ASCO 2014: Adding Tykerb to Herceptin fails to improve breast cancer survival

June 1, 2014 | by   

A plenary study presented at the American Society of Clinical Oncology’s annual meeting found that adding lapatinib (marketed as Tykerb) to trastuzumab (marketed as Herceptin) did not improve survival outcomes for women with early-stage breast cancer that is sensitive to HER2-targeted therapy.


Researchers found that adding lapatinib (modeled above) to standard trastuzumab therapy did not improve survival outcomes for women with early-stage, HER2-positive breast cancers

This finding came as a shock and a disappointment for many breast cancer clinicians, researchers, patients and advocates, since lapatinib also acts upon the HER2 receptor, and an earlier trial on the lapatinib-trastuzumab combination showed promising results.

Despite this discouraging news, the study’s lead author, Edith A. Perez, M.D., did find a silver lining when reporting her results.

“We were encouraged to see that most patients with HER2-positive early breast cancer are doing well with standard trastuzumab therapy,” said Perez, a deputy director at large at the Mayo Clinic Cancer Center in Jacksonville, Florida, in a press release. “But we were surprised that adding lapatinib did not provide further benefit.”

In this phase III clinical trial, called ALTTO, Perez and her colleagues followed more than 8,000 women with early-stage, HER2-positive breast cancer. After these patients underwent surgery, they were randomized to receive standard chemotherapy in combination with either trastuzumab, lapatinib, trastuzumab followed by lapatinib or trastuzumab concurrent with lapatinib. » Continue Reading

ASCO 2014: Two drug combo boosts ovarian cancer survival

May 31, 2014 | by   

For women with ovarian cancer, the results of recent study could mean new hope for future treatments. The findings, reported at the American Society of Clinical Oncology’s annual meeting, found that a combination of two experimental drugs, olaparib and cediranib, significantly lengthened the duration of progression-free survival compared to olaparib alone and standard chemotherapy.

A new study found that a combination of two experimental drugs, olaparib and cediranib, can boost progression-free survival duration for patients with recurrent, platinum-sensitive ovarian cancer.

A new study found that a combination of two experimental drugs, olaparib and cediranib, can boost progression-free survival duration for patients with recurrent ovarian cancer.

The phase II trial is the first time that a PARP inhibitor is combined with an anti-angiogenic drug to treat ovarian cancer. PARP inhibitors such as oliparib work by thwarting cancer cells’ ability to repair their own DNA, while anti-angiogenic drugs such as cediranib halts growth of new blood vessels in tumors.

“The significant activity that we saw with the combination suggests that this could potentially be an effective alternative to standard chemotherapy,” said the study’s lead author Joyce Liu, M.D., M.P.H., in a press release.

Liu, an instructor in medical oncology at Dana Farber Cancer Institute, added that these findings showed that the two drugs worked synergistically and bolstered each other’s effectiveness against the cancer.

For this clinical trial, Liu and her colleagues randomized 90 patients with recurrent, platinum-sensitive ovarian cancer into either olaparib-only or olaparib+cediranib groups. In their analysis, they found that progression-free survival was significantly higher in the combination group, over 17 months compared to nine months in oliparib only. Meanwhile, previous trials with standard chemotherapy in this population showed a progression-free survival range from eight to 13 months.

» Continue Reading

Meet our doctors: Urologist Jonathan Yamzon on curing testicular cancer

May 31, 2014 | by   

Testicular cancer is the most common form of cancer in men 15 to 34 years old. Yet it accounts for only 1 percent of all cancers in men in the United States. According to the American Cancer Society, about 8,800 men are diagnosed with testicular cancer each year, and about 380 men die of the disease. However, if detected early, the disease has an overall five-year survival rate of 96 percent. For Stage 1 patients, the five-year survival rate is an astonishing 99 percent.

Although rare, testicular cancer is one of the most curable forms of cancer says Dr. Jonathan Yamzon.

Although rare, testicular cancer is one of the most curable forms of cancer, says City of Hope’s Jonathan Yamzon.

