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lung cancer

Online Tool May Improve Guideline Concordance for Patients With Lung Cancer

An online tool that allows patients to input their clinical and pathologic features as well as explore treatment options in a structured manner based on National Comprehensive Cancer Network® Clinical Practice Guidelines in Oncology (NCCN Guidelines) may help drive smoking cessation and testing for ...

Expert Point of View: Kristin Higgins, MD

The discussant of the abstract on repeat positron-emission tomography (PET) and/or computed tomography (CT) scans prior to chemoradiation in locally advanced non–small cell lung cancer, Kristin Higgins, MD, emphasized the importance of timing of imaging when staging patients and the need for...

lung cancer

Role of Repeat PET/CT Scans in Ensuring Accuracy of Staging of Locally Advanced NSCLC

Findings from a new study highlight the importance of timing in initial staging positron-emission tomography (PET) and/or computed tomography (CT) scans for patients with locally advanced non–small cell lung cancer (NSCLC) receiving chemoradiation therapy.1 According to data presented at the 2019...

lung cancer

Mitigating Frailty and Sarcopenia to Improve Treatment Outcomes in Lung Cancer

Frailty and sarcopenia are common conditions among patients with lung cancer and are linked with decreased survival as well as increased surgical complications, chemotherapy toxicity, and cost of care. If a survey of oncologists at the 2019 Multidisciplinary Thoracic Cancers Symposium is any...

multiple myeloma

DNA Rearrangement May Predict Treatment Resistance and Poor Outcomes in Multiple Myeloma

A certain type of DNA marker may predict poor outcomes in multiple myeloma, researchers at Winship Cancer Institute of Emory University have found. The marker is a particular rearrangement of chromosomes that is rarely tested for but may indicate resistance to immunomodulatory drugs such as...

breast cancer
cost of care

Does Oncotype DX–Guided Treatment Reduce Initial Costs of Breast Cancer Care?

A new study suggests that Oncotype DX–guided treatment could reduce the cost for the first year of breast cancer care in the United States by about $50 million (about 2% of the overall costs in the first year). These findings were published by Mariotto et al in the Journal of the...

lung cancer
issues in oncology

Combined Crowd Innovation and AI in Producing Algorithms for Radiotherapy Targeting

In a study reported in JAMA Oncology, Mak et al found that a crowd innovation contest produced automated artificial intelligence (AI) algorithms “that replicated the skills of a highly trained physician” in segmenting lung tumors for radiotherapy targeting. The investigators also noted...

breast cancer

Low-Dose Tamoxifen vs Placebo in Preventing Local and Contralateral Recurrence in Breast Intraepithelial Neoplasia

In an Italian phase III study reported in the Journal of Clinical Oncology, DeCensi et al found that tamoxifen at 5 mg/d vs placebo for 3 years reduced the risk of recurrence of breast intraepithelial neoplasia and was associated with limited toxicity. As noted by the investigators,...

Well-Deserved Attention on Lung Cancer Screening

SCREENING FOR LUNG CANCER among high-risk groups deserves the attention that Steven E. Vogl, MD, brought to it in his column At Microphone 1 in the February 10 issue of The ASCO Post. Subspecialist oncologists are not always attuned to the needs of their patients outside of their own specialty.1...

gynecologic cancers

Modeling Projections of Global Cervical Cancer Control

In a modeling study reported in The Lancet Oncology, Karen Canfell, DPhil, and colleagues detailed the preventive effects on cervical cancer that could be achieved by scaled-up human papillomavirus (HPV) vaccination and cervical screening efforts with the aim of disease elimination. The major...

gynecologic cancers

Effect of Lymphadenectomy on Progression-Free and Overall Survival in Advanced Ovarian Cancer

In the international phase III LION study reported in The New England Journal of Medicine, Philipp Harter, MD, and colleagues found that lymphadenectomy did not improve progression-free or overall survival vs no lymphadenectomy in women with advanced ovarian cancer. Study Details The trial...

