Latest Cancer News

Long Term Follow Up Shows Durability of Jakafi® Response in Patients with Polycythemia Vera

CancerConnect News: Jakafi® (ruxolitinib) was initially reported to help patients with polycythemia vera (PV) maintain hematocrit control more effectively than the best available therapy at the 56th American Hematology Society Annual Meeting in 2014.1,2 Now with a full 4 years of follow-up from this trial the benefit of Jakafi® continues to be confirmed. Results recently presented at the 59th American Society of Hematology (ASH) Annual Meeting 2017 in Atlanta, Georgia demonstrate that the effectiveness and safety of Jakafi used to treat PV patients who were resistant to or intolerant of hydroxyurea (HU) continue beyond 4 years of treatment and are consistent with the results initially reported.3

Polycythemia vera is a slow-growing type of blood cancer that belongs to a group of blood disorders called myeloproliferative neoplasms (MPN). In these disorders, the bone marrow cells that produce blood cells develop and function abnormally. In PV the bone marrow makes too many blood cells, particularly red blood cells. These excess cells thicken the blood and can cause complications, such as a risk of blood clots or bleeding. Without treatment, PV can be life threatening and can eventually progress to more serious blood cancers, such as myelofibrosis or acute leukemia. Effective treatment, however, can significantly decrease risks and complications.

The goal of treatment for PV is to reduce the thickness of the blood and prevent bleeding and clotting. Jakafi has proven effective in the treatment of PV, including in patients with intolerance or resistance to HU the most common first-line treatment for patients with high-risk PV. Jakafi works by inhibiting proteins that may play a role in the development of MPNs by causing the body to make the wrong number of blood cells (JAK1/JAK2 proteins).

The RESPONSE trial compared outcomes between Jakafi and best available therapy (BAT) in patients with PV who can’t tolerate Hydrea or are resistant to it. In the primary analysis of RESPONSE Jakafi more effectively improved clinical signs of disease (hematocrit control and at least a 35% reduction in spleen size) and symptoms in patients with PV. After eights months of study, patients on best available therapy who had not reached desired disease control were allowed to switch to treatment with Jakafi.4

At the week 208 analysis 37% of patients originally treated with Jakafi were still receiving therapy and no patients treated with best available therapy BAT remained on their treatment.  Importantly 98 patients initially treated with BAT were allowed to “cross over” and receive Jakafi after week 32. Overall 38% of these patients responded to and remain on Jakafi.

Learn more about myeloproliferative neoplasms

This analysis of findings from the RESPONSE trial indicates that Jakafi more effectively helps patients with PV maintain long-term hematocrit control than best available therapy. As more study data is released, Jakafi appears increasingly promising in the treatment of PV.  With this 30 months of additional follow-up, the four-year RESPONSE data further reinforces Jakafi as a standard long-term treatment for patients with PV.

About Jakafi® (ruxolitinib)

Jakafi is a first-in-class JAK1/JAK2 inhibitor approved by the U.S. Food and Drug Administration for treatment of people with polycythemia vera (PV) who have had an inadequate response to or are intolerant of hydroxyurea.

Jakafi is also indicated for treatment of people with intermediate or high-risk myelofibrosis (MF), including primary MF, post–polycythemia vera MF, and post–essential thrombocythemia MF.

References:

[1] Verstovse S, Kiladjian J-J, Mesa R, et al. Ruxolitinib. Efficacy By Hematocrit Control in Patients with Polycythemia Vera: An Analysis of the RESPONSE Trial. Program and Abstracts of 56th American Hematological Society Annual Meeting and Exposition; December 6–9, 2014; San Francisco, California. Abstract 3201.

[2] Study of Efficacy and Safety in Polycythemia Vera Subjects Who Are Resistant to or Intolerant of Hydroxyurea: JAK Inhibitor INC424 (INCB018424) Tablets Versus Best Available Care: (The RESPONSE Trial) ((RESPONSE)). ClinicalTrials.gov website. Available at: http://clinicaltrials.gov/ct2/show/NCT01243944. Accessed December 6, 2014.

3.  Kiladjian J, Verstovsek S, Griesshammer M, et al. Results From The 208-Week (4-year) Follow-Up Of RESPONSE Trial, A Phase 3 Study Comparing Ruxolitinib (Rux) With Best Available Therapy (BAT) For The Treatment Of Polycythemia Vera (PV). Abstract #322. 59th American Society of Hematology (ASH) Annual Meeting 2017, Atlanta, Georgia, USA.

