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breast cancer

In Ductal Carcinoma in Situ, Benefit of Wider Margins Tied to Radiation Use

The relationship between margin width and risk of recurrence after breast-conserving surgery for ductal carcinoma in situ depends on the use of radiation, according to a surgical oncologist who sought to determine the optimal margin width in these patients.1 “Positive margins are associated with an ...

lymphoma

Interim FDG-PET Response-Adapted Therapy May Be of Benefit in Hodgkin Lymphoma

In a phase II US Intergroup trial (Southwest Oncology Group S0816) reported in the Journal of Clinical Oncology, Press et al found that early interim fluorodeoxyglucose positron-emission tomography (FDG-PET) to guide response-adapted therapy resulted in progression-free survival substantially...

lung cancer

Dabrafenib Active in BRAF-Mutant Metastatic NSCLC

Planchard et al found that the BRAF kinase inhibitor dabrafenib (Tafinlar) produced responses in previously treated and untreated patients with BRAF-mutant metastatic non–small cell lung cancer (NSCLC), according to a phase II trial reported in The Lancet Oncology. Activating BRAF V600E...

gynecologic cancers

Study Supports Initial Attempt at Debulking Surgery in Stage IIIC Ovarian, Fallopian Tube, and Peritoneal Carcinoma

In a study exploring the effect of primary debulking surgery in women with bulky stage IIIC ovarian, fallopian tube, and primary peritoneal cancers, cytoreduction to no gross residual disease was associated with the best survival outcomes.1 Cytoreduction to 1 to 10 mm of residual disease was also...

gynecologic cancers

Genetic Testing in Women With Ovarian Cancer Helps to Determine Prognosis

A new study suggests that homologous recombination deficiency may have significant prognostic implications for patients with ovarian cancer, highlighting the importance of genetic testing in this population.1 According to the data, patients with ovarian cancer who have mutations in genes affecting...

issues in oncology

Physicians as Champions for Quality Improvement

Interest in quality measurement and improvement was once primarily a concern of regulators, insurers, and consumer advocates. Today, quality improvement is front and center in health care—a continuous mission requiring the efforts of everyone on the health-care team. At the recent ASCO Quality Care ...

multiple myeloma

Benefits and Risks of Transplantation: The Changing Therapeutic Paradigm for Multiple Myeloma

Although high-dose chemotherapy plus autologous transplantation has been a standard of care in the treatment of younger patients with newly diagnosed multiple myeloma, the advent of effective novel agents for the cancer over the past 15 years has raised the question of whether transplantation, with ...

breast cancer

Novel Strategies Emerging for Triple-Negative Breast Cancer

Compelling hypotheses are emerging about the mechanisms driving triple-negative breast cancer, and they are driving drug development in this area, according to Joyce O’Shaughnessy, MD, Celebrating Women Chair of Breast Cancer Research at Baylor Charles A. Sammons Cancer Center. She is also Medical...

skin cancer

AACR 2016: 5-Year Survival Rates for Patients With Metastatic Melanoma Treated With Nivolumab Much Higher Than Historical Rates

More than a third of metastatic melanoma patients (34%) who received the anti–programmed cell death protein 1 (PD-1) immunotherapeutic nivolumab (Opdivo) in a phase I clinical trial are still alive 5 years after starting treatment, according to research presented by Hodi et al at the 2016...

health-care policy

AACR 2016: Report Identifies Considerations for Alternative Payment Models for Cancer Care

A roundtable convened by the Turning the Tide Against Cancer initiative, composed of a multidisciplinary group of stakeholders, put forth five policy considerations that are critical to ensuring the delivery of high-quality oncology care while supporting innovation. The report was published by...

gastrointestinal cancer

Pazopanib of Benefit in Imatinib- and Sunitinib-Resistant GIST in French Phase II Trial

In a French phase II trial reported in The Lancet Oncology, Mir et al found that pazopanib (Votrient) plus best supportive care increased progression-free survival vs best supportive care in patients with advanced gastrointestinal stromal tumors (GIST) resistant to imatinib and sunitinib. Study...

pancreatic cancer

CCR2 Inhibitor Active in Combination With FOLFIRINOX in Advanced Pancreatic Cancer

A CCR2 inhibitor (PF-04136309) was active in combination with FOLFIRINOX (oxaliplatin, irinotecan, leucovorin, fluorouracil) in treatment-naive patients with borderline resectable or locally advanced pancreatic ductal adenocarcinoma, according to a single-center phase Ib study reported by Nywening...

breast cancer

French Study Suggests No Apparent Benefit of Bevacizumab in Nonmetastatic HER2-Negative Inflammatory Breast Cancer

In a French single-arm phase II study reported in The Lancet Oncology, Bertucci et al found little evidence of benefit from the addition of bevacizumab (Avastin) to neoadjuvant and adjuvant therapies in women with nonmetastatic HER2-negative inflammatory breast cancer. Study Details In the study, ...

