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issues in oncology

Legal Duties of Clinicians When Terminally Ill Patients With Cancer or Their Surrogates Insist on ‘Futile’ Treatment

Law and Ethics in Oncology explores the legal and ethical issues oncologists must be aware of in this era of precision medicine and changing health-care policy, both to protect patients’ rights and to safeguard against potential legal jeopardy. For years, ASCO and other medical societies have...

kidney cancer

Cabozantinib in Advanced Renal Cell Carcinoma

ON DECEMBER 19, 2017, cabozantinib (Cabometyx) was granted regular approval for the treatment of advanced renal cell carcinoma.1,2 Cabozantinib was initially granted approval in 2016 for the treatment of patients with advanced renal cell carcinoma who had received prior antiangiogenic therapy. The...

leukemia

Bosutinib in Newly Diagnosed Chronic-Phase Philadelphia Chromosome–Positive Chronic Myeloid Leukemia

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On December 19, 2017, bosutinib (Bosulif) was granted...

issues in oncology
survivorship

It Starts With a Discussion: ASCO Guideline on Interventions to Address Sexual Problems in People With Cancer

Dr. Katz is a certified sexuality counselor at CancerCare Manitoba, Canada. SEXUALITY AND SEXUAL functioning are important to cancer survivors, and considering the significant number of survivors, this is an issue that should not be ignored. In a survey of cancer survivors who had completed...

issues in oncology
survivorship

Interventions to Address Sexual Problems in People With Cancer: ASCO Clinical Practice Guideline Adaptation of CCO Guideline

AS REPORTED in the Journal of Clinical Oncology by Jeanne Carter, PhD, of Memorial Sloan Kettering Cancer Center, and colleagues, ASCO has issued a clinical practice guideline adaptation of the Cancer Care Ontario (CCO) guideline on interventions to address sexual problems in people with cancer.1 ...

lung cancer

Osimertinib Improves Progression-Free Survival vs Standard EGFR Inhibitors in EGFR-Mutant NSCLC

AS REPORTED in The New England Journal of Medicine by Jean-Charles Soria, MD, PhD, of Gustave Roussy Cancer Campus and University Paris-Sud, and colleagues, the phase III FLAURA trial has shown a significant progression-free survival benefit with the third-generation epidermal growth factor...

breast cancer

EXPERT POINT OF VIEW: Aditya Bardia, MD

ADITYA BARDIA, MD, Director of Precision Medicine at the Center for Breast Cancer, Massachusetts General Hospital, Harvard Medical School, Boston, said: “This large, well-powered trial that included 181 centers and more than 2,600 patients unfortunately failed to show that celecoxib improved...

breast cancer

No Evidence of Celecoxib Benefit Reported in Patients With Early Breast Cancer

TWO YEARS of treatment with celecoxib had no observed effect on 5-year outcomes of patients with early breast cancer in the large REACT trial presented at the 2017 San Antonio Breast Cancer Symposium.1 “There was no overall benefit observed in disease-free survival or overall survival for...

breast cancer

Selected Abstracts From the San Antonio Breast Cancer Symposium

EACH YEAR, The ASCO Post asks Jame Abraham, MD, FACP, Director of the Breast Oncology Program at Taussig Cancer Institute and Co-Director of the Cleveland Clinic Comprehensive Breast Cancer Program, to give his picks for the most important research presented at the San Antonio Breast Cancer...

multiple myeloma

EXPERT POINT OF VIEW: Andrzej Jakubowiak, MD, PhD

INTERVIEWED BY The ASCO Post, Andrzej Jakubowiak, MD, PhD, Director of the Multiple Myeloma Program at the University of Chicago Medical Center, commented on the “controversial findings” of EMN02/HO95. “This European study has opened the gate toward showing the benefit of a second transplant,...

multiple myeloma

European Study Shows Double Transplant Improves Survival in Myeloma

FOR NEWLY DIAGNOSED patients with multiple myeloma considered to be at high risk of disease progression, double autologous stem cell transplantation (ASCT) significantly prolongs progression-free and overall survival, vs single transplant, according to the phase III EMN02/HO95 study. The findings...

