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Expert Point of View: Catherine C. Park, MD, FASTRO

Discussant of the 12-year report from the NRG/RTOG 9804 trial, Catherine C. Park, MD, FASTRO, Professor and Chair of the Department of Radiation Oncology at the University of California, San Francisco, underscored the high prevalence of ductal carcinoma in situ, which comprises approximately 20%...

lung cancer

Lorlatinib Shows Overall and Intracranial Activity in ALK-Positive NSCLC

In a global phase II study reported in The Lancet Oncology, Solomon et al found that lorlatinib (Lorbrena) showed high overall and intracranial activity in patients with advanced ALK-positive non–small cell lung cancer (NSCLC) who were treatment-naive or who had received crizotinib (Xalkori)...

issues in oncology

Dealing With the Challenges Presented by the Parenteral Opioid Shortage

The opioid drug problem in the United States is a crisis, with unprecedented numbers of overdose deaths. The reaction to this has resulted in new federal laws and regulations aimed at restricting overuse and overprescribing of opioids. However, these well-intentioned actions, along with other...

lung cancer

Lung Cancer Screening: Proven Effective but Still Fighting for Acceptance

In 2010, the long-awaited findings from the National Lung Screening Trial (NLST) revealed that participants who received low-dose helical computed tomography (CT) scans had a 15% to 20% lower risk of dying of lung cancer than participants who received standard chest x-rays. In response, the U.S....

Expert Point of View: Nadia Harbeck, MD, PhD, and Fatima Cardoso, MD

Serving as European Society for Medical Oncology (ESMO) expert at a press briefing, Nadia Harbeck, MD, PhD, Head of the Breast Center at the University of Munich, called the findings “practice-changing” in some parts of the world and “practice-reinforcing” in others. She said the 10-month...

breast cancer

Impact of Palbociclib on Survival in Hormone Receptor–Positive, HER2-Negative Advanced Breast Cancer

Much anticipated overall survival data for palbociclib (Ibrance) plus fulvestrant (Faslodex) in advanced breast cancer were presented at the European Society for Medical Oncology (ESMO) 2018 Congress.1 Although overall survival in PALOMA-3 was not designed to detect a statistically significant...

prostate cancer
symptom management

NCRI 2018: COMPARE Study: Side Effects and Quality of Life Associated With Prostate Cancer Care

Men who have been newly diagnosed with prostate cancer say they would trade some improvement in their odds of survival for improvements in side effects and quality of life, according to research presented by Ahmed et al at the 2018 National Cancer Research Institute (NCRI) Cancer Conference...

breast cancer

Neoadjuvant Chemotherapy With vs Without Anthracyclines Plus Dual HER2 Inhibitors in HER2-Positive Breast Cancer

In the Dutch Breast Cancer Research Group’s phase III TRAIN-2 trial reported in The Lancet Oncology, van Ramshorst et al found no difference in pathologic complete response rate with neoadjuvant chemotherapy with vs without an anthracycline plus dual HER2 blockade in women with HER2-positive...

ME STRONG Joins With ASCO’s Conquer Cancer Foundation to Support Research for Men’s Cancers and Neuroblastoma

ME STRONG, a nonprofit public charity in Deland, Florida, is one of the newest supporters of Conquer Cancer. Linda Ryan, ME STRONG co-founder and 16-year cancer survivor, understands the importance of research: it saved her life decades ago, and she’s relying on experimental treatment as she...

ASCO in the Community: Listening and Learning From Our Patients in Appalachia

2018–2019 ASCO President Monica M. Bertagnolli, MD, FACS, FASCO, is putting the words of her presidential theme— “caring for every patient, learning from every patient” —into action. During her term, she and other ASCO leaders will be traveling to local communities around the United States to...

lymphoma

FDA Expands Approved Use of Brentuximab Vedotin in Some Types of PTCL

Today, the U.S. Food and Drug Administration (FDA) expanded the approved use of brentuximab vedotin (Adcetris) injection in combination with chemotherapy for adult patients with certain types of peripheral T-cell lymphoma (PTCL)—adults with previously untreated systemic anaplastic large cell...

skin cancer

Meta-Analysis of Voriconazole Exposure and Risk of Cutaneous SCC

Voriconazole is an antifungal medication that is sometimes used to treat fungal infection in immunocompromised patients, including patients undergoing various transplants. In order to better assess the risk associated with voriconazole use after lung or hematopoietic stem cell transplant and...

hepatobiliary cancer

Risk Factors for Late Recurrence After Resection for Hepatocellular Carcinoma

In a Chinese retrospective study reported in JAMA Surgery, Xu et al found that risk of late recurrence (> 2 years) of hepatocellular carcinoma (HCC) after curative liver resection was associated with male sex, presence of cirrhosis, and aggressive characteristics of the initial HCC. The study...

