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issues in oncology

Caring: Isn’t That Why We Went to Medical School?

YOU CANNOT write about caring; you must practice it. None of us went to medical school thinking we would be an oncologist or a neurosurgeon or a stem cell biologist. But we did have vague aspirations of wanting to help others: to be involved in other lives. It was an altruistic avocation; how...

lung cancer
immunotherapy

Expert Point of View: Siwen Hu-Lieskovan, MD, PhD

DISCUSSANT OF the CheckMate 384 trial, Siwen Hu-Lieskovan, MD, PhD, Director of Solid Tumor Immunotherapy at the Huntsman Cancer Institute, University of Utah, called the short-term safety data “convincing.” However, she noted that the long-term impact of intermittent, lower-minimum concentration...

lung cancer
immunotherapy

CheckMate 384 Supports More Convenient Dosing of Nivolumab in Advanced NSCLC

PATIENTS WITH advanced non–small cell lung cancer (NSCLC) may no longer have to come to the clinic every 2 weeks for treatment. According to a descriptive analysis of the phase IIIb/IV CheckMate 384 study, a more convenient dosing option of nivolumab has demonstrated convincing short-term safety...

prostate cancer

Addition of Docetaxel to Androgen Suppression and Radiotherapy for Localized High-Risk Prostate Cancer

As reported in the Journal of Clinical Oncology by Rosenthal et al, the phase III NRG Oncology RTOG 0521 trial showed that the addition of docetaxel to androgen suppression and radiotherapy improved overall and disease-free survival as well as the distant metastasis rate in patients with high-risk...

breast cancer
survivorship

Patient Preferences for Oncologist and Primary Care Provider Roles After Initial Breast Cancer Treatment

In a study reported in the Journal of Oncology Practice, Radhakrishnan et al found that the level of involvement of medical oncologists and primary care physicians during initial cancer care in women with early-stage breast cancer affected patients’ preference for provider roles after initial ...

prostate cancer

Focal Laser Ablation in Prostate Cancer

Researchers have shown that selectively destroying cancerous prostate tissue may be as effective as complete prostate removal or radiation therapy, while preserving more sexual and urinary function than these other treatments. The study was published by Wasler et al in the Journal of Vascular and...

breast cancer

Breast Density Assessment Variation by Screening Modality

Fewer women are assigned to a dense-breast category when evaluated with advanced mammographic screening technologies compared to standard digital mammography, according to a new study published by Gastounioti et al in Radiology. Density Assessment A woman’s breast density is assessed during ...

skin cancer

Chrysalyne Schmults, MD, on Basal and Squamous Cell Carcinomas: Trends in Data and Practice

Chrysalyne Schmults, MD, of Brigham and Women’s Hospital, discusses treatment strategies in these nonmelanoma skin cancers, including surgery, forthcoming staging systems, and ongoing trials combining adjuvant radiotherapy and immunotherapy.

colorectal cancer

Wells A. Messersmith, MD, on Managing Metastatic Colorectal Cancer: NCCN Guidelines Update

Wells A. Messersmith, MD, of the University of Colorado Cancer Center, discusses results of recent clinical trials, emerging treatment options, and approaches that may improve outcomes in patients with metastatic colorectal cancer.

lung cancer

Ultradeep Next-Generation Sequencing in Patients With Lung Cancer

A new method of determining the sequence of molecules in DNA can be used to detect small fragments of cancerous genetic material in blood samples from patients with lung cancer with a high degree of accuracy, according research published by Li et al in Annals of Oncology. Liquid Biopsies and...

breast cancer
cost of care

Genomic Testing Associated With Lower Health-Care Costs in Patients With High-Risk Breast Cancer

New research published by Dinan et al in JNCCN—Journal of the National Comprehensive Cancer Network provides evidence that genomic recurrence score testing using the 21-gene assay is associated with decreased cancer care costs in real-world practice among certain patients with breast...

cns cancers

Pachymeningeal Seeding After Neurosurgical Resection in Patients With Brain Metastases

In a retrospective cohort study reported in JAMA Oncology, Cagney et al found that pachymeningeal seeding was fairly common after neurosurgical resection in patients with brain metastases treated with adjuvant stereotactic radiation. Study Details The study involved 1,188 consecutive patients...

colorectal cancer
immunotherapy

Pertuzumab Plus Trastuzumab in HER2-Amplified Metastatic Colorectal Cancer

As reported in The Lancet Oncology by Meric-Bernstam et al, the combination of pertuzumab and trastuzumab showed activity in HER2-amplified metastatic colorectal cancer in the phase IIa multiple basket study MyPathway. The study is evaluating activity of targeted therapies in nonindicated tumor...

