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issues in oncology

ESMO 2017: Some Stroke Survivors May Have Underlying Cancer

Some stroke survivors may have underlying cancer, according to an observational study presented at the European Society for Medical Oncology (ESMO) 2017 Congress in Madrid (Abstract 1412P_PR). “Postmortem studies have suggested that cancer can develop after a stroke, but the magnitude of...

gynecologic cancers

ESMO 2017: Rucaparib Boosts Progression-Free Survival in BRCA-Mutant Recurrent Ovarian Cancer

Rucaparib (Rubraca) maintenance therapy increases progression-free survival in BRCA-mutant recurrent ovarian cancer by 77%, according to late-breaking results from the ARIEL3 trial reported at the European Society for Medical Oncology (ESMO) 2017 Congress in Madrid (Abstract LBA40_PR). Most...

lung cancer

ESMO 2017: ALEX and ALUR Trials: Alectinib Shows CNS Benefit in ALK-Positive NSCLC

Data from two separate phase III studies presented at the European Society for Medical Oncology (ESMO) 2017 Congress in Madrid show the particular central nervous system (CNS) activity of alectinib (Alecensa) in patients with advanced non–small cell lung cancer involving a mutation of the...

gastrointestinal cancer

Cytoreductive Surgery With Hyperthermic Intraperitoneal Chemotherapy

In a single-center experience reported in JAMA Surgery, Eng et al found that an increased intraoperative fluid rate was associated with increased perioperative morbidity in patients with peritoneal cancer undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy. Study...

head and neck cancer

Cabozantinib Salvage Therapy in Tyrosine Kinase Inhibitor–Refractory Differentiated Thyroid Cancer

A phase II study has shown that cabozantinib (Cometriq) produces responses in patients with tyrosine kinase inhibitor–refractory differentiated thyroid cancer. The findings were reported by Cabanillas et al in the Journal of Clinical Oncology. MET plays a role in vascular endothelial growth...

breast cancer

ESMO 2017: MINDACT Study in Early-Stage Breast Cancer Shows Even Small Tumors Can Be Aggressive

Even small tumors in the breast can be aggressive, according to a study in patients with early-stage breast cancer presented at the 2017 European Society for Medical Oncology (ESMO) Congress in Madrid (Abstract 150O_PR). Researchers found that 24% of small tumors were aggressive, and patients...

issues in oncology

ESMO 2017: Overuse of Tumor Marker Tests in Primary and Secondary Care

The vast majority of tumor marker tests in primary and secondary care are not necessary, according to a study presented at the 2017 European Society for Medical Oncology (ESMO) Congress in Madrid (Abstract 1410P_PR). The tests assisted with a cancer diagnosis in just 2% of patients....

leukemia

Guadecitabine in Treatment-Naive Older Patients With Acute Myeloid Leukemia

The results of a phase II trial have shown high activity of guadecitabine, a next-generation hypomethylating drug, in treatment-naive older patients with acute myeloid leukemia. The findings were reported in The Lancet Oncology by Kantarjian et al. Guadecitabine has a longer half-life and exposure...

hematologic malignancies

Immunologic Biomarkers and Survival in Third-Generation CAR T-Cell Therapy

A phase I/IIa study investigating the safety and effectiveness of a third-generation CD19-specific chimeric antigen receptor (CAR) T-cell therapy in patients with lymphoma or leukemia has found that the treatment led to a complete response in 6 of the 15 patients in the study and that overall...

issues in oncology

FDA Pilot Program Aims to Encourage Students to Pursue STEM Careers

When I was in high school, I spent summers working as a restaurant dishwasher, grocery store stock boy, and gardener in northwest Indiana. The idea of spending those weeks learning about science and medicine would not have been an option for me at that time. Yet it is precisely those students who...

gastrointestinal cancer

Relationship Between Molecular Subtypes of Gastric Cancer and Prognosis

In 2014, The Cancer Genome Atlas (TCGA) project discovered there are four molecular subtypes of gastric cancer: Epstein-Barr virus (EBV), microsatellite instability, genomically stable, and chromosomal instability. However, their clinical significance is unknown.  Now, a study by Bo Hwa Sohn, PhD,...

skin cancer

Immune-Related Toxicity and Time to Treatment Failure With Nivolumab Plus Ipilimumab in Advanced Melanoma

As reported in JAMA Oncology by Shoushtari et al, a single-center experience has shown a very high rate of clinically significant immune-related adverse events with nivolumab (Opdivo) plus ipilimumab (Yervoy) for advanced melanoma. Their findings suggest that the full course of four doses of...

