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WHAT SHOULD PUMA DO?

Puma should invest in developing an escalating-dose schedule for neratinib (Nerlynx). If one plans on giving a drug for a year, and starts after finishing a year of effective adjuvant therapy, there is no hurry to begin at full, intolerable doses. Starting at a lower dose and escalating slowly as...

solid tumors
breast cancer

Neratinib Is Approved: Should We Reject It Anyway?

The U.S. Food and Drug Administration (FDA) approved 1 year of extended adjuvant neratinib (Nerlynx) after chemotherapy and a year of trastuzumab (Herceptin) for HER2-positive breast cancer this summer on the basis of the ExteNET trial. Many were surprised at the approval, since the evidence of...

Fulvestrant Monotherapy for Postmenopausal Women With Advanced Breast Cancer

On August 28, 2017, fulvestrant (Faslodex) was approved at 500 mg as monotherapy for expanded use in postmenopausal women with hormone receptor–positive, HER2-negative advanced breast cancer who have not received previous endocrine therapy.1 Supporting Efficacy Data Approval was based on improved...

colorectal cancer

Outcomes Associated With Higher Fiber Intake After Colorectal Cancer Diagnosis

IN A STUDY reported in JAMA Oncology, Mingyang Song, MD, ScD, of Massachusetts General Hospital and Harvard Medical School, and colleagues found that higher fiber intake after diagnosis of nonmetastatic colorectal cancer is associated with improved colorectal cancer–specific and overall survival.1 ...

solid tumors
lung cancer

Lung Cancer in Never Smokers: A Complex Clinical Phenomenon

Despite advances in prevention, early detection, and treatments, lung cancer remains the leading cause of cancer-related death in the United States. Although cigarette smoking is the main cause of lung cancer, about 10% of these patients are lifelong never smokers for whom the molecular...

Balancing Opioid Use to Relieve Cancer-Related Pain and Protecting Patients From Addiction and Death

According to the Centers for Disease Control and Prevention (CDC), from 1999 to 2015, more than 183,000 people have died in the United States from overdoses related to prescription opioids, including methadone, oxycodone, and hydrocodone.1 To stem the epidemic in prescription opioid–related use and ...

lymphoma

Front-Line Brentuximab Plus AVD vs Standard ABVD in Advanced Hodgkin Lymphoma

FRONT-LINE TREATMENT of advanced Hodgkin lymphoma with brentuximab vedotin (Adcetris) plus doxorubicin/ vinblastine/dacarbazine (A+AVD) achieved superior outcomes compared with the standard four-drug regimen of doxorubicin/bleomycin/vinblastine/dacarbazine (ABVD). The substitution of brentuximab...

multiple myeloma

Daratumumab Improves Progression-Free Survival in Front-Line Myeloma Setting

FOR NEWLY DIAGNOSED multiple myeloma patients not eligible for transplant, the addition of the anti-CD38 monoclonal antibody daratumumab (Darzalex) to subcutaneous bortezomib (Velcade), melphalan, and prednisone (VMP) reduced the risk of disease progression or death by 50%, the phase III ALCYONE...

leukemia

Bosutinib Improves Response Rate vs Imatinib as First-Line Treatment of Chronic Myeloid Leukemia

IN THE PHASE III BFORE trial reported in the Journal of Clinical Oncology by Jorge E. Cortes, MD, of The University of Texas MD Anderson Cancer Center, and colleagues, the SRC/ABL kinase inhibitor bosutinib (Bosulif) improved response rates vs imatinib in the first-line treatment of patients with...

Alexander Fleming Would Have Loved Our Success With Cancer Immunotherapy

THE UNIVERSITY of Edinburgh Medical School was established in 1726 during the Scottish Enlightenment. As one of the oldest medical schools in the English-speaking world, it is interesting to reflect on the seminal contributions made centuries ago by several alumni that are still relevant to the...

colorectal cancer

Combination Agent in Asian Patients With Previously Treated Metastatic Colorectal Cancer

In the Asian phase III TERRA trial, trifluridine/tipiracil (Lonsurf) produced a significant improvement in overall survival vs placebo among patients with metastatic colorectal cancer refractory or intolerant of standard chemotherapies with or without exposure to biologic therapies. These findings...

lymphoma

ASH 2017: Acalabrutinib Demonstrates Activity in Relapsed or Refractory Mantle Cell Lymphoma

At the 59th American Society of Hematology (ASH) Annual Meeting & Exposition, Wang et al presented results from the open-label, single-arm phase II ACE-LY-004 clinical trial, which served as the basis for the recent U.S. Food and Drug Administration (FDA) accelerated approval of acalabrutinib...

lymphoma

ASH 2017: ALCANZA Trial: Brentuximab Vedotin in CD30-Expressing Cutaneous T-Cell Lymphoma

