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Luspatercept May Reduce the Need for Transfusion in Lower-Risk Myelodysplastic Syndromes

IN THE RANDOMIZED, double-blind, phase III MEDALIST trial, the experimental drug luspatercept significantly reduced the need for frequent red blood cell transfusions in patients with lower-risk myelodysplastic syndromes (MDS) and ring sideroblasts. With luspatercept, 37.8% of patients remained...

breast cancer

SABCS Presentations Offer New Data on Biomarkers and Novel Treatment Approaches in Early and Metastatic Breast Cancers

REPORTERS FOR The ASCO Post captured the following summaries of noteworthy studies presented at the 2018 San Antonio Breast Cancer Symposium. In HER2-Negative Metastatic Disease, CTCs Frequently HER2-Positive ALMOST HALF of all patients with HER2-negative metastatic breast cancer have circulating...

issues in oncology
health-care policy

‘Curve 2’ and Oncology: What Those in Charge Don’t Understand … or Ignore

THERE IS little doubt that the U.S. health-care system is under assault from many directions.1 It is clear that the costs of health management are no longer sustainable, and the United States has one of the highest per capita health costs among the 36 member nations of the Organisation for...

pancreatic cancer

Emerging Role for Neoadjuvant Treatment of Resectable Pancreatic Cancer

SEVERAL STUDIES presented at the 2019 Gastrointestinal Cancers Symposium evaluated the benefits of neoadjuvant treatment in patients with pancreatic cancer—and in patients deemed fully resectable, not just “borderline” resectable.1-3 Although the standard of care for resectable pancreatic ductal...

hematologic malignancies

Crizanlizumab Improves Prevention of Vaso-occlusive Crises in Patients With Sickle Cell Disease

For the first time in more than 20 years, patients with sickle cell disease may have another treatment option to reduce painful vaso-occlusive crises, according to data presented at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition.1 Results of the phase II, randomized,...

hematologic malignancies

Pilot Study Tests Novel Approach to Gene Therapy for Sickle Cell Disease

Initial findings from a first-in-human trial have provided proof of principle for a groundbreaking approach to gene therapy for sickle cell disease, according to data presented at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition.1 Early results of genetic targeting of...

skin cancer
immunotherapy

FDA Approves Adjuvant Pembrolizumab for Melanoma

On February 15, the U.S. Food and Drug Administration (FDA) approved pembrolizumab (Keytruda) for the adjuvant treatment of patients with melanoma with lymph node involvement following complete resection. Approval was based on the phase III EORTC1325/KEYNOTE-054 trial, a randomized, double-blind,...

lymphoma

Alisertib vs Investigator’s Choice in Relapsed or Refractory Peripheral T-Cell Lymphoma

In the phase III Lumiere trial reported in the Journal of Clinical Oncology, O’Connor et al found that the Aurora A kinase inhibitor alisertib did not improve outcomes vs investigator’s choice of single-agent treatment in relapsed or refractory peripheral T-cell lymphoma (PTCL). Study...

skin cancer

Updated German Guidelines for Basal Cell Carcinoma

The German S2k guidelines for cutaneous basal cell carcinoma were recently updated to include new developments regarding the epidemiology, diagnosis, and histology of the disease. Commissioned by the Dermatologic Cooperative Oncology Group of the German Cancer Society and the German Society of...

breast cancer

Breast Cancer Surgical Terminology Should Be Updated to Reflect Modern Medical Practice

BREAST CANCER is a microscopic disease, with most patients presenting with “localized” stage I to III disease, for which they are offered curative-intent surgery often accompanied by radiation therapy, chemotherapy, and hormonal therapy. More accurately, we now know that patients with localized...

lung cancer

Encourage Lung Cancer Screening to Prevent Early Deaths

Discussions of benefits and harms from screening of high-risk populations for lung cancer have missed the point. The National Lung Screening Trial (NLST) showed an early and statistically significant major benefit in all-cause mortality from computed tomography (CT) screening.1 Those referred for...

integrative oncology

Integrative Oncology Scholars Program: Model for Evidence-Based Complementary Care

THE FIRST full year of educational training in the practice of complementary therapies is now underway at the University of Michigan in Ann Arbor through its Integrative Oncology Scholars Program, which launched in 2017. The program, which is supported through a 5-year grant from the National...

colorectal cancer

Do Certain Sedentary Behaviors Increase the Risk of Young-Onset Colorectal Cancer?

