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Anthony L. Back, MD, on Physician Burnout: The Response That’s Needed
Anthony L. Back, MD, of the University of Washington, talks about how clinicians can protect themselves from burnout and develop resilience. The default approach––“pretending we are not affected by stress”––often backfires, he says, and makes caregivers more susceptible to workplace pressures.
AACR-NCI-EORTC: Rising Number of Seamless Clinical Trials in Oncology
The number of early-phase trials in oncology that adopted a seamless approach—as opposed to a traditional trial approach with defined phase I, II, and III plans—is rising, with data from the majority of them presented after 2014, according to a study presented by Barata et al at the...
AACR-NCI-EORTC: NCI-MATCH Reaches Central Patient-Screening Goal
The National Cancer Institute (NCI) Molecular Analysis for Therapy Choice (MATCH) clinical trial has achieved the goal of screening nearly 6,000 patients in just under 2 years, according to data presented by Chen et al at the AACR-NCI-EORTC International Conference on Molecular Targets and Cancer...
AACR-NCI-EORTC: Noninvasive Computational Imaging Approach May Help Predict Response to Immunotherapy
A computational imaging-based signature of immune-cell infiltration in and around a tumor could predict patients’ responses to treatment with anti–programmed cell death protein 1/programmed death-ligand 1 (PD-1/PD-L1) immunotherapies, according to data from a study presented by Sun et...
AACR-NCI-EORTC: Colorectal Cancer Test Could Detect Early Cancer-Causing Genetic Biomarkers With High Degree of Sensitivity
An investigational test that screens for colorectal cancer could detect genetic mutations that are indicative of the disease with a high degree of sensitivity and specificity, according to results of a study presented by Powell et al at the AACR-NCI-EORTC International Conference on Molecular...
FDA Approves Axicabtagene Ciloleucel for Large B-Cell Lymphoma
On October 18, 2017, the U.S. Food and Drug Administration (FDA) granted regular approval to axicabtagene ciloleucel (Yescarta) for the treatment of adult patients with relapsed or refractory large B-cell lymphoma after two or more lines of systemic therapy, including diffuse large B-cell lymphoma...
Gary Gilliland, MD, PhD, Testifies Before Congress on NIH Funding System
Gary Gilliland, MD, PhD, President and Director of Fred Hutchinson Cancer Research Center, recently delivered the following testimony and answered questions from members of the House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies. His remarks...
AACR-NCI-EORTC: Tazemetostat as Treatment for Certain Pediatric Relapsed or Refractory Solid Tumors
Children with relapsed or refractory malignant rhabdoid tumors, epithelioid sarcomas, or poorly differentiated chordomas with a particular genetic defect tolerated treatment with the investigational drug tazemetostat well, and some had objective and durable responses, according to data from a phase ...
AACR-NCI-EORTC: Colorectal Cancers May Mutate to Escape Immune System Detection
Whole-exome sequencing revealed that colorectal cancers with high mutational load (microsatellite instability–high, or MSI-H) predominantly use “immunoediting” to escape immune surveillance, while colorectal cancers with low mutational load (microsatellite stable, or MSS) use...
AACR-NCI-EORTC: Gene Therapy Shows Early Efficacy Against Recurrent Brain Cancer
More than a quarter of patients with recurrent high-grade glioma treated with the retroviral vector Toca 511 (vocimagene amiretrorepvec) combined with Toca FC (an extended-release formulation of fluorocytosine, a prodrug of fluorouracil [5-FU]) were alive more than 3 years after...
Potential Risk Activities and Breast Cancer–Related Lymphedema in Patients Undergoing Bilateral Surgery
In a study reported in the Journal of Clinical Oncology, Asdourian et al found that several factors considered to pose an increased risk of lymphedema were not significantly associated with the occurrence of lymphedema among women undergoing bilateral breast cancer surgery. Study Details In the...
FDA Approves Intravenous Rolapitant for Delayed Chemotherapy-Induced Nausea and Vomiting
On October 25, the U.S. Food and Drug Administration (FDA) approved intravenous (IV) rolapitant (Varubi) in combination with other antiemetic agents in adults for the prevention of delayed nausea and vomiting associated with initial and repeat courses of emetogenic cancer chemotherapy, including,...
Potential Treatment of Chordoma With PI3K Inhibitors
Patients with chordoma—a rare bone cancer of the skull and spine—could be helped by existing treatments, suggest scientists from the Wellcome Trust Sanger Institute, University College London Cancer Institute, and the Royal National Orthopaedic Hospital NHS Trust. In the largest...
