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hematologic malignancies
palliative care

Palliative Care Still in Its Infancy in Hematologic Malignancies

Palliative care is slowly but surely being integrated into the treatment of patients with solid tumors, but its role in the hematopoietic stem cell transplant setting is still lagging, speakers said at the 2016 Palliative Care in Oncology Symposium. “There is a huge symptom burden among patients...

leukemia

Donor Selection for HLA-Matched Hematopoietic Cell Transplantation

Question 1: Which statement about donor selection for allogeneic hematopoietic cell transplant is correct? Correct Answer: C. If a donor is available, the genotypic identity between the patient and his brother should be established by typing the patient’s parents; if this is not possible, the...

leukemia

Donor Selection for HLA-Matched Hematopoietic Cell Transplantation

Case Study A 33-year-old white male is diagnosed with acute myeloid leukemia (AML) with complex cytogenetics. A decision is made in favor of performing allogeneic hematopoietic cell transplantation in first complete remission. The patient has a 35-year-old brother who is healthy and motivated to...

integrative oncology

Bromelain

Scientific Names: Sulfydryl proteolytic enzyme, cysteine proteinase Common Names: Ananase, Dayto Anase, Traumanase Overview Derived from the fruits and stems of pineapples, bromelain is a proteolytic enzyme that is used to treat burns and skin conditions, and as an anti-inflammatory agent....

head and neck cancer

Rise in Oropharyngeal Cancer Incidence in the UK Not Solely Driven by HPV

The rise in the incidence of oropharyngeal squamous cell carcinoma in the United Kingdom from 2002 to 2011 was not solely attributable to a rise in the incidence of human papillomavirus (HPV)-positive disease, according to a study published in Cancer Research,1 which reported that the proportion of ...

colorectal cancer

ESMO 2016: Dabrafenib/Trametinib/Panitumumab Improves Efficacy in BRAF Mutation–Positive Metastatic Colorectal Cancer

Patients with metastatic colorectal cancer and tumors harboring the BRAF V600E mutation who received triple therapy with dabrafenib (Tafinlar), trametinib (Mekinist), and panitumumab (Vectibix) showed an improved best overall response and prolonged progression-free survival compared to...

solid tumors
hematologic malignancies

ESMO 2016: Vemurafenib Shows Clinical Benefit in Diverse BRAF V600–Mutated Tumors

Findings from a phase II trial of vemurafenib in previously treated patients with advanced disease and BRAF-mutated tumors indicate that the drug is effective in patients with diverse BRAF V600­–mutated tumors but not in patients with BRAF non-V600 mutations. After a mean treatment...

skin cancer

Personalized Vaccines May Protect Patients With High-Risk Melanoma

The field of cancer vaccines may be reinvigorated by a new understanding, and the therapeutic leveraging, of neoantigens. Researchers from Dana-Farber Cancer Institute in Boston are exploring this novel approach as a means of protecting patients with high-risk melanoma from recurrence. Early...

skin cancer

Association of PD-L1 Expression and Response to Pembrolizumab in Advanced Melanoma

In an analysis from the phase IB KEYNOTE-001 trial, Daud et al found that the level of programmed cell death ligand 1 (PD-L1) expression was associated with outcomes of pembrolizumab (Keytruda) treatment in patients with advanced melanoma. These findings were reported in the Journal of Clinical...

head and neck cancer

Study Finds Nivolumab Improves Survival vs Standard Therapy in Recurrent Squamous Cell Carcinoma of the Head and Neck

In the phase III CheckMate 141 trial reported in The New England Journal of Medicine, Ferris et al found that nivolumab (Opdivo) increased overall survival vs standard therapies in patients with recurrent platinum-refractory squamous cell carcinoma of the head and neck. Study Details In this...

gynecologic cancers

What We Know and What We Need to Know About Neoadjuvant Chemotherapy in Advanced Ovarian Cancer

Ever since the landmark studies of Griffiths and colleagues in the 1970s,1 primary cytoreductive surgery followed by chemotherapy with the objective of achieving minimal residual disease has been the standard approach for women with advanced-stage epithelial ovarian cancer. However, what is...

gynecologic cancers

SGO and ASCO Clinical Practice Guideline on Neoadjuvant Chemotherapy for Newly Diagnosed Advanced Ovarian Cancer

As reported by Alexi A. Wright, MD, MPH, of Dana-Farber Cancer Institute, and colleagues in the Journal of Clinical Oncology, ASCO and the Society of Gynecologic Oncology (SGO) have released a clinical practice guideline on neoadjuvant therapy for patients with newly diagnosed stage IIIC or IV...

