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issues in oncology
cost of care

COA Releases 2016 Community Oncology Practice Impact Report

On October 4, the Community Oncology Alliance (COA) released the 2016 Community Oncology Practice Impact Report, which tracks the changing landscape of cancer care in the United States. It documents a 121% increase in community cancer clinic closings and a 172% increase in consolidation into...

prostate cancer

Safety of Extreme Hypofractionation Reassuring in Intermediate-Risk Prostate Cancer

Giving patients larger fractions of radiation over shorter periods (ie, hypofractionation) is gaining ground in several types of cancers. This approach is attractive for patients’ convenience, shortening treatment and travel times, and also for resource utilization. Several studies have shown that ...

lung cancer
skin cancer
kidney cancer

Modification of Dosage Regimen for Nivolumab in Renal Cell Carcinoma, Melanoma, and NSCLC

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 September 13, 2016, the U.S. Food and Drug Administration...

Expert Point of View: Brian Kavanagh, MD

“Lung cancer patients are living longer with stereotactic body radiation therapy. Patients should have access to this care. It would be tragic if we couldn’t give this treatment to patients who need it,” said Brian Kavanagh, MD, President of the American Society for Radiation Oncology (ASTRO) and...

skin cancer

Investigational Immunotherapy Appears Safe and Somewhat Active in Advanced Melanoma

The investigational immunotherapeutic IMC-20D7S was found to be well tolerated and somewhat active in patients with advanced melanoma, including one complete response, according to the results of a phase I/Ib trial reported by Khalil et al in Clinical Cancer Research.  IMD-20D7S is a...

lung cancer

Retrospective Studies Confirm Survival Benefit of Stereotactic Body Radiotherapy in Early-Stage NSCLC

Stereotactic body radiation therapy is becoming more widely adopted for the treatment of early-stage non–small cell lung cancer (NSCLC). Along with its increasing uptake, survival has significantly increased over the past decade, according to two large retrospective studies presented at the 58th...

lung cancer

Atezolizumab Approved for the Treatment of Metastatic NSCLC That Has Progressed During or After Platinum-Containing Therapy

On October 18, 2016, the U.S. Food and Drug Administration (FDA) approved atezolizumab (Tecentriq) for the treatment of patients with metastatic non–small cell lung cancer (NSCLC) whose disease progressed during or following platinum-containing chemotherapy. Patients with EGFR or ALK genomic...

breast cancer

New SSO-ASTRO-ASCO Clinical Practice Guideline Clarifies the Question of Margins for Breast-Conserving Surgery in Ductal Carcinoma in Situ

In 2014, the Society of Surgical Oncology (SSO) and the American Society for Radiation Oncology (ASTRO) published a “Consensus Guideline on Margins for Breast-Conserving Surgery With Whole-Breast Irradiation in Stages I and II Invasive Breast Cancer.”1 A multidisciplinary expert guideline used a...

lung cancer

FDA Modifies the Indication of Erlotinib in Non–Small Cell Lung Cancer to Patients With Specific EGFR Mutations

On October 18, 2016, the U.S. Food and Drug Administration (FDA) modified the indication for erlotinib (Tarceva) in the treatment of non–small cell lung cancer (NSCLC) to limit its use to patients whose tumors have specific epidermal growth factor receptor (EGFR) mutations. The labeling...

breast cancer

Margins for Breast-Conserving Surgery With Whole-Breast Irradiation in Ductal Carcinoma in Situ

A clinical practice guideline on margins for breast-conserving surgery with whole-breast irradiation in ductal carcinoma in situ has been jointly developed by the Society of Surgical Oncology (SSO), the American Society for Radiation Oncology (ASTRO), and ASCO.1-3 The recommendations were...

issues in oncology

‘Dear Presidential Candidates’: A Letter From an Oncologist

Dear Presidential Candidates: Wouldn’t it be great if history’s Alexander the Great was actually Dr. Alexander Fleming, the doctor-scientist who saved millions of lives by discovering penicillin, rather than the other Alexander, who conquered and killed thousands of innocent people? Wouldn’t it be...

