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issues in oncology
cost of care

Higher Costs for Complex Cancer Surgery May Be an Indicator of Lower-Quality Care

Higher costs for complex cancer surgery may be an indicator of worse—rather than better—quality of care, according to new research by experts at Rice University and The University of Texas MD Anderson Cancer Center. Their findings are published by Ho et al in Surgery, and provide...

colorectal cancer

Perioperative Hepatic Arterial Infusion Pump Chemotherapy After Resection of Colorectal Liver Metastases

A propensity score analysis in a prospectively maintained database at Memorial Sloan Kettering Cancer Center (MSKCC) has shown that use of perioperative hepatic arterial infusion pump chemotherapy after complete resection of colorectal liver metastases is associated with a marked improvement in...

prostate cancer

Prostate-Specific Antigen Testing Rates Appear to Level Off After Recent Drop

Declines in prostate-specific antigen (PSA) testing that came after changes in government screening guidelines have abated in recent years, according to a new study. In JAMA Internal Medicine, American Cancer Society (ACS) investigators led by Stacy A. Fedewa, PhD, wrote that about 1 in 3 men aged...

kidney cancer

Complete Surgical Metastasectomy for Patients With Metastatic Renal Cell Carcinoma May Extend Life Expectancy

Mayo Clinic researchers have discovered that surgery could more than double life expectancy for many patients with late-stage kidney cancer, giving them anywhere from 2 to almost 10 years more than they would have without the surgery. A paper published by Zaid et al in The Journal of Urology found...

colorectal cancer

Nomogram for Early Mortality in Metastatic Colorectal Cancer

As reported in the Journal of Clinical Oncology, Renfro et al have derived a nomogram for predicting early mortality in metastatic colorectal cancer using data from more than 20,000 patients in the ARCAD (Aide et Recherche en Cancérologie Digestive) database. Study Details The analysis...

lung cancer

FDA Approves Brigatinib for Metastatic ALK-Positive Non–Small Cell Lung Cancer

On April 28, 2017, the U.S. Food and Drug Administration (FDA) granted accelerated approval to brigatinib (Alunbrig) for the treatment of patients with metastatic anaplastic lymphoma kinase (ALK)-positive non­–small cell lung cancer (NSCLC) who have had disease progression on or are...

lung cancer

Potential Predictive Biomarker of Response to Crizotinib in Lung Cancer

Although the duration and magnitude of clinical response are unpredictable in patients with ALK-rearranged non–small cell lung cancer (NSCLC) treated with crizotinib (Xalkori), eventually all patients develop resistance to the drug. A study by Pailler et al evaluating whether circulating...

breast cancer

Benefit of Survivorship Care Plans Among Low-Income, Predominantly Latina Breast Cancer Survivors

A randomized trial, reported by Maly et al in the Journal of Clinical Oncology, has shown that having an individualized survivorship care plan in place was associated with increased physician implementation of recommended breast cancer survivorship care among low-income, predominantly Latina breast ...

issues in oncology

Second Cancers May Be Deadlier in Pediatric, Adolescent, and Young Adult Patients

Second cancers in children as well as adolescents and young adults (AYAs) are far deadlier than they are in older adults and may partially account for the relatively poor outcomes of cancer patients aged 15 to 39 years overall, according to a new study by University of California (UC), Davis...

lung cancer
issues in oncology

ELCC 2017: Patients With Lung Cancer Treated With PD-1/PD-L1 Checkpoint Inhibitors May Experience Adverse Events After Influenza Vaccination

Patients with lung cancer treated with programmed cell death protein 1/programmed cell death ligand 1 (PD-1/PD-L1) checkpoint inhibitors may be at increased risk of adverse events after receiving the seasonal influenza vaccination, according to the first study measuring this effect. The results, to ...

breast cancer
symptom management

Joint Position Statement on Management of Aromatase Inhibitor–Associated Bone Loss in Postmenopausal Women With Hormone-Sensitive Breast Cancer

A new position statement, jointly published by seven international and European organizations, identifies fracture-related risk factors in patients treated with aromatase inhibitors and outlines key management strategies to help prevent bone loss and related fractures. It was published by Hadji et...

solid tumors

Estimates of Cancer Population Reference Values for PROMIS Patient-Reported Outcome Domains

  As reported in the Journal of Clinical Oncology, Jensen et al have undertaken a study to estimate cancer population–based reference values for patient-reported outcome domains in the Patient-Reported Outcomes Measurement Information System (PROMIS). Study Details The study included...

