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hematologic malignancies
issues in oncology

ASH 2017: Direct Oral Anticoagulant May Reduce Recurrence of VTE in Patients With Cancer

People with cancer have an increased risk of developing blood clots, with roughly one in five experiencing venous thromboembolism (VTE). International guidelines recommend treatment using low–molecular-weight heparin, an anticoagulant that is injected subcutaneously; however, new results from ...

breast cancer

SABCS 2017: Older Women With Hormone Receptor–Positive Breast Cancer May Receive Similar Benefit From CDK4/6 Inhibitors as Younger Women

Older women with hormone receptor–positive, HER2-negative metastatic breast cancer who were treated with cyclin-dependent kinase (CDK) 4/6 inhibitors achieved progression-free survival at a rate similar to that of younger women, according to data presented by Singh et al at the 2017 San...

breast cancer

SABCS 2017: Postmenopausal Women Who Lose Weight May Have Reduced Breast Cancer Risk

Postmenopausal women who lose weight may have a significantly reduced chance of developing breast cancer, according to data presented by Chlebowski et al at the 2017 San Antonio Breast Cancer Symposium (Abstract GS5-07). “Breast cancer is among the leading types of cancer and...

breast cancer

SABCS 2017: Circulating Tumor Cells May Predict Late Recurrence in Patients With Hormone Receptor–Positive Breast Cancer

Among patients with hormone receptor–positive HER2-negative stage II–III breast cancer without clinical evidence of recurrence, those who had circulating tumor cells (CTCs) detected in blood 5 years after diagnosis had an increased risk for late recurrence of breast cancer, according to ...

FDA Announces Approval, CMS Proposes Coverage of Diagnostic Test for Cancer Biomarkers

On November 30, the U.S. Food and Drug Administration (FDA) approved CDx (F1CDx), a breakthrough-designated, next-generation sequencing–based in vitro diagnostic test that can detect genetic mutations in 324 genes and 2 genomic signatures in any solid tumor type. The Centers for Medicare &...

breast cancer

SABCS 2017: Phase III EMBRACA Trial Meets Primary Endpoint

Patients with advanced HER2-negative breast cancer with germline BRCA mutations had significantly prolonged progression-free survival when treated with the poly(ADP-ribose) polymerase (PARP) inhibitor talazoparib, compared with those who received chemotherapy of physician’s choice, according...

solid tumors
breast cancer

AKT Inhibitor Ipatasertib in Metastatic Triple-Negative Breast Cancer

The randomized phase II LOTUS trial has shown improved progression-free survival with the addition of the AKT inhibitor ipatasertib to paclitaxel in the first-line treatment of metastatic triple-negative breast cancer. These results were reported by Sung-Bae Kim, MD, of the University of Ulsan...

solid tumors
breast cancer

Partial-Breast and Reduced-Dose Radiotherapy After Breast-Conserving Surgery

The UK IMPORT LOW phase III trial has shown noninferiority in local relapse for partial-breast and reduced-dose vs standard whole-breast radiotherapy after breast-conserving surgery in early breast cancer. These study results were reported by Charlotte E. Coles, PhD, of the University of...

hematologic malignancies
leukemia

Asparaginase-Associated Pancreatitis in Childhood Acute Lymphoblastic Leukemia

An observational study reported in The Lancet Oncology by -Wolthers et al in the Ponte di Legno Toxicity Working Group identified characteristics and the course of asparaginase-associated pancreatitis in childhood acute lymphoblastic leukemia. Kjeld Schmiegelow, MD, of The University Hospital...

hematologic malignancies

Untangling the Controversies of Hematopoietic Cell Transplantation

BOOKMARK Title: Hematopoietic Cell Transplants: Concepts, Controversies, and Future DirectionsEditors: Hillard M. Lazarus, MD; Robert Peter Gale, MD, PhD, DSc (hon), FACP; Armand Keating, MD, FRCP(C); Andrea Bacigalupo, MD; Reinhold Munker, MD; Kerry Atkinson, MBBS, MD, DTM&H, FRCP, FRACP; and...

Radiation Oncologist Gives Clear Advice to Patients With Cancer

BOOKMARK Title: Cancer: What You Need to Know: Overcome the 10 Common Mistakes Patients MakeAuthor: Stephen A. Rosenberg, MDPublisher: Stephen Rosenberg, MDYear Published: November 2017Price: $9.99, paperback, 248 pages Stephen A. Rosenberg, MD, is Chief Resident in Radiation Oncology at the...