gynecologic cancers
head and neck cancer
lung cancer
skin cancer

AACR 2016: RAF-Targeted Therapeutic BGB-283 Shows Early Promise Against Tumors With BRAF and RAS Mutations

The new investigational anticancer therapeutic BGB-283, which targets the RAF family of proteins, was safe, tolerable, and showed signs of clinical activity in patients who had a range of types of cancer with mutations in BRAF, KRAS, and NRAS, according to results from a phase I clinical trial...

prostate cancer

Hypofractionated Radiotherapy Not Inferior to Conventional Radiotherapy in Low-Risk Prostate Cancer

Hypofractionated radiotherapy was not inferior to conventional radiotherapy in terms of disease-free survival among men with low-risk prostate cancer, according to the results of the phase III NRG Oncology RTOG 0415 trial reported in the Journal of Clinical Oncology by Lee et al. However, it was...

sarcoma

Nomograms for Predicting Survival and Distant Metastasis After Resection of Localized Soft-Tissue Sarcoma of the Extremities

As reported in The Lancet Oncology, Callegaro et al have developed nomograms to predict overall survival and risk of distant metastases in patients undergoing resection of soft-tissue sarcomas of the extremities. Study Details The study involved data from a development cohort of 1,452 consecutive ...

breast cancer

Greatest Benefit of Adjuvant Exemestane Seen in Premenopausal Women at Higher Risk of Breast Cancer Recurrence

In an analysis of the SOFT and TEXT trials reported in the Journal of Clinical Oncology, Regan et al found that the greatest benefit of adjuvant exemestane in reducing breast cancer recurrence was among women with the highest risk of recurrence on the basis of clinicopathologic characteristics....

lung cancer

ELCC 2016: Immunotherapy With Live Bacterium Improves Response Rate in Malignant Pleural Mesothelioma

Immunotherapy with a live bacterium combined with chemotherapy demonstrated more than 90% disease control and a 59% response rate in patients with malignant pleural mesothelioma, according to the results of a phase Ib trial presented by Jahan et al April 14 (Abstract 208O_PR) at the European Lung...

head and neck cancer

FDA Accepts Supplemental Biologics License Application for Pembrolizumab in Recurrent or Metastatic Head and Neck Cancer, Grants Priority Review

Merck today announced that the U.S. Food and Drug Administration (FDA) has accepted for review the supplemental Biologics License Application (sBLA) for pembrolizumab (Keytruda), a monoclonal antibody and anti–programmed cell death 1 (PD-1) therapy, for the treatment of...

hematologic malignancies
myelodysplastic syndromes

Prognostic Scoring System for Patients Undergoing Allogeneic Hematopoietic Cell Transplantation for Myelodysplastic Syndrome

As reported in the Journal of Clinical Oncology, Shaffer et al have developed a prognostic scoring system for patients undergoing allogeneic hematopoietic cell transplantation for myelodysplastic syndrome. Study Details The study involved data from 2,133 patients with myelodysplastic syndrome in...

lung cancer

Noninferiority of Gefitinib vs Erlotinib Not Established in Japanese Trial in Advanced Lung Adenocarcinoma

In a Japanese phase III trial (WJOG 5108L) reported in the Journal of Clinical Oncology, Urata et al found that noninferiority of gefitinib vs erlotinib was not established in previously treated patients with advanced non–small cell lung cancer. Study Details In the open-label trial, 559...

breast cancer
symptom management

Acupuncture Improves Hot Flashes in Women With Breast Cancer in Italian Trial

In an Italian trial reported in the Journal of Clinical Oncology, Lesi et al found that the addition of acupuncture to enhanced self-care improved hot flashes, climacteric symptoms, and quality-of-life measures in women with breast cancer. Study Details In the trial, 190 women were randomized to...

breast cancer

Adding Ovarian Function Suppression to Tamoxifen Worsened Some Patient-Reported Outcomes in Premenopausal Women With Early Breast Cancer

Ribi et al reported in the Journal of Clinical Oncology that addition of ovarian function suppression to tamoxifen resulted in greater endocrine and sexual function symptoms among premenopausal patients with early breast cancer in the Suppression of Ovarian Function Trial (SOFT). The SOFT study...

solid tumors
lymphoma
multiple myeloma

Relatives of Patients With Carcinoma of Unknown Primary at Increased Risk for This and Other Cancers

Relatives of patients with carcinoma of unknown primary are at increased risk of developing it themselves as well as several other malignant neoplasms, including lung, pancreatic, and colon cancers; non-Hodgkin lymphoma; and myeloma, according to a study published in JAMA Oncology. “Some of...

