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issues in oncology

The Mystery of Grace

The day after I told Nell she had seven metastases to her brain, she sent me flowers. She was my patient; I was her oncologist. I had met her 1 year prior, when she was well into her cancer journey, stage IV breast cancer at diagnosis. I took over from her current oncologist, who was moving. At...

gynecologic cancers

Expert Point of View: Eloise Chapman-Davis, MD

Eloise Chapman-Davis, MD, a gynecologic oncologist at New York-Presbyterian and Weill Cornell Medicine, commented on the SOLO2 trial results for The ASCO Post. “SOLO2 is the third randomized trial to evaluate the use of maintenance therapy in a selected subgroup of ovarian cancer patients with...

gynecologic cancers

Olaparib Maintenance Prolongs Progression-Free Survival in Ovarian Cancer

Maintenance therapy with the tablet formulation of olaparib (Lynparza) significantly prolonged progression-free survival in patients with platinum-sensitive relapsed ovarian cancer and mutations in BRCA1/2 in the phase III SOLO2 trial, presented at the 2017 Society of Gynecologic Oncology (SGO)...

breast cancer

AACR 2017: Patients With Triple-Negative Breast Cancer Who Responded to Atezolizumab Had Long-Term Survival Benefit

Among patients with metastatic triple-negative breast cancer who were treated with the anti–programmed death-ligand 1 (PD-L1) immunotherapy atezolizumab (Tecentriq), those who responded to the treatment had a longer overall survival compared with those who did not respond, according to data...

breast cancer

Palbociclib Receives FDA Approval and Expanded Indication for First-Line Metastatic Breast Cancer

On March 31, the U.S. Food and Drug Administration (FDA) approved a supplemental New Drug Application (sNDA) for a first-in-class cyclin-dependent kinase (CDK) 4/6 inhibitor, palbociclib (Ibrance), based on the results from the confirmatory phase III trial PALOMA-2. The FDA action converts the...

solid tumors

High-Throughput Genomics May Improve Outcomes in Difficult-to-Treat Cancers

A study investigating the hypothesis that testing a large number of genes across all cancer tumor types could improve outcomes for patients with difficult-to-treat cancers by using targeted therapies has found that progression-free survival was significantly higher in the those treated with...

breast cancer

Racial and Ethnic Disparities in Gene-Expression Profiling Tests in Breast Cancer

For a proportion of patients, including women with hormone receptor–positive breast cancer, gene-expression profiling has a substantial impact on treatment decision-making by determining which patients might—or might not—respond to particular treatment options. Gene-expression...

palliative care

Pediatric Oncology Patient and Parent Attitudes on Early Palliative Care Integration

Few pediatric oncology patients or their parents expressed negative attitudes toward early integration of palliative care during cancer treatment, according to a study by Levine et al reported in JAMA Oncology. Study Details The study involved completion of surveys by 129 patient-parent dyads...

solid tumors

First-in-Human Clinical Trial of ONC201 in Patients With Refractory Solid Tumors

A first-in-human clinical trial examining the investigational small-molecule drug ONC201 in patients with advanced solid tumors showed the oral agent to be well tolerated at the recommended phase II dose, according to Rutgers Cancer Institute of New Jersey investigators whose research also showed...

breast cancer
gynecologic cancers

Significant Increase in Number of Women Tested for BRCA Gene, but Many High-Risk Patients Remain Unidentified

About 5% to 10% of breast cancer cases and 10% to 18% of ovarian cancer cases can be attributed to two BRCA genetic mutations. Testing for these genetic abnormalities has risen steadily over the past decade. Previously, mainly women with a history of cancer were referred for genetic testing, but as ...

palliative care
issues in oncology

Palliative Care Consultations for Patients With Advanced Cancers May Reduce Hospitalization and Improve Quality of Care

Patients admitted to the hospital with advanced cancers who were referred early to palliative care had decreased health-care utilization and increased use of support services following discharge, according to a new study led by researchers at the Icahn School of Medicine at Mount Sinai. Published...

breast cancer

Effect of Polypharmacy on Adherence to Adjuvant Endocrine Therapy for Breast Cancer

In a retrospective cohort study reported in the Journal of Oncology Practice, Calip et al found that polypharmacy overall was associated with increased adherence to adjuvant endocrine therapy for breast cancer. However, frequent use of some medication classes was associated with decreased...

gynecologic cancers

FDA Approves Maintenance Niraparib for Recurrent Epithelial Ovarian, Fallopian Tube, or Primary Peritoneal Cancer

