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Sharing 50 Years of Christmas: A Quality Metric?

A very pleasant 68-year-old woman was referred to my clinic with biopsy-proven liver metastasis from primary colon cancer. She was initially diagnosed with colon cancer, which was resected, and she then received chemotherapy. A suspicious liver lesion was biopsied in the adjuvant setting, which...

Leading Cancer Researcher and Public Health-Care Expert, Eddie Reed, MD, Dies

In a 2010 interview, Eddie Reed, MD, a pioneer in the molecular pharmacology of DNA-damaging anticancer agents and the clinical development of paclitaxel for ovarian cancer, was asked what lay ahead. Before answering, Dr. Reed first acknowledged the esteemed mentors who gave him their most precious ...

breast cancer

Long-Term Follow-up Confirms Low Incidence of Cardiac Events Associated With Trastuzumab

At a median follow-up of 8 years, patients receiving trastuzumab (Herceptin) sequentially after chemotherapy and radiotherapy in the Herceptin Adjuvant (HERA) trial had a low incidence of cardiac events and these were reversible in the vast majority of patients. This long-term assessment confirms...

breast cancer

New Option for Preserving Fertility in Women Being Treated With Chemotherapy for Early-Stage Breast Cancer

One of the most reported studies emanating from the 2014 ASCO Annual Meeting involves the use of the luteinizing hormone–releasing hormone (LHRH) agonist goserelin (Zoladex) to reduce the risk of ovarian failure among women being treated with chemotherapy for early-stage breast cancer, and to...

cost of care
health-care policy

Cancer Care Under the Affordable Care Act

The problematic rollout of the Affordable Care Act’s website, HealthCare.gov, made good political theater, but while much of the heated discussion centered on the plan’s need to enroll “young invincibles,” America’s cancer care system and the older patients it serves were also affected by parts of...

pain management

Federal Pain Research Database Launched

The Interagency Pain Research Portfolio (IPRP), a database that provides information about pain research and training activities supported by the federal government, has been launched by six federal agencies. “This database will provide the public and the research community with an important tool...

breast cancer

Issues in the Management of the Axilla in Patients With Breast Cancer

For the past 40 years the story of breast cancer surgery in general, and for the past 20 years the management of the axilla in particular, has been one of increasing conservatism. To give our readers insight into the current and future direction of axillary management, The ASCO Post spoke with...

breast cancer

A New Era in the Management of Advanced HER2-Positive Breast Cancer

Approximately 20% of all breast cancers are human epidermal growth factor receptor 2 (HER2)-positive. Prior to the era of HER2-targeted therapy, HER2-positive breast cancer was characterized by a poor prognosis.1,2 The development of the first HER2-targeted therapy, trastuzumab (Herceptin), led to...

breast cancer

ASCO Clinical Practice Guideline: Systemic Therapy for Patients With Advanced HER2-Positive Breast Cancer

Approximately 15% of patients with breast cancer have tumors that overexpress the HER2 protein and these patients can benefit from HER2-targeted therapies. The American Society of Clinical Oncology recently released a clinical practice guideline on systemic therapy for patients with advanced...

Congress Salutes ASCO’s 50th Anniversary on House Floor

On May 8, 2014, the House of Representatives held a Special Order in honor of ASCO as it celebrates its 50th anniversary. Representatives Leonard Lance (R-NJ), Brian Higgins (D-NY), Chuck Fleischmann (R-TN), and Sheila Jackson Lee (D-TX) spoke during the Special Order, which took place on the House ...

Conquering Cancer With 2013 Career Development Award Recipient Rebecca A. Gardner, MD

Rebecca A. Gardner, MD is an Assistant Professor at the University of Washington and Attending Physician at Seattle Children’s Hospital. She received a 2013 Conquer Cancer Foundation of ASCO Career Development Award (CDA) for her project “Autologous T cells genetically modified to express a CD19...

colorectal cancer

Colorectal Cancer Screening Poised for Change

New screening modalities and the customization of the screening population could soon change the way that screening for colorectal cancer is done. At Digestive Disease Week 2014, the largest gathering of gastrointestinal disease specialists in the world, researchers presented data suggesting that...

breast cancer

Preoperative Breast MRI: Does Higher Sensitivity Equal Better Outcomes?

Breast magnetic resonance imaging (MRI) is superior to more commonly used imaging modalities in preoperative breast cancer staging and should be a key element in routine workup. But despite its high sensitivity for catching cancers, breast MRI still does not deliver maximum value for the patient....

breast cancer

FDA Approves Magnetic Resonance Contrast Agent for Evaluation of Breast Cancer

The U.S. Food and Drug Administration has approved a new indication for gadobutrol (Gadavist) injection for intravenous use with magnetic resonance imaging (MRI) of the breast to assess the presence and extent of malignant breast disease. The approval is based on priority review of two multicenter...

