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supportive care

Family Perspectives Support Advance Care Planning With Patient Preferences in End-of-Life Care

Three measures of aggressive end-of-life care “were associated with relatively large differences in family member–reported quality ratings for end-of-life care and a lower likelihood that patients with advanced-stage cancer received care congruent with their preferences,”...

colorectal cancer

High Expression of Epiregulin or Amphiregulin Predicts Benefit of Panitumumab in RAS Wild-Type Advanced Colorectal Cancer

In the UK phase III PICCOLO trial reported in JAMA Oncology, Seligmann et al found that high expression of either of the epidermal growth factor receptor (EGFR) ligands epiregulin or amphiregulin was associated with a progression-free survival benefit with panitumumab (Vectibix)/irinotecan vs...

issues in oncology

Cultural Awareness and Sensitivity Among Surgeons Do Not Always Result in Culturally Competent Care

A survey of oncology surgeons from six hospitals in Washington State found that the surgeons in the sample “displayed and valued cultural awareness and sensitivity” but that “cultural awareness and sensitivity did not necessarily result in culturally competent behavior.” These findings highlight...

skin cancer

Melanoma-Specific Survival Significantly Higher With Wider Excision Margins

Among patients with high-risk, primary cutaneous melanomas, the risk of death from melanoma, at a median follow-up of 8.8 years, was significantly higher among those randomized to surgery with a 1-cm excision margin than among those randomized to surgery with a 3-cm excision margin. Although...

hematologic malignancies
leukemia

Increasing the Dose of Obinutuzumab Monotherapy Raised the Response Rate

A randomized phase II study in symptomatic, untreated patients with chronic lymphocytic leukemia (CLL) found an increased overall response rate with obinutuzumab (Gazyva) at a 2,000 mg vs 1,000 dose. In addition, the “data demonstrate that obinutuzumab produces a higher response rate in...

breast cancer

A TV Host’s Breast Cancer Survival Story

Bookmark Title: Had I Known: A Memoir of SurvivalAuthor: Joan Lunden with Laura MortonPublisher: Harper CollinsPublication date: September 2015Price: $26.99; hardcover, 336 pages In 1974, several weeks after Betty Ford became the nation’s First Lady, she underwent a mastectomy for breast cancer....

Questions From Younger Patients About Colorectal Cancer Should Be Addressed Promptly

A study in Cancer1 finding an increasing rate of colorectal cancer among patients under the age of 50 should serve to raise awareness about the need for testing among those with “red-flag” symptoms and earlier screening for those at high risk, the study’s corresponding author, Samantha Hendren, MD, ...

gastrointestinal cancer

‘Red-Flag’ Symptoms That Could Signal Colorectal Cancer in Patients Under 50 Years Old Should Be Taken Seriously

In clinical practice, Samantha Hendren, MD, MPH, has been “shocked by what a large proportion of patients we are seeing who are under 50 and presenting with colorectal cancer,” often with advanced disease due to delayed diagnosis. “And that is because patients and physicians don’t even think of...

symptom management

Selected Abstracts From 2015 ASH Annual Meeting: Part 3

Here are several more abstracts selected from the proceedings of the 2015 American Society of Hematology (ASH) Annual Meeting and Exposition, focusing on the topic of anticoagulation and the cancer patient. For other selected abstracts from this conference, see the December 25, 2015, and the...

leukemia

Adding Targeted Therapy to Chemoimmunotherapy in Patients With Chronic Lymphocytic Leukemia: Questions as to Optimal Strategy Remain

The HELIOS study is an international phase III trial of bendamustine (Treanda) plus rituximab (Rituxan) in combination with ibrutinib (Imbruvica) vs placebo in patients with previously treated chronic lymphocytic leukemia. As reported by Chanan-Khan in The Lancet Oncology1 and reviewed in this...

hematologic malignancies

Adding Ibrutinib to Bendamustine/Rituximab Improves Outcome in Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma

In the phase III HELIOS trial reported in The Lancet Oncology, Asher Chanan-Khan, MD, of the Mayo Clinic Cancer Center, Jacksonville, Florida, and colleagues found that addition of the Bruton’s tyrosine kinase (BTK) inhibitor ibrutinib (Imbruvica) to bendamustine (Treanda)/rituximab (Rituxan)...

legislation
health-care policy

An Increase for the National Institutes of Health Budget

The National Institutes of Health (NIH) received a nearly $2 billion funding increase—the first large increase for the agency in more than 12 years—in the federal omnibus spending bill Congress passed on December 18, 2015. And President Barack Obama signed the bill into law a day later. The 6.6%...