kidney cancer

Noninvasive Imaging Test May Accurately Rule Out Kidney Cancers

The latest in a series of studies led by researchers at Johns Hopkins Medicine shows that addition of a widely available, noninvasive imaging test called 99mTc-sestamibi SPECT/CT (single-photon emission computed tomography plus computed tomography) to conventional CT or magnetic resonance imaging...

health-care policy

NCCN Survey Reveals Oncology Community Professionals’ Concerns About Financial Distress, Access to Care

Oncology community professionals are concerned about the ability of their patients to access cancer screening and treatment under the proposed American Health Care Act (AHCA), according to a survey conducted March 23–24, 2017, at the National Comprehensive Cancer Network® (NCCN®) 22nd ...

breast cancer

Neoadjuvant Chemotherapy for Breast Cancer and Risk for Local Metastases

A pathologic complete response to presurgical therapy occurs in between 40% and 50% of patients with HER2-positive and triple-negative breast cancer, raising the question of the need for surgery for all patients after neoadjuvant chemotherapy indicates a pathologic complete response in...

gynecologic cancers

Low Cervical Cancer Screening Rates Found Among Women With Severe Mental Illness

Women enrolled in California's Medicaid program (Medi-Cal) who have been diagnosed with severe mental illness have been screened for cervical cancer at much lower rates than other women, according to a new study by researchers at the University of California, San Francisco (UCSF), published by...

breast cancer

Efficacy Analysis of ABC Breast Cancer Trials of Adjuvant Taxane With/Without Anthracycline in HER2-Negative Disease

As reported by Blum et al in the Journal of Clinical Oncology, the efficacy analysis of the combined adjuvant Anthracyclines in Early Breast Cancer (ABC) Trials showed better invasive disease-free survival with taxane plus doxorubicin/cyclophosphamide (TaxAC) regimens vs six cycles of...

solid tumors

Metastatic Uveal Melanoma Response to Adoptive Transfer of Autologous Tumor-Infiltrating Lymphocytes

As reported by Chandran et al in The Lancet Oncology, a single-center study has shown that adoptive transfer of autologous tumor-infiltrating lymphocytes produces tumor responses in metastatic uveal melanoma. Study Details The study involved 21 consecutive patients treated at the Surgery Branch...

head and neck cancer

Higher Rates of Bone Metastases and Increased Risk of Death in Follicular and Medullary Thyroid Cancer

In the largest-known study on bone metastases in thyroid cancer, researchers at the University of Michigan Comprehensive Cancer Center found that patients with follicular and medullary thyroid cancer had the highest rate of cancer-related bone lesions and fractures and an increased risk of death....

breast cancer

Breast Cancer Rates Increasing Among Asian Americans

In contrast to other racial/ethnic groups in the United States, Asian Americans have experienced steadily increasing breast cancer rates over the past 15 years, according to findings published by Gomez et al in Breast Cancer Research and Treatment. To better understand potential contributors to...

breast cancer

21-Gene Assay Score and Chemotherapy Decision-Making in Node-Positive Early Breast Cancer

The 21-gene recurrence score assay, Oncotype DX, determines a score that estimates the likelihood of distant recurrence of disease in women with early-stage estrogen receptor–positive breast cancer; this score is used to assess the benefit of adjuvant chemotherapy. Testing with this assay is...

pancreatic cancer

Update to ASCO Clinical Practice Guideline on Potentially Curable Pancreatic Cancer

An ASCO clinical practice guideline update, reported by Khorana et al in the Journal of Clinical Oncology, includes the recommendation of gemcitabine-capecitabine doublet therapy as an adjuvant therapy option in potentially curable pancreatic cancer. The updated recommendation (4.1) modifies the...

Keith T. Flaherty, MD, Named New Editor-in-Chief of Clinical Cancer Research

The American Association for Cancer Research (AACR) recently announced the appointment of Keith T. Flaherty, MD, as Editor-in-Chief of Clinical Cancer Research. Dr. Flaherty is Director of the Termeer Center for Targeted Therapies and Director of Clinical Research at the Massachusetts General...

gastroesophageal cancer

More on Treatment Decisions in Esophageal Cancer

In the March 25, 2017, issue of The ASCO Post, Steven H. Lin, MD, PhD, shared his thoughts on the role of positron-emission tomography (PET) in assessing response to induction chemotherapy in patients with resectable esophageal or gastroesophageal junction cancer. He noted that complete pathologic...

multiple myeloma

Link Between Obesity and Transformation of MGUS to Myeloma

In a population-based cohort study reported in the Journal of the National Cancer Institute, Su-Hsin Chang, PhD, of the Washington University School of Medicine, and colleagues found that overweight and obesity were associated with an increased risk of transformation of monoclonal gammopathy of...