Expert Point of View: Geraldine M. Jacobson, MD

Geraldine M. Jacobson, MD, of West Virginia University, Morgantown, commented on the study by Moran et al at a press conference held during the American Society of Radiation Oncology (ASTRO) meeting, where the data were presented. “To date evidence has been lacking for a radiation boost following...

breast cancer

Study Shows Strong Evidence Supporting Radiation Boost to Tumor Bed in Ductal Carcinoma in Situ

A radiation boost to the local tumor bed following treatment with breast-conserving therapy (ie, local excision followed by whole-breast radiation therapy) improves local control for patients with ductal carcinoma in situ, according to a study of pooled data from 10 academic centers,1 presented at...

cns cancers

Dutch Study Shows High Prevalence of Early Endocrine Disorders in Survivors of Childhood Brain Tumors

Clement et al found that 25% of survivors of childhood brain tumors were diagnosed with endocrine disorders over 6.6 years of follow-up, based on a Dutch nationwide study reported in the Journal of Clinical Oncology. The study involved data from 718 survivors diagnosed at age ≤ 18 years with a...

prostate cancer

Study Finds PFS Benefit, but No Overall Survival Benefit, for Ipilimumab in Metastatic Castration-Resistant Prostate Cancer

Ipilimumab (Yervoy) was associated with prolonged progression-free survival—but not overall survival—compared with placebo in men with asymptomatic or minimally symptomatic chemotherapy-naive metastatic castration-resistant prostate cancer without visceral metastases, according to a...

lung cancer

Adding Pembrolizumab to Carboplatin/Pemetrexed Seems to Improve Response in Advanced Nonsquamous NSCLC

As reported by Langer et al in The Lancet Oncology, findings in a phase II cohort of the multicohort KEYNOTE-021 study showed that the addition of first-line pembrolizumab (Keytruda) to carboplatin/pemetrexed (Alimta) significantly increased the response rate in patients with advanced nonsquamous...

multiple myeloma

Does Adding Daratumumab to Lenalidomide/Dexamethasone Improve Outcomes in Previously Treated Multiple Myeloma?

The addition of the CD38-targeted antibody daratumumab (Darzalex) to lenalidomide (Revlimid)/dexamethasone improved progression-free survival in patients with previously treated multiple myeloma, according to the results of the phase III POLLUX trial reported by Dimopoulos et al in The New England...

Expert Point of View: Stephen R.D. Johnston, MD

“These results apply to about two-thirds of women with advanced breast cancer, ie, those with hormone receptor–positive metastatic breast cancer,” noted the formal discussant of this paper, Stephen R.D. Johnston, MD, of the Royal Marsden Hospital, London. “At present with first-line endocrine...

lung cancer

Martin Reck, MD, PhD, on NSCLC: Results of KEYNOTE-024 (German Language Version)

Martin Reck, MD, PhD, of the LungenClinic, discusses in German study findings on pembrolizumab vs platinum-based chemotherapy as first-line therapy for advanced non-small cell lung cancer with a PD-L1 tumor proportion score ≥50%. (Abstract LBA8)

breast cancer

Combination of Ribociclib and Letrozole Improved Progression-Free Survival in Hormone Receptor–Positive Advanced Breast Cancer

The combination of the selective CDK4/6 inhibitor ribociclib plus letrozole significantly improved progression-free survival in hormone receptor–positive advanced breast cancer. When ribociclib was added to letrozole, progression-free survival improved by 44% compared with letrozole alone,...

lung cancer

ESMO 2016: First-Line Pembrolizumab Plus Chemotherapy Significantly Improves Outcomes in Advanced NSCLC

The addition of the programmed cell death protein 1 (PD-1) antibody pembrolizumab (Keytruda) to standard first-line chemotherapy for treatment-naive advanced non–small cell lung cancer significantly improves response rates and progression-free survival, Langer et al reported at the 2016...