Old and New Perspectives on the Theory of Cancer

BOOKMARK Title: Tripping Over the Truth: How the Metabolic Theory of Cancer Is Overturning One of Medicine’s Most Entrenched ParadigmsAuthor: Travis Christofferson, MSPublisher: Chelsea Green PublishingPublication Date: February 2017Price: $24.95, hardcover; 288 pages Bringing a book to market is...

solid tumors
pancreatic cancer

Achieving One’s Childhood Dreams While Facing Pancreatic Cancer

BOOMARK Title: The Last LectureAuthor: Randy Pausch with Jeffrey ZaslowPublisher: HyperionDate: April 2008Price: $21.95, hardcover; 206 pages Faced with imminent death, how does one chose to live out the remainder of one’s life? Such is the question at the heart of The Last Lecture, a memoir...

Love Triumphs Amid a Battle With Cancer

BOOKMARK Title: The Red Devil: To Hell With Cancer—and BackAuthor: Katherine Russell RichPublisher: CrownDate Published: October 1999Price: $23.95, hardcover, 256 pages Over the past year or so, there have been several best-selling memoirs of people fighting and ultimately losing their battle with ...

hematologic malignancies
leukemia

Clinical Trials Actively Recruiting Patients With Pediatric Leukemia

The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies focused on pediatric leukemia. These studies highlight quality-of-life reporting; neutropenia management; combination chemotherapy; chimeric antigen receptor (CAR) T-cell therapy and some...

Gratitude

The following essay by Stan Winokur, MD, is adapted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was coedited by Dr. Winokur and -Vincent Coppola and published in May 2014. The book is available on Amazon.com and thebigcasino.org. I looked into her...

hematologic malignancies

Liposome-Encapsulated Daunorubicin and Cytarabine for AML Subtypes

On August 3, 2017, a liposome-encapsulated combination of daunorubicin and cytarabine (Vyxeos) was approved for treatment of adults with newly diagnosed therapy-related acute myeloid leukemia (AML) or AML with myelodysplasia-related changes.1,2 This is the first U.S. Food and Drug...

hematologic malignancies

Ibrutinib in Chronic Graft-vs-Host Disease

On August 2, 2017, ibrutinib (Imbruvica) was approved for treatment of adult patients with chronic graft-vs-host disease after failure of one or more lines of systemic therapy.1,2 This is the first U.S. Food and Drug Administration (FDA)-approved therapy for treatment of chronic graft-vs-host...

hematologic malignancies
lymphoma

Acalabrutinib in Previously Treated Mantle Cell Lymphoma

On October 31, 2017, the Bruton’s tyrosine kinase (BTK) inhibitor acalabrutinib (Calquence) was granted accelerated approval for treatment of adult patients with mantle cell lymphoma who have received at least one prior therapy.1,2 Supporting Efficacy Data Approval was based on objective response...

breast cancer

SABCS 2017: Combined Residual Risk Score Test and Predicting Breast Cancer Risk in Women Who Tested Negative for Hereditary Mutations

Results from a validation study to better define the risk of breast cancer in women of European ancestry who tested negative for a hereditary cancer mutation with a hereditary cancer risk test (myRisk Hereditary Cancer test) were reported earlier this week in a spotlight presentation at the 2017...

solid tumors

Future Directions for CAR T-Cell Therapy

Chimeric antigen receptor (CAR) T-cell therapy burst upon the scene as an innovative approach to the treatment of hematologic malignancies, mainly for patients who have exhausted all other treatment options. Recently two CAR T-cell products were approved by the U.S. Food and Drug Administration...

solid tumors
gynecologic cancers

Olaparib Tablets for Maintenance Treatment in Ovarian Cancer

On August 17, 2017, olaparib -(Lynparza) in tablet form was granted regular approval for maintenance treatment of adult patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in complete or partial response to platinum-based chemotherapy.1,2 Olaparib...

hematologic malignancies
lymphoma

Born in Chicago, Lymphoma Specialist Sonali M. Smith, MD, Never Left the Windy City

Nationally recognized lymphoma expert Sonali M. Smith, MD, was born and reared in Chicago to a mother who was a pediatrician and allergist, and a father who was an engineer. Her parents were first-generation immigrants from India who placed the value of education second to none. “I became used to...

breast cancer

NCCN Awards Nine Grants for Quality Improvement in Breast Cancer Care

The National Comprehensive Cancer Network® (NCCN®) Oncology Research Program in collaboration with Pfizer Global Medical Grants announced they have awarded funding to nine projects that use clinical care pathways to implement quality-improvement initiatives along the continuum of care for...

head and neck cancer

ASCO Clinical Practice Guideline Update: Use of Larynx-Preservation Strategies in the Treatment of Laryngeal Cancer

As reported in the Journal of Clinical Oncology by Arlene A. Forastiere, MD, of The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, and colleagues, ASCO has issued a clinical practice guideline update on the use of larynx-preservation strategies in the treatment of laryngeal cancer. The ...