Updated results from the phase III ALCANZA clinical trial evaluating brentuximab vedotin (Adcetris) in CD30-expressing cutaneous T-cell lymphoma (CTCL) were presented by Horwitz et al at the 59th American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 1509). The presentation...

hematologic malignancies

ASH 2017: HERCULES Trial: Caplacizumab Shows Dramatic Improvements for Acquired Thrombotic Thrombocytopenic Purpura

In a phase III trial, patients with acquired thrombotic thrombocytopenic purpura (TTP), a rare blood clotting disorder, who received the investigational drug caplacizumab showed significant improvements in the time it took to normalization of their platelet count compared to those receiving a...

head and neck cancer

Number of Metastatic Lymph Nodes and Survival in Hypopharyngeal/Laryngeal Cancer

A study using National Cancer Database data has shown that the number of metastatic nodes is a primary independent factor associated with an increased mortality risk in patients with hypopharyngeal and laryngeal cancers. The study was reported in JAMA Oncology by Ho et al. Study Details The study ...

breast cancer

Hormonal Contraception and Breast Cancer Risk

As reported in The New England Journal of Medicine by Mørch et al, a Danish study has shown that the risk of breast cancer is increased in hormonal contraception users vs nonusers, with the absolute increase in risk being small. Study Details The study assessed the association between the...

Radiation Oncologist Gives Clear Advice to Patients With Cancer

BOOKMARK Title: Cancer: What You Need to Know: Overcome the 10 Common Mistakes Patients MakeAuthor: Stephen A. Rosenberg, MDPublisher: Stephen Rosenberg, MDYear Published: November 2017Price: $9.99, paperback, 248 pages Stephen A. Rosenberg, MD, is Chief Resident in Radiation Oncology at the...

breast cancer

SABCS 2017: SOLD Trial Data Support Current Standard 12-Month Adjuvant Trastuzumab for HER2-Positive Breast Cancer

Disease-free survival after 9 weeks of adjuvant trastuzumab (Herceptin) and standard chemotherapy was not comparable to disease-free survival after 12 months of adjuvant trastuzumab and standard chemotherapy for women with early-stage HER2-positive breast cancer, supporting the current...

supportive care
palliative care

‘Triple Threat’ Conditions May Predict Mortality in Patients With Cancer Presenting to Emergency Departments

Dyspnea, delirium, and poor performance—so-called “triple threat” conditions—are known to predict short survival in palliative care. According to data presented at the 2017 Palliative and Supportive Care in Oncology Symposium,1 however, the presence of at least two of these symptoms in patients...

breast cancer
pain management

SABCS 2017: Acupuncture May Reduce Joint Pain Caused by Aromatase Inhibitor Treatment

Acupuncture significantly reduced joint pain for postmenopausal women with early-stage breast cancer receiving treatment with an aromatase inhibitor compared with both sham acupuncture and no treatment, according to data from the randomized, phase III SWOG S1200 trial presented by Hershman et al at ...

colorectal cancer

Association of Fiber Intake After Colorectal Cancer Diagnosis and Survival

In a study reported in JAMA Oncology, Song et al found that higher fiber intake after diagnosis of nonmetastatic colorectal cancer is associated with improved colorectal cancer–specific and overall survival. The benefit was also observed with a higher intake of whole grains. Study Details...

prostate cancer

Adverse Pathologic Findings in Low-Volume Intermediate-Risk Prostate Cancer

In a single-center analysis reported in JAMA Oncology, Hiten D. Patel, MD, MPH, of The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, and colleagues found that among men undergoing elective radical prostatectomy, those with low-volume intermediate-risk...

pain management

Relieving Pain During an Opioid Epidemic

“WE’VE GOT A CHALLENGING TIME right now, trying to relieve pain during the time of an opioid epidemic,” Judith A. Paice, RN, PhD, acknowledged at the 2017 Lynn Sage Breast Cancer Symposium in Chicago.1 She cited a recent study reporting that up to 40% of cancer survivors are living with pain, and...

hematologic malignancies

Recent Study Findings in Hematologic Malignancies

HERE IS A BRIEF LOOK at the study findings and clinical implications of several recent and important clinical trials in neoplastic hematology. Attention is focused on clonal myeloid disorders, acute lymphoblastic leukemia, lymphoma, and plasma cell dyscrasias.  Clonal Myeloid Disorders  STUDY:...

