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issues in oncology

Staff Support Sessions in an Oncology Setting

Work-related issues such as coping skills, stress management, burnout, and compassion fatigue are among the challenges faced by clinical and other staff in cancer treatment centers. Given the emotional consequences of professional caregiving, staff support group meetings are valuable resources for...

gynecologic cancers

FDA Grants Breakthrough Therapy Designation to Rucaparib in Advanced Ovarian Cancer With BRCA Mutations

The U.S. Food and Drug Administration (FDA) has granted Breakthrough Therapy designation to Clovis Oncology’s investigational agent rucaparib as monotherapy treatment of advanced ovarian cancer in patients who have received at least two lines of prior platinum-containing therapy, with ­BRCA-mutated ...

breast cancer

Triple Negative Breast Cancer Foundation Works to Change the Treatment Landscape of an Aggressive Form of Breast Cancer

Hayley Dinerman, Cofounder and Executive Director of the Triple Negative Breast Cancer Foundation, remembers how she and a group of close female friends first learned about the devastating effects of triple-negative breast cancer. It was 2005 when these new mothers, who had recently formed a...

geriatric oncology

Preparing for the ‘Silver Tsunami’ and the Impact of an Aging Population on Cancer Care

“Older adults constitute the only increasing natural resource in the entire world.” —Linda Fried, PhD, Columbia School of Public Health The good and bad news about our changing demographic world is that the population of older adults is increasing in the United States and worldwide. While it is...

sarcoma

Persistence of HER2-Specific CAR T Cells in HER2-Positive Sarcoma

In a phase I/II study reported in the Journal of Clinical Oncology,1 Nabil Ahmed, MD, MSc, of Baylor College of Medicine, Houston, and colleagues, found that infusion of T cells expressing HER2-specific chimeric antigen receptor (CAR) with a CD28.ζ signaling domain (HER2-CAR T cells) could produce...

issues in oncology
cost of care

In Search of ‘Just’ Prices: Questioning the High Cost of New Cancer Drugs

As the oncology community begins the slow and often difficult-to-define transition from volume to value in the delivery of cancer care, the relationship between the price and value of certain high-priced cancer drugs is getting more scrutiny. We generally correlate the efficacy of a new drug and...

colorectal cancer

Aspirin as Adjuvant Therapy for Colon Cancer: Is the Time Right?

Aspirin has long proved to be a multipotent drug, with efficacy as a pain reliever, anti-inflammatory agent, antiplatelet agent, and cardioprotective agent. In the cancer world, a large literature has accumulated demonstrating its ability to prevent various epithelial malignancies, most notably...

breast cancer
survivorship

Breast Cancer Management in Review

With the field of breast oncology as complex as ever, a brief update of the latest findings impacting breast cancer treatment seems timely. To that end, I have assembled highlights from a collection of newsworthy studies featured over the past year and into early 2015. Part 1 of this review, which...

breast cancer
pain management

Opioid-Reduction Strategy for Postoperative Pain After Breast Cancer Surgery

One persistent and potentially debilitating problem breast cancer patients suffer with is postoperative pain. Studies show that proper pain management is an essential component in the healing process, but undertreatment of pain symptoms remains an ongoing issue in the oncology community. Opioids,...

gynecologic cancers

Complete Regression of Metastatic Cervical Cancer Is Observed After Treatment With HPV-Targeted Tumor-Infiltrating T Cells

As reported in the Journal of Clinical Oncology,1 researchers at the National Cancer Institute observed complete regression of metastatic cervical tumors in two patients following a single infusion of human papillomavirus (HPV)-targeted tumor-infiltrating T cells. In the protocol, nine patients...

breast cancer

Should We Be Worried If Patients Tolerate Endocrine Therapy Well?

When meeting with patients to discuss adjuvant endocrine therapy for breast cancer, the question often arises, “How will I know that the treatment is working?” While the efficacy of these treatments has been demonstrated for the majority of patients in multiple large randomized clinical trials,...

breast cancer

Analysis Shows No Link Between Aromatase Inhibitor–Related Musculoskeletal/Vasomotor Symptoms and Relapse-Free Survival

Retrospective analyses of the ATAC, TEAM, and BIG 1-98 adjuvant endocrine therapy trials in breast cancer have suggested that treatment-emergent endocrine symptoms may be associated with superior survival outcomes. In a study reported in the Journal of Clinical Oncology, Vered Stearns, MD,...

issues in oncology
global cancer care

Noncommunicable Diseases Are the Leading Cause of Death in Low- and Middle-Income Countries

The greatest health threat to people living in low- and middle-income countries is no longer infectious diseases like HIV/AIDS, which has seen a 33% decline in the global rate of new infections since 2001.1 It is the rise of noncommunicable diseases (including cancer, cardiovascular disease, and...

breast cancer
issues in oncology

PRIME II and the Omission of Radiation Therapy in Low-Risk, Elderly Patients Undergoing Breast Conservation: The Time Has Come

Despite the high prevalence of breast cancer worldwide, it is important to recognize that > 40% of all cases occur in women aged 65 years or older in both the United States and the United Kingdom.1,2 Breast cancers in older patients are more often associated with indolent features and with...

breast cancer
issues in oncology

Radiotherapy or Not in Older Women Receiving Breast-Conserving Surgery and Endocrine Treatment?

