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issues in oncology

27% Drop in Overall U.S. Cancer Mortality Rate From 1991 to 2016

A steady 25-year decline has resulted in a 27% drop in the overall cancer death rate in the United States between 1991 and 2016. The data come from “Cancer Statistics, 2019,” the American Cancer Society’s annual report on cancer rates and trends. The report was published in CA: A...

skin cancer

Association Between Sun Exposure and BMI in the Development of Nonmelanoma Skin Cancer

Exposure to the sun, whether cumulative or intermittent, is a known risk factor for the development of nonmelanoma skin cancer (NMSC). Past studies have found that greater body mass index (BMI) actually lessens the risk of women developing NMSCs. With this in mind, researchers sought to determine...

solid tumors

Detection of Relapse in Children and Adolescents With Nongerminomatous Malignant Germ Cell Tumors

In a report from the Children’s Oncology Group published in the Journal of Clinical Oncology, Fonseca et al found that relapse in children and adolescents with nongerminomatous malignant germ cell tumors (MGCTs) was most frequently identified by tumor markers rather than imaging. Study...

issues in oncology

Quality of Life and Patient- and Clinician-Reported Cumulative Toxicity

New research has found that quality of life for people with cancer is reduced by an accumulation of low-level toxicities just as much as it is from high-level adverse events. Additionally, patient-reported outcomes were more likely to reflect the impact on a patient’s physical well-being than ...

issues in oncology

Association Between Systemic Lupus Erythematosus and Cancer Risk

New research published by Song et al in Arthritis Research & Therapy evaluated the link between lupus and cancer risk, supporting the data from earlier studies. The newer study indicates an association between systemic lupus erythematosus (SLE) and increased risk for several cancers (blood,...

breast cancer

Study Assesses Impact of Digital Mammography on Breast Cancer Detection and Recall Rates

The shift from film to digital mammography increased the detection of breast cancer overall in the United Kingdom—without increasing the recall rate—according to a study published by Blanks et al in Radiology. “Image quality with digital mammography is improved over that of...

hematologic malignancies

FDA Approves Ravulizumab-cwvz for Paroxysmal Nocturnal Hemoglobinuria

On December 21, 2018, the U.S. Food and Drug Administration (FDA) approved ravulizumab-cwvz (Ultomiris) for adult patients with paroxysmal nocturnal hemoglobinuria (PNH). PNH is a rare bone marrow failure disorder that manifests with hemolytic anemia, thrombosis, and peripheral blood cytopenias....

hematologic malignancies

FDA Approves Tagraxofusp-ezrs for Blastic Plasmacytoid Dendritic Cell Neoplasm

On December 21, the U.S. Food and Drug Administration (FDA) approved tagraxofusp-erzs (Elzonris) infusion for the treatment of blastic plasmacytoid dendritic cell neoplasm (BPDCN) in adults and in pediatric patients aged 2 years and older. “Prior to [this] approval, there had been no...

supportive care

Fecal Microbiota Transplantation May Help Restore Beneficial Bacteria in Patients With Cancer

Researchers have shown that autologous fecal microbiota transplantation may be a safe and effective way to help replenish beneficial gut bacteria in patients with cancer who require intense antibiotics during allogeneic hematopoietic stem cell transplantation. Their findings were published by Ying ...

Anil K. Rustgi, MD, Named Director of Herbert Irving Comprehensive Cancer Center

ANIL K. RUSTGI, MD, has been named Director of the Herbert Irving Comprehensive Cancer Center at Columbia University Irving Medical Center and NewYork-Presbyterian/Columbia University Irving Medical Center. Pending approval of the university’s trustees, Dr. Rustgi will serve as Professor of...

leukemia

Priority Review for Quizartinib in Relapsed or Refractory FLT3-ITD–Positive AML

THE U.S. FOOD AND DRUG ADMINISTRATION (FDA) accepted a new drug application and granted Priority Review to quizartinib, a FLT3 inhibitor, for the treatment of adult patients with relapsed or refractory FLT3-ITD–positive acute myeloid leukemia (AML). The FDA is expected to make a decision on...

symptom management

Clinician Survey to Explore Direct-Acting Oral Anticoagulants vs Low–Molecular-Weight Heparin in Cancer-Related VTE

Injectable low–molecular-weight heparin has long been considered the standard of care for treatment of venous thromboembolism (VTE) in patients with cancer. However, low–molecular-weight heparin is costly and often disliked by patients due to injection-related discomfort and bruising....

supportive care
palliative care

Improving Palliative Care in Low-Resource Settings

In 2016, ASCO published an update to its Clinical Practice Guideline, “Integration of Palliative Care Into Standard Oncology Care,” which provides evidence-based recommendations for symptom management, clarification of treatment goals, support of coping and distress management, and coordination of...

