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Showing 351 - 400Use of Valerian to Relieve Anxiety in Patients With Cancer
The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies sometimes used by patients with cancer. Eugenie Spiguel, MSN, ANP-BC, and Jyothirmai Gubili, MS, explore the use of valerian for...
Is There a Benefit to Adding Rituximab to Methotrexate-Based Chemotherapy in Primary CNS Lymphoma?
In a phase III trial (HOVON 105/ALLG NHL 24) reported in The Lancet Oncology, Bromberg et al found no significant benefit of the addition of rituximab to high-dose methotrexate-based chemotherapy in patients with newly diagnosed primary central nervous system (CNS) lymphoma. Study Details In the...
Higher Incidence of Brain and CNS Tumors Among People Living in Appalachia
A recent study published by Ostrom et al in the Journal of Neuro-Oncology showed that compared to the rest of the United States, the Appalachian region has a 5% higher incidence of malignant primary brain tumors and other central nervous system (CNS) tumors, a higher mortality rate due to ...
Risk of Intracranial Malignancy After Stereotactic Radiosurgery for Nonmalignant Conditions
In a retrospective cohort study reported in The Lancet Oncology, Wolf et al found that patients undergoing Gamma Knife stereotactic radiosurgery for nonmalignant neurosurgical conditions did not appear to be at long-term increased risk of radiation-associated secondary intracranial malignancy or...
Transformation of EGFR-Mutant NSCLC to SCLC
In a study reported in the Journal of Clinical Oncology, Marcoux et al provided further evidence that EGFR-mutant non–small cell lung cancer (NSCLC) can undergo transformation to small cell lung cancer (SCLC) and identified factors associated with such transformation. It has been estimated...
Regorafenib vs Lomustine in Relapsed Glioblastoma
In the Italian phase II REGOMA trial reported in The Lancet Oncology, Lombardi et al found that regorafenib was associated with improved overall survival vs lomustine in patients with relapsed glioblastoma. In the open-label trial, 119 patients from 10 Italian sites were randomly assigned between...
Lorlatinib in Second- or Third-Line Treatment of ALK-Positive Metastatic Non–Small Cell Lung Cancer
On November 2, 2018, lorlatinib (Lorbrena) was granted accelerated approval for the treatment of patients with ALK-positive metastatic non–small cell lung cancer (NSCLC) whose disease has progressed on crizotinib (Xalkori) and at least one other ALK inhibitor for metastatic disease or whose disease ...
New Data Reported From International Studies of Lung Cancer Treatment
At the European Society for Medical Oncology (ESMO) 2018 Congress, important studies were presented for every cancer type. Here, The ASCO Post offers some snapshots of lung cancer studies that may inform approaches to treating this common cancer, which—despite the advances in recent years—remains...
Expert Point of View: Christina I. Tsien, MD
DISCUSSANT OF the NRG-CC001 trial, Christina I. Tsien, MD, Professor of Radiation Oncology at Washington University School of Medicine, St. Louis, underscored the importance of this research, noting that cognitive impairment affects nearly 50% of patients who undergo whole-brain radiation therapy. ...
Hippocampus-Sparing Whole-Brain Radiotherapy and Neurocognitive Function in Patients With Brain Metastases
ANALYSIS OF a phase III trial has confirmed that conformal avoidance of the hippocampal dentate gyrus using intensity-modulated radiotherapy during whole-brain radiotherapy for brain metastases preserves neurocognitive function and improves patient-reported symptom burden while achieving similar...
Talazoparib for Germline BRCA-Mutated HER2-Negative Advanced Breast Cancer
On October 16, 2018, the poly (ADP-ribose) polymerase (PARP) inhibitor talazoparib (Talzenna) was approved for the treatment of patients with deleterious or suspected deleterious germline BRCA-mutated, HER2-negative locally advanced or metastatic breast cancer.1,2 Patients must be selected for...
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...
Lorlatinib Shows Overall and Intracranial Activity in ALK-Positive NSCLC
In a global phase II study reported in The Lancet Oncology, Solomon et al found that lorlatinib (Lorbrena) showed high overall and intracranial activity in patients with advanced ALK-positive non–small cell lung cancer (NSCLC) who were treatment-naive or who had received crizotinib (Xalkori)...
