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issues in oncology

An ASCO Survey, Hope, and Conventional Therapies

HOW DO YOU respond when patients with a good prognosis want to delay chemotherapy to try an anticancer diet for a few months or visit an unregulated clinic for unproven therapies? I’m asking because of an alarming finding of ASCO’s 2018 National Cancer Opinion Survey: “Nearly 4 in 10 Americans...

prostate cancer

Chemotherapy and/or Hormonal Agents: Differing Perspectives

WHEN ASKED which treatment to start with—docetaxel or enzalutamide, Dr. Sweeney said, “Patients fit for chemotherapy with high-volume disease can receive chemotherapy [docetaxel] and come back to these newer hormonal treatments or start with anyone of the hormonal options. Choosing among the newer...

prostate cancer

ENZAMET Trial Shows Enzalutamide Improves Overall Survival in Hormone-Sensitive Metastatic Prostate Cancer

Agents that improve survival in metastatic castration-resistant prostate cancer when added to background androgen-deprivation therapy (ADT) are showing success in treating metastatic prostate cancer earlier while it is still hormone-sensitive. These agents include docetaxel (chemotherapy) and...

issues in oncology

FDA Announces Project Facilitate to Access Investigational Therapies for Patients With Cancer

The Oncology Center of Excellence of the U.S. Food and Drug Administration (FDA) recently announced a new pilot program to assist oncology health-care professionals in requesting access to unapproved therapies for patients with cancer. A new call center designated Project Facilitate will be a...

breast cancer

Evidence Lacking That Denosumab Alters the Course of Breast Cancer

I am writing to provide personal context to my column on adjuvant denosumab or bisphosphonates for resected breast cancer, which appears on page 52 in this issue of The ASCO Post. I have been upset since 2013 that adjuvant zoledronate has been recommended for women with breast cancer onset after...

hematologic malignancies
lymphoma

Transitioning From Healthy Physician to Patient With Cancer

As you probably already know, physicians do not make the best patients. When I began experiencing the early signs of Hodgkin lymphoma, in 2007, including a persistent cough, unusual fatigue, and pruritus, I self-diagnosed allergic rhinitis and began treatment with intranasal corticosteroids....

Ask Your Patients About Complementary and Alternative Therapies

The most common reason that patients with cancer do not tell their physicians about using complementary and alternative medicines is that their physicians do not ask, according to a nationwide survey.1 Among 3,118 survey participants who reported a history of cancer, 1,023 (33.3%) had used a...

supportive care

Are Your Patients Using Complementary and Alternative Therapies? You Might Not Know If You Don’t Ask

Nearly one-third of patients with cancer who reported that they used complementary and alternative therapies in a nationwide survey did not tell their physicians about the use of those therapies, and the most frequently cited reason for not telling their physicians was that their physicians did...

breast cancer

Denosumab Prevents Neither Breast Cancer Relapse Nor Death

The recently published report of Austrian Breast and Colorectal Cancer Study Group’s Study 18 (ABCSG-18)1 for the secondary endpoint of disease-free survival suggests that denosumab given in a low dose of 60 mg subcutaneously every 6 months during aromatase inhibitor adjuvant therapy is...

NYU Langone’s Perlmutter Cancer Center Expands Care With New Outpatient Facility

NYU Langone Health has opened the doors to a new multispecialty outpatient facility in Sunset Park, Brooklyn. This new location features the capabilities of the Perlmutter Cancer Center. Previously, patients received radiation treatment at NYU Langone Hospital–Brooklyn and chemotherapy and other...

issues in oncology
legislation

Curbside Consults: New Liability Risks to Avoid When You Are Not a Patient’s Physician

Like most clinicians, oncologists often informally consult their colleagues, both asking questions and seeking suggestions on how best to care for their patients.1,2 These informal or “curbside” consults (sometimes called “sidewalk,” “elevator,” or “hallway” consults) are valuable, because the...

prostate cancer

Darolutamide in Nonmetastatic Castration-Resistant Prostate Cancer: Delaying Overt Metastatic Disease Is a Major Advance

Nonmetastatic (M0) castration-resistant prostate cancer arises in the subset of men with biochemically recurrent disease (ie, rising prostate-specific antigen [PSA] level after definitive therapy in the absence of metastases) who develop PSA progression after chronic exposure to...

prostate cancer

ARAMIS Trial: Darolutamide in Nonmetastatic Castration-Resistant Prostate Cancer

In a phase III ARAMIS trial reported in The New England Journal of Medicine, Karim Fizazi, MD, of the Institut Gustave Roussy, Universite Paris-Sud, Villejuif, France, and colleagues found that the androgen-receptor antagonist darolutamide significantly prolonged metastasis-free survival vs placebo ...

