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issues in oncology

HIV-Infected People With Early-Stage Cancers Are Up to Four Times More Likely to Go Untreated for Cancer

HIV-infected people diagnosed with cancer are two to four times more likely to go untreated for their cancer compared to uninfected cancer patients, according to a large retrospective study from researchers in Penn Medicine’s Abramson Cancer Center and the National Cancer Institute (NCI). The ...

colorectal cancer

Postdiagnosis Calcium and Milk Intake May Be Associated With Improved Overall Survival in Colorectal Cancer Patients

Higher intakes of calcium, vitamin D, and dairy product are associated with lower risk of colorectal cancer, but the effect of such intake on survival in colorectal cancer is unclear. In a study reported in the Journal of Clinical Oncology, Yang et al found that higher postdiagnosis intake of...

breast cancer

Telephone-Based Intervention Produces Weight Loss in Postmenopausal Women With Breast Cancer Receiving Letrozole

Obesity is associated with poorer outcome in women with operable breast cancer. In the LISA study reported in the Journal of Clinical Oncology, Goodwin et al found that a 24-month telephone-based intervention was effective in reducing body weight in postmenopausal breast cancer patients receiving...

breast cancer
health-care policy

Immediate Breast Reconstruction After Mastectomy More Likely Among Canadian Women With Higher Income Who Are Treated at Teaching Hospitals

In a study reported in the Journal of Clinical Oncology, Zhong et al assessed factors associated with use of immediate breast reconstruction after treatment or prophylaxis for breast cancer among women in the Canadian universal health-care system. Immediate breast reconstruction was more likely in...

health-care policy

Uninsured Young Adults Have Poorer Cancer-Specific Outcomes

The Patient Protection and Affordable Care Act is likely to improve insurance coverage for young adults. In a study reported in the Journal of Clinical Oncology, Aizer et al examined the association between insurance status and cancer outcomes among young adults, finding that the uninsured...

head and neck cancer

HPV-Positive Disease Predicts Longer Overall Survival After Progression of Oropharyngeal Squamous Cell Carcinoma

Patients with human papillomavirus (HPV)-positive oropharyngeal cancer have reduced risk of progression compared with those with HPV-negative disease, but the effect of HPV status on overall survival after progression has not been clear. In a study reported in the Journal of Clinical Oncology,...

issues in oncology

Oncologist Communication Skills Training Program Effective for Both Oncologists and Patients

In a Japanese study reported in the Journal of Clinical Oncology, Fujimori et al found that an oncologist communication skills training program based on patient preferences in receiving bad news was of benefit to both oncologists and patients. Study Details In the study, 30 oncologists were...

breast cancer
supportive care

HERA Trial 8-Year Follow-up Shows Low Rate of Trastuzumab-Associated Cardiac Dysfunction

In a study reported in Journal of Clinical Oncology, Azambuja et al found low rates of trastuzumab (Herceptin)-related cardiac dysfunction over a median of 8 years of follow-up in the HERceptin Adjuvant (HERA) trial. The majority of patients with cardiac dysfunction achieved acute recovery. Study...

cns cancers

Glioma-Associated Antigen Peptide Vaccination Produces Antigen-Specific T-Cell Response and Clinical Activity in Children With High-Grade Gliomas

In a study reported in the Journal of Clinical Oncology, Pollack et al found antigen-specific immune responses and evidence of clinical activity with glioma-associated antigen (GAA) peptide vaccination in children with newly diagnosed malignant brainstem and nonbrainstem gliomas. Study Details In ...

multiple myeloma

Combined Index Predicts Early Multiple Myeloma Progression-Related Death in Patients Receiving Front-Line Autologous Stem Cell Transplantation

In a European study reported in the Journal of Clinical Oncology, Moreau et al developed and validated a combined index for prognosis in patients with multiple myeloma treated with front-line autologous stem cell transplantation. The index, consisting of high lactate dehydrogenase (LDH) level,...

breast cancer
issues in oncology

Study Finds Changes in Brain Activity in Breast Cancer Patients Receiving Chemotherapy

