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issues in oncology
cost of care
symptom management

ASCO 2017: Many Emergency Department Visits Among Patients With Cancer Appear Preventable

Among patients with cancer, as many as 53% of emergency department visits that do not require admission could be avoided with better symptom management and greater availability of outpatient care tailored to their needs, according to a new study from Fred Hutchinson Cancer...

lung cancer

ASCO 2017: Research Suggests Possible New Treatment for EGFR-Positive Lung Cancer

Findings from a phase III clinical trial point to a potential new treatment for patients newly diagnosed with advanced, epidermal growth factor receptor (EGFR)-positive non–small cell lung cancer (NSCLC). Compared to the EGFR inhibitor gefitinib (Iressa), one of the standard targeted...

breast cancer

OlympiAD Trial: Olaparib in Metastatic Breast Cancer With Germline BRCA Mutation

As reported in the Plenary Session at the 2017 ASCO Annual Meeting and in The New England Journal of Medicine by Robson et al, the phase III OlympiAD trial showed that the poly (ADP-ribose) polymerase (PARP) inhibitor olaparib (Lynparza) prolonged progression-free survival vs standard therapy in...

issues in oncology
legislation

Xuesong Han, PhD, on Early-Stage Diagnosis and the Affordable Care Act: An Epidemiologic Study

Xuesong Han, PhD, of the American Cancer Society, discusses the Affordable Care Act and her study findings showing how implementation of the law is associated with a shift to early-stage diagnosis for all screenable cancers except prostate cancer (likely due to Task Force recommendations against...

breast cancer

ASCO 2017: OlympiAD Trial: Olaparib Slows Growth of BRCA-Related Metastatic Breast Cancer

Findings from a phase III clinical trial of about 300 women may introduce poly ADP ribose polymerase (PARP) inhibitors as a new type of treatment for breast cancer. Compared to standard chemotherapy, the oral targeted medicine olaparib (Lynparza) reduced the chance of progression of advanced,...

solid tumors

ASCO 2017: Larotrectinib Shows Durable Efficacy Across Diverse Pediatric and Adult Cancers

Scientists may have developed the first targeted, oral, tumor-type agnostic therapy—an agent that works comparably well across many kinds of cancer, regardless of patient age. In clinical trials of adults and children with 17 different types of advanced cancer, larotrectinib treatment...

solid tumors

ASCO 2017: New High-Intensity Genomic Sequencing Approach Detects Circulating Tumor DNA at a High Rate

In a study of 124 patients with advanced breast, lung, and prostate cancers, a new high-intensity genomic sequencing approach detected circulating tumor DNA at a high rate. In 89% of patients, at least one genetic change detected in the tumor was also detected in the blood. Overall, 627 (73%)...

survivorship

ASCO 2017: Steady Decrease in Severe Health Problems for Childhood Cancer Survivors

Treatments for childhood cancer are often intense and carry the risk of lifelong health problems for survivors. An analysis of 23,600 childhood cancer survivors in the Childhood Cancer Survivor Study (CCSS), funded by the National Institutes of Health, found that the rate of severe health problems...

survivorship

Celebrating Cancer Survivorship

Sunday, June 4, 2017, marks the 30th anniversary of National Cancer Survivors Day. Here’s a look at the progress that has been made over the past 2 to 3 decades in reducing cancer incidence and cancer deaths and the challenges that remain. Increasing Rates of Cancer Survivorship In 1971, the...

lung cancer

Japanese Phase III Trial of Alectinib vs Crizotinib in ALK-Positive NSCLC

The Japanese phase III J-ALEX trial has shown improved progression-free survival with alectinib (Alecensa) vs crizotinib (Xalkori) in ALK inhibitor–naive patients with ALK-positive non–small-cell lung cancer (NSCLC). Results were reported by Hida et al in The Lancet. Study Details In...

gynecologic cancers

Pembrolizumab in Advanced PD-L1–Positive Endometrial Cancer

Pembrolizumab (Keytruda) showed activity in previously treated patients with advanced programmed cell death ligand 1 (PD-L1)–positive endometrial cancer in a cohort of the phase Ib KEYNOTE-028 study. These findings were reported in the Journal of Clinical Oncology by Ott et al. Study Details ...

lung cancer

FDA Broadens Ceritinib Indication to Previously Untreated ALK-Positive Metastatic NSCLC

On May 26, 2017, the U.S. Food and Drug Administration (FDA) granted regular approval to ceritinib (Zykadia) for patients with metastatic non–small cell lung cancer (NSCLC) whose tumors are anaplastic lymphoma kinase (ALK)-positive as detected by an FDA-approved test. In April 2014,...

