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issues in oncology

Physicians Should Lead by Example to Combat the Obesity Epidemic

American patients are suffering from an obesity crisis, where it is estimated that 300,000 deaths per year are due to obesity.1 The obesity trend is predicted to worsen, where it is projected that 85% of U.S. adults will be overweight or obese by 2030.2 Consequently, obesity-related illnesses are...

Navneet S. Majhail, MD, MS, Was Inspired by His Father’s Career as a Military Doctor and His Mother’s Battle With Cancer

In this installment of the Living a Full Life series, guest editor Jame Abraham, MD, FACP, spoke with Navneet S. Majhail, MD, MS, about his journey from India to the Cleveland Clinic, where he is Director of the Blood and Marrow Transplant Program. He is also President of the American Society for...

head and neck cancer

Nivolumab vs Chemotherapy in Advanced Esophageal Cancer

Nivolumab improved overall survival compared with chemotherapy in previously treated patients with esophageal squamous cell carcinoma in the final analysis of the phase III ATTRACTION-3 study. The data were presented at the European Society for Medical Oncology (ESMO) Congress 2019 Presidential...

issues in oncology
survivorship

ASCO Provides Guidance on Managing Osteoporosis in Cancer Survivors

Cancer survivors are at an increased risk of osteoporotic fractures due to the accelerated loss of bone mineral density as a result of their treatment. Bone loss from cancer therapy is faster and more severe than bone less from aging; rates of bone loss are up to sevenfold higher when they occur...

prostate cancer

Apalutamide for Metastatic Castration-Sensitive Prostate Cancer

On September 17, 2019, apalutamide was approved for the treatment of patients with metastatic castration-sensitive prostate cancer.1,2 Supporting Efficacy Data The approval is based on overall survival and radiographic progression-free survival findings in the phase III double-blind TITAN trial.2,3 ...

National Comprehensive Cancer Network Oncology Research Program Supports Clinical Trial for Lung Cancer

The National Comprehensive Cancer Network (NCCN®) Oncology Research Program (ORP) has announced plans to support a phase II randomized trial for lung cancer patients. The study is titled, “TH-138: Phase II randomized trial of carboplatin + pemetrexed + bevacizumab, with or without atezolizumab in...

breast cancer

Breast Cancer Treatments Targeting Estrogen May Be Putting Patients at Risk for Long-Term Comorbidities

“The majority of breast cancers are hormone receptor–positive, and treatments that target the estrogen receptors are very effective, but they also cause havoc in many tissues that are dependent on estrogen for normal functioning. As a result, breast cancer survivors suffer from ongoing symptoms and ...

Prescribing Hope

“There is no medicine like hope, no incentive so great, and no tonic so powerful as expectation of something tomorrow.” –Orison Swett Marden I was informed that my patient, a 58-year-old man recently diagnosed with pancreatic cancer, and his wife were becoming impatient waiting for me in the exam...

global cancer care

Challenging the Global Community to Deliver Equitable Cancer Care for All

For Her Royal Highness Princess Dina Mired of Jordan, ensuring that every patient with cancer receives high-quality care is not an abstract goal—it is personal. Princess Dina saw firsthand the life-and-death differences that access to state-of-the-art oncology care makes in a patient’s life when...

leukemia

Glasdegib in Older Patients With AML or Those With Comorbidities

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. Late in 2018, the Hedgehog pathway inhibitor glasdegib...

lung cancer
immunotherapy

Nivolumab/Ipilimumab: Another First-Line Option for Advanced NSCLC

The combination of nivolumab and ipilimumab improved overall survival compared with chemotherapy as first-line therapy for patients with advanced non–small cell lung cancer (NSCLC) and programmed cell death ligand 1 (PD-L1) expression of at least 1%, according to the results of CheckMate 227....

issues in oncology
pain management

Opioid Prescriptions in Patients With Cancer in Southwest Virginia

In a study in residents of rural southwest Virginia reported in the Journal of Oncology Practice, Virginia T. LeBaron, PhD, and colleagues found that most patients with cancer never received a prescription opioid medication, that few patients were admitted to hospital for opioid use disorders, and...

head and neck cancer
immunotherapy

Pembrolizumab With or Without Chemotherapy vs Cetuximab Plus Chemotherapy in Recurrent or Metastatic HNSCC

As reported in The Lancet by Barbara Burtness, MD, and colleagues, the phase III KEYNOTE-048 trial has shown improved overall survival with first-line pembrolizumab plus chemotherapy vs cetuximab plus chemotherapy among patients with recurrent or metastatic squamous cell carcinoma of the head and...

