palliative care
colorectal cancer
lung cancer
cost of care

Geographic Differences in End-of-Life Cancer Care

When it comes to how much end-of-life care a patient with cancer receives, geography may, indeed, be destiny, according to new research led by Harvard Medical School that found differences in this type of cancer care across different parts of the country. The findings, published by Keating et al...

Lung Cancer

Expert Point of View: David Rimm, MD, PhD

“TUMOR MUTATIONAL burden is an emerging biomarker independent of programmed cell death ligand 1 (PD-L1) level. There are a few reasons for enthusiasm. Tumor mutational burden is a compelling biomarker for response and progression-free survival. Six-month progression-free survival is 50% with a...

Lung Cancer

Evidence Builds for Tumor Mutational Burden as Biomarker in Lung Cancer

TUMOR MUTATIONAL burden is emerging as a predictive biomarker for the combination of nivolumab (Opdivo) plus ipilimumab (Yervoy) in non–small cell lung cancer (NSCLC), as well as other tumor types. However, experts say tumor mutational burden has hurdles to overcome. At the 2018 Annual Meeting of...

Lung Cancer

Expert Point of View: David Graham, MD, FASCO

ASCO EXPERT David Graham, MD, FASCO, Medical Director at the Levine Cancer Institute in Charlotte, North Carolina, was enthusiastic about this new technology. “This is an important first step showing there is an easier way to detect lung cancer at earlier stages. If the promise of this report...

Lung Cancer

Genome Sequencing of Blood Samples May Lead to Detection of Early- Stage Lung Cancer

IF THE INITIAL promise of research presented at the 2018 ASCO Annual Meeting bears fruit, we may one day have a simple blood test to screen for early-stage lung cancer and possibly other cancers. Although it is still very early days for this test, an initial report from the ongoing Circulating...

Lung Cancer

Expert Point of View: Marina Chiara Garassino, MD, and Justin Gainor, MD

“TODAY WE HAVE good news, because IMpower 150 is another clear positive trial on the combination of chemotherapy with immunotherapy. This is true in terms of progression-free and overall survival, which are both statistically significant [for atezolizumab (Tecentriq) plus bevacizumab (Avastin)...

Lung Cancer

More Evidence of Benefit With Immunotherapy and Chemotherapy in Nonsquamous Non–Small Cell Lung Cancer

ATEZOLIZUMAB (TECENTRIQ) plus bevacizumab (Avastin) plus a platinum doublet (ABCP) improved overall survival by 22% compared with bevacizumab plus a platinum doublet (BCP) in patients with advanced wild-type (without an identified mutation) nonsquamous non–small cell lung cancer (NSCLC), according...

Lung Cancer

Expert Point of View: Charles Drake, MD, PhD

“THIS TRIAL is a clear winner for the treatment of squamous non–small cell lung cancer [NSCLC],” stated formal discussant Charles Drake, MD, PhD, of Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York.  “The concept underlying the combination of checkpoint...

Lung Cancer

KEYNOTE-407: Pembrolizumab Plus Chemotherapy Benefits Response, Survival in Squamous NSCLC

THE COMBINATION of pembrolizumab (Keytruda) plus platinum-based chemotherapy improved overall survival, response rates, and duration of response in patients with advanced squamous cell non–small cell lung cancer (NSCLC) compared with chemotherapy alone irrespective of programmed cell death ligand 1 ...

Solid Tumors
Lung Cancer
Issues in Oncology
Supportive Care

Racial/Ethnic Disparities in End-of-Life Care Among Patients With Lung Cancer

Significant disparities in the quality of end-of-life lung cancer care were found among racial/ethnic minorities, with higher odds of experiencing potentially preventable medical encounters during end of life as compared with non-Hispanic whites. These findings were published by Siddharth Karanth, ...

