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issues in oncology

Annual Report to the Nation: Cancer Death Rates Continue to Decline

Overall cancer death rates continue to decrease in men, women, and children for all major racial and ethnic groups, according to the latest Annual Report to the Nation on the Status of Cancer, 1975–2014, published by Jemal et al in the Journal of the National Cancer Institute.1 The report finds...

leukemia

Expert Point of View: Nitin Jain, MD, and Susan O'Brien, MD

Formal discussant of the GENUINE trial, Nitin Jain, MD, of The University of Texas MD Anderson Cancer Center, Houston, noted that the majority of responses to ibrutinib (Imbruvica) in high-risk patients are partial responses. “These patients [have disease progression] even in the context of...

leukemia

Ublituximab/Ibrutinib Beneficial in Patients With Chronic Lymphocytic Leukemia

The addition of ublituximab (a glycoengineered anti-CD20 antibody) to ibrutinib (Imbruvica) improved response rates, depth of response, and led to quicker resolution of ibrutinib-associated lymphocytosis in patients with high-risk chronic lymphocytic leukemia (CLL) in the phase III GENUINE trial,...

pain management
supportive care

Pediatric Cancer Pain May Be Misunderstood and Largely Undertreated

Cancer pain in children poses certain unique challenges. Over the past decade, insightful research into pediatric cancer pain has focused on pain management that incorporates nonopioid therapies into standard care. To shed light on this important issue, The ASCO Post spoke with Christine T....

supportive care

New Supportive Care Resources From NCCN Help Patients With Cancer Confront Distress

All patients with cancer experience some level of distress associated with their cancer diagnosis and the effects of the disease and its treatment—regardless of the stage of disease. Not only does distress affect a patient’s mental and psychosocial well-being, but because distress is a risk...

issues in oncology

Overcoming Sexism in Academic Medicine

The troubling results from a survey1 investigating the sexual harassment and discrimination experiences of academic medical faculty show that such incidents continue to happen with unexpected frequency despite increasing awareness of the problem. The study by Reshma Jagsi, MD, DPhil, and...

cost of care

The Emperor’s New Clothes: Biosimilars and Cost in Oncology

Biosimilars are biologic products similar to the parent (branded) molecule in structure and function—such as erythropoietin and filgrastim (Neupogen).1 To truly bend the cost curve, we want to see a dramatic economic savings achieved as oncology biosimilars for rituximab (Rituxan), trastuzumab...

myelodysplastic syndromes

High-Risk Mutations Predict Poor Outcomes for Patients With Myelodysplastic Syndromes Undergoing Transplantation

Although several treatment options are available for patients with myelodysplastic syndromes (MDS), hematopoietic stem cell transplantation (HSCT) remains the only curative therapy.1 The risks of complications and death from transplantation can be substantial. Determining which patients may...

breast cancer

Expert Point of View: Leisha A. Emens, MD, PhD

Leisha A. Emens, MD, PhD, of the Bloomberg~Kimmel Institute for Cancer Immunotherapy at Johns Hopkins University, commented on the promise of anti–programmed cell death protein 1/programmed cell death ligand 1 (PD-1/PD-L1) agents in triple-negative breast cancer. She noted that “an emerging theme...

myelodysplastic syndromes

Mutations in Myelodysplastic Syndrome Associated With Poorer Outcome After Stem Cell Transplantation

In a study reported in The New England Journal of Medicine, R. Coleman Lindsley, MD, PhD, of Dana-Farber Cancer Institute, and colleagues found that a number of mutations present in patients with myelodysplastic syndromes (MDS) were associated with poorer clinical outcome after allogeneic...

breast cancer

Scalp Cooling to Prevent Chemotherapy-Induced Alopecia: Is It Now Ready for Prime Time?

In oncology, sometimes we forget about the small, everyday things that can significantly impact a patient’s life. When patients are explained the side effects of chemotherapy and chemotherapy-induced alopecia, most women will cry or become visibly upset. When a woman loses her hair, it represents...

pancreatic cancer

WCHN Launches Trial to Screen Newly Diagnosed Patients With Diabetes for Early-Stage Pancreatic Cancer

Western Connecticut Health Network (WCHN) has announced the launch of a 3-year research study that will investigate the link between new-onset diabetes and pancreatic cancer. The main goal of the study is to detect the often lethal cancer at a curable stage. The study was developed by a team of...

palliative care
supportive care

Understanding the Cultural Differences Among Ethnic Minorities in Palliative and End-of-Life Care

GUEST EDITOR Addressing the evolving needs of cancer survivors at various stages of their illness and care, Palliative Care in Oncology is guest edited by Jamie H. Von Roenn, MD. Dr. Von Roenn is ASCO’s Vice President of Education, Science, and Professional Development.   Because cultural origins...

