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lung cancer

New First-Line Options for ALK-Positive Lung Cancer on the Horizon

Anaplastic lymphoma kinase (ALK) rearrangements define a subset of non–small cell lung cancer (NSCLC) patients for whom ALK inhibitors are highly effective. In PROFILE 1014, the multitargeted ALK inhibitor crizotinib (Xalkori) was shown to be superior to platinum/pemetrexed (Alimta) chemotherapy...

head and neck cancer

Making the Case for Sentinel Node Biopsy in Early Cancers of the Oral Cavity

“The majority of patients with oral cavity cancers will undergo an unnecessary operation,” ­Sandeep Samant, MD, stated at a session on managing N0 neck cancer at the 2016 Lurie Cancer Center Multidisciplinary Head & Neck Symposium in Chicago.1 That operation is elective neck dissection, and it ...

breast cancer
symptom management
survivorship

Expert Point of View: Ann H. Partridge MD, MPH

Ann H. Partridge MD, MPH, Director of Adult Cancer Survivorship Program at the Dana-Farber Cancer Institute, praised the “tremendous work” of Dr. Paskett and her colleagues but referred to the findings as “disappointing to say the least.”1 “Developing interventions to prevent or treat lymphedema...

gastroesophageal cancer

Expert Point of View: Nancy Baxter, MD, PhD & Steven H. Lin, MD, PhD

“CALGB 80803 really helps move the field forward,” said press briefing moderator and ASCO spokesperson Nancy Baxter, MD, PhD, a surgeon from St. Michael’s Hospital in Toronto, Ontario, Canada. “PET [positron-emission tomography] scans may prove to be a valuable tool to help oncologists fine-tune...

hematologic malignancies

New Antiviral Agent May Prevent Posttransplant Cytomegalovirus Infections

Patients receiving the antiviral letermovir (MK-8228, AIC246), as compared to placebo, were almost twice as likely to avoid infection with cytomegalovirus or fail for other reasons in a randomized phase III international trial presented at the 2017 BMT Tandem Meetings, the joint meeting of the...

issues in oncology
skin cancer

Progress Being Made in Understanding Immunotherapy Resistance

A key challenge in advancing immunotherapies is to understand mechanisms of response and resistance. Emerging research in this area—including evidence that early on-treatment biopsies can predict response—was discussed at the 2017 ASCO-SITC (Society for Immunotherapy of Cancer) Clinical...

cns cancers

Low-Grade Gliomas: Understanding the New Treatment Paradigm

Diffuse infiltrating low-grade gliomas include oligodendrogliomas and astrocytomas and account for about 5% of all primary brain tumors. Treatment strategies for these low-grade gliomas in adults have recently changed, as detailed in a recent review in the Journal of Oncology Practice.1 The...

hepatobiliary cancer

Can Antiviral Therapy Prevent Liver Cancer in Patients With Chronic Hepatitis?

Chronic viral hepatitis is a major causative factor for hepatocellular carcinoma, but antiviral therapy might reduce the incidence of hepatocellular carcinoma by preventing or eliminating chronic hepatitis infections, according to Adrian M. Di Bisceglie, MD, Professor of Internal Medicine at Saint ...

head and neck cancer

Immunotherapy for Head and Neck Cancer: ‘The Fourth Modality Has Arrived’

“This is a big deal. This is going to change all of oncology, not just head and neck cancer,”1 Tanguy ­Seiwert, MD, remarked following a summary by Jeffrey Sosman, MD, on advances in immunotherapy for treating cancer.2 Dr. Sosman, Director of the Melanoma Program and Clinical Director of Cancer...

lung cancer

Expert Point of View: David Planchard, MD, PhD, Luboš Petruželka, MD, PhD, and Clarissa ­Baldotto, MD, MSc

Three invited discussants explored the results of these recent immunotherapy studies in lung cancer as well as their potential clinical implications at the International Association for the Study of Lung Cancer 17th World Conference on Lung Cancer. KEYNOTE-021 trial “Pembrolizumab (Keytruda) is...

issues in oncology

Make Vaccination Great Again

Human papillomavirus (HPV) is the most common sexually transmitted infection worldwide. It affects 80% of individuals, with the initial infection usually occurring between the ages of 15 and 24. Persistent infection with oncogenic HPV genotypes, primarily 16 and 18, is the cause of virtually all...

breast cancer

FALCON Trial Informs the Evolving Role of Fulvestrant in Advanced Hormone Receptor–Positive Breast Cancer

Endocrine therapy for breast cancer has evolved over the years. Initial endocrine therapies consisted of ablative procedures (oophorectomy, adrenalectomy, and hypophysectomy). With the availability of pharmaceutical estrogens, progestins, and androgens, ablative procedure utilization begin to...

