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issues in oncology

Overdiagnosis of Those in Higher Income Brackets

According to researchers from the Dartmouth Institute for Health Policy and Clinical Practice, being in a high-income bracket may lead to overdiagnosis of cancer and the subsequent harms associated with unnecessary medical treatments. To shed light on this interesting finding and its broader...

Original Report in JCO CCI Describes How Authors Developed a Process to Automate a QOPI Measure

A NEW ARTICLE published in JCO Clinical Cancer Informatics (JCO CCI), “Automating QOPI Quality Measure NHL78a,” by Richard P. Mansour, MD, and Samip Master, MD, reports how the authors were able to use data from an electronic health record (EHR) and Microsoft SQL Server database management system...

lymphoma

Tisagenlecleucel for B-Cell Acute Lymphoblastic Leukemia

On August 30, 2017, tisagenlecleucel (Kymriah) was granted regular approval for the treatment of patients up to age 25 years with B-cell precursor acute lymphoblastic leukemia (ALL) that is refractory or in second or later relapse.1,2 Tisagenlecleucel is the first chimeric antigen receptor (CAR)...

issues in oncology

Balancing Harms and Benefits of Cancer Screening: The Debate Continues

Over the past several decades, widespread cancer screening has saved lives from various cancer types. However, despite advances in early-detection technologies, many cancers still remain undetected until they become symptomatic, conferring poor prognoses and outcomes. Moreover, some methods of...

palliative care

How Early Palliative Care May Benefit Patients With Incurable Cancer

Palliative care provided soon after a patient is diagnosed with incurable cancer not only helps improve the patient’s overall quality of life but also improves communication about the patient’s wishes for end-of-life care, according to a study by Jennifer S. Temel, MD, Clinical Director of Thoracic ...

leukemia

Inotuzumab Ozogamicin for Relapsed/Refractory B-Cell Precursor ALL

On August 17, 2017, inotuzumab ozogamicin (Besponsa) was approved for the treatment of adults with relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL).1,2  Supporting Efficacy Data  APPROVAL WAS BASED on complete remission rates in the open-label phase III INO-VATE ALL...

solid tumors
lymphoma

FDA Recent Approvals Include First Oncology Biosimilar

ON SEPTEMBER 14, 2017, the U.S. Food and Drug Administration (FDA) approved bevacizumab-awwb (Mvasi) as a biosimilar to bevacizumab (Avastin) for the treatment of multiple types of cancer. Bevacizumab-awwb is the first biosimilar approved in the United States for the treatment of cancer....

issues in oncology

Duration Studies in Oncology Have Often Been Poorly Designed and Analyzed

The ASCO Post is pleased to introduce “At Microphone 1,” an occasional column written by Steven E. Vogl, MD, of Bronx, New York. When he’s not in his clinic, Dr. Vogl can generally be found at major oncology meetings, and often at the microphone where he stands ready with important questions for...

skin cancer

No Improvement in Melanoma-Specific Survival With Completion Dissection vs Observation for Sentinel-Node Metastasis

THE PHASE III MSLT- II TRIAL showed that completion dissection was not associated with improved melanoma-specific overall survival vs observation in patients with sentinel-node metastasis, although a benefit was observed in regional disease control. The findings were reported in The New England...

thyroid cancer
prostate cancer
lung cancer
survivorship
palliative care

News From JCO and JOP

STAYING UP-TO-DATE in the fast-paced world of oncology literature is a daunting task at best. To assist with that task, The ASCO Post has assembled an assortment of studies recently published in the Journal of Clinical Oncology (JCO) and the Journal of Oncology Practice (JOP). Future installments...

sarcoma

Sarcoma Management Is Slowly Evolving

THE BACKBONE treatment for soft-tissue sarcomas has long been anthracycline-based, but new approaches are coming. These novel strategies were discussed at the 2017 Debates and Didactics in Hematology and Oncology Conference in Sea Island, Georgia, by Melinda L. Yushak, MD, MPH, Assistant Professor ...

