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issues in oncology
health-care policy

Advancing Cancer Research in Challenging Times

ON OCTOBER 17, 2017, Norman E. Sharpless, MD, became the 15th Director of the National Cancer Institute (NCI), succeeding Harold E. Varmus, MD, who stepped down as Director of the agency in March 2015, and replacing Douglas R. Lowy, MD, who had served as Acting Director for 2 years. The...

kidney cancer

EXPERT POINT OF VIEW: Sumanta K. Pal, MD

ASCO EXPERT Sumanta K. Pal, MD, of City of Hope, Duarte, California, commented, “IMmotion 151 is a positive trial and represents an important breakthrough. We have debated combination treatment strategies for advanced kidney cancer. This study looks at the combination of a programmed cell death...

kidney cancer
immunotherapy

Atezolizumab Plus Bevacizumab Improves Progression-Free Survival in First-Line Treatment of Advanced Renal Cell Carcinoma

THE TYROSINE KINASE inhibitor sunitinib (Sutent) has been the mainstay of treatment for first-line treatment of advanced renal cell carcinoma for about a decade. The IMmotion151 study reported at the 2018 Genitourinary Cancers Symposium found that the combination of the immune checkpoint inhibitor...

prostate cancer

New Agents for Initial Treatment of Metastatic Prostate Cancer: A New Standard of Care?

FOR DECADES, the status of metastatic prostate cancer trials was not particularly exciting. With an absence of high-impact novel agents, the focus of cancer trial groups was on the improvement of standard care. Well-crafted, large trials of hormonal therapy demonstrated the utility of combined...

multiple myeloma
symptom management

Analysis of Carfilzomib-Related Cardiotoxicity

In a systematic review and meta-analysis reported in Leukemia & Lymphoma, Shah et al identified the risk of cardiotoxicity among patients, most with multiple myeloma, receiving carfilzomib (Kyprolis) in clinical trials. Study Details The study included data from 4,164 patients who received...

issues in oncology

Pretreatment Cancer-Associated Weight Loss and Prognosis

In a study reported in the Journal of Oncology Practice, Gannavarapu et al found that substantial unintentional weight loss prior to treatment is common among patients with cancer across stages of disease and is associated with poorer outcome. Study Details The retrospective cohort study included ...

skin cancer

Adjuvant Vemurafenib in Resected BRAF V600–Mutant Melanoma

In the international phase III BRIM8 trial reported in The Lancet Oncology, Maio et al found inconclusive evidence of benefit of adjuvant vemurafenib treatment in patients with BRAF V600–mutant melanoma.   Study Details In the double-blind trial, 498 patients with fully resected...

prostate cancer

Multimodal Treatment in Patients With Gleason Score 9–10 Prostate Cancer

University of California, Los Angeles (UCLA) researchers have discovered that a combination of high doses of radiotherapy and hormonal therapy provides the best chance of decreasing the mortality rate in men with aggressive prostate cancer. The findings, published by Kishan et al in JAMA, also...

solid tumors
lymphoma
immunotherapy

FDA Approves sBLA Updating Nivolumab Dosing Schedule Across Indications

On March 6, Bristol-Myers Squibb announced the U.S. Food and Drug Administration (FDA) has approved a supplemental Biologics License Application (sBLA) updating the nivolumab (Opdivo) dosing schedule to include 480 mg infused every 4 weeks for a majority of approved indications. This approval will ...

skin cancer
immunotherapy

Circulating Tumor DNA and Pseudoprogression in Metastatic Melanoma Treated with Anti–PD-1 Antibodies

In a study reported in JAMA Oncology, Lee et al found that measurement of circulating tumor DNA (ctDNA) can help distinguish between pseudoprogression (radiologic progression prior to response) and true progression in patients with metastatic melanoma receiving anti­–programmed cell death ...

breast cancer

Upfront Adjuvant Aromatase Inhibitor Therapy vs Aromatase Inhibitors After Tamoxifen in Hormone Receptor–Positive Early Breast Cancer

An Italian phase III trial (FATA-GIM3) has shown no difference in disease-free survival with 5 years of upfront adjuvant aromatase inhibitor therapy vs 2 years of tamoxifen followed by 3 years of aromatase inhibitor therapy in women with hormone receptor–positive early breast cancer. The...

hematologic malignancies

Novel PI3Kδ Inhibitor in Relapsed or Refractory Hematologic Malignancies

In a phase I trial reported in The Lancet Oncology, Burris et al determined the phase II dose of the next-generation PI3Kδ inhibitor umbralisib and found evidence of the agent’s activity in relapsed or refractory hematologic malignancies. Umbralisib exhibits improved PI3K isoform...

gynecologic cancers

Multitargeted Tyrosine Kinase Inhibitor Shows Activity in Small Cell Carcinoma of the Ovary

An multitargeted tyrosine kinase inhibitor used to treat leukemia has shown promise against a rare and aggressive type of ovarian cancer—small cell carcinoma of the ovary hypercalcemic type (SCCOHT)—that strikes young women and girls, according to a study led by the Translational...