breast cancer

SABCS 2017: 2 Years of Extended Anastrozole Therapy Proved as Effective as 5 Years in Hormone Receptor–Positive Breast Cancer

Postmenopausal women with hormone receptor–positive breast cancer who took the aromatase inhibitor anastrozole for 2 years after an initial 5 years of adjuvant endocrine therapy received an equal benefit to those who took the drug for 5 additional years. The trial results suggest that a...

breast cancer

SABCS 2017: SOLD Trial Data Support Current Standard 12-Month Adjuvant Trastuzumab for HER2-Positive Breast Cancer

Disease-free survival after 9 weeks of adjuvant trastuzumab (Herceptin) and standard chemotherapy was not comparable to disease-free survival after 12 months of adjuvant trastuzumab and standard chemotherapy for women with early-stage HER2-positive breast cancer, supporting the current...

solid tumors

Immunotherapy Has Indelibly Changed the Treatment Paradigm in Urothelial Carcinoma

Cisplatin-based combination chemotherapy is the preferred first-line therapy for metastatic urothelial cancer and the only treatment shown to improve survival in patients with previously untreated disease for many years. This chemotherapy also has proven to be beneficial in the neoadjuvant and...

solid tumors

First-Line Pembrolizumab in Cisplatin-Ineligible Advanced Urothelial Cancer

As reported in The Lancet Oncology by Arjun V. Balar, MD, of Perlmutter Cancer Center of New York York Langone Medical Center, and colleagues, first-line pembrolizumab (Keytruda) produced durable responses in cisplatin-ineligible patients with locally advanced and unresectable or metastatic...

solid tumors
lung cancer

Immunotherapy Plus Chemotherapy in Non–Small Cell Lung Cancer: Despite the Failure of Ipilimumab, Guarded Optimism Persists

Ipilimumab (Yervoy) is a fully human monoclonal antibody that inhibits cytotoxic T-lymphocyte–associated protein 4 (CTLA-4) and was the first checkpoint inhibitor approved after showing survival benefit in metastatic melanoma.1 Indeed, in the first-line setting for metastatic melanoma, ipilimumab ...

sarcoma
solid tumors

NCCN Introduces New Guidelines for Patients With AIDS-Related Kaposi Sarcoma

The National Comprehensive Cancer Network® (NCCN®) has created a new resource for patients living with human immunodeficiency virus (HIV) who develop acquired immune deficiency syndrome (AIDS)-related Kaposi sarcoma. This newly released NCCN Clinical Practice Guidelines in Oncology (NCCN...

supportive care
palliative care

Helping Patients With Advanced Disease Transition From Focused to Intrinsic Hope

While hope for a cure after a cancer diagnosis is a feeling both patients and oncologists rightly cling to during treatment, when too much emphasis is placed on this type of “focused” hope, it can make it more difficult for patients to face their mortality. Moreover, such a focus can deny patients ...

supportive care
palliative care

Walther Cancer Foundation Endows New ASCO Special Award and Lecture for Palliative and Supportive Care

The Walther Cancer Foundation, Inc., a private foundation based in Indianapolis, Indiana, has endowed a new ASCO award and lecture bearing its name to be presented annually at the Palliative and Supportive Care in Oncology Symposium. This grant represents a new foray for the foundation as it...

hematologic malignancies

Answers to Hematology Expert Review Questions

Question 1  Which statement about epidemiology and clinical features of atypical CML is correct? Correct answer: C. Symptoms of atypical CML may be related to anemia and thrombocytopenia. Expert PerspectiveThe exact incidence of atypical CML is unknown, but the median patient age at diagnosis is in ...

hematologic malignancies

New WHO Classification of Tumors of Hematopoietic and Lymphoid Tissues

The ASCO Post is pleased to present Hematology Expert Review, an ongoing feature that quizzes readers on issues in hematology. In this installment, Drs. Abutalib and Medeiros explore the recently updated World Health Organization (WHO) classification of hematopoietic and lymphoid tissue...

hematologic malignancies

Recent Study Findings in CAR T-Cell Therapy for Neoplastic Malignancies

Here is an update on two recent clinical trials focusing on chimeric antigen receptor (CAR) T-cell therapy for neoplastic malignancies. Highlighted are the findings from an early-phase study in refractory aggressive lymphoma and a study in chronic lymphocytic leukemia after failure of ibrutinib...

hematologic malignancies
lymphoma

Follicular Lymphoma: Is the Road to Cure Paved With Gallium?

