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palliative care

How Effective Communication Can Improve Patient Care—and Reduce Physician Burnout

Surveys conducted between 1950 and 1970 show that most physicians considered it inhumane to give patients with a poor cancer prognosis the bad news.1,2 Since then, it has been well established that open communication between physician and patient is an essential part of effective cancer care and...

lung cancer

The Evolving Treatment Landscape of ALK-Positive NSCLC

Since the initial discovery of ALK rearrangement in non–small cell lung cancer (NSCLC) in 2007,1 small molecule tyrosine kinase inhibitors of ALK have transformed the course of disease for those patients with ALK-rearranged (ie, ALK-positive) NSCLC. Crizotinib (Xalkori), a multitargeted tyrosine...

lung cancer

Global and North American Phase II Studies Show Alectinib Is Highly Active in Crizotinib-Resistant/Refractory ALK-Rearranged NSCLC

In two phase II trials, reported in the Journal of Clinical Oncology and The Lancet Oncology, the ALK inhibitor alectinib (Alecensa), which is active against acquired crizotinib resistance mutations and exhibits high central nervous system (CNS) penetration, was associated with considerable...

issues in oncology
hematologic malignancies

Blood Test Can Predict High-Risk Cancers in Patients Treated With CAR-T

Dramatic advances have been made in using genetically engineered chimeric antigen receptor–modified T cells (CAR-T) with anti-CD19 specificity to treat highly refractory hematologic malignancies. The highest complete remission rates have been achieved in patients with relapsed or refractory acute...

multiple myeloma
palliative care

Study Confirms Benefit of Triplet vs Doublet in Newly Diagnosed Multiple Myeloma

Triplets should be the standard of care in most newly diagnosed multiple myeloma patients, according to a study that validated a practice that has become common in the United States, though not necessarily elsewhere. The use of three drugs led to significant reductions in disease progression and...

colorectal cancer

I Am Not Afraid of Cancer

At age 73, I’m no shrinking violet and I don’t run to the doctor at the first sign of a problem. I practice naturopathy and can usually ward off potential health issues by maintaining a healthy diet and lifestyle. When I began experiencing some mild discomfort in my rectum 2½ years ago, I was...

issues in oncology
supportive care
geriatric oncology

Deconditioning in Older Adults With Cancer: A Cascade to Dependency

It is estimated that nearly half of adults over age 80 living in the community are frail despite apparent functional well-being.1 Frailty is recognized as a clinical syndrome in which three or more of the following criteria are present: unintentional weight loss, self-reported exhaustion, weakness, ...

breast cancer

Exploratory Analysis of ExteNET Trial Shows Consistency of Benefit With Neratinib

An exploratory analysis of the ­ExteNET study of neratinib in early HER2-positive breast cancer after treatment with trastuzumab (Herceptin) upheld the findings previously reported for the 2-year analysis, according to the study’s principal investigator Arlene Chan, MD, of the Breast Cancer...

Expert Point of View: George Sledge, MD

George Sledge, MD, Professor, and Chief, Division of Oncology, Stanford University Medical Center, told The ASCO Post that he found the data from the pooled analysis “very exciting.” “One of the big questions in triple-negative breast cancer is how to select which drugs work best for which...

breast cancer

Homologous Recombination Deficiency Score Correlated With Response to Platinum in Breast Cancer

The homologous recombination deficiency (HRD) score may be a predictive biomarker of response to neoadjuvant platinum-based therapy in patients with triple-negative breast cancer, according to studies presented at the 2015 San Antonio Breast Cancer Symposium. “We found, in our adjusted analysis,...

pancreatic cancer

Pancreas Cancer Liquid Biopsy: Proof-of-Principle Study

Pancreatic cancer tumors are ripe for analysis with a liquid biopsy, according to researchers at The University of Texas MD Anderson Cancer Center. In a proof-of-principle study published recently in Annals of Oncology,1 the investigators reported on research in which they conducted whole-genome,...

supportive care

Uridine Triacetate Granules for Fluorouracil or Capecitabine Overdose or Early Severe Toxicity

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On December 11, 2015, uridine triacetate (Vistogard) was approved...

breast cancer

Role of Carboplatin in Triple-Negative Breast Cancer Still Unclear

Studies presented at the 2015 San Antonio Breast Cancer Symposium built upon an increasing body of data in support of the neoadjuvant use of carboplatin in patients with triple-negative breast cancer. Overall, however, the studies fell short of establishing carboplatin’s role in this malignancy and ...

breast cancer

Immunotherapy for Breast Cancer: Early Lackluster Study Results yet Promise Remains

Immunotherapy is at the forefront of exciting new approaches to cancer, with excellent and long-lasting responses in metastatic melanoma and non–small cell lung cancer (NSCLC) and several immunotherapy agents now approved for those malignancies by the U.S. Food and Drug Administration (FDA). The...