NIH Partners With 11 Biopharmaceutical Companies on PACT Collaboration

On October 12, 2017, the National Institutes of Health (NIH) and 11 leading biopharmaceutical companies launched the Partnership for Accelerating Cancer Therapies (PACT), a 5-year public-private research collaboration totaling $215 million as part of the Cancer Moonshot. PACT will initially focus...

issues in oncology
cost of care

Tackling the High Cost of Cancer Care

AT THE 2017 ASCO ANNUAL MEETING, the leaders of the newly formed Value in Cancer Care Consortium (vi3c; vi3c.org) met to discuss the group’s plan to study how to improve the affordability of cancer drugs and make them more accessible to patients. The goal of the Value in Cancer Care Consortium is...

supportive care
palliative care
cost of care
issues in oncology

Palliative Care Intervention Reduces Total Health-Care Costs in Patients With Advanced Cancer

A matched case-controlled study among Medicare beneficiaries with metastatic lung, colorectal, breast, and prostate cancers has found that palliative care consultation significantly reduced total health-care costs following intervention. According to data presented at the 2017 Palliative and...

integrative oncology

University of Michigan Medical School Launches Integrative Oncology Scholars Program

THE UNIVERSITY OF MICHIGAN Medical School in Ann Arbor recently received a $1,167,943 5-year grant from the National Cancer Institute to launch the Integrative Oncology Scholars Program. The goal of the program is to teach oncology health-care providers how to evaluate the scientific evidence of...

integrative oncology
symptom management

Cognitive Behavior Therapy for Insomnia: Sleeping Well With Cancer and Beyond

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, Sheila N. Garland, PhD, R Psych, and Jun J. Mao, MD, MSCE, present...

IDEA Trial: ‘Going Beyond Statistics’ in Stage III Colon Cancer

According to Alberto Sobrero, MD, Head of Medical Oncology at Ospedale San Martino in Genova, Italy, the results of the pivotal IDEA trial, which evaluated the optimal duration of adjuvant chemotherapy for stage III colon cancer, were not clear to clinicians.1 The combined analysis of six...

solid tumors
breast cancer

Neratinib for Extended Adjuvant Treatment of Early-Stage HER2-Positive Breast Cancer

On July 17, 2017, neratinib (Nerlynx) a dual inhibitor of HER2 and epidermal growth factor receptor (EGFR), was approved for extended adjuvant treatment of adults with early-stage HER2-overexpressed/amplified breast cancer following adjuvant trastuzumab (Herceptin)-based therapy.1,2 Supporting...

solid tumors
breast cancer

Gauging the Impact of Weight Loss Intervention on Breast Cancer Outcomes

“Growing research suggests that body weight is not only related to the risk of developing malignancy, but also prognosis after diagnosis, especially in breast cancer,” said Jennifer A. Ligibel, MD, of Dana-Farber Cancer Institute and Harvard Medical School, at the 19th Annual Lynn Sage Breast...

hematologic malignancies
leukemia

Clinical Relevance of Minimal Residual Disease Monitoring Limited in Acute Myeloid Leukemia

Although a majority of major cancer centers may test for minimal residual disease (MRD), a recent survey conducted by researchers at Moffitt Cancer Center, Tampa, Florida, suggests most oncologists remain uncertain about what to do with the results. At the National Comprehensive Cancer Network®...

gynecologic cancers

PARP Inhibitors in BRCA-Related Ovarian Cancer—and Beyond!

Poly (ADP ribose) polymerase (PARP) inhibitors are among the most exciting new classes of oncology drugs, and their development has coincided with the increasing recognition of the therapeutic vulnerability in targeting DNA damage response and DNA repair. The initial clinical testing of PARP...

leukemia

Comparison of First-Line Treatments in Chronic Myeloid Leukemia

In the phase III BFORE trial reported in the Journal of Clinical Oncology by Cortes et al, the SRC/ABL kinase inhibitor bosutinib (Bosulif) improved response rates vs imatinib in first-line treatment of patients with Philadelphia chromosome (Ph)-positive chronic phase chronic myeloid leukemia (CML) ...

lymphoma

Long-Term Results of First-Line Regimens in Advanced Symptomatic Follicular Lymphoma

Long-term results of the Italian phase III FOLL05 trial, reported by Luminari et al in the Journal of Clinical Oncology, indicate superior progression-free survival with R-CHOP (rituximab [Rituxan] plus cyclophosphamide, doxorubicin, vincristine, and prednisone) and R-FM (rituximab plus fludarabine ...

gynecologic cancers

Study Finds HPV Screening May Be More Sensitive Than Pap Test for Detecting Cervical Cancer

The main goal of cervical screening programs is to detect and treat precancer before the cancer develops. Human papillomavirus (HPV) testing is more sensitive than cytology for detecting precancer. However, reports of rare HPV-negative, cytology-positive cancers are motivating the continued use of...

colorectal cancer

Association of Tumor HER3 Expression With Treatment Outcome in Advanced Colorectal Cancer

