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issues in oncology

Impact of Establishment of Cancer Urgent Care Clinic on Emergency Department Visits

In a study reported in the Journal of Oncology Practice, Hong et al found that the establishment of a cancer urgent care clinic slowed the increasing rate of visits to regional emergency departments among adults newly diagnosed with cancer.  Study Details The study involved data on 33,316...

issues in oncology

Control Arm Quality in Randomized Oncology Trials Leading to FDA Approval

In a study reported in JAMA Oncology, Hilal et al found that 17% of recent cancer drug approvals based on randomized controlled trials featured a suboptimal control arm. Study Details The study involved analysis of a total of 145 studies that led to 143 drug approvals between January 2013 and...

breast cancer

Sentinel Lymph Node Biopsy With or Without Use of Preoperative Lymphoscintigraphy in Early Breast Cancer

In a German/Swiss phase III trial (SenSzi [GBG80]) reported in the Journal of Clinical Oncology, Kuemmel et al found that preoperative lymphoscintigraphy was not associated with an increased number of histologically detected sentinel lymph nodes with sentinel lymph node biopsy in women with early...

lymphoma
immunotherapy

Addition of Decitabine to Camrelizumab in Relapsed or Refractory Classical Hodgkin Lymphoma

In a single-center phase II trial reported in the Journal of Clinical Oncology, Nie et al found a higher complete response rate with the addition of low-dose decitabine to the programmed cell death protein 1 (PD-1) inhibitor camrelizumab in anti–PD-1 treatment–naive patients with...

hepatobiliary cancer

Minimal Adjuvant Chemotherapy for Pediatric Hepatoblastoma Resected at Diagnosis

In an analysis from the Children’s Oncology Group phase III AHEP0731 trial reported in The Lancet Oncology, Katzenstein et al found that minimal adjuvant chemotherapy with two cycles of cisplatin, fluorouracil, and vincristine was associated with disease control in pediatric patients with...

hematologic malignancies
lymphoma

Risk Model for Disease Progression in Asymptomatic Waldenström’s Macroglobulinemia

In a study reported in the Journal of Clinical Oncology, Bustoros et al developed a model for predicting risk of progression from asymptomatic Waldenström’s macroglobulinemia to symptomatic disease requiring treatment. The study involved 439 patients with asymptomatic...

lung cancer
issues in oncology

Combined Crowd Innovation and AI in Producing Algorithms for Radiotherapy Targeting

In a study reported in JAMA Oncology, Mak et al found that a crowd innovation contest produced automated artificial intelligence (AI) algorithms “that replicated the skills of a highly trained physician” in segmenting lung tumors for radiotherapy targeting. The investigators also noted...

lung cancer
immunotherapy

KEYNOTE-042: Pembrolizumab vs Chemotherapy in Previously Untreated Locally Advanced or Metastatic NSCLC With PD-L1 Expression ≥ 1%

As reported in The Lancet by Mok et al, the KEYNOTE-042 trial has shown an improvement in overall survival with pembrolizumab vs standard chemotherapy in previously untreated patients with locally advanced or metastatic non–small cell lung cancer (NSCLC) without a sensitizing EGFR mutation or ...

multiple myeloma

Patient-Reported Outcomes With Salvage Autologous Stem Cell Transplantation vs Nontransplantation in Relapsed Multiple Myeloma

In an analysis of the phase III UK Myeloma X trial reported in the Journal of Clinical Oncology, Ahmedzai et al found that patient-reported outcomes tended to be worse with salvage autologous stem cell transplantation (ASCT) vs nontransplantation consolidation in relapsed multiple myeloma. The...

head and neck cancer

Lenvatinib in Recurrent or Metastatic Adenoid Cystic Carcinoma

In a single-center phase II study reported in the Journal of Clinical Oncology, Tchekmedyian et al found that the multitargeted tyrosine kinase inhibitor lenvatinib was active in progressive recurrent or metastatic adenoid cystic carcinoma. Study Details In the study, 32 evaluable patients at...

issues in oncology
pain management

Opioid-Related Hospitalizations Among Patients With Cancer in the United States

In a study reported in a research letter in JAMA Oncology, Chua et al found that opioid-related hospitalizations among American patients with cancer are rare, increasing at a very low rate, and consist mostly of hospitalization for nonheroin opioid poisoning. The study analyzed trends and risk...

issues in oncology

Initiative to Improve Tobacco Cessation Efforts in a Radiation Oncology Department

