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skin cancer

Are Most Patients With Metastatic Melanoma Eligible for Immunotherapy Clinical Trials?

A Danish study reported in the European Journal of Cancer by Donia et al indicates that more than half of patients with metastatic melanoma do not satisfy requirements for enrollment in phase III trials of immune checkpoint inhibitors. Study Details The study involved 276 unselected cases...

hepatobiliary cancer

Regorafenib Improves Survival in Patients With Hepatocellular Carcinoma Progressing on Sorafenib

In the phase III RESORCE trial reported in The Lancet, Jordi Bruix, MD, Head of the Barcelona Clinic Liver Cancer Group, University of Barcelona, and colleagues found that regorafenib (Stivarga) improved overall survival vs placebo in patients with hepatocellular carcinoma who had progressed on...

lung cancer

Bright Future for Osimertinib in EGFR T790M–Positive Lung Cancer

The AURA3 study—reported by Mok and colleagues and reviewed in this issue of The ASCO Post—confirms the dramatic activity of osimertinib (Tagrisso) in patients with advanced epidermal growth factor receptor (EGFR)-mutant non–small cell lung cancer (NSCLC) and acquired resistance to prior EGFR...

lung cancer

Osimertinib Improves Progression-Free Survival vs Platinum/Pemetrexed in EGFR T790M–Positive NSCLC

In the phase III AURA3 trial reported in The New England Journal of Medicine by Tony S. Mok, MD, of the Chinese University of Hong Kong, and colleagues, osimertinib (Tagrisso) significantly improved progression-free survival vs platinum/pemetrexed (Alimta) among patients with epidermal growth...

cns cancers

Radiotherapy vs Temozolomide in Low-Grade Glioma: The Importance of Molecular Classification

The optimal treatment strategy for low-grade glioma has yet to be established, and practice patterns vary in regard to the timing of treatment, as well as the chosen treatment modality. It was against this backdrop, at a time when the benefits of radiation and chemotherapy remained uncertain but ...

leukemia

Study Finds Children, Parents Overreport Adherence to Leukemia Treatment

New research suggests that young patients with acute lymphocytic leukemia (ALL)—the most common type of pediatric cancer—and their parents are likely to report to their physician that they took more of their anticancer medication than they actually did. The study, published by Landier et al in...

issues in oncology
survivorship

Update on Fertility Outcomes Among Survivors of Childhood Cancer

“Estimates suggest that by the year 2020, there will be over 500,000 adult survivors of childhood cancer in the United States,” Daniel A. Mulrooney, MD, MS, of the Division of Cancer Survivorship, St. Jude Children’s Research Hospital, Memphis, reported at the 10th Oncofertility Conference in...

An Introduction to Recognizing and Managing Professional Burnout

There’s no getting around it: the practice of oncology can be inherently stressful. First, there’s the workload: compared to other medical specialists, oncologists see a larger number of patients and spend more time with them in face-to-face interactions. It’s not unusual for oncologists to work 60 ...

Expert Point of View: Jose Leis, MD, PhD

Jose Leis, MD, PhD, of the Mayo Clinic in Arizona, commented on the promise of checkpoint inhibitors in Richter transformation. “At Mayo, we have treated more than 30 patients with programmed cell death protein 1 (PD-1) blockade. We do see that chronic lymphocytic leukemia (CLL) has low expression ...

leukemia

Phase II Studies Evaluate New Approaches in Richter Transformation

Despite advances in treating chronic lymphocytic leukemia (CLL), the 5% to 10% of patients who develop Richter transformation continue to have poor outcomes. For these patients, median progression-free survival is approximately 6 months, and median overall survival is about 8 months. Phase II...

American Cancer Society Honors William Breitbart, MD, With the Trish Greene Quality of Life Award

William Breitbart, MD, has been honored with the 2017 American Cancer Society Trish Greene Quality of Life Award, a prestigious national honor that recognizes an outstanding individual who dedicates a significant portion of his or her career to research that improves the quality of life for cancer ...

breast cancer

Chinese Trial Adds Utidelone to Capecitabine in Heavily Pretreated Patients With Metastatic Breast Cancer

In a Chinese phase III trial reported in The Lancet Oncology, Zhang et al found that adding the epothilone analog utidelone to capecitabine prolonged progression-free survival in women with heavily pretreated metastatic breast cancer refractory to both anthracycline and taxane treatment. Study...

hematologic malignancies

Myeloablative vs Reduced-Intensity HCT for Acute Myeloid Leukemia and Myelodysplastic Syndromes

In a phase III trial reported in the Journal of Clinical Oncology, Scott et al found that myeloablative conditioning for allogeneic hematopoietic cell transplantation was associated with a reduced risk of relapse and a nonsignificant overall survival advantage vs reduced-intensity conditioning in...