Expect Questions About Screening and Potential Overdiagnosis

“The big thing that is going to become more and more of an issue, and that you are going to hear a lot more of this year, and in the next several years, is overdiagnosis,” Otis W. Brawley, MD, FACP, Chief Medical Officer of the American Cancer Society, told The ASCO Post in an interview following...

issues in oncology

Continued Reduction in Cancer Mortality Requires Increasing Healthy Behaviors and Removing Inequities in Care

Many news reports about the latest cancer statistics released by the American Cancer Society (ACS) have focused on the 25% reduction in cancer mortality since 1991. Several reports quoted ACS Chief Medical Officer Otis W. Brawley, MD, FACP, who said in a statement1 announcing the publication of...

integrative oncology

Soy

Scientific Name: Glycine max Common Names: Soybean, soya, tofu, miso, tempeh Overview An annual herb indigenous to East Asia, soy was domesticated more than 3,000 years ago for its pods and edible seeds. It is now the world’s most important legume crop and is grown in diverse climates. Foods...

breast cancer

Results From MONALEESA-2: Are All CDK4/6 Inhibitors Equal?

Hormone receptor–positive breast cancer is the most common subtype of breast cancer, and while endocrine therapy has long been a mainstay of therapy for these patients, treatment resistance ultimately develops. Therefore, better therapeutic approaches are needed. There are some data to suggest...

breast cancer

First-Line Ribociclib Prolongs Progression-Free Survival in Hormone Receptor–Positive, HER2-Negative Breast Cancer

As reported by The ASCO Post from the recent European Society for Medical Oncology Conference, first-line treatment with ribociclib, a selective inhibitor of cyclin-dependent kinases 4 and 6 (CDK4/6), resulted in significantly longer progression-free survival vs placebo in women with hormone...

hepatobiliary cancer

Regorafenib in Second-Line Setting for Hepatocellular Carcinoma: Balancing Benefit With Toxicity

During the past 40 years, hundreds of randomized trials testing treatments for advanced hepatocellular carcinoma have been published.1 Conventional systemic chemotherapy and radiotherapy lack survival advantages for these patients.1,2 In 2007, a phase III trial demonstrated survival benefits for...

lung cancer

Bright Future for Osimertinib in EGFR T790M–Positive Lung Cancer

The AURA3 study—reported by Mok and colleagues and reviewed in this issue of The ASCO Post—confirms the dramatic activity of osimertinib (Tagrisso) in patients with advanced epidermal growth factor receptor (EGFR)-mutant non–small cell lung cancer (NSCLC) and acquired resistance to prior EGFR...

lung cancer

Osimertinib Improves Progression-Free Survival vs Platinum/Pemetrexed in EGFR T790M–Positive NSCLC

In the phase III AURA3 trial reported in The New England Journal of Medicine by Tony S. Mok, MD, of the Chinese University of Hong Kong, and colleagues, osimertinib (Tagrisso) significantly improved progression-free survival vs platinum/pemetrexed (Alimta) among patients with epidermal growth...

cns cancers

Radiotherapy vs Temozolomide in Low-Grade Glioma: The Importance of Molecular Classification

The optimal treatment strategy for low-grade glioma has yet to be established, and practice patterns vary in regard to the timing of treatment, as well as the chosen treatment modality. It was against this backdrop, at a time when the benefits of radiation and chemotherapy remained uncertain but ...

geriatric oncology
colorectal cancer

Tailoring Treatment for Older Adults With Colorectal Cancer

Nearly 60% of colorectal cancer cases are diagnosed in patients ≥ 65 years, with a median age at diagnosis of 68 years,1 but this population makes up only 34% of clinical trial participants.2 In addition, the older adults enrolled on clinical trials are traditionally the most-fit older adults....

Exploring the Opportunities and Challenges of Seamless Drug Development

The traditional three-phase clinical trial process for testing new drugs does not necessarily make sense when it comes to targeted therapies, according to many experts, including regulators, academic researchers, industry chief executive officers, and patient advocates alike. Instead of three...

issues in oncology

Exploring the Opportunities and Challenges of Seamless Drug Development

The traditional three-phase clinical trial process for testing new drugs does not necessarily make sense when it comes to targeted therapies, according to many experts, including regulators, academic researchers, industry chief executive officers, and patient advocates alike. Instead of three...

issues in oncology
survivorship

Many Cancer Survivors Find Online and Telephone Communication With Health-Care Professionals Beneficial

Researchers from the School of Health Sciences at the University of Surrey, Guildford, United Kingdom, have completed the first-ever systematic review of cancer survivors’ experience of online and telephone telehealth interventions in cancer care, according to a recent study reported by Anna Cox,...

