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skin cancer

Management of Merkel Cell Carcinoma

A recent report regarding pembrolizumab (Keytruda) for advanced Merkel cell carcinoma ushered in a more optimistic era in the treatment of this rare but often lethal skin cancer.1 The ASCO Post spoke with one of the field’s leaders, Paul Nghiem, MD, PhD—the first author of the study—about the...

prostate cancer

Hypofractionated Radiotherapy for Localized Prostate Cancer: A New Standard of Care?

For at least the past quarter of a century, radiobiologists and radiation oncologists have debated the role of hypofractionation (fewer total fractions with a higher dose per fraction) for prostate cancer. The debate stems from the unique radiobiology of prostate cancer and the best means to...

breast cancer

Discrepancies Between Current ASCO-CAP Guidelines on HER2 Amplification Testing and Designations in BCIRG Trials

In an analysis reported in the Journal of Clinical Oncology, Press et al found notable discrepancies between recent ASCO–College of American Pathologists (ASCO-CAP) changes in the recommendations for evaluation of HER2 amplification by fluorescent in situ hybridization (FISH) and FISH scores...

prostate cancer

Early-Stage Prostate Cancer Incidence Rates Decline, Distant-Stage Disease Rates Unchanged in 2013

Jemal et al described findings indicating a continued decline in the incidence of localized/regional-stage prostate cancer at 2 years after the U.S. Preventive Services Task Force recommendation against routine prostate-specific antigen (PSA) screening in men aged ≥ 50 years in 2011, in a letter ...

palliative care

Palliative Care 2016: Family Caregivers for Patients With Advanced Cancer Often Experience High Levels of Anxiety, Depression

A new multistate survey showed that nearly one-quarter to one-third of family caregivers of patients with high-mortality cancers experience high levels of depression and anxiety symptoms. The study also found that family caregivers can spend over 8 hours per day providing care and that as this time ...

palliative care

Palliative Care 2016: Cancer Caregivers Experience Unique Burdens Compared With Those Caring for Patients With Other Conditions

An analysis of data from more than 1,200 caregivers in the United States finds that cancer caregivers report a higher burden and spend significantly more hours per week caregiving, as opposed to individuals who care for people with other conditions. The analysis was based on survey data from the...

prostate cancer

European Studies Compare Conventional vs Hypofractionated Radiotherapy for Localized Prostate Cancer

Two recent European phase III trials with different study designs focused on hypofractionated vs conventional radiotherapy in localized prostate cancer. Investigators in the CHHiP trial1 showed that the hypofractionated approach is noninferior to standard fractionation, with no increase in side...

colorectal cancer

Tumor-Infiltrating Lymphocytes and Crohn’s-Like Lymphoid Reaction May Be Prognostic Indicators for Colorectal Cancer

Intratumoral tumor-infiltrating lymphocyte level and prominent peritumoral Crohn’s-like lymphoid reaction appear to be independent prognostic factors for survival in colorectal cancer, according to a study reported by Rozek et al in the Journal of the National Cancer Institute. The findings...

gynecologic cancers

Predicted Burden of Cervical Cancer With vs Without Effective Screening in Baltic, Central, and Eastern European Countries

Vaccarella et al estimated changes in the incidence of cervical cancer through 2040 in six Baltic, central, and eastern European (BCEE) countries on the hypotheses of continued absence of effective screening programs vs progressive implementation of such programs. Their findings were reported in...

breast cancer

Study Finds Chemotherapy May Be Avoidable in Women With Early Breast Cancer at High Clinical but Low Genomic Risk on 70-Gene Signature Assay

In a phase III trial (MINDACT) reported in The New England Journal of Medicine, Cardoso et al found that adjuvant chemotherapy may be avoidable in women with early-stage breast cancer who are at high clinical risk but low genomic risk as determined by the 70-gene signature assay (MammaPrint)....

kidney cancer

Extended Active Surveillance Prior to Systemic Therapy May Be Safe in Some Patients With Metastatic Renal Cell Carcinoma

In a phase II trial reported in The Lancet Oncology, Rini et al found that some patients with metastatic renal cell carcinoma can safely undergo active surveillance for an extended duration prior to initiation of systemic therapy. Indolent growth of metastases is known to occur in some patients...

breast cancer

Overall Survival With Bevacizumab/Capecitabine Noninferior vs Bevacizumab/Paclitaxel in HER2-Negative Breast Cancer

As reported in The Lancet Oncology by Zielinski et al, the final results of the phase III TURANDOT trial showed that overall survival with first-line bevacizumab (Avastin)/capecitabine was noninferior vs bevacizumab/paclitaxel in per-protocol analysis among patients with advanced HER2-negative...