sarcoma

Eribulin Mesylate in Advanced Liposarcoma Previously Treated With an Anthracycline

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On January 28, 2016, eribulin mesylate (Halaven) was approved for...

cns cancers

Hyperthermic Laser Surgery Disrupts Blood-Brain-Barrier in Glioblastoma, Opening Path for Chemotherapy

Neurosurgeons at Washington University School of Medicine in St. Louis used hyperthermic laser ablation to shrink tumors in patients with recurrent glioblastoma and noted a temporary disruption of the blood-brain barrier, thereby enabling them to deliver chemotherapy to the peritumoral region....

breast cancer

Geriatric Assessment Is Key to Treatment Decisions for Patients 80 Years and Older With Breast Cancer

A review of major studies and the current literature underscored the role of geriatric assessment in making treatment recommendations for patients aged 80 years and older with early and metastatic breast cancer. The review was reported by Shachar et al in the Journal of Oncology Practice. The...

head and neck cancer

Loss of Skeletal Muscle Before or After Radiotherapy Linked to Poorer Survival in Head and Neck Squamous Cell Carcinoma

In a single-center retrospective study reported in JAMA Oncology, Grossberg et al found that skeletal muscle loss before or after radiotherapy was associated with poorer overall survival in patients with head and neck squamous cell carcinoma. Study Details The study included 2,840 patients...

breast cancer

Adjuvant Endocrine Therapy for Primary Breast Cancer Treatment Associated With Increased Symptom Burden Over 12 Months

Patients in the observational Mind-Body Study receiving adjuvant endocrine therapy for primary breast cancer treatment reported a greater symptom burden than did patients not receiving endocrine therapy over 12 months, as reported by Ganz et al in the Journal of Clinical Oncology. No differences in ...

breast cancer

Role of Ado-Trastuzumab Emtansine in Metastatic Breast Cancer Solidified

Ado-trastuzumab emtansine (formerly T-DM1; Kadcyla) improved overall survival compared with treatment of physician’s choice of therapy for patients with pretreated HER2-positive metastatic breast cancer, according to the phase III TH3RESA trial.1 Patients enrolled in the trial had previously been...

Expert Point of View: Kathy S. ­Albain, MD, FACP, FASCO, and Jame Abraham, MD

The general consensus of breast cancer experts of the initial findings of BCIRG-006 triggered a more judicious use of anthracyclines, and this trend continues. Kathy S. ­Albain, MD, FACP, FASCO, Professor of Medicine at Loyola University Chicago Stritch School of Medicine, Maywood, Illinois, said...

breast cancer

Final Analysis of BCIRG-006 Supports Use of Non–Anthracycline-Containing Regimen in Treatment of Women With Early Breast Cancer

The final analysis of the BCIRG-006 trial confirmed the long-term efficacy of trastuzumab (Herceptin) in early breast cancer and also validated the concept that anthracyclines increase toxicity and they are not always necessary for a good outcome.1 The 10-year follow-up of the landmark trial was...

palliative care

2015 Palliative Care in Oncology Symposium Highlights

The Palliative Care in Oncology Symposium, held October 9–10, 2015, in Boston, Massachusetts, brought together more than 670 members of the cancer care community, including oncologists, radiologists, palliative care specialists, nurses, and patient advocates. Sessions delivered information on...

Conquer Cancer Foundation–Funded Research Published in High-Impact Journals

The Conquer Cancer Foundation of the American Society of Clinical Oncology (CCF) encourages grantees to share the results of their research to help advance progress against cancer. Publication in peer-reviewed journals is one of the most important ways for scientists to achieve recognition. That...

ASCO’s Incoming President-Elect Charts His Course for 2017

Bruce E. Johnson, MD, FASCO, was elected ASCO President for the 2017–2018 term this past December and will take office as President-Elect during the ASCO Annual Meeting, June 3–7, 2016, in Chicago. As an ASCO member since 1986, Dr. Johnson brings over 30 years of experience with ASCO to the...

hematologic malignancies
multiple myeloma

Carfilzomib Plus Dexamethasone in Previously Treated Multiple Myeloma

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On January 21, 2016, carfilzomib (Kyprolis) was approved for use in ...

health-care policy

Pediatric Oncology Groups Endorse Ethical Framework for Rationing Scarce Drugs

The Children’s Oncology Group (COG) and the American Society of Pediatric Hematology/Oncology (ASPHO) have endorsed formal clinical recommendations for rationing chemotherapy and supportive care agents during times of shortage. The guidance is needed because persistent shortages of many standard...

