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breast cancer

Autologous Breast Reconstruction Associated With Fewer Complications and Failures Than Implants in Women Who Have Received Radiation

Postmastectomy radiation is becoming more commonly used to treat breast cancer, and at the same time, there is an increasing trend among women to have breast reconstruction. Until now, oncologists have had little evidence on what the best reconstruction options are in women who require radiation...

breast cancer
symptom management

Randomized Trial Demonstrates Benefit of Scalp-Cooling in Prevention of Chemotherapy-Induced Hair Loss

A scalp-cooling device was found safe and effective in preventing chemotherapy-induced hair loss in women undergoing adjuvant treatment for breast cancer in an interim analysis of the first prospective, randomized trial of a modern scalp-cooling system. The study was presented at the 2016 San...

hematologic malignancies
symptom management

Expert Point of View: Kanti R. Rai, MD

Kanti R. Rai, MD, Professor of Medicine, Hofstra Northwell School of Medicine, New Hyde Park, New York, commented on these study findings. “I congratulate the investigators for a work done with discipline, excellent collaboration, and speed.” “All of us who have become familiar with ibrutinib...

hematologic malignancies
symptom management

Ibrutinib: A Potential Option for Chronic Graft-vs-Host Disease?

Currently, there is no U.S. Food and Drug Administration (FDA)-approved therapy for chronic graft-vs-host disease—a life-threatening consequence of stem cell or bone marrow transplant—that has not responded to corticosteroids, but this may be about to change. Ibrutinib (Imbruvica) achieved...

lymphoma

CAR T-Cell Therapy KTE-C19 Appears Successful in Aggressive B-Cell Lymphoma

Chimeric antigen receptor (CAR) T-cell therapy continues to have impressive showings in patients with aggressive hematologic malignancies and no other good treatment options. Interim results of the pivotal phase II ZUMA-1 trial, the first multicenter trial of the experimental CAR T-cell therapy...

leukemia

Expert Point of View: Richard Furman, MD

“These results are interesting, important, and relevant for maintenance post chemotherapy, but if we are not using chemotherapy, they may not be relevant,” said Richard Furman, MD, of Weill Cornell Medical College, New York Presbyterian Hospital, New York. He said that newer drugs such as...

leukemia

Lenalidomide Maintenance Extends Progression-Free Survival in CLL

Lenalidomide (Revlimid), a cornerstone of therapy for multiple myeloma in the modern era, is making headway as maintenance therapy in chronic lymphocytic leukemia (CLL). Separate phase III studies presented at the 2016 American Society of Hematology (ASH) Annual Meeting & Exposition showed...

breast cancer

Expert Point of View: Carlos L. Arteaga, MD

Press conference moderator ­Carlos L. Arteaga, MD, of Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, said that buparlisib will probably not be clinically useful, partly because it crosses the blood-brain barrier , thus causing mood disorders, and is not an ideal phosphoinositide 3-kinase...

breast cancer

Buparlisib Phase III Findings: Glass Half Empty or Half Full?

The pan-phosphoinositide 3-kinase (PI3K) inhibitor buparlisib combined with fulvestrant (Faslodex) prolonged progression-free survival compared with placebo and fulvestrant in postmenopausal women with hormone receptor–positive, HER2-negative advanced breast cancer previously treated with an...

breast cancer

Expert Point of View: Myles Brown, MD, Carlos L. Arteaga, MD, and Eric Winer, MD

Myles Brown, MD, Director of the Center for Functional Cancer Epigenetics at Dana-Farber Cancer Institute, Boston, suggested the failure of the endocrine therapy to increase the pathologic complete response rates “may be related to the fact that the aromatase inhibitor was not the optimal...

breast cancer

Expert Point of View: Carlos L. Arteaga, MD

Press conference moderator ­Carlos L. Arteaga, MD, said: “This drug is not necessarily the same as palbociclib [Ibrance] or ribociclib. There are subtle differences among these three [cyclin-dependent kinase (CDK) 4/6] inhibitors. The tissue analysis provides us with an enormous opportunity to...

breast cancer

Abemaciclib Plus Anastrozole: Promising Signals Reported in Phase II Study of Early Breast Cancer

As neoadjuvant therapy, abemaciclib alone or in combination with anastrozole achieved strong signals of anticancer activity in postmenopausal patients with hormone receptor–positive, HER2-negative breast cancer in the neoMONARCH phase II study.1 Abemaciclib alone or in combination with anastrozole...

breast cancer
genomics/genetics

Expert Point of View: Leif Ellisen, MD, PhD

Results of this trial have been anticipated for a long time. Women were enrolled between 2000 and 2008,” said Leif Ellisen, MD, PhD, Program Director of Breast Medical Oncology at Massachusetts General Hospital Cancer Center in Boston. Regarding the survival advantage in triple-negative...

