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supportive care
integrative oncology

Acupuncture for the Management of Chemotherapy-Induced Peripheral Neuropathy

The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies commonly used by patients with cancer. In this installment, Ting Bao, MD, DABMA, MS, reviews the current data on the use of acupuncture...

solid tumors
gastrointestinal cancer

Lutetium Lu-177 Dotatate in Gastroenteropancreatic Neuroendocrine Tumors

On January 26, 2018, the radiolabeled somatostatin analog lutetium Lu-177 dotatate (Lutathera) was approved for the treatment of somatostatin receptor–positive gastroenteropancreatic neuroendocrine tumors, including foregut, midgut, and hindgut neuroendocrine tumors, in adults.1,2 Supporting...

breast cancer

Neoadjuvant Therapy in Triple-Negative Breast Cancer

In a phase III trial (BrighTNess) reported in The Lancet Oncology, Loibl et al found that the addition of the PARP inhibitor veliparib to carboplatin and paclitaxel in neoadjuvant therapy did not increase pathologic complete response rate in women with triple-negative breast cancer. Study Details ...

bladder cancer

EXPERT POINT OF VIEW: Timothy Gilligan, MD

“POUT IS an impressive study, given that the authors were able to complete a trial in this relatively rare cancer. We still need overall survival data to determine the role of adjuvant chemotherapy for upper tract urothelial cancer. We need to know if it makes people live longer or have a better...

bladder cancer

Adjuvant Chemotherapy for Upper Tract Urothelial Cancer

ADJUVANT CHEMOTHERAPY achieved robust improvements in disease-free survival and metastasis-free survival compared with surveillance in the phase III POUT study of patients with upper tract urothelial cancer.1 Further, there was an early trend toward improved overall survival with adjuvant...

solid tumors
immunotherapy

Combination PARP and PD-1 Inhibition Shows Antitumor Activity in Advanced Malignancies

IN A PHASE I trial of patients with advanced solid tumors, the combination of pamiparib (BGB-290), a selective poly (ADP-ribose) polymerase (PARP) inhibitor, and tislelizumab (BGB-A317), an agent targeting the programmed cell death protein 1 (PD-1) receptor, was well tolerated while demonstrating...

prostate cancer

Apalutamide, Enzalutamide Improve Metastasis-Free Survival in Nonmetastatic Castrate-Resistant Prostate Cancer

IN TWO SEPARATE TRIALS presented at the 2018 Genitourinary Cancers Symposium, apalutamide and enzalutamide (Xtandi), respectively, reduced the risk of metastasis and prolonged metastasis-free survival in men with high-risk nonmetastatic castrate-resistant prostate cancer. In the SPARTAN trial,1,2...

skin cancer

Adjuvant Vemurafenib in Resected BRAF V600–Mutant Melanoma

In the international phase III BRIM8 trial reported in The Lancet Oncology, Maio et al found inconclusive evidence of benefit of adjuvant vemurafenib treatment in patients with BRAF V600–mutant melanoma.   Study Details In the double-blind trial, 498 patients with fully resected...

breast cancer

FDA Authorizes Direct-to-Consumer Test That Reports Three Mutations in the BRCA1/BRCA2 Breast Cancer Genes

Today, the U.S. Food and Drug Administration (FDA) authorized the Personal Genome Service Genetic Health Risk (GHR) Report for BRCA1/BRCA2 (Selected Variants). It is the first direct-to-consumer (DTC) test to report on three specific BRCA1/BRCA2 breast cancer gene mutations that are most common in...

cost of care

Use of Charity Assistance to Pay for Novel Oral Anticancer Agents

In a study reported in the Journal of Oncology Practice, Olszewski et al found that 36% of patients receiving novel oral anticancer agents in a Rhode Island academic research center received charity assistance to pay for treatment, including 47% of patients aged ≥ 65 years. Study Details The...

