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Pioneer in Chemoradiation Robert B. Livingston, MD, Dies

Over the past couple of decades, chemoradiation for several cancers, such as lung and breast, has advanced in efficacy and side-effect tolerance, prolonging survival and quality of life for patients. One of the pioneers in chemoradiation, Robert B. Livingston, MD, died on September 8, 2016. Dr....

issues in oncology

Recognizing the Unique Experiences of Cancer Among Adolescent and Young Adult Survivors

Studies show that adolescent and young adult cancer survivors experience distinct challenges and quality-of-life issues from those experienced by either younger or older adult cancer survivors and that those challenges and issues can persist long after the cancer diagnosis and the end of...

Researcher Spotlight: Conquering Cancer With Dr. Effinger

When it comes to pediatric cancer, there are so many signs of hope, starting with the fact that the childhood cancer 5-year survival rate has climbed all the way up to 83%. But while we celebrate the victories of all these children over cancer, little is known about the long-term health effects,...

issues in oncology

Breaking the ‘Conspiracy of Silence’

A new study1 showing that just 1 in 20 terminally ill patients with cancer has sufficient understanding about the prognosis or purpose of treatment is highlighting the need for improvements in both the way oncologists communicate prognosis with their patients and in the development of educational...

integrative oncology

The Role of Music Therapy in Cancer Care

Music therapy, an established adjuvant to standard cancer care, is offered in a growing number of cancer centers throughout the United States and internationally. Defined by the American Music Therapy Association (AMTA) as “the evidence-based use of music interventions to accomplish individual...

survivorship
issues in oncology

Improving Management of Sexual Problems for Cancer Survivors

What do up to 60% of cancer survivors have in common? Answer: some type of long-term sexual dysfunction. How many cancer survivors seek professional help for sexual problems? Answer: less than 20%. Even when they do seek help, they may not be successful in finding professionals with expertise in...

issues in oncology

Why Patients’ Understanding of Their Prognosis Often Differs From Their Oncologists’

A recent study1 published in the Journal of Clinical Oncology (see “Breaking the ‘Conspiracy of Silence’” in this issue of The ASCO Post) found that just 1 in 20 patients with advanced, incurable cancer has sufficient understanding of his or her prognosis or life expectancy. Now, another new study ...

gynecologic cancers

An Oncologist Battles a Preventable Epidemic: Cancer of the Cervix

Cervical cancer incidence and mortality rates—perhaps more than any other chronic disease—shine a grim spotlight on global disparities of care. It is one of the most preventable of human malignancies, yet it is the leading cause of cancer deaths in women around the world. It kills 260,000 women...

breast cancer

I-SPY 2: Separating Contenders From Pretenders in Breast Cancer

With the expansion of our understanding of signaling pathways in normal cells and how they are co-opted or corrupted in malignancy, the number of potential antitumor agents to be tested has exploded, exposing the limitations of traditional antineoplastic drug development and challenging us to...

skin cancer

Nonwhite Organ Transplant Recipients Also at Heightened Risk for Skin Cancer

A new study from Drexel University College of Medicine suggests all organ transplant recipients, regardless of race, should receive routine, total-body screenings for skin cancer. Out of 259 nonwhite transplant recipients who were evaluated in the study, 19 skin cancer lesions were identified in...

pancreatic cancer

Comparison of Second-Line Treatments in Advanced Pancreatic Cancer After Gemcitabine-Based Chemotherapy

In the Canadian phase III PANCREOX trial reported in the Journal of Clinical Oncology, Gill et al found no benefit of modified FOLFOX6 (infusional fluorouracil [5-FU], leucovorin, and oxaliplatin) vs infusional 5-FU/leucovorin as second-line treatment in patients with advanced pancreatic cancer who ...

gynecologic cancers

Survival Benefit Reported With Maintenance Olaparib in Platinum-Sensitive Recurrent Serous Ovarian Cancer With BRCA Mutation

Maintenance olaparib (Lynparza) appeared to be associated with an overall survival benefit vs placebo in women with platinum-sensitive serous ovarian cancer and BRCA1 and BRCA2 mutations, according to an updated analysis of a phase II trial reported in The Lancet Oncology by Ledermann et al....

breast cancer

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

As reported by Hope S. Rugo, MD, and John W. Park, MD, both of the University of California, San Francisco, and colleagues in The New England Journal of Medicine, the multiarm adaptive randomization phase II I-SPY 2 trial has shown that the addition of veliparib/carboplatin and the addition of...

lung cancer

Lung Cancer Specialist Shares Clinical Pearls for Managing Stage IIIA Non–Small Cell Lung Cancer

