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issues in oncology
breast cancer
geriatric oncology

Study Suggests No Evidence for Screening Mammography Cutoff Age

An analysis of data from nearly 6 million screening mammograms found no evidence for a clear cutoff age to stop breast cancer screening. Screening mammography among women aged 75 years was associated with higher cancer detection and lower recall rates than among younger women in the study. These...

global cancer care
issues in oncology

Exploring Practical Strategies for Cancer Care in Low-Resource Settings

One of the featured “Big Debates” at the 2016 World Cancer Congress in Paris addressed this question: Are scarce resources best applied to prevention rather than treatment? Many experts do not see prevention vs treatment in such stark terms or even as a realistic scenario. It’s a false dichotomy,...

geriatric oncology

Co-occurrence of Cancer and Cognitive Impairment in Older Adults

The prevalence of both cancer and cognitive impairment increases with age.1-3 Based upon Surveillance, Epidemiology, and End Results (SEER)-Medicare studies, it is estimated that 3% to 7% of patients with cancer aged ≥ 65 also suffer from dementia, although the true prevalence of dementia in this...

integrative oncology

The Best of SIO

The following five abstracts were chosen as the best submitted studies presented at this year’s International Conference of the Society for Integrative Oncology (SIO). They represent a diverse group of integrative therapies and interventions in the care of patients with cancer, including an...

breast cancer

Buparlisib Phase III Findings: Glass Half Empty or Half Full?

The pan-phosphoinositide 3-kinase (PI3K) inhibitor buparlisib combined with fulvestrant (Faslodex) prolonged progression-free survival compared with placebo and fulvestrant in postmenopausal women with hormone receptor–positive, HER2-negative advanced breast cancer previously treated with an...

breast cancer

Abemaciclib Plus Anastrozole: Promising Signals Reported in Phase II Study of Early Breast Cancer

As neoadjuvant therapy, abemaciclib alone or in combination with anastrozole achieved strong signals of anticancer activity in postmenopausal patients with hormone receptor–positive, HER2-negative breast cancer in the neoMONARCH phase II study.1 Abemaciclib alone or in combination with anastrozole...

breast cancer
genomics/genetics

BRCA Status Does Not Seem to Affect Survival Outcomes in Young Women With Early Breast Cancer

Young women who carry the BRCA1 and/or BRCA2 mutation and develop breast cancer seem to have similar survival compared with young women who have BRCA-negative breast cancer. However, women with BRCA-positive triple-negative breast cancer have an 11% survival advantage compared with those with...

breast cancer
genomics/genetics

Genomic Landscape of Metastatic Breast Cancer Differs From That of Primary Breast Cancer

Researchers working on whole-exome and transciptome sequencing of endocrine-resistant estrogen receptor–positive metastatic breast cancer have shown that the mutational landscape differs from that of estrogen receptor–positive primary breast cancer, and these differences have the potential to...

leukemia

Expert Point of View: Armand Keating, MD

“This study shows that a great deal of innovation can come from existing knowledge. The 7+3 regimen has been around since I was an intern,” admitted Armand Keating, MD, of the University of Toronto and Princess Margaret Hospital, Toronto, Ontario, Canada. “Using the liposomal formulation of...

leukemia

Vadastuximab Talirine Shows Early Promise in Newly Diagnosed Acute Myeloid Leukemia

The investigational CD33-directed antibody-drug conjugate vadastuximab talirine yielded high overall and complete response rates when combined with standard “7+3” chemotherapy for patients newly diagnosed with acute myeloid leukemia.1 Results from this phase Ib study were presented at the 2016...

A Lesson From David

The following essay by Jeremy K. Hon, MD, is adapted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was coedited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and thebigcasino.org. As physicians, ...

lymphoma

Expert Point of View: Lawrence Kaplan, MD

“This study is important because R-CHOP [rituximab and cyclophosphamide, doxorubicin, vincristine, prednisone] has been the standard of care for many years. CHOP, the chemotherapy backbone, has withstood challenges from more aggressive regimens in the past. The excellent clinical outcomes observed ...

palliative care

Weighing the Benefits and Risks of Medical Marijuana

Despite the fact that 28 states and the District of Columbia have enacted laws to permit the use of cannabis and cannabinoid-based drugs to treat medical conditions, including cancer and symptoms from its treatment, federal law prohibits physicians from prescribing marijuana to their patients,...

lymphoma

Dose-Adjusted EPOCH-R No Better Than R-CHOP in Diffuse Large B-Cell Lymphoma

Long-awaited results of the Cancer and Leukemia Group B ­(CALGB)/Alliance 50303 trial were a disappointment to many hematologists/oncologists at the 2016 American Society of Hematology (ASH) Annual Meeting & Exposition. The study failed to show that dose-adjusted EPOCH-R ­(etoposide,...