Anti–T-Lymphocyte Globulin and Chronic GVHD-Free Survival in Unrelated Myeloablative HCT
A double-blind phase III trial has shown no benefit of anti–T-lymphocyte globulin (ATLG) vs placebo on chronic graft-vs-host disease (GVHD)-free survival in patients undergoing human leukocyte antigen (HLA)-matched unrelated myeloablative hematopoietic cell transplantation (HCT). The study...
2017 ASCO Palliative Care: Yoga Can Be an Effective Supportive Therapy for People With Lung Cancer and Their Caregivers
In a feasibility trial of people with advanced lung cancer receiving radiation therapy and their caregivers, yoga was beneficial to both parties. These findings will be presented by Milbury et al at the upcoming 2017 Palliative and Supportive Care in Oncology Symposium in San Diego (Abstract 125). ...
2017 ASCO Palliative Care: People With Leukemia and Their Oncologists Have Vastly Different Perceptions of Prognosis
A study of 100 people with acute myeloid leukemia (AML) receiving chemotherapy found that patient and physician perceptions of treatment risk and the likelihood of a cure varied widely. Overall, patients tended to overestimate both the risk of dying due to treatment and the likelihood of a cure....
MAF Amplification and Outcomes With Adjuvant Zoledronic Acid in Early Breast Cancer
An analysis from the phase III AZURE trial has shown that MAF-negative status was associated with a benefit and MAF-positive status, with a detriment of adjuvant zoledronic acid in early breast cancer. The analysis was reported by Coleman et al in The Lancet Oncology. Study Details The current...
BE PREPARED TO ENCOURAGE HPV VACCINATION
“Human papillomavirus (HPV) vaccination coverage lags behind coverage for the other vaccines recommended for preteens,” according to the Centers for Disease Control and Prevention (CDC).1 A recent report about vaccination coverage in the United States among adolescents aged 13 to 17 found that...
2017 ASCO Palliative Care: Patients With Advanced Cancer Prefer Oncologists Not Use Computers in the Exam Room
Although the use of electronic health records in oncology care has led to improved care for patients, results from a new study show that oncologists need to be cautious about using computers during exam room visits, especially for patients with advanced cancer. The randomized study compared...
Documentary Film Takes a Walk on the Wild Side With Oncology Pioneers
Oncology luminaries. Thought leaders. The soul of chemotherapy. These are just a few of the phrases used to describe Emil Frei, MD, FASCO, Emil J Freireich, MD, FASCO, James F. Holland, MD, FASCO, Georges Mathé, MD, and their historic contributions to the world of oncology. Inspired by these...
FDA Accepts sBLA for Durvalumab in Locally Advanced Unresectable NSCLC
On October 17, the U.S. Food and Drug Administration (FDA) has accepted a supplemental Biologics License Application (sBLA) for durvalumab (Imfinzi) for the treatment of patients with locally advanced (stage III) unresectable non–small cell lung cancer (NSCLC) whose disease has not progressed ...
FDA Awards Grants for Clinical Trials to Stimulate Product Development for Rare Diseases
THE U.S. FOOD and Drug Administration (FDA) has awarded numerous new clinical trial research grants, totaling more than $22 million over the next 4 years, to boost the development of products for patients with rare diseases. These new grants were awarded to principal investigators from academia and ...
Carfilzomib May Be a Strong Candidate for Salvage Therapy in Relapsed/Refractory Multiple Myeloma—but Questions Remain
WITH THE INCLUSION of proteasome inhibitors and immunomodulatory agents first into salvage and then as components of first-line, consolidation, and maintenance regimens, response rates, depth of response, and median progression-free and overall survival have all improved for patients suffering...
Carfilzomib Improves Overall Survival vs Bortezomib in Relapsed/Refractory Multiple Myeloma
AT A PRESPECIFIED interim analysis, the phase III ENDEAVOR trial has shown a significant overall survival benefit for carfilzomib (Kyprolis) vs bortezomib (Velcade) in patients with relapsed/refractory multiple myeloma, as reported by Meletios A. Dimopoulos, MD, of the National and Kapodistrian...
Regional Radiation Therapy Reduces Risk of Regional Recurrence in Node-Positive Cutaneous Melanoma
IN A LARGE single-institution study reported in the Journal of the National Comprehensive Cancer Network, Tobin Strom, MD, and colleagues found that regional radiotherapy was associated with a reduced risk of regional recurrence in patients with node-positive cutaneous melanoma, including those...