Although colorectal cancer rates in older adults have been decreasing in the United States since the mid-1980s, incidence rates for the cancer have been increasing among young and middle-aged adults, according to a study by the American Cancer Society (ACS). Based on the new data, in 2018, the ACS...

lung cancer
issues in oncology

Multiethnic Cohort Study Update on Racial/Ethnic Differences in Lung Cancer Incidence

In an update from the Multiethnic Cohort Study reported in the Journal of the National Cancer Institute, Stram et al found persistent racial/ethnic differences in risk for lung cancer at similar levels of cigarette smoking intensity. A prior report from the study found that African Americans and...

breast cancer

Effect of Peer Review Within a Cancer Care Network on Use of Hypofractionated Radiotherapy for Early-Stage Breast Cancer

In a study reported in the Journal of Oncology Practice, Ganju et al found that implementation of a cancer care network–wide peer review process aimed at standardizing treatment resulted in increasing use of hypofractionated radiotherapy in early-stage breast cancer at community-based...

leukemia

Data Mount for Venetoclax as Add-on Therapy in Acute Myeloid Leukemia

The benefit of adding venetoclax to a hypomethylating agent or low-dose cytarabine in the front-line treatment of acute myeloid leukemia (AML) was evident from a number of studies reported at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition (see Table 1). For elderly...

supportive care
hematologic malignancies

Luspatercept May Reduce the Need for Transfusion in Lower-Risk Myelodysplastic Syndromes

In the randomized, double-blind, phase III MEDALIST trial, the experimental drug luspatercept significantly reduced the need for frequent red blood cell transfusions in patients with lower-risk myelodysplastic syndromes (MDS) and ring sideroblasts. With luspatercept, 37.9% remained transfusion-free ...

breast cancer

Small Differences Found in Breast Cancer Recurrence With Partial-Breast vs Whole-Breast Irradiation

Partial-breast irradiation delivered over 5 to 10 days did not meet noninferiority criteria compared with whole-breast irradiation given over 5 to 7 weeks, according to 10-year results of the large NRG (NSABP B-39/RTOG 0413) trial presented at the 2018 San Antonio Breast Cancer Symposium.1 However, ...

lung cancer

Genomic Classification of Lung Cancers Diagnosed in Patients From Appalachian Kentucky

Squamous cell carcinoma of the lung represents approximately one-quarter (26.4%) of all lung cancers diagnosed in Appalachian Kentucky, where death from lung cancer is higher than the national average. Researchers sought to characterize genetic alterations specifically found in lung squamous cell...

breast cancer

Selected Abstracts From the San Antonio Breast Cancer Symposium

Each year, The ASCO Post asks Jame Abraham, MD, FACP, Director of the Breast Oncology Program at Taussig Cancer Institute and Professor of Medicine at the Cleveland Clinic Lerner College of Medicine, to offer his picks for the most important research presented at the 2018 San Antonio Breast Cancer ...

issues in oncology
global cancer care

World Cancer Day 2019: Emphasis on Early Detection

World Cancer Day 2019—February 4—highlights the need for urgent action to increase early-stage cancer detection, screening, and diagnosis to significantly improve patients’ chances of survival. Taking place with the theme of “I Am and I Will,” World Cancer...

geriatric oncology

Changing Perceptions on Surgical Intervention for Geriatric Patients With Cancer: Role of the SIOG Surgical Task Force

Surgery is an integral part of treatment of elderly patients with solid malignancies. The times we are living in will be remembered by health-care providers for the significant “contradictions” in the medical and surgical care of elderly patients with cancer. On the one hand, it has been...

breast cancer
symptom management

Oxybutynin: A Novel Option for Managing Hot Flashes?

OXYBUTYNIN, AN ANTICHOLINERGIC drug approved for the treatment of overactive bladder, reduced the frequency and intensity of hot flashes in women who were suffering frequent hot flashes, including breast cancer survivors who were receiving tamoxifen or aromatase inhibitors. These results of the...

issues in oncology

Two Retrospective Studies Find Increased Risk of Suicide Among Patients Diagnosed With Cancer

In a news item reported in The Lancet Oncology, The Lancet journalist Manjulika Das reviewed two U.S. retrospective studies indicating that patients diagnosed with cancer are at increased risk of suicide. High Standardized Mortality Ratio In one study, published by Zaorsky et al in Nature...

lymphoma

PET-Adapted Treatment in Newly Diagnosed Advanced Hodgkin Lymphoma

In the phase III AHL2011 trial reported in The Lancet Oncology, Casasnovas et al found that positron-emission tomography (PET)-guided treatment produced good outcomes in newly diagnosed advanced Hodgkin lymphoma, allowing de-escalation of induction to ABVD (doxorubicin, bleomycin, vinblastine, and...

issues in oncology
cost of care

How to Save Billions on Cancer Care Costs: The Potential of Value-Based Prescribing in Oncology

