Christin Melton

New treatments are desperately needed for neuroendocrine tumors, said Leonard Saltz, MD, Memorial Sloan-Kettering Cancer Center.

At NCCN, Richard Klausner, MD, gave a spirited presentation on "New Advances in Molecular Diagnostics and Cancer."

Gardasil, a vaccine that prevents cervical cancer, also reduces the likelihood of recurrence after surgery by 40%.

NCCN included a dinner symposium on Maintenance Therapy for Non-Small Cell Lung Cancer.

Paul F. Engstrom, MD, reviewed the recent changes to the National Comprehensive Cancer Network guidelines for colon and rectal cancer.

Specialty pharmacies are meant to address gaps in care provided by community pharmacy practices.

For some time, medical science has recognized that the human papilloma virus (HPV) causes nearly all cases of cervical cancer.

A study presented at the ASCO 2010 Genitourinary Cancers Symposium found that adding urine testing to cystoscopy to monitor patients for bladder cancer recurrence greatly increases costs without a corresponding clinical benefit.

The National Comprehensive Cancer Network (NCCN) has issued new practice guidelines for managing certain patients with prostate cancer.

For the first time, scientists have constructed a complete genetic map for two types of cancer: small cell lung cancer and malignant melanoma. The melanoma DNA came from a 45-year-old man, and the lung cancer cells were sampled from a 55-year-old man. The research team compared the genetic sequence of the diseased cells with that of healthy cells from the same patients, documenting all genetic mutations.

Panitumumab plus chemotherapy significantly improved survival in patients with metastatic colorectal cancer, compared with chemotherapy alone.

Several studies were presented at the 51st American Hematology Society Annual Meeting and Expository that have the potential to change practice now or in the future. Here are 10 we covered that you do not want to miss.

Several studies have been examining various 3- and even 4-drug regimens in patients with newly diagnosed multiple myeloma. Paul G. Richardson, MD, and colleagues from the Dana-Farber Cancer Institute in Boston, Massachusetts, conducted a phase I/II study investigated the novel combination of lenalidomide (Revlimid), bortezomib (Velcade), and dexamethasone (Decadron). In an interview with Oncology & Biotech News/Oncology NetGuide, Dr Richardson said response was “unprecedented.” In presenting data from the studies, Dr Richardson said, “Partial responses or better were seen in all of the 66 patients treated with the drug combination…with 74% having a VGPR rate in the phase II portion.” He added that the 54% rate of CR/near CR in patients enrolled in the phase II study “was also encouraging.”

In a plenary session at the 51st ASH Annual Meeting, data from a randomized trial in elderly patients with multiple myeloma (MM) showed combining bortezomib (Velcade) and prednisone with the alkylating agent melphalan (VMP) is safer than adding thalidomide (VTP), an immunomodulatory drug, and just as effective. Maria-Victoria Mateos, MD, PhD, attending physician in hematology at Hospital Universitario de Salamanca in Spain, presented the results from the two-stage phase III trial conducted by the Spanish Myeloma Group.

A study being presented at the 51st ASH Annual Meeting, however, has found that patients with hematologic malignancies who participate in advanced care planning are no more likely to have psychosocial problems than their counterparts who lack an advanced care plan.

Researchers at ASH presented data that showed patients with diffuse large B-cell lymphoma (DLBCL) who had deficient vitamin D levels—defined as serum 25-hydroxyvitamin (25-OH-VitD)

Romiplostim is a peptibody protein that increases platelet production by binding to and activating the thrombopoietin receptor. Patients with MDS frequently develop clinically significant thrombocytopenia (CST) or other bleeding problems for which transfusion has long been the only available treatment. Three studies presented at ASH suggest that romiplostim might be a safe, effective method for increasing platelet counts in MDS patients and that further trials are warranted.

The fourth quarter has been busy in oncology, with the US Food and Drug Administration issuing approvals for new drugs and clinical trials and pharmaceutical companies announcing various filings. Here are some recent FDA updates from the world of oncology.

Many patients with advanced cancer require opioids to treat pain. In some patients, this leads to opioid-induced constipation. In a plenary session at the recent American College of Gastroenterology in San Diego, researchers presented data from a phase II study of the novel oral drug NKTR-118 (PEG-naloxol) that showed it increased the frequency of spontaneous bowel movements (SBMs) without negatively affecting the opioids’ analgesic effects.

