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breast cancer

New SSO, ASTRO, ASCO Joint Ductal Carcinoma in Situ Consensus Guideline Could Curb Unnecessary Breast Surgery and Reduce Health-System Costs

Three leading national cancer organizations have issued a consensus guideline for physicians treating women who have ductal carcinoma in situ treated with breast-conserving surgery with whole-breast irradiation. The new guideline has the potential to save many women from unnecessary surgeries,...

breast cancer

Nipple-Sparing Mastectomy Shown to Be Safe—and Increasingly Preferred

Prophylactic mastectomy that preserves a woman’s nipple is oncologically safe in patients with deleterious BRCA mutations, according to the largest study yet to evaluate this approach in this high-risk population. “In more than 500 risk-reducing nipple-sparing mastectomies in 348 deleterious...

issues in oncology

Mastery Learning: A New Paradigm for Oncology Medical Education?

According to William C. McGaghie, PhD, Professor of Medical Education and Professor of Preventive Medicine at Northwestern University Feinberg School of Medicine in Chicago, the principles of today’s clinical medical education are rooted in a 19th century model that is no longer useful in a...

USPSTF Issues Final Research Plan to Screen for Intimate Partner Violence, Elder Abuse, and Abuse of Vulnerable Adults, Including LGBTQ Population

On August 25, 2016, the U.S. Preventive Services Task Force (USPSTF) posted a final research plan on screening for intimate partner violence, elder abuse, and abuse of vulnerable adults. The draft research plan for this topic was posted for public comment from May 26 to June 22, 2016. The Task...

issues in oncology

Addressing the Significant Disparities and Barriers to Health Care Experienced by LGBT Cancer Survivors

In 2011, the Institute of Medicine (IOM) published its landmark report “The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding,” which recognized the scarcity of research in lesbian, gay, bisexual, and transgender (LGBT) individuals and the...

leukemia

Venetoclax Produces High Response Rate in Relapsed or Refractory CLL With 17p Deletion

In a pivotal phase II study reported in The Lancet Oncology, Stephan Stilgenbauer, MD, of Ulm University, Germany, and colleagues found that the BCL2 inhibitor venetoclax (ABT-199) produced a high response rate in patients with relapsed or refractory chronic lymphocytic leukemia (CLL) with the 17p ...

hematologic malignancies
leukemia

Is Extramedullary Disease at Diagnosis Prognostic in Adult Acute Myeloid Leukemia?

The presence of extramedullary disease at acute myeloid leukemia (AML) diagnosis was not an independent prognostic factor for worse survival, based on an analysis of data from the Eastern Cooperative Oncology Group–American College of Radiology Imaging Network (ECOG-ACRIN) reported by Ganzel...

lymphoma

Nivolumab Achieves Response in Most Patients With Classical Hodgkin Lymphoma After ASCT and Brentuximab Vedotin

In a phase II trial reported in The Lancet Oncology by Anas Younes, MD, of Memorial Sloan Kettering Cancer Center, and colleagues, treatment with the anti–PD-1 (programmed cell death protein 1) immune checkpoint inhibitor nivolumab (Opdivo) produced response in two-thirds of patients with...

bladder cancer
kidney cancer
prostate cancer

Multitude of Mentors Help Shape an Illustrious Career in Oncology

Sumanta K. Pal, MD, has had a longer career in oncology than many other colleagues his age. Perhaps the reason for that may center on his starting college at the age 13 and medical school at the age of 17. Today this internationally recognized leader in genitourinary cancers is Assistant Professor ...

skin cancer

Clinical Trials Actively Recruiting Patients With Basal Cell Carcinoma

Study Title: Long-Pulsed 1064 nm Nd:YAG Laser Treatment of Basal Cell Carcinoma (BCC) Study Type: Interventional/single-group assignment Study Sponsor and Collaborators: University of California, San Diego; Massachusetts General Hospital Purpose: To evaluate the safety and efficacy of laser...

skin cancer

Management of Merkel Cell Carcinoma

A recent report regarding pembrolizumab (Keytruda) for advanced Merkel cell carcinoma ushered in a more optimistic era in the treatment of this rare but often lethal skin cancer.1 The ASCO Post spoke with one of the field’s leaders, Paul Nghiem, MD, PhD—the first author of the study—about the...

head and neck cancer

Use of Pembrolizumab in Recurrent/Metastatic Head and Neck Squamous Cell Carcinoma After Platinum-Containing Therapy

On August 5, 2016, pembrolizumab (Keytruda) was granted accelerated approval for treatment of patients with recurrent or metastatic head and neck squamous cell carcinoma and disease progression on or after platinum-containing chemotherapy.1,2 As a condition of the accelerated approval, Merck is...

