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issues in oncology

Inpatient Radiation Oncology Consult Model for Metastatic Cancer to Reduce Hospital Length of Stay

In a single-institution study reported in JCO Oncology Practice, Xu et al found that implementation of a novel inpatient radiation oncology consult service was associated with a significant increase in consults involving metastatic disease specialists, as well as a reduction in hospital length of...

immunotherapy
genomics/genetics
solid tumors

Is Tumor Mutational Burden Alone Sufficient to Predict Response to Immunotherapy?

In a letter to the editor published in The New England Journal of Medicine, Benoit Rousseau, MD, and colleagues presented evidence that high tumor mutational burden (TMB) alone is not sufficient to predict improved outcomes with immune checkpoint inhibitor therapy in patients with solid tumors. As...

breast cancer
genomics/genetics

Germline BRCA1/2 and Other Predisposition Genes in Patients With Metastatic Breast Cancer: Prevalence and Association With Prognosis

In a German prospective registry study reported in the Journal of Clinical Oncology, Peter A. Fasching, MD, and colleagues identified the prevalence of germline mutations in BRCA1/2 and other breast cancer risk genes in patients with metastatic disease and found similar prognosis with presence vs...

gynecologic cancers

Overall Survival With Olaparib vs Placebo Maintenance in Patients With Platinum-Sensitive Relapsed Ovarian Cancer and BRCA1/2 Mutation

As reported in The Lancet Oncology by Andrés Poveda, MD, and colleagues, the phase III SOLO2/ENGOT-Ov21 trial has shown a large numeric but statistically nonsignificant improvement in the secondary endpoint of overall survival with olaparib tablet maintenance therapy vs placebo in patients with...

gastroesophageal cancer

Locally Advanced Esophageal Cancer: Neoadjuvant Chemoradiotherapy vs Chemotherapy Followed by Minimally Invasive Esophagectomy

In an early analysis from a Chinese phase III trial reported in JAMA Surgery, Wang et al found similar safety and improved histopathologic outcome among patients undergoing minimally invasive esophagectomy for locally advanced esophageal squamous cell carcinoma following neoadjuvant...

head and neck cancer
genomics/genetics

Tipifarnib for Patients With Advanced HRAS-Mutant Head and Neck Cancer and High Variant Allele Frequency

In a phase II trial reported in the Journal of Clinical Oncology, Ho et al found that tipifarnib produced a high response rate among patients with recurrent or metastatic head and neck squamous cell carcinoma with HRAS mutations and high variant allele frequency. As stated by the investigators,...

breast cancer
symptom management

Low-Dose Tamoxifen for Reduction of Mammographic Density in Women Undergoing Breast Cancer Screening

In the Swedish phase II KARISMA study reported in the Journal of Clinical Oncology, Eriksson et al found noninferior mammographic density reduction and reduced vasomotor symptoms following tamoxifen therapy at 2.5, 5, and 10 mg vs the standard dose of 20 mg among women undergoing breast cancer...

issues in oncology
lung cancer

Detection of Emphysema Among Patients With or Without Prior COPD Diagnosis Undergoing Low-Dose CT Screening for Lung Cancer

In a prospective cohort study reported in Clinical Imaging, researchers in the International Early Lung Cancer Action Program (I-ELCAP) identified emphysema in nearly one-quarter of patients undergoing baseline low-dose computed tomography (CT) screening for lung cancer. Three-quarters of those...

leukemia

Addition of Pegaspargase Intensification to Standard Low-Intensity Chemotherapy Backbone in Pediatric Low-Risk B-Cell ALL

In an analysis from the Children’s Oncology Group (COG) AALL0331 trial reported in the Journal of Clinical Oncology, Mattano et al found that the addition of pegaspargase intensification did not improve the high rate of continuous complete remission achieved with a standard COG low-intensity...

breast cancer
covid-19

Impact of COVID-19 Pandemic on Delivery of Breast Cancer Care in New York

In a single-institution retrospective study focused on a New York City location reported in JCO Oncology Practice, Satish et al found that more than 40% of patients with breast cancer not infected with COVID-19 had a delay or change in care delivery due to the pandemic. Study Details The study...

