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breast cancer

EXPERT POINT OF VIEW: Eric P. Winer, MD, FASCO; Heikki Joensuu, MD; and Julie Gralow, MD, FASCO

IN INTERVIEWS with The ASCO Post and in discussions held during the meeting, several breast cancer experts weighed in on the findings of GeparSepto and CALGB 40502.  Eric P. Winer, MD, FASCO, Chief of the Division of Women’s Cancers and the Thompson Senior Investigator in Breast Cancer Research at ...

breast cancer

Updates of Key Studies Differ on Relative Benefit of Nab-Paclitaxel in Breast Cancer

TWO IMPORTANT STUDIES, both updates of earlier findings and presented at the 2017 San Antonio Breast Cancer Symposium, provided different findings as to the relative benefit of nanoparticle albumin-bound (nab)-paclitaxel (Abraxane), vs solvent-based paclitaxel in breast cancer.  “The two studies...

breast cancer

EXPERT POINT OF VIEW: C. Kent Osborne, MD, and Joseph Sparano, MD

“ONCOLOGISTS WANT to find drugs that will delay the use of chemotherapy, and cyclin-dependent kinase (CDK) 4/6 inhibitors provide that. These agents work better than chemotherapy and with less toxicity,” said press conference moderator C. Kent Osborne, MD, Director of the Duncan Cancer Center at...

breast cancer

CDK 4/6 Inhibitors May Be Effective but More Toxic in Older Women

OLDER WOMEN with breast cancer derive benefit from treatment with cyclin-dependent kinase (CDK) 4/6 inhibitors as part of initial endocrine-based therapy for hormone receptor–positive, HER2-negative, metastatic breast cancer, according to a retrospective pooled subgroup analysis of women aged 70 or ...

breast cancer

EXPERT POINT OF VIEW: William Sikov, MD, and Carlos L. Arteaga, MD

BREAST CANCER EXPERTS found the small differences in benefit for 1 year vs 9 weeks of adjuvant trastuzumab (Herceptin) in the SOLD trial to be provocative. William Sikov, MD, of Women and Infants Hospital of Rhode Island’s Breast Health Center and the Warren Alpert Medical School of Brown...

breast cancer
immunotherapy

Trastuzumab for 9 Weeks Fails to Show Noninferiority in HER2-Positive Breast Cancer

ANOTHER TRIAL has validated that 1 year of adjuvant trastuzumab (Herceptin) remains the standard in HER2-positive breast cancer, but the margin of difference, compared with just 9 weeks of the drug, was slim, based on the findings of the phase III SOLD trial reported at the 2017 San Antonio Breast...

breast cancer

Precision Medicine: Hope or Hype?

ALTHOUGH PRECISION medicine may be a recent discovery in some fields, it is an old story in the field of breast cancer, and one that has been exceptionally important in terms of managing the disease, according to George Sledge, MD, FASCO, Professor of Medicine and Medical Oncologist at the...

hematologic malignancies

EXPERT POINT OF VIEW: Neil P. Shah, MD, PhD; Joseph M. Connors, MD; and Kenneth C. Anderson, MD

NEIL P. SHAH, MD, PhD, Leader of the Hematopoietic Malignancies Program at the University of California, San Francisco, Helen Diller Family Cancer Comprehensive Cancer Center, noted that BLU- 285 could fill an “unmet medical need” for a KIT inhibitor that is “both potent and selective.” He pointed ...

hematologic malignancies

Novel Agent Appears Active in Advanced or Aggressive Systemic Mastocytosis

THE INVESTIGATIONAL agent BLU-285 (avapritinib) has shown significant activity in patients with advanced or aggressive forms of systemic mastocytosis, a rare blood disorder that originates in mast cells, according to the findings of a phase I trial reported at the 2017 American Society of...

global cancer care

CONCORD-3: Global Surveillance of Cancer Survival Trends, 2000–2014

In an article in The Lancet, Allemani et al reported findings from the CONCORD program for global surveillance of cancer survival trends updated through 2014 (CONCORD-3).   Study Details CONCORD-3 includes data on 37.5 million patients diagnosed with cancer between 2000 and 2014 from...

lung cancer

ASCO Clinical Practice Guideline: Treatment of Malignant Pleural Mesothelioma

As reported by Hedy L. Kindler, MD, of the University of Chicago, and colleagues in the Journal of Clinical Oncology, ASCO has released a clinical practice guideline on treatment of malignant pleural mesothelioma. The guideline was informed by a systematic literature search and expert panel review ...

gastroesophageal cancer

Patient Refusal of Esophagectomy and Long-Term Survival

Patients with esophageal cancer who refuse surgery when it is recommended are less likely to survive long term than similar groups of patients who undergo an operation, according to research presented by Ghaly et al at the 54th Annual Meeting of The Society of Thoracic Surgeons (P78). ...

