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lung cancer

SELECT Trial: Adjuvant Erlotinib in Resected EGFR-Mutant NSCLC

In a phase II trial reported in the Journal of Clinical Oncology, Pennell et al found that adjuvant erlotinib (Tarceva) improved disease-free survival over historical controls in patients with resected EGFR-mutant non­–small cell lung cancer (NSCLC).  In the study, 100 patients with ...

leukemia
issues in oncology

Reducing Infections in Patients With AML Receiving Induction and Reinduction Chemotherapy

In a report in the Journal of Oncology Practice, Morris et al described an initiative that has been successful in reducing the incidence of invasive fungal infections in patients with acute myeloid leukemia (AML) receiving induction and reinduction therapy at the University of Virginia Health...

issues in oncology

Vitamin D Supplementation and Cancer Risk

In a trial reported in The New England Journal of Medicine by Manson et al, vitamin D supplementation was found to have no benefit in reducing risk of invasive cancer vs placebo over 5 years of follow-up. Study Details The trial was a randomized, placebo-controlled trial, with a two-by-two...

colorectal cancer
immunotherapy

Primary Resistance to Immune Checkpoint Inhibitors in Metastatic Colorectal Cancer and Misdiagnosis of MSI or dMMR Status

In a study reported in JAMA Oncology, Cohen et al found evidence that primary resistance to immune checkpoint inhibitor treatment in metastatic colorectal cancer (CRC) can be explained in some cases by misdiagnosis of microsatellite instability (MSI) or defective mismatch repair (dMMR) status....

breast cancer
survivorship

POEMS/SWOG Intergroup S0230 Study on Preventing Early Menopause

In the long-term follow-up of the Prevention of Early Menopause Study (POEMS)/SWOG Intergroup S0230 trial reported in the Journal of the National Cancer Institute, Moore et al found that the addition of goserelin (Zoladex) to cyclophosphamide-containing chemotherapy was associated with a higher...

breast cancer
solid tumors
leukemia
lung cancer
lymphoma
multiple myeloma
issues in oncology
immunotherapy

FDA Pipeline: New Priority Reviews, Designations, and Clearances, Plus Statements on Genetic Testing and Class Labeling

The U.S. Food and Drug Administration (FDA) recently issued the following new approvals and designations: Priority Review for Atezolizumab in Combination With Chemotherapy for the Initial Treatment of Extensive-Stage SCLC The FDA accepted a supplemental biologics license application...

2019 Medicare Physician Fee Schedule and Quality Payment Program Final Rule Released

AT THE BEGINNING of November, the Centers for Medicare & Medicaid Services (CMS) released the final rule for the Medicare Physician Fee Schedule and Quality Payment Program (QPP) outlining reimbursement changes for 2019. CMS estimates that the overall impact will be a 1% reimbursement cut for...

Oncology Care Team Reduces Opioid Use After Surgery by Using Quality Improvement Approach

IN A QUALITY improvement project that was featured in the Quality Care Symposium press program,1 members of an oncology care team achieved a 46% reduction in opioid use among patients who underwent a range of urologic surgeries. They did this by using a systemic approach that identified multiple...

genomics/genetics

Role of Genomic Profiling in Younger Patients With Cancer

Although overall cancer survival rates continue to improve among all age groups in the United States—there are currently an estimated 15.5 million cancer survivors, and that number is expected to increase to 20.3 million by 20261—survival rates for adolescents and young adults with cancer (AYAs)...

