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head and neck cancer

No Benefit Seen for Cetuximab Added to Cisplatin and Accelerated Radiotherapy in Advanced Head and Neck Carcinoma

Use of cisplatin or cetuximab (Erbitux) with radiotherapy improves overall survival in stage III or IV head and neck carcinoma, and adding cetuximab to platinum therapy improves overall survival in metastatic disease. In the phase III Radiation Therapy Oncology Group (RTOG) 0522 trial reported in...

lymphoma

Beyond R-CHOP for Lymphoma

The R-CHOP regimen (rituximab [Rituxan] plus cyclophosphamide, doxorubicin, vincristine, and prednisone) was a major advance in treating diffuse large B-cell lymphoma, but experts are seeking to up the ante and identify ways to continue to improve outcomes beyond that achieved with R-CHOP. “We are...

multiple myeloma

Experts Debate the Need for Upfront vs Late Stem Cell Transplant in Multiple Myeloma

With powerful new drugs capable of achieving sustained and deep remissions in multiple myeloma, the role of upfront stem cell transplantation is being questioned by experts, who debated the pros and cons at the National Comprehensive Cancer Network (NCCN) 9th Annual Congress on Hematologic...

breast cancer

Variety of Adjuvant Strategies Explored in HER2‑Positive and Other Breast Cancer Types

Adjuvant trastuzumab (Herceptin) was shown to be effective in patients with breast cancers ≤ 2 cm, regardless of estrogen receptor status, in a meta-analysis1 of five chemotherapy trials, but a “pressing question” remaining is whether T1a/b, N0 tumors warrant the use of adjuvant trastuzumab, Andrew ...

breast cancer

For Triple-Negative Breast Cancer, Adding Carboplatin to Anthracycline/Taxane Produces Benefit, but How Much?

Combination chemotherapy for triple-negative breast cancer is anthracycline- and taxane-based and has not really changed much in the past 10 years, but “we are starting to see emerging data with selective activity of platinum agents,” Priyanka ­Sharma, MD, told participants at the Best of ASCO...

prostate cancer

Radiotherapy Should Be Added to Hormone Therapy in Node-Positive Prostate Cancer

Node-positive prostate cancer has typically been excluded from clinical trials, leaving oncologists with little evidence to guide management for this group of patients. A study presented at the European Society for Medical Oncology (ESMO) 2014 Congress sheds light on this issue, providing the...

supportive care

FDA Approves Netupitant and Palonosetron Combination Capsule for Chemotherapy-Induced Nausea and Vomiting

The U.S. Food and Drug Administration (FDA) has approved a combination of netupitant and palonosetron (Akynzeo) to treat nausea and vomiting in patients undergoing cancer chemotherapy. The new drug, also known as NEPA, is a fixed-combination capsule comprised of two agents: oral palonosetron, which ...

lymphoma

FDA Approves Bortezomib Injection for Previously Untreated Patients With Mantle Cell Lymphoma

The U.S. Food and Drug Administration (FDA) has approved bortezomib (Velcade) injection for previously untreated patients with mantle cell lymphoma. This is the first treatment in the United States to be approved for use in previously untreated patients with mantle cell lymphoma. Bortezomib was...

lung cancer
palliative care

Novel Oral Agent Treats Cachexia in Patients With Non–Small Cell Lung Cancer

For the first time, studies show that a drug is effective in treating several domains of cancer-related cachexia. Oral anamorelin increased lean body mass, achieved weight gain, and improved quality of life in patients with cancer-related cachexia in two pivotal phase III studies presented together ...

skin cancer

Nivolumab Yields ‘Impressive’ Duration of Response as Late-Line Melanoma Treatment

Nivolumab yielded an “impressive” duration of response when used as second- or third-line treatment for patients with advanced melanoma, according to Jeffrey S. Weber, MD, of the Moffitt Cancer Center in Tampa, Florida, who presented preliminary results of a phase III trial at the European Society...

Expert Point of View: Christian Blank, MD, PhD

Oncologists are now “in the luxury position of having two highly potent agents to treat BRAF V600–mutated melanoma,” noted Christian Blank, MD, PhD, Group Leader of Immunology at The Netherlands Cancer Institute, Amsterdam, who discussed the two papers at the ESMO 2014 Presidential Symposium....

skin cancer

BRAF/MEK Inhibitor Combinations Impressive in Melanoma Trials

For advanced/metastatic melanoma patients with BRAF mutations, two pathway inhibitors are better than one, according to studies presented at the European Society for Medical Oncology (ESMO) 2014 Congress that demonstrated improved progression-free and overall survival for regimens combining a BRAF...

