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issues in oncology
hematologic malignancies

Blood Test Can Predict High-Risk Cancers in Patients Treated With CAR-T

Dramatic advances have been made in using genetically engineered chimeric antigen receptor–modified T cells (CAR-T) with anti-CD19 specificity to treat highly refractory hematologic malignancies. The highest complete remission rates have been achieved in patients with relapsed or refractory acute...

Expert Point of View: Sagar Lonial, MD

Responding to the assertion that bortezomib (Velcade)/lenalidomide (Revlimid)/low-dose dexamethasone induction followed by continuous lenalidomide/dexamethasone is potentially a new standard of care in newly diagnosed multiple myeloma, Sagar Lonial, MD, Chief Medical Officer of Winship Cancer...

Patient Guides Available Through ASCO University Bookstore

ASCO Answers: Managing the Cost of Cancer Care explains the various costs associated with cancer treatment, including health-care coverage through the Affordable Care Act. It also provides a list of financial resources available to help offset expenses related to care and tips for organizing...

colorectal cancer

I Am Not Afraid of Cancer

At age 73, I’m no shrinking violet and I don’t run to the doctor at the first sign of a problem. I practice naturopathy and can usually ward off potential health issues by maintaining a healthy diet and lifestyle. When I began experiencing some mild discomfort in my rectum 2½ years ago, I was...

issues in oncology
supportive care
geriatric oncology

Deconditioning in Older Adults With Cancer: A Cascade to Dependency

It is estimated that nearly half of adults over age 80 living in the community are frail despite apparent functional well-being.1 Frailty is recognized as a clinical syndrome in which three or more of the following criteria are present: unintentional weight loss, self-reported exhaustion, weakness, ...

breast cancer

Exploratory Analysis of ExteNET Trial Shows Consistency of Benefit With Neratinib

An exploratory analysis of the ­ExteNET study of neratinib in early HER2-positive breast cancer after treatment with trastuzumab (Herceptin) upheld the findings previously reported for the 2-year analysis, according to the study’s principal investigator Arlene Chan, MD, of the Breast Cancer...

breast cancer

Homologous Recombination Deficiency Score Correlated With Response to Platinum in Breast Cancer

The homologous recombination deficiency (HRD) score may be a predictive biomarker of response to neoadjuvant platinum-based therapy in patients with triple-negative breast cancer, according to studies presented at the 2015 San Antonio Breast Cancer Symposium. “We found, in our adjusted analysis,...

pancreatic cancer

Pancreas Cancer Liquid Biopsy: Proof-of-Principle Study

Pancreatic cancer tumors are ripe for analysis with a liquid biopsy, according to researchers at The University of Texas MD Anderson Cancer Center. In a proof-of-principle study published recently in Annals of Oncology,1 the investigators reported on research in which they conducted whole-genome,...

supportive care

Uridine Triacetate Granules for Fluorouracil or Capecitabine Overdose or Early Severe Toxicity

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, uridine triacetate (Vistogard) was approved...

Expert Point of View: Angela DeMichele, MD, and Melinda L. Telli, MD

The formal discussant for the CALGB 40603 and GeparSixto studies at the San Antonio Breast Cancer Symposium was Angela DeMichele, MD, Professor of Medicine and Miller Chair in Breast Cancer Excellence at the Perelman School of Medicine, University of Pennyslvania. “The key questions raised by these ...

breast cancer

Role of Carboplatin in Triple-Negative Breast Cancer Still Unclear

Studies presented at the 2015 San Antonio Breast Cancer Symposium built upon an increasing body of data in support of the neoadjuvant use of carboplatin in patients with triple-negative breast cancer. Overall, however, the studies fell short of establishing carboplatin’s role in this malignancy and ...

Expert Point of View: Lisa Carey, MD

For the most part, the cardiotoxicity with trastuzumab appears to be largely reversible, unlike anthracyclines, which cause permanent cardiac damage,” said Lisa Carey, MD, Distinguished Professor at the UNC Lineberger Breast Center, Chapel Hill, North Carolina. “In this small study, they saw no...