Expert Point of View: Olivier Michielin, MS, MD, PhD

The paper’s invited discussant was Olivier Michielin, MS, MD, PhD, Head of Personalized Analytical Oncology and the Melanoma Clinic at Lausanne University Hospital in Switzerland. He called the findings of the European Organisation for Research and Treatment (EORTC) 18071 trial a “new landmark in...

skin cancer

Adjuvant Ipilimumab Improves Survival in High-Risk Melanoma

Patients with stage III melanoma who were considered to be at high risk for recurrence derived an overall survival benefit from adjuvant treatment with ipilimumab (Yervoy), although it came at the price of considerable toxicity, according to updated survival results from the phase III European...

breast cancer
supportive care

Consensus on Defining and Measuring Lymphedema Is Needed to Advance Efforts to Intervene Early and Prevent Progression

“Early intervention might prevent lymphedema progression,” Alphonse Taghian, MD, PhD, said at the 18th Annual Lynn Sage Breast Cancer Symposium in Chicago, but the lack of a universal definition of lymphedema and agreement on how to optimally measure it impedes phase III studies to test that...

kidney cancer

Study Finds Adjuvant Sunitinib Improves Disease-Free Survival in High-Risk Renal Cell Carcinoma After Nephrectomy

In the phase III S-TRAC trial reported at the 2016 European Society for Medical Oncology Congress and in The New England Journal of Medicine by Ravaud et al, adjuvant sunitinib (Sutent) significantly prolonged disease-free survival vs placebo in patients with high-risk renal cell carcinoma after...

skin cancer

ESMO 2016: Pooled Analysis Shows PD-L1 Expression as a Biomarker for Nivolumab Plus Ipilimumab Response in Advanced Melanoma

A pooled analysis from three clinical trials in advanced melanoma shows that although patients treated with nivolumab and nivolumab plus ipilimumab with ≥ 5% programmed death-ligand 1 (PD-L1) tumor expression have similar progression-free survival, durable response rates were higher for the...

cns cancers

Stereotactic Radiosurgery Achieves Better Quality of Life and Improved Cognition Than Whole-Brain Radiotherapy

Two separate randomized trials presented at the 58th Annual Meeting of the American Society of Radiation Oncology (ASTRO) affirmed the value of stereotactic radiosurgery as an option for postoperative treatment of the surgical cavity of resected brain metastases, potentially avoiding the cognitive...

prostate cancer

Safety of Extreme Hypofractionation Reassuring in Intermediate-Risk Prostate Cancer

Giving patients larger fractions of radiation over shorter periods (ie, hypofractionation) is gaining ground in several types of cancers. This approach is attractive for patients’ convenience, shortening treatment and travel times, and also for resource utilization. Several studies have shown that ...

lung cancer
skin cancer
kidney cancer

Modification of Dosage Regimen for Nivolumab in Renal Cell Carcinoma, Melanoma, and NSCLC

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On September 13, 2016, the U.S. Food and Drug Administration...

skin cancer

Investigational Immunotherapy Appears Safe and Somewhat Active in Advanced Melanoma

The investigational immunotherapeutic IMC-20D7S was found to be well tolerated and somewhat active in patients with advanced melanoma, including one complete response, according to the results of a phase I/Ib trial reported by Khalil et al in Clinical Cancer Research.  IMD-20D7S is a...

lung cancer

Atezolizumab Approved for the Treatment of Metastatic NSCLC That Has Progressed During or After Platinum-Containing Therapy

