Adding Lapatinib to Paclitaxel Does Not Improve Survival as Second-Line Therapy in Asian Patients With HER2-Positive Advanced Gastric Cancer

Weekly paclitaxel is used as second-line treatment in advanced gastric cancer, including HER2-positive disease, in Asian countries. In the phase III TyTAN trial in Asian patients reported in the Journal of Clinical Oncology, Satoh et al assessed the addition of the anti-HER2 agent lapatinib...

breast cancer
issues in oncology

Modeling Shows Digital vs Film Mammography Screening for Breast Cancer Produces Small Benefit at Increased Cost

A study reported in the Journal of the National Cancer Institute by Stout et al suggests that the switch from film to digital mammography screening in the United States has produced a small health benefit at increased cost and with an increased false-positive rate. Biennial digital screening...

supportive care

MEK Inhibitor Use Associated With Bilateral Subfoveal Neurosensory Retinal Detachment

As reported in JAMA Ophthalmology, McCannel and colleagues identified three cases of subfoveal neurosensory retinal detachment among patients receiving MEK inhibitor therapy for metastatic cancer in clinical trials requiring ophthalmologic examination at their institution. In all cases, the toxic...

prostate cancer

ASCO 2014: Enzalutamide Before Chemotherapy Prolongs Progression-Free and Overall Survival in Metastatic Prostate Cancer

The androgen receptor inhibitor enzalutamide (Xtandi) has been shown to prolong survival in men with metastatic castration-resistant prostate cancer with progressive disease after chemotherapy. In the phase III PREVAIL trial reported in The New England Journal of Medicine, Beer et al found that...

gynecologic cancers
issues in oncology

Greater Progression-Free Survival Benefit of Maintenance Olaparib in BRCA-Mutant Platinum-Sensitive Recurrent Serous Ovarian Cancer

A recently reported phase II trial indicated that maintenance therapy with the PARP inhibitor olaparib significantly improved progression-free survival vs placebo in patients with platinum-sensitive serous ovarian cancer. As reported in The Lancet Oncology by Ledermann et al, a preplanned...

leukemia

First-Line Lenalidomide Plus Rituximab Is Safe and Effective in Older and Younger CLL Patients, Phase II Study Shows

The combination of lenalidomide (Revlimid) and rituximab (Rituxan) has shown synergistic activity in chronic lymphocytic leukemia (CLL) preclinical models. In a CLL Research Consortium phase II study of the combination in treatment-naive patients reported in the Journal of Clinical Oncology, James...

breast cancer

Early Change in Chemotherapy Based on Elevated Circulating Tumor Cells Does Not Improve Outcome in Metastatic Breast Cancer

Elevated circulating tumor cells are associated with poor prognosis in metastatic breast cancer. In the phase III Southwest Oncology Group (SWOG) S0500 trial reported in the Journal of Clinical Oncology, Smerage et al assessed whether changing chemotherapy after one cycle of first-line treatment in ...

breast cancer

Adjuvant! Online Performs Poorly in Older Patients With Breast Cancer in Dutch Study

In a Dutch population-based study reported in The Lancet Oncology, de Glas et al found that the Adjuvant! Online prediction tool performed poorly in older patients with early-stage breast cancer, significantly overestimating or underestimating overall survival depending on comorbidity...

leukemia
issues in oncology

Ibrutinib Resistance Mutations Identified in CLL Patients

Ibrutinib is an irreversible inhibitor of Bruton’s tyrosine kinase that was recently approved for treatment of chronic lymphocytic leukemia (CLL) patients who have received at least one prior therapy. A small proportion of CLL patients have been observed to relapse during ibrutinib treatment, ...

breast cancer
supportive care

Greater Risk of Pretreatment Cognitive Impairment in Older Breast Cancer Patients With More Advanced Disease and Greater Comorbidity

In a study reported in the Journal of Clinical Oncology, Mandelblatt and colleagues attempted to determine whether cognitive impairment is present in older patients with breast cancer prior to systemic therapy. They found that although there were no global differences in cognitive function between...

pancreatic cancer

Central Pancreatectomy for Low-Grade Neoplasms Results in 'Excellent' Pancreatic Function but Substantial Morbidity