Oncology Researcher Catherine J. Wu, MD, Always Knew She Wanted to Be a Doctor

Catherine J. Wu, MD, Professor at Dana-Farber Cancer Institute, was reared in a medical environment, which shaped her career path as a physician-scientist. “Both of my parents are physicians and were trained in internal medicine. Medicine was always part of my life as I grew up, and it seemed like...

leukemia

Moxetumomab Pasudotox-tdfk for Relapsed or Refractory Hairy Cell Leukemia

ON SEPTEMBER 13, 2018, moxetumomab pasudotox-tdfk (Lumoxiti), a CD22-directed cytotoxin, was approved for the treatment of adult patients with relapsed or refractory hairy cell leukemia who received at least two prior systemic therapies, including with a purine nucleoside analog.1,2 Supporting...

skin cancer

Encorafenib and Binimetinib: A New Benchmark in Metastatic Melanoma Therapy?

IN JULY 2018, the U.S. Food and Drug Administration (FDA) approved the combination of the oral BRAF inhibitor encorafenib (Braftovi) and the oral MEK inhibitor binimetinib (Mektovi) for BRAF V600E– or V600K– positive metastatic melanoma. The FDA approval was based on the results of the COLUMBUS...

skin cancer

Encorafenib Plus Binimetinib vs Vemurafenib in Advanced BRAF-Mutant Melanoma

AS REPORTED in The Lancet Oncology by Reinhard Dummer, MD, of the University Hospital Zurich Skin Cancer Center, and colleagues, the phase III COLUMBUS trial has shown a significant improvement in overall survival with the combination of the BRAF inhibitor encorafenib (Braftovi) and the MEK...

leukemia
lymphoma

Duvelisib for Relapsed or Refractory CLL/SLL and for Relapsed or Refractory Follicular Lymphoma

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On September 24, 2018, duvelisib (Copiktra) was granted...

bladder cancer
immunotherapy

Bladder Cancer: Strategies to Address Checkpoint Inhibitor Failure

CHECKPOINT INHIBITORS have rapidly become the standard of care as second-line treatment, and in some patients first-line treatment, of advanced bladder cancer. However, the majority of patients do not respond and eventually experience disease progression; these patients will need subsequent...

prostate cancer

Shedding Light on Mechanisms of Resistance to Treatment of Metastatic Castration-Resistant Prostate Cancer

ONE OF the pressing issues in metastatic castration-resistant prostate cancer is the development of resistance to therapies directed at the androgen receptor (AR), such as enzalutamide (Xtandi) and abiraterone acetate (Zytiga). Research is ongoing to identify mechanisms of resistance in the hope of ...

breast cancer

Management of HER2-Positive Breast Cancer: Business as Usual?

MANAGEMENT OF HER2-positive breast cancer changed after the introduction of trastuzumab (Herceptin), the first anti-HER2 therapy to be approved by the U.S. Food and Drug Administration (FDA) for this type of cancer. Recent studies have more clearly defined the role of pertuzumab (Perjeta) and...

colorectal cancer
immunotherapy

Expert Point of View: Julien Taieb, MD

JULIEN TAIEB, MD, Professor of Medicine at Paris Descartes University in France, said the MODUL cohort was based on a clear rationale for adding atezolizumab (Tecentriq) to bevacizumab (Avastin) in the metastatic colorectal cancer setting. In immunodeficient mice, the combination of an...

colorectal cancer
immunotherapy

No Benefit for Atezolizumab Plus Standard of Care for Maintenance in Colorectal Cancer Subset

ADDING ATEZOLIZUMAB (Tecentriq) to a fluoropyrimidine plus bevacizumab (Avastin) did not improve outcomes for patients with BRAF wild-type metastatic colorectal cancer enrolled in the umbrella MODUL trial.1 “Despite activity in other, immune-responsive tumor types, there was no improvement in...

skin cancer
immunotherapy

Pembrolizumab Triplet Shows Activity in BRAF-Mutant Melanoma

AS FIRST-LINE treatment of advanced BRAF-mutant melanoma, pembrolizumab (Keytruda) added to dabrafenib (Tafinlar) and trametinib (Mekinist) produced a nonsignificant improvement in progression-free survival. It also increased the rate of grade 3 to 5 treatment-related adverse events in the phase II ...