In a study reported in JAMA Oncology, Seligmann et al found that higher tumor HER3 messenger RNA expression among patients with RAS wild-type tumors was associated with a better outcome with panitumumab (Vectibix) plus irinotecan vs irinotecan alone among patients with advanced colorectal cancer in ...

hepatobiliary cancer

Internal Radiotherapy vs Kinase Inhibitor in Advanced Hepatocellular Carcinoma

A French phase III trial has shown no significant survival difference between selective internal radiotherapy with yttrium-90 resin microspheres vs sorafenib (Nexavar) in patients with advanced hepatocellular carcinoma. The findings were reported by Vilgrain et al in The Lancet Oncology. Study...

issues in oncology

Hospital Emergency Department Practices for Treating Older Adults With Cancer

A new study published by Lipitz-Snyderman et al in JNCCN–Journal of the National Comprehensive Cancer Network found that among patients presenting to the emergency department, those with cancer, especially those aged 75 years or older, are more likely to be admitted to the hospital—and...

issues in oncology

Worldwide Cancer Incidence and Mortality Among Persons Aged 20 to 39 in 2012

In a study reported in The Lancet Oncology, Fidler et al found that cancer burden was higher worldwide among women vs men aged 20 to 39 in 2012 and that the incidence was higher but mortality lower in very high vs low Human Development Index regions. Study Details The study involved data from the ...

survivorship
lymphoma

Life After Treatment: Managing Lymphoma Survivors

According to Surveillance, Epidemiology, and End Results (SEER) data, patients with Hodgkin lymphoma and non-Hodgkin lymphoma (NHL) have 5-year survival rates of 86% and 71%, respectively.1 Although the increased number of survivors is welcome proof of the success of new treatment regimens, it also ...

lung cancer

PanCan Risk Model for Lung Cancer Screening

Results of the Pan-Canadian Early Detection of Lung Cancer (PanCan) study, reported in The Lancet Oncology by Tammemagi et al, indicate that the PanCan risk model is effective in identifying persons found to have early-stage lung cancer on low-dose computed tomography (CT) screening. Study Details ...

hepatobiliary cancer

The Liver Meeting: Direct-Acting Antiviral Medications as Hepatitis C Treatment May Reduce Risk of Liver Cancer

A new study presented at The Liver Meeting—held by the American Association for the Study of Liver Diseases—found that eradication of the hepatitis C virus induced by direct-acting antiviral medications is associated with a 71% reduction in the risk of liver cancer (Abstract 142)....

survivorship

Long-Term Survivors of Childhood Cancer Prone to ‘Job Lock’ due to Worries About Losing Health Insurance

The results of a national cancer survey reveal a significant number of childhood cancer survivors are worried about keeping their health insurance, to the point of letting it affect their career decisions. The findings were published by Kirchhoff et al in JAMA Oncology. Anne Kirchhoff, PhD,...

gynecologic cancers

CD8-Positive Tumor-Infiltrating Lymphocytes and Survival in High-Grade Serous Ovarian Cancer

As reported in JAMA Oncology by Goode et al in the Ovarian Tumor Tissue Analysis Consortium, higher levels of cytotoxic CD8-positive tumor-infiltrating lymphocytes were associated with significantly improved overall survival among women with high-grade serous ovarian carcinomas. Study Details The ...

lymphoma

FDA Approves Axicabtagene Ciloleucel for Large B-Cell Lymphoma

On October 18, 2017, the U.S. Food and Drug Administration (FDA) granted regular approval to axicabtagene ciloleucel (Yescarta) for the treatment of adult patients with relapsed or refractory large B-cell lymphoma after two or more lines of systemic therapy, including diffuse large B-cell lymphoma...

ASTRO Names Recipients of Junior Faculty, Resident/Fellow Awards at Annual Meeting

THE AMERICAN SOCIETY FOR RADIATION ONCOLOGY (ASTRO) has awarded $275,000 in research awards to four early-career scientists as part of the Society’s efforts to retain and foster the intellectual research talent currently entering the field of radiation oncology. For 2017, the Research Grants...

head and neck cancer

Cutting Radiation Exposure by 50% Appears Safe and Effective in HPV-Positive Head and Neck Cancer

AGGRESSIVE REDUCTION in radiation therapy appears to be a potential win-win situation for patients with human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma, according to the results of a phase II trial presented at the 2017 Annual Meeting of the American Society for...

colorectal cancer
issues in oncology

Could the Rising Rates of Colorectal Cancer in AYAs Be Linked to HPV Infection?

TWO STUDIES published this year examining the incidence of colorectal cancer in adolescents and young adults (AYAs) show an undeniable and sobering trend: Colorectal cancer rates are increasing in this age group, and younger people are dying of the cancer at slightly higher rates than in previous...

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