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lymphoma

Autologous Transplantation as Consolidation Improves Progression-Free Survival in Aggressive Non-Hodgkin Lymphoma

The strategy of autologous stem-cell transplantation as consolidation in high-intermediate– or high-risk diffuse aggressive non-Hodgkin lymphoma (NHL) has not been specifically examined in the rituximab (Rituxan) era. In the phase III Southwest Oncology Group (SWOG)-led intergroup 9704 trial...

issues in oncology

Consent Is Informed and Shared, But Is It Compassionate?

A 72-year-old, obese male patient and a poor operative candidate is diagnosed with esophageal carcinoma. He has multiple comorbidities and a past history of colon carcinoma. His staging workup, which included a colonoscopy, revealed recurrent colon carcinoma. Thus, we have a patient who we...

colorectal cancer

Call for Expanded Genetic Profiling in Colorectal Cancer

Testing for codons 12 and 13 on the KRAS gene and BRAF testing can predict whether patients with colorectal cancer will respond to anti–epidermal growth factor receptor (EGFR) therapies. However, genetic alterations not captured by testing for KRAS codon 12 and 13 mutations may play an important...

gynecologic cancers

Using Hyperthermia for Cancer Treatment: Proofs, Promises, and Uncertainties

With the headline, “Rare Cancer Treatments, Cleared by F.D.A. but Not Subject to Scrutiny,” a recent article in The New York Times reported that several medical centers were treating patients with cancer using a hyperthermia system that had received a Humanitarian Use Device approval from the U.S....

issues in oncology

Developing Intermediate Endpoints in Immunotherapy

“The immune system holds tremendous potential for long-term sustained antitumor activity,” said James P. Allison, PhD, Immunology Chair, The University of Texas MD Anderson Cancer Center, Houston, as he opened a panel discussion at a meeting cosponsored by the Friends of Cancer Research and the...

lung cancer

Activation of Innovative Lung Cancer Master Protocol Officially Announced, Enrollment to Begin in March

At a recent meeting in Washington, DC, Friends of Cancer Research and the Engelberg Center for Health Care Reform at the Brookings Institution officially announced activation of the Lung Cancer Master Protocol, a new research strategy that has the potential to hurdle or bypass known clinical trial...

lung cancer

Adjuvant Gefitinib in Patients With NSCLC: Bad Idea or Wrong Patient Selection?

Despite optimal surgical resection and adjuvant chemotherapy with cisplatin-based doublets, the 5-year overall survival for patients with early-stage non–small cell lung cancer (NSCLC) remains suboptimal. In the International Association for the Study of Lung Cancer (IASLC) staging project, the...

issues in oncology

Overcoming Drug Development Challenges in the New Era of Cancer Care

While the last 15 years have brought unprecedented advances in oncology drug development, the next 10 years promise to usher in even greater opportunities to realize the goal of precision medicine in the treatment of cancer, providing patients with more effective care and better outcomes. Reaching...

thyroid cancer

Sorafenib in Differentiated Thyroid Carcinoma

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. New Indication On November 22, 2013, sorafenib (Nexavar) was...

prostate cancer

Inhibition of LAT Transporters and Leucine Uptake: A Step Forward for Therapeutic Strategies in Prostate Cancer  

The seminal study by Wang and colleagues reported in the Journal of the National Cancer Institute1 and reviewed in this issue of The ASCO Post suggests a potential new therapeutic option in the treatment of advanced prostate cancer. The authors draw attention to the reliance of cancer cells on...

breast cancer
colorectal cancer
lung cancer
prostate cancer

Ongoing NCI-Funded Clinical Trials Actively Recruiting Patients With Advanced Cancer

This issue of The ASCO Post launches a Clinical Trials Resource Guide to increase awareness of NCI-funded phase I, II, and III clinical studies for your patients with advanced cancer. All of the studies are listed on the National Institutes of Health website at ClinicalTrials.gov. The clinical...

breast cancer

Cautious Comments on the TARGIT-A Trial

Numerous randomized trials have demonstrated that whole-breast irradiation plays an important role after breast-conserving surgery for invasive breast cancer. A recent meta-analysis of these trials indicated that whole-breast irradiation decreased the risk of total breast cancer relapse events and...

lung cancer

Molecularly Targeted Therapy for Lung Cancer

INSIDE THE BLACK BOX is an occasional column offering insight into the FDA and its policies and procedures. This installment addresses a changing paradigm in the treatment of lung cancer, exemplified by concurrent approval of a companion diagnostic with each of several new targeted agents or new...

multiple myeloma

IFM 2005-02 Update Differs From CALGB 100104: Why? 

