Caroline Helwick

Rules balance access to promising new therapies against the need to protect patient safety.

A high intake of dietary polyamines, which are commonly found in orange juice, corn, red meat, peas, and nuts, has been linked to the size and grade of colorectal adenomas found on screening colonoscopy.

Confusion over important prognostic indicator may lead to unnecessary treatment.

A novel IGF-receptor inhibitor stabilized disease in a majority of pancreatic cancer patients, according to a report at the 2010 GI Cancers Symposium.

A primer on managing the chemorefractory patient from Eric Van Cutsem, MD, PhD.

Screening is the key to protecting those at risk for pancreatic cancer, according to presenters at the 2010 Gastrointestinal Cancers Symposium.

The RIBBON-2 trial met its primary endpoint of prolonged progression-free survival.

The seminal IPASS study by Tony Mok, MD, and colleagues demonstrated moderate efficacy for gefitinib (Iressa) in advanced non–small–cell lung cancer patients, most notably in patients with predictive factors, including adenocarcinoma histology, no history of smoking, and Asian ethnicity.

Higher doses of the estrogen-receptor antagonist fulvestrant (Faslodex) may increase treatment benefit without increasing toxicity, according to results from the international, randomized, double-blind phase III CONFIRM trial.

The RANK ligand inhibitor was better tolerated and more convenient for patients with skeletal metastasis.

Multi-targeted TKI inhibitors are gaining traction in the treatment of advanced breast cancer, although results from four different trials do show varying degrees of efficacy.

Sorafenib (Nexavar) has antiangiogenic and antiproliferative activity and is FDA-approved for advanced renal and hepatocellular cancers.

The targeted combination of lapatinib (Tykerb) plus trastuzumab (Herceptin) led to a median overall survival of 14 months in women with refractory metastatic breast cancer.

Shortages in funding, manpower, and willing patients have created the proverbial perfect storm in the current clinical trial system. The fact that traditional clinical trial endpoints in assessing novel agents are being reconsidered only puts more pressure on an already strained system. As the cancer research community navigates the troubled waters of clinical trials, one question is: Should traditional phase II trials be phased out?

The targeted combination of lapatinib (Tykerb) plus trastuzumab (Herceptin) led to a median overall survival of 14 months in women with refractory metastatic breast cancer, according to an updated analysis of the phase III EGF104900 trial. A bonus: The majority of toxicities were low-grade.

The RIBBON-2 trial met its primary endpoint to prolong progression-free survival, making the bevacizumab-chemotherapy combination a new treatment option, said principal investigator Adam Brufsky, MD. The trial continued the evaluation of bevacizumab plus chemotherapy to treat metastatic breast cancer after previous treatment failures.

Denosumab prevented more events, was better tolerated, and was more convenient for breast cancer patients with skeletal metastasis, according to results from a randomized double-blind trial that matched the RANK ligand inhibitor against zoledronic acid.

Results from the CONFIRM trial found that a higher dose of fulvestrant was significantly more effective than a lower dose but did not lead to more toxicity, reported Angelo DiLeo, MD, who added “we anticipate that the 500-mg regimen will become the established dose for fulvestrant.”

The first major study to address the cardiovascular adverse effects of endocrine therapy for prostate cancer could change attitudes toward treatment options because testosterone deprivation may have more impact on the patient’s life than it does on the androgen receptor.

ORLANDO-Breast cancer experts gathered at ASCO 2009 to answer five important questions about anthracyclines, taxanes, HER2-positive disease, trastuzumab (Herceptin), and anti-VEGF agents. Their key message for adjuvant therapy: One size does not fit all. The participants were:

BERLIN-The failure of a major colon cancer trial to reach its primary endpoint surprised even the most seasoned gastrointestinal cancer investigators. Overall survival was not improved when cetuximab (Erbitux) was added to a first-line oxaliplatin-based regimen (Eloxatin), according to phase III COIN trial at ECCO/ESMO 2009.

Low tumor levels of the MSH2 protein predict long-term response to cisplatin-based chemotherapy in patients with resected non-small-cell lung cancer, according to an analysis from the International Adjuvant Lung Trial.

In about 30% of U.S. women who receive a diagnosis of early breast cancer, the cancer will progress to metastatic disease, but in the developing world, most cancer is initially diagnosed at an advanced stage, said William Gradishar, MD, director of medical breast oncology at the Robert H. Lurie Comprehensive Cancer Center, at Northwestern University, Chicago.

Final results from a phase II study of an enhanced version of Herceptin upheld the emerging benefits previously seen with this novel approach in HER2-positive breast cancer.

Routine surgery to remove the primary tumor in patients with unresectable colon metastases is no longer necessary, according to a group at New York’s Memorial Sloan-Kettering Cancer Center. They based their decision on six years of clinical experience at their institution and reported on them at ASCO 2009.

Identify theft is one of the country’s fastest growing crimes. Half of the annual 8.3 million identity thefts occur in the workplace, and medical practices are no exception, according to the Federal Trade Commission. Medical records are rich in information, such as a patient’s Social Security number, date of birth, credit card numbers, and insurance information, which can be misused for financial gain and for medical fraud.

ORLANDO-Oncologists can expect to hear more about inhibitors of the enzyme poly (ADP-ribose) polymerase-1, or PARP. An experimental agent in this class, BSI-201, prolonged event-free and overall survival in patients with triple-negative breast cancer when used together with gemcitabine (Gemzar) and carboplatin, according to early study results.

ORLANDO-Results of a pivotal trial presented at ASCO 2009 boosted the concept of maintenance chemotherapy for advanced non-small-cell lung cancer, but not everyone is ready to wholeheartedly embrace the idea.

ORLANDO-In a head-to-head comparison, two common regimens for metastatic breast cancer matched up, though the difference in toxicity profiles may give capecitabine (Xeloda) the edge over gemcitabine (Gemzar). The results “suggest that gemcitabine/docetaxel (Taxotere) followed by capecitabine at progression may be preferable,” said lead author Andrew Seidman, MD, of Memorial Sloan-Kettering Cancer Center, New York.

By supporting the growth of blood vessels that absorb nutrients and oxygen, angiogenesis allows tumors to progress from clonal populations to cell masses that can expand and ultimately metastasize. This is a well-established concept, but some of the premises underlying anti-angiogenic drug development are now being revised, according to Luisa Iruela-Arispe, PhD, of the molecular, cell and developmental biology department at the University of California, Los Angeles.