Expert Point of View: Carlos L. Arteaga, MD

Carlos L. Arteaga, MD, the Donna S. Hall Chair in Breast Cancer Research and Director of the Center for Cancer Targeted Therapies at Vanderbilt University School of Medicine, Nashville, commented on the BELLE-2 trial for The ASCO Post. “We have learned that there is a subgroup of patients, who are...

breast cancer
issues in oncology

PI3K Inhibitor Buparlisib Extends Progression-Free Survival  in Advanced Breast Cancer

Addition of the oral investigational pan-PI3K inhibitor buparlisib to the endocrine agent fulvestrant (Faslodex) improved progression-free survival among postmenopausal women with advanced hormone receptor–positive/HER2-negative advanced breast cancer. “We are happy to announce that the phase III...

colorectal cancer

Study Finds Colorectal Cancer More Likely to Affect Minorities at Younger Age

Researchers at the University of Missouri School of Medicine reported that minority and ethnic groups are being diagnosed with colorectal cancer at younger ages and more advanced stages than non-Hispanic whites. The study was recently published in Cancer Medicine.1 “While we know the risk of...

myelodysplastic syndromes
leukemia
hematologic malignancies

Myeloablative Conditioning for Stem Cell Transplantation Remains Standard of Care in Patients With MDS and AML

A randomized trial from the Bone and Marrow Transplant Clinical Trials Network was halted early after concluding that allogeneic stem cell transplantation after a reduced-intensity conditioning regimen resulted in higher relapse rates compared to myeloablative conditioning. The phase III randomized ...

leukemia

Self-Reports Overestimate Mercaptopurine Intake in Childhood Acute Lymphoblastic Leukemia

Mercaptopurine is critical for maintaining remission in childhood acute lymphoblastic leukemia (ALL). However, a study has shown that overreporting of intake is common, and self-reports of intake are not as reliable as electronic reporting.1 About 86% of parents and children overreported the number ...

leukemia

Venetoclax May Prove to Be Strong Weapon Against Poor-Prognosis Chronic Lymphocytic Leukemia

Venetoclax, the latest entry into the field of treatment of chronic lymphocytic leukemia (CLL), is a powerful investigational therapy that promises to fill an important niche: treatment of high-risk relapsed/refractory patients with deletions of 17p. Nearly 80% of patients with relapsed/refractory...

leukemia

Severe Toxicities Seen in Younger Patients Receiving  Front-Line Idelalisib for Chronic Lymphocytic Leukemia

Hematologists and patients with chronic lymphocytic leukemia (CLL) are excited about new drugs that have dramatically improved outcomes. But all drugs have side effects, and it is important to be aware of potential consequences. Hepatotoxicity turns out to be a major concern in younger CLL patients ...

leukemia
issues in oncology

Idelalisib Improves Progression-Free Survival Over Bendamustine Plus Rituximab in Chronic Lymphocytic Leukemia

Idelalisib (Zydelig) combined with bendamustine (Bendeka, Treanda) plus rituximab (Rituxan) was superior to chemotherapy with bendamustine/rituximab plus placebo, reducing the risk of progressive disease and death while improving progression-free survival and overall survival in patients with...

Expert Point of View: Robert Hromas, MD, and Timothy A. Graubert, MD

Robert Hromas, MD, of the University of Florida College of Medicine, Gainesville, who moderated a press briefing, commented that the finding of benefit with rituximab “resolves a long-standing controversy” with this cancer. “These results are exciting for those of us who treat leukemia,” he...

leukemia

Rituximab Adds Benefit to Chemotherapy in Adult B-Cell Precursor ALL

The addition of rituximab (Rituxan) to the pediatric-inspired chemotherapy protocol for B-cell precursor acute lymphoblastic leukemia (ALL) significantly improved event-free survival in a large European study presented at the 2015 ASH Annual Meeting.1 The GRAALL-R 2005 phase III study is the first...

lung cancer

ALK Rearrangements Common in Young Patients With Lung Cancer

Two investigative groups have reported interesting observations about genomic alterations in the tumors of young patients with lung cancer. Notably, ALK rearrangement was the most common driver mutation found, in studies reported at the 16th World Conference on Lung Cancer.1,2 “To our knowledge,...

issues in oncology

Patient-Centric Care: Translating Research to Results

The 2016 Genitourinary Cancers Symposium was held earlier this month in San Francisco. Abstracts and presentations included data and discussion on the latest strategies in the prevention, screening, diagnosis, and treatment of prostate, kidney, testicular, and urothelial cancers. Snapshots of data...

multiple myeloma

Elotuzumab in Previously Treated Multiple Myeloma

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 November 30, 2015, elotuzu­mab (Empliciti) was approved for...

breast cancer

Plasma-Based Test Identifies Impactful Mutations in BOLERO-2 Population

A plasma-based cell-free DNA test identified mutations in the estrogen receptor 1 gene (ESR1) in 30% of patients from the BOLERO-2 trial of everolimus (Afinitor) plus exemestane, and these mutations were correlated with survival. The results, which support the use of plasma as a source of...

