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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....

lung cancer

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 ...

issues in oncology
health-care policy

Road to Successful Use of Real-World Evidence for Drug Development Is Long and Rocky

Friends of Cancer Research (Friends) has been a leader in the push for better and faster cancer drug development. Now it is tackling the use of real-world evidence in clinical trials. This is the report of a meeting on the subject that took place on June 16 in Washington, DC.1 Real-world evidence...

hematologic malignancies
leukemia
lymphoma
multiple myeloma

Selected Hematology Abstracts From the 2016 ASCO Annual Meeting

Here are several abstracts selected from the proceedings of the 2016 ASCO Annual Meeting, focusing on clinical trials on therapeutics in different types of leukemia, multiple myeloma, follicular lymphoma, and central nervous system (CNS) lymphoma. For full details of these study abstracts, visit...

Stereo X-Ray of Stomach Cancer

A few months after William Roentgen’s first publications, x-rays were being produced as stereoroentgenograms. Doctors Emil Beck, James MacKenzie, Charles Leonard, Hildebrand, Walsham, and others used stereoroentgenography during the first decade of the 20th century to study the lungs, heart, and...

lymphoma

Comparison of Chemotherapy Regimens After Negative Interim PET-CT in Advanced Hodgkin Lymphoma

In a phase III trial reported in The New England Journal of Medicine, Johnson et al found similar efficacy with continued ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) chemotherapy vs omission of bleomycin (AVD) after negative interim PET-CT (positron-emission tomography–computed...

leukemia

CAR T-Cell Dose Refinement May Reduce Cytokine-Release Syndrome in Patients With Advanced Acute Lymphoblastic Leukemia

Chimeric antigen receptor (CAR) T-cell therapy has been effective in adults and children with advanced acute lymphoblastic leukemia (ALL), but along with efficacy, the treatment can stimulate cytokine-­release syndrome, which can be deadly if it goes unrecognized and untreated. Adjusting the dose...

breast cancer

Mixed Results With Resection of Primary Tumor in Stage IV Breast Cancer

For de novo stage IV breast cancer, does resection of the primary tumor improve outcomes? Two studies presented at the 2016 ASCO Annual Meeting reached different conclusions. A prospective randomized study conducted in Turkey concluded there is a survival benefit at 5 years,1 whereas a U.S....

solid tumors
sarcoma

French Phase III Trial Shows No Benefit of Adding Zoledronate to Chemotherapy and Surgery in Osteosarcoma

In the French phase III OS2006 trial reported by Piperno-Neumann et al in The Lancet Oncology, the addition of zoledronate to chemotherapy and surgery provided no event-free survival benefit in the treatment of patients with newly diagnosed high-grade osteosarcoma. Study Details In the open-label ...

hematologic malignancies
lymphoma

Adding Obinutuzumab to Bendamustine Improves Progression-Free Survival in Rituximab-Refractory NHL

In the phase III GADOLIN trial reported in The Lancet Oncology, Sehn et al found that adding the anti-CD20 antibody obinutuzumab (Gazyva) to bendamustine (Bendeka, Treanda) increased progression-free survival in patients with rituximab-refractory indolent non-Hodgkin lymphoma (NHL). Outcomes in...

hepatobiliary cancer

FDA Approves Sofosbuvir/Velpatasvir for Treatment of Chronic Hepatitis C Virus Infection

On June 28, the U.S. Food and Drug Administration (FDA) approved a fixed-dose combination of sofosbuvir, 400 mg, plus velpatasvir, 100 mg (Epclusa) to treat adult patients with chronic hepatitis C virus (HCV) either with or without cirrhosis. For patients with moderate to severe cirrhosis...

lymphoma

Study Finds Addition of High-Dose Cytarabine to Immunochemotherapy Before Transplant Improves Outcomes in Younger Patients With MCL

The phase III European MCL Younger trial has shown that adding high-dose cytarabine to immunochemotherapy prior to autologous stem cell transplantation (ASCT) increased the time to treatment failure among patients with mantle cell lymphoma (MCL) aged ≤ 65 years. The results were reported by...

