scout

All News

ORLANDO-The ancillary treatment costs of managing side effects can be burdensome to patients, so Harvard Medical School investigators were somewhat surprised when clinical trial patients reported little anxiety about paying for these drugs. But as more people become uninsured or underinsured, and the costs of drugs rise, patient anxiety could increase and adherence to treatment diminish, the lead author predicted.

ORLANDO-Ginger has been used for years to treat gastrointestinal upset, but for the first time, a large double-blind multicenter randomized study has shown ginger supplements can successfully stem chemotherapy-related nausea, University of Rochester in New York investigators reported at ASCO 2009 (abstract 9511). Some 70% of patients experience nausea and vomiting related to chemotherapy. While vomiting can largely be prevented with anti-emetics, nausea is typically more difficult to prevent and treat.

ORLANDO-Preliminary data suggested that Novartis’ RAD001 is moderately active in stabilizing the progression of HCC, according to a poster presentation at ASCO 2009 (abstract 4587). In this phase I trial, researchers in Taiwan enrolled 36 advanced HCC patients whose disease was not suitable for local therapy or had progressed after local therapy.

Music is a powerful tool that can evoke latent emotions, induce a range of emotional states, and enhance communication. It also offers a creative, lyrical, and symbolic means of addressing spiritual needs, and is increasingly used in end-of-life care.

Abstract 8506

A phase III trial comparing R–CHOP14 and R–CHOP21 for the treatment of patients with newly diagnosed diffuse large B–cell non–Hodgkin's lymphoma D. Cunningham, P. Smith, P. Mouncey, et al Methods: Patients were randomized to either 8 cycles of standard R–CHOP21 or 6 cycles of R–CHOP14 (+ G–CSF) with 2 additional cycles of single–agent rituximab (Rituxan). Patients were stratified by age (≤ 60 vs > 60), World Health Organization performance status (0–1 vs 2), and LDH (lactate dehydrogenase) level (normal vs raised). The primary endpoint was overall survival. Among 1,080 patients (median age 61 years), IPI (International Prognostic Index) scores of ≥ 4 were found in 17% of R–CHOP21 patients and in 15% of the R–CHOP14 arm. Stage 3/4 disease was reported in 63%/62% of patients in the R–CHOP21/R–CHOP14 arms, B symptoms in 44%/47%, and bulky disease in 51%/48%, respectively. Results: Reported grade 3/4 toxicities in the R–CHOP21 and R–CHOP14 arms were neutropenia 57%/31%, thrombocytopenia 5%/9%, infection 22%/17%, cardiac symptoms 1%/2%, nausea and vomiting 8%/8%, and mucositis 2%/3%. The radiologic complete response rates (CR/CRu [unconfirmed]) were 63% in the R–CHOP21 arm (49%/14%) and 58% (40%/18%) in the R–CHOP14 arm (P = .183). With a median follow–up of 17 months, there have been 150 deaths (14%). Conclusions: Response rates with 6 x R–CHOP14 (+2xR) are no better than with 8 x R–CHOP21. There are no differences among prognostic subgroups (including IPI). Acute toxicity levels are comparable. Final analysis will be performed when 330 deaths have occurred.

Abstract 8512

Methods: Among 63 chemotherapy-naive and 138 pretreated FL patients receiving 4 weekly rituximab (Rituxan) doses, those responding or with stable disease were randomized to observation (n = 78) or to consolidation with 4 additional rituximab doses at 2-month intervals (n = 73).

Abstract 8507

Benefit of rituximab combined to ACVBP (R-ACVBP) over ACVBP in 209 poor- risk DLBCL patients treated with up-front consolidative autotransplantation: A GELA phase II trial (LNH 2003-3)

Abstract 8509

R-ICE versus R-DHAP in relapsed patients with CD20 diffuse large B-cell lymphoma followed by autologous stem cell transplantation: CORAL study

Abstract 2

Idiotype vaccine therapy (BiovaxID) in follicular lymphoma in first complete remission: Phase III clinical trial results

Abstract 8500

Complete remissions with weekly dosing of SGN-35, a novel antibody-drug conjugate targeting CD30, in a phase I dose-escalation study in patients with relapsed or refractory Hodgkin lymphoma or systemic anaplastic large cell lymphoma

Abstract 7044

Activity of ofatumumab, a novel CD20 mAb, and prior rituximab exposure in patients with fludarabine- and alemtuzumab-refractory or bulky fludarabine-refractory chronic lymphocytic leukemia

Abstract 8546

Pooled analyses of two international, multicenter clinical studies of romidepsin in 167 patients with cutaneous T-cell lymphoma (CTCL)

In spite of significant advances in the understanding and treatment of hematologic malignancies over the past 5 years or so, these cancers remain challenges for clinicians. We always await the results of studies presented at the annual meeting of the American Society of Clinical Oncology (ASCO), hoping that they will be practice–changing for us and life–altering for our patients. This year, at the 45th ASCO in Orlando, we instead heard results that further refined or validated the treatment approaches we often take.

Studies presented at this year’s ASCO annual meeting gave us a glimpse of the future, which looks promising with regard to improved treatments for the major hematologic malignancies. Several new compounds are in preliminary trials and others are on the fast track to approval, offering some very new options for attacking a variety of these cancers.

A psychoanalyst describes her intimate psychosocial care with a dying patient. But her musings on caring for the terminally ill leave out one crucial thing--pain relief.

The recent decision by CMS to deny coverage for CT colonography in colorectal cancer screening has been seen by some as a favorable trend toward using evidence-based medicine to make more cost-effective coverage decisions. With the Medicare hospital insurance trust fund projected to become insolvent by 2017, perhaps the agency is responding to the impending fiscal realities.

A novel drug that targets an important protein receptor that supports B-cell lymphoma cells produced significant responses in non-Hodgkin’s lymphoma patients who had failed prior therapies. Results from the phase II trial of fostamatinib disodium in 68 heavily pretreated relapsed and refractory B-cell NHL patients revealed that the treatment has significant promise and should undergo further clinical testing, according to lead investigator Jonathan W. Friedberg, MD, of the James P. Wilmot Cancer Center at the University of Rochester in New York.

Who's News

Recipients of the 2009 ASCO Special Awards have been announced. Clara D. Bloomfield, MD, (left) will be given the David A. Karnofsky Memorial Award; the Science of Oncology Award will go to Bert Vogelstein, MD; Olufunmilayo Olopade, MBBS, will receive the ASCO-American Cancer Society Award; the B.J. Kennedy Award for Scientific Excellence in Geriatric Oncology will be given to Martine Extermann, MD, PhD; the Pediatric Oncology Award will be presented to William E. Evans, PharmD, and Mary V. Relling, PharmD; John H. Glick, MD, will take home the Distinguished Achievement Award; Diane S. Blum, MSW, is the recipient of Partners in Progress Award; Richard Pazdur, MD, will be given the Special Recognition Award.

As comparative effectiveness research matures from a political buzz phrase to a decision-making process, leaders in the oncology community are concerned about the effect this latest government initiative might have on community practices that already feel overregulated.

One of the most discussed elements of President Obama's health-care reform is the the initiative to launch comparative effectiveness research. The administration contends that CER is about enhancing the quality of care by choosing more effective clinical options. Pharma is worried that comparative effectiveness code for cost-effectiveness, and oncologists are concerned that CER could effect the autonomy of their clinical decision making.