prostate cancer

Expert Point of View: Joaquin Mateo, MD, PhD

FORMAL DISCUSSANT Joaquin Mateo, MD, PhD, of the Prostate Cancer Translational Research Group, Vall d’Hebron Institute of Oncology, Barcelona, said that the TRITON2 findings were encouraging, although still preliminary. “We should interpret these results with caution, because this interim analysis ...

kidney cancer

Expert Point of View: Manuela Schmidinger, MD

“TARGETED AGENTS were a breakthrough in the treatment of renal cell carcinoma, and immunotherapy also works well, improving survival. In the past 2 years, combining a checkpoint inhibitor with targeted agents appears to work even better, and multiple combination trials are underway. The outcomes...

kidney cancer

Progress Made in Identifying Gene-Signature Biomarkers in Renal Cell Carcinoma

A NEW ANALYSIS of the phase III IMmotion151 trial identified gene signatures in renal cell carcinoma that correlate with improved progression-free survival in patients treated with atezolizumab (Tecentriq) plus bevacizumab (Avastin) vs sunitinib (Sutent). These findings were presented at the...

skin cancer

Using Tumor‑Infiltrating Lymphocytes to Treat Metastatic Melanoma

STEVEN A. ROSENBERG, MD, PhD, Chief of Surgery at the National Cancer Institute (NCI), began his pioneering research in adoptive cell transfer using interleukin (IL)-2 in the mid-1970s. His IL-2 studies were among the clinical trials that led to the first U.S. Food and Drug Administration approval ...

cns cancers

Expert Point of View: Christina I. Tsien, MD

DISCUSSANT OF the NRG-CC001 trial, Christina I. Tsien, MD, Professor of Radiation Oncology at Washington University School of Medicine, St. Louis, underscored the importance of this research, noting that cognitive impairment affects nearly 50% of patients who undergo whole-brain radiation therapy. ...

cns cancers

Hippocampus-Sparing Whole-Brain Radiotherapy and Neurocognitive Function in Patients With Brain Metastases

ANALYSIS OF a phase III trial has confirmed that conformal avoidance of the hippocampal dentate gyrus using intensity-modulated radiotherapy during whole-brain radiotherapy for brain metastases preserves neurocognitive function and improves patient-reported symptom burden while achieving similar...

solid tumors

Stereotactic Ablative Radiotherapy May Improve Outcomes in Some Patients With Oligometastatic Tumors

IN PATIENTS with a controlled primary tumor and up to 5 oligometastatic lesions, delivering stereotactic ablative radiotherapy was associated with a 13-month improvement in overall survival when compared with palliative standard-of-care treatments alone (41 months vs 28 months; P = .09).1...

lung cancer

Expert Point of View: Catherine C. Park, MD, FASTRO

DISCUSSANT OF the abstract, Catherine C. Park, MD, FASTRO, Professor and Chair of the Department of Radiation Oncology at the University of California, San Francisco, expressed excitement about this study’s results, which suggest the possibility of curing patients with stage IV disease. “We’re...

lung cancer

Local Consolidative Therapy Associated With Survival Benefit for Some With Oligometastatic NSCLC

FOR A SUBSET of patients with stage IV lung cancer, aggressive treatment may improve overall survival, according to data presented at the 2018 Annual Meeting of the American Society for Radiation Oncology (ASTRO).1 The results of the phase II study showed that with long-term follow-up, local...

lymphoma

Expert Point of View: Laurie H. Sehn, MD

LAURIE H. SEHN, MD, Chair, Lymphoma Tumour Group, BC Cancer Agency, Vancouver, British Columbia, Canada, said these results are not unexpected and support de-escalation in selected patients. “The FLYER trial evaluates treatment with four cycles compared with six cycles of cyclophosphamide,...