supportive care

Michelle B. Riba, MD, on Screening for Distress in Cancer: Implementing the Standard of Care

Michelle B. Riba, MD, of the University of Michigan Rogel Cancer Center, discusses the prevalence of distress in patients with cancer, the need for a quick and simple screening method to identify patients with distress, and strategies for improving integration of psychosocial care into routine...

prostate cancer

James L. Mohler, MD, on Managing Prostate Cancer: NCCN Guidelines Updates

James L. Mohler, MD, of the Roswell Park Comprehensive Cancer Center, discusses updated recommendations in prostate cancer: more specificity for family history and genomic sequencing, as well as the evolving uses of androgen-deprivation therapy.

pancreatic cancer

Margaret A. Tempero, MD, on Pancreatic Cancer: NCCN Guidelines Updates

Margaret A. Tempero, MD, of the UCSF Helen Diller Family Comprehensive Cancer Center, discusses new adjuvant therapy options for patients with pancreatic cancer, and germline testing, including testing for microsatellite instability/mismatch repair genes as well as molecular analysis of all tumors.

hematologic malignancies

Gary H. Lyman, MD, MPH, on Myeloid Growth Factors: New Biosimilar Approvals

Gary H. Lyman, MD, MPH, of the Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance, discusses current strategies for the use of biosimilars to treat cancer-induced anemia and neutropenia, and the need to provide evidence for the efficacy of these agents to allay any concerns about...

leukemia

Neil P. Shah, MD, PhD, on CML: NCCN Guidelines Updates on Discontinuing Tyrosine Kinase Inhibitor Therapy

Neil P. Shah, MD, PhD, of the UCSF Helen Diller Family Comprehensive Cancer Center, discusses the feasibility of discontinuing tyrosine kinase inhibitor therapy in select patients with chronic phase chronic myeloid leukemia outside of clinical trials.

breast cancer

Artificial Intelligence vs Radiologists in Breast Cancer Detection With Digital Mammography

In a study reported in the Journal of the National Cancer Institute, Rodriguez-Ruiz et al found that a stand-alone artificial intelligence (AI) system had accuracy comparable to an average breast radiologist in detecting breast cancer using digital mammography. Study Details In the retrospective...

survivorship

Therapy-Related Cardiac Disease Risk in Childhood Cancer Survivors

As reported by Bates et al in the Journal of Clinical Oncology, an analysis from the Childhood Cancer Survivor Study indicated that radiation doses in conjunction with heart volume exposed to radiation and anthracycline treatment were associated with increased risk of late-onset cardiac disease in...

skin cancer
immunotherapy

Immunotherapy Directed Against Precancerous Skin Lesions May Prevent Squamous Cell Carcinoma

A treatment previously shown to treat the precancerous skin lesions called actinic keratosis now appears to also reduce the chance that these pretreated lesions will develop into squamous cell carcinoma. In a report published by Rosenberg et al in JCI Insight, researchers found that treatment with...

multiple myeloma
pain management

FDA Pipeline: Safety Warning About Investigational Use of Venetoclax in Multiple Myeloma, Warning Letter on Unapproved Products

This week, the U.S. Food and Drug Administration (FDA) posted a safety statement on the investigational use of venetoclax in multiple myeloma, and also posted a warning letter against a company for illegally marketing unapproved products labeled as homeopathic. Safety Statement The FDA posted...

breast cancer

Melinda L. Telli, MD, on NCCN Guidelines Updates for HR-Positive, HER2-Negative Early-Stage Breast Cancer

Melinda L. Telli, MD, of the Stanford Cancer Institute, discusses the various systemic therapies for patients with early-stage hormone receptor–positive, HER2-negative disease.

kidney cancer
immunotherapy

Eric Jonasch, MD, on Kidney Cancer: A Year in Review

Eric Jonasch, MD, of The University of Texas MD Anderson Cancer Center, discusses major findings over the past 12 months in kidney cancer, including combination immunotherapies and trends in surgical oncology.

immunotherapy
lung cancer

Matthew A. Gubens, MD, on Non–Small Cell Lung Cancer: New Immunotherapy Strategies in the NCCN Guidelines

Matthew A. Gubens, MD, of the UCSF Helen Diller Family Comprehensive Cancer Center, discusses recent updates to the NCCN Guidelines in non–small cell lung cancer, including the use of pembrolizumab as a single agent or in combination based on PD-L1 status, treatment selection in squamous and...

breast cancer

William J. Gradishar, MD, on HR-Positive, HER2-Negative Advanced Breast Cancer: NCCN Guidelines Updates