4.  Vannucchi AM, Kiladjian JJ, Griesshammer M, et al. Ruxolitinib versus standard therapy for the treatment of polycythemia vera. N Engl J Med. 2015;372(5):426-435.

Copyright © 2017 CancerConnect. All Rights Reserved.


Oral Contraceptive Use Still Linked to Breast Cancer

Women who rely on birth control pills or contraceptive devices that release hormones face a small but significant increase in the risk for breast cancer, according to a large study published in the New England Journal of Medicine.1 This study is the first to examine the risks associated with current formulations of birth control pills and devices in a large population.

The study followed nearly 1.8 million women in Denmark of childbearing age for over a decade. During that time period, 11,517 cases of breast cancer were identified. Although the study had some minor limitations because the authors could not take into account factors impacting the development of breast cancer like physical activity, breast-feeding, and alcohol consumption the following general conclusions were reached.

  • The researchers reported that hormone users over all experienced a 20 percent increase in the relative risk of breast cancer compared to nonusers.
  • For every 100,000 women, hormone contraceptive use causes an additional 13 breast cancer cases a year. That is, for every 100,000 women using hormonal birth control, there are 68 cases of breast cancer annually, compared with 55 cases a year among nonusers.
  • Among those who used hormones for five years, an increased breast cancer risk persisted even after they discontinued use.
  • Women who stayed on hormones for 10 or more years experienced a 38 percent increase in their relative risk of developing breast cancer, compared with nonusers. By contrast, there was no increased risk for breast cancer seen in women who used hormones for less than one year.
  • The study found few differences in risk between the formulations; women cannot protect themselves by turning to implants or intrauterine devices that release a hormone directly into the uterus.
  • The increased risk was not confined to women using oral contraceptive pills, but also was seen in women using implanted intrauterine devices, or I.U.D.’s, that contain the hormone progestin. (Not all I.U.D.’s release hormones.)
  • Women who used an intrauterine device that releases only progestin had a 21 percent increase in risk, compared with nonusers.
  • The research also suggests that the hormone progestin — widely used in today’s birth control methods — may be raising breast cancer risk.
  • The study also found that the risk increased the longer women used contraceptives involving hormones, suggesting the relationship is causal.

Physicians and women alike had hoped that contemporary preparations in oral contraceptives would be associated with lower risks for developing breast cancer than the older generation of pills.  This however does not appear to be the case. This is the first study with substantial data to show that newer preparations still increase the risk of developing breast cancer.

Learn more about the risk of developing breast cancer

“Nothing is risk-free, and hormonal contraceptives are not an exception to that rule,” said Dr. Øjvind Lidegaard, the paper’s senior author. Doctors will need to take the time to discuss the pros and cons of different types of contraception with their patients. Hormonal contraceptives provide benefits to many women and remain among the most safe, effective and accessible options for birth control available.

References:

  1. http://www.nejm.org/doi/full/10.1056/NEJMoa1700732

Copyright © 2017 CancerConnect. All Rights Reserved.


Diagnosed with Pancreatic Cancer: 10 Tips on How to Get The Most From Your Doctor

1) Choose Your Doctor Carefully

Surgeons, medical oncologists and radiation oncologists are the primary doctors involved with pancreatic cancer and often work in collaboration. Pick your primary oncologist carefully, rely on people you trust including nurses and other health care professionals who make help with recommendations.  Make sure your doctor is someone you feel comfortable interacting with and shares your goals. It’s also important he/she has a specific interest in pancreatic cancer and has access to clinical trials.

2) Be Your Own Advocate

Inform yourself about multiple myeloma  before you see your doctor.  Make sure you understand your stage, range of treatment options, and role of precision medicine.  All treatment is discussed based on stage and testing for precision medicines. You can begin to learn about pancreatic cancer here or receive a helpful newsletter.

3) Join an on line support community

An on line community can be a great resource to help find a doctor as well as to share information and learn about treatment choices with other individuals in your situation.  CancerConnect will link you to pancreatic cancer patients being treated at leading cancer centers.

4) Bring written questions to your visit

A doctor’s visit is stressful, it is much easier to bring a list of written questions to ensure they all get answered and none are forgotten.  Bring someone with you to take notes or consider using a recorder so you can listen and engage your doctor carefully. Being able to “replay the conversation is very helpful.