In the phase III PRIME II trial, designed to assess whether whole-breast irradiation could be omitted in women aged ≥ 65 years with early-stage breast cancer undergoing breast-conserving surgery and receiving adjuvant endocrine treatment, Ian H. Kunkler, MB BChir, FRCR, of Western General Hospital, ...

multiple myeloma
geriatric oncology

‘Frailty Profile’ Predicts Survival and Toxicities in Elderly Patients With Multiple Myeloma

A frailty score predicts mortality and the risk of toxicity in elderly patients with multiple myeloma and can be used to determine more suitable therapies for these patients, the International Myeloma Working Group reported in Blood. “Chronologic age, performance status, and physician’s clinical...

2015 Oncology Meetings

MAY 13th Annual Meeting of the Association for Cancer Immunotherapy (CIMT)May 11-13 • Mainz, Germany For more information: www.meeting.cimt.eu 54th Annual Conference of the Particle Therapy Co-Operative GroupMay 18-23 • San Diego, California For more information: http://ptcog54.org American...

cns cancers

Clinical Trials Actively Recruiting Patients With Neuroblastoma

The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies for patients with newly diagnosed or relapsed or refractory neuroblastoma. The studies include pilot, observational, phase I, phase II, and phase III trials investigating single-agent and...

colorectal cancer

FDA Approves Ramucirumab for Metastatic Colorectal Cancer

The U.S. Food and Drug Administration (FDA) today approved ramucirumab (Cyramza) for use in combination with FOLFIRI (leuco­vorin, fluorouracil, irinotecan) for the treatment of patients with metastatic colorectal cancer whose disease has progressed on a first-line bevacizumab (Avastin)-,...

gynecologic cancers
issues in oncology

Bombarded With Changes in Health Care and Beyond, Gynecologic Oncologists Prepare for the Challenges Ahead

Physicians are being “bombarded” with changes in health care and beyond, Richard R. Barakat, MD, FACS, noted in his Presidential Address at the Society of Gynecologic Oncology (SGO) Annual Meeting on Women’s Cancer. These changes are being precipitated by steeply rising health-care costs amid...

issues in oncology
breast cancer

Informing Decision-Making About Mammography Screening

Overdiagnosis associated with breast cancer screening has been the subject of much attention in recent years. The notion that cancer screening—largely believed to be beneficial—could actually be harmful is simultaneously fascinating and difficult to believe. With the publication of multiple studies ...

breast cancer
issues in oncology

Impact of Informed Decision-Making on Breast Cancer Screening

In a study reported in Lancet, Jolyn Hersch, MApplSc, of the University of Sydney, and colleagues found that use of a decision aid containing information on overdetection in breast cancer screening was associated with an increased rate of informed choice regarding screening, a reduced rate of...

lymphoma

Brentuximab Vedotin After Autologous Stem Cell Transplantation in High-Risk Hodgkin Lymphoma: Implications of the AETHERA Trial

Hodgkin lymphoma is generally thought to be a malignancy with a favorable prognosis. Overall, approximately 80% of patients will have durable, long-term remissions with initial chemotherapy. Some patients, however, demonstrate evidence of disease progression, and these patients usually receive...

lymphoma

Improved Progression-Free Survival With Brentuximab Vedotin After Transplantation in Hodgkin Lymphoma Patients

In the phase III AETHERA trial reported in The Lancet, Craig H. Moskowitz, MD, of Memorial Sloan Kettering Cancer Center, and colleagues found that brentuximab vedotin (Adcetris) consolidation therapy after autologous stem cell transplantation prolonged progression-free survival by 18 months vs...

gynecologic cancers

Combining Antiangiogenic and Vascular-Disrupting Agents Improves Progression-Free Survival in Persistent Ovarian Cancer

“Bevacizumab [Avastin] prevents new blood vessels from growing, but what about the blood vessels that are already in the tumor?” Presenting that challenge to participants at the Society of Gynecologic Oncology Annual Meeting on Women’s Cancer in Chicago, Bradley J. Monk, MD, of the University of...

