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breast cancer

ASCO Guideline on Endocrine Therapy for Metastatic Breast Cancer: Reaffirming Principles for Making Treatment Decisions

The role of endocrine therapy for hormone receptor–positive metastatic breast cancer is well established, and clinicians are strongly encouraged to consider one of several therapeutic options for the majority of patients who present with metastatic disease. The recent ASCO guideline on this topic, ...

breast cancer

ASCO Guideline on Endocrine Therapy for Hormone Receptor–Positive Metastatic Breast Cancer

As reported by Hope S. Rugo, MD, of the University of California San Francisco Comprehensive Cancer Center, and colleagues in the Journal of Clinical Oncology, ASCO has released a clinical practice guideline on endocrine therapy for hormone receptor–positive metastatic breast cancer.1 The...

issues in oncology

Discovery of Fragment Length of Circulating Tumor DNA Might Increase Liquid Biopsy Sensitivity

The liquid biopsy may be a welcome reprieve from typical biopsies. The minimally invasive test could reduce the need for the sometimes painful and risky procedures involved in sampling tumors, particularly those that reside deep within the body. However, thus far, the utility of the test has been...

lymphoma

Five-Year Survival Data: Brentuximab Vedotin May Be Curative in Some Patients With Hodgkin Lymphoma

Five-year survival data published by Chen et al in Blood suggest that the targeted therapy brentuximab vedotin (Adcetris) may be curative in some patients with Hodgkin lymphoma whose disease has persisted despite receiving previous therapies. This multinational phase II study examined brentuximab...

issues in oncology
health-care policy

Road to Successful Use of Real-World Evidence for Drug Development Is Long and Rocky

Friends of Cancer Research (Friends) has been a leader in the push for better and faster cancer drug development. Now it is tackling the use of real-world evidence in clinical trials. This is the report of a meeting on the subject that took place on June 16 in Washington, DC.1 Real-world evidence...

breast cancer
solid tumors

Study Finds Wide Variation in Breast Density Assessments Among Radiologists

A large observational study examining the variation in breast density assessment among radiologists in clinical practice has found a wide variation—from 6.3% to 84.5%—in the percentage of mammograms rated as showing dense breasts, which persisted after adjusting for patient...

breast cancer
issues in oncology
genomics/genetics

Using Social Media to Accelerate Genomic Research

The success of using social media to push forward causes for social good was a driving factor in the launch this past October of the Metastatic Breast Cancer Project (MBC project), which aims to accelerate the understanding of what makes patients with metastatic breast cancer genetically unique....

ASCO Resolutions Supported by AMA House of Delegates

At the American Medical Association’s (AMA) annual House of Delegates meeting, delegates approved four resolutions submitted by ASCO, demonstrating the entire medical community’s commitment to key cancer care priorities. These resolutions have been incorporated into the AMA’s policy system and will ...

HHS Announces Physician Groups Selected for Initiative Promoting Better Cancer Care

The U.S. Department of Health and Human Services (HHS) has announced that it has selected nearly 200 physician group practices and 17 health insurance companies to participate in a care delivery model that supports and encourages higher quality and more coordinated cancer care. The Medicare arm of...

American Cancer Society Endorses HPV Vaccine Recommendations From CDC ACIP

The American Cancer Society (ACS) has endorsed human papillomavirus (HPV) vaccination recommendations from the Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP), the principal source of guidance on U.S. immunization policy. The ACS's...

Expert Point of View: Patricia A. Ganz, MD & Gregory A. Masters, MD

“This is a tremendous advance. If we had a drug that could achieve these results we would rush to use it. This is also personalized medicine that alerts the health-care team when symptoms need addressing. And it is very important that using the app led to appropriate use of scans and tests, which...

lung cancer

App Triggers Earlier Detection of Relapse, May Help Improve Survival of Patients With Lung Cancer

Web-based applications have invaded mainstream culture and grabbed the attention of multitudes of people around the world. According to a study presented at the 2016 ASCO Annual Meeting, an app may also contribute to extending the lives of people with cancer and, at the same time, reduce...

Expert Point of View: Isabelle Ray-Coquard, MD, PhD

Isabelle Ray-Coquard, MD, PhD, of the Centre Leon Berard, Claude Bernard, and Professor at Claude Bernard University Lyon, France, was the study’s formal discussant. She noted the “great benefits” provided by hormonal therapy in terms of progression-free survival and, in the subset with no...

gynecologic cancers

Benefit Strongly Suggested With Hormonal Maintenance in Low-Grade Serous Carcinoma

In patients with low-grade serous carcinoma, maintenance hormonal therapy reduced the risk of recurrence by 77%, compared with surveillance, in a retrospective cohort from The University of Texas MD Anderson Cancer Center. The study was reported by David Marc Gershenson, MD, at the 2016 ASCO...

