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solid tumors

Iobenguane I-131 for Advanced Pheochromocytoma or Paraganglioma

ON JULY 30, 2018, the radiotherapeutic agent iobenguane I-131 (Azedra) was approved for the treatment of adult and pediatric patients (aged ≥ 12 years) with iobenguane scan–positive, unresectable, locally advanced or metastatic pheochromocytoma or paraganglioma who require systemic anticancer...

issues in oncology

ASCO President-Elect Candidates Identify Key Issues Facing the Field of Oncology

Lori J. Pierce, MD, FASTRO, FASCO, of the University of Michigan, and Carolyn D. Runowicz, MD, FASCO, of Herbert Wertheim College of Medicine, Florida International University, Miami, were selected by the ASCO Nominating Committee as candidates for President-Elect. Why do you want to serve as ASCO...

skin cancer

Cemiplimab-rwlc for Metastatic or Locally Advanced Cutaneous Squamous Cell Carcinoma

On September 28, 2018, cemiplimab-rwlc (Libtayo) was approved for the treatment of patients with metastatic cutaneous squamous cell carcinoma or locally advanced cutaneous squamous cell carcinoma who are not candidates for curative surgery or curative radiation.1 Supporting Efficacy Data Approval...

skin cancer
immunotherapy

Neoadjuvant Therapy With Reduced-Dose Immunotherapy for Stage III Melanoma

In patients with stage III melanoma, a reduced-dose neoadjuvant immunotherapy combination was well tolerated and led to high pathologic response rates, in the phase II OpACIN-neo trial presented at the European Society for Medical Oncology (ESMO) 2018 Congress.1 “Neoadjuvant ipilimumab (Yervoy) at...

gastrointestinal cancer
colorectal cancer
immunotherapy

First-Line Immunotherapy Shows Benefit in Metastatic Colorectal Cancer Subset

In previously untreated patients with metastatic colorectal cancer and tumors demonstrating microsatellite instability–high (MSI-high) or mismatch repair deficiency (dMMR), immunotherapy with nivolumab (Opdivo) and low-dose ipilimumab (Yervoy) produced a durable clinical benefit in the...

prostate cancer

Adding Pelvic Node Radiation and Short-Term Hormone Therapy to Salvage Radiation Provides Significant Benefit in Prostate Cancer

For patients with prostate cancer who have persistent or rising prostate-specific antigen (PSA) levels after radical prostatectomy, the addition of short-term androgen-deprivation therapy and radiotherapy to the pelvic lymph nodes demonstrated increased rates of freedom from disease progression,...

issues in oncology

Dealing With the Challenges Presented by the Parenteral Opioid Shortage

The opioid drug problem in the United States is a crisis, with unprecedented numbers of overdose deaths. The reaction to this has resulted in new federal laws and regulations aimed at restricting overuse and overprescribing of opioids. However, these well-intentioned actions, along with other...

solid tumors

NCRI 2018: HiLo Trial: Rate of Thyroid Cancer Recurrence After Adjuvant Lower-Dose Radiation

Patients with thyroid cancer whose disease is at low risk of returning can be treated safely with a smaller amount of radiation following surgery, according to results from the HiLo trial presented by Wadsley et al at the 2018 National Cancer Research Institute (NCRI) Cancer Conference (Abstract...

issues in oncology
cost of care

Financial Toxicity Experienced by Adults With Cancer

In a study reported in the Journal of Oncology Practice, Knight et al found that 26% of patients with cancer acknowledged ‘financial toxicity’—treatment-related financial harm—with respect to cancer care, and that this toxicity was associated with consequences such as...

breast cancer

Neoadjuvant Chemotherapy With vs Without Anthracyclines Plus Dual HER2 Inhibitors in HER2-Positive Breast Cancer

In the Dutch Breast Cancer Research Group’s phase III TRAIN-2 trial reported in The Lancet Oncology, van Ramshorst et al found no difference in pathologic complete response rate with neoadjuvant chemotherapy with vs without an anthracycline plus dual HER2 blockade in women with HER2-positive...

ME STRONG Joins With ASCO’s Conquer Cancer Foundation to Support Research for Men’s Cancers and Neuroblastoma

ME STRONG, a nonprofit public charity in Deland, Florida, is one of the newest supporters of Conquer Cancer. Linda Ryan, ME STRONG co-founder and 16-year cancer survivor, understands the importance of research: it saved her life decades ago, and she’s relying on experimental treatment as she...

hematologic malignancies
cost of care

New Report Demonstrates Cost of Blood Cancer Care

The costs to treat blood cancer are higher than costs for other cancers, and the costs incurred by a patient diagnosed with a blood cancer do not return to precancer levels, according to a Milliman study commissioned by The Leukemia & Lymphoma Society (LLS). The study—The...

