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cns cancers

Improved Understanding of Glioma Tumor Biology

The management of patients with lower-grade gliomas is evolving. As evidenced by two recent publications in The New England Journal of Medicine,1,2 reviewed in this issue of The ASCO Post, there has been a substantial increase in our knowledge of the molecular characteristics of these neoplasms....

cns cancers

New Molecular Classifications of Gliomas Established

Two studies reported in The New England Journal of Medicine identified new molecular classifications of glioma that capture biologic and prognostic differences. The Cancer Genome Atlas Research Network identified three prognostically significant subtypes of lower-grade glioma that were identified...

breast cancer

The Conundrum of Estrogen-Receptor Signaling in HER2-Positive Breast Cancer

BOLERO-1—reviewed in this issue of The ASCO Post—is the next installment in a series of randomized trials evaluating the addition of everolimus (Afinitor) to standard therapy in metastatic breast cancer.1 The initial evaluation of everolimus in the HER2-positive metastatic setting looked extremely...

breast cancer

Adding Everolimus to First-Line Trastuzumab/Paclitaxel Does Not Increase Progression-Free Survival in HER2-Positive Metastatic Breast Cancer

In the phase III BOLERO-1 trial, reported in The Lancet Oncology, Sara A. Hurvitz, MD, of the University of California, Los Angeles, and colleagues found that the addition of the mTOR inhibitor everolimus (Afinitor) to trastuzumab (Herceptin)/paclitaxel did not significantly increase...

multiple myeloma

Carfilzomib in Combination With Lenalidomide and Dexamethasone in Relapsed Multiple Myeloma

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 July 24, 2015, carfilzomib (Kyprolis) was approved for use in...

colorectal cancer

Learning to Refine the Use of Regorafenib to Best Advantage in Advanced Colorectal Cancer

In patients with advanced colorectal cancer who have been heavily treated with a sequence of chemotherapy regimens and/or targeted therapies, the goals of treatment on or off a clinical trial are readily definable. These patients and their managing teams are striving to extend the length of lives,...

colorectal cancer

Regorafenib Improves Overall Survival in Asian Patients  With Previously Treated Metastatic Colorectal Cancer

In a phase III trial (CONCUR) reported in The Lancet Oncology, Jin Li, MD, and colleagues found that the multikinase inhibitor regorafenib (Stivarga) improved overall survival vs placebo in Asian patients with previously treated metastatic colorectal cancer.1 Regorafenib is approved in the United...

head and neck cancer
supportive care
palliative care
symptom management

Dispelling the Myths Associated With Osteonecrosis of the Jaw

Osteonecrosis of the jaw associated with cancer treatment is frequently misunderstood, according to Cesar ­Augusto Migliorati, DDS, MS, PhD, who delivered an update on its proper recognition and management at the 2015 Multinational Association of Supportive Care in Cancer/International Society of...

cns cancers

Short Course of Radiotherapy May Be Adequate for Elderly and Frail Patients With Glioblastoma Multiforme

No difference in overall survival or progression-free survival was observed between elderly and/or frail patients undergoing short and standard courses of radiotherapy for glioblastoma multiforme, according to data presented by Elena Fidarova, MD, at the 2015 Multinational Association of Supportive ...

multiple myeloma

FDA Approves Carfilzomib Combination for Patients With Relapsed Multiple Myeloma

The U.S. Food and Drug Administration (FDA) approved carfilzomib (Kyprolis) in combination with lenalidomide (Revlimid) and dexamethasone for the treatment of patients with relapsed multiple myeloma who have received one to three prior lines of therapy. In the United States, there are nearly...

lung cancer

Immunotherapy Makes Inroads in Small Cell Lung Cancer

Early data on immunotherapy for small cell lung cancer (SCLC) have been encouraging. SCLC may catch up to non–small cell lung cancer (NSCLC), where immunotherapy is now standard of care, if these early data are borne out in phase III trials. Phase Ib and II studies of immunotherapy in SCLC were...

lung cancer

Moving Forward in Non–Small Cell Lung Cancer: Targeted Combinations and Immunotherapy

The newer targeted therapies and immunotherapies have proven to be a boon to the treatment of lung and other cancers, but how best to deploy those therapies remains a burning question. Another important focus of current research is the identification and validation of biomarkers for these...

lung cancer

Immune Checkpoint Inhibitors: The Dawn of a New Era for Lung Cancer Therapy

The therapeutic paradigm for lung cancer has changed rapidly over the past few years toward individualized therapy. For certain subsets of patients, molecularly targeted agents have resulted in robust gains in overall survival and quality of life. However, for the majority of patients with...

breast cancer

Studies Explore New Avenues to Pursue in Metastatic Triple-Negative Breast Cancer

Two agents targeting novel pathways show promise in metastatic triple-negative breast cancer, according to separate studies presented at the 2015 ASCO Annual Meeting and reviewed at the Best of ASCO® meeting by Steven J. Isakoff, MD, PhD, of Massachusetts General Hospital, Boston. The first study...