gynecologic cancers

Groups Join Together to Form Ovarian Cancer Research Team

Stand Up To Cancer , Ovarian Cancer Research Fund, Ovarian Cancer National Alliance, and National Ovarian Cancer Coalition, along with the American Association for Cancer Research (AACR), announced the formation of a “Dream Team” devoted to ovarian cancer research at the AACR Annual Meeting 2015....

breast cancer
gynecologic cancers
kidney cancer
skin cancer
cost of care

NCCN Posters of Interest Included Studies in Kidney, Breast, and Endometrial Cancers, Melanoma, and Cost Issues

The quality and quantity of original research presented at the National Comprehensive Cancer Network (NCCN) Annual Conference continue to grow since poster sessions debuted a few years ago. The ASCO Post offers summaries for just a few that caught our eye, out of more than 65 presented this year....

skin cancer

Combination Immunotherapy Better Than Monotherapy in Advanced Melanoma

As clinical research struggles to keep up with the pace of new immunotherapies, one of the burning questions is how best to combine the new drugs. A new study found that the combination of nivolumab (Opdivo) and ipilimumab (Yervoy) is superior to ipilimumab alone as front-line therapy for untreated ...

breast cancer

Experts Debate: Can We Cure Metastatic Breast Cancer?

Can metastatic breast cancer ever be cured? This issue was debated at the 32nd Annual Miami Breast Cancer Conference by two experts in the field: George W. Sledge, Jr, MD, Professor of Medicine at Stanford University Medical Center, Palo Alto, California, and Clifford A. Hudis, MD, Chief of the...

skin cancer

Practice-Changing Study: Pembrolizumab Outperforms Ipilimumab in Advanced Melanoma

Pembrolizumab (Keytruda) proved superior to ipilimumab (Yervoy) for the treatment of unresectable advanced melanoma in the global phase III KEYNOTE-006 trial. Pembrolizumab significantly improved overall survival, progression-free survival, and overall response rate compared with ipilimumab, which...

Expect Questions About Physical Activity and Reduced Mortality Risks

A study finding that just doing some leisure time physical activity reduces overall and cancer-specific mortality by 20% and that more activity can provide even greater survival benefits concludes that health-care professionals should encourage inactive patients to perform more leisure time...

issues in oncology

Just Engaging in ‘Some’ Leisure Time Physical Activity Reduces Overall and Cancer-Specific Mortality

There’s good news for those who recognize the benefits of exercise but feel they have neither the time nor energy for frequent workouts: A recent study reported in JAMA Internal Medicine1 has found that just performing “some” leisure time physical activity, even below the recommended minimum level, ...

Remembering Multiple Myeloma Patient Advocate Michael S. Katz, MBA

I first met Michael Katz, MBA, in 2004, 3 years after my brother, Dom, was diagnosed with multiple myeloma, and we were at a crossroads in his care and needed advice. Although an experimental regimen of thalidomide (Thalomid) and dexamethasone had successfully put Dom in remission for a year (the...

issues in oncology

The Paradox of Positive Thinking

The ASCO Post is pleased to reproduce installments of the “Art of Oncology” as published previously in the Journal of Clinical Oncology (JCO). These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

breast cancer

CLEOPATRA Overall Survival Analysis: Significant Benefit for Pertuzumab Plus Trastuzumab/Docetaxel in HER2-Positive Metastatic Breast Cancer

As reported in The New England Journal of Medicine by Sandra M. Swain, MD, of Washington Cancer Institute, MedStar Washington Hospital Center, and colleagues, the final prespecified overall survival analysis in the phase III CLEOPATRA study showed a significant 15.7-month increase in median overall ...

solid tumors

Living With a Rare Cancer—My Dr. Seuss World

No one ever expects to hear the words “you have cancer,” but over the course of the day, over 5,000 people in the United States are given that news.1 I first heard those words in the summer of 2007 and have been living with cancer ever since. At the time of my diagnosis, I knew this would forever...

A Less Is More View of Medicine

BOOKMARKTitle: Less Medicine, More Health: 7 Assumptions That Drive Too Much Medical CareAuthor: H. Gilbert Welch, MDPublisher: Beacon PressPublication date: March 3, 2015Price: $24.95; hardcover, 241 pages He’s the best physician that knows the worthlessness of most medicines. —Benjamin Franklin...