head and neck cancer

Waun Ki Hong, MD, FACP, Helped Change the Standard of Care in Laryngeal Cancer, Now Focuses on Chemoprevention and Precision Medicine

Waun Ki Hong, MD, FACP, one of the nation’s leading experts in head and neck and lung cancers, was born in South Korea and grew up in a tiny village outside the nation’s capital of Seoul. Number six of seven siblings, Dr. Hong described his early life in the cozy village as blissful, until the...

breast cancer

Final Overall Survival Results of TH3RESA Trial in Breast Cancer

The final overall survival results of the phase III TH3RESA trial indicate a 32% reduction in risk of death with ado-trastuzumab emtansine (Kadcyla) vs treatment of physician’s choice in patients with previously treated HER2-positive metastatic breast cancer. The findings were reported in The ...

lung cancer

ASCO President, Bruce E. Johnson, MD, FASCO, Participates in Key Research With EGFR Mutation in Lung Cancer

Bruce E. Johnson, MD, FASCO, 2017–2018 ASCO President, was born in St. Peter, Minnesota, and grew up on a rural dairy farm. “Neither of my parents had college degrees, but working on a dairy farm with them gave me a solid work ethic. I was working outside on the farm before I was 10 years old. In...

breast cancer
symptom management

OPTIMIZE-2 Trial Offers Reassuring Data on Deescalation of Bisphosphonate Therapy for Breast Cancer–Related Bone Metastases

Bisphosphonates were first synthesized more than a century ago, with their initial usage restricted to a range of industrial processes until their potential clinical relevance was appreciated in the late 1960s.1 Then, following development for the treatment of osteoporosis and Paget’s disease of...

issues in oncology

Tackling the Obesity and Cancer Epidemic

Research is still lacking to support a link between obesity and an increased risk of developing all types of cancer. Nevertheless, a review1 of more than 1,000 epidemiologic studies by the International Agency for Research on Cancer (IARC), a division of the World Health Organization, examining...

breast cancer
issues in oncology

Unique Challenges Facing Young Women With Breast Cancer

According to the American Cancer Society, over 252,700 new cases of invasive breast cancer will be diagnosed in 2017, and about 40,610 women will die of their disease. Between 7% and 10% of those new cases will be diagnosed in women younger than age 40, accounting for more than 40% of all cancer...

gynecologic cancers

Niraparib in Recurrent Epithelial Ovarian, Fallopian Tube, or Primary Peritoneal Cancer

On March 27, 2017, the oral poly ADP-ribose polymerase (PARP) inhibitor niraparib (Zejula) was approved for maintenance treatment of patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in complete or partial response to platinum-based chemotherapy.1,2...

multiple myeloma

Smoldering and Relapsed or Refractory Multiple Myeloma

Here are several abstracts selected from the proceedings of the 2016 American Society of Hematology (ASH) Annual Meeting & Exposition, highlighting newer therapeutics in smoldering and relapsed and/or refractory multiple myeloma. For the full details of these study abstracts, visit...

solid tumors

AKT Inhibitor Activity in AKT1-Mutant Solid Tumors

As reported by Hyman et al in the Journal of Clinical Oncology, a basket study has shown activity of an investigational ATP-competitive pan-AKT kinase inhibitor (AZD5363) in solid tumors with AKT1 E17K mutation. Study Details In the study, 52 patients with advanced estrogen...

breast cancer

Final Overall Survival Results of EMILIA Trial in Breast Cancer

As reported in The Lancet Oncology by Diéras et al, the final overall survival results of the phase III EMILIA trial show improved outcome with ado-trastuzumab emtansine (Kadcyla) vs capecitabine plus lapatinib (Tykerb) in previously treated HER2-positive advanced breast cancer. Approval of...

ASCO Issues Recommendations for Reducing Cancer Disparities Among Sexual and Gender Minority Populations

ASCO has issued recommendations addressing the needs of sexual and gender minority populations as they relate to cancer.  The recommendations, published in a policy statement in the Journal of Clinical Oncology,1 are designed to focus attention on the challenges facing the sexual and gender...

bladder cancer

CheckMate 275 Supports FDA Approval of Nivolumab in Metastatic Urothelial Carcinoma After Platinum Therapy

As reported in The Lancet Oncology by Padmanee Sharma, MD, PhD, of MD Anderson Cancer Center, and colleagues, the phase II CheckMate 275 trial has shown that nivolumab (Opdivo) produced durable responses in patients with metastatic urothelial cancer who had received at least one prior...

