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Showing 1851 - 1900Hypofractionated Radiotherapy Not Inferior to Conventional Radiotherapy in Low-Risk Prostate Cancer
In a phase III noninferiority trial (NRG Oncology RTOG 0415) reported by Lee et al in the Journal of Clinical Oncology, W. Robert Lee, MD, MS, Med, of Duke University Medical Center, and colleagues found that hypofractionated radiotherapy was not inferior to conventional hypofractionated...
Integrating Early Palliative Medicine Into Oncology Care to Improve Patients’ Quality of Life
At the 2015 Palliative Care in Oncology Symposium in Boston, Vicki Jackson, MD, MPH, Chief in the Division of Palliative Care and Geriatrics at Massachusetts General Hospital, Co-Director of the Harvard Center for Palliative Care, and Associate Professor of Medicine at Harvard Medical School,...
New Analysis Shows Advertising by U.S. Cancer Centers Has Soared Over Past Decade
American cancer centers promoting their services dramatically increased their advertising spending from 2005 to 2014, with the bulk of the spending by for-profit organizations, according to the results of a study published by Vater et al in JAMA Internal Medicine.1 Small Percentage Responsible for...
Effectiveness of Organized National Breast Cancer Screening: The Israeli Experience
Recent years have seen the publication of a considerable amount of scientific literature questioning the effectiveness of mammography screening in decreasing breast cancer mortality.1-4 This article explores how the Israeli experience has demonstrated the efficacy of organized national...
Is Post-Transplantation Cyclophosphamide Disruptive Technology?
There was a time when transplantation across human leukocyte antigen (HLA) barriers was fraught with so much difficulty that many thought it was impossible and we should stop trying. However, most patients do not have an HLA-matched sibling donor, and death was therefore certain if they had a...
Effects of the Global Economic Crisis on Cancer Care
The global economic crisis beginning in 2008 was associated with substantial public health effects, especially with respect to mental health.1–3 Nevertheless, there is also evidence of a paradoxical association between recessions and reduced all-cause mortality, in part because of reductions in...
The Complexities of Care for Older Cancer Survivors
Integrated care, a focus on prevention and screening, and acknowledgment of comorbidities on the impact of treatment all play a critical role in the cancer survivorship of older patients, according to Martine Extermann, MD, PhD, a medical oncologist at Moffitt Cancer Center in Tampa, Florida....
More Focus Needed on Chemotherapy-Induced Nausea as a Cluster of Symptoms
Management of chemotherapy-induced vomiting has improved with the use of antiemetics, but chemotherapy-induced nausea remains a major clinical problem, according to Alex Molassiotis, RN, PhD, Professor and Head of the School of Nursing at The Hong Kong Polytechnic University. And, he added, the...
Use of Dexamethasone Mouthwash in Managing mTOR Inhibitor–Associated Stomatitis in Patients With Breast Cancer
Prophylactic use of dexamethasone mouthwash significantly minimized the incidence of all grades of stomatitis in postmenopausal women receiving everolimus (Afinitor, Zortress) and exemestane for the treatment of hormone receptor–positive metastatic breast cancer, according to data presented by...
Dealing With GI Toxicities After Chemoradiation
Chemotherapy- and radiotherapy-induced gastrointestinal (GI) toxicities have risen alongside improved survival rates for many cancers, according to Jervoise Andreyev, MA, PhD, Consultant Gastroenterologist in GI Consequences of Cancer Treatment at the Royal Marsden Hospital in London. “For every...
Neoadjuvant Veliparib/Carboplatin and Neratinib ‘Graduate’ From Adaptive Randomization I-SPY 2 Trial in Early Breast Cancer
As reported by Rugo et al and Park et al in The New England Journal of Medicine, the adaptive randomization phase II I-SPY 2 trial has shown that the addition of veliparib/carboplatin and the addition of neratinib to standard neoadjuvant therapy have met criteria predictive of success in a phase...
Potential Link Between Pembrolizumab Use and Demyelinating Polyradiculoneuropathy Reported in Two Cases of Advanced Melanoma
In a letter to the editor in The New England Journal of Medicine, de Maleissye et al described two cases of severe demyelinating polyradiculoneuropathy that occurred after pembrolizumab (Keytruda) treatment for advanced melanoma. Case 1 A 45-year-old woman receiving pembrolizumab at 2 mg/kg every ...