Expert Point of View: Lisa Carey, MD

For the most part, the cardiotoxicity with trastuzumab appears to be largely reversible, unlike anthracyclines, which cause permanent cardiac damage,” said Lisa Carey, MD, Distinguished Professor at the UNC Lineberger Breast Center, Chapel Hill, North Carolina. “In this small study, they saw no...

breast cancer

Prophylactic Beta-Blocker Preserves Left-Ventricular Function in Patients Receiving Trastuzumab

The beta-blocker bisoprolol was able to prevent trastuzumab (Herceptin)-associated declines in left-ventricular ejection fraction, whereas the effect of the angiotensin-converting–enzyme (ACE) inhibitor perindopril was less robust. Use of bisoprolol reduced dose interruptions for trastuzumab due to ...

breast cancer

Surgical Margin Width Not Related to Breast Cancer Recurrence

The width of the surgical margin doesn’t matter, as long as the margin is negative, according to a large study of breast-conserving surgery in patients with invasive breast cancer. The risk of ipsilateral breast tumor recurrence was similar for wide negative margins (2–4 mm) or narrow negative...

breast cancer
issues in oncology

PI3K Inhibitor Buparlisib Extends Progression-Free Survival  in Advanced Breast Cancer

Addition of the oral investigational pan-PI3K inhibitor buparlisib to the endocrine agent fulvestrant (Faslodex) improved progression-free survival among postmenopausal women with advanced hormone receptor–positive/HER2-negative advanced breast cancer. “We are happy to announce that the phase III...

colorectal cancer

Study Finds Colorectal Cancer More Likely to Affect Minorities at Younger Age

Researchers at the University of Missouri School of Medicine reported that minority and ethnic groups are being diagnosed with colorectal cancer at younger ages and more advanced stages than non-Hispanic whites. The study was recently published in Cancer Medicine.1 “While we know the risk of...

myelodysplastic syndromes
leukemia
hematologic malignancies

Myeloablative Conditioning for Stem Cell Transplantation Remains Standard of Care in Patients With MDS and AML

A randomized trial from the Bone and Marrow Transplant Clinical Trials Network was halted early after concluding that allogeneic stem cell transplantation after a reduced-intensity conditioning regimen resulted in higher relapse rates compared to myeloablative conditioning. The phase III randomized ...

leukemia

Self-Reports Overestimate Mercaptopurine Intake in Childhood Acute Lymphoblastic Leukemia

Mercaptopurine is critical for maintaining remission in childhood acute lymphoblastic leukemia (ALL). However, a study has shown that overreporting of intake is common, and self-reports of intake are not as reliable as electronic reporting.1 About 86% of parents and children overreported the number ...

hematologic malignancies

New Use for CAR-T Cells Post Transplantation

The approach of using genetically engineered chimeric antigen receptor (CAR)-T cells has received much attention for treating leukemias, where it has achieved spectacular long-lasting complete remissions in some patients with no other treatment options. CAR-T cells are also being studied in...

leukemia

Venetoclax May Prove to Be Strong Weapon Against Poor-Prognosis Chronic Lymphocytic Leukemia

Venetoclax, the latest entry into the field of treatment of chronic lymphocytic leukemia (CLL), is a powerful investigational therapy that promises to fill an important niche: treatment of high-risk relapsed/refractory patients with deletions of 17p. Nearly 80% of patients with relapsed/refractory...

leukemia

Severe Toxicities Seen in Younger Patients Receiving  Front-Line Idelalisib for Chronic Lymphocytic Leukemia

Hematologists and patients with chronic lymphocytic leukemia (CLL) are excited about new drugs that have dramatically improved outcomes. But all drugs have side effects, and it is important to be aware of potential consequences. Hepatotoxicity turns out to be a major concern in younger CLL patients ...

Expert Point of View: Susan O’Brien, MD

Clearly idelalisib improved overall survival when added to bendamustine (Bendetta/Treanda)/rituximab (Rituxan). These results are similar to those from the HELIOS trial reported at last year’s ASCO meeting,” said Susan O’Brien, MD, Associate Director for Clinical Science for the Chao Family...

leukemia
issues in oncology

Idelalisib Improves Progression-Free Survival Over Bendamustine Plus Rituximab in Chronic Lymphocytic Leukemia

Idelalisib (Zydelig) combined with bendamustine (Bendeka, Treanda) plus rituximab (Rituxan) was superior to chemotherapy with bendamustine/rituximab plus placebo, reducing the risk of progressive disease and death while improving progression-free survival and overall survival in patients with...

