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colorectal cancer

Adjuvant Chemotherapy May Confer Survival Benefit in Patients Older than 75 with Stage III Disease

Because few people over 75 participate in clinical trials, it is unknown whether adjuvant chemotherapy could benefit this population. Faced with this gap in clinical trial evidence, researchers reviewed data from 5,489 patients ≥ 75 years with stage III colon cancer. The review suggests that...

solid tumors

Screening Should Begin Early for Survivors of Childhood Cancer

Survivors of childhood cancer, particularly those treated for childhood Hodgkin lymphoma or Wilms tumor with abdominal radiation, procarbazine (Matulane), and platinum chemotherapy, are at an increased risk of developing gastrointestinal subsequent malignant neoplasms, according to a retrospective...

SIDEBAR: Expect Questions from Your Patients

Promising results announced at the recent ASCO Annual Meeting from studies with BRAF and MEK inhibitors have made headlines, but only one of these agents—the BRAF inhibitor vemurafenib (Zelboraf)—has been approved by the FDA. The others are still investigational. Patients interested in gaining...

skin cancer

MEK Inhibitor Reduces Progression of BRAF-mutated Melanoma and Might also Benefit Others

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. The MEK inhibitor trametinib...

Mitotane-containing Regimens Explored for a Rare Tumor

Response rates and progression-free survival rates were significantly better among patients with advanced adrenocortical carcinoma receiving mitotane (Lysodren) plus EDP (etoposide, doxorubicin, and cisplatin) than in patients receiving mitotane with streptozocin (Zanosar), according to results of...

gastroesophageal cancer

Most Hospitals Do Not Meet Benchmark for Examining Lymph Nodes following Esophagectomy

“Fewer than one-third of patients and fewer than 1 in 10 hospitals met the benchmark of examining at least 15 lymph nodes” following esophagectomy for patients with esophageal cancer, according to a retrospective observational study reported in the Archives of Surgery. That benchmark was set by the ...

solid tumors

Regorafenib Has ‘Notable Anticancer Activity’ after Patients Develop Resistance to Imatinib and Sunitinib

The orally administered investigational multikinase inhibitor regorafenib demonstrated “notable anticancer activity” in a phase II trial among patients with advanced gastrointestinal stromal tumor (GIST) who developed resistance to imatinib (Gleevec) and sunitinib (Sutent). Researchers reported in...

pancreatic cancer

Adjuvant Chemotherapy May Improve Survival for Patients with Periampullary Disease

The European Study Group for Pancreatic Cancer (ESPAC)-3 periampullary cancer trial found that adjuvant chemotherapy following surgical resection of periampullary adenocarcinoma “was not associated with a significant survival benefit in the primary analysis; however, multivariate analysis adjusting ...

solid tumors

‘Strong Persistent Benefit’ from Radiochemotherapy after Curative Gastric Cancer Resection

An update, with more than a 10-year median follow-up, from Intergroup 0116 (INT-0116), a randomized phase III trial of postoperative chemotherapy in patients at moderate risk of locoregional failure following curative gastric cancer resection, “demonstrates strong persistent benefit from adjuvant...

cns cancers

Bevacizumab/Temozolomide Combination Safe and Active against Advanced Neuroendocrine Tumors

The combination of bevacizumab (Avastin) and temozolomide can be safely administered together in patients with advanced neuroendocrine tumors, and “the combination regimen appears promising for patients with pancreatic [neuroendocrine tumors],” according to results of a phase II study reported in...

lymphoma

Children with Favorable-risk Disease and Complete Response to Chemotherapy Have High Survival Rates without Radiotherapy

Among children with favorable-risk Hodgkin lymphoma, those who achieved a complete response after two cycles of chemotherapy and received no radiotherapy had high rates of survival similar to those who had a less complete response to chemotherapy and received radiotherapy, according to a study in...

SIDEBAR: Expect Questions from Your Patients

For now, genomic sequencing seems to have a greater presence in the news than in the clinic. What can physicians tell their patients who ask about genetic testing to identify mutations driving cancer growth?  “The real answer is that when you get down to it, genomics is like any other test,”...

