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issues in oncology
health-care policy

The Path Forward for Clinical Pathways in Oncology

The year 2016 was a memorable one for oncology. In January, President Barack Obama announced the launch of the National Cancer Moonshot initiative, spearheaded by Vice President Joe Biden, which aims to accelerate cancer research. And in December, through bipartisan Congressional support, the 21st ...

kidney cancer

Active Surveillance Appears to Be Safe for Small Renal Masses

The prospective Delayed Intervention and Surveillance for Small Renal Masses (DISSRM) registry shows that over the intermediate term, active surveillance appears to be as safe as primary intervention for carefully selected, older, sicker patients with small renal masses.1 As the data mature,...

lung cancer

Expert Point of View: Ann W. Silk, MD

Ann W. Silk, MD, of Rutgers Cancer Institute of New Jersey, New Brunswick, presented the day’s highlights and commented that the study by Hellmann et al shows the utility, and, in fact, the necessity, of developing a new means of estimating outcomes for patients treated with immunotherapies....

lung cancer

Pembrolizumab Affords Long-Term Survival to One-Fourth of Selected Patients With NSCLC, Alternative Statistical Model Suggests

Statistical modeling of long-term survival from the KEYNOTE trials of the programmed cell death protein 1 (PD-1)–inhibitor pembrolizumab ­(Keytruda) estimates that one-quarter of appropriately selected patients with advanced non–small cell lung cancer (NSCLC) may attain long-term survival.1 “In...

breast cancer

Association of Metformin Use for Diabetes With Outcomes in HER2-Positive Breast Cancer

In an analysis from the phase III ALTTO trial reported in the Journal of Clinical Oncology, Sonnenblick et al found that among patients receiving adjuvant therapy for HER2-positive breast cancer, those with diabetes who received metformin had better outcomes than those who did not receive...

symptom management

Dexamethasone Mouthwash in Preventing Everolimus-Related Stomatitis in Women With Breast Cancer

In the phase II SWISH study reported in The Lancet Oncology, Rugo et al found that use of a dexamethasone-based mouthwash may prevent everolimus-related stomatitis in postmenopausal women receiving everolimus (Afinitor) for hormone receptor–positive, HER2-negative metastatic breast cancer....

lung cancer

Thoracic 2017: SBRT Offers Curative Option for Patients With Lung Cancer Aged 80 and Older

Patients in their 80s and 90s who have early-stage lung cancer but cannot undergo an operation can be treated safely and effectively with stereotactic body radiation therapy (SBRT), according to research presented by Cassidy et al at the 2017 Multidisciplinary Thoracic Cancers Symposium (Abstract...

lung cancer

Thoracic 2017: Updated Data Confirm Benefits of Single-Fraction SBRT for NSCLC

New research led by a radiation oncologist at Roswell Park Cancer Institute indicates that less may be more when it comes to some forms of radiation therapy for cancer. In a presentation highlighted in a plenary session (Abstract 4) at the 2017 Multidisciplinary Thoracic Cancers Symposium in San...

skin cancer

Belgian Study Combines BRAF and MEK Inhibition in Advanced BRAF 600–Mutant Melanoma

In a Belgian two-center phase II trial reported in The Lancet Oncology, Schreuer et al found that rechallenge with the BRAF inhibitor dabrafenib (Tafinlar) and the MEK inhibitor trametinib (Mekinist) showed activity in patients with BRAF V600–mutant melanoma whose disease had progressed on...

lung cancer

Charles B. Simone, II, MD, on NSCLC: CTCs as a Biomarker for Early Detection

Charles B. Simone, II, MD, of the University of Maryland Medical Center, discusses results from a large prospective study in locally advanced non–small cell lung cancer, which suggest that circulating tumor cells may be a promising biomarker of progressive or recurrent disease and may help guide...

lung cancer

Jennifer Ho, MD, on Thoracic Cancers: Reirradiation With IMPT

Jennifer Ho, MD, of The University of Texas MD Anderson Cancer, discusses study results on the use of intensity-modulated proton therapy, which can provide durable local control with minimal toxicity in patients who can have extended survivals; the data also suggest that higher doses may improve...

lung cancer

Thoracic 2017: Combination of Radiation and Immune Checkpoint Therapy Holds Potential for Lung Cancer

An emerging approach for cancer treatment seeks to combine radiation therapy with immune checkpoint inhibitors to more effectively control tumors in the chest with an acceptable risk of severe treatment-related side effects. About 10% of patients in a retrospective analysis of metastatic lung...

lung cancer

Thoracic 2017: Proton Therapy Offers New Treatment Possibility for Recurrent Lung Cancer