Researchers with the German Hodgkin Study Group (GHSG) recently published an update to the GHSG HD9 study in the Journal of Clinical Oncology. The trial was initiated in 1993, when standard treatment for advanced Hodgkin’s Lymphoma (HL) consisted of cycles of cyclophosphamide, vincristine, procarbazine, and prednisone (COPP) alternated with doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD). The COPP/ABVD regimen was compared with a new regimen that added bleomycin, etoposide, and doxorubicin to COPP.

In October 2009, the FDA approved the Gardasil vaccine to immunize men and boys against two strains of the human papillomavirus (HPV). The virus causes genital warts, though the primary concern with these strains is their relationship with cervical cancer. As Professor Jack Cuzick, head of the Centre for Epidemiology, Mathematics, and Statistics, at the Wolfson Institute in London, told attendees at the September ECCO-ESMO Congress, “It’s important to say up front that HPV is responsible for all cervix cancer. If you can eradicate the virus, the cancer will not appear.”

Read updates from the FDA about oncology drug approvals, clinical trials, and committee rulings.

Researchers from the William Beaumont Hospital in Michigan conducted a comparative analysis of the three modalities used in accelerated partial breast irradiation (APBI) in women with early stage breast cancer and found all three methods comparable in terms of local control, survival, and cosmesis. The methods examined included interstitial brachytherapy (low and high dose), 3-D conformal external beam radiotherapy (3-D CRT), and MammoSite (MS). MammoSite is the newest of these methods, approved by the FDA in May 2002.

Many women who survive breast cancer spend a lot of time worrying about the risk of recurrence, but a study presented at the ASCO Breast Cancer Symposium in San Francisco suggests at least three-quarters of the women have as much risk of suffering a serious cardiovascular event, such as heart attack or stroke. Aditya Bradia, MD, a fellow at Johns Hopkins School of Medicine, presented the data from the study, which was a 2009 Breast Cancer Symposium Merit Award Recipient.

Poly(ADP-Ribose) Polymerase (PARP) inhibitors have been gaining increasing attention as a possible breakthrough in the treatment of triple negative breast cancer and cancers with mutations in BRCA1, BRCA2, or PTEN genes. Several studies attesting to the efficacy of PARP inhibitors in breast and ovarian cancer were presented at the 2009 ASCO Annual Meeting. Antoinette Tan, MD, assistant professor, The Cancer Institute of New Jersey, provided an “Update on the Clinical Status of PARP Inhibitors for the Treatment of Breast Cancer” in a special session at the Breast Cancer Symposium in San Francisco, California.

The identification of an association between mutations in BRCA 1/2 and hereditary breast and ovarian cancer has allowed many women to learn of their increased cancer risk at a young age and take measures to identify developing tumors early. According to Jennifer Litton, MD, assistant professor, Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, women positive for a deleterious eVmutation in one of the BRCA genes typically receive a breast cancer diagnosis 6 years earlier than did mothers or aunts with the mutation who had breast or ovarian cancer.

Breast cancer survival outcomes vary significantly according to race in the United States, but a University of Texas MD Anderson Cancer Center found that race/ethnicity did not significantly affect the rate of pathologically complete response (pCR) in women with locally advanced breast cancer treated with neoadjuvant chemotherapy.

Quality of life (QOL) is an important consideration for clinicians when treating patients. Treatments that diminish QOL can result in the patient discontinuing therapy or switching to another drug. Either can thwart efforts to control tumor growth. Beth Sherrill, MS, Global Head, Biometrics, RTI Health Solutions, Research Triangle Park in North Carolina, and associates sought to determine the effects on QOL of adding lapatinib (Tykerb) to letrozole (Femara) in women with HER2-positive metastatic breast cancer (MBC).

HER2-positive breast cancer has long been recognized as an aggressive disease, but women with small node-negative tumors are considered low risk for recurrence and do not always receive adjuvant therapy. Data presented by Heather L. McArthur, MD, MPH, Memorial Sloan-Kettering Cancer Center in New York, and colleagues in a poster session at this week’s Breast Cancer Symposium in San Francisco suggests perhaps they should. In comparing outcomes between women who received adjuvant trastuzumab for low-risk HER2-positive tumors and those treated before trastuzumab was available, they concluded adjuvant trastuzumab (Herceptin) reduces recurrence rates and mortality.

In 30% of women with early stage breast cancer who were scheduled for lumpectomy, axillary ultrasound (AUS) combined with fine-needle aspiration cytology (FNAC) allowed researchers to detect macrometastases in axillary lymph nodes prior to resection, sparing the patients from subsequent sentinel lymph node biopsy (SLNB). Data were presented at the ASCO Breast Cancer Symposium in a general session titled “Controversies in the Management of the Axilla.”