Clinicians face a number of questions in evaluating and treating patients with stage IIIA non–small cell lung cancer (NSCLC). One expert in the field, Rafael Santana-Davila, MD, reviewed key issues in managing this disease in the Journal of Oncology Practice (JOP). The ASCO Post asked Dr....

prostate cancer

Testosterone-Related Genetic Mutation Associated With Poorer Survival in Prostate Cancer

A collaborative Cleveland Clinic–Mayo Clinic team of researchers has shown for the first time that patients with advanced prostate cancer are more likely to die earlier of their disease if they carry a specific testosterone-related genetic abnormality. The findings, published by Hearn et al in The...

breast cancer

Everolimus in Advanced HER2-Positive Breast Cancer With PIK3CA Mutation, PTEN Loss, or Hyperactive PI3K Pathway

In an analysis of the phase III BOLERO-1 and -3 trials reported in the Journal of Clinical Oncology, Fabrice André, MD, of Institut Gustav-Roussy, Paris, France, and colleagues found that the addition of everolimus (Afinitor) to trastuzumab (Herceptin) and chemotherapy was associated with a...

lymphoma

Novel Agents on the Horizon in Lymphoma

Attendees at the 2016 Pan Pacific Lymphoma Conference held July 18–22 in Koloa, Hawaii, got a peek at early data for a number of novel agents in the treatment of various lymphoma subtypes. The ASCO Post captured these findings. Denintuzumab Mafodotin in Diffuse Large B-Cell Lymphoma Denintuzumab...

lymphoma

Routine PET Surveillance Discouraged in Large Cell Lymphoma

There is no role for routine imaging as a means of following patients with large cell lymphoma, according to Bruce D. Cheson, MD, Deputy Chief of Hematology-Oncology and Professor of Medicine at Georgetown University Hospital, Lombardi Comprehensive Cancer Center, Washington, DC. “Routine...

breast cancer

Enhanced Survival With Implantable Scaffolds That Capture Metastatic Breast Cancer Cells in Vivo

A small device implanted under the skin may improve breast cancer survival by catching cancer cells, slowing the development of metastatic tumors in other organs, and allowing time to intervene with surgery or other therapies. These findings, reported by Rao et al in Cancer Research, suggest a path ...

head and neck cancer

Specimen Margin Tops Frozen Margin as Prognostic Marker in Oral Cancer Surgery

Intraoperative frozen margins from the tumor bed help to assess the prognosis of oral cancer, but the permanent specimen margin remains king, according to a retrospective cohort study reported at the 9th International Conference on Head and Neck Cancer.1 Results indicated that the rate of local...

head and neck cancer

Testosterone Therapy May Be Cardioprotective in Patients Undergoing Chemotherapy

The anabolic hormone testosterone may lessen the early adverse cardiovascular effects of chemotherapy and chemoradiation for advanced or recurrent cancer, according to a randomized controlled trial reported at the 9th International Conference on Head and Neck Cancer.1 Among the patients studied,...

issues in oncology

ASCO and AACI Initiative to Reduce Administrative and Regulatory Burden in Cancer Clinical Trials

As reported in the Journal of Clinical Oncology, Julie M. Vose, MD, MBA, FASCO, of the University of Nebraska Medical Center, Omaha, and colleagues have provided a summary of the groundwork of an initiative by ASCO and the Association of American Cancer Institutes (AACI) to identify and reduce...

lung cancer

Immune Checkpoint Inhibitors March to First-Line Treatment in Advanced NSCLC

For the majority of patients who are diagnosed with advanced-stage non–small cell lung cancer (NSCLC), platinum-based doublets have been the standard of care for over 30 years. Recently, the immune checkpoint inhibitors nivolumab (Opdivo) and pembrolizumab (Keytruda) demonstrated superior survival ...

Conflicting Interpretations of Genetic Findings on Multiplex Testing in Clinical Practice

In a study reported in the Journal of Clinical Oncology, Balmaña et al found that conflicting interpretations of findings on multiplex testing for cancer genes are fairly common among reporting laboratories and may have implications for medical management decisions. Study Details The study ...

lung cancer

First-Line Nivolumab Alone and Combined With Platinum-Based Chemotherapy in Advanced NSCLC

The phase I CheckMate 012 study examined the effects of nivolumab (Opdivo) monotherapy and nivolumab combined with platinum-based doublets as first-line treatments in patients with advanced non–small cell lung cancer (NSCLC). Encouraging efficacy and safety findings were reported in the Journal...

