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issues in oncology
issues in oncology

ASCO Issues New Recommendations for Family History-Taking in Oncology Setting

When oncologists see a new patient, they should emphasize careful documentation of first- and second-degree cancer family history, according to new recommendations published by the American Society of Clinical Oncology. The recommendations are the first to focus on family history-taking...

kidney cancer

Cytoreductive Nephrectomy Improves Survival in Metastatic Renal Cell Carcinoma Patients With Longer Life Expectancy

Prior to the advent of targeted therapy, cytoreductive nephrectomy was associated with a 6-month improvement in overall survival in metastatic renal cell carcinoma. With the development of new and better targeted therapies for metastatic renal cell carcinoma, the appropriate use of cytoreductive...

leukemia

Alternative Mechanism of Action Suggested for Vemurafenib in Hairy Cell Leukemia With BRAF V600E Mutation

The finding that the BRAF V600E mutation is present in nearly all cases of hairy cell leukemia has resulted in the use of BRAF inhibitors to treat chemotherapy-resistant disease, with good responses to vemurafenib (Zelboraf) being observed. BRAF inhibition has been thought to result in...

solid tumors
bladder cancer

Patients With Near-Complete Response After Induction Therapy May Be Candidates for Bladder-Sparing Therapy

Bladder-sparing approaches are typically reserved for patients with bladder cancer who have a complete response to combined modality induction therapy (radiation plus chemotherapy). A new phase II study suggests that patients with near-complete response should also be considered for bladder-sparing ...

solid tumors

Studies Evaluate Trends in the Surgical Management of Penile Cancer

A large retrospective population-based study shows that potentially fatal penile cancers are surgically undertreated in the United States and more benign penile cancers are surgically overtreated. Even though penile cancer is rare in the United States, accounting for about 1,570 new cases in 2013...

prostate cancer
issues in oncology

Prostate Health Index May Provide New Tool to Identify Patients Assigned to Watchful Waiting Who Require Immediate Treatment

A simple tool called “phi” appears to be able to identify which patients assigned to active surveillance for prostate cancer are more likely to require treatment. Phi, or the prostate health index, is calculated from three serum measurements: PSA, free/total PSA, and a new measurement,...

prostate cancer

Prolonged Hormone Therapy Exposure Increases Risk of Diabetes and Cardiovascular Disease in Older Patients With Prostate Cancer

Although androgen deprivation therapy extends survival in men with prostate cancer, its use is associated with unwanted side effects. In addition to the well-known side effects of impaired sexual function and hot flashes, prolonged exposure to androgen deprivation therapy can also lead to diabetes...

prostate cancer

Study Examines Immunotherapy in Metastatic Castration-Resistant Prostate Cancer

In the randomized, phase III CA184-043 trial, ipilimumab (Yervoy) improved progression-free survival and prostate-specific antigen (PSA) response compared with placebo, but failed to improve overall survival significantly in postdocetaxel metastatic castration-resistant prostate cancer....

breast cancer

New Findings Contradict Current Understanding of How to Manage Breast Biopsy Abnormalities

A long-term follow-up study by Hartmann et al of patients with two types of breast tissue abnormalities—atypical ductal hyperplasia and atypical lobular hyperplasia—suggests that both abnormalities have the same potential to advance to breast cancer. The findings could help improve...

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. ...

New Clues May Link Hereditary Cancer Genes to Increased Risk of Cancer From Alcohol

In laboratory experiments conducted on human cell lines at the Johns Hopkins Sidney Kimmel Cancer Center, scientists have shown that people carrying certain mutations in two hereditary cancer genes, BRCA2 and PALB2, may have a higher than usual susceptibility to DNA damage caused by acetaldehyde, a ...

breast cancer

Melatonin May Potentially Slow Tumor Growth in Estrogen Receptor–Negative Breast Cancers

An early-stage study shows melatonin may have the potential to help slow the growth of certain breast cancer tumors, according to researchers from Henry Ford Hospital in Detroit and Foundation for Research Support of the State of São Paulo. The study, published online in the journal PLoS...

