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cost of care
issues in oncology

Study Finds African American Cancer Survivors More Likely to Experience Lasting Debt Related to Cancer and Its Treatment

African American cancer survivors are more likely than whites to experience lasting debt or forgo necessary medical care as they struggle with the financial burden of cancer, whereas white cancer survivors are somewhat more likely to use existing assets to pay for their cancer care, according to a...

Face Mask for Radiation Therapy

By the 1930s, the dangers of radiation were well known. American Martyr’s to Science Through the Roentgen Rays, published in 1936, documented the dead heroes of American radiology, from Clarence Daly, Thomas Edison’s associate, to Elizabeth Fleischman, the only woman in the group, who was a U.S....

Lombardi’s Ruesch Center Policy Briefing Features Strategies to Reduce Costs

Two major developments in oncology—the dramatic success of some immunotherapies and targeted drugs and an equally dramatic rise in the cost of care—have created policy issues, more serious than ever, regarding access to care. It is a time “of extraordinary opportunities combined with inequities in ...

A Cancer Diagnosis Brings Two Sisters Back Together

Elizabeth Lesser is an award-winning writer and co-founder of the Omega Institute, the largest adult education center in the United States focusing on health, wellness, spirituality, and creativity. She is the author of several acclaimed books including Broken Open: How Difficult Times Can Help...

breast cancer
symptom management

Dexamethasone Mouth Rinse Should Be Routine Part of Everolimus Treatment

Dexamethasone mouth rinse should be given prophylactically to prevent stomatitis associated with everolimus (Afinitor)/exemestane in metastatic breast cancer, according to Hope S. Rugo, MD, principal investigator of the SWISH trial and Director of Breast Oncology and Clinical Trials Education at...

hematologic malignancies
palliative care

Palliative Care Still in Its Infancy in Hematologic Malignancies

Palliative care is slowly but surely being integrated into the treatment of patients with solid tumors, but its role in the hematopoietic stem cell transplant setting is still lagging, speakers said at the 2016 Palliative Care in Oncology Symposium. “There is a huge symptom burden among patients...

colorectal cancer

ESMO 2016: Longer Interval Between Preoperative Chemoradiotherapy and Surgery Urged in Locally Advanced Rectal Cancer

A longer waiting interval from the end of preoperative chemoradiotherapy to surgery increases the rate of pathologic complete response and yields a higher proportion of patients achieving tumor downstaging in patients with locally advanced rectal cancer, according to new findings from a...

head and neck cancer

Rise in Oropharyngeal Cancer Incidence in the UK Not Solely Driven by HPV

The rise in the incidence of oropharyngeal squamous cell carcinoma in the United Kingdom from 2002 to 2011 was not solely attributable to a rise in the incidence of human papillomavirus (HPV)-positive disease, according to a study published in Cancer Research,1 which reported that the proportion of ...

colorectal cancer

ESMO 2016: Dabrafenib/Trametinib/Panitumumab Improves Efficacy in BRAF Mutation–Positive Metastatic Colorectal Cancer

Patients with metastatic colorectal cancer and tumors harboring the BRAF V600E mutation who received triple therapy with dabrafenib (Tafinlar), trametinib (Mekinist), and panitumumab (Vectibix) showed an improved best overall response and prolonged progression-free survival compared to...

solid tumors
hematologic malignancies

ESMO 2016: Vemurafenib Shows Clinical Benefit in Diverse BRAF V600–Mutated Tumors

Findings from a phase II trial of vemurafenib in previously treated patients with advanced disease and BRAF-mutated tumors indicate that the drug is effective in patients with diverse BRAF V600­–mutated tumors but not in patients with BRAF non-V600 mutations. After a mean treatment...

When Breath Becomes Air: Dr. Lucy Kalanithi Reflects on Dr. Paul Kalanithi’s Life and Writing

Perhaps more than any other book in recent memory, When Breath Becomes Air has struck a chord among readers, both inside the medical community and among the public, desiring an honest and philosophical consideration of death. The autobiographical account of Paul Kalanithi, MD, a physician diagnosed ...

skin cancer

Association of PD-L1 Expression and Response to Pembrolizumab in Advanced Melanoma

In an analysis from the phase IB KEYNOTE-001 trial, Daud et al found that the level of programmed cell death ligand 1 (PD-L1) expression was associated with outcomes of pembrolizumab (Keytruda) treatment in patients with advanced melanoma. These findings were reported in the Journal of Clinical...

head and neck cancer

Study Finds Nivolumab Improves Survival vs Standard Therapy in Recurrent Squamous Cell Carcinoma of the Head and Neck

In the phase III CheckMate 141 trial reported in The New England Journal of Medicine, Ferris et al found that nivolumab (Opdivo) increased overall survival vs standard therapies in patients with recurrent platinum-refractory squamous cell carcinoma of the head and neck. Study Details In this...

