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breast cancer
symptom management

Acupuncture Improves Hot Flashes in Women With Breast Cancer in Italian Trial

In an Italian trial reported in the Journal of Clinical Oncology, Lesi et al found that the addition of acupuncture to enhanced self-care improved hot flashes, climacteric symptoms, and quality-of-life measures in women with breast cancer. Study Details In the trial, 190 women were randomized to...

breast cancer

Adding Ovarian Function Suppression to Tamoxifen Worsened Some Patient-Reported Outcomes in Premenopausal Women With Early Breast Cancer

Ribi et al reported in the Journal of Clinical Oncology that addition of ovarian function suppression to tamoxifen resulted in greater endocrine and sexual function symptoms among premenopausal patients with early breast cancer in the Suppression of Ovarian Function Trial (SOFT). The SOFT study...

solid tumors
lymphoma
multiple myeloma

Relatives of Patients With Carcinoma of Unknown Primary at Increased Risk for This and Other Cancers

Relatives of patients with carcinoma of unknown primary are at increased risk of developing it themselves as well as several other malignant neoplasms, including lung, pancreatic, and colon cancers; non-Hodgkin lymphoma; and myeloma, according to a study published in JAMA Oncology. “Some of...

symptom management

In Early Brain Radiation Recovery Studies, Cranial Grafting of Stem Cell–Derived Therapy Improves Cognition and Reduces Neuropathology

While stem cells have shown promise for treating brain regions damaged by cancer radiation treatments, University of California, Irvine (UCI) researchers have found that microscopic vesicles isolated from these cells provide similar benefits without some of the risks associated with stem cells....

colorectal cancer

Next-Generation Sequencing Assay May Permit Accurate Detection of Mismatch Repair Deficiency in Colorectal Cancer

Use of a custom next-generation sequencing assay may accurately predict mismatch repair deficiency on the basis of mutational load in colorectal cancer, according to a report by Stadler et al in the Journal of Clinical Oncology. Study Details The study involved data from 224 patients with...

prostate cancer

Adding 6 Months of Androgen Suppression to Radiotherapy Improves Disease-Free Survival in Intermediate- and High-Risk Prostate Cancer

In the phase III EORTC 22991 trial reported in the Journal of Clinical Oncology, Bolla et al found that the addition of 6 months of androgen suppression to radiotherapy improved biochemical and clinical disease-free survival in patients with intermediate- and high-risk prostate cancer. Study...

Compartmentalizing Cancer

I was the last one on the oncology team to meet Mel. He was 36 years old, and by then Mel had been living with metastatic colon cancer for several years. During that time, his clinicians had never referred him to our psycho-oncology team because of his strong attitude and outlook. Mel’s outward...

geriatric oncology
breast cancer

Geriatric Assessment Is Key to Treatment Decisions for Patients 80 Years and Older

A review of major studies and the current literature underscored the role of geriatric assessment in making treatment recommendations for patients aged 80 years and older with early and metastatic breast cancer. The review was published in the Journal of Oncology Practice. The corresponding author...

skin cancer

Most Patients With Melanoma Had Few Nevi, None Atypical

Although nevi are considered among the strongest risk factors for melanoma, most patients with melanoma had few total nevi and no atypical nevi, according to an analysis of 566 patients with invasive cutaneous melanoma. “Three notable findings emerged from this case study,” Alan C. Geller, MPH, RN, ...

10 Bladder Cancer Projects Awarded Research Grants by Johns Hopkins Greenberg Bladder Cancer Institute

The Johns Hopkins Greenberg Bladder Cancer Institute is a collaborative initiative of the Johns Hopkins Kimmel Cancer Center, the Brady Urological Institute, the Bloomberg School of Public Health, and the School of Medicine. It aims to develop new clinical strategies for combating bladder cancer...

2016 Oncology Meetings

APRIL European Lung Cancer ConferenceApril 13-16 • Geneva, SwitzerlandFor more information:www.esmo.org/Conferences/ELCC-2016-Lung-Cancer American Society for Colposcopy and Cervical Pathology (ASCCP) Annual MeetingApril 13-16 • New Orleans, LouisianaFor more...

lung cancer

Crizotinib in ROS1-Positive Metastatic Non–Small Cell Lung Cancer

On March 11, 2016, crizotinib (Xalkori) was approved for treatment of patients with metastatic non–small cell lung cancer (NSCLC) with ROS1 rearrangement–positive tumors.1,2 A U.S. Food and Drug Administration–approved test for the detection of ROS1 rearrangements in NSCLC is not currently...

pancreatic cancer

Phase Ib/II Study Reports High Response Rates Seen With Addition of Cisplatin to Regimen for Advanced Pancreatic Cancer