Lung Cancer

Disparities Found in Lung Cancer Care, Survival in United States vs England

DESPITE STEADY declines in death rates in recent years, lung cancer remains the leading cause of cancer deaths in wealthy countries. In a study published by Anita Andreano, MD, of the University of Milan-Ciocco, and colleagues in the Journal of Thoracic Oncology,1 Yale researchers collaborated with ...

Solid Tumors
Lung Cancer

Nivolumab Plus Ipilimumab Improves Progression-Free Survival in NSCLC With High Tumor Mutational Burden

The combination of nivolumab (Opdivo) plus ipilimumab (Yervoy) improved progression-free survival compared with chemotherapy as first-line treatment for patients with advanced non–small cell lung cancer (NSCLC) and a high tumor mutational burden irrespective of programmed cell death ligand 1...

lung cancer
multiple myeloma

Studies of Daratumumab in Combination With Anti–PD-L1 Agents Stopped

On May 26, Genmab A/S announced that following a planned review, the Data Monitoring Committee (DMC) has recommended that the phase Ib/II study (CALLISTO/LUC2001) of daratumumab (Darzalex) in combination with the anti–programmed cell death ligand 1 (PD-L1) antibody atezolizumab (Tecentriq) vs ...

breast cancer
lung cancer

Characteristics and Screening of Brain Metastases in Breast Cancer and NSCLC

In a research letter published in JAMA Oncology, Cagney et al found that brain metastases were more advanced and more likely to be symptomatic in patients with breast cancer compared to patients with non–small cell lung cancer (NSCLC). Current guidelines recommend magnetic resonance imaging...

Lung Cancer

Expert Point of View: John V. Heymach, MD, PhD

FORMAL DISCUSSANT of this trial, John V. Heymach, MD, PhD, of The University of Texas MD Anderson Cancer Center, Houston, also was optimistic about these early findings. “This is a proof-of-concept study showing this approach is safe. Only modest activity was observed with standard [Response...

Lung Cancer

Early Evidence of Neoadjuvant PD-1 Blockade in Non–Small Cell Lung Cancer

A NOVEL APPROACH using two doses of nivolumab (Opdivo) prior to surgery achieved major pathologic responses in 45% of patients with resectable stages I to IIIA non–small cell lung cancer (NSCLC), according to the results of a small Stand Up 2 Cancer–Cancer Research Institute Dream Team study...

Lung Cancer
Symptom Management
CNS Cancers

Quick Takes From Original Research Presented at the 2018 NCCN Annual Conference

THE QUANTITY of original research presented at the National Comprehensive Cancer Network® (NCCN®) Annual Conference has been growing, and at the 2018 meeting, 121 researchers presented their work. The ASCO Post captured some of the findings for this report.  Blood Markers Correlate With Anti–PD-1...

Lung Cancer
Cost of Care
Genomics/Genetics

Expert Point of View: Bruce Johnson, MD, FASCO

“PRECISION MEDICINE is driving the most exciting and powerful advances in cancer care today, particularly in lung cancer. It’s encouraging to see that next-generation genetic testing tools can help physicians and their patients get the crucial genomic information needed to make treatment decisions, ...

Lung Cancer
Cost of Care
Genomics/Genetics

Decision-Analytic Model Finds Upfront, Comprehensive Genetic Testing in Advanced Lung Cancer Is Cost-Efficient

AN ECONOMIC model comparing different types of genetic testing in metastatic non–small cell lung cancer (NSCLC) found using next-generation sequencing to test for all known lung cancer–related gene changes at the time of diagnosis was less costly and faster than sequentially testing one or a...

Lung Cancer

Expert Point of View: Bruce Johnson, MD, FASCO

“THIS STUDY makes a strong case that our country needs an effective public service campaign about encouraging lung cancer screening,” said ASCO President Bruce E. Johnson, MD, FASCO, during a press briefing before the 2018 ASCO Annual Meeting. “Public service campaigns from the 1990s encouraged...

