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issues in oncology
colorectal cancer
issues in oncology

Only Small Number of Genetic Markers Show Association With Capecitabine Toxicity in Colorectal Cancer

In a study reported in the Journal of Clinical Oncology, Rosmarin et al assessed the association of reported fluorouracil (5-FU) toxicity genetic markers with occurrence of capecitabine toxicity of grade ≥ 3 in the QUASAR2 trial in colorectal cancer and with occurrence of capecitabine and 5-FU...

issues in oncology
issues in oncology
issues in oncology

Satisfaction With Work-Life Balance Among U.S. Oncologists Lower Than Other Medical Specialties, Survey Says

The American Society of Clinical Oncology (ASCO) conducted a survey of U.S. oncologists between October 2012 and March 2013, evaluating satisfaction with work-life balance and career plans. The findings, reported in the Journal of Clinical Oncology by Shanafelt et al, indicate that most are...

breast cancer

Fertility Concerns Affect Treatment Choices in Young Women With Breast Cancer, but Few Use Preservation Options

Little is known about how fertility concerns affect treatment decisions or fertility preservation strategies at the time of initial diagnosis of breast cancer. In an ongoing multicohort study reported in the Journal of Clinical Oncology, Ruddy et al found that most young women with breast cancer...

prostate cancer

No Benefit of Early Zoledronic Acid in Reducing Skeletal-Related Events in Castration-Sensitive Prostate Cancer With Bone Metastases

As reported in the Journal of Clinical Oncology by Smith et al, the double-blind phase III Cancer and Leukemia Group B (CALGB) 9020/Alliance trial assessed the effect of early initiation of zoledronic acid in reducing risk of skeletal-related events in men with castration-sensitive prostate cancer. ...

issues in oncology
breast cancer
issues in oncology

Correlation of PIK3CA Mutation and Neoadjuvant Lapatinib/Letrozole Response in Hormone Receptor–Positive, HER2-Negative Breast Cancer

In a phase IIB study reported in the Journal of Clinical Oncology, Guarneri et al compared neoadjuvant letrozole plus lapatinib (Tykerb) or placebo in postmenopausal women with hormone receptor–positive, HER2-negative breast cancer. Response rates were similar in the two groups, but a...

skin cancer

Durable Tumor Responses With Nivolumab in Long-Term Follow-up of Patients With Advanced Melanoma

In a dose-escalation, cohort expansion study reported in the Journal of Clinical Oncology, Topalian et al found that treatment with the PD-1 immune checkpoint inhibitor nivolumab produced durable responses in patients with advanced melanoma. Long-term follow-up also showed promising survival rates...

lung cancer

Trends in Phase III Trials in Advanced NSCLC: Decline in Use of Overall Survival as Primary Endpoint, More ‘Positive’ Outcomes

In a study published in the Journal of Clinical Oncology, Sacher et al identified trends in reporting of phase III trials in advanced non–small cell lung cancer (NSCLC) that include reduced use of overall survival as the primary endpoint and an increase in claims of positive outcomes despite...

issues in oncology
cns cancers

Blood Test Could Improve Treatment for Children With Late-Stage Neuroblastoma

Research by Viprey et al has found that the detection of neuroblastoma mRNAs in peripheral blood and bone marrow aspirates from children diagnosed with stage IV neuroblastoma are independent predictors of event-free survival and overall survival. Their findings could help identify children with...

breast cancer
integrative oncology

Yoga Regulates Stress Hormones and Improves Quality of Life for Women With Breast Cancer Undergoing Radiation Therapy

For women with breast cancer undergoing radiation therapy, yoga offers unique benefits beyond fighting fatigue, according to a study by Chandwani et al published in the Journal of Clinical Oncology. While simple stretching activities counteracted fatigue, patients who participated in yoga exercises ...

lymphoma

Event-Free Survival at 24 Months Can Serve as Endpoint for Disease-Related Outcome in Diffuse Large B-Cell Lymphoma Treated With Immunochemotherapy