breast cancer
genomics/genetics

BRCA Status Does Not Seem to Affect Survival Outcomes in Young Women With Early Breast Cancer

Young women who carry the BRCA1 and/or BRCA2 mutation and develop breast cancer seem to have similar survival compared with young women who have BRCA-negative breast cancer. However, women with BRCA-positive triple-negative breast cancer have an 11% survival advantage compared with those with...

breast cancer
genomics/genetics

Genomic Landscape of Metastatic Breast Cancer Differs From That of Primary Breast Cancer

Researchers working on whole-exome and transciptome sequencing of endocrine-resistant estrogen receptor–positive metastatic breast cancer have shown that the mutational landscape differs from that of estrogen receptor–positive primary breast cancer, and these differences have the potential to...

breast cancer

Expert Point of View: Virginia Kaklamani, MD

How can the results of this trial be applied to clinical practice? Press conference moderator, Virginia Kaklamani, MD, of the University of Texas Health Science Center in San Antonio, said: “The landscape has changed. Now we treat postmenopausal hormone receptor–positive, HER2-negative metastatic...

breast cancer

Fulvestrant Plus Everolimus: New Second-Line Option for Postmenopausal Metastatic Breast Cancer

The addition of everolimus (Afinitor) to fulvestrant (Faslodex) doubled progression-free survival in postmenopausal women with hormone receptor–positive, HER2-negative metastatic breast cancer resistant to aromatase inhibitor therapy compared with fulvestrant plus placebo, according to the...

leukemia

Expert Point of View: Armand Keating, MD

“This study shows that a great deal of innovation can come from existing knowledge. The 7+3 regimen has been around since I was an intern,” admitted Armand Keating, MD, of the University of Toronto and Princess Margaret Hospital, Toronto, Ontario, Canada. “Using the liposomal formulation of...

leukemia

CPX-351 Improves Survival Post Transplant in Older High-Risk Patients With Acute Myeloid Leukemia

Induction therapy with the experimental chemotherapy called CPX-351—a liposomal formulation of cytarabine and daunorubicin—outperformed standard “7+3” cytarabine plus daunorubicin by extending survival in older high-risk patients with acute myeloid leukemia (AML) who subsequently underwent...

lymphoma

Expert Point of View: Lawrence Kaplan, MD

“This study is important because R-CHOP [rituximab and cyclophosphamide, doxorubicin, vincristine, prednisone] has been the standard of care for many years. CHOP, the chemotherapy backbone, has withstood challenges from more aggressive regimens in the past. The excellent clinical outcomes observed ...

lymphoma

Dose-Adjusted EPOCH-R No Better Than R-CHOP in Diffuse Large B-Cell Lymphoma

Long-awaited results of the Cancer and Leukemia Group B ­(CALGB)/Alliance 50303 trial were a disappointment to many hematologists/oncologists at the 2016 American Society of Hematology (ASH) Annual Meeting & Exposition. The study failed to show that dose-adjusted EPOCH-R ­(etoposide,...

lymphoma

Expert Point of View: Brad S. Kahl, MD

Speaking about the GALLIUM study in the ASH News Daily, Brad S. Kahl, MD, of Washington University School of Medicine, St. Louis, commented, “It is a potentially practice-changing study that clearly shows an 8% absolute improvement in progression-free survival at 2 years for the patients getting...

lymphoma

Obinutuzumab Prolongs Disease-Free Survival vs Rituximab in Follicular Lymphoma

Induction and maintenance therapies with obinutuzumab (Gazyva) were superior to rituximab (Rituxan) induction and maintenance in patients with untreated follicular lymphoma, according to results of the phase III GALLIUM study presented at the Plenary Session during the 58th American Society of...

leukemia

Expert Point of View: Amir T. Fathi, MD

“In the past few years, there has been increased reporting of other, less traditional, response criteria in acute myeloid leukemia (AML), including morphologic leukemia-free state, partial response, and complete remission [or complete response] with incomplete recovery. There is some concern that...

leukemia

Achieving Complete Response Is Key to Improving Survival in Older Patients With AML

The importance of achieving complete response after intensive therapy in older adults with acute myeloid leukemia (AML) was confirmed in a follow-up analysis of the E2906 North American Intergroup trial.1 Patients in complete response had superior survival in this landmark analysis. This finding...

leukemia

Expert Point of View: Mikkael Sekeres, MD

In his practice, Mikkael Sekeres, MD, of the Cleveland Clinic Foundation, has not initiated dose reductions of tyrosine kinase inhibitors, but “anecdotally, my patients tell me that they have reduced the dose. Many of them cannot afford to continue treatment indefinitely, and some have side...