A small study of 18 patients with breast cancer treated with chemotherapy has found a significant increase in cognitive complaints and significant correlations between these increases and decreases in multitasking-related brain activation. The study by Deprez et al is published in the Journal of...

breast cancer

Higher Distant Invasive Breast Cancer Recurrence Risk for HER2-Positive T1b vs T1a Node-Negative Localized Breast Cancer

In a study of data from an integrated health-care delivery system reported in the Journal of Clinical Oncology, Fehrenbacher et al found that patients with T1b node-negative localized breast cancer have a higher risk of distant invasive recurrence than those with T1a disease. Risk was highest among ...

breast cancer

Needle Biopsy Underused in the United States, Adversely Affecting Breast Cancer Treatment

In a study reported in the Journal of Clinical Oncology, Eberth et al found that needle biopsy is underused in diagnosis and treatment of breast cancer, with a number of surgeon factors contributing to underuse. The study involved Medicare data from 89,712 patients with breast cancer seen between...

lung cancer

Phase III Trial of Adding Figitumumab to Chemotherapy in Advanced Nonadenocarcinoma NSCLC Stopped Early for Futility and Increased Harm

In the first phase III trial assessing the combination of an insulin-like growth factor 1 receptor (IGF-1R) inhibitor with chemotherapy as first-line treatment for advanced nonadenocarcinoma non–small cell lung cancer (NSCLC), the addition of the fully human immunoglobulin G2 monoclonal...

solid tumors

Adding Lapatinib to Paclitaxel Does Not Improve Survival as Second-Line Therapy in Asian Patients With HER2-Positive Advanced Gastric Cancer

Weekly paclitaxel is used as second-line treatment in advanced gastric cancer, including HER2-positive disease, in Asian countries. In the phase III TyTAN trial in Asian patients reported in the Journal of Clinical Oncology, Satoh et al assessed the addition of the anti-HER2 agent lapatinib...

leukemia

First-Line Lenalidomide Plus Rituximab Is Safe and Effective in Older and Younger CLL Patients, Phase II Study Shows

The combination of lenalidomide (Revlimid) and rituximab (Rituxan) has shown synergistic activity in chronic lymphocytic leukemia (CLL) preclinical models. In a CLL Research Consortium phase II study of the combination in treatment-naive patients reported in the Journal of Clinical Oncology, James...

breast cancer

Early Change in Chemotherapy Based on Elevated Circulating Tumor Cells Does Not Improve Outcome in Metastatic Breast Cancer

Elevated circulating tumor cells are associated with poor prognosis in metastatic breast cancer. In the phase III Southwest Oncology Group (SWOG) S0500 trial reported in the Journal of Clinical Oncology, Smerage et al assessed whether changing chemotherapy after one cycle of first-line treatment in ...

breast cancer

Study Identifies Risk of Chemotherapy-Related Hospitalization for Early-Stage Breast Cancer Patients

Oncologists now have a new understanding of the toxicity levels of specific chemotherapy regimens used for women with early-stage breast cancer, according to research from The University of Texas MD Anderson Cancer Center. The retrospective study, reported in the Journal of Clinical Oncology by...

breast cancer
supportive care

Greater Risk of Pretreatment Cognitive Impairment in Older Breast Cancer Patients With More Advanced Disease and Greater Comorbidity

In a study reported in the Journal of Clinical Oncology, Mandelblatt and colleagues attempted to determine whether cognitive impairment is present in older patients with breast cancer prior to systemic therapy. They found that although there were no global differences in cognitive function between...

colorectal cancer

No Differences in Surgical Outcomes With Four Different Chemotherapy Regimens Plus Preoperative Radiotherapy in Rectal Cancer

As reported in the Journal of Clinical Oncology by O’Connell et al, the National Surgical Adjuvant Breast and Bowel Project (NSABP) Trial R-04 is assessing four chemotherapy regimens given concurrently with preoperative radiotherapy in order to help identify optimal treatment in patients with ...

breast cancer

ASCO Guideline Update Recommends Tamoxifen for Up to 10 Years for Women With Nonmetastatic Hormone Receptor–Positive Breast Cancer