In a study reported in the Journal of Clinical Oncology, Maurer et al found that patients with diffuse large B-cell lymphoma (DLBCL) treated with immunochemotherapy who achieve event-free survival at 24 months have overall survival that does not differ significantly from that in the general...

gynecologic cancers
issues in oncology

Large Study Shows Preventive Ovarian Surgery in BRCA1 Mutation Carriers Should Be Performed Early for Greatest Benefit

The findings of a large international prospective study published in the Journal of Clinical Oncology by Finch et al suggest for the first time that women with BRCA1 mutations should have prophylactic oophorectomy by age 35, as waiting until a later age appears to increase the risk of ovarian...

leukemia
issues in oncology

Methotrexate-Induced Neurotoxicity Does Not Preclude Rechallenge in Children With ALL

In a study reported in the Journal of Clinical Oncology, Bhojwani et al from St. Jude Children’s Research Hospital assessed clinical, pharmacokinetic, and genetic risk factors for methotrexate-related clinical neurotoxicity and asymptomatic leukoencephalopathy in children with acute...

breast cancer

Rates of Breast Reconstruction After Mastectomy Increase, but Use Varies Widely According to Numerous Factors

In a study reported in the Journal of Clinical Oncology, Jagsi et al found that use of breast reconstruction in patients with breast cancer undergoing mastectomy has increased over time but varies according to a number of treatment and demographic characteristics. Study Details The study involved ...

lung cancer

Minimal Pleural Effusion Predicts Poorer Survival in Non–Small Cell Lung Cancer

In a study reported in the Journal of Clinical Oncology, Ryu et al found that presence of minimal pleural effusion is associated with worsened survival in patients with non–small cell lung cancer (NSCLC) compared with no effusion, particularly among patients with early-stage disease. Study...

leukemia

Use of Intravenous Pegaspargase in Adapted Pediatric Regimen Is Feasible in Adults With Newly Diagnosed ALL

Asparaginase treatment, standard in pediatric acute lymphoblastic leukemia (ALL) regimens, is excluded or used for shorter durations in treatment of adults with ALL due to risk of toxicity. In a study reported in Journal of Clinical Oncology, Douer et al evaluated a pegaspargase (Oncaspar) dosing...

issues in oncology
hematologic malignancies
leukemia

CD49d-Positivity Is the Strongest Flow Cytometry–Based Predictor of Overall Survival in CLL

In a study reported in the Journal of Clinical Oncology, Bulian et al found that CD49d-positive chronic lymphocytic leukemia (CLL) patients have significantly poorer overall survival and treatment-free survival and that CD49d status is the strongest flow cytometry–based predictor of overall...

skin cancer

Nonsentinel Lymph Node Status Independently Predicts Melanoma-Specific Survival in Patients With Two or Three Positive Nodes

In a study reported in the Journal of Clinical Oncology, Pasquali et al assessed the prognostic utility of nonsentinel lymph node status in patients with cutaneous melanoma. They found that nonsentinel lymph node status was a significant independent predictor of melanoma-specific survival in...

breast cancer

Age and Comorbidity Affect Completion of Adjuvant Trastuzumab Therapy in Older Patients With Early-Stage Breast Cancer

In a population-based study reported in the Journal of Clinical Oncology, Vaz-Luis et al assessed duration and toxicity of adjuvant trastuzumab (Herceptin) in older patients with early-stage breast cancer. They found that age and comorbidity affected treatment completion rates and that significant...

lymphoma

Rituximab Active in Nodular Lymphocyte–Predominant Hodgkin Lymphoma

Mature results of a phase II study reported in the Journal of Clinical Oncology by Advani et al indicate that rituximab (Rituxan) is active in nodular lymphocyte–predominant Hodgkin lymphoma, which is characterized by expression of CD20 by malignant cells. Most patients relapsed, but durable...

breast cancer

No Difference in Recurrence After 5 Years With or Without Radiotherapy Following Sector Resection in Stage I Breast Cancer

The 20-year follow-up of the Swedish Uppsala/Örebro trial, reported by Wickberg et al in the Journal of Clinical Oncology, shows that improved control of recurrence over 5 years with radiotherapy after sector resection in patients with stage I breast cancer is followed by similar...