head and neck cancer

ESMO 2016: Nivolumab Maintains Function and Reduces Symptoms in Relapsed Metastatic Head and Neck Cancer

Nivolumab (Opdivo) maintains function and reduces symptoms in treatment of relapsed metastatic head and neck cancer, according to results from the CheckMate 141 trial presented by Harrington et al at the 2016 European Society for Medical Oncology (ESMO) Congress in Copenhagen, Denmark (Abstract...

lung cancer

Intensity-Modulated vs 3D Conformal External-Beam Radiation Therapy in Locally Advanced Non–Small Cell Lung Cancer

In a secondary analysis from the NRG Oncology RTOG 0617 trial reported in the Journal of Clinical Oncology, Chun et al found that use of intensity-modulated vs three-dimensional (3D) conformal external-beam radiation therapy was associated with a reduced risk for severe pneumonitis and reduced the...

skin cancer

Adjuvant Ipilimumab Prolongs Survival in High-Risk Stage III Melanoma, Phase III Study Reports

In the phase III European Organisation for Research and Treatment of Cancer (EORTC) trial 18071 reported at the recent European Society for Medical Oncology meeting and in The New England Journal of Medicine by Eggermont et al, adjuvant ipilimumab (Yervoy) was found to improve recurrence-free and...

lymphoma

Study Finds Increased Risk for Non-Hodgkin Lymphoma in HIV-Infected Patients

In the HIV-negative population, there is growing evidence suggesting that chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) are both associated with the development of non-Hodgkin lymphoma (NHL), although the mechanisms underlying this association remain unclear. The incidence rate of NHL ...

health-care policy

Vice President Biden Delivers Cancer Moonshot Report, Announces Public and Private Sector Actions to Advance Cancer Moonshot Goals

Today in the Oval Office, Vice President Joe Biden delivered the Cancer Moonshot report to the President and the American public. The report summarizes the work of the Cancer Moonshot Task Force since its creation in January and lays out the Vice President’s strategic plan for transforming...

lymphoma

Impact of Severe Fatigue on Treatment Outcome and Social Reintegration in Hodgkin Lymphoma

Severe cancer-related fatigue was associated with poorer clinical outcomes in patients receiving standard therapies for Hodgkin lymphoma and poorer social reintegration, according to an analysis of data from German Hodgkin Study Group trials reported in the Journal of Clinical Oncology by Behringer ...

breast cancer

Genetic Markers Associated With Pathologic Complete Response to Neoadjuvant Therapy Identified in HER2-Positive Breast Cancer

In an analysis reported in JAMA Oncology, Fumagalli et al identified genetic markers associated with pathologic complete response among women with early-stage HER2-positive breast cancer receiving neoadjuvant therapy in the phase III NeoALTTO trial. Study Details In the NeoALTTO trial, 455...

lung cancer

First-Line Pembrolizumab Improves Survival vs Platinum-Based Chemotherapy in Advanced PD-L1–Positive NSCLC

Pembrolizumab (Keytruda) significantly improved progression-free and overall survival vs platinum-based chemotherapy in patients with previously untreated advanced non–small cell lung cancer (NSCLC) with ≥ 50% PD-L1 (programmed cell death ligand 1) expression and no sensitizing EGFR...

health-care policy

HHS Finalizes MACRA Rule, ASCO Applauds Focus on High-Quality Patient-Centered Care

Today, the Department of Health & Human Services (HHS) finalized a landmark new payment system for Medicare clinicians that will continue the Administration’s progress in reforming how the health-care system pays for care. The Medicare Access and CHIP Reauthorization Act of ...

palliative care

ESMO 2016: Researchers Identify Factors Associated With End-of-Life Chemotherapy Use