In a study reported in the Journal of Oncology Practice, Singer et al found that a quality improvement initiative was successful in increasing a radiation oncology department’s efforts in encouraging patients with cancer to cease tobacco use prior to radiation therapy. As noted by the...

lung cancer

Lorlatinib in Advanced NSCLC With ALK Resistance Mutations

In a study reported in the Journal of Clinical Oncology, Shaw et al found that lorlatinib showed greater efficacy in patients with vs without anaplastic lymphoma kinase (ALK) resistance mutations among patients with advanced ALK-positive non–small cell lung cancer (NSCLC) in whom one or more...

breast cancer

Trastuzumab Biosimilar for HER2-Overexpressing Breast Cancer

ON DECEMBER 14, 2018, trastuzumab-pkrb (Herzuma) was approved as a biosimilar to trastuzumab for patients with HER2-overexpressing breast cancer.1 Trastuzumab-pkrb is indicated for adjuvant treatment of HER2-overexpressing breast cancer and metastatic HER2-overexpressing breast cancer.2 Health-care ...

cns cancers

Pachymeningeal Seeding After Neurosurgical Resection in Patients With Brain Metastases

In a retrospective cohort study reported in JAMA Oncology, Cagney et al found that pachymeningeal seeding was fairly common after neurosurgical resection in patients with brain metastases treated with adjuvant stereotactic radiation. Study Details The study involved 1,188 consecutive patients...

survivorship

Therapy-Related Cardiac Disease Risk in Childhood Cancer Survivors

As reported by Bates et al in the Journal of Clinical Oncology, an analysis from the Childhood Cancer Survivor Study indicated that radiation doses in conjunction with heart volume exposed to radiation and anthracycline treatment were associated with increased risk of late-onset cardiac disease in...

symptom management

Effect of Medical Cannabis on Symptom Control in Patients With Cancer

As reported in the Journal of Oncology Practice by Anderson et al, a study of patients enrolled in Minnesota’s Medical Cannabis Program showed that the use of medical cannabis was associated with improvement in reported symptoms in patients with cancer. The study involved data on 1,120...

breast cancer

Neratinib Plus Capecitabine Active Against HER2-Positive Breast Cancer Brain Metastases

In the phase II TBCRC 022 trial reported in the Journal of Clinical Oncology, Freedman et al found that the combination of neratinib and capecitabine was active against brain metastases in women with HER2-positive breast cancer. Modest activity of neratinib monotherapy had been found in previous...

breast cancer
colorectal cancer
lung cancer
pain management

Opioid Use Among Older Survivors of Colorectal, Lung, and Breast Cancers

In a linked Surveillance, Epidemiology, and End Results and Medicare study reported in the Journal of Clinical Oncology, Salz et al found that chronic opioid use varied by cancer among older cancer survivors. By 6 years after diagnosis, survivors were no more likely to be chronic opioid users...

issues in oncology
survivorship

Perceived Infertility Risk and Actual Fertility Status in Adult Survivors of Childhood Cancer

In a report from the St. Jude Lifetime Cohort Study in the Journal of Clinical Oncology, Lehmann et al found that perceptions of risk of infertility were often discordant with laboratory-assessed fertility status in adult survivors of childhood cancer. Study Details In the study, 1,067 survivors...

lymphoma

Update on Newer Treatments in Non-Hodgkin Lymphomas

AS PART of The ASCO Post’s continued coverage of the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition, here is an update on several different studies on new therapeutics in non-Hodgkin lymphomas (NHLs), including follicular lymphoma, diffuse large B-cell lymphoma (DLBCL), ...

multiple myeloma

Addition of Elotuzumab to Pomalidomide and Dexamethasone in Previously Treated Patients With Multiple Myeloma

AS REPORTED in The New England Journal of Medicine by Meletios A. Dimopoulos, MD, of the National and Kapodistrian University of Athens, and colleagues, the phase II ELOQUENT-3 trial has shown that the addition of elotuzumab to pomalidomide and dexamethasone significantly prolonged...

leukemia

Effect of Hematopoietic Stem Cell Transplantation on Outcome in Pediatric Hypodiploid B-ALL

In a report from the Children’s Oncology Group (COG) in the Journal of Clinical Oncology, McNeer et al found that hematopoietic stem cell transplantation (HSCT) did not improve outcomes in pediatric patients with hypodiploid B-lymphoblastic leukemia (B-ALL). Study Details The study was a...

