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Showing 20451 - 20500Pembrolizumab Is Active in Platinum- and Cetuximab-Refractory Head and Neck Cancer
IN THE PHASE II KEYNOTE-055 trial, pembrolizumab (Keytruda) was found to produce durable responses in patients with platinum- and cetuximab (Erbitux)-refractory head and neck squamous cell carcinoma.1 Results of the trial were reported by Joshua Bauml, MD, of the University of Pennsylvania,...
Pembrolizumab in Second-Line Therapy for Advanced Urothelial Carcinoma
THE TREATMENT OF metastatic urothelial carcinoma experienced a long period of stagnation until the recognition that targeting the programmed cell death protein 1 (PD-1) pathway could yield deep and durable responses.1-3 Cisplatin-based combination chemotherapy has been the reference standard for...
Insurance Approval Rates for Enrollment in Oncology Clinical Trials Increased Under Affordable Care Act
The Patient Protection and Affordable Care Act (ACA) of 2010 was the first federal law to mandate that group health insurance plans and state-licensed insurance issuers provide coverage of standard-of-care costs for patients enrolled in approved clinical trials, effective on January 1, 2014. Under...
Understanding and Managing Radiation-Induced Bystander Effect
More than half of patients with cancer undergo radiotherapy. Due to a phenomenon known as radiation-induced bystander effect, in which irradiated cells leak chemical signals that can travel some distance to damage unexposed healthy cells, many suffer side effects such as hair loss, fatigue, and...
Analysis Reveals Genomic Alterations, Oncogenes Driving Medulloblastoma Subtypes
The most comprehensive analysis yet of medulloblastoma has identified genomic changes responsible for more than 75% of the brain tumors, including two new suspected cancer genes that were found exclusively in the least understood disease subgroups. The study from an international research...
Comparison of MRI vs PET-CT in Multiple Myeloma
A study reported by Moreau et al in the Journal of Clinical Oncology indicated no difference between magnetic resonance imaging (MRI) and positron-emission tomography–computed tomography (PET-CT) in detecting bone lesions at diagnosis in patients with multiple myeloma. PET-CT normalization...
Single-Center Trial of Stereotactic Radiosurgery for Completely Resected Brain Metastases
In a U.S. single-institution study reported in The Lancet Oncology, Mahajan et al found that stereotactic radiosurgery to the surgical cavity reduced local recurrence vs observation in patients with completely resected brain metastases. Study Details In the trial, 128 evaluable patients at MD...
Addition of Cetuximab to Concurrent Chemoradiation in Esophageal Cancer
The phase III NRG Oncology RTOG 0436 trial has shown no survival benefit of adding cetuximab (Erbitux) to paclitaxel/cisplatin and radiation therapy in patients with esophageal cancer treated without surgery. These results were reported by Suntharalingam et al in JAMA Oncology. Study Details In...
Pembrolizumab Improves Overall Survival vs Chemotherapy in Second-Line Therapy for Advanced Urothelial Carcinoma
IN THE PHASE III KEYNOTE-045 trial reported in The New England Journal of Medicine, Joaquim Bellmunt, MD, PhD, of Dana-Farber Cancer Institute, and colleagues found that pembrolizumab (Keytruda) significantly improved overall survival vs investigator choice of chemotherapy as second-line treatment ...
Ongoing Research in Cancer Immunotherapy for Children With Leukemia
THE CANCER IMMUNOTHERAPY PROGRAM at Children’s Hospital of Philadelphia has several clinical trials of chimeric antigen receptor (CAR) T-cell therapy available to eligible patients. Pilot Study of Redirected Autologous T Cells Engineered to Contain Anti-CD19 Attached to TCRζ and 4-1BB Signaling...
NCCN Panelists Relay ‘What’s Hot’ in Their Fields
AT THE NATIONAL Comprehensive Cancer Network® (NCCN®) 22nd Annual Conference, experts from several fields met with journalists to highlight “what’s hot” in their specialties. The ASCO Post captured that conversation. Myeloproliferative Neoplasms Guidelines NCCN HAS LAUNCHED new NCCN Clinical...
Digital Tomosynthesis vs Mammography in Unmasking Breast Cancer
DIGITAL TOMOSYNTHESIS is rapidly replacing full-field digital mammography, because “it allows a more efficient diagnostic workflow and leads to a more confident interpretation,” according to Elizabeth A. Morris, MD, FACR, Chief of the Breast Imaging Service, Memorial Sloan Kettering Cancer Center, ...