sarcoma

Southern Surgical Association Annual Meeting: Isolated Limb Infusion for Extremity Sarcoma May Preserve Limbs

Patients with advanced malignant soft-tissue sarcoma of the extremities have typically faced amputation of the afflicted limb as the only treatment option. However, a technique that limits the application of chemotherapy to the cancerous region can preserve limbs in a high percentage of these...

breast cancer

More Patients With Early-Stage Breast Cancer May Be Able to Avoid Chemotherapy in the Future

Women with early-stage breast cancer who had an intermediate risk recurrence score from a 21-gene expression assay had similar outcomes, regardless of whether they received chemotherapy, a new study from The University of Texas MD Anderson Cancer finds. The research, published by Barcenas et al in ...

colorectal cancer

ASCO-SITC Clinical Immuno-Oncology Symposium: Utility of Biomarkers for Predicting Colorectal Cancer Survival Depends on Tumor Location

A large population-based study suggests that the utility of particular types of tumor-infiltrating lymphocytes (TILs) to predict colorectal cancer survival depends on where the tumor originates in the body. Although prior research has shown an association between high TIL density and longer...

skin cancer

ASCO-SITC Clinical Immuno-Oncology Symposium: Response to Cancer Immunotherapy May Depend on Gut Bacteria

Researchers have found a link between microbes in the gut (the microbiome) and response to immunotherapy. In the study, the ability of patients with advanced melanoma to respond to programmed cell death protein 1 (PD-1) immune checkpoint inhibitors depended on the presence of a diverse microbiome...

issues in oncology

Study Finds Cancer Mortality in Hispanics Varies Among Ethnic Groups

Although cancer is a leading cause of death among Hispanics, the burden of cancer mortality within Hispanic groups has not been well quantified. Now, a study by Pinheiro et al comparing the differences among Hispanic populations and cancer incidence has found that cancer mortality varies...

kidney cancer

2017 GU Cancers Symposium: Atezolizumab Plus Bevacizumab Shows Potential in Metastatic Renal Cell Carcinoma

Results from the phase II IMmotion150 study that compared atezolizumab (Tecentriq) plus bevacizumab (Avastin) and atezolizumab monotherapy to sunitinib (Sutent) alone in patients with previously untreated, locally advanced or metastatic renal cell carcinoma were presented at the 2017 Genitourinary...

cost of care

Variable Transparency of Industry-Sponsored Oncology Financial Assistance Programs

A “secret shopper” study reported by Zafar et al in the Journal of Oncology Practice found that transparency of industry-sponsored oncology patient assistance programs varied among programs. Study Details The study involved accessing pharmaceutical manufacturer–sponsored patient ...

issues in oncology
survivorship

Many Cancer Survivors Find Online and Telephone Communication With Health-Care Professionals Beneficial

Researchers from the School of Health Sciences at the University of Surrey, Guildford, United Kingdom, have completed the first-ever systematic review of cancer survivors’ experience of online and telephone telehealth interventions in cancer care, according to a recent study reported by Anna Cox,...

lung cancer

Three Assays and Several Laboratory-Developed Tests Highly Concordant Across Platforms in PD-L1 Immunohistochemistry Testing for NSCLC

Programmed cell death ligand 1 (PD-L1) expression assessed by immunohistochemistry in formalin-fixed, paraffin-embedded tumor tissues is currently the main predictive biomarker for the benefit of anti–programmed cell death protein 1 (PD-1) and anti–PD-L1 agents in patients with non–small cell lung ...

lung cancer

New Lung Cancer Staging Manual Set to Modify Clinical Practice

A revised tumor classification based on 70,967 evaluable patients with non–small cell lung cancer (NSCLC) and 6,189 patients with small cell lung cancer is now available to lung cancer specialists around the world in the form of the 8th edition of the tumor, node, and metastasis (TNM)...

lung cancer

Efficacy, Toxicity on a Par for Different Classes of Immune Checkpoint Inhibitors

The two main classes of immune checkpoint inhibitors used to treat non–small cell lung cancer (NSCLC) have essentially the same efficacy and toxicity profiles, according to a systematic review and meta-analysis of 23 trials with a total of 5,899 patients.1 Results showed that about one-fifth of...

lung cancer

Durable Responses Reported With Pembrolizumab in Heavily Pretreated Extensive-Stage Small Cell Lung Cancer

The programmed cell death protein 1 (PD-1) inhibitor pembrolizumab (Keytruda) has shown durable antitumor activity in patients with extensive-stage small cell lung cancer (SCLC) that expresses programmed cell death ligand 1 (PD-L1), according to an update of the KEYNOTE-028 trial.1 “Median overall ...