No Progression-Free Survival Benefit With First-Line Nivolumab vs Chemotherapy in Advanced PD-L1–Positive NSCLC
AS REPORTED BY David P. Carbone, MD, PhD, of The Ohio State University Comprehensive Cancer Center, Columbus, and colleagues in The New England Journal of Medicine, the phase III CheckMate 026 trial has shown no progression-free survival benefit for first-line nivolumab (Opdivo) vs platinum-based...
For HPV Vaccine to Have Optimal Impact, ‘Provider Hesitancy’ Must Be Overcome
Honoring National Cancer Institute researchers Douglas R. Lowy, MD, and John T. Schiller, PhD, with the Lasker-DeBakey Clinical Medical Research Award for advances in technology that enabled the development of human papillomavirus (HPV) vaccines to prevent cervical cancer and other tumors caused by ...
Phase III Trial Shows No Survival Benefit to Adding First-Line Ipilimumab to Chemotherapy in Advanced Squamous NSCLC
IN A PHASE III trial reported by Ramaswamy Govindan, MD, of Washington University School of Medicine, and colleagues in the Journal of Clinical Oncology, the addition of first-line ipilimumab (Yervoy) to paclitaxel/carboplatin did not improve overall survival in patients with advanced squamous...
ASCO Clinical Practice Guideline Update on Antiemetics in Patients With Cancer
AS REPORTED BY Paul J. Hesketh, MD, of Lahey Hospital and Medical Center, Burlington, Massachusetts, and colleagues in the Journal of Clinical Oncology, ASCO has updated its clinical practice guideline on the use of antiemetics in patients with cancer.1 The update was based on an expert panel...
Nivolumab/Ipilimumab in Patients With Advanced Melanoma Who Did or Did Not Discontinue Induction Treatment due to Adverse Events
IN A RETROSPECTIVE pooled analysis of the CheckMate 069 and 067 studies reported in the Journal of Clinical Oncology, Dirk Schadendorf, MD, of the University Hospital Essen and the German Cancer Consortium, and colleagues found little difference in the efficacy of combined nivolumab (Opdivo) and...
Tremelimumab in Previously Treated Advanced Malignant Mesothelioma
In the randomized phase IIB DETERMINE trial, the cytotoxic T-lymphocyte–associated protein 4 (CTLA-4) inhibitor tremelimumab did not improve overall survival vs placebo as second- or third-line treatment of relapsed malignant mesothelioma. These findings were reported in The Lancet Oncology by...
Nivolumab Treatment Beyond Disease Progression in Advanced Melanoma
In a retrospective analysis reported in JAMA Oncology, Georgina V. Long, MBBS, PhD, of the Melanoma Institute Australia, North Sydney, and colleagues found that a substantial proportion of patients with advanced melanoma derived benefit from continued nivolumab (Opdivo) treatment after Response...
FDA Conducts Global Operation to Protect Consumers From Potentially Dangerous Prescription Drugs Sold Online
THE U.S. FOOD AND DRUG ADMINISTRATION (FDA), in partnership with international regulatory and law enforcement agencies, recently took action against more than 500 websites that illegally sell potentially dangerous, unapproved versions of prescription medicines, including opioids, antibiotics, and...
Expert Point of View: Markus Joerger, MD, PhD, and Domenica Lorusso, MD, PhD
PRESS CONFERENCE MODERATOR Markus Joerger, MD, PhD, of St. Gallen Cancer Center, Switzerland, indicated that prior to the current study, it was unclear whether chemotherapy followed by surgery would be superior to chemoradiotherapy. “I think we all agree that it has been confirmed as the standard...
Breast Cancer Has Changed Me, But the Change Has Been Positive
I’ve always had dense breasts and avoided doing breast self-exams because I couldn’t tell if the lumpiness I was feeling was something serious or merely normal fibrous tissue. Instead I relied on my yearly mammogram to spot any early signs of cancer. Four years ago, I was once again relieved to...
Standard of Care Upheld for Locally Advanced Cervical Cancer
THE FIRST FORMAL comparison of two acceptable approaches to locally advanced cervical cancer has concluded that standard chemoradiotherapy is preferable to neoadjuvant chemotherapy plus surgery. The findings confirm what most specialists have believed to be the optimal treatment. The results came ...
Stalked by BRCA1: A Women Struggles to Survive the Same Disease That Killed Her Mother
No matter what a person does in life, for good and bad, his or her inherited genetic makeup follows along the way. Such was the case with British journalist Sarah Gabriel, who inherited the BRCA1 mutation from her mother, who died of ovarian cancer when Ms. Gabriel was in college. Much of her...