prostate cancer

2018 GU CANCERS SYMPOSIUM: Chemotherapy Added to Hormone Therapy for Prostate Cancer Improves Quality of Life

A new analysis of the ongoing STAMPEDE clinical trial found that adding docetaxel to hormone therapy for advanced prostate cancer improves quality of life and lowers the need for subsequent therapy. Docetaxel was also found to be cost-effective. These findings will be presented by James et al at...

kidney cancer
immunotherapy

2018 GU CANCERS SYMPOSIUM: Adding Immunotherapy to Standard Treatment Slows Growth of Advanced Kidney Cancer—With Fewer Side Effects

In a phase III clinical trial of patients with previously untreated metastatic renal cell cancer combining the immunotherapy atezolizumab (Tecentriq) with the targeted therapy bevacizumab (Avastin) delayed cancer growth by about 3 months longer than sunitinib, another targeted therapy. The benefit...

bladder cancer
immunotherapy

2018 GU CANCERS SYMPOSIUM: New Model Predicts Survival for People With Bladder Cancer Receiving Immunotherapy

Researchers have developed a model to predict overall survival for people with advanced urothelial cancers treated with the immune checkpoint inhibitor atezolizumab (Tecentriq). The model, which is based on six clinical factors, may help inform treatment decisions for use of atezolizumab in these...

prostate cancer

2018 GU CANCERS SYMPOSIUM: Apalutamide Delays Prostate Cancer Metastases by More Than 2 Years

Findings from the phase III placebo-controlled SPARTAN trial suggest that apalutamide is an effective treatment for men with nonmetastatic castration-resistant prostate cancer who are at high risk for developing metastatic disease and for whom no approved treatments exist. Men who received...

gastrointestinal cancer

EXPERT POINT OF VIEW: Stephen Leong, MD

STEPHEN LEONG, MD, of the University of Colorado Comprehensive Cancer Center, Aurora, discussed the RAINFALL findings at the symposium, commenting, “The study did meet its primary endpoint of progression-free survival; however, it was disappointing not to see a benefit in overall survival or...

gastrointestinal cancer

Ramucirumab/Chemotherapy in Gastric Cancer: ‘Positive’ Trial but Insufficient Benefit

BASED ON EFFICACY seen in the second-line setting for the treatment of metastatic gastric or gastroesophageal junction adenocarcinoma, ramucirumab (Cyramza) was evaluated as first-line therapy in the international phase III RAINFALL trial. Although the study met its primary endpoint, with a 25%...

breast cancer

Bone-Modifying Agents in Metastatic Breast Cancer: Time to De-escalate Dosing Intervals

AS REVIEWED in this issue of The ASCO Post, ASCO and Cancer Care Ontario (CCO) have issued an updated guideline on the role of bone-modifying agents in metastatic breast cancer.1 The updated guideline supports a change in clinical practice for our patients with breast cancer and bone metastasis....

global cancer care

Changing Negative Perceptions on the Impact of Clinical Trials in Brazil

CLINICAL TRIALS are an essential research tool to advance medical knowledge and patient care. Traditionally, the majority of pharmaceutical-sponsored clinical trials have been implemented in Western Europe and North America. More recently, however, large pharmaceutical companies have increased...

solid tumors
gastrointestinal cancer

FDA Approves Radiopharmaceutical for Rare Gastrointestinal Cancers

On January 26, 2018, the U.S. Food and Drug Administration (FDA) approved lutetium Lu-177 dotatate (Lutathera) for the treatment of gastroenteropancreatic neuroendocrine tumors (GEP-NETs). The drug is indicated for adult patients with somatostatin receptor–positive GEP-NETs. GEP-NETs can be...

Expect Questions About Necessity of Chemotherapy for Early-Stage Breast Cancer

“For patients with early-stage breast cancer, we’ve seen a significant decline in chemotherapy use over the past few years without a real change in evidence,” or in national guidelines and recommendations, reported Allison W. Kurian, MD, MSc, lead author of a study on chemotherapy recommendations ...

solid tumors
breast cancer

Steep Decline in Chemotherapy Use for Early-Stage Breast Cancer

The use of chemotherapy to treat women with early-stage breast cancer “declined markedly over time,” according to analysis of data from 2,926 women between the ages of 20 and 79. The trends documented “are remarkable for their steepness of decline, independent of clinical factors and despite no...

solid tumors
breast cancer

I’m Not a Victim of Cancer

What I thought after feeling a large, hard lump—similar to the feel of a granola bar—in my left breast was that I probably pulled a muscle while playing with my two young children, ages 7 and 5. Cancer never entered my mind until I asked my husband to feel the lump, and he immediately said, with...