William J. Gradishar, MD, of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University, discusses evidence-based first-line treatment options for patients with advanced hormone receptor–positive, HER2-negative breast cancer and toxicities associated with the various therapeutic...

immunotherapy
leukemia
lymphoma

Frederick L. Locke, MD, on Innovative CAR-T Cell Therapies: The Patient Experience

Frederick L. Locke, MD, of the H. Lee Moffitt Cancer Center and Research Institute, discusses recent approvals of chimeric antigen receptor T-cell therapies in leukemia and lymphoma, and how clinicians are using infrastructure, navigation, and early referrals to maximize response and minimize...

gynecologic cancers

Does Minimally Invasive Robotic Surgery for Early-Stage Endometrial Cancer Decrease the Risk of Surgical Complications?

In a Danish study reported in JAMA Surgery, Jørgensen et al found that the nationwide introduction of minimally invasive robotic surgery for early-stage endometrial cancer was associated with a reduction in the incidence of severe complications. The nationwide prospective cohort study...

colorectal cancer

Effect of Microsatellite Instability and Tumor Mutational Burden on Outcome in First-Line Treatment of Metastatic Colorectal Cancer

In an analysis of the phase III CALGB/SWOG 80405 trial reported in the Journal of Clinical Oncology, Innocenti et al found that tumor mutational burden and microsatellite instability status affected overall survival in patients receiving first-line chemotherapy plus bevacizumab or cetuximab for...

breast cancer

Validation Study of Several Models of Breast Cancer Risk

In a validation study reported in The Lancet Oncology, Terry et al found that the Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm model (BOADICEA) and the International Breast Cancer Intervention Study model (IBIS) were the best of 4 models tested for predicting...

gynecologic cancers
survivorship

Persistent Long-Term Fatigue and Impact on Quality of Life Among Epithelial Ovarian Cancer Survivors

A study among epithelial ovarian cancer survivors from 25 cooperative Gynecologic Cancer Intergroup centers in France showed similar quality of life compared to healthy controls who were randomly selected from the electoral rolls, but persistent long-term fatigue. The researchers found depression,...

issues in oncology

Infertility in Women and Low Absolute Risk of Cancer

A study of over 64,000 women of childbearing age in the United States has found that infertility is associated with a higher risk of developing cancer compared to a group of over 3 million women without fertility problems—although the absolute risk is very low, at just 2%. These findings ...

breast cancer
issues in oncology

Number of Pregnancies May Influence Breast Cancer Risk in Women With BRCA Mutations

Researchers have found the lower risk of breast cancer associated with multiple pregnancies and breastfeeding in the general population extends to those at the highest risk of breast cancer. These results were published by Terry et al in the JNCI Cancer Spectrum. Methods and Findings The...

hepatobiliary cancer

Demographic Factors Increasing Risk of Liver Cancer Development in Patients With Fatty Liver Disease

A new study published by Zarrinpar et al in Liver International has found that elderly, diabetic, and Hispanic patients with steatohepatitis—fatty liver disease—may have a higher risk of developing liver cancer. Ali Zarrinpar, MD, PhD, Associate Professor of Surgery at the...

prostate cancer

AR-V7 Assay Findings and Outcomes With Hormone Therapy in High-Risk Castration-Resistant Prostate Cancer

In the PROPHECY study, reported in the Journal of Clinical Oncology, Armstrong et al found that positive findings on 2 assays for circulating tumor cell (CTC) androgen receptor splice variant 7 (AR-V7) were associated with poorer outcomes for abiraterone and enzalutamide therapy in men with...

symptom management

Effect of Medical Cannabis on Symptom Control in Patients With Cancer

As reported in the Journal of Oncology Practice by Anderson et al, a study of patients enrolled in Minnesota’s Medical Cannabis Program showed that the use of medical cannabis was associated with improvement in reported symptoms in patients with cancer. The study involved data on 1,120...

breast cancer

Neratinib Plus Capecitabine Active Against HER2-Positive Breast Cancer Brain Metastases

In the phase II TBCRC 022 trial reported in the Journal of Clinical Oncology, Freedman et al found that the combination of neratinib and capecitabine was active against brain metastases in women with HER2-positive breast cancer. Modest activity of neratinib monotherapy had been found in previous...

lung cancer
immunotherapy

Jyoti D. Patel, MD, on Stage III Non–Small Cell Lung Cancer: A Look at New Systemic Treatments

Jyoti D. Patel, MD, of the University of Chicago, discusses immunotherapy for locally advanced NSCLC, selecting patients for these treatments, and the potential toxicities of combination therapies.

lung cancer

Susan Y. Wu, MD, on Non–Small Cell Lung Cancer: Using an Online Tool in Treatment