leukemia

Inotuzumab Ozogamicin Improves Outcomes vs Standard Therapy in Relapsed/Refractory Acute Lymphoblastic Leukemia

In a phase III trial reported in The New England Journal of Medicine, Hagop M. Kantarjian, MD, of The University of Texas MD Anderson Cancer Center, and colleagues found that treatment with the antibody-drug conjugate inotuzumab ozogamicin resulted in a greater complete remission rate and improved ...

breast cancer

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

In a phase III trial (CALGB 40503/Alliance) reported in the Journal of Clinical Oncology, Maura N. ­Dickler, MD, of Memorial Sloan Kettering Cancer Center, and colleagues found that the addition of bevacizumab (Avastin) to first-line endocrine therapy with letrozole improved progression-free...

ASTRO Awards $275,000 in Grants to Support Early Career Researchers in Radiation Oncology

The American Society for Radiation Oncology (ASTRO) has selected four early career scientists to receive a total of $275,000 in research awards, including one winner of the ASTRO Junior Faculty Career Research Training Award and three recipients of ASTRO Resident/Fellows in Radiation Oncology...

gastroesophageal cancer

New Preclinical Study Shows Esophageal Cancers Driven by 'Marginal Gain' Rather Than Speed

Wellcome Trust Sanger Institute scientists have shown that unexpectedly, esophageal cancer cells do not divide faster than their normal neighbors. Unlike normal cells, however, the tumor cells produce slightly more dividing daughter cells than nondividing cells, forming a tumor. The study,...

breast cancer

ASCO Guideline Addresses Controversial Areas in Adjuvant Therapy for Breast Cancer

ASCO has published an adaptation of the 2015 Cancer Care Ontario (CCO) clinical practice guideline on adjuvant chemotherapy for early-stage breast cancer.1 There were several areas of controversy that the guideline attempts to address. Should Anthracyclines Be Standard of Care? The guideline...

breast cancer

ASCO Adapts CCO Guideline on Selection of Optimal Adjuvant Therapies for HER2-Negative and HER2-Positive Breast Cancers

As reported in the Journal of Clinical Oncology by Neelima Denduluri, MD, and colleagues, ASCO has adapted a Cancer Care Ontario (CCO) clinical practice guideline on selection of optimal adjuvant chemotherapy for HER2-negative and adjuvant targeted therapy for HER2-positive breast cancer.1 The...

breast cancer
solid tumors

Breast Density and Risk Factors May Be Useful for Tailoring Breast Cancer Screening for Older Women

A collaborative modeling study evaluating outcomes for various screening intervals for women over the age of 50 based on breast density and risk for breast cancer has found that average-risk women with low breast density undergoing triennial screening and higher-risk women with high breast density...

breast cancer

Needle Biopsies for Noninvasive Breast Cancer: Routine Analysis Wastes Millions

For patients with the most common type of noninvasive breast cancer, routine testing for estrogen and progesterone receptors in tissue taken at the first needle biopsy is both unnecessary and wasteful, according to results of a study led by Johns Hopkins pathologists. The results for people with...

health-care policy

Study Finds United States Ranks First in Health-Care Spending, but Cancer Outcomes Do Not Reflect the Investment

The U.S. health-care system is characterized—on a global level—by its unsustainable spending, which does not necessarily correlate to better outcomes in patients with cancer. With $2.9 trillion spent in 2013, the United States ranks first in health-care spending among the world’s...

solid tumors
gynecologic cancers

CA-125 Tests and CT Scans Still Routinely Used for Surveillance in Ovarian Cancer, Yet Benefit Remains Unproved

As reported by Esselen et al in JAMA Oncology, cancer antigen 125 (CA-125) tests and computed tomography (CT) scans for surveillance in women with ovarian cancer continue to be used routinely, although their benefit has not been proven and the practices have significant quality-of-life and economic ...

health-care policy
issues in oncology

New American Cancer Society Cancer Action Network Report Shows States Are Making Progress Implementing Policies to Reduce Toll of Cancer

Although a majority of states are still missing important opportunities to pass and implement legislative solutions proven to prevent and fight cancer, there is progress being made to move the nation closer to ending cancer as we know it, according to a report recently released by the American...

colorectal cancer

Multiple Means to Realize the Benefits of Colorectal Cancer Screening

In an updated recommendation statement, the U.S. Preventive Services Task Force (USPSTF) continues to strongly recommend screening for colorectal cancer for asymptomatic adults aged 50 through 75; but rather than emphasize specific screening strategies, it notes there are multiple screening...