On October 18, 2016, the U.S. Food and Drug Administration (FDA) approved atezolizumab (Tecentriq) for the treatment of patients with metastatic non–small cell lung cancer (NSCLC) whose disease progressed during or following platinum-containing chemotherapy. Patients with EGFR or ALK genomic...

breast cancer

New SSO-ASTRO-ASCO Clinical Practice Guideline Clarifies the Question of Margins for Breast-Conserving Surgery in Ductal Carcinoma in Situ

In 2014, the Society of Surgical Oncology (SSO) and the American Society for Radiation Oncology (ASTRO) published a “Consensus Guideline on Margins for Breast-Conserving Surgery With Whole-Breast Irradiation in Stages I and II Invasive Breast Cancer.”1 A multidisciplinary expert guideline used a...

breast cancer

Margins for Breast-Conserving Surgery With Whole-Breast Irradiation in Ductal Carcinoma in Situ

A clinical practice guideline on margins for breast-conserving surgery with whole-breast irradiation in ductal carcinoma in situ has been jointly developed by the Society of Surgical Oncology (SSO), the American Society for Radiation Oncology (ASTRO), and ASCO.1-3 The recommendations were...

issues in oncology

‘Dear Presidential Candidates’: A Letter From an Oncologist

Dear Presidential Candidates: Wouldn’t it be great if history’s Alexander the Great was actually Dr. Alexander Fleming, the doctor-scientist who saved millions of lives by discovering penicillin, rather than the other Alexander, who conquered and killed thousands of innocent people? Wouldn’t it be...

breast cancer

Study Shows Strong Evidence Supporting Radiation Boost to Tumor Bed in Ductal Carcinoma in Situ

A radiation boost to the local tumor bed following treatment with breast-conserving therapy (ie, local excision followed by whole-breast radiation therapy) improves local control for patients with ductal carcinoma in situ, according to a study of pooled data from 10 academic centers,1 presented at...

prostate cancer

Study Finds PFS Benefit, but No Overall Survival Benefit, for Ipilimumab in Metastatic Castration-Resistant Prostate Cancer

Ipilimumab (Yervoy) was associated with prolonged progression-free survival—but not overall survival—compared with placebo in men with asymptomatic or minimally symptomatic chemotherapy-naive metastatic castration-resistant prostate cancer without visceral metastases, according to a...

lung cancer

Adding Pembrolizumab to Carboplatin/Pemetrexed Seems to Improve Response in Advanced Nonsquamous NSCLC

As reported by Langer et al in The Lancet Oncology, findings in a phase II cohort of the multicohort KEYNOTE-021 study showed that the addition of first-line pembrolizumab (Keytruda) to carboplatin/pemetrexed (Alimta) significantly increased the response rate in patients with advanced nonsquamous...

multiple myeloma

Does Adding Daratumumab to Lenalidomide/Dexamethasone Improve Outcomes in Previously Treated Multiple Myeloma?

The addition of the CD38-targeted antibody daratumumab (Darzalex) to lenalidomide (Revlimid)/dexamethasone improved progression-free survival in patients with previously treated multiple myeloma, according to the results of the phase III POLLUX trial reported by Dimopoulos et al in The New England...

breast cancer

Combination of Ribociclib and Letrozole Improved Progression-Free Survival in Hormone Receptor–Positive Advanced Breast Cancer

The combination of the selective CDK4/6 inhibitor ribociclib plus letrozole significantly improved progression-free survival in hormone receptor–positive advanced breast cancer. When ribociclib was added to letrozole, progression-free survival improved by 44% compared with letrozole alone,...

lung cancer

ESMO 2016: First-Line Pembrolizumab Plus Chemotherapy Significantly Improves Outcomes in Advanced NSCLC

The addition of the programmed cell death protein 1 (PD-1) antibody pembrolizumab (Keytruda) to standard first-line chemotherapy for treatment-naive advanced non–small cell lung cancer significantly improves response rates and progression-free survival, Langer et al reported at the 2016...

kidney cancer

Is Nivolumab Active in Recurrent Advanced Urothelial Carcinoma?