A new study offers hope for patients with recurrent lung cancer, who historically have been considered ineligible for curative treatment. In the largest analysis to date of reirradiation using intensity-modulated proton therapy for lung and other thoracic tumors, more than three-fourths of patients ...

lung cancer

Thoracic 2017: Genetic Profile of Treatment-Resistant Lung Cancer More Variable Than Previously Thought

The genetic mutations underlying treatment resistance in non–small cell lung cancer (NSCLC) are more complex and dynamic than previously thought. Analysis of 355 biopsied tumors from patients who acquired resistance to epidermal growth factor receptor (EGFR) inhibitors, the most common form...

lung cancer

Thoracic 2017: Biomarker Test Shows Cancer Recurrence Months Before CT Scans

Results from a prospective clinical trial showed that a blood test looking at specific biomarkers was able to detect recurrences of lung cancer an average of 6 months before conventional imaging methods found evidence of recurrence. In the largest prospective clinical trial to date of circulating...

gynecologic cancers

SGO 2017: Hospital Readmission Metrics May Not Be an Ideal Measure in Ovarian Cancer Cases

To reduce costs and improve quality of care, the Centers for Medicare & Medicaid Services (CMS) has made reducing hospital readmission rates a priority, yet two research studies presented at the 2017 Society of Gynecologic Oncology (SGO) Annual Meeting on Women’s Cancer question the use...

gynecologic cancers

SGO 2017: New Immunotherapy Axalimogene Filoslisbac Shows Positive Results in Cervical Cancer

A new immunotherapy drug, axalimogene filoslisbac (AXAL), showed improved survival rates for patients with cervical cancer, according to a study presented at the 2017 Society of Gynecologic Oncology (SGO) Annual Meeting on Women’s Cancer. Study coauthor Charles Leath, MD, MSPH, an SGO member ...

lymphoma

FDA Approves Pembrolizumab for Relapsed or Refractory Classical Hodgkin Lymphoma in Adult and Pediatric Patients

The U.S. Food and Drug Administration (FDA) has approved pembrolizumab (Keytruda), an anti–PD-1 (programmed cell death protein 1) therapy, for the treatment of adult and pediatric patients who have refractory classical Hodgkin lymphoma or have relapsed after three or more prior lines of...

breast cancer

Researchers Find Evidence-Based Radiation Treatment After Lumpectomy Leads to High-Quality, High-Value Care

A new study demonstrates that the use of less radiation therapy for patients with breast cancer who have undergone lumpectomy does not negatively impact patient outcomes, and could result in significant reductions in health-care costs. These findings, which examine patient eligibility for...

breast cancer

Cancer Care Ontario and ASCO Clinical Practice Guideline: Use of Adjuvant Bisphosphonates and Other Bone-Modifying Agents in Breast Cancer

As reported in the Journal of Clinical Oncology by Dhesy-Thind, ofJuravinski Cancer Centre, Hamilton Health Sciences, and colleagues, Cancer Care Ontario and ASCO have issued a clinical practice guideline on the use of adjuvant bisphosphonates and other bone-modifying agents in breast cancer. The...

gynecologic cancers

Evidence of Stage Shift in Ovarian Cancer Detected in UK Screening Study

As reported in the Journal of Clinical Oncology, Rosenthal et al found evidence of a shift to an earlier stage among ovarian cancers detected in high-risk women in the UK Familial Ovarian Cancer Screening Study. Study Details The study was performed to evaluate performance of screening using...

leukemia

Blinatumomab vs Chemotherapy in Advanced Acute Lymphoblastic Leukemia

In the phase III TOWER trial reported in The New England Journal of Medicine, Kantarjian et al found that blinatumomab (Blincyto) treatment improved overall survival vs chemotherapy in heavily pretreated patients with B-cell precursor acute lymphoblastic leukemia (ALL). Blinatumomab received...

prostate cancer

Preclinical Study Finds SPOP Mutation Drives Prostate Cancer Subtype

A genetically engineered mouse model developed by Blattner et al investigating the role of the gene Speckle Type BTB/POZ Protein, or SPOP, as a driver of prostate cancer has found that the mutation drives prostate neoplasia through coordinate deregulation of both P13K/mTOR and androgen receptor...

prostate cancer

Use of Evidence-Based Prostate Cancer Imaging in an Integrated Health-Care System

In a study reported in the Journal of Oncology Practice, Salloum et al found that use of nonindicated imaging for diagnostic staging of low-risk prostate cancer in a nonprofit integrated health-care system remained common but has decreased in frequency. As noted by the authors: “The overuse...