skin cancer

Some Melanoma Survivors Continue to Seek Sun Exposure, Risking Second, Potentially More Serious Melanoma

Long-term survivors of melanoma are more likely than those who have not been diagnosed with the disease to use sunscreen, protective clothing, and other means to limit exposure to the sun, according to a survey of melanoma survivors and controls about ultraviolet radiation exposure and protective...

breast cancer

Fear Has Become a Big Part of My Survivorship

Just 32 when I first felt a lump in the top of my left breast, I never expected it to be cancer or my life would irrevocably change in that instant. With no history of breast cancer in my family, I initially shook off any thoughts that I could have a serious disease and instead consoled myself...

breast cancer
cost of care

Trastuzumab Biosimilar Could Lead to Lower Health-Care Costs and Greater Drug Access for Patients With Metastatic Breast Cancer

The human epidermal growth factor receptor (HER) family consists of four members—epidermal growth factor receptor (EGFR), HER2, HER3, and HER4—all transmembrane receptor tyrosine kinases, which regulate cell growth and survival, differentiation, and migration, as well as other cellular responses.1 ...

geriatric oncology

Using Geriatric Assessment Strategies to Inform Patient-Centered End-of-Life Care

End-of-life care in any patient with cancer is challenging for the patient, family, and physician. Issues faced at the end of life include pain, depression, loss of dignity, and hopelessness. In the geriatric patient, additional complexities are present in the form of comorbid conditions,...

breast cancer

Equivalent Response Rates With Trastuzumab or a Trastuzumab Biosimilar Plus Taxane in HER2-Positive Metastatic Breast Cancer

In part 1 of the Heritage study, a phase III equivalence trial reported in JAMA, Hope S. Rugo, MD, of the University of California Helen Diller Family Comprehensive Cancer Center, San Francisco, and colleagues found that treatment with trastuzumab (Herceptin) or a proposed trastuzumab biosimilar...

issues in oncology
health-care policy

Accelerating Pediatric Drug Development: Master Protocols May Be a Way to Go

Development of pediatric cancer drugs has long lagged behind adult drug development for two major reasons: The process is more difficult, and childhood cancer is rarer by far than adult cancer. These and other phenomena in pediatric oncology were the subject of a workshop held by the Friends of...

multiple myeloma

Adding Daratumumab to Lenalidomide/Dexamethasone Increases Progression-Free Survival in Previously Treated Multiple Myeloma

As reported in The New England Journal of Medicine by Meletios A. Dimopoulos, MD, of the National and Kapodistrian University of Athens, and colleagues, the phase III POLLUX trial has shown that the addition of the CD38-targeted antibody daratumu­mab (Darzalex) to lenalidomide...

leukemia

Updated Data on Treatment With Ibrutinib and Venetoclax in Patients With CLL/SLL

Long-term follow-up of treatment with ibrutinib (Imbruvica) in patients with previously untreated and treated chronic lymphocytic leukemia (CLL)/small lymphocytic leukemia (SLL) has shown high response rates that are durable. At 5 years, 89% of patients with treatment-naive and relapsed or...

lymphoma

Treating Human Immunodeficiency Virus–Related Lymphoma

Alexandra Levine, MD, MACP, is Professor in the Department of Hematology and Hematopoietic Cell Transplantation at City of Hope, Duarte, California, and has been on the front lines of the AIDS epidemic from the beginning—before the disease even had a name. Dr. Levine spoke with The ASCO Post about ...

lymphoma

Treatment of Diffuse Large B-Cell Lymphoma Continues to Evolve

Although the prognosis of patients with diffuse large B-cell lymphoma (DLBCL) has improved with R-CHOP—the addition of rituximab (Rituxan) to the cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy regimen—one-third of patients still relapse after therapy, and patients with the ...

bladder cancer

Nivolumab in Urothelial Carcinoma After Platinum Therapy

On February 2, 2017, nivolumab (Opdivo) was granted accelerated approval for the treatment of patients with locally advanced or metastatic urothelial carcinoma who have disease progression during or after platinum-containing chemotherapy or have disease progression within 12 months of neoadjuvant...

kidney cancer

Combination of Atezolizumab and Bevacizumab in PD-L1–Positive Patients With Metastatic Kidney Cancer

The combination of atezolizumab (Tecentriq) and bevacizumab (Avastin) appears to be promising in the first-line treatment of patients with metastatic renal cell carcinoma, according to results of a phase II trial presented at the 2017 Genitourinary Cancers Symposium.1 Despite the failure of the...

