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evista
soltamox

USPSTF Recommendation on Medication Use to Reduce Breast Cancer Risk

In a statement published in JAMA, the U.S. Preventive Services Task Force (USPSTF) recommended that clinicians offer to prescribe risk-reducing medications to women who are at an increased risk of breast cancer and at low risk of adverse events related to medications. However, the Task Force...

gynecologic cancers
immunotherapy

Avelumab for Mismatch Repair–Deficient and Mismatch Repair–Proficient Endometrial Cancer

In a phase II trial reported in the Journal of Clinical Oncology, Panagiotis A. Konstantinopoulos, MD, PhD, and colleagues found evidence of promising activity of the programmed cell death ligand 1 (PD-L1) inhibitor avelumab in mismatch repair–deficient (MMRD) recurrent or persistent endometrial...

First-Line Nivolumab and Ipilimumab vs Sunitinib in Advanced Renal Cell Carcinoma

This week, we’ll be talking about an extended follow-up of a phase III trial that investigated first-line nivolumab and ipilimumab vs sunitinib in advanced renal cell carcinoma. Then we’ll go over a research letter that identified strong predictors of response to immune checkpoint inhibitor...

gynecologic cancers

Does PTSD Increase the Risk of Developing Ovarian Cancer?

Women who experienced six or more symptoms of posttraumatic stress disorder (PTSD) at some point in life had a twofold greater risk of developing ovarian cancer compared with women who never experienced any PTSD symptoms. These findings were published by Roberts et al in Cancer Research. The...

pancreatic cancer

ASTRO Guideline on Use of Radiation Therapy for Patients With Pancreatic Cancer

A new clinical guideline from the American Society for Radiation Oncology (ASTRO) provides recommendations on the use of radiation therapy to treat patients diagnosed with pancreatic cancer, including when radiation treatments are appropriate, as well as the optimal dosing, timing, and...

lymphoma

Tumor Immune Infiltration and Disease Progression in Follicular Lymphoma

In a study reported in the Journal of Clinical Oncology, Tobin et al found that low tumor immune infiltration—indicated by low programmed cell death ligand 2 (PD-L2) expression—was associated with earlier disease progression in follicular lymphoma. As stated by the investigators, “Understanding the ...

breast cancer

Menopausal Hormone Therapy Use and Risk of Breast Cancer

In a study reported in The Lancet, the Collaborative Group on Hormonal Factors in Breast Cancer found that the use of menopausal hormone therapy is associated with an increased risk of breast cancer, with risk increasing as the duration of use increases, in both current and past users. Study...

breast cancer
survivorship

Pregnancy Appears Safe After Treatment for Breast Cancer in Patients With BRCA Mutations

Pregnancy after breast cancer appears to be safe in patients with germline BRCA mutations—and particularly among those with BRCA1 mutations—according to new research. Limited data are available on the safety of pregnancy and reproductive outcomes in patients with breast cancer and BRCA mutations,...

symptom management

ASCO and MASCC/ISOO Release a Clinical Practice Guideline on Medication-Related Osteonecrosis of the Jaw

ASCO and the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) have published a clinical practice guideline on medication-related osteonecrosis of the jaw in the Journal of Clinical Oncology.1 The guideline outlines the latest recommendations ...

lung cancer
immunotherapy

Does the Addition of Bevacizumab to Erlotinib in Advanced EGFR-Mutant NSCLC Improve PFS?

In a phase II trial reported in JAMA Oncology, Thomas E. Stinchcombe, MD, and colleagues found that the addition of bevacizumab to erlotinib did not significantly improve progression-free survival (PFS) in patients with advanced EGFR-mutant non–small cell lung cancer (NSCLC). Study Details The...

issues in oncology

New Report Finds Cancer Drugs Account for Over a Quarter of All New Drug Approvals in the United States

Cancer drugs currently account for 27% of all new drug approvals in the United States since 2010—an increase from the 4% share they occupied in the 1980s, a newly completed analysis summarized in the most recent issue of the Tufts CSDD Impact Report. From 1980 through 2018, the U.S. Food and Drug...

issues in oncology

Association Between Postdischarge Bleeding in Patients With Acute Coronary Syndrome and Subsequent Cancer Diagnosis

Bleeding during the first 6 months after discharge from the hospital for acute coronary syndrome may be linked to subsequent cancer diagnosis, according to research presented by Muñoz Pousa et al at the European Society of Cardiology Congress 2019 (Abstract P677). “Our results suggest that patients ...

breast cancer

Neoadjuvant Talazoparib for Operable BRCA-Mutated Breast Cancer

In a study reported in the Journal of Clinical Oncology, Jennifer K. Litton, MD, and colleagues found that 6 months of neoadjuvant talazoparib therapy resulted in a high rate of residual cancer burden (RCB) of 0 (pathologic complete response) in patients with stage I–III breast cancer with germline ...

supportive care

ASCO Expands Therapeutic Options for Venous Thromboembolism Prophylaxis in Patients With Cancer

ASCO has updated its recommendations for the prevention and treatment of venous thromboembolism (VTE) in patients with cancer. “The recommendations were last updated in 2015, but since then, new, significant publications have emerged, which prompted this update,” said Nigel S. Key, MBChB, of the...

multiple myeloma

Is It Time to Intervene in Smoldering Myeloma?