Here, urologist Jonathan Yamzon, M.D., assistant clinical professor and surgeon in City of Hope’s Division of Urology and Urologic Oncology, discusses how early detection and the use of advanced treatment options can help cure men of this rare disease and allow them to lead healthy, normal lives.

What is testicular cancer?

Testicular cancer occurs when cells in the testicles grow and multiply uncontrollably, damaging surrounding tissue and interfering with the normal function of the testicle. If the disease spreads, it is still called testicular cancer.

The most common types of testicular cancer form in germ cells, where sperm is made. They fall into two categories: seminomas and nonseminomas. Seminomas are slow-growing and tend to stay within the testicle. Nonseminomas are faster-growing, tend to spread outside the testicle and strike younger men. More than 90 percent of testicular cancers begin in the germ cells. » Continue Reading

ASCO 2014: Simple step could protect fertility for women treated for some breast cancers

May 30, 2014 | by   

Preserving fertility is an important and common concern among young women who are diagnosed with cancer. New study findings offer women a simple new option for treating hormone receptor-negative breast cancer and protecting their fertility.

Women at an elevated risk of developing breast cancer, should be offered drugs, such as tamoxifen or raloxifene, to reduce that risk, the U.S. Preventive Services Task Force suggests.

A Cleveland Clinic study presented at ASCO found that adding a hormone-suppressing drug to chemotherapy treatment protected fertility and increased survival among women with hormone receptor-negative breast cancer.

The study, presented at the 2014 Annual Meeting of the American Society of Clinical Oncology in Chicago, suggests adding a hormone suppressing drug called goserelin (trade name Zoladex) to standard chemotherapy may be an effective method of preserving fertility for those women with early-stage breast cancer that is hormone receptor-negative.

In the Cleveland Clinic study, women who received the drug along with chemotherapy were 64 percent less likely to develop premature ovarian failure compared to women who received chemotherapy alone. Further, the study found, they were also more likely to have successful pregnancies. The study also found a surprising survival benefit: Those women who took goserelin were 50 percent more likely to be alive four years after starting chemotherapy than those who took the standard treatment.

“This is a really important trial for young women with hormone-independent breast cancer because they now have the option of taking goserelin – an LHRH agonist therapy – to preserve their fertility,” said Joanne Mortimer, M.D., director of the Women’s Cancers Programs at City of Hope, who was not involved in the study. “Although there were problems accruing the number of patients the researchers had hoped for, there were still enough data that women on this therapy were more likely to have children. Additionally, one of the more interesting findings of this study is that women on LHRH agonist therapy had a longer disease-free survival, which we wouldn’t expect for women with hormone-independent breast cancer.”

Ovarian failure is a common side effect of chemotherapy, and risk of ovarian failure varies depending on the type and dose of chemotherapy as well as a patient’s age. Goserelin, and other lutenizing hormone-releasing hormone analogs, can temporarily stop the ovaries from functioning – putting the patient into a postmenopausal state. Researchers speculated this protects the eggs from chemotherapy damage. These medications are commonly used to control ovulation timing for in vitro fertilization and other fertility procedures, and they’re also used to treat advanced prostate and breast cancers.

The study included 257 women with early stage hormone receptor-negative breast cancer, and were randomized to treatment with chemotherapy alone or chemotherapy with the hormone suppressing drug. Two years after starting chemotherapy, 8 percent of women who took goserelin had ovarian failure, compared to 22 percent of women in the standard arm.

The abstract (#LBA505) is available on ASCO’s website.

Learn more about breast cancer treatments available at City of Hope.


ASCO 2014: Lower radiation dose effective for HPV-positive head and neck cancers

May 30, 2014 | by   

Patients diagnosed with human papillomavirus (HPV)-positive head and neck cancers could be treated with a lower-dose of intensity-modulated radiation therapy, reducing the risks of side effects, according to a new study.

Head and neck

A new study presented at this year’s ASCO conference suggests patients who are diagnosed with HPV-positive head and neck cancers could be treated with a lower-dose of radiation than the standard practice suggests.