Inside Knowledge From a Cancer Survivor

Curtis Pesmen is a well-regarded writer who has authored six books of nonfiction as well as numerous articles for publications such as Esquire and The New York Times. He also has served as founding editor of LIVESTRONG Quarterly and often speaks and writes on patient advocacy. Shortly after...

breast cancer

Hypofractionated Radiation Found Equivalent to Conventionally Fractionated Regimen in Early-Stage Breast Cancer

Early-stage breast cancer patients receiving a shorter course of whole-breast irradiation with higher radiation doses per fraction reported equivalent cosmetic, functional, and pain outcomes over time as those receiving a longer, lower-dose per fraction course of treatment, according to researchers ...

skin cancer

Sequential Nivolumab/Ipilimumab Appears More Active Than Reverse Sequence in Advanced Melanoma

In the phase II CheckMate 064 trial reported in The Lancet Oncology, Weber et al found that sequential nivolumab (Opdivo)/ipilimumab (Yervoy) was more active than the reverse sequence (ipilimumab/nivolumab) in patients with advanced melanoma. Study Details In the open-label study, 138 patients...

issues in oncology

Creating Hybrid Academic-Community Cancer Centers to Improve Patient Care

Five years ago, the Helen F. Graham Cancer Center and Research Institute at Christiana Care Health System in Newark, Delaware, and The Wistar Institute, a National Cancer Institute (NCI)-designated biomedical research center, in Philadelphia, Pennsylvania, joined forces to collaborate on...

lung cancer

Once-Daily Radiation (66 Gy) Appears No Better Than Twice-Daily Radiation (45 Gy) for Small Cell Lung Cancer

A schedule of once-daily radiation therapy (66 Gy) was no better than a twice-daily schedule (45 Gy) for optimization of chemoradiotherapy in patients with limited-stage small cell lung cancer (SCLC), according to the eagerly anticipated results of the phase III ­CONVERT trial, presented at the...

bladder cancer
colorectal cancer
hepatobiliary cancer
lung cancer

Matching Treatment to Tumor Abnormalities Seems to Pay Off

A strategy of matching molecular abnormalities in patients’ tumors to therapies targeted to those abnormalities is gaining ground, according to preliminary results of the phase IIb MyPathway study presented at the 2016 ASCO Annual Meeting.1 These are still early days for this “matching” strategy,...

lung cancer
skin cancer

Pembrolizumab Active for Untreated/Progressive Brain Metastases in Melanoma or NSCLC

Goldberg et al found that pembrolizumab (Keytruda) was active in untreated or progressive brain metastases in melanoma and non–small cell lung cancer (NSCLC), according to a single-center phase II trial reported in The Lancet Oncology. Study Details The study included 36 patients at Yale...

breast cancer

Joint Analysis Confirms Benefit of Anthracyclines for High-Risk Early-Stage Breast Cancer

For the treatment of high-risk, HER2-negative early-stage breast cancer, anthracyclines were confirmed as beneficial in a joint analysis of the Anthracyclines in Early Breast Cancer (ABC) trials. Presented at the 2016 ASCO Annual Meeting, the joint analysis of the ABC trials validated taxane plus...

cns cancers

For High-Risk Neuroblastoma, Two Transplants May Be Better Than One

In children with high-risk neuroblastoma, tandem autologous stem cell transplant (ASCT) improved event-free survival rates in the ANBL0532 trial from the Children’s Oncology Group. The study was presented at the plenary session of the 2016 ASCO Annual Meeting by Julie R. Park, MD, of Seattle...

breast cancer

SNMMI 2016: VASH Collimator Allows Three-Dimensional Imaging of the Breast With Less Radiation

Preliminary tests have demonstrated that a new device may enable existing breast cancer imagers to provide up to six times better contrast of tumors in the breast, while maintaining the same or better image quality and halving the radiation dose to patients. The advance is made possible by a new...

pancreatic cancer

Japanese Trial Shows Improved Survival With Adjuvant S-1 vs Gemcitabine in Resected Pancreatic Cancer

Updated results of a Japanese phase III trial (JASPAC 01) reported in The Lancet by Uesaka et al showed that adjuvant S-1 was associated with significantly better overall survival compared with gemcitabine in patients with resected pancreatic cancer. Study Details In the open-label noninferiority ...

hematologic malignancies
leukemia

Study Finds Inotuzumab Ozogamicin Improves Outcomes vs Standard Therapy in Relapsed/Refractory ALL

In a phase III trial reported in The New England Journal of Medicine, Kantarjian et al found that treatment with the antibody-drug conjugate inotuzumab ozogamicin resulted in a greater complete remission rate and improved overall survival vs standard therapy in patients with relapsed/refractory...

colorectal cancer

ASCO 2016: Nivolumab Shows Promise in Refractory, Metastatic Anal Cancer

In the first-ever clinical trial for metastatic patients previously treated for the disease, research led by The University of Texas MD Anderson Cancer Center found that the immune checkpoint inhibitor nivolumab (Opdivo) shows promise for the majority of patients with squamous cell carcinoma of the ...