IT IS TIME for value-based prescribing—the reduction of prescribing costs using basic pharmacologic principles—to be tested and deployed in oncology. The savings are real and there for the taking. If you are concerned about the high costs in cancer care, here is a chance to get maximum value for...

breast cancer

Low-Dose Tamoxifen Halves Breast Cancer Risk in Women With Preinvasive Breast Lesions

A VERY LOW DOSE of tamoxifen—5 mg/d, given for 3 years rather than 5 years—halved the risk of breast cancer recurrence or new lesions over placebo in women with breast intraepithelial neoplasia, without producing the usual toxicities seen with the standard dose, Italian researchers reported at the...

health-care policy
lung cancer

Shared Decision-Making and Use of Low-Dose CT Screening for Lung Cancer

In a study reported in a research letter in JAMA Internal Medicine, Goodwin et al found that only a small proportion of Medicare enrollees undergoing low-dose computed tomography (CT) screening for lung cancer had a prescreening shared decision-making session, which is mandated by the Centers for...

27% Drop in Overall U.S. Cancer Mortality Rate From 1991 to 2016

A steady 25-year decline has resulted in a 27% drop in the overall cancer death rate in the United States between 1991 and 2016. The data come from “Cancer Statistics, 2019,” the American Cancer Society’s annual report on cancer rates and trends. The report was published by Siegel et al in CA: A...

hematologic malignancies
multiple myeloma
immunotherapy

Novel Therapeutics for Relapsed or Refractory Multiple Myeloma, Part 2

Here is an update on several different studies focusing on novel treatments for patients with relapsed or refractory multiple myeloma presented at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition. The featured therapeutics include the oral agent selinexor in...

hepatobiliary cancer

FDA Approves Cabozantinib in Previously Treated Hepatocellular Carcinoma

On January 14, the U.S. Food and Drug Administration (FDA) approved cabozantinib (Cabometyx) tablets for patients with hepatocellular carcinoma who have been previously treated with sorafenib. The FDA’s approval of this oral tyrosine kinase inhibitor was based on the results of the phase III...

hepatobiliary cancer

FDA Approves Cabozantinib for Previously Treated Hepatocellular Carcinoma

On January 14, the U.S. Food and Drug Administration (FDA) approved cabozantinib (Cabometyx) tablets for patients with hepatocellular carcinoma who have been previously treated with sorafenib. The FDA’s approval of cabozantinib was based on results from the phase III CELESTIAL trial....

issues in oncology
symptom management

Incidence of Acute Kidney Injury in Patients Receiving Systemic Therapy for Cancer

In a Canadian population–based cohort study reported in the Journal of the National Cancer Institute, Kitchlu et al found that acute kidney injury (AKI) is common in patients receiving systemic therapy for newly diagnosed cancer and has increased in incidence in recent years. Study Details...

kidney cancer

Immediate vs Deferred Cytoreductive Nephrectomy in Patients With Metastatic Renal Cell Carcinoma Treated With Sunitinib

In a trial with a modified primary endpoint due to slow accrual reported in JAMA Oncology, Bex et al found that deferred cytoreductive nephrectomy after sunitinib did not improve 28-week progression-free rate (PFR) vs immediate nephrectomy followed by sunitinib in patients with metastatic renal...

issues in oncology

27% Drop in Overall U.S. Cancer Mortality Rate From 1991 to 2016

A steady 25-year decline has resulted in a 27% drop in the overall cancer death rate in the United States between 1991 and 2016. The data come from “Cancer Statistics, 2019,” the American Cancer Society’s annual report on cancer rates and trends. The report was published in CA: A...

issues in oncology

Unplanned Hospitalizations in the Year After Cancer Diagnosis

In a California population–based cohort study reported in the Journal of Oncology Practice, Whitney et al found that 67% of hospitalizations in the year after cancer diagnosis were unplanned, with 67% of such hospitalizations originating in the emergency department. The study involved data...

skin cancer

Association Between Sun Exposure and BMI in the Development of Nonmelanoma Skin Cancer

Exposure to the sun, whether cumulative or intermittent, is a known risk factor for the development of nonmelanoma skin cancer (NMSC). Past studies have found that greater body mass index (BMI) actually lessens the risk of women developing NMSCs. With this in mind, researchers sought to determine...

cns cancers

Risk of Intracranial Malignancy After Stereotactic Radiosurgery for Nonmalignant Conditions

In a retrospective cohort study reported in The Lancet Oncology, Wolf et al found that patients undergoing Gamma Knife stereotactic radiosurgery for nonmalignant neurosurgical conditions did not appear to be at long-term increased risk of radiation-associated secondary intracranial malignancy or...