Selected Abstracts From the 2016 ASH Annual Meeting

Here are several abstracts selected from the proceedings of this year’s American Society of Hematology (ASH) Annual Meeting & Exposition, highlighting newer therapeutics in high-grade, aggressive B-cell non-Hodgkin lymphomas (NHLs), including newly diagnosed as well as relapsed or refractory...

breast cancer

New Data on Prognostic Factors, Disease Detection, Drug Toxicities, and Treatment Adherence Presented at SABCS

The San Antonio Breast Cancer Symposium (SABCS) offers state-of-the-art information on all aspects of breast cancer biology, diagnosis, and treatment, drawing an international audience of more than 7,500 physicians, researchers, and other health-care professionals from over 90 countries. Through...

lung cancer

Managing Toxicities Associated With Immunotherapy for Lung Cancer

Understanding, anticipating, and managing the toxicities associated with immunotherapies for lung cancer are key to steps to safely using and achieving the most benefit from these new agents, according to Beth Eaby-Sandy, MSN, CRNP, OCN, a nurse practitioner at the University of Pennsylvania’s...

head and neck cancer

Twice-Daily Radiation Therapy May Reduce Mortality in Head/Neck Cancer

Treating patients with head and neck cancer with hyperfractionated twice-daily radiation therapy combined with chemotherapy may potentially reduce mortality, according to new research presented by Claire Petit, PhD, and colleagues at the 2017 European Cancer Congress (ECCO).1 The study included...

lung cancer

New Analysis of CheckMate 057: Search Continues for Predictors of Outcome With Nivolumab

Prognostic factors and tumor expression of programmed cell death ligand 1 (PD-L1) predict early mortality among patients with previously treated nonsquamous advanced non–small cell lung cancer (NSCLC) who receive nivolumab instead of docetaxel. But these features are not reliable for excluding...

lung cancer

Expert Point of View: Paul Mitchell, MD

“The KEYNOTE-010 updated survival is looking even more impressive with the benefit of pembrolizumab (Keytruda) over docetaxel. Survival at 2 years with pembrolizumab is more than double that with chemotherapy,” commented invited discussant, Paul Mitchell, MD, Associate Professor at the Olivia...

lung cancer

KEYNOTE-010 Update Shows ‘Striking’ Durability of Second-Line Pembrolizumab in NSCLC

Pembrolizumab’s benefit in previously treated advanced non–small cell lung cancer (NSCLC) that expresses programmed cell death ligand 1 (PD-L1) is long lasting, persisting even after therapy ends, suggests an update of the KEYNOTE-010 trial.1 Initial results of the randomized phase II/III trial,...

neuroendocrine tumors

Expert Point of View: Vincent J. Picozzi, MD

Vincent J. Picozzi, MD, a pancreatic cancer specialist at Virginia Mason Hospital in Seattle, commented on the findings by Chan et al presented at the 2017 Gastrointestinal Cancers Symposium. Dr. Picozzi first acknowledged that there is a strong biologic rationale for evaluating cabozantinib...

neuroendocrine tumors

Cabozantinib Elicits Responses in Neuroendocrine and Carcinoid Tumors

In a phase II study reported at the 2017 Gastrointestinal Cancers Symposium, the tyrosine kinase inhibitor cabozantinib (Cometriq) was evaluated in advanced carcinoid and pancreatic neuroendocrine tumors. Radiographic responses to therapy were observed in both tumor subtypes, and compared to other ...

hepatobiliary cancer

Novel Bridge to Liver Transplant May Improve Upon Standard of Care

For hepatocellular carcinoma patients awaiting a liver transplant, locoregional treatment as a “bridge” is a standard strategy for reducing tumor progression. The most common approach is transarterial chemoembolization, but a study from a large-volume liver transplant center questions whether it...

gastroesophageal cancer

Sarcopenia in Esophageal Cancer Represents a Significant Risk to Survival

Patients with esophageal cancer who suffer sarcopenia (loss of muscle mass) during neoadjuvant chemotherapy survive, on average, 32 months less than patients with no sarcopenia. This is the central finding of a recent study conducted at the Comprehensive Cancer Center (CCC) of MedUni Vienna and...

breast cancer

Study Finds Suboptimal Use of Adjuvant Endocrine Therapy in Breast Cancer

In a retrospective cohort study reported in JAMA Oncology, Daly et al found that recommended use of adjuvant endocrine therapy for breast cancer improved in the United States between 2004 and 2013 but remains suboptimal. The study included data on 981,729 women with stage I to III breast cancer...

lung cancer

Durvalumab Shows Activity in Heavily Pretreated Patients With Non–Small Cell Lung Cancer

The immune checkpoint inhibitor durvalumab (also known as MEDI4736) is active and achieves durable responses in patients with heavily pretreated advanced non–small cell lung cancer (NSCLC) that does not have any epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK)...