The Importance of Listening to Patients

My experience with cancer, or more accurately, cancers, is complicated. In 2002, after returning from a medical mission to Honduras, I noticed a bean-sized lymph node above my left clavicle. As an oncology-certified nurse, I knew not to ignore any unusual nodules that pop up on the body and asked...

prostate cancer

Increased Survival and Toxicity With Docetaxel, No Benefit of Zoledronic Acid, When Added to First-Line Hormone Therapy in Prostate Cancer

As reported in The Lancet by Nicholas D. James, BSc, MBBS, PhD, of the University of Warwick, and colleagues, survival results of the STAMPEDE trial, which used a multiarm, multistage seamless phase II/III design, provide little evidence of benefit of zoledronic acid and showed increased survival ...

multiple myeloma

Daratumumab Shows High Activity in Heavily Pretreated and Refractory Multiple Myeloma

In the phase II SIRIUS trial reported in The Lancet, Sagar Lonial, MD, of Winship Cancer Institute, Emory University, and colleagues found that the CD38-targeted monoclonal antibody daratumumab (Darzalex) produced durable responses in patients with multiple myeloma who had received at least three ...

skin cancer

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...

cns cancers

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...

issues in oncology
cost of care

Global Economic Crisis May Be Linked to Increased Cancer Mortality

The global economic crisis has been associated with increased unemployment and reduced public-sector expenditure on health care. In a study reported in The Lancet, Maruthappu et al found that the global economic crisis beginning in 2008 was also associated with a large excess in cancer mortality...

leukemia
cost of care

ASCO 2016: Patients With Cancer With ACA Policies Swiftly Reach Out-of-Pocket Caps

Duke Cancer Institute researchers have found that a hypothetical leukemia patient buying the life-extending drug therapy for his condition would reach his annual out-of-pocket maximum in a month on most of the bronze policies and half of the silver policies offered through the Affordable Care Act...

issues in oncology

Patricia J. Goldsmith on Patient Access and Engagement: Results of the CancerCare Report

Patricia J. Goldsmith, Chief Executive Officer of CancerCare, which provides free, professional support services to anyone affected by cancer, discusses findings from six distinct surveys with input from more than 3,000 individuals at varying stages of their cancer experience.

leukemia

First-Line Fludarabine, Cyclophosphamide, and Rituximab vs Bendamustine/Rituximab in Advanced CLL

In a European phase III noninferiority trial reported in The Lancet Oncology, Eichhorst et al found that progression-free survival was better with standard first-line fludarabine/cyclophosphamide/rituximab vs bendamustine/rituximab in fit patients with advanced chronic lymphocytic leukemia (CLL)...

solid tumors

Investigational Drug Abemaciclib Shows Promising Activity Against Several Cancer Types in Early Study

An experimental CDK inhibitor, abemaciclib, yielded encouraging and durable results against several different types of cancers, including breast cancer, lung cancer, glioblastoma, and melanoma, according to a report published by Patnaik et al in Cancer Discovery. The results of the trial supported ...

ASCO 2016: ASCO Announces Milestones of TAPUR Study

ASCO announced that Bayer and Merck are the most recent companies to sign on to provide study drugs at no cost to patients enrolled in the Targeted Agent and Profiling Utilization Registry (TAPUR) study, joining six other companies in ASCO’s first-ever clinical trial. Since opening on March...

cns cancers

ASCO 2016: Tandem Autologous Stem-Cell Transplant Improves Outcomes for Children With High-Risk Neuroblastoma

Historically, less than 50% of children with high-risk neuroblastoma live 5 or more years after diagnosis. A National Cancer Institute (NCI)-funded phase III trial performed by the Children’s Oncology Group found that adding a second autologous stem-cell transplant to standard therapy...

bladder cancer

Atezolizumab in Previously Treated Advanced Urothelial Carcinoma

The recent study by Rosenberg et al in The Lancet—summarized in this issue of The ASCO Post—is a very important paper in the field of bladder cancer therapy.1 It is the first phase II trial in metastatic transitional cell carcinoma that demonstrates the single-agent activity of the...

prostate cancer
geriatric oncology

Significant Increased Risk of Noncancer Hospitalization Following Diagnosis of Prostate Cancer in the Elderly

Elderly men had a significant increase in the risk of noncancer hospitalizations following the diagnosis of prostate cancer, according to a population-based retrospective cohort study conducted by Amit D. Raval, PhD, and colleagues at West Virginia University, Morgantown. Results were published in...

hepatobiliary cancer

Cases of Mixed Hepatocellular Carcinoma–Cholangiocarcinoma Emerging

Combined hepatocellular carcinoma–cholangiocarcinoma is a histopathologically distinct tumor for which no formal treatment guidelines exist. It is also a malignancy that is being diagnosed more often, according to researchers from Mount Sinai Beth Israel Medical Center, New York, who reported...

integrative oncology

Fitness: Can Exercise Lengthen Survival in Patients With Cancer?