In the phase I/II CheckMate 032 trial reported in The Lancet Oncology, Sharma et al found that nivolumab (Opdivo) was active in locally advanced or metastatic urothelial carcinoma progressing after platinum-based therapy. In the study, 78 patients with urothelial carcinoma of the renal pelvis,...

lung cancer

Intensity-Modulated vs 3D Conformal External-Beam Radiation Therapy in Locally Advanced Non–Small Cell Lung Cancer

In a secondary analysis from the NRG Oncology RTOG 0617 trial reported in the Journal of Clinical Oncology, Chun et al found that use of intensity-modulated vs three-dimensional (3D) conformal external-beam radiation therapy was associated with a reduced risk for severe pneumonitis and reduced the...

skin cancer

Adjuvant Ipilimumab Prolongs Survival in High-Risk Stage III Melanoma, Phase III Study Reports

In the phase III European Organisation for Research and Treatment of Cancer (EORTC) trial 18071 reported at the recent European Society for Medical Oncology meeting and in The New England Journal of Medicine by Eggermont et al, adjuvant ipilimumab (Yervoy) was found to improve recurrence-free and...

skin cancer

Paolo A. Ascierto, MD, on Metastatic Melanoma: Ipilimumab Study Results (Italian Language Version)

Paolo A. Ascierto, MD, of the Istituto Nazionale Tumori–Fondazione Pascale, discusses in Italian overall survival and safety results from a phase 3 trial of ipilimumab at 3 mg/kg vs 10 mg/kg in patients with metastatic melanoma. (Abstract 1106O)

breast cancer

Genetic Markers Associated With Pathologic Complete Response to Neoadjuvant Therapy Identified in HER2-Positive Breast Cancer

In an analysis reported in JAMA Oncology, Fumagalli et al identified genetic markers associated with pathologic complete response among women with early-stage HER2-positive breast cancer receiving neoadjuvant therapy in the phase III NeoALTTO trial. Study Details In the NeoALTTO trial, 455...

lung cancer

First-Line Pembrolizumab Improves Survival vs Platinum-Based Chemotherapy in Advanced PD-L1–Positive NSCLC

Pembrolizumab (Keytruda) significantly improved progression-free and overall survival vs platinum-based chemotherapy in patients with previously untreated advanced non–small cell lung cancer (NSCLC) with ≥ 50% PD-L1 (programmed cell death ligand 1) expression and no sensitizing EGFR...

palliative care

ESMO 2016: Researchers Identify Factors Associated With End-of-Life Chemotherapy Use

The rates of administering chemotherapy to patients with solid cancers within a month of succumbing to their disease remain high, which calls for a paradigm shift to consider initiating palliative care at an earlier stage and formulating clear guidelines for end-of-life care, according to findings...

breast cancer

ESMO 2016: Antitumor Activity Demonstrated With Lurbinectedin in Patients With Metastatic Breast Cancer and BRCA Mutations

Lurbinectedin showed promising clinical benefit in pretreated patients with metastatic breast cancer and BRCA1 or BRCA2 mutations, including patients previously treated with platinum, according to phase II trial results presented by Balmaña et al at the 2016 European Society for Medical...

colorectal cancer

Massachusetts Health Insurance Expansion Associated With Increased Resection and Reduced Emergent Resection for Colorectal Cancer

In a study reported in the Journal of Clinical Oncology, Loehrer et al found that the 2006 Massachusetts health-care reform has resulted in increased rates of resection and reduced emergent resection for colorectal cancer. The study used the Hospital Cost and Utilization Project State Inpatient...

gynecologic cancers

Study Finds Niraparib Maintenance Improves Progression-Free Survival in Platinum-Sensitive Recurrent Ovarian Cancer

In a phase III trial reported at the recent European Society for Medical Oncology Congress and in The New England Journal of Medicine by Mirza et al, maintenance therapy with the PARP (poly ADP ribose polymerase) 1/2 inhibitor niraparib significantly prolonged progression-free survival vs placebo...

