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Clinical Implications of Survivorship Study Findings

Based on study findings presented at the 2015 ASCO Annual Meeting, Arif Kamal, MD, MHS, of Duke University, Durham, North Carolina, listed six points for clinicians to consider that could change practice now or in the near future for cancer survivors. “Drugs for cancer cachexia are on their...

supportive care
survivorship

Patient and Survivor Care Studies Yield Useful Results to Improve Quality of Life

Recent studies have yielded useful results that clinicians can put into practice, some right now, to help improve the quality of life for patients with cancer. Concerns addressed included cachexia, pain, “chemobrain,” and fertility preservation. At the Best of ASCO®/Chicago meeting, Arif ­Kamal,...

lung cancer

Nivolumab in Lung Cancer Supported by Updated Trial Data

For the treatment of advanced squamous non–small cell lung cancer (NSCLC), the programmed cell death protein 1 (PD-1) antibody nivolumab (Opdivo) continues to show results in key trials that now report 18-month data. The updates were reported at the 16th World Conference on Lung Cancer in Denver,...

lung cancer

AZD9291 Updates Encouraging for Treatment-Resistant NSCLC

At the 16th World Conference on Lung Cancer, several studies showed consistent activity with the investigational third-generation inhibitor AZD9291 in patients with advanced non–small cell lung cancer (NSCLC) that is resistant to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors....

breast cancer

Ductal Carcinoma in Situ: Where We Have Been and Where We Can Be

Ductal carcinoma in situ has been a recent topic of debate in the news because of a recent article by Narod et al1 and an accompanying editorial2 about the study in JAMA Oncology. This study, summarized in this issue of The ASCO Post, chronicled the long-term outcomes for women diagnosed with...

issues in oncology

NCCN Turns 20: Value-Based Care Has Arrived

Twenty years ago, the National Comprehensive Cancer Network (NCCN) began as a cooperative effort of 12 prestigious cancer centers, working to define and promote national guidelines for the care of patients with cancer. A major goal was to encourage uniformity in the management of malignant...

lung cancer

EGFR Gene Copy Number as Biomarker for Antibody Treatment in Squamous Cell NSCLC

Two studies presented at the 16th World Conference on Lung Cancer suggest that high expression of the epidermal growth factor receptor (EGFR), or gene copy number, may indicate potential benefit from EGFR antibodies in squamous cell non–small cell lung cancer (NSCLC). The studies were presented by...

colorectal cancer
issues in oncology

Important Caveats to Consider Concerning Low-Dose Daily Aspirin for the Primary Prevention of Colorectal Cancer

The use of low-dose aspirin by most adults aged 50 to 59 for the primary prevention of colorectal cancer is now included in the U.S. Preventive Services Task Force (USPSTF) updated draft recommendation statement, “Aspirin to Prevent Cardiovascular Disease and Cancer.”1 The release of the statement...

American Cancer Society Awards 2015 Medals of Honor

The American Cancer Society has bestowed its highest honor on four individuals and one foundation during the Society’s 2015 Medal of Honor ceremony and celebration dinner in Washington, DC. The Medal of Honor is awarded to those who have made the most valuable contributions and impact in the fight...

breast cancer

Clinical Trials Actively Recruiting Patients With Breast Cancer

The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies for patients with breast cancer. The trials are investigating cancer risk based on breast density; novel imaging techniques; fasting and chemotherapy; radiosurgery; lymph node dissection; ...

lymphoma

Answers: Primary Diffuse Large B-Cell Lymphoma of the Central Nervous System

Question 1: What is the most likely diagnosis for this patient? Correct Answer: B. Primary central nervous system lymphoma. Expert Perspective In an immunocompetent host, the differential diagnosis of isolated or multiple brain lesion(s) includes autoimmune etiologies such as neurosarcoidosis,...

lymphoma

Questions: Primary Diffuse Large B-Cell Lymphoma of the Central Nervous System

Hematology Expert Review is an occasional feature that includes a case report followed by questions,answers, and expert commentary. In this issue of The ASCO Post, Drs. Abutalib and Lukas present part 1 of a case report on primary diffuse large B-cell lymphoma. Part 2 will be published in an...