Expert Point of View: Sherene Loi, MD PhD

Sherene Loi, MD PhD, Head of the Translational Breast Cancer Genomics Lab at the Peter McCallum Cancer Centre, Victoria, Australia, commented on the N9831 study presentation and referred to her group’s own work on tumor-infiltrating lymphocytes. These investigators have shown a positive association ...

breast cancer

Goserelin With Chemotherapy Prevents Early Menopause, Helps Preserve Fertility in Younger Women With Hormone Receptor–Negative Breast Cancer

The good news for younger women with hormone receptor–negative early breast cancer is that adding goserelin (Zoladex), a luteinizing hormone–releasing hormone (LHRH) agonist, to chemotherapy can prevent sudden menopause, better preserve ovarian function and fertility, and lead to successful...

gynecologic cancers

Oral Two-Drug Regimen Appears Promising in Phase II Trial of Recurrent Platinum-Sensitive Ovarian Cancer

An all-oral combination of the investigational agents olaparib and cediranib nearly doubled progression-free survival in platinum-sensitive recurrent ovarian cancer in a National Cancer Institute (NCI)-sponsored randomized phase II trial reported at the 2014 ASCO Annual Meeting.1 The toxicity...

Expert Point of View: Nasser H. Hanna, MD

Formal discussant of the study by Park et al, Nasser H. Hanna, MD, Associate Professor of Medicine at the Indiana University Simon Cancer Center, Indianapolis, said that the trial confirms the difficulty of giving consolidation therapy, since less than two-thirds of patients were able to get the...

lung cancer

Pieces of the Puzzle in Treating Early Non–Small Cell Lung Cancer

Separate studies in early-stage non–small cell lung cancer (NSCLC) found that the addition of consolidation chemotherapy to concurrent chemoradiotherapy did not improve survival and that adjuvant erlotinib (Tarceva) did not improve survival. There was a suggestion of benefit for adjuvant erlotinib...

leukemia

Ibrutinib Surpasses Ofatumumab as Second-Line Treatment of Chronic Lymphocytic Leukemia

Ibrutinib (Imbruvica) significantly improved progression-free survival, overall survival, and response when compared with ofatumumab (Arzerra) as second-line treatment of chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) in the phase III RESONATE study. The study results were...

gynecologic cancers

Early Study Explores New Approach to Treating Advanced Cervical Cancer

A small, federally funded study of nine patients treated with human papillomavirus (HPV)-targeted adoptive T-cell therapy gives reason to hope that this type of therapy may be a new effective approach for patients with metastatic cervical cancer and possibly other solid tumors.1 In the study, two...

Expert Point of View: Scott T. Tagawa, MD

Formal discussant Scott T. Tagawa, MD, Associate Professor of Clinical Medicine and Urology at Weill Cornell Medical College, New York, had the task of putting the three prostate cancer trials—PREVAIL, ELM-PC 4, and SWOG S0925—into context. “Since the approval of docetaxel, we have learned much...

prostate cancer

Updated Information on Prostate Cancer Drugs: Enzalutamide, Orteronel, and Cixutumumab

Three separate studies of treatments for prostate cancer reported at the 2014 ASCO Annual Meeting in Chicago showed excellent, intermediate, and disappointing results. An update of the previously reported PREVAIL trial (see March 1 issue of The ASCO Post, page 1) was overwhelmingly positive for the ...

colorectal cancer

Combined With Chemotherapy, Cetuximab and Bevacizumab Found Comparable for First-Line Metastatic Colorectal Cancer Treatment

Call it a draw: Cetuximab (Erbitux), an EGFR inhibitor,  and bevacizumab (Avastin), a VEGF inhibitor, confer comparable benefits as first-line treatment with chemotherapy for metastatic colorectal cancer, according to the phase III Cancer and Leukemia Group B (CALGB)/Southwest Oncology Group (SWOG) ...