Molecular and Clinical Heterogeneity in Histologically Diagnosed CNS-PNET
As reported by Hwang et al in the Journal of Clinical Oncology, subsequent molecular profiling of histologically diagnosed central nervous system supratentorial primitive neuroectodermal tumors (CNS-PNET) in patients showed molecular and clinical heterogeneity that strongly affected prognosis. The ...
Brigatinib Improves Outcomes Over Crizotinib in ALK-Positive Non–Small Cell Lung Cancer
THE FIRST-LINE USE of brigatinib (Alunbrig) was superior to standard-of-care crizotinib (Xalkori) in patients with advanced anaplastic lymphoma kinase (ALK)-positive non–small cell lung cancer (NSCLC), according to the first report of the phase III ALTA-1L trial presented at the International...
Activity of Vemurafenib in BRAF V600–Mutant Gliomas
In a multicohort study (VE-BASKET study) in patients with BRAF V600–mutant nonmelanoma cancers in the Journal of Clinical Oncology, Kaley et al found evidence of activity of vemurafenib (Zelboraf) in gliomas that appeared to vary by glioma subtype. Study Details In the study, 24...
2018 ASTRO: Impact of MGMT Gene Expression on Overall Survival in Patients With Anaplastic Glioma
A phase III trial revealed that elevated MGMT gene expression is independently associated with worse overall survival for patients with anaplastic grade III gliomas. These findings were presented by Fleming et al at the 60th Annual Meeting of the American Society for Radiation Oncology (ASTRO) and...
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...
Talazoparib Improves Progression-Free Survival in Advanced Breast Cancer With Germline BRCA Mutation
As reported in The New England Journal of Medicine by Jennifer K. Litton, MD, of The University of Texas MD Anderson Cancer Center, and colleagues, the phase III EMBRACA trial has shown significantly improved progression-free survival with the poly (ADP-ribose) polymerase (PARP) inhibitor...
Health Resource Utilization and CNS Metastases in EGFR-Mutant Advanced NSCLC
In a single-center study reported in the Journal of Oncology Practice, Chooback et al found that central nervous system (CNS) metastases are frequent in patients with EGFR-mutant advanced non–small cell lung cancer (NSCLC) and are associated with increased health resource...
Pazopanib in Treatment of von Hippel-Lindau Disease
In a single-center phase II trial reported in The Lancet Oncology, Jonasch et al found evidence of activity of pazopanib in the treatment of patients with von Hippel-Lindau disease. Study Details The study involved 31 eligible adult patients with clinical manifestations of von Hippel-Lindau...
WCLC 2018: IMpower132: Atezolizumab Plus Carboplatin and Pemetrexed in Stage IV Nonsquamous NSCLC
Findings from the IMpower132 trial demonstrate that the use of the programmed cell death ligand 1 (PD-L1) inhibitor atezolizumab in combination with carboplatin plus pemetrexed as first-line therapy and pemetrexed as maintenance therapy improved progression-free survival in patients with stage IV...
Factors in Endocrine Deficiency in Pediatric and Young Adult Patients Receiving Radiotherapy for Brain Tumors
In a study reported in the Journal of Clinical Oncology, Vatner et al identified factors associated with an increased risk of endocrine deficiency in pediatric and young adult patients receiving radiation therapy for brain tumors, including hypothalamus and pituitary radiation dose. Study Details ...
Comparison of Methotrexate Intensification Regimens in Children and Young Adults With T-Cell ALL
As reported by Winter et al in the Journal of Clinical Oncology, findings in the Children’s Oncology Group (COG) AALL0434 trial indicate improved outcomes with a COG methotrexate intensification regimen vs a high-dose methotrexate intensification regimen in children and young adults with...
First Large-Scale Survey of APPs in Oncology Shows Growing Role for Nurse Practitioners and Physician Assistants
Advanced practice providers (APPs) have increasingly become integral members of the oncology care delivery team, according to the first large-scale study of nurse practitioners (NPs) and physician assistants (PAs) in oncology. The study was conducted collaboratively by ASCO, the American Academy of ...
