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palliative care
pancreatic cancer
supportive care

German Trial Shows Reduced Risk of Venous Thromboembolism With Prophylactic Enoxaparin in Ambulatory Patients With Advanced Pancreatic Cancer

In the German CONKO-004 trial reported in the Journal of Clinical Oncology, Pelzer et al found that prophylactic treatment with the low-molecular-weight heparin enoxaparin reduced the risk of symptomatic venous thromboembolic events in ambulatory patients receiving first-line chemotherapy for...

palliative care
lung cancer

ASCO 2015: Experimental Immunotherapy Shows High Response Rate in Advanced Lung Cancer

An early-phase study testing the anti–PD-L1 agent MPDL3280A in combination with standard chemotherapy in the treatment of advanced non–small cell lung cancer (NSCLC) has provided promising early results, prompting multiple phase III studies in lung cancer. The findings are being...

palliative care
prostate cancer

ASCO 2015: Adding Chemotherapy to Initial Therapy Improves Survival in Patients With Advanced, Hormone-Naive Prostate Cancer

The UK-led STAMPEDE trial found that adding docetaxel chemotherapy to standard hormone therapy markedly improved survival for men with newly diagnosed advanced prostate cancer not previously treated with hormone therapy (hormone-naive). Men who received docetaxel plus standard therapy lived on...

palliative care
issues in oncology
palliative care

Surgical Interventions for Terminal Cancer Patients Remain Prevalent

The number of surgeries performed on terminally ill cancer patients has not dropped in recent years, despite more attention to the importance of less invasive care for these patients to relieve symptoms and improve quality of life. But new research from the University of California, Davis, also...

palliative care
breast cancer

AACR 2015: Dual mTOR Inhibitor-Fulvestrant Combination Feasible, With Clinical Benefit for Advanced Breast Cancer Patients

The dual mTOR inhibitor AZD2014, when combined with the hormonal therapy fulvestrant (Faslodex), was found to be safe in patients with advanced estrogen receptor–positive breast cancer, and some of them experienced clinical benefit from the drug combination, according to phase I clinical...

palliative care
skin cancer

AACR 2015: Combining Two Investigational Immunotherapy Drugs Safe, With Early Signs of Effectiveness

Combining the immunostimulatory anti-CD40 monoclonal antibody CP-870,893 with the immune checkpoint inhibitor tremelimumab was found to be safe, with clinical evidence of response in patients with advanced melanoma, according to phase I clinical trial data presented at the AACR Annual Meeting 2015, ...

palliative care
skin cancer

AACR 2015: Improved Responses With Ipilimumab-Nivolumab Combination vs Ipilimumab Alone in Advanced Melanoma

Giving the two immunotherapies ipilimumab (Yervoy) and nivolumab (Opdivo) simultaneously yielded better treatment responses than ipilimumab alone in patients with advanced melanoma who received no prior treatment, according to phase II clinical trial data presented at the AACR Annual Meeting 2015,...

palliative care
gynecologic cancers
pancreatic cancer
solid tumors

AACR 2015: Investigational CART-meso Immunotherapy Feasible for Patients With Advanced Cancers

Patients with advanced cancers who received mesothelin-directed chimeric antigen receptor–modified T cells (CART-meso), a type of investigational adoptive immunotherapy, tolerated the treatment well, and there was evidence that the infused immune cells persisted in the patients’ blood...

lung cancer
palliative care

Identifying Processes That Lead to Discontinuation of Chemotherapy for Patients With NSCLC at End of Life

According to a recent study by Perl et al published in the Journal of Oncology Practice, the administration of chemotherapy near death is recognized by patients, their families, and oncologists as “aggressive and poor-quality care.” Despite this, rates of end-of-life chemotherapy have...

supportive care
issues in oncology

No Differences in Patient-Reported Outcomes or Resource Use With Early vs Delayed Initiation of Palliative Care Intervention

In the ENABLE III study reported in the Journal of Clinical Oncology, Bakitas et al found that early vs delayed initiation of a palliative care intervention did not result in improved patient-reported outcomes or resource use. Early initiation was associated with better 1-year survival. Study...

supportive care
issues in oncology

Reduced Family Caregiver Depression With Early vs Delayed Palliative Care Intervention for Caregivers

In the ENABLE III study reported in the Journal of Clinical Oncology, Dionne-Odom et al found that early vs delayed use of a palliative care intervention for family caregivers of patients with advanced cancer reduced caregiver depression scores and caregiver stress burden. No differences in...

palliative care
breast cancer

Women With Diabetes More Likely to be Diagnosed With Advanced-Stage Breast Cancer

Diabetes is associated with more advanced stage breast cancer, according to a new study by the Institute for Clinical Evaluative Sciences (ICES) and Women's College Hospital. The findings, published by Lipscombe et al in Breast Cancer Research and Treatment, confirm a strong link between diabetes...