breast cancer

Dutch Study Examines Effect of Internet-Based Cognitive Behavioral Therapy on Sexual Functioning in Breast Cancer Survivors

In a Dutch study reported in the Journal of Clinical Oncology, Hummel et al found that use of an Internet-based cognitive behavioral therapy intervention improved sexual functioning among breast cancer survivors. Study Details In the study, 169 women with a diagnosis of sexual dysfunction from 10 ...

lymphoma

Ibrutinib in Marginal Zone Lymphoma

On January 19, ibrutinib (Imbruvica) was granted accelerated approved for treatment of patients with marginal zone lymphoma who require systemic therapy and have received at least one prior anti-CD20–based therapy.1 Supporting Efficacy Data Approval was based on overall response rate in a...

cns cancers

Low-Grade Gliomas: Understanding the New Treatment Paradigm

Diffuse infiltrating low-grade gliomas include oligodendrogliomas and astrocytomas and account for about 5% of all primary brain tumors. Treatment strategies for these low-grade gliomas in adults have recently changed, as detailed in a recent review in the Journal of Oncology Practice.1 The...

head and neck cancer

Expert Point of View: Cornelius J.M. Melief, MD, PhD

Cornelius J.M. Melief, MD, PhD, Emeritus Professor at Leiden University Medical Center in the Netherlands and Chief Scientific Officer at ISA Pharmaceuticals, noted that toll-like receptors (TLRs) are useful in promoting immune activation in a variety of leukocytes and that the signaling pathways...

head and neck cancer

Novel Immunotherapy Added to Standard Care Did Not Meet Endpoint in Patients With Advanced Head and Neck Cancer

In the phase II Active8 trial, a novel immunotherapy agent, motolimod, failed to improve outcomes over chemotherapy plus cetuximab (Erbitux) in patients with recurrent or metastatic squamous cell carcinoma of the head and neck. In a post hoc analysis, however, patients with injection-site...

issues in oncology

Scientists Tackle Next Set of Immunotherapy Challenges

Cancer immunotherapy is about to get much more complicated. Just as oncologists are becoming familiar with checkpoint inhibitors and their growing indications, they will eventually be challenged with using them in novel combinations and in new tumor types. This will be the fruit that comes from...

hepatobiliary cancer

Can Antiviral Therapy Prevent Liver Cancer in Patients With Chronic Hepatitis?

Chronic viral hepatitis is a major causative factor for hepatocellular carcinoma, but antiviral therapy might reduce the incidence of hepatocellular carcinoma by preventing or eliminating chronic hepatitis infections, according to Adrian M. Di Bisceglie, MD, Professor of Internal Medicine at Saint ...

lung cancer
bladder cancer

Study Identifies How Cancer Cells May Develop Resistance to FGFR Inhibitors

A new study by researchers at The Ohio State University Comprehensive Cancer Center–Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC– James) has identified a mechanism by which cancer cells develop resistance to a class of drugs called fibroblast growth...

lung cancer

Osimertinib in EGFR Inhibitor–Pretreated T790M-Positive Advanced NSCLC

In the phase II extension component of the phase I/II AURA trial, reported by Yang et al in the Journal of Clinical Oncology, osimertinib (Tagrisso) was found to be highly active in epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor–pretreated T790M-positive advanced...

colorectal cancer

Clinical Trials Actively Recruiting Patients With Colorectal Cancer

Phase I Study Title: A Pilot Study of SGI-110 in Combination With an Allogeneic Colon Cancer Cell Vaccine and Cyclophosphamide in Metastatic Colorectal Cancer as Maintenance Therapy Study Type: Phase I/interventional/parallel assignment Study Sponsor and Collaborators: Sidney Kimmel Comprehensive...

gynecologic cancers

Expect Questions About the Cervical Cancer Mortality Study

A widely reported study found that cervical cancer mortality was higher and the racial disparity between black and white women greater than previously reported.1 The study omitted from the mortality estimates those women who had undergone hysterectomies, usually involving removal of the cervix....

gynecologic cancers

Cervical Cancer Mortality Is Higher and Racial Disparity Wider Than Previously Reported

Cervical cancer mortality rates were significantly higher, particularly among black women, when national data were corrected to exclude women who have had hysterectomies. For black women, the cervical cancer mortality rate rose from 5.7 to 10.1 per 100,000 when corrected for hysterectomy, an...

head and neck cancer

Immunotherapy for Head and Neck Cancer: ‘The Fourth Modality Has Arrived’

“This is a big deal. This is going to change all of oncology, not just head and neck cancer,”1 Tanguy ­Seiwert, MD, remarked following a summary by Jeffrey Sosman, MD, on advances in immunotherapy for treating cancer.2 Dr. Sosman, Director of the Melanoma Program and Clinical Director of Cancer...