cns cancers
issues in oncology

Small Panel of FISH Cytogenetic Markers Distinguishes Risk in Medulloblastoma Subgroups

Among the four major molecular subgroups of medulloblastoma, WNT tumors are associated with excellent prognosis, whereas SHH and Group 4 tumors are associated with intermediate and Group 3 tumors with poor prognosis. In a study reported in the Journal of Clinical Oncology, Shih et al identified a...

breast cancer

SSO-ASTRO Consensus Guideline: Margins Wider Than 'No Ink on Tumor' Do Not Further Reduce Risk of Ipsilateral Breast Tumor Recurrence

The Society of Surgical Oncology (SSO) and American Society for Radiation Oncology (ASTRO) formed a multidisciplinary expert panel in 2013 to examine the relationship between surgical margin width and ipsilateral breast tumor recurrence and develop guidelines on margins for breast-conserving...

skin cancer

Antifungal Itraconazole Shows Activity in Basal Cell Carcinoma

In an open-label exploratory phase II trial reported in the Journal of Clinical Oncology, Kim et al found that the antifungal agent itraconazole, which inhibits the Hedgehog signaling pathway, reduced tumor cell proliferation, Hedgehog pathway activity, and tumor area in patients with basal cell...

lymphoma

Radiotherapy for Bulky Disease Added to R-CHOP Improves Outcome in Elderly Patients With Aggressive B-Cell Lymphoma

In an analysis reported in the Journal of Clinical Oncology, Held et al studied elderly patients with aggressive B-cell non-Hodgkin lymphoma and bulky disease in the most effective treatment arm of the RICOVER-60 trial, which included radiotherapy. The investigators compared outcomes ...

colorectal cancer
supportive care

Coordination of Care Improves Patient-Reported Quality of Supportive Care Among Patients With Colorectal Cancer

In a study reported in the Journal of Clinical Oncology, van Ryn et al assessed patient-reported quality of care among patients with colorectal cancer in the Veterans Affairs health-care system. The investigators found significant gaps in patient-centered quality of supportive care, but also found...

issues in oncology

Hyaluronan Synthase 3 Variant Associated With Increased Risk of Anthracycline-Related Cardiomyopathy

In a study reported in the Journal of Clinical Oncology, Wang et al in the Children’s Oncology Group identified a common single nucleotide polymorphism, rs2232228, in the hyaluronan synthase 3 (HAS3) gene that is associated with anthracycline dose–related risk of cardiomyopathy in...

kidney cancer
supportive care

Expressive Writing Improves Symptoms and Physical Function in Patients With Renal Cell Carcinoma

In a trial reported in the Journal of Clinical Oncology, Milbury et al compared cancer symptoms, physical and mental function, depressive symptoms, fatigue, and sleep outcomes after sessions of expressive writing about cancer vs writing about neutral topics in patients with renal cell carcinoma....

breast cancer
supportive care
survivorship
integrative oncology

Yoga Improves Inflammation, Fatigue, and Vitality in Breast Cancer Survivors

In a study reported in the Journal of Clinical Oncology, Kiecolt-Glaser et al found that yoga reduced levels of inflammatory cytokines and fatigue and increased vitality in breast cancer survivors. Study Details In the study, 200 women with stage 0 to IIIA breast cancer who had completed...

multiple myeloma

Improved Survival With Four-Drug Induction Regimen Followed by Maintenance in Initial Treatment of Transplant-Ineligible Multiple Myeloma

In an updated analysis of an Italian phase III trial reported in the Journal of Clinical Oncology, Palumbo et al found that induction with bortezomib (Velcade), melphalan, prednisone, and thalidomide (Thalomid) followed by bortezomib plus thalidomide maintenance (VMPT-VT) significantly improved...

survivorship

Is the Traumatic Impact of Cancer Overestimated in Children With Cancer?

