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supportive care
pain management
issues in oncology
symptom management

Medical Marijuana: The Topic You Can’t Escape

With reports about new marijuana dispensaries sprouting up as more states approve the legal use of medical marijuana, and patients and family members questioning how to get it, medical marijuana is a “topic you can’t escape,” noted Judith A. Paice, PhD, RN.1 Dr. Paice is Director of the Cancer...

The Smartest Guys in the Room

The smartest guys in the room were never from the big energy companies, and they’re not running hedge funds on Wall Street or building the next Facebook. For me, the smartest guys in the room are the selfless men and women who’ve transformed cancer from what was all too often a death sentence to...

colorectal cancer

New Blood Test for Colorectal Cancer Recurrence: Twice as Sensitive as CEA Test

In a new report published by Young et al in Cancer Medicine,1 a two-gene circulating tumor DNA (ctDNA) blood test for postsurgical monitoring of colorectal cancer recurrence has been shown to detect twice the number of recurrence cases as carcinoembryonic antigen (CEA) testing, a standard-of-care...

issues in oncology
supportive care

Talking to Children With Cancer: Sometimes Less Is More

I still remember the day I met Kensie. It was Valentine’s Day. I had sneaked out of the hospital to get my wife a Valentine’s Day card, taking my place among scores of other husbands and boyfriends in front of the rapidly emptying rack of cards. As I started browsing, my beeper sounded. It was the ...

geriatric oncology
symptom management

Cardio-oncology in the Geriatric Patient

As cancer therapies improve and the population as a whole increases, there are rising numbers of elderly patients with cancer. More than half of patients newly diagnosed with cancer are aged 65 years or older.1 In January 2012, it was estimated that more than 8 million cancer survivors were over...

breast cancer
genomics/genetics

Chemotherapy May Be Avoidable in Some Women With Early-Stage Breast Cancer Based on Clinical and Genomic Risks

In the phase III MINDACT trial reported in The New England Journal of Medicine, Fatima Cardoso, MD, of Champalimaud Clinical Center–Champalimaud Foundation, Lisbon, and colleagues found that adjuvant chemotherapy may be avoidable in women with early-stage breast cancer who are at high clinical...

survivorship

Adult Survivors of Childhood Cancers Report Long-Term Health Issues

Although progress in treatment and supportive care for children with cancer has resulted in improved survival of these patients, some survivors experience ongoing medical conditions from their cancer or its treatment, including poor general health, poor mental health, functional impairment,...

pancreatic cancer

Scientists Are Boosting Immune Responses in Pancreatic Tumors

The successes observed with various immune oncologic treatment approaches have largely bypassed pancreatic cancer, but this may be about to change, based on emerging insights into how and why these tumors evade attacks by T cells. At the 2nd International Cancer Immunotherapy Conference, two...

head and neck cancer

Better Quality of Life Reported in Patients With Head and Neck Cancer Receiving Nivolumab vs Chemotherapy

Standard treatment for advanced head and neck cancer—including chemotherapy and radiation—causes painful side effects that impair quality of life, as well as the ability to socialize and engage in daily life activities. A new study of patients with platinum-refractory recurrent, metastatic head...

lung cancer

Pembrolizumab, but Not Nivolumab, Improves Outcomes in Front-Line Setting for PD-L1–Positive Advanced NSCLC

Checkpoint inhibitors have revolutionized the treatment of advanced non–small cell lung cancer (NSCLC), but evidence of their benefit was restricted to the second-line setting. However, early-phase trials with both pembrolizumab (Keytruda) and nivolumab (Opdivo) demonstrated favorable results in...

kidney cancer

Phase III Study of Sunitinib Is First to Show Benefit in Adjuvant Setting for Treatment of Renal Cell Carcinoma

Sunitinib (Sutent) improved disease-free survival by more than 1 year when used as adjuvant treatment for high-risk locoregional renal cell carcinoma following nephrectomy, but with the cost of toxicity. S-TRAC is the first phase III trial showing a benefit for adjuvant therapy in renal cell...

lymphoma

Daratumumab Produces Sustained Remission in a Patient With Refractory Extranodal NK Cell–T-Cell Lymphoma

In a letter to the editor in The New England Journal of Medicine, Hari et al described a sustained response to the anti-CD38 antibody daratumumab (Darzalex) in a patient with relapsed, refractory nasal-type extranodal natural killer (NK) cell–T-cell lymphoma. In September 2014, a 56-year-old ...

issues in oncology

Evaluating the FDA’s Approach to Cancer Clinical Trials

Since the announcement of the U.S. Food and Drug Administration (FDA) Oncology Center of Excellence (OCE) on June 29, 2016, as part of the White House’s Cancer Moonshot, we’ve been working to further the FDA’s efforts to get new oncology products into the hands of patients. We are committed to...

