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issues in oncology

Increased Physical Activity Associated With Lower Risk of 13 Types of Cancer

A new study of the relationship between physical activity and cancer has shown that greater levels of leisure-time physical activity were associated with a lower risk of developing 13 different types of cancer. The risk of developing seven cancer types was 20%, or more, lower among the...

bladder cancer

Anti–PD-L1 Antibody Atezolizumab Active in Previously Treated Advanced Urothelial Carcinoma

In a phase II trial reported in The Lancet, Jonathan E. Rosenberg, MD, of Memorial Sloan Kettering Cancer Center, and colleagues found that the anti–PD-L1 (programmed cell death ligand 1) antibody atezolizumab produced durable responses in a marked proportion of patients with previously treated...

kidney cancer

Curb Your Enthusiasm: No Benefit of Adjuvant Sorafenib or Sunitinib in Nonmetastatic Renal Cell Carcinoma

Renal cell carcinoma is the most common cancer of the kidneys. Up to 30% of patients present with advanced/metastatic disease, and recurrence can develop in patients at high risk treated by nephrectomy for localized tumors. Renal cell carcinoma is notoriously resistant to chemotherapy and...

kidney cancer

No Disease-Free Survival Benefit of Adjuvant Sunitinib or Sorafenib in High-Risk Nonmetastatic Renal Cell Carcinoma

In the phase III ECOG-ACRIN E2805 trial reported in The Lancet by Naomi B. Haas, MD, of Abramson Cancer Center, University of Pennsylvania, and colleagues, no benefit of adjuvant vascular endothelial growth factor receptor (VEGFR) inhibitor treatment with sunitinib or sorafenib (Nexavar) was...

Expert Point of View: Mayer Fishman, MD, PhD

“This was a difficult study to conduct. It required 13 centers in 8 countries over 3 years to recruit these patients—that’s about 1 patient per site per year,” said Mayer Fishman, MD, PhD, of Moffitt Cancer Center in Tampa, Florida. “It’s an important study, because these patients are typically...

breast cancer
prostate cancer
hematologic malignancies

Highlights From the 2016 AACR Annual Meeting

This year’s Annual Meeting of the American Association for Cancer Research (AACR) featured outstanding research in the field of cancer, as well as an inspiring talk by Vice President Joe Biden (see the May 10 issue of The ASCO Post). Here are some summaries of studies that warrant attention; they...

integrative oncology

Fitness: Can Exercise Lengthen Survival in Patients With Cancer?

Integrative Oncology is guest edited by Barrie R. Cassileth, MS, PhD, of Memorial Sloan ­Kettering Cancer Center, New York. Regular physical activity has long been associated with decreased risk of disease, including many types of cancer. Such benefits may translate into increased life expectancy...

issues in oncology

Maximizing Cancer Cure: How Do We Get There?

Is cancer really “curable,” and if so, how? For a “Cancer Dialogue” held during the 2016 American Association of Cancer Research (AACR) Annual Meeting, half a dozen stellar participants from the research, industry, regulatory, and advocacy communities convened to debate the topic. The ASCO Post was ...

cost of care
leukemia

The Arrival of Generic Imatinib Into the U.S. Market: An Educational Event

Imatinib mesylate (Gleevec), a Bcr-Abl tyrosine kinase inhibitor, is approved therapy for chronic myeloid leukemia (CML) in the United States. Imatinib is a miraculous drug that results in a normal functional lifespan in most patients with CML who can afford and comply with the treatment and who ...

prostate cancer

French Trial Shows Benefit of Adding Short-Term Hormone Therapy to Salvage Radiotherapy for Rising PSA After Prostatectomy

In the phase III GETUG-AFU 16 trial reported in The Lancet Oncology, Carrie et al found that adding short-term androgen suppression therapy to salvage radiotherapy was associated with improved biochemical or clinical progression-free survival among patients with prostate cancer who exhibited rising ...

breast cancer

Use of Complementary and Alternative Medicine Affects Breast Cancer Chemotherapy Initiation

Women with early-stage breast cancer for whom chemotherapy was indicated and who used dietary supplements and multiple types of complementary and alternative medicine were less likely to start chemotherapy than nonusers of alternative therapies, according to research led by Heather Greenlee, ND,...

breast cancer
solid tumors

Adding Bevacizumab to Letrozole Improves Progression-Free Survival but Increases Toxicity in Metastatic Breast Cancer

The addition of bevacizumab (Avastin) to first-line endocrine therapy with letrozole improved progression-free survival but increased toxicity among postmenopausal women with hormone receptor–positive metastatic breast cancer, according to the results of the phase III CALGB 40503/Alliance...

breast cancer

Same vs Different Order for Second Readings of Mammograms in Rates of Breast Cancer Detection

A new study has found there is no decline over time in the accuracy of medical staff who analyze mammogram scans for indications of breast cancer. Researchers at the University of Warwick investigated whether detection rates dropped toward the end of each batch of mammogram readings. The study...

prostate cancer

AUA 2016: Relationship Between Testosterone Therapy and Prostate Cancer Explored

Men with low levels of the male sex hormone testosterone need not fear that testosterone replacement therapy will increase their risk of prostate cancer. This is the finding of an analysis of more than a quarter-million medical records of mostly white men in Sweden, research led by investigators at ...

breast cancer

Some Diagnostic Variability in Interpreting Breast Biopsy Slides

Pathologists disagree about 8% of the time when interpreting a single breast biopsy slide, with more overinterpretation than underinterpretation in discordant cases, according to an analysis combining results from the B-Path (Breast Pathology) study with data on the prevalence of breast cancer...