Breast Cancer and Brain Metastases: Whole-Brain Radiotherapy May Not Be the Answer
FOR PATIENTS WITH BREAST CANCER who have metastases to the central nervous system (CNS), clinicians should think twice before administering whole-brain radiotherapy, according to Kimberly Blackwell, MD, Professor of Medicine and Assistant Professor of Radiation Oncology at Duke University Medical...
Are Wearable Physical Activity Monitors Coming of Age in Oncology?
COMMERCIALLY AVAILABLE wearable physical activity monitors have been making their way into clinical research in recent years; however, most studies on these devices have been related to non-cancer conditions including obesity, depression, and physical activity. Their application in the field of...
Expert Point of View: Anne Tsao, MD, and John Heymach, MD, PhD
STUDY DISCUSSANT Anne Tsao, MD, Director of the Mesothelioma Program at The University of Texas MD Anderson Cancer Center in Houston, indicated the response rates seen in the MAPS-2 trial are comparable to those demonstrated in smaller studies of pembrolizumab (Keytruda). She considered the...
Checkpoint Inhibitors May Prove to Be Effective in Mesothelioma
CHECKPOINT INHIBITION was effective against malignant pleural mesothelioma in the MAPS-2 study of the French Cooperative Thoracic Intergroup. At the 2017 ASCO Annual Meeting, researchers reported a disease control rate of up to 50% when patients were treated with immunotherapy after relapse in a...
Expert Point of View: Ritu Salani, MD, MBA
STUDY DISCUSSANT Ritu Salani, MD, MBA, of The Ohio State University Wexner Medical Center, Columbus, agreed with the LION trial investigators. “Omitting systemic lymph node dissection in patients who have both radiographic and clinically negative lymph nodes is acceptable,” she said. “I always...
Study Supports Omission of Lymphadenectomy in Node-Negative Advanced Ovarian Cancer
SYSTEMATIC LYMPHADENECTOMY in patients with advanced ovarian cancer and complete resection offered no improvement in progression-free or overall survival in the Gynecologic Cancer Intergroup’s LION trial, reported at the 2017 ASCO Annual Meeting by Philipp Harter, MD, PhD, of the German...
Expert Point of View: Siwen Hu-Lieskovan, MD
“COMBINATION STRATEGIES are being developed, but the big question is what and how to combine,” said formal discussant Siwen Hu-Lieskovan, MD, of the University of California Los Angeles. “Anti–programmed cell death protein 1 (PD-1) therapy works at the last step of T-cell activation and relies on...
Combination Strategies for Jump-Starting the Immune Response
CHECKPOINT INHIBITORS have dramatically changed the landscape of the treatment of melanoma, lung, bladder, and other cancers. Researchers are focusing on exploring ways to extend the use of checkpoint inhibitors to other disease states and to combine them with novel agents and improve outcomes. At ...
Expert Point of View: Steven J. Cohen, MD, and Josep Tabarnero, MD, PhD
STEVEN J. COHEN, MD, Director of the Rosenfeld Cancer Center at Jefferson Health/Abington Hospital, Abington, Pennsylvania, and Vice Chair of Medical Oncology at Sidney Kimmel Cancer Center at Jefferson, and Josep Tabernero, MD, PhD, Head of Medical Oncology and the Gastrointestinal Tumors and...
Tumor ‘Sidedness’ in Colon Cancer: Studies Look for Explanations
TUMOR “SIDEDNESS” in colon cancer has become a topic of great interest, after right-sided tumors were shown to have a worse prognosis than left-sided ones and biologics were found to differ in efficacy based on side. At the 2017 ASCO Annual Meeting, studies explored why this might be so. Three...
Expert Point of View: Joshua Jones, MD
ASCO EXPERT Joshua Jones, MD, Assistant Professor of Radiation Oncology at the Hospital of the University of Pennsylvania, Philadelphia, commented on the study at a press briefing. “This is a case where less is more. This is an important study and the first to show equal outcomes and meaningful...
Radiation Therapy for Spinal Cord Compression: One Treatment Is Sufficient
SPINAL CORD COMPRESSION associated with metastatic cancer can be effectively treated with a single dose of radiotherapy, according to the results of a phase III British study that showed multiple radiotherapy doses to be no better than one treatment.1 Up to 10% of all patients with cancer will...