The oncology research team at HonorHealth Research Institute in Scottsdale, Arizona, is spearheading a phase Ib/II trial that is demonstrating promising results with a novel regimen in patients with advanced pancreatic cancer. “The patients we are treating have advanced adenocarcinoma of the...

neuroendocrine tumors

Everolimus Improves Progression-Free Survival in Advanced Neuroendocrine Tumors of the Lung or Gastrointestinal Tract

In a phase III trial (RADIANT-4) reported in The Lancet, James C. Yao, MD, of the University of Texas MD Anderson Cancer Center, and colleagues found that everolimus (Afinitor) and supportive care significantly prolonged progression-free survival vs placebo and supportive care in patients with...

lymphoma
leukemia

Selected Abstracts From 2015 ASH Annual Meeting: Part 4

Here is the final installment of selected abstracts from the proceedings of the 2015 American Society of Hematology (ASH) Annual Meeting and Exposition, focusing on Hodgkin lymphoma, follicular lymphoma, diffuse large B-cell lymphoma, and chronic lymphocytic leukemia. For other selected abstracts...

FDA Approves Defibrotide for Complication of Stem Cell Transplant

On March 30, 2016, the U.S. Food and Drug Administration (FDA) approved defibrotide sodium (Defitelio) for the treatment of adult and pediatric patients with hepatic veno-occlusive disease, also known as sinusoidal obstructive syndrome, with renal or pulmonary dysfunction following hematopoietic...

health-care policy

Providing Perspective on Pressing Economic Issues Facing Cancer Care—Now and in the Future

CANCERSCAPE, the 2016 Annual Meeting of the Association of Community Cancer Centers (ACCC), provided a forum for about 300 attendees to gain insight into the complexities of oncology treatment, where “clinical advances, policy mandates, and value-based payment reform intersect.” Of particular...

Understanding and Preparing for MACRA

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was passed in April 2015, introducing comprehensive changes to how Medicare pays physicians for services. As the policies passed in MACRA are rolled out over the coming years, they will profoundly impact reimbursement and care...

Diversity Training Key to Increasing Cultural Competence Among Oncology Surgeons

A study in the Journal of Oncology Practice (JOP)1 measured the level of cultural competence among surgeons from six hospitals in the Puget Sound region of Washington State, home to a large population of American Indians and Alaskan Natives. According to the study, “Assessing Cultural Competence...

lung cancer

Update of ASCEND-1 Trial Shows Ceritinib Highly Active in ALK-Rearranged NSCLC, Including Intracranial Disease

Updated results of the phase I ­ASCEND-1 trial, reported by Kim et al in The Lancet Oncology, indicate that the ALK inhibitor ceritinib (Zykadia) produced high response rates in advanced ALK-rearranged non–small cell lung cancer (NSCLC), including intracranial disease, in both patients with and...

gynecologic cancers

Study Reports No Overall Benefit of Adding Farletuzumab to Chemotherapy in Relapsed Ovarian Cancer, but Potential Subgroup Benefit Identified

Addition of the antifolate receptor-α antibody farletuzumab to carboplatin/taxane did not improve progression-free survival in patients with ovarian cancer in first platinum-sensitive relapse, reported Vergote et al in the Journal of Clinical Oncology. However, benefit was observed in...

issues in oncology
cost of care

Experts Consider What It Means to Improve Quality of Care in an Era of Increasing Reliance on Targeted Therapies

Precision medicine is judged according to different values across the multiple stakeholders involved in cancer care. At this year’s Quality Care Symposium, presenters from different sectors of oncology addressed a central question: How do we assess quality in the age of precision medicine?1,2 Right ...

breast cancer

A Business Professor and Husband Turns Breast Cancer Researcher

In more than 25 years of viewing posters at oncology meetings, I’ve met researchers from virtually all professional walks of life, but it was not until the 2016 Miami Breast Cancer Conference, that the author’s affiliation turned my head: It was a business school. “Utilizing Metastatic Tumor...

breast cancer

Metastatic Breast Cancer With Discordant Tumors: Small Study Reports Treatment by Primary Status May Improve Survival

In a small retrospective series, patients with metastatic breast cancer treated according to the receptor status of the primary tumor, not the metastatic one, had significantly longer median overall survival. The study was reported at the 2016 Miami Breast Cancer Conference by T. Allen Pannell, Jr, ...

breast cancer

Breast Cancer Vaccines Moving Forward at a Fast Clip

Vaccines for both secondary and primary prevention of breast cancer are showing potential in clinical trials, according to Elizabeth A. Mittendorf, MD, PhD, who is leading much of the vaccine research at the University of Texas MD Anderson Cancer Center, Houston. Vaccine platforms being explored...

gynecologic cancers

Trabectedin Improves Progression-Free Survival in Uterine Leiomyosarcoma

In women with uterine leiomyosarcoma, trabectedin (Yondelis), a novel cytotoxic agent, significantly improved progression-free survival, compared with dacarbazine (4.2 vs 1.5 months, hazard ratio [HR] = 0.55, P < .001). According to the study’s authors, a lack of cumulative toxicity allows...

