Older multiple myeloma patients show active response to novel agents
October 1st 2008Fully 88% of older adults with newly diagnosed multiple myeloma have at least a very good partial response when treated with low-dose autologous stem cell transplantation that is preceded by bortezomib-containing induction therapy and followed by lenalidomide-containing consolidation and maintenance therapy, according to trial results from the University of Turin in Italy.
Anti-IGF-1R antibody plus chemo active in advanced non-small-cell lung cancer
August 1st 2008An antibody to the insulin-like growth factor type 1 receptor (IGF-1R), when given with chemotherapy, is active as first-line therapy in advanced non-small-cell lung cancer, especially squamous type, finds the first trial to test an IGF inhibitor in lung cancer. Daniel D. Karp, MD, of M.D. Anderson Cancer Center, reported the trial results at ASCO 2008 (abstract 8015).
An Odd But Synergistic Couple: Immunotherapy Combined With Radiotherapy
August 1st 2008Radiation therapy (RT) and immunotherapy of cancer both date back more than 100 years, and yet, because radiation was often considered immunosuppressive, there had been little enthusiasm for combining them until recently. Immunotherapy has an established role in the treatment of some cancers-superficial bladder cancer treated with bacillus Calmette-Guérin (BCG), renal cell carcinoma and melanoma treated with interferon and interluekin (IL)-2 (Proleukin), and breast cancer and lymphoma treated with monoclonal antibodies such as trastuzumab (Herceptin) and rituximab (Rituxan), which partly function through antibody-dependent cellular cytotoxicity.
Temsirolimus Plus Bevacizumab to Be Studied in Advanced Kidney Cancer
July 1st 2008Wyeth Pharmaceuticals recently announced the initiation of the INTORACT (INvestigation of TORisel and Avastin Combination Therapy) study, a worldwide randomized, open-label, phase IIIB study comparing temsirolimus (Torisel) plus bevacizumab (Avastin) vs bevacizumab plus interferon-alfa for first-line treatment of patients with advanced renal cell carcinoma (RCC). Wyeth Research is conducting the INTORACT study with the support and assistance of Roche and Genentech
Epratuzumab Plus Rituximab and Chemotherapy Is Active, Safe, and Tolerable in Aggressive Lymphoma
July 1st 2008Immunomedics, Inc. a biopharmaceutical company focused on developing monoclonal antibodies to treat cancer and other serious diseases, today announced that adding epratuzumab (LymphoCIDE) to rituximab (Rituxan) and combined cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy (ER-CHOP) for the therapy of patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL) produced promising results.
INTORACT trial of Torisel/Avastin in RCC is initiated
June 1st 2008COLLEGEVILLE, Pennsylvania-Wyeth Pharmaceuticals has initiated the INTORACT (Investigation of Torisel and Avastin Combination Therapy) trial, a worldwide randomized open-label phase IIIb study comparing temsirolimus (Torisel) plus bevacizumab (Avastin) vs bevacizumab plus interferon-alfa for the first-line treatment of patients with advanced renal cell carcinoma.
Oncotype DX Test Expanded to Include ER and PR Scores
June 1st 2008Genomic Health, Inc, recently announced that its Oncotype DX report is now providing quantitative estrogen receptor (ER) and progesterone receptor (PR) scores to physicians and patients in addition to the trademarked Recurrence Score. This expansion of the assay is based on the results of a study published in the Journal of Clinical Oncology, which confirmed that reverse transcriptase polymerase chain reaction (RT-PCR) by Oncotype DX can deliver quantitative gene expression levels for assessing ER and PR status, which are critical factors in determining the use and benefit of hormonal therapy for the treatment of breast cancer.
Gene therapy ups survival in end-stage head & neck cancer
June 1st 2008BOSTON-A gene therapy agent that delivers a normal p53 gene to the tumor significantly increased survival by 4.5 months in end-stage head and neck cancer patients with p53-favorable tumor profiles, compared to those with unfavorable profiles.
Management of a Patient With Stage IIIA (N2) NSCLC
April 30th 2008The appropriate treatment of patients with stage IIIA (N2) non–small-cell lung cancer (NSCLC) is unclear. With this case report and review, we address the history, assessment, and management of a 67-year-old patient with this diagnosis, and then discuss the challenges in managing N2 disease, as well as the roles of systemic therapy, surgery, and postoperative radiation therapy.