Expert Point of View: Alexander Eggermont, MD, PhD
BASED ON THE RESULTS of COMBI-AD1 and CheckMate 238,2 invited discussant Alexander Eggermont, MD, PhD, Professor of Oncology at Gustave Roussy in Paris, commented: “It’s a good day for melanoma!” In COMBI-AD, treatment with the combination of dabrafenib (Tafinlar) and trametinib (Mekinist)...
CheckMate 238: Nivolumab Shows Benefit as Adjuvant Melanoma Treatment
IN THE TREATMENT of malignant melanoma, immune checkpoint inhibitors are no longer just for metastatic disease, and the best type may be agents targeting the programmed cell death protein 1 (PD-1), according to results of CheckMate 238, presented at the European Society for Medical Oncology (ESMO)...
Adjuvant BRAF/MEK Inhibition Improves Survival in Resectable Melanoma
FOR PATIENTS with locally advanced, resectable melanoma harboring BRAF mutations, adjuvant treatment with BRAF/ MEK inhibition significantly improves overall survival, results of the COMBI-AD trial have shown. The study was presented at the European Society for Medical Oncology (ESMO) 2017...
Alectinib Yields Favorable Results in Phase III Trials of ALK-Positive NSCLC
RESULTS OF TWO separate phase III trials confirm the activity of alectinib (Alecensa) in the central nervous system (CNS) in patients with anaplastic lymphoma kinase (ALK)-positive non–small cell lung cancer (NSCLC). Results lend support for alectinib as the better first-line treatment option over...
Expert Point of View: Stéphane Oudard, MD
DURING A DISCUSSION of Dr. Vale’s poster, Stéphane Oudard, MD, Professor of Oncology and Chief of the Oncology Clinical and Translational Research Unit at Georges Pompidou Hospital in Paris, France, said that although newer treatments have improved survival, there are still many challenges in...
Abiraterone or Docetaxel: Which Is Optimal for Hormone-Sensitive High-Risk Prostate Cancer?
ABIRATERONE ACETATE (Zytiga) plus prednisone and docetaxel have moved up from the castrate-resistant metastatic setting to earlier in the course of disease as treatment of high-risk hormone-sensitive prostate cancer in men who are initiating androgen-deprivation therapy, based on level 1 evidence...
Expert Point of View: Yohann Loriot, MD, PhD
FORMAL DISCUSSANT of the RANGE trial at the ESMO 2017 Congress, Yohann Loriot, MD, PhD, of the Institut Gustave Roussy and University of Paris-Saclay, Villejuif, Paris, said that although the study met its primary endpoint, he was not sure the absolute improvement in progression-free survival is...
Positive Early Data on Second-Line Ramucirumab/Docetaxel in Platinum-Refractory Advanced Urothelial Cancer
RAMUCIRUMAB (CYRAMZA) added to docetaxel improved progression-free survival and almost doubled the overall response rate compared with docetaxel alone in patients with advanced or metastatic urothelial cancer that has progressed on platinum-based chemotherapy. These results of the phase III RANGE...
Immunotherapy Plus Radiation Appears Active in Patients With Solid Tumors and Lung or Liver Metastases
THE NOVEL COMBINATION of immunotherapy with ipilimumab (Yervoy) plus radiation achieved a clinical benefit in up to 57% of patients with solid tumors and metastases to the lungs or liver, according to evidence from a phase II trial presented at the 2017 Annual Meeting of the American Society for...
Consolidative Radiation Therapy: New Paradigm for Limited Metastatic NSCLC?
ADDING CONSOLIDATIVE RADIATION therapy to maintenance chemotherapy had a robust effect on preventing disease progression compared with maintenance chemotherapy alone in patients with limited metastatic non–small cell lung cancer (NSCLC), according to a late-breaking study presented at the 2017...
Could the Rising Rates of Colorectal Cancer in AYAs Be Linked to HPV Infection?
TWO STUDIES published this year examining the incidence of colorectal cancer in adolescents and young adults (AYAs) show an undeniable and sobering trend: Colorectal cancer rates are increasing in this age group, and younger people are dying of the cancer at slightly higher rates than in previous...
Smashing the Glass Ceiling in Medicine
IT IS A SAD TRUTH that academic medicine, like many other professions, has a glass ceiling that hampers its ambitions. In medicine, this glass ceiling blocks women and minority faculty from reaching the highest ranks of leadership. Even if the root cause is not yet known, we want to eliminate...
Expert Point of View: Maria De Santis, MD
THE 2017 EUROPEAN SOCIETY for Medical Oncology (ESMO) Congress spokesperson Maria De Santis, MD, of the University of Warwick, Coventry, and Queen Elizabeth Hospital, Cancer Center, in Birmingham, UK, said the survival advantage in KEYNOTE-045 updated results was noteworthy. “These results...