Expert Point of View: Andrés Poveda, MD

Andrés Poveda, MD, Fundación Instituto Valenciano de Oncologia, Valencia, Spain, who was not involved in the Cediranib in Recurrent Cervical Cancer (CIRCCa) trial, said that the study provides supportive evidence that adding an antiangiogenic drug is beneficial in recurrent cervical cancer. Dr....

gynecologic cancers

Encouraging Early Signals for Cediranib in Recurrent Cervical Cancer

Cediranib (a potent tyrosine kinase inhibitor of vascular endothelial growth factor receptor (VEGFR)-1, -2, and -3) produced a modest improvement in progression-free survival and a robust improvement in response rates compared with placebo when added to chemotherapy in patients with recurrent...

breast cancer

Novel Agents May Address Endocrine Therapy Resistance

Progress has recently been swift in the development of new drugs to improve the response to hormone therapy in breast cancer, according to Hope S. Rugo, MD, Professor of Medicine and Director of Breast Oncology and Clinical Trials Education at the University of California, San Francisco, Helen...

leukemia

Linking Biology and Therapy in Chronic Lymphocytic Leukemia

Recent discoveries in biology, therapy, and (most importantly) the interplay between these two have led to groundbreaking advances in chronic lymphocytic leukemia (CLL). These advances underline the impact of the “translational” approach to cancer management in general. Standard of Care...

breast cancer

CLEOPATRA: Survival With Dual HER2 Blockade ‘Unprecedented’

In the final overall survival analysis of the phase III CLEOPATRA trial, HER2-positive metastatic breast cancer patients lived 15.7 months longer if they received pertuzumab (Perjeta) in addition to trastuzumab ­(Herceptin) and docetaxel, investigators reported at the European Society for Medical...

gastroesophageal cancer

Ramucirumab in Combination With Paclitaxel in Advanced Gastric or Gastroesophageal Junction Adenocarcinoma

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 November 5, 2014, ramucirumab (Cyramza) was approved for use...

integrative oncology
pain management
symptom management

Acupuncture Treatment for Cancer Pain and Chemotherapy-Induced Peripheral Neuropathy

Acupuncture is a traditional Chinese medicine technique that involves inserting and manipulating filiform needles into specific points of the body to achieve a therapeutic effect. According to traditional Chinese medicine, disruptions in the flow of “vital energy” (qi) throughout the body are the...

colorectal cancer

Clinical Trials Actively Recruiting Patients With Colon or Rectal Cancer

The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies of people with colon or rectal cancer in the newly diagnosed and metastatic settings. The studies include phase I, Ib, II, observational, and interventional trials investigating new drug...

lung cancer

ASCO Endorses Guideline for Molecular Testing for Selecting Lung Cancer Patients for EGFR and ALK Inhibitor Treatment

ASCO has endorsed the recently developed joint College of American Pathologists (CAP), International Association for the Study of Lung Cancer (IASLC), and Association for Molecular Pathology (AMP) guideline on molecular testing for selection of patients with lung cancer for EGFR and ALK inhibitor...

gastrointestinal cancer

The RAINBOW Trial: Dawn of a New Era in Upper Gastrointestinal Malignancies

As reviewed in this issue of The ASCO Post (page 155), the RAINBOW trial is an international phase III study demonstrating improved overall survival with ramucirumab (Cyramza) plus paclitaxel as second-line therapy for patients with advanced gastric/gastroesophageal junction adenocarcinoma over...

gastrointestinal cancer

Adding VEGFR2 Inhibitor Ramucirumab to Paclitaxel Increases Overall Survival as Second-Line Treatment for Advanced Gastric Cancer

In the phase III RAINBOW trial reported in The Lancet Oncology, Hansjochen Wilke, MD, Director of Medical Oncology/Hematology at Kliniken Essen-Mitte, Essen, Germany, and colleagues found that adding the vascular endothelial growth factor receptor 2 (VEGFR2) inhibitor ramucirumab (Cyramza) to...

skin cancer

BRAF/MEK Inhibition in BRAF-Mutant Advanced Melanoma

Preliminary evidence of efficacy for BRAF inhibitors as monotherapy in advanced melanoma first emerged in 2009.1 Phase II and III trials rapidly ensued for vemurafenib (Zelboraf) and dabrafenib (Tafinlar), leading to U.S. Food and Drug Administration (FDA) approval in 2011. As a result of melanoma...

skin cancer

Two Phase III Trials Show Benefit With BRAF/MEK Inhibitor Combination vs BRAF Inhibitor Alone in Advanced Melanoma

Two phase III trials have shown that the strategy of adding MEK inhibitor therapy to BRAF inhibitor therapy significantly improves progression-free survival in previously untreated patients with advanced BRAF-mutant melanoma.1,2 Overall survival benefit is also suggested by interim analysis in both ...

