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issues in oncology

Pegfilgrastim-jmdb as Biosimilar to Pegfilgrastim to Decrease Risk of Infection During Cancer Treatment

On June 4, 2018, pegfilgrastim-jmdb (Fulphila) was approved as a biosimilar to pegfilgrastim (Neulasta) to decrease infection risk in patients with nonmyeloid cancer receiving myelosuppressive chemotherapy associated with a significant incidence of febrile neutropenia.1,2 Approval Basis Approval...

issues in oncology

Opportunities, Issues, and Challenges for Biosimilars in Oncology

In an article published recently in TheNew England Journal of Medicine, Gary H. Lyman, MD, MPH, FACP, FRCP (Edin), FASCO, of Fred Hutchinson Cancer Research Center in Seattle, and colleagues reviewed opportunities, issues, and challenges posed by the advent of biosimilar medications, focusing on...

solid tumors
lung cancer

New LUNGevity Foundation Campaign Launched

LUNGevity Foundationhas announced the launch of a new lung cancer awareness campaign called 234. The social media campaign utilizes graphic animation to engage the public in understanding facts about lung cancer. “Our goal with the 234 campaign is to educate the general public about the...

solid tumors
prostate cancer

When Can Patients With Gleason 6 Prostate Cancer Safely Undergo Active Surveillance?

Prior to ASCO’s 2016 endorsement of the Cancer Care Ontario (CCO) guideline on active surveillance in the management of localized prostate cancer,1 most men—over 90%—diagnosed with low-risk localized disease were treated with active therapy.2 Today, about 50% of American men with low-risk disease...

health-care policy
cost of care

Cost Differences in Chemotherapy Administration by Site

Critics of health-care consolidation have cited higher costs of chemotherapy administration as an example of how mergers drive up costs. A new study by Kalidindi et al in The American Journal of Managed Care found that although drug administration costs in hospitals are higher,...

cns cancers
issues in oncology

Pediatric CT Scans and Subsequent Malignancy Risk

A new study by Meulepas et al in the Journal of the National Cancer Institute suggests that computed tomography (CT) scans may increase the risk of brain tumors. The use of CT scans has increased dramatically over the past 2 decades. CT scans greatly improve diagnostic capabilities,...

hepatobiliary cancer
immunotherapy

FDA Grants Breakthrough Therapy Designation for Atezolizumab/Bevacizumab Combination as First-Line Treatment for Advanced or Metastatic HCC

The U.S. Food and Drug Administration (FDA) recently granted Breakthrough Therapy designation for atezolizumab (Tecentriq) in combination with bevacizumab (Avastin) as a first-line treatment for people with advanced or metastatic hepatocellular carcinoma (HCC), the most common form of liver...

integrative oncology

Acupressure for Cancer-Related Fatigue

Difficult-to-treat, cancer-related fatigue is a common, distressing clinical issue. It impedes daily activities, severely affecting patients’ quality of life. Compounding the problem is a lack of consensus on an effective pharmacologic intervention. Acupressure is a traditional Chinese medicine...

breast cancer

Olaparib for Germline BRCA-Mutated Metastatic Breast Cancer

EARLY IN 2018, olaparib tablets (Lynparza) were granted regular approval for treatment of patients with deleterious or suspected deleterious germline BRCA-mutated, HER2-negative metastatic breast cancer who have been treated with chemotherapy in the neoadjuvant, adjuvant, or metastatic setting.1,2...

hematologic malignancies

Answers to Hematology Expert Review Questions

Question 1  Which of the following is one of the four major criteria for the diagnosis of essential thrombocythemia?  Correct Answer: A. Platelet count ≥ 450 × 109/L.  Expert Perspective  The diagnosis of essential thrombocythemia requires that all four major criteria or the first three major...

hematologic malignancies

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...

prostate cancer

Abiraterone Plus Prednisone in High-Risk Metastatic Castration-Sensitive Prostate Cancer

EARLY IN 2018, abiraterone acetate tablets (Zytiga) in combination with prednisone were approved for the treatment of metastatic high-risk castration-sensitive prostate cancer.1,2  Supporting Efficacy Data  APPROVAL WAS based on the findings of the phase III LATITUDE trial, in which 1,199 patients...