2015 Oncology Meetings

OCTOBER Modern Management of Urologic Cancers: A Multidisciplinary Approach (Memorial Sloan Kettering) October 29-31 • New York, New York For more information: http://www.themerzgroup.com/mskcc/mskcc-urologic-conference/ Lynn Sage Breast Cancer SymposiumOctober 29-November 1 • Chicago, Illinois...

hematologic malignancies

Early Research of David G. Nathan, MD, Ushered in the Field of Pediatric Hematology

When David G. Nathan, MD, was admitted to Harvard University in 1947, he had every intention of becoming an English professor. It was only his lack of writing talent that dissuaded him from a life in the classroom and propelled him into a medical career that has spanned more than 5 decades and has...

pain management

Pain, Still Undertreated and Misunderstood

Bookmark Title: A Nation in Pain: Healing Our Biggest Health ProblemAuthor:  Judy ForemanPublisher: Oxford University PressPublication date: May 1, 2015Price: $19.95, paperback; 464 pages The subject of pain has been written about extensively, from the intriguing sociopolitical history of opium to...

colorectal cancer

Trifluridine/Tipiracil in Previously Treated Metastatic Colorectal Cancer

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 September 22, 2015, trifluridine/tipiracil (Lonsurf) was...

gynecologic cancers

Bevacizumab in Ovarian Cancer: Results of ICON7

Based on preclinical (in vitro and in vivo) data, there is a strong biologic rationale for the addition of an antiangiogenic drug strategy in the treatment of epithelial ovarian cancer.1 Single-agent trials have confirmed both the biologic and clinical activity of bevacizumab (Avastin) in the...

gynecologic cancers

Addition of Bevacizumab to Standard Chemotherapy Improves Overall Survival Only in High-Risk Ovarian Cancer

Final overall survival results of the phase III ICON7 trial reported in The Lancet Oncology by Amit M. Oza, MD, and colleagues indicate no significant improvement with the addition of bevacizumab (Avastin) to standard chemotherapy in women with newly diagnosed ovarian cancer.1 However, an overall...

lung cancer

Anti-EGFR Therapy in Squamous Cell Lung Carcinoma: Swimming With or Against the Tide?

Lung cancer is the most common, lethal, and costly cancer worldwide, accounting for at least 1.8 million new cases per year (12.9% of the total).1 Over the past decade, there has been a major shift in the treatment of non–small cell lung cancer (NSCLC), especially in adenocarcinoma, accompanied by...

cns cancers

FDA Approves Expanded Indication for Medical Device to Treat Newly Diagnosed Glioblastoma Multiforme

The U.S. Food and Drug Administration (FDA) has approved an expanded indication for the Optune tumor-treating fields device to treat patients with newly diagnosed glioblastoma multiforme. It is given along with the chemotherapy drug temozolomide following standard treatments that include surgery,...

lung cancer

Addition of Necitumumab to First-Line Gemcitabine/Cisplatin Improves Overall Survival in Stage IV Squamous NSCLC

In the phase III SQUIRE trial reported in The Lancet Oncology, Nick Thatcher, PhD, FRCP, of The Christie Hospital NHS Trust, Manchester, UK, and colleagues found that the addition of the second-generation epidermal growth factor receptor (EGFR) antibody necitumumab to first-line...

lung cancer

Pembrolizumab in Previously Treated PD-L1–Positive Metastatic NSCLC

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 October 2, 2015, the U.S. Food and Drug Administration granted...

lung cancer

FDA Grants Accelerated Approval to Pembrolizumab for Advanced NSCLC

The U.S. Food and Drug Administration (FDA) has granted accelerated approval for pembrolizumab (Keytruda) to treat patients with metastatic non–small cell lung cancer (NSCLC) whose disease has progressed after other treatments and with tumors that express programmed cell death-ligand 1 (PD-L1)....

lung cancer

FDA Approves Use of Nivolumab in Metastatic Nonsquamous Lung Cancer

The U.S. Food and Drug Administration (FDA) has approved nivolumab (Opdivo) to treat patients with metastatic nonsquamous non–small cell lung cancer (NSCLC) whose disease progressed during or after platinum-based chemotherapy. Nivolumab is a monoclonal antibody that that blocks the PD-1/PD-L1...