The updated analysis of the Intergroupe Francophone du Myelome (IFM) 2005-02 trial in newly diagnosed multiple myeloma patients showed that lenalidomide (Revlimid) maintenance prolongs progression-free survival after stem cell transplantation, but does not improve overall survival, according to...

multiple myeloma

Surprising Findings for Lenalidomide Maintenance in Updated IFM 2005-02 Analysis 

A new analysis of the multiple myeloma Intergroupe Francophone du Myelome (IFM) 2005-02 trial showed that lenalidomide (Revlimid) maintenance prolongs progression-free survival after stem cell transplantation, but does not improve overall survival.1 This is possibly attributed to the shorter...

kidney cancer

Tivozanib Improves Progression-Free but Not Overall Survival vs Sorafenib in Metastatic Renal Cell Carcinoma

The investigational agent tivozanib is a selective tyrosine kinase inhibitor of vascular endothelial growth factor receptor (VEGFR)-1, -2, and -3. In a phase III trial reported in the Journal of Clinical Oncology by Robert J. Motzer, MD, of Memorial Sloan-Kettering Cancer Center (MSKCC), and...

breast cancer

Seven Studies at SABCS Make Dr. Jame Abraham's List of 'Practice-Changing' Talks

From December 10 to 14, 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 once again hosted the San Antonio Breast Cancer Symposium (SABCS), presenting...

Expert Point of View: Joseph R. Mikhael, MD

These are exciting data from the head-to-head phase III comparison of MPT [melphalan, prednisone, and thalidomide (Thalomid)], a globally accepted standard of care, to the novel combination of lenalidomide/low-dose dexamethasone in newly diagnosed multiple myeloma patients ineligible for...

multiple myeloma

Continuous Lenalidomide/Low-Dose Dexamethasone: A New Option for Older Patients With Newly Diagnosed Myeloma 

First-line treatment of newly diagnosed multiple myeloma using the Rd regimen (continuous lenalidomide [Revlimid] plus low-dose dexamethasone) was superior to standard triplet treatment with MPT (melphalan, prednisone, and thalidomide [Thalomid]) for 72 weeks, according to initial results of the...

breast cancer

Final Overall Survival Data Show Better Results With Higher Dose of Fulvestrant

Among patients with locally advanced or metastatic estrogen receptor–positive breast cancer, fulvestrant (Faslodex) given at 500 mg “is associated with a 19% reduction in risk of death and a 4.1-month difference in median overall survival compared with fulvestrant 250 mg,” according to final...

Texas Children’s Hospital Announces New Chief of Interventional Radiology

The Department of Pediatric Radiology at Texas Children’s Hospital recently announced that Kamlesh U. Kukreja, MD, has been named the new Chief of Interventional Radiology. Dr. Kukreja has also been appointed as Assistant Professor of Radiology at Baylor College of Medicine. “For more than a...

cns cancers

An Overview of the REGAL Trial and Anti-VEGF Therapies in Recurrent Glioblastoma

As published in the Journal of Clinical Oncology by Batchelor and colleagues1 and reviewed in a recent issue of The ASCO Post (November 15, 2013, page 106), the REGAL trial was a randomized, phase III, placebo-controlled, partially blinded trial evaluating the efficacy of cediranib, an...

skin cancer

FDA Approves Combination Therapy for Unresectable or Metastatic Melanoma With BRAF V600E/K Mutations

The U.S. Food and Drug Administration (FDA) has approved trametinib (Mekinist) for use in combination with dabrafenib (Tafinlar) for the treatment of patients with unresectable melanoma or metastatic melanoma with BRAF V600E or V600K mutations. These mutations must be detected by an FDA-approved...

breast cancer

Drugging PI3K in Breast Cancer: Findings From SABCS 2013

Components of the phosphatidylinositide 3-kinase/mammalian target of rapamycin (PI3K/mTOR) pathway are deregulated in many human cancers, with about 30% of breast cancers harboring PIK3CA gene mutations. Emerging research shows that these mutations may render estrogen receptor alpha-positive tumors ...

issues in oncology

Cancer Genes, Promiscuity, and the National Debt

There is no doubt that this is a halcyon period in oncology. The unraveling of the genome has been tremendously important, and finally has helped us to move treatment selection from an era of rational empiricism to one of refined, molecular prognostication. In the care of breast cancer, the impact...

breast cancer

Addition of Carboplatin to Standard Neoadjuvant Chemotherapy in Triple-Negative Breast Cancer Supported by SABCS Studies

The achievement of a pathologic complete response in patients with triple-negative breast cancer was boosted by the addition of carboplatin to a standard neoadjuvant chemotherapy regimen, and by the addition of veliparib, an investigational oral PARP inhibitor, plus carboplatin to a standard...