CNS Activity of First-Line Osimertinib in EGFR-Mutant Advanced NSCLC
In a subgroup analysis of the phase III FLAURA trial reported in the Journal of Clinical Oncology, Reungwetwattana et al found evidence of greater central nervous system (CNS) activity of osimertinib (Tagrisso) vs standard EGFR tyrosine kinase inhibitors in patients with previously untreated...
Immunotherapy Combination in Melanoma Brain Metastases
In the phase II CheckMate 204 study reported in The New England Journal of Medicine, Tawbi et al found that combined nivolumab (Opdivo) and ipilimumab (Yervoy) produced a high rate of intracranial clinical benefit in patients with melanoma brain metastases. Study Details The study included 94...
Oncology Organizations Remember Senator John McCain
United States Senator from Arizona John McCain passed away on August 25 of the brain cancer glioblastoma multiforme (GBM). Numerous medical societies issued statements in light of his death, reprinted below. ASCO ASCO President Monica M. Bertagnolli, MD, FACS, FASCO, issued the following...
Memory Issues in Children With Medulloblastoma Undergoing Radiation Therapy
Children with certain types of brain tumors who undergo radiation treatment are less likely to recall the specifics of events they experienced after radiation than to remember pretreatment happenings, according to a Baylor University study comparing them to children with healthy brains. These...
First Large-Scale Survey of Advanced Practice Providers in Oncology Shows Growing Role for Nurse Practitioners and Physician Assistants
Advanced practice providers (APPs) have increasingly become integral members of the oncology care delivery team, according to the first large-scale study of nurse practitioners (NPs) and physician assistants (PAs) in oncology published by Bruinooge et al in the Journal of Oncology Practice....
A Firsthand Account of Cancer and Mental Illness
Brain tumors are among the most challenging clinical scenarios faced by the oncology community. Along with devastating physiologic damage, brain tumors often have a dramatic effect on the patient’s cognitive, neurologic, and psychological functions. However, the body of literature focusing on...
SMARTIE Initiative for Advanced Practitioners in Oncology Recognized by Alliance for Continuing Education
AN ONGOING educational initiative, the Study to Measure Advanced Practitioner Retention of Targeted Information and Education (SMARTIE), measures oncology learning and how it is used with advanced practitioners and their patients with cancer. The initiative, conducted by Harborside Medical...
Bevacizumab and Temozolomide in First Recurrence of Glioma Without 1p/19q Codeletion
In a phase II trial funded by the European Organisation for Research and Treatment of Cancer and reported in The Lancet Oncology, van den Bent et al found no evidence of a survival benefit with the addition of bevacizumab (Avastin) to temozolomide in patients with a first recurrence of World Health ...
Functional and Social Independence in Survivors of Pediatric CNS Tumors
In a report from the St. Jude Lifetime Cohort Study published in the Journal of Clinical Oncology, Brinkman et al found that 60% of adult survivors of pediatric central nervous system (CNS) tumors do not achieve full functional or social independence in adult life. In the study, functional and...
Cannabinoids for Cancer Pain: Dangerous or Beneficial?
Cannabis has been used in health care for millennia, and its use has been well documented, albeit never definitively integrated into clinical practice. Recent societal changes and the increasing acceptance and availability of cannabis have reignited the medical and public debate around its role in...
CNS Activity of EGFR Tyrosine Kinase Inhibitor in T790M-Positive Advanced NSCLC
In a planned subgroup analysis of the phase III AURA3 trial reported in the Journal of Clinical Oncology, Wu et al found that the third-generation EGFR tyrosine kinase inhibitor osimertinib (Tagrisso) produced higher central nervous system (CNS) response rates vs platinum plus pemetrexed (Alimta)...
Actively Recruiting Clinical Trials Focused on Neurotoxicities of Treatment
The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies focused on neurotoxicities of cancer treatment. These studies focus on the effects of chemotherapy on cognitive function, changes in resting state brain networks after stem cell...
Philip J. Bierman, MD, on DLBCL: Managing Patients at Risk of CNS Involvement and Systemic Disease
Philip J. Bierman, MD, of the University of Nebraska Medical Center, discusses how to identify and treat the 1% to 2% of patients with diffuse large B-cell lymphoma who have central nervous system involvement as well as systemic sites at the time of diagnosis.