5) Be organized

It’s not unusual for patients to be treated by multiple doctors. To stay on top of the treatment routine, it’s critical to record notes from doctor appointments, questions/answers for your physician, dates of appointments, test results blood cell counts, medications and dosing schedules, prescription refills and other information.

6) Make sure you understand the treatment outcomes.

Your doctor should be able to tell you what you chance of survival/cure is if you elect to receive no treatment then explain how each proposed treatment improves upon that outcome. If you don’t know the expected outcome of no treatment vs the proposed treatment how can you possibly decide what to do?

7) Ask about the role of precision medicine

Unlike traditional chemotherapy, which attacks any cell in the body that is rapidly dividing, precision cancer medicine aims to target specific genetic alterations that allow cancer cells to grow.  Pancreatic cancer often results from abnormal genes or gene regulation.  The strategy of precision cancer medicine is to define abnormalities at the most basic genetic level.  These abnormalities in the DNA are called genomic alterations and they are responsible for driving cancer cell growth.  Once the abnormality is identified, genomic tests are created to measure the specific genes in multiple myeloma that are abnormal or are not working properly.  By identifying the genomic changes and knowing which genes are altered in a patient, cancer drugs that specifically attack that gene (or the later consequences of that gene) can be used to precisely target the cancer and avoid affecting healthy cells. Visit www.oncoprecison.org

8) Ask about clinical trials

Ongoing research is being conducted to find new treatments for multiple myeloma. When new treatments are discovered, they must be developed in humans. By learning about clinical trials you can identify opportunities that advance the treatment of pancreatic cancer and possibly benefit your personal prognosis. Learn more about clinical trials.

9) Strongly consider a second opinion.

The more you can learn about your diagnosis and your treatment options, the better chance you have of receiving the best treatment.  Getting a second opinion will help you understand ALL available treatment options, and provide reassurance to you and your family that you are receiving the most appropriate therapy.

Learn more about why getting a second opinion may be the most important decision you make.

10) Make sure you have an overall care coordinator

Everyone needs a single point of contact is responsible for your overall care. This can be your oncologist, your primary care doctor, or a specialized nurse navigator. Without a “quarterback” the potential for miscommunication, and frustration is considerable.  Make sure you have one primary contact that is your advocate!

 

Copyright © 2017 CancerConnect. All Rights Reserved.


Diagnosed with Gastric Cancer: 10 Tips on How to Get The Most From Your Doctor

1) Choose Your Doctor Carefully

Surgeons, medical oncologists and radiation oncologists are the primary doctors involved with gastric cancer and often work in collaboration. Pick your primary oncologist carefully, rely on people you trust including nurses and other health care professionals who make help with recommendations.  Make sure your doctor is someone you feel comfortable interacting with and shares your goals. It’s also important he/she has a specific interest in gastric cancer and has access to clinical trials.

2) Be Your Own Advocate

Inform yourself about multiple myeloma  before you see your doctor.  Make sure you understand your stage, range of treatment options, and role of precision medicine.  All treatment is discussed based on stage and testing for precision medicines. You can begin to learn about gastric cancer here or receive a helpful newsletter.

3) Join an on line support community

An on line community can be a great resource to help find a doctor as well as to share information and learn about treatment choices with other individuals in your situation.  CancerConnect will link you to gastric cancer patients being treated at leading cancer centers.

4) Bring written questions to your visit

A doctor’s visit is stressful, it is much easier to bring a list of written questions to ensure they all get answered and none are forgotten.  Bring someone with you to take notes or consider using a recorder so you can listen and engage your doctor carefully. Being able to “replay the conversation is very helpful.

5) Be organized

It’s not unusual for patients to be treated by multiple doctors. To stay on top of the treatment routine, it’s critical to record notes from doctor appointments, questions/answers for your physician, dates of appointments, test results blood cell counts, medications and dosing schedules, prescription refills and other information.

6) Make sure you understand the treatment outcomes.

Your doctor should be able to tell you what you chance of survival/cure is if you elect to receive no treatment then explain how each proposed treatment improves upon that outcome. If you don’t know the expected outcome of no treatment vs the proposed treatment how can you possibly decide what to do?