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...

lymphoma

PI3K-Delta Inhibitor Idelalisib Produces High Response Rates in Relapsed Indolent Lymphoma

Phosphatidylinositol 3-kinase (PI3K)-delta mediates B-cell receptor signaling and microenvironment support signals that promote the growth and survival of malignant B lymphocytes. In a phase II study reported in The New England Journal of Medicine, Gopal et al found that the PI3K-delta inhibitor...

NCI Scientists Map Genetic Changes in Rhabdomyosarcoma Tumors

Researchers from the National Cancer Institute (NCI) have found two distinct genotypes in rhabdomyosarcoma tumors: those characterized by the PAX3 or PAX7 fusion and those that lack these fusions but harbor mutations in key signaling pathways. The discovery could lead to the development of targeted ...

skin cancer

Dermoscopy Shows Characteristics of Cutaneous Metastases of Visceral Cancers

In a case series reported in JAMA Dermatology, Chernoff et al found that dermoscopic identification of vascular structures in cutaneous nodules in patients with known cancer diagnosis should raise suspicion for cutaneous metastasis. Study Details In the study, high-quality dermoscopic images of...

head and neck cancer

Intensity-Modulated Radiation Therapy Improves Survival in Patients With Head and Neck Cancer

Patients with cancers of the head and neck who received intensity-modulated radiation therapy experienced improved outcomes, as well as reduced toxicities, compared to patients receiving conventional radiation therapy, according to findings published online in Cancer by Beadle et al. The study is...

prostate cancer
issues in oncology

Model of Individualized Estimates Shows Risk of Overdiagnosis in Screening-Detected Prostate Cancers Varies Widely by Age, PSA, and Gleason Score

It is estimated that overdiagnosis occurs in approximately 20% to 40% of prostate cancers detected at screening in U.S. men aged 50 to 84 years, with the likelihood of overdiagnosis varying widely according to patient age and tumor characteristics. In a study reported in the Journal of the...

issues in oncology
breast cancer

11-Protein Signature Distinguishes Good and Poor Outcome in Node-Negative, Adjuvant Therapy–Naive, Triple-Negative Breast Cancer

In a study reported in the Journal of the National Cancer Institute, Liu et al performed global proteomic profiling in samples from patients with triple-negative breast cancer in an attempt to identify a risk signature. They identified a novel 11-protein signature that independently predicts...

colorectal cancer

Long-Term/High-Dose Use of ACE Inhibitors Associated With Reduced Colorectal Cancer Risk in Hypertensive Subjects

Preclinical data suggest a role of angiotensin II in colorectal cancer. In a study reported in the Journal of the National Cancer Institute, Makar et al assessed whether use of angiotensin converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) treatment for hypertension was...

breast cancer

Many Patients Have Some Pain 12 Months After Breast Cancer Surgery

In a prospective study reported as a research letter in JAMA, Meretoja et al found that 50% of patients had mild pain and 16% moderate or severe pain at 12 months after surgery for breast cancer. Factors predictive of pain were chronic preoperative pain, preoperative pain in the area of surgery,...

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 ...

breast cancer

Breast-Conservation Therapy Associated With Better Cancer-Specific Survival Than Mastectomy in Patients With Early-Stage Invasive Ductal Carcinoma

In a study reported in JAMA Surgery, Agarwal et al compared breast cancer–specific survival rates of patients with early-stage invasive ductal carcinoma undergoing breast-conservation therapy (lumpectomy followed by radiation), mastectomy alone, or mastectomy with radiation using the SEER...

gastroesophageal cancer

Cetuximab Fails to Improve Survival in Nonoperable Esophageal Cancer

More data have emerged that discount the potential for benefit with epidermal growth factor receptor (EGFR) inhibitors in esophageal cancer. The latest comes from the RTOG 0436 randomized phase III trial in patients with nonoperable esophageal cancer, the results of which were presented at the 2014 ...

cns cancers

Study Questions the Anticancer Mechanism of Metformin

The drug metformin, which is approved for the treatment of type 2 diabetes, has been tested in clinical trials as a tumor suppressor in different cancers due to its role in activating the AMPK signaling pathway. However, a new study by Liu et al published in Proceedings of the National Academy of...