immunotherapy

Risk of Venous and Arterial Thromboembolism in Patients With Cancer Receiving Immune Checkpoint Inhibitors

In a single-institution retrospective analysis reported in the journal Blood, Moik et al found a substantial risk of thromboembolic events in patients receiving immune checkpoint inhibitor therapy for cancer, as well as an increased risk of mortality among those experiencing venous ...

supportive care

Effect of Gamification With Social Incentives on Increased Mobility After Hospital Discharge

In a single-institution study reported in JAMA Network Open, Greysen et al found that a strategy of behaviorally designed gamification with social support did not increase mobility among patients discharged from inpatient general medicine or oncology units, although benefit was observed in a...

skin cancer
immunotherapy

Chronic Immune-Related Adverse Events Associated With Adjuvant Immunotherapy for Advanced Melanoma

In a retrospective cohort study reported in JAMA Oncology, Patrinely et al found that chronic immune-related adverse events occurred in a high proportion of patients receiving adjuvant PD-1–targeted therapy for high-risk resected melanoma and frequently persisted even during prolonged follow-up....

multiple myeloma
immunotherapy

FDA Approves Isatuximab-irfc Combination for Relapsed or Refractory Multiple Myeloma

On March 31, the U.S. Food and Drug Administration (FDA) approved isatuximab-irfc (Sarclisa) in combination with carfilzomib and dexamethasone for the treatment of adult patients with relapsed or refractory multiple myeloma who have received one to three prior lines of therapy. IKEMA The efficacy...

breast cancer
immunotherapy

Does Adding Adjuvant Concurrent Trastuzumab to Radiotherapy After Lumpectomy for HER2-Positive DCIS Reduce Ipsilateral Recurrence?

As reported in the Journal of Clinical Oncology by Cobleigh et al, the phase III NRG Oncology/NSABP B-43 trial did not show a significant reduction in ipsilateral breast tumor recurrence with the addition of adjuvant concurrent trastuzumab to radiotherapy in women undergoing lumpectomy for...

lymphoma
immunotherapy

Pembrolizumab vs Brentuximab Vedotin in Relapsed or Refractory Classical Hodgkin Lymphoma: KEYNOTE-204 Trial

As reported in The Lancet Oncology by John Kuruvilla, MD, and colleagues, an interim analysis of the phase III KEYNOTE-204 trial has shown significantly improved progression-free survival with pembrolizumab vs brentuximab vedotin in patients with relapsed or refractory classical Hodgkin lymphoma....

integrative oncology
pain management
survivorship

Electroacupuncture and Auricular Acupuncture vs Usual Care for Chronic Musculoskeletal Pain in Cancer Survivors

In the PEACE study, reported in JAMA Oncology, Jun J. Mao, MD, MSCE, and colleagues found that both electroacupuncture and auricular acupuncture significantly reduced pain severity vs usual care in cancer survivors with chronic musculoskeletal pain. Noninferiority of auricular acupuncture to...

issues in oncology

Risk of Artery Dissection or Aneurysm With Use of Antiangiogenic Drugs

In a pharmacovigilance study reported as a research letter in JAMA Oncology, Guyon et al found evidence that use of antiangiogenic drugs in cancer treatment is associated with increased risk of artery dissection and aneurysm. Study Details All artery dissection or aneurysm cases from July 2005 to...

gynecologic cancers

WEE1 Inhibition in Patients With Recurrent Uterine Serous Carcinoma

In a single-institution phase II trial reported in the Journal of Clinical Oncology, Joyce F. Liu, MD, MPH, and colleagues found that the WEE1 inhibitor adavosertib produced durable responses in women with recurrent uterine serous carcinoma. The investigators stated, “Uterine serous carcinoma is a...

survivorship
supportive care

Inclusion of Surveillance Ejection Fraction in Predicting Risk of 10-Year Left-Ventricular Systolic Dysfunction in Survivors of Childhood Cancer