Pathway Defects in Acquired Resistance to PD-1 Inhibition in Melanoma Identified
In a study reported in The New England Journal of Medicine, Zaretsky et al found that defects in interferon receptor signaling and antigen-presenting pathways were associated with acquired resistance to PD-1 (programmed cell death protein 1) inhibition in melanoma. Resistance Mutations Identified ...
Olanzapine Combination Reduces Nausea and Vomiting in Patients Receiving Highly Emetogenic Chemotherapy
In 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...
Genomic Classification and Outcome in Acute Myeloid Leukemia
As reported in The New England Journal of Medicine, Elli Papaemmanuil, PhD, of the Cancer Genome Project, Wellcome Trust Sanger Institute, and colleagues have identified 11 genomic subgroups in acute myeloid leukemia (AML) associated with distinct diagnostic features and clinical outcomes. AML...
Using Simulation-Based Training to Improve the Procedural Skills of Oncology/Hematology Fellows
Simulation-based education in medicine programs implemented in cancer centers for oncology/hematology fellows recreates real-world patient experiences and provides a safe—and stress-free—learning environment in which trainees can enhance their clinical and procedural skills in a variety of areas....
Acupuncture: Does It Alleviate Symptoms Associated With Cancer Care?
A therapeutic modality of traditional Chinese medicine, acupuncture has been extensively investigated in Western medical settings. Its clinical use is increasingly common for the management of pain and other conditions. In the oncology setting, research demonstrates that acupuncture can...
Lung Cancer Screening: Beneficial for Certain Populations but Not Without Controversy
The National Cancer Policy Forum of the National Academies of Sciences took up the issue of lung cancer screening at its mid-June workshop. Greta Massetti, PhD, Associate Director for Science, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention (CDC), and chair of ...
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...
Expert Point of View: Sunil Verma, MD
Sunil Verma, MD, Professor and Head of the Department of Oncology and Medical Director of the Tom Baker Cancer Centre of the University of Calgary in Canada, was the study’s formal discussant. He cited several limitations of the study: It was an open-label study, was initially a phase II study but ...
Study Finds Incidence of Mutations in DNA-Repair Genes Significantly Higher in Men With Metastatic Prostate Cancer
The incidence of mutations in DNA-repair genes was significantly higher among men with metastatic prostate cancer than among men with localized disease (11.8% vs 4.6%), according to a study by Pritchard et al reported in The New England Journal of Medicine. In addition, the frequency ...
Increased Risk for Cardiovascular Events Seen in Patients With CML Taking Tyrosine Kinase Inhibitors
Although tyrosine kinase inhibitors have dramatically increased survival for patients with chronic myeloid leukemia (CML), continuous administration of these drugs may elicit long-term toxicity, including cardiovascular adverse events. To investigate the incidence of vascular events in patients...
Managing Upper Extremity Dysfunction in Breast Cancer Survivors
With an increased number of breast cancer survivors and patients with metastatic disease living longer, it is imperative for oncology care providers to manage issues of new and chronic upper extremity dysfunction as a result of the malignancy itself or its treatment. As one of my patients...
Complexities in the Diagnosis and Management of Amyloidosis
Question 1: What is the next best step for this patient? Correct Answer: C. Determination of amyloid subtype. Expert Perspective Amyloidosis encompasses a heterogeneous group of diseases bound by the characteristic deposition of amyloid fibrils in soft tissues and bone marrow, and it could be...
Expert Point of View: David Reardon, MD
“Adjuvant temozolomide does represent a new standard of care for 1p/19q-intact anaplastic glioma patients,” according to David Reardon, MD, Clinical Director at the Dana-Farber Center for Neuro-Oncology and the study’s formal discussant at the 2016 ASCO Annual Meeting. “We see a significant...
Expert Point of View: Elizabeth Mittendorf, MD, PhD
The discussant of these studies was Elizabeth Mittendorf, MD, PhD, Associate Professor of Breast Surgical Oncology at the University of Texas MD Anderson Cancer Center, Houston. Dr. Mittendorf noted that approximately 3% of U.S. breast cancer patients present with de novo stage IV disease. For...
Assessment of Fitness, Function, and Quality of Life Essential in Treatment of Older Patients With CLL
Significant progress has been made in the past 2 decades in the care of patients with chronic lymphocytic leukemia (CLL). Recently, the therapeutic armamentarium has expanded for such patients with the introduction of new targeted agents. CLL is predominantly a disease of the elderly, with a...
