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Leukemia

Three Novel Agents Show Promise in Acute Lymphoblastic Leukemia

Susan O’Brien, MD, Professor in the Department of Leukemia at The University of Texas MD Anderson Cancer Center, Houston, has a special interest in novel developments in the treatment of acute lymphoblastic leukemia (ALL). At the 2011 ASH Annual Meeting, she discussed her picks of top newsmakers in ...

Leukemia

Expert Point of View: Ponatinib Continues to Impress in Patients with Leukemia

At the 2011 ASH Annual Meeting, Pierre Laneuville, MD, Director of Hematology at McGill University in Montreal, predicted that ponatinib may be “the drug that will replace them all” in the treatment of chronic myeloid leukemia. Dr. Laneuville explained his rationale, recalling that in the pivotal...

Leukemia

Ponatinib Continues to Impress in Patients with Leukemia

Initial results from the PACE (Ponatinib Ph+ ALL and CML Evaluation) trial added to accumulating evidence that the tyrosine kinase inhibitor ponatinib should soon be considered for front-line treatment of chronic myeloid leukemia (CML). “Robust responses were observed in all patient cohorts,” said...

Leukemia

Expert Point of View: BELA Trial Reborn: Bosutinib Produces Improved Results in Chronic Myeloid Leukemia

Given the results of the BELA trial, with the problems of treatment side-effect management realized and seemingly resolved, Elias Jabbour, MD, Assistant Professor of Medicine at The University of Texas MD Anderson Cancer Center, Houston, assumes bosutinib will be approved in chronic myeloid...

Leukemia

BELA Trial Reborn: Bosutinib Produces Improved Results in Chronic Myeloid Leukemia

The initial reports of the BELA trial (Bosutinib Efficacy and safety in chronic myeloid LeukemiA), presented at ASH 2010, were deflating. At 12-month follow-up, bosutinib failed to meet BELA’s primary endpoint. Things have since turned around, however, and results from the 24-month analysis...

Hematologic Malignancies
Leukemia
Lymphoma

ASH 2011 Presentations Include Novel Agents and New Strategies in Leukemia, Lymphoma, and Myeloma

Attendees at the 53rd Annual Meeting of the American Society of Hematology (ASH), held recently in in San Diego, were able to choose from a wide range of interesting and important sessions exploring hematologic malignancies. In addition to The ASCO Post’s regular news coverage from the meeting,...

Leukemia

Autologous Transplant vs Consolidation Chemotherapy in Acute Myeloid Leukemia: A Recent European Trial

Investigators in the Dutch-Belgian Hemato-Oncology Cooperative Group and the Swiss Group for Clinical Cancer Research Collaborative Group recently reported in the journal Blood that autologous peripheral blood stem cell transplantation significantly reduced relapse rate compared with intensive...

Leukemia

Autologous Hematopoietic Cell Transplantation for Adult Acute Myeloid Leukemia: A Question That Doesn’t Go Away

More than 3 decades ago, the first trials of autologous hematopoietic cell transplantation as consolidation therapy for acute myeloid leukemia (AML) in first remission were conducted. The initial results were inconclusive; most patients survived the procedure, but post-transplant relapse was common ...

Leukemia

Liposomal Vincristine Receives Positive Vote from ODAC

Talon Therapeutics, Inc, announced the Oncologic Drugs Advisory Committee voted 7 yes, 4 no, and 2 abstain that evidence from clinical studies supports a favorable benefit-risk assessment for use of vincristine sulfate liposomes injection (Marqibo). The manufacturer is seeking an indication for the ...

Leukemia

Erwinia chrysanthemi Asparaginase for Acute Lymphoblastic Leukemia in Patients with Hypersensitivity to E coli–derived Asparaginase

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. Indication Erwinia chrysanthemi asparaginase (Erwinaze) was...

Leukemia

Treating Acute Promyelocytic Leukemia without Chemotherapy

Throughout the course of medical history, we have witnessed innovations that have initially been met with skepticism but have later revolutionized our management of patients with specific disorders. The recent history of oncology drug development is full of instances where a drug that was...

Breast Cancer
Kidney Cancer
Lung Cancer
Skin Cancer
Leukemia
Lymphoma
Issues in Oncology

NCCN Clinical Practice Guidelines: Important Updates for 2012

The National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology have become the most widely used guidelines in oncology practice. The Guidelines cover 97% of all patients with cancer and are continually updated by expert panels. The 2012 Guidelines include some completely...

