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issues in oncology

Quality Improvement Projects Aim at Reducing Errors in Prescribing IV and Oral Chemotherapy

Two quality improvement projects described in the Journal of Oncology Practice resulted in reduced errors in prescribing intravenous (IV) and oral chemotherapy. A project at the University of Texas Medical Branch in Galveston outpatient infusion centers first identified 15 different types of...

colorectal cancer

Patients Diagnosed With Stage I to III Rectal Cancer at Younger Age Have Increased Risk for Positive Lymph Nodes

Patients diagnosed with stage I to III rectal cancer at a younger age are at increased risk of having positive lymph nodes, according to an analysis of data published in the Journal of the National Cancer Institute. “This finding merits further investigation and may ultimately impact treatment...

skin cancer

Long Noncoding RNA SAMMSON Linked to Malignant Melanoma

In collaboration with researchers from Ghent University, Vlaams Instituut voor Biotechnologie (VIB) scientists from the University of Leuven have revealed a remarkable link between malignant melanoma and a noncoding RNA gene called SAMMSON. The SAMMSON gene is specifically expressed in human...

solid tumors
prostate cancer

Survival Differs With Metastatic Site in Castration-Resistant Prostate Cancer

Overall survival differed according to the site of metastases in men with castration-resistant prostate cancer, according to a meta-analysis reported in the Journal of Clinical Oncology by Halabi et al. Study Details The study involved data from 8,820 men who received docetaxel chemotherapy in...

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...

skin cancer

Study Explores Genomic and Transcriptomic Features of Anti–PD-1 Resistance in Advanced Melanoma

Immunotherapy using anti­–programmed cell death 1 (PD-1) antibodies has revolutionized the treatment of advanced melanoma and a growing list of other cancers. But 60% to 70% of melanoma tumors are resistant to anti–PD-1 antibodies, and there is an urgent need to understand how to...

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...

health-care policy

ASCO Issues Report on State of Cancer Care in America: 2016

The State of Cancer Care in America: 2016, published online in the Journal of Oncology Practice1 and presented earlier this month at a Congressional briefing in Washington, DC, is ASCO’s third annual assessment of national trends in cancer care delivery. The report highlights many promising cancer...

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...

Expect Questions and Heightened Interest About Bilateral Mastectomy

Recently released data from the Agency for Healthcare Research and Quality (AHRQ) showed that the rate of mastectomies increased between 2005 and 2013, with much of that increase attributed to bilateral mastectomies among women with early-stage cancer in one breast opting for bilateral...

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...

A Doctor’s Prescription for a Long Life

Longevity is a common goal among humans. And like all things human, it is not distributed equally. According to world health data, Japan is number one on the longevity list; its 130 million citizens have a life expectancy of about 84.74 years. The sub-Saharan country of Chad is number 224, having ...

A Gene Hunter’s Advice on How to Take Control of Your Genetic Inheritance

Since the late 1970s, researchers have identified several gene mutations that are implicated in cancer. Many of these mutations are acquired during our lifetime, but, as we know, some are inherited in families. Identifying heritable cancer-causing genetic mutations is a double-edged sword,...

2016 Oncology Meetings

MARCH 2016 Methods in Clinical Research Workshop for Minority PhysiciansMarch 17-20 • Fort Lauderdale, FloridaFor more information:https://www.roswellpark.edu/education/diversity-clinical-research-workshop The 16th Multidisciplinary Management of Cancers: A Case-Based ApproachMarch 18-20 • Napa,...

integrative oncology

Benefiting From Mind-Body Therapy

My diagnosis of early-stage breast cancer at age 35 was a shock, also because I come from a family with no history of cancer. In disbelief, I was literally speechless—I lost my voice completely for several days. I grew up in the former Soviet Union and then in the newly independent Kyrgyzstan. My...

