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symptom management

International Guidelines for Treatment and Prophylaxis of VTE in Patients With Cancer

The 2019 International Initiative on Thrombosis and Cancer (ITAC) has issued updated clinical practice guidelines for the treatment and prophylaxis of venous thromboembolism (VTE) in patients with cancer. They were published by Farge et al in The Lancet Oncology. The guidelines consist of...

genomics/genetics
immunotherapy

POLE/POLD1 Mutations Across Cancer Types and Association With Immune Checkpoint Inhibitor Therapy Outcomes

In a research letter published in JAMA Oncology, Wang et al identified the frequency of mutations in DNA polymerase epsilon (POLE) and delta 1 (POLD1) genes across cancer types and found that these mutations were associated with better survival outcomes among patients receiving immune checkpoint...

lung cancer
immunotherapy

ASTRO 2019: Patterns of Disease Progression in Patients With Unresectable Stage III NSCLC: Analysis of the PACIFIC Trial

Andreas Rimner, MD, of Memorial Sloan Kettering Cancer Center, presented an update of the landmark PACIFIC trial at the 61st Annual Meeting of the American Society for Radiation Oncology (ASTRO) (Abstract LBA-6). In earlier reports from the randomized phase III trial, Antonia et al had evaluated...

gynecologic cancers
immunotherapy

FDA Grants Approval to Lenvatinib/Pembrolizumab in Advanced Endometrial Cancer, Announces Project Orbis

The U.S. Food and Drug Administration (FDA) has announced Project Orbis, an initiative of the FDA Oncology Center of Excellence (OCE). Project Orbis provides a framework for concurrent submission and review of oncology drugs among its international partners. Under this project, the FDA, the...

onivyde
lynparza

Targeting an Important Tumor Vulnerability With Maintenance Olaparib in Germline BRCA-Mutated Pancreatic Cancer

In the POLO trial, which is discussed in this issue of The ASCO Post, Golan and colleagues evaluated the potential benefit of maintenance olaparib after disease stability or response to a minimum of 4 months of platinum-based chemotherapy in patients with metastatic pancreatic cancer and a...

gemzar
onivyde
lynparza
eloxatin

POLO Trial: Maintenance Olaparib in Germline BRCA-Mutated Metastatic Pancreatic Cancer

As reported in The New England Journal of Medicine by Talia Golan, MD, of Sheba Medical Center, Tel Aviv University, and colleagues, the phase III POLO trial showed that maintenance treatment with the poly (ADP ribose) polymerase (PARP) inhibitor olaparib improved progression-free survival vs...

prostate cancer

ASTRO 2019: Long-Term Hormone Therapy May Increase Other-Cause Mortality in Men With Prostate Cancer Receiving Early Salvage Radiotherapy

Findings from the randomized phase III NRG Oncology/RTOG 9601 trial were initially reported in 2017, and showed that the addition of 2 years of antiandrogen therapy to postsurgical radiation treatment for men with recurrent prostate cancer increased their long-term overall survival rate. That study ...

head and neck cancer
symptom management

ASTRO 2019: Machine-Learning Model May Accurately Predict Radiation Side Effects in Patients With Head and Neck Cancers

A study by Reddy et al investigating the use of a machine-learning model to predict which patients with head and neck cancer being treated with radiation may experience significant weight loss, feeding tube placement, and unplanned hospitalization has found that the model accurately identified the...

gynecologic cancers
immunotherapy

Bevacizumab/Niraparib vs Niraparib Alone for Platinum-Sensitive Recurrent Ovarian Cancer

In the phase II NSGO-AVANOVA2/ENGOT-ov24 trial reported in The Lancet Oncology, Mansoor Raza Mirza, MD, and colleagues found that the combination of bevacizumab plus niraparib prolonged progression-free survival vs niraparib alone in women with platinum-sensitive recurrent ovarian cancer. Study...

