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palliative care

How Early Palliative Care May Benefit Patients With Incurable Cancer

Palliative care provided soon after a patient is diagnosed with incurable cancer not only helps improve the patient’s overall quality of life but also improves communication about the patient’s wishes for end-of-life care, according to a study by Jennifer S. Temel, MD, Clinical Director of Thoracic ...

leukemia

Inotuzumab Ozogamicin for Relapsed/Refractory B-Cell Precursor ALL

On August 17, 2017, inotuzumab ozogamicin (Besponsa) was approved for the treatment of adults with relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL).1,2  Supporting Efficacy Data  APPROVAL WAS BASED on complete remission rates in the open-label phase III INO-VATE ALL...

skin cancer

No Improvement in Melanoma-Specific Survival With Completion Dissection vs Observation for Sentinel-Node Metastasis

THE PHASE III MSLT- II TRIAL showed that completion dissection was not associated with improved melanoma-specific overall survival vs observation in patients with sentinel-node metastasis, although a benefit was observed in regional disease control. The findings were reported in The New England...

thyroid cancer
prostate cancer
lung cancer
survivorship
palliative care

News From JCO and JOP

STAYING UP-TO-DATE in the fast-paced world of oncology literature is a daunting task at best. To assist with that task, The ASCO Post has assembled an assortment of studies recently published in the Journal of Clinical Oncology (JCO) and the Journal of Oncology Practice (JOP). Future installments...

sarcoma

Sarcoma Management Is Slowly Evolving

THE BACKBONE treatment for soft-tissue sarcomas has long been anthracycline-based, but new approaches are coming. These novel strategies were discussed at the 2017 Debates and Didactics in Hematology and Oncology Conference in Sea Island, Georgia, by Melinda L. Yushak, MD, MPH, Assistant Professor ...

skin cancer

Significant Improvement in Outcomes Reported With Adjuvant Therapy for Melanoma

FOR PATIENTS with malignant melanoma, the significant improvement in outcomes with targeted agents and antibodies against the programmed cell death protein 1 (PD-1) has now been observed in the adjuvant setting. Two landmark studies presented at the European Society for Medical Oncology (ESMO) 2017 ...

gynecologic cancers

Final Efficacy Analysis of 9-Valent Human Papillomavirus Vaccine Trial

The final efficacy analysis of a trial of 9-valent human papillomavirus (HPV) vaccine has shown a high preventive effect against disease due to the additional HPV pathogenic strains covered compared with the quadrivalent vaccine at up to 6 years. These findings were reported by Huh et al in The...

prostate cancer

Alzheimer’s Disease Risk in Medicare Patients Receiving Androgen-Deprivation Therapy for Prostate Cancer

As reported by Baik et al in the Journal of Clinical Oncology, Medicare patients who received androgen-deprivation therapy for prostate cancer do not appear to be at increased risk for Alzheimer’s disease and may have an extremely small increased risk for dementia. Study Details The study...

cns cancers

Dinutuximab vs Temsirolimus in Combination Therapy for Children With Resistant Neuroblastoma

A randomized phase II trial (Children’s Oncology Group [COG] ANBL1221) has resulted in the selection of dinutuximab (Unituxin) plus irinotecan/temozolomide as a regimen to be further evaluated in the treatment of pediatric patients with refractory or relapsed neuroblastoma. Study results were...

skin cancer

Immune-Related Toxicity and Time to Treatment Failure With Nivolumab Plus Ipilimumab in Advanced Melanoma

As reported in JAMA Oncology by Shoushtari et al, a single-center experience has shown a very high rate of clinically significant immune-related adverse events with nivolumab (Opdivo) plus ipilimumab (Yervoy) for advanced melanoma. Their findings suggest that the full course of four doses of...

breast cancer

Accelerated vs Standard Epirubicin and Capecitabine vs CMF in Breast Cancer

The phase III UK TACT2 trial has shown no efficacy benefit of accelerated vs standard epirubicin and a potential quality-of-life benefit of capecitabine vs CMF (cyclophosphamide, methotrexate, fluorouracil) as adjuvant therapy for breast cancer. The findings were reported in The Lancet Oncology by ...

