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issues in oncology

Outcome Measures in Quality and Identifying High-Quality Practice

At this year’s ASCO Quality Care Symposium, Craig Earle, MD, MSc, of the Ontario Institute for Cancer Research, used Donabedian’s Triad—structure, process, and outcome—to set the stage for his presentation on the science of quality. “The theory behind Donabedian’s Triad is that structure...

issues in oncology
cost of care

Experts Consider What It Means to Improve Quality of Care in an Era of Increasing Reliance on Targeted Therapies

Precision medicine is judged according to different values across the multiple stakeholders involved in cancer care. At this year’s Quality Care Symposium, presenters from different sectors of oncology addressed a central question: How do we assess quality in the age of precision medicine?1,2 Right ...

breast cancer

A Business Professor and Husband Turns Breast Cancer Researcher

In more than 25 years of viewing posters at oncology meetings, I’ve met researchers from virtually all professional walks of life, but it was not until the 2016 Miami Breast Cancer Conference, that the author’s affiliation turned my head: It was a business school. “Utilizing Metastatic Tumor...

breast cancer

Metastatic Breast Cancer With Discordant Tumors: Small Study Reports Treatment by Primary Status May Improve Survival

In a small retrospective series, patients with metastatic breast cancer treated according to the receptor status of the primary tumor, not the metastatic one, had significantly longer median overall survival. The study was reported at the 2016 Miami Breast Cancer Conference by T. Allen Pannell, Jr, ...

Jeffrey Fowler, MD, Begins Presidency of Society of Gynecologic Oncology

Jeffrey Fowler, MD, John G. Boutselis Chair in Gynecologic Oncology and Professor and Vice-Chair of Obstetrics and Gynecology at The Ohio State University Wexner Medical Center, started his 1-year term as the 48th President of the Society of Gynecologic Oncology (SGO) at the conclusion of the...

breast cancer

Breast Cancer Vaccines Moving Forward at a Fast Clip

Vaccines for both secondary and primary prevention of breast cancer are showing potential in clinical trials, according to Elizabeth A. Mittendorf, MD, PhD, who is leading much of the vaccine research at the University of Texas MD Anderson Cancer Center, Houston. Vaccine platforms being explored...

gynecologic cancers

Expert Point of View: Kathleen Moore, MD

Session moderator Kathleen Moore, MD, Associate Professor of Obstetrics and Gynecology at the University of Oklahoma College of Medicine, Oklahoma City, said that while the response rates are “not incredibly high,” trabectedin offers another line of therapy where there previously was none. “I think ...

gynecologic cancers

Trabectedin Improves Progression-Free Survival in Uterine Leiomyosarcoma

In women with uterine leiomyosarcoma, trabectedin (Yondelis), a novel cytotoxic agent, significantly improved progression-free survival, compared with dacarbazine (4.2 vs 1.5 months, hazard ratio [HR] = 0.55, P < .001). According to the study’s authors, a lack of cumulative toxicity allows...

Clifford A. Hudis, MD, FACP, Named ASCO’s Next CEO

Clifford A. Hudis, MD, FACP, Chief of the Breast Medicine Service, Vice President for Government Relations, and Chief Advocacy Officer at Memorial Sloan Kettering Cancer Center (MSKCC), and Professor of Medicine at Weill Cornell Medical College, has been named the next Chief Executive Officer...

issues in oncology

Computer-Assisted Decision Support in Medical Oncology: We Need It Now

Today’s medical oncologist is increasingly challenged to stay current with the latest developments in cancer treatment. I have been fortunate to speak with many oncologists over the past quarter-century on how professional life has evolved since the 1990s. These conversations have left me with a...

pain management

Judith Paice, PhD, RN, on Managing Cancer Pain: Strategies for Prescribing Opioids

Judith Paice, PhD, RN, of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University, discusses strategies for safe opioid prescribing: making a comprehensive assessment, stratifying risk, using universal precautions, and educating practitioners on safe storage and disposal.

lung cancer

Douglas E. Wood, MD, on Lung Cancer: Workup and Staging

Douglas E. Wood, MD, of the University of Washington, discusses best practices, which enable a complete workup in 1 to 2 weeks in almost all patients, saving unnecessary testing. 

prostate cancer

Throwing Out the Baby With the Bathwater: A Critical Appraisal of the USPSTF Recommendation Against Screening for Prostate Cancer

In 2012, the U.S. Preventive Services Task Force (USPSTF) issued a recommendation against routine screening for prostate cancer.1,2 The grade D recommendation was considered controversial at the time, and remains so now, because many stakeholders have weighed the same body of evidence and come to...

lung cancer

The POPLAR Trial: PD-L1 Blockade With Atezolizumab in Second- or Third-Line Non–Small Cell Lung Cancer