multiple myeloma

Initiative Aims to Accelerate Development of Targeted Therapies for Multiple Myeloma

Multiple Myeloma Research Foundation (MMRF) has announced an initiative designed to accelerate the evaluation of new investigational therapies for multiple myeloma. The MMRF, in collaboration with the U.S. Food and Drug Administration (FDA), the National Cancer Institute (NCI), pharmaceutical,...

multiple myeloma

Impact of High-Dose Melphalan/Autologous Stem Cell Transplant and Lenalidomide Maintenance in Myeloma Patients ≤ Age 65

In a phase III trial reported in The New England Journal of Medicine, Antonio Palumbo, MD, Chief of the Myeloma Unit at the University of Turin, Italy, and colleagues found that high-dose melphalan plus autologous stem cell transplantation improved progression-free survival and overall survival...

skin cancer

Ipilimumab/Sargramostim Improves Overall Survival vs Ipilimumab Alone in Patients With Advanced Metastatic Melanoma

A randomized clinical trial of patients with advanced metastatic melanoma treated with ipilimumab (Yervoy), an immune checkpoint inhibitor, in combination with sargramostim (Leukine), an immune stimulant, vs ipilimumab alone, has found a 1-year survival rate of 68.9% vs 52.9% in the ipilimumab-only ...

pancreatic cancer

Pancreatic Cancer in 2014

Adenocarcinoma of the pancreas is the fourth leading cause of cancer death in men and women in the United States. This year, about 46,000 people in this country will be diagnosed with pancreatic cancer, and more than 39,000 will die of the disease. The ASCO Post recently spoke with Margaret A....

supportive care

Fixed-Combination Netupitant/Palonosetron for Prevention of Chemotherapy-Induced Nausea and Vomiting

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 October 10, 2014, oral fixed-combination netupitant and...

lymphoma

Bortezomib in Previously Untreated Mantle Cell Lymphoma

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 October 9, 2014, bortezomib (Velcade) was granted approval for ...

gynecologic cancers

Maintenance Therapy in Ovarian Cancer: What’s at Stake?

Maintenance therapy in ovarian cancer refers to a cohort of women achieving response to initial adjuvant chemotherapy who then go on to additional therapy in the hopes of extending time to recurrence or inducing a lasting remission. The concept is not new and retains its scientific and clinical...

gynecologic cancers

Pazopanib Maintenance Improves Progression-Free Survival in Ovarian Cancer

In a phase III trial reported in the Journal of Clinical Oncology, ­Andreas du Bois, MD, PhD, Professor of Gynecologic Oncology at Kliniken Essen-Mitte in Essen, Germany, and colleagues found that maintenance therapy with the vascular endothelial growth factor receptor (VEGFR) and platelet-derived...

breast cancer

Study Finds Significant Increase in Bilateral Mastectomy for Unilateral Breast Cancer Despite Lack of Survival Benefit

In an observational cohort study reported in JAMA, Allison W. Kurian, MD, MSc, Assistant Professor of Medicine and of Health Research and Policy at Stanford University School of Medicine, and colleagues assessed use of and mortality after bilateral mastectomy, breast-conserving surgery plus...

multiple myeloma

Continuous Lenalidomide/Dexamethasone Improves Progression-Free  Survival in Transplant-Ineligible Patients With Myeloma

In the phase III FIRST trial reported in The New England Journal of Medicine, Lotfi Benboubker, MD, Service d’Hématologie et Thérapie Cellulaire, Hôpital Bretonneau, Centre Hospitalier Régional Universitaire (CHRU), Tours, France, and colleagues found that continuous lenalidomide (Revlimid) plus...

Expert Point of View: Hope S. Rugo, MD

Hope S. Rugo, MD, Professor of Medicine and Director of Breast Oncology and Clinical Trials Education at the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, discussed the results of the RESILIENCE trial presented at the European Society for Medical Oncology ...

breast cancer

Adding Sorafenib to Capecitabine Fails to Improve Progression-Free Survival in Advanced Breast Cancer

In patients with locally advanced or metastatic breast cancer, the addition of sorafenib (Nexavar), a broad-spectrum tyrosine kinase inhibitor, to capecitabine did not improve progression-free or overall survival in the phase III RESILIENCE trial. The findings were presented at the European Society ...