The availability of cross-sectional imaging has resulted in increased diagnosis of low-grade pancreatic neoplasms and use of central pancreatectomy as an alternative to standard resection for such lesions. In a French single-center experience reported in JAMA Surgery, Goudard et al found that...

colorectal cancer

No Differences in Surgical Outcomes With Four Different Chemotherapy Regimens Plus Preoperative Radiotherapy in Rectal Cancer

As reported in the Journal of Clinical Oncology by O’Connell et al, the National Surgical Adjuvant Breast and Bowel Project (NSABP) Trial R-04 is assessing four chemotherapy regimens given concurrently with preoperative radiotherapy in order to help identify optimal treatment in patients with ...

colorectal cancer

Korean Trial Shows Similar Disease-Free Survival With Laparoscopic vs Open Surgery in Mid- or Low-Rectal Cancer After Neoadjuvant Chemoradiotherapy

In the noninferiority COREAN trial reported in The Lancet Oncology, Jeong et al found that laparoscopic surgery was associated with disease-free survival similar to that with open surgery for mid- or low-rectal cancer. Study Details In this open-label trial, 340 patients with cT3N0–2M0...

head and neck cancer

Physicians and Patients/Caregivers Frequently Disagree on Medicare Resource Allocations for Patients With Advanced Head and Neck Cancer

In a study reported in JAMA Otolaryngology–Head & Neck Surgery, Rocke et al compared hypothetical resource allocation by otolaryngology–head and neck surgery physicians and patients with that by advanced cancer patients or their caregivers. They found significant differences in...

hepatobiliary cancer

No Apparent Benefit of Adding Cetuximab to Gemcitabine Plus Oxaliplatin in Advanced Biliary Tract Cancer

Gemcitabine plus a platinum agent is standard treatment in advanced biliary cancer. In the phase II open-label noncomparative BINGO trial, reported in The Lancet Oncology, Malka et al found no apparent benefit of adding the EGFR inhibitor cetuximab (Erbitux) to gemcitabine/oxaliplatin in first-line ...

lymphoma

No Apparent Benefit of Rituximab After Lymphoma-Directed Conditioning and Allogeneic Stem Cell Transplantation for Relapsed/Refractory Aggressive NHL

In an open-label phase II trial reported in The Lancet Oncology, Glass et al examined the strategy of adding rituximab (Rituxan) to standard prophylaxis for graft-vs-host disease after allogeneic stem cell transplantation in relapsed or refractory aggressive non-Hodgkin lymphoma. Rituximab did not...

lung cancer

No Progression-Free or Overall Survival Benefit With Second- or Third-Line Erlotinib vs Docetaxel in EGFR-Unselected Japanese NSCLC Patients

In a Japanese phase III trial (DELTA) reported in the Journal of Clinical Oncology, Kawaguchi et al found that erlotinib (Tarceva) was associated with no progression-free survival or overall survival advantage as second- or third-line therapy in EGFR-unselected patients with non–small cell...

breast cancer

Circulating Tumor Cells Predict Disease-Free Survival and Overall Survival in Patients With Early Average- to High-Risk Breast Cancer

Although presence of circulating tumor cells has been shown to predict reduced survival in metastatic breast cancer, data on their predictive performance in earlier breast cancer are lacking. In a study reported in the Journal of the National Cancer Institute, Rack et al found that presence of...

breast cancer
issues in oncology

Percentage Dense Area Stronger Than Absolute Dense Area as Mammography Risk Factor for Breast Cancer

In a meta-analysis reported in the Journal of the National Cancer Institute, Pettersson et al found that percentage dense area on breast mammography is a stronger predictor of breast cancer than absolute dense area. An inverse association of absolute nondense area and risk was also observed. The...

leukemia

No Overall Survival Improvement With Elacytarabine vs Investigator Choice in Patients With Relapsed/Refractory AML

Current treatment options for relapsed/refractory acute myeloid leukemia (AML), which carries a very poor prognosis, are generally ineffective. In a phase III trial (CLAVELA) reported in the Journal of Clinical Oncology, Roboz et al found that elacytarabine, a novel elaidic acid ester of...

lymphoma

Lenalidomide Plus R-CHOP21 Highly Active in Elderly Patients With Untreated Diffuse Large B-Cell Lymphoma