pancreatic cancer
supportive care
palliative care

Palliative Care Consultation Associated With Less Aggressive End-of-Life Care in Advanced Pancreas Cancer

In a study reported in the Journal of the National Cancer Institute, Jang et al found that palliative care consultation was associated with decreased use of chemotherapy near death and lower risks of ICU admission, multiple emergency department visits, and multiple hospitalizations near death in...

palliative care

Japanese Study Indicates Death at Home Is Better for Terminally Ill Cancer Patients

In a Japanese study reported in the Journal of Clinical Oncology, Kinoshita et al found that death at home vs palliative care units or hospitals was better for terminally ill cancer patients and was not associated with an increased caregiver burden. Study Details The study included two...

palliative care
supportive care

Meaning-Centered Group Psychotherapy Improves Psychological Well-Being in Patients With Advanced Cancer

In a randomized trial reported in the Journal of Clinical Oncology, Breitbart et al found that meaning-centered group psychotherapy significantly improved psychological well-being compared with supportive group psychotherapy in patients with advanced or terminal cancer. Meaning-centered group...

palliative care
supportive care
palliative care

Study Identifies Eight Signs Associated With Impending Death in Cancer Patients

Researchers at The University of Texas MD Anderson Cancer Center have identified eight highly specific physical and cognitive signs associated with imminent death in cancer patients. The findings, published by Hui et al in Cancer, could offer clinicians the ability to better communicate with...

prostate cancer
issues in oncology

Widespread Use of Docetaxel Preceded Phase III Evidence of Usefulness in Patients With Metastatic Prostate Cancer

Docetaxel was being widely used by patients with metastatic prostate cancer before phase III evidence that it was more effective than standard-of-care for patients with castration-resistant prostate cancer, according to an analysis of Medicare claims from before and after the trial results and...

supportive care
issues in oncology
issues in oncology
palliative care

End-of-Life Discussions Are Associated With Longer Survival and Higher Quality of Life

A review of advance care planning and end-of-life communication practices among physicians by the American College of Physicians has found that implementing early discussions about goals of care with seriously ill patients results in better quality of life, reduced use of life-sustaining treatments ...

supportive care
issues in oncology

Survey Finds High Rates of Burnout Among Palliative Care Physicians, With Over 50% Predicted to Leave the Field in 10 Years

Physician burnout in palliative care is higher—over 62%—than the burnout rate reported in medical oncology—45%—according to a large survey of over 1,200 hospice and palliative care clinicians. The factors contributing to professional burnout severity included younger age,...

cost of care

Many Insured Patients Alter Their Lifestyles and Medical Care to Cope With Cancer Treatment Costs

A small nationwide survey finds many insured patients are changing their lifestyle and medical care in the face of treatment-related financial burdens. In fact, more than one-third adopted medical care–altering strategies, with younger and lower-income patients being more likely to alter...

survivorship

One-Third of U.S. Cancer Survivors May Be Experiencing Financial or Work-Related Hardship

New results from a survey of nearly 1,600 cancer survivors indicate a high prevalence of financial and work-related difficulties: 27% reported at least one financial problem (eg, debt, bankruptcy), and 37% reported having to modify work plans, such as taking extended time off or delaying...

supportive care

‘Smart Technology’ System for Home Hospice Symptom Management and Care Helps Both Patients With Cancer and Family Caregivers

Early findings from a study of 319 families suggest that use of an innovative, telephone-based symptom monitoring and coaching system during home hospice care leads to significantly decreased patient symptoms in the final weeks of life. The findings will be presented at the 2014 Palliative Care in...

supportive care

Partnership Between Medical Oncologists and Palliative Care Specialists Improves Outcomes at an Inpatient Oncology Unit

First evaluation of a pioneering “co-rounding” partnership between medical oncologists and palliative care specialists at Duke University Medical Center shows improvements in both health system–related and patient-related outcomes. The first year of the new partnership—set...

supportive care
issues in oncology

Having Dependent Children Motivates Parents With Advanced Cancer to Pursue More Aggressive, Life-Extending Treatments

Findings from a pilot study of 42 parents with advanced cancer indicate that parental status is an important factor in treatment decision-making. When asked how having children influences their treatment decisions, the majority of parents (64%) responded that being a parent motivates them to pursue ...

lung cancer

SMaRT Oncology-3 Trial Reports Collaborative Care Program Reduces Major Depression in Patients With Lung Cancer

In the SMaRT Oncology-3 study reported in The Lancet Oncology, Walker et al found that an integrated collaborative treatment program for depression (‘depression care for people with cancer’) was associated with significantly reduced severity of depression compared with usual care in...