The randomized phase II ­POPLAR trial—reported by Fehrenbacher and colleagues and reviewed in this issue of The ASCO Post—is another key piece of information for the medical community regarding the value of immune checkpoint blockers in second/third-line treatment of patients with non–small cell...

lung cancer

Atezolizumab Improves Survival vs Docetaxel in Previously Treated NSCLC: Increased Benefit With Increased PD-L1 Expression

In the phase II POPLAR trial reported in The Lancet, Louis Fehrenbacher, MD, of Kaiser Permanente Medical Center, and colleagues found that the investigational anti–programmed cell death ligand 1 (PD-L1) antibody atezolizumab improved overall survival vs docetaxel in patients with non–small cell...

cns cancers

Glioblastoma Multiforme With Mismatch Repair Deficiency May Be Target for Immune Checkpoint Inhibition

Glioblastoma multiforme resulting from germline biallelic mismatch repair deficiency was characterized by hypermutation and elevated neoantigen load—characteristics associated with response to immune checkpoint inhibitors in other settings—according to a study reported in the Journal of ...

breast cancer

Ultrasound Screening for Breast Cancer May Be Linked to Increased Detection of Invasive Tumors but More False-Positive Results

As reported in the Journal of the National Cancer Institute by Berg et al, an analysis from the American College of Radiology Imaging Network (ACRIN) 6666 study indicates that use of ultrasound in primary screening for breast cancer resulted in increased detection of invasive cancers but more...

survivorship

Effects of Chemotherapy on Pregnancy for Survivors of Childhood Cancer Treated Between 1970 and 1999

In an analysis in the Childhood Cancer Survivor Study cohort reported in The Lancet Oncology, Chow et al found that increasing doses of several alkylating agents reduced the likelihood of fathering a pregnancy among male survivors of childhood cancer, with fewer drug associations with pregnancy...

survivorship

ENDO 2016: Engineered Ovary Implant Restores Fertility in Mice

Northwestern University scientists used a three-dimensional (3D) printer to create a prosthetic ovary—an implant that allowed mice that had their ovaries surgically removed to bear live young. The results were presented by Laronda et al on Saturday, April 2, at the Endocrine Society's Annual...

breast cancer

ENDO 2016: BPA Changes Fetal Development of the Mammary Gland, Can Raise Breast Cancer Risk

A new culture system that tests the role of chemical exposure on the developing mammary gland has found that bisphenol A (BPA) directly affects the mammary gland of mouse embryos. The study results, presented by Speroni et al Friday, April 1, at the Endocrine Society's Annual Meeting in Boston...

breast cancer

Good Outcome Reported With Endocrine Therapy and Omission of Chemotherapy Based on 21-Gene Recurrence Score in Breast Cancer

Treatment with adjuvant endocrine therapy and omission of chemotherapy on the basis of a 21-gene recurrence score ≤ 11 was associated with a high 3-year disease-free survival rate in women with hormone receptor–positive, HER2-negative breast cancer, according to a trial reported in...

issues in oncology

TP53 Gene Variant S47 May Contribute to Increased Cancer Risk in People of African Descent

For years, clinical data have shown that African Americans have a higher death rate and shorter period of survival among patients with commonly diagnosed cancers. While studies have focused on whether socioeconomic factors contribute to these statistics, researchers have been diligently trying to...

prostate cancer

Widely Cited Prostate-Specific Antigen Screening Publications Influence Biopsy Rates and Associated Complications

While absolute rates of biopsy and postbiopsy complications have decreased following several benchmark prostate-specific antigen (PSA) screening publications, the relative risk for each patient continues to increase, according to a new study by Mayo Clinic researchers. The study is the largest to...

lung cancer

Lung Cancer Incidence and Mortality in Individuals With a Negative Low-Dose CT Prevalence Screen

In an analysis of the National Lung Screening Trial (NLST) cohort reported in The Lancet Oncology, Patz et al found that participants who had a negative low-dose computed tomography (CT) prevalence screen had a low incidence of lung cancer detected at first annual screen and exhibited reduced...

breast cancer

ASCO Endorses Cancer Care Ontario Recommendations on Decision-Making in Adjuvant Systemic Therapy for Early-Stage, Operable Breast Cancer

As reported in the Journal of Clinical Oncology by N. Lynn Henry, MD, PhD, of the University of Michigan Comprehensive Cancer Center, and colleagues, ASCO has endorsed Cancer Care Ontario (CCO) guideline recommendations on the role of patient and disease factors in decisions on adjuvant systemic...

prostate cancer

Lower Vitamin D Levels Associated With Adverse Pathology at Prostatectomy in Men With Localized Prostate Cancer

In a study reported in the Journal of Clinical Oncology, Nyame et al found that lower serum 25-hydroxyvitamin D (25-OH D) levels were associated with an increased likelihood of adverse pathology at radical prostatectomy in men with localized prostate cancer. Study Details The cross-sectional...