symptom management

Study Identifies Significant Risk Factors for Chemotherapy-Induced Febrile Neutropenia

New research by Family et al in JNCCN—Journal of the National Comprehensive Cancer Network identifies risk factors for chemotherapy-induced febrile neutropenia, a dangerously low white blood cell count that increases the risk of serious infection and fever. The study was led...

breast cancer
gynecologic cancers
lymphoma
pancreatic cancer
gastroesophageal cancer
bladder cancer
symptom management
gastrointestinal cancer

FDA Pipeline: What’s New in Biosimilars, Drug Reviews, Designations, and More

The U.S. Food and Drug Administration (FDA) recently issued the following new approvals and designations: Approval for Pegfilgrastim Biosimilar The FDA recently approved a pegfilgrastim biosimilar, pegfilgrastim-cbqv (Udenyca). The biosimilar has been approved to decrease the incidence...

gastrointestinal cancer

PERSIST-5: 5-Year Adjuvant Imatinib in Resected Intermediate- or High-Risk Primary Gastrointestinal Stromal Tumor

In the phase II PERSIST-5 study reported in JAMA Oncology, Raut et al found that 5 years of adjuvant imatinib therapy was associated with little risk of recurrence in patients with resected intermediate- or high-risk primary gastrointestinal stromal tumor (GIST). As noted by the investigators, 3...

breast cancer

Patient-Reported Cosmetic Outcomes With Radiotherapy in Early Breast Cancer

As reported in the Journal of Clinical Oncology by Shaitelman et al, 3-year outcomes of a phase III noninferiority trial indicate that hypofractionated whole-breast irradiation (HF-WBI) followed by a tumor bed boost is not inferior to conventionally fractionated whole-breast irradiation (CF-WBI)...

palliative care
issues in oncology
symptom management

2018 Palliative Care: Can an AI-Based App Help Manage Cancer-Related Pain?

A study of 112 patients with metastatic solid tumors found that the use of an artificial intelligence (AI)-based smartphone app reduced both the severity of patients’ reported pain and hospital admissions. After an 8-week period, patients who used the AI-powered app to monitor and address...

issues in oncology
symptom management

2018 Palliative Care: Immunotherapy-Related Adverse Events May Be More Common Than Initially Reported

An analysis of nearly 2,800 patients with non­–small cell lung cancer (NSCLC) who received the immune checkpoint inhibitors nivolumab (Opdivo), pembrolizumab (Keytruda), or atezolizumab (Tecentriq) found that adverse events may be more common than reported in the initial trials that led...

gynecologic cancers

Overall Survival After Minimally Invasive Radical Hysterectomy for Early-Stage Cervical Cancer

In a cohort study reported in The New England Journal of Medicine, Melamed et al found that minimally invasive radical hysterectomy was associated with poorer overall survival compared with open radical hysterectomy in women with early-stage cervical cancer. Study Details The study involved...

hepatobiliary cancer

FDA Approves Pembrolizumab for Hepatocellular Carcinoma Previously Treated With a Kinase Inhibitor

On November 9, 2018, the U.S. Food and Drug Administration (FDA) granted accelerated approval to pembrolizumab (Keytruda) for patients with hepatocellular carcinoma who have been previously treated with the kinase inhibitor sorafenib. KEYNOTE-224 Approval was based on KEYNOTE-224, a single-arm,...

hematologic malignancies

The WHO Classification of Tumors of Hematopoietic and Lymphoid Tissues

The ASCO Post is pleased to present Hematology Expert Review, an ongoing feature that quizzes readers on issues in hematology. In this installment, Drs. Abutalib and Medeiros explore the recently updated World Health Organization (WHO) classification of hematopoietic and lymphoid tissue...

immunotherapy
lung cancer

Corticosteroids and Immunotherapy: Guilty or Guilt By Association?

FIRST-LINE TREATMENT options for advanced non–small cell lung cancer (NSCLC) include single- agent immunotherapy for patients with a programmed cell death ligand 1 (PD-L1) tumor proportion score of at least 50% or in combination with chemotherapy in unselected patients.1-3 Single immunotherapy is...

lung cancer
immunotherapy

Corticosteroid Use at Start of PD-1/PD-L1 Inhibitor Therapy Affects Outcomes in NSCLC

IN A STUDY reported in the Journal of Clinical Oncology, Kathryn C. Arbour, MD, of Memorial Sloan Kettering Cancer Center, and colleagues found that baseline treatment with corticosteroids was associated with poorer efficacy of programmed cell death protein 1/programmed cell death ligand 1...

palliative care

Developing Patient-Centered Palliative Care From Diagnosis to End of Life

In December, The University of Texas at Austin Dell Medical School will launch an innovative cancer care model called the CaLM (cancer life re-imagined) Clinic as part of its new cancer center, the Livestrong Cancer Institutes. The goal of the Livestrong Cancer Institutes and the CaLM Clinic is to...