hematologic malignancies

Study Findings on Myeloproliferative Neoplasms Including Systemic Mastocytosis

HERE IS AN UPDATE on six different studies featured at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition. Topics focused on novel treatments for myelofibrosis, polycythemia vera and essential thrombocythemia, as well as systemic mastocytosis. Myelofibrosis ABSTRACT...

issues in oncology

How to Build a Clinical Trial Infrastructure in the Community Oncology Setting

HISTORICALLY, CLINICAL research has been viewed as an entity belonging to academic settings alone. With the advent of the Community Clinical Oncology Program (CCOP) in the 1980s and later with the Cancer Trials Support Unit, cancer clinical trials have begun to emerge in the community setting....

lung cancer

New Data Reported From International Studies of Lung Cancer Treatment

At the European Society for Medical Oncology (ESMO) 2018 Congress, important studies were presented for every cancer type. Here, The ASCO Post offers some snapshots of lung cancer studies that may inform approaches to treating this common cancer, which—despite the advances in recent years—remains...

breast cancer

International Trials Present New Findings in Treatment of Breast Cancer

The European Society for Medical Oncology (ESMO) 2018 Congress featured an assortment of study findings, many with far-reaching clinical implications for the treatment of patients with various cancers. Many of these trials were covered in-depth in recent issues of The ASCO Post. Here, we present...

immunotherapy
skin cancer

Optimal Duration of Checkpoint Inhibition in Melanoma Is No More Than 2 Years

For patients with advanced melanoma, the concept of treating to disease progression does not always apply. With many patients responding to checkpoint inhibition for years, when can treatment be safely discontinued? This important clinical question was addressed at the European Society for Medical...

breast cancer
supportive care

Has Scalp Cooling Reached the Level of Standard of Care?

Does evidence of the effectiveness and safety of scalp cooling to reduce hair loss among women being treated for breast cancer mean that scalp cooling is a new standard of care? “I would suggest that it is,” stated Mikel Ross, MSN, RN, AGNP-BC, of the Breast Medicine Service, Memorial Sloan...

FDA Issues Guidance on Endpoints for Cancer Clinical Trials

This week, the U.S. Food and Drug Administration (FDA) issued a guidance titled Clinical Trial Endpoints for the Approval of Cancer Drugs and Biologics. The guidance provides recommendations to applicants on endpoints for cancer clinical trials submitted to the FDA to support effectiveness claims...

solid tumors

Larotrectinib for Solid Tumors With NTRK Gene Fusions

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On November 26, 2018, larotrectinib (Vitrakvi) was...

global cancer care
hepatobiliary cancer

Controlling the Global Burden of Liver Cancer

The burden of mortality related to liver cancer is increasing worldwide. Prevention and control of viral hepatitis will be vital in combating this burden, but curbing the growing epidemic of obesity must also be seen as a key part of liver cancer prevention, according to Rosmawati Mohamed, MD, of...

leukemia

Nuclear Excision Repair as a Possible Predictor of Early Relapse in Pediatric ALL

Researchers recently discovered that by testing the level of nucleotide excision repair (NER) gene expression, pediatric oncologists may be able to determine the likelihood of early relapse (less than 3 years) in patients with acute lymphoblastic leukemia (ALL). These findings were published by...

skin cancer

FDA Approves Pembrolizumab for Merkel Cell Carcinoma

Today, the U.S. Food and Drug Administration (FDA) granted accelerated approval to pembrolizumab (Keytruda) for adult and pediatric patients with recurrent locally advanced or metastatic Merkel cell carcinoma. The FDA’s approval was based on Cancer Immunotherapy Trials Network protocol 9...

breast cancer
issues in oncology

Increased Risk for Breast Cancer After Childbirth May Last More Than 2 Decades

Although parity—time since most recent birth— is recognized as a protective factor against breast cancer, an analysis of data from 15 prospective cohort studies to assess breast cancer risk in relation to recent childbirth has found that compared to women of the same age who had never...

issues in oncology
health-care policy
legislation
cost of care

Will the Trump Administration’s Plan to Reduce Cancer Drug Prices Work?

High drug prices are the number one health-care concern of many Americans. The average price of a cancer drug rose from less than $10,000/yr before 2000 to more than $170,000/yr in 2017.1-3 Between 1995 and 2013, the launch price of cancer drugs increased by 10% to 12% every year, and the average...