Pivotal CAR T-Cell Data Reported in Relapsed/Refractory B-Cell ALL
UPDATED RESULTS from the ELIANA clinical trial of CTL019 (tisagenlecleucel)—an investigational chimeric antigen receptor (CAR) T-cell therapy—found that remission rates are maintained at 6 months in relapsed/refractory pediatric and young adult patients with B-cell acute lymphoblastic leukemia....
Expert Point of View: Lynn Schuchter, MD
DISCUSSANT LYNN SCHUCHTER, MD, the C. Willard Professor of Medicine at the Abramson Cancer Center at the University of Pennsylvania, Philadelphia, said the findings herald “a new era on two fronts…. Systemic therapy as initial treatment for patients with asymptomatic central nervous system (CNS)...
Drug Combinations Prove Effective Against Melanoma Brain Metastases
STUDIES PRESENTED at the 2017 ASCO Annual Meeting have shown that for melanoma that metastasizes to the brain, the combined use of checkpoint inhibitors and targeted agents can be effective. In COMBI-MB, 58% of patients responded intracranially to the BRAF inhibitor dabrafenib (Tafinlar) plus the...
Maintaining Predictable Increases in NIH Funding for Cancer Research
CONGRESS RECENTLY passed its fiscal year (FY) 2017 spending bill, which contains an additional $2 billion for the National Institutes of Health (NIH). This marks the first time in more than a dozen years that Congress funded back-to-back increases for the NIH, demonstrating the bipartisan...
ASCO Offers Path to Addressing Affordability of Cancer Drugs in New Position Statement
Today, ASCO issued a position statement aimed at contributing to the national dialogue on rising cancer drug prices. The statement, which asserts that any solutions must also preserve patients' access to care and foster innovation, analyzes a wide array of options and recommends that a panel of...
FDA Approves Three-Drug Combination Tablet for Hepatitis C
On July 18, the U.S. Food and Drug Administration (FDA) approved a combination tablet (Vosevi) to treat adults with chronic hepatitis C virus genotypes 1–6 without cirrhosis or with mild cirrhosis. This fixed-dose, combination tablet contains two previously approved drugs—sofosbuvir and ...
Understanding of Stage and Cancer Status Among Patients in a Community-Based Cancer Institute
As reported by Sivendran et al in the Journal of Oncology Practice, half of patients in a large community-based cancer institute did not know their stage of cancer, and one-third did not know of their cancer-free/in-remission status. Study Details The study involved 208 adult patients treated at...
Nivolumab Plus Ipilimumab in Metastatic Renal Cell Carcinoma
The phase I CheckMate 016 trial has shown activity of the combination of nivolumab (Opdivo) plus ipilimumab (Yervoy) in metastatic renal cell carcinoma. These findings were reported in the Journal of Clinical Oncology by Hammers et al. Study Details In the dose-escalation study, patients were...
Stereotactic Radiosurgery vs Whole-Brain Radiotherapy for Resected Metastatic Brain Disease
In the phase III NCCTG N107C/CEC.3 trial, stereotactic radiosurgery to the surgical cavity reduced cognitive deterioration and was associated with similar overall survival vs whole-brain radiotherapy in patients with resected brain metastasis. These results were reported by Brown et al in The...
Edus H. Warren, MD, PhD, Named Leader of Fred Hutch Global Oncology Program
Immunotherapy researcher and oncologist Edus H. Warren, MD, PhD, has been selected to lead the Fred Hutchinson Cancer Research Center (Fred Hutch) program in Global Oncology in its effort to transform cancer care in sub-Saharan Africa, China, and other regions by providing greater access to the...
Spark Discussions About Indoor-Tanning Devices
“Strong evidence suggests that using a tanning bed during adolescence or young adulthood can increase the risk of early-onset melanoma by over 40%,” Jeffrey E. Gershenwald, MD, wrote in an opinion piece for Newsweek.1 Dr. Gershenwald is Professor of Surgical Oncology, Medical Director of the...
Educating Young People on Sun-Safe Behaviors and Reducing the Risk of Melanoma
“If minors don’t tan, then they may never become adult tanners,” Jeffrey E. Gershenwald, MD, said in explaining the emphasis on teaching sun safety behaviors to young children as part of the Melanoma Moon Shot Program at The University of Texas MD Anderson Cancer Center, Houston. Dr. Gershenwald is ...
Prophylactic Cranial Irradiation vs Observation in Extensive-Disease Small Cell Lung Cancer
A Japanese phase III trial has shown no survival benefit of prophylactic cranial irradiation vs observation in patients with extensive-disease small cell lung cancer who had any response to platinum-based doublet chemotherapy and no brain metastases at baseline. These findings were reported in The...