breast cancer

Increased Frequency of BRCA Mutation Testing in Young Women With Breast Cancer

Rosenberg et al found that the proportion of women diagnosed with breast cancer at age ≤ 40 years who have undergone BRCA1 and BRCA2 testing has increased during recent years. These findings, which were reported in JAMA Oncology, were part of the ongoing prospective Helping Ourselves, Helping...

bladder cancer

Study Finds Adaptive Image-Guided Radiation Therapy for Bladder Preservation Clinically Feasible in Urinary Bladder Cancer

A prospective study examining a trimodality treatment approach in localized bladder cancer cases using adaptive image-guided, intensity-modulated radiation therapy found that the bladder preservation rate at 3 years was 83%. These findings were published by Murthy et al in the International Journal ...

colorectal cancer

Endoscopic Mucosal Resection Is an Alternative to Surgery in Most Patients With Complex Colon Polyps

Using the latest advances in endoscopic resection techniques, more than 75% of patients with complex colon polyps could avoid surgery for their polyp removal, according to new research from The University of Texas MD Anderson Cancer Center. The findings, published by Raju et al in Gastrointestinal ...

symptom management

FDA Approves Defibrotide Sodium for the Treatment of Hepatic Veno-Occlusive Disease Following Hematopoietic Stem Cell Transplantation

On March 30, 2016, the U.S. Food and Drug Administration (FDA) approved defibrotide sodium (Defitelio) for the treatment of adult and pediatric patients with hepatic veno-occlusive disease, also known as sinusoidal obstructive syndrome, with renal or pulmonary dysfunction following hematopoietic...

breast cancer

Danish Study Shows Increased Risk for Cancers in Addition to Breast Cancer in CHEK2 Mutation Heterozygotes

In a study reported in the Journal of Clinical Oncology, Näslund-Koch et al found an increased risk for cancers in addition to breast cancer in individuals heterozygous for the CHEK2*1100delC germline mutation associated with an increased breast cancer risk. CHEK2 is a cell-cycle checkpoint...

lymphoma

Greater Prognostic Value of Ki67 Index vs Cytology and Growth Pattern in Mantle Cell Lymphoma

Hoster et al found that Ki67 index had greater prognostic value than cytology or growth pattern in mantle cell lymphoma, based on data from European Mantle Cell Lymphoma Network randomized trials reported in the Journal of Clinical Oncology. A modified combination of Ki67 index and Mantle Cell...

breast cancer
supportive care

Epoetin Alfa vs Best Standard of Care in Treatment of Anemia in Patients With Metastatic Breast Cancer Receiving Chemotherapy

Use of epoetin alfa (Epogen, Procrit) vs best standard of care to treat anemia did not achieve noninferiority for investigator-assessed progression-free survival in patients receiving chemotherapy for metastatic breast cancer, reported Leyland-Jones et al in the Journal of Clinical Oncology....

bladder cancer

ASCO Endorses European Association of Urology Guideline on Muscle-Invasive and Metastatic Bladder Cancer

As reported in the Journal of Clinical Oncology by Matthew I. Milowsky, MD, of the University of North Carolina Lineberger Comprehensive Cancer Center, and colleagues, ASCO has endorsed the European Association of Urology clinical practice guideline on muscle-invasive and metastatic bladder cancer. ...

issues in oncology

PET Probe [18F]CFA Detects Deoxycytidine Kinase Activity, May Lead to New Ways to Improve Response to Treatment

A promising new discovery by University of California, Los Angeles (UCLA) scientists could lead to a new method of identifying cancer patients whose disease expresses high levels of an enzyme and who are more likely to respond to particular treatments. Their findings were published by Kim et al in...

breast cancer

Therapeutic Combinations May Prevent Resistance to CDK4/6 Inhibition in Estrogen Receptor–Positive Breast Cancer

In preclinical studies, breast cancer cells became resistant to therapeutics targeting CDK4/6, such as palbociclib (Ibrance), in multiple ways. According to the research published by Herrera-Abreu et al in Cancer Research, different combinations of therapeutics might prevent and overcome the...

breast cancer
symptom management

DigniCap Scalp Cooling System Now Available for Women With Breast Cancer at 10 U.S. Cancer Treatment Centers

Dignitana Inc. announced today that the DigniCap scalp cooling system, which was cleared by the U.S. Food and Drug Administration (FDA) in December 2015 to effectively reduce the likelihood of chemotherapy-induced hair loss in women with breast cancer, is now available at 10 cancer treatment...

pancreatic cancer

Meta-analysis of Gene-Expression Datasets Identifies Novel Five-Gene Pancreatic Cancer Classifier