lymphoma

De-escalation of Chemotherapy in Favorable-Risk Diffuse Large B-Cell Lymphoma

THE REGIMEN of four cycles of rituximab (Rituxan)/cyclophosphamide, doxorubicin, vincristine, prednisone (R-CHOP) plus two cycles of rituximab was noninferior to that of six cycles of R-CHOP in younger patients with favorable-risk diffuse large B-cell lymphoma (DLBCL), according to the results of...

immunotherapy

Beyond Checkpoint Inhibitors: Novel Immunotherapy Combinations With Antitumor Activity

THE 2018 Society for Immunotherapy of Cancer (SITC) Annual Meeting hosted a meeting of the minds of the world’s premier cancer immunologists. In addition to the cutting-edge laboratory science explored and presented at the meeting, numerous phase I clinical trials and a few phase II studies offered ...

issues in oncology

Should Oncologists Recommend Cannabis?

A RECENT survey of 400 clinical oncologists found that 80% discuss the use of medical cannabis with their patients, and although nearly 50% recommend it, fewer than 30% consider themselves knowledgeable enough to make such recommendations.1 Oncologists are perhaps among the most evidence-demanding ...

leukemia
geriatric oncology

Expert Point of View: Susan M. O’Brien, MD

THE STUDY’S discussant, Susan M. O’Brien, MD, Associate Director for Clinical Science, Chao Family Comprehensive Cancer Center, University of California Irvine Health, said the results of the Alliance North American Intergroup Study A041202—demonstrating that ibrutinib (Imbruvica) is more...

leukemia
geriatric oncology

Ibrutinib vs Standard of Care in Front-Line Treatment of Older Patients With Chronic Lymphocytic Leukemia

IBRUTINIB (IMBRUVICA) as a front-line agent proved superior to standard-of-care chemoimmunotherapy for chronic lymphocytic leukemia (CLL) in older patients in A041202, an Alliance-led National Clinical Trials Network study.1 At a follow-up of 38 months, the median progression-free survival was not ...

breast cancer

Shom Goel, MD, PhD, on Breast Cancer: Impact of CDK4/6 Inhibitors on Immunity

Shom Goel, MD, PhD, of the Dana-Farber Cancer Institute, discusses preclinical data that suggest CDK4/6 inhibitors not only stop the growth of breast cancer cells, but also enhance antitumor immunity, a phenomenon that might help improve outcomes for people with advanced disease.

breast cancer
survivorship
symptom management

SABCS 2018: Oxybutynin for the Management of Hot Flashes in Women Unable to Receive Hormone Replacement Treatment

Treatment with oxybutynin helped reduce the frequency and intensity of hot flashes for women who could not take hormone replacement therapy, including breast cancer survivors, according to the results of a trial presented at the 2018 San Antonio Breast Cancer Symposium by Leon-Ferre et al (Abstract ...

breast cancer

SABCS 2018: SOLAR-1: Liquid Biopsies in Predicting Benefit of Alpelisib in PIK3CA-Mutant Breast Cancer

Liquid biopsy–based assessment of PIK3CA mutational status served as a better indicator of progression-free survival compared with analysis of tissue biopsy in patients with breast cancer enrolled in the phase III SOLAR-1 clinical trial, according to data presented by Juric et al at the 2018...

breast cancer

SABCS 2018: TAILORx Results Show Association Between Clinical Outcomes in Breast Cancer and Race

An analysis of the association between clinical outcomes and race in participants enrolled in the TAILORx trial found that even with equivalent treatments among women with hormone receptor–positive, HER2-negative breast cancer, black women had worse clinical outcomes than white women, despite ...

lung cancer
immunotherapy

FDA Approves Atezolizumab in Combination With Bevacizumab and Chemotherapy for First-Line Treatment of Metastatic, Nonsquamous NSCLC

On December 6, 2018, the U.S. Food and Drug Administration (FDA) approved atezolizumab (Tecentriq) in combination with bevacizumab (Avastin), paclitaxel, and carboplatin for the first-line treatment of patients with metastatic, nonsquamous non–small cell lung cancer (NSCLC) with no EGFR or...