In a study reported in the Journal of Clinical Oncology, Phipps et al found no evidence of increased post-traumatic stress disorder (PTSD) or post-traumatic stress symptoms (PTSS) in children with cancer and observed a heightened sense of perceived growth related to cancer events in these children. ...

breast cancer
gynecologic cancers
issues in oncology

Good Results With Telephone Genetic Counseling for Breast and Ovarian Cancer

As genomic testing becomes more common, genetic counseling is increasingly performed via telephone. BRCA1/2 mutation carries increased risk for breast and ovarian cancer. In a noninferiority study reported in the Journal of Clinical Oncology, Schwartz et al compared genetic counseling for BRCA1/2...

colorectal cancer
issues in oncology

Telephone-Based Intervention Improves Colorectal Cancer Screening in At-Risk Relatives of Patients With Colorectal Cancer

Individuals at increased familial risk of colorectal cancer have poor adherence to colonoscopy screening recommendations, especially those in rural and other geographically underserved populations. In a study (Family CARE trial) reported in the Journal of Clinical Oncology, Kinney et al found that...

issues in oncology

ASCO Survey of Oncologists Finds High Overall Career Satisfaction, but Nearly Half Report Burnout

A survey of oncologists by Shanafelt et al has found that approximately 45% had at least one symptom of burnout, with risk being greatest among younger oncologists and those spending more hours per week devoted to direct patient care. However, overall career satisfaction remains high, especially...

breast cancer
supportive care

Cognitive-Behavioral Therapy Plus Hypnosis Controls Fatigue in Breast Cancer Patients Receiving Radiotherapy

In a study reported in the Journal of Clinical Oncology, Montgomery et al found that an intervention consisting of cognitive-behavioral therapy plus hypnosis produced better control of fatigue than supportive meetings with trained interventionists for women undergoing radiotherapy for breast...

solid tumors

One-Fifth of Hospitalizations for Patients With Gastrointestinal Cancer Considered Avoidable

In a study reported in the Journal of Clinical Oncology, Brooks et al found that oncology clinicians considered 19% of hospitalizations for patients with gastrointestinal cancers to be avoidable. Study Details In the study, 201 sequential hospital admissions in 154 patients with gastrointestinal...

colorectal cancer

Pilot Study Shows Promise of Neoadjuvant Chemotherapy Without Routine Radiotherapy in Patients With Locally Advanced Rectal Cancer

Neoadjuvant chemoradiotherapy delays administration of optimal chemotherapy in stage II to III rectal cancer. In a pilot study reported in the Journal of Clinical Oncology, Schrag et al assessed outcomes with neoadjuvant FOLFOX (fluorouracil, leucovorin, oxaliplatin)/bevacizumab (Avastin) with...

cns cancers

High Prevalence of Platinum-Related Hearing Loss in Children With High-Risk Neuroblastoma, With Differences According to Audiometry Scales

The reported prevalence of platinum-associated ototoxicity in children with high-risk neuroblastoma varies widely due to small patient samples and use of disparate grading scales. In a study reported in the Journal of Clinical Oncology, Landier et al in the Children’s Oncology Group assessed...

cns cancers

Adding Chemotherapy to Radiotherapy Does Not Appear to Affect Cognitive Function in Patients With Low-Grade Glioma

The addition of PCV (procarbazine [Matulane], lomustine [CeeNu], vincristine) chemotherapy to radiotherapy improves progression-free survival in patients with grade 2 glioma, but the potential effect of treatment intensification on cognitive function is a concern in this group of patients with good ...

leukemia
issues in oncology

Seven-Gene Score Incorporating Methylation and Expression Distinguishes AML Risk Groups

In a study reported in the Journal of Clinical Oncology, Marcucci et al assessed whether including epigenetic changes—ie, DNA methylation—as molecular risk factors could improve risk stratification in acute myeloid leukemia (AML). They found that a seven-gene score integrating DNA...

issues in oncology
lung cancer
issues in oncology

MicroRNA Test Reduces False-Positive CT Screening Rate for Lung Cancer

Although recent data indicate that low-dose computed tomography (CT) reduces lung cancer mortality in high-risk patients, high false-positive rates, costs, and the potential for harm point out the need for biomarkers that can improve risk assessment. In a study reported in the Journal of Clinical...

supportive care

Both Mindfulness-Based Stress Reduction and, More So, Cognitive Behavioral Therapy Improve Insomnia in Cancer Patients