kidney cancer

ESMO 2016: Cabozantinib Improves Progression-Free Survival in Metastatic Renal Cell Carcinoma

Cabozantinib (Cabometyx, Cometriq) significantly improves progression-free survival and response rate in patients with metastatic renal cell carcinoma compared to sunitinib (Sutent), according to research presented by Choueiri et al at the 2016 European Society for Medical Oncology (ESMO)...

breast cancer

First-Line Ribociclib Prolongs Progression-Free Survival in Hormone Receptor–Positive, HER2-Negative Advanced Breast Cancer

In a phase III trial reported at the recent European Society for Medical Oncology Congress and in The New England Journal of Medicine by Hortobagyi et al, first-line treatment with ribociclib, a selective inhibitor of cyclin-dependent kinases 4 and 6 (CDK4/6), resulted in significantly longer...

lung cancer

ESMO 2016: Ceritinib Provides Longer Progression-Free Survival Than Chemotherapy in Phase III Trial of ALK-Rearranged Lung Cancer Treatment

Ceritinib (Zykadia) provides longer progression-free survival than chemotherapy in crizotinib–pretreated patients with non–small cell lung cancer harboring an ALK rearrangement, according to results of the phase III ASCEND-5 study presented by Scagliotti et al at the European Society...

kidney cancer

Does Adding IMA901 Vaccine to Sunitinib Improve Survival in Advanced Renal Cell Carcinoma?

In the phase III IMPRINT trial reported in The Lancet Oncology, Rini et al found no overall survival benefit of adding the multipeptide cancer vaccine IMA901 to sunitinib (Sutent) in the first-line treatment of locally advanced or metastatic renal cell carcinoma. IMA901 contains 10 tumor-associated ...

lung cancer

ESMO 2016: Significant Survival Gains With Atezolizumab vs Docetaxel for Non–Small Cell Lung Cancer

The first phase III study of programmed cell death ligand 1 (PD-L1) inhibitor atezolizumab (Tecentriq) in previously treated non–small cell lung cancer has seen significant improvements in survival compared to standard chemotherapy, reported Barlesi et al at the European Society for Medical...

kidney cancer

ESMO 2016: Longer Disease-Free Survival in Phase III Trial of Sunitinib as Adjuvant Treatment for Kidney Cancer

A phase III trial of sunitinib (Sutent) has met its primary endpoint of disease-free survival for adjuvant treatment of high-risk renal cell carcinoma after nephrectomy, reported Ravaud et al at the European Society for Medical Oncology (ESMO) 2016 Congress in Copenhagen (Abstract LBA11_PR)....

leukemia

Study Indicates Safety of Stopping Imatinib in CML With Undetectable Minimal Residual Disease for at Least 2 Years

As reported in the Journal of Clinical Oncology by Etienne et al, long-term follow-up in the French Stop Imatinib (STIM1) study indicates imatinib can be safely stopped in patients with chronic myeloid leukemia (CML) with undetectable minimal residual disease sustained for at least 2 years. Study...

lung cancer

ESMO 2016: Pembrolizumab a New Option for First-Line Treatment of Patients With Advanced Lung Cancer and High PD-L1 Expression

Pembrolizumab (Keytruda) is set to become a new option for first-line treatment of patients with advanced lung cancer and high programmed cell death ligand 1 (PD-L1) expression, according to the results of the phase III KEYNOTE-024 trial presented by Reck et al at the 2016 European Society for ...

gynecologic cancers

ESMO 2016: Niraparib Significantly Improves Outcomes in Platinum-Sensitive Recurrent Ovarian Cancer

The PARP inhibitor niraparib significantly improves the outcome of platinum-sensitive recurrent ovarian cancer, according to full data from the ENGOT-OV16/NOVA trial presented by Mirza et al at the 2016 European Society for Medical Oncology (ESMO) Congress in Copenhagen (Abstract LBA3_PR), and...

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