The American Society of Clinical Oncology (ASCO) has issued an update to its clinical practice guideline on the use of adjuvant endocrine therapy for women with stage I to III hormone receptor–positive breast cancer. The guideline was published in the Journal of Clinical Oncology. Duration...

lung cancer

No Progression-Free or Overall Survival Benefit With Second- or Third-Line Erlotinib vs Docetaxel in EGFR-Unselected Japanese NSCLC Patients

In a Japanese phase III trial (DELTA) reported in the Journal of Clinical Oncology, Kawaguchi et al found that erlotinib (Tarceva) was associated with no progression-free survival or overall survival advantage as second- or third-line therapy in EGFR-unselected patients with non–small cell...

leukemia

No Overall Survival Improvement With Elacytarabine vs Investigator Choice in Patients With Relapsed/Refractory AML

Current treatment options for relapsed/refractory acute myeloid leukemia (AML), which carries a very poor prognosis, are generally ineffective. In a phase III trial (CLAVELA) reported in the Journal of Clinical Oncology, Roboz et al found that elacytarabine, a novel elaidic acid ester of...

lung cancer

IASLC/American Thoracic Society/European Respiratory Society Classification of Lung Adenocarcinoma Has Predictive Value for Recurrence and Survival

In a study reported in the Journal of Clinical Oncology, Hung et al assessed the ability of the 2011 International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society (IASLC/ATS/ERS) adenocarcinoma classification system to predict disease recurrence and...

solid tumors
bladder cancer

Accelerated Methotrexate, Vinblastine, Doxorubicin, Cisplatin With Pegfilgrastim Is Effective, Well-Tolerated Neoadjuvant Therapy for Bladder Cancer

Although neoadjuvant cisplatin-based chemotherapy is standard of care for muscle-invasive bladder cancer, it is not widely used due to concerns over toxicity and delayed cystectomy. In a phase II trial reported in the Journal of Clinical Oncology, Plimack et al evaluated whether a neoadjuvant...

solid tumors
bladder cancer

Neoadjuvant Dose-Dense Methotrexate, Vinblastine, Doxorubicin, Cisplatin With Pegfilgrastim: Safe and Effective in Muscle-Invasive Urothelial Cancer

In a phase II trial reported in the Journal of Clinical Oncology, Choueiri et al found that a neoadjuvant four-cycle/8-week regimen of dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin was well tolerated and effective in patients with muscle-invasive urothelial cancer. Study Details ...

supportive care
issues in oncology
issues in oncology

Frequent but Nontargeted Use of Pharmacologic Thromboprophylaxis in Hospitalized Patients With Cancer

Retrospective studies have shown that pharmacologic thromboprophylaxis is underutilized in hospitalized patients with cancer, who are believed to be at high risk of venous thromboembolism. In a prospective cross-sectional study reported in Journal of Clinical Oncology, Zwicker et al found that...

lymphoma

PET Plus CT-Assessed Relative Tumor Size Reduction After Chemotherapy Identifies High Risk for Progression and Relapse in Advanced Hodgkin Lymphoma

Positive positron-emission tomography (PET) scans have low positive predictive value after chemotherapy in patients with Hodgkin lymphoma. In a study reported in the Journal of Clinical Oncology, Kobe et al assessed whether use of pretreatment and post-treatment computed tomography (CT) could...

issues in oncology

Cowden Syndrome With Germline PTEN Mutations Puts Patients at High Risk of Second Cancers

Cowden syndrome, an autosomal-dominant disorder characterized by the development multiple hamartomas, is associated with increased risk of breast, thyroid, endometrial, and renal cancers in patients with underlying germline PTEN mutations. In a study reported in the Journal of Clinical Oncology,...

cns cancers

Phase I Study Finds Novel Antibody Shows Promise in Children With Advanced Neuroblastoma

Researchers from St. Jude Children’s Research Hospital conducted a phase I study of hu14.18K322A, an experimental monoclonal antibody genetically engineered at the hospital, in 38 children with refractory or recurrent neuroblastoma. The patients received escalating doses of hu14.18K322A...

colorectal cancer

No Difference in Postsurgery Fatigue With Laparoscopic vs Open Surgery for Colorectal Cancer With Enhanced Recovery Program