leukemia
issues in oncology

Adolescent Girls With Leukemia May Not Be Screened for Pregnancy Before Beginning Chemotherapy

A new study indicates that adolescent females with acute leukemia have low rates of pregnancy screening prior to receiving chemotherapy that can cause birth defects. These findings were published by Rao et al in Cancer. Although many chemotherapy drugs can cause birth defects, there are no...

hematologic malignancies

Good Outcome Reported With Unrelated-Donor Cord Blood Transplantation in Patients With Minimal Residual Disease

Survival with hematopoietic cell transplantation (HCT) from unrelated cord-blood donors was at least as good as that with HLA-matched unrelated donors and better than that with HLA-mismatched unrelated donors in patients with acute leukemia or myelodysplastic syndrome who had pretransplantation...

colorectal cancer

Joint Presence of Metabolic Syndrome and Obesity Seems to Be Associated With Poorer Survival in Early-Stage Colorectal Cancer

In a study in Kaiser Permanante patients reported in the Journal of Clinical Oncology, Cespedes Feliciano et al found that the joint presence of obesity and metabolic syndrome in those with early-stage colorectal cancer was associated with poorer overall and colorectal cancer–specific...

breast cancer
gynecologic cancers

Study Suggests Role of Bilateral Oophorectomy in Preventing Premenopausal Breast Cancer in BRCA2- but Not BRCA1-Mutation Carriers

Bilateral oophorectomy was associated with prevention of premenopausal breast cancer in BRCA2- but not BRCA1-mutation carriers, according to a study reported by Kotsopoulos et al in the Journal of the National Cancer Institute. The study included 3,722 women with BRCA mutations in a prospective...

prostate cancer

Decline in Circulating Tumor Cell Count and Treatment Outcome in Advanced Prostate Cancer

A drop in the number of cancer cells detected in a patient’s blood could be the best indicator yet as to whether treatment for prostate cancer is working. A new study, published by Lorente et al in European Urology, shows that a 30% decline in a patient’s numbers of circulating tumor...

kidney cancer

Everolimus Plus Bevacizumab Shows Activity in Advanced Non–Clear Cell Renal Cell Carcinoma

The combination of everolimus (Afinitor, Zortress) and bevacizumab (Avastin) was associated with clinical benefit in advanced non–clear cell renal cell carcinoma with a major papillary component, according to a single-center phase II trial reported by Voss et al in the Journal of Clinical...

lung cancer

Combined FISH and IHC Identifies Patients With NSCLC With Rare ALK Fusions That Respond to Crizotinib

The combined use of fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) identified non–small cell lung cancer (NSCLC) patients with rare or novel anaplastic lymphoma kinase (ALK) gene rearrangements, not otherwise identified by FISH alone, that showed response to...

prostate cancer

PSA Failure Seems to Be Linked to Poorer Survival in Men With Unfavorable-Risk Prostate Cancer and No/Minimal Comorbidity

In an analysis of a clinical trial population reported in the Journal of Clinical Oncology, Giacalone et al found that prostate-specific antigen (PSA) failure was associated with an increased risk of mortality among men with unfavorable-risk prostate cancer who had no or minimal comorbidity burden. ...

colorectal cancer

NCI Colorectal Cancer Risk Assessment Tool Estimates Current Risk of Advanced Neoplasia

In a study reported in the Journal of the National Cancer Institute, Imperiale et al found that the National Cancer Institute (NCI) colorectal cancer risk assessment tool was able to estimate the current risk for advanced colorectal neoplasia. Study Details The study involved 4,457 persons aged...

gynecologic cancers

Shorter Survival Reported With Neoadjuvant Chemotherapy vs Primary Reductive Surgery in Stage IIIC Ovarian Cancer

Neoadjuvant chemotherapy was associated with shorter survival vs primary cytoreductive surgery in patients with stage IIIC ovarian cancer, according to a multi-institute observational study reported by Meyer et al in the Journal of Clinical Oncology. The study involved 1,538 women with stage IIIC...

palliative care

Palliative Care 2016: Rehospitalization of Patients With Advanced Cancer in the Year After Diagnosis

Among individuals with advanced cancer, frequent hospitalization is often at odds with patient preference and is increasingly viewed as a hallmark of poor quality care. Hospitalization contributes substantially to costs and regional spending variation in this population, but patterns and reasons...

skin cancer

Durable Responses Reported With Avelumab in Chemotherapy-Refractory Metastatic Merkel Cell Carcinoma

In a phase II trial reported in The Lancet Oncology, Kaufman et al found that the anti–PD-L1 (programmed cell death ligand 1) monoclonal antibody avelumab produced durable responses in patients with stage IV Merkel cell carcinoma progressing after cytotoxic chemotherapy. Study Details In...