The study, led by researchers at Vanderbilt-Ingram Cancer Center in Nashville, Tennessee, was highlighted at the 2014 Annual Meeting of the American Society of Clinical Oncology in Chicago.

The phase II study included 90 patients with stage III and IV HPV-positive oropharyngeal squamous carcinoma who received induction chemotherapy with paclitaxel, cisplatin and cetuximab.

Researchers focused on both clinical outcomes as well as long-term side effects.

City of Hope’s Sagus Sampath, M.D., assistant clinical professor in the Department of Radiation Oncology, helped enroll patients in the ECOG 1308 trial while at the University of New Mexico. He found the results to be an exciting step forward in the goal of reducing treatment intensity for HPV-positive oropharynx squamous cell cancers.

“These results show for the first time that a reduced dose of radiation is associated with high rates of local-regional disease control in the setting of ‘clinical complete response’ [cCR] following induction chemotherapy,” Sampath said. “This also points to the potential reliability of an endoscopic assessment of clinical response following induction chemotherapy.”

However, while the study’s results show great progress, more work still needs to be done before the practice can be widely accepted, Sampath noted.

“What is unknown is whether with longer follow-up these excellent control rates will be maintained,” Sampath said. “A similar trial design in the definitive chemoradiotherapy setting will be necessary before implementing reduced radiation dose as a standard-of-care practice.”

The abstract (#LBA6006) is available on ASCO’s website.

Learn more about head and neck cancer treatment at City of Hope.



National Cancer Survivors Day: Celebrate survival – and research

May 30, 2014 | by   

Nearly 14 million Americans are cancer survivors, an impressive community that will celebrate their survival, their lives, on National Cancer Survivors Day, also known as June 1.

On this day each year, survivors, their families, their caregivers and the medical professionals who treated them pause to celebrate milestones, to give thanks for support – and to appreciate all those things in life that cannot be taken for granted.

Survivors remind everyone at City of Hope why they do what they do  – and not just those people who directly care for patients. City of Hope is devoted to scientific discovery, in hopes of developing better treatments, finding ways to prevent and cure cancer and perhaps – as it did when tuberculosis ceased to be a leading health scourge – eventually devoting itself to curing a new disease.

Steven T. Rosen, M.D., City of Hope’s provost and chief scientific officer, explains why research is so crucial in the fight to increase cancer survival. » Continue Reading

In the oncology world, ASCO is the hive – and researchers are the bees

May 30, 2014 | by   

Scientists know that bees often will travel great distances to explore the world around them, then return to the hive to share what they’ve learned through intricate and detailed communication with thousands of their comrades. These journeys of discovery keep the colony educated about its surroundings and better able to survive and thrive in a sometimes challenging environment.


Steven T. Rosen, City of Hope’s provost and chief scientific officer.

Not unlike these apian explorers, cancer researchers spend much of their time studying a particular corner of the scientific world. They then gather with their colleagues to share their findings, spreading the wealth of their knowledge to benefit all.

Many City of Hope physicians will journey to one such hive of information this week — the annual meeting of the American Society of Clinical Oncology, or ASCO, which takes place May 30 to June 3 in Chicago. Hosting more than 25,000 oncology professionals, the meeting is among the largest of its kind.

City of Hope’s work is well-represented, with more than 40 researchers sharing their progress. While there, these leaders in the field will learn about the work of other scientists and spread awareness about City of Hope itself.

Major advances over the past half century have prolonged many lives and reduced human suffering due to cancer, but further work is needed, said Steven T. Rosen, M.D., City of Hope’s provost and chief scientific officer.

“The interaction that takes place at the ASCO annual meeting will foster collaboration among researchers and clinicians, renewing our sense of urgency and ultimately furthering our collective progress to make a meaningful, tangible impact against the disease,” he said.

The roster of findings to be presented by City of Hope experts will include:

But that’s just the beginning. Learn more about the research to be presented at the 50th annual ASCO meeting. Scientists will be.


Brain tumors Q&A: New advances in research, treatment, technology

May 29, 2014 | by   

Brain cancer may be one of the most-frightening diagnoses people can receive, striking at the very center of who we are as individuals. Further, it often develops over time, causing no symptoms until it’s already advanced.

breast to brain cancer

Sometimes, brain tumors begin in the brain; other times, they arise from cancers elsewhere in the body.

