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hepatobiliary cancer
pancreatic cancer
gastrointestinal cancer

Important Data and Treatment Advances Reported in GIST and in Pancreatic and Liver Cancers 

The 10th annual Gastrointestinal Cancers Symposium, held recently in San Francisco, was jointly sponsored by ASCO, the AGA (American Gastroenterological Association), ASTRO (American Society for Radiation Oncology), and the SSO (Society of Surgical Oncology). “We seek to present the newest...

bladder cancer

Clinical-Pathologic Stage Discrepancy High in Patients with Bladder Cancer Undergoing Surgery 

About 48% of all patients with bladder cancer undergoing radical cystectomy have a discrepancy between their clinical stage and pathologic stage, according to the largest study to date to examine this issue. Upstaging after surgery is associated with reduced survival, while downstaging after...

kidney cancer
prostate cancer

New Findings in Prostate and Kidney Cancers Clarify the Roles of Abiraterone, Finasteride, Bevacizumab, and Surveillance 

Attendees at the 2013 Genitourinary Cancers Symposium in Orlando, Florida, were brought up to date with the latest news on cancers of the prostate, testes, bladder, and kidney. Below are selected highlights from the meeting describing findings of noteworthy abstracts to extend our regular news...

colorectal cancer

Is Aspirin Protective against Colorectal Cancer? 

A growing body of evidence provides biologic and clinical evidence that nonsteroidal anti-inflammatory agents are protective against colorectal cancer. “It is fascinating for me as a medical oncologist and epidemiologist to see how the worlds of colorectal cancer treatment and epidemiology are...

pain management

Duloxetine Reduced Painful Chemotherapy-induced Peripheral Neuropathy  

The use of duloxetine (Cymbalta) for 5 weeks “was associated with a statistically and clinically significant improvement” in painful chemotherapy-induced peripheral neuropathy when compared with placebo in a phase III randomized, double-blind crossover trial reported in the Journal of the American...

leukemia

Bortezomib Added to Standard Induction Therapy Produced Encouraging AML Remission Rate  

Adding bortezomib (Velcade) to standard daunorubicin and cytarabine induction chemotherapy for acute myeloid leukemia (AML) “resulted in an encouraging remission rate” in previously untreated older adults, according to results of Cancer and Leukemia Group B (CALGB/Alliance) study 10502. The...

breast cancer

Progression-free Survival in HER2-positive Metastatic Breast Cancer Improved with T-DM1 

First-line treatment with ado-trastuzumab emtansine (T-DM1) “provided a significant improvement” in progression-free survival when compared to trastuzumab (Herceptin) plus docetaxel in a randomized phase II study among patients with HER2-positive metastatic or recurrent locally advanced breast...

skin cancer

Alopecia a Common but Underreported Side Effect of Endocrine Agents 

At the recent American Academy of Dermatology Annual Meeting in Miami, researchers presented interesting findings regarding melanoma and other skin cancers, as well as dermatologic effects of cancer agents. The following is a summary of one such study. While alopecia is a common side effect of many ...

hematologic malignancies
leukemia

A Promising New Agent's Road to Approval in CLL Raises Questions, Stirs Controversy 

Early trial results in single-agent therapy with the oral Bruton’s tyrosine kinase (BTK) inhibitor ibrutinib have produced excellent responses in patients with chronic lymphocytic leukemia (CLL). Moreover, ibrutinib is extremely well tolerated, allowing patients to remain on trial and receive the...

issues in oncology

Access to Care: Who Gets Referred to a Medical Oncologist and/or Another Cancer Specialist and Who Receives Treatment for Advanced Cancer? 

What factors determine who is referred to a medical oncologist and receives treatment for advanced cancers? Several articles in the Journal of Oncology Practice suggest that factors influencing referral and treatment go beyond the patient’s medical condition and preference and include such details...

SIDEBAR: Prolonged VEGF Inhibition 

The so-called TML (Treatment across Multiple Lines) study reported by Bennouna and colleagues investigated the efficacy of bevacizumab (Avastin) beyond progression from first- to second-line therapy in advanced colorectal cancer, a strategy that was supported by data from observational cohort...

solid tumors
colorectal cancer

Benefit of Continued Antiangiogenic Treatment with Bevacizumab after Progression in Metastatic Colorectal Cancer 

As reported recently in Lancet Oncology by Jaafar Bennouna, MD, of Institut de Cancérologie de l’Ouest, Nantes, France, and colleagues, the phase III ML18147 trial showed a survival benefit with continued bevacizumab (Avastin) treatment after first progression in metastatic colorectal cancer.1 The...