issues in oncology

Two Societies Issue Statements on E-Cigarettes

Today, the American Cancer Society (ACS) announced an update to the organization’s position on e-cigarettes, and the American Medical Association (AMA) called for a total ban on all e-cigarette and vaping products that do not meet U.S. Food and Drug Administration (FDA) approval as cessation ...

kidney cancer
immunotherapy

Atezolizumab/Bevacizumab in Metastatic Renal Cell Carcinoma With Variant Histology or Sarcomatoid Features

In a phase II trial reported in the Journal of Clinical Oncology, Toni K. Choueiri, MD, and colleagues found that the combination of atezolizumab and bevacizumab was active in metastatic renal cell carcinoma with variant histology and clear cell renal cell carcinoma with ≥ 20% sarcomatoid...

issues in oncology
pain management

Prescribed Opioid Use and Infection Risk in Patients With Cancer and Treatment-Associated Neutropenia

In a German study reported in a research letter in JAMA Internal Medicine, Jakob et al found that prescribed opioid use did not appear to increase risk of infection in hospitalized patients with cancer who developed treatment-associated neutropenia. According to the investigators, recent data have...

solid tumors
immunotherapy

Pembrolizumab in Noncolorectal MSI-H/dMMR Solid Tumors

As reported in the Journal of Clinical Oncology by Marabelle et al, the phase II KEYNOTE-158 trial has shown robust activity of pembrolizumab in patients with noncolorectal microsatellite instability­–high (MSI-H)/mismatch repair–deficient (dMMR) solid tumors. Findings in the study supported the...

multiple myeloma

Selinexor Plus Dexamethasone Studied in Triple-Class Refractory Multiple Myeloma

In a phase IIb study (STORM Part 2) reported in TheNew England Journal of Medicine, Ajai Chari, MD, of Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, and colleagues found that oral selinexor and dexamethasone were active in some patients with multiple myeloma refractory to prior...

lymphoma
immunotherapy

Polatuzumab Vedotin Plus Bendamustine/Rituximab for Transplantation-Ineligible Relapsed or Refractory DLBCL

In a phase Ib/II trial reported in the Journal of Clinical Oncology, Laurie H. Sehn, MD, MPH, and colleagues found that the addition of polatuzumab vedotin to bendamustine/rituximab improved response rate and progression-free and overall survival among transplantation-ineligible patients with...

issues in oncology

Presenting Symptoms and Cancer Stage at Diagnosis

In a population-based study reported in The Lancet Oncology, Koo et al found that presenting symptoms of cancer were mostly associated with stage earlier than stage IV, suggesting a benefit of symptom awareness campaigns based on common symptoms. As stated by the investigators, “Early diagnosis...

gynecologic cancers
immunotherapy

Nivolumab Plus Bevacizumab in Relapsed Ovarian Cancer

In a phase II trial reported in JAMA Oncology, Liu et al found evidence of the activity of combined nivolumab and bevacizumab in relapsed ovarian cancer, with activity appearing to be greater in platinum-sensitive disease. Study Details In the trial, 38 women with relapsed epithelial ovarian cancer ...

skin cancer

5-Year Efficacy Outcomes With Dabrafenib Plus Trametinib in BRAF-Mutated Metastatic Melanoma

As reported in The New England Journal of Medicine by Caroline Robert, MD, PhD, of the Institut Gustave Roussy and Paris-Sud-Paris-Saclay University, Villejuif, and colleagues, the long-term follow-up of the phase III COMBI-d and COMBI-v trials has shown a pooled 5-year overall survival rate of 34% ...

prostate cancer
breast cancer
bladder cancer
pancreatic cancer
kidney cancer
thyroid cancer
gynecologic cancers
immunotherapy

ESMO Congress 2019: Quick Takes From Key Clinical Trials

The ESMO Congress continues to grow as a pivotal platform for research in clinical oncology. At the ESMO Congress 2019, important findings were showcased in more than 2,200 studies, including 93 late-breaking abstracts. The ASCO Post summarized much of that news in separate articles over several...

prostate cancer

Phase III PROfound Study Evaluates Olaparib in Setting of Metastatic, Castration-Resistant Prostate Cancer

Treatment with the poly (ADP-ribose) polymerase (PARP) inhibitor olaparib delayed disease progression and appears to improve survival, compared with newer hormonal agents in men with pretreated metastatic castration-resistant prostate cancer and homologous recombinant repair (HRR) genetic...