Global Cancer Institute Launches New Patient Navigation Program to Accelerate Treatment for Patients in Brazil

GLOBAL CANCER INSTITUTE (GCI), focused on survival and quality of underserved patients with cancer worldwide, has announced it is launching a new Patient Navigation Program in Rio de Janeiro, Brazil. The program went live in early August 2017 and is intended to help promote adherence to Brazil’s...

global cancer care

Emerging Global Leaders in Biosimilar Development: Regulatory Guidance and Cost Impact

BIOLOGICS PLAY A KEY ROLE in cancer treatment and are the principal components of many therapeutic regimens.1 However, they require complex manufacturing processes, resulting in high cost and occasional shortages in supply, limiting the accessibility of cancer treatment for many patients, more so ...

issues in oncology

Initiating the Topic of Weight and Health With Patients With Obesity

Rates of obesity have been steadily rising over the past 3 decades in both adults and children. Today, more than one-third of American adults and about 17% of children and adolescents, ages 6 to 19, have obesity.1 Cancer rates have risen in tandem with obesity rates, making obesity the second...

gastrointestinal cancer

‘Sidedness’ in Colon Cancer: Using the Data in the Clinic

The evidence from clinical trials has established that “side matters” when it comes to colorectal cancer outcomes. How do clinicians use this information in their practices? Christina Wu, MD, of Emory University, shared her thoughts with attendees at the 2017 Debates and Didactics in Hematology and ...

hematologic malignancies

Recent FDA Actions Include New Formulation, Expanded Indications for Oncology-Hematology Drug Products

The U.S. Food and Drug Administration (FDA) recently granted approval to olaparib tablets (Lynparza) as a maintenance therapy for ovarian cancer and to inotuzumab ozogamicin (Besponsa), for the treatment of adults with relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL)....

issues in oncology
health-care policy
global cancer care
cost of care

For the Impoverished, Health Care Is a Luxury

Cancer is the second leading cause of death worldwide, and the global burden is on an inexorably upward trajectory. For the year 2012, there were 14.1 million new cancer cases and 8.2 million cancer-related deaths worldwide.1 It is predicted that by the year 2035, there will be 23.9 million new...

colorectal cancer

Labetuzumab Govitecan in Heavily Pretreated Patients With Metastatic Colorectal Cancer

As reported by Dotan et al in the Journal of Clinical Oncology, the antibody-drug conjugate labetuzumab govitecan showed antitumor activity in a phase I/II trial in patients with heavily pretreated metastatic colorectal cancer who had received prior irinotecan therapy. The agent comprises...

2018 Pershing Square Sohn Cancer Research Prize Opens for Applications on October 2, 2017

The Pershing Square Sohn Cancer Research Alliance (PSSCRA) will begin accepting applications for its 2018 Pershing Square Sohn Prize for Young Investigators on October 2, 2017. At least six New York City area–based scientists will each be awarded $200,000 per year—for up...

gastroesophageal cancer

Prolonged and Intensified Neoadjuvant Therapy for Esophageal Adenocarcinoma

A UK phase III trial (UK MRC OE05) has shown no significant survival benefit of extended and intensified neoadjuvant chemotherapy with epirubicin, cisplatin, and capecitabine vs standard cisplatin/fluorouracil followed by resection in patients with esophageal adenocarcinoma. The findings were...

head and neck cancer

Medical Costs and HPV Vaccination in Oropharyngeal Cancer

According to the Centers for Disease Control and Prevention, human papillomavirus (HPV)-related cancers, including oropharyngeal, vulvar, cervical, vaginal, penile, anal, and rectal cancers, have increased in recent years, with oropharyngeal cancer the most common HPV-related cancer—from 2008 ...

issues in oncology

Liquid Biopsies Identify Distinct Genomic Profiles With Potentially Targetable Alterations in Carcinoma of Unknown Primary

Next-generation sequencing of circulating tumor DNA (ctDNA) identified distinct genomic profiles with potentially targetable alterations in 99.7% of patients with carcinoma of unknown primary (CUP) who have detectable alterations, according to results published by Kato et al in Cancer Research....

lymphoma

Crizotinib in Pediatric ALK-Positive Anaplastic Large Cell Lymphoma and Inflammatory Myofibroblastic Tumors

In a Children’s Oncology Group study, high response rates were achieved with crizotinib (Xalkori) treatment in pediatric ALK-positive anaplastic large cell lymphomas (ALCL) and inflammatory myofibroblastic tumors. These results were reported by Mossé et al in the Journal of Clinical...