cns cancers

Effect of Radiosurgery Alone vs With Whole-Brain Radiotherapy on Cognitive Function in Patients With Brain Metastases

Physicians from Carolinas HealthCare System’s Neurosciences Institute and Levine Cancer Institute are among the authors of a recent study published by Brown et al in JAMA.1 The study showed how among patients with one to three brain metastases, the use of stereotactic radiosurgery alone, compared...

issues in oncology

Global Curriculum in Surgical Oncology Outlined by Society of Surgical Oncology and European Society of Surgical Oncology

As reported by Chandrakanth Are, MBBS, MBA, FRCS, FACS, of the University of Nebraska Medical Center, Omaha, and colleagues at the Society of Surgical Oncology (SSO) and European Society of Surgical Oncology (ESSO), the rising global burden of cancer and inequalities in surgical oncology education ...

geriatric oncology

ASCO 2016: Geriatric Oncology Highlights

Clinical trials focused on older adults with cancer were featured prominently at the 2016 ASCO Annual Meeting. There was a plenary session in glioblastoma, a clinical symposium on immunotherapy, and multiple educational lectures highlighting the growing literature and unique challenges in the...

lymphoma

FDA Grants Orphan Drug Designation to CD4CAR for the Treatment of Peripheral T-Cell Lymphoma

The U.S. Food and Drug Administration (FDA) has granted Orphan Drug designation for chimeric antigen receptor–engineered T cells directed against the target protein CD4 (CD4CAR) for the treatment of peripheral T-cell lymphoma. William Tse, MD, Chief of the Blood and Marrow Transplantation Division ...

lymphoma

Interim PET-Adapted Treatment in Advanced Hodgkin Lymphoma

The ability to cure a majority of patients with advanced Hodgkin lymphoma is one of the major milestones of success in the combination chemotherapy era. It has been over 40 years since Bonadonna and colleagues in Milan developed the ABVD regimen (doxorubicin, bleomycin, vinblastine, and...

lymphoma

Continued ABVD vs Omission of Bleomycin (AVD) After Negative Imaging Findings in Advanced Hodgkin Lymphoma

In a phase III trial reported in The New England Journal of Medicine, Peter Johnson, MD, of the Cancer Research UK Centre, University of Southampton, and colleagues found similar efficacy with continued ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) vs omission of bleomycin (AVD) after...

skin cancer

Immune Analysis of On-Treatment Longitudinal Biopsies Predicts Response to Melanoma Immunotherapy

Immune response measured in tumor biopsies during the course of early treatment predicts which melanoma patients will benefit from specific immune checkpoint blockade drugs, researchers at The University of Texas MD Anderson Cancer Center found in a report published by Chen et al in Cancer...

breast cancer

Posttreatment Problems Surveyed in African American Breast Cancer Survivors

Although there is some overlap, past research has shown that the challenges faced by African American breast cancer survivors differ somewhat from Caucasian women. But the studies that demonstrated difference were not designed to explore those challenges in depth. Now new research from Thomas...

leukemia

Study Finds Minimal Residual Disease Assessment Improves Prediction of Outcome in CLL Responders

Assessment of minimal residual disease was associated with improved prediction of outcome in responders, as well as complete responders, in patients with chronic lymphocytic leukemia (CLL) who respond to treatment. Kovacs et al reported these findings, which are based on an analysis of two phase...

sarcoma

Does Intensified Postoperative Chemotherapy for High-Grade Osteosarcoma Benefit Poor Responders to Preoperative Therapy?

In a phase III trial (EURAMOS-1) reported in The Lancet Oncology, Marina et al found no improvement in event-free survival by adding postoperative ifosfamide/etoposide to cisplatin, doxorubicin, and methotrexate in patients with newly diagnosed high-grade osteosarcoma who responded poorly to...

prostate cancer

Continuation of Docetaxel May Improve Survival in Metastatic Castration-Resistant Prostate Cancer

The number of docetaxel cycles completed was associated with improved overall survival among men with metastatic castration-resistant prostate cancer receiving docetaxel, prednisone, and lenalidomide (Revlimid; DPL) or docetaxel/prednisone (DP), in the phase III Mainsail trial. de Morrée et...

prostate cancer

Hypofractionated Radiotherapy for Localized Prostate Cancer: A New Standard of Care?