pancreatic cancer

Immunotherapy Strategy Boosts Survival in Metastatic Pancreatic Cancer

Overall survival was improved in patients with metastatic pancreatic cancer through an innovative immunotherapy strategy in a multicenter study to be reported at the 2014 Gastrointestinal Cancers Symposium (Abstract 177). The results were announced at a press briefing prior to the meeting....

issues in oncology
solid tumors

High Presurgical Levels of Angiogenic and Growth Factors Are Associated With Poorer Survival After Gastric Resection

In patients undergoing gastric resection for gastric/gastroesophageal junction cancers, high levels of angiogenic and growth factors are associated with poorer overall survival, according to the results of a retrospective study presented by Park et al in the Annals of Surgical Oncology. Thus, these ...

multiple myeloma
issues in oncology

Multiple Myeloma Study Shows Widespread Genetic Heterogeneity

A detailed study of tissue samples from more than 200 patients with multiple myeloma has found that an individual patient’s tumor can harbor populations of cancer cells equipped with different mutations. The result could have therapeutic ramifications for future patients, according to study...

cns cancers
pancreatic cancer

Combination Capecitabine/Temozolomide Appears Highly Effective in Patients With Treatment-Resistant Neuroendocrine Tumors

Interim results from an ongoing phase II clinical trial in patients with various types of advanced neuroendocrine tumors show that a new chemotherapy combination of capecitabine and temozolomide either stalled disease progression or shrank tumors in 95% of patients whose disease worsened after...

breast cancer

No Increased Risk of Local Recurrence After Breast-Conserving Surgery in Triple-Negative Breast Cancer in Single-Center Study

Triple-negative breast cancer may be considered a relative contraindication to breast-conserving surgery. In a study reported in JAMA Surgery, Gangi et al from Cedars-Sinai Medical Center in Los Angeles assessed outcomes in a large cohort of women undergoing breast-conserving surgery at their...

issues in oncology

Smoking Prevalence Declines Among Health-Care Professionals

In a study reported as a research letter in JAMA, Sarna et al found that the prevalence of smoking among U.S. health-care professionals was 8.3% in 2010/2011, representing decreases of 23.4% since 2003 and 19.3% since 2006/2007. A previous study had shown no marked reduction in smoking rates among...

colorectal cancer
issues in oncology

Known Lung Cancer Oncogenes ALK and ROS1 May Also Drive Certain Colorectal Tumors

ALK and ROS1 gene rearrangements, which are known to drive subsets of lung cancer, appear to be present in some colorectal cancers as well, according to the results of a study published in Molecular Cancer Research. The findings by Aisner et al suggest that therapies used to target these two...

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...

leukemia

Ibrutinib Promising as Initial Therapy for Elderly Patients With CLL in Phase IB/II Trial

Chemoimmunotherapy has produced improved response and survival in young patients with chronic lymphocytic leukemia (CLL), but its use in elderly patients has been limited by myelosuppression and infection. In a phase IB/II study reported in The Lancet Oncology, O’Brien et al assessed the use...

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 ...

skin cancer

Sentinel Lymph Node Biopsy Associated With Survival Advantage in Merkel Cell Carcinoma

In patients with Merkel cell carcinoma, sentinel lymph node biopsy was shown to be associated with improved survival, according to the results of a retrospective study reported by Kachare et al in the Annals of Surgical Oncology. Thus, sentinel lymph node biopsy offers prognostic information that...

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...

kidney cancer
kidney cancer
issues in oncology

Renal Cell Carcinoma Onset at ≤ 46 Years Could Serve as Marker for Genetic Testing

Approximately 5% to 8% of renal cell carcinoma cases are hereditary, and there are no guidelines for patient selection for germline mutation testing in this disease. In a study reported in the Journal of Clinical Oncology, Shuch et al from the National Cancer Institute assessed whether age at onset ...

supportive care
issues in oncology

Most Physicians Would Enroll in Hospice If They Were Terminally Ill With Cancer, Study Finds