Gene therapy adds new dimension of color sensation in primates
April 29th 2008In results that challenge conventional models for color vision circuitry, researchers used gene therapy in a dichromatic primate model to add a third photopigment and bring about red-green vision. This successful treatment of adult monkeys with a congenital color vision defect shows that the adult nervous system can respond to newly added sensory input and is encouraging for the possibility of using gene therapy to treat various cone-based vision disorders in human adults, said Katherine Mancuso, MD, of the Department of Ophthalmology, Medical College of Wisconsin, Milwaukee.
Hearing Loss in Pediatric Cancer Survivors Treated With Cisplatin
April 1st 2008Cisplatin is effective in treating several types of childhood cancers (eg, CNS tumors, osteosarcoma, hepatoblastoma, neuroblastoma, germ cell tumors). It is the most ototoxic drug used clinically, and hearing loss is a well-recognized toxicity of cisplatin therapy.
PORTable Indications in Non–Small-Cell Lung Carcinoma
March 1st 2008Drs. Kelsey, Marks, and Wilson open their excellent review article by asking “Where do we stand?” with respect to postoperative radiation therapy (PORT) for non–small-cell lung cancer (NSCLC).[1] Frankly, PORT has not exactly been standing tall for the past decade-leaning, crouching, or perhaps squatting might be a better verb.
VTD induction boosts CRs in newly diagnosed myeloma
February 1st 2008;In patients with newly diagnosed multiple myeloma, the addition of bortezomib (Velcade) to thalidomide (Thalomid) and dexamethasone significantly increased response rates, compared with thalidomide plus dexamethasone alone, when used as induction therapy prior to autologous stem cell transplant (ASCT
RT improves outcomes of early-stage DLBCL patients
January 1st 2008Patients with early-stage diffuse large B-cell lymphoma (DLBCL) have improved long-term disease-free and overall survival if their first-line treatment includes radiation therapy, according to the largest outcomes study to date among this population.
Diagnostic Dilemma: GI Disease
January 1st 2008A 68-year-old man with a history of small-cell lung cancer with bony metastases was admitted with diarrhea. The patient had completed chemotherapy one week earlier with cisplatin and etoposide, along with radiation therapy, and irinotecan (Camptosar). The patient was found to be neutropenic.
High-Dose Chemo with Stem Cell Transplant Shows Little to No Survival Benefit in Adjuvant Setting
December 14th 2007When used as adjuvant therapy for node-positive breast cancer, the combination of high-dose chemotherapy (HDC) and stem cell transplantation modestly improves relapse-free survival relative to standard-dose chemotherapy (SDC). But it offers at best minimal benefit in terms of overall survival, according to a meta-analysis presented at SABCS.
Treating Bladder Cancer: Neoadjuvant vs Adjuvant Therapy
December 1st 2007Occult distant micrometastasis at the time of radical cystectomy leads predominantly to distant failures in patients with locally advanced muscle-invasive transitional cell carcinoma of the bladder. Cisplatin-based combination chemotherapy enhances survival in patients with metastatic urothelial cancer. Studies evaluating adjuvant chemotherapy have been limited by inadequate statistical power. However, randomized clinical trials have demonstrated a survival benefit for neoadjvuant cisplatin-based combination chemotherapy, which should be considered a standard of care. In addition, neoadjuvant therapy may assist in the rapid development of novel systemic therapy regimens, since pathologic complete remission appears to be a powerful prognostic factor for long-term outcomes. Patients who are either unfit for or refuse radical cystectomy may benefit from neoadjuvant chemotherapy with or without radiation to enable bladder preservation.
