Susan London

In patients with resected pancreatic cancer, adjuvant cisplatin, 5-FU, and interferon chemoradiation produces a median survival of 27 months, according to initial results of the ACOSOG Z05031 trial. However, nearly all patients experience grade 3 or 4 toxicities.

Current evidence does not support the routine use of breast MRI in women with newly diagnosed breast cancer, according to Monica Morrow, MD, chief of the breast service, department of surgery, at Memorial Sloan-Kettering Cancer Center.

Patients with operable triple-negative breast cancer are at increased risk for recurrence if their tumor has higher levels of a protein-encoding gene implicated in migration, proliferation, and other cellular processes, reported Joseph A. Sparano, MD, from the Eastern Cooperative Oncology Group.

Neoadjuvant therapy that includes trastuzumab (Herceptin) prolongs event-free survival and has an acceptable safety profile in women with HER2-positive locally advanced breast cancer, based on results from the largest trial testing such therapy in this setting.

Insight into the molecular workings of HER2-positive breast cancer has paved the way for targeted agents that are showing great promise in clinical trials, according to a presentation at SABCS 2008. José Baselga, MD, from Barcelona, offers a primer on pertuzumab, trastuzumab-DM1, heat shock protein 90, and other agents that will provide “tremendous opportunity” in HER2-positive cancer treatment.

Combining endocrine therapy with signal transduction inhibition is an effective means of overcoming endocrine resistance in at least some populations of patients with breast cancer. Stephen R.D. Johnston, MA, PhD, director of clinical research and development at the Royal Marsden Hospital in London, discussed the data on this emerging strategy during an SABCS plenary lecture.

Women with breast cancer who have isolated tumor cells or micrometastases in their sentinel lymph nodes are at increased risk for recurrence, even if their cancer otherwise has favorable features. Adjuvant systemic therapy, however, can attenuate that elevated risk, according to the findings of a major Dutch study.

CHICAGO-The combination of cyclophosphamide, bortezomib, and dexamethasone is associated with high rates of response and manageable toxicity among patients with newly diagnosed multiple myeloma, according to results from a single-arm phase II trial.

About 80% of cancer patients undergoing chemotherapy, and 89% of those who undergo radiation therapy, experience fatigue during their treatment. But about 30% of cancer patients continue to feel fatigued for years aft er treatment. A phase III study demonstrated that the eugeroic agent modafinil (Provigil) reduces severe fatigue and sleepiness among cancer patients undergoing chemotherapy.

WASHINGTON-Loss of HER2 positivity is common among women with initially HER2-positive breast cancer who do not have a pathologic complete response (pCR) to neoadjuvant chemotherapy with trastuzumab (Herceptin), according to a report at the ASCO 2008 Breast Cancer Symposium (abstract 150).

Fully 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.

The combination of intravenous calcium and magnesium salts (CaMg) is associated with a nearly one-half reduction in the rate of chronic oxaliplatin (Eloxatin)-induced sensory neurotoxicity among patients receiving adjuvant FOLFOX therapy for colon cancer, compared with placebo.

WASHINGTON-Molecular breast imaging appears to be a promising adjunctive modality for breast cancer screening among women with an elevated risk of breast cancer who have dense breast tissue, according to a report at the ASCO 2008 Breast Cancer Symposium (abstract 68).

Some clinical trials of HER2-targeted therapies have found that patients assessed to have HER2-negative breast cancer nonetheless derive benefit. Is this a real benefit stemming from unrecognized biological factors in the adjuvant setting?

CHICAGO-Compared with observation, adjuvant gemcitabine (Gemzar) reduces the risk of recurrence by 45% and the risk of death by 28% in patients with resected pancreatic cancer, according to final results of the CONKO-001 trial.

CHICAGO-Increasing the dose density of rituximab in the R-CHOP-14 regimen yields better rituximab (Rituxan) pharmacokinetics and improved clinical outcomes among older adults with high-risk diffuse large B-cell lymphoma (DLBCL), reported lead investigator Michael G.M. Pfreundschuh, MD.