Expert Point of View: Robert Hromas, MD, and Timothy A. Graubert, MD

Robert Hromas, MD, of the University of Florida College of Medicine, Gainesville, who moderated a press briefing, commented that the finding of benefit with rituximab “resolves a long-standing controversy” with this cancer. “These results are exciting for those of us who treat leukemia,” he...

leukemia

Rituximab Adds Benefit to Chemotherapy in Adult B-Cell Precursor ALL

The addition of rituximab (Rituxan) to the pediatric-inspired chemotherapy protocol for B-cell precursor acute lymphoblastic leukemia (ALL) significantly improved event-free survival in a large European study presented at the 2015 ASH Annual Meeting.1 The GRAALL-R 2005 phase III study is the first...

lung cancer

ALK Rearrangements Common in Young Patients With Lung Cancer

Two investigative groups have reported interesting observations about genomic alterations in the tumors of young patients with lung cancer. Notably, ALK rearrangement was the most common driver mutation found, in studies reported at the 16th World Conference on Lung Cancer.1,2 “To our knowledge,...

prostate cancer

Even After Antiandrogen Therapy, Docetaxel Remains Useful in Prostate Cancer

A study presented at the 2016 Genitourinary Cancers Symposium showed that 40% of patients with metastatic castration-resistant prostate cancer treated with docetaxel following abiraterone (Zytiga) had at least a 50% reduction in prostate-specific antigen (PSA), demonstrating the activity of this...

issues in oncology

Patient-Centric Care: Translating Research to Results

The 2016 Genitourinary Cancers Symposium was held earlier this month in San Francisco. Abstracts and presentations included data and discussion on the latest strategies in the prevention, screening, diagnosis, and treatment of prostate, kidney, testicular, and urothelial cancers. Snapshots of data...

multiple myeloma

Elotuzumab in Previously Treated Multiple Myeloma

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs.   On November 30, 2015, elotuzu­mab (Empliciti) was approved for...

breast cancer

Ado-Trastuzumab Emtansine Improved Overall Survival for Heavily Pretreated Patients With HER2-Positive Breast Cancer

Among patients with HER2-positive, metastatic breast cancer that had progressed despite treatment with two or more forms of HER2-targeted therapy (trastuzumab [Herceptin] and lapatinib [Tykerb]), median overall survival was increased for those treated with ado-trastuzumab emtansine (aka T-DM1...

breast cancer

Plasma-Based Test Identifies Impactful Mutations in BOLERO-2 Population

A plasma-based cell-free DNA test identified mutations in the estrogen receptor 1 gene (ESR1) in 30% of patients from the BOLERO-2 trial of everolimus (Afinitor) plus exemestane, and these mutations were correlated with survival. The results, which support the use of plasma as a source of...

breast cancer

Study Suggests Luminal A Breast Cancer Patients May Not Need Chemotherapy

The ability to classify breast cancer according to biologic subtype has enabled researchers to dig deeper and determine which therapies benefit specific subgroups. Encouraging evidence from an analysis of a Danish trial presented at the 2015 San Antonio Breast Cancer Symposium suggests that...

hematologic malignancies
lymphoma

Could CAR-T Therapy Be Moving Into Lymphoma?

The use of T cells that are genetically engineered to express chimeric antigen receptor (CAR-T) has made headway as an approach to hematologic malignancies, with the best results achieved in leukemia. At the 2015 American Society of Hematology (ASH) Annual Meeting and Exposition, a preliminary...

multiple myeloma

Multiple Myeloma in 2015: A Year for the Record Books

Few malignancies have received as much attention, in the way of newly approved drugs, as multiple myeloma did in 2015. In November alone, 3 new agents were approved, bringing the total to 4 for the year as part of a record 7 approvals and to 16 regulatory approvals over the past 12 years. Speakers...

lung cancer

Study Finds Alectinib Highly Active in ALK-Positive, Crizotinib-Resistant NSCLC

In a North American phase II trial reported in The Lancet Oncology, Shaw et al found that alectinib (Alecensa), which is active against acquired crizotinib (Xalkori) resistance mutations and exhibits high central nervous system (CNS) penetration, was associated with considerable activity in...

hematologic malignancies
lymphoma

Swedish Study Indicates No Pregnancy-Related Increase in Risk of Relapse in Hodgkin Lymphoma