palliative care

Food as Medicine: Study Sets Out to Prove Its Effectiveness

Could the quality of life of patients with advanced-stage cancer be improved by personal delivery of nutritious, medically tailored meals? Researchers at the New York University School of Medicine Perlmutter Cancer Center think so, and they have set out to prove it in a randomized clinical trial....

leukemia

Donor Selection for HLA-Matched Hematopoietic Cell Transplantation

Question 1: Which statement about donor selection for allogeneic hematopoietic cell transplant is correct? Correct Answer: C. If a donor is available, the genotypic identity between the patient and his brother should be established by typing the patient’s parents; if this is not possible, the...

integrative oncology

Bromelain

Scientific Names: Sulfydryl proteolytic enzyme, cysteine proteinase Common Names: Ananase, Dayto Anase, Traumanase Overview Derived from the fruits and stems of pineapples, bromelain is a proteolytic enzyme that is used to treat burns and skin conditions, and as an anti-inflammatory agent....

head and neck cancer

Study Finds Nivolumab Improves Survival vs Standard Therapy in Recurrent Squamous Cell Carcinoma of the Head and Neck

In the phase III CheckMate 141 trial reported in The New England Journal of Medicine, Ferris et al found that nivolumab (Opdivo) increased overall survival vs standard therapies in patients with recurrent platinum-refractory squamous cell carcinoma of the head and neck. Study Details In this...

gynecologic cancers

What We Know and What We Need to Know About Neoadjuvant Chemotherapy in Advanced Ovarian Cancer

Ever since the landmark studies of Griffiths and colleagues in the 1970s,1 primary cytoreductive surgery followed by chemotherapy with the objective of achieving minimal residual disease has been the standard approach for women with advanced-stage epithelial ovarian cancer. However, what is...

skin cancer

Adjuvant Ipilimumab Improves Survival in High-Risk Melanoma

Patients with stage III melanoma who were considered to be at high risk for recurrence derived an overall survival benefit from adjuvant treatment with ipilimumab (Yervoy), although it came at the price of considerable toxicity, according to updated survival results from the phase III European...

breast cancer

Mammography-Detected Small Breast Cancers May Represent Overdiagnosis, With Survival Gains Reflecting Improved Systemic Therapy

In a study using SEER (Surveillance, Epidemiology, and End Results) data reported in The New England Journal of Medicine, Welch et al found that screening mammography has resulted in a substantial increase in detection of small breast tumors, many of which represent overdiagnosis, accompanied by...

kidney cancer

Study Finds Adjuvant Sunitinib Improves Disease-Free Survival in High-Risk Renal Cell Carcinoma After Nephrectomy

In the phase III S-TRAC trial reported at the 2016 European Society for Medical Oncology Congress and in The New England Journal of Medicine by Ravaud et al, adjuvant sunitinib (Sutent) significantly prolonged disease-free survival vs placebo in patients with high-risk renal cell carcinoma after...

multiple myeloma

Does Adding Daratumumab to Lenalidomide/Dexamethasone Improve Outcomes in Previously Treated Multiple Myeloma?

The addition of the CD38-targeted antibody daratumumab (Darzalex) to lenalidomide (Revlimid)/dexamethasone improved progression-free survival in patients with previously treated multiple myeloma, according to the results of the phase III POLLUX trial reported by Dimopoulos et al in The New England...

breast cancer

Combination of Ribociclib and Letrozole Improved Progression-Free Survival in Hormone Receptor–Positive Advanced Breast Cancer

The combination of the selective CDK4/6 inhibitor ribociclib plus letrozole significantly improved progression-free survival in hormone receptor–positive advanced breast cancer. When ribociclib was added to letrozole, progression-free survival improved by 44% compared with letrozole alone,...

skin cancer

Adjuvant Ipilimumab Prolongs Survival in High-Risk Stage III Melanoma, Phase III Study Reports

In the phase III European Organisation for Research and Treatment of Cancer (EORTC) trial 18071 reported at the recent European Society for Medical Oncology meeting and in The New England Journal of Medicine by Eggermont et al, adjuvant ipilimumab (Yervoy) was found to improve recurrence-free and...

lung cancer

First-Line Pembrolizumab Improves Survival vs Platinum-Based Chemotherapy in Advanced PD-L1–Positive NSCLC

Pembrolizumab (Keytruda) significantly improved progression-free and overall survival vs platinum-based chemotherapy in patients with previously untreated advanced non–small cell lung cancer (NSCLC) with ≥ 50% PD-L1 (programmed cell death ligand 1) expression and no sensitizing EGFR...