Expert Point of View: Carlos Arteaga, MD

Carlos Arteaga, MD, of Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, said, “Breast-conserving therapy is the right thing to do. This study will not change current practice guidelines. Mastectomy is generally reserved for larger tumors and those with multifocal disease. The study just...

pancreatic cancer

‘Know Your Tumor’ Program Aids Patients With Pancreatic Cancer

Patients with pancreatic cancer can obtain molecular tumor profiling through the Pancreatic Cancer Action Network’s Know Your TumorSM precision medicine initiative, a partnership with Perthera, a personalized medicine service company that facilitates the multi-omic profiling and generates the...

colorectal cancer

Studies Evaluate Bevacizumab-Containing Regimens in Metastatic Colorectal Cancer

Two trials reported at the 2016 Gastrointestinal Cancers Symposium evaluated bevacizumab (Avastin)-containing regimens in the first-line treatment of metastatic colorectal cancer and supported some, but not all, previous findings. The STEAM trial found some numerical differences but no...

prostate cancer

Biomarkers in Prostate Cancer: PARP Inhibitors and Defects in DNA Repair

New data on molecular biomarkers in advanced prostate cancer are accumulating at a fast pace. The studies in this area can now be broadly grouped in two distinct areas—those that broadly relate to androgen signaling and those that relate to DNA-repair pathways. The Androgen-Signaling Pathway With...

breast cancer

Introduction of New Diagnostic Devices in Oncology: New Is Not Necessarily Better

“New!” “Improved!” “Throw out that old [fill in the blank] and go buy a new [fill in the blank]!” Sound familiar? The key to marketing is to convince customers that they need a product without which they had previously been quite happy. All too often, this strategy is accompanied by a caveat emptor ...

breast cancer

Potential Overdiagnosis of Contralateral Breast Cancer With Preoperative Breast MRI in Older Women With Breast Cancer

In an analysis of the Surveillance, Epidemiology, and End Results (SEER)-Medicare database reported in the Journal of Clinical Oncology, Shi-Yi Wang, MD, PhD, of Yale School of Public Health, and colleagues found that the use of preoperative magnetic resonance imaging (MRI) was associated with...

supportive care

How Rehabilitation Services Provide Benefit for Patients With Spinal Metastases

The benefits of rehabilitation in traumatic spinal injuries are well established. Recently, studies have shown similarly positive results in cancer-related spinal injuries, indicating that rehabilitation can play a complementary role in the care management of this patient population....

solid tumors

Modified CAR T Cells Overcome Immune Suppression, Effective Against Solid Tumors in Preclinical Models

Adding a genetically engineered “switch receptor” to second-generation CAR T cells blocked PD-1–mediated immune suppression, and made the immunotherapy effective against solid tumors in preclinical models, according to a study published by Liu et al in Cancer Research....

lung cancer

Occult Metastasis on Immunohistochemistry May Affect Survival in Stage I NSCLC

Mature results of the Cancer and Leukemia Group B 9761/Alliance study, reported in the Journal of Clinical Oncology by Martin et al, indicate that occult metastases detected by immunohistochemistry in N2 lymph nodes may be associated with poorer overall survival after resection in clinical stage I...

issues in oncology

Closing the Clinical Trial Gap for Adolescents and Young Adults With Cancer

Although overall survival rates for patients with cancer continue to soar—with 14.5 million cancer survivors today1—most of that gain is among pediatric and older adult patients. For adolescents and young adults with cancer—defined by the National Cancer Institute (NCI) as those in the 15- to...

geriatric oncology

Geriatric Assessment of Transplant-Ineligible Older Adults With Multiple Myeloma: A Novel Approach in the Era of Novel Agents

Myeloma is a disease of aging, with a median age at diagnosis in the United States of 69 years.1 As the population ages, forecasts estimate that, within 20 years, 3 of every 4 people diagnosed with multiple myeloma in the United States will be between the ages of 64 and 84 years.2 In anticipation...

issues in oncology

Is This the Dawn of Cancer Biosimilars?

The Patient Protection and Affordable Care Act, signed into law in 2010, did more than make it possible for millions of Americans to afford health care; it also established an abbreviated approval pathway for biologic products that are “biosimilar” to, or shown to be “interchangeable” with, a U.S....

lymphoma

Obinutuzumab in Relapsed or Refractory Follicular Lymphoma

On February 26, 2016, obinutuzumab (Gazyva) was approved for use in combination with bendamustine (Bendeka, Treanda) followed by obinutuzumab monotherapy for treatment of patients with follicular lymphoma who have relapsed after or are refractory to a rituximab (Rituxan)-containing regimen.1,2...