Genomics vs Site of Cancer Origin as Basis for Treatment of Cancer Is ‘False Dichotomy’

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. Despite recent news reports...

lung cancer

Response Rate Is Significantly Improved with Nab- vs Solvent-based Paclitaxel plus Carboplatin in Advanced NSCLC

Final results of a phase III trial found nanoparticle albumin-bound (nab)-paclitaxel (Abraxane) plus carboplatin as first-line therapy in patients with advanced non–small cell lung cancer (NSCLC) resulted in a significantly improved overall response rate vs conventional solvent-based paclitaxel...

lung cancer

Study Reports ‘Strong and Consistent Relation’ between Exposure to Diesel Exhaust and Risk of Dying of Lung Cancer

A nested case-control study of 198 lung cancer deaths among a cohort of 12,315 mine workers “showed a strong and consistent relation between quantitative exposure to diesel exhaust and increased risk of dying of lung cancer,” researchers reported in the Journal of the National Cancer Institute.1...

gynecologic cancers

Adding Bevacizumab to Chemotherapy Improves Progression-free Survival in Platinum-sensitive Recurrent Ovarian Cancer

The addition of bevacizumab (Avastin) to gemcitabine and carboplatin, followed by bevacizumab until disease progression, resulted in significantly improved progression-free survival compared to gemcitabine and carboplatin plus placebo among women with platinum-sensitive recurrent ovarian, primary...

breast cancer

‘Young and Strong’ Program Addresses Multiple Needs of Women in 40s and Younger Diagnosed with Breast Cancer

“Young and Strong” is an exportable model of a program developed at Dana-Farber Cancer Institute and Brigham and Women’s Hospital in Boston to address the significant challenges facing young women with breast cancer. The new model has been designed to “serve young women with breast cancer who are...

SIDEBAR: Dating among Adolescents and Young Adults with Cancer

How do you tell somebody you are dating that you have cancer or that you may not be able to have children? These are among the issues explored in “Dating and Disclosure for the Cancer Patient,” part of a new book, Sexuality and Cancer, scheduled for release in the fall by Springer, New York. “The...

SIDEBAR: Don’t Expect Questions: Be Proactive with Younger Patients

It is unrealistic to expect adolescents and young adults with cancer to initiate questions about disease-related or or treatment-related issues that are troubling them, according to Bradley Zebrack, PhD, MSW, MPH, Associate Professor of Social Work at the University of Michigan, Ann Arbor....

supportive care

Adolescent and Young Adult Patients Report Unmet Needs for Cancer Information and Psychosocial Support Services

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. Psychosocial care needs are not...

Kidney Transplant Recipients Switching to Sirolimus Had Lower Risk of Secondary Squamous Cell Carcinomas

Kidney transplant recipients with at least one previous cutaneous squamous cell carcinoma decreased their risk of developing new cutaneous squamous cell carcinomas by switching from calcineurin inhibitors (cyclosporine or tacrolimus) to sirolimus (Rapamune) in a multicenter phase III study. New...

breast cancer

Taxane-induced Neuropathy Does Not Correlate with Improved Outcomes in Operable Breast Cancer

An analysis of 4,554 patients who received adjuvant weekly paclitaxel and other taxane-based regimens in the E1199 trial “demonstrated that taxane-induced peripheral neuropathy does not correlate with improved outcomes in patients with operable breast cancer,” investigators reported in the Journal...

New Agents That Improve Efficacy Can Also Increase Morbidity and Treatment-related Mortality

Newly approved anticancer drugs that lead to improvements in efficacy can also lead to increased morbidity and treatment-related mortality, according to a study in the Journal of Clinical Oncology. The investigators conducted a meta-analysis of 38 randomized controlled trials evaluating agents...

cns cancers

Chemotherapy plus Radiation Improved Progression-free Survival in Adults with Low-grade Glioma

Adult patients with supratentorial low-grade glioma who received chemotherapy with PCV (procarbazine [Matulane], lomustine [CeeNu], and vincristine) in addition to radiation therapy had improved progression-free survival but not overall survival compared to patients receiving radiotherapy alone,...

solid tumors

Ipsilateral Radiotherapy for Cervical Lymph Node Metastases

Ipsilateral neck–only radiation therapy “demonstrated excellent locoregional control with no adverse effect on disease-free survival or overall survival” among patients with cervical metastases from an unknown primary site, according to a retrospective review of medical records from 46 patients...