lung cancer
issues in oncology
gastroesophageal cancer

PET Scan Use in Follow-up Care for Lung and Esophageal Cancer Shows Wide Variation Between Hospitals, No Impact on Survival

A new study suggests that one approach to watching for a cancer's return is being inappropriately used at many hospitals and isn't helping patients survive longer. The findings are published by Healy et al in the Journal of the National Cancer Institute. The study looked at how often survivors ...

cns cancers

Two Forms of Radiosurgery for Brain Metastases Are Equally Effective

While two advanced radiosurgery approaches—Gamma Knife and RapidArc—offer different strengths, they are equally effective at eradicating cancer in the brain, say researchers at Sidney Kimmel Cancer Center at Jefferson. Their study, published by Liu et al in Frontiers in Oncology,...

multiple myeloma

CAR-T Cell Therapy May Have Role in Treating Multiple Myeloma

Among the burgeoning options for treating multiple myeloma could be an approach that is proving to be exciting in leukemia: CAR-T (chimeric antigen receptor T cells) therapy. Preliminary results of the first-in-humans study in myeloma were presented as a late-breaking abstract at the 2015 ASH...

breast cancer

Genomic Alterations in Primary Invasive Lobular Breast Cancer

In a study reported in the Journal of Clinical Oncology, Desmedt et al identified genomic alterations in invasive lobular breast cancer, including several that may serve as targets for current treatment and for treatment research. Invasive lobular breast cancer cells are characterized by...

breast cancer
survivorship

Patient and Provider Engagement With Healthy Lifestyle Information

Most young women diagnosed with breast cancer are not physically active in the months after a cancer diagnosis, but physical activity increased over time. According to data presented at the 2016 Cancer Survivorship Symposium, higher levels of physical activity were seen among women whose oncology...

Expert Point of View: Daniel Hamstra, MD

Formal discussant of these trials Daniel Hamstra, MD, of Texas Center for Proton Therapy, Irving, offered his perspective. With increased doses of radiation using additional conventional fractions, tumor control is improved, but the risk of damage to normal tissue is increased. Hypofractionation is ...

colorectal cancer
issues in oncology

Half of Elderly Patients With Colorectal Cancer Receive Expensive Therapy With Little Survival Benefit

A study published by Bradley et al in Medical Care showed that over a recent 10-year period, the rate of metastatic colorectal cancer patients older than age 75 receiving three or more treatments increased from 2% to 53%. During this period, 1-year treatment costs increased 32% to reach an...

prostate cancer

Hypofractionation Is Ready for Prime Time in Prostate Cancer, but Will It Be Adopted?

Separate phase III trials presented at the 2016 Genitourinary Cancers Symposium demonstrated that modest hypofractionated radiotherapy is noninferior to conventional radiotherapy for men with intermediate- and low-risk prostate cancer and should be considered a new standard of care.1,2 However, it...

Marc S. Ernstoff, MD, Named UB Chief of Hematology/Oncology, Roswell Park Chair of Medicine

Marc S. Ernstoff, MD, has been appointed Professor and Chief of the Division of Hematology/Oncology in the Department of Medicine in the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo (UB) and Chair of the Department of Medicine and Senior Vice President of Clinical...

Expert Point of View: Irvin M. Modlin, MD, Lisa Bodei, MD, and Eric Liu, MD

The ASCO Post interviewed Irvin M. Modlin, MD, Emeritus Professor of Gastroenterological Surgery, Yale University School of Medicine, regarding his thoughts on the NETTER-1 results and peptide receptor radionuclide therapies for neuroendocrine tumors. Dr. Modlin led the first study of a peptide...

skin cancer

Study Finds Most Patients With Melanoma Had Few Total Nevi and No Atypical Nevi

Although nevi are considered among the strongest risk factors for melanoma, most patients with melanoma had few total and no atypical nevi, according to a study of 566 patients with invasive cutaneous melanoma. “Three notable findings emerged from this case study,” Alan C. Geller, MPH, ...

gastrointestinal cancer

Radiolabeled Somatostatin Analog May Represent A Paradigm Change in the Treatment of Neuroendocrine Tumors

A radiolabeled somatostatin analog compound, 177Lu-DOTA0-Tyr3-Octreotate (Lu-177 dotatate), reduced the risk of disease progression or death by 79% in the international phase III NETTER-1 population of previously treated, advanced neuroendocrine tumors of midgut origin.1 Lu-177 dotatate belongs to...

