Oncology NEWS International Vol 18 No 2

Consortium advances multidisciplinary program for colon cancer

February 26, 2009

Colorectal cancer is the second leading cause of cancer-related deaths in the United States. According to the most recent data from NCI, the relative five-year survival rate among metastatic colorectal cancer patients is 8%. While colorectal cancer can metastasize to other organs, including the lung, the liver is the most frequent site of metastasis. Metastases to the liver occur in approximately 50% of colorectal cancer patients and account for at least two-thirds of all colorectal cancer deaths.

Celator joins leukemia society for phase II trial of CPX-351

February 25, 2009

Celator Pharmaceuticals and the Leukemia & Lymphoma Society have partnered for the phase II development of CPX-351 (cytarabine:daunorubicin), a liposome injection for treatment of adults with acute myeloid leukemia.

Genzyme nabs FDA approval for stem cell mobilizing agent

February 25, 2009

Genzyme has won a nod from the FDA to market Mozobil (plerixafor) in the U.S. The drug is intended to be used in combination with granulocyte-colony stimulating factor to mobilize hematopoietic stem cells to the bloodstream for collection and subsequent autologous transplantation in patients with non-Hodgkin’s lymphoma and multiple myeloma. The product has also been granted orphan drug designation by the FDA.

FDA launches pilot safety program for foreign drugs

February 25, 2009

The Food and Drug Administration has kicked off a voluntary pilot program to help promote the safety of drugs, and active drug ingredients, produced outside the U.S. The FDA plans to select 100 applicants to participate in the Secure Supply Chain pilot program.

Radiation oncology society adopts new moniker

February 25, 2009

The American Society for Therapeutic Radiology and Oncology (ASTRO) has changed its name to the American Society for Radiation Oncology, but will continue to use the “T’ in its logo as part of its tagline “Targeting Cancer Care.”

Elderly multiple myeloma patients remain responsive to novel therapy teamed with conventional treatment

February 25, 2009

SAN FRANCISCO-Adding thalidomide to a regimen of bortezomib (Velcade), melphalan, and prednisone nearly doubled the rate of complete responses and improved the overall response rate in elderly patients with newly diagnosed multiple myeloma, according to the results of a phase III trial.

NSABP B-30: Amenorrhea relates to survival

February 25, 2009

In a subset of 2,366 patients from NSABP B-30 with menstrual history available at follow-up, amenorrheic patients (≥ six months) had significantly improved overall and diseasefree survival across treatment arms. Mortality was significantly reduced by 24% and recurrence by 30%.

Easy methods curtail toxins in food linked to cancer in Africa

February 25, 2009

WASHINGTON, DC- In much of the developing world, exposure to mycotoxins, which are generated by various types of fungus that grow on food, is ubiquitous. Th e most well-known mycotoxin, aflatoxin, is commonly found on nuts and is a known carcinogen, according to the International Agency for Research on Cancer (IARC).

Growth of Medicare HMOs could impact clinical trials

February 25, 2009

A study of Pittsburgh-area cancer patients suggests that many are opting out of clinical trials because, as members of Medicare HMO plans, they cannot afford the additional expense such trials entail.

Trastuzumab in the adjuvant setting: Is concurrent treatment better than sequential?

February 25, 2009

STOCKHOLM-Published data overwhelmingly support the use of trastuzumab (Herceptin) concurrently with chemotherapy, according to John Crown, MD, a consultant oncologist at St. Vincent’s Hospital in Dublin, Ireland. On the other hand, there is no evidence that sequential delivery is less effective than concurrent therapy, and it is definitely less toxic, commented Ian E. Smith, MD, head of the Breast Unit at Royal Marsden Hospital in London.

Cancer luminary lambasts slow-moving U.S. clinical trials

February 25, 2009

The clinical trials program in the U.S. is broken and apparently nobody has noticed,” Vincent T. DeVita, Jr., MD, wrote in a recent editorial in Nature Clinical Practice Oncology (5:683, 2008), of which he is editor-in-chief.

Multidisciplinary approach improves rectal cancer outcomes

February 25, 2009

STOCKHOLM-For rectal cancer patients, a multidisciplinary team is critical to success because it increases the possibility of a curative resection, Andres Cervantes, MD, associate professor of medicine at University Hospital, Valencia, Spain, said at ESMO 2008. “Every patient should be treated within an expert multidisciplinary team,” he emphasized.

Adjuvant taxanes: Is benefit due to more cycles or addition of taxane?

February 24, 2009

The studies presented at SABCS 2008 regarding adjuvant taxane schedules are well designed and add to a growing body of data on how best to use these drugs, although they leave some questions unresolved. NSABP B-30 nicely controlled for number of cycles of treatment. All patients received four cycles of doxorubicin and four of docetaxel (Taxotere), and some got four cycles of cyclophosphamide, so there was some control over the duration of exposure and total number of doses for each drug.

Best schedule for adjuvant taxanes Rx remains elusive

February 24, 2009

The optimal use of taxanes in the adjuvant treatment of breast cancer continues to inspire debate. Questions remain regarding the relative efficacy of sequential vs concurrent treatment, the most effective doses and schedules, and the best combinations of agents. Key studies presented at SABCS 2008 offered insight into these issues, but no definitive resolutions. In fact, two studies designed to establish optimal scheduling reached conflicting conclusions.