For at least the past quarter of a century, radiobiologists and radiation oncologists have debated the role of hypofractionation (fewer total fractions with a higher dose per fraction) for prostate cancer. The debate stems from the unique radiobiology of prostate cancer and the best means to...

hematologic malignancies
leukemia
lymphoma
multiple myeloma

Roundup of Selected Abstracts in Multiple Myeloma, Acute and Chronic Leukemia, and Advanced Lymphoma

In June 2016, the European Hematology Association Congress convened in Copenhagen, Denmark. The educational and scientific program highlighted state-of-the-art clinical practice and the latest findings in hematology research. The ASCO Post brings its readers brief summaries of some of the important ...

lymphoma

For High-Grade and Aggressive Non-Hodgkin Lymphomas, Treat Adults Like Children

Outcomes for adults with high-grade and aggressive non-Hodgkin lymphomas (NHLs) appear to be better when these patients are treated with pediatric-inspired protocols, according to Mitchell S. Cairo, MD, Chief of the Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Maria...

head and neck cancer

Predictors of Readmission in Patients Requiring Free Tissue Reconstruction for Head and Neck Cancer

Certain factors increase the risk of unplanned readmission in the month after head and neck cancer resection requiring free tissue reconstruction, finds an analysis of data from the National Surgical Quality Improvement Program (NSQIP) of the American College of Surgeons.1 Nearly 1 in 10 patients...

Expert Point of View: M. Boyd Gillespie, MD, MSCR

“This study is actually surprising to me, because earlier studies of that particular antibody as a single therapy for this disease, salivary duct carcinoma, showed it was not very effective, with only 10% to 15% response rates,” session co-moderator, M. Boyd Gillespie, MD, MSCR, Professor and Vice ...

head and neck cancer

Benefits Seen From Extending Steroids After Transoral Robotic Surgery for Head and Neck Cancer

Patients undergoing transoral robotic surgery for head and neck cancer may experience improvements in some outcomes when given an extended course of corticosteroids, finds a randomized controlled trial reported at the 9th International Conference on Head and Neck Cancer.1 Relative to peers given...

head and neck cancer

Nerve Stimulation During Oncologic Neck Dissection May Help to Preserve Shoulder Function

Electrical stimulation of the spinal accessory nerve during neck dissection for head and neck cancer may reduce the development of shoulder dysfunction, according to a double-blind randomized controlled trial.1 A year after surgery, patients given intraoperative electrical stimulation had...

breast cancer

Discrepancies Between Current ASCO-CAP Guidelines on HER2 Amplification Testing and Designations in BCIRG Trials

In an analysis reported in the Journal of Clinical Oncology, Press et al found notable discrepancies between recent ASCO–College of American Pathologists (ASCO-CAP) changes in the recommendations for evaluation of HER2 amplification by fluorescent in situ hybridization (FISH) and FISH scores...

prostate cancer

Early-Stage Prostate Cancer Incidence Rates Decline, Distant-Stage Disease Rates Unchanged in 2013

Jemal et al described findings indicating a continued decline in the incidence of localized/regional-stage prostate cancer at 2 years after the U.S. Preventive Services Task Force recommendation against routine prostate-specific antigen (PSA) screening in men aged ≥ 50 years in 2011, in a letter ...

head and neck cancer

Use of Lugol’s Iodine Stain May Reduce the Need for Repeat Resection of Oral and Oropharyngeal Cancers

By identifying residual dysplasia in the tumor bed, Lugol’s iodine staining may improve pathologic outcomes with resection of oral and oropharyngeal cancers, according to interim findings of a UK randomized controlled trial reported at the 9th International Conference on Head and Neck Cancer.1...

palliative care

Palliative Care 2016: 'Mystery Shopper' Study Finds Barriers to Accessing Palliative Care Services at Major Cancer Centers

A team of researchers, using a novel approach, found that while many cancer centers offer palliative and supportive care services, patients may face challenges when trying to access them. The study showed that expanding awareness and education to patient-facing cancer center employees about such...

palliative care

Palliative Care 2016: Early Palliative Care Improves Coping, Quality of Life for Patients With Incurable Cancers

A randomized clinical trial found that introducing palliative care shortly after a diagnosis of certain metastatic cancers greatly increases a patient’s coping abilities, as well as overall quality of life. Researchers also found that early integration of palliative care results in an...

issues in oncology

Patients With Cancer May Be at Heightened Risk of Injuries During Diagnostic Process

Patients with cancer have heightened risks of unintentional and intentional injuries during the diagnostic process, revealed findings from a large study published by Shen et al in The BMJ. A range of injuries are common, and some are potentially life-threatening, the study showed. The authors...

hematologic malignancies

Autologous Stem Cell Transplant May Age Immune Cells as Much as 30 Years

University of North Carolina (UNC) Lineberger Comprehensive Cancer Center researchers, by tracking p16INK4a, a molecular marker that has been shown to increase in white blood cells as people age, have uncovered clues suggesting that stem cell transplant is linked to a marked increase in the...

issues in oncology

Is Human Life Worth No More Than a Text Message?