gynecologic cancers

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

In a phase III trial reported at the recent European Society for Medical Oncology Congress and in The New England Journal of Medicine by Mirza et al, maintenance therapy with the PARP (poly ADP ribose polymerase) 1/2 inhibitor niraparib significantly prolonged progression-free survival vs placebo...

breast cancer

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

In a phase III trial reported at the recent European Society for Medical Oncology Congress and in The New England Journal of Medicine by Hortobagyi et al, first-line treatment with ribociclib, a selective inhibitor of cyclin-dependent kinases 4 and 6 (CDK4/6), resulted in significantly longer...

breast cancer

Tailoring Breast Cancer Screening for Older Women by Breast Density and Risk

A collaborative modeling study evaluating outcomes for various screening intervals for women over the age of 50 based on breast density and risk for breast cancer has found that average-risk women with low breast density undergoing triennial screening and higher-risk women with high breast density...

multiple myeloma

Daratumumab Plus Bortezomib/Dexamethasone: Changing the Treatment Paradigm in Relapsed or Refractory Myeloma

The CD38 antigen was first recognized on normal and abnormal plasma cells over 3 decades ago. Indeed, this antigen was originally classified as T10, as it was the tenth antigen described on T cells. Its distribution of expression included activated B and T cells, natural killer cells, leukocytes,...

multiple myeloma

Study Finds Adding Daratumumab to Bortezomib/Dexamethasone Improves Progression-Free Survival in Relapsed/Refractory Multiple Myeloma

In the phase III CASTOR trial reported in The New England Journal of Medicine, Antonio Palumbo, MD, of the University of Turin, and colleagues found that adding the anti-CD38 antibody daratumumab (Darzalex) to bortezomib (Velcade) and dexamethasone markedly improved progression-free survival among ...

hematologic malignancies

Update on Neoplastic Hematology: Review of Recent Clinical Trials

Here is a brief look at the study findings and clinical implications of several recent clinical trials on newer treatment options in neoplastic hematology. Attention is focused on several types of leukemia, Hodgkin lymphoma, and multiple myeloma. Leukemia Clinical Trial: INO-VATE ALL phase III...

supportive care
survivorship

Prehabilitation and Rehabilitation May Improve Work-Related Outcomes in Cancer Survivors

In August 2016, the Healthcare Delivery Research Program of the Division of Cancer Control and Population Sciences at the National Cancer Institute convened a group of experts in a variety of fields to identify a research agenda for optimizing employment outcomes among cancer survivors. A core...

prostate cancer

Surgery and Radiation ProtecT Against Progression/Metastasis vs Active Monitoring in Prostate Cancer, but at What Cost?

The ProtecT trial showing similar 10-year survival with active monitoring, surgery, or radiotherapy for prostate-specific antigen (PSA)-detected localized prostate cancer but a greater risk of disease progression/metastasis with monitoring was recently reported by Hamdy and colleagues and is...

prostate cancer

Risk of Metastasis With Active Monitoring in PSA-Detected Localized Prostate Cancer: The ProtectT Trial

The ProtecT study findings1 are provocative. Despite having a control arm of active monitoring with serial prostate-specific antigen (PSA) testing, as compared with watchful waiting in the prior randomized trials (ie, SPCG-42 and PIVOT3), and also enrolling men with more favorable-risk disease...

prostate cancer

Similar 10-Year Survival With Active Monitoring, Surgery, or Radiotherapy for PSA-Detected Clinically Localized Prostate Cancer

In the UK ProtecT trial reported in The New England Journal of Medicine, Freddie C. Hamdy, FRCS, FMedSci, of the University of Oxford, and colleagues found no significant differences in prostate cancer–specific or overall mortality among men with clinically localized prostate cancer detected by...

prostate cancer

Patient-Reported Outcomes After Active Monitoring, Surgery, or Radiotherapy in PSA-Detected Localized Prostate Cancer

Patient-reported outcomes differed among men with localized prostate cancer detected by prostate-specific antigen (PSA) testing who were randomized to receive active monitoring, surgery, or radiotherapy in the UK ProtecT trial, according to a report by Donovan et al in The New England Journal of...

hematologic malignancies
leukemia

Improved Event-Free Survival With Addition of Rituximab to Chemotherapy in B-Lineage Adult ALL

In the phase III GRAALL-2005 trial reported in The New England Journal of Medicine, Maury et al found that the addition of rituximab (Rituxan) to standard chemotherapy resulted in improved event-free survival in adult patients with B-lineage acute lymphoblastic leukemia (ALL). Study Details In...

symptom management

Olanzapine Combination Reduces Nausea and Vomiting in Patients Receiving Highly Emetogenic Chemotherapy