Corporate Angel Network’s 50,000th Patient Flight Benefits Young Retinoblastoma Patient

On April 14, 2016, an 18-month-old patient with cancer named Baron Yerby flew home to Atlanta after receiving treatment at Memorial Sloan Kettering Cancer Center. However, instead of flying on a crowded commercial plane with the potential for immune deficiency issues, he and his parents flew on a...

breast cancer

Recurrences Observed in More Than 50% of Inadequately Treated Patients With Ductal Carcinoma in Situ

A mid much debate about the potential for overly aggressive treatment of ductal carcinoma in situ comes a study that gives one pause. According to research presented at the 17th Annual Meeting of the American Society of Breast Surgeons, more than half of all women with ductal carcinoma in situ that ...

leukemia

Risk Factors for Acute Pancreatitis in Children/Young Adults With Acute Lymphoblastic Leukemia

In a study reported in the Journal of Clinical Oncology, Liu et al found that Native American ancestry, older age, higher cumulative dose of asparaginase, and a rare variant of the CPA2 gene increased risk for pancreatitis in children/young adults with acute lymphoblastic leukemia (ALL). Study...

Donor Spotlight: Gateway for Cancer Research

The Conquer Cancer Foundation of ASCO is collaborating with Gateway for Cancer Research (Gateway) to fund a 2016 and 2017 Young Investigator Award through the Conquer Cancer Foundation Grants and Awards program.  “Conquer Cancer Foundation is grateful for the generous support from Gateway and...

colorectal cancer

Little Apparent Activity of Cetuximab in Refractory Metastatic Colorectal Cancer With KRAS G13D Mutation

Cetuximab (Erbitux) exhibited little apparent activity in refractory metastatic colorectal cancer harboring the KRAS G13D mutation, according to the findings of the phase II Australasian Gastro-Intestinal Trials Group ICECREAM study, which were reported by Segelov et al in the Journal of Clinical...

colorectal cancer

Trastuzumab/Lapatinib Active in Refractory, KRAS Codon 12/13 Wild-Type, HER2-Positive Metastatic Colorectal Cancer

Dual HER2 inhibition with trastuzumab (Herceptin) and lapatinib (Tykerb) was active in patients with refractory, KRAS codon 12/13 wild-type, HER2-positive metastatic colorectal cancer, according to an Italian phase II trial reported by Sartore-Bianchi et al in The Lancet Oncology. Study Details...

lymphoma

Genomic Profiling of Orbital and Ocular Adnexal Lymphomas

In a study reported in Modern Pathology, Cani et al used next-generation sequencing to identify actionable mutations in orbital and ocular adnexal lymphomas, finding frequent alterations in MYD88 and chromatin modifiers. Study Details The study involved next-generation sequencing of 36...

breast cancer

ASCO Adapts CCO Guideline on Selection of Optimal Adjuvant Therapy for Breast Cancer

ASCO has adapted a Clinical Care Ontario (CCO) clinical practice guideline on the selection of optimal adjuvant chemotherapy for early breast cancer and adjuvant targeted therapy for HER2-positive breast cancer, as reported in the Journal of Clinical Oncology. The adaptation was based on review by...

Radiation: Myths, Facts, Dangers and Benefits

For many, the word “radiation” conjures up images of mushroom clouds and the nightmarish nuclear disaster at Chernobyl. It also brings to mind those pesky dental x-rays and lifesaving cancer treatments. However, to most people, radiation is a mysterious invisible power to be feared and embraced...

breast cancer

ACS/ASCO Breast Cancer Survivorship Care Guideline

The American Cancer Society (ACS) and ASCO have issued a Breast Cancer Survivorship Care guideline, published jointly in the Journal of Clinical Oncology and CA: A Cancer Journal for Clinicians.1,2 The guideline recommendations were formulated by a multidisciplinary expert work group and are based...

cost of care

Drug Prices and Value: Finding Middle Ground

The advent of targeted therapies along with complex personalized treatment regimens has added many effective tools to the oncology armamentarium. But progress has a price tag. Although the oncology community needs new drugs, there is growing concern that the price of many newer compounds is...

lymphoma

Adding Rituximab to Dose-Dense Chemotherapy May Be of Benefit in Burkitt Lymphoma

In a French phase III trial reported in The Lancet, Ribrag et al showed that adding rituximab (Rituxan) to dose-dense chemotherapy improved event-free survival among adults with Burkitt lymphoma. Study Details In the open-label trial, 260 patients were randomized between October 2004 and...