Early intervention in smoldering multiple myeloma prevents progression to symptomatic disease and should be strongly considered for patients meeting new criteria for high risk, according to Sagar Lonial, MD, Professor and Chair of Hematology and Medical Oncology and the Anne and Bernard Gray...

survivorship

Solid Organ Transplantation in Aging Survivors of Childhood Cancer

A retrospective analysis from the Childhood Cancer Survivor Study reported in The Lancet Oncology by Dietz et al found that the need for solid organ transplantation was infrequent in aging survivors of childhood cancer, with greater organ-specific risk being associated with particular therapeutic...

issues in oncology

2019 Quality Care: Socioeconomic Deprivation and Outcomes in Cancer Clinical Trials

In a study to be presented by Unger et al at the 2019 ASCO Quality Care Symposium, researchers found patients living in socioeconomically deprived areas were more likely to experience worse survival in cancer clinical trials, even after adjustments for race and insurance (Abstract 162). Methods...

issues in oncology

2019 Quality Care: End-of-Life Care in Western Washington State vs Alberta, Canada

In a study to be presented by Khaki et al at the 2019 ASCO Quality Care Symposium, researchers found more aggressive end-of-life measures—including use of chemotherapy and admissions to the intensive care unit (ICU)—were employed in the last 30 days of life in Western Washington state vs Alberta,...

kidney cancer
immunotherapy

Individualized Axitinib Regimens After Immunotherapy for Advanced Renal Cell Carcinoma

In a phase II study reported in The Lancet Oncology, Ornstein et al found that individualized axitinib regimens showed activity in patients with locally recurrent or metastatic renal cell carcinoma who had previously received immune checkpoint inhibitor therapy, although the progression-free...

issues in oncology
cost of care

2019 Quality Care: Cost of Treatment, Prior Authorization of Treatment Plans May Cause Barriers to Care

Drug costs and requirements for prior authorization of treatment plans pose barriers to cancer treatment and can potentially affect outcomes for many patients, according to two studies that will be presented at the ASCO Quality Care Symposium. The studies respectively examine how the high...

issues in oncology
lung cancer

2019 Quality Care: Clinical Trial Enrollment May Be Associated With Reduced Mortality in Patients With Metastatic Lung Cancer

Researchers from the University of Washington and Fred Hutchinson Cancer Research Center in Seattle investigated the relationship between participation in a clinical trial and overall survival in patients with advanced non–small cell lung cancer (NSCLC). Cristina Merkhofer, MD, MHS, will present...

prostate cancer

TITAN Trial: Apalutamide Adds to Options for Men With Metastatic Hormone-Sensitive Prostate Cancer

Androgen-deprivation therapy has been, and remains, the standard of care for patients with metastatic prostate cancer. Patients are often surprised to know that was all we would do to control their disease and sometimes asked why they would not get chemotherapy, as for other cancers. I would take...

prostate cancer

Addition of Apalutamide to Androgen-Deprivation Therapy in Metastatic Castration-Sensitive Prostate Cancer

As reported in The New England Journal of Medicine by Kim N. Chi, MD, of BC Cancer and Vancouver Prostate Centre, and colleagues, the first analysis of the phase III TITAN trial has shown that the addition of apalutamide to androgen-deprivation therapy improved radiographic progression-free and...

issues in oncology

FDA Recommendation on Duodenoscopes With Disposable Components

The U.S. Food and Drug Administration (FDA) has recommended that duodenoscope manufacturers and health-care facilities transition to different types of duodenoscopes that may pose less risk to patient safety. Specifically, because of challenges with cleaning these devices for reuse and persistent...

issues in oncology

Analysis of HPV-Related Cancers Reported From 2012 to 2016

During 2012–2016, an average of approximately 34,800 human papillomavirus (HPV)-associated cancers were reported each year, according to a new study published by Senkomago et al in Morbidity and Mortality Weekly Report. Among the cancers probably caused by HPV, 92% are attributable to the HPV types ...

leukemia
survivorship

Risk of Infections in Survivors of Childhood Leukemia

In a study reported in the Journal of Clinical Oncology, Pelland-Marcotte et al found that survivors of childhood leukemia remained at significantly increased risk of infection compared with matched controls during an extended period following completion of treatment.   Study Details The...

hematologic malignancies
issues in oncology

Reducing Time to Chemotherapy Initiation in Patients Electively Admitted to a Hematologic Malignancy Service

In a single-institution study reported in the Journal of Oncology Practice, Galeas et al found that intervention in key drivers in the care process could reduce the time to initiation of chemotherapy in patients with elective admission to a hematologic malignancy service. Study Details The goal of...