Expert Point of View: Eric P. Winer, MD, and Jame Abraham, MD

Commenting on the findings of the KATHERINE trial were Eric P. Winer, MD, Director of the Breast Oncology Program in the Susan F. Smith Center for Women’s Cancers at Dana-Farber Cancer Institute and the Thompson Senior Investigator in Breast Cancer Research andProfessor of Medicine at Harvard...

breast cancer

KATHERINE Trial: Adjuvant T-DM1 Reduces Invasive Disease Risk by 50% vs Trastuzumab in HER2-Positive Early Breast Cancer

In patients with HER2-positive early breast cancer and residual disease after neoadjuvant chemotherapy, adjuvant treatment with trastuzumab emtansine (T-DM1; Kadcyla) reduced the risk of invasive disease by 50% over trastuzumab (Herceptin).1 The phase III KATHERINE study was presented at the 2018...

lung cancer
immunotherapy

ESMO Immuno-Oncology 2018: KEYNOTE-010: Long-Term Treatment With Pembrolizumab in Previously Treated NSCLC

Patients with previously treated, advanced non–small cell lung cancer (NSCLC) who received pembrolizumab (Keytruda) showed significantly longer overall survival (OS) compared to those treated with docetaxel, Herbst et al reported at the ESMO Immuno-Oncology Congress 2018 in Geneva,...

issues in oncology

ASCO and ESMO Publish Joint Assessment of Their Value Frameworks

To better understand the performance characteristics of ASCO’s Value Framework Net Health Benefit Score version 2 (ASCO-NHB v2) and the European Society for Medical Oncology’s (ESMO’s) Magnitude of Clinical Benefit Scale version 1.1 (ESMO-MCBS v1.1), ASCO and ESMO undertook a...

head and neck cancer
immunotherapy

Pembrolizumab vs Standard of Care in Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma

In the phase III KEYNOTE-040 trial reported in The Lancet, Cohen et al found that pembrolizumab (Keytruda) was associated with a “clinically meaningful prolongation of overall survival” vs investigator’s choice of standard therapies in patients with previously treated recurrent or ...

breast cancer

FDA Approves Trastuzumab-pkrb for HER2-Overexpressing Breast Cancer

On December 14, the U.S. Food and Drug Administration (FDA) approved trastuzumab-pkrb (Herzuma), a HER2/neu receptor antagonist biosimilar to trastuzumab (Herceptin), for the following indications: Adjuvant breast cancer of HER2 overexpressing node-positive or node-negative (estrogen...

colorectal cancer
issues in oncology

Does Tailored Lifestyle Feedback Given During Colorectal Cancer Screening Improve Disease-Preventive Behaviors?

A program that provided individually tailored lifestyle recommendations for patients undergoing screening for colorectal cancer helped encourage healthy behavior, according to results published by Knudsen et al in Cancer Epidemiology, Biomarkers & Prevention. “It is well known that...

breast cancer

RSNA 2018: Breast Cancer Risk-Based Mammography Screening in Younger Women

A new, large-scale study of more than 5 million mammograms found that annual mammography screening beginning at age 30 may benefit women with at least 1 of 3 specific risk factors: dense breasts, a personal history of breast cancer, or a family history of breast cancer. The study was presented at...

colorectal cancer

Eicosapentaenoic Acid and Aspirin in Preventing Colorectal Adenomas

In a UK trial (seAFOod Polyp Prevention) reported in The Lancet by Hull et al, no differences in adenoma prevention were found after treatment with omega-3 polyunsaturated fatty acid eicosapentaenoic acid (EPA), aspirin, both, or placebo in patients with high-risk findings on colonoscopy. On the...

breast cancer

Hope S. Rugo, MD, on Metastatic Breast Cancer: Treatment for Pretreated Hormone Receptor–Positive Disease

Hope S. Rugo, MD, of the University of California, San Francisco, discusses how treatment with a lower dose of palbociclib (100 mg vs 125 mg) in combination with fulvestrant or tamoxifen is associated with a lower rate of high-grade neutropenia (Abstract PD2-12).

breast cancer
solid tumors
leukemia
lung cancer
lymphoma
multiple myeloma
issues in oncology
immunotherapy

FDA Pipeline: New Priority Reviews, Designations, and Clearances, Plus Statements on Genetic Testing and Class Labeling

The U.S. Food and Drug Administration (FDA) recently issued the following new approvals and designations: Priority Review for Atezolizumab in Combination With Chemotherapy for the Initial Treatment of Extensive-Stage SCLC The FDA accepted a supplemental biologics license application...

