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supportive care
symptom management
breast cancer

Use of Dexamethasone Mouthwash in Managing mTOR Inhibitor–Associated Stomatitis in Patients With Breast Cancer

Prophylactic use of dexamethasone mouthwash significantly minimized the incidence of all grades of stomatitis in postmenopausal women receiving everolimus (Afinitor, Zortress) and exemestane for the treatment of hormone receptor–positive metastatic breast cancer, according to data presented by...

supportive care
symptom management

Dealing With GI Toxicities After Chemoradiation

Chemotherapy- and radiotherapy-induced gastrointestinal (GI) toxicities have risen alongside improved survival rates for many cancers, according to Jervoise Andreyev, MA, PhD, Consultant Gastroenterologist in GI Consequences of Cancer Treatment at the Royal Marsden Hospital in London. “For every...

colorectal cancer

Anti–Interleukin-1 Alpha Antibody MABp1 Improves Outcomes Significantly Over Placebo in Advanced Colorectal Cancer

A novel anti–interleukin-1 alpha (IL-1α) antibody has shown a significant impact on symptoms and a high level of safety and tolerability in patients with advanced colorectal cancer, according to phase III data presented by Hickish et al at the European Society for Medical Oncology’s 18th World...

gastrointestinal cancer

Chemoradiotherapy After Surgery for Gastric Cancer Shows Similar Outcomes to Postoperative Chemotherapy

Postoperative treatment intensification with chemoradiotherapy does not achieve better outcomes when compared with postoperative chemotherapy in patients with gastric cancer who have already undergone preoperative chemotherapy, according to phase III data presented by Marcel Verheij, MD, PhD, et...

hepatobiliary cancer

Phase III RESORCE Study Data Show Regorafenib Improves Overall Survival in Previously Treated Patients With Unresectable Liver Cancer

Results from the phase III RESORCE trial show that regorafenib (Stivarga) tablets achieved a median overall survival improvement in patients with unresectable hepatocellular carcinoma that progressed after treatment with sorafenib (Nexavar) tablets. The study, presented by Jordi Bruix, MD, et al...

head and neck cancer
issues in oncology

New Study Finds Increase in Imaging After Thyroid Cancer Treatment Identifies Recurrence but May Not Improve Survival

More imaging after thyroid cancer treatment identifies recurrence, but it does not always improve survival, a new study published by Banerjee et al in The BMJ suggests. Researchers from the University of Michigan Comprehensive Cancer Center looked at 28,220 patients diagnosed with...

breast cancer

African American Women More Likely to Choose Autologous Breast Reconstruction Over Implant-Based Reconstruction

African American women undergoing mastectomy for breast cancer are more likely than white women to undergo autologous breast reconstruction using their own tissue, rather than implant-based reconstruction, reported Sharma et al in Plastic and Reconstructive Surgery. “African American race...

breast cancer

Social Media Engagement May Be Linked to More Satisfaction With Breast Cancer Treatment Decisions

Women who engaged on social media after a breast cancer diagnosis expressed more deliberation about their treatment decision and more satisfaction with the path they chose, a new study from the University of Michigan Comprehensive Cancer Center finds. Findings were published by Wallner et al in...

breast cancer
solid tumors

Neoadjuvant Veliparib/Carboplatin and Neratinib ‘Graduate’ From Adaptive Randomization I-SPY 2 Trial in Early Breast Cancer

As reported by Rugo et al and Park et al in The New England Journal of Medicine, the adaptive randomization phase II I-SPY 2 trial has shown that the addition of veliparib/carboplatin and the addition of neratinib to standard neoadjuvant therapy have met criteria predictive of success in a phase...

lymphoma

CAR T-Cell Therapy Promising in Non-Hodgkin Lymphoma

Research conducted at the Fred Hutchinson Cancer Research Center, Seattle, is moving the field of chimeric antigen receptor (CAR) T-cell therapy forward in the treatment of B-cell malignancies. At the 2016 Pan Pacific Lymphoma Conference in Koloa, Hawaii, David G. Maloney, MD, PhD, Professor of...