Malignant, or cancerous, tumors that begin in the brain are called primary brain tumors. Lung cancer, breast cancer, kidney cancer, melanoma and other types of cancer commonly spread to the brain as well. When this happens, the tumors are called metastatic brain tumors. Secondary tumors can also prove fatal.

But researchers are making progress against these cancers.

Here, Behnam Badie , M.D., director of the Brain Tumor Program and chief of the Division of Neurosurgery at City of Hope, discusses advances in treatment and research in brain cancer, including the installation of the Monteris Medical system, an MRI-guided laser that contours neurosurgical lesions, making City of Hope the only institution in Los Angeles that uses this groundbreaking technology. » Continue Reading

ASCO 2014: Younger women with breast cancer are less likely to survive

May 29, 2014 | by   

Cancer can affect a person at any age, with the disease often considered one of aging. But increased age isn’t always linked to an increased risk of death. City of Hope researchers have found that, when it comes to breast cancer, younger women are more likely to die than their older counterparts.

Breast cancer

Younger women diagnosed with breast cancer face poorer outcomes, according to a new study by City of Hope researchers.

That research will be presented on June 2 by Julie Wolfson, M.D., M.S.H.S., assistant professor of City of Hope’s Department of Pediatrics and Department of Population Sciences, in an abstract at the American Society of Clinical Oncology’s annual meeting in Chicago.

“Adolescents and young adults are documented to have poorer cancer outcomes, but no one has studied outcome differences for cancers that are typical in young adults, including breast cancer,” Wolfson said.

In their research, Wolfson and her colleagues analyzed data on more than 67,000 patients from the Los Angeles County cancer registry from 1998 to 2008, including almost 6,000 from the young adult age group (22 to 39 years old). They then looked at overall survival and mortality rates for the seven cancers most common in young adults (breast, liver, lung, colorectal, gastric, cervical and oral).

After adjusting for demographic and clinical characteristics (such as stage of cancer and race/ethnicity), the researchers found that younger women with breast cancer have worse outcomes than older women with breast cancer. In their analysis, the mortality rate for this group was 10 to 30 percent higher than that of older women (40 to 65 years old). » Continue Reading

ASCO 2014: For kids taking medication, fewer adults is sometimes better

May 28, 2014 | by   

Missing an occasional dose of medicine may not seem like a big deal, but for kids with acute lymphoblastic leukemia (ALL), it can have dire consequences. Now City of Hope researchers have assessed the factors that can contribute to so-called medication non-adherence. One of their more surprising discoveries: Having multiple adults involved with administering medication actually lowers the likelihood that kids will take the drugs as they should.

medication adherence

For children with acute lymphoblastic leukemia, it is crucial to take oral chemotherapy regularly after remission. In a new study, City of Hope researchers found factors linked to medication non-adherence, which can be used to identify at-risk groups.

The results will be presented at the American Society of Clinical Oncology annual meeting on June 1.

“ALL is a highly treatable cancer, but patients need to take ongoing oral chemotherapy for two years after the initial remission to reduce likelihood of relapses,” said Smita Bhatia, M.D., M.P.H., senior author of the study and the Ruth Ziegler Chair in Population Sciences at City of Hope. “By identifying factors linked to non-adherence, we can identify at-risk patients and intervene to ensure that they stay on track with the medication schedule.”

City of Hope researchers had already found that not non-adherence to medication regimens can triple a patient’s risk of relapse. They also knew that almost half of pediatric ALL patients don’t take their medication as they should. Understanding the reasons for such non-adherence is a first step in reducing the risk of relapse.

In their new analysis, Bhatia, Wendy Landier, Ph.D., R.N., assistant professor in the Department of Population Sciences, and their colleagues studied 462 pediatric ALL patients taking maintenance oral chemotherapy. Using a combination of questionnaires, demographic data and devices that track when the drug bottles were opened, the researchers found that the following factors are associated with non-adherence: » Continue Reading