Lenalidomide (Revlimid) is active in relapsed or refractory aggressive B-cell lymphomas. In a European phase II trial (REAL07) reported in The Lancet Oncology, Vitolo et al examined the addition of lenalidomide to rituximab (Rituxan), cyclophosphamide, doxorubicin, vincristine, and prednisolone...

leukemia
issues in oncology

Mutations Associated With Arsenic Resistance in Acute Promyelocytic Leukemia

In a letter to The New England Journal of Medicine, Zhu et al described identification of resistance mutations in acute promyelocytic leukemia patients receiving arsenic trioxide (Trisenox) and all-trans retinoic acid (ATRA) therapy. The direct-binding targets of arsenic trioxide in the...

lung cancer

Proteomic Signature for EGFR Inhibitor Therapy Predicts Survival Benefit of Second-Line Chemotherapy vs Erlotinib in NSCLC

There are conflicting data on whether epidermal growth factor receptor (EGFR) inhibitor therapy is beneficial in second-line treatment of lung cancer patients with unknown or wild-type EGFR status. In a phase III trial (PROSE) reported in The Lancet Oncology, Gregorc et al assessed the predictive...

hepatobiliary cancer

Insulin-Like Growth Factor-1 Score Improves Assessment of Prognosis in Hepatocellular Carcinoma

In a study reported in the Journal of the National Cancer Institute, Kaseb et al developed a plasma insulin-like growth factor 1 (IGF-1)–based score for hepatic reserve in hepatocellular carcinoma and compared its predictive ability with that of the Child-Turcotte-Pugh (CTP) score in two...

breast cancer

High Expression of Brachyury Associated With Poor Prognosis in Breast Cancer Patients Receiving Adjuvant Tamoxifen

Epithelial-mesenchymal transition plays a key role in tumor cell invasion, metastasis, and drug resistance and the transcription factor brachyury has recently been identified as a driver of this process. In a study reported in the Journal of the National Cancer Institute, Palena et al found that a...

prostate cancer

No Overall Survival Improvement With Ipilimumab After Radiotherapy in Metastatic Castration-Resistant Prostate Cancer Progressing After Docetaxel

In a phase III trial (CA184-043) reported in The Lancet Oncology, Kwon et al assessed the effects of adding ipilimumab (Yervoy) after radiotherapy in patients with metastatic castration-resistant prostate cancer progressing after docetaxel chemotherapy. The investigators found no improvement...

issues in oncology

Low Use of Chemotherapy in Last 14 Days of Life at MD Anderson Cancer Canter

A proposed metric of quality of cancer care is whether chemotherapy is administered in the last 14 days of life. In a retrospective study of patients at The University of Texas MD Anderson Cancer Center reported in JAMA Internal Medicine, Rodriguez et al found an overall rate of chemotherapy use in ...

prostate cancer

Radium-223 Dichloride Significantly Prolongs Time to First Symptomatic Skeletal Event in Patients With Castration-Resistant Prostate Cancer

In an article in The Lancet Oncology, Sartor et al report symptomatic skeletal event outcomes in the phase III ALSYMPCA trial, which was the study supporting the May 2013 approval of radium-233 dichloride (Xofigo) in patients with castration-resistant prostate cancer and bone metastases. They found ...

lung cancer

IASLC/American Thoracic Society/European Respiratory Society Classification of Lung Adenocarcinoma Has Predictive Value for Recurrence and Survival

In a study reported in the Journal of Clinical Oncology, Hung et al assessed the ability of the 2011 International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society (IASLC/ATS/ERS) adenocarcinoma classification system to predict disease recurrence and...

solid tumors
bladder cancer

Accelerated Methotrexate, Vinblastine, Doxorubicin, Cisplatin With Pegfilgrastim Is Effective, Well-Tolerated Neoadjuvant Therapy for Bladder Cancer

Although neoadjuvant cisplatin-based chemotherapy is standard of care for muscle-invasive bladder cancer, it is not widely used due to concerns over toxicity and delayed cystectomy. In a phase II trial reported in the Journal of Clinical Oncology, Plimack et al evaluated whether a neoadjuvant...

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