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solid tumors
head and neck cancer

Esomeprazole With Aspirin in Patients With Barrett’s Esophagus

An updated analysis of a randomized phase III trial showed that taking a high dose of esomeprazole with low-dose aspirin for at least 7 years may moderately reduce the risk of developing high-grade dysplasia or esophageal cancer and may delay death from any cause in people with Barrett’s esophagus. ...

Expert Point of View: Richard L. Schilsky, MD

“This study shows us that it is possible to get equally good outcomes with lower costs. In the United States, we have no real way to constrain the costs of health care, including the cost of drugs. The U.S. Food and Drug Administration does not consider drug price in deliberations about bringing...

solid tumors
gastrointestinal cancer
colorectal cancer

Care for Colorectal Cancer Costs Twice as Much in Western Washington vs British Columbia, With Similar Survival

It is widely acknowledged that the costs of cancer care are much higher in the United States than in Canada, with outcomes that are thought to be similar. A new study presented at the 2018 ASCO Annual Meeting supports that view, by documenting and quantifying the differences in health-care costs...

Expert Point of View: Kenneth C. Anderson, MD, FASCO, Adam D. Cohen, MD, Craig Hofmeister, MD, MPH, and Bruce Cheson, MD

Kenneth C. Anderson, MD, FASCO, of Dana-Farber Cancer Institute, Boston, noted that the iNNOVATE trial is the first randomized comparison of ibrutinib (Imbruvica) plus rituximab (Rituxan) vs “a very active control—rituximab—to which 50% of patients responded.” The study showed that “the...

hematologic malignancies
lymphoma

Outcomes in Waldenström’s Macroglobulinemia Improved With Ibrutinib Plus Rituximab

In patients with Waldenström’s macroglobulinemia, the risk of disease progression was reduced by 80% with the combination of ibrutinib (Imbruvica) and rituximab (Rituxan) over rituximab alone, in the international phase III iNNOVATE trial, reported at the 2018 ASCO Annual Meeting1 and...

Expert Point of View: Andrew Epstein, MD

“This is a very important study,” said ASCO expert Andrew Epstein, MD, of Memorial Sloan Kettering Cancer Center (MSK), New York. “Hyperthermic intraperitoneal chemotherapy is used in the United States and elsewhere, even though the benefits are unknown. This study shows there are no benefits, and ...

solid tumors
gastrointestinal cancer
colorectal cancer

Less Is More: No Benefit Reported for Hyperthermic Intraperitoneal Chemotherapy in Colorectal Cancer

With a growing emphasis on value in cancer care, some types of resource-intensive therapies may need to be reconsidered. One such treatment may be hyperthermic intraperitoneal chemotherapy, which showed no benefit during surgery for colorectal cancer confined to the peritoneum in the PRODIGE 7...

Expert Point of View: Charles G. Drake, MD, PhD and Hatem H. Soliman, MD

Formal discussant of the GeparNuevo presentation, Charles G. Drake, MD, PhD, of the Herbert Irving Comprehensive Cancer Center at Columbia University Medical Center, New York, said, “It is important that neoadjuvant immunotherapy combinations are being studied. There is a lot of enthusiasm for...

breast cancer
immunotherapy

Priming the Immune System: Neoadjuvant Durvalumab Plus Chemotherapy May Be Beneficial in Triple-Negative Breast Cancer

The addition of durvalumab -(Imfinzi) to anthracycline/taxane-based chemotherapy had encouraging results as neoadjuvant therapy for early triple-negative breast cancer in the randomized phase II GeparNuevo study presented at the 2018 ASCO Annual Meeting.1 The results were positive in a subgroup of...

Expert Point of View: Daniel George, MD, Robert J. Motzer, MD, and Paul Russo, MD

Formal discussant of the CARMENA trial, Daniel George, MD, of Duke University Medical Center, Durham, North Carolina, had reservations about the broad application of these results. “CARMENA was designed to reassess the value and role of nephrectomy in patients who present with metastatic renal...

lymphoma

EHA 2018: Tazemetostat in Relapsed or Refractory Follicular Lymphoma

Positive interim data were recently presented from an ongoing phase II study of tazemetostat—a potent, selective, orally available EZH2 inhibitor—as a monotherapy for patients with relapsed or refractory follicular lymphoma. The data, presented by Salles et al at the 23rd Annual...

solid tumors
skin cancer

The Raven

The call from the dermatologist came at noon on Good Friday, just after my wife left with our two young daughters for a week on her family’s tree farm in Northern Michigan. I was on call for the hospital inpatient leukemia service, so I could not join them. When the dermatologist solemnly began,...

hematologic malignancies
leukemia

Minimal Residual Disease Testing in AML: Still a Shifting Target

Testing for minimal residual disease (MRD) has become an established part of the management of acute lymphoblastic leukemia (ALL), but in acute myeloid leukemia (AML), the technology still warrants validation. To address issues and set new standards, the European LeukemiaNet Working Party recently ...