Integrated Collaborative Care Program Highly Successful in Treating Major Depression in Patients With Cancer

In a Scottish study (SMaRT Oncology-2) reported in The Lancet, Sharpe, Walker et al found that an integrated collaborative treatment program for depression (‘depression care for people with cancer’) was associated with significantly higher depression response and remission rates...

solid tumors

Second-Line Ramucirumab Plus Paclitaxel Improves Overall Survival in Patients With Advanced Gastric Cancer

The addition of the monoclonal antibody VEGFR-2 antagonist ramucirumab (Cyramza) to paclitaxel led to a statistically significant improvement in median overall survival in patients with advanced gastric cancer or gastroesophageal junction adenocarcinoma in a phase III trial, reported Wilke et al in ...

gastroesophageal cancer

ASTRO: Radiation Therapy Alone vs Chemoradiotherapy for Reducing Dysphagia in Advanced Esophageal Cancer

Radiation therapy alone is as effective in decreasing swallowing complications experienced by advanced esophageal cancer patients as radiation therapy combined with chemotherapy, thus allowing patients to forgo chemotherapy, according to research presented at the American Society for Radiation...

prostate cancer

ASCO and Cancer Care Ontario Release Clinical Practice Guideline for Systemic Therapy in Men With Metastatic Castration-Resistant Prostate Cancer

The ASCO Clinical Practice Guidelines Committee and the Cancer Care Ontario (CCO) program in evidence-based care have released a clinical practice guideline on systemic therapy in men with metastatic castration-resistant prostate cancer. The guideline is reported by Basch et al in the Journal of...

breast cancer

ASCO Issues New Guideline on Chemotherapy and Targeted Therapy in Advanced HER2-Negative or Unknown HER2 Status Breast Cancer

The American Society of Clinical Oncology has released a new clinical practice guideline on chemotherapy and targeted therapy for women with advanced HER2-negative or unknown HER2 status breast cancer. The guideline is published in the Journal of Clinical Oncology. In formulating the consensus...

Significant Variation in Use of Single-Fraction Radiation Therapy for Palliation of Bone Metastases

Standardizing prescribing practices for single-fraction radiation therapy for palliation of bone metastases could lead to cost savings and improvement in patients’ quality of life, according to a study published in the August issue of the International Journal of Radiation Oncology •...

gastroesophageal cancer

No Overall Survival Improvement but Some Palliative Benefit With Gefitinib vs Placebo in Esophageal Cancer Progressing After Chemotherapy

In what may be the first randomized trial of systemic therapy in this setting, Dutton and colleagues evaluated gefitinib (Iressa) vs placebo in patients with esophageal cancer progressing after chemotherapy. As reported in The Lancet Oncology, the COG trial showed no survival benefit with gefitinib ...

colorectal cancer

Palliative Resection of Primary Tumor May Improve Survival in Patients With Metastatic Colorectal Cancer

Palliative resection of the primary tumor was associated with a statistically significant and clinically meaningful improvement in overall survival in patients with metastatic colorectal cancer, according to the results of a study reported in the Annals of Surgical Oncology. Gresham et al noted...

issues in oncology

ASCO 2014: Stopping Statins Is Safe and Can Improve Quality of Life for Patients With Cancer Near the End of Life

Stopping statin therapy is safe for patients with cancer who have a life expectancy of less than 1 year, according to a randomized study reported at the 2014 ASCO Annual Meeting in Chicago (Abstract LBA9514). Discontinuing statins did not shorten survival and provided a number of important...

breast cancer
survivorship

ASCO 2014: Goserelin Helps Preserve Fertility Among Women Receiving Chemotherapy for Hormone Receptor–Negative Breast Cancer

Adding goserelin (Zoladex) to standard chemotherapy may be an effective method of preserving fertility among women with early-stage hormone receptor–negative breast cancer, according to findings from a federally funded phase III clinical trial. In the S0230/POEMS study, reported at the 2014...

supportive care
issues in oncology

ASCO 2014: Starting Palliative Care Support for Family Caregivers at the Time of Cancer Diagnosis Improves Quality of Life

Introducing a palliative care support program for caregivers of patients with advanced cancer at or near the time patients are diagnosed provides greater benefits than delayed palliative care services, according to results of the ENABLE III study reported at the 2014 ASCO Annual Meeting in Chicago...

breast cancer
issues in oncology

ASCO 2014: Women With Breast Cancer and Bone Metastasis Can Safely Scale Back Frequency of Zoledronic Acid Dosing

Findings from a phase III randomized study suggest that women with breast cancer and bone metastasis who have received at least nine doses of zoledronic acid over the previous year can safely scale back dosing from every 4 weeks to every 12 weeks without compromising the effectiveness of the...

head and neck cancer

Physicians and Patients/Caregivers Frequently Disagree on Medicare Resource Allocations for Patients With Advanced Head and Neck Cancer

In a study reported in JAMA Otolaryngology–Head & Neck Surgery, Rocke et al compared hypothetical resource allocation by otolaryngology–head and neck surgery physicians and patients with that by advanced cancer patients or their caregivers. They found significant differences in...