leukemia

Idelalisib in Resistant CLL: Benefit Shown, Questions Remain

As reported in The Lancet Oncology by Dr. Andrew Zelenetz and colleagues and reviewed in this issue of The ASCO Post, an international phase III trial in 416 patients with refractory or recurrent chronic lymphocytic leukemia (CLL) addressed the benefit of adding the first-in-class phosphoinositide...

leukemia

Adding Midostaurin to Chemotherapy in Newly Diagnosed Acute Myeloid Leukemia With FLT3 Mutation

In a phase III trial (Cancer and Leukemia Group B 10603 [RATIFY]/Alliance) reported in The New England Journal of Medicine, Stone et al found that the addition of midostaurin (Rydapt) to standard chemotherapy improved overall survival in patients with newly diagnosed acute myeloid leukemia with...

colorectal cancer

ESMO World GI 2017: Right-Sided Colorectal Tumors: An Internal Radiation Advantage

For patients with colorectal cancer that has metastasized to the liver, having a primary tumor on the left side as opposed to the right side of the colon is known to be a significant advantage in terms of treatment response. But a new study, presented by van Hazel et al at the European Society for...

solid tumors

FDA Clears Expanded Use of Cooling Cap to Reduce Hair Loss During Chemotherapy

On July 3, the U.S. Food and Drug Administration (FDA) cleared the expanded use of a cooling cap, DigniCap Cooling System, to reduce hair loss during chemotherapy. This is the first cooling cap cleared by the agency for use in cancer patients with solid tumors. “We are pleased to expand the...

lung cancer

European Commission Expands Use of Ceritinib for First-Line Use in ALK-Positive Advanced NSCLC

On June 29, the European Commission approved expanding the use of ceritinib (Zykadia) to include the first-line treatment of patients with advanced non–small cell lung cancer (NSCLC) whose tumors are anaplastic lymphoma kinase (ALK)–positive. Approval follows a positive opinion granted...

pancreatic cancer

ESMO World GI 2017: Pegilodecakin Plus FOLFOX in Advanced Pancreatic Cancer

Clinical data on an investigational immuno-oncology drug pegilodecakin (PEGylated human interleukin-10, also known as AM0010) was presented by Hecht et al at the ESMO 19th World Congress on Gastrointestinal Cancer in Barcelona, Spain (Abstract O-004). Pegilodecakin is being evaluated in an ongoing...

hepatobiliary cancer

ESMO World GI 2017: Phase I Data on Anti–PD-1 Antibody BGB-A317 in Hepatocellular Carcinoma

Preliminary results from patients with advanced hepatocellular carcinoma enrolled in a phase I study of the investigational anti–programmed cell death protein 1 (PD-1) antibody BGB-A317 in advanced solid tumors were presented by Yen et al at the ESMO 19th World Congress on Gastrointestinal...

health-care policy

FDA Unveils Plan to Eliminate Orphan Designation Backlog

Today, the U.S. Food and Drug Administration (FDA) unveiled a strategic plan to eliminate the agency’s existing Orphan Drug designation request backlog and ensure continued timely response to all new requests for designation with firm deadlines. The agency’s Orphan Drug Modernization...

health-care policy

FDA Takes Steps to Increase Drug Competition to Improve Patient Access

On June 27, the U.S. Food and Drug Administration (FDA) took two new, important steps to increase competition in the market for prescription drugs and facilitate entry of lower-cost alternatives. The agency published a list of off-patent, off-exclusivity branded drugs without approved generics, and ...

colorectal cancer

Underused Blood Test Could Improve Treatment for Large Swath of Patients With Colon Cancer

A simple blood test could improve treatment for more than one in six patients with stage II colon cancer, suggests new research from the Mayo Clinic. Researchers also discovered that many patients who could benefit from the test likely aren’t receiving it. These findings were published by...

multiple myeloma

EHA 2017: Ixazomib Plus Lenalidomide/Dexamethasone in Newly Diagnosed Multiple Myeloma With No Stem Cell Transplant, Followed by Maintenance Ixazomib

Data from two phase I/II clinical trials evaluating ixazomib (Ninlaro) in patients with newly diagnosed multiple myeloma was presented at the 2017 European Hematology Association (EHA) Annual Meeting (Abstracts S408, S780). Both studies evaluated ixazomib plus lenalidomide (Revlimid) and...

lymphoma

ICML 2017: Nivolumab Shows Durable Response in Relapsed or Progressed Classical Hodgkin Lymphoma, Regardless of Brentuximab Vedotin History

Extended follow-up data demonstrated responses from nivolumab (Opdivo) in adult patients with relapsed or progressed classical Hodgkin lymphoma after autologous stem-cell transplant (ASCT), irrespective of brentuximab vedotin (Adcetris) therapy history. Results from the phase II CheckMate-205 study ...

leukemia

EHA 2017: Updated CTL019 ELIANA Data Show Durable Remission Rates in Children, Young Adults With Relapsed/Refractory B-Cell ALL

Updated results from the ELIANA clinical trial demonstrated CTL019 (tisagenlecleucel) remission rates are maintained at 6 months in relapsed/refractory pediatric and young adult patients with B-cell acute lymphoblastic leukemia (ALL). These data from this pivotal trial of CTL019 show that 83% (52...

