“Former President Jimmy Carter’s announcement that he is free of metastatic melanoma surprised many people but, not most melanoma specialists contacted byMedPage Today.
“With the evolution of modern radiation therapy techniques and targeted drugs, more patients with metastatic melanoma achieve complete and partial remissions, including remission of small brain metastases like the ones identified during the evaluation and initial treatment of Carter. However, the experts — none of whom have direct knowledge of Carter’s treatment or medical records — cautioned that early remission offers no assurance that the former president is out of the woods.”
“ ‘You are being deported,’ a surgeon announced to me last fall. That’s a scary thing for a child of two immigrants to hear. But he was referring to the removal of my port, a medical device implanted just beneath my right collarbone — a gateway for the dozens of rounds of chemotherapy, antibiotics and blood transfusions that have entered my body since I received a leukemia diagnosis at age 22.
“I love a good pun, but I wasn’t in the mood for laughter or lightness that day. After three and a half years of cancer treatment, I no longer needed the port. My doctors had finally pronounced me in remission. I had thought I’d want to celebrate or dance a jig in my hospital gown or throw a rager when I got there. But it didn’t feel anything like the endgame I had imagined.
“It took me a long time to be able to say I was a cancer patient. Then, for a long time, I was only that: A cancer patient. Now that I’m done with my treatment, I’m struggling to figure out who I am. On paper, I am better: I no longer have cancer, and with every passing day I’m getting stronger. The constant flood of doctor’s appointments, blood tests and phone calls from concerned family and friends have trickled to a slow drip. But off paper, I feel far from being a healthy 26-year-old woman.”
“A team of researchers from The University of Texas at Arlington and the University of Central Florida have determined that years after going into remission, many adult cancer survivors still encounter challenges arising from their disease and its treatment.
“From anxiety about a cancer recurrence to physical problems such as chronic pain, survivors aren’t quite done battling the effects of cancer even 2, 5, and 10 years after treatment for the disease.
“The study, ‘Current unmet needs of cancer survivors: Analysis of open-ended responses to the American Cancer Society Study of Cancer Survivors II,’ is published online and in the February issue of Cancer, a journal of the American Cancer Society.
” ‘So often, the expectation is that a cancer survivor should be grateful for having survived a diagnosis of cancer. And while this may be true, those survivors with debilitating, lingering effects of cancer and its treatment are not always acknowledged within healthcare systems as needing continued care based on their cancer survivor status,’ said Gail Adorno, assistant professor in the UT Arlington School of Social Work and co-principal investigator on the study.”
The gist: People with early-stage HER-2-negative breast cancer might benefit from a new drug called nintedanib combined with standard chemotherapy. That insight came from a recently completed clinical trial—a research study with volunteer patients. 50% of the patients who took the new treatment in the trial had total remission of their tumors.
“The experimental drug nintedanib, combined with standard chemotherapy with paclitaxel, causes a total remission of tumours in 50% of patients suffering from early HER-2- negative breast cancer, the most common type of breast cancer. These are the conclusions of the Phase I Clinical Trial, sponsored by the Spanish National Cancer Research Centre (CNIO) and carried out by CNIO ́s Breast Cancer Clinical Research Unit. The study has been published today in British Journal of Cancer.
“According to Miguel Ángel Quintela, head of the Unit: ‘The drug combination of paclitaxel and nintedanib has turned out to be a complete success, given that it is proved to be safe and that the pathologic complete response [rate of complete recovery] was 50%, which doubles the response compared to patients treated with standard therapy with paclitaxel.’ The trial has also included 10 HER-2-negative breast cancer patients, all of them in early stages of the disease.
“In light of the results, the CNIO Breast Cancer Clinical Research Unit has already launched a large-scale Phase II Clinical Trial to validate the results in a large group of patients. These results, including biomarker studies that will facilitate advances in personalised medicine, will be released by early 2015.”
Editor’s note: In a recent study, scientists compared two different post-remission treatments for children and adolescents with acute lymphoblastic leukemia (ALL) who had only a small number of cancerous cells left in the body (minimal residual disease, MRD) after initial treatment (remission induction therapy). The scientists found that patients who received an augmented post-remission treatment, compared to the standard one, experienced better outcomes. However, these patients also had worse side effects. Ongoing clinical trials will reveal more about improved post-remission treatment and reduction of side effects.
“Children and adolescents with acute lymphoblastic leukemia who had minimal residual disease at the end of remission induction therapy demonstrated improved outcomes with augmented post-remission therapy compared with standard treatment, according to study results.
“However, patients who received augmented therapy experienced higher rates of adverse events, results showed.”
“AG-221, a novel inhibitor of isocitrate dehydrogenase (IDH) 2-mutant metabolic enzyme, was well tolerated and showed early promise in patients with advanced and refractory blood cancers harboring IDH2 mutations, according to the initial results of a phase I study presented here at the AACR Annual Meeting 2014, April 5-9.
” ‘Mutations in the genes for the metabolic enzymes IDH1 and IDH2 are thought to be the drivers of distinct subsets of acute myeloid leukemias (AML),’ said Eytan M. Stein, M.D., assistant attending physician in the Leukemia Service at Memorial Sloan Kettering Cancer Center in New York. ‘They lead to the production of increased levels of an oncometabolite called 2-hydroxyglutarate (2-HG), which is hypothesized to prevent normal healthy bone marrow cells from maturing, leading to cancer.’ ”
Editor’s note: AG-221 is a targeted therapy drug. The goal of this phase I clinical trial was to test the safety of AG-221 for patients. The trial found that AG-221 is safe and shows real promise as a cancer-fighting treatment for patients whose blood cancers have mutations in the IDH2 gene, as detected by molecular testing.