issues in oncology

Computer-Assisted Decision Support in Medical Oncology: We Need It Now

Today’s medical oncologist is increasingly challenged to stay current with the latest developments in cancer treatment. I have been fortunate to speak with many oncologists over the past quarter-century on how professional life has evolved since the 1990s. These conversations have left me with a...

prostate cancer

Throwing Out the Baby With the Bathwater: A Critical Appraisal of the USPSTF Recommendation Against Screening for Prostate Cancer

In 2012, the U.S. Preventive Services Task Force (USPSTF) issued a recommendation against routine screening for prostate cancer.1,2 The grade D recommendation was considered controversial at the time, and remains so now, because many stakeholders have weighed the same body of evidence and come to...

lung cancer

The POPLAR Trial: PD-L1 Blockade With Atezolizumab in Second- or Third-Line Non–Small Cell Lung Cancer

The randomized phase II ­POPLAR trial—reported by Fehrenbacher and colleagues and reviewed in this issue of The ASCO Post—is another key piece of information for the medical community regarding the value of immune checkpoint blockers in second/third-line treatment of patients with non–small cell...

lung cancer

Atezolizumab Improves Survival vs Docetaxel in Previously Treated NSCLC: Increased Benefit With Increased PD-L1 Expression

In the phase II POPLAR trial reported in The Lancet, Louis Fehrenbacher, MD, of Kaiser Permanente Medical Center, and colleagues found that the investigational anti–programmed cell death ligand 1 (PD-L1) antibody atezolizumab improved overall survival vs docetaxel in patients with non–small cell...

breast cancer

Ultrasound Screening for Breast Cancer May Be Linked to Increased Detection of Invasive Tumors but More False-Positive Results

As reported in the Journal of the National Cancer Institute by Berg et al, an analysis from the American College of Radiology Imaging Network (ACRIN) 6666 study indicates that use of ultrasound in primary screening for breast cancer resulted in increased detection of invasive cancers but more...

bladder cancer

Phase II Trial Shows Benefit of Adding Ramucirumab to Docetaxel in Previously Treated Advanced Urothelial Carcinoma

Adding the anti–vascular endothelial growth factor receptor 2 (VEGFR-2) antibody ramucirumab to docetaxel improved progression-free survival among previously treated patients with locally advanced or metastatic urothelial carcinoma, reported Petrylak et al in the Journal of Clinical Oncology. ...

breast cancer

Good Outcome Reported With Endocrine Therapy and Omission of Chemotherapy Based on 21-Gene Recurrence Score in Breast Cancer

Treatment with adjuvant endocrine therapy and omission of chemotherapy on the basis of a 21-gene recurrence score ≤ 11 was associated with a high 3-year disease-free survival rate in women with hormone receptor–positive, HER2-negative breast cancer, according to a trial reported in...

breast cancer

ASCO Endorses Cancer Care Ontario Recommendations on Decision-Making in Adjuvant Systemic Therapy for Early-Stage, Operable Breast Cancer

As reported in the Journal of Clinical Oncology by N. Lynn Henry, MD, PhD, of the University of Michigan Comprehensive Cancer Center, and colleagues, ASCO has endorsed Cancer Care Ontario (CCO) guideline recommendations on the role of patient and disease factors in decisions on adjuvant systemic...

bladder cancer

Study Finds Adaptive Image-Guided Radiation Therapy for Bladder Preservation Clinically Feasible in Urinary Bladder Cancer

A prospective study examining a trimodality treatment approach in localized bladder cancer cases using adaptive image-guided, intensity-modulated radiation therapy found that the bladder preservation rate at 3 years was 83%. These findings were published by Murthy et al in the International Journal ...

symptom management

FDA Approves Defibrotide Sodium for the Treatment of Hepatic Veno-Occlusive Disease Following Hematopoietic Stem Cell Transplantation

On March 30, 2016, the U.S. Food and Drug Administration (FDA) approved defibrotide sodium (Defitelio) for the treatment of adult and pediatric patients with hepatic veno-occlusive disease, also known as sinusoidal obstructive syndrome, with renal or pulmonary dysfunction following hematopoietic...

lung cancer

No Treatment Failure or Survival Benefit but Less Toxicity With Comprehensive Geriatric Assessment in Elderly Patients With Advanced NSCLC

Use of comprehensive geriatric assessment to guide therapy in elderly patients with stage IV non–small cell lung cancer (NSCLC) did not improve treatment failure–free or overall survival but was associated with slightly reduced toxicity, based on the results of the phase III...

breast cancer

Digital Breast Tomosynthesis Shows Sustained Effectiveness in Breast Cancer Screening

In a single-center retrospective study reported in JAMA Oncology, McDonald et al found that adding digital breast tomosynthesis to digital mammography reduced recall rates, increased cancer detection, and was associated with a numeric reduction in interval cancers. Study Details The analysis...

leukemia

Minimal Residual Disease in AML: Worth Looking?