The rates of administering chemotherapy to patients with solid cancers within a month of succumbing to their disease remain high, which calls for a paradigm shift to consider initiating palliative care at an earlier stage and formulating clear guidelines for end-of-life care, according to findings...

breast cancer

ESMO 2016: Antitumor Activity Demonstrated With Lurbinectedin in Patients With Metastatic Breast Cancer and BRCA Mutations

Lurbinectedin showed promising clinical benefit in pretreated patients with metastatic breast cancer and BRCA1 or BRCA2 mutations, including patients previously treated with platinum, according to phase II trial results presented by Balmaña et al at the 2016 European Society for Medical...

colorectal cancer

Massachusetts Health Insurance Expansion Associated With Increased Resection and Reduced Emergent Resection for Colorectal Cancer

In a study reported in the Journal of Clinical Oncology, Loehrer et al found that the 2006 Massachusetts health-care reform has resulted in increased rates of resection and reduced emergent resection for colorectal cancer. The study used the Hospital Cost and Utilization Project State Inpatient...

gynecologic cancers

Study Finds Niraparib Maintenance Improves Progression-Free Survival in Platinum-Sensitive Recurrent Ovarian Cancer

In a phase III trial reported at the recent European Society for Medical Oncology Congress and in The New England Journal of Medicine by Mirza et al, maintenance therapy with the PARP (poly ADP ribose polymerase) 1/2 inhibitor niraparib significantly prolonged progression-free survival vs placebo...

breast cancer

ESMO 2016: Fulvestrant Improves Progression-Free Survival in Advanced Breast Cancer

Fulvestrant (Faslodex) significantly increases progression-free survival in women with hormone receptor–positive advanced breast cancer, particularly those with less aggressive lower-volume disease, Ellis et al reported at the 2016 European Society for Medical Oncology (ESMO) Congress in ...

colorectal cancer

ESMO 2016: Nintedanib Improves Progression-Free Survival but Not Overall Survival in Metastatic Colorectal Cancer

Nintedanib (Ofev) improves progression-free survival but not overall survival in patients with metastatic colorectal cancer who are not responding to standard therapies, according to the results of the phase III LUME-colon 1 trial presented by Van Cutsem et al at the 2016 European Society of...

bladder cancer

ESMO 2016: Immunotherapy Shows Promising Results in First- and Second-Line Treatment of Metastatic Bladder Cancer in Two Trials

Immunotherapy has shown promising results in the first- and second-line treatment of metastatic bladder cancer in two phase II trials presented by Galsky et al and Balar et al at the 2016 European Society for Medical Oncology (ESMO) Congress in Copenhagen (Abstracts LBA31_PR and LBA32_PR,...

kidney cancer

ESMO 2016: Cabozantinib Improves Progression-Free Survival in Metastatic Renal Cell Carcinoma

Cabozantinib (Cabometyx, Cometriq) significantly improves progression-free survival and response rate in patients with metastatic renal cell carcinoma compared to sunitinib (Sutent), according to research presented by Choueiri et al at the 2016 European Society for Medical Oncology (ESMO)...

prostate cancer

Long-Term Effects of Finasteride in Patients From the Prostate Cancer Prevention Trial

In a study reported in the Journal of the National Cancer Institute, Unger et al found that use of finasteride vs placebo in the Prostate Cancer Prevention Trial was associated with a modestly increased risk of depression and a modestly reduced risk of procedures for benign prostatic...

head and neck cancer

Characteristics of HPV-Driven Nonoropharyngeal Squamous Cell Carcinomas of the Head and Neck

In a study reported in the Journal of Clinical Oncology, Chakravarthy et al found that human papillomavirus (HPV)-driven tumors accounted for 4.1% of nonoropharyngeal squamous cell carcinomas of the head and neck. HPV-positive tumors were associated with poorer survival and reduced...

breast cancer

First-Line Ribociclib Prolongs Progression-Free Survival in Hormone Receptor–Positive, HER2-Negative Advanced Breast Cancer