supportive care
solid tumors

The Toxicity of Time

The ASCO Post is pleased to reproduce installments of the “Art of Oncology” as published previously in the Journal of Clinical Oncology. These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

issues in oncology

Up-to-Date Labels for Older Drugs Essential for Appropriate Use

  Oncology drug labels, especially those that have been on the market for more than 15 years, may not always be up-to-date. Critical data about safety, efficacy, or prescribing information may be missing. Modernizing the labeling process can correct inaccurate information, add data for indications ...

hematologic malignancies
multiple myeloma
immunotherapy

Daratumumab in Previously Treated Multiple Myeloma

  On June 16, 2017, daratumumab -(Darzalex) was approved for use in combination with pomalidomide (Pomalyst) and dexamethasone for treatment of patients with multiple myeloma who have received at least two prior therapies including lenalidomide (Revlimid) and a proteasome inhibitor.1,2 Supporting...

solid tumors
immunotherapy

Pembrolizumab in MSI-H or dMMR Solid Tumors: ‘First Tissue/Site-Agnostic’ Approval by FDA

  On May 23, 2017, pembrolizumab (Keytruda) was granted accelerated approval for treatment of adult and pediatric patients with unresectable or metastatic microsatellite instability–high (MSI-H) or mismatch repair deficient (dMMR) solid tumors progressing following prior treatment and who have no...

hematologic malignancies
leukemia

Enasidenib in IDH2-Mutant Relapsed or Refractory Acute Myeloid Leukemia

  On August 1, 2017, the IDH2 inhibitor enasidenib (Idhifa) was granted regular approval for treatment of adult patients with relapsed or refractory acute myeloid leukemia (AML) with an isocitrate dehydrogenase-2 (IDH2) mutation as detected by a U.S. Food and Drug Administration (FDA)-approved...

hematologic malignancies
leukemia
immunotherapy

Blinatumomab in Relapsed or Refractory B-Cell Precursor ALL

On July 11, 2017, blinatumomab (Blincyto) was approved for the treatment of relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL) in adults and children.1,2 Blinatumomab received accelerated approval in December 2014 for the treatment of Philadelphia chromosome (Ph)-negative...

gynecologic cancers

Potential Effect of Excess Body Weight on Detection of Cervical Precancer

In a study reported in the Journal of Clinical Oncology, Clarke et al found that increasing body mass index (BMI) was associated with lower rates of cervical precancer diagnosis and higher rates of cervical cancer diagnosis. The investigators had hypothesized that increased body mass could decrease ...

breast cancer

Evaluating the Need for Biopsies During Follow-up Care in Early Breast Cancer

In an analysis of more than 120,000 women diagnosed with and treated for early-stage breast cancer, researchers from The University of Texas MD Anderson Cancer Center determined the rate of additional breast biopsies needed for these patients during their follow-up care. The findings, reported by...

The Roller Coaster

  The following essay by Shaker R. Dakhil, MD, FACP, is adapted, with permission, from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was coedited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and...

genomics/genetics
issues in oncology

Making Personalized Medicine a Reality for More Patients With Cancer

  This past September, Olivier Elemento, PhD, Associate Director of the Institute for Computational Biomedicine and Director of the Laboratory of Cancer Systems Biology at Weill Cornell Medicine in New York, was named Director of Weill Cornell’s Englander Institute for Precision Medicine. In this...

supportive care
integrative oncology

The State of Integrative Oncology: A New Era

Now that we have entered 2018, let’s take a moment to reflect on how far we have come and what lies ahead in integrative oncology care. Overview To cope with the physical, emotional, and spiritual effects of cancer, and in search of relief from symptoms that their conventional treatments have not...

issues in oncology

FDA Takes Steps to Improve Transparency in Clinical Trial Information Related to New Drugs

  As part of the U.S. Food and Drug Administration’s (FDA) efforts to enhance transparency around its drug-approval decisions, the FDA is exploring new ways to build on its obligation to share information about product approvals, as announced by FDA Commissioner Scott Gottlieb, MD. The FDA is...

supportive care

For Holly G. Prigerson, PhD, Psychosocial Issues Are at the Heart of End-of-Life Cancer Care

Holly G. Prigerson, PhD, Co-Director of the Weill Cornell Medicine’s Center for Research on End-of-Life Care, was born in Maimonides Hospital in Brooklyn, where her father had been a resident. Her family moved to Long Island, first living in Islip, where Dr. Prigerson’s father practiced medicine...

lung cancer

CAP, IASLC, AMP Update Guideline for Molecular Testing and Targeted Therapies in Lung Cancer

To ensure that clinicians stay apace and provide optimal patient care, three leading medical societies—the College of American Pathologists (CAP), the International Association for the Study of Lung Cancer (IASLC), and the Association for Molecular Pathology (AMP)—have updated their...

