In this slide show we present some of the top cancer stories of 2014, including a newly discovered gene that confers a high-risk of breast cancer and the impressive survival improvement with the addition of docetaxel to ADT in newly diagnosed metastatic prostate cancer.
A germline loss-of-function mutation in the PALB2 gene was previously linked to breast cancer, but the lifetime risk of a breast cancer diagnosis for those with the mutation was previously unknown. Now researchers have shown that patients with mutations in PALB2 have a lifetime risk of breast cancer similar to BRCA2 mutation carriers.
At the ASCO Annual Meeting, Christopher Sweeney, MBBS, presented results from the phase III CHAARTED trial, which showed that adding docetaxel to standard hormone therapy extends survival for men with metastatic hormone-sensitive prostate cancer by 13.6 months. The extension of survival was greatest among men with extensive disease-a difference of 17 months. Photo by Â© ASCO/Silas Crews 2014.
On November 10, 2014, the Centers for Medicare & Medicaid Services announced plans to cover lung cancer screening with low-dose computed tomography, based primarily on the National Lung Screening Trial. This comes as good news to many lung cancer specialists who have been calling for Medicare to cover the screening test, though it sits in contrast to a Medicare panel that recommended against covering screening earlier in the year.
At the ASCO Annual Meeting, Olivia Pagani, MD, presented data from the combined analysis of two phase III clinical trials that found that exemestane, an aromatase inhibitor, may better prevent breast cancer recurrence in women with early-stage hormone receptorâpositive breast cancer, as compared with tamoxifen. The results of the Tamoxifen and Exemestane Trial (TEXT) and the Suppression of Ovarian Function Trial (SOFT) show that combining exemestane with ovarian function suppression in premenopausal breast cancer patients who have hormone-sensitive disease results in a reduction in the risk of breast cancer recurrence by 34%, compared with treatment with tamoxifen in combination with ovarian suppression. Photo by Â© ASCO/Silas Crews 2014.
On December 10, 2014, the US Food and Drug Administration (FDA) approved Gardasil 9, a new human papillomavirus (HPV) vaccine that protects against nine types of the virus. The previous Gardasil vaccine protected against four types of HPV. The new version of this vaccine could prevent about 90% of cervical cancers.
Data presented at the 2014 ASH Annual Meeting found that adding carfilzomib to a standard combination of lenalidomide plus dexamethasone in relapsed multiple myeloma increased median progression-free survival by 8.7 months. The median progression-free survival was 26.3 months in the triplet combination arm compared to 17.6 months in the control arm (hazard ratio = 0.69, P
Data reported at the ESMO Annual Meeting showed that metastatic melanoma patients treated with the anti-PD-1 immunotherapy nivolumab had a 32% response rate compared with an 11% rate in patients treated with chemotherapy. The phase III trial, called CheckMate 037, randomized 405 melanoma patients 2:1. All patients had previously been treated with at least one systemic therapy for their advanced disease. Median response time was 3.6 months in the chemotherapy arm and has not yet been reached in the nivolumab arm. Some patients in the nivolumab arm have been responding for 10 months or more and 36 of the 38 responsive patients are continuing to respond. These are the first phase III clinical trial results with nivolumab reported. The drug was approved by the FDA later in the year.
After a follow-up of 50 months, the final overall survival analysis of the pivotal CLEOPATRA trial, which randomized 808 previously untreated patients, demonstrated a 15.7 month overall survival advantage for HER2-positive metastatic breast cancer patients treated with trastuzumab, chemotherapy, and pertuzumab compared with trastuzumab and chemotherapy alone. Median overall survival was 40.8 months in the control arm compared with 56.5 months in the pertuzumab experimental arm (hazard ratio = 0.68). The data were reported at the ESMO Annual Meeting.
Data presented at the ASH Annual Meeting found that patients with Hodgkin lymphoma who received brentuximab vedotin as consolidation therapy after an autologous stem cell transplantation (ASCT) lived significantly longer and without disease progression compared with those who received ASCT alone. The median progression-free survival was 43 months in the brentuximab vedotin arm compared with 24 months in the control arm (hazard ratio = 0.57; P = .001). The estimated 2-year progression-free survival rate was 54%, and the estimated 2-year overall survival rate was 88%. Image source: KGH, Wikimedia Commons.
At the ASCO Annual Meeting, Martine J. Piccart, MD, presented data from the ALTTO clinical trial-the largest adjuvant breast cancer trial ever-which found that adjuvant therapy with trastuzumab alone is just as effective as trastuzumab combined with lapatinib after surgery for women with early-stage HER2-positive breast cancer. Photo by Â© ASCO/Phil McCarten 2014.
Patients with previously untreated BRAF V600E or V600K metastatic melanoma had a significant improvement in overall survival when treated with a combination of a BRAF inhibitor and a MEK inhibitor compared with treatment with a BRAF inhibitor alone, according to the results of a study published in the New England Journal of Medicine. In fact, patients treated with dabrafenib and trametinib had a 31% relative risk reduction for death compared with patients assigned monotherapy with the BRAF inhibitor vemurafenib, with no significant increase in toxicity.
Treatment with combined chemotherapy and the luteinizing hormone-releasing hormone (LHRH) analog triptorelin may help to preserve fertility in premenopausal women with breast cancer. Women who received the combined treatment had trends toward improved rates of menses resumption and becoming pregnant compared with the women treated with chemotherapy alone. The results of this trial also echo those of the POEMS trial presented at the ASCO Annual Meeting, which showed that concurrent administration of chemotherapy with an LHRH analog resulted in less premature ovarian failure and more pregnancies.
At the ASCO Annual Meeting, Alan P. Venook, MD, presented long-awaited results of the phase III CALGB/SWOG 80405 trial, which found that first-line treatment with a chemotherapy backbone plus either the anti-VEGF bevacizumab (Avastin) or the anti-EGFR cetuximab (Erbitux) resulted in equally effective outcomes for patients with metastatic colorectal cancer and wild-type KRAS. Photo by Â© ASCO/Phil McCarten 2014.
Data from the phase III RESONATE trial reported at the ASCO Annual Meeting showed that ibrutinib substantially increased progression-free survival (78% reduction in risk) and overall survival over ofatumumab in patients with relapsed and refractory chronic lymphocytic leukemia and small lymphocytic lymphoma. The trial showed that at 12 months, patients had a 57% reduction in the risk for death with ibrutinib. Image source: Ed Uthman, Wikimedia Commons.
A large study that included over 90,000 women, published in the British Medical Journal, found that death rates for all causes were the same between women randomly assigned to receive mammograms and women who were not. The study, which included Canadian women aged 40 to 59, found that 1 in 424 women who had mammograms received unnecessary treatment.