Access Program to Be Established for Patients After Olaratumab Is Withdrawn From the Global Market

ELI LILLY AND COMPANY recently announced that it has been working to facilitate the withdrawal of olaratumab from the market for the treatment of advanced soft-tissue sarcoma. Lilly’s actions to withdraw olaratumab from the market follow completion of the international phase III ANNOUNCE clinical...

multiple myeloma

Are Cardiac Events During Proteasome Inhibitor Therapy for Relapsed Multiple Myeloma Common?

In a study reported in the Journal of Clinical Oncology, Cornell et al found that cardiovascular adverse events are common in patients receiving proteasome inhibitor therapy for relapsed multiple myeloma and are associated with poorer outcome. The prospective observational study involved 95...

head and neck cancer

Immune Response to HPV16-Driven Tumorigenesis May Be Detectable Before Clinical Diagnosis of Oropharyngeal Squamous Cell Carcinoma

An international group of researchers has found that antibodies to the human papillomavirus type 16 (HPV16) may develop in the body between 6 to 40 years prior to a clinical diagnosis of oropharyngeal squamous cell carcinoma, and their presence indicates a strong increased risk of the disease....

issues in oncology
survivorship

Study Finds Primary Care Providers Are Engaged in Cancer Survivorship Care but Report Barriers to Optimal Care Delivery

A new study published by McDonough et al in the Journal of Oncology Practice found that while primary care physicians are often involved in cancer survivorship care, many do not feel adequately prepared for key components of it. The study shared the results of a survey of 117...

skin cancer

Performance of Machine-Learning Classifiers in the Diagnosis of Pigmented Skin Lesions

In a study conducted under the supervision of researchers from the MedUni Vienna, human experts competed against computer algorithms in diagnosing pigmented skin lesions. The algorithms achieved better results when diagnosing, but had decreased performance for out-of-distribution images. These...

hematologic malignancies

Gait Speed Identifies Frailty, Could Help Predict Outcomes in Older Patients With Hematologic Cancers

The speed at which older individuals with blood cancers are able to walk 4 meters (about 13 feet) holds information about their overall health and may help to predict survival and unplanned hospital visits, according to study published by Liu et al in Blood. The association was...

breast cancer

Personalized Assay May Aid in Determining Risk of Recurrence of Triple-Negative Breast Cancer

Sixty percent of patients with triple-negative breast cancer will survive more than 5 years without disease after standard treatment, but 4 out of 10 women will have a rapid recurrence of the disease. There are currently no clinical tests to assess an individual patient’s prognosis, so all...

leukemia

Association of Antibodies With Pegaspargase Allergic Reactions and Failure of Rechallenge in Pediatric ALL

In a study reported in the Journal of Clinical Oncology, Liu et al determined the frequency of allergic reactions and consequences of development of antibodies to pegaspargase (PEG-ASP) among pediatric patients with newly diagnosed acute lymphoblastic leukemia (ALL).    As noted by the...

What We Remember: From D-Day to Cancer Care

I RECENTLY returned from Normandy, France, where my wife and I attended events honoring the 75th Anniversary of D-Day and the millions, including close friends and family, who fought and died in the Second World War. My wife and a journalist from Los Angeles laid a wreath on Omaha Beach in honor of ...

leukemia
immunotherapy

EHA 2019: ASCEND Trial Compares Acalabrutinib vs Investigator’s Choice in Relapsed or Refractory CLL

The randomized, global, multicenter, open-label phase III ASCEND trial evaluated the efficacy and safety of acalabrutinib vs investigator’s choice of rituximab/idelalisib or rituximab/bendamustine in patients with relapsed or refractory chronic lymphocytic leukemia (CLL). Ghia et al presented ...

leukemia

EHA 2019: CLL12 Trial Investigates Ibrutinib in Previously Untreated, Asymptomatic Early-Stage CLL

At the 24th Annual Congress of the European Hematology Association (EHA), Langerbeins et al presented findings from the phase III CLL12 trial, which evaluated whether ibrutinib prolongs event-free survival in patients with previously untreated, Binet stage A chronic lymphocytic leukemia (CLL)...

multiple myeloma

EHA 2019: BELLINI Trial Evaluates Addition of Venetoclax to Bortezomib/Dexamethasone in Relapsed or Refractory Multiple Myeloma

The phase III BELLINI trial—reported by Kumar et al at the 24th Annual Congress of the European Hematology Association (EHA; Abstract LB2601) investigated the efficacy and safety of venetoclax/bortezomib/dexamethasone vs bortezomib/dexamethasone in patients with relapsed or refractory...

sarcoma

Cediranib in Alveolar Soft-Part Sarcoma

In the phase II CASPS trial reported in The Lancet Oncology, Judson et al found evidence of activity of cediranib in alveolar soft-part sarcoma. In the double-blind trial, 48 patients from 12 sites in the United Kingdom, Spain, and Australia were randomly assigned 2:1 between July 2011 and July...