Study Uses Music Medicine to Reduce Stress in Pediatric Patients

In a first-of-its-kind collaboration, the Children’s Cancer Association, Randall Children’s Hospital at Legacy Emanuel, and Legacy Research Institute, of Portland, Oregon, co-led a study to assess the impact of using live music as medicine on postoperative pediatric patients to reduce pain and...

lymphoma

TAT 2018: Epigenetics Therapy Shows Promise in Patients With Lymphoma

New compounds targeting epigenetics have shown early activity in patients with lymphoma, according to data presented at the TAT (Targeted Anticancer Therapies) International Congress 2018 in Paris. The meeting, which focused on phase I research, featured early clinical studies with BET inhibitors...

supportive care
integrative oncology

Acupuncture for the Management of Chemotherapy-Induced Peripheral Neuropathy

The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies commonly used by patients with cancer. In this installment, Ting Bao, MD, DABMA, MS, reviews the current data on the use of acupuncture...

solid tumors
gastrointestinal cancer

Lutetium Lu-177 Dotatate in Gastroenteropancreatic Neuroendocrine Tumors

On January 26, 2018, the radiolabeled somatostatin analog lutetium Lu-177 dotatate (Lutathera) was approved for the treatment of somatostatin receptor–positive gastroenteropancreatic neuroendocrine tumors, including foregut, midgut, and hindgut neuroendocrine tumors, in adults.1,2 Supporting...

solid tumors

TAT 2018: EXPRESS Study Explores the Genomic Landscape of Patients Achieving an 'Exceptional' Response to Targeted Therapy

The level of genomic alterations in genes associated with the oncogenesis of specific solid tumor types is being investigated in patients that have demonstrated an exceptional response to currently approved targeted therapies, researchers announced at the International Congress on Targeted...

breast cancer

PIK3CA Mutation and Prognosis in Early-Stage Breast Cancer

In a study reported in the Journal of Clinical Oncology, Zardavas et al found that the prognostic effect of PIK3CA mutation in early breast cancer was reduced after adjustment for other prognostic factors. Study Details The study involved analysis of individual patient data from a pooled...

breast cancer

Neoadjuvant Therapy in Triple-Negative Breast Cancer

In a phase III trial (BrighTNess) reported in The Lancet Oncology, Loibl et al found that the addition of the PARP inhibitor veliparib to carboplatin and paclitaxel in neoadjuvant therapy did not increase pathologic complete response rate in women with triple-negative breast cancer. Study Details ...

bladder cancer

EXPERT POINT OF VIEW: Timothy Gilligan, MD

“POUT IS an impressive study, given that the authors were able to complete a trial in this relatively rare cancer. We still need overall survival data to determine the role of adjuvant chemotherapy for upper tract urothelial cancer. We need to know if it makes people live longer or have a better...

bladder cancer

Adjuvant Chemotherapy for Upper Tract Urothelial Cancer

ADJUVANT CHEMOTHERAPY achieved robust improvements in disease-free survival and metastasis-free survival compared with surveillance in the phase III POUT study of patients with upper tract urothelial cancer.1 Further, there was an early trend toward improved overall survival with adjuvant...

issues in oncology
survivorship

Adolescent and Young Adult Cancer Survivors Often Struggle With Reproductive and Sexual Health Concerns

FOR MANY adolescents and young adults (AYAs), the most distressing and troubling phase of the cancer continuum that began with diagnosis is survivorship, and among the toughest challenges are those involving sexual health and reproduction, Jessica Gorman, PhD, MPH, stated at the 11th Annual...

hepatobiliary cancer

In Unresectable Liver Cancer, Progression-Free Survival Doubled When Sorafenib Added to TACE

SORAFENIB (Nexavar) added to transarterial chemoembolization (TACE) doubled the median progression-free survival over TACE alone in patients with unresectable hepatocellular carcinoma, Japanese investigators reported at the 2018 Gastrointestinal Cancers Symposium.1 The results of the randomized,...

colorectal cancer

EXPERT POINT OF VIEW: Wafik S. El-Deiry, MD, PhD, FACP

WAFIK S. EL-DEIRY, MD, PhD, FACP, Deputy Cancer Center Director for Translational Research, and Co-Leader of the Molecular Therapeutics Program at Fox Chase Cancer Center, Philadelphia, shared his thoughts on these findings with The ASCO Post. In essence, Dr. El-Deiry suggested the comparison does ...

colorectal cancer

Small Study Evaluates Treatment Sequencing in Patients With Metastatic Colorectal Cancer

THE OPTIMAL treatment sequence for two approved agents in metastatic colorectal cancer may be regorafenib (Stivarga) before cetuximab (Erbitux), according to results from the small randomized Japanese REVERCE trial presented at the 2018 Gastrointestinal Cancers Symposium.1 Giving regorafenib...

colorectal cancer

Investigational Genomic Tool Identifies Consensus Molecular Subtype of Colon Tumor and May Predict Risk of Recurrence

AN INVESTIGATIONAL TOOL called ColotypeR classifies colon cancers by molecular subtype and creates a subtype-specific risk of recurrence, according to research. Developers of the tool say it will be able to guide treatment decisions. Colon cancer is highly heterogeneous in prognosis and response to ...