Retroviral Replicating Vector That Delivers Cytosine Deaminase to Cancer Cells Active in Recurrent Glioblastoma
A phase I study by Timothy F. Cloughesy, MD, Director of the Neuro-Oncology Program at the UCLA Jonsson Comprehensive Cancer Center, and colleagues published in Science Translational Medicine investigated the effectiveness of vocimagene amiretrorepvec (Toca 511), an experimental nonlytic,...
Black Cohosh
Scientific Name: Cimicifuga racemosa Common Names: Black snakeroot, rattlesnake root, squawroot, bugbane, bugwort Brand Names: Remifemin, Menofem, Klimadynon Overview A perennial plant native to the eastern United States and Canada, black cohosh root was used by Native Americans to treat colds,...
Anti–PD-1 Treatment With Pembrolizumab in Gastric/Gastroesophageal Junction Cancers: Who Is Likely to Respond?
Immune checkpoint inhibitors have emerged as one of the most promising new areas of drug development in oncology. Broad activity has been observed for these agents across a spectrum of hematologic malignancies and solid tumors. As reviewed in this issue of The ASCO Post, Muro and colleagues now...
Ixazomib: A Relevant Addition to Myeloma Therapy
In 2015, four new drugs were approved for the treatment of multiple myeloma by the U.S. Food and Drug Administration: panobinostat (Farydak), daratumumab (Darzalex), elotuzumab (Empliciti), and ixazomib (Ninlaro). Of them, the first three are drugs with unique new targets, whereas ixazomib is the...
Addition of Ixazomib to Lenalidomide/Dexamethasone Improves Progression-Free Survival in Relapsed/Refractory Multiple Myeloma
In the phase III TOURMALINE-MM-1 trial reported in The New England Journal of Medicine, Philippe Moreau, MD, of the University Hospital Hôtel Dieu, Nantes, France, and colleagues found that adding the oral proteasome inhibitor ixazomib (Ninlaro) to lenalidomide (Revlimid) and dexamethasone...
Updated WHO Classification of Hematologic Malignancies
Question 1: Which statement about the classification of tumors of hematopoietic and lymphoid tissues is true? Correct Answer: A. The revised WHO classification defines distant disease entities that can be reliably diagnosed using proposed criteria. Expert Perspective WHO last updated its...
Treatment Update in Gastric, Pancreatic, and Colorectal Cancers
Although new gastrointestinal cancers are on the rise, advancements in their treatment, as well as the upcoming results of perioperative trials, could prove to be “clinical practice game-changers,” declared Thomas J. George, Jr, MD, FACP, at the 2016 Community Oncology Conference in Orlando,...
Expert Point of View: Peter C. Enzinger, MD
Not so FAST? The study discussant Peter C. Enzinger, MD, Director of the Center for Esophageal and Gastric Cancer at Dana-Farber/Brigham and Women’s Cancer Center, Boston, viewed the findings of the FAST trial as promising but voiced several considerations, as did Gulam A. Manji, MD, PhD,...
Increased Risk for Cardiovascular Events Seen in Patients With CML Taking Tyrosine Kinase Inhibitors
Although tyrosine kinase inhibitors have dramatically increased survival for patients with chronic myeloid leukemia (CML), continuous administration of these drugs may elicit long-term toxicity, including cardiovascular adverse events. To investigate the incidence of vascular events in patients...
SIRIUS Trial Heralds a New Era of Promise in Treating Resistant Myeloma
Multiple myeloma cells uniformly overexpress CD38.1 Daratumumab (Darzalex), a CD38-targeting human IgG1 kappa monoclonal antibody, has been evaluated in a series of phase I/II trials involving patients with relapsed or relapsed and refractory myeloma who have received at least two or more prior...
PALOMA-3 Trial in HER2-Negative Metastatic Breast Cancer: Challenge of Moving Beyond Estrogen Receptor Positivity
Hormone receptor–positive breast cancer represents the largest therapeutic subgroup of the disease. The development of endocrine therapies has shaped the treatment paradigm for both advanced- and early-stage disease for decades.1 Still, despite their significant impact, advanced breast cancer...