Expert Point of View: Sunil Verma, MD

Sunil Verma, MD, Professor and Head of the Department of Oncology and Medical Director of the Tom Baker Cancer Centre of the University of Calgary in Canada, was the study’s formal discussant. He cited several limitations of the study: It was an open-label study, was initially a phase II study but ...

health-care policy
legislation

CMS Proposal for Part B Drug Payment: A Poorly Conceived Experiment

On March 11, 2016, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule in the Federal Register to test a change in reimbursement for Part B drugs.1 The first phase involves changing the 6% add-on to the average sales price (ASP) used to make drug payments under Part B to...

hematologic malignancies
lymphoma

CNS-IPI for CNS Relapse in Diffuse Large B-Cell Lymphoma

As reported in the Journal of Clinical Oncology, Schmitz et al have developed and validated a risk score for CNS relapse—the Central Nervous System International Prognostic Index (CNS-IPI)—in patients with diffuse large B-cell lymphoma (DLBCL) treated with R-CHOP (rituximab [Rituxan]...

health-care policy
cost of care
issues in oncology

Charting a New Course at the FDA

In February, after serving for a year as the U.S. Food and Drug Administration’s (FDA’s) Deputy Commissioner for Medical Products and Tobacco, Robert M. Califf, MD, MACC, was named the agency’s Commissioner of Food and Drugs. Prior to his appointment at the FDA, Dr. Califf was the Donald F....

solid tumors
gastroesophageal cancer

Comparison of Chemotherapy Regimens in Metastatic Esophageal and Gastroesophageal Junction Adenocarcinoma

FOLFOX (oxaliplatin, leucovorin, fluorouracil [5-FU]) seems to be a safer and more reliable regimen than ECF (epirubicin, cisplatin, 5-FU) and irinotecan/cisplatin as a backbone for treatment in future studies of metastatic esophageal and gastroesophageal junction cancers. This finding from the...

issues in oncology

Patient-Oncologist Difference of Opinion About Advanced Cancer Prognosis Is Common, Study Shows

Misunderstandings about prognosis between patients with advanced cancer and their doctors was common, according to a study by Gramling et al in JAMA Oncology—and the vast majority of patients didn't know that their doctors held different opinions about how long they might live. “We've...

prostate cancer

Early Evidence of Anti–PD-1 Activity in Enzalutamide-Resistant Prostate Cancer

Restoring tumor-specific immunity is a treatment strategy that works well in melanoma and lung cancer patients. Now a new study out of the Oregon Health & Science University (OSHU) Knight Cancer Institute is reviving hope that the approach also may help men with life-threatening prostate...

breast cancer
symptom management

Preclinical Study Shows Target of Trastuzumab, Receptor Protein ErbB2, Needed for Coronary Vasculature Patterning

A receptor protein that is the target of the breast cancer drug trastuzumab (Herceptin) is needed for proper heart blood vessel development, reported researchers from the Perelman School of Medicine at the University of Pennsylvania, Philadelphia. They published their findings this month in a paper ...

prostate cancer

PET/MRI: A One-Stop Imaging Test to Detect Prostate Cancer?

A University of Michigan study published by Piert et al in The Journal of Nuclear Medicine reported that the addition of molecular imaging based on F-18-choline positron-emission tomography (PET) improves the identification of significant prostate cancer over multiparametric prostate magnetic...

solid tumors
issues in oncology

Weight Loss in Overweight and Obese People May Lower Levels of Certain Proteins Linked to Cancer

A new study investigating the effects of dietary weight loss and exercise on circulating levels of certain angiogenesis-related proteins, including vascular endothelial growth factor (VEGF), plasminogen activator inhibitor-1 (PAI-1), and pigment epithelium-derived factor (PEDF), in postmenopausal...

gynecologic cancers

Opportunistic Salpingectomy for Ovarian Cancer Prevention Adopted Without Adverse Surgical Outcomes

A surgical procedure recommended to reduce the future risk of ovarian cancer has been successfully implemented throughout Kaiser Permanente in Northern California without a change in surgical outcomes, according to research published by Garcia et al in Obstetrics & Gynecology. Previous...

solid tumors

Immune Cell Infiltrates May Portend Better Prognosis Across Several Tumor Types

High expression of T-cell and B-cell signatures in infiltrates in the tumor microenvironment predicted improved overall survival across many tumor types, according to a study reported by Iglesia et al in the Journal of the National Cancer Institute. Study Details The study involved use of mRNA...