issues in oncology
pain management

Access to Cannabis Products for Patients With Cancer in a State With Restrictive Medical Marijuana Laws

Results of a survey reported by Singh et al in the Journal of Oncology Practice found that a population of primarily patients with cancer enrolled in Georgia’s medical marijuana program reported concerns about the legality of marijuana-related products and their ability to obtain the products. As...

breast cancer
issues in oncology

FDA Issues Drug Safety Communication on Lung Inflammation Due to Treatment With CDK4/6 Inhibitors

On September 13, the U.S. Food and Drug Administration (FDA) issued a drug safety communication warning that palbociclib, ribociclib, and abemaciclib—used to treat some patients with advanced breast cancer—may cause rare but severe inflammation of the lungs. The agency approved new warnings about...

velcade
fragmin
lipodox
savaysa
lixiana
etopophos
xarelto
nolvadex
soltamox
venclexta
velban

Conundrums in Managing Cancer-Associated Thrombosis

Although there may be a clear role for prophylactic anticoagulation in hospitalized patients and those undergoing surgery, indication for prophylactic anticoagulation for patients with cancer seen in the ambulatory setting has yet to emerge. Until clinical trial data on prophylactic...

issues in oncology
gynecologic cancers
health-care policy

ASTRO 2019: Effect of Closure of Women’s Health Clinics From 2010 to 2013 on Cervical Cancer Screening and Detection

Following the closure of nearly 100 women’s health clinics across the United States from 2010 to 2013, fewer women were screened for cervical cancer; more women were diagnosed with advanced stages of the disease; and disease mortality rates rose. Findings from a new analysis combining several...

lung cancer
immunotherapy

ASTRO 2019: SBRT After Disease Progression on Immunotherapy Increases PFS in Patients With Metastatic NSCLC

Non–small cell lung cancer (NSCLC) accounts for the vast majority of all lung cancers—between 80% and 85% of those diagnosed in the United States—and is among the most deadly cancers for both men and women, exceeding the mortality rate of colon, breast, and pancreatic cancers combined. The results...

prostate cancer

ASTRO 2019: ORIOLE Trial: Observation vs SABR for Oligometastatic Prostate Cancer

The randomized, phase II ORIOLE trial studying the efficacy of targeted high-dose radiation for men with oligometastatic prostate cancer has shown that stereotactic ablative radiation (SABR) is an effective and safe option for patients who wish to delay hormone-suppression therapy. Data from the...

breast cancer
survivorship
symptom management

Home-Based Exercise and Weight Loss Programs for Lymphedema Management in Overweight Breast Cancer Survivors

As reported in JAMA Oncology by Schmitz et al, the WISER Survivor trial showed no benefit of home-based exercise and weight loss programs on lymphedema outcomes vs facility-based lymphedema care among overweight breast cancer survivors. Study Details In the trial, 351 overweight breast cancer...

hematologic malignancies
issues in oncology

Single-Center Study of Human Herpesvirus 6B Detection in Bronchoalveolar Lavage Fluid After Hematopoietic Cell Transplantation

In a single-institution study reported in the Journal of Clinical Oncology, Hill et al found that detection of human herpesvirus 6B (HHV-6B) in bronchoalveolar lavage fluid was associated with increased mortality in recipients of allogeneic hematopoietic cell transplantation (HCT) with lower...

breast cancer

Meta-analysis of Chemotherapy and Hormonal Treatments for Postmenopausal Women With Metastatic Breast Cancer

In a systematic review and network meta-analysis reported in The Lancet Oncology, Giuliano et al found that progression-free survival in postmenopausal women with hormone receptor (HR)-positive, HER2-negative metastatic breast cancer was improved with first- or second-line CDK4/6 inhibitors plus...

supportive care

Chef Uses Flavor to Fuel Her Mother’s Appetite During Cancer Treatment

The battle against cancer is typically waged by the surgeon and oncologist, but a Lexington, Kentucky–based, award-winning restaurateur and chef discovered her role as a foot soldier when she applied her culinary skills to deal with the debilitating side effects of her mother’s lung cancer...

