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November is National Pancreatic Cancer Awareness Month, the impetus for this article. Pancreatic cancer is a huge health challenge. It's the eighth most common cancer in the United States and the fourth most common cause of cancer deaths but is expected to become the second most common cause of...
Another Step Forward for Genomic Assays in Early-Stage Breast Cancer: Findings With MammaPrint in the MINDACT Trial
Genomic assays have had a powerful influence on the management of early-stage breast cancer, particularly estrogen receptor–positive tumors. The mainstay of adjuvant treatment for early-stage, hormone receptor–positive breast cancer has been endocrine therapy, either with tamoxifen and an...
Pembrolizumab as First-Line Therapy in Metastatic NSCLC: Practice-Changing Implications of KEYNOTE-024 Trial
We are in the midst of a paradigm shift in lung cancer. In the past 2 years, the anti–programmed cell death protein 1 (anti–PD-1) inhibitors nivolumab (Opdivo) and pembrolizumab (Keytruda) were found to improve overall survival in the second-line setting compared with docetaxel for patients with...
Pembrolizumab Improves Outcomes vs Platinum-Based Chemotherapy in Advanced PD-L1–Positive NSCLC
In the phase III KEYNOTE-024 trial reported in The New England Journal of Medicine by Martin Reck, MD, PhD, of the German Center of Lung Research, Grosshansdorf, and colleagues, pembrolizumab (Keytruda) significantly improved progression-free and overall survival vs platinum-based chemotherapy in...
Update on Neoplastic Hematology: Review of Recent Clinical Trials
Here is a brief look at the study findings and clinical implications of several recent and important clinical trials in neoplastic hematology. Attention is focused on myelodysplastic syndromes, multiple myeloma, and chronic lymphocytic leukemia. Myelodysplastic Syndromes Clinical Trial:...
Phase III Trial Shows Improved PFS With Addition of Palbociclib to Letrozole in ER-Positive, HER2-Negative Breast Cancer
In the phase III PALOMA-2 trial reported in The New England Journal of Medicine, Finn et al found that the addition of palbociclib (Ibrance) to letrozole significantly improved progression-free survival in postmenopausal women with previously untreated advanced estrogen receptor–positive,...
Risk for Non-Hodgkin Lymphoma in HIV-Infected Patients
In the HIV-negative population, there is growing evidence suggesting that chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) are both associated with the development of non-Hodgkin lymphoma (NHL), although the mechanisms underlying this association remain unclear. The incidence rate of NHL ...
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...
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...
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 ...
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...
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...
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,...
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...
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...
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...
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...
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 ...
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...
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....
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...
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....
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...
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...
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...
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...
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...
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...
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,...
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...
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...
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...
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...
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...
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,...
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 ...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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 ...
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...
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...
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...