SIDEBAR: The Ethical Imperative of Clinical Equipoise 

In her editorial about the RESONATE trial (page 1), Dr. O’Brien raises the issue of equipoise in this phase III clinical trial that compares the efficacy of ibrutinib and ofatumumab (Arzerra) in patients with relapsed or refractory chronic lymphocytic leukemia (CLL) who are not appropriate...

leukemia

Ibrutinib CLL Trial: Where Is the Equipoise?

The RESONATE trial is randomly assigning patients with refractory or relapsed CLL to either ofatumumab (Arzerra) or the investigational oral agent ibrutinib. Ofatumumab is an anti-CD20 monoclonal antibody like rituximab (Rituxan), but is more potent as a single agent. It was approved for refractory ...

breast cancer

Higher HER2 Expression Linked to Best Results with T-DM1 in Patients with HER2-positive Metastatic Breast Cancer

A biomarker analysis of the pivotal EMILIA trial suggests that women with metastatic HER2-positive breast cancer with tumors that have high expression of HER2 derive the most robust benefit from treatment with the antibody-drug conjugate T-DM1 (also now known as ado-trastuzumab emtansine...

Emil 'Tom' Frei III, MD, Trailblazer in the Development of Combination Chemotherapy, Dies at 89 

The pages of medical history are dog-eared with breakthroughs that have transformed medicine and saved lives. One of those dog-eared pages belongs to Emil Frei III, MD, known to his colleagues and friends as Tom. In the dawn of oncology, Dr. Frei, along with his associate, Emil Freireich, MD, did...

issues in oncology

Ruxolitinib Results in Clinically Meaningful Symptom Improvement 

Patients with myelofibrosis who received ruxolitinib (Jakafi) therapy experienced “meaningful reductions in symptom burden” and improvements in quality of life in a double-blind, placebo-controlled phase III trial published in the Journal of Clinical Oncology. The COMFORT-I (Controlled...

leukemia

High-dose Liposomal Vincristine Produces Durable Responses in Advanced ALL

High-dose monotherapy with vincristine sulfate liposome injection (Marqibo) resulted in meaningful clinical outcomes, including durable responses and bridging to hematopoietic cell transplantation, in adult patients with advanced, relapsed, and refractory Philadelphia chromosome (Ph)-negative acute ...

breast cancer

Exemestane an Adjuvant Option for Postmenopausal Hormone Receptor–positive Breast Cancer

A phase III open-label trial of exemestane vs anastrozole in postmenopausal women with hormone-dependent early breast cancer found that both agents produced similar median rates of event-free survival—91% for exemestane and 91.2% for anastrozole—as well as similar distant disease-free and...

Expect Questions about Experience and Outcomes  

“Patients are becoming more sophisticated in their ability and willingness to interrogate the health-care system about their care,” according to Robert E. Bristow, MD, MBA, lead author of the study finding that many women with ovarian cancer are not receiving care consistent with National...

gynecologic cancers

Most Women with Ovarian Cancer Do Not Get Guideline-specified Treatment Linked to Survival Benefits 

Most women with ovarian cancer are not receiving adequate treatment, as specified in National Comprehensive Cancer Network (NCCN) Guidelines,1 and as a result are being deprived of the survival benefits correlated with guideline-recommended treatment, according to a study presented at the Society...

leukemia

Drug Approvals in Acute Myeloid Leukemia: Can We Do Better? 

Forty years ago, President Richard Nixon announced a “war on cancer.” Some of that war’s first battles were won in the field of acute myeloid leukemia (AML) with two agents, cytarabine and daunorubicin, receiving U.S. Food and Drug Administration (FDA) approval based on their ability to produce...

solid tumors
pancreatic cancer
global cancer care

Oral S-1 Noninferior to Gemcitabine in Advanced Pancreatic Cancer in Japan and Taiwan 

As reported by Hideki Ueno, MD, PhD, of National Cancer Center Hospital, Tokyo, and colleagues in Journal of Clinical Oncology, treatment with the oral fluoropyrimidine derivative S-1 was associated with noninferior overall survival and reduced hematologic toxicity compared with gemcitabine...

gynecologic cancers

Combinatorial Immunologic Approach Yields Benefit in Preliminary Study of Recurrent Ovarian Cancer

A two-step immunologic approach that includes a personalized dendritic cell vaccine for each patient followed by adoptive T-cell therapy holds promise for the treatment of recurrent ovarian cancer, according to results of two consecutive phase I studies presented at the American Association for...

colorectal cancer

Emerging Prognostic Markers in Colon Cancer 

Patients with stage II colon cancer generally have a favorable prognosis, with about 80% of patients surviving 5 years after surgery and the majority of these long-term survivors presumed to be cured. Clearly though, some patients are destined to recur after surgery, and there is an urgent need to...