Institute for Clinical Immuno-Oncology White Paper Highlights Challenges, Progress, and Priorities in Immunotherapy

Momentum around immunotherapies for cancer continues to build, but the high cost of these therapies places them at the center of debate about how best to define and measure value in cancer care. As these therapies are increasingly integrated into practice, all stakeholders—providers, patients,...

leukemia

CAR T-Cell Therapy Shows Benefit in Patients With Treatment-Resistant Chronic Lymphocytic Leukemia

Researchers from Fred Hutchinson Cancer Research Center in Seattle reported early results from a small study of their chimeric antigen receptor (CAR) T-cell product (JCAR014) in chronic lymphocytic leukemia (CLL) at the 2016 American Society of Hematology (ASH) Annual Meeting & Exposition....

solid tumors

Expert Point of View: Prof. Noel Clarke, MBBS, FRCS, ChM

Formal discussant of the 111 trial, Prof. Noel Clarke, MBBS, FRCS, ChM, The Christie Hospital, Manchester, UK, had some concerns, but overall felt that the study could be practice-changing. “In this paper, single-cycle treatment is safe and effective, and two cycles of adjuvant BEP (bleomycin,...

solid tumors

One Cycle of BEP as Good as Two in High-Risk Testicular Cancer

The approach to treatment of high-risk, clinical stage I, nonseminomatous or combined germ cell tumors of the testis is not written in stone. ­Orchiectomy followed by surveillance or chemotherapy with two cycles of bleomycin, etoposide, and cisplatin (BEP) is a favored approach by most experts. A...

multiple myeloma

Two Studies Show Potential of Venetoclax as Single Agent and in Combination for Myeloma

Early-phase studies suggest that venetoclax (Venclexta) holds promise as a treatment for myeloma. At the 2016 American Society of Hematology (ASH) Annual Meeting & Exposition, investigators reported strong activity in heavily pretreated patients, especially those with the t(11;14)...

FNIH Awards Lurie Prize in Biomedical Sciences to David M. Sabatini, MD, PhD

The Foundation for the National Institutes of Health (FNIH) has selected David M. Sabatini, MD, PhD, to receive its 5th annual Lurie Prize in Biomedical Sciences for discovery of the mTOR (mechanistic target of rapamycin) cellular pathway as a key regulator of growth and metabolism in response to...

leukemia

Different Subtypes of Acute Myeloid Leukemia Create Both Clinical and Research Challenges

Acute myeloid leukemia (AML) is the most common leukemia in adults. Each year, about 20,000 Americans will be diagnosed with AML, and roughly 10,000 people in this country will die of the disease. AML progresses quickly, and unless treatment begins soon and is effective , the prognosis is grim....

prostate cancer

Progress in Defining Molecular Signature for Aggressive Androgen-Indifferent Prostate Cancer

Prostate cancer has lagged behind breast cancer in the identification of predictive and prognostic biomarkers, but the field is catching up. Researchers have identified a molecular signature that can distinguish aggressive prostate cancer that is androgen-indifferent and will have a better response ...

New Study Finds Global Smoking Rates on Decline but Shows More Work Is Still Needed

On March 21, 2017, Gravely et al published a study1 in Lancet Public Health on the 2003 global tobacco control treaty’s impact on the adoption of tobacco-reduction measures around the world, which has led to a 2.5% reduction in global smoking rates. The treaty obligates the 180 countries committed...

Research Reveals New Treatment Possibilities for Prostate Cancer

Not all cancer research will result in a positive outcome for patients, but all research does provide information that continues to advance the treatment of cancer care. Recent clinical trials, including one funded in part by the Conquer Cancer Foundation (CCF) of ASCO, show that most prostate...

Conquer Cancer Foundation Recognizes Global Oncology Researchers With International Innovation Grant

The Conquer Cancer Foundation (CCF) of ASCO recently announced the recipients of its 2017 International Innovation Grant. The 1-year grant of up to $20,000, given directly to each awardee’s nonprofit organization or government agency, funds research projects aimed at improving cancer care in low-...

skin cancer

Pembrolizumab Active in Mucosal Melanoma in KEYNOTE Studies

Three clinical trials of the immunotherapy pembrolizumab ­(Keytruda) have shown that it is active against a rare subtype of skin cancer, mucosal melanoma. The findings were presented by Butler et al at the 2017 European Cancer Congress (ECCO).1 Mucosal melanoma has often been excluded from...

New ASCO Answers Managing Cancer-Related Pain Booklet for Your Patients

In this new booklet, patients and their caregivers explore the topic of cancer-related pain relief, including its causes, how it is diagnosed, and types of relief strategies. Pain medications are covered extensively, including:  Types of medications  Safe handling  Common concerns Managing...

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