High-cost Imaging Used Frequently in Elderly with Stage IV Cancer

Patients with stage IV breast, colorectal, lung, and prostate cancers undergo frequent high-cost imaging procedures throughout the continuum of their care, and rates of imaging have steadily increased, according to an analysis of claims from the Surveillance, Epidemiology, and End Results...

colorectal cancer

Patients with Unresectable Metastases Can Be Spared Noncurative Resection of Intact Primary Tumor

Patients with surgically unresectable metastatic colon cancer and an asymptomatic intact primary tumor can be spared initial noncurative resection of their intact primary tumor, National Surgical Adjuvant Breast and Bowel Project (NSABP) C-10 trial investigators reported in the Journal of Clinical...

colorectal cancer

Cetuximab Dose Escalation May Increase Responses among Patients with Mild or No Initial Skin Reactions

Escalating the dose of cetuximab (Erbitux) among patients with metastatic colorectal cancer who developed no or mild skin reactions on standard-dose cetuximab plus irinotecan “seemed to lead to an increase in response rate” as well as in the disease-control rate, according to a phase I/II study...

prostate cancer

Enzalutamide Significantly Prolonged Survival in Men with Castrate-resistant Metastatic Prostate Cancer

“Enzalutamide significantly prolonged the survival of men with metastatic castration-resistant prostate cancer after chemotherapy” in an international phase III, double-blind, placebo-controlled trial, investigators reported in The New England Journal of Medicine. Median overall survival, the...

SIDEBAR: Unique Considerations for Radiation Exposure in Children

There are three “unique considerations” for radiation exposure in children, according to Radiation Risks and Pediatric Computed Tomography (CT): A Guide for Health Care Providers, an educational leaflet for health-care providers that was developed by the NCI: Children are considerably more...

SIDEBAR: Expect Questions from Parents

Results of a study finding that exposure to radiation from multiple CT scans in childhood can triple the risk of leukemia and brain tumors may cause some parents to question the overall benefit of CT scans and to directly question physicians. “The three key questions that parents can ask are: (1)...

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...

breast cancer

Physical Activity Benefits Breast Cancer Survivors, but Role in Reducing Breast Cancer Risk Is Less Clear

Breast cancer survivors who engage in moderate to high levels of physical activity have reduced mortality and improved quality of life, according to recent studies. In addition, exercise may play a role in lowering the risk of breast cancer. “Physical activity can hasten recovery from the immediate ...

lymphoma
survivorship

Long-term Survivors of Hodgkin Lymphoma May Have Increased Risk of Neurocognitive Impairment

A “new finding” that long-term survivors of childhood Hodgkin lymphoma may be at risk for neurocognitive impairment and central nervous system (CNS) pathology arose from a study among 62 patients treated with either high-dose (≥ 30 Gy) thoracic radiation or lower-dose (< 30 Gy) thoracic...

Reduced Disease Progression in Patients with Continued Gemcitabine Maintenance or Erlotinib Switch Maintenance

A phase III study showed that progression-free survival was significantly prolonged with continuation maintenance with gemcitabine or switch maintenance with erlotinib (Tarceva) compared with observation in patients with advanced non–small cell lung cancer (NSCLC) who received first-line treatment...

breast cancer

Anthracycline/Trastuzumab Treatment Linked to Increased Risk of Heart Failure, Cardiomyopathy

A population-based, retrospective cohort study of 12,500 women diagnosed with incident, invasive breast cancer found that anthracycline and trastuzumab (Herceptin) were associated with increased risk of heart failure and/or cardiomyopathy. “Compared with women who received no chemotherapy, our...

head and neck cancer

Radiotherapy Not Helpful in Early-stage Parotid Acinic Cell Cancer

Adjuvant radiotherapy for patients with parotid acinic cell carcinoma “does not confer a therapeutic advantage in low-grade and early-stage tumors if resection is complete,” but the benefit for patients with higher-grade or higher-stage disease is uncertain because there were few of these patients...