Pediatric CT Scans and Subsequent Malignancy Risk
A new study by Meulepas et al in the Journal of the National Cancer Institute suggests that computed tomography (CT) scans may increase the risk of brain tumors. The use of CT scans has increased dramatically over the past 2 decades. CT scans greatly improve diagnostic capabilities,...
First-Line Treatment With Checkpoint Inhibitors in Patients With Melanoma Brain Metastases
An analysis of newly diagnosed patients with cutaneous melanoma brain metastases treated with checkpoint blockade immunotherapy has found the treatment was associated with an increase in median overall survival of 12.4 months compared with 5.2 months—a 1.4-fold improvement. The benefit was...
Intratumoral Recombinant Poliovirus in Grade IV Glioblastoma
In a study reported in The New England Journal of Medicine, Desjardins and colleagues found that convection-enhanced intratumoral delivery of a recombinant nonpathogenic polio–rhinovirus chimera (PVSRIPO) was not associated with neurovirulence in patients with recurrent grade IV glioma and...
Surgery Followed by Salvage Stereotactic Radiosurgery vs Whole-Brain Radiotherapy for Four or Fewer Brain Metastases
In a Japanese phase III noninferiority trial (JCOG0504) reported in the Journal of Clinical Oncology, Kayama et al found that salvage stereotactic radiosurgery (SRS) was noninferior to whole brain radiation therapy (WBRT) for survival in patients with 1 to 4 resected brain metastases. In the...
Outcomes of Tisagenlecleucel Therapy in Children and Young Adults With B-Cell Acute Lymphoblastic Leukemia
As reported in The New England Journal of Medicine by Shannon L. Maude, MD, PhD, of Perelman School of Medicine, University of Pennsylvania, Philadelphia, and colleagues, the phase II ELIANA trial has shown that the anti-CD19 chimeric antigen receptor (CAR) T-cell therapy tisagenlecleucel (Kymriah) ...
Long-Term Outcomes With Dasatinib Plus Intensive Chemotherapy in Pediatric/Young Adult Ph-Positive ALL
In an analysis of the Children’s Oncology Group (COG) AALL0622 trial reported in the Journal of Clinical Oncology, Slayton et al found that adding dasatinib (Sprycel) to intensive chemotherapy produced good long-term outcomes in pediatric/young adult patients with newly diagnosed Philadelphia ...
Addition of Tumor-Treating Fields to Maintenance Temozolomide in Glioblastoma
The final results of a phase III trial reported by Roger Stupp, MD, of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University, and colleagues in JAMA indicate that adding antimitotic treatment with tumor-treating fields to maintenance temozolomide is associated with improved...
Risk-Adapted Treatment for Young Children With Medulloblastoma
In a phase II trial (SJYC07) reported in The Lancet Oncology, Robinson et al found that risk-adapted treatment did not improve event-free survival in young children with medulloblastoma. Analysis by methylation status showed superior outcome in the sonic hedgehog (SHH) subgroup. Study Details The ...
Quick Takes From Original Research Presented at the 2018 NCCN Annual Conference
THE QUANTITY of original research presented at the National Comprehensive Cancer Network® (NCCN®) Annual Conference has been growing, and at the 2018 meeting, 121 researchers presented their work. The ASCO Post captured some of the findings for this report. Blood Markers Correlate With Anti–PD-1...
Durable Responses Observed With Novel Oncolytic Therapy in Recurrent Glioma
IN A PILOT study of recurrent glioma, 26% of patients treated with the optimal dose of vocimagene amiretroprepvec (aka Toca 511), a novel oncolytic virus therapy, achieved durable, long-term responses and remained alive 3 or more years later. This outcome far exceeded “historical benchmarks” for...
Characteristics of Long-Term Survivors of Diffuse Intrinsic Pontine Glioma
In a report from the diffuse intrinsic pontine glioma (DIPG) registries of the International and European Societies for Pediatric Oncology, published in the Journal of Clinical Oncology, Hoffman et al identified characteristics of long-term survivors among pediatric and young adult...
Treating Pediatric Glioma With Bevacizumab and Standard Treatment
Children with nonbrainstem high-grade glioma could benefit from potentially life-extending treatment if genetic testing was used to personalize therapy as it is in many adults, new research published by Mackay et al in Cancer Cell reported. Scientists analyzed the DNA of children taking an...