In a noninferiority trial reported in the Journal of Clinical Oncology, Garland et al compared the effects of mindfulness-based stress reduction vs cognitive-behavioral therapy for treatment of insomnia in patients with cancer. They found that both techniques improved insomnia, with...

gynecologic cancers
issues in oncology

Quadrivalent HPV Vaccine Provides Poorer Protection in Women 18 and Older or With Abnormal Cytology

In a study reported in the Journal of Clinical Oncology, Mahmud et al evaluated the effectiveness of the quadrivalent human papillomavirus (HPV) vaccine against cervical dysplasia using population-based individual level data routinely collected in Manitoba. They found that a high proportion of...

supportive care

Short-Term Follow-up Reveals Suboptimal Pain Relief and Marked Pain Worsening in Ambulatory Cancer Patients

In an analysis reported in the Journal of Clinical Oncology, Zhao et al assessed factors associated with pain severity changes in ambulatory patients with solid tumors in the Eastern Cooperative Oncology Group E2Z02 (Symptom Outcomes and Practice Patterns) trial. They found that approximately...

breast cancer
issues in oncology

Meta-Analysis Indicates No Reduction in Risk of Local or Distant Breast Cancer Recurrence With Preoperative Staging MRI

In an individual patient data meta-analysis reported in the Journal of Clinical Oncology, Houssami et al found that preoperative magnetic resonance imaging (MRI) was not associated with differences in local recurrence or distant recurrence compared with conventional imaging in women with breast...

supportive care

Web-Based Self-Care Support and Communication Coaching Program Reduces Symptom Distress in Cancer Patients

In the ESRA-CII trial reported in the Journal of Clinical Oncology by Berry et al, patient use of a Web-based self-care program featuring tailored education and communication coaching resulted in significantly reduced symptom distress compared with symptom/quality-of-life tracking alone in patients ...

gynecologic cancers

Half of Patients With Stage I Pediatric Malignant Ovarian Germ Cell Tumors Can Be Spared Chemotherapy After Initial Surgery With Surveillance Strategy

In a Children’s Oncology Group study (AGCT0132) reported in the Journal of Clinical Oncology, Billmire et al found that overall survival can be preserved in patients with stage I pediatric malignant ovarian germ cell tumor with a strategy of initial surveillance after surgical resection....

leukemia

Good Results Using Loss of Major Molecular Response as Criterion for Restarting Tyrosine Kinase Inhibitor Therapy in CML

Many patients with chronic-phase chronic myelogenous leukemia (CML) in complete molecular response have molecular relapse after discontinuation of imatinib (Gleevec) treatment. In a French multicenter observational study reported in the Journal of Clinical Oncology, Rousselot et al assessed the...

gynecologic cancers
gynecologic cancers

No Benefit of Adding Tirapazamine to Cisplatin Chemoradiation in Locally Advanced Cervical Cancer

In a phase III intergroup trial (Gynecologic Oncology Group Protocol 219) reported in the Journal of Clinical Oncology, DiSilvestro et al in the Gynecologic Oncology Group and National Cancer Institute of Canada Clinical Trials Group evaluated the addition of the hypoxic cell sensitizer...

leukemia
issues in oncology

Higher Copayment Associated With Greater Discontinuation of and Nonadherence to Tyrosine Kinase Inhibitor Treatment in CML

The availability of the tyrosine kinase inhibitor imatinib (Gleevec) has dramatically increased survival in chronic myeloid leukemia (CML). Nonadherence to therapy with imatinib and other tyrosine kinase inhibitors is associated with disease progression and treatment resistance. In a study reported ...

gynecologic cancers

No Survival Benefit of Erlotinib in EGFR-Unselected Patients With Nonprogressing Ovarian Cancer After Platinum Therapy

EGFR is overexpressed in the majority of advanced epithelial ovarian carcinomas, and there is evidence indicating that overexpression is associated with poorer prognosis. In a phase III European Organisation for Research and Treatment of Cancer (EORTC)-Gynaecological Cancer Group and Gynecologic...

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