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Expect Questions About Updated Dietary Guidelines

The 2015–2020 Dietary Guidelines for Americans1 have generated comments and controversy, with some organizations expressing concern that the guidelines did not recommend limiting the consumption of red and processed meat. These organizations include the American Institute for Cancer Research...

issues in oncology

Failure of Updated Dietary Guidelines to Advise Limiting Red and Processed Meat Deemed a ‘Missed Opportunity’

“A missed opportunity” is how Susan Higginbotham, PhD, RD, Vice President for Research, American Institute for Cancer Research (AICR), described the “failure” of updated dietary guidelines to recommend limiting consumption of red and processed meat. Doing so would have “the potential to save...

hematologic malignancies
multiple myeloma

Selected Abstracts From 2015 ASH Annual Meeting: Part 3

Here are several more abstracts selected from the proceedings of the 2015 American Society of Hematology (ASH) Annual Meeting and Exposition, focusing on newly diagnosed multiple myeloma, relapsed/refractory multiple myeloma, and amyloid light-chain (AL) amyloidosis. For other selected abstracts...

supportive care

Rolapitant Reduces Chemotherapy-Induced Nausea and Vomiting in Patients Receiving Moderately and Highly Emetogenic Chemotherapy

In three phase III studies reported in The Lancet Oncology, the addition of the neurokinin-1 (NK-1) receptor antagonist rolapitant to serotonin (5-HT3) receptor antagonist and dexamethasone treatment significantly improved complete response rates in the prevention of chemotherapy-induced nausea and ...

issues in oncology
lung cancer
geriatric oncology

Management of Advanced Lung Cancer in the Elderly: A Reason to Rejoice or a Cause for Concern?

There is ample evidence to suggest that older adults with a good performance status (0 or 1) with advanced non–small cell lung cancer (NSCLC) should be treated with combination chemotherapy akin to younger patients.1,2 However, older adults comprise a heterogeneous group that has been...

leukemia

Ofatumumab for Extended Treatment of Patients With Recurrent or Progressive Chronic Lymphocytic Leukemia

On January 19, 2016, ofatumumab (Arzerra) was approved for extended treatment of patients in complete or partial response after at least two lines of therapy for recurrent or progressive chronic lymphocytic leukemia (CLL).1,2 Ofatumumab was previously approved for treatment of untreated patients...

Expert Point of View: Elizabeth Plimack, MD

The Egyptian study presented by Brian Baumann, MD, of the University of Pennsylvania, Philadelphia, was a “valiant effort” to determine whether sequential adjuvant chemotherapy added to adjuvant radiation would improve disease-free survival, said formal discussant of this trial Elizabeth Plimack,...

bladder cancer

Adjuvant Chemoradiotherapy in Locally Advanced Bladder Cancer: Hint of Benefit That Needs Confirmation

Adjuvant sequential chemotherapy plus radiation therapy and adjuvant radiation therapy alone significantly improved local tumor control compared with adjuvant chemotherapy alone in locally advanced bladder cancer but the improvement in disease-free survival (3-year disease-free survival of 68% vs...

prostate cancer

Active Holistic Surveillance May Prevent Unnecessary Biopsies in Low- and Low/Intermediate-Risk Prostate Cancer

The use of prostate-specific antigen (PSA) screening has led to a dramatic rise in the number of men diagnosed with low-grade prostate cancer. Active surveillance is recommended to manage patients with favorable-risk, low-grade prostate cancer, with the goal of avoiding overtreatment of these...

head and neck cancer
cost of care

2016 Head and Neck Cancer Symposium: Cost-Coping Strategies and Perceived Social Isolation in Locally Advanced Head and Neck Cancer

The majority of patients with locally advanced head and neck cancers rely on cost-coping strategies that alter their lifestyle in order to manage the financial burden of their care, according to research presented by Kung et al at the 2016 Multidisciplinary Head and Neck Cancer Symposium (Abstract...

survivorship

Study Finds Abnormal Insulin and Glucose Dynamics in Childhood Survivors Treated With Abdominal Radiation

An ongoing pilot study, designed to assess dynamic indices of insulin and glucose homeostasis in childhood cancer survivors exposed to abdominal radiation, has found a variety of derangements in glucose and insulin homeostasis in this cohort.1 According to an analysis presented at the 2016 Cancer...

survivorship
thyroid cancer

Detection of Thyroid Cancer Most Cost-Effective With Physical Examination, Not Ultrasound Screening