multiple myeloma
immunotherapy

EHA 2019: CASSIOPEIA Trial Examines Addition of Daratumumab to Standard Treatment Before and After ASCT in Multiple Myeloma

In the phase III CASSIOPEIA trial, reported in The Lancet and presented at the 24th Annual Congress of the European Hematology Association (EHA; Abstract S145) by Moreau et al, daratumumab plus bortezomib/thalidomide/dexamethasone (D-VTd) given before and after autologous stem cell transplantation...

lung cancer
issues in oncology

Radiotherapy Increases Adverse Cardiovascular Event Risk for Patients With Lung Cancer

A new retrospective study led by investigators from Brigham and Women’s Hospital and Dana-Farber Cancer Institute examined outcomes for patients after receiving treatment for locally advanced non–small cell lung cancer (NSCLC), finding that the average radiation dose delivered to the...

cns cancers
lymphoma

Cytoreductive Surgery for Primary Central Nervous System Lymphoma

Through a systematic review of published studies, researchers report they have identified a distinct subtype of primary central nervous system (PCNS) lymphoma that should be considered for surgical removal, suggesting a major shift in how this type of tumor is evaluated and managed. These findings...

issues in oncology
survivorship

U.S. Cancer Survivors Numbered Nearly 17 Million at the Start of 2019

There were more than 16.9 million Americans with a history of cancer on January 1, 2019, and that number is projected to reach more than 22.1 million by 2030 based on the growth and aging of the population alone, according to estimates from Cancer Treatment and Survivorship Statistics, 2019....

prostate cancer

Toxicity With Prostate-Only vs Prostate and Pelvic Lymph Node Intensity-Modulated Radiation Therapy

In a UK national population-based study reported in the Journal of Clinical Oncology, Parry et al found virtually no difference in gastrointestinal or genitourinary toxicity associated with prostate-only (PO-IMRT) vs prostate and pelvic lymph node intensity-modulated radiation therapy (PPLN-IMRT)...

breast cancer
gastroesophageal cancer
gastrointestinal cancer

FDA Approves New Trastuzumab Biosimilar

Today, the U.S. Food and Drug Administration (FDA) approved trastuzumab-anns (Kanjinti) for all approved indications of the reference product trastuzumab (Herceptin): for the treatment of HER2-overexpressing breast cancer and HER2-overexpressing metastatic gastric or gastroesophageal...

issues in oncology
supportive care

Patient Perceptions of Management of Cancer-Related Pain, Fatigue, and Emotional Distress in Community Oncology Centers

In a study reported in the Journal of Clinical Oncology, Smith et al found that a high proportion of patients in community cancer centers did not report discussing, getting advice, or receiving desired help for cancer-related pain, fatigue, or emotional distress. The study involved surveys of...

gynecologic cancers

2019 ASCO: Paclitaxel/Carboplatin vs Paclitaxel/Ifosfamide in Carcinosarcoma of the Uterus or Ovary

Results from the phase III NRG Oncology clinical trial GOG 0261 comparing paclitaxel plus carboplatin to paclitaxel plus ifosfamide in women with stage I–IV recurrent carcinosarcoma of the uterus or ovary found that treatment with paclitaxel/carboplatin was not inferior to...

skin cancer
immunotherapy

2019 ASCO: OPTiM Study on T-VEC for Unresectable Melanoma

New research on the immunotherapy talimogene laherparepvec (T-VEC)—an injectable oncolytic virus—for patients with unresectable melanoma was presented by Milhem et al at the 2019 ASCO Annual Meeting (Abstract 9524). Researchers reported the ad hoc analysis of progression-free survival...

issues in oncology

Survival Improvements for AYA Survivors Undermined by Late-Stage Diagnosis, Racial and Socioeconomic Disparities

The 2006 publication of the National Cancer Institute’s report Closing the Gap: Research and Care Imperatives for Adolescents and Young Adults With Cancer highlighted the lack of improvement in cancer survival among people between the ages of 15 and 39 compared to children and older adults...

breast cancer

2019 ASCO: New TAILORx Data Provide Treatment Guidance for Women Under 50 With Early Breast Cancer

New information about adjuvant therapy to prevent recurrence of breast cancer in women 50 years of age or younger has emerged from the Trial Assigning Individualized Options for Treatment (Rx), or TAILORx. An analysis of a prespecified secondary endpoint in this trial found that an assessment of a ...

kidney cancer

2019 ASCO: No Benefit From Pazopanib in Advanced Renal Cell Carcinoma After Metastasectomy

The E2810 trial was conducted to determine whether treatment with the oral drug pazopanib following surgery to remove further metastases in patients with advanced renal cell carcinoma would improve their disease-free survival. Results from the study—which showed that primary endpoint of...