Lung Cancer

Despite USPSTF Recommendations, Majority of Heavy Smokers Not Screened for Lung Cancer

AN ANALYSIS of 1,800 lung cancer screening sites nationwide found that only 1.9% of more than 7 million eligible current and former heavy smokers were screened for lung cancer in 2016, despite U.S. Preventive Services Task Force (USPSTF) and ASCO screening recommendations. Results from this...

Lung Cancer

Expert Point of View: John Heymach, MD, PhD, and Leena Gandhi, MD

“THIS STUDY represents a true milestone in the field of lung cancer. For the first time, the vast majority of patients with non–small cell lung cancer (NSCLC) can receive immunotherapy with pembrolizumab (Keytruda),” said ASCO expert John Heymach, MD, PhD, of MD Anderson Cancer Center, Houston,...

Lung Cancer

Immunotherapy Benefits Survival, Improves Safety, vs Platinum-Based Chemotherapy for PD-L1–Expressing NSCLC

IMMUNOTHERAPY WITH pembrolizumab (Keytruda) improved overall survival compared with investigator’s choice of platinum-based chemotherapy as first-line treatment for patients with advanced non–small cell lung cancer (NSCLC) in the KEYNOTE-042 trial. Median overall survival was improved by 4 to 8...

Solid Tumors
Issues in Oncology
Geriatric Oncology
Lung Cancer

Chemoradiation in Elderly Patients With Stage III NSCLC Improves Overall Survival

Elderly patients with stage III non–small cell lung cancer (NSCLC) showed improved overall survival when treated with chemoradiation compared with definitive radiation alone, according to findings published by Eric D. Miller, MD, PhD, of The Ohio State University, Columbus, and colleagues in the...

lung cancer

Raymond U. Osarogiagbon, MBBS, on NSCLC: A Lymph Node Collection Kit

Raymond U. Osarogiagbon, MBBS, of Baptist Cancer Center, discusses a kit used in non–small cell lung cancer resection that improves staging quality and overall survival without adding to morbidity of curative surgery (Abstract 8502).

lung cancer

Naoki Furuya, MD, PhD, on NSCLC: Results From the NEJ026 Study

Naoki Furuya, MD, PhD, of the St. Marianna University School of Medicine, discusses phase III study findings on a comparison of bevacizumab plus erlotinib to erlotinib in patients with untreated non–small cell lung cancer with activating EGFR mutations (Abstract 9006).

lung cancer

Tony Mok, MD, on NSCLC: Results From the ARCHER 1050 Trial

Tony Mok, MD, of the Chinese University of Hong Kong, discusses study findings on dacomitinib vs gefitinib for first-line treatment of advanced non–small cell lung cancer, a final overall survival analysis.

lung cancer
genomics/genetics

Nathan A. Pennell, MD, PhD, on NSCLC: Lowering Genetic Testing Costs

Nathan A. Pennell, MD, PhD, of the Cleveland Clinic, discusses the economic impact of next generation sequencing vs sequential single-gene testing modalities to detect genomic alterations in newly diagnosed metastatic non–small cell lung cancer (Abstract 9031).

lung cancer
issues in oncology

Danh Pham, MD: Lung Cancer Screening Rates Still Too Low

Danh Pham, MD, of the James Graham Brown Cancer Center, University of Louisville, discusses his findings using a registry on the low rates of screening with low-dose computed tomography, despite its potential to prevent thousands of lung cancer deaths each year (Abstract 6504).

lung cancer

Gilberto Lopes, MD, MBA, on NSCLC: Results From the KEYNOTE-042 Trial

Gilberto Lopes, MD, MBA, of the Sylvester Comprehensive Cancer Center at the University of Miami, discusses phase III findings on pembrolizumab vs platinum-based chemotherapy as first-line treatment for advanced/metastatic non–small cell lung cancer with a PD-L1 tumor proportion score ≥ to 1% (Abstract LBA4).

lung cancer

Geoffrey R. Oxnard, MD, on Lung Cancer: Results From the Circulating Cancer Genome Atlas Study