A Ruby Anniversary

On July 16, 1975, at 26 years of age, after almost 6 months of observing a left epididymal mass slowly enlarge, with workup for epididymal tuberculosis, I finally underwent a left inguinal orchiectomy and resection of what proved to be a pure seminoma. A subsequent lymphangiogram was reported to...

breast cancer

Effectiveness of Organized National Breast Cancer Screening: The Israeli Experience

Recent years have seen the publication of a considerable amount of scientific literature questioning the effectiveness of mammography screening in decreasing breast cancer mortality.1-4 This article explores how the Israeli experience has demonstrated the efficacy of organized national...

supportive care
symptom management
breast cancer

Use of Dexamethasone Mouthwash in Managing mTOR Inhibitor–Associated Stomatitis in Patients With Breast Cancer

Prophylactic use of dexamethasone mouthwash significantly minimized the incidence of all grades of stomatitis in postmenopausal women receiving everolimus (Afinitor, Zortress) and exemestane for the treatment of hormone receptor–positive metastatic breast cancer, according to data presented by...

hematologic malignancies
lymphoma

High Cumulative Burden of Cardiovascular Morbidity in Young Survivors of Hodgkin Lymphoma

In an analysis from the St. Jude Lifetime Cohort Study reported in The Lancet Oncology, Bhakta et al found a high cumulative burden of cardiovascular morbidity among pediatric, adolescent, and young adult survivors of Hodgkin lymphoma. Study Details The study involved data from 670 survivors of...

cost of care

ASCO Plenary Studies: Assessing the ‘Value’ of New Treatments

At the 2016 ASCO Annual Meeting, studies presented at the Plenary Session gave attendees new treatment strategies to employ back home. But in the emerging push to contain the cost of new cancer treatments, do the four interventions fit within the new “value framework” for oncology? Deborah Schrag, ...

ASCO Outlines Opposition to Medicare Part B Demo for Senate Finance Hearing

ASCO voiced its strong opposition to the proposed Medicare Part B demonstration project in comments submitted on June 28 for the U.S. Senate Finance Committee hearing, “Examining the Proposed Medicare Part B Drug Demonstration.” ASCO underscored the urgent need to advance a fairer and more...

integrative oncology

Acupuncture: Does It Alleviate Symptoms Associated With Cancer Care?

A therapeutic modality of traditional Chinese medicine, acupuncture has been extensively investigated in Western medical settings. Its clinical use is increasingly common for the management of pain and other conditions. In the oncology setting, research demonstrates that acupuncture can...

lung cancer

Lung Cancer Screening: Beneficial for Certain Populations but Not Without Controversy

The National Cancer Policy Forum of the National Academies of Sciences took up the issue of lung cancer screening at its mid-June workshop. Greta Massetti, PhD, Associate Director for Science, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention (CDC), and chair of ...

pancreatic cancer

ASCO Guideline on Treatment of Locally Advanced, Unresectable Pancreatic Cancer

As reported by Edward P. Balaban, DO, FASCO, of Penn State Hershey Cancer Institute, and colleagues in the Journal of Clinical Oncology, ASCO has released a clinical practice guideline on the treatment of locally advanced, unresectable pancreatic cancer.1 The recommendations are based on expert...

pancreatic cancer

ASCO 2016 Guidelines for the Treatment of Pancreatic Cancer: Why Another Guideline?

The 5-year survival rate of those diagnosed with pancreatic cancer remains stubbornly fixed around 5%. Even in the 20% of cases in which surgical resection is undertaken for curative intent, the 5-year survival rate after surgery is 20% to 30%. As we make progress in other cancers with decreasing...

lung cancer

App Triggers Earlier Detection of Relapse, May Help Improve Survival of Patients With Lung Cancer

Web-based applications have invaded mainstream culture and grabbed the attention of multitudes of people around the world. According to a study presented at the 2016 ASCO Annual Meeting, an app may also contribute to extending the lives of people with cancer and, at the same time, reduce...

Expert Point of View: Marc S. Ernstoff, MD

The field of studies of combination immunotherapies is exploding, and “the future looks bright, with currently 71 trials of combination therapy in melanoma,” said formal discussant of these trials Marc S. Ernstoff, MD, of Roswell Park Cancer Institute, Buffalo, New York. “We now know that...

health-care policy
legislation

CMS Proposal for Part B Drug Payment: A Poorly Conceived Experiment

On March 11, 2016, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule in the Federal Register to test a change in reimbursement for Part B drugs.1 The first phase involves changing the 6% add-on to the average sales price (ASP) used to make drug payments under Part B to...

lung cancer
cost of care
global cancer care

Swiss Study Examines Cost-Effectiveness of Nivolumab vs Docetaxel in Advanced Nonsquamous NSCLC