gastrointestinal cancer

Regorafenib in Hepatocellular Carcinoma Previously Treated With Sorafenib

On April 27, 2017, the indications for regorafenib (Stivarga) were expanded to include treatment of patients with hepatocellular carcinoma who have been previously treated with sorafenib (Nexavar).1,2 Supporting Efficacy Data The new approval was based on the finding of improved overall survival...

cns cancers

Small Steps Forward in Brain Tumor Therapy

SOME RECENT ADVANCES in the treatment of brain tumors are promising, but others are less so, according to Jeffrey J. Olson, MD, Professor of Neurosurgery at Emory University, Atlanta. At the 2017 Debates and Didactics in Hematology and Oncology Conference, held in Sea Island, Georgia, and...

skin cancer

Is Complete Lymphadenectomy Still Standard of Care in Melanoma?

DOES COMPLETE lymph node dissection for sentinel node–positive melanoma still have a role in the management of this disease? That’s debatable. Although it does not improve overall survival over observation alone, complete lymphadenectomy may have other benefits, according to a dialogue at the...

hematologic malignancies

Amyloidosis: Pearls for Simplifying the Diagnosis

AMYLOIDOSIS REMAINS a challenging and nuanced diagnosis. At the 2017 Debates and Didactics in Hematology and Oncology Conference, held in Sea Island, Georgia, Jonathan L. Kaufman, MD, discussed his approach to diagnosing amyloid light-chain amyloidosis. Dr. Kaufman is Associate Professor of...

lung cancer

Expert Point of View: Johan Vansteenkiste, MD, PhD

FORMAL DISCUSSANT of this trial, Johan Vansteenkiste, MD, PhD, Head of the Respiratory Oncology Unit at the University Hospital KU Leuven, Belgium, was enthusiastic about the PACIFIC trial results. “We had an earthquake of immunotherapy in lung cancer this past year at ESMO. After an earthquake,...

lung cancer

PD-L1 Inhibitor Consolidation Therapy for NSCLC: New Standard of Care?

THE PROGRAMMED CELL DEATH ligand 1 (PD-L1) inhibitor durvalumab (Imfinzi) improved progression-free survival by 11.2 months compared with placebo in patients with locally advanced, unresectable stage III non–small cell lung cancer (NSCLC) whose disease did not progress following standard treatment ...

hepatobiliary cancer

Hepatocellular Carcinoma: Current Thoughts on Liver Transplantation

LIVER TRANSPLANT offers the highest rates of long-term survival for patients with hepatocellular carcinoma, according to Maria Russell, MD, Assistant Professor of Surgery at Emory University, Atlanta. At the 2017 Debates and Didactics in Hematology and Oncology Conference at Sea Island, Georgia,...

breast cancer

Religiously Tailored Educational Intervention to Encourage Mammography in American Muslim Women

Despite the U.S. Preventive Services Task Force recommendation that women between the ages of 50 and 74 undergo mammography every 2 years, only about 50% of American Muslim women do so, compared with 67% of all American women. A study by Padela et al investigating the mammography-related barrier...

skin cancer

Expert Point of View: Reinhard Dummer, MD, and Jeffrey Weber, MD, PhD

ASSUMING THE regimens evaluated in COMBI-AD and CheckMate 238 are both approved by the U.S. Food and Drug Administration for the treatment of high-risk resected melanoma, clinicians may be faced with a tough choice. ESMO experts and the study’s investigators weighed in on this issue in a lively...

issues in oncology

Adoptive Cell Therapy—Act 1: The Beginning

ON AUGUST 30, 2017, the first genetically engineered T-cell therapy (tisagenlecleucel [Kymriah]) was approved by the U.S. Food and Drug Administration (FDA) for the treatment of patients up to 25 years of age with B-cell precursor acute lymphoblastic leukemia that is refractory or in second or...