ASCO University “Business of Health Care Fundamentals” Course: Education for the Complete Care Team

As the economics and management of health care change, it has become essential for the clinician to evolve as well in order to navigate these changing waters.  Whether you are a medical student, a senior oncologist, or an advanced practice provider, the necessity is the same: understanding the...

lung cancer

Atezolizumab as First-Line or Subsequent Treatment in PD-L1–Selected Advanced NSCLC

In the phase II BIRCH trial, atezolizumab (Tecentriq) was found to produce higher response rates as first-line or subsequent therapy in patients with advanced non–small cell lung cancer (NSCLC) with higher levels of programmed cell death ligand 1 (PD-L1) expression. Study findings were...

breast cancer

Expert Point of View: Harold Burstein, MD, Carey Anders, MD, and William Sikov, MD

Several breast cancer experts weighed in on the findings of the APHINITY trial. At an ASCO press briefing, Harold Burstein, MD, Associate Professor of Medicine at Harvard Medical School and breast cancer specialist at Dana-Farber Cancer Institute, Boston, pointed out that investigators estimated a ...

breast cancer

Positive Results for APHINITY, but Value of Benefit of Dual HER2 Blockade Questioned

The results of the long-awaited APHINITY trial are in, and although the phase III study met its primary endpoint, it failed to establish dual HER2 blockade as the optimal adjuvant treatment for early HER2-positive breast cancer. After 3 years of follow-up, the addition of pertuzumab (Perjeta) to...

colorectal cancer

ASCP/CAP/AMP/ASCO Colorectal Cancer Biomarker Guideline: A Clinician's Perspective

The joint American Society for Clinical Pathology (ASCP), College of American Pathologists (CAP), Association for Molecular Pathology (AMP), and ASCO guideline reported by Sepulveda et al, and reviewed in this issue of The ASCO Post, represents a collaboration of three pathology societies and ASCO ...

colorectal cancer

ASCP/CAP/AMP/ASCO Guideline on Molecular Biomarkers in Colorectal Cancer

As reported in the Journal of Clinical Oncology by Antonia R. Sepulveda, MD, PhD, of Columbia University, and colleagues, a joint guideline on the use of molecular biomarkers for evaluation of colorectal cancer has been developed by an expert panel from the American Society for Clinical Pathology...

bladder cancer

Strides Being Made in Advanced Urothelial Cancer

According to Srikala S. Sridhar, MD, MSc, FRCPC, of the Princess Margaret Cancer Centre, Toronto, Canada, “It’s an exciting time in the field of urothelial cancer,” thanks to the emergence of new therapies such as the immune checkpoint inhibitors and other approaches that aim to improve both...

genomics/genetics

Identifying Genetic Basis for Extraordinary Clinical Responses May Accelerate Development of New Therapies

Accelerating the discovery of targeted cancer therapies requires defining the targets present in individual tumors, and there are two main ways to do this, David B. Solit, MD, told participants at the inaugural OncoSET Symposium: Emerging Approaches to Precision Medicine in Chicago.1 The...

leukemia

Expert Point of View: Susan O'Brien, MD

Commenting on the studies of CAR T cells in chronic lymphocytic leukemia (CLL) thus far, Susan O’Brien, MD, of the University of California at Irvine, said: “Some people are disappointed in the results, but the problem is there was too much hype to begin with. The first article on CAR T published...

leukemia

Newer Approaches With CAR T Cells Explored in CLL

Chimeric antigen receptor (CAR) T-cell therapy is a hot area of research and development in hematologic malignancies and, more recently, some solid tumors. Results have been particularly good in acute lymphocytic leukemia, and one or more CAR T-cell products may be getting close to approval by the ...

solid tumors

Expert Point of View: Sumanta Kumar Pal, MD and John V. Heymach, MD, PhD

ASCO spokespersons at the press briefing lauded the results with larotrectinib and called for broader testing for tropomyosin receptor kinase fusions.  The data for larotrectinib “bring us into a new era where treatment is truly based on mutation, not location,” said Sumanta Kumar Pal, MD, a...

