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gynecologic cancers

ASTRO 2017: GOG-249 Confirms Adjuvant Pelvic Radiation as Standard of Care for High-Risk, Early-Stage Endometrial Cancer

In a new phase III trial report from the National Clinical Trial Network group, NRG Oncology, recurrence-free and overall survival rates for women with stage I–II high-risk endometrial cancer were not superior following adjuvant vaginal cuff brachytherapy plus chemotherapy when compared with...

FDA Approves New CDK4/6 Inhibitor for Certain Advanced or Metastatic Breast Cancers

The U.S. Food and Drug Administration today approved abemaciclib (Verzenio) to treat adult patients who have hormone receptor–positive, human epidermal growth factor receptor 2 (HER2)-negative advanced or metastatic breast cancer that has progressed after endocrine therapy. Abemaciclib is...

survivorship

Cumulative Burden of Chronic Health Conditions in Childhood Cancer Survivors

In a report from the St Jude Lifetime Cohort Study published in The Lancet, Bhakta et al detailed the burden of lifetime chronic health conditions in survivors of childhood cancers. The report included retrospectively collected data on chronic health conditions in 5,522 patients treated for...

lung cancer

MicroRNA-Loaded Minicells in Recurrent Malignant Pleural Mesothelioma

An Australian phase I first-in-human trial has shown early activity of microRNA-loaded minicells in patients with malignant pleural mesothelioma. These findings were reported in The Lancet Oncology by van Zandwijk et al. The minicells (TargomiRs) are loaded with miR-16–based mimic microRNA...

solid tumors

ASTRO 2017: Radiation-Immunotherapy Combination May Benefit Some Patients With Late-Stage Cancer

A new study involving patients with stage IV cancer has found that treatment with radiation therapy and immunotherapy can slow tumor growth by stimulating the body’s immune system to attack the cancer. In the phase II trial, patients with end-stage cancer that had metastasized to the lungs or ...

lung cancer

ASTRO 2017: Adding Radiation to Maintenance Chemotherapy May Benefit Patients With Limited Metastatic NSCLC

For patients with limited metastatic non–small cell lung cancer (NSCLC), adding radiation therapy before maintenance chemotherapy may curb disease progression when compared to maintenance chemotherapy alone, according to a randomized phase II clinical trial reported by Iyengar et al. at the...

breast cancer

Study Finds Smoking Negatively Impacts Long-Term Survival After Breast Cancer

According to the American Cancer Society, about 316,120 new cases of breast cancer will be diagnosed this year, and over 40,000 women will die of the disease. Between 10% and 20% of women diagnosed with cancer are current smokers. Now, a prospective study by Parada et al investigating whether...

lung cancer

ASTRO 2017: Biomarker Blood Test Predicts Survival Following Localized Lung Cancer Treatment

A new study demonstrates that a blood test to detect cancer may predict treatment outcomes for patients with localized non–small cell lung cancer (NSCLC) and afford physicians additional lead time to personalize treatment for recurrent disease. Patients in the study with detectable levels of...

gynecologic cancers

ASTRO 2017: IAEA Trial: Safety, Efficacy of High-Dose Brachytherapy Plus Pelvic Radiation for Cervical Cancer

Findings from a new multicenter, international clinical trial confirm the effectiveness of high-dose brachytherapy, or internal radiation therapy, for managing locally advanced cervical cancer. Tumor control was significantly better following four fractions of 7 Gy each than following two 9-Gy...

issues in oncology

ASTRO 2017: Urban Cancer Center Finds 75% of Its Patients With Depression Were Previously Undiagnosed

A new study of patients at an urban cancer center points to a potentially serious problem that may limit the impact of clinical cancer care—undiagnosed depression. Among the 40% of patients at the center who were diagnosed with depression, three in four had not previously been told they were ...

gastrointestinal cancer

FDA Grants Accelerated Approval to Pembrolizumab for Advanced Gastric Cancer

On September 22, 2017, the U.S. Food and Drug Administration (FDA) granted accelerated approval to pembrolizumab (Keytruda) for patients with recurrent locally advanced or metastatic, gastric or gastroesophageal junction adenocarcinoma whose tumors express programmed cell death ligand 1 (PD-L1) as...

hepatobiliary cancer

FDA Grants Accelerated Approval to Nivolumab for Hepatocellular Carcinoma Previously Treated With Sorafenib

On September 22, 2017, the U.S. Food and Drug Administration (FDA) granted accelerated approval to nivolumab (Opdivo) for the treatment of hepatocellular carcinoma in patients who have been previously treated with sorafenib (Nexavar). CheckMate 040 Approval was based on a 154-patient subgroup of...

I Don’t Feel Like I Have Incurable Cancer

A series of medical mishaps has led me to a diagnosis of stage IV carcinoid neuroendocrine cancer and a shortened lifespan. This never should have happened. For months in early 2015, I was plagued with all the signs of a serious illness, including chronic stomach, bowel, and digestive issues;...

Neurocognitive Function in Patients Treated for B-Lineage ALL

In a Children’s Oncology Group (COG) study (AALL06N1) reported in the Journal of Clinical Oncology, Hardy et al found that age < 10 years at diagnosis was associated with poorer neurocognitive function in patients with high-risk B-lineage acute lymphoblastic leukemia (ALL) regardless of...

Adding Midostaurin to Chemotherapy in AML With FLT3 Mutation

In a phase III trial (Cancer and Leukemia Group B 10603 [RATIFY]/Alliance) reported in The New England Journal of Medicine, Stone et al found that the addition of midostaurin (Rydapt) to standard chemotherapy improved overall survival in patients with newly diagnosed acute myeloid leukemia (AML)...

breast cancer

Tumor-Infiltrating Lymphocytes in African Americans and European Americans With Triple-Negative Breast Cancer

Triple-negative breast cancer is a highly aggressive breast cancer that lacks hormone receptors and overexpression of human epidermal growth factor receptor 2 (HER2/neu), and, therefore, there are no targeted treatments available for the cancer. Triple-negative breast cancer afflicts African...

The Dark Side of Medicine: Physician Suicide

The statistics on physician suicide are stark: Physicians are more than twice as likely to take their own lives as nonphysicians, and more than 400 physicians commit suicide each year in the United States. Moreover, young physicians at the early part of their training are reported to be...

Stemming the Growing Cancer Crisis in Rural Appalachia

A pair of recent studies show a troubling trend: Despite a 20% decrease in cancer mortality rates nationwide over the past 2 decades,1 Americans living in rural regions of the United States are more likely to die of cancer than persons living in metropolitan areas of the country. An analysis of...

prostate cancer

Emotional and Psychological Distress Associated With Prostate Cancer

A cancer diagnosis presents emotional and psychological challenges for patients and caregivers, and prostate cancer has some unique challenges, in part because management is not writ in stone. At several points along the trajectory of illness, men with prostate cancer face decisions that can be...

skin cancer

Adjuvant Nivolumab vs Ipilimumab in Resected Stage III or IV Melanoma

The phase III Checkmate 238 trial has shown improved recurrence-free survival with adjuvant nivolumab (Opdivo) vs ipilimumab (Yervoy) in patients with resected advanced melanoma. The findings were reported by Weber and colleagues in The New England Journal of Medicine. Study Details In the...

How a Child With Cancer Moved From Vulnerability to Resilience

At the time this article was published in the Journal of Clinical Oncology, Dr. Danaher was practicing at Monash -University, -Melbourne, Australia; Drs. Brand and Mack, at Dana-Farber Cancer Institute, Boston; Dr. Pickard, at the Imperial College -Healthcare NHS Trust, London; and Dr. Berry,...

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...

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