colorectal cancer

Nut Consumption in Patients With Stage III Colon Cancer

People with stage III colon cancer who regularly eat nuts are at significantly lower risk of cancer recurrence and mortality than those who don’t, according to findings published by Fadelu et al in the Journal of Clinical Oncology. Findings The study followed 826 participants in the CALGB...

leukemia

FDA Accepts BLA for Calaspargase Pegol in Acute Lymphoblastic Leukemia

On February 28, Shire announced that the U.S. Food and Drug Administration (FDA) accepted the company’s biologics license application (BLA) for calaspargase pegol (Cal-PEG; SHP663). The investigational-stage compound is being reviewed as a component of a multiagent chemotherapeutic regimen...

gynecologic cancers

Adjuvant Chemoradiotherapy vs Radiotherapy in High-Risk Endometrial Cancer

As reported in The Lancet Oncology by de Boer et al, the phase III PORTEC-3 trial has shown no significant improvement in 5-year overall survival with adjuvant chemoradiotherapy vs radiotherapy alone in women with high-risk endometrial cancer. Adjuvant chemoradiotherapy, however, was associated...

symptom management
immunotherapy

ASCO Clinical Practice Guideline: Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy

As reported in the Journal of Clinical Oncology by Julie R. Brahmer, MD, of the Johns Hopkins Kimmel Cancer Center, and colleagues, ASCO has released a clinical practice guideline on management of immune-related adverse events in patients receiving immune checkpoint inhibitor therapy. To develop...

solid tumors

Larotrectinib in TRK Fusion–Positive Cancers in Adults and Children

In a study reported in The New England Journal of Medicine, Drilon et al found that the oral tropomyosin receptor kinase (TRK) inhibitor larotrectinib produced a high response rate and enduring responses in patients with TRK fusion–positive cancers. These fusions have been found to lead to...

leukemia

Guadecitabine in Treatment-Naive Older Patients With Acute Myeloid Leukemia

The results of a phase II trial have shown high activity of guadecitabine, a next-generation hypomethylating drug, in treatment-naive older patients with acute myeloid leukemia. The findings were reported in The Lancet Oncology by Hagop M. Kantarjian, MD, of The University of Texas MD Anderson...

multiple myeloma

Overall Survival With Carfilzomib vs Bortezomib in Relapsed or Refractory Multiple Myeloma

As reported by Meletios A. Dimopoulos, MD, of the National and Kapodistrian University of Athens, Alexandra Hospital, and colleagues in The Lancet Oncology, a prespecified interim analysis of the phase III ENDEAVOR trial has shown a significant overall survival benefit for carfilzomib (Kyprolis)...

breast cancer

Addition of Metronomic Chemotherapy to Dual Anti-HER2 Treatment in Older Patients With Metastatic Breast Cancer

In the phase II EORTC 75111-10114 trial reported in The Lancet Oncology, Wildiers et al found that the addition of metronomic oral cyclophosphamide to pertuzumab (Perjeta) and trastuzumab (Herceptin) improved progression-free survival in elderly or frail women with HER2-positive metastatic breast...

skin cancer

U.S. Incidence and Projected Rise of Merkel Cell Carcinoma

The number of U.S. cases of Merkel cell carcinoma is rising about six times faster than most other cancers, and at nearly twice the rate of melanoma. Paulson et al reported these findings in The Journal of the American Academy of Dermatology, which are based on research conducted at the University...

palliative care

Why Palliative Care Isn’t Just for Older Patients With Cancer

It is well established that adolescents and young adults (AYAs) with cancer—defined by the National Cancer Institute as those between the ages of 15 and 39 years—have not reaped a comparable survival benefit as either younger or older adult cancer survivors over the past 4 decades, despite...

issues in oncology

Providing Cancer Treatment Without Patient Consent

Law and Ethics in Oncology explores the legal and ethical issues oncologists must be aware of in this era of precision medicine and changing health-care policy, both to protect patients’ rights and to safeguard against potential legal jeopardy. Increasingly, across the United States, hospitals are...

cns cancers

Does Treatment With Tumor-Treating Fields Plus Temozolomide Influence Quality of Life in Patients With Newly Diagnosed Glioblastoma?