symptom management

In Early Brain Radiation Recovery Studies, Cranial Grafting of Stem Cell–Derived Therapy Improves Cognition and Reduces Neuropathology

While stem cells have shown promise for treating brain regions damaged by cancer radiation treatments, University of California, Irvine (UCI) researchers have found that microscopic vesicles isolated from these cells provide similar benefits without some of the risks associated with stem cells....

colorectal cancer

Next-Generation Sequencing Assay May Permit Accurate Detection of Mismatch Repair Deficiency in Colorectal Cancer

Use of a custom next-generation sequencing assay may accurately predict mismatch repair deficiency on the basis of mutational load in colorectal cancer, according to a report by Stadler et al in the Journal of Clinical Oncology. Study Details The study involved data from 224 patients with...

prostate cancer

Adding 6 Months of Androgen Suppression to Radiotherapy Improves Disease-Free Survival in Intermediate- and High-Risk Prostate Cancer

In the phase III EORTC 22991 trial reported in the Journal of Clinical Oncology, Bolla et al found that the addition of 6 months of androgen suppression to radiotherapy improved biochemical and clinical disease-free survival in patients with intermediate- and high-risk prostate cancer. Study...

Compartmentalizing Cancer

I was the last one on the oncology team to meet Mel. He was 36 years old, and by then Mel had been living with metastatic colon cancer for several years. During that time, his clinicians had never referred him to our psycho-oncology team because of his strong attitude and outlook. Mel’s outward...

geriatric oncology
breast cancer

Geriatric Assessment Is Key to Treatment Decisions for Patients 80 Years and Older

A review of major studies and the current literature underscored the role of geriatric assessment in making treatment recommendations for patients aged 80 years and older with early and metastatic breast cancer. The review was published in the Journal of Oncology Practice. The corresponding author...

skin cancer

Most Patients With Melanoma Had Few Nevi, None Atypical

Although nevi are considered among the strongest risk factors for melanoma, most patients with melanoma had few total nevi and no atypical nevi, according to an analysis of 566 patients with invasive cutaneous melanoma. “Three notable findings emerged from this case study,” Alan C. Geller, MPH, RN, ...

10 Bladder Cancer Projects Awarded Research Grants by Johns Hopkins Greenberg Bladder Cancer Institute

The Johns Hopkins Greenberg Bladder Cancer Institute is a collaborative initiative of the Johns Hopkins Kimmel Cancer Center, the Brady Urological Institute, the Bloomberg School of Public Health, and the School of Medicine. It aims to develop new clinical strategies for combating bladder cancer...

2016 Oncology Meetings

APRIL European Lung Cancer ConferenceApril 13-16 • Geneva, SwitzerlandFor more information:www.esmo.org/Conferences/ELCC-2016-Lung-Cancer American Society for Colposcopy and Cervical Pathology (ASCCP) Annual MeetingApril 13-16 • New Orleans, LouisianaFor more...

lung cancer

Crizotinib in ROS1-Positive Metastatic Non–Small Cell Lung Cancer

On March 11, 2016, crizotinib (Xalkori) was approved for treatment of patients with metastatic non–small cell lung cancer (NSCLC) with ROS1 rearrangement–positive tumors.1,2 A U.S. Food and Drug Administration–approved test for the detection of ROS1 rearrangements in NSCLC is not currently...

pancreatic cancer

Phase Ib/II Study Reports High Response Rates Seen With Addition of Cisplatin to Regimen for Advanced Pancreatic Cancer

The oncology research team at HonorHealth Research Institute in Scottsdale, Arizona, is spearheading a phase Ib/II trial that is demonstrating promising results with a novel regimen in patients with advanced pancreatic cancer. “The patients we are treating have advanced adenocarcinoma of the...

neuroendocrine tumors

Everolimus Improves Progression-Free Survival in Advanced Neuroendocrine Tumors of the Lung or Gastrointestinal Tract

In a phase III trial (RADIANT-4) reported in The Lancet, James C. Yao, MD, of the University of Texas MD Anderson Cancer Center, and colleagues found that everolimus (Afinitor) and supportive care significantly prolonged progression-free survival vs placebo and supportive care in patients with...

lymphoma
leukemia

Selected Abstracts From 2015 ASH Annual Meeting: Part 4

Here is the final installment of selected abstracts from the proceedings of the 2015 American Society of Hematology (ASH) Annual Meeting and Exposition, focusing on Hodgkin lymphoma, follicular lymphoma, diffuse large B-cell lymphoma, and chronic lymphocytic leukemia. For other selected abstracts...