pancreatic cancer
immunotherapy

Small Study Evaluates Novel Immunotherapeutic in Metastatic Pancreatic Cancer

IN PATIENTS WITH metastatic pancreatic adenocarcinoma, 1-year survival reached 43% following treatment with a novel immunotherapy—PEGylated human IL-10 (AM0010, pegilodecakin)—plus chemotherapy, in a small study reported at the 2018 Gastrointestinal Cancers Symposium.1 “We saw a very high disease...

lymphoma
immunotherapy

Responses Reported With CAR T-Cell Therapy in High-Risk NHL

LISOCABTAGENE MARALEUCEL (Liso-cel; JCAR017), a CD19-directed chimeric antigen receptor (CAR) T-cell therapy with defined composition, has shown “potent and durable” responses in poor-prognosis patients with relapsed or refractory aggressive non-Hodgkin lymphoma (NHL) in a phase I trial.1 According ...

prostate cancer

EXPERT POINT OF VIEW: Philip Kantoff, MD

  PHILIP KANTOFF, MD, of Memorial Sloan Kettering Cancer Center, New York, was the formal discussant of both trials. “At first glance, these are two positive trials,” Dr. Kantoff said. Although he praised the results, he said that overall survival is the best demonstration of clinical benefit, and ...

prostate cancer

Apalutamide, Enzalutamide Improve Metastasis-Free Survival in Nonmetastatic Castrate-Resistant Prostate Cancer

IN TWO SEPARATE TRIALS presented at the 2018 Genitourinary Cancers Symposium, apalutamide and enzalutamide (Xtandi), respectively, reduced the risk of metastasis and prolonged metastasis-free survival in men with high-risk nonmetastatic castrate-resistant prostate cancer. In the SPARTAN trial,1,2...

issues in oncology
health-care policy

Advancing Cancer Research in Challenging Times

ON OCTOBER 17, 2017, Norman E. Sharpless, MD, became the 15th Director of the National Cancer Institute (NCI), succeeding Harold E. Varmus, MD, who stepped down as Director of the agency in March 2015, and replacing Douglas R. Lowy, MD, who had served as Acting Director for 2 years. The...

kidney cancer
immunotherapy

Atezolizumab Plus Bevacizumab Improves Progression-Free Survival in First-Line Treatment of Advanced Renal Cell Carcinoma

THE TYROSINE KINASE inhibitor sunitinib (Sutent) has been the mainstay of treatment for first-line treatment of advanced renal cell carcinoma for about a decade. The IMmotion151 study reported at the 2018 Genitourinary Cancers Symposium found that the combination of the immune checkpoint inhibitor...

prostate cancer

New Agents for Initial Treatment of Metastatic Prostate Cancer: A New Standard of Care?

FOR DECADES, the status of metastatic prostate cancer trials was not particularly exciting. With an absence of high-impact novel agents, the focus of cancer trial groups was on the improvement of standard care. Well-crafted, large trials of hormonal therapy demonstrated the utility of combined...

issues in oncology

Pretreatment Cancer-Associated Weight Loss and Prognosis

In a study reported in the Journal of Oncology Practice, Gannavarapu et al found that substantial unintentional weight loss prior to treatment is common among patients with cancer across stages of disease and is associated with poorer outcome. Study Details The retrospective cohort study included ...

skin cancer

Adjuvant Vemurafenib in Resected BRAF V600–Mutant Melanoma

In the international phase III BRIM8 trial reported in The Lancet Oncology, Maio et al found inconclusive evidence of benefit of adjuvant vemurafenib treatment in patients with BRAF V600–mutant melanoma.   Study Details In the double-blind trial, 498 patients with fully resected...

prostate cancer

Multimodal Treatment in Patients With Gleason Score 9–10 Prostate Cancer

University of California, Los Angeles (UCLA) researchers have discovered that a combination of high doses of radiotherapy and hormonal therapy provides the best chance of decreasing the mortality rate in men with aggressive prostate cancer. The findings, published by Kishan et al in JAMA, also...

solid tumors
lymphoma
immunotherapy

FDA Approves sBLA Updating Nivolumab Dosing Schedule Across Indications

On March 6, Bristol-Myers Squibb announced the U.S. Food and Drug Administration (FDA) has approved a supplemental Biologics License Application (sBLA) updating the nivolumab (Opdivo) dosing schedule to include 480 mg infused every 4 weeks for a majority of approved indications. This approval will ...

skin cancer
immunotherapy

Circulating Tumor DNA and Pseudoprogression in Metastatic Melanoma Treated with Anti–PD-1 Antibodies

In a study reported in JAMA Oncology, Lee et al found that measurement of circulating tumor DNA (ctDNA) can help distinguish between pseudoprogression (radiologic progression prior to response) and true progression in patients with metastatic melanoma receiving anti­–programmed cell death ...