Selected Abstracts From the 2016 ASH Annual Meeting

Here are several abstracts selected from the proceedings of this year’s American Society of Hematology (ASH) Annual Meeting & Exposition, highlighting newer therapeutics in high-grade, aggressive B-cell non-Hodgkin lymphomas (NHLs), including newly diagnosed as well as relapsed or refractory...

lung cancer

New Analysis of CheckMate 057: Search Continues for Predictors of Outcome With Nivolumab

Prognostic factors and tumor expression of programmed cell death ligand 1 (PD-L1) predict early mortality among patients with previously treated nonsquamous advanced non–small cell lung cancer (NSCLC) who receive nivolumab instead of docetaxel. But these features are not reliable for excluding...

lung cancer

Quality-of-Life Data From KEYNOTE-024: First-Line Pembrolizumab vs Chemotherapy in Advanced NSCLC

When used as first-line therapy for advanced non–small cell lung cancer (NSCLC), pembrolizumab (Keytruda) yields better health-related quality of life than platinum-based chemotherapy, suggest new data from the randomized phase III KEYNOTE-024 trial.1 After 15 weeks of treatment, changes in scores...

lung cancer

Clinical Trials Study the Role of Immunotherapy in the First-Line Setting of Non–Small Cell Lung Cancer

In 2016, the KEYNOTE-024 trial set the bar for first-line immunotherapy in non–small cell lung cancer (NSCLC). Trial results showed that pembrolizumab (Keytruda), an antibody to programmed cell death protein 1 (PD-1), reduced the risk of disease progression or death by 50% and the risk of death by...

survivorship
health-care policy

Timing Is Everything

In 1959, my 5-year-old cousin, Kim, was diagnosed with acute lymphocytic leukemia (ALL). As an 8-year-old, I didn’t really understand what was happening to him, except that he had to go to the Riley Hospital for Children in Indianapolis, Indiana, for treatment. The haunting vision of his looking...

lung cancer

Understanding the Role of Immunotherapy for Lung Cancer: A Paradigm Shift for the Better

“Immunotherapy for lung cancer is a paradigm shift. I would never have thought when I started my career taking care of lung cancer patients in the mid 1990s that we’d now be substituting chemotherapy with an antibody immunotherapy in 2017. It’s incredible,” commented Roy S. Herbst, MD, PhD, Chief...

hematologic malignancies

Study Finds Mutations in Myelodysplastic Syndrome Linked to Poorer Outcome After Stem Cell Transplantation

In a study reported in The New England Journal of Medicine, Lindsley et al found that a number of mutations present in patients with myelodysplastic syndrome (MDS) were associated with poorer clinical outcome after allogeneic hematopoietic stem cell transplantation (HSCT). Study Details The study ...

neuroendocrine tumors

Telotristat Ethyl: A Novel Therapy for Carcinoid Syndrome—Not a Panacea but a Step in the Right Direction

The multihumoral manifestations of neuroendocrine tumors include diarrhea, cutaneous flushing, wheezing, and right-sided valvular heart disease.1 Serotonin, a biogenic amine and product of tryptophan metabolism,2 mediates several of these symptoms.3,4 Diarrhea is a cardinal and often disabling...

lymphoma

Liquid Biopsies Show Promise in Diffuse Large B-Cell Lymphoma

Technologic advances for detecting and analyzing cell-free circulating tumor DNA (ctDNA) from peripheral blood offer a precision method for monitoring diffuse large B-cell lymphoma (DLBCL). Although most patients with DLBCL are cured with initial therapy, those who are not cured have a poor...

lymphoma

Circulating Tumor DNA Profiling Identifies Clonal Evolution Patterns and Permits Classification of Tumor Subtypes in DLBCL

In a study reported in Science Translational Medicine, Florian Scherer, MD, David M. Kurtz, MD (Conquer Cancer Foundation Young Investigator), Aaron M. Newman, PhD, and colleagues from Stanford University found that analysis of circulating tumor DNA (ctDNA) permits identification of patterns of...

lung cancer

Expert Point of View: Fiona Blackhall, PhD, FRCP

“There has undoubtedly been extremely rapid progress made in establishing effective therapies for anaplastic lymphoma kinase (ALK)-positive non–small cell lung cancer (NSCLC) patients in less than a decade,” said Fiona Blackhall, PhD, FRCP, Chair of Thoracic Oncology and medical oncologist at the...

prostate cancer

Adding Antiandrogen Therapy to Radiation Therapy in Recurrent Prostate Cancer

As reported in The New England Journal of Medicine by Shipley et al in the NRG Oncology Radiation Therapy Oncology Group (RTOG), the final analysis of the phase III RTOG 9601 trial showed that the addition of antiandrogen therapy with bicalutamide to radiation therapy significantly improves overall ...

breast cancer

Veliparib Improves Reponse but Not Progression-Free Survival in BRCA-Mutation Carriers