supportive care
symptom management

Tibetan Yoga Practice May Improve Sleep Quality for Patients With Breast Cancer Undergoing Chemotherapy

Participating in twice-weekly practice of Tibetan yoga may reduce sleep disturbances and improve sleep quality in breast cancer patients receiving chemotherapy, according to a study published by Chaoul et al in Cancer. The study, led by researchers from The University of Texas MD Anderson Cancer...

breast cancer

Surgeon-Initiated Gene-Expression Profile Testing in Early-Stage Breast Cancer and Time to Start of Chemotherapy

In a single-center study reported in the Journal of Oncology Practice, Losk et al found that an intervention including surgeon initiation of gene-expression profile testing with Oncotype DX significantly reduced the time to testing, receipt of testing results, and initiation of chemotherapy in...

gynecologic cancers

Final Efficacy Analysis of 9-Valent Human Papillomavirus Vaccine Trial

The final efficacy analysis of a trial of 9-valent human papillomavirus (HPV) vaccine has shown a high preventive effect against disease due to the additional HPV pathogenic strains covered compared with the quadrivalent vaccine at up to 6 years. These findings were reported by Huh et al in The...

leukemia

Combination of Inotuzumab Ozogamicin and Low-Intensity Chemotherapy in Relapsed or Refractory Ph-Negative ALL

In a single-center phase II trial reported in JAMA Oncology, Jabbour et al found that the combination of inotuzumab ozogamicin (Besponsa) and low-intensity chemotherapy produced promising results in patients with relapsed or refractory Philadelphia chromosome (Ph)-negative acute lymphoblastic...

health-care policy
issues in oncology

AACR Releases 2017 Cancer Progress Report: Harnessing Research Discoveries to Save Lives

Federally funded research that provides a deep understanding of cancer is spurring advances against many types of the disease. With a strong bipartisan commitment from Congress to keep investment in biomedical research a national priority, we can accelerate our pace of progress and save more lives...

issues in oncology
symptom management

Assessing and Managing CAR T-Cell Treatment Toxicities

Immune-cell based therapies opening a new frontier for cancer treatment carry unique, potentially lethal side effects that provide a new challenge for oncologists—one addressed by a team led by clinicians at The University of Texas MD Anderson Cancer Center with proposed guidelines for...

hepatobiliary cancer

Does Reducing the Starting Dose of Sorafenib Affect Outcomes in Hepatocellular Carcinoma?

In a retrospective study reported in the Journal of Clinical Oncology, Reiss et al found that reducing the starting dose of sorafenib (Nexavar) was associated with noninferior overall survival, reduced cost, and lower risk of discontinuing treatment in patients with advanced hepatocellular...

lymphoma

Addition of Bortezomib to R-CHOP in Non–Germinal Center B-Cell–Like Lymphoma

A phase II trial reported in the Journal of Clinical Oncology by Leonard et al showed no significant progression-free survival benefit of adding bortezomib (Velcade) to R-CHOP (rituximab [Rituxan], cyclophosphamide, doxorubicin, vincristine, and prednisone) in previously untreated patients with...

bladder cancer

ESMO 2017: KEYNOTE-045: Updated Results Support Pembrolizumab as Second-Line Treatment in Advanced Urothelial Cancer

Mature results from the KEYNOTE-045 trial presented at the European Society for Medical Oncology (ESMO) 2017 Congress in Madrid (Abstract LBA37_PR) confirmed significantly longer survival in patients with advanced urothelial cancer who received the checkpoint inhibitor pembrolizumab after initial...

bladder cancer

Adjuvant Chemotherapy vs Observation After Neoadjuvant Therapy and Radical Cystectomy for Bladder Cancer

In an analysis reported in JAMA Oncology, Seisen et al found that adjuvant chemotherapy was associated with a survival benefit vs observation in patients with adverse prognostic features after neoadjuvant therapy and radical cystectomy for urothelial carcinoma of the bladder. Study Details The...