lung cancer

Atezolizumab Benefits Survival vs Docetaxel Across Multiple Subtypes of Non–Small Cell Lung Cancer

A wide range of patients with advanced non–small cell lung cancer (NSCLC) see a survival advantage from second- or third-line atezolizumab (Tecentriq) as compared with docetaxel, according to new data from the OAK trial.1 The main results of the randomized phase III trial, previously reported,...

lung cancer

Quality-of-Life Data From KEYNOTE-024: First-Line Pembrolizumab vs Chemotherapy in Advanced NSCLC

When used as first-line therapy for advanced non–small cell lung cancer (NSCLC), pembrolizumab (Keytruda) yields better health-related quality of life than platinum-based chemotherapy, suggest new data from the randomized phase III KEYNOTE-024 trial.1 After 15 weeks of treatment, changes in scores...

colorectal cancer

Expert Point of View: Philip B. Paty, MD

Philip B. Paty, MD, a surgical oncologist at Memorial Sloan Kettering Cancer Center, New York, commented on the findings for The ASCO Post. Dr. Paty is leading studies of surveillance at his own institution, which is not part of the International Watch & Wait Database. Consistency of Outcomes...

colorectal cancer

‘Watch-and-Wait’ Strategy Does Not Compromise Survival in Selected Patients With Rectal Cancer

A “watch-and-wait” approach to treating rectal cancer patients with complete responses to chemoradiotherapy resulted in a 3-year survival rate of 91%, which is similar to historic survival rates after surgical resection, according to an analysis of the International Watch & Wait Database.1 For ...

lung cancer

Clinical Trials Study the Role of Immunotherapy in the First-Line Setting of Non–Small Cell Lung Cancer

In 2016, the KEYNOTE-024 trial set the bar for first-line immunotherapy in non–small cell lung cancer (NSCLC). Trial results showed that pembrolizumab (Keytruda), an antibody to programmed cell death protein 1 (PD-1), reduced the risk of disease progression or death by 50% and the risk of death by...

survivorship
health-care policy

Timing Is Everything

In 1959, my 5-year-old cousin, Kim, was diagnosed with acute lymphocytic leukemia (ALL). As an 8-year-old, I didn’t really understand what was happening to him, except that he had to go to the Riley Hospital for Children in Indianapolis, Indiana, for treatment. The haunting vision of his looking...

lung cancer

Understanding the Role of Immunotherapy for Lung Cancer: A Paradigm Shift for the Better

“Immunotherapy for lung cancer is a paradigm shift. I would never have thought when I started my career taking care of lung cancer patients in the mid 1990s that we’d now be substituting chemotherapy with an antibody immunotherapy in 2017. It’s incredible,” commented Roy S. Herbst, MD, PhD, Chief...

colorectal cancer

CheckMate 142 Update: Prolonged Disease Control With Nivolumab in Deficient Mismatch Repair Colorectal Cancer

With 6 additional months of follow-up since the initial presentation of results, in the phase II CheckMate 142 trial, 74% of heavily pretreated patients with metastatic colorectal microsatellite instability–high (MSI-H) cancers are alive after single-agent treatment with nivolumab (Opdivo).1...

head and neck cancer
lymphoma
gastrointestinal cancer

Protein Component of the Epstein-Barr Virus May Promote the Development of Cancer

After an infection with the Epstein-Barr virus (EBV), the virus persists in the body throughout a person's lifetime, usually without causing any symptoms. About one-third of infected teenagers and young adults nevertheless develop infectious mononucleosis, which usually wears off after a few weeks. ...

breast cancer

Effect of Scalp-Cooling Device on Hair Loss in Women Receiving Chemotherapy for Breast Cancer

An interim analysis of the SCALP trial, reported in JAMA by Nangia et al, showed that use of a scalp-cooling device significantly reduced hair loss in women receiving chemotherapy for stage I or II breast cancer compared with no scalp cooling. The study was stopped early on the basis of efficacy....

hematologic malignancies

Study Finds Mutations in Myelodysplastic Syndrome Linked to Poorer Outcome After Stem Cell Transplantation

In a study reported in The New England Journal of Medicine, Lindsley et al found that a number of mutations present in patients with myelodysplastic syndrome (MDS) were associated with poorer clinical outcome after allogeneic hematopoietic stem cell transplantation (HSCT). Study Details The study ...

skin cancer

Intermittent Vismodegib Regimens in Patients With Multiple Basal Cell Carcinomas

In a phase II trial reported in The Lancet Oncology, Dréno et al found that two long-term intermittent vismodegib (Erivedge) dosing regimens provided a similar reduction in the number of clinically significant basal cell carcinomas among patients with multiple lesions. Study Details In the ...

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