The Boy I Never Knew

The ASCO Post is pleased to reproduce installments of the Art of Oncology as published previously in the Journal of Clinical Oncology. These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

integrative oncology

Dance/Movement Therapy: Getting to Feelings That Have No Words

Dance/movement therapy is a complementary modality that is being explored for symptom control and for improving the quality of life of patients with cancer, especially pediatric patients. Self-expression as well as the creative and interpersonal aspects of dance/movement therapy can help patients...

issues in oncology

The Evolving Role of Pathologists in the Diagnosis and Treatment of Cancer

In the past, the role of the pathologist was primarily to present anatomic pathology findings on various specimens, particularly at tumor boards. However, in the emerging age of personalized medicine and molecular diagnostics, the responsibilities of pathologist have greatly expanded into...

multiple myeloma

Expert Point of View: High-Risk Smoldering Multiple Myeloma

IN SPITE of the high response rates and lack of progression to active disease with the regimens described at the 2018 American Society of Hematology Meeting & Exposition, several myeloma experts interviewed by The ASCO Post said the data do not yet move them to routinely intervene in high-risk...

myelodysplastic syndromes

Early Studies of Two Regimens Show Benefit in High-Risk Smoldering Multiple Myeloma

MORE DATA are in to support early intervention for high-risk smoldering multiple myeloma—an early, asymptomatic entity lacking the presence of CRAB criteria (elevated calcium, renal failure, anemia, bone lesions). The latest come from two phase II studies presented at the 2018 American Society of...

myelodysplastic syndromes

New Model May Improve Prediction of Risk in Myelodysplastic Syndromes

A PERSONALIZED risk-prediction model for myelodysplastic syndromes (MDS) has been developed through the use of a machine-learning approach that analyzes genomic and clinical data for an individual patient. According to lead investigator Aziz Nazha, MD, of the Cleveland Clinic, the model provides...

Expert Point of View: Aaron S. Mansfield, MD

The discussant of the STELLAR trial abstract, Aaron S. Mansfield, MD, a translational scientist at the Mayo Clinic in Rochester, called the survival outcomes “very promising” for a trial that included a relatively large population of patients with the more aggressive sarcomatoid variant of...

Cancer Research UK Tackles Global Cancer Challenges With £60 Million

CANCER RESEARCH UK announced recently that it is funding three new international oncology research initiatives. Collectively, the teams have been awarded almost £60 million. These 5-year research programs will investigate how the microbiome can be manipulated to treat bowel cancer, find new ways to ...

palliative care

House Calls With Her Physician Father Sparked an Interest in Palliative Care for Janet L. Abrahm, MD

Nationally regarded palliative care expert Janet L. Abrahm, MD, was born and reared in San Francisco. Her father was a solo practitioner who saw medicine as a great profession. “My father would come home from his office for dinner and when he finished, he’d do house calls, often bringing us with...

solid tumors

Tumor-Treating Fields Plus Chemotherapy Improved Survival in Unresectable Malignant Pleural Mesothelioma

The addition of tumor-treating fields to standard-of-care chemotherapy has been found to be safe and effective in the treatment of unresectable malignant pleural mesothelioma. Data presented at the 2019 Multidisciplinary Thoracic Cancers Symposium showed that patients receiving the combination of...

solid tumors

SABR-COMET: Stereotactic Ablative Radiotherapy vs Standard Palliative Treatment in Oligometastatic Cancers

Results of the phase II SABR-COMET trial reported by Palma et al in The Lancet indicate that stereotactic ablative radiotherapy (SABR) was associated with improved survival vs standard palliative treatment in patients with oligometastatic cancers, although it was also associated with...

colorectal cancer
issues in oncology

Colonoscopy Polyp Detection Rates and Endoscopist Characteristics

Previous research has suggested that specific factors about the doctor performing colonoscopy—for example, a gastroenterologist vs a surgeon, female vs male—were associated with different rates of detection of precancerous polyps. However, a Cleveland Clinic–led research team...

issues in oncology
lung cancer

Shared Decision-Making in Lung Cancer Screening: Whence? Whither?

We read with interest a recent article published on ASCOPost.com, which summarized a paper on the role of shared decision-making in lung cancer screening.1,2 The summary and original report highlight a mandate by the Centers for Medicare & Medicaid Services (CMS) that bears careful...

colorectal cancer

SUNSHINE Trial: High-Dose Vitamin D May Benefit Patients With Metastatic Colorectal Cancer

Results of a small clinical trial suggest that supplementing chemotherapy with high doses of vitamin D may benefit patients with metastatic colorectal cancer by delaying progression of the disease. These findings were published by Ng et al in JAMA. Initial trial findings were reported at the 2017...

immunotherapy

The Microbiome: The Next Target in Cancer Therapy

With the recent breakthroughs in immunotherapy, treatments that modulate the immune system are now being used across numerous cancer types and across the spectrum of disease with significant success, but not all patients achieve objective responses. There is still a critical need to better...