A study evaluating annual physical examination as a screening method to detect thyroid cancer in cancer survivors exposed to neck radiation has shown a substantial cost reduction compared with ultrasound screening, with no thyroid cancer–related mortality.1 According to the analysis, this method...

survivorship

Bridging the Medical Gap in Long-Term Cancer Survivorship Care

Although more people than ever before are surviving cancer—there are currently 14.5 million cancer survivors, and that number is expected to climb to 19 million by 20241—they often experience long-lasting physical, emotional, and financial concerns related to the disease. To address the unmet...

gastrointestinal cancer

Carboplatin/Paclitaxel Tops Oxaliplatin/Capecitabine as Neoadjuvant Regimen for Esophageal Cancer

The United Kingdom’s phase II ­NEOSCOPE trial compared the toxicity and efficacy of two preoperative chemoradiation regimens—carboplatin/paclitaxel and oxaliplatin/capecitabine—and judged one to be the winner. “CarPacRT passed the prespecified efficacy criteria for taking forward to phase III, but...

head and neck cancer
issues in oncology

2016 Head and Neck Cancer Symposium: Study Maps Distinct Molecular Signatures of HPV-Positive Throat Cancer by Smoking Status

Patients with throat cancer exposed to both human papillomavirus (HPV) and tobacco smoke demonstrate a pattern of mutations along several key cancer genes, according to research presented by Zevallos et al at the 2016 Multidisciplinary Head and Neck Cancer Symposium (Abstract 1). These distinct...

Expert Point of View: Claus Rödel, MD

Claus Rödel, MD, Director and Chair of the Department of Radiotherapy and Oncology, University of Frankfurt, Germany, and invited discussant of the study, pointed out that these investigators found “the opposite” of what most previous studies have shown: Others have found an increased risk for...

solid tumors
issues in oncology

Serum Tumor Marker Testing Overused, Especially for Solid Tumors

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...

colorectal cancer

Shorter Radiation Course May Benefit Patients With Locally Advanced Rectal Cancer

As neoadjuvant treatment for locally advanced rectal cancer, a shorter course of radiation therapy followed by chemotherapy may be as good as, or better than, standard chemoradiotherapy, according to a study from the Polish Colorectal Study Group presented at the 2016 Gastrointestinal Cancers...

Expert Point of View: Bertram Wiedenmann, MD, PhD and Markus Moehler, MD, PhD

Commenting on the programmed cell death protein 1 (PD-1)/PD-1 ligand (PD-L1) antibodies in tumors with mismatch repair deficiency, Bertram Wiedenmann, MD, PhD, Professor of Internal Medicine and Gastroenterology, Universitätsmedizin Berlin, Germany, suggested, “The efficacy of pembrolizumab...

cost of care

Cost in the Context of Value for Cancer Medicines

Bringing new cancer therapies through the discovery and development process entails considerable risk and many years of study. It also requires substantial investment and incentives from the public and private sectors to fuel future investment and discovery. A system that rewards advances in cancer ...

survivorship

Surveillance for Recurrence and Second Cancers: Guidelines and Caveats

Striking the right balance between under- and oversurveillance of cancer survivors is challenging, and oncology providers are best served by knowing and following guidelines—though they can change often. Cancer recurrence and second cancers are two of the major threats to the health of cancer...

gastrointestinal cancer

Anti–PD-1/PD-L1 Antibodies Make Strong Showing in Gastrointestinal Cancers

Although the results may not yet be as impressive as those seen in melanoma, lung, and kidney cancers, monoclonal antibodies targeting the programmed cell death protein 1 (PD-1) are producing responses, with some durability, in gastrointestinal cancers, according to studies presented at the 2016...

colorectal cancer
issues in oncology

Fecal Immunochemical Test Sensitive and Effective for Annual Colorectal Cancer Screening

Annual screening with the fecal immunochemical test is highly sensitive for detecting colorectal cancer and “is feasible and effective for population-level colorectal cancer screening,” according to a large-scale retrospective cohort study assessing the fecal immunochemical...

colorectal cancer
issues in oncology
issues in oncology

Updated Guidelines Recommend That Patients With Colorectal Cancer Undergo Colonoscopy After Cancer Resection

According to new recommendations from the U.S. Multi-Society Task Force on Colorectal Cancer published by Kahi et al in Gastroenterology, postoperative colonoscopy is associated with improved overall survival for colorectal cancer patients. Therefore, it is critically important that colorectal...

survivorship
cns cancers
issues in oncology

Increased Risk of Severe Neurocognitive Impairment in Adult Survivors of Pediatric CNS Tumors