In a Dutch study reported in JACC: CardioOncology, Leerink et al found that the addition of ejection fraction measurement at the time of first surveillance echocardiogram improved prediction of 10-year risk of left-ventricular systolic dysfunction vs prediction based on cumulative anthracycline and ...

pancreatic cancer

Definitive Ablative Radiation Therapy in Inoperable Locally Advanced Pancreatic Cancer

In a single-institution study reported in JAMA Oncology, Reyngold et al found that definitive hypofractionated ablative radiation therapy following induction chemotherapy was associated with prolonged locoregional control and favorable survival in patients with inoperable locally advanced...

breast cancer
genomics/genetics

U.S. Population–Based Study of Prevalence of and Risk Associated With Breast Cancer–Predisposition Genes

In a U.S. population–based, case-control study reported in The New England Journal of Medicine, Chunling Hu, MD, PhD, of the Mayo Clinic, Rochester, Minnesota, and colleagues identified the prevalence of and breast cancer risk associated with germline pathogenic variants in established and...

kidney cancer
immunotherapy

Nivolumab Plus Cabozantinib as First-Line Treatment of Advanced Renal Cell Carcinoma

On January 22, 2021, the U.S. Food and Drug Administration approved the combination of nivolumab and cabozantinib as first-line treatment for patients with advanced renal cell carcinoma.1-3 Supporting Efficacy Data Approval was based on the findings of the phase III, open-label CheckMate 9ER trial...

breast cancer

Distant Metastasis–Free Survival With Adjuvant vs No Adjuvant Chemotherapy According to Genomic and Clinical Risk in Early Breast Cancer

In an updated analysis of the European phase III MINDACT trial reported in The Lancet Oncology, Martine Piccart, MD, and colleagues found confirmatory evidence of the initial finding of a high rate of distant metastasis–free survival among patients with high–clinical-risk but low–genomic-risk...

breast cancer
covid-19

Time to Treatment Initiation for Breast Cancer During the COVID-19 Pandemic: Single-Institution Study

In a single-institution study reported in JCO Oncology Practice, Hawrot et al found that there was no increase in time to treatment initiation after histologic diagnosis in patients with newly diagnosed breast cancer during the first wave of the COVID-19 pandemic in 2020. However, they did find...

bladder cancer
immunotherapy

Adjuvant Atezolizumab in Muscle-Invasive Urothelial Carcinoma: IMvigor010

As reported in The Lancet Oncology by Joaquim Bellmunt, MD, PhD, and colleagues, the phase III IMvigor010 trial showed no improvement in disease-free survival with adjuvant atezolizumab vs observation in patients with muscle-invasive urothelial carcinoma. Study Details In the open-label trial, 809...

pancreatic cancer
genomics/genetics

Olaparib for Previously Treated Patients With Pancreatic Cancer and DDR Genetic Alterations Other Than BRCA Variants

Combined results of two parallel phase II studies reported in JAMA Oncology by Milind Javle, MD, and colleagues indicated that olaparib may have therapeutic value in previously treated patients with platinum-sensitive pancreatic ductal carcinoma with DNA damage repair (DDR) genetic alterations...

myelodysplastic syndromes
immunotherapy

Identification of Genomic Subgroups of Patients With Myelodysplastic Syndromes: New Prognostic Modeling

In a study reported in the Journal of Clinical Oncology, Bersanelli et al reported that researchers in the EuroMDS Project found that patients with myelodysplastic syndromes (MDS) could be classified into eight distinct subtypes based on genomic characteristics. They also developed a new prognostic ...

solid tumors

Analysis From the International Germ Cell Cancer Collaborative Group Update Consortium

In an analysis of a modern cohort of patients with metastatic seminoma reported in the Journal of Clinical Oncology, Beyer et al, members of the International Germ Cell Cancer Collaborative Group (IGCCCG) Update Consortium, found that progression-free and overall survival have improved compared...

head and neck cancer

First-Line TPEx vs EXTREME Regimen for Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma

In a phase II trial (GORTEC 2014-01 TPExtreme) reported in The Lancet Oncology, Joël Guigay, MD, and colleagues found that first-line TPEx (docetaxel/platinum/cetuximab) did not improve overall survival vs the standard-of-care EXTREME regimen (fluorouracil [5-FU]/platinum/cetuximab) in patients...