cost of care

Cost of Cancer Care in Community vs Hospital Settings

In a study reported in the Journal of Oncology Practice, Gordan et al found that costs of care for patients with breast, colorectal, and lung cancers were significantly higher at hospital-based vs community-based clinics, largely reflecting higher costs of chemotherapy and provider visits. Study...

palliative care
issues in oncology
symptom management

2018 Palliative Care: Can an AI-Based App Help Manage Cancer-Related Pain?

A study of 112 patients with metastatic solid tumors found that the use of an artificial intelligence (AI)-based smartphone app reduced both the severity of patients’ reported pain and hospital admissions. After an 8-week period, patients who used the AI-powered app to monitor and address...

issues in oncology
symptom management

2018 Palliative Care: Immunotherapy-Related Adverse Events May Be More Common Than Initially Reported

An analysis of nearly 2,800 patients with non­–small cell lung cancer (NSCLC) who received the immune checkpoint inhibitors nivolumab (Opdivo), pembrolizumab (Keytruda), or atezolizumab (Tecentriq) found that adverse events may be more common than reported in the initial trials that led...

immunotherapy
lung cancer

Corticosteroids and Immunotherapy: Guilty or Guilt By Association?

FIRST-LINE TREATMENT options for advanced non–small cell lung cancer (NSCLC) include single- agent immunotherapy for patients with a programmed cell death ligand 1 (PD-L1) tumor proportion score of at least 50% or in combination with chemotherapy in unselected patients.1-3 Single immunotherapy is...

bladder cancer
immunotherapy

Expert Point of View: Shahrokh Shariat, MD

“BACILLUS CALMETTE-GUÉRIN (BCG) failures are quite common, with a 66% recurrence rate at 5 years, and about 25% of patients will have disease progression,” explained formal discussant Shahrokh Shariat, MD, Chair of the Department of Urology at Medical University, Vienna, and Adjunct Professor at...

gynecologic cancers

Results Reported for Olaparib Maintenance in Ovarian Cancer

TWO-YEAR MAINTENANCE therapy with olaparib (Lynparza), a poly (ADP-ribose) polymerase inhibitor, achieved a significant improvement in progression-free survival in patients with newly diagnosed advanced ovarian cancer and a BRCA1 or BRCA2 mutation, according to results of the phase III SOLO-1...

breast cancer
immunotherapy

Immunotherapy Improves Survival in a Subset of Patients With Metastatic Triple-Negative Breast Cancer

IMMUNOTHERAPY APPEARS to be the new upfront standard of care for patients with metastatic triple-negative breast cancer, based on a late-breaking presentation at the European Society for Medical Oncology (ESMO) 2018 Congress1 and simultaneously published in The New England Journal of Medicine.2 In ...

gastrointestinal cancer

Trifluridine/Tipiracil in Heavily Pretreated Metastatic Gastric Cancer

In the phase III TAGS trial reported in The Lancet Oncology, Shitara et al found that trifluridine/tipiracil (Lonsurf) significantly improved overall survival vs placebo in patients with heavily pretreated metastatic gastric cancer. In the double-blind trial, 507 patients with nonresectable...

multiple myeloma

FDA Approves Elotuzumab Plus Pomalidomide and Dexamethasone for Relapsed or Refractory Multiple Myeloma

On November 6, the U.S. Food and Drug Administration (FDA) approved elotuzumab (Empliciti) injection for intravenous use in combination with pomalidomide (Pomalyst) and dexamethasone for the treatment of adult patients with multiple myeloma who have received at least two prior therapies,...

FDA Releases Draft Guidance for Clinical Trial Design

The U.S. Food and Drug Administration (FDA) announced the availability of the Draft Guidance Master Protocols: Efficient Clinical Trial Design Strategies to Expedite Development of Cancer Drugs and Biologics. Master protocol trial designs are complex due to the concurrent evaluation of multiple...

Family Archivist Holds Joyful Memories Amid Grief of Losing Loved Ones

BOOKMARK Title: The Trail to Tincup: Love Stories at Life’s EndEditors: Joyce Lynnette HockerPublisher: She Writes PressPublication date: May 2018Price: $23.95, hardcover, 288 pages Human mortality is embedded in the day-to-day challenges of clinical oncology; a cancer diagnosis is a reality...

issues in oncology

Cancer Care in the U.S. Prison System

A health-care system is evaluated by various metrics: one is how it cares for its most vulnerable patients. The United States spends far more on health care than any nation in the world, yet access to high-quality oncology services remains elusive to certain minority populations—none more so than...

issues in oncology

Study Suggests Risk of Cancer Death Increases With Each Generation of Latinos Born in the United States

According to the U.S. Census Bureau, as of July 2016, the Hispanic population in the United States had grown to 57.5 million, making people of Hispanic origin the nation’s largest ethnic or racial minority group. Studies have shown that U.S.-born Latinos have a higher incidence of cancer than ...