Neurologic Knowledge to Enhance Well-Being and Happiness

BOOKMARK Title: Your Happy Brain: Why and How to Hug ItAuthors: Philomena Lawrence, BA, BEd, and Gilbert Lawrence, MD, FRCRPublisher: CreateSpace Independent Publishing PlatformPublication date: June 2018Price: $16.00, paperback, 390 pages Some 2,400 years ago, the ancient Greeks were among the...

breast cancer
solid tumors
lung cancer

A Diagnosis of Li-Fraumeni Syndrome Has Focused My Life Direction

Despite the fact that I had to have open heart surgery at age 7 to fix a congenital heart defect and then more surgery, chemotherapy, and radiation therapy to treat a diagnosis of rhabdomyosarcoma a year later, I never felt like I was a sick kid. Children don’t have the existential worries about...

breast cancer

SABCS 2018: Whole-Breast Irradiation vs Accelerated Partial-Breast Irradiation for Preventing Ipsilateral Breast Tumor Recurrence

Data from the NSABP B-39/RTOG 0413 trial indicated that ipsilateral breast tumor recurrence (IBTR) rates 10 years after treatment could not reject the hypothesis that accelerated partial-breast irradiation (PBI) after lumpectomy was inferior to whole-breast irradiation (WBI), according to a...

breast cancer

SABCS 2018: Low-Dose Tamoxifen in Reducing Recurrence and New Disease for Patients With Breast Intraepithelial Neoplasia

Treatment with a low dose of tamoxifen (5 mg/d), compared with placebo, decreased the risk of disease recurrence and new disease for women who had been treated with surgery following a diagnosis of breast intraepithelial neoplasia. Moreover, it did not cause more serious adverse events, according...

breast cancer

SABCS 2018: AMAROS Trial: 10-Year Follow-up of Axillary Radiotherapy or Surgery in Early-Stage Breast Cancer

Patients with early-stage breast cancer who had cancer detected in a sentinel lymph node biopsy had comparable 10-year recurrence and survival rates following either axillary radiotherapy or axillary lymph node dissection, according to data from the randomized, phase III AMAROS clinical trial...

breast cancer

SABCS 2018: Circulating Tumor Cell Count May Help Choose First-Line Treatment for Metastatic Breast Cancer

A phase III study by Bidard et al investigated whether circulating tumor cells could help physicians choose between hormone therapy or chemotherapy as front-line therapy for patients with estrogen receptor (ER)-positive, HER2-negative metastatic breast cancer. The researchers concluded that the...

issues in oncology

A Feminist Take on Health-Care Disparities

BOOKMARK Title: Doing Harm: The Truth About Bad Medicine and Lazy Science Leave Women Dismissed, Misdiagnosed, and SickAuthor: Maya DusenberyPublisher: HarperOnePublication date: March 2018Price: $27.99, hardcover, 400 pages Over the past year or so, there have been several books by women focused...

Denial’s Many Faces

The ASCO Post is pleased to reproduce installments of the Art of Oncology as published previously in the Journal of Clinical Oncology. These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

issues in oncology

University Collaboration Aims to Tackle Cancer Health Disparities

The National Cancer Institute has provided a grant to develop a joint cancer drug discovery/development and research education program to focus on cancers that have an increased risk of incidence and/or mortality among underserved communities, namely African Americans, Hispanics, and Native...

lung cancer

Pembrolizumab With Chemotherapy for First-Line Treatment of Metastatic Nonsquamous NSCLC

On August 20, 2018, pembrolizumab (Keytruda) in combination with pemetrexed (Alimta) and platinum was granted regular approval as first-line treatment of patients with metastatic nonsquamous non–small cell lung cancer (NSCLC) with no epidermal growth factor receptor (EGFR) or anaplastic lymphoma...

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