Expert Point of View: W. Robert Lee, MD

Formal discussant W. Robert Lee, MD, of Duke University School of Medicine, Durham, North Carolina, placed himself firmly in the camp supporting hypofractionation as a new standard of care. “We now have three large noninferiority trials with different eligibility criteria and different regimens....

prostate cancer

Hypofractionation May Be Poised to Become New Standard of Care for Prostate Cancer

There has been an ongoing debate about which type of radiation therapy is preferable in the treatment of localized prostate cancer: hypofractionation (larger fractions given over 4–5 weeks) or conventional radiotherapy (given over 8–9 weeks). A new study presented at the 2016 ASCO Annual Meeting...

issues in oncology
health-care policy

Moonshots and ‘Onco-nauts’

Where were you on July 20, 1969? I certainly remember where I was—sitting in a mess hall at summer camp watching a grainy black-and-white TV as Neil Armstrong took “one small step for man, one giant leap for mankind.” I recall the sense of jubilation and accomplishment that all American citizens...

issues in oncology

ASCO and Friends of Cancer Research Launch Initiative to Modernize Eligibility Criteria for Clinical Trials

The dismal accrual rates in cancer clinical trials are well known: Just 3% to 5% of adults with cancer enroll in clinical trials.1 The reasons patients are reluctant to participate in clinical trials are equally well known: fear of reduced quality of life, concern about receiving a placebo, and...

cost of care

ASCO Plenary Studies: Assessing the ‘Value’ of New Treatments

At the 2016 ASCO Annual Meeting, studies presented at the Plenary Session gave attendees new treatment strategies to employ back home. But in the emerging push to contain the cost of new cancer treatments, do the four interventions fit within the new “value framework” for oncology? Deborah Schrag, ...

survivorship
pain management

ASCO Releases Clinical Practice Guideline on Management of Chronic Pain in Survivors of Adult Cancers

As reported in the Journal of Clinical Oncology by Judith A. Paice, PhD, RN, of Northwestern University, and colleagues, ASCO has released a clinical practice guideline on management of chronic pain in survivors of adult cancers. The guideline was based on literature review by an expert panel, with ...

breast cancer

Insurance, Distance to Care Can Be Barriers to Breast Reconstruction

Women were less likely to have breast reconstruction surgery after mastectomy if they had Medicaid or Medicare rather than private insurance or if they lived 10 or more miles from a plastic surgeon’s office, a University of North Carolina (UNC) Lineberger Comprehensive Cancer Center study has ...

breast cancer

Sampling Method Used for New Breast Cancer Tests May Lead to Underestimation of Risk

Not only is breast cancer more than one disease, but a single breast cancer tumor can vary within itself, a finding that University of Pittsburgh Cancer Institute (UPCI) researchers discovered has the potential to lead to very different patient treatment plans depending on the tumor sample and...

skin cancer

Potential Link Between Pembrolizumab Use and Demyelinating Polyradiculoneuropathy Reported in Two Cases of Advanced Melanoma

In a letter to the editor in The New England Journal of Medicine, de Maleissye et al described two cases of severe demyelinating polyradiculoneuropathy that occurred after pembrolizumab (Keytruda) treatment for advanced melanoma. Case 1 A 45-year-old woman receiving pembrolizumab at 2 mg/kg every ...

prostate cancer

Sociodemographic and Clinical Predictors of Switching to Active Treatment From Observational Management in Low-Risk Prostate Cancer

Although active surveillance for patients with low-risk prostate cancer has become an increasingly acceptable strategy for disease management, many men opt for definitive therapies such as radical prostatectomy or radiation therapy. A new study of more than 2,200 patients with low-risk prostate...

solid tumors
lung cancer

Ceritinib Shows Overall and Intracranial Activity in Advanced NSCLC Previously Treated With Crizotinib and Chemotherapy

Crinò et al found that ceritinib (Zykadia) was active overall and in central nervous system (CNS) metastases in patients with ALK-rearranged advanced non–small cell lung cancer (NSCLC) previously treated with crizotinib (Xalkori) and chemotherapy, according to the ASCEND-2 phase II...

skin cancer

USPSTF Issues Final Recommendation Statement on Screening for Skin Cancer

The U.S. Preventive Services Task Force (USPSTF) has concluded that the current evidence is insufficient to assess the balance of benefits and harms of visual skin examination by a clinician to screen for skin cancer in asymptomatic adults. The report was published in JAMA. This is an “I...

issues in oncology

Delirium Frequent and Underdiagnosed Among Advanced Cancer Patients Presenting to an Emergency Department

A new study indicates that delirium is relatively frequent and underdiagnosed by physicians in patients with advanced cancer visiting the emergency department. Delirium was similarly common among older and younger patients, which suggests that in the setting of advanced cancer, all patients should...

supportive care
symptom management

Olanzapine Combination Reduces Nausea and Vomiting in Patients Receiving Highly Emetogenic Chemotherapy

In a phase III trial reported by Navari et al in The New England Journal of Medicine, the addition of the antipsychotic agent olanzapine vs placebo to dexamethasone, aprepitant, or fosaprepitant, and a 5-hydroxytryptamine type 3–receptor antagonist reduced nausea and improved antiemetic...