Advancing Immune Checkpoint Targeting in Cancer Treatment

James P. Allison, PhD, Professor and Chair of the Department of Immunology, Executive Director of the Moon Shots Immunotherapy Platform, and Deputy Directory of the David H. Koch Center for Applied Research of Genitourinary Cancers at The University of Texas MD Anderson Cancer Center, Houston, is...

breast cancer

Exemestane/Ovarian Suppression Reduces Recurrence vs Tamoxifen/Ovarian Suppression in Premenopausal Breast Cancer

A joint analysis of two important phase III clinical trials—TEXT (Tamoxifen and Exemestane Trial) and SOFT (Suppression of Ovarian Function Trial)—showed that exemestane plus ovarian function suppression was superior to tamoxifen plus ovarian suppression in preventing recurrence in premenopausal...

hematologic malignancies

Siltuximab for Multicentric Castleman’s Disease

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 April 23, 2014, the anti–interleukin (IL)-6 monoclonal antibody...

Life: Magnified

On June 10, Life: Magnified, an eye-catching photo exhibit of scientific images, opened at Washington Dulles International Airport’s Gateway Gallery in Chantilly, Virginia. The exhibit features 46 high-resolution backlit images of cells from the body, including the brain, blood, eye, skin, liver,...

issues in oncology

'Physician Education Is Key' to Continued Advances in Geriatric Oncology

Several times during his lecture at the 2014 ASCO Annual Meeting, Stuart M. Lichtman, MD, FACP, FASCO, the recipient of the B.J. Kennedy Award for Scientific Excellence in Geriatric Oncology, emphasized, “Physician education is the key” to continued advances in geriatric oncology. He specified that ...

lung cancer

Importance of Using Multiplex Testing for Oncogenic Drivers to Select Targeted Drugs in Lung Cancer

Lung cancer is the leading cause of cancer death in the world as well as in the United States, where it is the leading cancer killer in both men and women. The majority of lung cancer patients present with metastatic (stage IV) disease that cannot be cured with current therapies. Standard cytotoxic ...

lung cancer

Lung Cancer Mutation Consortium Finds Oncogenic Drivers in Majority of Metastatic Lung Adenocarcinomas

The Lung Cancer Mutation Consortium (LCMC) was formed to test adenocarcinomas of the lung for 10 oncogenic drivers in order to enable clinicians to select targeted treatments and enroll patients into suitable clinical trials. As recently reported in JAMA by Mark G. Kris, MD, William and Joy Ruane...

Following ‘Fruitful’ Year of Collaboration, Advocacy, and Growth, Pediatric Hematology/Oncology Moves to Next Level

Finishing up a 2-year term as President of the American Society of Pediatric Hematology/Oncology (ASPHO), A. Kim Ritchey, MD, summarized ASPHO’s achievements in advocacy, education, and professional development in his State of the Society address at the ASPHO 27th Annual Meeting in Chicago. He also ...

2014 Breast Cancer Symposium to Focus on Collaborative Learning

ASCO’s educational symposia have historically provided attendees with a forum for learning and discussion, demonstrating ASCO’s commitment to promoting a network of global oncology expertise. The 2014 Breast Cancer Symposium, to be held in San Francisco from Thursday, September 4, to Saturday,...

colorectal cancer

Panitumumab Plus FOLFOX for KRAS Wild-Type Metastatic Colorectal Cancer

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. Panitumumab (Vectibix) was recently approved by the U.S. Food and...

breast cancer

Ado-Trastuzumab Emtansine as a Late Treatment for HER2-Positive Metastatic Breast Cancer—Better and Less Toxic Than Physician’s Choice

TH3RESA is a randomized phase III open-label study, reported in The Lancet Oncology and summarized in this issue of The ASCO Post, which examined the activity of ado-trastuzumab emtansine (Kadcyla) in heavily pretreated HER2-positive metastatic breast cancer.1 Formerly known as T-DM1,...

breast cancer

Ado-Trastuzumab Emtansine Improves Progression-Free Survival vs Physician’s Choice in Advanced HER2-Positive Breast Cancer

There are few treatment options for breast cancer patients with progressive disease after two or more HER2-directed regimens for recurrent or metastatic disease. In the open-label phase III TH3RESA trial reported in The Lancet Oncology by Ian E. Krop, MD, PhD, of the Dana-Farber Cancer Institute,...

issues in oncology

Navigating Cancer in the Era of Personalized Medicine: Rev 2014 Explores Emerging Issues, Ideas for Action

Diagnosed with stage IV non–small cell lung cancer in 2011, Stephen Wright turned to patient support groups where he learned about the anaplastic lymphoma kinase (ALK) mutation and a new drug that targeted it, crizotinib (Xalkori). He asked—then insisted—that he be tested for the mutation. He found ...

gynecologic cancers

FDA Advisory Committee Votes Against Accelerated Approval for Olaparib in Ovarian Cancer