Geoffrey R. Oxnard, MD, of Dana-Farber Cancer Institute, discusses genome-wide sequencing for early-stage lung cancer detection from plasma cell–free DNA (Abstract LBA8501).

lung cancer

Robert M. Jotte, MD, PhD, on NSCLC: Results From the IMpower131 Trial

Robert M. Jotte, MD, PhD, of Rocky Mountain Cancer Centers, discusses phase III study findings on atezolizumab plus carboplatin plus paclitaxel or nab-paclitaxel vs carboplatin plus nab-paclitaxel, as first-line therapy in advanced squamous non–small cell lung cancer (Abstract LBA9000).

lung cancer
symptom management

Safety of PD-1/PD-L1 Inhibitors in Patients With NSCLC and Preexisting Autoimmune Disorders

In a study reported in the Journal of Clinical Oncology, Leonardi et al found that programmed cell death protein 1 (PD-1)/programmed cell death ligand 1 (PD-L1) inhibitor monotherapy in patients with non–small cell lung cancer (NSCLC) and autoimmune disorders worsened such disorders in a...

Lung Cancer

Valued Mentors and a Link Between Science and Medicine Paved the Road to Oncology for Alice Tsang Shaw, MD, PhD

Lung cancer expert Alice Tsang Shaw, MD, PhD, was born and reared in Gaithersburg, a small suburb located to the northwest of Washington, DC. Both her parents were chemists, and during high school, Dr. Shaw had a keen interest in science, particularly biology, yet the thought of pursuing a career...

lung cancer
issues in oncology

Risk-Prediction Tool Helps Tailor Lung Cancer Screening to Patient Preference and Clinical Benefit

A microsimulation model study found that the benefits of low-dose computed tomography (CT) screening for lung cancer varied substantially across the eligible population, with 3 factors being particularly influential: lung cancer risk, competing risks or life expectancy, and patient...

Lung Cancer

Stage IV Lung Cancer Did Not Stop Me From Climbing Mera Peak

A veteran mountain climber and skier, I’ve been healthy for most of my 61 years, so it was especially shocking to experience a bout of shortness of breath during a moderately intense mountain bike ride with my wife, Jan, in the spring of 2014. A never-smoker, I was used to climbing up high mountain ...

Lung Cancer

Treatment of Malignant Pleural Mesothelioma: ASCO Clinical Practice Guideline

As reported by Hedy L. Kindler, MD, of the University of Chicago, and colleagues in the Journal of Clinical Oncology, ASCO has released a clinical practice guideline on the treatment of malignant pleural mesothelioma.1 The guideline was based on a systematic literature search and expert panel...

lung cancer
skin cancer
issues in oncology

Survival in Male vs Female Patients Receiving Immune Checkpoint Inhibitors

In a systematic review and meta-analysis reported in The Lancet Oncology, Conforti et al found a significant difference in overall survival benefit favoring male vs female patients receiving immune checkpoint inhibitor therapy for advanced cancers. Study Details The study involved database...

Colorectal Cancer
Breast Cancer
Hepatobiliary Cancer
Lung Cancer
Kidney Cancer
Prostate Cancer
CNS Cancers
Leukemia

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®): 2018 Guidelines Updates

In 1996, the National Comprehensive Cancer Network® (NCCN®) published its first set of Clinical Practice Guidelines in Oncology (NCCN Guidelines®) covering 8 tumor types. Guidelines are now published for more than 60 tumor types and topics. Some of the key updates were presented at NCCN’s 23rd...

palliative care
lung cancer

Racial/Ethnic Disparities in the Quality of End-of-Life Care Among Patients With Lung Cancer

Significant disparities in the quality of end-of-life lung cancer care were found among racial/ethnic minorities, with higher odds of experiencing potentially preventable medical encounters during end of life as compared with non-Hispanic whites. These findings were published by Karanth et al in...