hematologic malignancies
multiple myeloma

Obesity Linked to Increased Risk of Multiple Myeloma Mortality in African Americans

Obesity may be associated with an increased risk for death from multiple myeloma in African Americans, according to a study reported by Sonderman et al in the Journal of the National Cancer Institute. Multiple myeloma incidence and mortality rates have been reported to be twice as high among...

breast cancer

Better 10-Year Survival Reported With Breast-Conserving Surgery and Radiotherapy vs Mastectomy in Early Breast Cancer

In a Dutch population-based study reported in The Lancet Oncology, van Maaren et al found that breast-conserving surgery plus radiotherapy was associated with improved 10-year survival vs mastectomy in women with early breast cancer. Study Details The study included data from 37,207 women from...

breast cancer

New Analysis Evaluates Predictors of Persistent Pain After Breast Cancer Surgery

An analysis led by McMaster University researchers has found that women who undergo armpit lymph node surgery for breast cancer are much more likely to develop chronic pain. Wang et al published their review of studies exploring risk factors for developing chronic pain after breast cancer...

issues in oncology

Heart Failure After First Heart Attack Associated With Increased Risk of Cancer

Patients who develop heart failure after their first heart attack have a greater risk of developing cancer when compared to first-time heart attack survivors without heart failure, according to a study published by Hasin et al in the Journal of the American College of Cardiology. Heart failure...

lung cancer

Plasma vs Tissue Genotyping and Outcomes With Osimertinib in Advanced Non–Small Cell Lung Cancer

Patients with advanced non–small cell lung cancer (NSCLC) positive for the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor T790M resistance mutation on a plasma assay had similar outcomes with the EGFR tyrosine kinase inhibitor osimertinib (Tagrisso) as did those who were...

leukemia

Shorter Remission Telomere Length Associated With Prolonged Neutropenia After Pediatric AML Treatment

In a study reported in the Journal of Clinical Oncology, Gerbing et al found that prolonged posttreatment neutropenia was associated with shorter chromosomal telomere length in pediatric patients receiving chemotherapy for acute myeloid leukemia (AML). Study Details The study included 53 patients ...

palliative care

Despite Increasing Global Legalization of Physician-Assisted Suicide, Use Remains Rare

Despite increasing legalization of euthanasia and physician-assisted suicide worldwide, the practices remain relatively rare and, when carried out, are primarily motivated by psychological factors such as loss of autonomy or enjoyment of life, rather than physical pain. A new comprehensive...

gynecologic cancers

FDA Approves First HPV Test for Use With SurePath Preservative Fluid

On July 7, the U.S. Food and Drug Administration (FDA) approved the Roche cobas HPV Test as the first test for Human Papilloma Virus (HPV) that can be used with cervical cells obtained for a Papanicolau (Pap) test and collected in SurePath Preservative Fluid. The FDA approves HPV tests to be used...

health-care policy

FDA Advances Precision Medicine Initiative by Issuing Draft Guidances on Next-Generation Sequencing–Based Tests

In support of the President’s Precision Medicine Initiative, on July 6, the U.S. Food and Drug Administration (FDA) issued two draft guidances that, when finalized, will provide a flexible and streamlined approach to the oversight of tests that detect medically important differences in a...

kidney cancer

When Combined With Targeted Therapy, Cytoreductive Nephrectomy May Improve Survival in Metastatic RCC

In a National Cancer Data Base study reported in the Journal of Clinical Oncology, Hanna et al found that cytoreductive nephrectomy may improve survival in patients receiving targeted therapy for metastatic renal cell carcinoma. Study Details The study involved data from 15,390 patients treated...

gastrointestinal cancer

World GI 2016: Chemoradiotherapy After Surgery for Gastric Cancer Shows Similar Outcomes to Postoperative Chemotherapy

Postoperative treatment intensification with chemoradiotherapy does not achieve better outcomes compared to postoperative chemotherapy in patients with gastric cancer who have already undergone preoperative chemotherapy, according to phase III data presented by Verheij et al at the ESMO 18th World...

colorectal cancer

World GI 2016: Anti–PD-L1 Immunotherapy Combined With MEK Inhibition Shows Response in Microsatellite-Stable Metastatic Colorectal Cancer

Anti–PD-L1 (programmed cell death ligand 1) immunotherapy may achieve a response in patients with microsatellite-stable metastatic colorectal cancer if combined with a MEK inhibitor, according to phase I data presented at the European Society for Medical Oncology (ESMO) 18th World Congress on ...