The roadside along the path to curing follicular lymphoma is riddled with the debris of failed cytotoxic regimens. For decades, clinical trials unsuccessfully pitted various chemotherapy combinations against each other. It took but a single, noncytotoxic molecule, rituximab (Rituxan), to forever...

hematologic malignancies
lymphoma

Obinutuzumab-Based First-Line Treatment Improves Progression-Free Survival vs Rituximab-Based Treatment in Follicular Lymphoma

In the phase III GALLIUM trial reported in The New England Journal of Medicine by Robert Marcus, MBBS, of University College London, and colleagues, obinutuzumab (Gazyva)-based therapy significantly prolonged progression-free survival vs rituximab (Rituxan)-based therapy in patients with previously ...

Mary Pazdur Award for Excellence in Advanced Practice in Oncology Announced

The inaugural Mary Pazdur Award for Excellence in Advanced Practice in Oncology was announced at the 2017 JADPRO Live at APSHO (Advanced Practitioner Society for Hematology and Oncology) conference. Jack Gentile, Chairman of Harborside, which sponsors the JADPRO Live at APSHO conference (and...

issues in oncology

Shifting Landscape of Oncology Drug Development and Approvals

Future oncology drug development and approvals will be faster and more efficient as well as take the patient experience more into account, said Richard Pazdur, MD, Director of the Oncology Center of Excellence at the U.S. Food and Drug Administration (FDA). The Center was established as part of...

Mount Sinai Institutes Join $215 Million Partnership to Increase Patients’ Immunotherapy Success

The Tisch Cancer Institute and the Precision Immunology Institute at Mount Sinai Health System are part of a $215 million public-private Cancer Moonshot research collaboration launched by the National Institutes of Health and 11 leading pharmaceutical companies. The 5-year initiative, called...

issues in oncology

Cancer and Obesity: Not Such a Linear Relationship

Obesity has been established as a strong risk factor for the development of cancer. African Americans and Hispanics are particularly at risk, and their access to health care is often poor. How do racial and ethnic disparities in the development of obesity as well as access to care intersect to...

supportive care
palliative care

Caring for the Frail, Older Patient With Cancer: Four Practical Approaches

Cancer may be a disease of aging, but data suggest that older patients with cancer are undertreated, especially with respect to chemotherapy. One analysis showed that approximately 40% of patients in their 70s—and 60% of patients in their 80s—do not receive adjuvant therapy after surgery for colon...

Louis M. Weiner, MD, Appointed Director of MedStar Georgetown Cancer Institute

MedStar Health, the largest not-for-profit health-care system across Maryland and the Washington, DC, region, has named Louis M. Weiner, MD, as Director of its MedStar Georgetown Cancer Institute. Dr. Weiner will serve in this capacity while also remaining Director of Georgetown Lombardi...

Expert Point of View: Eduardo Bruera, MD, FAAHPM

Eduardo Bruera, MD, FAAHPM, Medical Director, Department of Supportive Care Center, The University of Texas MD Anderson Cancer Center, Houston, underscored the study’s potential to influence clinical care decisions. “The emergency department is a ‘hard hat’ area of care where bad things happen and ...

supportive care
palliative care

‘Triple Threat’ Conditions May Predict Mortality in Patients With Cancer Presenting to Emergency Departments

Dyspnea, delirium, and poor performance—so-called “triple threat” conditions—are known to predict short survival in palliative care. According to data presented at the 2017 Palliative and Supportive Care in Oncology Symposium,1 however, the presence of at least two of these symptoms in patients...

supportive care
palliative care

Concurrent Palliative Care: Recommendations From the ASCO Clinical Practice Guideline

Updated in 2016, the ASCO clinical practice guideline on the integration of palliative care into standard oncology care provides evidence-based recommendations to oncology clinicians, patients, family and friend caregivers, and palliative care specialists about providing high-quality care for...

issues in oncology
global cancer care

Launching Harmonized NCCN Guidelines for Sub-Saharan Africa

Cancer care in Sub-Saharan Africa, as in other low-resource settings, can be a challenge: The right medications and equipment may be in short supply, maintaining equipment can be a problem, basic chemotherapy drugs may be unaffordable, and patients may not see doctors until the cancer is advanced....

International Society of Geriatric Oncology Awards Leaders at 2017 Conference

The International Society of Geriatric Oncology (SIOG) Annual Conference took place November 9–11, 2017, in Warsaw, Poland. Over 350 delegates representing 41 countries attended the meeting, along with more than 60 faculty from 22 countries. Stuart Lichtman, MD, FACP, FASCO, SIOG President, and...

solid tumors
breast cancer

Preparing for Steep Increase in Breast Cancer Among the Elderly

“We are in the midst of a steep increase” in the incidence of breast cancer among women aged 65 years and older, Arti Hurria, MD, reported at the 19th Annual Lynn Sage Breast Cancer Symposium, Chicago.1 “Are we prepared as a health-care system and as providers to address this burgeoning need?” she...

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