In a phase III trial reported at the recent European Society for Medical Oncology Congress and in The New England Journal of Medicine by Hortobagyi et al, first-line treatment with ribociclib, a selective inhibitor of cyclin-dependent kinases 4 and 6 (CDK4/6), resulted in significantly longer...

lung cancer

ESMO 2016: Ceritinib Provides Longer Progression-Free Survival Than Chemotherapy in Phase III Trial of ALK-Rearranged Lung Cancer Treatment

Ceritinib (Zykadia) provides longer progression-free survival than chemotherapy in crizotinib–pretreated patients with non–small cell lung cancer harboring an ALK rearrangement, according to results of the phase III ASCEND-5 study presented by Scagliotti et al at the European Society...

kidney cancer

Does Adding IMA901 Vaccine to Sunitinib Improve Survival in Advanced Renal Cell Carcinoma?

In the phase III IMPRINT trial reported in The Lancet Oncology, Rini et al found no overall survival benefit of adding the multipeptide cancer vaccine IMA901 to sunitinib (Sutent) in the first-line treatment of locally advanced or metastatic renal cell carcinoma. IMA901 contains 10 tumor-associated ...

lung cancer

ESMO 2016: Significant Survival Gains With Atezolizumab vs Docetaxel for Non–Small Cell Lung Cancer

The first phase III study of programmed cell death ligand 1 (PD-L1) inhibitor atezolizumab (Tecentriq) in previously treated non–small cell lung cancer has seen significant improvements in survival compared to standard chemotherapy, reported Barlesi et al at the European Society for Medical...

kidney cancer

ESMO 2016: Longer Disease-Free Survival in Phase III Trial of Sunitinib as Adjuvant Treatment for Kidney Cancer

A phase III trial of sunitinib (Sutent) has met its primary endpoint of disease-free survival for adjuvant treatment of high-risk renal cell carcinoma after nephrectomy, reported Ravaud et al at the European Society for Medical Oncology (ESMO) 2016 Congress in Copenhagen (Abstract LBA11_PR)....

sarcoma

ESMO 2016: Significant Survival Gains From Neoadjuvant Chemotherapy for High-Risk Soft-Tissue Sarcoma

Neoadjuvant chemotherapy with an anthracycline plus ifosfamide was associated with significant survival gains in patients with soft-tissue sarcoma of the trunk or extremities who are at high-risk of recurrence, in an interim analysis that led to the early discontinuation of a trial presented by...

solid tumors
palliative care

Philippe Rochigneux, MD, on Solid Tumors: Use of Chemotherapy Near End of Life (French Language Version)

Philippe Rochigneux, MD, of the Paoli Calmettes Institute, Marseille Cancer Center, discusses in French his findings on the high rates of chemotherapy used at the end of life for metastatic solid cancer, especially in young patients treated in high-volume centers without a palliative care unit....

kidney cancer

Alain Ravaud, MD, PhD, on RCC: Results of the S-TRAC Trial (French Language Version)

Alain Ravaud, MD, PhD, of Bordeaux University Hospital, discusses in French phase III findings on sunitinib vs placebo as adjuvant treatment for high-risk renal cell carcinoma after nephrectomy. (Abstract LBA11)

breast cancer

Women With Breast Cancer Report Primary Care Physician Involvement in Care and Participation in Decision-Making

Most women with breast cancer reported high primary care physician quality, engagement, and communication, with a minority reporting high levels of primary care physician participation in treatment decisions, according to a study reported by Wallner et al in the Journal of Clinical Oncology....

leukemia

Study Indicates Safety of Stopping Imatinib in CML With Undetectable Minimal Residual Disease for at Least 2 Years

As reported in the Journal of Clinical Oncology by Etienne et al, long-term follow-up in the French Stop Imatinib (STIM1) study indicates imatinib can be safely stopped in patients with chronic myeloid leukemia (CML) with undetectable minimal residual disease sustained for at least 2 years. Study...

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