lymphoma

Obinutuzumab Prolongs Disease-Free Survival vs Rituximab in Follicular Lymphoma

Induction and maintenance therapies with obinutuzumab (Gazyva) were superior to rituximab (Rituxan) induction and maintenance in patients with untreated follicular lymphoma, according to results of the phase III GALLIUM study presented at the Plenary Session during the 58th American Society of...

genomics/genetics
bladder cancer

Study Identifies Factors in Clonal Evolution of Chemotherapy-Resistant Urothelial Carcinoma

In a study reported in Nature Genetics, Bishoy M. Faltas, MD, of Weill Cornell Medicine, and colleagues identified factors in the clonal evolution of chemotherapy-resistant urothelial carcinoma.1 As stated by the investigators: “Chemotherapy-resistant urothelial carcinoma has no uniformly curative...

breast cancer

Confirmation or Transformation? The Case of Palbociclib in Hormone Receptor–Positive Metastatic Breast Cancer

Women with hormone receptor–positive metastatic breast cancer are witnessing an unprecedented time of success in the battle against their disease. Just in the past 12 months, a number of prospective, randomized, phase III studies were reported, with positive results indicating the value of...

breast cancer

Addition of Palbociclib to Letrozole in Previously Untreated Advanced Estrogen Receptor–Positive, HER2-Negative Breast Cancer

In the phase III PALOMA-2 trial reported in The New England Journal of Medicine, Richard S. Finn, MD, of the David Geffen School of Medicine at the University of California, Los Angeles, and colleagues found that the addition of palbociclib (Ibrance) to letrozole significantly improved...

multiple myeloma

Expert Point of View: Sergio A. Giralt, MD

Sergio A. Giralt, MD, Chief of the Adult Bone Marrow Transplant Service at Memorial Sloan Kettering Cancer Center, New York, and the Melvin Berlin Family Chair in Multiple Myeloma, commented on the findings of the StaMINA trial for The ASCO Post. He said the results of the largest randomized U.S....

multiple myeloma

Single Autotransplant Not Enhanced by Additional Interventions in Multiple Myeloma

Additional interventions following upfront autologous stem cell transplant in multiple myeloma did not further improve progression-free or overall survival over transplant alone in a multicenter study presented as a late-breaking abstract at the 2016 American Society of Hematology (ASH) Annual...

Women in Oncology: Breaking Down Barriers and Looking to the Future

There has been no better time than the present for women in the field of oncology: Women at all stages of their careers are finding more opportunities and avenues to excel. At the time of the last ASCO workforce survey, women made up 28.4% of the oncologist workforce, and that proportion is rising...

leukemia

Achieving Complete Response Is Key to Improving Survival in Older Patients With AML

The importance of achieving complete response after intensive therapy in older adults with acute myeloid leukemia (AML) was confirmed in a follow-up analysis of the E2906 North American Intergroup trial.1 Patients in complete response had superior survival in this landmark analysis. This finding...

leukemia

Reducing Doses and Stopping Tyrosine Kinase Inhibitors Gain Favor in Chronic Myeloid Leukemia

Tyrosine kinase inhibitors, such as imatinib, nilotinib (Tasigna), and dasatinib (Sprycel), have revolutionized the treatment of chronic myeloid leukemia (CML). A substantial percentage of patients achieve deep and meaningful remissions on these agents. More recently, partly driven by patients’ and ...

leukemia

Reduced-Intensity Chemotherapy Leads to More Relapses in Childhood ALL

Children with acute lymphoblastic leukemia (ALL) considered at standard risk for relapse should continue to receive standard-intensity regimens, according to findings from the international randomized AIEOP-BFM ALL 2000 trial.1 A reduced-intensity treatment for children with ALL considered to have ...

prostate cancer
issues in oncology

A Gleason 6 Tumor: Is It Cancer, and Should It Be Treated?