The words “cost control,” “value-based health care,” and similar iterations are floating around freely these days to make us aware of the unsustainable upward trajectory of health-care costs. We are reminded constantly about how health care in America currently costs more than $3.4 trillion...

lymphoma

Early Relapse in Follicular Lymphoma: Clinical Trial Data May Guide Management Decisions

Approximately 20% of patients with follicular lymphoma will relapse within 2 years of diagnosis. Although the optimal management of these patients has not been established, clinicians may be guided by data from recent clinical trials, according to Nathan H. Fowler, MD, Associate Professor and...

prostate cancer

European Studies Compare Conventional vs Hypofractionated Radiotherapy for Localized Prostate Cancer

Two recent European phase III trials with different study designs focused on hypofractionated vs conventional radiotherapy in localized prostate cancer. Investigators in the CHHiP trial1 showed that the hypofractionated approach is noninferior to standard fractionation, with no increase in side...

issues in oncology

Gene Overexpression Scoring System May Accurately Predict Patient Response to Cancer Treatments

Researchers at the Department of Energy's Lawrence Berkeley National Laboratory (Berkeley Lab) identified 14 genes regulating genome integrity that were consistently overexpressed in a wide variety of cancers. They then created a scoring system based upon the degree of gene overexpression. For...

kidney cancer

Accumulation of Metabolite Fumarate May Be Linked to Hereditary Leiomyomatosis and Renal Cell Cancer

Researchers funded by the Medical Research Council (MRC) have shown that when the metabolite fumarate accumulates in a hereditary form of renal cancer, it leads to an epigenetic reprogramming that drives cancer, according to a study published by Sciacovelli et al in Nature. The tumor growth...

colorectal cancer

Tumor-Infiltrating Lymphocytes and Crohn’s-Like Lymphoid Reaction May Be Prognostic Indicators for Colorectal Cancer

Intratumoral tumor-infiltrating lymphocyte level and prominent peritumoral Crohn’s-like lymphoid reaction appear to be independent prognostic factors for survival in colorectal cancer, according to a study reported by Rozek et al in the Journal of the National Cancer Institute. The findings...

prostate cancer

PSA-Based Computational Model Predicts Time to Relapse After Prostate Cancer Surgery

Approximately one in four patients who undergo radical prostatectomy experience a cancer recurrence. Now a study by Stura et al investigating a prostate-specific antigen (PSA)-based computational model that uses four consecutive postsurgical PSA values has found the mathematical model to be highly...

kidney cancer
lung cancer
skin cancer

Incidence of PD-1 Inhibitor–Related Pneumonitis in Advanced NSCLC, Renal Cell Carcinoma, and Melanoma

In a systematic review and meta-analysis reported in JAMA Oncology, Nishino et al identified the rates of PD-1 (programmed cell death protein 1) inhibitor–related pneumonitis in patients with advanced non–small cell lung cancer (NSCLC), renal cell carcinoma, and melanoma. Rates were...

colorectal cancer

Retinoic Acid May Suppress Colorectal Cancer Development

Retinoic acid may play a critical role in suppressing colorectal cancer in mice and humans, according to researchers at the Stanford University School of Medicine. Mice with the cancer have lower-than-normal levels of the metabolite in their gut, the researchers found. Furthermore, colorectal...

breast cancer

Psychosocial Adjustment, Breast Cancer–Specific Distress in Adolescent Girls From BRCA1/2-Positive and Breast Cancer Families

Adolescent girls from BRCA1/2-positive and breast cancer families appear to have higher self-esteem and similar psychosocial adjustment compared with their peers but experience greater breast cancer–specific distress and perceived risk of breast cancer. Bradbury et al reported these findings...

multiple myeloma

Adding Daratumumab to Bortezomib/Dexamethasone Improves Progression-Free Survival in Relapsed/Refractory Multiple Myeloma

In the phase III CASTOR trial reported in The New England Journal of Medicine, Palumbo et al found that adding the anti-CD38 antibody daratumumab (Darzalex) to bortezomib (Velcade) and dexamethasone markedly improved progression-free survival among patients with relapsed or relapsed and refractory...

health-care policy
issues in oncology

Researchers Question Process for Reviewing Coverage of 'Off-Label' Cancer Drug Use

A group of University of North Carolina (UNC) Lineberger Comprehensive Cancer Center researchers is calling for an overhaul of the process that determines which cancer drugs used off-label—or beyond their approved use—are reimbursed by federally funded health insurance in the United...

breast cancer

Study Finds Chemotherapy May Be Avoidable in Women With Early Breast Cancer at High Clinical but Low Genomic Risk on 70-Gene Signature Assay

In a phase III trial (MINDACT) reported in The New England Journal of Medicine, Cardoso et al found that adjuvant chemotherapy may be avoidable in women with early-stage breast cancer who are at high clinical risk but low genomic risk as determined by the 70-gene signature assay (MammaPrint)....

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