Pooled Survival Analysis of Patients With NSCLC Treated With Nivolumab

This week, we review a pooled analysis of long-term survival rates in patients with previously treated non–small cell lung cancer treated with nivolumab. We then turn to the recently reported USPSTF recommendation on risk assessment, genetic counseling, and genetic testing for BRCA1 or BRCA2...

supportive care
symptom management

Study Explores Efficacy of Lower-Dose Olanzapine in Combination With Standard Antiemetic Regimen

Olanzapine at a 5-mg dose, when combined with aprepitant, palonosetron, and dexamethasone, significantly reduced the risk of delayed nausea and vomiting in patients receiving cisplatin-based chemotherapy, according to new research. The study investigators believe this approach may be considered a...

issues in oncology
survivorship

What Role Do Physicians Play in Health Promotion Among Patients With Cancer?

A recent study published by Stump et al in Cancer indicated that certain physicians who care for patients with cancer do not often promote healthy lifestyle changes to cancer survivors, and they may fear that providing such advice would distress or overwhelm patients. The findings are noteworthy...

hepatobiliary cancer
pancreatic cancer

Results From the TAPUR Study on Palbociclib for Pancreatic Cancer and Cholangiocarcinoma

New results from ASCO’s Targeted Agent and Profiling Utilization Registry (TAPUR) study have demonstrated that single-agent palbociclib has no meaningful clinical activity in patients with CDKN2A-mutated or -deleted advanced pancreatic adenocarcinoma and cholangiocarcinoma. These findings were...

immunotherapy

Key Predictors of Response Rates to PD-1/PD-L1 Inhibitor Therapy Across Cancer Types

In a study reported in JAMA Oncology, Lee and Ruppin found that CD8-positive T-cell abundance, tumor mutational burden, and high PD1 gene expression were the strongest predictors of response to anti–programmed cell death protein 1/programmed cell death ligand 1 (PD-1/PD-L1) treatment across cancer...

breast cancer

Pyrotinib or Lapatinib With Capecitabine in Previously Treated HER2-Positive Metastatic Breast Cancer

In a Chinese phase II trial reported in the Journal of Clinical Oncology by Ma et al, the combination of the pan-ErbB inhibitor pyrotinib and capecitabine improved response rate vs lapatinib/capecitabine in women with HER2-positive relapsed or metastatic breast cancer previously treated with...

genomics/genetics
leukemia

Chromosomal Abnormalities and Prognosis in NPM1-Mutant AML

In a study reported in the Journal of Clinical Oncology, Angenendt et al found that adverse-risk cytogenetics were associated with significantly poorer outcomes vs normal karyotype among patients with acute myeloid leukemia (AML) with a nucleophosmin 1 (NPM1) mutation. As stated by the...

prostate cancer

Many Choices Now for Men With Metastatic Hormone-Sensitive Prostate Cancer: How to Decide?

Based on the recently published ENZAMET, ARCHES, and TITAN trials,1-3 we now have several choices of systemic combination therapies for men with metastatic hormone-sensitive prostate cancer; the ENZAMET trial is reviewed in this issue of The ASCO Post. In 2019, men are now faced with decisions of...

prostate cancer

Enzalutamide Improves Survival vs Standard First-Line Treatment in Hormone-Sensitive Metastatic Prostate Cancer

As reported in The New England Journal of Medicine by Ian D. Davis, MBBS, PhD, FRACP, FAChPM, of Monash University and Eastern Health in Melbourne, and colleagues, the phase III ENZAMET trial has shown that the androgen receptor inhibitor enzalutamide improved progression-free and overall survival ...

colorectal cancer
issues in oncology

Text Instructions and Reminders May Improve Colonoscopy Adherence Rates

Having text message conversations with patients 1 week before they are scheduled for a colonoscopy decreased “no-show” rates, according to a recent study published by Mahmud et al in Health Education & Behavior. Through sending reminders and instruction, the team increased the rate of...

head and neck cancer

Maura L. Gillison, MD, PhD, Pioneer in HPV-Related Head and Neck Cancer, Has Often Changed Lanes in Her Career