The Cancer Community Mourns the Passing of Selma Schimmel

The cancer community is mourning the death of Selma Schimmel who passed away on May 21, 2014, from malignant psoas syndrome, a complication of ovarian cancer. Ms. Schimmel died at Providence Tarzana Medical Center near her home in Los Angeles, California. She was 59. A tireless and fierce advocate ...

breast cancer

ASCO Releases Companion Guideline on Disease Management for Patients With Advanced HER2-Positive Breast Cancer and Brain Metastases

As many as half of patients with metastatic HER2-positive breast cancer develop brain metastases over time. The American Society of Clinical Oncology recently released a clinical practice guideline on disease management for patients with advanced HER2-positive breast cancer and brain metastases. A...

gynecologic cancers

Findings of AURELIA Trial Support Consideration of Bevacizumab/Chemotherapy in Carefully Selected Patients With Platinum-Resistant Ovarian Cancer

The recently reported open-label phase III AURELIA trial showed that the addition of bevacizumab (Avastin) to chemotherapy resulted in significant improvements in progression-free survival, the primary study endpoint, and objective response rate in women with recurrent platinum-resistant ovarian...

lung cancer
supportive care

Experts Call for More Awareness of Sexual Dysfunction in Lung Cancer Patients

Many lung cancer patients suffer difficulties with sexual expression and intimacy, yet for too long the topic has been ignored by doctors and researchers, experts said at the 4th European Lung Cancer Conference (ELCC) in Geneva, Switzerland. Researchers have estimated that sexual dysfunction...

issues in oncology

Children With Cancer, Parents, and Providers Value Patient-Reported Outcomes Feedback

In a pilot trial (PediQUEST) reported in the Journal of Clinical Oncology, Wolfe et al assessed the effects of use of the PediQUEST electronic patient-reported feedback survey on health-related quality of life in children with advanced cancer. Although few significant improvements were observed,...

supportive care
issues in oncology

Study Finds More Hospital Deaths and Invasive Care for Terminal Cancer Patients Receiving Palliative Chemotherapy

Patients with terminal cancer who receive chemotherapy during the last months of their lives are less likely to die where they want and more likely to endure invasive medical procedures than those who do not receive chemotherapy, according to a study by Wright et al published in BMJ. The findings...

supportive care

Early Palliative Care Benefits Patients With Advanced Cancer

In a study published in The Lancet, Zimmermann et al compared quality of life, symptom severity, and care satisfaction with early initiation of palliative care vs standard cancer care in patients with advanced cancer. Although early palliative care was not associated with improved quality of life...

lymphoma

Standard 24 Gy More Effective Than 4 Gy in Radiotherapy for Indolent Lymphoma

Follicular lymphoma has been found to respond to radiotherapy doses as low as 4 Gy. In the phase III FORT trial reported in The Lancet Oncology, Hoskin et al compared radiotherapy with 4 Gy in two fractions vs 24 Gy in 12 fractions in patients with indolent lymphoma, finding that the 24-Gy regimen...

solid tumors

One-Fifth of Hospitalizations for Patients With Gastrointestinal Cancer Considered Avoidable

In a study reported in the Journal of Clinical Oncology, Brooks et al found that oncology clinicians considered 19% of hospitalizations for patients with gastrointestinal cancers to be avoidable. Study Details In the study, 201 sequential hospital admissions in 154 patients with gastrointestinal...

supportive care

Single Fractions of Radiation for Painful Bone Metastases May Be Noninferior to Multiple Fractions

Optimal dose fractionation for radiation therapy of painful bone metastases from multiple primary sites remains undefined. In a phase III noninferiority trial reported in The Lancet Oncology, Chow et al compared 8 Gy in a single fraction vs 20 Gy in multiple fractions in patients with painful bone...

issues in oncology

Over-Regulation of Opioids Is Resulting in Untreated Cancer Pain for Millions of Patients Worldwide

The results from the European Society for Medical Oncology (ESMO)-led Global Opioid Policy Initiative (GOPI) project show that due to a lack of access to essential opioids, more than 4 billion people—over half the world’s population—live in countries where regulatory barriers,...

supportive care
issues in oncology

Palliative Care Services and Outcomes Improve Using a Standardized Approach

Standardized criteria for initiating palliative care consultations can substantially improve the care of patients with advanced solid tumors, according to research from Mount Sinai School of Medicine, New York, led by Kerin Adelson, MD, Coordinator for Ambulatory Oncology Quality for the Tisch...

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