2015 Oncology Meetings

MAY American Association for Cancer Research: Advances in Brain Cancer ResearchMay 27-30 • Washington, DC For more information: www.aacr.org ASCO Annual MeetingMay 29-June 2 • Chicago, Illinois For more information: am.asco.org 2015 ASCO State Affiliates’ ReceptionMay 31 • Chicago, Illinois For...

skin cancer

FDA Accepts Supplemental Biologics License Application for Nivolumab in Patients With Previously Untreated Advanced Melanoma

The U.S. Food and Drug Administration (FDA) has accepted for filing and review Bristol-Myers Squibb’s supplemental Biologics License Application (sBLA) for nivolumab ­(Opdivo) for the treatment of previously untreated patients with unresectable or metastatic melanoma. The FDA also granted Priority...

colorectal cancer

Ramucirumab With FOLFIRI in 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 April 24, the monoclonal antibody ramucirumab ­(Cyramza) was...

skin cancer

Pembrolizumab vs Ipilimumab: Good vs Better

The treatment landscape for metastatic melanoma has recently undergone a remarkable transformation. Prior to 2011, clinicians and patients were presented with difficult decisions between therapies without proven survival benefit. Now, similarly difficult but much more hopeful choices are posed...

skin cancer

Anti–PD-1 Antibody Pembrolizumab Improves Progression-Free and Overall Survival vs Ipilimumab in Advanced Melanoma

In the phase III KEYNOTE-006 trial reported in The New England Journal of Medicine,1 Caroline Robert, MD, PhD, Head of the Dermatology Unit at the Institut Gustave Roussy, Paris, and colleagues found that the anti–programmed cell death protein 1 (PD-1) antibody pembrolizumab (Keytruda) increased...

issues in oncology
geriatric oncology

Guidelines for the Treatment of Older Cancer Patients: Task Forces of the International Society of Geriatric Oncology

Geriatrics for the Oncologist is guest edited by Stuart Lichtman, MD, FACP, FASCO, and developed in collaboration with the International Society of Geriatric Oncology (SIOG). Visit SIOG.org for more on geriatric oncology. The Task Forces of the International Society of Geriatric Oncology (SIOG) are ...

supportive care

Potential Power of Meaning-Centered Group Psychotherapy in Patients With Advanced Cancer

The recent publication of the results of our National Cancer Institute (NCI) RO1-funded randomized controlled trial of meaning-centered group psychotherapy for advanced cancer patients in the Journal of Clinical Oncology,1 and the accompanying summary published in this issue of The ASCO Post,...

supportive care
survivorship

Physiatry Has Become a Valuable Component of Survivorship Care in Cancer Centers

The role of a physical medicine and rehabilitation physician at cancer centers continues to grow, as survivors live longer and national cancer organizations advocate for more rehabilitation services throughout the continuum of survivorship care. Working with physiatrists at your institution can...

thyroid cancer

Welcome to Multikinase Inhibitors in Radioiodine-Refractory Thyroid Cancer

In the past 2 decades, the incidence of thyroid cancer has risen steeply, with rates now growing by 5.5% annually.1 In 2014, 62,980 new cases of thyroid cancer were diagnosed in the United States. The good news is that, overall, the prognosis of thyroid cancer remains excellent; 97.8% of patients...

thyroid cancer

Large Improvement in Progression-Free Survival With Lenvatinib in Radioiodine-Refractory Thyroid Cancer

In a phase III trial reported in The New England Journal of Medicine, Martin Schlumberger, MD, of Institut Gustave Roussy, and colleagues found that the multikinase inhibitor lenvatinib (Lenvima) produced a large improvement in progression-free survival vs placebo in patients with advanced...

breast cancer

A Closer Look at the Disparities in Breast Cancer Outcome by Race and Ethnicity

The report from Dr. Steven Narod and colleagues recently published in JAMA1 and reviewed in this issue of The ASCO Post adds to the growing evidence regarding observed disparities in breast cancer outcomes by race and ethnicity among women in the United States. Since 1990, breast cancer death rates ...

breast cancer

Optimizing Treatment for Small, Lymph Node–Negative, HER2-Overexpressing Breast Cancers

Large, randomized phase III clinical trials showed that the addition of HER2-targeted therapy to chemotherapy for patients with early-stage, HER2-overexpressing breast cancers substantially decreased the risk of recurrence and improved survival. The chemotherapy given in these trials varied, but it ...

breast cancer

High Invasive Disease-Free Survival With Adjuvant Paclitaxel and Trastuzumab in Small, Node‑Negative, HER2-Positive Breast Cancers

In a phase II study reported in The New England Journal of Medicine, Sara M. Tolaney, MD, MPH, of Dana-Farber Cancer Institute, and colleagues found that adjuvant paclitaxel and trastuzumab (Herceptin) was associated with high invasive disease-free survival in women with small, node-negative,...

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