leukemia

Reducing Doses and Stopping Tyrosine Kinase Inhibitors Gain Favor in Chronic Myeloid Leukemia

Tyrosine kinase inhibitors, such as imatinib, nilotinib (Tasigna), and dasatinib (Sprycel), have revolutionized the treatment of chronic myeloid leukemia (CML). A substantial percentage of patients achieve deep and meaningful remissions on these agents. More recently, partly driven by patients’ and ...

lymphoma

‘Clinically Useful’ Findings for Brentuximab Vedotin in CTCL, Rituximab Maintenance in MCL

Positive studies about brentuximab vedotin ­(Adcetris) in cutaneous T-cell lymphoma1 and rituximab (Rituxan) maintenance therapy in mantle cell lymphoma (MCL)2 were reported at the 2016 Annual Meeting of the American Society for Hematology (ASH). “These abstracts each focus on approved agents and...

issues in oncology
lung cancer
gastrointestinal cancer
prostate cancer
colorectal cancer

At ESMO 2016, Many Phase III Trials Fail to Meet Primary Endpoints

The 2016 European Society for Medical Oncology (ESMO) Congress revealed many important positive findings from key trials in a number of tumor types, but many highly anticipated phase III trials in advanced disease failed to meet their primary endpoints. The ASCO Post has summarized several of these ...

Expert Point of View: Laurence Albiges, MD, PhD

Formal discussant Laurence Albiges, MD, PhD, of Institut Gustave Roussy, Villejuif, France, tried to put the results of KEYNOTE-052 and CheckMate 275 into perspective. “Anti–PD-1 (programmed cell death protein 1) and anti–PD-L1 (programmed cell death ligand 1) agents represent a revolution in the...

bladder cancer

Anti–PD-1 Contenders in Advanced Urothelial Cancer

Immunotherapy with anti–PD-1 (programmed cell death protein 1) and anti–PD-L1 (programmed cell death ligand 1) agents continues to advance in metastatic urothelial cancer, with positive showings in two clinical trials presented at the 2016 European Society for Medical Oncology (ESMO) Congress. The...

lymphoma
skin cancer

Lack of Standardized Definitions of Cutaneous T-Cell Lymphomas Hampers the Collection of Reliable Data

Cutaneous T-cell lymphomas are a heterogeneous group of cancers. Some subtypes of cutaneous T-cell lymphomas are often misdiagnosed as benign skin diseases, making it challenging to gather reliable epidemiologic data. At the 3rd World Congress of Cutaneous Lymphomas (sponsored by the International...

lymphoma
skin cancer

Encouraging First Study of Pembrolizumab in Cutaneous T-Cell Lymphoma

Immunotherapy with an anti–programmed cell death protein 1 (PD-1) inhibitor—pembrolizumab (Keytruda)—showed encouraging responses in patients with advanced cutaneous T-cell lymphoma (either mycosis fungoides or Sézary syndrome). Pembrolizumab achieved a 38% overall response rate and responses...

lymphoma
skin cancer

Prospective Cutaneous Lymphoma International Prognostic Index Initiative Moves Forward

A collaboration of international experts is tackling the challenges involved in understanding and managing the treatment of cutaneous lymphomas. The Prospective Cutaneous Lymphoma International Prognostic Index ­(PROCLIPI) study from the Cutaneous Lymphoma International Consortium brings together...

Expert Point of View: Youn Kim, MD

Commenting on this talk during the discussion afterward, Youn Kim, MD, of Stanford University School of Medicine, Stanford, California, said: “At our center, we use high-throughput sequencing of T-cell receptors daily in patients with cutaneous T-cell lymphomas, and it is a billable service paid...

lymphoma
skin cancer

High-Throughput Sequencing of T-Cell Receptors May Transform Diagnosis and Treatment of Cutaneous T-Cell Lymphomas

High-throughput sequencing of T-cell receptors may be a solution to some of the challenges confronting oncologists who treat cutaneous T-cell lymphomas. According to experts who presented talks on high-throughput sequencing of T-cell receptors at the 3rd World Congress of Cutaneous Lymphoma...

Expert Point of View: Axel Le Cesne, MD

“The debate about perioperative chemotherapy in localized high-grade soft-tissue sarcoma is never-ending. Can this study resolve the debate?” asked formal discussant Axel Le Cesne, MD, of the Institute de Cancerologie Gustave-Roussy, Villejuif, France. “Surgery remains the standard of care for all ...

sarcoma

Neoadjuvant Chemotherapy in High-Risk Soft-Tissue Sarcoma: A New Standard?