When The ASCO Post asked physician-scientist Maura L. Gillison, MD, PhD, where she was from, she answered, “North America.” Actually, she was born in Canada, but her father worked for a large international company, so the family moved regularly through Canada, the United States, and Mexico. “I...

issues in oncology

Exposure to Secondhand E-Cigarette Aerosols Increasing Among Middle and High School Students

A growing number of middle and high school students are being exposed to secondhand aerosols from electronic cigarettes (e-cigarettes) by living with or being around individuals who are vaping, according to data from a national survey. Such exposure increased rapidly in 2018 compared to the years...

issues in oncology
survivorship

High-Deductible Health Plans, Access to Care, and Emergency Department Use Among Cancer Survivors

In a study reported in the Journal of Oncology Practice, Zheng et al found that patients with cancer and high-deductible health plans had increases in delayed/forgone care, an effect that was attenuated for those with health savings accounts. Emergency department use was similar across insurance...

survivorship
issues in oncology

Risks of Cardiovascular Diseases in Survivors of Adult Cancers

In a study reported in The Lancet, Strongman et al found that survivors of most site-specific cancers had an increased risk for one or more cardiovascular diseases during follow-up compared with a matched control group of patients without cancer. This population-based cohort study employed multiple ...

kidney cancer
immunotherapy

Extended Follow-up of CheckMate 214: Nivolumab/Ipilimumab vs Sunitinib as First-Line Treatment for Advanced RCC

As reported in The Lancet Oncology by Robert J. Motzer, MD, and colleagues, extended follow-up of the phase III CheckMate 214 trial has shown a maintained survival benefit for first-line nivolumab/ipilimumab vs sunitinib in patients with previously untreated intermediate- or poor-risk advanced...

LEAD Conference to Focus on Empowering Women in Hematology/Oncology

Nearly 46% of medical school graduates are women, yet women physicians remain underrepresented in leadership roles. A recent report on The State of Women in Academic Medicine notes that women make up nearly 50% of medical school applicants, but only 21% of full professors, 16% of deans, and 15% of...

immunotherapy
skin cancer

Phase Ib Trial of Toripalimab/Axitinib in Asian Patients With Advanced Mucosal Melanoma

In a Chinese phase Ib study reported in the Journal of Clinical Oncology, Sheng et al reported activity with the combination of the anti–programmed cell death protein 1 (PD-1) agent toripalimab plus axitinib in patients with metastatic mucosal melanoma. As stated by the investigators, whereas...

hepatobiliary cancer

Direct-Acting Antiviral Therapy and Reduced Mortality in Patients With Hepatitis C and a History of Liver Cancer

A study published by Singal et al in Gastroenterology demonstrated that treatment with antiviral therapy for hepatitis C reduced liver-related deaths by nearly 50% in patients with a history of liver cancer. Previous Research The finding builds on a December 2018 study by Singal et al also...

pancreatic cancer

Role of the YAP Regulatory Network in Pancreatic Ductal Adenocarcinoma

Researchers have decoded a chain of molecules that are critical for the growth and survival of pancreatic ductal adenocarcinoma. They say their findings, published by Murakami et al in Developmental Cell, suggest that inhibiting the YAP biologic network may effectively regress early-stage...

breast cancer
issues in oncology

FDA Issues Draft Guidance Encouraging Inclusion of Male Patients in Breast Cancer Clinical Trials

A draft guidance issued by the U.S. Food Drug Administration (FDA) on August 26 includes draft recommendations for the inclusion of male patients in breast cancer clinical trials. Historically, males either have not been included in clinical trials for drugs to treat breast cancer, or inclusion of...

neuroendocrine tumors

Prognostic Tool for Advanced, Well-Differentiated Neuroendocrine Tumors Treated With a Somatostatin Analog

In the GETNE-TRASGU study (Spanish Group of Neuroendocrine and Endocrine Tumors Treated With Analog of Somatostatin in Gastroenteropancreatic and Unknown Primary NETs) reported in the Journal of Clinical Oncology, Carmona-Bayonas et al developed a predictive model for progression-free survival in...

multiple myeloma

Selinexor/Dexamethasone in Triple-Class Refractory Multiple Myeloma

In the phase IIb STORM Part 2 study reported in The New England Journal of Medicine, Chari et al found that the combination of oral selinexor and dexamethasone produced responses in patients with multiple myeloma refractory to prior treatment with an alkylating agent, immunomodulatory agent, and...

solid tumors

FDA Clears Next-Generation Scalp-Cooling Device

ON JUNE 27, 2019, the U.S. Food and Drug Administration (FDA) granted clearance of the DigniCap Delta scalp-cooling system to Dignitana, for use by health-care providers in the United States. The device is a fourth generation of the DigniCap scalp-cooling system. It is indicated to reduce the...

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