breast cancer

High Body Fat Levels in Postmenopausal Women With Normal BMI May Be Associated With Increased Breast Cancer Risk

Among postmenopausal women with normal body mass index (BMI), those with higher body fat levels had an increased risk for invasive breast cancer, according to data presented at an American Association for Cancer Research (AACR) Special Conference titled Obesity and Cancer: Mechanisms...

hematologic malignancies

Clinical Hold on BPX-501 Trials in the United States Announced

On January 30, Bellicum Pharmaceuticals announced it has received notice from the U.S. Food and Drug Administration (FDA) that U.S. studies of BPX-501—an agent being studied to improve outcomes for patients undergoing stem cell transplant who lack a matched donor—have been placed...

immunotherapy

CAR T-Cell Immunotherapy Named Advance of the Year in ASCO’s Clinical Cancer Advances 2018

A new and unique new way to treat cancer—chimeric antigen receptor (CAR) T-cell therapy—is poised to transform the outlook for children and adults with certain otherwise incurable cancers. ASCO named this type of adoptive-cell immunotherapy the Advance of the Year in its annual...

pancreatic cancer
gastrointestinal cancer

FDA Approves Lutetium Lu-177 Dotatate for Treatment of Gastroenteropancreatic Neuroendocrine Tumors

On January 26, the U.S. Food and Drug Administration (FDA) approved lutetium Lu-177 dotatate (Lutathera) for the treatment of gastroenteropancreatic neuroendocrine tumors (GEP-NETs). This is the first time a radiopharmaceutical has been approved for the treatment of GEP-NETs. Lu-177 dotatate is...

breast cancer
colorectal cancer
gynecologic cancers
hepatobiliary cancer
lung cancer
pancreatic cancer
gastroesophageal cancer

Detecting and Localizing Eight Cancer Types With One Multianalyte Blood Test

Johns Hopkins Kimmel Cancer Center researchers developed a single blood test that screens for eight common cancer types and also helps identify the location of the cancer. The test, called CancerSEEK, is a unique noninvasive, multianalyte test that simultaneously evaluates levels of eight cancer...

gynecologic cancers

Addition of Hyperthermic Intraperitoneal Chemotherapy to Cytoreductive Surgery in Advanced Ovarian Cancer

In a Dutch/Belgian phase III trial reported in The New England Journal of Medicine by van Driel et al, the addition of hyperthermic intraperitoneal chemotherapy to interval cytoreductive surgery following neoadjuvant chemotherapy was associated with significantly improved recurrence-free and...

Former President and Director of Fred Hutchinson Cancer Research Center, Robert W. Day, MD, Dies at 87

ROBERT W. DAY, MD, the longest-serving President and Director of Fred Hutchinson Cancer Research Center and the leader who brought into being its campus overlooking Seattle’s South Lake Union, died in his Seattle home on January 6, 2018 of lung cancer. He was 87.  “It is a tragic loss for all of...

The Telltale Heart: A Surgeon’s Memoir

We don’t feel our liver or pancreas working, but we all feel our hearts beating—the drumbeat of our mortality since we all have a finite number of heartbeats from birth to death. And unlike with most other organs, we are painfully aware of how fragile this mighty muscle can be. About 610,000 people ...

prostate cancer

Internationally Renowned Prostate Cancer Expert Gerald E. Hanks, MD, Dies

FROM WILHELM RÖNTGEN’S groundbreaking discovery of x-rays in 1895, the history of radiotherapy has been rich with colorful paradigm-changing researchers and physicians who over the past century have transformed the field into one of the pillars of cancer treatment. One such trailblazer who...

A Neuroscientist Examines Intact Minds Adrift in Damaged Brains and Bodies

Understanding what consciousness is, and why and how it evolved, is perhaps the greatest mystery known to science. With its 100 billion or so neurons and a processing rate of about 4 billion bits per second, the human brain is a miraculously complicated entity, much of which is still under...

solid tumors
issues in oncology
global cancer care

Second Global AYA Cancer Congress Highlights Research Advances and the Global Burden of Cancer Among Young Adults

This past December, nearly 400 medical professionals from a variety of fields—including medical oncology, palliative care, science, nursing, social work, and psychology—and 23 countries traveled to Atlanta, to attend the 2nd Global Adolescent & Young Adult (AYA) Cancer Congress. The 3-day...

leukemia

Against All Odds

The days leading up to our daughter Emily’s diagnosis of acute lymphoblastic leukemia (ALL) on May 28, 2010, when she was just 5, offered few clues about the terrifying, life-and-death months and years we were about to experience. She was happy and seemingly healthy, literally until the day before...

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