In a research letter published in JAMA Internal Medicine, Chinn et al surveyed physicians’ attitudes towards hospice treatment if they were terminally ill with cancer and assessed how physician preferences might affect timing of hospice discussions with their terminally ill patients. They...

lung cancer

Preclinical Study Suggests E-Cigarettes May Contribute to Lung Cancer in High-Risk Individuals

A study of human bronchial epithelial cells carrying mutations in the TP53 and KRAS genes has found that e-cigarette vapors enhanced the cells’ cancerous behaviors. The study suggests that e-cigarette exposure may contribute to lung cancer in individuals at high risk for the disease. The...

supportive care

Single Fractions of Radiation for Painful Bone Metastases May Be Noninferior to Multiple Fractions

Optimal dose fractionation for radiation therapy of painful bone metastases from multiple primary sites remains undefined. In a phase III noninferiority trial reported in The Lancet Oncology, Chow et al compared 8 Gy in a single fraction vs 20 Gy in multiple fractions in patients with painful bone...

lymphoma

No Survival Difference for Autologous vs Reduced-Intensity Conditioning Allogeneic Stem Cell Transplant in Chemotherapy-Sensitive Mantle Cell Lymphoma

In an analysis reported in the Journal of Clinical Oncology, Fenske et al compared outcomes with early or late autologous vs reduced-intensity conditioning allogeneic hematopoietic stem cell transplantation in a population of patients with chemotherapy-sensitive mantle cell lymphoma. They found no...

gynecologic cancers
gynecologic cancers

Recurrent Ovarian Cancers Respond to Cancer Vaccine After ‘Reprogramming’ With Decitabine

Treatment with the drug decitabine prior to administration of chemotherapy and a cancer vaccine yielded clinical benefit for women with recurrent ovarian cancer, suggesting that this combinatorial chemoimmunotherapy may provide a new treatment option for patients with the disease, according to a...

skin cancer

Phase II Pilot Study Does Not Support Phase III Investigation of IV High-Dose Interferon Without Maintenance in Resected Melanoma

There is evidence that high-dose interferon alfa-2b consisting of 4 weeks of daily intravenous interferon alfa-2b followed by 48 weeks of subcutaneous maintenance interferon alfa-2b three times per week reduces risk of recurrence of resected melanoma and that response may depend on the early...

lung cancer

Study Evaluates Risk of Depression by Race and Sex Among Patients With Newly Diagnosed Lung Cancer

In a study reported in the Journal of Clinical Oncology, Traeger et al evaluated risk of depression symptoms and psychosocial service use by race and sex among patients with newly diagnosed lung cancer. The investigators found that black men have the highest prevalence of depressive symptoms, white ...

Oral Insulin Sensitizers Associated With Decreased Cancer Risk in Women With Type 2 Diabetes

According to the findings of a meta-analysis by Sun et al published in Diabetes, Obesity, and Metabolism, patients with type 2 diabetes mellitus who are on certain therapies, such as insulin secretagogues, may be at higher risk for cancer. This increased risk was seen more frequently in women, and...

skin cancer

Imiquimod 5% Cream Inferior to Surgical Excision in Nodular and Superficial Basal Cell Carcinoma

In a noninferiority trial (SINS) reported in The Lancet Oncology, Bath-Hextall et al compared imiquimod 5% cream vs surgical excision for nodular and superficial basal cell carcinomas. Imiquimod cream was found to be inferior to surgical excision, but it may have a role in treatment of low-risk...

breast cancer

Wider Surgical Margins Do Not Appear To Reduce Local Recurrence Rates in Triple-Negative Breast Cancer

Wider surgical margins did not reduce the rate of local recurrence in women with triple-negative breast cancer treated with breast-conserving therapy, according to the results of a study published in the Annals of Surgical Oncology. Pilewskie et al reported that their data support the definition of ...

lymphoma

Sustained Complete Responses With Novel Immunotherapy in Lymphoma

Approximately 40% of patients with Hodgkin or non-Hodgkin lymphoma have tumor cells that express the type II latency Epstein-Barr virus (EBV) antigens latent membrane protein 1 (LMP1) and LMP2. T cells specific for these antigens are present in low levels and may be rendered nonreactive by the...

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