Prolonged Progression-Free Survival With Addition of Palbociclib to Fulvestrant in HER2-Negative Metastatic Breast Cancer
As reported in The Lancet Oncology by Massimo Cristofanilli, MD, of the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, and colleagues, the final results of the phase III PALOMA-3 trial showed that the addition of the CDK4/CDK6 inhibitor palbociclib (Ibrance) to fulvestrant...
Anti–PD-1 Inhibitor Gains Foothold in Merkel Cell Carcinoma
Immunotherapy marches on! One of the latest frontiers for checkpoint inhibitors is the treatment of Merkel cell carcinoma, a rare but aggressive type of cancer. First-line therapy with pembrolizumab (Keytruda)—an anti–PD-1 (programmed cell death protein 1) inhibitor—achieved an objective response...
Combined-Modality Therapy for Low-Grade Gliomas: Balancing Toxicity, Delivery Logistics, and Survival Benefit
Low-grade gliomas account for 15% of all primary brain tumors and represent a heterogeneous group of glial neoplasms. Although these tumors have been termed low-grade, this is a misnomer, especially for some grade II gliomas, which may exhibit a more aggressive behavior and variable natural...
Ovarian Suppression in Premenopausal Women With Estrogen Receptor–Positive Breast Cancer
Oophorectomy was the first proposed form of endocrine therapy for women with breast cancer. Over 100 years ago, Thomas Nunn reported a relationship between menopause and regression of breast cancer.1 This incited interest in the induction of menopause as an anticancer therapy, and in 1986, a...
Improvement in Overall Survival With Addition of Chemotherapy to Radiotherapy in Low-Grade Glioma
Final results of the RTOG 9802 phase III trial reported in The New England Journal of Medicine by Jan C. Buckner, MD, of Mayo Clinic, Rochester, and colleagues, showed that the addition of chemotherapy with procarbazine, lomustine, and vincristine to radiotherapy significantly prolonged overall...
Providing Inpatient Physical Rehabilitation for Patients With Advanced Cancer
Guest Editor Physiatry in Oncology explores the benefits of cancer rehabilitation in oncology practice to screen survivors for physical and cognitive impairments along the care continuum to minimize survivors’ disability and maximize their quality of life. The column is guest edited by Sean Smith, ...
Moving the Needle on HPV Vaccination
In 2012–2013, members of the President’s Cancer Panel (prescancerpanel.cancer.gov) focused their efforts on accelerating widespread acceptance of and use of approved human papillomavirus (HPV) vaccines to prevent cancer. The topic is important, because HPVs cause most cases of cervical cancer and...
Additional 5 Years of Letrozole May Benefit Some Postmenopausal Women With Early-Stage Breast Cancer
Five years of aromatase inhibitor as upfront therapy or after tamoxifen is the current standard of care for postmenopausal women with early hormone receptor–positive breast cancer. A new trial suggests that extending aromatase inhibitor therapy with letrozole for an additional 5 years may improve...
The ENDEAVOR Trial: A Case Study in the Interpretation of Modern Cancer Trials
It can be easy to miss the forest for the trees in the interpretation of clinical trials. In particular, trials for the treatment of cancer are exceedingly complex, with long lists of inclusion and exclusion criteria, designs with hidden biases, drugs with unpronounceable names (if not cumbersome...
Pembrolizumab Improves Survival vs Docetaxel in Previously Treated PD-L1–Positive Advanced Non–Small Cell Lung Cancer
As reported in The Lancet by Roy S. Herbst, MD, PhD, of Yale School of Medicine, and colleagues,1 the phase II/III KEYNOTE-010 trial showed that pembrolizumab (Keytruda) significantly improved overall survival vs docetaxel in patients with previously treated programmed cell death ligand 1...
Leisure-Time Physical Activity Reduces Risk of Multiple Cancer Types
In a study reported in JAMA Internal Medicine, Moore et al found that greater leisure-time physical activity was associated with a reduced risk for many types of cancer. Study Details The study used pooled data on 1.44 million adults from 12 prospective U.S. and European cohorts with...
Surgical Oncologist Suzanne L. Topalian, MD, Shines at the Forefront of Groundbreaking Research in Cancer Immunotherapy
Nationally recognized surgical oncologist and researcher Suzanne L. Topalian, MD, had an early interest in the arts as well as science and decided to major in English upon entering Wellesley College in Wellesley, Massachusetts. “I wanted to keep all my options open, so I also enrolled in a pre-med...