Conquering Cancer With Dr. Kim

There are many different ways to treat cancer: surgery, radiation therapy, chemotherapy, and more, sometimes used alone and sometimes in combination. But, in certain circumstances, the best treatment option for a patient may not look much like treatment at all. Instead of attempting to eliminate...

survivorship

Cancer Survivorship Research: Learning From the Past to Improve Future Outcomes

Soon after effective therapies for some childhood malignancies were first identified, early leaders in our field had concerns about what would happen to surviving patients as they aged. In 1975, Giulio D’Angio, MD, one of the founders of modern pediatric radiation oncology, presciently called for...

Douglas A. Levine, MD, FACOG, FACS, Appointed Director of Gynecologic Oncology at NYU Langone

Douglas A. Levine, MD, FACOG, FACS, will join the faculty of NYU Langone Medical Center as Director of the Division of Gynecologic Oncology at its Laura and Isaac Perlmutter Cancer Center and the Department of Obstetrics and Gynecology, effective May 15, 2016. Dr. Levine brings an exceptional...

Expert Point of View: David Raben, MD

“Proton therapy may very well offer reduced late toxicities. Reflecting back on past reirradiation studies both within and outside of the cooperative groups, it seems that the late toxicities in this retrospective study were somewhat similar,” said David Raben, MD, Professor of Radiation Oncology...

head and neck cancer

Markedly Improved Toxicity Rates With Proton-Beam Reirradiation for Recurrent Head and Neck Cancer

Proton-beam radiation therapy may be an attractive option for reirradiation of recurrent head and neck cancer, with encouraging disease control and survival rates and improved toxicity rates compared to photon reirradiation, according to John Han-Chih Chang, MD. Most head and neck cancers present...

head and neck cancer

Study Supports an Immune Effect of Chemoradiation in Head and Neck Cancer

Definitive radiation, with or without chemotherapy, induces a combination of immune-stimulating and inhibitory effects in patients with squamous cell carcinoma of the head and neck, according to research presented by Jonathan Schoenfeld, MD, MPhil, MPH, at the 2016 Multidisciplinary Head and Neck...

head and neck cancer

Mutational Profile May Impact Treatment Decisions for Smokers With Human Papillomavirus–Positive Oropharyngeal Cancer

Smokers whose oropharyngeal tumors are positive for the human papillomavirus (HPV) might need more aggressive treatment for their disease, according to research presented by Jose Zevallos, MD, at the 2016 Multidisciplinary Head and Neck Cancer Symposium in Scottsdale, Arizona.1 Over time,...

hepatobiliary cancer

Annual Report Cites Continued Decline in Most Cancer Mortality but Trends Toward Increased Liver Cancer Incidence, Mortality

Earlier this month, experts from four major institutions issued the annual Report to the Nation on the Status of Cancer (1975–2012). This year’s report showed that death rates continued to decline for all cancers combined, as well as for most cancer sites for men and women of all major racial and...

Surgeons—Yes, Surgeons—Have a Role in Translational Cancer Research

Surgeons are clearly more comfortable in the operating room than the laboratory, but there is a place for them in translational cancer research as well, according to one surgeon who has led cutting-edge research in pancreatic cancer. “Translational studies require access to patients, to tissue, and ...

symptom management

Phone Triage System Offers Potential to Reduce Patient Visits to the Emergency Department for Cancer Treatment–Related Symptoms

A quality improvement initiative to reduce the reliance of patients on visits to the emergency department for treatment of side effects related to cancer treatment was reported to be highly effective, according to early findings from a new study. 1 The strategy, involving a telephone triage...

health-care policy

Regulators Embrace Immunotherapy

The Cancer Drug Development Forum exists to provide, as the name implies, a meeting place to bring together academia, the pharmaceutical industry, and most important regulators for full and frank discussions to facilitate anticancer drug development. In the recent past, the Cancer Drug Development...

symptom management

Anticoagulation in Patients With Cancer: Understanding the Complexities of Prophylaxis and Management

Venous thromboembolic events are more prevalent in patients with cancer than in persons without it. Cancer is associated with a high rate of venous thromboembolism recurrence, bleeding, requirement for long-term anticoagulation, and reduced quality of life. Moreover, thrombosis is the second most...

leukemia

Chronic Lymphocytic Leukemia: The Golden Drug Only for Golden Agers?