Lung Cancer

Afatinib in Previously Untreated Metastatic NSCLC With Nonresistant EGFR Mutations

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs.  On January 12, 2018, afatinib (Gilotrif) was approved...

Lung Cancer

Expert Point of View: Roy S. Herbst, MD, PhD

FORMAL DISCUSSANT of the KEYNOTE-189 trial, Roy S. Herbst, MD, PhD, Chief of Medical Oncology at Smilow Cancer Hospital, Yale Cancer Center, New Haven, heartily endorsed the new triplet combination of pembrolizumab, pemetrexed, and a platinum in advanced nonsquamous non– small cell lung cancer...

Lung Cancer

Pembrolizumab Plus Standard Chemotherapy Improves Survival in Newly Diagnosed Metastatic Non–Small Cell Lung Cancer

ADDING THE IMMUNE checkpoint inhibitor pembrolizumab (Keytruda) to standard chemotherapy with pemetrexed (Alimta) and a platinum as first-line therapy was superior to chemotherapy alone in the KEYNOTE-189 trial.1 Induction and maintenance therapies with the new triplet therapy improved overall...

lung cancer
prostate cancer

By 2030, Prostate and Lung Cancers Are Expected to Be the Most Common Cancer Types Among HIV-Infected Adults

While effective antiretroviral therapy, which suppresses HIV replication and improves immune function, has resulted in increased longevity for people living with HIV and reduced the risk of certain cancers, including Kaposi sarcoma and non-Hodgkin lymphoma, other cancers are expected to become more ...

lung cancer
gastroesophageal cancer

ESTRO 37: Positioning for Radiotherapy and Impact on Survival in Patients With Lung or Esophageal Cancers

Very small differences in the way a patient lies during radiotherapy treatment for lung or esophageal cancer can have an impact on survival, according to research presented at the European Society for Radiotherapy & Oncology (ESTRO) 37 Conference (Abstract OC-0322). These differences of only a...

Solid Tumors
Lung Cancer
Issues in Oncology

Enormous Cost of Failure to Screen Heavy Smokers for Lung Nodules

In 2011 the American College of Radiology Imaging Network (ACRIN) group published its publicly funded study of three annual screening chest computed tomography (CT) scans among heavy smokers aged 55 to 74.1 The results remain the first and only screening study for any cancer demonstrating a...

solid tumors
lung cancer

AACR 2018: Selective Inhibitor Shows Early Promise in Patients With RET-Altered Cancers

BLU-667, a next-generation inhibitor that selectively targets the oncogenic receptor tyrosine kinase RET, was well tolerated and had broad clinical benefit in patients with advanced cancer that had progressed on previous therapies, including multikinase inhibitor therapy. Proof-of-concept data from ...

palliative care
lung cancer

Updated ASTRO Guideline for Palliative Radiotherapy in Lung Cancer

The American Society for Radiation Oncology (ASTRO) has issued an update to its clinical guideline for the use of palliative-intent radiation therapy for patients with incurable non–small cell lung cancer (NSCLC). Reflecting new evidence from randomized clinical trials, the guideline now...

Lung Cancer

Osimertinib: A New Standard of Care in Initial Treatment of EGFR-Mutant NSCLC

Dr. Ramalingam is Professor of Hematology and Medical Oncology, Emory University School of Medicine, Winship Cancer Institute, Atlanta. MUTATIONS IN the epidermal growth factor receptor (EGFR) gene were discovered in 2004. These mutations, localized most commonly to exon 19 or 21, vary in...

Lung Cancer

Osimertinib Improves Progression-Free Survival vs Standard EGFR Inhibitors in EGFR-Mutant NSCLC

AS REPORTED in The New England Journal of Medicine by Jean-Charles Soria, MD, PhD, of Gustave Roussy Cancer Campus and University Paris-Sud, and colleagues, the phase III FLAURA trial has shown a significant progression-free survival benefit with the third-generation epidermal growth factor...

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