breast cancer
issues in oncology
survivorship

Breakthroughs in Targeted Therapies for Breast Cancer Are Improving Patient Survival Rates 

For more than 20 years, José Baselga, MD, PhD, has devoted his medical and scientific career to caring for breast cancer patients and the development of novel molecular targeted agents to treat the disease. From 1996 to 2010, he was Head of the Oncology Department of Vall d’Hebron University...

breast cancer

Reducing Incidental Cardiac Irradiation during Breast Radiotherapy  

In the treatment of breast cancer, a wealth of data from prospective clinical trials and meta-analyses has documented the benefits of radiation to prevent local-regional recurrence and improve survival. Accordingly, important quality indicators in breast cancer care include: (1) receipt of...

SIDEBAR: Left-sided Adjuvant Breast Radiotherapy: A Change of Heart? 

Darby and colleagues are to be congratulated for an ambitious population-based case-control study that demonstrates the impact of postoperative adjuvant ionizing radiation for early-stage breast cancer on ischemic heart disease.1 The study examined roughly 1,000 cases and 1,000 controls in Sweden...

lung cancer

New Molecular Testing Guideline for Selection of Lung Cancer Patients for EGFR and ALK Tyrosine Kinase Inhibitor Treatment 

A new guideline for molecular testing to select lung cancer patients for treatment with epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors has been jointly developed by the College of American Pathologists, International Association for the Study ...

NCCN Clinical Practice Guidelines in Oncology: 2013 Updates 

At the 18th Annual Conference of the National Comprehensive Cancer Network (NCCN), representatives of NCCN Guidelines panels presented two new sets of guidelines along with updates for several tumor types, summarized in this issue of The ASCO Post. New NCCN Guidelines for Survivorship “The...

More Recollections on Emil 'Tom' Frei III, MD

I have read with interest the recent tributes to Emil “Tom” Frei III, MD, who passed away in April. I was backstage at the ASCO Annual Meeting in 1981, when Dr. Frei was giving his Karnofsky acceptance address. I had a slide presentation at the combined ASCO/American Association for Cancer Research ...

breast cancer

Black, Asian, and Younger Women at Increased Risk of PTSD after Diagnosis of Localized Breast Cancer 

Nearly one-quarter of women in a large prospective study of racially diverse patients with stage I to III breast cancer reported symptoms consistent with posttraumatic stress disorder (PTSD), with increased risk of PTSD among black, Asian, and younger women. “These potential risk factors can be...

breast cancer
issues in oncology

Some Stage II/III HER2-positive Tumors May Be Treated with Targeted Therapy without Chemotherapy 

Results from a multicenter phase II study of patients with locally advanced HER2-positive breast cancer who receive targeted therapy with trastuzumab (Herceptin) and lapatinib (Tykerb) “support the hypothesis that selected patients with HER2-positive tumors may not need chemotherapy,” investigators ...

solid tumors
colorectal cancer

Smoking Linked to Shorter Disease-free Survival in Stage III Colon Cancer 

According to an analysis reported by Amanda Phipps, PhD, MPH, Assistant Professor of Epidemiology at the University of Washington and Assistant Member at Fred Hutchinson Cancer Research Center, Seattle, and colleagues in the Journal of Clinical Oncology, patients with stage III colon cancer who...

solid tumors
kidney cancer

No Difference in Overall Survival with Axitinib or Sorafenib in Second-line Treatment for Advanced Renal Cell Carcinoma 

The phase III open-label AXIS trial comparing axitinib (Inlyta) vs sorafenib (Nexavar) as second-line treatment for metastatic renal cell carcinoma showed significantly prolonged independent radiology committee–assessed progression-free survival with axitinib treatment (hazard ratio [HR] = 0.665, P ...

lung cancer

Peregrine Pharmaceuticals Reaches Agreement with FDA on Phase III Trial Design for Bavituximab in NSCLC

Peregrine Pharmaceuticals recently announced that it has reached agreement with the U.S. Food and Drug Administration (FDA) on a phase III registration trial design of the company’s lead clinical immunotherapeutic candidate bavituximab in second-line non–small cell lung cancer (NSCLC). The trial...

geriatric oncology
issues in oncology

Improving the Care and Study of Older Patients with Cancer 

Predicting toxicity in older patients receiving chemotherapy is an important clinical problem. It has been shown that standard oncology measures such as performance status are not adequate to predict outcomes in the elderly. Clinical measures that are important in geriatric oncology are not...

solid tumors
colorectal cancer
issues in oncology

Geriatric Factors Predict Severe Toxicity in Elderly Patients on First-line Treatment for Metastatic Colorectal Cancer 