Avelumab in Refractory Metastatic Urothelial Carcinoma
The programmed cell death ligand 1 (PD-L1)–inhibitor avelumab (Bavencio) has shown activity in patients with refractory metastatic urothelial cancer, according to findings in a phase Ib study reported by Andrea B. Apolo, MD, of the Genitourinary Malignancies Branch, Center for Cancer Research,...
Music Therapy: Relevance in Oncology
The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies commonly used by patients with cancer. In this installment, authors Karen Popkin, LCAT, MT-BC, and Jyothirmai Gubili, MS, present the case ...
Shiitake Mushroom: Insufficient Evidence to Support It Boosts Immune System
In the June 25 issue of The ASCO Post, the Integrative Oncology column by Ting Bao, MD, DABMA, MS, and Jyothirmai Gubili, MS, focused on how to counsel a patient about shiitake mushroom. They concluded: “We advised our patient that it is safe to take shiitake mushroom to boost her immune system.”...
A Frank Memoir About Doctors, Patients, and the Health-Care System
“In 1981, 2 days after my older brother Matthew was born, my father sawed off the tip of his index finger.” So begins No Apparent Distress: A Doctor’s Coming of Age on the Front Lines of American Medicine, a memoir by Rachel Pearson, MD, who is currently a resident at Seattle Children’s Hospital. ...
Stereotactic Body Radiotherapy for Poor Performance Status Patients With Pancreatic Cancer
There are few data to guide the management of nonmetastatic pancreatic ductal adenocarcinoma in patients who are elderly or have a poor performance status. Although most such patients are offered supportive care or gemcitabine alone, the addition of stereotactic body radiotherapy may improve...
Living With Cancer Survivorship Guilt
Although I was officially diagnosed with multiple myeloma in 1997, the first sign of the cancer was evident 2 years earlier, when a single lesion (a plasmacytoma) was found in a bone in my lower back. The bone was replaced with two thin stainless steel rods, and after a course of radiation therapy, ...
Huntsman Unveils New Primary Children’s and Families’ Cancer Research Center
On June 21, 2017, the Huntsman Cancer Institute (HCI) at the University of Utah announced the official opening of its Primary Children’s and Families’ Cancer Research Center, a world-class facility dedicated to advancing research in cancer. Jon M. Huntsman also announced a commitment from the...
A Social Media Guide by a Doctor for Doctors
Today’s brave new world of digital technology has both enhanced and compromised the day-to-day operational efficiency of ultrabusy oncologists who are struggling to balance patient care with the rapid evolution of technology. Like all scientific advances, health-care technology is a double-edged...
Ensuring Advance Directives Are Followed and Lawsuits Are Avoided
Thaddeus Mason Pope, JD, PhD, has focused his legal career on improving medical care decision-making and protecting patients’ rights at the end of life. His specific areas of legal expertise include patients’ rights, informed consent, and end-of-life medicine. Dr. Pope is the coauthor of The Right ...
Advance Care Planning: Ensuring Patients’ End-of-Life Wishes Are Honored
When Amy Berman, BSN, LHD (aged 58), stood in front of the mirror to perform a routine breast self-exam and saw redness and dimpling on her right breast, she feared they were the telltale signs of inflammatory breast cancer. “I have never self-diagnosed myself before, but I had recently read an...
Adding Pravastatin to Chemotherapy in Small Cell Lung Cancer
Following early reports associating favorable outcomes in cancer patients with the use of statins,1,2 further observational studies in this area have provided mixed findings.3 As recently reported in the Journal of Clinical Oncology, and reviewed in this issue of The ASCO Post, Seckl and colleagues ...
No Survival Benefit When Pravastatin Is Added to Standard Chemotherapy in Small Cell Lung Cancer
In a UK phase III study (LUNGSTAR) reported in the Journal of Clinical -Oncology, Michael J. Seckl, MD, PhD, of Imperial College London, and colleagues found that adding pravastatin to first-line standard chemotherapy did not improve overall survival in patients with small cell lung cancer...
CDK4/6 Inhibitors Have a Manageable Toxicity Profile, Are Generally Well Tolerated in Patients With Breast Cancer
A class of oral drugs for treating breast cancer known as cyclin-dependent kinase (CDK) 4/6 inhibitors are generally well-tolerated, with a manageable toxicity profile for most patients. This is the conclusion of a comprehensive review of toxicities and drug interactions related to this class of...