colorectal cancer

2019 ASCO: Addition of Veliparib to Total Neoadjuvant Therapy in Locally Advanced Rectal Cancer

Results from an experimental arm of the phase II NRG-GI002 trial using veliparib, a poly (ADP-ribose) polymerase (PARP) inhibitor, as part of total neoadjuvant therapy (induction chemotherapy followed by chemoradiotherapy and surgery) in patients with locally advanced rectal adenocarcinoma were...

colorectal cancer

Åsmund A. Fretland, MD, on Colorectal Cancer Liver Metastases: Laparoscopic vs Open Resection

Åsmund A. Fretland, MD, of Oslo University Hospital, discusses clinical trial findings on survival outcomes after laparoscopic vs open resection for colorectal liver metastases. The study he conducted with his team showed that the laparoscopic procedure did not jeopardize long-term survival...

cns cancers
immunotherapy

2019 ASCO: Combination Therapy With SurVaxM in Newly Diagnosed Glioblastoma

Ahluwalia et al shared research results on SurVaxM at the 2019 ASCO Annual Meeting, reporting that combination therapy with the immunotherapy vaccine was more effective than standard therapy for nearly all patients with newly diagnosed glioblastoma in a phase II trial (Abstract 2016). SurVaxM...

breast cancer
colorectal cancer
health-care policy
issues in oncology

Medicaid Expansion and Colorectal Cancer Screening

A new study examining Medicaid expansion and cancer screening found that the five states and District of Columbia that first adopted Medicaid expansion saw larger increases in colorectal cancer screening than states that did not expand Medicaid. The study—published by Fedewa et al in...

lymphoma
immunotherapy

CheckMate 205: Nivolumab in Newly Diagnosed, Advanced Classical Hodgkin Lymphoma

Findings in a cohort of the phase II CheckMate 205 study, reported in the Journal of Clinical Oncology by Ramchandren et al, indicate that nivolumab monotherapy followed by nivolumab plus doxorubicin, vinblastine, and dacarbazine (N-AVD) is highly active in newly diagnosed, advanced-stage classical ...

cns cancers

2019 ASCO: Subgroups of Patients With Low-Grade Glioma May Benefit From PCV Chemotherapy Plus Radiotherapy

A recent, updated predictive analysis of the three World Health Organization (WHO)-defined molecular subgroups based on IDH mutation status and 1p/19q codeletion status represented in the high-risk treatment arms of a phase III trial found that both IDH-mutant subgroups may derive benefit ...

prostate cancer

Cancer-Specific and Other-Cause Mortality Among Black Men With Prostate Cancer

In a study reported in JAMA Oncology, Dess et al found that after adjustment for nonbiologic differences, black men with nonmetastatic prostate cancer did not appear to have higher rates of prostate cancer–specific mortality vs white men. Black patients had higher rates of other-cause...

lymphoma

Prognostic Significance of PET Score in Early-Stage Hodgkin Lymphoma

In an analysis from the UK RAPID study reported in the Journal of Clinical Oncology, Barrington et al found that a postchemotherapy positron-emission tomography (PET) score of 5 was associated with poorer outcomes among patients with early-stage Hodgkin lymphoma. Study Details In the trial,...

head and neck cancer
immunotherapy

FDA Approves Pembrolizumab for the First-Line Treatment of Head and Neck Squamous Cell Carcinoma

On June 10, the U.S. Food and Drug Administration (FDA) approved the anti–programmed cell death protein 1 immunotherapy pembrolizumab (Keytruda) for the first-line treatment of patients with metastatic or unresectable recurrent head and neck squamous cell carcinoma. Pembrolizumab was...

lymphoma
immunotherapy

FDA Approves Polatuzumab Vedotin-piiq in Combination With Bendamustine and a Rituximab Product for DLBCL

On June 10, the U.S. Food and Drug Administration (FDA) granted accelerated approval to polatuzumab vedotin-piiq (Polivy), a CD79b-directed antibody-drug conjugate, in combination with bendamustine and a rituximab product for adult patients with relapsed or refractory diffuse large B-cell lymphoma...

cns cancers

As My Outside World Became Smaller, My Family Focus Became Larger

As I write this, I think I’m making sense but am not 100% sure. My brain is a little scrambled after nearly 4 years of treatment for grade 4 glioblastoma multiforme, but I think the essence of my humor and humanity is still intact. When I experienced my first partial seizure while riding my...

lung cancer

Addition of Bevacizumab to Erlotinib Improves Progression-Free Survival in EGFR-Mutated, Nonsquamous NSCLC

In an interim analysis of the phase III NEJ026 trial reported in The Lancet Oncology, Makoto Maemondo, MD, and colleagues found that the addition of bevacizumab to erlotinib improved progression-free survival in patients with EGFR-positive, nonsquamous non–small cell lung cancer (NSCLC). In the...

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