Scientific and Career Development Retreat: Networking and Collaborating With Promising Researchers

ASCO’s Conquer Cancer Foundation is committed to supporting the research and career development of young researchers through its Grants & Awards Program. On October 10–11, 2018, Conquer Cancer hosted its 4th Scientific and Career Development Retreat at ASCO headquarters in Alexandria,...

prostate cancer

Shedding Light on Mechanisms of Resistance to Treatment of Metastatic Castration-Resistant Prostate Cancer

ONE OF the pressing issues in metastatic castration-resistant prostate cancer is the development of resistance to therapies directed at the androgen receptor (AR), such as enzalutamide (Xtandi) and abiraterone acetate (Zytiga). Research is ongoing to identify mechanisms of resistance in the hope of ...

breast cancer

Management of HER2-Positive Breast Cancer: Business as Usual?

MANAGEMENT OF HER2-positive breast cancer changed after the introduction of trastuzumab (Herceptin), the first anti-HER2 therapy to be approved by the U.S. Food and Drug Administration (FDA) for this type of cancer. Recent studies have more clearly defined the role of pertuzumab (Perjeta) and...

skin cancer
immunotherapy

Expert Point of View: Reinhard Dummer, MD

KEYNOTE-022’S invited discussant, Reinhard Dummer, MD, Professor of Dermatologic Oncology at the University Hospital Zurich Skin Cancer Center in Switzerland, told attendees, “We’ve been waiting for this small prospective randomized phase II trial, and the initial results appear very promising.”...

skin cancer

Using Tumor‑Infiltrating Lymphocytes to Treat Metastatic Melanoma

STEVEN A. ROSENBERG, MD, PhD, Chief of Surgery at the National Cancer Institute (NCI), began his pioneering research in adoptive cell transfer using interleukin (IL)-2 in the mid-1970s. His IL-2 studies were among the clinical trials that led to the first U.S. Food and Drug Administration approval ...

Antonio Omuro, MD, Named Neuro-Oncology Chief at Smilow Cancer Hospital

ANTONIO OMURO, MD, a clinician and researcher with expertise in brain tumors, has been appointed Chief of Neuro-Oncology and a leader for the Brain Tumor Program at Smilow Cancer Hospital. “We are so fortunate to have recruited Dr. Omuro to lead our efforts in Brain Tumors and other nervous...

cns cancers

Hippocampus-Sparing Whole-Brain Radiotherapy and Neurocognitive Function in Patients With Brain Metastases

ANALYSIS OF a phase III trial has confirmed that conformal avoidance of the hippocampal dentate gyrus using intensity-modulated radiotherapy during whole-brain radiotherapy for brain metastases preserves neurocognitive function and improves patient-reported symptom burden while achieving similar...

solid tumors

Stereotactic Ablative Radiotherapy May Improve Outcomes in Some Patients With Oligometastatic Tumors

IN PATIENTS with a controlled primary tumor and up to 5 oligometastatic lesions, delivering stereotactic ablative radiotherapy was associated with a 13-month improvement in overall survival when compared with palliative standard-of-care treatments alone (41 months vs 28 months; P = .09).1...

immunotherapy

Beyond Checkpoint Inhibitors: Novel Immunotherapy Combinations With Antitumor Activity

THE 2018 Society for Immunotherapy of Cancer (SITC) Annual Meeting hosted a meeting of the minds of the world’s premier cancer immunologists. In addition to the cutting-edge laboratory science explored and presented at the meeting, numerous phase I clinical trials and a few phase II studies offered ...

issues in oncology

Should Oncologists Recommend Cannabis?

A RECENT survey of 400 clinical oncologists found that 80% discuss the use of medical cannabis with their patients, and although nearly 50% recommend it, fewer than 30% consider themselves knowledgeable enough to make such recommendations.1 Oncologists are perhaps among the most evidence-demanding ...

breast cancer
immunotherapy

Hope S. Rugo, MD, on Immunotherapy for Breast Cancer: Expert Perspective

Hope S. Rugo, MD, of the University of California, San Francisco, summarizes a spotlight session she chaired, which included discussion of new immunotherapy drug combinations, predictive factors, and the immune microenvironment.

breast cancer
issues in oncology

Kathy S. Albain, MD, on Breast Cancer, Ethnicity, and Clinical Outcomes: Results From the TAILORx Trial

Kathy S. Albain, MD, of Loyola University Stritch School of Medicine, discusses study findings on race, ethnicity, and patient outcomes in hormone receptor–positive, HER2-negative, node-negative breast cancer (Abstract GS4-07).

breast cancer
issues in oncology

Laura S. Dominici, MD, on Young Women With Breast Cancer: Local Therapy and Quality of Life

Laura S. Dominici, MD, of the Dana-Farber Cancer Institute, discusses the lower quality-of-life scores seen after unilateral or bilateral mastectomy compared with breast-conserving surgery in women younger than age 40 who are treated for breast cancer (Abstract GS6-05).

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