issues in oncology

Some Adolescent Survivors of Childhood Cancer May Benefit From More Comprehensive Mental Health Screening

Most adolescent survivors of childhood cancer have no reported psychological symptoms, but an analysis led by St. Jude Children's Research Hospital found that those who do often have multiple symptoms and distinct symptom profiles. The findings, published by Krull et al in the Journal of Clinical...

health-care policy

The National Cancer Moonshot Lifts Off

Just 6 months after President Barack Obama announced the establishment of a National Cancer Moonshot Initiative to accelerate the pace of research discoveries, improve patient access and care, and encourage data-sharing, dozens of new initiatives to accomplish those and other goals were rolled out...

survivorship
leukemia
lymphoma

My Commitment to Helping Other Survivors of Childhood Cancers

When I was diagnosed with acute lymphocytic leukemia (ALL) at the age of 2 in 1974, not much was known about the cancer or the side effects of its treatment. Too young to understand what was happening to me, the burden fell to my parents and older sibling to protect and care for me. For more than...

Revisiting Ovarian Ablation in Early Breast Cancer: A Mismatch Between Global Values and Clinical Practice Guidelines

ASCO recently released a clinical practice guideline update on ovarian suppression as part of the extant guideline on adjuvant endocrine therapy in hormone receptor–positive breast cancer, and the recommendations were summarized in the June 10, 2016, issue of The ASCO Post. Also in this issue,...

leukemia

Clinical Trials Actively Recruiting Patients With Acute Myeloid Leukemia

Phase I/II Study Title: A Phase I-II Randomized Trial of a Combination of ­Nintedanib/Placebo in Combination With Induction Chemotherapy for Patients With Refractory or First-Relapse AML Study Type: Phase I/II/interventional/parallel assignment Study Sponsor and Collaborators: Yale University,...

breast cancer

Mindfulness-Based Stress-Reduction Program May Reduce Psychological and Physical Symptoms in Breast Cancer Survivors

A mindfulness-based stress-reduction program for breast cancer survivors was associated with psychological and physical symptom benefits during and at 6 weeks after intervention, according to a randomized trial reported in the Journal of Clinical Oncology by Cecile A. Lengacher, RN, PhD, of the...

David Bartels, DO, Joins Summit Cancer Center–Post Falls

David Bartels, DO, will be joining Summit Cancer Center–Post Falls as a medical oncologist effective August 1, 2016, leaving his current position as a medical oncologist with Kootenai Health in Coeur d’Alene, Idaho. Summit Cancer Centers, associated with the Seattle Cancer Care Alliance, now...

Dean Lee, MD, PhD, to Lead Cell Therapy Programs at Nationwide Childrens and OSUCCC–James

Dean Lee, MD, PhD, has been named the Director of the Cellular Therapy and Cancer Immunotherapy Program for Nationwide Children’s Hospital’s Division of Hematology/Oncology/Blood and Marrow Transplant and Center for Childhood Cancer and Blood Diseases. Dr. Lee will also serve as the Director of...

An Epic Medical Story by an Old-Style Doctor on the Front Lines of Care

The U.S. health-care system is a $3 trillion behemoth of dizzying complexity. Government oversight, ever-changing regulations, mountains of paperwork, electronic health records, initiative after initiative, and so forth, all of which has reshaped the delivery of care, for the good and bad. But...

Using Simulation-Based Training to Improve the Procedural Skills of Oncology/Hematology Fellows

Simulation-based education in medicine programs implemented in cancer centers for oncology/hematology fellows recreates real-world patient experiences and provides a safe—and stress-free—learning environment in which trainees can enhance their clinical and procedural skills in a variety of areas....

Fentanyl Nasal Spray Now Available at a Dose of 300 µg for Treatment of Breakthrough Cancer Pain

Fentanyl (Lazanda) nasal spray, a schedule II narcotic, is now available at a 300-µg dose to treat breakthrough cancer pain, offering physicians another titration option for dosing flexibility. The new strength can help physicians more easily and accurately target the appropriate dose for patients, ...