In a UK trial (EnROL) reported in the Journal of Clinical Oncology, Kennedy et al compared outcomes with open vs laparoscopic resection of colorectal cancer within a multimodality enhanced recovery program. Such programs are intended to improve all aspects of perioperative care and have been shown...

leukemia

Good Prognosis for High-Risk Ph-Negative ALL With Chemotherapy After Early Cytologic Response and Low Minimal Residual Disease Level on Flow Cytometry

In a Spanish trial (PETHEMA ALL-AR-03) reported in the Journal of Clinical Oncology, Ribera et al found high disease-free and overall survival rates with delayed consolidation and maintenance chemotherapy in high-risk Philadelphia chromosome–negative acute lymphoblastic leukemia (ALL)...

survivorship

Minority of Oncologists and Primary Care Physicians Fully Discuss Survivorship Care Plans With Cancer Survivors

Of 53 National Cancer Institute cancer centers, only 43% report implementing survivorship care plans for at least some of their cancer survivors. In a study reported in the Journal of Clinical Oncology, Blanch-Hartigan et al found that a minority of a nationally representative sample of oncologists ...

head and neck cancer

No Apparent Increase in Risk of Oral HPV Infection in Sexual Partners of HPV-Positive Patients With Oropharyngeal Cancer

In a study reported in the Journal of Clinical Oncology, D’Souza et al found that while human papillomavirus (HPV)-positive patients with oropharyngeal cancer had high prevelances of oncogenic oral HPV DNA and oral HPV16 DNA, their sexual partners did not appear to have increased risk of...

breast cancer

ASCO Releases Companion Guideline on Disease Management for Patients With Advanced HER2-Positive Breast Cancer and Brain Metastases

As many as half of patients with metastatic HER2-positive breast cancer develop brain metastases over time. The American Society of Clinical Oncology recently released a clinical practice guideline on disease management for patients with advanced HER2-positive breast cancer and brain metastases. A...

breast cancer

ASCO Releases Clinical Practice Guideline on Systemic Therapy for Patients With Advanced HER2-Positive Breast Cancer

Approximately 15% of patients with breast cancer have tumors that overexpress the HER2 protein, and these patients can benefit from HER2-targeted therapies. The American Society of Clinical Oncology recently released a clinical practice guideline on systemic therapy for patients with advanced...

lung cancer
supportive care

Modafinil Not Better Than Placebo for Fatigue in Lung Cancer Patients

In a trial reported in the Journal of Clinical Oncology, Spathis et al found that that the central nervous system (CNS) stimulant modafinil had no effect on fatigue compared with placebo in patients with advanced non–small cell lung cancer (NSCLC). Fatigue improved in both groups during the...

breast cancer
survivorship

Cumulative Risk of Breast Cancer Reaches 30% by Age 50 After Chest Irradiation for Childhood Cancer

The incidence of breast cancer in women treated with chest radiation therapy for childhood cancer previously has been estimated at 5% to 14% by age 40 years and is among the highest reported for any population. In a study reported in the Journal of Clinical Oncology, Moskowitz et al found that the...

colorectal cancer

Tumor Regression Grading After Preoperative Chemoradiotherapy for Rectal Carcinoma Predicts Distant Metastasis Risk and Disease-Free Survival

In a study reported in the Journal of Clinical Oncology, Fokas et al found that prospectively evaluated tumor regression grading was a significant prognostic factor for distant metastasis and disease-free survival after 132 months of follow-up in patients with locally advanced rectal carcinoma...

head and neck cancer
supportive care

Doxepin Rinse Reduces Radiotherapy-Associated Oral Mucositis Pain in Patients With Head and Neck Cancer

In a phase III double-blind crossover trial (North Central Cancer Treatment Group [NCCTG] N09C6, Alliance for Clinical Trials in Oncology cooperative group) reported in the Journal of Clinical Oncology, Leenstra et al found that oral doxepin hydrochloride rinse significantly reduced...

breast cancer

Ado-Trastuzumab Emtansine Plus Pertuzumab Shows Activity and No Unexpected Toxicity in HER2-Positive Locally Advanced or Metastatic Breast Cancer