Expert Point of View: Ian E. Krop, MD, PhD

Ian E. Krop, MD, PhD, of Dana-Farber Cancer Institute, Boston, commented on the findings by Ma et al in an interview with The ASCO Post, calling the study “very elegantly designed.” “The study provides three important pieces of information. One, it suggests that palbociclib can add to the benefit...

breast cancer

Neoadjuvant Palbociclib Enhances Effect of Anastrozole on Complete Cell-Cycle Arrest

The cyclin-dependent kinase (CDK) 4/6  inhibitor palbociclib (Ibrance) enhanced cell-cycle control over that achieved with anastrozole alone in a study that evaluated the drugs’ ability to induce complete cell-cycle arrest in tumor cells and to produce clinical responses, as neoadjuvant therapy for ...

breast cancer

Study Suggests Luminal A Breast Cancer Patients May Not Need Chemotherapy

The ability to classify breast cancer according to biologic subtype has enabled researchers to dig deeper and determine which therapies benefit specific subgroups. Encouraging evidence from an analysis of a Danish trial presented at the 2015 San Antonio Breast Cancer Symposium suggests that...

Expert Point of View: Paul Bunn, Jr, MD

Although the results for E1505 were negative, “overall survival and disease-free survival are not the only things we can learn from this trial,” said Paul Bunn, Jr, MD, Distinguished Professor in the Division of Medical Oncology at the University of Colorado, Denver, who formally discussed the...

cost of care

The 340B Drug Pricing Program: Background, Concerns, and Solutions

The 340B Drug Pricing Program was created by Congress through the Veterans Health Care Act of 1992 to allow some health-care entities—including safety-net providers with large shares of uninsured and low-income patients and other “covered entities”—to obtain drugs at discounted prices.1,2 Congress...

multiple myeloma

Multiple Myeloma in 2015: A Year for the Record Books

Few malignancies have received as much attention, in the way of newly approved drugs, as multiple myeloma did in 2015. In November alone, 3 new agents were approved, bringing the total to 4 for the year as part of a record 7 approvals and to 16 regulatory approvals over the past 12 years. Speakers...

breast cancer
supportive care
survivorship

Risk Factors for Lymphedema in Patients Treated for Breast Cancer

In a study reported in the Journal of Clinical Oncology, Ferguson et al found that cellulitis in the affected arm, but not blood draws, injections, trauma to the affected arm, or air travel, was associated with an increased risk of lymphedema in women treated for breast cancer. Study Details In...

prostate cancer

DNA Damage and Repair Pathway Signature May Be Associated With Prognosis After Prostatectomy in High-Risk Prostate Cancer

In a study reported in JAMA Oncology, Evans et al identified a DNA damage and repair pathway gene signature that was significantly associated with outcomes after prostatectomy for high-risk prostate cancer independent of standard clinicopathologic factors. Study Details The study involved 1,090...

gastroesophageal cancer
issues in oncology
issues in oncology

STS 2016: Race, Lower Socioeconomic Status Linked With Worse Survival Following Esophageal Cancer Surgery

Poor black patients undergoing surgery for esophageal cancer are at higher risk for death than white patients and patients with higher socioeconomic status, according to a scientific presentation by Erhunmwunsee et al at the 52nd Annual Meeting of The Society of Thoracic Surgeons. The abstract,...

lung cancer

STS 2016: Body Mass Index Linked With Complications After Lung Cancer Surgery

Body mass index affects outcomes following lung resection for lung cancer. Patients with very high or very low body mass index measurements have the highest risks for complications, according to a scientific presentation at the 52nd Annual Meeting of The Society of Thoracic Surgeons. The abstract...

pancreatic cancer

2016 GI Symposium: Tumor-Treating Fields Plus Chemotherapy May Be Safe as First-Line Treatment in Advanced Pancreatic Cancer

Novocure presented data from its ongoing phase II PANOVA clinical trial at the 2016 Gastrointestinal Cancers Symposium in San Francisco, showing that tumor-treating fields therapy plus first-line gemcitabine is tolerable and safe in patients with advanced pancreatic cancer. The data also suggest...

palliative care
solid tumors

2016 GI Symposium: New Regimen for Locally Advanced Rectal Cancer as Effective as, but Less Toxic Than, Chemoradiation

Findings from a Polish phase III study point to an additional treatment option for patients with advanced rectal cancer. Patients who received short-course (5-day) radiation followed by consolidation chemotherapy before surgery achieved  outcomes similar to those of patients treated with...

