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palliative care

Despite Increasing Global Legalization of Physician-Assisted Suicide, Use Remains Rare

Despite increasing legalization of euthanasia and physician-assisted suicide worldwide, the practices remain relatively rare and, when carried out, are primarily motivated by psychological factors such as loss of autonomy or enjoyment of life, rather than physical pain. A new comprehensive...

gynecologic cancers

FDA Approves First HPV Test for Use With SurePath Preservative Fluid

On July 7, the U.S. Food and Drug Administration (FDA) approved the Roche cobas HPV Test as the first test for Human Papilloma Virus (HPV) that can be used with cervical cells obtained for a Papanicolau (Pap) test and collected in SurePath Preservative Fluid. The FDA approves HPV tests to be used...

health-care policy

FDA Advances Precision Medicine Initiative by Issuing Draft Guidances on Next-Generation Sequencing–Based Tests

In support of the President’s Precision Medicine Initiative, on July 6, the U.S. Food and Drug Administration (FDA) issued two draft guidances that, when finalized, will provide a flexible and streamlined approach to the oversight of tests that detect medically important differences in a...

kidney cancer

When Combined With Targeted Therapy, Cytoreductive Nephrectomy May Improve Survival in Metastatic RCC

In a National Cancer Data Base study reported in the Journal of Clinical Oncology, Hanna et al found that cytoreductive nephrectomy may improve survival in patients receiving targeted therapy for metastatic renal cell carcinoma. Study Details The study involved data from 15,390 patients treated...

gastrointestinal cancer

World GI 2016: Chemoradiotherapy After Surgery for Gastric Cancer Shows Similar Outcomes to Postoperative Chemotherapy

Postoperative treatment intensification with chemoradiotherapy does not achieve better outcomes compared to postoperative chemotherapy in patients with gastric cancer who have already undergone preoperative chemotherapy, according to phase III data presented by Verheij et al at the ESMO 18th World...

colorectal cancer

World GI 2016: Anti–PD-L1 Immunotherapy Combined With MEK Inhibition Shows Response in Microsatellite-Stable Metastatic Colorectal Cancer

Anti–PD-L1 (programmed cell death ligand 1) immunotherapy may achieve a response in patients with microsatellite-stable metastatic colorectal cancer if combined with a MEK inhibitor, according to phase I data presented at the European Society for Medical Oncology (ESMO) 18th World Congress on ...

gynecologic cancers

Neoadjuvant Chemotherapy May Render Advanced Ovarian Cancers Responsive to Immunotherapy

Although most patients with advanced ovarian cancer initially respond to platinum-based chemotherapy, they usually relapse. According to a study by Frances R. Balkwill, PhD, Professor of Cancer Biology at Barts Cancer Institute, Queen Mary University of London, United Kingdom, and colleagues...

colorectal cancer

Norwegian Study Shows Benefit of Aspirin as Secondary Prevention in Patients With Colorectal Cancer

A Norwegian population-based study reported in the Journal of Clinical Oncology by Simer J. Bains, MD, PhD, of the Centre for Molecular Medicine Norway, University of Oslo, and colleagues showed that use of aspirin after diagnosis of colorectal cancer was associated with improved colorectal...

leukemia

Increased Risk for Cardiovascular Events Seen in Patients With CML Taking Tyrosine Kinase Inhibitors

Although tyrosine kinase inhibitors have dramatically increased survival for patients with chronic myeloid leukemia (CML), continuous administration of these drugs may elicit long-term toxicity, including cardiovascular adverse events. To investigate the incidence of vascular events in patients...

colorectal cancer

Prevention Needed to Stem Global Rise in Human Papillomavirus–Related Anal Cancer

The incidence rate of human papillomavirus (HPV)-related anal cancer and its precursor lesion, anal intraepithelial neoplasia, is rising in the United States and globally. Although 5-year survival rates in localized disease are generally favorable, survival in metastatic disease remains poor,...

breast cancer
survivorship
supportive care

Managing Upper Extremity Dysfunction in Breast Cancer Survivors

With an increased number of breast cancer survivors and patients with metastatic disease living longer, it is imperative for oncology care providers to manage issues of new and chronic upper extremity dysfunction as a result of the malignancy itself or its treatment. As one of my patients...

breast cancer

Greatest Benefit of Adjuvant Exemestane 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, Meredith M. Regan, ScD, of Dana-Farber Cancer Institute, and colleagues found that the greatest benefit of adjuvant exemestane in reducing breast cancer recurrence was among women with the greatest risk of...

hematologic malignancies

Complexities in the Diagnosis and Management of Amyloidosis

Question 1: What is the next best step for this patient? Correct Answer: C. Determination of amyloid subtype. Expert Perspective Amyloidosis encompasses a heterogeneous group of diseases bound by the characteristic deposition of amyloid fibrils in soft tissues and bone marrow, and it could be...