prostate cancer

Brachytherapy for Prostate Cancer: An Old Form of Radiation Treatment That Is Still One of the Most Effective

BRACHYTHERAPY HAS a long track record in treating cancer, dating back to the first reported use of an implanted radioactive source in 1901, and brachytherapy for the treatment of prostate cancer dates back to 1914, when Pasteu and Degrais used a radium source inserted through a urethral catheter. ...

multiple myeloma

Cutting-Edge Induction Strategies and Novel Approach to Reducing Skeletal-Related Events Explored in Multiple Myeloma

THE ADDITION of daratumumab (Darzalex) to a triplet induction regimen led to good responses in newly diagnosed multiple myeloma, but not without toxicities. And in the treatment of myeloma bone disease, denosumab (Xgeva) in place of zoledronic acid preserved renal function and may be associated...

leukemia

FDA Approves Inotuzumab Ozogamicin for Relapsed or Refractory B-Cell Precursor ALL

On August 17, 2017, the U.S. Food and Drug Administration (FDA) approved inotuzumab ozogamicin (Besponsa) for the treatment of adults with relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL). INO-VATE ALL The approval was based on data from INO-VATE ALL, a randomized (1:1), ...

solid tumors
skin cancer

Dabrafenib Plus Trametinib in BRAF V600–Mutant Melanoma Brain Metastases

A phase II trial has shown that the combination of the BRAF inhibitor dabrafenib (Tafinlar) and the MEK inhibitor trametinib (Mekinst) produces responses in brain metastases in patients with BRAF V600–mutant melanoma. These findings were reported by Michael A. Davies, MD, of The University of...

hematologic malignancies

Effect of Azithromycin on Airflow Decline–Free Survival After Allogeneic HSCT for Hematologic Malignancy

The French phase III ALLOZITHRO trial, stopped early due to excessive hematologic relapse in the azithromycin group, showed worse airflow decline–free survival with azithromycin vs placebo after hematopoietic stem cell transplantation (HSCT) for hematologic malignancy. The study findings were ...

colorectal cancer

Colorectal Cancer Mortality Rates in Adults Aged 20 to 54 Years From 1970 to 2014

In a research letter to JAMA, Siegel et al reported that overall colorectal cancer mortality rates have declined in the United States between 1970 and 2014 in patients aged 20 to 54 years but increased in white persons in this age group between 2004 and 2014. Study Details In the study,...

breast cancer

Genomic Characteristics and Immune Infiltration in Triple-Negative Breast Cancer

In a study reported in JAMA Oncology, Karn et al found that triple-negative breast cancers with high immune gene expression levels were characterized by lower clonal heterogeneity, reduced copy number alterations, and lower somatic mutation and neoantigen loads. Study Details In the study, DNA...

issues in oncology

Factors in Discontinuation of Palliative Radiotherapy

In a study reported by Puckett et al in the Journal of Oncology Practice, factors associated with premature discontinuation of palliative radiotherapy in cancer patients included poorer performance status, higher number of prescribed radiotherapy fractions, and treatment site other than bone...

thyroid cancer

Are Thyroid Cancer Incidence and Mortality Rates Truly Increasing in the United States?

THYROID CANCER diagnoses are increasing at a rate faster than any other malignancy in the United States. In 2017, there will be 56,870 new cases, accounting for 3.4% of all cancers, and 2,010 people will die of thyroid cancer.1 This represents a more than 200% increase in incidence since the...

thyroid cancer

Trends in Thyroid Cancer Incidence and Mortality in the United States

THE REPORTED INCIDENCE of thyroid cancer has markedly increased in the United States in recent decades, largely reflecting an increase in reported rates of papillary thyroid cancer. It has been unclear whether the increase in incidence is reflected in mortality rates over time. In a study of...

solid tumors

First-in-Class T-Cell Stimulator Varlilumab in Advanced Tumors

A phase I study reported by Howard A. Burris, MD, of Sarah Cannon Research Institute, Tennessee Oncology, and colleagues in the Journal of Clinical Oncology has shown that the first-in-class agonist anti-CD27 antibody varlilumab is well tolerated and active in patients with advanced solid tumors....

cost of care

Cost of Hospitalization for Cancer-Related Neutropenia or Fever

In a study of 2012 data, Eric Tai, MD, of the Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, and colleagues estimated that average costs per hospital stay for cancer-related neutropenia or fever were approximately $25,000, with a total cost of more than $2.7 ...