The U.S. Food and Drug Administration (FDA) Oncologic Drugs Advisory Committee (ODAC) voted 11 to 2 that current evidence from clinical studies does not support an accelerated approval for use of olaparib as a maintenance treatment for women with platinum-sensitive relapsed ovarian cancer who have...

skin cancer

Concurrent Immunotherapy Pays Off in Advanced Melanoma

In advanced melanoma, two immune checkpoint inhibitors may be better than one, according to the promising outcomes of a study reported at the 2014 ASCO Annual Meeting. Concurrent treatment with the anti–CTLA-4 antibody ipilimumab (Yervoy) and nivolumab, an antibody targeting the programmed death...

prostate cancer

AR-V7 Predicts Resistance to Enzalutamide and Abiraterone in Men With Castration-Resistant Prostate Cancer

Androgen receptor (AR) splice variant 7 (V7) appears to be a new biomarker for response and disease progression in patients treated with enzalutamide (Xtandi) or abiraterone (Zytiga). The presence of AR-V7 in circulating tumor cells predicted resistance to both drugs in men with metastatic...

lung cancer

Strong Showing for Anti–PD-1 Agents in Non–Small Cell Lung Cancer

Monoclonal antibodies targeting the programmed death receptor-1 (PD-1) pathway are expected to answer an unmet need in non–small cell lung cancer (NSCLC). With first-line platinum-doublets, 1-year overall survival is 30% to 50%, and while treatments targeting sensitizing mutations are more...

skin cancer

Ipilimumab Reduces Recurrences as Adjuvant Treatment of Melanoma

Ipilimumab (Yervoy) has transformed the treatment of metastatic melanoma, producing long-term responses in about 20% of patients. A phase III study has now evaluated its impact in the adjuvant setting, and the results are a bit less striking. Primary Endpoint The European Organisation for Research...

health-care policy

IOM Workshop Explores Growing Problems in Patient Access to Cancer Drugs

Cancer patients’ out-of-pocket costs are rising dramatically, and insurance premiums, cost sharing, and ancillary expenses can be devastating. Many people go bankrupt as a result of the high costs of health care. Drugs are among the most serious economic culprits. They grow more expensive every...

Expert Point of View: Jeffrey S. Weber, MD, PhD

Jeffrey S. Weber, MD, PhD, Director of the Donald A. Adam Comprehensive Melanoma Research Center at the Moffitt Cancer Center and Research Institute in Tampa, Florida, formally discussed the prembrolizumab study at the ASCO Annual Meeting. He called the response rate and the ongoing responses...

skin cancer

'Impressive' Outcomes Achieved With Pembrolizumab in Advanced Melanoma

The latest bit of good news for the programmed death receptor-1 (PD-1)–targeting antibodies in advanced melanoma comes for pembrolizumab (MK-3475). While the results came from only a phase I study, they were among those chosen for presentation at an ASCO press briefing during the Annual Meeting....

colorectal cancer
survivorship

Colorectal Cancer Survivors Prefer More Information on Late Effects of Treatment and Recurrence Risks

Survivors of nonmetastatic colorectal cancer, when surveyed about their needs and preferences for survivorship information, responded that they would prefer receiving more information about late effects of treatment, challenges to expect, general health maintenance, and risks of recurrence. Most of ...

International Leader in Urology, Professor John Fitzpatrick, Dies

His life was gentle, and the elements So mixed in him that Nature might stand up And say to all the world, “This was a man!” —William Shakespeare   I have too many positive memories of John to regale you with here,” said Roger Kirby, MD, in a tribute to his close friend and colleague, John Michael...

prostate cancer

Prostate Cancer Biomarkers: Improvement in Predicting Clinically Significant Disease

Prostate cancer will be diagnosed in 233,000 American men in 2014. It is one of the leading causes of death by a cancer (killing ~29,500 men annually).1 Hundreds of thousands of men undergo prostate biopsies each year, most for either benign disease or for a cancer that will never lead to their...

Focus on the Ohio Hematology Oncology Society

The Ohio Hematology Oncology Society (OHOS) was formed 2 decades ago to advocate for and provide educational seminars and networking opportunities to hematologists and medical oncologists throughout the states of Ohio and West Virginia. Today, the society is focused on the needs of its nearly 200...

lung cancer

Lung-MAP Trial Debuts—Other Personalized Studies Will Follow

Oncologists now have a means of bringing personalized medicine to advanced squamous cell carcinoma, and it involves a biomarker-driven clinical trial that maximizes the chance of successful treatment and new drug approvals. Lung-MAP (Lung Cancer Master Protocol) is a unique concept in which the...

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