gynecologic cancers

Neoadjuvant Chemotherapy May Render Advanced Ovarian Cancers Responsive to Immunotherapy

Although most patients with advanced ovarian cancer initially respond to platinum-based chemotherapy, they usually relapse. According to a study by Frances R. Balkwill, PhD, Professor of Cancer Biology at Barts Cancer Institute, Queen Mary University of London, United Kingdom, and colleagues...

colorectal cancer

Norwegian Study Shows Benefit of Aspirin as Secondary Prevention in Patients With Colorectal Cancer

A Norwegian population-based study reported in the Journal of Clinical Oncology by Simer J. Bains, MD, PhD, of the Centre for Molecular Medicine Norway, University of Oslo, and colleagues showed that use of aspirin after diagnosis of colorectal cancer was associated with improved colorectal...

leukemia

Increased Risk for Cardiovascular Events Seen in Patients With CML Taking Tyrosine Kinase Inhibitors

Although tyrosine kinase inhibitors have dramatically increased survival for patients with chronic myeloid leukemia (CML), continuous administration of these drugs may elicit long-term toxicity, including cardiovascular adverse events. To investigate the incidence of vascular events in patients...

colorectal cancer

Prevention Needed to Stem Global Rise in Human Papillomavirus–Related Anal Cancer

The incidence rate of human papillomavirus (HPV)-related anal cancer and its precursor lesion, anal intraepithelial neoplasia, is rising in the United States and globally. Although 5-year survival rates in localized disease are generally favorable, survival in metastatic disease remains poor,...

breast cancer
survivorship
supportive care

Managing Upper Extremity Dysfunction in Breast Cancer Survivors

With an increased number of breast cancer survivors and patients with metastatic disease living longer, it is imperative for oncology care providers to manage issues of new and chronic upper extremity dysfunction as a result of the malignancy itself or its treatment. As one of my patients...

breast cancer

Greatest Benefit of Adjuvant Exemestane in Premenopausal Women at Higher Risk of Breast Cancer Recurrence

In an analysis of the SOFT and TEXT trials reported in the Journal of Clinical Oncology, Meredith M. Regan, ScD, of Dana-Farber Cancer Institute, and colleagues found that the greatest benefit of adjuvant exemestane in reducing breast cancer recurrence was among women with the greatest risk of...

hematologic malignancies

Complexities in the Diagnosis and Management of Amyloidosis

Question 1: What is the next best step for this patient? Correct Answer: C. Determination of amyloid subtype. Expert Perspective Amyloidosis encompasses a heterogeneous group of diseases bound by the characteristic deposition of amyloid fibrils in soft tissues and bone marrow, and it could be...

pain management

Fentanyl Nasal Spray Now Available at a Dose of 300 μg for Treatment of Breakthrough Cancer Pain

Fentanyl (Lazanda) nasal spray, a schedule II narcotic, is now available at a 300-μg dose to treat breakthrough cancer pain, offering physicians another titration option for dosing flexibility. The new strength can help physicians more easily and accurately target the appropriate dose for...

leukemia

Relapse of Leukemia After Bone Marrow Transplantation: Cytomegalovirus Infection Has No Protective Effect

Recent studies on a small number of patients with leukemia treated with bone marrow transplantation have suggested that the presence of the common cytomegalovirus (CMV) in patients or their donors may protect against relapse or even death after the transplant. A large international study published...

gastrointestinal cancer

Higher Prediagnostic Plasma Vitamin D Levels May Be Associated With Prolonged Survival in Pancreatic Cancer

In a study reported by Yuan et al in the Journal of Clinical Oncology, higher prediagnostic plasma 25-hydroxyvitamin D [25(OH)D] levels were found to be associated with prolonged overall survival in patients with pancreatic cancer. Study Details The study involved data from 493 patients from 5...

lymphoma

Comparison of Chemotherapy Regimens After Negative Interim PET-CT in Advanced Hodgkin Lymphoma

In a phase III trial reported in The New England Journal of Medicine, Johnson et al found similar efficacy with continued ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) chemotherapy vs omission of bleomycin (AVD) after negative interim PET-CT (positron-emission tomography–computed...

issues in oncology

Computed Tomography–Based Lean Body Mass Calculations May Improve Accuracy of PET for Patients With Cancer

Patients with cancer often experience significant fluctuations in weight and lean body mass. Neglecting to account for these changes can prevent clinicians from obtaining precise data from molecular imaging, but a new method of measuring lean body mass takes changes in individual body composition...

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