Texas Society of Clinical Oncology Makes Investment in Young Investigators

The Texas Society of Clinical Oncology (TxSCO) is one of the newest supporters of the Conquer Cancer Foundation’s Young Investigator Award (YIA) program. A state affiliate of ASCO, TxSCO currently has more than 600 members who represent a diverse array of oncology health providers in Texas. “We are ...

symptom management

Dexamethasone-Sparing Antiemetic Regimen in Patients Receiving Highly Emetogenic Chemotherapy

In a Japanese phase III noninferiority trial reported in the Journal of Clinical Oncology, Ito et al found that dexamethasone could be spared on days 2 and 3 in an antiemetic regimen including the neurokinin-1 (NK1) receptor antagonist aprepitant and palonosetron in patients receiving highly...

breast cancer
survivorship
symptom management

Internet-Delivered Cognitive-Behavioral Therapy for Insomnia in Breast Cancer Survivors

In a Danish study reported in the Journal of the National Cancer Institute, Zachariae et al found that an Internet-delivered cognitive-behavioral therapy intervention improved insomnia among breast cancer survivors. Study Details In the study, 255 patients from a national sample of Danish breast...

hematologic malignancies
symptom management

Cognitive Decline Prevalent Among Elderly Patients With Hematologic Cancers

A sizable percentage of elderly patients with blood-related cancers such as leukemia and multiple myeloma are apt to show signs of diminished cognitive functioning—a decline that may impact their survival—a new study by investigators at Dana-Farber Cancer Institute and Brigham and...

Called to Lead: Tara O. Henderson, MD, MPH, Selected for Presidential Leadership Scholars Program

ASCO congratulates pediatric oncologist Tara O. Henderson, MD, MPH, on being selected for the 2018 Presidential Leadership Scholars (PLS) program. This highly competitive and prestigious national program was created to help individuals from many professional backgrounds develop the practical...

cns cancers
immunotherapy

Bevacizumab in Recurrent Glioblastoma

On December 5, 2017, bevacizumab (Avastin) was granted regular approval for the treatment of recurrent glioblastoma in adults.1 Bevacizumab was granted accelerated approval in May 2009 for use in treating patients with glioblastoma who had disease progression on prior therapy. Supporting Efficacy...

solid tumors
skin cancer

The Skin Cancer Foundation Announces Office Relocation

The Skin Cancer Foundation, the leading nonprofit organization for public and professional skin cancer education, recently moved to a new office space at 205 Lexington Avenue in midtown Manhattan. The new office will allow the Foundation to grow its staff as it develops new patient support programs ...

legislation
health-care policy

Why Right-to-Try Laws Are Dangerous

Why wouldn’t you support a patient with a terminal illness the “right to try” any therapy that may save his or her life? The answer to this question—one engulfed in a political debate in Congress—seems simple. It is not. [Editor’s Note: On May 30, 2018, the President signed into law the Trickett...

colorectal cancer

Study Finds Colorectal Cancer Screenings Vary Widely Throughout the United States

A study examining prevalence estimates of colorectal cancer screening at the county level in the United States has found that the country is far behind reaching the goal of screening 80% of adults aged 50 and older for colorectal cancer by 2018, which is supported by the National Colorectal Cancer...

issues in oncology

Genomic Analyses Highlight Need for Precision Therapies That Target Pediatric Cancers

Researchers have determined that children and adults with cancer often have different mutated genes driving their disease, which suggests they would likely benefit from different therapies. The finding, from a collaborative study led by St. Jude Children’s Research Hospital and published by...

cost of care

Use of Charity Assistance to Pay for Novel Oral Anticancer Agents

In a study reported in the Journal of Oncology Practice, Olszewski et al found that 36% of patients receiving novel oral anticancer agents in a Rhode Island academic research center received charity assistance to pay for treatment, including 47% of patients aged ≥ 65 years. Study Details The...

gynecologic cancers

Chemoradiotherapy vs Neoadjuvant Chemotherapy and Radical Surgery in Locally Advanced Squamous Cervical Cancer

In an Indian single-center phase III trial reported in the Journal of Clinical Oncology, Gupta et al found that cisplatin-based chemoradiotherapy improved disease-free survival vs neoadjuvant chemotherapy and radical surgery in women with locally advanced squamous cervical cancer. Study Details...

multiple myeloma

Denosumab vs Zoledronic Acid in Newly Diagnosed Multiple Myeloma With Bone Disease