Elderly patients differ with respect to tolerance of therapy for colorectal cancer. In a study reported in Journal of Clinical Oncology, Thomas Aparicio, MD, PhD, of the University of Paris, and colleagues analyzed geriatric factors for potential association with severe toxicity, dose-intensity...

lymphoma

John P. Leonard, MD, Leads NCI's Alliance for Clinical Trials in Oncology Lymphoma Committee

John P. Leonard, MD, a hematology and oncology expert specializing in the treatment of lymphomas at Weill Cornell Medical College, has been named Chair of the Lymphoma Committee for the National Cancer Institute (NCI)-sponsored group, the Alliance for Clinical Trials in Oncology. Dr. Leonard is the ...

issues in oncology

Determining the Best Diet for Patients with Cancer  

How much does diet and body weight influence the effectiveness of cancer treatment and reduce the risk of cancer recurrence? What is the optimal diet for patients with cancer and survivors to follow? There are currently no hard and fast rules, but some dietary clues are starting to emerge. Search...

A New Center for Lymphoid Malignancies Aims to Provide Precision Patient Care  

In January, New York-Presbyterian Hospital/Columbia University Medical Center opened the Center for Lymphoid Malignancies, a 3,700 square foot outpatient clinic, in the heart of Midtown Manhattan. The Center is solely focused on the treatment of all forms of Hodgkin and non-Hodgkin lymphoma,...

hematologic malignancies
leukemia

Potent Activity Shown for First-in-class PI3K-delta Inhibitor in Chronic Lymphocytic Leukemia 

Heavily pretreated patients with chronic lymphocytic leukemia (CLL) responded robustly to the first-in-class small-molecule inhibitor idelalisib (formerly GS1101), in a phase I dose-finding study reported in a press briefing prior to the 2013 ASCO Annual Meeting.1 Idelalisib, a specific inhibitor...

Expert Point of View: Roy S. Herbst, MD, PhD

This study should be placed in the context of treating to cure, said Roy S. Herbst, MD, PhD, Ensign Professor of Medicine and Chief of Medical Oncology at Yale University School of Medicine, New Haven, Connecticut. “If we can further increase the cure rate in stage III non–small cell lung cancer...

solid tumors

Impressive Results Shown for Immune Checkpoint Inhibitors: Anti-PD1 and Anti-PD-L1 Antibodies 

Antibody-mediated blockade of the programmed death 1 protein (PD-1) and its ligand (PD-L1) resulted in potent and durable tumor regression and prolonged stabilization of disease in patients with advanced solid tumors, according to early data on these drugs presented at the 2013 ASCO Annual Meeting. ...

lung cancer

'Less Is More' with Regard to Adjuvant Radiation in Stage III Non–Small Cell Lung Cancer

Standard-dose conformal radiotherapy (60 Gy) is more effective and safer than high-dose radiotherapy (74 Gy) in patients with locally advanced stage III non–small cell lung cancer (NSCLC) undergoing chemotherapy, according to results of the phase III randomized, controlled Radiation Therapy...

palliative care

Caring for the Whole Patient Both during Active Treatment and at End of Life

Despite studies showing that a majority of patients prefer to die at home rather than in an institutional setting,1 in many parts of the country, over 30% die in nursing homes and over 50% die in hospitals, according to Ira Byock, MD, Director of Palliative Medicine, Dartmouth-Hitchcock Medical...

Distinguished Researcher Changed the Face of Hematologic Malignancies

Clara D. Bloomfield, MD, grew up in a steadfastly academic environment that spurned typical children’s entertainment such as comic books or television. Born in New York City during World War II, she moved to Washington, DC, with her family while her father, an expert on labor and industrial...

Emil 'Tom' Frei III, MD 1924–2013

The pages of medical history are dog-eared with breakthroughs that have transformed medicine and saved lives. One of those dog-eared pages belongs to Emil Frei III, MD, known to his colleagues and friends as Tom. In the dawn of oncology, Dr. Frei, along with his associate, Emil Freireich, MD, did...

skin cancer

Dabrafenib for Unresectable or Metastatic Melanoma with BRAF V600E Mutation 

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.  Indication On May 29, 2013, dabrafenib (Tafinlar) was approved for ...

colorectal cancer

Similar Short-term Outcomes with Laparoscopic vs Open Surgery for Rectal Cancer 

As recently reported in Lancet Oncology by Martijn H.G.M. van der Pas, MD, of VU University Medical Center, Amsterdam, and colleagues, the phase III COLOR II trial has shown that laparoscopic surgery can produce similar safety outcomes, resection margins, and completeness of resection compared with ...

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