cns cancers
survivorship

Late Morbidity and Mortality in Survivors of Medulloblastoma

In a report from the Childhood Cancer Survivor Study published in the Journal of Clinical Oncology, Salloum et al found that changes in medulloblastoma therapy over 3 decades that have improved survival have also increased risk for subsequent neoplasms and debilitating health conditions. As noted...

breast cancer

Estradiol as Potential Treatment for Subset of Triple-Negative Breast Cancers

Mayo Clinic researchers have identified estradiol as a potential new treatment for a subset of women with triple-negative breast cancer. Their findings were published by Reese et al in the Proceedings of the National Academy of Sciences of the United States of America. “Triple-negative breast...

gastroesophageal cancer
gastrointestinal cancer
immunotherapy

Addition of First-Line Ramucirumab to Cisplatin and Fluoropyrimidine in Metastatic Gastric or Gastroesophageal Junction Adenocarcinoma

In the phase III RAINFALL trial reported in The Lancet Oncology, Fuchs et al found no apparent benefit of the addition of the VEGFR-2 inhibitor ramucirumab to first-line cisplatin and fluoropyrimidine treatment in metastatic gastric or gastroesophageal junction adenocarcinoma. Study Details The...

survivorship
symptom management

Late-Onset Cardiotoxicity in Pediatric Cancer Survivors: Comparison of Regimens

In a study reported in JAMA Oncology, Feijen et al found that daunorubicin was associated with decreased cardiomyopathy risk vs doxorubicin among pediatric cancer survivors, with epirubicin being approximately isoequivalent to doxorubicin. Risk associated with the anthraquinone mitoxantrone was...

lymphoma

Alisertib vs Investigator’s Choice in Relapsed or Refractory Peripheral T-Cell Lymphoma

In the phase III Lumiere trial reported in the Journal of Clinical Oncology, O’Connor et al found that the Aurora A kinase inhibitor alisertib did not improve outcomes vs investigator’s choice of single-agent treatment in relapsed or refractory peripheral T-cell lymphoma (PTCL). Study...

solid tumors

Inherited Variants in CHEK2 and Susceptibility to Testicular Germ Cell Tumors

In a study reported in JAMA Oncology, AlDubayan et al found that inherited pathogenetic variants in the checkpoint kinase 2 gene (CHEK2), among inherited pathogenetic DNA-repair gene (DRG) alterations, were associated with susceptibility to testicular germ cell tumors. The study involved screening ...

lung cancer
pain management

Opioid Use Following Thoracoscopic Surgery in Early-Stage Lung Cancer

In a study reported in a research letter in JAMA Oncology, Stephanie Tuminello, MPH, and colleagues found that video-assisted thoracoscopic surgery (VATS) was less likely than open resection to be associated with long-term opioid use in patients undergoing surgery for early-stage lung cancer....

skin cancer

In Vitro and Ex Vivo Activity of Gentian Violet in Cutaneous T-Cell Lymphoma

As reported in JAMA Dermatology, Jianqiang Wu, MD, PhD, and Gary S. Wood, MD, found that the widely available nonprescription topical antimicrobial agent gentian violet has potent activity against cutaneous T-cell lymphoma (CTCL) in studies in vitro and ex vivo. The study involved high-throughput ...

lung cancer

Clonal MET Amplification and Tyrosine Kinase Inhibitor Treatment Outcome in EGFR-Mutant NSCLC

In a Singaporean study reported in the Journal of Clinical Oncology, Lai et al found that tyrosine kinase inhibitor treatment outcome did not differ according to mesenchymal epithelial transition factor (MET)-high vs MET-low status in treatment-naive, EGFR-mutant non–small cell lung cancer...

leukemia

Treatment Outcomes for Children With Hypodiploid Acute Lymphoblastic Leukemia

In a retrospective study reported in the Journal of Clinical Oncology, Pui et al found that minimal residual disease (MRD)-negative status, high hypodiploidy with 44 chromosomes, and MRD-stratified treatment were associated with improved outcomes among children treated for newly diagnosed...

breast cancer
issues in oncology

Racial Differences in Time to Breast Cancer Surgery and Survival in the U.S. Military Health System

In a retrospective cohort study reported in JAMA Surgery, Eaglehouse et al found that time to breast cancer surgery was delayed for non-Hispanic black vs non-Hispanic white women in the Military Health System but that this difference did not account for poorer overall survival in non-Hispanic black ...

