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colorectal cancer

Cetuximab Confers Survival Benefit in All-RAS Wild-Type Colorectal Tumors

The FIRE-3 study compared the two epidermal growth factor receptor (EGFR) antibodies, on top of chemotherapy, in the first-line treatment of metastatic colorectal cancer. A preplanned analysis of KRAS wild-type patients without RAS mutations, ie, “all-RAS wild-type,” showed overall survival to be...

colorectal cancer

Time to Think Beyond KRAS in Metastatic Colorectal Cancer

Eric Van Cutsem, MD, PhD, Professor of Internal Medicine at the University of Leuven in Belgium, told attendees at the 2013 European Cancer Congress that in the management of metastatic colorectal cancer, it is time to expand KRAS testing to include more rare mutations. Until recently, KRAS status...

Expert Point of View: David Sebag-Montefiore, MD

David Sebag-Montefiore, MD, Professor of Clinical Oncology at the University of Leeds and St. James’s Institute of Oncology in the United Kingdom, was the invited discussant of the PROCTOR/SCRIPT study. He noted that in this 470-patient study, the disease-free and overall survival hazard ratios...

colorectal cancer

In Operable Rectal Cancer, No Support Found for Adjuvant Chemotherapy 

For patients with operable rectal cancer, there is no clear role for adjuvant chemotherapy, according to an analysis of the PROCTOR and SCRIPT trials from the Dutch Colorectal Cancer Group. The findings were presented by Anne J. Breugom, MD, of Leiden University Medical Center in the Netherlands,...

skin cancer

Metastatic Melanoma: Encouraging Data Keep Coming 

Excitement continues to build in the metastatic melanoma arena, as novel agents keep upping the ante for efficacy. The following news from the 2013 European Cancer Congress has added to the buzz. New MEK Inhibitor In the phase IB BRIM7 study, cobimetinib, a novel MEK inhibitor, when combined with...

lymphoma

Brentuximab Vedotin Improves Response Rates to ABVD in Hodgkin Lymphoma

For the front-line treatment of advanced Hodgkin lymphoma, ABVD is a standard treatment, but not all patients have good outcomes with this regimen. The addition of brentuximab vedotin (Adcetris), or its substitution for bleomycin, produces high complete response rates but with a moderate increase...

breast cancer

Response-Guided Neoadjuvant Therapy for Breast Cancer: A Promising Model Warranting Additional Investigation 

GeparTrio was an innovative phase III trial conducted by the German Breast Group, enrolling over 2,000 women with early breast cancer who were candidates for neoadjuvant chemotherapy. Patients with evidence of early response, defined as reduction in clinical tumor size by 50% or more, following two ...

integrative oncology

The Best of SIO

The following four abstracts, which describe findings in three clinical studies and one basic science study, were singled out as the top abstracts at this year’s International Conference of the Society for Integrative Oncology. Self-Administered Acupressure Zick S, Wyatt G, Murphy S; et al: The...

health-care policy

National Cancer Policy Summit: Setting Priorities for the Next 3 Years

Welcome to the meeting we hold every 3 years to choose our next projects,” said John Mendelsohn, MD, Chair of the National Cancer Policy Forum and Director of the Khalifa Institute for Personalized Cancer Therapy at The University of Texas M.D. Anderson Cancer Center, Houston. “We have here a...

issues in oncology

Oncology Drug Dosing: Can an Optimal Dose Be Fine-Tuned for Each Patient?

ASCO Chief Medical Officer Richard L. Schilsky, MD, and other oncology drug experts presented a panel on drug dosing at a recent meeting, cosponsored by the Friends of Cancer Research and the Brookings Institution, in Washington, DC.1 The presentations made it clear that issues surrounding drug...

lung cancer

No Apparent Benefit of Adjuvant Gefitinib in Resected NSCLC in Prematurely Closed Trial

As reported in Journal of Clinical Oncology by Glenwood D. Goss, MD, of the Ottawa Hospital Cancer Center, and colleagues, the prematurely closed NCIC CTG BR19 study showed no apparent survival benefit of adjuvant gefitinib (Iressa, withdrawn from U.S. market) vs placebo in patients with completely ...

prostate cancer

Correctly Assessing Pain Progression and Quality-of-Life Deterioration in Metastatic Castration-Resistant Prostate Cancer

The therapeutic landscape for the treatment of castration-resistant prostate cancer has changed dramatically in the past 4 years, as five new agents affecting different aspects of the malignant process were proven to prolong life. The results are a great benefit to patients, but at the same time...

prostate cancer

Adding Abiraterone to Prednisone Significantly Prolongs Time to Pain Progression in Chemotherapy-Naive Men With Metastatic Castration-Resistant Prostate Cancer

An interim analysis of the COU-AA-302 phase III trial in asymptomatic or mildly symptomatic chemotherapy-naive men with metastatic castration-resistant prostate cancer showed that the addition of abiraterone (Zytiga) to prednisone significantly delayed radiographic progression and improved overall...

breast cancer

Similar High Complete Response Rate With Neoadjuvant Trastuzumab, Lapatinib, and Combined Therapy in HER2-Positive Breast Cancer

In a phase III trial (NSABP B-41) performed to assess the potential benefit of neoadjuvant dual HER2 blockade in HER2-positive breast cancer, André Robidoux, MD, of Centre Hospitalier de l’Université de Montréal, and colleagues in the National Surgical Adjuvant Breast and Bowel Project (NSABP)...

breast cancer

Long-Term Follow-up of the HERA Trial Shows No Benefit of 2 Years vs 1 Year of Trastuzumab in Early Breast Cancer 

As reported in The Lancet by Aron Goldhirsch, MD, of the European Institute of Oncology in Milan, Italy, and colleagues from the Breast International Group (BIG), the comparison of 1 vs 2 years of trastuzumab (Herceptin) in patients with HER2-positive early breast cancer in the phase III HERA trial ...

breast cancer

Breast Cancer Vaccines for Primary Prevention Move Toward Clinical Use

The first candidate vaccine to prevent recurrence of breast cancer entered clinical trials about 8 years ago, and since then, the idea of a vaccine for secondary prevention has gained traction; more such vaccines are now in development. But this fall, it was vaccines for primary prevention that had ...

multiple myeloma

Treating Earlier to Avoid Progression to Multiple Myeloma 

With an expanded list of drugs to treat multiple myeloma, experts are interested in whether treating precursor diseases to multiple myeloma can prevent progression to full-blown myeloma. In addition, new drugs are entering the armamentarium for treating multiple myeloma, noted Ruben Niesvizky, MD,...

neuroendocrine tumors

Extended-Release Lanreotide Significantly Delays Disease Progression in Patients With Neuroendocrine Tumors in Large Phase III CLARINET Trial

A strong antiproliferative response was shown for the somatostatin analog lanreotide (subcutaneous, extended-release formulation, Somatuline Autogel [Somatuline Depot in the United States]) in patients with gastroenteropancreatic neuroendocrine tumors, in the large multinational prospective phase...

breast cancer

PIK3CA-Mutant Tumors Not Likely to Respond to Neoadjuvant HER2 Blockade

In early breast cancer patients receiving anti-HER2 therapy in the NeoALTTO trial, mutations in PIK3CA were associated with lower rates of pathologic complete response, according to a study reported at the 2013 European Cancer Congress by José Baselga, MD, Physician-in-Chief at Memorial...

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....

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