Four Generations of Doctors, One Oncologist, in the Family of Hanna K. Sanoff, MD, MPH

Medicine is a family tradition for Hanna K. Sanoff, MD, MPH. “I was born and reared in a suburb just outside of Philadelphia and lived there my whole life until after college. I was one of those people who always knew they wanted to be a doctor. There were four generations of physicians on my...

solid tumors

Risk of Cancer After Treatment of Testicular Germ Cell Cancer

In a Dutch study reported in the Journal of Clinical Oncology, Groot et al found that the risk of subsequent malignant neoplasms was increased in the long-term follow up of patients receiving cisplatin or radiotherapy for testicular germ cell cancer. Risk vs General Population The study involved...

symptom management
immunotherapy

Delayed Skin Effects of Anti–PD-1 Therapy

Patients with cancer receiving anti–programmed cell death protein 1 (anti–PD-1) therapies who develop lesions, eczema, psoriasis, or other forms of autoimmune diseases affecting the skin may experience those adverse reactions on a delay—sometimes even after treatment has...

colorectal cancer

By Sending Tests by Mail, Researchers Boost Colorectal Cancer Screening Rates Among Medicaid Patients

Mailing colorectal cancer screening tests to patients insured by Medicaid increased screening rates for this population, reported researchers at the University of North Carolina (UNC) Lineberger Comprehensive Cancer Center. In collaboration with the Mecklenburg County Health Department in...

gynecologic cancers
health-care policy

Study Evaluates Effects of Affordable Care Act on Young Women With Gynecologic Cancer

The gains in insurance coverage with the Patient Protection and Affordable Care Act (ACA) have already translated into improved health for young women with gynecologic cancers, who are getting diagnosed at earlier stages of their disease because of ACA benefits. That’s the conclusion of a new ...

prostate cancer

Prostate-Specific Membrane Antigen–Targeted Docetaxel Nanoparticle in Metastatic Castration-Resistant Prostate Cancer

In a phase II trial reported in JAMA Oncology, Autio et al found that prostate-specific membrane antigen (PSMA)–targeted docetaxel nanoparticle (BIND-014) treatment was active in patients with metastatic castration-resistant prostate cancer (mCRPC). Study Details In the multicenter trial,...

lung cancer

Brain Metastases in ROS1-Positive Lung Cancer and Treatment With Crizotinib

A study published by Patil et al in the Journal of Thoracic Oncology explores the occurrence and treatment of brain metastases in stage IV ROS1-positive non–small cell lung cancer. ROS1-Positive Disease vs Other Genetic Mutations Importantly, and in contrast with the findings ...

multiple myeloma

Phase III TOURMALINE-MM3 Trial of Ixazomib as Maintenance Therapy in Patients With Multiple Myeloma Posttransplant

The randomized, phase III TOURMALINE-MM3 study met its primary endpoint, demonstrating single-agent oral ixazomib (Ninlaro) as a maintenance therapy resulted in a statistically significant improvement in progression-free survival (PFS) vs placebo. The trial evaluated the effect of ixazomib as a...

issues in oncology

In Cases Where Early Detection of Metastatic Disease Offers No Advantage, Why Conduct Routine Surveillance?

“What is a reasonable plan of follow-up for patients with cancers for which early detection of metastatic disease offers no advantage?” Posing that question during his Presidential Address at the 2018 Society of Surgical Oncology (SSO) Annual Cancer Symposium, Kelly M. McMasters, MD,PhD,...

hematologic malignancies
leukemia

NCCN Releases New Guidelines for Patients With AML

The National Comprehensive Cancer Network® (NCCN®) has recently released The NCCN Guidelines for Patients with Acute Myeloid Leukemia (AML), which includes resources for better-informed medical decision-making. The NCCN Guidelines for Patients with AML is endorsed by the Aplastic Anemia and MDS...

solid tumors
head and neck cancer

Study Finds Gender Disparities in Head and Neck Cancer Treatment and Outcomes

An analysis of cancer registry data from a California hospital system showed that women with head and neck cancer were less likely to receive intensive chemotherapy (35% vs 46%) and radiation (60% vs 70%) compared to men. Controlling for factors such as age and serious medical conditions, a...

issues in oncology

In Case You Missed It: Short Takes on Current Cancer Research

It would be impossible to cover all of the important presentations from the 5,000-plus abstracts accepted for the 2018 ASCO Annual Meeting. In addition to our regular meeting coverage of the top news stories, the following highlights focus on novel investigational approaches to therapy for various...

solid tumors
breast cancer

Oral Taxane Shows Strong Activity and Good Tolerability in Metastatic Breast Cancer

As first-line treatment for metastatic breast cancer, the oral taxane tesetaxel produced a 45% confirmed response rate and was well tolerated, producing little alopecia or neuropathy, according to Andrew D. Seidman, MD, and colleagues from several cancer centers. Dr. Seidman, of Memorial Sloan...