cns cancers

2016 GI Symposium: Everolimus Slows Growth of Neuroendocrine Tumors

Researchers report the results of a new analysis from a phase III trial of patients with neuroendocrine tumors that begin in the gastrointestinal (GI) tract or have an unknown origin. Compared to placebo, everolimus (Afinitor) was associated with a 6- to 8-month longer time period before the cancer ...

cns cancers

2016 GI Symposium: New Targeted Hormone-Radiation Treatment Slows Growth of Midgut Neuroendocrine Tumors

Early results from the NETTER-1 phase III study of patients with previously treated, advanced midgut neuroendocrine tumors show that a novel therapy, lutetium Lu-177 dotatate (Lutathera), may substantially slow tumor growth. Patients treated with the experimental drug had a 79% lower risk ...

issues in oncology
skin cancer
issues in oncology

Inherited Genetic Markers May Predict Melanoma Survival and Help Plot Course of Disease

At NYU Langone Medical Center and its Laura and Isaac Perlmutter Cancer Center, researchers have discovered an inherited genetic marker that might provide clinicians with a personalized tool to gauge an individual’s survival and determine which patients require closer monitoring in the years...

skin cancer

Pregnancy-Associated Melanoma Is Linked With Higher Death Rates

Melanoma is on the rise in women of childbearing age. Those at the greatest risk, according to new Cleveland Clinic research, are women younger than 50 who are pregnant or have recently been pregnant. After adjusting for age, tumor location, and stage, researchers from Cleveland Clinic's...

breast cancer
supportive care

No Association Seen Between New or Worsening Aromatase Inhibitor–Related Musculoskeletal or Vasomotor Symptoms and Relapse-Free Survival

Retrospective analyses of the ATAC, TEAM, and BIG 1-98 adjuvant endocrine therapy trials in breast cancer have suggested that treatment-emergent endocrine symptoms may be associated with superior survival outcomes. However, in a study reported in the Journal of Clinical Oncology, Stearns et al...

issues in oncology

Quality Improvement Projects Aim at Reducing Prescribing Errors for Chemotherapy

Two quality improvement projects described by Bryant-Bova in the Journal of Oncology Practiceresulted in reduced errors in prescribing intravenous and oral chemotherapy. A project at The University of Texas Medical Branch at Galveston outpatient infusion centers first identified 15 different types ...

colorectal cancer
hepatobiliary cancer
lung cancer
lymphoma

Increased Cancer Mortality Rate Among Recipients of Solid-Organ Transplants

Solid-organ transplant recipients have a higher rate of cancer mortality than what is expected in the general population, according to a Canadian study by Acuna et al published in JAMA Oncology. Cancer mortality among transplant recipients was significantly elevated compared with data for the...

gynecologic cancers
issues in oncology

New Method to Improve Preoperative Diagnosis of Ovarian Cancer Based on Ultrasound

In a landmark study, investigators from Europe proposed a new and simple method to assess the risk of malignancy of women with an adnexal mass. The method identified between 89% and 99% of patients with ovarian cancer using the results of ultrasound examination, which can be obtained in referral...

breast cancer
issues in oncology

Higher Risk of Radiation-Induced Breast Cancer Found in Women Screened More Frequently and in Women With Larger Breasts

Radiation-induced breast cancer risk from digital mammography is low for the majority of women, but the risk is higher in women with large breasts, who received 2.3 times more radiation and required more views per examination to image as much of the breast as possible compared to those with small...

gynecologic cancers
issues in oncology

UK Study Suggests Potential Mortality Benefit of Ovarian Cancer Screening in Postmenopausal Women

As reported in The Lancet by Jacobs et al, the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) suggests there may be a mortality benefit of ovarian cancer screening in postmenopausal women. Study Details In the trial, 202,546 postmenopausal women aged 50 to 74 years from 13 centers...

breast cancer

Use of 21-Gene Recurrence Score May Be Linked to Chemotherapy Use and Health-Care Costs in Women With Breast Cancer

In a study using Pennsylvania Cancer Registry data reported in the Journal of Clinical Oncology, Epstein et al found that use of the 21-gene recurrence score (RS) assay was associated with lower use of chemotherapy and lower medical spending among patients younger than age 55 with early-stage...

palliative care
issues in oncology
palliative care

Palliative Care Initiated in the Emergency Department Associated With Improved Quality of Life

A palliative care consultation initiated in the emergency department for patients with advanced cancer was associated with improved quality of life and did not seem to shorten survival, according to an article published by Grudzen et al in JAMA Oncology. Visits to the emergency department are...

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