Pancreatic cancer is often diagnosed at a late stage, when curative treatment is no longer possible. A team led by investigators at Beth Israel Deaconess Medical Center (BIDMC) identified and validated an accurate five-gene classifier for discriminating early pancreatic cancer from nonmalignant...

lung cancer

No Treatment Failure or Survival Benefit but Less Toxicity With Comprehensive Geriatric Assessment in Elderly Patients With Advanced NSCLC

Use of comprehensive geriatric assessment to guide therapy in elderly patients with stage IV non–small cell lung cancer (NSCLC) did not improve treatment failure–free or overall survival but was associated with slightly reduced toxicity, based on the results of the phase III...

breast cancer

Digital Breast Tomosynthesis Shows Sustained Effectiveness in Breast Cancer Screening

In a single-center retrospective study reported in JAMA Oncology, McDonald et al found that adding digital breast tomosynthesis to digital mammography reduced recall rates, increased cancer detection, and was associated with a numeric reduction in interval cancers. Study Details The analysis...

survivorship

Survivors of Adolescent and Young Adult Cancer May Be at Increased Risk of Cardiovascular Disease

Survivors of adolescent and young adult cancer were at a greater than twofold increased risk for cardiovascular disease than their counterparts without cancer, according to a study reported in the Journal of Clinical Oncology by Chao et al. Study Details The study involved data from a...

lung cancer
gastroesophageal cancer

Possible Overuse of PET to Detect Recurrence of Lung and Esophageal Cancers

Healy et al found that greater use of positron-emission tomography (PET) for detection of recurrence of lung and esophageal cancers was not associated with improved survival, suggesting potential overuse of the modality in this setting. They reported their results in the Journal of the National...

hematologic malignancies
lymphoma

Italian Study Suggests Benefit of Interim PET Response–Adapted Therapy in High-Risk Advanced Hodgkin Lymphoma

The phase II portion of the Italian HD0801 study suggests that treatment based on positron-emission tomography (PET) performed early in first-line therapy for advanced Hodgkin lymphoma may improve outcome in patients at risk of first-line treatment failure. Zinzani et al reported their findings in...

breast cancer

ASCO Guideline on Use of Biomarkers to Guide Decisions on Adjuvant Systemic Therapy in Women With Early-Stage Invasive Breast Cancer

As reported in the Journal of Clinical Oncology by Harris et al, ASCO released a clinical practice guideline on the use of biomarkers in addition to estrogen receptor/progesterone receptor and HER2 status to guide decisions on adjuvant systemic therapy in women with early-stage invasive breast...

colorectal cancer

Japanese Trial Shows Reduced Risk of Subsequent Colorectal Adenomas and Polyps With Low-Dose Metformin

Treatment with low-dose metformin reduced the risk of metachronous colorectal adenomas and polyps over 12 months in nondiabetic patients who had undergone endoscopic polypectomy, according to a report by Higurashi et al in The Lancet Oncology. Study Details In the double-blind phase III trial,...

bladder cancer

MRI-Guided Adaptive Reoptimization in Radiotherapy Shows Promise in Urinary Bladder Cancer Treatment

A new radiotherapy technique could help doctors to focus treatment more precisely on tumors in the bladder and reduce damage to surrounding healthy tissue. Researchers showed that pretreatment imaging using magnetic resonance imaging (MRI) was effective at guiding radiotherapy toward tumors in the...

survivorship

Low-Magnitude, High-Frequency Mechanical Stimulation May Improve Bone Mineral Density in Young Childhood Cancer Survivors

In a small trial reported in JAMA Oncology, Mogil et al found that low-magnitude, high-frequency mechanical stimulation improved the whole-body bone mineral density score in childhood cancer survivors with low bone mineral density. Study Details In the double-blind trial, 65 survivors of...

skin cancer

Microneedle Patch Delivers Localized Anti–PD-1 Antibody Immunotherapy to Melanoma in Preclinical Models

Biomedical engineering researchers at North Carolina State University (NC State) and the University of North Carolina at Chapel Hill (UNC Chapel Hill) have developed a technique that uses a patch embedded with microneedles to deliver cancer immunotherapy treatment directly to the site of melanoma....

leukemia

Minimal Residual Disease in AML: Worth Looking?

As summarized in this issue of The ASCO Post, Ivey and colleagues demonstrated that assessing for NPM1-mutated gene transcripts by reverse-transcriptase quantitative polymerase chain reaction assay is a feasible approach for measuring minimal residual disease after acute myeloid leukemia (AML)...

issues in oncology

Quality Improvement Projects Aim at Reducing Errors in Prescribing IV and Oral Chemotherapy

Two quality improvement projects described in the Journal of Oncology Practice resulted in reduced errors in prescribing intravenous (IV) and oral chemotherapy. A project at the University of Texas Medical Branch in Galveston outpatient infusion centers first identified 15 different types of...

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