prostate cancer

Long-Term Effects of Finasteride vs Placebo on Prostate Cancer Mortality

In a letter to the editor of The New England Journal of Medicine, Goodman et al reported a long-term follow-up of the Prostate Cancer Prevention Trial indicating that finasteride treatment was not associated with an increased risk of death from prostate cancer. Study Details As previously...

lymphoma
skin cancer

2018 Update of WHO-EORTC Classification of Primary Cutaneous Lymphomas

As reported by Willemze and colleagues in Blood, the World Health Organization (WHO) and the European Organisation for Research and Treatment of Cancer (EORTC) have released a 2018 update of their classification of primary cutaneous lymphomas. As noted by the authors, “Primary cutaneous...

breast cancer
immunotherapy

Addition of Atezolizumab to Nab-Paclitaxel in Advanced Triple-Negative Breast Cancer: IMpassion130 Trial

AS REPORTED in The New England Journal of Medicine by Peter Schmid, MD, PhD, of the Barts Cancer Institute, Queen Mary University of London, and colleagues, the phase III IMpassion130 trial has shown that the addition of atezolizumab to nanoparticle albumin-bound (nab)-paclitaxel significantly...

issues in oncology

Two Retrospective Studies Find Increased Risk of Suicide Among Patients Diagnosed With Cancer

In a news item reported in The Lancet Oncology, The Lancet journalist Manjulika Das reviewed two U.S. retrospective studies indicating that patients diagnosed with cancer are at increased risk of suicide. High Standardized Mortality Ratio In one study, published by Zaorsky et al in Nature...

health-care policy
lung cancer

Shared Decision-Making and Use of Low-Dose CT Screening for Lung Cancer

In a study reported in a research letter in JAMA Internal Medicine, Goodwin et al found that only a small proportion of Medicare enrollees undergoing low-dose computed tomography (CT) screening for lung cancer had a prescreening shared decision-making session, which is mandated by the Centers for...

lung cancer
immunotherapy

Updated Survival Analysis of KEYNOTE-024: Pembrolizumab vs Platinum-Based Chemotherapy in Previously Untreated, Advanced NSCLC

As reported in the Journal of Clinical Oncology by Reck et al, an updated analysis of the phase III KEYNOTE-024 trial indicates continued overall survival benefit of first-line pembrolizumab vs platinum-based chemotherapy in patients with advanced non–small cell lung cancer (NSCLC) with a...

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...

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 ...

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...

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 ...

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...

lung cancer

Pembrolizumab With Chemotherapy for First-Line Treatment of Metastatic Nonsquamous NSCLC

On August 20, 2018, pembrolizumab (Keytruda) in combination with pemetrexed (Alimta) and platinum was granted regular approval as first-line treatment of patients with metastatic nonsquamous non–small cell lung cancer (NSCLC) with no epidermal growth factor receptor (EGFR) or anaplastic lymphoma...

hepatobiliary cancer

Lenvatinib in Unresectable Hepatocellular Carcinoma

On August 16, 2018, lenvatinib (Lenvima) was approved for the first-line treatment of patients with unresectable hepatocellular carcinoma.1,2 Supporting Efficacy Data Approval was based on the findings of a phase III open-label noninferiority trial (REFLECT), in which 954 patients with previously...

survivorship

Risk of Chronic Health Conditions in Survivors of Childhood Cancer Diagnosed From 1970 to 1999

In a report from the Childhood Cancer Survivor Study cohort published in The Lancet Oncology, Gibson et al found that more recently treated survivors of childhood cancer had reduced risk of chronic health conditions compared to those diagnosed early in the study period. The study involved data...

gynecologic cancers

Ultrasonography Findings and Risk of Ovarian Cancer

In a study reported in JAMA Internal Medicine, Smith-Bindman et al found that the appearance of ovarian masses on ultrasonography was highly associated with risk of ovarian cancer in a large unselected population of women undergoing pelvic ultrasonography. Study Details The study was a nested...

cns cancers
immunotherapy

Addition of Interleukin-2 to Dinutuximab Beta in High-Risk Neuroblastoma

In an international phase III trial (HR-NBL1/SIOPEN) reported in The Lancet Oncology, Ladenstein et al found that the addition of interleukin (IL)-2 to dinutuximab beta did not improve event-free survival in children and young people with high-risk neuroblastoma. Study Details The current report...

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