hematologic malignancies

EHA 2018: Ruxolitinib Reduces Risk of Thrombosis, Death in Patients With Polycythemia Vera

A new comparison study showed that among polycythemia vera patients who were resistant or intolerant to hydroxyurea, those treated with ruxolitinib (Jakavi) had a significantly reduced risk of thrombosis and death compared to those who received best available therapy. The study findings are based...

leukemia

EHA 2018: Single-Agent Quizartinib vs Chemotherapy in Relapsed or Refractory AML

Results from the phase III QuANTUM-R study of single-agent quizartinib in relapsed or refractory acute myeloid leukemia (AML) were presented by Cortes et al at the 23rd Annual Congress of the European Hematology Association (EHA) (Abstract LB2600). Study Findings QuANTUM-R study results showed...

leukemia

EHA 2018: Undetectable MRD Rates With Venetoclax Plus Rituximab in Relapsed or Refractory CLL

Investigational data from a new analysis of undetectable minimal residual disease (MRD) rates from the phase III MURANO trial of venetoclax (Venclexta, a first-in-class oral B-cell lymphoma 2 [BCL2] inhibitor) in combination with rituximab (Rituxan) in patients with relapsed or refractory chronic...

Expert Point of View: Colin D. Weekes, MD, PhD and Andrew Epstein, MD

Colin D. Weekes, MD, PhD, of Massachusetts General Hospital and Harvard Medical School, called the results of the PRODIGE trial “practice-changing.” Dr. Weekes was the invited discussant of the study and was interviewed by The ASCO Post. “The magnitude of effect is beyond what we have ever seen in...

skin cancer
immunotherapy

Activity of the PD-1 Inhibitor Cemiplimab in Advanced Cutaneous Squamous Cell Carcinoma

As reported at the 2018 ASCO Annual Meeting (Abstract 9519) and in The New England Journal of Medicine by Migden et al, results of early-phase testing show activity of the programmed cell death protein 1 (PD-1) inhibitor cemiplimab in advanced cutaneous squamous cell carcinoma. Currently, no...

lymphoma
immunotherapy

EHA 2018: Tisagenlecleucel Demonstrates More Than 1-Year Durability of Response in Adults With Relapsed or Refractory DLBCL

Fourteen-month results from the JULIET clinical trial showed ongoing durable responses are achievable with tisagenlecleucel (Kymriah) when administered to adult patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL). This updated analysis was presented by Borchmann et al at ...

leukemia

EHA 2018: Alvocidib in Patients With Relapsed or Refractory MCL-1–Dependent AML

Preliminary data from Zella 201—an ongoing phase II study evaluating the efficacy and safety of alvocidib, a potent cyclin-dependent kinase 9 (CDK9) inhibitor, in combination with cytarabine and mitoxantrone in patients with relapsed or refractory MCL-1–dependent acute myeloid leukemia...

palliative care
issues in oncology

AMA Rejects Recommendation to Reaffirm Opposition to Medical Aid in Dying

On June 11, the American Medical Association (AMA) House of Delegates voted 56% to 44% to reject a report by its Council on Ethical and Judicial Affairs (CEJA) that recommended the AMA maintain its Code of Medical Ethics’ opposition to medical aid in dying. Instead, the House of Delegates...

head and neck cancer
survivorship

Male Thyroid Cancer Survivors Face 50% Higher Risk of Cardiovascular Disease Than Women

Male thyroid cancer survivors have a nearly 50% higher risk of developing cardiovascular disease than women within 5 years of cancer diagnosis, according to a new study published by Park et al in the Journal of Clinical Endocrinology & Metabolism. More than 62,000 new cases of thyroid cancer...

breast cancer

FDA and EMA Accept Regulatory Submissions for Review of Talazoparib for Patients With Germline BRCA-Mutated Metastatic Breast Cancer

The U.S. Food and Drug Administration (FDA) recently accepted for filing and granted Priority Review designation a new drug application for talazoparib. The submission is based on results from the EMBRACA trial, which evaluated talazoparib vs chemotherapy in patients with germline BRCA-mutated,...

issues in oncology

ASCO Guideline for Geriatric Oncology: Practical Assessment and Management of Vulnerabilities in Older Patients Receiving Chemotherapy

As reported in the Journal of Clinical Oncology by Supriya G. Mohile, MD, of the University of Rochester Medical Center, and colleagues, ASCO has produced a guideline on the practical assessment and management of vulnerabilities in geriatric patients receiving chemotherapy. To develop the...

pancreatic cancer

Study Finds Recent-Onset Type 2 Diabetes May Be Early Manifestation of Pancreatic Cancer