Stanford Cancer Institute Designated NCI Comprehensive Cancer Center

The Stanford Cancer Institute has been designated a Comprehensive Cancer Center by the National Cancer Institute (NCI), a part of the National Institutes of Health. The designation is recognition of the Institute’s robust and integrated programs encompassing laboratory research, clinical care, and ...

colorectal cancer

New ASTRO Clinical Practice Statement Updates Treatment Standard for Rectal Cancer

The American Society for Radiation Oncology (ASTRO) recently issued a new clinical practice statement, “Appropriate Customization of Radiation Therapy for Stage II and III Rectal Cancer: An ASTRO Clinical Practice Statement Using the RAND/UCLA Appropriateness Method.” An executive...

lung cancer

Lung Cancer Screening: Beneficial for Certain Populations but Not Without Controversy

The National Cancer Policy Forum of the National Academies of Sciences took up the issue of lung cancer screening at its mid-June workshop. Greta Massetti, PhD, Associate Director for Science, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention (CDC), and chair of ...

pancreatic cancer

ASCO Guideline on Metastatic Pancreatic Cancer

As reported in the Journal of Clinical Oncology by Davendra P.S. Sohal, MD, MPH, of Cleveland Clinic, and colleagues, ASCO has released a clinical practice guideline on the treatment of patients with metastatic pancreatic cancer.1 Recommendations are based on an expert panel systematic review of...

pancreatic cancer

ASCO Guideline on Treatment of Locally Advanced, Unresectable Pancreatic Cancer

As reported by Edward P. Balaban, DO, FASCO, of Penn State Hershey Cancer Institute, and colleagues in the Journal of Clinical Oncology, ASCO has released a clinical practice guideline on the treatment of locally advanced, unresectable pancreatic cancer.1 The recommendations are based on expert...

pancreatic cancer

ASCO 2016 Guidelines for the Treatment of Pancreatic Cancer: Why Another Guideline?

The 5-year survival rate of those diagnosed with pancreatic cancer remains stubbornly fixed around 5%. Even in the 20% of cases in which surgical resection is undertaken for curative intent, the 5-year survival rate after surgery is 20% to 30%. As we make progress in other cancers with decreasing...

colorectal cancer

POLE Mutations in Colorectal Cancer May Identify Patients With a Better Prognosis

A collaboration between multiple European institutions has uncovered a correlation between a rare mutation in colorectal cancers and a better prognosis, raising the possibility that patients with such tumors may not require chemotherapy after surgery. Findings were published by Domingo et al in The ...

leukemia
lymphoma

Susan M. O’Brien, MD, on ALL/Lymphoma: Upfront and Salvage Treatments in Older Patients

Susan M. O’Brien, MD, of the University of California, Irvine, discusses the challenges of treating older patients with acute lymphoblastic leukemia and lymphoma, and the positive results with newer regimens using blinatumomab and inotuzumab.

pancreatic cancer

ASCO Guideline on Potentially Curable Pancreatic Cancer

As reported in the Journal of Clinical Oncology by Alok A. Khorana, MD, of Cleveland Clinic, and colleagues, ASCO has released a clinical practice guideline on the treatment of potentially curable pancreatic cancer.1 The recommendations are based on an expert panel systematic review of the...

issues in oncology

Discovery of Fragment Length of Circulating Tumor DNA Might Increase Liquid Biopsy Sensitivity

The liquid biopsy may be a welcome reprieve from typical biopsies. The minimally invasive test could reduce the need for the sometimes painful and risky procedures involved in sampling tumors, particularly those that reside deep within the body. However, thus far, the utility of the test has been...

lymphoma

Five-Year Survival Data: Brentuximab Vedotin May Be Curative in Some Patients With Hodgkin Lymphoma

Five-year survival data published by Chen et al in Blood suggest that the targeted therapy brentuximab vedotin (Adcetris) may be curative in some patients with Hodgkin lymphoma whose disease has persisted despite receiving previous therapies. This multinational phase II study examined brentuximab...

survivorship

Endocrine Abnormalities Increase Over Time in Aging Survivors of Childhood Cancer

The cumulative incidence of endocrinopathies steadily increased over time in aging survivors of childhood cancers, according to an analysis of data from the Childhood Cancer Survivor Study reported by Mostoufi-Moab et al in the Journal of Clinical Oncology. Study Details The study included...

issues in oncology
health-care policy

Road to Successful Use of Real-World Evidence for Drug Development Is Long and Rocky

Friends of Cancer Research (Friends) has been a leader in the push for better and faster cancer drug development. Now it is tackling the use of real-world evidence in clinical trials. This is the report of a meeting on the subject that took place on June 16 in Washington, DC.1 Real-world evidence...

breast cancer
solid tumors

Study Finds Wide Variation in Breast Density Assessments Among Radiologists

A large observational study examining the variation in breast density assessment among radiologists in clinical practice has found a wide variation—from 6.3% to 84.5%—in the percentage of mammograms rated as showing dense breasts, which persisted after adjusting for patient...

breast cancer

The Metastatic Breast Cancer Project: Direct-to-Patient Research Initiative

A nationwide project is enlisting patients with breast cancer to share their tumor samples and clinical information. Launched in October 2015, the Metastatic Breast Cancer (MBC) Project has enrolled more than 2,000 patients from all 50 states and is yielding information that will be shared with...

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