7) Ask about the role of precision medicine

Unlike traditional chemotherapy, which attacks any cell in the body that is rapidly dividing, precision cancer medicine aims to target specific genetic alterations that allow cancer cells to grow.  Gastric cancer often results from abnormal genes or gene regulation.  The strategy of precision cancer medicine is to define abnormalities at the most basic genetic level.  These abnormalities in the DNA are called genomic alterations and they are responsible for driving cancer cell growth.  Once the abnormality is identified, genomic tests are created to measure the specific genes in multiple myeloma that are abnormal or are not working properly.  By identifying the genomic changes and knowing which genes are altered in a patient, cancer drugs that specifically attack that gene (or the later consequences of that gene) can be used to precisely target the cancer and avoid affecting healthy cells. Visit www.oncoprecison.org

8) Ask about clinical trials

Ongoing research is being conducted to find new treatments for multiple myeloma. When new treatments are discovered, they must be developed in humans. By learning about clinical trials you can identify opportunities that advance the treatment of gastric cancer and possibly benefit your personal prognosis. Learn more about clinical trials.

9) Strongly consider a second opinion.

The more you can learn about your diagnosis and your treatment options, the better chance you have of receiving the best treatment.  Getting a second opinion will help you understand ALL available treatment options, and provide reassurance to you and your family that you are receiving the most appropriate therapy.

Learn more about why getting a second opinion may be the most important decision you make.

10) Make sure you have an overall care coordinator

Everyone needs a single point of contact is responsible for your overall care. This can be your oncologist, your primary care doctor, or a specialized nurse navigator. Without a “quarterback” the potential for miscommunication, and frustration is considerable.  Make sure you have one primary contact that is your advocate!

Copyright © 2017 CancerConnect. All Rights Reserved.


What to Tell Children when Facing a Diagnosis of Cancer

If you have children in your life, you already know that they tend to be creatures of habit who rely on their daily routine. There may be unexpected changes in their routine with your fight against cancer, and you may be concerned about the best way to talk to them about it. Whether you’re a parent or have children you love in your life, you probably already know how children can react to different types of stress. In order to set things on the right track, it’s best to be open and honest with them. If you have children in school, it’s also a good idea to inform your children’s teachers or other care providers that your children may be facing some tough challenges. Here are some informative tips to help the children in your life understand what is going on:

  • Hold regular family meetings to discuss your diagnosis, how treatments are going, and what your doctors are telling you.
  • If you are unable to go to your children’s special events—like games or school plays—have another parent tape the event so you can watch it with your children at a later date.
  • Reassure children that you did not get cancer because of something they did. Also be sure to let them know that you cannot “catch” cancer like you can catch a cold.
  • Make every effort to be there for the children in your life—as long as your doctor says it’s safe to do so. For the times you can’t be there, send along a good luck note to let them know that you care.

While it might take your children a little while to adapt, your honesty and love will help them through this difficult and challenging time.

Copyright © 2017 CancerConnect. All Rights Reserved.


Acupuncture Reduces Aromatase Inhibitor Joint Pain in Women with Breast Cancer

According to a well designed study presented at the 2017 San Antonio Breast Cancer Symposium acupuncture is effective in reducing pain and stiffness associated with aromatase inhibitor (AI) therapy in women with early-stage breast cancer.1

Stiffness and joint pain is a well documented concern of women undergoing AI therapy for the treatment and prevention of breast cancer that may contribute to non-compliance or the discontinuation of treatment.

Understanding Acupuncture

In order to formally evaluate acupuncture as a treatment of AI associated joint pain researchers designed and completed a clinical trail to be performed in women with early stage breast cancer taking a third-generation AI and experiencing joint pain.  The study enrolled 226 patients who were treated with one of the following approaches:

  • True acupuncture: a 30- to 45-minute session including a full body, auricular, and joint-specific acupuncture protocol tailored to the most painful joints.
  • Sham acupuncture: shallow needle insertion with thin, short needles at 4 standardized non-acupuncture points.
  • Waitlist control: patients were under the impression they would receive true acupuncture following the 24-week trial.

The study revealed that following 6 weeks of treatment pain decreased significantly in the “true acupuncture” treated women compared to the “sham acupuncture” and “waitlist control” groups.  True acupuncture also demonstrated a greater proportion of patients reporting clinically meaningful reductions in the severity of pain.