sarcoma
issues in oncology

Regionalization of Surgery for Retroperitoneal Sarcoma Surgery to High-Volume Hospitals

In a study reported in the Journal of Oncology Practice, Villano et al found that regionalization of retroperitoneal sarcoma surgery—recognized as a complex cancer surgery—to high-volume hospitals has been slower than that observed for similarly complex pancreatic cancer surgery over...

issues in oncology
cost of care

New Study Examines Orphan Drug Exclusivity and Pricing

A new report commissioned by the National Organization for Rare Disorders (NORD) and published by the IQVIA Institute demonstrates that the 7-year market exclusivity granted to drugs designated under the Orphan Drug Act of 1983 for rare diseases is working as intended. In nearly every case, orphan...

multiple myeloma

Lenalidomide Maintenance vs Observation in Newly Diagnosed Multiple Myeloma

In a UK phase III trial (Myeloma XI) reported in The Lancet Oncology, Jackson et al found that lenalidomide maintenance was associated with improved progression-free survival but not overall survival among patients with newly diagnosed multiple myeloma with at least minimal response to induction...

skin cancer
immunotherapy

Pilot Study of Intratumoral G100 in Merkel Cell Carcinoma

Multiple recent reports have addressed the activity of programmed cell death protein 1 (PD-1) inhibitors, such as pembrolizumab and avelumab, in Merkel cell carcinoma. However, approximately half of all patients who receive these agents do not maintain a persistent response. In an...

gynecologic cancers

Comparing Survival Outcomes With Minimally Invasive and Open Surgical Approaches to Early-Stage Cervical Cancer

MINIMALLY INVASIVE radical hysterectomy for women with early-stage cervical cancer has been associated with reduced rates of disease-free and overall survival in the phase III LACC randomized noninferiority trial comparing minimally invasive and open abdominal radical hysterectomy. The results...

hematologic malignancies
cost of care

New Report Demonstrates Cost of Blood Cancer Care

THE COSTS to treat blood cancer are higher than the costs to treat other cancers, and the costs incurred by a patient diagnosed with a blood cancer do not return to precancer levels, according to a Milliman study commissioned by The Leukemia & Lymphoma Society (LLS). The study—The Cost Burden...

hepatobiliary cancer
immunotherapy

Pembrolizumab in Sorafenib-Pretreated Hepatocellular Carcinoma

ON NOVEMBER 9, 2018, pembrolizumab (Keytruda) was granted accelerated approval for treatment of patients with hepatocellular carcinoma previously treated with sorafenib (Nexavar).1,2 Supporting Efficacy Data APPROVAL WAS BASED on durable responses in the phase II KEYNOTE-224 trial...

hematologic malignancies

Study Findings on Myeloproliferative Neoplasms Including Systemic Mastocytosis

HERE IS AN UPDATE on six different studies featured at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition. Topics focused on novel treatments for myelofibrosis, polycythemia vera and essential thrombocythemia, as well as systemic mastocytosis. Myelofibrosis ABSTRACT...

lung cancer

Lorlatinib in Second- or Third-Line Treatment of ALK-Positive Metastatic Non–Small Cell Lung Cancer

On November 2, 2018, lorlatinib (Lorbrena) was granted accelerated approval for the treatment of patients with ALK-positive metastatic non–small cell lung cancer (NSCLC) whose disease has progressed on crizotinib (Xalkori) and at least one other ALK inhibitor for metastatic disease or whose disease ...

issues in oncology
prostate cancer
geriatric oncology

Overscreening for Prostate Cancer in Older Men Remains an Issue

Although most major cancer organizations agree on the guidelines for prostate cancer screening, there is still uneven application of the test, such as in the older patient population, resulting in overdiagnosis and waste in an already fiscally challenged health-care system. Researchers from the...

lung cancer
immunotherapy

ESMO Immuno-Oncology 2018: OAK Trial: Fast Progression in Patients With NSCLC Treated With Atezolizumab vs Chemotherapy

Overall survival (OS) was improved across all subgroups of patients with non–small cell lung cancer (NSCLC) who received atezolizumab (Tecentriq) compared with chemotherapy, including poor prognostic factors that were evaluated in an analysis of data from the OAK trial. Additionally, this...

breast cancer

Disease-Free Survival With Letrozole vs Placebo After Aromatase Inhibitor–Based Therapy in Postmenopausal Breast Cancer

As reported by Mamounas et al in The Lancet Oncology, the phase III NRG Oncology/NSABP B-42 trial has shown no disease-free survival benefit with 5 years of letrozole (Femara) vs placebo after 5 years of aromatase inhibitor–based therapy in women with hormone receptor–positive...

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