Arti Hurria, MD: From Leadership Development Program to Board of Directors

Arti Hurria, MD, a geriatric oncologist at City of Hope in Duarte, California, is the first graduate of ASCO’s Leadership Development Program to be elected to ASCO’s Board of Directors. Within 5 years of completing the program, Dr. Hurria went from learning leadership skills to applying them to...

gynecologic cancers

What We Know and What We Need to Know About Neoadjuvant Chemotherapy in Advanced Ovarian Cancer

Ever since the landmark studies of Griffiths and colleagues in the 1970s,1 primary cytoreductive surgery followed by chemotherapy with the objective of achieving minimal residual disease has been the standard approach for women with advanced-stage epithelial ovarian cancer. However, what is...

gynecologic cancers

SGO and ASCO Clinical Practice Guideline on Neoadjuvant Chemotherapy for Newly Diagnosed Advanced Ovarian Cancer

As reported by Alexi A. Wright, MD, MPH, of Dana-Farber Cancer Institute, and colleagues in the Journal of Clinical Oncology, ASCO and the Society of Gynecologic Oncology (SGO) have released a clinical practice guideline on neoadjuvant therapy for patients with newly diagnosed stage IIIC or IV...

skin cancer

Adjuvant Ipilimumab Improves Survival in High-Risk Melanoma

Patients with stage III melanoma who were considered to be at high risk for recurrence derived an overall survival benefit from adjuvant treatment with ipilimumab (Yervoy), although it came at the price of considerable toxicity, according to updated survival results from the phase III European...

head and neck cancer

With Changing Strategies for Laryngeal Cancer, Multidisciplinary Team Approach Is Key

The treatment of cancer of the larynx has changed dramatically in recent years. With organ preservation now possible in many cases, it is more important than ever for patients to receive guidance from every corner of the field. In a recent article in the Journal of Oncology Practice (JOP),1 a...

breast cancer
supportive care

Consensus on Defining and Measuring Lymphedema Is Needed to Advance Efforts to Intervene Early and Prevent Progression

“Early intervention might prevent lymphedema progression,” Alphonse Taghian, MD, PhD, said at the 18th Annual Lynn Sage Breast Cancer Symposium in Chicago, but the lack of a universal definition of lymphedema and agreement on how to optimally measure it impedes phase III studies to test that...

breast cancer

Mammography-Detected Small Breast Cancers May Represent Overdiagnosis, With Survival Gains Reflecting Improved Systemic Therapy

In a study using SEER (Surveillance, Epidemiology, and End Results) data reported in The New England Journal of Medicine, Welch et al found that screening mammography has resulted in a substantial increase in detection of small breast tumors, many of which represent overdiagnosis, accompanied by...

kidney cancer

Study Finds Adjuvant Sunitinib Improves Disease-Free Survival in High-Risk Renal Cell Carcinoma After Nephrectomy

In the phase III S-TRAC trial reported at the 2016 European Society for Medical Oncology Congress and in The New England Journal of Medicine by Ravaud et al, adjuvant sunitinib (Sutent) significantly prolonged disease-free survival vs placebo in patients with high-risk renal cell carcinoma after...

sarcoma

FDA Grants Accelerated Approval to Olaratumab for Treatment of Advanced Soft-Tissue Sarcoma

Today, the U.S. Food and Drug Administration (FDA) granted accelerated approval to olaratumab (Lartruvo) in combination with doxorubicin to treat adults with certain types of soft-tissue sarcoma. Olaratumab is approved for use with the FDA-approved chemotherapy drug doxorubicin for the treatment of ...

prostate cancer

Prognostic and Predictive Molecular Subtypes of Prostate Cancer Identified

Members of the oncology community have long complained that prostate cancer lags behind breast cancer regarding biomarkers for prognosis and treatment, but the good news is that this gap is narrowing. In the largest study of its kind to date, presented at the 58th Annual Meeting of the American...

skin cancer

ESMO 2016: Pooled Analysis Shows PD-L1 Expression as a Biomarker for Nivolumab Plus Ipilimumab Response in Advanced Melanoma

A pooled analysis from three clinical trials in advanced melanoma shows that although patients treated with nivolumab and nivolumab plus ipilimumab with ≥ 5% programmed death-ligand 1 (PD-L1) tumor expression have similar progression-free survival, durable response rates were higher for the...

head and neck cancer

ESMO 2016: Meta-analysis Confirms Superiority of Concomitant Over Induction Chemotherapy in Nonmetastatic Head and Neck Cancer

Patients with head and neck squamous cell carcinoma achieved prolonged overall survival when concomitant chemotherapy was administered with locoregional treatment or radiotherapy, according to findings from a large meta-analysis reported by Blanchard et al at the European Society for Medical...