In a Swedish study reported in the Journal of Clinical Oncology, Weibull et al found that pregnancy did not appear to increase the risk of subsequent relapse in women with Hodgkin lymphoma in remission. Study Details The study included data from Swedish health-care registers and medical records...

lymphoma
survivorship
issues in oncology

Study Shows Inferior Outcomes for African American Pediatric Lymphoma Patients

Researchers from Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine have published a study showing that African American pediatric patients with Hodgkin lymphoma have inferior overall survival compared with their white and Hispanic peers. The study, published ...

sarcoma

FDA Approves Eribulin Mesylate in Unresectable or Metastatic Liposarcoma

The U.S. Food and Drug Administration today approved eribulin mesylate (Halaven), an antimicrotubular antineoplastic agent, for the treatment of unresectable or metastatic liposarcoma. This treatment is approved for patients who received prior chemotherapy that contained an anthracycline drug....

palliative care
colorectal cancer

One in Seven Colorectal Cancer Patients Diagnosed Before Recommended Screening Age

Nearly 15% of patients diagnosed with colorectal cancer were younger than 50, the age at which screening recommendations begin. The study by researchers at the University of Michigan Comprehensive Cancer Center also found that younger patients were more likely to have advanced disease. The authors ...

prostate cancer

DNA Damage and Repair Pathway Signature May Be Associated With Prognosis After Prostatectomy in High-Risk Prostate Cancer

In a study reported in JAMA Oncology, Evans et al identified a DNA damage and repair pathway gene signature that was significantly associated with outcomes after prostatectomy for high-risk prostate cancer independent of standard clinicopathologic factors. Study Details The study involved 1,090...

gastroesophageal cancer
issues in oncology
issues in oncology

STS 2016: Race, Lower Socioeconomic Status Linked With Worse Survival Following Esophageal Cancer Surgery

Poor black patients undergoing surgery for esophageal cancer are at higher risk for death than white patients and patients with higher socioeconomic status, according to a scientific presentation by Erhunmwunsee et al at the 52nd Annual Meeting of The Society of Thoracic Surgeons. The abstract,...

lung cancer

STS 2016: Body Mass Index Linked With Complications After Lung Cancer Surgery

Body mass index affects outcomes following lung resection for lung cancer. Patients with very high or very low body mass index measurements have the highest risks for complications, according to a scientific presentation at the 52nd Annual Meeting of The Society of Thoracic Surgeons. The abstract...

breast cancer
issues in oncology

UK Study Suggests Association Between Screen-Detected Ductal Carcinoma in Situ and Reduced Invasive Interval Breast Cancers

In a UK retrospective population-based study reported in The Lancet Oncology, Duffy et al found a significant inverse association between the detection of ductal carcinoma in situ in breast cancer screening and the incidence of invasive interval cancers diagnosed within 3 years after screening....

pancreatic cancer

2016 GI Symposium: Tumor-Treating Fields Plus Chemotherapy May Be Safe as First-Line Treatment in Advanced Pancreatic Cancer

Novocure presented data from its ongoing phase II PANOVA clinical trial at the 2016 Gastrointestinal Cancers Symposium in San Francisco, showing that tumor-treating fields therapy plus first-line gemcitabine is tolerable and safe in patients with advanced pancreatic cancer. The data also suggest...

palliative care
pancreatic cancer

2016 GI Symposium: Irinotecan Liposome Injection in Metastatic Pancreatic Cancer: Updated Results of the Phase III NAPOLI-1 Study

Merrimack Pharmaceuticals, Inc, announced that an updated overall survival analysis of the phase III NAPOLI-1 study of irinotecan liposome injection (Onivyde) in combination with fluorouracil (5-FU) and leucovorin achieved a substantial improvement in 12-month overall survival compared to 5-FU and...

cns cancers

2016 GI Symposium: Everolimus Slows Growth of Neuroendocrine Tumors

Researchers report the results of a new analysis from a phase III trial of patients with neuroendocrine tumors that begin in the gastrointestinal (GI) tract or have an unknown origin. Compared to placebo, everolimus (Afinitor) was associated with a 6- to 8-month longer time period before the cancer ...

cns cancers

2016 GI Symposium: New Targeted Hormone-Radiation Treatment Slows Growth of Midgut Neuroendocrine Tumors

Early results from the NETTER-1 phase III study of patients with previously treated, advanced midgut neuroendocrine tumors show that a novel therapy, lutetium Lu-177 dotatate (Lutathera), may substantially slow tumor growth. Patients treated with the experimental drug had a 79% lower risk ...

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