Leukemia

Integrated Genetic Profiling Can Identify Predictors of Outcome and Improve Risk Stratification in AML Patients

A mutational analysis of 18 genes in 398 patients with acute myeloid leukemia (AML) found at least one somatic alteration in 97.3% of the patients and identified genetic predictors of outcome that improved risk stratification among patients with AML, independent of age, white-cell count, induction...

Leukemia

Study Shows Steady Increases in Survival for Children with ALL

A study by the Children’s Oncology Group (COG) reported that 5-year survival for acute lymphoblastic leukemia (ALL) among children treated through COG clinical trials increased from 83.7% during the period 1990-1994 to 90.4% in the period 2000-2005. The improvements in survival were observed among...

Leukemia

Progress in Treating Chronic Lymphocytic Leukemia Has Led to Across-the-board Improvements in Survival

Four decades ago, Kanti R. Rai, MD, was determined to figure out why some of his patients with chronic lymphocytic leukemia (CLL) died within 2 years after their diagnosis, while others lived for 20 or even 30 years. At the time, Dr. Rai was a young scientist doing research in leukemia at...

Leukemia

Pediatric ALL with Induction Failure Is Highly Heterogeneous with Varying Outcomes

While failure of remission-induction therapy is rare in children and adolescents with acute lymphoblastic leukemia (ALL), when it does occur it is highly adverse and heterogeneous, according to a study in The New England Journal of Medicine. “Patients who have T-cell leukemia appear to have a...

Leukemia

Prognostic Value of Integrated Cytogenetic and Mutational Risk Classification in Acute Myeloid Leukemia

Jay P. Patel, BS, and colleagues from Memorial Sloan-Kettering Cancer Center in New York recently performed mutational analysis of 18 genes in a subgroup of newly diagnosed acute myeloid leukemia (AML) patients who had been randomized to receive cytarabine plus high-dose or standard-dose...

Leukemia

Updated Findings Further Define Role of Tyrosine Kinase Inhibitors in CML

With three available tyrosine kinase inhibitors for the treatment of chronic myeloid leukemia (CML), attention has turned from the ability to achieve a sustained response to the possibility of “curing” patients. Updates of pivotal trials presented at ASCO may help define the role of the tyrosine...

Leukemia

PACE Trial Update: Ponatinib Produces High Response Rates in CML

The third-generation tyrosine kinase inhibitor ponatinib showed robust efficacy in the 10-month follow-up of the phase II PACE trial (Ponatinib Ph+ALL and CML Evaluation), which is evaluating ponatinib in treatment-refractory chronic myeloid leukemia (CML)1 At the 2012 ASCO Annual Meeting, Jorge E. ...

Leukemia

Novel Agents Should Have Impact in Lymphocytic Leukemias

Agents with novel mechanisms of action may strongly impact outcomes in chronic lymphocytic leukemia (CLL) and acute lymphocytic leukemia (ALL), if data from early-phase studies presented at this year’s ASCO Annual Meeting are any indication. There is a clear unmet need for more effective therapies...

Leukemia

Liposomal Vincristine Approved in Acute Lymphoblastic Leukemia

The FDA has approved vincristine sulfate liposome injection (Marqibo) to treat adults with Philadelphia chromosome–negative acute lymphoblastic leukemia (ALL). Administered once a week, liposomal vincristine is approved for patients whose leukemia has relapsed two or more times, or whose leukemia...

Leukemia

CT Scans in Childhood Can Triple Risk of Leukemia and Brain Cancer Later in Life, Study Finds

In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. Computed tomography scans with...

Leukemia

FDA Approves New Orphan Drug for Chronic Myelogenous Leukemia

The FDA has approved bosutinib (Bosulif) to treat chronic myelogenous leukemia (CML). The drug is intended for patients with chronic, accelerated, or blast phase Philadelphia chromosome–positive CML who are resistant to or who cannot tolerate other therapies, including imatinib (Gleevec). The...

Leukemia

New Agents Are Achieving Deeper Responses in CML

As tyrosinse kinase inhibitors become increasingly effective in treating chronic myeloid leukemia (CML), major molecular responses (≥ 3-log reduction in BCR-ABL transcripts) are being achieved for a growing percentage of patients. “In the new era of tyrosinse kinase inhibitors, we are learning how...

Solid Tumors
Breast Cancer
Leukemia

New Studies Explore Exposure to Cancer-causing Agents

Key studies on cancer epidemiology and prevention delivered both reassuring and not-so-reassuring findings on exposure to agents believed to be cancer-promoting. Kala Visvanathan, MD, MHS, of The Sidney Kimmel Cancer Center, Johns Hopkins School of Medicine and School of Public Health, Baltimore,...