issues in oncology

ESMO 2017: Patients Struggle With Key Aspects of Clinical Trial Methodology

Clinical trials are fundamental to the development of new treatments for cancer, yet the annual accrual to cancer clinical trials worldwide is low, estimated at 3%–5%. A nationwide study in Ireland, the preliminary results of which were presented at the European Society for Medical Oncology...

head and neck cancer

ESMO 2017: KEYNOTE-040 Evaluates Pembrolizumab in Head and Neck Cancer

Immunotherapy with the checkpoint inhibitor pembrolizumab (Keytruda) may be a better option than standard treatments for patients whose head and neck cancer has spread or recurred after an initial round of chemotherapy, according to results of the KEYNOTE-040 trial presented at the European Society ...

breast cancer

ESMO 2017: MONARCH 3: Abemaciclib as Initial Therapy Improves Outcome in Endocrine-Sensitive Advanced Breast Cancer

The results of the MONARCH 3 trial, presented at the European Society for Medical Oncology (ESMO) 2017 Congress in Madrid (Abstract 236O_PR), showed that adding the cyclin-dependent kinase (CDK) 4/6 inhibitor abemaciclib to endocrine therapy improved progression-free survival compared to endocrine...

issues in oncology
survivorship

ESMO 2017: NOR-CAYACS Trial: Factors That May Limit Work Ability of Young Adult Cancer Survivors

Factors that may limit the ability of young adult cancer survivors to work were reported at the European Society for Medical Oncology (ESMO) 2017 Congress in Madrid (Abstract 1110PD_PR). Late side effects can occur months or years after cancer treatment. In patients diagnosed with cancer in young...

bladder cancer

Recombinant Adenovirus Interferon-α With Syn3 in BCG-Refractory or Relapsed Non–Muscle Invasive Bladder Cancer

A phase II study has shown activity of recombinant adenovirus interferon-α with Syn3 (rAd-IFNα/Syn3), a replication-deficient recombinant adenovirus gene transfer vector, in patients with high-grade bacillus Calmette-Guerin (BCG)-refractory or -relapsed non–muscle invasive bladder ...

lung cancer

Osimertinib in First-Line Treatment of EGFR Mutation–Positive Advanced NSCLC

Osimertinib (Tagrisso) has shown high activity in the phase I expansion component of the AURA trial in previously untreated patients with EGFR mutation–positive advanced non–small cell lung cancer (NSCLC). These findings were reported by Ramalingam et al in the Journal of Clinical...

lymphoma

FDA Approves Copanlisib for Adults With Relapsed Follicular Lymphoma

Today, the U.S. Food and Drug Administration (FDA) granted accelerated approval to copanlisib (Aliqopa) for the treatment of adults with relapsed follicular lymphoma who have received at least two prior systemic therapies. “For patients with relapsed follicular lymphoma, the cancer often...

lung cancer

ESMO 2017: PACIFIC Trial: Durvalumab Improves Progression-Free Survival in Stage III Lung Cancer

Durvalumab improves progression-free survival in patients with locally advanced, unresectable stage III lung cancer, according to late-breaking results from the phase III PACIFIC trial presented at the European Society for Medical Oncology (ESMO) 2017 Congress in Madrid (Abstract LBA1_PR) and...

gastrointestinal cancer

ESMO 2017: Pembrolizumab Shows Promising Response Rate in Pretreated Metastatic Gastric Cancer

Pembrolizumab (Keytruda) has shown a promising response rate in patients with pretreated metastatic gastric cancer, according to late-breaking results from the KEYNOTE-059 trial presented at the 2017 European Society for Medical Oncology (ESMO) Congress in Madrid (Abstract LBA28_PR). The expected...

