FALL 2007

BRAIN TUMORS

Commentary by Henry S. Friedman, MD, James B. Powell Jr. Professor of Neuro-Oncology, Professor of Pediatrics, Associate Professor of Surgery and Medicine, Assistant Professor of Pathology, and Deputy Director, the Preston Robert Tisch Brain Tumor Center, Duke University, Durham, North Carolina

9

Bevacizumab-irinotecan combination shows activity in recurrent glioma

10

VEGF inhibitor cediranib active in recurrent glioblastoma

10

Motexafin gadolinium delays progression in NSCLC brain metastases

11

Dendritic cell vaccine shows promise in glioblastoma

11

Temozolomide and vaccination can work together to treat GBM

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BREAST CANCER

Commentary by Hope S. Rugo, MD, Clinical Professor of Medicine, University of California, San Francisco, and Director, Breast Oncology Clinical Trials Program, UCSF Comprehensive Cancer Center, San Francisco, California, and William J. Gradishar, MD, Professor of Medicine and Director, Breast Medical Oncology, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois

Local-Regional and Adjuvant Therapy

12

MRI more sensitive than mammogram in DCIS diagnosis

12

BIG I-98: cardiac events rare but more common with letrozole

15

Reduced radiation effective for early breast cancer

15

Two large studies report good long-term survival in DCIS

16

Adjuvant taxanes produce similar disease-free survival

16

Updated results mixed for adjuvant doxorubicin-paclitaxel

Metastatic Breast Cancer

17

FDA asked to approve ixabepilone after phase III trial

17

Axitinib combination doubles response to docetaxel alone

18

Bevacizumab-capecitabine may favor ER-positive women

19

Weekly paclitaxel boosts response in Anglo-Celtic trial

19

African Americans fare worse with stage III, IV disease HER2-positive breast cancer

23

Trastuzumab benefits are durable in early-stage disease

23

NSABP-31 revisited: cardiotoxicity stays constant at 5 years

27

Trastuzumab may benefit some HER2-negative patients

28

Carboplatin does not enhance docetaxel-trastuzumab

28

Merged trial data find no further cardiac risk with lapatinib

31

Lapatinib shrinks brain mets in previously treated patients

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GASTROINTESTINAL MALIGNANCIES

Commentary by Stuart M. Lichtman, MD, Associate Attending, Clinical Geriatrics Program, Memorial Sloan-Kettering Cancer Center, Commack and New York, New York, and Malcolm J. Moore, MD, Professor of Medicine and Pharmacology, Head, Division of Medical Oncology and Hematology, Princess Margaret Hospital/University Health Network and Mt. Sinai Hospital, and Director, Drug Development Program, and Chief of Medical Services, Princess Margaret Hospital, Toronto, Canada

Colorectal Cancer

32

Perioperative FOLFOX4 improves survival with liver metastases

33

Phase III trials show Xelox equivalent to FOLFOX

34

Adding bevacizumab to oxaliplatin delays progression

34

Cetuximab increases response to FOLFOX4 in OPUS trial

35

Lymph node evaluations not meeting guideline standards

35

Cetuximab cuts progression risk by 15% in CRYSTAL trial

36

MOSAIC update confirms FOLFOX4 disease-free survival advantage

41

Cetuximab improves quality of life in advanced disease

41

Chemotherapy break shortens survival in OPTIMOX2 trial

Gastric Cancer

42

Preop chemotherapy may boost esophageal cancer survival

43

S-1 rivals 5-FU but has more toxicity in Japanese trial

43

S-1 plus cisplatin confers longer survival than S-1 alone

Gastrointestinal Stromal Tumors

44

GIST subgroup benefits from imatinib dose hike

Hepatocellular Carcinoma

47

Sorafenib extends overall survival by 44% versus placebo

Neuroendocrine Tumors

48

Sorafenib, everolimus active in neuroendocrine tumors

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GENITOURINARY MALIGNANCIES

Commentary by Judd W. Moul, MD, Professor and Chief, Division of Urology, and Director, Duke Prostate Center;Stephen J. Freedland, MD, Assistant Professor of Urology and Pathology; Daniel J. George, MD, Associate Professor of Medicine and Surgery, Divisions of Medical Oncology and Urology; and W. Robert Lee, MD, Professor of Radiation Oncology, Duke University Medical Center, Durham, North Carolina

Prostate Cancer

49

Satraplatin boosts progression-free survival in SPARC

50

Intermittent androgen suppression is safe alternative

50

Postsurgical prognostic tools give inaccurate predictions

51

Adjuvant radiotherapy averts biochemical progression

51

Circulating tumor cells may be better surrogate than PSA

52

Flaxseed slows prostate cancer growth in randomized study

52

PSA decline of 30% may be surrogate marker for overall survival

53

Stress management eases fear, aids postsurgical function

54

More positive needle biopsies in African American men

55

Choice of consultation specialist sways treatment decisions

56

Follow-up after EBRT falls short of guideline

Renal Cell Carcinoma

57

Bevacizumab plus interferon-a improves survival

61

Sunitinib active in bevacizumab-resistant kidney cancer

61

Low-dose adjuvant immunotherapy fails to improve survival

Testicular Cancer

62

Better QOL with adjuvant chemotherapy than radiation

62

Adjuvant radiotherapy linked to better cause-specific survival

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GYNECOLOGIC MALIGNANCIES

Commentary by J. Tate Thigpen, MD, Professor of Medicine and Director of the Division of Medical Oncology, University of Mississippi School of Medicine, Jackson, Mississippi