Leukemia

Bosutinib in Chronic Myelogenous Leukemia Patients with Resistance or Intolerance of Prior Therapy

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. Indication In September 4, 2012, bosutinib (Bosulif) was approved...

Leukemia

Kinase Inhibitors Compared in First-line Treatment of CML

Bosutinib (Bosulif) is an oral dual Src/Abl kinase inhibitor that is active against many Bcr-Abl mutations associated with imatinib (Gleevec) resistance and that has reduced activity against nonspecific molecular targets associated with toxicities reported for other second-generation kinase...

Leukemia

Adjuvant Chemotherapy for Breast Cancer Not Linked to Acute Myeloid Leukemia and Myelodysplastic Syndromes

Contradicting what some previous investigations have found, a study from The US Oncology Network found that adjuvant chemotherapy for breast cancer does not increase the risk of acute myeloid leukemia and myelodysplastic syndromes (AML/MDS), at least within the first 3 years of treatment.1 The...

Leukemia
Lymphoma

Developments in Hematologic Cancers Include New Considerations in Treating Challenging Leukemias and Multiple Myelomas

Speakers at the National Comprehensive Cancer Network (NCCN) 7th Annual Congress on Hematologic Malignancies reviewed the current standard of care for various hematologic cancers and explored new concepts in treatment. Below are highlights from presentations on chronic myelogenous leukemia (CML),...

Leukemia

Challenges Persist in Treatment of Elderly Patients with CLL, but Novel Agents Hold Promise for Future Strategies

Chronic lymphocytic leukemia (CLL) is mainly a disease of the elderly, and the lack of a standard regimen for elderly patients has been a major challenge. The myelosuppressive regimens used to treat younger patients are not well tolerated by the elderly. However, some newer approaches currently...

Hematologic Malignancies
Leukemia

SIDEBAR: REPORT ADVERSE EVENTS

Health-care professionals should report all serious adverse events suspected to be associated with the use of any medicine or device to FDA’s MedWatch Reporting System by completing a form online at http://www.fda.gov/medwatch/report.htm, by faxing (1-800-FDA-0178), by mailing the postage-paid...

Hematologic Malignancies
Leukemia

Liposomal Vincristine for Adult Patients with Relapsed/Refractory Acute Lymphoblastic Leukemia

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. Indication In August 2012, vinCRIStine sulfate LIPOSOME injection...

Leukemia

Chlorambucil, but Not Fludarabine, Confers Significant Benefit in Older Patients with CLL

Among patients aged 70 years and older with chronic lymphocytic leukemia (CLL), “front-line therapy with fludarabine does not improve outcomes” compared to chlorambucil (Leukeran), according to an analysis of patients enrolled in successive front-line Cancer and Leukemia Group B (CALGB) studies...

Leukemia

Omacetaxine for Chronic or Accelerated Phase CML Patients with Resistance/Intolerance to Tyrosine Kinase Inhibitors

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. Indication On October 26, 2012, the FDA granted accelerated...

Leukemia

Excellent Preliminary Results for Ibrutinib in Chronic Lymphocytic Leukemia

Although still in preliminary testing with no phase III data, ibrutinib is poised to become an important new agent for patients with chronic lymphocytic leukemia (CLL). Two phase II trials reported at the 54th Annual Meeting of the American Society of Hematology (ASH) found that ibrutinib achieved...

Leukemia

FDA Approves Ponatinib to Treat CML and Philadelphia Chromosome–positive ALL

In December, the FDA granted accelerated approval to ponatinib (Iclusig) for the treatment of adult patients with chronic-, accelerated-, or blast-phase chronic myeloid leukemia (CML) that is resistant or intolerant to prior tyrosine kinase inhibitor therapy or Philadelphia chromosome–positive...

Hematologic Malignancies
Leukemia

Pivotal Trial Shows Robust Activity of Ponatinib in Some Heavily Pretreated Leukemias

The pivotal phase II Ponatinib Ph+ ALL and CML Evaluation (PACE trial) found that 1 year of treatment with the novel investigational drug ponatinib achieved robust activity in heavily pretreated patients with chronic myeloid leukemia (CML) and Philadelphia chromosome–positive acute lymphoblastic...