According to the American Cancer Society, pancreatic cancer is one of the most deadly cancers, with an overall 5-year survival rate of just 8%, mainly because the vast majority of patients, about 80%, are diagnosed at a late stage of disease. Research has shown that identification of high-risk ...

lung cancer
multiple myeloma

Studies of Daratumumab in Combination With Anti–PD-L1 Agents Stopped

On May 26, Genmab A/S announced that following a planned review, the Data Monitoring Committee (DMC) has recommended that the phase Ib/II study (CALLISTO/LUC2001) of daratumumab (Darzalex) in combination with the anti–programmed cell death ligand 1 (PD-L1) antibody atezolizumab (Tecentriq) vs ...

issues in oncology

AMA Releases New Physician Guide on Caring for the Caregiver

Every day in their treatment rooms, physicians encounter individuals who are making profound sacrifices to help a loved one who is seriously ill, often at the expense of their own well-being. To help physicians understand the day-to-day challenges and risk of burnout faced by informal caregivers,...

breast cancer
issues in oncology
survivorship

Study Finds Breast Cancer Survivors Are Not Getting Recommended Number of Mammograms Postsurgery

Breast cancer survivors are not getting the recommended level of screening postsurgery, according to a study by Ruddy et al in JNCCN–Journal of the National Comprehensive Cancer Network. The study was led by Kathryn Ruddy, MD, MPH, Director of Cancer Survivorship for the Department of...

issues in oncology

Opportunities, Issues, and Challenges for Biosimilars in Oncology

In an article in The New England Journal of Medicine, Lyman et al reviewed opportunities, issues, and challenges posed by the advent of biosimilar medications, focusing on biosimilars in cancer treatment. Although these agents could help to meet the health-care goals of high quality care with cost...

lung cancer

Lung Cancer Incidence in Young Women vs Men in the United States

In a study reported in The New England Journal of Medicine, Jemal et al found that the incidence of lung cancer in young white and Hispanic women is now higher than that in men in the US. Study Details The study involved analysis of data from the North American Association of Central Cancer...

Barbara L. McAneny, MD, Inaugurated as 173rd President of the AMA

Barbara L. McAneny, MD, an oncologist from Albuquerque, has been sworn in as the 173rd President of the American Medical Association (AMA). She will focus her tenure on the AMA’s three strategic arcs: attacking the dysfunction in health care by removing obstacles and barriers that interfere...

leukemia
lymphoma
immunotherapy

iLLUMINATE Trial of Ibrutinib Plus Obinutuzumab for First-Line Therapy of CLL/SLL Meets Primary Endpoint

The phase III iLLUMINATE (PCYC-1130) trial recently met its primary endpoint of improvement in progression-free survival. The study evaluated ibrutinib (Imbruvica) in combination with obinutuzumab (Gazyva) in patients with previously untreated chronic lymphocytic leukemia or small lymphocytic...

breast cancer

ASCO Clinical Practice Guideline Focused Update: Selection of Optimal Adjuvant Chemotherapy and Targeted Therapy for Early Breast Cancer

As reported by Neelima Denduluri, MD, of US Oncology Network, Virginia Cancer Specialists, and colleagues in the Journal of Clinical Oncology, ASCO has issued a focused update on the clinical practice guideline on optimal chemotherapy and targeted therapy in early breast cancer. To develop the...

issues in oncology

Cancer Prevention Report Shows Consensus Among Global Experts on 10 Steps to Reduce Risk

An internationally released comprehensive analysis of research on lifestyle factors and cancer prevention confirms the critical links between cancer diagnoses and diet, physical activity, and weight. Independent experts from across the globe reviewed decades of scientific evidence to develop the...

prostate cancer

AUA 2018: Finasteride Reduces Risk of Prostate Cancer and Is Safe, Long-Term Results Show

Twenty-five years after it opened for enrollment, the Prostate Cancer Prevention Trial (PCPT) has delivered a final verdict: finasteride, a common hormone-blocking drug, reduces men's risk of getting prostate cancer without increasing their risk of dying from the disease. Initial study...

ASCO’s TAPUR Study Website Now Features Updates on Patient Cohort Expansions and Closures

ASCO’S TARGETED Agent and Profiling Utilization Registry (TAPUR) Study now provides a full list of patient cohort expansions and closures on its website. Based on treatment responses in stage I, patient cohorts are either expanded to stage II for further study and identification of a signal or...

John V. Cox Reflects on 10 Years as Editor-in-Chief of the Journal of Oncology Practice

John V. Cox, DO, FASCO, of the Parkland Hospital and Health System/University of Texas Southwestern Medical Center, has served as the Editor-in-Chief of the Journal of Oncology Practice (JOP) since 2008. As a member of the journal’s inaugural Editorial Board, he has seen the publication evolve...