issues in oncology
prostate cancer

Patient Refusal of Provider-Recommended Locoregional Treatment for Prostate Cancer: Sociodemographic Factors

In a study reported in JCO Oncology Practice, Dee et al found that the rate of refusal of provider-recommended locoregional treatment for localized prostate adenocarcinoma has increased over time, with Black and Asian men with intermediate- or higher-risk disease being more likely to refuse such...

issues in oncology

Association of Cardiovascular Risk Factors With Risk of Subsequent Cancer

In a study reported in JACC: CardioOncology, Emily S. Lau, MD, and colleagues found that the presence of cardiovascular disease risk factors was significantly associated with an increased risk of future cancer, although no increased risk was observed among individuals who had a history of...

hematologic malignancies
leukemia
lymphoma

Noncovalent BTK Inhibitor Pirtobrutinib in Relapsed or Refractory B-Cell Malignancies

In the phase I/II BRUIN trial reported in The Lancet, Anthony R. Mato, MD, and colleagues found that the noncovalent Bruton’s tyrosine kinase (BTK) inhibitor pirtobrutinib produced durable responses in patients with relapsed or refractory B-cell malignancies, including those previously treated with ...

gastroesophageal cancer

Hybrid Minimally Invasive vs Open Esophagectomy for Esophageal Cancer: 5-Year Outcomes

In long-term follow-up of the French phase III MIRO trial reported in JAMA Surgery, Nuytens et al found no significant difference in 5-year overall or disease-free survival with hybrid minimally invasive esophagectomy vs open esophagectomy in patients with esophageal cancer. In the multicenter...

lung cancer
immunotherapy

Immunotherapy Doublet as Maintenance Therapy for Extensive-Disease SCLC

As reported in the Journal of Clinical Oncology by Taofeek K. Owonikoko, MD, PhD, and colleagues, the phase III CheckMate 451 trial showed no improvement in overall survival with combined nivolumab and ipilimumab vs placebo as maintenance therapy for extensive-disease small cell lung cancer. Study ...

lymphoma

Umbralisib for Relapsed or Refractory Indolent Non-Hodgkin Lymphoma

As reported in the Journal of Clinical Oncology by Nathan H. Fowler, MD, and colleagues, the phase IIb UNITY-NHL trial has shown that the dual PI3Kδ/casein kinase (CK) 1ε inhibitor umbralisib produced durable responses in patients with relapsed or refractory indolent non-Hodgkin lymphoma. The study ...

colorectal cancer
survivorship

Use of Chemotherapy and Risk of Alzheimer’s Disease in Colorectal Cancer Survivors

In a retrospective cohort study reported in JCO Oncology Practice, Akushevich et al found that receipt of chemotherapy was associated with a reduced risk of Alzheimer’s disease in colorectal cancer survivors. As stated by the investigators, “Evidence on the nature of the relationship between...

lung cancer

Updated Evidence Report and Systematic Review of Low-Dose CT Screening for Lung Cancer

In an analysis of updated evidence on low-dose computed tomography (CT) screening for lung cancer reported in JAMA, Jonas et al found that screening can reduce lung cancer mortality but may be associated with a range of potential harms. The analysis was performed to inform the new U.S. Preventive...

leukemia
myelodysplastic syndromes
genomics/genetics

Whole-Genome Sequencing vs Cytogenetic Analysis in Myeloid Cancers

In a study reported in The New England Journal of Medicine, Duncavage et al found that whole-genome sequencing in patients with acute myeloid leukemia (AML) or myelodysplastic syndromes (MDS) provided rapid genomic profiling that improved diagnostic yield vs conventional cytogenetic analysis, as...

breast cancer
immunotherapy

Pembrolizumab vs Chemotherapy in Previously Treated Patients With Metastatic Triple-Negative Breast Cancer: KEYNOTE-119