Nivolumab, a checkpoint inhibitor approved for patients with squamous and nonsquamous non–small cell lung cancer (NSCLC) in 2015, is not cost-effective when compared to treatment with docetaxel, chemotherapy medication. However, a Swiss analysis showed the cost-effectiveness of nivolumab is...

hematologic malignancies
multiple myeloma

Long-Term Benefit of Lenalidomide/Dexamethasone Reported in High-Risk Smoldering Multiple Myeloma

As reported by Mateos et al in The Lancet Oncology, long-term follow-up in the phase III QuiRedex trial indicates continued benefit of lenalidomide (Revlimid)/dexamethasone vs observation in preventing disease progression in patients with high-risk smoldering multiple myeloma. Study Details In...

prostate cancer

Mixed Results With Hypofractionated vs Conventional Radiotherapy for Localized Prostate Cancer

Investigators of two European phase III trials have reached different conclusions on whether hypofractionated radiotherapy should replace conventional radiotherapy as a new standard of treatment in localized prostate cancer. The CHHiP trial findings favoring hypofractionation were reported by David ...

leukemia

Increased Risk for Cardiovascular Events Seen in Patients With CML Taking Tyrosine Kinase Inhibitors

Although tyrosine kinase inhibitors have dramatically increased survival for patients with chronic myeloid leukemia (CML), continuous administration of these drugs may elicit long-term toxicity, including cardiovascular adverse events. To investigate the incidence of vascular events in patients...

colorectal cancer

Prevention Needed to Stem Global Rise in Human Papillomavirus–Related Anal Cancer

The incidence rate of human papillomavirus (HPV)-related anal cancer and its precursor lesion, anal intraepithelial neoplasia, is rising in the United States and globally. Although 5-year survival rates in localized disease are generally favorable, survival in metastatic disease remains poor,...

breast cancer

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

As reported in the Journal of Clinical Oncology by Alberto S. Tagliafico, MD, of the University of Genoa, and colleagues, interim findings in the Italian prospective ASTOUND study indicate that ultrasound is associated with improved incremental detection of breast cancer at screening compared with ...

gastrointestinal cancer

Higher Prediagnostic Plasma Vitamin D Levels May Be Associated With Prolonged Survival in Pancreatic Cancer

In a study reported by Yuan et al in the Journal of Clinical Oncology, higher prediagnostic plasma 25-hydroxyvitamin D [25(OH)D] levels were found to be associated with prolonged overall survival in patients with pancreatic cancer. Study Details The study involved data from 493 patients from 5...

QOPI Certification Program Certifies First International Practice

On June 1, 2016, ASCO announced that the Contemporary Oncology Team of Athens, Greece, as part of the new international pilot project, is the first international practice to receive Quality Oncology Practice Initiative (QOPI®) certification through QOPI Certification Program, LLC (QCP). What is...

breast cancer

Mixed Results With Resection of Primary Tumor in Stage IV Breast Cancer

For de novo stage IV breast cancer, does resection of the primary tumor improve outcomes? Two studies presented at the 2016 ASCO Annual Meeting reached different conclusions. A prospective randomized study conducted in Turkey concluded there is a survival benefit at 5 years,1 whereas a U.S....

colorectal cancer

Primary Care Visits Result in More Colorectal Cancer Screening, Better Follow-up

People who visit their primary care physicians are more likely to get potentially life-saving colon cancer screenings and follow-up on abnormal stool blood test results—even in health systems that heavily promote mail-in home stool blood tests that don’t require a doctor visit, a study...

solid tumors
sarcoma

French Phase III Trial Shows No Benefit of Adding Zoledronate to Chemotherapy and Surgery in Osteosarcoma

In the French phase III OS2006 trial reported by Piperno-Neumann et al in The Lancet Oncology, the addition of zoledronate to chemotherapy and surgery provided no event-free survival benefit in the treatment of patients with newly diagnosed high-grade osteosarcoma. Study Details In the open-label ...

health-care policy

ASCO Outlines Opposition to Medicare Part B Demo for Senate Finance Hearing

ASCO voiced its strong opposition to the proposed Medicare Part B demonstration project in comments submitted on June 28 for the U.S. Senate Finance Committee hearing, “Examining the Proposed Medicare Part B Drug Demonstration.” ASCO underscored the urgent need to advance a fairer...

gastrointestinal cancer

Increased Risk of Gallbladder Cancer May Be Associated With Consuming Large Amounts of Sweetened Beverages

A large prospective Swedish study reported by Susanna C. Larsson, PhD, of the Unit of Nutritional Epidemiology at the Institute of Environmental Medicine at Karolinska Institutet in Stockholm, Sweden, and colleagues found a 2.2-fold increased risk of gallbladder cancer in people who consumed two or ...

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