The diagnosis and treatment of prostate cancer have long been a source of controversy among the oncology community, the political sector, and patient advocacy groups. Most notably, the decision to biopsy a man’s prostate gland rests largely on his prostate-specific antigen (PSA) test numbers, the...

breast cancer

Expert Point of View: Michael Gnant, MD

Michael Gnant, MD, Professor of Surgery at the Medical University of Vienna in Austria and President of the Austrian Breast & Colorectal Cancer Study Group, was the invited discussant of the three studies of extended endocrine therapy. “The trials did not reach the necessary statistical levels ...

breast cancer

Benefit of Extended Adjuvant Endocrine Therapy Not Upheld in Multiple Studies Reported in San Antonio

Extended endocrine therapy with an aromatase inhibitor did not improve disease-free survival in patients with hormone receptor–positive breast cancer enrolled in three studies presented at the 2016 San Antonio Breast Cancer Symposium. The results stand in contrast to the phase III National Cancer...

breast cancer

Improved Survival With Higher Tumor-Infiltrating Lymphocyte Values in Advanced HER2-Positive Breast Cancer

In a retrospective analysis of the phase III CLEOPATRA trial reported in The Lancet Oncology, Luen et al found that higher baseline tumor-infiltrating lymphocyte levels were associated with improved overall survival among patients with advanced HER2-positive breast cancer receiving trastuzumab...

palliative care

ESMO Asia 2016: Study Validates Set of Six Adaptable Prognosis Prediction Models for Patients With Cancer in Palliative Care Settings

A routine blood test may predict how long patients with cancer in palliative care will survive, researchers reported at the ESMO Asia 2016 Congress in Singapore. “Cancer patients in palliative care want honest and accurate prognostic information but this information needs to be shared...

issues in oncology

ESMO Asia 2016: Depressed Patients May Be Less Responsive to Chemotherapy

A brain-boosting protein plays an important role in how well people respond to chemotherapy, researchers reported at the ESMO Asia 2016 Congress in Singapore. A study (Abstract 497O_PR) found that patients with cancer suffering from depression have decreased amounts of brain-derived neurotrophic...

lung cancer

Atezolizumab Improves Survival vs Docetaxel in Previously Treated Non–Small Cell Lung Cancer

In the phase III OAK trial reported in The Lancet by Rittmeyer et al, treatment with the anti–programmed cell death ligand 1 (PD-L1) antibody atezolizumab (Tecentriq) improved overall survival vs docetaxel in previously treated non–small cell lung cancer (NSCLC). Results of the trial...

gynecologic cancers

FDA Approves Rucaparib and Companion Genetic Test in Advanced Deleterious BRCA-Mutated Ovarian Cancer

The U.S. Food and Drug Administration (FDA) today granted accelerated approval to rucaparib (Rubraca) to treat women with advanced ovarian cancer who have been treated with two or more chemotherapies and whose tumors have a specific gene mutation (deleterious BRCA) as identified by an FDA-approved...

sarcoma

ESMO Asia 2016: First Data Presented on Rare Sarcomas in Asian Patients

The first data on rare sarcomas in Asian patients were presented in three studies at the ESMO Asia 2016 Congress in Singapore. Just half of patients with advanced angiosarcoma received chemotherapy, although it improved overall survival. CIC-rearranged sarcomas were associated with a much worse...

colorectal cancer

T-Cell Transfer Therapy Targets Mutant KRAS in Metastatic Colorectal Cancer

In a case report in The New England Journal of Medicine, Tran et al at the National Cancer Institute describe response to adoptive transfer of ex vivo expanded tumor-infiltrating lymphocytes containing T cells targeting personalized cancer neoepitopes in a patient with lung metastases from...

pancreatic cancer

Circulating Tumor DNA May Serve as a Prognostic Marker in Pancreatic Cancer

Translational research in pancreatic adenocarcinoma has been limited by the difficulty of obtaining sufficient quality and quantity tumor tissue from patients. A study by Pietrasz et al assessing the feasibility and prognostic value of circulating tumor DNA (ctDNA) in pancreatic adenocarcinoma has...

hepatobiliary cancer

Study Finds Regorafenib Improves Survival in Patients With Hepatocelluar Carcinoma Progressing on Sorafenib

Regorafenib (Stivarga) improved overall survival vs placebo in patients with hepatocellular carcinoma who had experienced disease progression on sorafenib (Nexavar) treatment, according to the phase III RESORCE trial reported by Bruix et al in The Lancet. Study Details In this double-blind trial, ...

breast cancer
issues in oncology

ESMO Asia 2016: Almost 20% of Swedish Breast Cancer Patients Fail to Complete Prescribed Endocrine Therapy

Around 20% of patients with breast cancer in Sweden do not complete endocrine therapy, according to research that will be reported at the ESMO Asia 2016 Congress (Abstract 62O_PR), to be held December 16–19 in Singapore.The study in over 5,500 women found that younger patients and those who...

palliative care
hematologic malignancies

Effect of Inpatient Palliative Care on Quality of Life After Stem Cell Transplant

Integrating palliative care into the treatment of patients undergoing hematopoietic stem cell transplantation for cancers like leukemia and lymphoma can improve their quality of life, relieve symptoms associated with the procedure, and reduce depression and anxiety, not only during the 3- to 4-week ...