The U.S. Food and Drug Administration (FDA) has approved niraparib (Zejula) for the maintenance treatment of adult patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer, whose tumors have achieved complete or partial response to platinum-based chemotherapy....

prostate cancer

ASCO and Cancer Care Ontario Update Guideline on Radiation Therapy for Prostate Cancer

The American Society of Clinical Oncology (ASCO) and Cancer Care Ontario today issued a joint clinical practice guideline update on brachytherapy for patients with prostate cancer. The update provides evidence-based recommendations for different patient risk groups and specifies the most effective...

prostate cancer

Hypofractionated vs Conventional Radiotherapy for Localized Prostate Cancer

Hypofractionated radiotherapy was noninferior to standard radiotherapy in biochemical-clinical failure disease-free survival in men with localized prostate cancer, according to a study reported by Catton et al in the Journal of Clinical Oncology. Study Details In the trial, 1,206 patients with...

Guidelines Planned on Management of Immunotherapy Side Effects: ASCO and NCCN to Collaborate on Development

Given the pace of advances in immunotherapy in recent years and physicians’ need to keep up with these developments, ASCO and the National Comprehensive Cancer Network® (NCCN®) have announced a joint collaboration to publish practical clinical guidance on the management of side effects caused by...

An Evening for Cancer Survivors and Caregivers: Bringing Together a Community of Support

On January 26, 2017—prior to the official opening of the 2nd Annual Cancer Survivorship Symposium—cancer survivors, caregivers, patient advocates, family physicians, oncology providers, and others gathered in San Diego, California, to make connections, discuss survivorship issues, and get expert...

breast cancer

Mammography-Detected Small Breast Cancers May Represent Overdiagnosis, With Declining Mortality Reflecting Improved Systemic Therapy

In a study using Surveillance, Epidemiology, and End Results (SEER) data reported in The New England Journal of Medicine, H. Gilbert Welch, MD, of Dartmouth Institute for Health Policy and Clinical Practice, and colleagues found that screening mammography has resulted in a substantial increase in...

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...

prostate cancer

Celecoxib or Celecoxib/Zoledronic Acid in Men Initiating Hormone Therapy for Prostate Cancer

As reported by Mason et al in the Journal of Clinical Oncology, long-term survival results of the UK-based, multiarm, multistage platform–design STAMPEDE trial showed no survival benefit with the addition of celecoxib or celecoxib plus zoledronic acid in men initiating long-term hormone...

kidney cancer

Intermittent Sunitinib in Metastatic Renal Cell Carcinoma

In a phase II study reported in the Journal of Clinical Oncology, Moshe C. Ornstein, MD, of Cleveland Clinic Taussig Cancer Institute, and colleagues found that an intermittent schedule of sunitinib (Sutent) may be feasible in patients with previously untreated metastatic renal cell carcinoma. In...

prostate cancer

Potential Surrogate for All-Cause Mortality Risk in Localized Prostate Cancer

In a study reported in JAMA Oncology, Trevor J. Royce, MD, of Harvard Radiation Oncology Program, Brigham and Women’s Hospital, and colleagues found that a prostate-specific antigen (PSA) nadir > 0.5 ng/mL may be a dominant risk factor for all-cause mortality after radiation therapy and...

colorectal cancer

Reducing Debilitating Symptoms of Advanced Colorectal Cancer

In a phase III trial reported in The Lancet Oncology, Tamas Hickish, MD, of Poole Hospital NHS Foundation Trust, Dorset, England, and colleagues found that treatment with MABp1, an antibody that targets interleukin 1α and exhibits antitumor activity, was associated with improvement in the composite ...

supportive care
palliative care

Examining the Impact of ‘Death With Dignity’ Legislation

Despite the controversy surrounding “Death With Dignity” laws, which allow physicians to prescribe life-ending drugs to terminally ill patients, they have a long history of majority support from Americans. According to a Gallup poll taken in 2015, nearly 7 in 10 Americans (68%) agreed that...