As reported in The Lancet Oncology by Eric P. Winer, MD, FASCO, and colleagues, the phase III KEYNOTE-119 trial showed no significant improvement in overall survival with pembrolizumab vs investigator’s choice of chemotherapy in the second- or third-line treatment of metastatic triple-negative...

breast cancer

Persistent Use of Low-Value Breast Cancer Surgeries Designated for Deimplementation by Choosing Wisely

In a retrospective cohort study reported in JAMA Surgery, Wang et al found persistent use of low-value breast cancer surgeries designated for deimplementation by the Choosing Wisely program, with a wide interfacility variation in use of these procedures. Study Details The study used National Cancer ...

lymphoma

ROBUST Trial: Addition of Lenalidomide to R-CHOP in Previously Untreated ABC-Type DLBCL

As reported in the Journal of Clinical Oncology by Grzegorz S. Nowakowski, MD, and colleagues, the phase III ROBUST trial showed that the addition of lenalidomide to R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone; R2-CHOP) did not significantly improve...

gynecologic cancers

Secondary Cytoreduction Plus Chemotherapy vs Chemotherapy Alone in Relapsed Platinum-Sensitive Epithelial Ovarian Cancer

In a Chinese phase III trial (SOC-1) reported in The Lancet Oncology, Shi et al found that secondary cytoreduction followed by chemotherapy significantly prolonged progression-free survival vs chemotherapy alone in patients with platinum-sensitive relapsed epithelial ovarian cancer. No significant...

kidney cancer
immunotherapy

CheckMate 9ER: First-Line Nivolumab Plus Cabozantinib vs Sunitinib for Advanced Renal Cell Carcinoma

As reported in The New England Journal of Medicine by Toni K. Choueiri, MD, and colleagues, the phase III CheckMate 9ER trial has shown that the combination of nivolumab and cabozantinib improved progression-free survival and overall survival vs sunitinib in first-line treatment of patients with...

global cancer care

Value of Global Scale-up of Cancer Care: Investment in Treatment, Imaging, and Quality of Care

In a simulation-based analysis reported in The Lancet Oncology, Ward et al found that the scaling up of cancer treatment packages, imaging modalities, and quality of care to the levels found in high-income countries would markedly reduce cancer mortality in low- to middle-income countries, as well...

lung cancer

High- vs Standard-Dose Thoracic Radiotherapy for Limited-Stage Small Cell Lung Cancer

In a phase II trial reported in The Lancet Oncology, Grønberg et al found that use of high-dose vs standard-dose twice daily thoracic radiotherapy as part of first-line chemoradiotherapy was associated with significantly improved overall survival and similar toxicity in patients with limited-stage...

prostate cancer

Meta-analysis of Intermediate Clinical Endpoints as Surrogates for Overall Survival in Localized Prostate Cancer

In a meta-analysis reported in The Lancet Oncology, Gharzai et al found that commonly used intermediate clinical endpoints in clinical trials in localized prostate cancer do not correlate well with overall survival, apart from metastasis-free survival—supporting the establishment of metastasis-free ...

kidney cancer
immunotherapy

Immunotherapy for Advanced Kidney Cancer: Effect of Body Mass Index

In a study reported in a research letter in JAMA Oncology, Lalani et al found that higher body mass index (BMI) was associated with better overall survival among patients with metastatic renal cell carcinoma receiving anti­–PD-1/PD-L1–based immune checkpoint inhibitor treatment. No association of...

cns cancers
survivorship

Weight Gain in Childhood Brain Tumor Survivors and Potential Association With Hypothalamic-Pituitary Dysfunction

In a Dutch study reported in the Journal of Clinical Oncology, van Schaik et al found that significant weight gain and being overweight and/or obese are common in childhood brain tumor survivors and may be associated with hypothalamic-pituitary dysfunction. Study Details The study involved data...

leukemia

Responses to Conjugate Pneumococcal Vaccine in Patients With Chronic Lymphocytic Leukemia

In an Italian study reported in Leukemia, Mauro et al found that only a small minority of patients with chronic lymphocytic leukemia (CLL) developed an adequate immune response to pneumococcal vaccination, with response being more likely in patients who were younger, had previously untreated and...

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