cns cancers

Addition of EGFR-Targeting Vaccine to Temozolomide in EGFRvIII-Expressing Glioblastoma

The phase III ACT IV study has shown no survival benefit of adding rindopepimut, a vaccine targeting the epidermal growth factor receptor (EGFR) deletion mutation EGFRvIII, to temozolomide in patients with newly diagnosed EGFRvIII-positive glioblastoma. These findings were reported by Weller et al...

breast cancer

Accelerated vs Standard Epirubicin and Capecitabine vs CMF in Breast Cancer

The phase III UK TACT2 trial has shown no efficacy benefit of accelerated vs standard epirubicin and a potential quality-of-life benefit of capecitabine vs CMF (cyclophosphamide, methotrexate, fluorouracil) as adjuvant therapy for breast cancer. The findings were reported in The Lancet Oncology by ...

cns cancers

‘Substantial Improvements’ in the Treatment of Glioblastoma

NEWS ARTICLES about Senator John McCain’s diagnosis of glioblastoma accurately describe glioblastoma as aggressive and having a poor prognosis. But as Walter J. Curran, Jr, MD, pointed out in one of those reports, “substantial improvements in surgical approaches” have enabled more patients to...

Fever Therapy for Cancer

Fever therapy became firmly established as a significant therapeutic modality during the first decades of the 20th century. Physicians in this era believed the heat of a fever assisted in the control of numerous infections by killing the infective organism as it traveled through the bloodstream....

Control

Many Type A personalities deal with problems by controlling all aspects of the problem. Sometimes this works. Sometimes it works for a while. Sometimes it doesn’t work at all. The health-care system—hospitals, clinics, and doctors’ offices—have policies (specific office hours and strict...

head and neck cancer

Cancer Has Robbed Me of a Life I Loved

I always knew cancer was a real possibility for me. Both my mother and father died of the disease—my mother of lung cancer and my father of bone cancer—so when I started having chronic throat and chest infections, I was diligent about seeking immediate medical attention and felt relieved each time ...

To the Last Drop

It was 2:15 PM, and my afternoon clinic had not yet begun. The morning had been particularly trying as a result of disastrous clinical developments for two of my long-standing patients. Jessica had metastatic breast cancer, and I had been taking care of her for 7 years. Multiple lines of...

Addressing the Challenges of Intimacy After Cancer

The literature has documented the stress and damage that intimacy problems cause among women undergoing cancer treatment and during survivorship. A new book, Sex and Cancer: Intimacy, Romance, and Love After Diagnosis and Treatment, by Saketh R. Guntupalli, MD, and Maryann Karinch tackles the...

Tales From the OR: A Pediatric Surgeon’s Memoir

CARING FOR sick children brings with it a set of emotional and physical challeneges that differ from those with the adult patient population. In a new book, Healing Children: A Surgeon’s Stories From the Frontiers of Pediatric Medicine, Kurt Newman, MD, draws on more than 30 years of his...

A Doctor’s Call to Arms About the Overuse of Antibiotics

On September 3, 1928, Scottish biologist Alexander Fleming returned to London from a vacation and sorted through some petri dishes containing colonies of Staphylococcus. He noticed something unusual in one dish: It was dotted with colonies except for one area where a patch of mold grew....

thyroid cancer

The Rising Incidence of Thyroid Cancer Reconsidered

Despite a significant rise in the incidence of thyroid cancer, the U.S. Preventive Services Task Force (USPSTF), a panel of independent experts in primary care and screening, has given thyroid cancer screening a D recommendation, which is a recommendation against screening. To shed light on this...

leukemia

FDA Approves First CAR T-Cell Therapy for Pediatric, Young Adult Patients With ALL

ON AUGUST 30, 2017, the U.S. Food and Drug Administration (FDA) approved tisagenlecleucel (Kymriah) for pediatric and young adult patients up to 25 years with B-cell precursor acute lymphoblastic leukemia (ALL) that is refractory to initial treatment or in second or later relapse. Tisagenlecleucel ...

leukemia

Midostaurin in FLT3 Mutation–Positive Acute Myeloid Leukemia and Systemic Mastocytosis

ON APRIL 28, 2017, midostaurin (Rydapt) was approved for treatment of adults with newly diagnosed acute myeloid leukemia (AML) who have FLT3 mutation–positive disease, as detected by a U.S. Food and Drug Administration (FDA)-approved test, in combination with standard cytarabine and daunorubicin...

lymphoma

Pembrolizumab in Classical Hodgkin Lymphoma

On March 14, 2017, pembrolizumab (Keytruda) was granted accelerated approval for the treatment of adult and pediatric patients with refractory classical Hodgkin lymphoma or those who have relapsed after three or more prior lines of therapy.1,2  Supporting Efficacy Data  APPROVAL WAS BASED on...