breast cancer

Upfront Adjuvant Aromatase Inhibitor Therapy vs Aromatase Inhibitors After Tamoxifen in Hormone Receptor–Positive Early Breast Cancer

An Italian phase III trial (FATA-GIM3) has shown no difference in disease-free survival with 5 years of upfront adjuvant aromatase inhibitor therapy vs 2 years of tamoxifen followed by 3 years of aromatase inhibitor therapy in women with hormone receptor–positive early breast cancer. The...

breast cancer

FDA Authorizes Direct-to-Consumer Test That Reports Three Mutations in the BRCA1/BRCA2 Breast Cancer Genes

Today, the U.S. Food and Drug Administration (FDA) authorized the Personal Genome Service Genetic Health Risk (GHR) Report for BRCA1/BRCA2 (Selected Variants). It is the first direct-to-consumer (DTC) test to report on three specific BRCA1/BRCA2 breast cancer gene mutations that are most common in...

breast cancer
survivorship
symptom management

Internet-Delivered Cognitive-Behavioral Therapy for Insomnia in Breast Cancer Survivors

In a Danish study reported in the Journal of the National Cancer Institute, Zachariae et al found that an Internet-delivered cognitive-behavioral therapy intervention improved insomnia among breast cancer survivors. Study Details In the study, 255 patients from a national sample of Danish breast...

ASCO, NCCN Provide Guidance on Understanding and Managing Immunotherapy Side Effects

Immunotherapy with immune checkpoint inhibitors is the first of a new generation of immunotherapy treatments, revolutionizing treatment for many different types of cancer. By unleashing the body’s immune system to attack cancer, these treatments can send even the most hard-to-treat cancers into...

hematologic malignancies
symptom management

Cognitive Decline Prevalent Among Elderly Patients With Hematologic Cancers

A sizable percentage of elderly patients with blood-related cancers such as leukemia and multiple myeloma are apt to show signs of diminished cognitive functioning—a decline that may impact their survival—a new study by investigators at Dana-Farber Cancer Institute and Brigham and...

solid tumors
breast cancer

Conqueror in Action: Katherine Reeder-Hayes, MD, Takes on Breast Cancer

When a cutting-edge cancer tool becomes available, marginalized populations such as African Americans and older patients often have less access to it than other populations. This is problematic, especially when those with limited access are those who could benefit the most. As a result, public...

solid tumors
skin cancer

Clinical Trials Actively Recruiting Patients With Melanoma

The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies in melanoma. These studies focus on assessing response to checkpoint inhibitors; T-cell immunotherapy; combination therapies; adoptive cell therapy; combination therapy development; and...

cns cancers
immunotherapy

Bevacizumab in Recurrent Glioblastoma

On December 5, 2017, bevacizumab (Avastin) was granted regular approval for the treatment of recurrent glioblastoma in adults.1 Bevacizumab was granted accelerated approval in May 2009 for use in treating patients with glioblastoma who had disease progression on prior therapy. Supporting Efficacy...

legislation
health-care policy

Why Right-to-Try Laws Are Dangerous

Why wouldn’t you support a patient with a terminal illness the “right to try” any therapy that may save his or her life? The answer to this question—one engulfed in a political debate in Congress—seems simple. It is not. [Editor’s Note: On May 30, 2018, the President signed into law the Trickett...

issues in oncology

Genomic Analyses Highlight Need for Precision Therapies That Target Pediatric Cancers

Researchers have determined that children and adults with cancer often have different mutated genes driving their disease, which suggests they would likely benefit from different therapies. The finding, from a collaborative study led by St. Jude Children’s Research Hospital and published by...

pancreatic cancer

FDA Grants Fast Track Designation to Pamrevlumab in Locally Advanced Unresectable Pancreatic Cancer

On March 1, the U.S. Food and Drug Administration (FDA) granted Fast Track designation for the anti–connective tissue growth factor (CTGF) antibody pamrevlumab for the treatment of patients with locally advanced unresectable pancreatic cancer. This follows review of the phase II clinical...

breast cancer

Adjuvant Chemotherapy for ER-Negative and ER-Positive Isolated Locoregional Recurrence of Breast Cancer

As reported in the Journal of Clinical Oncology by Wapnir et al, the final analysis of the phase III CALOR trial showed benefit of adjuvant chemotherapy in estrogen receptor (ER)–negative but not ER-positive isolated locoregional recurrence of breast cancer. Study Details In this open-label ...

skin cancer
immunotherapy

Body Mass Index and Outcomes With Targeted Therapy, Immunotherapy, or Chemotherapy in Metastatic Melanoma

In a study reported in The Lancet Oncology, McQuade et al found that obesity was associated with improved outcomes in treatment of metastatic melanoma with targeted therapy or immunotherapy—but not chemotherapy—with a survival benefit appearing to be restricted to obese male patients....

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