pain management

Fentanyl Nasal Spray Now Available at a Dose of 300 μg for Treatment of Breakthrough Cancer Pain

Fentanyl (Lazanda) nasal spray, a schedule II narcotic, is now available at a 300-μg dose to treat breakthrough cancer pain, offering physicians another titration option for dosing flexibility. The new strength can help physicians more easily and accurately target the appropriate dose for...

leukemia

Relapse of Leukemia After Bone Marrow Transplantation: Cytomegalovirus Infection Has No Protective Effect

Recent studies on a small number of patients with leukemia treated with bone marrow transplantation have suggested that the presence of the common cytomegalovirus (CMV) in patients or their donors may protect against relapse or even death after the transplant. A large international study published...

gastrointestinal cancer

Higher Prediagnostic Plasma Vitamin D Levels May Be Associated With Prolonged Survival in Pancreatic Cancer

In a study reported by Yuan et al in the Journal of Clinical Oncology, higher prediagnostic plasma 25-hydroxyvitamin D [25(OH)D] levels were found to be associated with prolonged overall survival in patients with pancreatic cancer. Study Details The study involved data from 493 patients from 5...

lymphoma

Comparison of Chemotherapy Regimens After Negative Interim PET-CT in Advanced Hodgkin Lymphoma

In a phase III trial reported in The New England Journal of Medicine, Johnson et al found similar efficacy with continued ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) chemotherapy vs omission of bleomycin (AVD) after negative interim PET-CT (positron-emission tomography–computed...

issues in oncology

Computed Tomography–Based Lean Body Mass Calculations May Improve Accuracy of PET for Patients With Cancer

Patients with cancer often experience significant fluctuations in weight and lean body mass. Neglecting to account for these changes can prevent clinicians from obtaining precise data from molecular imaging, but a new method of measuring lean body mass takes changes in individual body composition...

prostate cancer

Novel Approach to PET/CT Imaging May Predict Location and Extent of Primary Prostate Cancer

With surgical removal at the front line of defense against prostate cancer, oncologists are considering prostate-specific molecular imaging at the point of initial biopsy and preoperative planning to root out the full extent of disease, researchers showed at the 2016 Annual Meeting of the Society...

lung cancer

FDG–PET Evaluates Immunotherapy for Non–Small Cell Lung Cancer

Researchers at the 2016 Annual Meeting of the Society of Nuclear Medicine and Molecular Imaging (SNMMI) presented study findings on a means of evaluating an immunotherapy for non–small cell lung cancer (NSCLC).1 Due to NSCLC’s relative insensitivity to chemotherapy, the use of immunotherapies,...

Expert Point of View: David Reardon, MD

“Adjuvant temozolomide does represent a new standard of care for 1p/19q-intact anaplastic glioma patients,” according to David Reardon, MD, Clinical Director at the Dana-Farber Center for Neuro-Oncology and the study’s formal discussant at the 2016 ASCO Annual Meeting. “We see a significant...

Expert Point of View: Steven M. Devine, MD

Formal discussant of these trials Steven M. Devine, MD, of The Ohio State University Comprehensive Cancer Center, Columbus, was not able to attend the ASCO Meeting, but his slides were presented to the audience. “CAR T-cell therapy was first thought of in the 1980s, but it is only recently that we ...

leukemia

CAR T-Cell Dose Refinement May Reduce Cytokine-Release Syndrome in Patients With Advanced Acute Lymphoblastic Leukemia

Chimeric antigen receptor (CAR) T-cell therapy has been effective in adults and children with advanced acute lymphoblastic leukemia (ALL), but along with efficacy, the treatment can stimulate cytokine-­release syndrome, which can be deadly if it goes unrecognized and untreated. Adjusting the dose...

Expert Point of View: Elizabeth Mittendorf, MD, PhD

The discussant of these studies was Elizabeth Mittendorf, MD, PhD, Associate Professor of Breast Surgical Oncology at the University of Texas MD Anderson Cancer Center, Houston. Dr. Mittendorf noted that approximately 3% of U.S. breast cancer patients present with de novo stage IV disease. For...