cns cancers
lung cancer

Little Benefit Reported With WBRT in NSCLC Patients With Brain Metastases Unsuitable for Resection or Stereotactic Radiotherapy

In a UK-based phase III noninferiority trial (QUARTZ) reported in The Lancet, Mulvenna et al found that use of whole-brain radiotherapy in addition to optimal supportive care including dexamethasone was associated with little additional benefit in non–small cell lung cancer (NSCLC) patients...

palliative care
issues in oncology

Palliative Care 2016: Usage of Oregon’s Death With Dignity Act

In 1997, Oregon enacted a voter initiative allowing terminally ill residents to self-administer physician-prescribed medication to end their lives called the Oregon Death With Dignity Act (ORDWDA). Statute requires prescriptions written for lethal medications be reported; the state also collects...

cns cancers

Is Weekly Vinblastine Active in Chemotherapy-Naive Children With Progressive Low-Grade Glioma?

In a phase II Canadian Pediatric Brain Tumor Consortium Study reported in the Journal of Clinical Oncology, Lassaletta et al found that vinblastine monotherapy was associated with response or stable disease in most children with chemotherapy-naive low-grade glioma. Vinblastine monotherapy has shown ...

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 characteristics. The...

lymphoma

Limited Access to Radioimmunotherapy in the Community Setting May Lead to Extinction of a Unique Lymphoma Treatment

I am writing to ask the ASCO community for help in addressing a policy decision by the Nuclear Regulatory Commission (NRC) that requires oncologists to take a 700-hour course (on the full range of nuclear medicines) to give one medicine to their patients: prepackaged radioimmunotherapy. It’s...

gastrointestinal cancer

Regorafenib Increases Progression-Free Survival in Advanced Gastric Cancer

The multikinase inhibitor regorafenib (Stivarga) prolonged progression-free survival vs placebo in patients with previously treated advanced gastric carcinoma, in a phase II trial reported in the Journal of Clinical Oncology by Nick Pavlakis, MBBS, PhD, of the University of Sydney, Australia, and...

issues in oncology
lymphoma
solid tumors

Media Reports of Dramatic Responses to Immunotherapy After All Else Fails May Prompt Patients to Seek It Out

Immunotherapy has received “a lot of attention, mainly because of the media coverage,” Anas Younes, MD, medical oncologist and Chief of the Lymphoma Service at Memorial Sloan Kettering Cancer Center in New York, said in an interview with The ASCO Post. “Many patients inquire, not about a specific...

skin cancer

Study Suggests Benefit of Adjuvant Radiation Therapy but Not Chemotherapy in Some Patients With Merkel Cell Carcinoma

In an analysis of National Cancer Data Base data reported in the Journal of the National Cancer Institute, Bhatia et al found that adjuvant radiotherapy was associated with a survival benefit in patients with stage I and II but not stage III Merkel cell carcinoma, with no benefit of adjuvant...

lymphoma
thyroid cancer

I’ve Survived Two Cancers

In 2012, my husband, Robert, and I were looking forward to starting the next phase of our lives and were feeling excited about the future. Although only in our 50s, we had decided to retire early from our full-time careers, move to our cabin in Hayward, Wisconsin, and find less stressful part-time ...

Oncologist’s Guilt

The best part of my day is hearing that little voice yell, “It’s ­Momma!” as my son rushes to greet me with a hug. It is humbling, and sometimes terrifying, to realize that I brought a little person into the world who is completely dependent on my husband and me for survival. Few would argue...

The Best Oncology Lesson

I was 2 months into my first-year fellowship at Georgetown Lombardi Comprehensive Cancer Center in Washington, DC, when I learned the best oncology lesson of my career. I owned a copy of DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology and had read Cancer Treatment...

American Society of Hematology Recognizes Laurence Boxer, MD, and Ralph Nachman, MD, for Outstanding Mentorship

The American Society of Hematology (ASH) will honor Laurence Boxer, MD, and Ralph Nachman, MD, with 2016 Mentor Awards at the 58th ASH Annual Meeting and Exposition in San Diego, California, for their sustained, outstanding commitment to the training and career development of early-career...

breast cancer

Nipple-Sparing Mastectomy Shown to Be Safe—and Increasingly Preferred

Prophylactic mastectomy that preserves a woman’s nipple is oncologically safe in patients with deleterious BRCA mutations, according to the largest study yet to evaluate this approach in this high-risk population. “In more than 500 risk-reducing nipple-sparing mastectomies in 348 deleterious...

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