A DETAILED quality-of-life analysis of the phase III EF-14 trial of tumor-treating fields (Optune) in combination with temozolomide for the treatment of newly diagnosed glioblastoma was published by Taphoorn et al in JAMA Oncology.1 This secondary endpoint analysis showed the addition of...

hematologic malignancies
symptom management

Use of Direct Oral Anticoagulants in Preventing VTE in Patients With Cancer

THE FIRST TWO randomized trials to directly compare direct oral anticoagulants vs low–molecular-weight heparin for management of venous thromboembolism (VTE) in patients with cancer suggest that direct oral anticoagulants may become the new standard of care.1,2 Direct oral anticoagulants appear to...

lung cancer
immunotherapy

Update on Phase III JAVELIN Lung 200 Trial of Avelumab Monotherapy in Previously Treated Patients With Advanced NSCLC

On February 15, updated results were made available from the phase III JAVELIN Lung 200 trial comparing avelumab (Bavencio) to docetaxel in patients with unresectable, recurrent, or metastatic non–small cell lung cancer (NSCLC) whose disease progressed after treatment with a...

EXPERT POINT OF VIEW: Ann H. Partridge, MD, MPH, FASCO

“The simple questions are whether ovarian function suppression adds clinical benefit in premenopausal women, and is ovarian function suppression better with an aromatase inhibitor or tamoxifen,” said formal discussant of these trials, Ann H. Partridge, MD, MPH, FASCO, Professor of Medicine at...

solid tumors
prostate cancer

Combined Medical and Psychological Approach May Help Couples Reclaim Intimacy After Prostate Cancer Treatment

“To what extent do treatments for prostate cancer impact sexual functioning? To a great extent,” Christian Nelson, PhD, Chief, Psychiatry Service, Memorial Sloan Kettering Cancer Center, New York, told participants at the 11th Annual Oncofertility Consortium Conference in Chicago.1 Most men with...

solid tumors

Cabozantinib Improves Survival in Advanced Hepatocellular Carcinoma

Patients with previously treated advanced hepatocellular carcinoma derived a survival benefit from cabozantinib (Cabometyx), in the phase III CELESTIAL trial.1 “Cabozantinib represents a new treatment option for patients with advanced hepatocellular carcinoma after prior systemic anticancer...

solid tumors
head and neck cancer

Laryngeal Preservation: All Patients Need a Voice

Following the publication of two landmark studies in the United States,1,2 laryngeal preservation with combined chemoradiotherapy has become standard practice as opposed to laryngectomy for patients with locally advanced laryngeal cancer. The Department of Veterans Affairs Laryngeal Cancer Study...

colorectal cancer
immunotherapy

Combination Immunotherapy in DNA Mismatch Repair–Deficient/Microsatellite Instability–High Metastatic Colorectal Cancer

As reported in the Journal of Clinical Oncology by Overman et al, findings in the nivolumab (Opdivo) plus ipilimumab (Yervoy) cohort of the CheckMate-142 study indicate a high response rate and durable responses with the combination in previously treated patients with DNA mismatch...

ASCO Examines the Current Oncology Clinical Pathways Landscape

ASCO has released its review of leading oncology pathway vendors in the United States. “Oncology Clinical Pathways: Charting the Landscape of Pathway Providers,” published in the Journal of Oncology Practice (JOP), examines the clinical pathways offered by six commercial vendors using...

survivorship

2018 SURVIVORSHIP: Therapeutic Sexual Aids Frequently Not Available for Cancer Survivors Who Need Them

Cancer care guidelines recommend that cancer survivors who experience sexual dysfunction after cancer treatment use therapeutic aids to help improve their sexual health. However, a new study of 25 leading cancer centers found that 87% of the centers reported having no sexual aids available on site...