Nuns Work Where None Work

It was December 9, 1975—a cold morning in the tribal village in Mahuadanr in Bihar, India. The valley was filled with an eerie mist coming down from the hills surrounding the village. Champa, a 5-year-old malnourished girl with sunken eyes, an emaciated face, and a huge ascites, was carried by her...

lung cancer

Anamorelin Increases Lean Body Mass in NSCLC Patients With Cachexia

Anamorelin (a ghrelin-receptor agonist) increased lean body mass but had no beneficial effect on handgrip strength vs placebo in patients with advanced non–small cell lung cancer (NSCLC) and cachexia, according to two international phase III trials (ROMANA 1 and 2) reported in The Lancet...

colorectal cancer

Selective Internal Radiotherapy Does Not Improve Any-Site but Prolongs Liver-Specific Progression-Free Survival in Metastatic Colorectal Cancer

In the phase III SIRFLOX trial reported in the Journal of Clinical Oncology, van Hazel et al found that adding selective internal radiation therapy with yttrium-90 resin microspheres to FOLFOX (fluorouracil, leucovorin, oxaliplatin) with or without bevacizumab (Avastin) did not improve any-site...

issues in oncology

ASCO Provides Support and Guidance for the White House Cancer Moonshot Initiative

Although President Richard Nixon signed the National Cancer Act in 1971, essentially declaring a war on cancer, the genesis of the idea had actually been born 2 years earlier, after the first landing on the moon set off a new era of scientific exploration and sparked a belief that any scientific...

breast cancer

Neratinib Shows Some Activity in Previously Treated HER2-Positive Breast Cancer Brain Metastases

In the phase II Translational Breast Cancer Research Consortium (TBCRC) 022 study, reported by Freedman et al in the Journal of Clinical Oncology, the erbB1, HER2, erbB4 inhibitor neratinib showed some activity in patients with HER2-positive breast cancer brain metastases. Study Details In the...

Expert Point of View: Irvin M. Modlin, MD, and Eric Liu, MD

Two neuroendocrine tumor experts had slightly different reactions to the latest RADIANT-4 data. Irvin M. Modlin, MD, Emeritus Professor of Gastroenterological Surgery at Yale University School of Medicine, New Haven, Connecticut, said in an interview that he essentially restricts his use of...

head and neck cancer

New Staging System for Human Papillomavirus–Related Oropharyngeal Cancer

As reported in The Lancet Oncology by O’Sullivan et al, a new staging system for human papillomavirus–related oropharyngeal cancer has been developed based on findings from the International Collaboration on Oropharyngeal Cancer Network for Staging (ICON-S) study. Study Details The...

neuroendocrine tumors

Everolimus Effective in Neuroendocrine Tumors of Gastrointestinal Origin

In a subgroup analysis of the phase III RADIANT-4 trial, focusing on neuroendocrine tumors of gastrointestinal origin, the mTOR inhibitor everolimus (Afinitor) essentially doubled the median progression-free survival time, compared with placebo, researchers reported at the 2016 Gastrointestinal...

colorectal cancer

Adding Immunotherapy to Radiofrequency Ablation in Colorectal Cancer With Liver Metastasis Shows Promise in Preclinical Models

In a retrospective case-controlled study conducted in patients with colorectal cancer who had received primary tumor resection with or without preoperative radiofrequency ablation for liver metastases, the electrical procedure was found to induce antitumor immune responses in the...

prostate cancer

Study Links Normal Stem Cells to Aggressive Prostate Cancer

A study that revealed new findings about prostate cells may point to future strategies for treating aggressive and therapy-resistant forms of prostate cancer. The study proved that the prostate basal cell layer contains adult stem cells, which possess a unique gene-expression profile resembling the ...

New Biomarker Identifies Uveal Melanoma Patients at High Risk for Metastasis

Among uveal melanomas categorized as class 1, those with high levels of PRAME mRNA were more likely to metastasize than those with low levels of PRAME mRNA, suggesting that patients who have class 1 uveal melanoma with high levels of PRAME mRNA should be monitored more closely for metastatic...

lung cancer

Metabolic Phenotyping of Blood Plasma Allows for the Detection of Lung Cancer

Metabolic phenotyping of blood plasma by proton nuclear magnetic resonance (H-NMR) identified unique metabolic biomarkers specific to lung cancer patients and allowed for the accurate identification of a cohort of patients with early and late-stage lung cancer. These findings were published by...

lung cancer

Racial/Ethnic Variations in Lung Cancer Incidence and Mortality in the Women’s Health Initiative Study Cohort

As reported by Patel et al in the Journal of Clinical Oncology, analysis of lung cancer incidence and mortality in the Women’s Health Initiative Study cohort of postmenopausal women showed a marginally significant lower risk of cancer in Hispanic women vs white women and no difference in...

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