Expert Point of View: Shannon Westin, MD

Shannon Westin, MD, Associate Professor, Department of Gynecologic Oncology and Reproductive Medicine at The University of Texas MD Anderson Cancer Center, Houston, served as an ASCO expert for the press briefing and made several comments. “What we’re learning is that among tumors with...

palliative care
colorectal cancer
lung cancer
cost of care

Geographic Differences in End-of-Life Cancer Care

When it comes to how much end-of-life care a patient with cancer receives, geography may, indeed, be destiny, according to new research led by Harvard Medical School that found differences in this type of cancer care across different parts of the country. The findings, published by Keating et al...

breast cancer

FDA Expands Ribociclib Indication in Hormone Receptor–Positive, HER2-Negative Advanced or Metastatic Breast Cancer

Today, the U.S. Food and Drug Administration (FDA) expanded the indication for ribociclib (Kisqali) in combination with an aromatase inhibitor for premenopausal or perimenopausal women with hormone receptor–positive, HER2-negative advanced or metastatic breast cancer as initial...

issues in oncology
genomics/genetics

MSI-High Status and Lynch Syndrome Found in Surprising Variety of Cancers

In a study that many consider to be practice-changing, Lynch syndrome, a hereditary cancer predisposition syndrome, was found in many persons who would not ordinarily be suspected of having it.1 The study, which was presented at the 2018 ASCO Annual Meeting, has implications for broader testing...

lymphoma

Progression-Free Survival as Surrogate for Overall Survival in First-Line Treatment of DLBCL

In an individual patient-level analysis reported in the Journal of Clinical Oncology, Shi et al found that progression-free survival could serve as a surrogate endpoint for overall survival in the first-line treatment of diffuse large B-cell lymphoma (DLBCL). The study involved data from 7,507...

hepatobiliary cancer

Cabozantinib vs Placebo in Advanced Hepatocellular Carcinoma Previously Treated With Sorafenib

As reported in The New England Journal of Medicine by Abou-Alfa and colleagues, the second interim analysis of the phase III CELESTIAL trial has shown a significant improvement in overall and progression-free survival with cabozantinib (Cabometyx) vs placebo in patients with sorafenib...

Expert Point of View: David Graham, MD, FASCO and Richard Schilsky, MD, FACP, FASCO, FSCT

ASCO expert David Graham, MD, FASCO, of the Levine Cancer Institute in Charlotte, North Carolina, was encouraged by the IMpower131 findings. “This is one more example of how immunotherapy is making steady gains against a number of cancers. Immunotherapy has been shown to be effective in other...

lung cancer
immunotherapy

Atezolizumab Plus Chemotherapy Extends Survival in Squamous NSCLC Regardless of PD-L1 Level

Patients with advanced squamous non–small cell lung cancer (NSCLC) had a greater benefit from first-line treatment with the combination of atezolizumab (Tecentriq) plus chemotherapy vs chemotherapy alone in the randomized, phase III, IMpower131 clinical trial.1 At the landmark of 12-month...

breast cancer

8-Year Update of SOFT and TEXT Trials: Positive but Not Definitive

At the 2017 San Antonio Breast Cancer Symposium (SABCS), the International Breast Cancer Study Group (IBCSG) and its collaborators presented the 8-year updates of the key modern trials of ovarian function suppression after local treatment for young women with resected breast cancer.1 These updates...

Expert Point of View: Selma Ugurel, MD

Selma Ugurel, MD, of the Skin Cancer Center Essen at the University of Duisburg-Essen, Germany, discussed the Merkel cell carcinoma presentations at the 2018 ASCO Annual Meeting. “Immunotherapy is of high interest in Merkel cell because of the high immunogenicity of the tumor—viral-induced and...

skin cancer
immunotherapy

Immunotherapy in Merkel Cell Carcinoma: ‘Field Has Been Thrown on Its Head’

At the 2018 ASCO Annual Meeting, investigators presented long-term follow-up data for immunotherapy in patients with Merkel cell carcinoma and new data for its use in the neoadjuvant setting. The results drew high interest from attendees and a number of questions were raised following the...

Expert Point of View: Colin D. Weekes, MD, PhD and Manish A. Shah, MD, FASCO

Two pancreatic cancer specialists commented on the PREOPANC-1 study for The ASCO Post: Colin D. Weekes, MD, PhD, of Massachusetts General Hospital and Harvard Medical School, Boston, who had discussed the abstract at the ASCO Annual Meeting, and Manish A. Shah, MD, FASCO, Chief of the Solid Tumor...

solid tumors
pancreatic cancer

Preliminary Data Suggest Neoadjuvant Chemoradiotherapy May Improve Outcomes in Patients With Early Stages of Pancreatic Cancer