solid tumors

Hospitalization and Rehospitalization After Diagnosis of Advanced Cancer

In a study reported in the Journal of Clinical Oncology, Whitney et al found that the majority of patients diagnosed with advanced cancer were hospitalized within 1 year of diagnosis, with a sizable proportion having multiple hospitalizations. Hospitalization Rates The study involved California...

breast cancer

Whole-Genome Sequencing Reveals Breast Cancers With Mismatch-Repair Deficiencies

Cancers caused by mismatch repair (MMR)-deficiency involve gene mutations that affect the ability of the cell to repair the mistakes that may occur during the DNA replication process. MMR-deficient tumors have 10 to 100 times more mutations than tumors with intact MMR pathways. A study...

hematologic malignancies

Survey on Training in Geriatrics/Geriatric Oncology for Hematology-Oncology Fellows

Results from an ASCO-sponsored survey study indicate that despite professed interest in the area, most hematology-oncology fellows have inadequate training in geriatrics/geriatric oncology. These findings were reported in the Journal of Oncology Practice by Maggiore et al. Study Details The...

head and neck cancer

Pembrolizumab in PD-L1–Positive Nasopharyngeal Carcinoma

As reported by Hsu et al in the Journal of Clinical Oncology, pembrolizumab (Keytruda) has shown activity in programmed cell death ligand 1 (PD-L1)–positive recurrent or metastatic nasopharyngeal carcinoma, in a cohort of the phase Ib KEYNOTE-028 trial. Study Details In the study, 27...

breast cancer

First-in-Human Study of Tamoxifen Metabolite Z-Endoxifen in Endocrine-Refractory Metastatic Breast Cancer

A first-in-human phase I study of the oral tamoxifen metabolite Z-endoxifen showed high drug exposure, acceptable toxicity, and antitumor activity in endocrine-refractory estrogen receptor–positive metastatic breast cancer. The findings were reported in the Journal of Clinical Oncology by...

breast cancer

ESMO 2017: Adding Taselisib to Neoadjuvant Letrozole Improves Outcomes in Early Breast Cancer

Adding taselisib to letrozole before surgery significantly improved outcomes for patients with early breast cancer that was both estrogen receptor–positive and HER2-negative, according to results of the LORELEI trial, presented at the European Society for Medical Oncology (ESMO) 2017 Congress ...

skin cancer

ESMO 2017: Combination Targeted Adjuvant Therapy Doubles Relapse-Free Survival in Stage III Melanoma

Combination targeted adjuvant therapy with dabrafenib (Tafinlar) and trametinib (Mekinist) doubles relapse-free survival in patients with stage III BRAF-mutant melanoma, according to late-breaking results from the COMBI-AD trial presented on September 11 at the European Society for Medical Oncology ...

skin cancer

ESMO 2017: Adjuvant Nivolumab Superior to Ipilimumab in Surgically Resected Stage III/IV Melanoma

Adjuvant nivolumab (Opdivo) is superior to standard-of-care ipilimumab (Yervoy) in patients with surgically resected stage III/IV melanoma who are at high risk of relapse, according to late-breaking results from the CheckMate 238 trial presented on September 11 at the European Society for Medical...

colorectal cancer

Remnant Liver Ischemia and Cancer-Specific Survival After Resection of Colorectal Liver Metastases

In a single-center experience reported by Yamashita et al in JAMA Surgery, postoperative remnant liver ischemia of grade ≥ 2 was associated with worse cancer-specific survival after resection of colorectal liver metastases. Study Details The retrospective analysis included 202 patients who...

lung cancer

Adding First-Line Ipilimumab to Paclitaxel/Carboplatin in Advanced Squamous NSCLC

In a phase III trial reported by Govindan et al in the Journal of Clinical Oncology, the addition of first-line ipilimumab (Yervoy) to paclitaxel/carboplatin did not improve overall survival in patients with advanced squamous non–small cell lung cancer (NSCLC). Study Details In the...

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