According to a phase III trial reported by Navari et al in The New England Journal of Medicine, the addition of the antipsychotic agent olanzapine vs placebo to dexamethasone, aprepitant, or fosaprepitant, and a 5-hydroxytryptamine type 3–receptor antagonist reduced nausea and improved antiemetic...

integrative oncology

The Role of Music Therapy in Cancer Care

Music therapy, an established adjuvant to standard cancer care, is offered in a growing number of cancer centers throughout the United States and internationally. Defined by the American Music Therapy Association (AMTA) as “the evidence-based use of music interventions to accomplish individual...

issues in oncology

Why Patients’ Understanding of Their Prognosis Often Differs From Their Oncologists’

A recent study1 published in the Journal of Clinical Oncology (see “Breaking the ‘Conspiracy of Silence’” in this issue of The ASCO Post) found that just 1 in 20 patients with advanced, incurable cancer has sufficient understanding of his or her prognosis or life expectancy. Now, another new study ...

breast cancer

I-SPY 2: Separating Contenders From Pretenders in Breast Cancer

With the expansion of our understanding of signaling pathways in normal cells and how they are co-opted or corrupted in malignancy, the number of potential antitumor agents to be tested has exploded, exposing the limitations of traditional antineoplastic drug development and challenging us to...

breast cancer

Neoadjuvant Veliparib/Carboplatin and Neratinib ‘Graduate’ From Adaptive Randomization I-SPY 2 Trial in Early Breast Cancer

As reported by Hope S. Rugo, MD, and John W. Park, MD, both of the University of California, San Francisco, and colleagues in The New England Journal of Medicine, the multiarm adaptive randomization phase II I-SPY 2 trial has shown that the addition of veliparib/carboplatin and the addition of...

colorectal cancer

Updated USPSTF Guidelines for Colorectal Cancer Screening: More Methods, More Challenges for Patients and Providers Alike

As reviewed in this issue of The ASCO Post, the U.S. Preventive Services Task Force (USPSTF) recently updated its guidelines for colorectal cancer screening1 from 2008 and has now included seven acceptable strategies, including direct-visualization modalities (ie, endoscopy and computed tomography...

lung cancer

Immune Checkpoint Inhibitors March to First-Line Treatment in Advanced NSCLC

For the majority of patients who are diagnosed with advanced-stage non–small cell lung cancer (NSCLC), platinum-based doublets have been the standard of care for over 30 years. Recently, the immune checkpoint inhibitors nivolumab (Opdivo) and pembrolizumab (Keytruda) demonstrated superior survival ...

hematologic malignancies

Good Outcome Reported With Unrelated-Donor Cord Blood Transplantation in Patients With Minimal Residual Disease

Survival with hematopoietic cell transplantation (HCT) from unrelated cord-blood donors was at least as good as that with HLA-matched unrelated donors and better than that with HLA-mismatched unrelated donors in patients with acute leukemia or myelodysplastic syndrome who had pretransplantation...

prostate cancer

Similar 10-Year Survival Reported With Active Monitoring, Surgery, or Radiotherapy for PSA-Detected Localized Prostate Cancer

In a UK trial (ProtecT) reported in The New England Journal of Medicine, Hamdy et al found no significant differences in prostate cancer–specific or overall mortality among men with localized prostate cancer detected by prostate-specific antigen (PSA) testing who underwent active monitoring,...

Study Finds Wide Variation in Breast Density Assessments Among Radiologists

A large observational study examining the variation in breast density assessment among radiologists in clinical practice has found a wide variation—from 6.3% to 84.5%—in the percentage of mammograms rated as showing dense breasts, which persisted after adjusting for patient characteristics. The...

issues in oncology
lymphoma
solid tumors

Media Reports of Dramatic Responses to Immunotherapy After All Else Fails May Prompt Patients to Seek It Out

Immunotherapy has received “a lot of attention, mainly because of the media coverage,” Anas Younes, MD, medical oncologist and Chief of the Lymphoma Service at Memorial Sloan Kettering Cancer Center in New York, said in an interview with The ASCO Post. “Many patients inquire, not about a specific...

skin cancer

Management of Merkel Cell Carcinoma

A recent report regarding pembrolizumab (Keytruda) for advanced Merkel cell carcinoma ushered in a more optimistic era in the treatment of this rare but often lethal skin cancer.1 The ASCO Post spoke with one of the field’s leaders, Paul Nghiem, MD, PhD—the first author of the study—about the...

lymphoma

Interim PET-Adapted Treatment in Advanced Hodgkin Lymphoma

The ability to cure a majority of patients with advanced Hodgkin lymphoma is one of the major milestones of success in the combination chemotherapy era. It has been over 40 years since Bonadonna and colleagues in Milan developed the ABVD regimen (doxorubicin, bleomycin, vinblastine, and...

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