The study confirms that acupuncture provides a safe and effective alternative treatment that can relieve joint symptoms and possibly increase AI adherence in women with early stage breast cancer.

What Other Symptoms can Acupuncture Relieve?

Reference: Hershman DL, Unger JM, Greenlee H, et al. Randomized blinded sham- and waitlist-controlled trial of acupuncture for joint symptoms related to aromatase inhibitors in women with early stage breast cancer (S1200). Presented at: 2017 San Antonio Breast Cancer Symposium; Dec. 5-9, 2017; San Antonio, TX. Abstract GS4-04. abstracts2view.com/sabcs/view.php?nu=SABCS17L_503&terms=

Copyright © 2017 CancerConnect. All Rights Reserved.


Questions to Ask Before Radiation Therapy for the Treatment of Cervical Cancer

Radiation therapy, or radiotherapy, is a common way to treat cervical cancer. Doctors who specialize in treating cancers with radiation are known as radiation oncologists. During radiation therapy, high-energy x-rays are used to kill cancer cells. Radiation therapy can be given by a machine that aims x-rays at the body (external beam radiation) or by placing small capsules of radioactive material directly into the cervix (internal or implant radiation or brachytherapy). Many patients receive both kinds of radiation therapy. For stage I cervical cancer, radiation therapy may be used instead of surgery or it may be used after surgery to destroy remaining cancer cells. For stages IB-IVA cervical cancer, radiation therapy is usually administered concurrently with chemotherapy.

Although patients do not feel anything while receiving radiation treatment, the effects of radiation gradually build up over time. Many patients become tired as treatment continues. Loose stools and diarrhea are also common. Urination may become more frequent or uncomfortable. Some patients may experience loss of pubic hair or irritation of the skin. After the radiation therapy is completed, the vagina can become narrower and less flexible. Finally, radiation therapy to the pelvis can stop the ovaries from functioning, thereby causing younger women to enter menopause early and subsequently be infertile.

With any treatment of cancer, you must first understand your responsibility, your medical team’s role, explore treatment options and get a second opinion(s) before you begin treatment. Since the side effects of radiation can be significant, talk to your doctor before treatment begins so that you understand the specific kind of radiation you will receive and the expected side effects. The following list of questions is meant as a guide to issues you should discuss with your radiation oncologist and medical team before undergoing radiation therapy for cervical cancer.

Questions to Ask When Exploring Your Options

  • What is the stage of my cancer?
  • Why do you recommend radiation?
  • What are my options besides radiation?
  • Is radiation the standard therapy for my stage of disease?
  • Are there clinical trials for my stage of disease?
  • Will I have chemotherapy concurrently with radiation?
  • Are there any protocols for neoadjuvant therapy for my stage of disease?
  • Are there any pre-radiation procedures I might benefit from to protect my fertility?

Questions to Ask about Radiation

  • What is your experience with complications from radiation?
  • What should I expect as far as complications and side effects?
  • Considering my age and general health, am I at higher or lower risk for complications and side effects?
  • Will my radiation treatments be external, internal or both?
  • How many treatments will I have?
  • How will the treatments be administered?
  • If I have both external and internal radiation, what type of internal radiation is used and when?
  • During external radiation treatments, do you use shields to protect the small bowel and other organs?
  • Will the beam be directed at all four sides (front, back, and laterals) to help diminish side effects?
  • If, for modesty reasons, I am uncomfortable having male technicians, is it possible to have only female technicians attend me during my treatments?
  • Have my radiation treatments been approved by my insurance?

Questions to Ask about Side Effects

  • What are the expected side effects and how do I deal with them?
  • Are the treatments painful?
  • How will treatment affect my sexuality, both long and short term?
  • Do you recommend use of a vaginal dilator? If so, how and when should I use it?
  • Do you prescribe medications to help me with emotional issues?
  • Will I get advice on my diet and supplemental nutrition from a registered nutritionist?
  • Will I get advice on caring for the radiated area from an oncology nurse?

Questions to Ask about Recovery

  • How long will my recovery take when I have completed my radiation treatment?
  • Who can I call with questions or concerns?
  • If my radiation therapy induces menopause, would I benefit from estrogen replacement therapy?
  • Who will be my follow-up doctor?