Expert Point of View: Hope S. Rugo, MD

Hope S. Rugo, MD, Professor of Medicine and Director of Breast Oncology and Clinical Trials Education for the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, discussed the two studies on maintenance bevacizumab (Avastin) for metastatic breast cancer...

breast cancer

Studies Evaluate Maintenance Bevacizumab in Metastatic Breast Cancer

Although bevacizumab (Avastin) may no longer be an active player in metastatic breast cancer, phase III studies presented at this year’s European Society for Medical Oncology (ESMO) Congress reignited interest in the drug as part of maintenance therapy. The TANIA trial met its primary endpoint,...

lung cancer

Moving Forward With Biomarkers in Non–Small Cell Lung Cancer

The effort to identify new biomarkers for response and outcomes in lung cancer is advancing, according to studies presented at the European Society for Medical Oncology (ESMO) 2014 Congress in Madrid. Immunohistochemical expression of folate receptor for vintafolide and thymidylate synthase for...

lung cancer

Emerging Drugs Effectively Tackle Non–Small Cell Lung Cancer Mutations

For advanced nonsquamous non–small cell lung cancer (NSCLC), targeting of the epidermal growth factor receptor (EGFR) mutation and the ALK abnormality has become an established strategy. Later-generation drugs in these categories are now showing efficacy in trials, including for the treatment of...

multiple myeloma

Single-Agent Carfilzomib, Compared to Corticosteroids Plus Cyclophosphamide, Fails to Improve Survival in Myeloma

Carfilzomib (Kyprolis), as a single agent, failed to improve survival in relapsed and refractory myeloma patients, as compared with a corticosteroid and optional cyclophosphamide, in the phase III FOCUS trial, presented at the European Society for Medical Oncology (ESMO) 2014 Congress in Madrid.1...

neuroendocrine tumors

Clinically Relevant Survival Benefit Seen for Everolimus in Pancreatic Neuroendocrine Tumors

Final results from the RADIANT-3 trial showed a 6-month difference in overall survival favoring everolimus (Afinitor) plus best supportive care over placebo plus best supportive care in patients with well-differentiated advanced and progressive pancreatic neuroendocrine tumors.1 Although the...

colorectal cancer

QUASAR2 Final Analysis: Bevacizumab Still of No Value in Adjuvant Treatment of Colorectal Cancer

The final analysis of the international phase III QUASAR2 trial confirmed the lack of benefit for bevacizumab (Avastin) as part of the adjuvant treatment of colorectal cancer. “There is no role for bevacizumab in combination with capecitabine as adjuvant treatment for colorectal cancer,” said...

colorectal cancer

Phase III Study Confirms Regorafenib’s Survival Benefit in Metastatic Colorectal Cancer

The phase III CONCUR trial1 of regorafenib (Stivarga) monotherapy in Asian patients with previously treated metastatic colorectal cancer confirmed the overall survival benefit seen in the previous ­CORRECT trial,2 and in a planned subgroup analysis, suggesting the benefit is substantial in patients ...

colorectal cancer

European Studies Explore Maintenance Strategies for Metastatic Colorectal Cancer

Studies presented at the European Society for Medical Oncology (ESMO) 2014 Congress in Madrid added insight regarding maintenance therapy in metastatic colorectal cancer, an area lacking a clear recommended strategy following first-line regimens. Two phase III trials found benefit for bevacizumab...

colorectal cancer

All-RAS Testing in Metastatic Colorectal Cancer: Just the First Step

Now that clinicians know to “think beyond KRAS” in metastatic colorectal cancer—and test for all RAS mutations, not just those in exon 2—it seems this is still not sufficient for selecting the best drugs. At the European Society for Medical Oncology (ESMO) 2014 Congress in Madrid, a proffered paper ...

breast cancer

Noteworthy Abstracts From the Breast Cancer Symposium Include Studies of Novel Therapies and of the Impact of Disease Subtypes on Outcomes

More than 150 oral and poster presentations were featured at the 2014 Breast Cancer Symposium, held September 4–6 in San Francisco. The multidisciplinary meeting is sponsored by ASCO, the American Society of Breast Disease, American Society of Breast Surgeons, American Society for Radiation...

colorectal cancer

For Selected Patients With Metastatic Colorectal Cancer, Taking a Break From Combination Chemotherapy Might Be Appropriate and Appreciated

Two phase III studies presented at the Best of ASCO meeting in Chicago shed more light on the role of maintenance therapy in patients with metastatic colorectal cancer undergoing first-line treatment with oxaliplatin-based chemotherapy. The two studies compared maintenance therapy with bevacizumab...

sarcoma

Advances in Sarcoma Owe Much to Children’s Oncology Group

Improvements over the past 3 decades in 5-year survival rates for patients with osteosarcoma and Ewing’s sarcoma owe a lot to chemotherapy clinical trials conducted by the Children’s Oncology Group (COG), Mark Agulnik, MD, acknowledged at the Best of ASCO meeting in Chicago. Dr. Agulnik is...

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