leukemia

In CLL With Coexisting Conditions, Chlorambucil Produces Better Outcomes With Obinutuzumab Than With Rituximab

A randomized phase III trial conducted in 26 countries found that combining chlorambucil (Leukeran) with an anti-CD20 antibody—either obinutuzumab (Gazya) or rituximab (Rituxan)—produced better outcomes among patients with previously untreated chronic lymphocytic leukemia (CLL) and coexisting...

colorectal cancer
gynecologic cancers
issues in oncology
survivorship

Nothing Prepared Me for Cancer

Fourteen years ago, when I was just 29, I was feeling weak and fatigued and had severe pain in my abdomen. I’d had these symptoms for about a year, but none of the several doctors I saw or any of the tests they performed could find the source of my problems. I even had one nurse practitioner tell...

pancreatic cancer

University of Pittsburgh Researchers Awarded More than $1 Million by NIH to Study New Treatments for Pancreatic Cancer Patients

The National Institutes of Health (NIH) has awarded a 5-year grant of more than $1.5 million to Herbert J. Zeh III, MD, and Michael T. Lotze, MD, at the University of Pittsburgh Cancer Institute (UPCI), partner with UPMC CancerCenter, to study a novel treatment for pancreatic ductal ...

lymphoma

Ibrutinib Induces Prompt and Durable Responses in Some Lymphomas

The Bruton’s tyrosine kinase inhibitor ibrutinib (Imbruvica) is changing the landscape of treatment in chronic lymphocytic leukemia. New research with the drug in lymphoma, presented at the 2013 American Society of Hematology (ASH) Annual Meeting in New Orleans, indicates it may be of benefit in...

lymphoma

ASH Studies Confirm Benefit of Rituximab Maintenance in Follicular Lymphoma

Findings from two major studies presented at the 2013 American Society of Hematology Annual Meeting not only confirm the benefit of rituximab (Rituxan) maintenance in follicular lymphoma, but also indicate that the longer the maintenance period, the greater the impact on progression-free survival....

multiple myeloma

ASH Studies Refine Myeloma Treatment and Show Promise for New Agents

Multiple myeloma researchers moved the field forward at the 2013 American Society of Hematology (ASH) Annual Meeting, presenting evaluations of treatment schedules and reports of encouraging activity with compounds in development. Alternating vs Sequential Regimens In 231 newly diagnosed elderly...

breast cancer

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

Elevated circulating tumor cells were prognostic for survival but did not pan out as a marker for switching after one cycle of chemotherapy in patients with metastatic breast cancer. The phase III Southwest Oncology Group (SWOG) S0500 clinical trial, presented at the 2013 San Antonio Breast Cancer...

breast cancer

Addition of Novel Antiangiogenic Agent of No Benefit in Metastatic Breast Cancer

Ramucirumab added to first-line docetaxel failed to improve progression-free survival in patients with metastatic breast cancer in the large, randomized, placebo-controlled ROSE/TRIO-12 trial.1 An interim analysis of overall survival showed no advantage for the addition of ramucirumab. This study,...

breast cancer

SABCS Highlights Include Findings in Triple-Negative Disease, Protective Effects of Exercise, and the Adherence-Copay Link

The San Antonio Breast Cancer Symposium brings together specialists from all over the world who focus on management of breast cancer. We have covered many of the important presentations in the pages of The ASCO Post and in our online Evening News. Below are summaries of additional noteworthy...

colorectal cancer

Maintenance Treatment With Capecitabine and Bevacizumab Is Effective in Metastatic Colorectal Cancer

In patients with metastatic colorectal cancer, maintenance treatment with capecitabine plus bevacizumab (Avastin) after induction treatment with capecitabine, oxaliplatin, and bevacizumab (CAPOX-B) significantly delayed disease progression, compared to observation, according to the final results of ...

gastrointestinal cancer

Ramucirumab Plus Paclitaxel Improves Overall Survival After First Progression in Metastatic Gastric Cancer

In the global phase III RAINBOW trial in patients with metastatic gastric cancer, the investigational monoclonal antibody ramucirumab significantly improved both progression-free and overall survival, when added to paclitaxel in second-line therapy, as reported at the 2014 Gastrointestinal Cancers...

lymphoma

R-GCVP Regimen for Patients With Diffuse Large B-Cell Lymphoma and Cardiac Comorbidity

For patients with diffuse large B-cell lymphoma (DLBCL) who are unable to receive anthracycline-containing chemoimmunotherapy because of cardiac comorbidity, a regimen of rituximab (Rituxan), gemcitabine, cyclophosphamide, vincristine, and prednisolone (R-GCVP) “is an active, reasonably...