Discrimination in Medical Education—Another Perspective

I read with great interest Dr. ­Robert E. Montenegro’s comments in the The ASCO Post, January 25, 2017, where he felt “marginalized” when questioned about his country of origin or the quality of his English. As physicians, we constantly deal in a world of uncertainties and are required to address...

supportive care
integrative oncology
symptom management
breast cancer

Acupuncture for the Management of Hot Flashes

The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies commonly used by patients with cancer. In this installment, authors Jun J. Mao, MD, MSCE, and Jyothirmai Gubili, MS, present a case study...

multiple myeloma

Implications of SWOG S0777 and the Future of Combination Treatments for Multiple Myeloma

The treatment of multiple myeloma is becoming increasingly complicated. This is not only because of the complexity of the disease, but also because of the increasing number of effective combination treatments and continuous development of new drugs. This has resulted in an ever-increasing number ...

lung cancer

New First-Line Options for ALK-Positive Lung Cancer on the Horizon

Anaplastic lymphoma kinase (ALK) rearrangements define a subset of non–small cell lung cancer (NSCLC) patients for whom ALK inhibitors are highly effective. In PROFILE 1014, the multitargeted ALK inhibitor crizotinib (Xalkori) was shown to be superior to platinum/pemetrexed (Alimta) chemotherapy...

lung cancer

Markedly Improved Progression-Free Survival With First-Line Ceritinib vs Platinum Chemotherapy in ALK-Rearranged NSCLC

In the phase III ASCEND-4 trial reported in The Lancet, Jean-Charles Soria, MD, of Institut Gustave Roussy, and colleagues found that ceritinib (Zykadia) improved progression-free survival vs platinum-based chemotherapy in the first-line treatment of advanced anaplastic lymphoma kinase...

A Case of Mistaken Identity

In the February 25, 2017, issue of The ASCO Post, in the article “‘Watch-and-Wait’ Strategy Does Not Compromise Survival in Selected Patients With Rectal Cancer,” a photo labeled Maxime van der Valk, MD, was incorrect.  A photo of Dr. van der Valk is shown here. Dr. van der Valk is a study...

health-care policy
pain management

ASCO Addresses New Policies That Threaten Access to Opioids

Since the mid-2000s, medication and illicit drug abuse in the United Sates has steadily increased, creating what has now been termed an “opioid epidemic.” In response, Congress and the Bush and Obama Administrations have launched intervention and regulatory proposals to help turn the troubling...

lymphoma

The Art of Medicine in the World of Evidence-Based Medicine

Christian Taverna, MD, a lymphoma specialist at the Hospital Münsterlingen in Switzerland, commented on this patient series for The ASCO Post. He noted that the Swiss Group for Clinical Cancer Research (SAKK) tried to address the question of the optimal duration of rituximab (Rituxan) maintenance...

lymphoma

For One Hematologist, No Disease Progressions in Follicular Lymphoma With Rituximab Maintenance

Patients with follicular lymphoma are clearly living longer without disease progression, but what clinician has had no patients progress? Michael Auerbach, MD, a hematologist/oncologist in private practice in Baltimore and Clinical Professor of Medicine at Georgetown University, may have these...

lung cancer

Plinabulin Improves Survival in Subset of Patients With Non–Small Cell Lung Cancer

The investigational small-molecule plinabulin yielded some interesting benefits when added to docetaxel in previously treated patients with stage III/IV non–small cell lung cancer (NSCLC), in a phase II study.1 Although the benefit of the doublet was modest in the overall study population, the...

solid tumors

Expert Point of View: Shridar Ganesan, MD, PhD

Shridar Ganesan, MD, PhD, of Rutgers Cancer Institute of New Jersey, discussed the study by Cristescu et al at the 2017 ASCO-SITC Clinical Immuno-Oncology Symposium. He noted that data from many sources have shown that point mutation burden correlates with response rate to checkpoint blockade....

solid tumors

KEYNOTE Trial Data Suggest Features Predicting Response to Pembrolizumab

A high mutational load and the presence of a T-cell–“inflamed” environment may independently predict for treatment response to pembrolizumab (Keytruda) and progression-free survival, according to a study presented by Tanguy Seiwert, MD, of the University of Chicago, at the 2017 ASCO-SITC Clinical...

prostate cancer

Expert Point of View: Joseph Greer, PhD

“These data are consistent with other studies we have conducted in advanced lung cancer, in which we similarly found that one-third of patients believed that their metastatic lung cancer was curable. These patients ostensibly already had conversations with their oncologists about their prognosis...

prostate cancer

Aligning Patient Expectations With Treatment Goals in the Metastatic Setting

More than one-third of men with incurable metastatic prostate cancer mistakenly believe that their cancer may be curable, according to a survey of patient expectations at an academic cancer center. “This study is part of a larger survey of treatment decision-making among men with metastatic...