Expert Point of View: Stephen K.L. Chia, MD

Stephen K.L. Chia, MD, of the British Columbia Cancer Agency, Vancouver, discussed two of these neoadjuvant breast cancer studies at the ASCO Annual Meeting. In the current landscape for neoadjuvant therapy in HER2-positive disease, said Dr. Chia, the NeoSphere, ­TRYPHAENA, KRISTINE, and I-SPY 2...

sarcoma

Kaposi Sarcoma–Associated Herpesvirus Mimics Host Signal to Drive Cell Growth, Protein Production

In a study report published by Bhatt et al in Proceedings of the National Academy of Sciences, researchers at the University of North Carolina Lineberger Comprehensive Cancer Center explained how a type of herpesvirus uses mimicry to trick the host cell to produce proteins the virus needs and...

cns cancers

Analysis of Cerebrospinal Fluid for D-2-Hydroxyglutarate May Detect Malignant Brain Tumors Nonsurgically

When a brain tumor is suspected, its presence is usually confirmed by anatomic imaging such as computed tomography (CT) or magnetic resonance imaging (MRI). But through imaging, not much about the tumor molecularly can be learned. Surgery and a biopsy are necessary to get a glimpse of the cancer...

The Age of the Atomic Hematologists/Oncologists

Every longstanding culture has ages: The Minoans were followed by the Mycenaeans and, later, the Hellenistic peoples. And so it is with hematology/oncology. A descriptive age dominated predominately by histopathologists was followed by an age of experimentalists. Development of the atomic bombs...

geriatric oncology
supportive care
leukemia

Assessment of Fitness, Function, and Quality of Life Essential in Treatment of Older Patients With CLL

Significant progress has been made in the past 2 decades in the care of patients with chronic lymphocytic leukemia (CLL). Recently, the therapeutic armamentarium has expanded for such patients with the introduction of new targeted agents. CLL is predominantly a disease of the elderly, with a...

symptom management

Factors Associated With Chemotherapy-Induced Peripheral Neuropathy in Older Patients

In an analysis of the linked Southwest Oncology Group–Medicare databases reported by Hershman et al in the Journal of Clinical Oncology, an increased risk of peripheral neuropathy in older patients receiving taxane therapy was associated with increasing age and a history of diabetes in...

breast cancer

Approximately 20% of Older Women With Early Breast Cancer Experience Some Form of Functional Decline After Treatment

In a study of older women with newly diagnosed stage I to III breast cancer, approximately 1 in 5 lost the ability to complete some of the basic tasks necessary for independent living within 1 year of initiating treatment. The study also found that a simple survey can help identify which women are...

colorectal cancer

Primary Care Visits Result in More Colorectal Cancer Screening, Better Follow-up

People who visit their primary care physicians are more likely to get potentially life-saving colon cancer screenings and follow-up on abnormal stool blood test results—even in health systems that heavily promote mail-in home stool blood tests that don’t require a doctor visit, a study...

breast cancer

No Advantage With Cyclophosphamide/Methotrexate Maintenance in Hormone Receptor–Negative Early Breast Cancer, but Subgroup May Benefit

Low-dose oral cyclophosphamide plus methotrexate maintenance therapy yielded no disease-free survival benefit in women with hormone receptor–negative early breast cancer, according to the phase III International Breast Cancer Study Group (IBCSG) 22-00 trial. Some evidence of benefit was...

gynecologic cancers

Women With High-Grade Cervical Intraepithelial Neoplasia Have Long-Term Increased Risk for HPV-Related Anal, Vulvar, and Vaginal Cancers

Although high-risk human papillomavirus (HPV) is essential for developing high-grade cervical intraepithelial neoplasia (CIN2 and CIN3) and has also been associated with noncervical anogenital cancers, little is known about the long-term risk for anal, vulvar, and vaginal cancer following a...

hepatobiliary cancer

FDA Approves Sofosbuvir/Velpatasvir for Treatment of Chronic Hepatitis C Virus Infection

On June 28, the U.S. Food and Drug Administration (FDA) approved a fixed-dose combination of sofosbuvir, 400 mg, plus velpatasvir, 100 mg (Epclusa) to treat adult patients with chronic hepatitis C virus (HCV) either with or without cirrhosis. For patients with moderate to severe cirrhosis...

gynecologic cancers

No Overall Advantage to Adding Pertuzumab to Chemotherapy in Platinum-Resistant Ovarian Cancer, but Subgroup May Benefit

According to the European phase III PENELOPE trial reported in the Journal of Clinical Oncology, Kurzeder et al found that adding pertuzumab (Perjeta) to investigator’s choice of chemotherapy did not improve progression-free survival in women with low-HER3 mRNA–expressing...

skin cancer

Ipilimumab Combined With Antigen-Specific Cytotoxic T Lymphocytes May Be of Benefit in Metastatic Melanoma

In a study reported in the Journal of Clinical Oncology by Chapuis et al, concurrent use of cytotoxic T lymphocyte (CTL) antigen-4 (CTLA-4) blockade with ipilimumab (Yervoy) and adoptively transferred antigen-specific CTLs produced enduring responses in patients with stage IV melanoma. Study...