Expert Point of View: Vinai Gondi, MD

Formal discussant of both trials, Vinai Gondi, MD, Director of CNS Radiation Oncology at Northwestern Medicine Cancer Center in Warrenville, Illinois, offered a somewhat more nuanced take on the data from these studies. To begin, he commended the authors of both studies. “These were both...

lung cancer

ESMO 2016: Clinical Benefit Demonstrated With Everolimus and Pasireotide LAR Alone or in Combination in Advanced Lung and Thymic Carcinoids

In patients with advanced lung or thymus carcinoid receiving everolimus, pasireotide LAR, or the combination of the two drugs, statistically significant positive impact was seen on proportion of patients’ progression-free rate at 9 months (primary endpoint) in all three arms, more relevant in ...

cns cancers

Stereotactic Radiosurgery Achieves Better Quality of Life and Improved Cognition Than Whole-Brain Radiotherapy

Two separate randomized trials presented at the 58th Annual Meeting of the American Society of Radiation Oncology (ASTRO) affirmed the value of stereotactic radiosurgery as an option for postoperative treatment of the surgical cavity of resected brain metastases, potentially avoiding the cognitive...

issues in oncology
cost of care

COA Releases 2016 Community Oncology Practice Impact Report

On October 4, the Community Oncology Alliance (COA) released the 2016 Community Oncology Practice Impact Report, which tracks the changing landscape of cancer care in the United States. It documents a 121% increase in community cancer clinic closings and a 172% increase in consolidation into...

prostate cancer

Safety of Extreme Hypofractionation Reassuring in Intermediate-Risk Prostate Cancer

Giving patients larger fractions of radiation over shorter periods (ie, hypofractionation) is gaining ground in several types of cancers. This approach is attractive for patients’ convenience, shortening treatment and travel times, and also for resource utilization. Several studies have shown that ...

skin cancer

Investigational Immunotherapy Appears Safe and Somewhat Active in 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 Khalil et al in Clinical Cancer Research.  IMD-20D7S is a...

lung cancer

Retrospective Studies Confirm Survival Benefit of Stereotactic Body Radiotherapy in Early-Stage NSCLC

Stereotactic body radiation therapy is becoming more widely adopted for the treatment of early-stage non–small cell lung cancer (NSCLC). Along with its increasing uptake, survival has significantly increased over the past decade, according to two large retrospective studies presented at the 58th...

lung cancer

FDA Modifies the Indication of Erlotinib in Non–Small Cell Lung Cancer to Patients With Specific EGFR Mutations

On October 18, 2016, the U.S. Food and Drug Administration (FDA) modified the indication for erlotinib (Tarceva) in the treatment of non–small cell lung cancer (NSCLC) to limit its use to patients whose tumors have specific epidermal growth factor receptor (EGFR) mutations. The labeling...

breast cancer

Study Shows Strong Evidence Supporting Radiation Boost to Tumor Bed in Ductal Carcinoma in Situ

A radiation boost to the local tumor bed following treatment with breast-conserving therapy (ie, local excision followed by whole-breast radiation therapy) improves local control for patients with ductal carcinoma in situ, according to a study of pooled data from 10 academic centers,1 presented at...

cns cancers

Dutch Study Shows High Prevalence of Early Endocrine Disorders in Survivors of Childhood Brain Tumors

Clement et al found that 25% of survivors of childhood brain tumors were diagnosed with endocrine disorders over 6.6 years of follow-up, based on a Dutch nationwide study reported in the Journal of Clinical Oncology. The study involved data from 718 survivors diagnosed at age ≤ 18 years with a...

prostate cancer

Study Finds PFS Benefit, but No Overall Survival Benefit, for Ipilimumab in Metastatic Castration-Resistant Prostate Cancer

Ipilimumab (Yervoy) was associated with prolonged progression-free survival—but not overall survival—compared with placebo in men with asymptomatic or minimally symptomatic chemotherapy-naive metastatic castration-resistant prostate cancer without visceral metastases, according to a...

lung cancer

Adding Pembrolizumab to Carboplatin/Pemetrexed Seems to Improve Response in Advanced Nonsquamous NSCLC

As reported by Langer et al in The Lancet Oncology, findings in a phase II cohort of the multicohort KEYNOTE-021 study showed that the addition of first-line pembrolizumab (Keytruda) to carboplatin/pemetrexed (Alimta) significantly increased the response rate in patients with advanced nonsquamous...

multiple myeloma

Does Adding Daratumumab to Lenalidomide/Dexamethasone Improve Outcomes in Previously Treated Multiple Myeloma?