colorectal cancer
immunotherapy

ESMO 2018: CheckMate-142 Reports New Data on First-Line Nivolumab Plus Low-Dose Ipilimumab in MSI-H/dMMR Metastatic Colorectal Cancer

The combination of nivolumab (Opdivo) and low-dose ipilimumab (Yervoy) could become a new first-line treatment in patients with microsatellite instability–high (MSI-H), mismatch repair–deficient (dMMR) metastatic colorectal cancer, following results from the CheckMate-142 trial reported ...

breast cancer

ESMO 2018: HOBOE-2: Zoledronic Acid in Premenopausal Hormone Receptor–Positive Early Breast Cancer

Adjuvant treatment with zoledronic acid, plus hormonal therapy with the aromatase inhibitor letrozole, significantly increases disease-free survival compared to tamoxifen in premenopausal women with hormone receptor–positive early breast cancer, according to results reported by Perrone et al...

skin cancer
immunotherapy

ESMO 2018: CheckMate 067: 4-Year Follow-up of Nivolumab Plus Ipilimumab in Advanced Melanoma

As reported in The Lancet Oncology and at the European Society for Medical Oncology 2018 Congress by Hodi et al, the 4-year follow-up of the phase III CheckMate 067 trial has shown a continued overall survival benefit with first-line nivolumab (Opdivo) plus ipilimumab (Yervoy) or nivolumab alone vs ...

breast cancer

Novel Statistical Model in Estimating the Risk of Breast Cancer Recurrence

Although population-based cancer registries data are useful in tracking and reporting the evolving burden of cancer in the population, the information they capture reflects the outcomes of diagnosis and death, regardless of whether the death is due to the disease or to other causes, and not data on ...

solid tumors

2018 ASTRO: SABR-COMET: Stereotactic Ablative Radiation Therapy for Oligometastatic Tumors

In the first randomized, phase II clinical trial of its kind, researchers have shown that an aggressive form of high-precision radiation therapy can increase survival in patients with oligometastatic tumors. These findings were presented by Palma et al in the plenary session at the 60th Annual ...

lung cancer

2018 ASTRO: Overall Survival With Local Consolidative Therapy in Oligometastatic NSCLC

Adding radiation therapy or surgery to systemic therapy for patients with stage IV lung cancer whose cancer has spread to a limited number of sites can significantly extend overall survival, according to new results from a multicenter, randomized, controlled phase II study. The findings were...

I’m Not Dying of Cancer: I’m Living With Cancer

I’m a psychiatrist, so I don’t say this lightly: receiving a diagnosis of stage IV gastric adenocarcinoma made me insane. I had remembered the horrible deaths due to abdominal cancer I had seen during my medical training and was terrified that would be my fate as well. I knew from looking at the...

Overcoming Long-Term Health and Economic Impact of Cancer on Young Adult Survivors

A pair of studies showcased the potentially devastating long-term health and financial consequences cancer has on adult survivors of childhood cancer compared with other adults, as well as survival disparities based on health insurance status.1,2 Despite increasing survival rates among the more...

gynecologic cancers

ESMO 2018: SOLO-1: Olaparib Maintenance Extends Progression-Free Survival in BRCA1/2-Mutated Advanced Ovarian Cancer

Two-year maintenance therapy with olaparib (Lynparza), a poly ADP-ribose polymerase (PARP) inhibitor, led to a substantial improvement in progression-free survival (PFS) in newly diagnosed patients with advanced ovarian cancer and a BRCA1/2 mutation, results from the phase III SOLO-1 trial...

issues in oncology

Multiple Financial Barriers Impede Patient Participation in Cancer Clinical Trials, According to New ASCO Policy Statement

ASCO issued a set of recommendations for overcoming financial barriers to patient participation in cancer clinical trials. The policy statement stresses the importance of increasing participation in clinical research, especially for patients from particular ethnic, racial, geographic, age,...

supportive care
pain management

The Opioid Crisis From the Oncology Perspective

As the nation battles an escalating opioid-overdose crisis, which claims more than 100 lives per day, a new study presented at the 2018 ASCO Quality Care Symposium was designed to answer a heretofore unanswered question: How common are opioid-related deaths in patients with cancer?1 Unintended...

solid tumors
hepatobiliary cancer

Cabozantinib in Advanced Hepatocellular Cancer: Call for Revision of Practice Standards

As reported in The New England Journal of Medicine by Ghassan K. Abou-Alfa, MD, and colleagues, and reviewed in this issue of The ASCO Post, the phase III CELESTIAL trial has demonstrated that cabozantinib (Cabometyx) improved the median overall survival to 10.2 months in comparison to 8 months...