Integrative Oncology is guest edited by Barrie R. Cassileth, MS, PhD, of Memorial Sloan ­Kettering Cancer Center, New York. Regular physical activity has long been associated with decreased risk of disease, including many types of cancer. Such benefits may translate into increased life expectancy...

gynecologic cancers
multiple myeloma
skin cancer
pancreatic cancer
lung cancer
prostate cancer
breast cancer
survivorship

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®): 2016 Guidelines

In 1996, the National Comprehensive Cancer Network (NCCN®) published its first set of Clinical Practice Guidelines in Oncology® (NCCN Guidelines®), covering eight tumor types. The NCCN Guidelines® are now published for more than 60 tumor types and topics. Some of the key updates for 2016 were...

supportive care
leukemia

Recent Reports on Treatment for Leukemias, Sinusoidal Obstruction Syndrome, and Graft-vs-Host Disease

In this installment of Hematology Expert Review, I will summarize five studies from the recent literature addressing important questions about leukemias and their treatment, anticoagulant therapy with the new agent defibrotide (Defitelio), and the use of antilymphocyte globulin to prevent chronic...

global cancer care

Oncology and Diplomacy in the Middle East

The Middle East is a vast region comprised largely of developing nations with complicated sociopolitical challenges, violent internecine disputes, and deeply fragmented health-care systems. Not surprisingly, the region’s suboptimal health care contributes to the late diagnosis and poor survival...

prostate cancer

AUA 2016: IsoPSA, a Novel, Structure-Based Biomarker Test for Prostate Cancer, Explored in a Multicenter Prospective Trial

A promising new test is detecting prostate cancer more precisely than current tests by identifying molecular changes in the prostate-specific antigen (PSA) protein, according to Cleveland Clinic research presented at the 111th Annual Scientific Meeting of the American Urological Association (AUA)...

gynecologic cancers

Intraperitoneal Chemotherapy in Question in Ovarian Cancers

A phase III trial of bevacizumab (Avastin) with intravenous vs intraperitoneal chemotherapy showed no improvement in progression-free survival for first-line treatment of patients with optimally surgically resected stage II and III ovarian, peritoneal, or fallopian tube cancer.1 When compared with...

issues in oncology

CancerCare Issues Report on Nationwide Surveys of 3,000 People Diagnosed With Cancer

The national nonprofit organization CancerCare has announced the publication of a comprehensive report on experiences, perceptions, and needs of people who are living with and beyond a cancer diagnosis. The 2016 CancerCare Patient Access and Engagement Report is a compilation of results from six...

colorectal cancer

Trastuzumab/Lapatinib Active in Refractory, KRAS Codon 12/13 Wild-Type, HER2-Positive Metastatic Colorectal Cancer

Dual HER2 inhibition with trastuzumab (Herceptin) and lapatinib (Tykerb) was active in patients with refractory, KRAS codon 12/13 wild-type, HER2-positive metastatic colorectal cancer, according to an Italian phase II trial reported by Sartore-Bianchi et al in The Lancet Oncology. Study Details...

skin cancer

Pembrolizumab Active in Virus-Positive and ‑Negative Advanced Merkel Cell Carcinoma

The PD-1 (programmed cell death protein 1) inhibitor pembrolizumab (Keytruda) was active in advanced Merkel cell carcinoma in both Merkel cell polyomavirus (MCP)-positive and -negative tumors, according to Nghiem et al, who reported their phase II study findings in The New England Journal of...

breast cancer

ESTRO 2016: New Study Sheds Light on Mastectomy vs Breast-Conserving Therapy in Older vs Younger Patients With Early Breast Cancer

New research presented at the ESTRO 35 Conference on April 30 (Abstract OC-0052) has shown women aged younger than 45 years with early-stage breast cancer that had not spread to the lymph nodes and who opted for breast-conserving therapy with radiation therapy had a 13% higher risk of developing a...

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