Determining that radiation therapy is the right treatment for you, as well as asking your radiation oncologist about treatment procedures and side effects are critical to making informed decisions about your disease. Exploring emotional and physical side effects of radiation therapy will give you some insight into potential problems before they occur. Although managing and living with these side effects may still be difficult, at least you will be aware and informed if they occur. Before undergoing any treatment for you disease you should understand your responsibility, your medical team’s role, explore treatment options, ask questions and get a second opinion(s).

Information presented in The Daily Tip is offered as a guide to augment a patient’s research of cancer and treatment and does not replace the advice of a doctor. For more information on a specific cancer, go to CancerConnect.com, www.cancer.gov, and consult your physician.

Questions to Ask Before Radiation Therapy for the Treatment of Cervical Cancer

Radiation therapy, or radiotherapy, is a common way to treat cervical cancer. Doctors who specialize in treating cancers with radiation are known as radiation oncologists. During radiation therapy, high-energy x-rays are used to kill cancer cells. Radiation therapy can be given by a machine that aims x-rays at the body (external beam radiation) or by placing small capsules of radioactive material directly into the cervix (internal or implant radiation or brachytherapy). Many patients receive both kinds of radiation therapy. For stage I cervical cancer, radiation therapy may be used instead of surgery or it may be used after surgery to destroy remaining cancer cells. For stages IB-IVA cervical cancer, radiation therapy is usually administered concurrently with chemotherapy.

Although patients do not feel anything while receiving radiation treatment, the effects of radiation gradually build up over time. Many patients become tired as treatment continues. Loose stools and diarrhea are also common. Urination may become more frequent or uncomfortable. Some patients may experience loss of pubic hair or irritation of the skin. After the radiation therapy is completed, the vagina can become narrower and less flexible. Finally, radiation therapy to the pelvis can stop the ovaries from functioning, thereby causing younger women to enter menopause early and subsequently be infertile.

With any treatment of cancer, you must first understand your responsibility, your medical team’s role, explore treatment options and get a second opinion(s) before you begin treatment. Since the side effects of radiation can be significant, talk to your doctor before treatment begins so that you understand the specific kind of radiation you will receive and the expected side effects. The following list of questions is meant as a guide to issues you should discuss with your radiation oncologist and medical team before undergoing radiation therapy for cervical cancer.

Questions to Ask When Exploring Your Options

  • What is the stage of my cancer?
  • Why do you recommend radiation?
  • What are my options besides radiation?
  • Is radiation the standard therapy for my stage of disease?
  • Are there clinical trials for my stage of disease?
  • Will I have chemotherapy concurrently with radiation?
  • Are there any protocols for neoadjuvant therapy for my stage of disease?
  • Are there any pre-radiation procedures I might benefit from to protect my fertility?

Questions to Ask about Radiation

  • What is your experience with complications from radiation?
  • What should I expect as far as complications and side effects?
  • Considering my age and general health, am I at higher or lower risk for complications and side effects?
  • Will my radiation treatments be external, internal or both?
  • How many treatments will I have?
  • How will the treatments be administered?
  • If I have both external and internal radiation, what type of internal radiation is used and when?
  • During external radiation treatments, do you use shields to protect the small bowel and other organs?
  • Will the beam be directed at all four sides (front, back, and laterals) to help diminish side effects?
  • If, for modesty reasons, I am uncomfortable having male technicians, is it possible to have only female technicians attend me during my treatments?
  • Have my radiation treatments been approved by my insurance?

Questions to Ask about Side Effects

  • What are the expected side effects and how do I deal with them?
  • Are the treatments painful?
  • How will treatment affect my sexuality, both long and short term?
  • Do you recommend use of a vaginal dilator? If so, how and when should I use it?
  • Do you prescribe medications to help me with emotional issues?
  • Will I get advice on my diet and supplemental nutrition from a registered nutritionist?
  • Will I get advice on caring for the radiated area from an oncology nurse?

Questions to Ask about Recovery

  • How long will my recovery take when I have completed my radiation treatment?
  • Who can I call with questions or concerns?
  • If my radiation therapy induces menopause, would I benefit from estrogen replacement therapy?
  • Who will be my follow-up doctor?

Determining that radiation therapy is the right treatment for you, as well as asking your radiation oncologist about treatment procedures and side effects are critical to making informed decisions about your disease. Exploring emotional and physical side effects of radiation therapy will give you some insight into potential problems before they occur. Although managing and living with these side effects may still be difficult, at least you will be aware and informed if they occur. Before undergoing any treatment for you disease you should understand your responsibility, your medical team’s role, explore treatment options, ask questions and get a second opinion(s).