News From the IASLC World Conference on Lung Cancer and the ASCO Quality Care Symposium

This week, we’ll be discussing findings presented at the International Association for the Study of Lung Cancer (IASLC) World Conference on Lung Cancer and the ASCO Quality Care Symposium, including a pooled analysis on 5-year overall survival rates in patients with previously treated non-small...

lung cancer
multiple myeloma
sarcoma

FDA Pipeline: Breakthrough Therapy Designation in Lung Cancer, Orphan Drug Designations in Myeloma and Soft-Tissue Sarcoma

Recently, the U.S. Food and Drug Administration (FDA) granted Breakthrough Therapy designation to tepotinib for metastatic non–small cell lung cancer harboring MET exon 14 skipping alterations, and Orphan Drug designations to novel chimeric antigen receptor T-cell therapies in both multiple myeloma ...

lung cancer

WCLC 2019: Video-Assisted Thoracic Surgery vs Open Surgery in Lung Cancer

Video-assisted thoracic surgery was associated with lower in-hospital complications and a shorter length of stay compared with open surgery among British patients who were diagnosed with early-stage lung cancer, according to research presented by Lim et al at the International Association for the...

lung cancer

WCLC 2019: Selpercatinib in RET Fusion–Positive NSCLC

Patients with RET fusion–positive non–small cell lung cancer (NSCLC) comprise up to 2% of all NSCLC cases, but there are no targeted therapies currently approved for patients with this form of lung cancer. Selpercatinib (also known as LOXO-292) is an oral and highly selective investigational drug...

lung cancer
immunotherapy

WCLC 2019: KEYNOTE-024 Survival Update Shows Benefit With Pembrolizumab vs Chemotherapy in Advanced NSCLC

First-line pembrolizumab monotherapy provides durable long-term overall survival benefit compared to chemotherapy in patients with advanced non–small cell lung cancer (NSCLC), according to data from the KEYNOTE-024 trial presented by Martin Reck, MD, PhD, at the International Association for the...

solid tumors
immunotherapy

Liquid Biopsy to Determine Patient Response to Immune Checkpoint Blockade

Although studies have demonstrated that microsatellite instability (MSI) and high tumor mutational burden (TMB) are promising pan-tumor biomarkers for identifying patients for treatment with immune checkpoint blockade, obtaining tissue from unresectable or metastatic solid tumors for genetic...

gynecologic cancers

Neoadjuvant Cisplatin/Gemcitabine Followed by Standard Chemoradiation in Locally Advanced Cervical Cancer

In a Brazilian single-center phase II trial reported in the Journal of Clinical Oncology, da Costa et al found that neoadjuvant cisplatin/gemcitabine followed by standard chemoradiation therapy with cisplatin did not improve outcomes vs chemoradiation therapy alone in locally advanced cervical...

issues in oncology

WCLC 2019: Declaration From IASLC on Tobacco Cessation After Cancer Diagnosis

The International Association for the Study of Lung Cancer (IASLC) used the platform of the 2019 World Conference on Lung Cancer (WCLC) to call attention to the importance of tobacco cessation after cancer diagnosis and urged all physicians to screen patients with cancer for tobacco use and...

lung cancer
immunotherapy

WCLC 2019: Final Overall Survival Results of IMpower131 Trial in Advanced Squamous NSCLC

Patients with stage IV squamous non–small cell lung cancer (NSCLC) with high programmed cell death ligand 1 (PD-L1) expression treated with atezolizumab and chemotherapy experienced longer overall survival rates than those treated with chemotherapy alone. The data from the IMpower131 trial were...

lung cancer

WCLC 2019: BioMILD Trial of Blood MicroRNA Plus Low-Dose CT to Reduce CT Repeats in Lung Cancer Screening