breast cancer

Influence of Microbiota of Breast Tissue on the Development of Cancers

Bacteria that have the potential to abet breast cancer are present in the breasts of cancer patients, while beneficial bacteria are more abundant in healthy breasts, where they may actually be protecting women from cancer, according to Gregor Reid, PhD, of the Lawson Health Research Institute, and...

bladder cancer

Nivolumab Receives FDA Breakthrough Therapy Designation for Advanced/Metastatic Urothelial Carcinoma

Bristol-Myers Squibb Company announced June 27 that the U.S. Food and Drug Administration (FDA) has granted Breakthrough Therapy Designation to nivolumab (Opdivo) for the potential indication of unresectable locally advanced or metastatic urothelial carcinoma that has progressed on or after a...

pancreatic cancer

Precision Medicine Clinical Trial for Metastatic Pancreatic Cancer Now Open at Multiple Sites

The first clinical trial to compare standard-of-care chemotherapy with molecularly tailored therapy (also known as precision medicine) for metastatic pancreatic cancer is now enrolling patients at multiple sites around the country. Patients who have been treated with one round of chemotherapy for...

hematologic malignancies

Four-Biomarker Panel Identified for Chronic Graft-vs-Host Disease

In a study reported in the Journal of Clinical Oncology, Jeffrey Yu, MD, of the Indiana University School of Medicine, Indianapolis, and colleagues identified a four-biomarker panel that was predictive of chronic graft-vs-host disease after allogeneic hematopoietic cell transplantation. Discovery...

gastrointestinal cancer

Increased Risk of Gallbladder Cancer May Be Associated With Consuming Large Amounts of Sweetened Beverages

A large prospective Swedish study reported by Susanna C. Larsson, PhD, of the Unit of Nutritional Epidemiology at the Institute of Environmental Medicine at Karolinska Institutet in Stockholm, Sweden, and colleagues found a 2.2-fold increased risk of gallbladder cancer in people who consumed two or ...

colorectal cancer

Adding Adjuvant Oxaliplatin to Fluoropyrimidine May Be of Benefit in Deficient Mismatch Repair Colon Cancer

In a French retrospective study reported by David Tougeron, MD, PhD, of Poitiers University Hospital, Poitiers, France, and colleagues in the Journal of the National Cancer Institute, the addition of adjuvant oxaliplatin to fluoropyrimidine treatment improved disease-free survival in patients with...

cns cancers

Retroviral Replicating Vector That Delivers Cytosine Deaminase to Cancer Cells Active in Recurrent Glioblastoma

A phase I study by Timothy F. Cloughesy, MD, Director of the Neuro-Oncology Program at the UCLA Jonsson Comprehensive Cancer Center, and colleagues published in Science Translational Medicine investigated the effectiveness of vocimagene amiretrorepvec (Toca 511), an experimental nonlytic,...

Use Questions From Patients to Help Them Make Informed Treatment Decisions

Recent reports about treatment options for patients with ductal carcinoma in situ, and the ensuing debate and comments played out in the media, may prompt increased questions from patients. A review summarizing data about these treatment options concluded that surgery and radiation therapy “remain...

breast cancer

Surgery and Radiation Therapy Remain Standard of Care for Managing Ductal Carcinoma in Situ

A review of more than 50 studies (many randomized controlled trials) concluded that surgery and radiation therapy “remain standard-of-care treatment options” in the management of ductal carcinoma in situ.1 The review continues the widely reported discussion on managing ductal carcinoma in situ,...

integrative oncology

Black Cohosh

Scientific Name: Cimicifuga racemosa Common Names: Black snakeroot, rattlesnake root, squawroot, bugbane, bugwort Brand Names: Remifemin, Menofem, Klimadynon Overview A perennial plant native to the eastern United States and Canada, black cohosh root was used by Native Americans to treat colds,...

issues in oncology

Moonshot Program for … Compassion

A 65-year-old patient with widely metastatic pancreatic cancer was emergently transferred to our facility in the early hours of the morning with free air suggestive of a perforated viscus. The patient is from a small town several hundred miles away from our academic center, which can be quite...

head and neck cancer

Clinical Trials Actively Recruiting Patients With Ocular Cancer

Phase 0 Study Title: Use of Definity® Contrast Agent for Ultrasound of Intraocular Tumors Study Type: Interventional/single-group assignment Study Sponsor and Collaborators: Emory University Purpose: To determine if microbubbles may be used as a contrast agent to help image tumors in the eye. In...

Vanguard Practices Support Sharing Big Data With CancerLinQ™

CancerLinQ LLC, recently announced that it has completed agreements with 36 vanguard oncology practices from around the country to begin implementing the tool. According to physicians at the vanguard practices, gaining access to the experience of oncology practices across the country motivated...

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