Information presented in The Daily Tip is offered as a guide to augment a patient’s research of cancer and treatment and does not replace the advice of a doctor. For more information on a specific cancer, go to CancerConnect.com, www.cancer.gov, and consult your physician.

Copyright © 2017 CancerConnect. All Rights Reserved.


Addition of Darzalex™ Improves Outcomes in Newly Diagnosed Multiple Myeloma

The addition of Darzalex™ (daratumumab) to the standard treatment combination consisting of Velcade (bortezomib), melphalan, and prednisone (VMP) reduces disease progression or death by 50%, among patients with newly diagnosed multiple myeloma who are not eligible to undergo a stem cell transplant. These results were presented as a late-breaking abstract at the 2017 annual meeting of the American Society of Hematology.

In the United States alone, approximately 30,000 people will be diagnosed with multiple myeloma in the year 2017. Multiple myeloma is a type of cancer that starts in immune cells called plasma cells. Treatment varies according to the extent or aggressiveness of the disease, as well as the patient’s other existing medical conditions or ability to tolerate some types of therapies.

About Darzalex™ (daratumumab)

Darzalex™ is a monoclonal antibody that has been produced in a laboratory to bind to a protein often found on the surface of multiple myeloma cancer cells, called CD38. The binding of Darzalex™ has direct killing effects on the cell, as well as stimulating effects on the immune system to attack the cancer cell. Darzalex™ is approved for the treatment of multiple myeloma in combinations with different types of treatment regimens among patients whose cancer has progressed following therapy.

Researchers recently conducted a clinical trial to evaluate the addition of Darzalex™ to VMP among patients who had not yet received prior treatment, and were not eligible for a stem cell transplant. Patients in the trial were at least 65 years of age and were divided into two groups: one group was treated with Darzalex™ plus VMP (D-VMP), and the other group was treated with VMP only.  Data was retrieved at a median follow-up of 16.5 months following initiation of treatment.

  • Patients treated with D-VMP had a 50% reduction in their risk of death or disease progression, compared to those treated with VMP only.
  • Treatment benefit of D-VMP remained among all treatment groups: for patients 75 years of age and older; for patients with later-stage multiple myeloma; and for patients whose genetic analysis determined that they were at a high risk for a cancer recurrence.
  • At this time, overall survival data are too immature to determine true overall survival differences between the two groups of patients.

The researchers concluded that the addition of Darzalex™ to VMP among patients who have not received prior therapy, but are not eligible for a stem cell transplant, significantly reduces their risk of death or disease progression. Longer follow-up will help determine potential survival benefits for this group of patients.

Reference: Mateos M-V, Dimopoulos M, Cavo M, et al. Phase 3 randomized study of Darzalex™  plus bortezomib, melphalan, and prednisone (D-VMP) versus bortezomib, melphalan, and prednisone (VMP) in newly diagnosed multiple myeloma (NDMM) patients (pts) ineligible for transplant (ALCYONE). Proceedings from the 59th annual meeting and exhibition of the American Society of Hematology; Atlanta, GA; December 9-12, 2017; Late-breaking abstract #4. Retrieved from https://ash.confex.com/ash/2017/webprogram/Paper109143.html

Copyright © 2017 CancerConnect. All Rights Reserved.


Mogamulizumab Superior to Vorinostat in Cutaneous T Cell Lymphoma

Results were recently presented at the 59th American Society of Hematology (ASH) Annual Meeting and Exposition in Atlanta from a international comparative clinical trail evaluating mogamulizumab in patients with previously treated cutaneous T-cell lymphoma (CTCL).

Precision cancer medicine utilizes molecular diagnostic testing, including DNA sequencing, to identify cancer-driving abnormalities in a cancer’s genome. Once a genetic abnormality is identified, a specific targeted therapy can be designed to attack a specific mutation or other cancer-related change in the DNA programming of the cancer cells. Precision cancer medicine uses targeted drugs and immunotherapies engineered to directly attack the cancer cells with specific abnormalities, leaving normal cells largely unharmed.  Because they are designed to specifically target cancer cells while leaving normal cells alone, targeted therapies usually have different, and sometimes milder, adverse side effects than standard chemotherapy drugs.