As summarized in this issue of The ASCO Post, Ivey and colleagues demonstrated that assessing for NPM1-mutated gene transcripts by reverse-transcriptase quantitative polymerase chain reaction assay is a feasible approach for measuring minimal residual disease after acute myeloid leukemia (AML)...

solid tumors

High Rate of Overuse of Serum Tumor Marker Testing

A retrospective review to evaluate the frequency of serum tumor marker testing “found a high rate of serum tumor marker testing overuse and extreme overuse in patients with advanced solid tumors,” Melissa K. Accordino, MD, of Columbia University College of Physicians and Surgeons, New York,...

breast cancer
solid tumors

Neoadjuvant Nab-Paclitaxel Improves Pathologic Complete Response Rate vs Solvent-Based Paclitaxel in Early-Stage Breast Cancer

In the phase III GeparSepto-GBG 69 trial, reported in The Lancet Oncology by Untch et al, neoadjuvant nab-paclitaxel (Abraxane) improved pathologic complete response rate vs conventional solvent-based paclitaxel in women with early-stage breast cancer. Study Details In the open-label trial, 1,206 ...

head and neck cancer
survivorship

New American Cancer Society Guideline Addresses Long-Term Needs of Head and Neck Cancer Survivors

A new American Cancer Society guideline provides clinicians with recommendations on key areas of clinical follow-up care for survivors of head and neck cancer, a growing population numbering approximately 436,060 and accounting for 3% of all cancer survivors living in the United States. The...

solid tumors
kidney cancer

Study Finds Apitolisib Less Effective Than Everolimus in Metastatic Renal Cell Carcinoma

As reported in the Journal of Clinical Oncology by Powles et al, the dual PI3K/mTOR inhibitor apitolisib was inferior to the mTOR inhibitor everolimus (Afinitor) in progression-free survival in a phase II trial in patients with metastatic clear cell renal cell carcinoma progressing on or after...

global cancer care

Unique Fellowship Aims to Lessen Global Cancer Burden by Training Foreign Medical Graduates in Surgical Oncology

Many low- and middle-income countries do not have a defined medical specialty in surgical oncology, and lack an educational infrastructure to respond to the local burden of cancer, but a Memorial Sloan Kettering Cancer Center (MSKCC) fellowship is succeeding in addressing this problem by training...

prostate cancer

Enzalutamide Improves Progression-Free Survival vs Bicalutamide in Nonmetastatic and Metastatic Castration-Resistant Prostate Cancer

Treatment with enzalutamide (Xtandi) tripled median progression-free survival vs bicalutamide in patients with nonmetastatic or metastatic castration-resistant prostate cancer, according to the phase II STRIVE trial reported in the Journal of Clinical Oncology by Penson et al. Study Details In...

gastroesophageal cancer

Swedish Study Shows Association of Survival Gain With Increased Surgeon Experience in Patients Undergoing Esophagectomy for Cancer

Increased surgeon experience was associated with markedly better short- and long-term survival in patients undergoing esophagectomy for esophageal cancer, according to a report by Markar et al in the Journal of Clinical Oncology. Study Details The study involved data from 1,821 patients who...

skin cancer

Assessment of Survival Impact of Atypical Responses With Pembrolizumab Treatment in Advanced Melanoma

As reported by Hodi et al in the Journal of Clinical Oncology, use of conventional Response Evaluation Criteria in Solid Tumors (RECIST) to assess response may have underestimated the benefit of treatment with the programmed cell death protein 1 (PD-1) inhibitor pembrolizumab (Keytruda) in the...

breast cancer

I Never Forget I Have Cancer

I have a history of fibrocystic breasts, which required biopsies to make certain the cysts were benign, and for years they were. But in 2009, my mammogram screening picked up a suspicious lump in my right breast, which turned out to be stage III estrogen receptor–positive/progesterone...

breast cancer

The Perplexing Increase in Bilateral Mastectomies

The increased rate of bilateral mastectomies, as shown in recently released data from the Agency for Healthcare Research and Quality (AHRQ), is “perplexing,” Ismail Jatoi, MD, PhD, told The ASCO Post. “We are seeing more and more women with unilateral breast cancer opt for bilateral mastectomy,...

A Hard Look at the Connection Between Germs and Mental Illness

The relationship between disease and microbes was first proposed in the 17th century, but the basic standards for proving that infection causes disease were not laid down until 1883, when the German bacteriologists Robert Koch and Friedrich Loeffler provided the first evidence of the processes...

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