lung cancer

Nintedanib Combined With Docetaxel Is Effective Second-Line Option for Advanced NSCLC

The combination of nintedanib and docetaxel “is an effective second-line option” for patients with advanced non–small cell lung cancer (NSCLC) who have received previous treatment with one line of platinum-based therapy, according to results from the phase III LUME-Lung 1 study published in The...

leukemia

Encouraging Early Results With Novel Agents in CLL

Two novel agents have shown promising activity in chronic lymphocytic leukemia (CLL), including poor-risk patients: the Bcl-2 inhibitor ABT-199 and the small-molecule PI3K inhibitor IPI-145. Both drugs achieved excellent response rates in heavily pretreated relapsed/refractory patients including...

breast cancer

Innovative I-SPY 2 Trial Yields First Results in Triple-Negative Breast Cancer

An innovative approach to streamlining the testing of novel agents in breast cancer has yielded some of its first results, which were reported at the 2013 San Antonio Breast Cancer Symposium.1 Adaptive Trial Design The veliparib/carboplatin plus standard neoadjuvant therapy regimen is currently...

colorectal cancer
pancreatic cancer

GI Symposium Presentations Include Important Updates in Treatment and Prognosis of Pancreatic and Colorectal Cancers

More than 650 studies were presented at the 2014 Gastrointestinal Cancers Symposium, which attracted a multidisciplinary group of more than 3,500 medical, surgical, and radiation oncologists and gastroenterologists. The following briefs highlight a handful of noteworthy studies from the meeting....

colorectal cancer

Capecitabine Acceptable in Neoadjuvant Rectal Cancer Setting

As neoadjuvant therapy for rectal cancer, infusional fluorouracil (5-FU) and oral capecitabine achieve similar outcomes, and the addition of oxaliplatin confers no additional benefit, according to the mature results of the National Surgical Adjuvant Breast and Bowel Project (NSABP) R-04 trial,...

Expert Point of View: Josep M. Llovet, MD

Josep M. Llovet, MD, Professor of Medicine at Mount Sinai Hospital, New York, commented on the findings reported by Faivre et al for The ASCO Post. “This is the first time a TGF-β inhibitor has been clinically tested in hepatocellular carcinoma, and the drug has a good safety profile. But this is a ...

colorectal cancer

Irinotecan Drug-Eluting Beads Improve Outcomes in Colorectal Cancer Patients With Liver Metastases

Irinotecan drug-eluting beads (DEBIRI) given simultaneously with FOLFOX (leucovorin, fluorouracil, oxaliplatin) and bevacizumab (Avastin) in patients with unresectable colorectal liver metastasis improved response rates, increased resectability, and prolonged hepatic progression–free survival in a...

prostate cancer

Long-Term Safety Data on Radium-223 in Prostate Cancer Reassuring

Long-term follow-up of the ALSYMPCA trial showed that radium Ra 223 dichloride (Xofigo) is extremely safe and active in men with castration-resistant prostate cancer and bone metastases. A snapshot of safety data from about 1.5 years after patients’ final radium-223 injection shows minimal...

kidney cancer

Sequencing Sorafenib and Sunitinib in Either Order Does Not Affect Survival in Metastatic Renal Cell Carcinoma

The explosion of new therapies for metastatic renal cell carcinoma is a welcome advance, but studies have not yet defined optimal sequencing of the newer therapies. According to the phase III SWITCH trial, it matters little whether therapy for metastatic renal cell carcinoma begins with sorafenib...

kidney cancer

Cytoreductive Nephrectomy Improves Survival in Metastatic Renal Cell Carcinoma Patients With Longer Life Expectancy

Prior to the advent of targeted therapy, cytoreductive nephrectomy was associated with a 6-month improvement in overall survival in patients with metastatic renal cell carcinoma. With new and better targeted therapies for the disease, the appropriate use of cytoreductive nephrectomy has been...

prostate cancer

PREVAIL Trial Shows Enzalutamide to Be a Promising Option for Metastatic Castration-Resistant Prostate Cancer

Encouraging results of the large phase III PREVAIL trial represent another positive milestone for men with metastatic castration-resistant prostate cancer. Enzalutamide (Xtandi) improved overall survival by 29% and reduced the risk of radiographic progression of disease by 81% in men who had not...

breast cancer
supportive care

Cognitive-Behavioral Therapy Plus Hypnosis Controls Fatigue in Breast Cancer Patients Receiving Radiotherapy

In a study reported in the Journal of Clinical Oncology,1 Guy H. ­Montgomery, PhD, Icahn School of Medicine at Mount Sinai, New York, and colleagues found that an intervention consisting of cognitive-behavioral therapy plus hypnosis produced better control of fatigue than supportive meetings with...

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