breast cancer
immunotherapy

ESMO 2018: IMpassion 130: Atezolizumab Plus Nab-Paclitaxel in Metastatic Triple-Negative Breast Cancer

A combination of immunotherapy and chemotherapy improves survival in some patients with metastatic triple-negative breast cancer, according to late-breaking results from the IMpassion130 trial reported by Schmid et al at the European Society for Medical Oncology (ESMO) 2018 Congress (Abstract...

breast cancer

ESMO 2018: HDAC Inhibitor Therapy in Advanced Hormone Receptor–Positive Breast Cancer

A phase III trial presented by Jiang et al at the European Society for Medical Oncology (ESMO) 2018 Congress showed activity of histone deacetylase (HDAC) inhibitor therapy in advanced hormone receptor–positive breast cancer (Abstract 283O_PR). Endocrine therapies are the foundation of...

leukemia

Current Treatment Landscape of Relapsed or Refractory Chronic Lymphocytic Leukemia

Novel agents such as ibrutinib (Imbruvica), idelalisib (Zydelig), and venetoclax (Venclexta) have transformed the treatment of chronic lymphocytic leukemia (CLL) and are increasingly used to treat the disease. The optimal sequencing of these agents is not clear in relapsed or refractory disease,...

lung cancer

Entrectinib Shows Activity in ROS1-Positive NSCLC

Although ROS1-mutated lung cancer accounts for about 1% to 2% of all non–small cell lung cancers (NSCLCs), it is an important druggable oncogene, and new data show that it can be successfully targeted for clinical gain. In a pooled analysis of phase I and II trials in patients with ROS1-positive...

immunotherapy
lung cancer

Durvalumab Improves Overall Survival in Unresectable Stage III NSCLC

Several lung cancer trials have shown prolonged progression-free survival with checkpoint inhibitor therapy. For the first time, the phase III PACIFIC trial has found an overall survival benefit for the selective programmed cell death ligand 1 (PD-L1) checkpoint inhibitor durvalumab (Imfinzi) vs...

issues in oncology
global cancer care

Cancer Care in the Palestinian Territories

The global burden of cancer is huge and growing. In 2018, there will be > 18 million new cancer cases and 9.6 million deaths.1,2 Although several recent articles have reviewed cancer in developing countries, few have focused on the Palestinian territories. There are several reasons for that,...

hematologic malignancies
immunotherapy

Adoptive T-Cell Therapy for Progressive Multifocal Leukoencephalopathy

An emerging treatment known as adoptive T-cell therapy has proven effective in a phase II clinical trial for treating progressive multifocal leukoencephalopathy (PML), a rare and often fatal brain infection sometimes observed in patients with cancer and other diseases in which the immune...

gynecologic cancers

Adjuvant Chemotherapy in High-Grade Uterine Leiomyosarcoma

As reported in the Journal of Clinical Oncology by Hensley et al, a phase III NRG Oncology/Gynecologic Oncology Group study assessing adjuvant chemotherapy vs observation in disease-free patients with uterus-confined high-grade leiomyosarcoma was stopped due to accrual futility; available data...

issues in oncology

Established, Modifiable Cancer Risk Factors

According to a new American Cancer Society report published by Gapstur et al in CA: A Cancer Journal for Clinicians, the highest priority in a national cancer control plan is the expansion of tobacco control—the intervention with the largest potential health benefits. This report is the...

lymphoma

Chemotherapy-Free Initial Treatment of Advanced Indolent Lymphoma

In an analysis of two Nordic Lymphoma Group trials with long-term follow up reported in the Journal of Clinical Oncology, Lockmer and colleagues found evidence that many patients receiving rituximab (Rituxan) as initial treatment for advanced indolent lymphoma may not require the addition of...

skin cancer
immunotherapy

Small Study of Neoadjuvant Combination Checkpoint Blockade in High-Risk Stage III Melanoma

Neoadjuvant combination checkpoint blockade showed activity among patients with high-risk stage III melanoma in a small study. However, a high incidence of side effects caused the trial to be closed early. These results were published by Amaria et al in Nature Medicine. The phase II...

issues in oncology

Report Outlines Cancer Risk Among Hispanics/Latinos in the United States

The cancer burden in Puerto Rico, a U.S. territory with a 99% Hispanic population, is substantially different from that of Hispanics in the continental United States, according to Cancer Statistics for Hispanics/Latinos, 2018. The report, published every 3 years, found that men in Puerto Rico...

solid tumors
issues in oncology

New Techniques in Intraoperative-Guided Imagery May Enhance Outcomes in Patients With Cancer

Primary treatment of most solid tumors includes surgical excision or radiation therapy, both of which require precise anatomic localization of the tumor as well as surrounding tissue and organs. If the targeting is too broad, unnecessary morbidity may occur to nearby structures, along with the...

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