leukemia

Tale of Two FLT3 Inhibitors in AML: Gilteritinib and Quizartinib

Data supporting the use of FLT3 inhibitors in patients with acute myeloid leukemia (AML) were featured at the 2018 ASH Annual Meeting & Exposition. Gilteritinib was evaluated in combination with induction and consolidation as front-line therapy in newly diagnosed patients with AML,1 and...

hematologic malignancies
leukemia

Phase III Data Support Use of Gilteritinib in Relapsed or Refractory FLT3-Mutated AML

Treatment with gilteritinib, an oral type 1, FLT inhibitor, significantly improved overall survival compared with chemotherapy in patients with FLT3-positive relapsed or refractory acute myeloid leukemia (AML), according to the final results of the phase III ADMIRAL trial.1 The longest survival for ...

kidney cancer
immunotherapy

FDA Approves Pembrolizumab Plus Axitinib for First-Line Treatment of Advanced Renal Cell Carcinoma

On April 19, 2019, the U.S. Food and Drug Administration (FDA) approved pembrolizumab (Keytruda) plus axitinib for the first-line treatment of patients with advanced renal cell carcinoma (RCC). KEYNOTE-426 Approval was based on KEYNOTE-426, a randomized, multicenter, open-label trial conducted in ...

lung cancer

Deep-Learning Model May Improve Predictions of Survival and Specific Outcomes in Lung Cancer

A study by Xu et al in Clinical Cancer Research evaluating deep-learning networks that analyze time-series computed tomography (CT) images of patients with locally advanced NSCLC has found these networks can integrate imaging scans at multiple time points to improve clinical outcome...

lung cancer
immunotherapy

KEYNOTE-042: Pembrolizumab vs Chemotherapy in Previously Untreated Locally Advanced or Metastatic NSCLC With PD-L1 Expression ≥ 1%

As reported in The Lancet by Mok et al, the KEYNOTE-042 trial has shown an improvement in overall survival with pembrolizumab vs standard chemotherapy in previously untreated patients with locally advanced or metastatic non–small cell lung cancer (NSCLC) without a sensitizing EGFR mutation or ...

lymphoma

Front-Line Dose-Adjusted EPOCH-R vs R-CHOP in Diffuse Large B-Cell Lymphoma

As reported in the Journal of Clinical Oncology by Bartlett et al, the phase III intergroup Alliance/CALGB 50303 trial showed front-line DA-EPOCH-R (dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab) did not improve outcomes vs standard R-CHOP...

colorectal cancer

Primary Surgery Outcomes in MRI-Based ‘Good-Prognosis’ Rectal Cancer

In a Canadian phase II trial reported in JAMA Oncology, Kennedy et al found a low rate of positive circumferential resection margins after primary surgery in patients with rectal cancer considered to have a ‘good prognosis’ based on magnetic resonance imaging (MRI) criteria.   As...

multiple myeloma

Patient-Reported Outcomes With Salvage Autologous Stem Cell Transplantation vs Nontransplantation in Relapsed Multiple Myeloma

In an analysis of the phase III UK Myeloma X trial reported in the Journal of Clinical Oncology, Ahmedzai et al found that patient-reported outcomes tended to be worse with salvage autologous stem cell transplantation (ASCT) vs nontransplantation consolidation in relapsed multiple myeloma. The...

issues in oncology
integrative oncology

Complementary and Alternative Medicine Use in Patients With Cancer

In a recent study focusing on patients with cancer and cancer survivors, one-third of patient participants reported use of complementary and alternative medicines such as meditation, yoga, acupuncture, herbal medicine, and supplements. These findings were published by Sanford et al in JAMA...

breast cancer

Addition of Radiotherapy After Breast-Conserving Surgery Based on Level of Tumor-Infiltrating Lymphocytes

In a long-term follow-up of the Swedish Breast Cancer Group 91 Radiotherapy trial reported in the Journal of Clinical Oncology, Kovács et al found that higher levels of stromal tumor–infiltrating lymphocytes (TILs) and receipt of radiotherapy were independently associated with reduced...

lymphoma

Addition of Bortezomib to R-CHOP in DLBCL Subtypes Identified With Gene-Expression Profiling

In the phase III REMoDL-B trial reported in The Lancet Oncology, Davies et al found that the addition of bortezomib to standard R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone) did not improve progression-free survival subtypes of diffuse large B-cell lymphoma...

gynecologic cancers
immunotherapy

KEYNOTE-158: Pembrolizumab in Previously Treated Advanced Cervical Cancer

As reported in the Journal of Clinical Oncology by Chung et al, the phase II KEYNOTE-158 trial showed activity of pembrolizumab in previously treated programmed cell death ligand 1 (PD-L1)-positive advanced cervical cancer. The study supported the 2018 accelerated approval of pembrolizumab in this...