head and neck cancer

Developing Better Multidisciplinary Strategies

“More than any other disease, head and neck cancer requires constant interplay between a number of different specialties,”  Sandeep Samant, MD, Chief, Head and Neck Surgery, Northwestern Medicine, and Chair of the Multidisciplinary Head & Neck Symposium sponsored by the Robert H. Lurie...

head and neck cancer

Making the Case for Sentinel Node Biopsy in Early Cancers of the Oral Cavity

“The majority of patients with oral cavity cancers will undergo an unnecessary operation,” ­Sandeep Samant, MD, stated at a session on managing N0 neck cancer at the 2016 Lurie Cancer Center Multidisciplinary Head & Neck Symposium in Chicago.1 That operation is elective neck dissection, and it ...

breast cancer
survivorship

Online Symptom-Management Curriculum May Improve Depression and Fatigue in Breast Cancer Survivors

With thousands of devices to track and manage health and wellness, eHealth tools are beginning to transform modern health care and research, demonstrating quantifiable improvements in patient outcomes. According to the results of a randomized controlled trial (Reimagine), breast cancer survivors...

breast cancer
symptom management
survivorship

Search Continues for Effective Way to Prevent Lymphedema in Breast Cancer Survivors

There was no difference in the incidence of lymphedema at 18 months in breast cancer patients randomized to a physical therapy intervention with education materials compared with a control.1 Although poor adherence to the intervention may have been a factor, these results, described as “very...

colorectal cancer

Expert Point of View: Manish A. Shah, MD

Manish A. Shah, MD, Director of Gastrointestinal Oncology at NewYorkPresbyterian and Weill Cornell Medicine, commented that “the benefit seen in patients who regularly exercise is equal to or better than the benefit seen with some chemotherapy drugs,” although he cautioned that exercise in this...

colorectal cancer

Moderate Activity May Improve Overall and Progression-Free Survival in Patients With Metastatic Colorectal Cancer

Patients with metastatic colon cancer who exercise may live longer, according to an analysis of the CALGB/SWOG 80405 trial presented at the 2017 Gastrointestinal Cancers Symposium.1 According to the authors, this is the first study to demonstrate an association between physical activity and...

gastroesophageal cancer

Expert Point of View: Nancy Baxter, MD, PhD & Steven H. Lin, MD, PhD

“CALGB 80803 really helps move the field forward,” said press briefing moderator and ASCO spokesperson Nancy Baxter, MD, PhD, a surgeon from St. Michael’s Hospital in Toronto, Ontario, Canada. “PET [positron-emission tomography] scans may prove to be a valuable tool to help oncologists fine-tune...

gastroesophageal cancer

Early PET Imaging May Guide Treatment Decisions in Esophageal Cancer

In patients with resectable esophageal or gastroesophageal junction cancer, positron-emission tomography (PET) imaging was used to assess response to induction chemotherapy. PET nonresponders were identified after the first few cycles and were switched to an alternate regimen. This strategy greatly ...

hepatobiliary cancer

Expert Point of View: Milind Javle, MD

Milind Javle, MD, Professor of Gastrointestinal Oncology at The University of Texas MD Anderson Cancer Center, Houston, discussed the findings from the CheckMate 040 trial presented at the 2017 Gastrointestinal Cancers Symposium. There is a strong rationale for investigating immunotherapy in liver ...

hematologic malignancies

New Antiviral Agent May Prevent Posttransplant Cytomegalovirus Infections

Patients receiving the antiviral letermovir (MK-8228, AIC246), as compared to placebo, were almost twice as likely to avoid infection with cytomegalovirus or fail for other reasons in a randomized phase III international trial presented at the 2017 BMT Tandem Meetings, the joint meeting of the...

issues in oncology
skin cancer

Progress Being Made in Understanding Immunotherapy Resistance

A key challenge in advancing immunotherapies is to understand mechanisms of response and resistance. Emerging research in this area—including evidence that early on-treatment biopsies can predict response—was discussed at the 2017 ASCO-SITC (Society for Immunotherapy of Cancer) Clinical...

colorectal cancer

Novel Immunotherapeutic Vaccine Studied in Colorectal Cancer

Patients with advanced colorectal cancer mounted a robust response to an experimental vaccine and low-dose cyclophosphamide, and strong responses were associated with improvements in survival in a phase I/II clinical trial of modified vaccinia virus Ankara–5T4 (TroVax).1 Martin Scurr, PhD, of...

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