From Small-Town Mexico to Big Pharma, a Look at Opiates for Good and Bad

Bookmark Title: Dreamland: The True Tale of America’s Opiate Epidemic Author: Sam Quinones Publisher: Bloomsbury Press Publication date:  April 21, 2015 Price: $28.00; hardcover, 384 pages Despite growing awareness within the oncology community and the emergence of the palliative care...

integrative oncology

Coriolus versicolor

The use of dietary supplements by patients with cancer has increased significantly over the past 20 years despite insufficient evidence of safety and effectiveness. Finding reliable sources of information about dietary supplements can be daunting. Patients typically rely on family, friends, and the ...

skin cancer

COMBI-d Trial and the Need to Guide Progress in Melanoma Treatment

As reviewed in this issue of The ASCO Post, Long et al1 have reported the final overall survival analysis of the COMBI-d phase III trial comparing combination therapy with the BRAF inhibitor dabrafenib (Tafinlar) and the MEK inhibitor trametinib (Mekinist) to monotherapy with dabrafenib alone,...

skin cancer

Dabrafenib Plus Trametinib Improves Overall Survival vs Dabrafenib in BRAF V600–Mutant Melanoma

Overall survival results of the phase III COMBI-d trial reported in The Lancet by Georgina V. Long, MD, and colleagues showed that the combination of the BRAF inhibitor ­dabrafenib (Tafinlar) with the MEK inhibitor trametinib (Mekinist) resulted in significantly prolonged overall survival vs...

lung cancer

Roswell Park Cancer Institute Partners With Cuban Scientists to Develop Lung Cancer Vaccine

Just 4 months after President Barack Obama’s announcement in December 2014 that there would be an easing of the trade embargo between the United States and Cuba, a deal was struck between Roswell Park Cancer Institute in Buffalo, New York, and the Center for Molecular Immunology (CIM) in Havana,...

leukemia

Novel Combination Increases Progression-Free Survival in CLL Patients Who Are Not Candidates for Fludarabine

In the phase III COMPLEMENT 1 trial reported in The Lancet, ­Peter Hillmen, MB, ChB, of St. James’s University Hospital, Leeds, and colleagues found that the addition of the anti-CD20 antibody ofatumumab (Arzerra) to chlorambucil (Leukeran) increased progression-free survival among patients with...

lymphoma

Brentuximab Vedotin for Consolidation Therapy in High-Risk Hodgkin 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 August 17, 2015, brentuximab vedotin (Adcetris) was approved...

prostate cancer

Optimal Timing of Hormonal Therapy for Biochemically Recurrent Prostate Cancer Remains Unclear

There is no consensus as to whether it is better to treat immediately or to delay androgen-deprivation therapy in patients with a rising prostate-specific antigen (PSA) level (“biochemical relapse”) after curative therapy for prostate cancer. A phase III study, selected for the Best of ASCO® 2015,...

colorectal cancer

Secondary Prevention in Metastatic Colorectal Cancer: Benefits of Vitamin D and Aspirin Explored

Two low-cost, low-tech options may lead to a survival benefit in metastatic colorectal cancer, according to separate retrospective studies selected for the Best of ASCO® 2015. The first study suggested that vitamin D supplementation is worthy of investigation in this regard,1 and the second study...

colorectal cancer
hepatobiliary cancer

Colorectal Liver Metastases: Thumbs Up for Radiofrequency Ablation, Jury Still Out for Selective Internal Radiotherapy

Two “firsts” in studies of colorectal liver metastases were highlighted at the 2015 ASCO Annual Meeting: the first prospective randomized trial to evaluate radiofrequency ablation plus chemotherapy1 and the first large randomized phase III trial to study liver-directed selective internal radiation...

lymphoma

Indolent Lymphoma: A More Complex Malignancy Than Once Thought

With a growing number of options for follicular lymphoma, clinicians may wonder whether there is one best regimen. James O. Armitage, MD, FACP, FRCP, Professor of Medicine at the University of Nebraska, Omaha—and Editor-in-Chief of The ASCO Post—tackled this question and offered recommendations at...