Get to Know Your ASCO President-Elect: Monica M. Bertagnolli, MD, FASCO

Monica M. Bertagnolli, MD, FASCO, a long-time member and volunteer, began her term as ASCO President-Elect in June 2017; she will serve as 2018–2019 ASCO President. An active ASCO member since 1995, Dr. Bertagnolli is Chief of the Division of Surgical Oncology at Dana-Farber/Brigham and Women’s...

thyroid cancer
survivorship

Bridging the Survivorship Care Gap for Young Adult Survivors of Thyroid Cancer

Although thyroid cancer is among the five most common carcinomas diagnosed in adolescents and young adults (AYAs) between the ages of 15 and 39—thyroid cancer is more common in young women than young men and is the most common cancer diagnosed in females between the ages of 15 and 29 and the second ...

issues in oncology
global cancer care

Shaping Real Careers With Virtual Mentorship

Institution: Postgraduate trainee and PhD candidate in medical oncology, Department of Clinical Oncology and Chemotherapy, Nagoya University Graduate School of MedicineMember since: 2014ASCO activities: Virtual Mentors, Journal of Global Oncology editorial fellow Of the many activities ASCO...

gastrointestinal cancer

Positioning Lu-177 Dotatate Therapy and 68-Ga Dotatate Scans in Management of Neuroendocrine Tumors

The results of the phase III NETTER-1 trial, recently published in The New England Journal of Medicine,1 have been met with great interest by clinicians who treat neuroendocrine tumors. In patients with advanced midgut lesions, treatment with the radiopharmaceutical lutetium Lu-177 dotatate...

solid tumors
bladder cancer

Atezolizumab in Patients With Advanced Urothelial Carcinoma Who Are Ineligible for Cisplatin

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On April 17, 2017, the programmed cell death ligand 1 (PD-L1)...

prostate cancer
kidney cancer
bladder cancer

Maha Hussain, MD, FACP, FASCO, Credits Collaboration for Her Contributions to Genitourinary Cancer

Internationally recognized genitourinary oncologist Maha Hussain, MD, FACP, FASCO, was born and reared in Baghdad, Iraq. “I came from a family that stressed the value of higher education and especially medicine. I have three uncles who are physicians, and my father encouraged my three siblings and...

Edith Peterson Mitchell, MD, Awarded ASTRO Honorary Membership

Edith Peterson Mitchell, MD, a leading researcher, medical oncologist, and proponent of combined-modality treatment, has been chosen as the 2017 American Society for Radiation Oncology (ASTRO) Honorary Member. Dr. Mitchell will receive this award—which is the highest honor ASTRO awards to...

solid tumors
hematologic malignancies
breast cancer
lung cancer
prostate cancer
multiple myeloma
kidney cancer

Journal of Clinical Oncology Literature Update

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. The topics range from therapy for stage IV non–small cell lung cancer...

prostate cancer

Long-Term Follow-up in PIVOT Trial Shows No Significant Benefit of Surgery vs Observation for Overall or Prostate Cancer Mortality

After 19.5 years of follow-up in the PIVOT trial, radical prostatectomy was not associated with significantly improved all-cause or prostate cancer mortality vs observation among men with localized prostate cancer.1 The long-term follow-up was reported in The New England Journal of Medicine by...

lung cancer

Non–Small Cell Lung Cancer: Emerging Concepts for Checkpoint Inhibitors

With checkpoint inhibitors vitally important in the treatment of advanced non–small cell lung cancer (NSCLC), clinicians must become familiar with the nuances of their use. At the 2017 Debates and Didactics in Hematology and Oncology Conference in Sea Island, Georgia, Suresh S. Ramalingam, MD,...

gastrointestinal cancer

‘Sidedness’ in Colon Cancer: Using the Data in the Clinic

The evidence from clinical trials has established that “side matters” when it comes to colorectal cancer outcomes. How do clinicians use this information in their practices? Christina Wu, MD, of Emory University, shared her thoughts with attendees at the 2017 Debates and Didactics in Hematology and ...

hematologic malignancies

Recent FDA Actions Include New Formulation, Expanded Indications for Oncology-Hematology Drug Products

The U.S. Food and Drug Administration (FDA) recently granted approval to olaparib tablets (Lynparza) as a maintenance therapy for ovarian cancer and to inotuzumab ozogamicin (Besponsa), for the treatment of adults with relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL)....