ASCO to Present Douglas W. Blayney, MD, FASCO, With Joseph V. Simone Award and Lecture

ASCO will recognize Douglas W. Blayney, MD, FASCO, medical oncologist and Professor at Stanford University School of Medicine, with the Joseph V. Simone Award and Lecture for Excellence in Quality and Safety in the Care of Patients with Cancer. Dr. Blayney will be presented with the award at the...

ASTRO Collaborates With ASCO and Conquer Cancer to Support Methods Workshop

For the third year, the American Society for Radiation Oncology (ASTRO) is supporting the ASCO/American Association for Cancer Research (AACR) Workshop on Methods in Clinical Cancer Research, to take place July 18–August 3, 2018, at Vail Mountain Marriott Resort in Vail, Colorado.  Celebrating its ...

lung cancer

Expert Point of View: John V. Heymach, MD, PhD

FORMAL DISCUSSANT of this trial, John V. Heymach, MD, PhD, of The University of Texas MD Anderson Cancer Center, Houston, also was optimistic about these early findings. “This is a proof-of-concept study showing this approach is safe. Only modest activity was observed with standard [Response...

lung cancer

Early Evidence of Neoadjuvant PD-1 Blockade in Non–Small Cell Lung Cancer

A NOVEL APPROACH using two doses of nivolumab (Opdivo) prior to surgery achieved major pathologic responses in 45% of patients with resectable stages I to IIIA non–small cell lung cancer (NSCLC), according to the results of a small Stand Up 2 Cancer–Cancer Research Institute Dream Team study...

gynecologic cancers
pain management

Study Evaluates Effect of Restrictive Opioid Protocol After Gynecologic Surgery

THE NUMBER of opioids prescribed after surgery for gynecologic cancer decreased significantly after implementation of an ultra-restrictive opioid prescription protocol, with no apparent negative effect on patient satisfaction or pain, according to research presented by Jaron Mark, MD, and...

gynecologic cancers

Expert Point of View: Shitanshu Uppal, MD

COMMENTING ON the study, invited discussant Shitanshu Uppal, MD, of the University of Michigan in Ann Arbor, called the data “provocative” but said he had progressed through the “five stages of grief” in reaction to the results. “I’ve gone through denial, I’ve gone through anger, I couldn’t...

gynecologic cancers

Expert Point of View: Oliver Dorigo, MD, PhD

COMMENTING ON the study, invited discussant Oliver Dorigo, MD, PhD, of Stanford University, said that tumor size and disease site are useful clinical parameters for predicting nonresponse to immunotherapy and should be considered when selecting and “unselecting” patients for immunotherapy...

gynecologic cancers

Clinical Findings Predict Early Treatment Discontinuation in Patients Receiving Immunotherapy for Ovarian Cancer

PRETREATMENT CLINICAL findings may predict early treatment discontinuation in patients with ovarian cancer receiving checkpoint blockade immunotherapy agents. Data presented by MD candidate Julia L. Boland at the 2018 Society of Gynecologic Oncology Annual Meeting on Women’s Cancer revealed that...

lung cancer
symptom management
cns cancers

Quick Takes From Original Research Presented at the 2018 NCCN Annual Conference

THE QUANTITY of original research presented at the National Comprehensive Cancer Network® (NCCN®) Annual Conference has been growing, and at the 2018 meeting, 121 researchers presented their work. The ASCO Post captured some of the findings for this report.  Blood Markers Correlate With Anti–PD-1...

pancreatic cancer

Using Neoadjuvant Therapy to Reduce Early Recurrences, Increase Survival in Patients With Pancreatic Cancer

USE OF THE FOLFIRINOX regimen (fluorouracil, leucovorin, irinotecan, and oxaliplatin) was associated with a 4.9-month improvement in overall survival compared to gemcitabine/ nab-paclitaxel (Abraxane) in the neoadjuvant treatment of resectable and borderline-resectable pancreatic head...

cns cancers

Durable Responses Observed With Novel Oncolytic Therapy in Recurrent Glioma

IN A PILOT study of recurrent glioma, 26% of patients treated with the optimal dose of vocimagene amiretroprepvec (aka Toca 511), a novel oncolytic virus therapy, achieved durable, long-term responses and remained alive 3 or more years later. This outcome far exceeded “historical benchmarks” for...

breast cancer

Expert Point of View: Sarah Blair, MD

SARAH BLAIR, MD, a breast surgeon at the University of California San Diego, noted that lymphedema remains a significant clinical problem, although the rates of lymphedema are decreasing, as fewer full axillary node dissections are performed.  “This study utilizes bioimpedance spectroscopy, a...

breast cancer

Expert Point of View: Judy C. Boughey, MD

JUDY C. BOUGHEY, MD, a breast surgeon and clinical and translational researcher at the Mayo Clinic, Rochester, Minnesota, said the two studies highlight the importance of discussing genetic testing with patients who are diagnosed with breast cancer. “With the advances in panel testing for...

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