Gliomas react to radiation plus chemotherapy

February 24, 2009

Adult patients with low-grade glioma had better survival if they received chemotherapy in addition to radiotherapy, according to the results of a Radiation Th erapy Oncology Group (RTOG) study. The data were presented at the 2008 Society for Neuro-Oncology meeting in Lake Las Vegas, Nev.

Patient markers pinpoint response to bortezomib Rx

February 24, 2009

Australian researchers reported that multiple myeloma patients who expressed cyclin DI were more likely to achieve a response to treatment with bortezomib (Velcade). Mark A. Dawson, MD, Andrew Spenser, MD, and colleagues aimed to identify the patients who would fare best with bortezomib salvage therapy.

England eliminates prescription copay for cancer patients

February 24, 2009

Cancer patients in England will no longer have to pay prescription charges for medicines that treat their side effects, starting in April. Drugs that will be exempt include those that address pain, nausea, chronic diarrhea, fatigue, and mouth ulcers. Tamoxifen and other long-term hormone treatments are also currently subject to this charge.

Data confirm feasibility of conducting studies in rare tumors

February 24, 2009

There is strong rationale for both the octreotide LAR and everolimus studies in NET”, said Dr. Siu, associate professor of medicine at the University of Toronto and Princess Margaret Hospital. “And I applaud both sets of authors for conducting trials in rare tumors.”

Complete response rate is improved with this regimen

February 24, 2009

This is one of a number of studies that show that adding novel drugs to conventional treatments can achieve higher response rates in multiple myeloma,” said Dr. Anderson, who is the Kraft Family Professor of Medicine at the Dana-Farber Cancer Institute in Boston.

Drug-safety experts call for consortium to oversee adverse reactions information

February 24, 2009

CHICAGO-Serious and fatal drug reactions tripled between 1998 and 2005, according to a 2007 FDA analysis. In that time period, the total number of serious adverse drug events multiplied 4 times faster than the number of prescriptions written. The number of serious drug reactions for biotechnology agents rose nearly 18-fold (T Moore et al: Analysis of FDA reported post marketing ADR database, Arch Intern Med 167:1752-1759, 2007).

Jimmie Holland, central founder of psycho-oncology

February 24, 2009

Jimmie C. Holland, MD, widely recognized as the founder of “psychooncology,” grew up in a rural part of Texas with fertile black soil, known as the Blackland Bible Belt. It was a time when cotton was king and little girls were named Bobbi and Jimmie. Back then, the gender line was clearly demarcated; girls became teachers and nurses and homemakers. Interested in medicine as a youngster, Jimmie thought about nursing, but decided instead to buck the old-boy tradition and become a doctor. Her family and teachers supported her dream, and she never looked back.

Medicare expands options for use of off-label drugs

February 24, 2009

In the first of what will become an annual review process, the nation’s largest cancer-care payer has added three new formularies to its drug coverage policy, giving oncologists even greater ability to prescribe off -label cancer drugs.

Lapatinib Plus Letrozole May Improve Efficacy

February 02, 2009

In metastatic breast cancer (MBC), lapatinib (Tykerb) + letrozole (Femara) delayed disease progression in HER2+, HR+ patients, according to initial results from a phase III trial (EGF30008) presented by Stephen Johnston, MD (abstract 46).

AIs vs Tamoxifen: Results of EBCTG Meta-Analyses

February 02, 2009

Based on 2 meta-analyses of nearly 20,000 HR+ early breast cancer patients, AIs are superior to tamoxifen in reducing recurrences, whether as initial monotherapy or given in a “switching” strategy (abstract 12).

More Notable Trials From SABCS 2008

February 02, 2009

Eidtmann H et al: The effect of zoledronic acid on aromatase inhibitor associated bone loss in postmenopausal women with early breast cancer receiving adjuvant letrozole: 36 months follow-up of ZO-FAST (abstract 44).

High-Dose Fulvestrant at Least as Good as Anastrozole in First-Line MBC

February 01, 2009

There is evidence that higher doses of fulvestrant (Faslodex) may have greater activity than the approved dose of 250 mg/mo. The FIRST trial (Fulvestrant First-Line Study) compared 500 mg vs anastrozole 1 mg/d in the first-line advanced disease setting, finding that a dose of 500 mg/mo achieved response rates and clinical benefit rates similar to those obtained with anastrozole 1 mg/d but gave a significantly longer time to progression (abstract 6126).

Optimizing the Use of Aromatase Inhibitors

February 01, 2009

EXPERT’S CORNER-Nearly three quarters of breast cancer patients have tumors that express estrogen receptors (ERs) or progesterone receptors (PRs); approximately half of these patients are postmenopausal. We look to endocrine therapy, therefore, to prevent recurrences and save lives in the majority of early breast cancer patients and to prolong survival in the advanced disease setting.

ABCSG Trial: Survival Benefit for Tamoxifen → Anastrozole

February 01, 2009

ABCSG Trial: Survival Benefit for Tamoxifen. Anastrozole Updated results from Austrian Breast and Colorectal Cancer Study Group Trial 8 confirmed a survival difference for the sequencing strategy of tamoxifen followed by anastrozole (Arimidex), compared to 5 years of tamoxifen (abstract 14). Preliminary results (median follow-up 55 mo) had previously revealed a 24% reduction in recurrence in favor of the sequencing strategy, although the difference was not statistically significant.