2017 Oncology Meetings

MARCH ESMO Symposium on Signaling Pathways in Cancer 2017March 17-18 • Barcelona, SpainFor more information: http://esmo.org/Conferences/Signalling-Pathways-2017 17th Multidisciplinary Management of Cancers: A Case-Based ApproachMarch 17-19 • Napa, CaliforniaFor more...

lung cancer

Immunotherapy Challenges in Lung Cancer: From Patient Selection to Clinical and Financial Toxicity

Immunotherapy has been a major advance in lung cancer, but it is not without its challenges, according to Sanjay Popat, PhD, FRCP, a consultant medical oncologist and reader in cancer medicine at the Royal Marsden Hospital, London, UK. He reviewed some of the challenges pertaining to the use of...

issues in oncology

Potential Biomarker of Recurrent Venous Thromboembolism in Patients Receiving Anticoagulants

In a biomarker analysis of the CATCH trial reported in the Journal of Clinical Oncology, Alok A. Khorana, MD, of the Cleveland Clinic, and colleagues found that elevated circulating tissue factor levels were associated with an increased risk of recurrent venous thromboembolism in cancer patients on ...

breast cancer

Cancer Has Aged Me

The news that I had breast cancer came at an especially difficult time in my life and was quite shocking to hear. My father had died of lung cancer just 1 month before my diagnosis, and I was still grieving his death when I suddenly had to confront my own mortality. In retrospect, the diagnosis...

solid tumors
survivorship

Expert Point of View: Kevin C. Oeffinger, MD

Kevin C. Oeffinger, MD, Director of the Adult Long-Term Follow-up Program at Memorial Sloan Kettering Cancer Center, New York, highlighted the typical fat distribution of this population while noting the limitations of standard criteria for metabolic syndrome, which include waist circumference....

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

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 immunotherapy. This novel collaboration aims to rapidly support improved quality of care for the growing number of...

hematologic malignancies

Pacritinib Reduces Spleen Volume in Myelofibrosis

The investigational drug pacritinib met the primary endpoint of the phase III PERSIST-2 trial in high-risk patients with myelofibrosis and thrombocytopenia. Treatment with the Janus kinase (JAK)1/2 inhibitor pacritinib achieved a significant reduction in spleen volume compared with best available...

multiple myeloma

CAR T-Cell Therapy Emerging in Multiple Myeloma

For patients with multiple myeloma, chimeric antigen receptor (CAR) T-cell therapy is gaining ground in pilot studies. At the 2016 American Society of Hematology (ASH) Annual Meeting & Exposition, researchers presented their latest findings for this innovative therapy, which has proven...

lung cancer

A Decade of Lessons Learned From EGFR-Targeted Therapy

To summarize the lessons learned from the development of epidermal growth factor receptor (EGFR)-targeted therapy, one only has to go back about 10 years, according to Frances A. Shepherd, MD, Scott Taylor Chair in Lung Cancer Research at Princess Margaret Cancer Centre and Professor of Medicine at ...

lung cancer

Expert Point of View: David Planchard, MD, PhD, Luboš Petruželka, MD, PhD, and Clarissa ­Baldotto, MD, MSc

Three invited discussants explored the results of these recent immunotherapy studies in lung cancer as well as their potential clinical implications at the International Association for the Study of Lung Cancer 17th World Conference on Lung Cancer. KEYNOTE-021 trial “Pembrolizumab (Keytruda) is...

lung cancer

Immunotherapy Combinations Gain Traction in Lung Cancer

Combining immunotherapies with each other or with other agents such as chemotherapy and growth factor inhibitors holds promise for better tapping their benefit in patients with lung cancer, data from several studies suggest. Results show that strategic combinations can achieve higher response...

prostate cancer

Expert Point of View: Susan F. Slovin, MD, PhD

Formal discussant for the presentation of SWOG S9921 results, Susan F. Slovin, MD, PhD, a medical oncologist at Memorial Sloan Kettering Cancer Center, New York, said there were some important points to understand about this “vintage” trial.  “The trial was designed 20 years ago, and the view is...

prostate cancer

No Benefit From Older Standard-of-Care Drug in Adjuvant Chemotherapy for High-Risk Prostate Cancer, but Newer Trials Feasible

An older trial designed to evaluate the benefits of adjuvant therapy following radical prostatectomy in patients with high-risk prostate cancer showed no difference in overall or disease-free survival between 2 years of androgen-deprivation therapy and 2 years of androgen-deprivation therapy plus...

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