issues in oncology
cost of care

Tackling Financial Toxicity: One Institution’s Roadmap Forward

  ALTHOUGH FINANCIAL toxicity has become an important issue in the oncology community, evidence suggests the subject is rarely addressed by oncologists, exacerbating its grave effects on patients with cancer and their families.1 “But I don’t think it’s because health-care providers don’t want to...

leukemia
lymphoma

Venetoclax for CLL or SLL With or Without 17p Deletion After Prior Therapy

On June 8, 2018, venetoclax (Venclexta) was granted regular approval for treatment of patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL), with or without 17p deletion, who have received at least one prior therapy.1,2 Supporting Efficacy Data APPROVAL WAS BASED on ...

issues in oncology

Do Incident Learning Systems Prevent Medical Errors?

ACCORDING TO a study by Johns Hopkins, medical errors are the third leading cause of death in the United States.1 Lakshmi Santanam, PhD, tackled such sobering data at the 2018 ASCO Quality Care Symposium. “Incident learning systems are not just about medical errors or data; it’s kind of a first...

issues in oncology

Challenges and Successes of Adopting an Oncology Care Model

IN ORDER TO rein in the untenable rise in costs while delivering high-value cancer care, the Centers for Medicare & Medicaid Innovation developed a new payment system—the Oncology Care Model. At the 2018 ASCO Quality Care Symposium, Cardinale B. Smith, MD, PhD, shed light on the system’s...

issues in oncology
palliative care

End-of-Life Dashboard Drives Transformation With Actionable Personalized Data

A NUMBER OF STUDIES from the palliative care literature have shown that nonbeneficial health-care interventions actually may harm patients’ quality of life, increase patient and caregiver distress, and drive costs. Yet, according to the National Cancer Institute, about 30% of all cancer spending...

WHO Announces New Global Childhood Cancer Initiative

THE AMERICAN Childhood Cancer Organization (ACCO) supported the World Health Organization’s (WHO) announcement of a new global initiative to address the disparity between childhood cancer survival in low-middle versus high-income countries. The announcement came at the United Nations General...

lung cancer
immunotherapy

Atezolizumab Plus Chemotherapy Improves Outcomes in Small Cell Lung Cancer

ATEZOLIZUMAB (TECENTRIQ), an anti–program cell death ligand 1 (PD-L1) antibody, combined with carboplatin/ etoposide as first-line treatment for extensive-stage small-cell lung cancer (SCLC) improved overall and progression-free survival and may represent a new standard of care, according to...

issues in oncology
lung cancer

Adding the Patient’s Voice to Collaborative Clinical Trial Efforts

THE INTERNATIONAL Association for the Study of Lung Cancer (IASLC) 19th World Conference on Lung Cancer was the largest in its history. One of the key themes of the meeting was to focus on the patient. Here are highlights of presentations from this conference that demonstrate the role of the...

bladder cancer
immunotherapy

Expert Point of View: Shahrokh Shariat, MD

“BACILLUS CALMETTE-GUÉRIN (BCG) failures are quite common, with a 66% recurrence rate at 5 years, and about 25% of patients will have disease progression,” explained formal discussant Shahrokh Shariat, MD, Chair of the Department of Urology at Medical University, Vienna, and Adjunct Professor at...

bladder cancer
immunotherapy

Pembrolizumab Shows Antitumor Activity in Non–Muscle Invasive Bladder Cancer

THE ANTI–PROGRAMMED cell death protein 1 (anti–PD-1) checkpoint inhibitor pembrolizumab (Keytruda) was found to have antitumor activity in patients with high-risk non–muscle invasive bladder cancer who were nonresponsive to bacillus Calmette-Guérin (BCG), according to the preliminary results of the ...

prostate cancer

Radiation to Primary Tumor Improves Survival in Subset of Men With Metastatic Prostate Cancer

MEN WITH newly diagnosed metastatic prostate cancer do not typically receive treatment to the primary tumor with radiation or surgery. A new analysis of the STAMPEDE trial found that radiation administered to the prostate can improve overall survival in men with newly diagnosed metastatic prostate...

gynecologic cancers

Expert Point of View: Jonathan Ledermann, MD, and Clara MacKay

“A KEY AIM of treatment is the need to focus on preventing recurrence, which happens in 70% of patients. Over the past 20 years, we have made few inroads in preventing recurrence. This study brings a poly (ADP-ribose) polymerase (PARP) inhibitor olaparib (Lynparza) to the first-line setting,...