cns cancers

Vaccine-Chemotherapy Combination in Glioblastoma

Despite highly aggressive therapy that includes maximal tumor resection, high-dose radiation, and temozolomide chemotherapy, the prognosis for patients with newly diagnosed glioblastoma is dismal, with a median survival of less than 15 months, prompting researchers to study novel approaches to...

health-care policy

A Deep and Incisive Look Into the Health-Care System

The seemingly impossible-to-cure maladies of our $3 trillion per year health-care system have been hyperanalyzed, fiercely debated, and voluminously written about by the country’s leading public health experts, opinionated doctors, and policymakers on Capitol Hill. The Affordable Care Act extended ...

A Textbook That Fills a Special Need in Oncology: Uncommon Cancers

A cancer diagnosis provokes a sea of emotions, fear and anxiety over the future foremost. However, being diagnosed with a common cancer such as breast or prostate cancer has a hard-won comfort zone, in that both patients and physicians are armed with a plethora of data and resources on how to treat ...

prostate cancer

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

In a single-center analysis reported in JAMA Oncology, Patel et al found that among men undergoing elective radical prostatectomy, those with low-volume intermediate-risk disease had significantly higher rates of adverse pathologic findings compared than did those with very low-risk and low-risk...

issues in oncology
survivorship

How to Help Young Patients Preserve Their Fertility

GUEST EDITOR Adolescent and Young Adult Oncology explores the unique physical, psychosocial, social, emotional, sexual, and financial challenges adolescents and young adults with cancer face. The column is guest edited by Brandon Hayes-Lattin, MD, FACP, Professor of Medicine and Medical Director...

genomics/genetics

Convergence of Precision Medicine and Immuno-oncology

“THE CONVERGENCE of two very hot and interesting topics—precision medicine and immuno-oncology”—is being advanced by next-generation sequencing, Douglas B. Johnson, MD, MSCI, made clear at the inaugural OncoSET Symposium: Emerging Approaches to Precision Medicine,” sponsored by the Robert H. Lurie ...

global cancer care

Cancer on the Global Stage: Incidence and Cancer-Related Mortality in Angola

The ASCO Post is pleased to continue this special feature on the worldwide cancer burden. Each installment focuses on a country from one of the six regions of the world, as defined by the World Health Organization (ie, Africa, the Americas, South-East Asia, Europe, Eastern Mediterranean, and...

breast cancer

MammaPrint Test Addressed in ASCO Breast Cancer Guideline Update

New recommendations on the use of the MammaPrint genomic test issued on July 10 will help guide decisions on adjuvant systemic therapy for women with early breast cancer. The recommendations update the ASCO 2016 clinical practice guideline on the use of biomarkers in these patients. The guideline ...

colorectal cancer

FDA Approves Nivolumab in MSI-H or dMMR Metastatic Colorectal Cancer

Today, the U.S. Food and Drug Administration (FDA) approved nivolumab (Opdivo) injection for intravenous use for the treatment of adult and pediatric (12 years and older) patients with microsatellite instability–high (MSI-H) or mismatch repair deficient (dMMR) metastatic colorectal cancer...

lung cancer

Regionalization and Lung Cancer Operative Mortality in Ontario, Canada

In a study reported in the Journal of Clinical Oncology, Bendzsak et al found that centralization of surgery services to high-volume hospitals in Ontario was not independently associated with improved operative mortality rates in lung cancer. In April 2007, a policy was implemented to regionalize...

Register Now for QOPI® QCDR for 2017 CMS MIPS Reporting: One Patient, One Measure, No Penalty

ASCO is pleased to announce that its Quality Oncology Practice Initiative (QOPI®) Qualified Clinical Data Registry (QCDR) is available now for the Centers for Medicare and Medicaid Services (CMS) Merit-Based Incentive Payment System (MIPS) reporting. By using the QOPI® QCDR for MIPS reporting,...

cost of care

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...

integrative oncology

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.”...

lung cancer

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...

issues in oncology

New CDC Report Shows Cancer Death Rates Are Higher in Rural America

Despite decreases in cancer death rates nationwide, a new report from the Centers for Disease Control and Prevention (CDC) shows slower reduction in cancer death rates in rural America (a decrease of 1.0% per year) compared with urban America (a decrease of 1.6% per year), according to data...

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