lung cancer

The Ongoing Challenges of Lung Cancer Screening

Lung cancer persistently remains the leading cause of cancer death among men and women in the United States. Only about 15% of lung cancers are diagnosed at the localized stage, when clinical intervention could markedly improve patient outcomes. For decades, lung cancer specialists and advocacy...

breast cancer

Atezolizumab Improves Overall Survival in Small Subset of Patients With Triple‑Negative Breast Cancer

Triple-negative breast cancer is an aggressive disease with no approved targeted therapy, and it remains challenging to treat. Early data from a phase I study suggest that the PD-L1 inhibitor atezolizumab (Tecentriq) can extend the lives of a subset of women who respond to this checkpoint...

breast cancer

Abemaciclib Active in Metastatic Breast Cancer

In the single-arm phase II MONARCH 1 trial, the investigational cyclin-dependent kinase 4/6 (CDK4/6) inhibitor abemaciclib achieved an objective response in about 20% of heavily pretreated patients with metastatic hormone receptor–positive, HER2-negative breast cancer and a disease control rate of...

kidney cancer

Managing Small Renal Masses: A Point-by-Point Consideration of ASCO’s Clinical Practice Guideline

As reviewed in this issue of The ASCO Post, a recent issue of the Journal of Clinical Oncology featured an ASCO Clinical Practice Guideline on the management of small renal masses reported by Finelli and colleagues.1 This comprehensive guideline is written by a group of well-regarded and...

prostate cancer

ASCO Provisional Clinical Opinion on Hormonal Therapy for Castration-Resistant Prostate Cancer

On April 25, ASCO issued a provisional clinical opinion on the use of second-line hormonal therapy for men with castration-resistant prostate cancer who have not yet received chemotherapy. The recommendations of this provisional clinical opinion were informed by evidence from a systematic review of ...

head and neck cancer

Rates of Oral HPV Infection Plummet After Vaccination

Vaccination against the human papillomavirus (HPV) reduced the risk of acquiring oral HPV infections by 88%, in one of the first large studies to explore vaccination’s impact in the oropharynx. The study will be presented at the 2017 ASCO Annual Meeting, and the findings were released in advance of ...

supportive care
integrative oncology

The Role of Meditation in Cancer Care

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, authors Shelly Latte-Naor, MD, and Jyothirmai Gubili, MS, present the case...

Expect Questions From Patients Who ‘Do Everything Right’ but Still Develop Cancer

A study reported in Science found that more than two-thirds of human cancers are caused by random mutations made during DNA replication.1 “The main message we would like to convey is that even for many patients who follow all of the guidelines from the advisory bodies—they don’t smoke, exercise...

genomics/genetics

Recognizing Major Role of Random Mutations in Causing Cancer Does Not Diminish Importance of Primary Prevention

Random mistakes made during DNA replication are responsible for about two-thirds of the mutations that cause human cancers, according to a study reported in Science.1 Recognizing the role of these replication errors “does not diminish the importance of primary prevention but emphasizes that not all ...

lung cancer

Lung Cancer: Hope From Science

The following essay by Paul A. Bunn, Jr, MD, is adapted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was coedited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and thebigcasino.org. I grew up in ...

lymphoma

RECIL 2017: New Response Evaluation Criteria in Lymphoma Clinical Trials

New criteria for evaluating response in lymphoma clinical trials—RECIL 2017—have been developed by an International Working Group with the aim of harmonizing criteria with the Response Evaluation Criteria in Solid Tumors (RECIST). The new criteria were reported by Younes et al in Annals ...

prostate cancer

AUA 2017: Studies Highlight Shifts in Prostate Cancer Screening and Management

Active surveillance in men under 60, use of telemedicine in the management of prostate cancer, and physicians' personal prostate cancer screening preferences were all highlighted at the 2017 Annual Scientific Meeting of the American Urological Association (AUA). Active Surveillance for Low-Risk...

gynecologic cancers

ASCO 2017: HPV Vaccination May Reduce Oral HPV Infections but Is Still Underutilized

In one of the first large studies to explore the possible impact of human papillomavirus (HPV) vaccination on oral HPV infections, researchers found it may confer a high degree of protection. The study of young adults in the United States showed that the prevalence of high-risk HPV infection was...

lung cancer

ASCO 2017: Gefitinib Treatment Can Delay Recurrence of Intermediate-Stage Lung Cancer