SIDEBAR: Expect Questions from Patients

A recently reported study finding that anticoagulants and particularly aspirin were associated with a reduced risk of prostate cancer–specific mortality1 has the potential to generate a lot of questions because of the large number of patients potentially affected. As the study’s corresponding...

prostate cancer

Link Found between Aspirin and Reduced Risk of Death Due to Prostate Cancer

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. Over the past few weeks, Stanley L....

issues in oncology

Tweeting at ASCO Annual Meetings Can Enhance the Experience

Tweeting at concerts or plays may earn you scornful looks or even stern warnings from ushers, but tweeting at the ASCO Annual Meeting may enhance the meeting experience for you and others. In a study comparing trends in Twitter use by physicians during the 2010 and 2011 ASCO Annual Meetings, some...

survivorship

Prone Position during Radiation Therapy for Breast Cancer Is Associated with Reduced Irradiation to Lung and Heart

Preliminary data on prone positioning during whole-breast radiotherapy following breast-preservation surgery “suggest that radiation exposure to the heart and lung can be reduced compared with supine positioning with similar efficacy,” according to a research letter in the Journal of the American...

skin cancer
survivorship

Radiation to the Skin and Later Risk of Basal Cell Carcinoma Studied

The likelihood of developing basal cell carcinoma was approximately 40 times higher among participants of the Childhood Cancer Survivor Study (CCSS) who received a dose of 35 Gy or more to the skin from radiation therapy than survivors who were not treated with radiation, according to a study...

SIDEBAR: From Small Centers to Academic Centers

The use of cytoreduction plus hyperthermic intraperitoneal chemotherapy (HIPEC) to treat carcinomatosis “came from the smaller centers,” noted Nita Ahuja, MD, Director of the Peritoneal Surface Malignancies Program at Johns Hopkins Medicine. “A lot of things in medicine come from academia and move...

Successful Use of Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy May Hinge on Prior Experience

A review of 60 consecutive patients with peritoneal carcinomatosis who underwent cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (HIPEC)—sometimes called “hot chemotherapy”—found 0% mortality and 33% morbidity, with “a significant reduction of grade III/IV morbidity,...

colorectal cancer

Patients with Lynch Syndrome Who Have Had Colorectal Cancer Are at Increased Risk of Other Cancers

Patients who have had colorectal cancer and who are carriers of the DNA mismatch repair gene mutations that cause Lynch syndrome “have an increased risk of a greater range of cancers than the recognized spectrum of Lynch syndrome cancers, including breast and prostate cancers,” according to a study ...

breast cancer

Short Interval between Initial and Contralateral Breast Cancer Increases Risk of Dying

Breast cancer survivors who develop contralateral breast cancer have an increased risk of dying from breast cancer throughout a follow-up period of 10 or more years, according to a study of a cohort of 42,670 women diagnosed with breast cancer in Sweden. “The added risk is considerable if the...

breast cancer

Pathologic Nodal Status and Tumor Response Can Predict Risk of Locoregional Recurrence

Pathologic nodal status/breast tumor response following neoadjuvant chemotherapy can be used to predict locoregional recurrence in women with operable, palpable breast cancer (T1-3, N0-1, M0) previously treated with mastectomy or lumpectomy plus radiotherapy. These results from the combined...

supportive care
pain management

SIDEBAR: Don’t Expect Direct Questions from Patients about Pain

Just asking patients “Is there something else you want to address in the visit,” rather than “Is there anything else you want to address in the visit today,” dramatically reduced patients’ unmet concerns during a primary care visit, according to a 2007 study.1 That learning can be applied to...

supportive care
pain management

Pain Remains Prevalent among Oncology Outpatients, with Odds of Undertreatment Twice as High among Minority Patients

In 1994, a landmark study of pain among oncology outpatients prompted a host of pain management initiatives.1 More than 18 years later, a recent study among more than 2,000 cancer outpatients has found that “one-third of the patients who had pain or used analgesics received inadequate treatment for ...

solid tumors

Socioeconomic Disparity in Colorectal Cancer Rates Attributed to Obesity and Behavioral Risks

More than one-third of the excess risk of invasive adenocarcinoma of the colon and rectum resulting from low socioeconomic status “could be explained by differences in exposure to behavioral risk factors, particularly a healthy diet,” researchers recently reported in the Journal of the National...

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