breast cancer

Expert Point of View: Richard S. Finn, MD and Ingrid A. Mayer, MD

Richard S. Finn, MD, of the David Geffen School of Medicine at UCLA, Los Angeles, commented on MONARCH 2 and the field of cyclin-dependent kinase 4/6 (CDK4/6) inhibition in general in an interview with The ASCO Post. “MONARCH 2 is confirmatory for the role of CDK4/6 inhibition in estrogen...

breast cancer

Abemaciclib Plus Fulvestrant Delays Breast Cancer Progression in MONARCH 2

In the treatment of metastatic estrogen receptor–positive breast cancer, a highly significant 45% reduction in progression was achieved with abemaciclib, combined with fulvestrant (Faslodex), in the global phase III MONARCH 2 trial, reported at the 2017 ASCO Annual Meeting by George W. Sledge, MD,...

prostate cancer

Two Studies Show Abiraterone Plus Prednisolone/Prednisone Added to Standard Hormone Therapy Improves Survival in Advanced Prostate Cancer

The addition of abiraterone acetate (Zytiga) plus prednisolone/prednisone to standard androgen-deprivation therapy improves survival in men starting treatment for locally advanced or metastatic, hormone--naive prostate cancer, according to the results of two potentially practice-changing studies...

global cancer care

Will the UK’s Departure From the EU Impact Oncology in Europe?

“No man is an island entire of itself; any man’s death diminishes me, because I am involved in mankind. And therefore never send to know for whom the bell tolls; it tolls for thee.”  —John Donne (1624) This statement is almost certainly true—and sadly in a negative way not just for the UK but for...

symptom management

Expert Point of View: Monika K. Krzyzanowska, MD, MPH

Formal discussant of the trial, Monika K. Krzyzanowska, MD, MPH, of the Princess Margaret Cancer Center in Toronto, Canada, commented on this trial assessing patient-reported outcomes for symptom monitoring. “This abstract is relevant to all of us, regardless of what cancers we treat or where we...

breast cancer

NCCN Guidelines® Compliance for Chest CT May Reduce False Positives and Decrease Health-Care Spending in Breast Cancer

According to Surveillance, Epidemiology, and End Results (SEER) data, more than 260,000 women were diagnosed with breast cancer in the United States in 2016, most of whom were diagnosed with early-stage (stage I or II) disease. For this demographic, the National Comprehensive Cancer Network®...

issues in oncology

Digital Technology Preferences of Adolescents and Young Adults With Cancer

There is considerable scope to develop digital resources by means of which teenagers and young adults living with cancer can receive information and connect with both professionals and fellow patients. Such tools could help them gain different perspectives on treatment and survivorship, said Esha...

pancreatic cancer

WCHN Launches Trial to Screen Newly Diagnosed Patients With Diabetes for Early-Stage Pancreatic Cancer

Western Connecticut Health Network (WCHN) has announced the launch of a 3-year research study that will investigate the link between new-onset diabetes and pancreatic cancer. The main goal is to detect the often lethal cancer at a curable stage. The study was developed by a team of physicians and...

gastrointestinal cancer

Some Patients With Stage III Low-Risk Colon Cancer May Require Less Oxaliplatin Therapy

Patients with stage III colon cancer considered at low risk for recurrence may be treated effectively—and incur less neurotoxicity—with 3 months of an oxaliplatin-based regimen as compared with the standard 6 months, according to the results of the International Duration Evaluation of Adjuvant...

breast cancer

Cancer Gave Me the Impetus to Lose Weight

Fifteen years ago, my internist advised me to lose weight. But after seeing the yo-yo effects of dieting on friends and colleagues, I knew I would find the process of losing weight and gaining it back frustrating, so I ignored my physician’s advice. It wasn’t until I was diagnosed late this past...

prostate cancer

Expect Questions About Shift in Prostate Cancer Screening Recommendation

A draft recommendation from the U.S. Preventive Services Task Force (USPSTF) advises that for men aged 55 to 69, the decision to be screened for prostate cancer should be an individual one, based on the man’s own values and priorities and discussions with a clinician about the potential benefits...

prostate cancer

USPSTF Emphasizes Importance of Informed Discussions About PSA Screening for Men Aged 55 to 69 Years

For a man aged 55 to 69 years, the decision to be screened for prostate cancer should be an individual one, based on the man’s own values and priorities and discussions with a clinician about the potential benefits and harms of screening, the U.S. Preventive Services Task Force (USPSTF) advised in ...

breast cancer

Growing Use of Molecular Pathology May Help Avoid Overtreatment of Early Breast Cancer

The emerging field of molecular pathology focuses on the study and diagnosis of disease through the examination of genes and gene activity within organs and tissues. This information has transformed our thinking about the biologic diversity of breast cancers and has enhanced our treatment...

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