lung cancer
issues in oncology

Positioning Targeted and Immunotherapy-Based Approaches in Lung Cancer

With immunotherapy changing the face of lung cancer, is there still a place for targeted therapy? Two experts from Emory University debated this issue at the 2015 Debates and Didactics in Hematology and Oncology Conference held in Sea Island, Georgia. Fadlo Khuri, MD, was recently named President...

multiple myeloma

Elotuzumab Ushers in a New Era in Myeloma Therapy

The long wait for monoclonal antibodies for the treatment of multiple myeloma is over. In the landmark ELOQUENT-2 study, reviewed in this issue of The ASCO Post, Lonial and colleagues convincingly demonstrate the effectiveness of elotuzumab, a monoclonal antibody directed against SLAMF7, in the...

multiple myeloma

Adding Elotuzumab to Lenalidomide Plus Dexamethasone Improves Progression-Free Survival in Refractory Multiple Myeloma

In an interim analysis of the phase III ELOQUENT-2 trial reported in The New England Journal of Medicine, Sagar Lonial, MD, of Emory University School of Medicine, Meletios Dimopoulos, MD, of National and Kapodistrian University of Athens, and colleagues found that the addition of elotuzumab to...

leukemia

Azacitidine Increased Median Overall Survival Among Patients Aged 65 and Older With > 30% Blasts

A multicenter, randomized, open-label, phase III trial among the difficult-to-treat population of patients aged aged 65 and older with acute myeloid leukemia (AML) with > 30% bone marrow blasts “showed that azacitidine was associated with a clinically meaningful improvement” in median overall...

kidney cancer

My Positive Attitude Is Keeping Me Alive

Until I was diagnosed with stage III renal cell carcinoma in early 2008, I had no firsthand experience with cancer. To my knowledge, there is no history of cancer in my immediate family, and despite a smoking habit I picked up when I was young, I had been in relatively good health in the 56 years...

lung cancer

Immune Checkpoint Inhibitor Nivolumab Is Active in Patients With Heavily Pretreated Advanced Non–Small Cell Lung Cancer

In a phase I cohort expansion trial reported in the Journal of Clinical Oncology, Scott N. Gettinger, MD, of Yale Cancer Center, New Haven, Connecticut, and colleagues found that monotherapy with the anti–programmed cell death protein 1 (PD-1) checkpoint inhibitor antibody nivolumab (Opdivo)...

multiple myeloma

FDA Accepts for Priority Review the Biologics License Application for Elotuzumab for the Treatment of Relapsed Multiple Myeloma

Bristol-Myers Squibb and AbbVie recently announced that the U.S. Food and Drug Administration has accepted for priority review the Biologics License Application for elotuzumab, an investigational signaling lymphocyte activation molecule (SLAMF7)-directed immunostimulatory antibody, for the...

lymphoma

FDA Grants Regular Approval to Brentuximab Vedotin in High-Risk Classical Hodgkin Lymphoma

The U.S. Food and Drug Administration has approved brentuximab vedotin (Adcetris) as post–autologous hematopoietic stem cell transplantation consolidation treatment for patients with classical Hodgkin lymphoma at high risk of relapse or progression, Seattle Genetics has announced. The approval is...

symptom management

FDA Approves Rolapitant for Prevention of Chemotherapy-Induced Nausea and Vomiting

The U.S. Food and Drug Administration (FDA) approved rolapitant (Varubi) to prevent delayed-phase chemotherapy-induced nausea and vomiting. Rolapitant is approved in adults in combination with other antiemetic agents that prevent nausea and vomiting associated with initial and repeat courses of...

lung cancer

Bevacizumab Plus Standard Chemotherapy Improves Survival in Mesothelioma

The standard of care for malignant pleural mesothelioma may be poised for change, judging by results from a study by the French Cooperative Thoracic Intergroup. The addition of bevacizumab (Avastin) in the first-line setting to the current standard of care, pemetrexed (Alimta)/cisplatin, improved...

symptom management

Rolapitant for Prevention of Delayed 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 September 2, 2015, rolapitant (Varubi) was approved for use in...

head and neck cancer

HPV-Positive Head and Neck Cancer: When Can Chemotherapy Be Omitted?