Three Young Investigators Named Winners of 2015 Paul Marks Prize for Cancer Research

Memorial Sloan Kettering Cancer Center (MSKCC) has named three investigators as recipients of this year’s Paul Marks Prize for Cancer Research. The award recognizes promising investigators aged 45 or younger for their efforts in advancing cancer research. The winners are Bradley E. ­Bernstein, MD,...

skin cancer

Nivolumab in Combination With Ipilimumab in BRAF V600 Wild-Type Unresectable or Metastatic Melanoma

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 September 30, 2015, the U.S. Food and Drug Administration...

kidney cancer

Nivolumab and Cabozantinib Improve Outcomes vs Everolimus in Previously Treated Advanced Renal Cell Carcinoma

The CheckMate 025 trial, reported in The New England Journal of Medicine by Robert J. Motzer, MD, and colleagues, showed that treatment with the programmed cell death protein (PD-1) checkpoint inhibitor nivolumab (Opdivo) increased overall survival vs the mTOR inhibitor everolimus (Afinitor) in...

breast cancer

Endocrine Therapy Alone Linked to Low Risk of Breast Cancer Recurrence in Women With a Low-Risk Score on 21-Gene Assay

A prospective validation study of a 21-gene expression assay showed that treatment with endocrine therapy alone in women with hormone receptor–positive, HER2-negative breast cancer who had a low recurrence risk score resulted in low risk of recurrence. All patients included in the study were...

Conquer Cancer Foundation Grants and Awards: Funding Opportunities Now Available

The Conquer Cancer Foundation (CCF) of the American Society of Clinical Oncology (CCF) is fueling cancer research and pursuing dramatic advances in the diagnosis, prevention, treatment, and cure of all types of cancer. CCF’s Grants and Awards program supports clinical and translational cancer...

lung cancer

Smoking Cessation Reduces Mortality in Lung Cancer Screening Population

Data from an analysis of lung cancer screening programs in Italy add further evidence that smoking cessation reduces mortality. Heavy smokers screened by low-dose computed tomography (CT) who stopped smoking before or during the screening period had a three- to fivefold reduction in mortality...

breast cancer

MRI Improves Breast Cancer Detection in Women at Average Risk

Magnetic resonance imaging (MRI) screening of women at average risk for breast cancer achieved a mean additional cancer yield of 15.8 cases per 1,000 women, greatly surpassing yields for supplemental digital breast tomosynthesis (1.25 per 1,000) or supplemental ultrasound (4.1 per 1,000). The...

breast cancer

Aromatase Inhibitors May Decrease Risk of Contralateral Breast Cancer in BRCA Mutation–Positive Patients

Given that BRCA1 and BRCA2 mutation carriers have an estimated 40% to 85% lifetime risk of breast cancer and an increased risk of developing contralateral breast cancer, risk reduction in this population remains essential. According to a study presented at the 2015 Breast Cancer Symposium, use of...

breast cancer

TAILORx: Chemotherapy Not Necessary for Women With a Low Recurrence Score

The long-awaited first results are in from the TAILORx study, showing that patients with early breast cancer considered at low risk for recurrence can forgo chemotherapy and be treated with endocrine therapy alone.1 “Women with axillary node-negative, estrogen receptor–positive, HER2-negative...

neuroendocrine tumors

Treatment Options Expanding for Neuroendocrine Tumors

Patients with advanced neuroendocrine tumors have two promising new treatment options, according to studies that earned spots in the Presidential Session of the 2015 European Cancer Congress, held recently in Vienna, Austria. The phase III studies evaluated the mTOR inhibitor everolimus (Afinitor)...

issues in oncology

Chemotherapy/Radiotherapy Safe in Second and Third Trimesters of Pregnancy

Children with in utero exposure to chemotherapy and/or radiation therapy during maternal treatment for cancer had no impairment in cognition, cardiac function, and general early childhood development, according to a study reported at the European Cancer Congress in Vienna, Austria, and published...

Expert Point of View: Luis Paz-Ares, MD

This is the first time we have seen data from the BIRCH trial in these three different cohorts using biomarker expression on tumor cells and immune cells,” said formal discussant Luis Paz-Ares, MD, Professor Medicine at the Hospital Universitario 12 de Octubre, Madrid, Spain. “BIRCH confirms the...

lung cancer

Atezolizumab Makes Inroads in Non–Small Cell Lung Cancer

The anti–PD-L1 (programmed cell death-ligand 1) antibody atezolizumab (formerly known as MPDL3280A) achieved encouraging outcomes in patients with non–small lung cancer (NSCLC) in two different trials: POPLAR1 and BIRCH.2 PD-L1 has emerged as a predictive biomarker for atezolizumab response in both ...