kidney cancer
immunotherapy

2018 GU CANCERS SYMPOSIUM: Combination Therapy Shows Antitumor Activity in Advanced Renal Cell Carcinoma

Combining the antiangiogenic agent axitinib (Inlyta) with the immunotherapy pembrolizumab (Keytruda) was found to have promising antitumor activity and no unexpected side effects in an early-phase clinical trial in patients with advanced kidney cancer who had not been previously treated. The full...

bladder cancer
immunotherapy

Avelumab Active in Advanced Urothelial Carcinoma After Platinum Failure

AS REPORTED in The Lancet Oncology by Manish R. Patel, MD, of Florida Cancer Specialists/Sarah Cannon Research Institute, and colleagues, the anti–programmed cell death ligand 1 (PD-L1) antibody avelumab (Bavencio) produced durable responses in patients with locally advanced or metastatic...

solid tumors
immunotherapy

Pembrolizumab Active in Thymic Carcinoma

In a single-center phase II study reported in The Lancet Oncology, Giaccone et al found that pembrolizumab (Keytruda) produced durable responses in patients with recurrent thymic carcinoma. Study Details In the study, 40 evaluable patients with advanced disease progressing after at least one line ...

breast cancer

Updates of Key Studies Differ on Relative Benefit of Nab-Paclitaxel in Breast Cancer

TWO IMPORTANT STUDIES, both updates of earlier findings and presented at the 2017 San Antonio Breast Cancer Symposium, provided different findings as to the relative benefit of nanoparticle albumin-bound (nab)-paclitaxel (Abraxane), vs solvent-based paclitaxel in breast cancer.  “The two studies...

hematologic malignancies

EXPERT POINT OF VIEW: Neil P. Shah, MD, PhD; Joseph M. Connors, MD; and Kenneth C. Anderson, MD

NEIL P. SHAH, MD, PhD, Leader of the Hematopoietic Malignancies Program at the University of California, San Francisco, Helen Diller Family Cancer Comprehensive Cancer Center, noted that BLU- 285 could fill an “unmet medical need” for a KIT inhibitor that is “both potent and selective.” He pointed ...

hematologic malignancies

Amyloid-Targeting Antibody Elicits Organ Responses in Patients With Amyloidosis

IN PREVIOUSLY treated patients with amyloid light-chain (AL) amyloidosis, the chimeric fibril-reactive monoclonal antibody 11-1F4 (CAEL-101) produced organ responses in about two-thirds of patients in a phase Ia/b trial reported at the 2017 American Society of Hematology (ASH) Annual Meeting &...

hematologic malignancies
immunotherapy

Daratumumab Shows Efficacy in Amyloid Light-Chain Amyloidosis

DARATUMUMAB (DARZALEX) may be an effective treatment for systemic amyloid light-chain (AL) amyloidosis, according to phase II studies reported at the 2017 American Society of Hematology (ASH) Annual Meeting & Exposition.1,2 While the cohorts were small and the arms uncontrolled, the findings...

cns cancers

Does Treatment With Tumor-Treating Fields Plus Temozolomide Influence Quality of Life in Patients With Newly Diagnosed Glioblastoma?

A detailed quality-of-life analysis of the phase III EF-14 trial of tumor-treating fields (Optune) in combination with temozolomide for the treatment of newly diagnosed glioblastoma was published by Taphoorn et al in JAMA Oncology. This secondary endpoint analysis demonstrated that the...

gastroesophageal cancer

Possible Link Between Drinking Hot Tea and Increased Chance of Esophageal Cancer in High-Risk Individuals

Esophageal cancer is the eighth most common cancer worldwide, with an estimated 456,000 new cases in 2012, and the sixth most common cause of death from cancer with an estimated 400,000 deaths, according to data from GLOBOCAN, which provides statistics on the incidence and mortality of cancer...