gynecologic cancers

Results Reported for Olaparib Maintenance in Ovarian Cancer

TWO-YEAR MAINTENANCE therapy with olaparib (Lynparza), a poly (ADP-ribose) polymerase inhibitor, achieved a significant improvement in progression-free survival in patients with newly diagnosed advanced ovarian cancer and a BRCA1 or BRCA2 mutation, according to results of the phase III SOLO-1...

issues in oncology

Cancer Taught Me to Help Patients Find Healing Hope

AS AN INTERNIST, I strived to give patients hope by prescribing therapies that increased their chance—their hope—of the best outcome and by encouraging them with hopeful words. My own hope was to care for patients until I was old. Just weeks after celebrating my 36th birthday, I was diagnosed with ...

lung cancer

Brigatinib Improves Outcomes Over Crizotinib in ALK-Positive Non–Small Cell Lung Cancer

THE FIRST-LINE USE of brigatinib (Alunbrig) was superior to standard-of-care crizotinib (Xalkori) in patients with advanced anaplastic lymphoma kinase (ALK)-positive non–small cell lung cancer (NSCLC), according to the first report of the phase III ALTA-1L trial presented at the International...

breast cancer
immunotherapy

Immunotherapy Improves Survival in a Subset of Patients With Metastatic Triple-Negative Breast Cancer

IMMUNOTHERAPY APPEARS to be the new upfront standard of care for patients with metastatic triple-negative breast cancer, based on a late-breaking presentation at the European Society for Medical Oncology (ESMO) 2018 Congress1 and simultaneously published in The New England Journal of Medicine.2 In ...

symptom management

Can Patients Use Topical Skin Creams During Radiation Therapy?

Contrary to the advice most patients with cancer receive when they go through radiation treatment, topical skin treatments, unless applied very heavily, may not increase the radiation dose to the skin and can be used in moderation before daily radiation treatments, according to findings from a new...

breast cancer

Final Analysis of SWOG POEMS: Goserelin and Chemotherapy in Breast Cancer

Final results of SWOG Cancer Research Network’s international Prevention of Early Menopause Study (POEMS) showed continued evidence that women who get injections of the hormone drug goserelin along with standard breast cancer chemotherapy are more likely to become pregnant, without developing ...

gastrointestinal cancer

Trifluridine/Tipiracil in Heavily Pretreated Metastatic Gastric Cancer

In the phase III TAGS trial reported in The Lancet Oncology, Shitara et al found that trifluridine/tipiracil (Lonsurf) significantly improved overall survival vs placebo in patients with heavily pretreated metastatic gastric cancer. In the double-blind trial, 507 patients with nonresectable...

issues in oncology

Progression-Free Survival and Health-Related Quality of Life in Randomized Clinical Trials

A review and analysis of randomized clinical trials published by Kovic et al in JAMA Internal Medicine questioned whether interventions that prolong progression-free survival (PFS) in patients with cancer improve their health-related quality of life (HRQoL). The systematic review and quantitative...

gynecologic cancers

Five-Year Risk of Cervical Precancer With p16/Ki67 Dual-Stain or Cytology Triage in HPV-Positive Women

In a study reported in JAMA Oncology, Clarke et al found that triage with p16/Ki-67 dual-stain testing (DS) was associated with better risk stratification for cervical precancer than Papanicolaou cytology testing over 5 years among human papilloma virus (HPV)–positive women. Study Details...

solid tumors

Incidental Germline Mutations in Patients With Advanced Solid Tumors Identified by Cell-Free Circulating Tumor DNA Testing

In a study reported in the Journal of Clinical Oncology, Slavin et al determined the prevalence of a set of germline cancer predisposition gene mutations incidentally identified by cell-free circulating tumor DNA (cfDNA) testing in patients with advanced solid tumors. Study Details The study...

colorectal cancer

Pre- and Postdiagnosis Diet and Risk of Mortality in Colorectal Cancer

In a study reported in the Journal of Clinical Oncology, Guinter et al found that better prediagnosis and postdiagnosis dietary patterns were associated with improved overall and colorectal cancer­–specific survival among patients diagnosed with colorectal cancer. Study Details The...

multiple myeloma

FDA Approves Elotuzumab Plus Pomalidomide and Dexamethasone for Relapsed or Refractory Multiple Myeloma

On November 6, the U.S. Food and Drug Administration (FDA) approved elotuzumab (Empliciti) injection for intravenous use in combination with pomalidomide (Pomalyst) and dexamethasone for the treatment of adult patients with multiple myeloma who have received at least two prior therapies,...

lung cancer

IASLC Issues Statement on Lung Cancer Screening With Low-Dose Computed Tomography

The International Association for the Study of Lung Cancer (IASLC) recently issued a statement on lung cancer screening with low-dose computed tomography (CT) based on the results of the Dutch-Belgian NELSON lung cancer screening trial presented at the IASLC 19th World Conference on Lung Cancer...

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