breast cancer
issues in oncology

Ovarian Suppression During Chemotherapy Preserves Fertility in Young Women With Breast Cancer

Several studies have addressed the risks and benefits of ovarian suppression during chemotherapy for breast cancer in women of childbearing age. A new meta-analysis of randomized trials found that it prevented premature ovarian failure and was associated with a higher number of pregnancies post...

cost of care

Discussing Financial Toxicity With Patients Who Have Cancer

Patient: “Doc, how much are these drugs going to cost me?” Physician: “They are expensive, and you can see our financial counselor to help you understand the costs.”   Cancer care is not a black-and-white endeavor, and costs are considered a distasteful subject to be passed over in tactful silence. ...

Expert Point of View: Cora N. Sternberg, MD, FACP

Cora N. Sternberg, MD, FACP, Chief of Medical Oncology at San Camillo Forlanini Hospital in Rome, Italy, formally discussed CheckMate 025 at the Presidential Session of the 2015 European Cancer Congress as well as findings from the METEOR trial of cabozantinib (Cometriq) in metastatic renal cell...

kidney cancer

Nivolumab Produces Survival Benefit in Advanced Renal Cell Carcinoma

Patients with advanced renal cell carcinoma treated with nivolumab (Opdivo) were 27% less likely to die than those receiving everolimus (Afinitor), in a planned interim analysis of the open-label phase III CheckMate 025 trial.1 These positive results prompted an early termination of the study by...

skin cancer

FDA Approves First Oncolytic Viral Therapy in the United States

The U.S. Food and Drug Administration (FDA) has approved the biologics license application for talimogene laherparepvec (Imlygic), a genetically modified oncolytic viral therapy indicated for the local treatment of unresectable cutaneous, subcutaneous, and nodal lesions in patients with melanoma...

solid tumors

Multiple Copies of TP53 Tumor-Suppressor Gene Potentially Related to Lower-Than-Expected Cancer Rate in Elephants

A lower-than-expected rate of cancer among elephants could be potentially related to multiple copies of TP53, “a crucial tumor suppressor gene mutated in the majority of human cancers,” according to a study published online by The Journal of the American Medical Association. “Compared with human...

gynecologic cancers

ASCO-Endorsed ASTRO Guidelines: Searching for Consensus on Radiotherapy for Endometrial Cancer

Endometrial cancer is the most common gynecologic cancer, but there has been little consensus about the appropriate indications for adjuvant therapy. One reason for the lack of consensus is the absence of randomized studies in endometrial cancer that report an overall survival benefit. This may be...

gynecologic cancers

ASCO Endorses ASTRO Guideline on Postoperative Radiation Therapy for Endometrial Cancer

As reported in the Journal of Clinical Oncology by Larissa A. Meyer, MD, MPH, and colleagues, ASCO has endorsed the recently published American Society for Radiation Oncology (ASTRO) guideline on postoperative radiation therapy for endometrial cancer.1 The ASCO clinical practice guideline...

breast cancer
leukemia

Shadowed by Cancer

Although genetic testing has not turned up any inherited mutations that might explain the number of cancers that have plagued my immediate family, over the past 15 years, I have lost my father, aunt, and sister to the disease. In 2001, my husband, Wayne, died of acute promyelocytic leukemia, and...

Equanimity

The following essay by S. Vincent Rajkumar, MD, is adapted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was coedited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and thebigcasino.org. It was...

lymphoma

Answers: Primary Diffuse Large B-Cell Lymphoma of the Central Nervous System

Question 1: What is next best step in the management of this patient? Correct Answer: C. Ophthalmoscopy/slit lamp examination. Expert Perspective Ophthalmic involvement should be sought by noninvasive procedures such as slit lamp examination and ophthalmoscopy and abnormal findings must be...

lymphoma

Questions: Primary Diffuse Large B-Cell Lymphoma of the Central Nervous System

The ASCO Post is pleased to present Hematology Expert Review, an occasional feature that includes a case report detailing a particular hematologic condition followed by questions. Answers to each question appear here with expert ­commentary. In the October 25 issue of The ASCO Post, part 1 of a...

2015 Oncology Meetings

NOVEMBER Best of ASTRONovember 13-14 • San Diego, California For more information: www.astro.org/Meetings-and-Events/2015-Best-of-ASTRO/Index.aspx 2015 Oncologic Emergency Medicine Conference November 13-14 • Houston, Texas For more information:...

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