For the first time, a randomized trial has provided good evidence to support the use of neoadjuvant chemotherapy for treatment of high-risk soft-tissue sarcoma of the extremities or trunk wall.1 But the findings of the study were surprising, because neoadjuvant chemotherapy with one-size-fits-all...

Expert Point of View: Sandro Pignata, MD

“This study represents a significant step forward in the treatment of recurrent ovarian cancer,” stated formal discussant Sandro Pignata, MD, of the IRCCS National Cancer Institute “Fondazione G. Pascale,” Naples, Italy. He highlighted some key factors: Patients selected for the study were those...

gynecologic cancers

‘Breakthrough’ in Recurrent Ovarian Cancer: Niraparib Extends Progression-Free Survival in Platinum-Sensitive Disease

A landmark study showed that the investigational PARP (poly ADP-ribose polymerase) 1/2 inhibitor niraparib, when used as maintenance therapy, significantly improves the outcome of platinum-sensitive recurrent ovarian cancer. Specifically, niraparib significantly prolonged progression-free survival ...

Expert Point of View: Anthony T.C. Chan, MD

These results showed nivolumab (Opdivo) to be the clear winner in this trial from the patients’ perspective, according to formal discussant Anthony T.C. Chan, MD, of the Chinese University of Hong Kong. “Taking the positive results of nivolumab in improving survival in these patients, and...

head and neck cancer

Better Quality of Life Reported in Patients With Head and Neck Cancer Receiving Nivolumab vs Chemotherapy

Standard treatment for advanced head and neck cancer—including chemotherapy and radiation—causes painful side effects that impair quality of life, as well as the ability to socialize and engage in daily life activities. A new study of patients with platinum-refractory recurrent, metastatic head...

Expert Point of View: Guido Reifenberger, MD

“Low-grade gliomas are biologically and clinically heterogeneous entities with different genetic drivers,” said formal discussant of this trial, Guido Reifenberger, MD, of Heinrich Heine University, Düsseldorf, ­Germany. “The BRAF V600 mutation is a novel therapeutic target in gliomas occurring in ...

cns cancers

Preliminary Data Indicate Potential Role for Dabrafenib as Part of Therapy for Pediatric Low-Grade Gliomas With BRAF V600 Mutation

About 10% of children with low-grade gliomas have the BRAF V600E mutation, and preliminary studies suggest that the BRAF inhibitor dabrafenib (Tafinlar) may play an important role in treating this group of patients. A phase I/II trial presented at the 2016 European Society for Medical Oncology...

Expert Point of View: Peter Schmid, MD, PhD

Several practice-changing studies have shown that adding a CDK4/6 inhibitor to an aromatase inhibitor improves survival in hormone receptor–positive advanced breast cancer, and those results should also be considered, said formal discussant Peter Schmid, MD, PhD, of Bart’s Cancer Institute, Queen...

breast cancer

Fulvestrant Superior to Anastrozole as Initial Therapy in Advanced Breast Cancer

Fulvestrant (Faslodex) was superior to anastrozole as initial treatment of hormone receptor–positive, endocrine therapy–naive, advanced breast cancer, significantly reducing the risk of disease progression or death, according to the results of the phase III FALCON study presented at the 2016...

Expert Point of View: Jean-Charles ­Soria, MD, PhD

Formal discussant Jean-Charles ­Soria, MD, PhD, of Institut Gustave Roussy, Villejuif, France, and Editor-in-Chief of Annals of Oncology (the official journal of the European Society for Medical Oncology [ESMO]), tried to put these findings into perspective. He pointed out that when applying the...

lung cancer

Pembrolizumab Plus Chemotherapy Improves Outcomes Over Chemotherapy Alone in Advanced NSCLC

Combining immunotherapy with a standard chemotherapy doublet appears to be an attractive option for the front-line treatment of advanced nonsquamous non–small cell lung cancer (NSCLC), according to the results of a phase II study presented at the 2016 European Society for Medical Oncology (ESMO)...

Expert Point of View: Axel Bex, MD, PhD

The formal discussant of this trial, Axel Bex, MD, PhD, of The Netherlands Cancer Institute in Amsterdam, was cautious in interpreting these results to be practice-changing. “I congratulate the investigators for the first-ever positive trial for adjuvant treatment of renal cell carcinoma,” he...

kidney cancer

Phase III Study of Sunitinib Is First to Show Benefit in Adjuvant Setting for Treatment of Renal Cell Carcinoma

Sunitinib (Sutent) improved disease-free survival by more than 1 year when used as adjuvant treatment for high-risk locoregional renal cell carcinoma following nephrectomy, but with the cost of toxicity. S-TRAC is the first phase III trial showing a benefit for adjuvant therapy in renal cell...

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