symptom management

ASCO and ASH Release Update to Clinical Practice Guidelines for Use of Erythropoiesis-Stimulating Agents

ASCO and the American Society of Hematology (ASH) have released an update to existing guidelines for the use of erythropoiesis-stimulating agents to manage anemia in patients with cancer. The update was simultaneously published in the Journal of Clinical Oncology and Blood Advances. “The...

symptom management

'Oral Cryotherapy' for Patients Undergoing Oxaliplatin-Based Chemotherapy

A study by Bauman et al in JNCCN—Journal of the National Comprehensive Cancer Network found that patients who kept ice chips in their mouths—what the study authors called “oral cryotherapy”—during oxaliplatin infusions reported less trouble with eating and...

pain management

Cost and Health-Care Utilization With Targeted Drug Delivery Plus Conventional Medical Management for Cancer-Related Pain

Results of a study published by Stearns et al in JAMA Network Open demonstrated a reduction in health-care utilization and cost for patients cancer-related pain using targeted drug delivery and conventional medical management vs conventional medical management alone. The study found...

issues in oncology

Treatment of Patients With Imminently Fatal de Novo Metastatic Cancer

Some patients who died within 1 month of being newly diagnosed with metastatic cancer in the United States received ineffective surgery, chemotherapy, radiotherapy, and hormonal therapy, according to a new study published by Sineshaw et al in JNCI Cancer Spectrum. The study authors said the...

breast cancer
gynecologic cancers

Actionable Pathogenic Variants in a Population-Based Cohort of Patients With Breast or Ovarian Cancer

In a study reported in the Journal of Clinical Oncology, Kurian et al found that approximately one-quarter of women with breast cancer and one-third of those with ovarian cancer underwent cancer genetic testing, and that 8% to 15% of those tested had actionable pathogenic variants. Study Details...

issues in oncology

Collaborative Telerehabilitation in Patients With Advanced Cancer

Recent research suggests that remotely delivering rehabilitation services to patients with advanced cancer may improve their physical function, pain, and quality of life, while allowing them to spend less time in hospitals and nursing homes. These findings were published by Cheville et al in JAMA...

issues in oncology

American Cancer Society Report Finds Application of Cancer-Reducing Strategies in the United States Is Suboptimal

The latest edition of the American Cancer Society’s (ACS) review on recent cancer prevention and early detection efforts has found that although many strategies have been proven to reduce cancer risk, their application has been suboptimal in the United States, especially in socioeconomically...

lung cancer

Five-Fraction SBRT for Centrally Located, Inoperable NSCLC

In the phase I/II NRG Oncology/RTOG 0813 study reported in the Journal of Clinical Oncology, Bezjak et al found that five-fraction stereotactic body radiotherapy (SBRT) was associated with relatively low rates of serious treatment-related toxicity and good outcomes in patients with centrally...

gynecologic cancers

Niraparib in Late-Line Treatment of Ovarian Cancer

In the phase II QUADRA trial reported in The Lancet Oncology, Moore et al found that the poly(ADP-ribose) polymerase (PARP) inhibitor niraparib was active in fourth- or later-line treatment of ovarian cancer, particularly in patients with homologous recombination deficiency (HRD)-positive,...

bladder cancer

FDA Grants Accelerated Approval to Erdafitinib for Metastatic Urothelial Carcinoma

Today, the U.S. Food and Drug Administration (FDA) granted accelerated approval to erdafitinib (Balversa) for patients with locally advanced or metastatic urothelial carcinoma with susceptible FGFR3 or FGFR2 genetic alterations that has progressed during or following platinum-containing...

pancreatic cancer

Factors Contributing to Improved Survival Following Total Neoadjuvant Therapy for Borderline/Locally Advanced Pancreatic Cancer

A newly published Mayo Clinic study has found that a presurgery treatment plan for patients with borderline/locally advanced pancreatic cancer undergoing total neoadjuvant therapy may improve outcomes. The findings were published by Truty et al in Annals of Surgery. The study followed 194...

gastroesophageal cancer

Paclitaxel or Cisplatin Plus Fluorouracil in Chemoradiotherapy for Locally Advanced Esophageal Cancer

In the Chinese phase III ESO-Shanghai 1 trial reported in the Journal of Clinical Oncology, Chen et al found that paclitaxel plus fluorouracil did not significantly prolong overall survival vs standard cisplatin plus fluorouracil in definitive concurrent chemoradiotherapy (dCRT) for locally...

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