In a phase IIa trial reported in the Journal of Clinical Oncology, Miller et al assessed combined HER2-targeted therapy with the antibody-drug conjugate ado-trastuzumab emtansine (Kadcyla) and pertuzumab (Perjeta) in women with HER2-positive locally advanced or metastatic breast cancer. Pertuzumab...

skin cancer

Swedish Men Living Alone Have Later Stage at Diagnosis and Worse Survival in Cutaneous Malignant Melanoma

In a population-based study reported in the Journal of Clinical Oncology, Eriksson et al found that Swedish men with cutaneous malignant melanoma have more advanced stage at diagnosis and worse disease-specific survival if they live alone. Women living alone did not have worse disease-specific...

hematologic malignancies
supportive care

Addition of Tigecycline to Empiric Therapy Improves Success Rate in Febrile Neutropenic Patients With Hematologic Malignancy

Antibiotic monotherapy is considered standard in empiric therapy in febrile neutropenic cancer patients, but the approach may be insufficient given the increase in infections due to multidrug-resistant microorganisms. Tigecycline (Tygacil), the first in a new class of glycylcycline antibiotics, has ...

leukemia

Novel Prognostic Indices Validated for Cytogenetically Normal Acute Myeloid Leukemia

Cytogenetically normal acute myeloid leukemia (AML) is the largest and most heterogeneous cytogenetic AML subgroup. As reported in the Journal of Clinical Oncology, Pastore et al have developed a widely applicable prognostic model for cytogenetically normal AML that combines established patient and ...

breast cancer

Investigators Attempt to Increase Lapatinib Exposure Through Intermittent Dosing in HER2-Positive Breast Cancer

HER3 links with HER2 in a reciprocal relationship including negative feedback signaling that can upregulate HER2-HER3 signaling to compensate for HER2 inhibition. This signal-buffering capacity protects HER2-HER3 against a nearly 2-log inhibition of HER2 catalytic activity. The anti-HER2 tyrosine...

breast cancer

Quality-of-Life Study in NCIC MAP.3 Trial Shows Limited Negative Impact of Daily Exemestane in Breast Cancer Prevention

The National Cancer Institute of Canada (NCIC) Clinical Trials Group MAP.3 (Mammary Prevention 3) trial showed that daily exemestane treatment reduced invasive breast cancer risk by 65% among postmenopausal women. In a quality-of-life study in the MAP.3 population reported in the Journal of...

supportive care

ASCO Releases Adapted Guideline on Screening, Assessment, and Management of Fatigue in Adult Survivors of Cancer

A majority of cancer patients experience some level of fatigue during their course of treatment, and approximately 30% contend with persistent fatigue for years after treatment. Fatigue is among the most common and distressing long-term effects of cancer treatment and significantly affects patient...

supportive care

ASCO Issues Adapted Guideline on Screening, Assessment, and Care of Anxiety and Depressive Symptoms in Adults With Cancer

ASCO has adapted the Pan-Canadian Practice Guideline on Screening, Assessment, and Care of Psychosocial Distress (Depression, Anxiety) in Adults With Cancer for use in the screening, assessment, and care of anxiety and depressive symptoms in adults with cancer. The adapted guideline, reported in...

supportive care

ASCO Releases Guideline on Prevention and Management of Chemotherapy-Induced Peripheral Neuropathy in Survivors of Adult Cancers

The American Society of Clinical Oncology has released a clinical practice guideline on prevention and treatment of chemotherapy-induced peripheral neuropathy in adult cancer patients, published in the Journal of Clinical Oncology. The overall incidence of chemotherapy-induced peripheral neuropathy ...

leukemia
issues in oncology

IGH@ Translocations Are Prevalent in Teenagers and Young Adults With Acute Lymphoblastic Leukemia

In a study reported in the Journal of Clinical Oncology, Russell et al found that immunoglobulin heavy chain (IGH@) translocations were present in a substantial proportion of younger patients with acute lymphoblastic leukemia (ALL), including those with B-cell precursor ALL. However, IGH@...

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