Are there patients with locally advanced squamous cell carcinoma of the head and neck associated with human papillomavirus (HPV) for whom chemotherapy can be omitted? Experts debated this question at the 2015 Debates and Didactics in Hematology and Oncology Conference in Sea Island, Georgia,...

lung cancer

First-Line Nivolumab/Ipilimumab Combination in Non–Small Cell Lung Cancer Shown to Be Tolerable

For advanced non–small cell lung cancer (NSCLC), first-line treatment with combined immune checkpoint blockade—in novel doses and schedules—was associated with deep and durable responses, encouraging progression-free survival, and much better tolerability than has been previously observed with...

breast cancer

Varied Reactions to Study Finding That Preventing Ipsilateral Recurrence Did Not Prevent Death From Breast Cancer

Women diagnosed with ductal carcinoma in situ have a low risk of dying of breast cancer, according to an observational study looking at data from 108,196 women diagnosed with ductal carcinoma in situ between 1988 and 2011.1 The breast cancer–specific mortality rate for these women was 1.1% at 10...

skin cancer

Anti–PD-1 Superior to Chemotherapy in the KEYNOTE-002 Trial

Immunotherapy, once considered a niche treatment for a few specific cancers, has rapidly emerged as an additional pillar of cancer therapeutics. With the proliferation of promising results, clinical trials, and new drug approvals, one cannot help but be amazed that only 3 years have elapsed since...

prostate cancer

Docetaxel Chemohormonal Therapy in Metastatic Hormone-Sensitive Prostate Cancer

Sweeney et al reported on the results of a seminal phase III trial (E3805) of chemohormonal therapy vs androgen-deprivation therapy in metastatic hormone-sensitive prostate cancer in a recent issue of The New England Journal of Medicine,1 and the study is summarized in this issue of The ASCO Post....

prostate cancer

Adding Docetaxel to Androgen-Deprivation Therapy Prolongs Overall Survival in Metastatic Prostate Cancer

In a phase III trial (E3805) reported in The New England Journal of Medicine, Christopher J. Sweeney, MBBS, of Dana-Farber Cancer Institute, Boston, and colleagues found that chemohormonal therapy with docetaxel plus androgen-deprivation therapy produced a significant 13.6-month increase in median...

colorectal cancer

FDA Approves New Oral Medication for the Treatment of Refractory Metastatic Colorectal Cancer

The U.S. Food and Drug Administration (FDA) has approved trifluridine/tipiracil (Lonsurf) for patients with metastatic colorectal cancer who have been previously treated with chemotherapy and biologic therapy and are no longer responding to treatment. Mechanism of Action The new oral agent is a...

supportive care
survivorship

Patient and Survivor Care Studies Yield Useful Results to Improve Quality of Life

Recent studies have yielded useful results that clinicians can put into practice, some right now, to help improve the quality of life for patients with cancer. Concerns addressed included cachexia, pain, “chemobrain,” and fertility preservation. At the Best of ASCO®/Chicago meeting, Arif ­Kamal,...

Expert Point of View: Solange Peters, MD, PhD

Solange Peters, MD, PhD, of the Lausanne University Hospital, Switzerland, put these updates in context of what is known about programmed cell death protein 1 (PD-1) antibodies in non–small cell lung cancer (NSCLC), concluding that nivolumab (Opdivo) is “one of the best options” for...

lung cancer

Nivolumab in Lung Cancer Supported by Updated Trial Data

For the treatment of advanced squamous non–small cell lung cancer (NSCLC), the programmed cell death protein 1 (PD-1) antibody nivolumab (Opdivo) continues to show results in key trials that now report 18-month data. The updates were reported at the 16th World Conference on Lung Cancer in Denver,...

lung cancer

AZD9291 Updates Encouraging for Treatment-Resistant NSCLC

At the 16th World Conference on Lung Cancer, several studies showed consistent activity with the investigational third-generation inhibitor AZD9291 in patients with advanced non–small cell lung cancer (NSCLC) that is resistant to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors....

issues in oncology

NCCN Turns 20: Value-Based Care Has Arrived

Twenty years ago, the National Comprehensive Cancer Network (NCCN) began as a cooperative effort of 12 prestigious cancer centers, working to define and promote national guidelines for the care of patients with cancer. A major goal was to encourage uniformity in the management of malignant...

lung cancer

EGFR Gene Copy Number as Biomarker for Antibody Treatment in Squamous Cell NSCLC

Two studies presented at the 16th World Conference on Lung Cancer suggest that high expression of the epidermal growth factor receptor (EGFR), or gene copy number, may indicate potential benefit from EGFR antibodies in squamous cell non–small cell lung cancer (NSCLC). The studies were presented by...

kidney cancer

Patient Characteristics Differ in Some Clinical Trials From Real-World Population

Patients with metastatic renal cell carcinoma treated with tyrosine kinase inhibitors in real-world clinical practice tend to be older and sicker than the patients enrolled in pivotal clinical trials of these agents. In addition, patients with metastatic renal cell carcinoma treated with the mTOR...

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