CHICAGO-In the adjuvant treatment of colon cancer, addition of oxaliplatin (Eloxatin) to the FULV regimen is associated with a near-significant 15% relative reduction in the risk of death, according to results from a National Surgical Adjuvant Breast and Bowel Project trial (NSABP C-07).

Anthracyclines have been a cornerstone in the adjuvant treatment of breast cancer for more than 25 years and have well-established risks and benefits. But new molecular assays may make it possible to predict which women will benefit from this therapy, and new agents may offer better alternatives.

The investigational tyrosine kinase inhibitor bosutinib has an acceptable safety profile and appears to be efficacious among patients with chronic-phase chronic myelogenous leukemia who have intolerance or resistance to other TKIs, according to new data presented at ASCO 2008 (abstract 7001).

An 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).

A combination of two antiangiogenic agents-bevacizumab (Avastin) and thalidomide (Thalomid)-with docetaxel (Taxotere) is associated with a median progression-free survival of about a year and a half among men with metastatic, hormone-refractory prostate cancer, finds a phase II trial presented at ASCO 2008 (abstract 5000).

CHICAGO-Two new agents-an inhibitor of heat shock protein 90 and an inhibitor of insulin-like growth factor 1 receptor-appear promising for treating gastrointestinal stromal tumors that are resistant to available tyrosine kinase inhibitors, researchers said at ASCO 2008.

When you have cancer, you can get diarrhea for a number of reasons. Most often, it is a side effect of treatments, such as chemotherapy or radiation therapy.

CHICAGO-A single 2-hour infusion of carboplatin appears to be an alternative to a course of radiation therapy for preventing relapse in patients with stage I seminoma after orchiectomy, according to mature results of an international trial reported at ASCO 2008 (plenary, abstract 1).

CHICAGO-Ongoing trials are still clarifying the optimal approach to management after induction therapy for non-Hodgkin’s follicular lymphoma. In the meantime, patients and physicians are left to ponder whether maintenance rituximab (Rituxan) should be used routinely in all cases. Leading researchers in hematology debated this topic in an education session at ASCO 2008.

CHICAGO-Temsirolimus (Torisel) prolongs progression-free survival in patients with relapsed and/or refractory mantle cell lymphoma when compared with commonly used conventional therapies, finds an international phase III trial.

CHICAGO-The combination of custir-sen sodium (OGX-011, OncoGenex Technologies Inc), an investigational agent, with docetaxel (Taxotere) or mitoxantrone has acceptable toxicity in patients with hormone-refractory prostate cancer who have experienced a failure of first-line docetaxel-based chemotherapy, investigators reported at ASCO 2008 (abstract 5002). Efficacy outcomes were somewhat better with the custirsen/docetaxel combination.

CHICAGO-Sorafenib (Nexavar) is safe and prolongs overall survival and time to progression in Asian patients with advanced hepatocellular carcinoma (HCC), finds the randomized phase III Asia-Pacific liver cancer study. Moreover, efficacy was similar to that in the Western population even though the Asian patients had more adverse prognostic factors.

MILAN-Some men with nonseminoma germ cell tumor (NSGCT) testicular cancer have a normalization of tumor markers and minimal or no residual masses in the retroperitoneum after chemotherapy. What then? Should all of them undergo retroperitoneal lymph node dissection (RPLND) to be on the safe side, or should the procedure be reserved for selected cases? Leading researchers in urology debated this topic at the 23rd Annual Congress of the European Association of Urology (plenary session 1).

CHICAGO-Everolimus prolongs progression-free survival in patients with metastatic renal cell carcinoma that has progressed despite treatment with inhibitors of the vascular endothelial growth factor (VEGF) receptor tyrosine kinase, finds an international phase III trial (RECORD-1) presented at ASCO 2008 (abstract LBA-5026).