Neoadjuvant Chemotherapy for Bladder Cancer
December 1st 2007Occult distant micrometastasis at the time of radical cystectomy leads predominantly to distant failures in patients with locally advanced muscle-invasive transitional cell carcinoma of the bladder. Cisplatin-based combination chemotherapy enhances survival in patients with metastatic urothelial cancer. Studies evaluating adjuvant chemotherapy have been limited by inadequate statistical power. However, randomized clinical trials have demonstrated a survival benefit for neoadjvuant cisplatin-based combination chemotherapy, which should be considered a standard of care. In addition, neoadjuvant therapy may assist in the rapid development of novel systemic therapy regimens, since pathologic complete remission appears to be a powerful prognostic factor for long-term outcomes. Patients who are either unfit for or refuse radical cystectomy may benefit from neoadjuvant chemotherapy with or without radiation to enable bladder preservation.
Bladder Cancer and Current Evidence for Treatment
December 1st 2007Occult distant micrometastasis at the time of radical cystectomy leads predominantly to distant failures in patients with locally advanced muscle-invasive transitional cell carcinoma of the bladder. Cisplatin-based combination chemotherapy enhances survival in patients with metastatic urothelial cancer. Studies evaluating adjuvant chemotherapy have been limited by inadequate statistical power. However, randomized clinical trials have demonstrated a survival benefit for neoadjvuant cisplatin-based combination chemotherapy, which should be considered a standard of care. In addition, neoadjuvant therapy may assist in the rapid development of novel systemic therapy regimens, since pathologic complete remission appears to be a powerful prognostic factor for long-term outcomes. Patients who are either unfit for or refuse radical cystectomy may benefit from neoadjuvant chemotherapy with or without radiation to enable bladder preservation.
Locally Advanced, Unresectable Non–Small-Cell Lung Cancer
December 1st 2007A significant proportion of patients with non-small cell lung cancer (NSCLC) present with locally advanced, unresectable disease. For the most part, fit patients with this diagnosis are treated with combined-modality therapy. Relatively few are rendered resectable. Over the past two decades, combination chemotherapy and radiation, preferably concurrent chemoradiation, has emerged as the standard of care. However, survival gains have been offset, to some extent, by local, normal-tissue, in-field toxicity, particularly esophagitis and pneumonitis.
Evolving Role of Stem Cell Transplant in the Elderly
November 15th 2007Hematopoietic stem cell (HSC) transplantation may improve outcomes of patients with hematologic malignancies not curable with conventional therapies. In some clinical settings, transplantation represents the only curative option. The feasibility and efficacy of this approach in older patients are undefined, since this population has been excluded from nearly all clinical trials. Advances in supportive care, HSC harvesting, and safer conditioning regimens have made this therapy available to patients well into their 6th and 7th decades of life. Recent evidence suggests that elderly patients with good performance status and no comorbidities could, in fact, not only survive the transplant with reasonable risk, but also benefit in the same measure as younger patients.
Hematopoietic Stem Cell Transplantation in the Elderly
November 15th 2007Hematopoietic stem cell (HSC) transplantation may improve outcomes of patients with hematologic malignancies not curable with conventional therapies. In some clinical settings, transplantation represents the only curative option. The feasibility and efficacy of this approach in older patients are undefined, since this population has been excluded from nearly all clinical trials. Advances in supportive care, HSC harvesting, and safer conditioning regimens have made this therapy available to patients well into their 6th and 7th decades of life. Recent evidence suggests that elderly patients with good performance status and no comorbidities could, in fact, not only survive the transplant with reasonable risk, but also benefit in the same measure as younger patients.
Hematopoietic Stem Cell Transplantation in the Elderly: More Questions Than Answers
November 15th 2007Hematopoietic stem cell (HSC) transplantation may improve outcomes of patients with hematologic malignancies not curable with conventional therapies. In some clinical settings, transplantation represents the only curative option. The feasibility and efficacy of this approach in older patients are undefined, since this population has been excluded from nearly all clinical trials. Advances in supportive care, HSC harvesting, and safer conditioning regimens have made this therapy available to patients well into their 6th and 7th decades of life. Recent evidence suggests that elderly patients with good performance status and no comorbidities could, in fact, not only survive the transplant with reasonable risk, but also benefit in the same measure as younger patients.
Systemic Therapy Options for Non–Small-Cell Lung Cancer in Patients with a Poor Performance Status
November 1st 2007Although significant advances have been made in the systemic therapy of non–small-cell lung cancer (NSCLC) in patients with a good performance status (PS), the subgroup of patients with a poor PS has not been studied as well.