Researchers from Milan reported that using a blood microRNA assay accompanied by low-dose computed tomography (CT) screening is safe and effective in screening patients for lung cancer. The results were shared at the International Association for the Study of Lung Cancer (IASLC) 2019 World...

lung cancer

WCLC 2019: Autoantibody Diagnostic Test Followed by CT Imaging May Improve Diagnosis, Reduce Mortality in Lung Cancer

A combination of the EarlyCDT-Lung Test followed by computed tomography (CT) imaging in Scottish patients at risk for lung cancer resulted in a significant decrease in late-stage diagnosis of lung cancer and may decrease lung cancer–specific mortality, according to research presented at...

cns cancers

Quality of Life and Neurocognitive Function With Lomustine/Temozolomide for MGMT-Methylated Glioblastoma

In an analysis of the phase III CeTeG/NOA-09 trial reported in The Lancet Oncology, Weller et al found no clinically relevant differences in health-related quality of life or neurocognitive function in patients with newly diagnosed MGMT-methylated glioblastoma treated with lomustine/temozolomide vs ...

issues in oncology
solid tumors
hematologic malignancies

Flu Vaccine Effectiveness in Patients With Cancer

In a Canadian study reported in the Journal of Clinical Oncology, Blanchette et al found the influenza vaccine was effective among patient with cancer, with greater effectiveness in patients with solid tumors vs those with hematologic malignancies. Study Details The population-based study involved...

issues in oncology
global cancer care

Michael Kenneth Keng, MD, on an ASCO Quality Training Program: 5-Year Review

Michael Kenneth Keng, MD, of the University of Virginia, gives a status update on this international program, and discusses future initiatives which include coaching mentorship and publishing articles on quality care (Abstract 7).

issues in oncology

Manali I. Patel, MD, on Community Practices: Enhancing Delivery of Value-Based Cancer Care

Manali I. Patel, MD, of Stanford Cancer Center, discusses enhancing value for patients with cancer treated by community practitioners at the end of life by also utilizing trained lay health workers in a novel intervention that reduced the use of acute care and emergency department visits while...

issues in oncology

Cary P. Gross, MD, on Creating and Implementing Clinical Pathways: Where is the Patient’s Voice?

Cary P. Gross, MD, of Yale School of Medicine, discusses the challenges of implementing pathways and guiding patient decision-making on treatment.

issues in oncology

Joseph O. Jacobson, MD, on Suffering, Systems, and Safety: The Joseph V. Simone Award Lecture

Joseph O. Jacobson, MD, of Dana-Farber Cancer Institute, and this year’s recipient of the award for excellence in quality cancer care, discusses the need for quality improvement (QI) to encompass systems of care, the role of QI in preventing suffering, how poor quality affects patient safety, and...

issues in oncology

Nadine Housri, MD, on Online Tumor Boards: A New Resource for Practicing Oncologists

Nadine Housri, MD, of the Yale School of Medicine, talks about a new paradigm in sharing knowledge from tumor board discussions at NCI-designated comprehensive cancer centers, with community oncologists on themednet.org. Currently, thoracic, breast, and GI cancers are included, with plans to expand ...

issues in oncology

Matthew B. Schabath, PhD, on Addressing Cultural Barriers to Equality in Oncology Among Sexual and Gender Minorities

Matthew B. Schabath, PhD, of H. Lee Moffitt Cancer Center and Research Institute, discusses the disparities in cancer care among members of the LGBTQ community and the need to collect more data in order to close that gap.

symptom management

Angela M. Stover, PhD, on Patient-Reported Outcome Performance Measures for Oncology Practice

Angela M. Stover, PhD, of the University of North Carolina at Chapel Hill, discusses ASCO’s initiative to develop patient-based performance measures for assessing and managing symptoms. The measures have made substantial differences in reducing nausea, constipation, and insomnia (Abstract 173).