multiple myeloma

Selinexor Plus Dexamethasone Studied in Triple-Class Refractory Multiple Myeloma

In a phase IIb study (STORM Part 2) reported in The New England Journal of Medicine, Ajai Chari, MD, of Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, and colleagues found that oral selinexor and dexamethasone were active in some patients with multiple myeloma refractory to prior...

hepatobiliary cancer

Oral Direct-Acting Antiviral Therapy May Improve Survival in Patients With Hepatitis C Virus–Related HCC

Data from a new study presented by Dang et al at The Liver Meeting (Abstract 40) found that patients with hepatitis C virus–related hepatocellular carcinoma (HCC) who achieved sustained virologic response (denoting an undetectable level of the virus) with any oral direct-acting antiviral therapy...

lung cancer
immunotherapy

CheckMate 227: Nivolumab Plus Ipilimumab Presents Another Option in First-Line Treatment of Advanced Non–Small Cell Lung Cancer

The combination of nivolumab and ipilimumab improved overall survival compared with chemotherapy as first-line therapy for patients with advanced non–small cell lung cancer (NSCLC) and programmed cell death ligand 1 (PD-L1) expression of at least 1%, according to the results of CheckMate 227....

breast cancer

MONALEESA-3, MONARCH 2: CDK4/6 Inhibitors Plus Fulvestrant Benefit Survival in Advanced Breast Cancer

CDK4/6 inhibitors improve overall survival in advanced breast cancer, according to results of two important phase III trials reported at the ESMO Congress 2019. Dennis J. Slamon, MD, PhD, of the University of California, Los Angeles Women’s Cancer Research Program, presented the findings from the...

gynecologic cancers

PRIMA Trial Reports Benefit With Niraparib Across Ovarian Cancer Subsets

In women with advanced ovarian cancer responding to first-line chemotherapy, maintenance therapy with the PARP inhibitor niraparib significantly reduced the risk of disease progression by 38% overall and by 60% in women with BRCA mutations. Even patients without a homologous recombination...

issues in oncology
hematologic malignancies
leukemia

How Clonal Hematopoiesis of Indeterminate Potential Increases the Risk of Heart Disease and Blood Cancers as People Age

Although stem cells throughout the body acquire genetic mutations over time, usually these alterations do not affect how the stem cells function or cause disease. However, recent research in clonal hematopoiesis and aging has found an association between clonal expansion of hematopoietic cells with ...

leukemia
lymphoma

Venetoclax for Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma

On May 15, 2019, venetoclax was approved for the treatment of adult patients with previously untreated chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL).1,2 Supporting Efficacy Data Approval was based on findings from the open-label phase III CLL14 trial (ClinicalTrials.gov...

lung cancer
issues in oncology

Early Lung Cancer Detection Followed by Minimally Invasive Surgery Saves Lives

Lung cancer remains the number one cancer killer, leading to about 150,000 deaths per year in the United States and accounting for approximately 25% of all cancer deaths in the nation. Early detection has improved survival in other malignancies such as breast, colon, and cervical cancers, but...

pancreatic cancer

Management of Locally Advanced Pancreatic Cancer: A Call for Action

Advances in systemic therapy and supportive care, as well as ongoing improvements in surgical techniques, have led to improved survival for many patients with pancreatic ductal adenocarcinoma. We have observed increased survival with FOLFIRINOX (leucovorin, fluorouracil, irinotecan,...

prostate cancer

Third-Line Cabazitaxel Improves Outcomes in Patients With Metastatic Prostate Cancer

Third-line treatment with cabazitaxel extended progression-free survival and overall survival in men with metastatic castration-resistant prostate cancer in the CARD trial. These results provide the first evidence from a randomized phase III trial for a survival benefit with third-line therapy, and ...

Pioneering Breast Surgeon and NSABP Chair, Bernard Fisher, MD, Dies at 101

American physicist and philosopher Thomas Kuhn coined the term “paradigm shift” to connote a fundamental change in the basic concepts and practices of a standard scientific discipline. They are few and far between. To convince the entrenched oncologic surgery community in the 1960s and 1970s that...

gynecologic cancers

Veliparib Plus Chemotherapy Meets Primary Endpoint in Advanced Ovarian Cancer

As first-line treatment for women with advanced ovarian cancer, the addition of veliparib during induction followed by veliparib maintenance therapy significantly reduced the risk of disease progression or death in the phase III VELIA/GOG-3005 trial reported at the European Society for Medical...

prostate cancer

2019 NCRI: Higher IGF-1 and Free Testosterone Levels May be Risk Factors for Prostate Cancer

Men with higher levels of free (biologically active) testosterone and insulin-like growth factor-1 (IGF-1) in their blood are more likely to be diagnosed with prostate cancer, according to research presented by Travis et al at the 2019 National Cancer Research Institute (NCRI) Cancer Conference....