FDA Approves Defibrotide for Complication of Stem Cell Transplant

On March 30, 2016, the U.S. Food and Drug Administration (FDA) approved defibrotide sodium (Defitelio) for the treatment of adult and pediatric patients with hepatic veno-occlusive disease, also known as sinusoidal obstructive syndrome, with renal or pulmonary dysfunction following hematopoietic...

health-care policy

Providing Perspective on Pressing Economic Issues Facing Cancer Care—Now and in the Future

CANCERSCAPE, the 2016 Annual Meeting of the Association of Community Cancer Centers (ACCC), provided a forum for about 300 attendees to gain insight into the complexities of oncology treatment, where “clinical advances, policy mandates, and value-based payment reform intersect.” Of particular...

Understanding and Preparing for MACRA

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was passed in April 2015, introducing comprehensive changes to how Medicare pays physicians for services. As the policies passed in MACRA are rolled out over the coming years, they will profoundly impact reimbursement and care...

Diversity Training Key to Increasing Cultural Competence Among Oncology Surgeons

A study in the Journal of Oncology Practice (JOP)1 measured the level of cultural competence among surgeons from six hospitals in the Puget Sound region of Washington State, home to a large population of American Indians and Alaskan Natives. According to the study, “Assessing Cultural Competence...

lung cancer

Update of ASCEND-1 Trial Shows Ceritinib Highly Active in ALK-Rearranged NSCLC, Including Intracranial Disease

Updated results of the phase I ­ASCEND-1 trial, reported by Kim et al in The Lancet Oncology, indicate that the ALK inhibitor ceritinib (Zykadia) produced high response rates in advanced ALK-rearranged non–small cell lung cancer (NSCLC), including intracranial disease, in both patients with and...

gynecologic cancers

Study Reports No Overall Benefit of Adding Farletuzumab to Chemotherapy in Relapsed Ovarian Cancer, but Potential Subgroup Benefit Identified

Addition of the antifolate receptor-α antibody farletuzumab to carboplatin/taxane did not improve progression-free survival in patients with ovarian cancer in first platinum-sensitive relapse, reported Vergote et al in the Journal of Clinical Oncology. However, benefit was observed in...

issues in oncology
cost of care

Experts Consider What It Means to Improve Quality of Care in an Era of Increasing Reliance on Targeted Therapies

Precision medicine is judged according to different values across the multiple stakeholders involved in cancer care. At this year’s Quality Care Symposium, presenters from different sectors of oncology addressed a central question: How do we assess quality in the age of precision medicine?1,2 Right ...

breast cancer

A Business Professor and Husband Turns Breast Cancer Researcher

In more than 25 years of viewing posters at oncology meetings, I’ve met researchers from virtually all professional walks of life, but it was not until the 2016 Miami Breast Cancer Conference, that the author’s affiliation turned my head: It was a business school. “Utilizing Metastatic Tumor...

breast cancer

Metastatic Breast Cancer With Discordant Tumors: Small Study Reports Treatment by Primary Status May Improve Survival

In a small retrospective series, patients with metastatic breast cancer treated according to the receptor status of the primary tumor, not the metastatic one, had significantly longer median overall survival. The study was reported at the 2016 Miami Breast Cancer Conference by T. Allen Pannell, Jr, ...

breast cancer

Breast Cancer Vaccines Moving Forward at a Fast Clip

Vaccines for both secondary and primary prevention of breast cancer are showing potential in clinical trials, according to Elizabeth A. Mittendorf, MD, PhD, who is leading much of the vaccine research at the University of Texas MD Anderson Cancer Center, Houston. Vaccine platforms being explored...

gynecologic cancers

Trabectedin Improves Progression-Free Survival in Uterine Leiomyosarcoma

In women with uterine leiomyosarcoma, trabectedin (Yondelis), a novel cytotoxic agent, significantly improved progression-free survival, compared with dacarbazine (4.2 vs 1.5 months, hazard ratio [HR] = 0.55, P < .001). According to the study’s authors, a lack of cumulative toxicity allows...

issues in oncology

Computer-Assisted Decision Support in Medical Oncology: We Need It Now

Today’s medical oncologist is increasingly challenged to stay current with the latest developments in cancer treatment. I have been fortunate to speak with many oncologists over the past quarter-century on how professional life has evolved since the 1990s. These conversations have left me with a...

prostate cancer

Throwing Out the Baby With the Bathwater: A Critical Appraisal of the USPSTF Recommendation Against Screening for Prostate Cancer

In 2012, the U.S. Preventive Services Task Force (USPSTF) issued a recommendation against routine screening for prostate cancer.1,2 The grade D recommendation was considered controversial at the time, and remains so now, because many stakeholders have weighed the same body of evidence and come to...

lung cancer

The POPLAR Trial: PD-L1 Blockade With Atezolizumab in Second- or Third-Line Non–Small Cell Lung Cancer

The randomized phase II ­POPLAR trial—reported by Fehrenbacher and colleagues and reviewed in this issue of The ASCO Post—is another key piece of information for the medical community regarding the value of immune checkpoint blockers in second/third-line treatment of patients with non–small cell...

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