The addition of the CD38-targeted antibody daratumumab (Darzalex) to lenalidomide (Revlimid)/dexamethasone improved progression-free survival in patients with previously treated multiple myeloma, according to the results of the phase III POLLUX trial reported by Dimopoulos et al in The New England...

breast cancer

Combination of Ribociclib and Letrozole Improved Progression-Free Survival in Hormone Receptor–Positive Advanced Breast Cancer

The combination of the selective CDK4/6 inhibitor ribociclib plus letrozole significantly improved progression-free survival in hormone receptor–positive advanced breast cancer. When ribociclib was added to letrozole, progression-free survival improved by 44% compared with letrozole alone,...

lung cancer

ESMO 2016: First-Line Pembrolizumab Plus Chemotherapy Significantly Improves Outcomes in Advanced NSCLC

The addition of the programmed cell death protein 1 (PD-1) antibody pembrolizumab (Keytruda) to standard first-line chemotherapy for treatment-naive advanced non–small cell lung cancer significantly improves response rates and progression-free survival, Langer et al reported at the 2016...

head and neck cancer

ESMO 2016: Nivolumab Maintains Function and Reduces Symptoms in Relapsed Metastatic Head and Neck Cancer

Nivolumab (Opdivo) maintains function and reduces symptoms in treatment of relapsed metastatic head and neck cancer, according to results from the CheckMate 141 trial presented by Harrington et al at the 2016 European Society for Medical Oncology (ESMO) Congress in Copenhagen, Denmark (Abstract...

lung cancer

Intensity-Modulated vs 3D Conformal External-Beam Radiation Therapy in Locally Advanced Non–Small Cell Lung Cancer

In a secondary analysis from the NRG Oncology RTOG 0617 trial reported in the Journal of Clinical Oncology, Chun et al found that use of intensity-modulated vs three-dimensional (3D) conformal external-beam radiation therapy was associated with a reduced risk for severe pneumonitis and reduced the...

skin cancer

Adjuvant Ipilimumab Prolongs Survival in High-Risk Stage III Melanoma, Phase III Study Reports

In the phase III European Organisation for Research and Treatment of Cancer (EORTC) trial 18071 reported at the recent European Society for Medical Oncology meeting and in The New England Journal of Medicine by Eggermont et al, adjuvant ipilimumab (Yervoy) was found to improve recurrence-free and...

lung cancer

First-Line Pembrolizumab Improves Survival vs Platinum-Based Chemotherapy in Advanced PD-L1–Positive NSCLC

Pembrolizumab (Keytruda) significantly improved progression-free and overall survival vs platinum-based chemotherapy in patients with previously untreated advanced non–small cell lung cancer (NSCLC) with ≥ 50% PD-L1 (programmed cell death ligand 1) expression and no sensitizing EGFR...

palliative care

ESMO 2016: Researchers Identify Factors Associated With End-of-Life Chemotherapy Use

The rates of administering chemotherapy to patients with solid cancers within a month of succumbing to their disease remain high, which calls for a paradigm shift to consider initiating palliative care at an earlier stage and formulating clear guidelines for end-of-life care, according to findings...

breast cancer

ESMO 2016: Antitumor Activity Demonstrated With Lurbinectedin in Patients With Metastatic Breast Cancer and BRCA Mutations

Lurbinectedin showed promising clinical benefit in pretreated patients with metastatic breast cancer and BRCA1 or BRCA2 mutations, including patients previously treated with platinum, according to phase II trial results presented by Balmaña et al at the 2016 European Society for Medical...

colorectal cancer

Massachusetts Health Insurance Expansion Associated With Increased Resection and Reduced Emergent Resection for Colorectal Cancer

In a study reported in the Journal of Clinical Oncology, Loehrer et al found that the 2006 Massachusetts health-care reform has resulted in increased rates of resection and reduced emergent resection for colorectal cancer. The study used the Hospital Cost and Utilization Project State Inpatient...

gynecologic cancers

Study Finds Niraparib Maintenance Improves Progression-Free Survival in Platinum-Sensitive Recurrent Ovarian Cancer

In a phase III trial reported at the recent European Society for Medical Oncology Congress and in The New England Journal of Medicine by Mirza et al, maintenance therapy with the PARP (poly ADP ribose polymerase) 1/2 inhibitor niraparib significantly prolonged progression-free survival vs placebo...

breast cancer

ESMO 2016: Fulvestrant Improves Progression-Free Survival in Advanced Breast Cancer

Fulvestrant (Faslodex) significantly increases progression-free survival in women with hormone receptor–positive advanced breast cancer, particularly those with less aggressive lower-volume disease, Ellis et al reported at the 2016 European Society for Medical Oncology (ESMO) Congress in ...

colorectal cancer

ESMO 2016: Nintedanib Improves Progression-Free Survival but Not Overall Survival in Metastatic Colorectal Cancer

Nintedanib (Ofev) improves progression-free survival but not overall survival in patients with metastatic colorectal cancer who are not responding to standard therapies, according to the results of the phase III LUME-colon 1 trial presented by Van Cutsem et al at the 2016 European Society of...

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