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palliative care

How When Breath Becomes Air Is Helping the Public—and Physicians—Confront Their Mortality

It should not come as a surprise to anyone who has read Dr. Paul Kalanithi’s brilliant—and unforgettable—memoir, When Breath Becomes Air (Random House, 2016), that nearly a year after publication, it remains on The New York Times best-seller list, its popularity only increasing with time. Written...

palliative care

How Video Support Tools Help Patients Make Informed Decisions About End-of-Life Care

A relatively recent study by Areej El-Jawahri, MD, and her colleagues is showing how the use of visual media can empower patients with advanced cancer, as well as other life-threatening illnesses, to make more informed decisions about their end-of-life care.1 The aim of Dr. El-Jawahri’s study was ...

kidney cancer

Adjuvant Sunitinib for Renal Cell Carcinoma: Not Ready for Prime Time

In renal cell carcinoma and other cancer types, a consistent paradigm in drug development exists: Observe efficacy of a drug in the metastatic setting and move quickly to explore the agent in the adjuvant setting. In the cytokine era, there were multiple efforts to characterize whether adjuvant...

kidney cancer

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

In the phase III S-TRAC trial reported at the recent European Society for Medical Oncology meeting and in The New England Journal of Medicine by Alain Ravaud, MD, PhD, of Bordeaux University Hospital, and colleagues, adjuvant sunitinib (Sutent) significantly prolonged disease-free survival vs...

lung cancer

Pembrolizumab in First-Line Treatment of Metastatic Non–Small Cell Lung Cancer

On October 24, 2016, pembrolizumab (Keytruda) was approved for use in patients with metastatic non–small cell lung cancer (NSCLC) whose tumors have high programmed cell death ligand 1 (PD-L1) expression (tumor proportion score ≥ 50%) as determined by a U.S. Food and Drug Administration...

breast cancer

Clinical Strategies for Improving Endocrine Therapy in Metastatic Breast Cancer

Most women with hormone receptor–positive breast cancer receive endocrine therapy as part of their treatment, but “the reality is that patients who receive antihormone therapy in the metastatic disease setting ultimately develop disease progression, ” William J. Gradishar, MD, stated at the 18th...

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,...

lymphoma
skin cancer

High-Throughput Sequencing of T-Cell Receptors May Transform Diagnosis and Treatment of Cutaneous T-Cell Lymphomas

High-throughput sequencing of T-cell receptors may be a solution to some of the challenges confronting oncologists who treat cutaneous T-cell lymphomas. According to experts who presented talks on high-throughput sequencing of T-cell receptors at the 3rd World Congress of Cutaneous Lymphoma...

skin cancer

Fulminant, Fatal Myocarditis Reported in Two Patients After Starting Combined Immune Checkpoint Blockade Treatment

In an article in The New England Journal of Medicine, Johnson et al reported the occurrence of fulminant, fatal immune-related myocarditis in two patients who received combined ipilimumab (Yervoy) and nivolumab (Opdivo) for metastatic melanoma. Patient Courses One patient was a 65-year-old woman...

kidney cancer

Vaccine Therapy in Metastatic Renal Cell Carcinoma: Past, Present, and Future

As reviewed in this issue of The ASCO Post, Brian Rini, MD, and colleagues recently reported results from the phase III IMPRINT trial,1 which randomized HLA-A*02–positive patients with treatment-naive metastatic clear cell variant renal cell carcinoma, in favorable- and intermediate- risk...

gynecologic cancers

‘Breakthrough’ in Recurrent Ovarian Cancer: Niraparib Extends Progression-Free Survival in Platinum-Sensitive Disease

A landmark study showed that the investigational PARP (poly ADP-ribose polymerase) 1/2 inhibitor niraparib, when used as maintenance therapy, significantly improves the outcome of platinum-sensitive recurrent ovarian cancer. Specifically, niraparib significantly prolonged progression-free survival ...

pancreatic cancer

Recent Progress and Concepts in Pancreatic Cancer

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...

breast cancer

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...

lung cancer

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...

lung cancer

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...

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 and important clinical trials in neoplastic hematology. Attention is focused on myelodysplastic syndromes, multiple myeloma, and chronic lymphocytic leukemia. Myelodysplastic Syndromes Clinical Trial:...

breast cancer

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,...

lymphoma

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 ...

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...

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