In a phase III trial reported in The Lancet Oncology, Raje et al found that denosumab was noninferior to zoledronic acid in preventing skeletal-related events (SREs) in newly diagnosed multiple myeloma patients with bone disease. Study Details In the double-blind trial, 1,718 patients with at...

breast cancer

Adjuvant Chemotherapy for ER-Negative and ER-Positive Isolated Locoregional Recurrence of Breast Cancer

As reported in the Journal of Clinical Oncology by Wapnir et al, the final analysis of the phase III CALOR trial showed benefit of adjuvant chemotherapy in estrogen receptor (ER)–negative but not ER-positive isolated locoregional recurrence of breast cancer. Study Details In this open-label ...

skin cancer
immunotherapy

Body Mass Index and Outcomes With Targeted Therapy, Immunotherapy, or Chemotherapy in Metastatic Melanoma

In a study reported in The Lancet Oncology, McQuade et al found that obesity was associated with improved outcomes in treatment of metastatic melanoma with targeted therapy or immunotherapy—but not chemotherapy—with a survival benefit appearing to be restricted to obese male patients....

symptom management

GC4419 Receives FDA Breakthrough Therapy Designation for the Reduction of Severe Oral Mucositis

On February 28, the U.S. Food and Drug Administration (FDA) granted Breakthrough Therapy designation to GC4419, a highly selective and potent small molecule dismutase mimetic, for the reduction of the duration, incidence, and severity of severe oral mucositis induced by radiation therapy with...

issues in oncology
gastrointestinal cancer

Rehospitalization Patterns After Gastrointestinal Cancer Hospitalizations

In a study reported in the Journal of Oncology Practice, Manzano et al found that unplanned rehospitalization within 30 days after gastrointestinal (GI) cancer hospitalization was more likely after medical vs surgical index hospitalizations among older patients. Some risk factors for...

sarcoma

Neoadjuvant Chemotherapy With or Without Regional Hyperthermia in Localized High-Risk Soft-Tissue Sarcoma

As reported in JAMA Oncology by Issels et al, long-term follow-up of the phase III EORTC 62961-ESHO 95 trial has shown improved outcomes with the addition of regional hyperthermia to neoadjuvant chemotherapy in patients with high-risk soft-tissue sarcoma. Study Details In the open-label trial,...

gynecologic cancers

Adjuvant Chemoradiotherapy vs Radiotherapy in High-Risk Endometrial Cancer

As reported in The Lancet Oncology by de Boer et al, the phase III PORTEC-3 trial has shown no significant improvement in 5-year overall survival with adjuvant chemoradiotherapy vs radiotherapy alone in women with high-risk endometrial cancer. Adjuvant chemoradiotherapy, however, was associated...

breast cancer

FDA Approves Abemaciclib as Initial Therapy for Hormone Receptor–Positive, HER2-Negative Metastatic Breast Cancer

On February 26, the U.S. Food and Drug Administration (FDA) approved abemaciclib (Verzenio) in combination with an aromatase inhibitor as initial endocrine-based therapy for postmenopausal women with hormone receptor–positive, human epidermal growth factor receptor 2 (HER2)-negative advanced...

symptom management

Edoxaban vs Dalteparin in Cancer-Associated Venous Thromboembolism

In the phase III Hokusai VTE Cancer trial reported by Raskob et al in The New England Journal of Medicine, the direct-acting oral factor Xa inhibitor edoxaban proved noninferior to the low–molecular-weight heparin dalteparin in the composite outcome of recurrent venous thromboembolism or...

solid tumors
immunotherapy

SBRT and Anti–PD-1 Treatment in Metastatic Solid Tumors

In a phase I study reported in the Journal of Clinical Oncology, Luke et al found that a strategy of multisite stereotactic body radiotherapy (SBRT) followed by pembrolizumab was feasible in patients with metastatic solid tumors. It was hypothesized that stimulation of immune responses by SBRT...

symptom management
immunotherapy

ASCO Clinical Practice Guideline: Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy

As reported in the Journal of Clinical Oncology by Julie R. Brahmer, MD, of the Johns Hopkins Kimmel Cancer Center, and colleagues, ASCO has released a clinical practice guideline on management of immune-related adverse events in patients receiving immune checkpoint inhibitor therapy. To develop...

issues in oncology

Adolescents in Economically Disadvantaged Urban Environments and Exposure to Tobacco Smoke

Research shows that secondhand smoke is a major cause of disease, including lung cancer and heart disease, as well as respiratory problems in nonsmokers. In addition, exposure to secondhand smoke increases the likelihood of nonsmokers becoming active smokers. In a study assessing the impact of...

prostate cancer

SPARTAN Trial: Metastasis-Free Survival in Nonmetastatic Castration-Resistant Prostate Cancer