Cervical Cancer

63

Model predicts response to cisplatin-based therapy

Endometrial Cancer

64

No benefit but more toxicity with EBRT in stage I disease

64

Advanced endometrial cancer treated with mTOR inhibitor

Ovarian Cancer

65

Doxil comparable to gemcitabine in phase III trial

65

Serial CA125 screening may flag early high-risk cancer

66

Maintenance paclitaxel fails to improve survival

67

Canfosfamide disappoints in two ovarian cancer trials

67

Nab-paclitaxel active in platinum-sensitive recurrent disease

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HEAD AND NECK CANCERS

Commentary by Marshall R. Posner, MD, Medical Director of the Head and Neck Oncology Program at Dana-Farber Cancer Institute and Associate Professor of Medicine, Harvard Medical School, Boston, Massachusetts

68

HPV confers 79% lower risk of death in prospective trial

69

Cetuximab prolongs survival in squamous cell cancers

69

Larynx preservation protocol does not improve survival

70

Axitinib shrinks advanced thyroid cancer in phase II trial

71

Erlotinib boosts response to standard chemotherapy

71

Cetuximab enhances chemoradiation results in advanced disease

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HEMATOLOGIC MALIGNANCIES

Commentary by Steven E. Coutré, MD, Director of the Hematology Clinic, Stanford Hospital and Clinics, and Associate Professor of Medicine, Stanford University School of Medicine, Stanford, California, and Steven T. Rosen, MD, Genevieve Teuton Professor of Medicine and Director, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois

Acute Promyelocytic Leukemia

72

First-line arsenic trioxide improves overall survival

Chronic Lymphocytic Leukemia

73

Five-year data back FCR as preferred first-line therapy

73

Investigational Bcl-2 blocker appears active in advanced CLL

Chronic Myelogenous Leukemia

74

Dasatinib 100 mg once daily is optimal dosing for CML

76

First-line dasatinib produces rapid cytogenetic response

76

Bosutinib, nilotinib clinically active in imatinib-resistant CML

Myelodysplastic Syndrome

78

AMG 531 evokes response in thrombocytopenic patients

78

MGCD0103 and azacitidine combination active in advanced MDS

Multiple Myeloma

79

Thalidomide-melphalan-prednisone is safe after age 75

79

Low-dose dexamethasone plus lenalidomide improves survival

87

Doxorubicin adds to bortezomib benefits in refractory disease

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LUNG CANCER

Commentary by Roy S. Herbst, MD, PhD, Professor of Medicine and Chief, Section of Thoracic Medical Oncology, Department of Thoracic/Head and Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas

88

Prophylactic brain irradiation improves SCLC survival

89

Genetic differences may vary response to paclitaxel

89

EGFR mutations predict response to erlotinib and gefitinib

90

Bevacizumab improves progression-free survival in AVAIL trial

90

Maintenance gefitinib worse than placebo in stage III NSCLC

91

Cetuximab and chemo encouraging in Phase II trials

91

Shark cartilage therapy sinks in NCI-sponsored Phase III trial

92

Axitinib emerges as potent VEGF inhibitor in NSCLC trial

92

Adjuvant MAGE A-3 immunotherapeutic cuts risk of recurrence

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MELANOMA / SARCOMA

Commentary by Jeffrey A. Sosman, MD, Professor of Medicine and Director, Melanoma Program, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee

93

Pegylated interferon alfa-2b aids relapse-free survival

94

Truncated interferon therapy may be comparable

94

Sorafenib trials report mixed results in advanced melanoma

95

Back to the drawing board in melanoma vaccine effort

96

Regional hyperthermia delays sarcoma progression

96

Adjuvant doxorubicin/ifosfamide disappoints in sarcoma

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PATIENT AND SURVIVOR CARE

Commentary by Charles L. Loprinzi, MD, Director, North Central Cancer Treatment Group (NCCTG) Cancer Control Program, Co-Director, Prevention and Control Program, Mayo Cancer Center, and Professor of Oncology, Mayo Medical School, Rochester, Minnesota and Lee S. Schwartzberg, MD, Medical Director, The West Clinic, Medical Director, Baptist Centers for Cancer Care–Stem Cell Transplant Program, Medical Director, Baptist Centers for Cancer Care–Cancer Genetics Program, and President and Chief Medical Officer, Accelerated Community Oncology Research Network (ACORN), Memphis, Tennessee

Anemia / Neutropenia

97

Intravenous iron augments erythropoiesis-stimulating drugs

98

Model identifies older cancer patients at risk for neutropenia

Bone Health

99

Jaw osteonecrosis risk correlates with number of infusions

99

Drop in NTx level with zoledronic acid linked to longer survival

Communication

100

Detailed information about a poor prognosis can give hope

100

Maintaining quality of life is prostate cancer patients' top concern

Hot Flashes

101

Gabapentin reduces hot flashes of androgen deprivation therapy

101

Hot flashes portend reduced risk of breast cancer recurrence

Other Side Effects

102

Ginseng capsules reduced fatigue in randomized trial

102

Tetracycline reduces severity of rash from EGFR inhibitors

103

Pyridoxine does not prevent hand-foot syndrome

103

Percutaneous biliary drainage fails to improve quality of life

Survivor Follow-Up

104

Childhood cancer survivors not screened for known risks

104

Study of elderly patients shows need for survivorship care plans

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