Leukemia
Breast Cancer

Oncology Trailblazer James F. Holland, MD, Recalls a Time of Unbridled Scientific Excitement 

James F. Holland, MD, began his journey into oncology when it was still a nascent discipline, working alongside groundbreaking pioneers in the field such as Drs. Emil “Tom” Frei and C. Gordon Zubrod. Dr. Holland recently shared a glimpse of his role in oncology’s formative years with The ASCO Post. ...

Leukemia

Patients Receiving Higher-intensity Chemotherapy for ALL Are at Greater Risk for Cognitive Deficits, Researchers Report 

Omitting cranial irradiation from the treatment regimen for acute lymphoblastic leukemia (ALL) may help preserve global cognitive abilities. “Treatment with chemotherapy alone is not without risks,” however, noted researchers from St. Jude Children’s Research Hospital in Memphis. “The St. Jude...

Leukemia

Inotuzumab Moves Forward in Relapsed/Refractory ALL 

Single-agent inotuzumab ozogamicin achieved an encouraging overall response rate of 57% in the treatment of relapsed/refractory acute lymphoblastic leukemia (ALL) in a phase II trial reported at the 54th Annual Meeting of the American Society of Hematology (ASH). Response was independent of monthly ...

Leukemia

Genetic Basis of High-risk Childhood Cancer Points to Possible New Drug Treatment Strategy

Research led by scientists at St. Jude Children’s Research Hospital, Memphis, Tennessee, has identified a possible lead in treatment of two childhood leukemia subtypes known for their dramatic loss of chromosomes and poor treatment outcomes. The findings also provide the first evidence of the...

Leukemia

Ponatinib in Chronic Myeloid Leukemia and Philadelphia Chromosome–positive Acute Lymphoblastic Leukemia 

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. Indication On December 14, 2012, ponatinib (Iclusig) was granted...

Leukemia

ASH International Clinical Collaboration Replicates High Cure Rate of APL in Developing Countries

The work of an American Society of Hematology (ASH) international clinical network collaborative focused on modernizing treatment protocols for patients in the developing world with acute promyeloctyic leukemia (APL) has drastically improved cure rates in patients in Central and South America. In...

Leukemia
Lymphoma
Multiple Myeloma

ASH Highlights Included New Data in Myeloma, Lymphoma, and Leukemia, plus Studies of Mucositis and Graft-vs-Host Disease

The 54th Annual Meeting of the American Society of Hematology (ASH) featured about 5,000 abstracts, including oral sessions and posters, as well as named lectures and symposia. In addition to our regular news coverage from the meeting, below are capsule summaries of a few news highlights that we...

Breast Cancer
Leukemia

Chemotherapy for Breast Cancer Carries a Small, but Concerning, Risk for Leukemia 

The risk for developing a secondary malignancy after chemotherapy for breast cancer is very small, but it is statistically significantly higher than for the general population, a review of the National Comprehensive Cancer Network (NCCN) database revealed in a study presented at the 2012 San...

Leukemia

Daunorubicin-free Induction Therapy for Standard-risk Childhood Acute Lymphoblastic Leukemia 

Omitting daunorubicin from induction therapy for children with standard-risk acute B-cell lymphoblastic leukemia (ALL) does not compromise survival and at the same time reduces the risk of associated toxicities, including myelosuppression and cardiac damage, according to results of the large phase...

Leukemia

Expert Point of View: Farhad Ravandi, MD 

Over the past 2 decades, we have witnessed remarkable progress in the treatment of patients with acute promyelocytic leukemia (APL). The introduction of all-trans retinoic acid (ATRA) in the front-line therapy setting and arsenic trioxide in the relapse setting had already led to a significant...

Leukemia

Chemotherapy-free Regimen Successful in Acute Promyelocytic Leukemia 

For the first time, a chemotherapy-free regimen was superior to conventional cytotoxic chemotherapy for the treatment of acute promyelocytic leukemia (APL). The combination of all-trans retinoic acid (ATRA) plus arsenic trioxide (Trisenox) achieved significantly superior overall survival compared...

Leukemia

We Need Gemtuzumab Available Again to Treat AML

The word “revival” signifies a renewed use or acceptance after a period of inactivity; similarly, the word “resurrection” refers to the concept of an entity coming back to life after death. In the past year, these terms have been used frequently by us (and others) in articles calling for the return ...

Leukemia

Imatinib Receives New Indication for Children with Acute Lymphoblastic Leukemia 

The FDA approved a new use of imatinib (Gleevec) to treat children newly diagnosed with Philadelphia chromosome–positive acute lymphoblastic leukemia (ALL). ALL is the most common type of pediatric cancer, affecting approximately 2,900 children annually, and progresses quickly if untreated....

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