issues in oncology

Lauren M. Hamel, PhD, on Race and Doctor-Patient Behavior

Lauren M. Hamel, PhD, of Wayne State University/Karmanos Cancer Institute, discusses her findings on the ways in which nonverbal behavior between doctors and patients of the same or different races can affect their relationship, quality of communication, and ultimately, perhaps outcomes as well...

issues in oncology

Mallika Sharma, MPH, on Eliminating Prior Authorizations, Anxiety, Delay in Care, Higher Costs

Mallika Sharma, MPH, of Seattle Cancer Care Alliance, discusses her findings that, by doing away with the many prior authorization denials based on administrative errors, providers may offer higher-value care by eliminating unnecessary anxiety among patients, administrative burdens, and increased...

issues in oncology

Grace C. Hillyer, EdD, MPH, on Enrolling Patients in Clinical Trials: Improving Clinician-Patient Communication

Grace C. Hillyer, EdD, MPH, of Columbia University Mailman School of Public Health, discusses the many barriers to enrolling patients in clinical trials, most notably different attitudes toward and perceptions about research studies among clinicians vs patients. Her findings point to the need for...

issues in oncology

Elena Martinez, PhD, MPH, on Diversity in Precision Oncology

Elena Martinez, PhD, MPH, of Moores Cancer Center at the University of California, San Diego, discusses the challenges of ensuring diversity in precision oncology and potential solutions to address the challenges.

issues in oncology

Oncology Communications Online: Pause and Think Before Hitting ‘Send’

The emergence of online technologies over the past few decades has fundamentally changed the way society communicates and shares information. This sea change has also had profound influence on the practice of medicine, from real-time information-sharing among colleagues, to having instant access...

cost of care
issues in oncology

Ryan Huey, MD, on the Financial Toxicity of Early-Phase Clinical Trials

Ryan Huey, MD, of The University of Texas MD Anderson Cancer Center, discusses his findings that showed the large financial burden on lower-income patients enrolled in phase I trials (Abstract 8).

lung cancer

Cristina Merkhofer, MD, MHS, on NSCLC: Survival Impact of Taking Part in a Clinical Trial

Cristina Merkhofer, MD, MHS, of Fred Hutchinson Cancer Research Center, discusses study results showing that for patients with metastatic non–small cell lung cancer at her institution, enrolling in a therapeutic drug clinical trial was associated with a 47% lower risk of death, compared with not...

cost of care
lung cancer

Bernardo H.L. Goulart, MD, on Stage IV NSCLC: High Drug Costs May Affect Survival

Bernardo H. L. Goulart, MD, of Seattle Cancer Care Alliance, discusses his findings that high out-of-pocket costs for oral tyrosine kinase inhibitors may lower survival rates, shorten the duration of therapy, and reduce the number of prescriptions for patients with metastatic EGFR- or ALK-positive...

lung cancer

WCLC 2019: Screening Efficacy of PLCOm2012 vs USPSTF Criteria

Researchers reported that a prospective trial comparing two screening methods for patients at risk of developing lung cancer found that a model used by Canadian, Australian, and European public health organizations detected more cancers than the screening model used by the United States Preventive...

solid tumors
immunotherapy

Pamiparib Plus Tislelizumab in Advanced Solid Tumors

In an Australian phase Ia/b trial reported in The Lancet Oncology, Friedlander et al found evidence of activity of the combination of the poly (ADP-ribose) polymerase inhibitor pamiparib and the programmed cell death protein 1 inhibitor tislelizumab in patients with previously treated advanced...

breast cancer
immunotherapy

T-DM1 Plus Neratinib in Metastatic HER2-Positive Breast Cancer

In the phase Ib NSABP Foundation Trial FB-10 reported in the Journal of Clinical Oncology, Jame Abraham, MD, and colleagues found evidence of activity of the combination of ado-trastuzumab emtansine (T-DM1) plus neratinib in metastatic HER2-positive breast cancer and identified the dose of the...

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