As reviewed in this issue of The ASCO Post, Burger and colleagues recently reported findings of the RESONATE-2 trial of ibrutinib (Imbruvica) vs chlorambucil (Leukeran) as initial therapy for elderly patients with chronic lymphocytic leukemia (CLL).1 The study met its primary endpoint of...

breast cancer

Little Effect of Pretreatment Renal Function on Outcomes in Older Women Receiving Chemotherapy for Early-Stage Breast Cancer

As reported by Lichtman et al in the Journal of Clinical Oncology, an ancillary study (Alliance A171201) of the CALGB 49907 trial showed no significant association of pretreatment creatinine clearance with grade ≥ 3 hematologic toxicity, dose modification, therapy completion, relapse-free...

colorectal cancer
gastrointestinal cancer

Long-Term Follow-up of Prospective U.S. Cohorts Shows Reduced Risk of GI Tract Cancers With Regular Aspirin Use

In a long-term follow up of two large U.S. prospective cohorts reported in JAMA Oncology, Cao et al found that regular use of aspirin was associated with a reduced risk of gastrointestinal (GI) tract cancers. In 2015, the U.S. Preventive Services Task Force recommended the use of aspirin in...

breast cancer
leukemia
lung cancer

Specific Form of CYP3A7 Gene Associated With Poor Outcomes for Patients With Several Cancer Types

Among patients with breast cancer, lung cancer, or chronic lymphocytic leukemia (CLL), those who had a specific form of the CYP3A7 gene (CYP3A7*1C) had worse outcomes compared with those who did not have CYP3A7*1C. This may be related to how the patients metabolize the therapeutics used to treat...

breast cancer

Processed Meat Consumption May Increase Risk of Breast Cancer for Latinas

Latinas who eat processed meats such as bacon and sausage may have an increased risk for breast cancer, according to a new study that did not find the same association among white women. The study, published by Kim et al in Cancer Causes & Control, suggests that race, ethnicity, genetics,...

lung cancer

Dietary Glycemic Index Linked to Lung Cancer Risk in Non-Hispanic White Populations

Consuming a diet with a high glycemic index was independently associated with an increased risk of developing lung cancer in non-Hispanic whites, according to a new epidemiologic study from The University of Texas MD Anderson Cancer Center. This research, published by Melkonian et al in Cancer...

myelodysplastic syndromes

No Significant Survival Advantage for Rigosertib in High-Risk Myelodysplastic Syndromes, but Subgroups May Benefit

As reported in The Lancet Oncology by Garcia-Manero et al, the phase III ONTIME trial showed that treatment with the Ras mimetic rigosertib did not significantly improve overall survival vs best supportive care in patients with high-risk myelodysplastic syndromes after failure of hypomethylating...

issues in oncology

Study Evaluates Patient/Oncologist Perceptions of Whole-Exome Sequencing in Advanced Cancer

A majority of people with advanced cancer want to hear findings from DNA sequencing and to learn how those results may affect their health and treatment options, Dana-Farber Cancer Institute scientists report. Their findings were reported by Gray et al in Genetics in Medicine. The discovery...

lung cancer

Resensitization to Crizotinib via Acquisition of Lorlatinib ALK Resistance Mutation Reported in Patient With NSCLC

As reported by Shaw et al in The New England Journal of Medicine, a woman with metastatic ALK-rearranged non–small cell lung cancer (NSCLC) who had received multiple prior therapies, including the first- and second-generation ALK inhibitors crizotinib (Xalkori) and ceritinib (Zykadia),...

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