CTCL is a rare cancer of the white blood cells, specifically T lymphocytes, that primarily occurs in the skin. It is caused when T cells (cells in the immune system that help the body fight infection) begin to grow uncontrollably and build up in the skin. CTCL can also involve the blood, lymph nodes, and internal organs.

Mogamulizumab is a novel precision cancer medicine that is given intravenously and targets a protein (CCR4) that is frequently found on the surface of cancer cells in patients with CTCL. As a CCR4 antibody, the drug exploits the patient’s immune cells to attack the cancer.

In a head to head comparison the study found that the precision cancer medicine mogamulizumab improved progression-free survival, response rate, and quality of life compared to Zolinza™ (vorinostat), a U.S. Food and Drug Administration (FDA)-approved standard-of-care treatment for patients with CTCL.  Mogamulizumab

Reference

Anti-CCR4 Monoclonal Antibody, Mogamulizumab, Demonstrates Significant Improvement in PFS Compared to Vorinostat in Patients with Previously Treated Cutaneous T-Cell Lymphoma (CTCL): Results from the Phase III MAVORIC Study [817]

Copyright © 2017 CancerConnect. All Rights Reserved.


Kisqali® Improves Outcomes of Premenopausal Women with HR+/HER2- Advanced Breast Cancer

It was announced today that results from the Phase III MONALEESA-7 trial evaluating Kisqali® (ribociclib) in combination endocrine-based therapy in premenopausal or perimenopausal women with hormone-receptor positive, human epidermal growth factor receptor-2 negative (HR+/HER2-) advanced or metastatic breast cancer will be presented as a late-breaking oral presentation at the 2017 Annual San Antonio Breast Cancer Symposium.  Kisqali significantly prolonged progression-free survival (PFS) compared to endocrine therapy alone.1

About Kisqali® 
Kisqali is a selective cyclin-dependent kinase inhibitor, a class of drugs that help slow the progression of cancer by inhibiting two proteins called cyclin-dependent kinase 4 and 6 (CDK4/6). These proteins, when over-activated, can enable cancer cells to grow and divide too quickly. Targeting CDK4/6 with enhanced precision may play a role in ensuring that cancer cells do not continue to replicate uncontrollably.

About MONALEESA-7

MONALEESA-7 is a comparative clinical trial designed to evaluate Kisqali in combination with hormone therapy consisting of tamoxifen or a non-steroidal aromatase inhibitor plus goserelin compared to treatment with tamoxifen or an aromatase inhibitor plus goserelin alone, in premenopausal or perimenopausal women with HR+/HER2- advanced breast cancer in women who had not previously received endocrine therapy for advanced disease.

Kisqali in combination with tamoxifen or an aromatase inhibitor plus goserelin demonstrated an improved time of survival without cancer progression of 23.8 months compared to 13.0 months for tamoxifen or an aromatase inhibitor plus goserelin.  Premenopausal women treated with the Kisqali combination therapy saw a response as early as eight weeks.

The Kisqali combination was well tolerated and women taking Kisqali also had a clinically meaningful improvement in pain symptoms as early as eight weeks; this improvement was sustained.  The most significant side effect observed in patients receiving Kisqali combination therapy compared to endocrine therapy alone was neutropenia which occurred in 60.6% compared to 3.6% of endocrine only treated patients.

Premenopausal breast cancer is a biologically distinct and more aggressive disease than postmenopausal breast cancer, and it is the leading cause of cancer death in women 20-59 years old.2,3 The Kisqali combination therapy represents a new and improved treatment option for these women.

References:

  1. Tripathy D, Sohn J, Im S, et al. First-line ribociclib or placebo combined with goserelin and tamoxifen or a non-steroidal aromatase inhibitor in premenopausal women with hormone receptor-positive, HER2-negative advanced breast cancer: results from the randomized Phase III MONALEESA-7 trial. Presented at the San Antonio Breast Cancer Symposium (SABCS), December 6, 2017, San Antonio, Texas (abstract#S2-05).
  2. Benz CC. Impact of aging on the biology of breast cancer. Crit Rev Oncol Hematol. 2008;66:65-74
  3. World Health Organization. Women’s health fact sheet. September 2013. Available at http://www.who.int/mediacentre/factsheets/fs334/en/. Accessed October 2017.

Copyright © 2017 CancerConnect. All Rights Reserved.


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