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Katherine C. Lee, MD, on Emergency Surgery and End-of-Life Care
Katherine C. Lee, MD, of Massachusetts General Hospital, discusses her study findings that showed older patients with metastatic cancer who survived emergency general surgery experienced higher intensity end-of-life care than similar patients who did not undergo surgery (Abstract 56).
Study Identifies Suitable Partner for Bevacizumab in Recurrent Ovarian Cancer
For patients with recurrent ovarian cancer who receive platinum-based retreatment, the more suitable partner for bevacizumab (Avastin) may be carboplatin plus pegylated liposomal doxorubicin, rather than carboplatin and gemcitabine, according to the results of a phase III ENGOT/GCIG Intergroup...
Neoadjuvant Therapy With Reduced-Dose Immunotherapy for Stage III Melanoma
In patients with stage III melanoma, a reduced-dose neoadjuvant immunotherapy combination was well tolerated and led to high pathologic response rates, in the phase II OpACIN-neo trial presented at the European Society for Medical Oncology (ESMO) 2018 Congress.1 “Neoadjuvant ipilimumab (Yervoy) at...
Expert Point of View: Daniel Heinrich, MD, and Silke Gillessen, MD
Formal discussant of the ERA 223 trial, Daniel Heinrich, MD, of Akershus University Hospital, Lørenskog, Norway, reminded listeners at the European Society for Medical Oncology (ESMO) 2018 Congress that radium-223 was developed in Norway. “When the ALSYMPCA results came out, we were celebrating....
Treatment With Radium-223 Plus Abiraterone Not Advisable in Metastatic Prostate Cancer
The combination of radium-223 plus AAP (abiraterone acetate [Zytiga] and prednisone) was not superior to placebo plus AAP in the phase III ERA 223 trial, which enrolled men with asymptomatic bone-predominant metastatic castration-resistant prostate cancer.1 Patients treated with the combination had ...
Immunotherapy and Tyrosine Kinase Inhibitor Combination in Advanced Renal Cell Carcinoma
In the JAVELIN Renal 101 phase III study, the combination of the immune checkpoint inhibitor avelumab (Bavencio), a programmed death ligand-1 (PD-L1) blocking antibody, plus the tyrosine kinase inhibitor axitinib (Inlyta) significantly improved progression-free survival in previously untreated...
Expert Point of View: Amanda Psyrri, MD, PhD
Formal discussant of this trial, Amanda Psyrri, MD, PhD, of the University of Athens Medical School, Attikon Hospital, Athens, Greece, commented on these results, suggesting they would affect clinical practice “tomorrow.” “Cisplatin/radiotherapy remains the standard of care for low-risk human...
Phase III Study Supports Use of Cisplatin Over Cetuximab in HPV-Positive Oropharyngeal Cancer
In the United States and European countries, many oncologists are using cetuximab (Erbitux)/radiotherapy instead of cisplatin/radiotherapy in the treatment of human papillomavirus (HPV)-positive oropharyngeal cancer, based on the belief that cetuximab is equally effective with less toxicity than...
Suleika Jaouad on Making the Most of a Life Interrupted: A Young Adult Perspective on Cancer
Suleika Jaouad, an Emmy Award–winning writer, advocate, and cancer survivor who was diagnosed at age 22 with myelodysplastic syndrome and acute myeloid leukemia, discusses what she has learned about coping with cancer, learning from it, and growing beyond it.
Expert Point of View: Jean-Pascal Machiels, MD, PhD, and Tanguy Seiwert, MD
Invited discussant Jean-Pascal Machiels, MD, PhD, Head of the Department of Medical Oncology at the Cliniques universitaires Saint-Luc, UCLouvain, Brussels, called the study “very important,” especially for showing that in patients with high expression of programmed cell death ligand 1 (PD-L1),...
Pembrolizumab Improves Survival in Advanced Head and Neck Cancer
An overall survival advantage has now been shown for first-line immunotherapy in recurrent or metastatic head and neck cancer, researchers reported at the European Society for Medical Oncology (ESMO) 2018 Congress.1 In the phase III KEYNOTE-048 trial, treatment with the anti–programmed cell death...
First-Line Immunotherapy Shows Benefit in Metastatic Colorectal Cancer Subset
In previously untreated patients with metastatic colorectal cancer and tumors demonstrating microsatellite instability–high (MSI-high) or mismatch repair deficiency (dMMR), immunotherapy with nivolumab (Opdivo) and low-dose ipilimumab (Yervoy) produced a durable clinical benefit in the...
Treatment With ADT May Be Linked to Higher Risk of Heart Failure in Patients With Prostate Cancer
Androgen-deprivation therapy (ADT) use was associated with a higher risk of heart failure in a study of patients with prostate cancer, according to findings published by Kao et al in The Journal of Clinical Pharmacology. Study Methods, Findings Study authors used data from the Taiwan...
ACS Report Looks at Ways to Improve Outcomes for Cancer Survivors and Caregivers
Growing numbers of cancer survivors, provider shortages, rising health-care costs, and socioeconomic disparities in health outcomes have created an urgent need to provide coordinated, comprehensive, personalized care for cancer survivors. A new report from the American Cancer Society (ACS) creates...
Neoadjuvant Immunotherapy Yields Major Response in Colon Cancer Subset
In a small study of patients with early-stage colon cancer, neoadjuvant ipilimumab (Yervoy) plus nivolumab (Opdivo) produced major pathologic responses in 100% of patients with mismatch repair (MMR)-deficient tumors but in none of the patients with MMR-proficient tumors, researchers reported at the ...
Adding Pelvic Node Radiation and Short-Term Hormone Therapy to Salvage Radiation Provides Significant Benefit in Prostate Cancer
For patients with prostate cancer who have persistent or rising prostate-specific antigen (PSA) levels after radical prostatectomy, the addition of short-term androgen-deprivation therapy and radiotherapy to the pelvic lymph nodes demonstrated increased rates of freedom from disease progression,...
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%...
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)...
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 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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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)...
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...
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...
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...
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,...
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...
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...
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...
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...
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...
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 ...
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...
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...
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...
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...
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...
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...