breast cancer

Neoadjuvant Endocrine Therapy Vastly Underutilized by U.S. Clinicians

Neoadjuvant endocrine therapy in the management of breast cancer is woefully underutilized by U.S. clinicians, according to advocates of this approach who made their case at the 2016 Miami Breast Cancer Conference.1 In postmenopausal women with estrogen receptor–rich tumors, neoadjuvant endocrine...

skin cancer

AACR 2016: 5-Year Survival Rates for Patients With Metastatic Melanoma Treated With Nivolumab Much Higher Than Historical Rates

More than a third of metastatic melanoma patients (34%) who received the anti–programmed cell death protein 1 (PD-1) immunotherapeutic nivolumab (Opdivo) in a phase I clinical trial are still alive 5 years after starting treatment, according to research presented by Hodi et al at the 2016...

head and neck cancer
lung cancer
sarcoma
gastrointestinal cancer

AACR 2016: LOXO-101 Shows Continued Promise in Patients Whose Tumors Had NTRK Gene Fusions

The investigational drug LOXO-101, which selectively targets a family of proteins called neurotrophic tyrosine kinase receptors (NTRKs), produced significant tumor regression in patients whose tumors had NTRK gene fusions, according to data from a phase I clinical trial presented by Hong et al at...

symptom management

In Early Brain Radiation Recovery Studies, Cranial Grafting of Stem Cell–Derived Therapy Improves Cognition and Reduces Neuropathology

While stem cells have shown promise for treating brain regions damaged by cancer radiation treatments, University of California, Irvine (UCI) researchers have found that microscopic vesicles isolated from these cells provide similar benefits without some of the risks associated with stem cells....

breast cancer

Some Diagnostic Variability in Interpreting Breast Biopsy Slides

Pathologists would disagree about 8% of the time when interpreting a single breast biopsy slide, with more overinterpretation than underinterpretation in discordant cases, according to an analysis combining results from the B-Path (Breast Pathology) study with data on the prevalence of breast...

head and neck cancer

UK Trial Shows Similar Survival With PET-CT Surveillance vs Planned Neck Dissection in Advanced Head and Neck Cancer

In a UK noninferiority trial reported in The New England Journal of Medicine, Mehanna et al found that positron-emission tomography–computed tomography (PET-CT) surveillance was associated with similar survival vs planned neck dissection in patients with stage N2 or N3 squamous cell carcinoma ...

breast cancer

Improved Detection of Breast Cancer With Ultrasound vs Tomosynthesis in Mammography-Negative Dense Breasts

Ultrasound was associated with improved incremental detection of breast cancer at screening compared with tomosynthesis in women with mammography-negative dense breasts, according to the interim findings of the Italian prospective ASTOUND study. Tagliafico et al reported these results in the...

colorectal cancer

New Study Links Coffee Consumption to Decreased Risk of Colorectal Cancer

Researchers at the University of Southern California (USC) Norris Comprehensive Cancer Center of Keck Medicine of USC and Clalit National Israel Cancer Control Center have found that coffee consumption may be inversely associated with the risk of colorectal cancer. The findings by Schmit et...

breast cancer

Study Finds Decreased Use of Primary Breast-Conserving Surgery for Women in New York State

In a study reported in JAMA Surgery, Isaacs et al found that use of primary breast-conserving surgery for early-stage breast cancer has declined somewhat in recent years in New York State, most steeply among younger women. In addition, 90-day reoperation rates have declined and are lower for...

lung cancer

Crizotinib in ROS1-Positive Metastatic Non–Small Cell Lung Cancer

On March 11, 2016, crizotinib (Xalkori) was approved for treatment of patients with metastatic non–small cell lung cancer (NSCLC) with ROS1 rearrangement–positive tumors.1,2 A U.S. Food and Drug Administration–approved test for the detection of ROS1 rearrangements in NSCLC is not currently...

prostate cancer

Decreased PSA Screening and Decreased Diagnosis of Early-Stage Prostate Cancer

Recent data indicate that the rate of prostate-specific antigen (PSA) screening and the rate of diagnosis of early-stage prostate cancer have decreased since a 2012 U.S. Preventive Services Task Force (USPSTF) statement (released in October 2011) gave a grade D recommendation against PSA...

Understanding and Preparing for MACRA

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was passed in April 2015, introducing comprehensive changes to how Medicare pays physicians for services. As the policies passed in MACRA are rolled out over the coming years, they will profoundly impact reimbursement and care...

skin cancer

Vitamin D Level Associated With Melanoma Outcome Independent of C-Reactive Protein Level

In a study reported in the Journal of Clinical Oncology, Fang et al found that lower vitamin D levels were associated with poorer outcome in patients with melanoma independent of C-reactive protein (CRP) levels. Study Details The study involved data from 1,042 prospectively observed patients with ...

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

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...

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 ...

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...

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...

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 ...

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....

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...

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