Susan Y. Wu, MD, of the University of California, San Francisco, discusses how patient exposure to treatment guidelines improved smoking cessation counseling and the use of molecular testing, and decreased the use of adjuvant chemotherapy in patients with early-stage disease (Abstract 5).

lung cancer
symptom management

Mark K. Ferguson, MD, on Mitigating Frailty and Sarcopenia to Improve Treatment Outcomes

Mark K. Ferguson, MD, of the University of Chicago Hospital, discusses frailty and loss of muscle tissue, which are common among patients with lung cancer. These conditions are linked with decreased survival as well as increased surgical complications, chemotherapy toxicity, and cost of care.

lung cancer

Jing Zeng, MD, on Non–Small Cell Lung Cancer: Therapeutic Implications of Proper Disease Staging

Jing Zeng, MD, of the University of Washington, discusses upstaging disease from stage III to stage IV, which can occur with repeat PET and/or CT scans for patients with locally advanced NSCLC, and the need for clinicians to stage disease properly to ensure appropriate treatment.

immunotherapy

Martin Edelman, MD, on Immunotherapy: How Safe Is It for Patients With Autoimmune Disease?

Martin Edelman, MD, of Fox Chase Cancer Center, discusses the limited retrospective data that indicate some patients with cancer and autoimmune disease (such as lupus or ulcerative colitis) can safely receive immunotherapy with checkpoint inhibitors.

lung cancer
immunotherapy

Ruqin Chen, MB, on Lung Cancer Treated With Immune Checkpoint Inhibitors: Survival Outcomes and Clinical and Molecular Features

Ruqin Chen, MB, of the Mayo Clinic Florida, discusses early study findings that show molecular profiling with NF1, CD79a, and AKT3 could potentially improve prediction of progression-free survival in patients with lung cancer who are receiving immunotherapy.

lung cancer
issues in oncology

Kyle F. Concannon, MD, on Lung Cancer in Homeless Patients: Outcomes and Quality Measures

Kyle F. Concannon, MD, of the University of Washington/Seattle Cancer Care Alliance, discusses study results on the delays in biopsy after radiographic findings among homeless vs housed patients with lung cancer, and the higher rates of missed appointments following diagnosis (Abstract 125).

lung cancer

J. Fletcher Drogos, MD, on Multiple Courses of Stereotactic Body Radiation Therapy: Outcomes in Patients With Lung Cancer

J. Fletcher Drogos, MD, of Rush University, discusses study findings on overall survival and toxicity among patients who undergo multiple radiation treatments for lung cancer.

lung cancer
issues in oncology

Shraddha M. Dalwadi, MD, MBA, on Non–Small Cell Lung Cancer: What Contributes to Disparities in Treating Stage I Disease

Shraddha M. Dalwadi, MD, MBA, of Baylor College of Medicine, discusses the nearly 12% of potentially curable patients with stage I NSCLC who do not receive treatment, the various socioeconomic reasons why, and how some patients may benefit from minimally invasive therapies (Abstract 127).

lung cancer
neuroendocrine tumors

Aaron S. Mansfield, MD, on Treating Rare Thoracic Cancers: Status Update

Aaron S. Mansfield, MD, of the Mayo Clinic, summarizes a session he moderated on rare thoracic cancers such as mesothelioma and thymic epithelial tumors, as well as novel imaging and treatments in neuroendocrine tumors.

lung cancer

Heather A. Wakelee, MD, on Advanced Non–Small Cell Lung Cancer: State-of-the-Art Treatment for EGFR-Positive and ALK-Positive Diseases

Heather A. Wakelee, MD, of Stanford University, discusses the most recent FDA-approved tyrosine kinase inhibitors that target EGFR and ALK mutations, how these agents fit into the treatment landscape, and the rapidly evolving field of TKI resistance.

lung cancer
immunotherapy

Leora Horn, MD, on Small Cell Lung Cancer and Immuno-oncology: Have We Finally Solved the Small Cell Paradox?

Leora Horn, MD, of Vanderbilt University Medical Center, discusses the progress made treating extensive-stage small cell lung cancer, improvements in progression-free and overall survival, and the fact that it’s still difficult to determine which patients will benefit most from immunotherapy.

gynecologic cancers

SGO 2019: Post Hoc Exploratory Analyses From the ARIEL3 Trial in Recurrent Ovarian Cancer

Data from post hoc exploratory analyses from the phase III ARIEL3 clinical study of rucaparib in recurrent ovarian cancer was presented during oral plenary and poster sessions at the Society of Gynecologic Oncology’s (SGO) 50th Annual Meeting on Women’s Cancer. These analyses...

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