prostate cancer

2018 GU CANCERS SYMPOSIUM: Chemotherapy Added to Hormone Therapy for Prostate Cancer Improves Quality of Life

A new analysis of the ongoing STAMPEDE clinical trial found that adding docetaxel to hormone therapy for advanced prostate cancer improves quality of life and lowers the need for subsequent therapy. Docetaxel was also found to be cost-effective. These findings will be presented by James et al at...

kidney cancer
immunotherapy

2018 GU CANCERS SYMPOSIUM: Adding Immunotherapy to Standard Treatment Slows Growth of Advanced Kidney Cancer—With Fewer Side Effects

In a phase III clinical trial of patients with previously untreated metastatic renal cell cancer combining the immunotherapy atezolizumab (Tecentriq) with the targeted therapy bevacizumab (Avastin) delayed cancer growth by about 3 months longer than sunitinib, another targeted therapy. The benefit...

prostate cancer

2018 GU CANCERS SYMPOSIUM: Apalutamide Delays Prostate Cancer Metastases by More Than 2 Years

Findings from the phase III placebo-controlled SPARTAN trial suggest that apalutamide is an effective treatment for men with nonmetastatic castration-resistant prostate cancer who are at high risk for developing metastatic disease and for whom no approved treatments exist. Men who received...

cns cancers

Addition of EGFR-Targeting Vaccine to Temozolomide in EGFRvIII-Expressing Glioblastoma

The phase III ACT IV study has shown no survival benefit of adding rindopepimut, a vaccine targeting the epidermal growth factor receptor (EGFR) deletion mutation EGFRvIII, to temozolomide in patients with newly diagnosed EGFRvIII-positive glioblastoma. These findings were reported in The Lancet...

solid tumors
breast cancer

Steep Decline in Chemotherapy Use for Early-Stage Breast Cancer

The use of chemotherapy to treat women with early-stage breast cancer “declined markedly over time,” according to analysis of data from 2,926 women between the ages of 20 and 79. The trends documented “are remarkable for their steepness of decline, independent of clinical factors and despite no...

hematologic malignancies
leukemia

Enasidenib in IDH2-Mutant Relapsed or Refractory Acute Myeloid Leukemia

  On August 1, 2017, the IDH2 inhibitor enasidenib (Idhifa) was granted regular approval for treatment of adult patients with relapsed or refractory acute myeloid leukemia (AML) with an isocitrate dehydrogenase-2 (IDH2) mutation as detected by a U.S. Food and Drug Administration (FDA)-approved...

hematologic malignancies
leukemia
immunotherapy

Blinatumomab in Relapsed or Refractory B-Cell Precursor ALL

On July 11, 2017, blinatumomab (Blincyto) was approved for the treatment of relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL) in adults and children.1,2 Blinatumomab received accelerated approval in December 2014 for the treatment of Philadelphia chromosome (Ph)-negative...

breast cancer

Germline BRCA Mutation and Outcomes in Young-Onset Breast Cancer

In the POSH study in the UK population reported in The Lancet Oncology, Copson et al found women with young-onset breast cancer who carry a germline BRCA mutation have survival similar to noncarriers, and BRCA-mutation carriers vs noncarriers with triple-negative breast cancer may have an early...

solid tumors
lung cancer
immunotherapy

Durvalumab Takes a Giant Leap Into Stage III NSCLC

Immune checkpoint inhibitors have had a dramatic impact on survival for patients with stage IV non–small cell lung cancer (NSCLC), with whispers that a cure might be achieved in a subset of patients. In typical fashion, active new agents are evaluated in earlier stages of disease. Stage III NSCLC...

colorectal cancer

2018 GI CANCERS SYMPOSIUM: Novel Triplet Combination Improves Progression-Free Survival in Patients With BRAF-Mutant Colorectal Cancer

Updated results were recently reported from the 30 patient safety lead-in of the phase III BEACON CRC trial evaluating the triplet combination of encorafenib (a BRAF inhibitor), binimetinib (an MEK inhibitor), and cetuximab (Erbitux, an anti–EGFR antibody) in patients with BRAF-mutant...

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