For patients with newly diagnosed, potentially resectable pancreatic cancer, neoadjuvant chemoradiotherapy led to better outcomes when compared with immediate surgery followed by chemoradiotherapy in the phase III PREOPANC-1 trial. Approximately 25% fewer deaths occurred among patients in the...

pancreatic cancer

Early Study Shows Elasticity of Cancer Cells May Determine Where Pancreatic Cancer Metastases Form

Pancreatic cancer often metastasizes to the liver or lungs. The prognosis is better for patients with metastases in the lungs. However, the organ that is more likely to be affected depends on the cancer cells’ ability to alter their characteristics and shape—as a research team at the...

palliative care
issues in oncology

Palliative Care Preferences in Male Patients With Cancer

Men with advanced cancer are 30% less likely than women to consider palliative care, according to a University of Rochester Medical Center (URMC) study. Researchers believe the findings reflect social norms about gender roles, as well as widespread messages in the media and society about...

skin cancer

Human Papillomavirus Vaccine in Cutaneous Basaloid Squamous Cell Carcinomas

Squamous cell carcinoma is the second-most-common form of skin cancer. Evidence suggests the human papillomavirus (HPV) plays a role in the development of some types of this skin cancer. Two years ago, a 97-year-old woman whose right leg was covered with squamous cell tumors went to see...

breast cancer

ASCO Clinical Practice Guideline Update: Systemic Therapy for Patients With Advanced HER2-Positive Breast Cancer

As reported in the Journal of Clinical Oncology by Sharon H. Giordano, MD, of The University of Texas MD Anderson Cancer Center, and colleagues, ASCO has released a clinical practice guideline update on systemic therapy for patients with advanced HER2-positive breast cancer. The guideline update...

cns cancers
skin cancer
immunotherapy

First-Line Treatment With Checkpoint Inhibitors in Patients With Melanoma Brain Metastases

An analysis of newly diagnosed patients with cutaneous melanoma brain metastases treated with checkpoint blockade immunotherapy has found the treatment was associated with an increase in median overall survival of 12.4 months compared with 5.2 months—a 1.4-fold improvement. The benefit was...

issues in oncology
pain management

Statement by FDA Commissioner on Opioid Access for Patients With Chronic and End-of-Life Pain

U.S. Food and Drug Administration (FDA) Commissioner Scott Gottlieb, MD, recently issued the following statement. The opioid epidemic continues to take an emotional, physical, and financial toll on Americans. The FDA is committed to taking every possible step to address the many facets of this...

issues in oncology

ESHRE 2018: Early-Stage Research Shows Potential of Artificial Ovary for Fertility Preservation Without the Risk of Reintroducing Malignancy

Important steps in the development of an artificial ovary have been successfully completed. Researchers from the Rigshospitalet in Copenhagen, Denmark, reported that they have—for the first time—isolated and grown human follicles to a point of biofunctionality on a bioengineered ovarian ...

solid tumors

PDL1 Amplification in Solid Tumors

In a study reported in JAMA Oncology, Goodman et al found amplification of PDL1 genes in 0.7% of solid tumors, including more than 100 tumor types. Response to checkpoint inhibition was high in a small group of patients with PDL1 amplification. Prevalence of PDL1 Amplification The study included...

lung cancer
immunotherapy

FDA Accepts sBLA for Pembrolizumab in Combination With Chemotherapy as First-Line Treatment for Metastatic Squamous NSCLC

The U.S. Food and Drug Administration (FDA) has accepted for review a supplemental biologics license application (sBLA) for pembrolizumab (Keytruda) in combination with carboplatin/paclitaxel or nab-paclitaxel (Abraxane) as a first-line treatment for metastatic squamous non–small cell lung...

pancreatic cancer

Study Finds Inherited Gene Variants in 10% of Patients With Pancreatic Cancer

A large study of pancreatic cancer patients found that almost 10% harbored inherited genetic variations or mutations that may have increased their susceptibility to the disease. At the same time, some of these mutations were associated with more favorable responses to certain chemotherapy agents,...

solid tumors
immunotherapy

Pembrolizumab in Platinum-Refractory or Relapsed Thymic Epithelial Tumors

In a Korean single-center phase II study reported in the Journal of Clinical Oncology, Cho et al found that pembrolizumab (Keytruda) was active in advanced thymic epithelial tumors progressing after platinum-based chemotherapy. Study Details The study included 26 patients with thymic carcinoma...

ASCO Supports NCI-Designated Cancer Centers’ Goal of Eliminating HPV-Related Cancers

ASCO HAS officially endorsed a statement by the 70 National Cancer Institute (NCI)-designated cancer centers calling for increased human papillomavirus (HPV) vaccination and screening to eliminate HPV-related cancers. The full uptake of the vaccine and screening could prevent 12,000 cervical...

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