gynecologic cancers

Targeted Treatments and Health-Related Quality of Life in Ovarian Cancer

Novel targeted treatment strategies and new trial endpoints in recurrent, platinum-sensitive ovarian cancer were highlighted in a gynecologic cancer session at the Best of ASCO New Orleans. At the meeting, Karen McLean, MD, PhD, of the University of Michigan Medical Center, Ann Arbor, presented...

prostate cancer

Long-Term Follow-up of PIVOT Argues for Immediate Treatment of Men With Unfavorable-Risk and Possibly High-Volume, Low-Risk Prostate Cancer

The updated results of the PIVOT1 study—reported in The New England Journal of Medicine by Wilt et al and reviewed in this issue of The ASCO Post—did not show a statistically significant difference between treatment and observation for the initial management approach to men with newly diagnosed...

hematologic malignancies

Update on Hematopoietic Cell Transplant Includes New Data in HIV-Infected and Follicular Lymphoma Patients

New hematology research, presented at the Best of ASCO New Orleans meeting, may help to guide the use of stem cell transplant in hematologic malignancies. At the meeting, Guillermo Garcia-Manero, MD, PhD, of The University of Texas MD Anderson Cancer Center, Houston, and Tycel Phillips, MD, of the...

palliative care

Assessment of Embedding Palliative Care Nurse Practitioners in Oncology Clinics

In a study reported by Walling et al in the Journal of Oncology Practice, the embedding of a palliative care nurse practitioner in an oncology clinic resulted in improved hospice referral, advance care planning documentation, and referral for psychosocial support. Study Details The study compared ...

multiple myeloma

Overall Survival With Carfilzomib vs Bortezomib in Relapsed or Refractory Multiple Myeloma

As reported by Dimopoulos et al in The Lancet Oncology, a prespecified interim analysis of the phase III ENDEAVOR trial has shown a significant overall survival benefit for carfilzomib (Kyprolis) vs bortezomib (Velcade) in patients with relapsed or refractory multiple myeloma. Carfilzomib was...

leukemia

FDA Approves Gemtuzumab Ozogamicin for Treatment of Acute Myeloid Leukemia

The U.S. Food and Drug Administration (FDA) today approved gemtuzumab ozogamicin (Mylotarg) for the treatment of adults with newly diagnosed acute myeloid leukemia (AML) whose tumors express the CD33 antigen. The drug was also approved for the treatment of patients aged 2 years and older with...

colorectal cancer

Labetuzumab Govitecan in Heavily Pretreated Patients With Metastatic Colorectal Cancer

As reported by Dotan et al in the Journal of Clinical Oncology, the antibody-drug conjugate labetuzumab govitecan showed antitumor activity in a phase I/II trial in patients with heavily pretreated metastatic colorectal cancer who had received prior irinotecan therapy. The agent comprises...

prostate cancer

On My Way to Hospice Care, Immunotherapy Saved My Life

Two years ago, I was on my way to hospice care after numerous treatments, including surgery, chemotherapy, and radiation therapy failed to stop the progression of my stage IV castration-resistant prostate cancer. A last-minute call from my oncologist about a phase I trial of combination...

bladder cancer

Durvalumab in Locally Advanced or Metastatic Urothelial Carcinoma

Updated results of a phase I/II study of durvalumab (Imfinzi) in locally advanced or metastatic urothelial carcinoma were reported by Powles et al in JAMA Oncology. Data from the ongoing study supported the recent approval of durvalumab as second-line treatment in this setting on the basis of...

prostate cancer

Postdiagnosis Statin Use and Mortality in Prostate Cancer

As reported by Larsen et al in the Journal of Clinical Oncology, a Danish retrospective study has shown reduced cancer-specific and all-cause mortality with postdiagnosis statin use in patients with prostate cancer. Study Details The study involved nationwide Danish registry data from 31,790...

skin cancer

Pembrolizumab vs Ipilimumab in Advanced Melanoma: Final Overall Survival Analysis of KEYNOTE-006

The final overall survival analysis of the phase III KEYNOTE-006 trial showed maintained superiority of pembrolizumab (Keytruda) vs ipilimumab (Yervoy) in advanced melanoma. The results were reported by Schachter et al in The Lancet. An interim analysis showed improved progression-free and overall...

leukemia

FDA Approves First CAR T-Cell Therapy for Pediatric and Young Adult Patients With B-Cell Precursor ALL

Today, the U.S. Food and Drug Administration (FDA) issued what it has called a “historic action,” making the first gene therapy available in the United States. The FDA approved tisagenlecleucel (Kymriah) for certain pediatric and young adult patients with a form of acute lymphoblastic...

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