lung cancer

WCLC 2016: Icotinib May Improve Progression-Free Survival vs Whole-Brain Irradiation in Patients With NSCLC With Brain Metastases

Patients whose lung cancer spreads to their brain typically have only 4 to 6 months left to live, but research presented by Chinese doctors suggests that using icotinib increases progression-free survival in these patients compared to whole-brain irradiation and chemotherapy combined. Yi-Long Wu,...

issues in oncology

ESMO Asia 2016: Patients in India Wait an Average of 4 Months Before Seeking a Cancer Diagnosis

Patients in Chandigarh, India, waited an average of 4 months before seeking a cancer diagnosis, according to a recent study. Some patients waited less than a week before seeing a doctor—while others waited 3 years. The researchers will report their findings at the ESMO Asia 2016 Congress ...

lung cancer

Promising Activity Seen With First-Line Nivolumab Plus Ipilimumab in Advanced Non–Small Cell Lung Cancer

As reported in The Lancet Oncology by Hellman et al, the combination of nivolumab (Opdivo) and ipilimumab (Yervoy) showed promising activity as first-line treatment in patients in the non–small cell lung cancer (NSCLC) cohort of the phase I CheckMate 012 study. Study Details In the...

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 Medicineby Mok et al, osimertinib (Tagrisso) significantly improved progression-free survival (PFS) vs platinum/pemetrexed (Alimta) among patients with epidermal growth factor receptor (EGFR) T790M–positive non–small...

gynecologic cancers

Rucaparib Appears Effective in Relapsed Platinum-Sensitive High-Grade Ovarian Carcinoma

In part 1 of the phase II ARIEL2 trial reported in The Lancet Oncology, Swisher et al found that the poly (ADP-ribose) polymerase (PARP) inhibitor rucaparib was associated with prolonged progression-free survival among patients with relapsed platinum-sensitive high-grade ovarian carcinoma who had...

breast cancer

Phase III Trial Shows Improved Progression-Free Survival With Fulvestrant vs Anastrozole in Hormone Receptor–Positive Advanced Breast Cancer

In the international phase III FALCON trial reported in The Lancet, Robertson et al found that progression-free survival was improved with intramuscular fulvestrant (Faslodex) vs oral anastrozole in endocrine therapy–naive women with hormone receptor–positive locally advanced or...

breast cancer

SABCS 2016: IBM Watson for Oncology Platform Shows High Degree of Concordance With Physician Recommendations

The artificial-intelligence platform Watson for Oncology (WFO) achieved a high degree of concordance with the recommendations of a panel of oncologists in a double-blinded validation study, according to results presented at the 2016 San Antonio Breast Cancer Symposium, held December 6 to 10...

breast cancer

SABCS 2016: Aromatase Inhibitors Were Associated With Reduced Endothelial Function in Postmenopausal Breast Cancer Patients

Postmenopausal women with breast cancer who took aromatase inhibitors demonstrated endothelial dysfunction, a predictor of cardiovascular disease, according to study results presented at the 2016 San Antonio Breast Cancer Symposium, held December 6 to 10 (Abstract s5-07). Aromatase inhibitors are...

Pioneer in Cancer Immunology, Richmond T. Prehn, MD, Dies

Until 1957, the prevailing thought was that since cancers develop in normal patients, they are not recognized as foreign by the immune system. That changed when Richmond T. Prehn, MD, and his laboratory assistant, Joan Main, showed that tumors induced by chemical carcinogens in mice could...

skin cancer

Investigational Immunotherapy for Advanced Melanoma

The investigational immunotherapeutic IMC-20D7S was found to be well tolerated and somewhat active in patients with advanced melanoma, including one complete response, according to the results of a phase I/Ib trial reported by Danny N. Khalil, MD, PhD, and colleagues in Clinical Cancer Research....

breast cancer

SABCS 2016: Scalp-Cooling Device Safe and Effective in Reducing Chemotherapy-Induced Alopecia in Women With Breast Cancer

Although adjuvant chemotherapy decreases the risk of breast cancer recurrence, it is associated with distressing side effects, including hair loss. A prospective randomized trial evaluating the safety and efficacy of the Orbis Paxman Hair Loss Prevention System (OPHLPS), a scalp-cooling device that ...

head and neck cancer

Characteristics of HPV-Driven Nonoropharyngeal Squamous Cell Carcinomas of the Head and Neck

In a study reported in the Journal of Clinical Oncology, Chakravarthy et al found that human papillomavirus (HPV)-driven tumors accounted for 4.1% of nonoropharyngeal squamous cell carcinomas of the head and neck. HPV-positive tumors were associated with poorer survival and reduced...

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