As reported in the Journal of Clinical Oncology by Brinkman et al, a study in the St. Jude Lifetime Cohort showed that adult survivors of pediatric central nervous system (CNS) tumors are at increased risk of severe neurocognitive impairment. Study Details The study involved 224 survivors of CNS...

skin cancer

Melanoma-Specific Survival Significantly Higher With Wider Excision Margins

Among patients with high-risk, primary cutaneous melanomas, the risk of death from melanoma at a median follow-up of 8.8 years was significantly higher among those randomized to surgery with a 1-cm excision margin than among those randomized to surgery with a 3-cm excision margin. Although overall...

sarcoma

Eribulin Improves Overall Survival vs Dacarbazine in Advanced Liposarcoma or Leiomyosarcoma

In a phase III trial reported in The Lancet, Schöffski et al found that eribulin improved overall survival vs dacarbazine in patients with advanced or metastatic soft-tissue sarcoma who had received at least two prior systemic treatments for advanced disease. Outcome in the subgroup with...

lung cancer

Intense Tumor Lymphocytic Infiltration Prognostic of Better Outcome in Resectable NSCLC

Intense tumor lymphocytic infiltration was associated with improved outcomes in patients with resectable non–small cell lung cancer, according to a study reported in the Journal of Clinical Oncology by Brambilla et al. Study Details The LACE-Bio (Lung Adjuvant Cisplatin Evaluation...

prostate cancer

Study Finds Enzalutamide Increases Progression-Free Survival vs Bicalutamide in Metastatic Prostate Cancer

Use of the androgen receptor–inhibitor enzalutamide (Xtandi) more than doubled progression-free survival vs the nonsteroidal antiandrogen bicalutamide in patients with metastatic prostate cancer progressing on androgen-deprivation therapy, according to the randomized phase II TERRAIN trial...

breast cancer
survivorship

ACS/ASCO Breast Cancer Survivorship Care Guideline

The American Cancer Society (ACS) and ASCO have issued a Breast Cancer Survivorship Care guideline, published jointly in the Journal of Clinical Oncology and CA: A Cancer Journal for Clinicians. The guideline recommendations were formulated by a multidisciplinary expert work group and are based on...

hepatobiliary cancer

Nanoparticle Therapy That Uses LDL and Fish Oil Kills Liver Cancer Cells

An experimental nanoparticle therapy that combines low-density lipoproteins (LDL) and fish oil preferentially kills primary liver cancer cells without harming healthy cells, UT Southwestern Medical Center researchers report. The study was published by Wen et al in Gastroenterology. “This...

Study Finds Time Lag Between Positive Fecal Blood Test and Follow-up Colonoscopy

Annual testing for blood in the stool using high-sensitivity guaiac fecal occult blood tests or fecal immunochemical tests is one of several recommended colorectal cancer screening strategies for adults 50 to 70 years old. However, although a positive finding requires a follow-up colonoscopy to...

lung cancer

Addition of TG4010 Vaccine to First-Line Chemotherapy Appears to Improve Progression-Free Survival in Advanced NSCLC

As reported in The Lancet Oncology by Quoix et al, the addition of immunotherapy with TG4010—the modified vaccinia Ankara expressing MUC1 and interleukin 2—to first-line chemotherapy improved progression-free survival in patients with advanced non–small cell lung cancer (NSCLC) in ...

lung cancer

Alectinib in ALK-Positive Metastatic NSCLC After Crizotinib

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 December 11, 2015, alectinib (Alecensa) was granted...

head and neck cancer

No Benefit of Adding Adjuvant and Maintenance Lapatinib to Chemoradiation in High-Risk Patients With Resected Squamous Cell Carcinoma of the Head and Neck

In a phase III trial reported in the Journal of Clinical Oncology, Harrington et al found that the addition of concurrent adjuvant lapatinib (Tykerb) to chemoradiation therapy and the use of maintenance lapatinib did not improve disease-free or overall survival in high-risk patients with resected...

The Sohn Conference Foundation Unveils The Sohn Precision Medicine Program at Columbia University Medical Center

The Sohn Conference Foundation unveiled The Sohn Precision Medicine Program at Columbia University Medical Center (CUMC) on January 14, 2016. Funded by a $1.5 million grant provided by The Sohn Conference Foundation over approximately a 3-year period, the Program will provide high-risk pediatric...