The targeted therapy gefitinib (Iressa) appears more effective in preventing recurrence after lung cancer surgery than the standard of care, chemotherapy. In a phase III clinical trial, patients with epidermal growth factor receptor (EGFR)-positive, stage II to IIIA non–small cell lung cancer ...

colorectal cancer

ASCO 2017: Healthy Lifestyle After Colon Cancer Diagnosis Helps Extend Survival

A study of 992 patients with stage III colon cancer found that those who reported a healthy lifestyle during and following adjuvant treatment had a 42% lower chance of death and a trend for lower chance of cancer recurrence than those who had less healthy lifestyles. The study will be presented by...

hepatobiliary cancer

ASCO 2017: Adjuvant Capecitabine May Extend Survival in Biliary Tract Cancer

A phase III randomized clinical trial in 447 patients with biliary tract cancers showed that treating the disease with capecitabine after surgery extends survival by a median of 15 months compared to surgery alone. The finding could provide the basis for a new standard of care in the disease. This ...

breast cancer

Hypofractionated Postmastectomy Radiation in Breast Cancer

In a phase II trial, Khan et al found that hypofractionated postmastectomy radiotherapy, completed in 15 treatment days, was safe and effective in women with stage II to IIIa breast cancer. The study was reported in the Journal of Clinical Oncology. Study Details In the study, 67 women from 2...

issues in oncology

Ensuring Equitable Cancer Care for All Patients

Cancer is the second-leading cause of death across the globe. Significant efforts, such as the National Cancer Moonshot Initiative and The University of Texas MD Anderson Cancer Center’s Moon Shots Program, will drive advances in cancer prevention, screening, and treatment. However, right now,...

bladder cancer

FDA Grants Accelerated Approval to Avelumab for Urothelial Carcinoma

Today, the U.S. Food and Drug Administration (FDA) granted accelerated approval to avelumab (Bavencio) for patients with locally advanced or metastatic urothelial carcinoma whose disease progressed during or following platinum-containing chemotherapy or within 12 months of neoadjuvant or adjuvant...

skin cancer

Intermittent Vismodegib Regimens in Basal Cell Cancers

In a phase II trial reported in The Lancet Oncology, Brigitte Dréno, MD, of Nantes University, Nantes, France, and colleagues found that two long-term intermittent vismodegib (Erivedge) dosing regimens provided a similar reduction in the number of clinically significant basal cell carcinomas among...

lung cancer

Never Smokers Account for Increased Proportion of NSCLC Cases

In a retrospective study in three U.S. institutions reported in the Journal of the National Cancer Institute, Pelosof et al found that never smokers accounted for an increasing proportion of cases of non–small cell lung cancer (NSCLC) during the period from 1990 to 2013. Joan Schiller, MD, of the...

lung cancer

Gefitinib or Erlotinib vs Chemotherapy in Advanced NSCLC

In an individual patient data meta-analysis reported in the Journal of the National Cancer Institute, Lee et al found no difference in overall survival for first-line treatment with the first-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors gefitinib (Iressa) or...

lung cancer

ELCC 2017: Prospective Study Shows Concordance of EGFR Mutation Detection Between ctDNA and Tumor Samples

Detection of EGFR mutations in circulating tumor (ct) DNA from plasma samples can be accomplished using the cobas platform, according to findings presented by Kumar et al at the 2017 European Lung Cancer Conference (ELCC) (Abstract 95PD). Assays of ctDNA offer a noninvasive method of finding EGFR...

multiple myeloma

Lenalidomide as Maintenance Therapy in Multiple Myeloma After Autologous Stem Cell Transplantation

On February 22, lenalidomide (Revlimid) was approved as maintenance therapy for patients with multiple myeloma following autologous hematopoietic stem cell transplantation.1,2 The drug was previously approved to treat multiple myeloma (in combination with dexamethasone), anemia caused by...

gastrointestinal cancer

Expert Point of View: Daniel G. Coit, MD

“While these results are clearly superior to historical controls, the study prompts a number of questions,” session moderator, ­Daniel G. Coit, MD, a surgical oncologist at Memorial Sloan Kettering Cancer Center in New York, commented in an interview. “Nearly half of the patients received systemic ...

lung cancer

Five-Year Survival Quadrupled in Responders to Immunotherapy for Non–Small Cell Lung Cancer

At 5 years, the overall survival rate was 16% in patients with advanced non–small cell lung cancer (NSCLC) treated with single-agent nivolumab (Opdivo), according to follow-up of a phase Ib dose-ranging study (CA209-003), presented at the American Association for Cancer Research (AACR) Annual...

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