As reported by Smith et al in The New England Journal of Medicine, the phase III SPARTAN trial has shown that the androgen receptor inhibitor apalutamide (Erleada) produces significant improvement in metastasis-free survival and time to symptomatic progression vs placebo among men with...

solid tumors

Larotrectinib in TRK Fusion–Positive Cancers in Adults and Children

In a study reported in The New England Journal of Medicine, Drilon et al found that the oral tropomyosin receptor kinase (TRK) inhibitor larotrectinib produced a high response rate and enduring responses in patients with TRK fusion–positive cancers. These fusions have been found to lead to...

solid tumors

Study Shows Need for Early Supportive Care in Patients Diagnosed With Uveal Melanoma

In a study published by Williamson et al in JAMA Ophthalmology, University of California, Los Angeles, (UCLA) researchers found that nearly all patients diagnosed with uveal melanoma had a number of unmet psychological and health information needs, particularly during the first 3 months after their ...

pancreatic cancer

Five Novel Genetic Changes Linked to Pancreatic Cancer Risk

In what is believed to be the largest pancreatic cancer genome-wide association study to date, researchers at the Johns Hopkins Kimmel Cancer Center, the National Cancer Institute, and collaborators from over 80 other institutions worldwide discovered changes to 5 new regions in the human genome...

hematologic malignancies
leukemia

Data Favoring Maintenance Therapy in Older Patients With AML Accumulate

The use of maintenance therapy in older patients with acute myeloid leukemia (AML) is theoretically sensible, but its clinical value remains uncertain. The phase III HOVON97 randomized study demonstrated that maintenance therapy with the hypomethylating agent azacitidine may improve disease-free...

hematologic malignancies

Study Findings on Novel Agents in Neoplastic Hematology

HERE IS AN UPDATE on four different studies featured at the 2017 American Society of Hematology (ASH) Annual Meeting & Exposition. Topics focus on advanced systemic mastocytosis, diffuse large B-cell lymphoma (DLBCL), amyloidosis, and myeloproliferative neoplasms.  Systemic Mastocytosis...

Team Wellness: Reflections From Front-Line Clinical Teams

In May 2017, I started to reflect on my own personal views of wellness and the importance of the team. Since that time, I have been fortunate to speak with members of front-line clinical teams from four different practices:  Eric Tetzlaff, MSH, PA-C, and Michael Hall, MD, MS, of Fox Chase Cancer...

gynecologic cancers

USPSTF Recommends Against Screening for Ovarian Cancer in Asymptomatic Women

THE U.S. PREVENTIVE Services Task Force (USPSTF) recently published a final recommendation statement and evidence summary on screening for ovarian cancer. Based on its review of the evidence, the USPSTF recommends against screening for ovarian cancer in women who do not have any signs or symptoms...

leukemia

Guadecitabine in Treatment-Naive Older Patients With Acute Myeloid Leukemia

The results of a phase II trial have shown high activity of guadecitabine, a next-generation hypomethylating drug, in treatment-naive older patients with acute myeloid leukemia. The findings were reported in The Lancet Oncology by Hagop M. Kantarjian, MD, of The University of Texas MD Anderson...

multiple myeloma

Overall Survival With Carfilzomib vs Bortezomib in Relapsed or Refractory Multiple Myeloma

As reported by Meletios A. Dimopoulos, MD, of the National and Kapodistrian University of Athens, Alexandra Hospital, and colleagues in The Lancet Oncology, a prespecified interim analysis of the phase III ENDEAVOR trial has shown a significant overall survival benefit for carfilzomib (Kyprolis)...

breast cancer

Addition of Metronomic Chemotherapy to Dual Anti-HER2 Treatment in Older Patients With Metastatic Breast Cancer

In the phase II EORTC 75111-10114 trial reported in The Lancet Oncology, Wildiers et al found that the addition of metronomic oral cyclophosphamide to pertuzumab (Perjeta) and trastuzumab (Herceptin) improved progression-free survival in elderly or frail women with HER2-positive metastatic breast...

breast cancer

Serum Bone Biomarkers in Early Breast Cancer and Risk of Bone Metastasis

In a study reported in the Journal of the National Cancer Institute, Brown et al found that the serum bone biomarkers P1NP, CTX, and 1-CTP showed good prognostic ability for bone metastasis in patients in the phase III AZURE (BIG01/04) trial of adjuvant zoledronic acid in early breast cancer....

skin cancer

U.S. Incidence and Projected Rise of Merkel Cell Carcinoma

The number of U.S. cases of Merkel cell carcinoma is rising about six times faster than most other cancers, and at nearly twice the rate of melanoma. Paulson et al reported these findings in The Journal of the American Academy of Dermatology, which are based on research conducted at the University...

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