Lewis C. Cantley, PhD, Wins Israel’s Wolf Prize in Medicine

Lewis C. Cantley, PhD, Director of the Sandra and Edward Meyer Cancer Center at Weill Cornell Medicine, was named a recipient of the 2016 Wolf Prize in Medicine, considered “Israel’s Nobel Prize.” The Wolf Foundation announced the 2016 winners. The seven winners share $100,000 awards in five...

kidney cancer
kidney cancer

Removal of Complex Renal Tumors Performed Safely by Robotic Surgery in Selected Patients

Renal cell carcinoma can sometimes spread to the inferior vena cava, posing a threat to the heart and brain. Robotic nephrectomy for inferior vena cava tumor thrombus has favorable outcomes in selected patients compared with open surgery, which can have a high rate of complications, reported Abaza...

Certainty

The following essay by William N. Harwin, MD, is adapted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was coedited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and thebigcasino.org.   My wife...

New AJCC Precision Medicine Guidelines Aimed at Improving Personalized Cancer Treatment Plans for Patients

A committee of national experts, led by a Cleveland Clinic researcher, has established first-of-its-kind guidelines to promote more accurate and individualized cancer predictions, guiding more precise treatment and leading to improved patient survival rates and outcomes. These guidelines were...

2016 Oncology Meetings

FEBRUARY 10th AACR-JCA Joint Conference on Breakthroughs in Cancer Research: From Biology to TherapeuticsFebruary 16-20 • Maui, Hawaii For more information: www.aacr.org The Biomarker ConferenceFebruary 18-20 • San Diego, California For more information:...

myelodysplastic syndromes

Selected Abstracts From 2015 ASH Annual Meeting: Part 2

Here are several more abstracts selected from the proceedings of the 2015 American Society of Hematology (ASH) Annual Meeting and Exposition, highlighting therapeutics in acute leukemias and myelodysplastic syndromes. For five other top abstracts on therapies for acute leukemias and myelodysplastic ...

skin cancer

Expanded Approval of Pembrolizumab in Unresectable or Metastatic Melanoma

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 December 18, 2015, approval of the programmed cell death...

A Pioneering Oncologist’s Roadmap Forward

Bookmark Title: The Death of Cancer: After Fifty Years on the Front Lines of Medicine, a Pioneering Oncologist Reveals Why the War on Cancer Is Winnable—and How We Can Get There Authors: Vincent T. DeVita, Jr, MD, and Elizabeth DeVita-Raeburn Publisher: Farrar, Straus and Giroux Publication date:...

Defibrotide Under Review for Transplant-Related Complication

A potentially fatal complication of hematopoietic stem cell transplantation may be reversed with the use of a novel drug currently under priority review at the U.S. Food and Drug Administration (FDA). Hepatic veno-occlusive disease/sinusoidal obstruction syndrome is usually a serious complication...

hematologic malignancies

Reduced-Intensity Conditioning Hematopoietic Stem Cell Transplantation in Older Patients With AML in First Remission

In a phase II study (CALGB 100103/Alliance/Blood and Marrow Transplant Clinical Trial Network 0502) reported in the Journal of Clinical Oncology,1 Steven M. Devine, MD, of The Ohio State University, Columbus, et al found that reduced-intensity conditioning allogeneic hematopoietic stem cell...

solid tumors
prostate cancer

Increased Survival and Toxicity With Docetaxel, No Apparent Benefit of Zoledronic Acid in Prostate Cancer

As reported in The Lancet by James et al, results of the STAMPEDE trial, which used a multiarm, multistage seamless phase II/III design, showed increased survival and toxicity with docetaxel and little benefit of zoledronic acid when added to first-line long-term hormone therapy in patients with...

APOS Launches Psychosocial Oncology Institute

The American Psychosocial Oncology Society (APOS) will launch the inaugural Psychosocial Oncology Institute on March 3, 2016, at the Sheraton San Diego Hotel & Marina in San Diego, California. Instructors for the full-day, interactive institute—leaders in the psychosocial oncology field—will...

breast cancer

For Postmenopausal Women With Ductal Carcinoma in Situ: NSABP B-35 and IBIS-II DCIS Trials Offer a Choice of Endocrine Therapy

The past year has produced an embarrassment of riches regarding the value of aromatase inhibitors for women with ductal carcinoma in situ of the breast. The long-awaited NSABP B-35 study matured and was reported by Margolese and colleagues at the 2015 ASCO Annual Meeting this past summer, followed...

breast cancer

Comparing Recurrence Risk With Anastrozole vs Tamoxifen in Postmenopausal Women With Ductal Carcinoma in Situ

Two recently reported phase III trials compared adjuvant anastrozole vs tamoxifen in postmenopausal women with hormone receptor–positive ductal carcinoma in situ. As reported in The Lancet by Margolese et al,1 the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-35 trial, performed in...

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