A randomized phase II study in women with metastatic breast cancer who have mutations in BRCA1 or BRCA2 evaluated the addition of the poly (ADP-ribose) polymerase (PARP) inhibitor veliparib to combination chemotherapy. The trial did not meet its primary endpoint.1 Hyo Sook Han, MD, of Moffitt...

breast cancer

Tumor-Infiltrating Lymphocytes Prognostic in the Metastatic and Neoadjuvant Breast Cancer Settings

Studies presented at the 2016 San Antonio Breast Cancer Symposium added to growing evidence that tumor-infiltrating lymphocytes are important prognostic factors in breast cancer. One investigation evaluated their impact in advanced HER2-positive breast cancer, finding a linear relationship between...

What Have We Got to Lose?

Tuesday morning was the regular time for the departmental meeting—an opportunity to discuss cases, troubleshoot, debrief, and expedite the necessary allied health referrals. As usual, patient cases were being discussed in alphabetical order of the attending oncologist. We were already three...

integrative oncology

Vitamin D and Cancer: A Uniform Dose Is Unlikely to Fit All Patients

Technically, vitamin D is a secosteroid hormone, not a vitamin. Increasing evidence indicates that vitamin D exerts effects beyond calcium homeostasis. Importantly, for example, higher serum vitamin D levels are associated with better cancer outcomes, including survival.1-3 The protective effects...

issues in oncology

Addressing Discrimination and Bias in Medical Education

“As a medical student, I often felt marginalized from my medical community. I have been told that my name is ‘not American,’ fallen prey to being confused for support staff such as a janitor (even while wearing my white coat) and been asked questions like, ‘Where are you really from?’ or ‘How old...

gynecologic cancers

PARP Inhibitor Niraparib Yields ‘Unprecedented’ Results in Ovarian Cancer in Phase III Trial

The first phase III trial of an inhibitor of poly (ADP-ribose) polymerase (PARP) yielded unprecedented results in treating ovarian cancer. The trial was presented at the European Society for Medical Oncology (ESMO) in Copenhagen, Denmark, and electronically reported concurrently in The New England ...

gynecologic cancers

Niraparib Maintenance Improves Progression-Free Survival in Platinum-Sensitive Recurrent Ovarian Cancer

In a phase III trial (ENGOT-OV16/NOVA) reported at the 2016 ESMO (European Society for Medical Oncology) Congress and in The New England Journal of Medicine by Mansoor R. ­Mirza, MD, of the Rigshospitalet–Copenhagen University Hospital, and colleagues, maintenance therapy with the PARP (poly...

leukemia

Diamonds Are Forever, Tyrosine Kinase Inhibitors Are Not?

Sir Donald Munger: “You have been on holiday, I understand. Relaxing, I hope?” James Bond: “Oh, hardly relaxing, but most satisfying.” (Diamonds Are Forever) As tyrosine kinase inhibitors became the mainstay of therapy for patients with chronic myeloid leukemia (CML), our assumption has been that...

geriatric oncology

Falls in Older Patients With Cancer: Recognizing and Reducing the Risk

In older patients, a current or previous cancer diagnosis confers a 15% to 20% greater risk of suffering a fall.1 Defined as an “unexpected event in which the participant comes to rest on the ground, floor, or lower level,” a fall occurs in 30% to 50% of cancer patients 65 years of age or...

head and neck cancer

Nivolumab in Squamous Cell Carcinoma of the Head and Neck in CheckMate 141: Game Not Over

Most patients with squamous cell carcinoma of the head and neck present with locally advanced disease. With combined-modality approaches, the chance of cure ranges from < 50% to up to 80%, depending on the site, stage, and other risk factors, such as human papillomavirus (HPV) status. When...

head and neck cancer

Nivolumab Improves Overall Survival in Recurrent Platinum-Refractory Squamous Cell Carcinoma of the Head and Neck

In the phase III CheckMate 141 trial reported in The New England Journal of Medicine, Robert L. Ferris, MD, PhD, of the University of Pittsburgh Medical Center and Cancer Institute, and colleagues found that nivolumab (Opdivo) increased overall survival vs standard therapies in patients with...

issues in oncology

Optimizing Access to Fertility Preservation Options

Ensuring that people with cancer understand how cancer treatment could affect their fertility and what options are available for preserving fertility were widely recognized as top priorities by attendees of the 2016 Oncofertility Conference in Chicago. As detailed at the conference, means of...

multiple myeloma

Expert Point of View: Philip ­McCarthy, MD

The ASCO Post asked Philip ­McCarthy, MD, Professor of Oncology and Internal Medicine at Roswell Park Cancer, Buffalo, and Director of the Blood and Marrow Transplant Center there, to comment on these study findings. He first addressed the need to study earlier intervention for smoldering ...

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