lung cancer

Dietary Fiber, Yogurt Consumption, and Lung Cancer Risk

In a pooled analysis reported in JAMA Oncology, Yang et al found that higher fiber and higher yogurt consumption were associated with significantly reduced risk of lung cancer. Study Details The analysis included 627,988 men (mean age = 57.9 years) and 817, 862 women (mean age = 54.8 years) from...

multiple myeloma

Daratumumab Combination Therapy for Patients With Multiple Myeloma Who Are Eligible for Transplantation

On September 26, 2019, daratumu-mab (Darzalex) was approved in combination with bortezomib, thalidomide, and dexamethasone for the treatment of multiple myeloma in newly diagnosed adult patients eligible for autologous stem cell transplantation (ASCT).1,2 Supporting Efficacy Data Approval was based ...

kidney cancer

CheckMate 214: Nivolumab/Ipilimumab vs Sunitinib in First-Line Treatment of Advanced Renal Cell Carcinoma

As reported in The Lancet Oncology by Robert J. Motzer, MD, of Memorial Sloan Kettering Cancer Center, New York, and colleagues, extended follow-up of the phase III CheckMate 214 trial has shown maintained survival benefit of first-line nivolumab/ipilimumab vs sunitinib among patients with...

ACCC Honors Seven Cancer Programs With Innovator Awards

ACCC Honors Seven Cancer Programs With Innovator Awards The Association of Community Cancer Centers (ACCC) honored the recipients of 2019 ACCC Innovator Awards at the ACCC 36th National Oncology Conference, October 30–November 1 in Orlando, Florida, where this year’s honorees shared innovative...

solid tumors
immunotherapy

High-Dose Bevacizumab for Patients With Neurofibromatosis Type 2 and Progressive Vestibular Schwannomas

In a phase II trial reported in the Journal of Clinical Oncology, Plotkin et al found that high-dose bevacizumab induction therapy did not appear to produce better outcomes compared with lower-dose treatment in patients with neurofibromatosis type 2 (NF2) and progressive vestibular schwannomas. As...

breast cancer

Scientific Session on Breast Cancer Explores Studies on Partial-Breast Irradiation, Chemoradiotherapy

Women with early-stage breast cancer treated with lumpectomy followed by radiation therapy rated the cosmetic results for whole-breast and partial-breast irradiation to be equivalent, according to a new analysis of results from the phase III NRG Oncology/NSABP B39-RTOG 0413 clinical trial. Results...

colorectal cancer

American College of Physicians Issues Guidance on Colorectal Cancer Screening for Average-Risk, Asymptomatic Adults Aged 50 to 75 Years

The American College of Physicians has issued a new guidance statement on colorectal cancer screening, which recommends screening for average-risk adults who do not have symptoms and are between the ages of 50 and 75 years. The guidelines were published by Qaseem et al in Annals of Internal...

multiple myeloma

Continuous Therapy for Multiple Myeloma Offers Survival Advantage, but Questions Remain

The number of approved agents in multiple myeloma has skyrocketed in recent years, leading to significant improvements in survival, but questions remain regarding the optimal duration of treatment. Although traditionally limited to a fixed number of cycles due to accumulating toxicity, novel agents ...

multiple myeloma

Levofloxacin Prophylaxis During Treatment of Newly Diagnosed Multiple Myeloma

In the phase III TEAMM trial reported in The Lancet Oncology, Drayson et al found that prophylactic treatment with levofloxacin during the first 12 weeks of multiple myeloma treatment in newly diagnosed patients was associated with a significant reduction in first febrile episodes or death from any ...

prostate cancer

Targeted Therapy Moves Into Metastatic Castration-Resistant Prostate Cancer With Strong Showing by Olaparib and Rucaparib

Treatment with olaparib delayed disease progression, and early survival data suggest a positive trend in favor of olaparib compared with newer hormonal agents in men with pretreated metastatic castration-resistant prostate cancer and homologous recombinant repair genetic alterations—specifically...

breast cancer

MONARCH 2: Interim Analysis of Overall Survival With Abemaciclib/Fulvestrant in Hormone Receptor–Positive, HER2-Negative Breast Cancer

As reported in JAMA Oncology by George W. Sledge, Jr, MD, and colleagues, an interim analysis of overall survival in the phase III MONARCH 2 trial has shown a significant advantage for abemaciclib plus fulvestrant vs fulvestrant alone in women with advanced hormone receptor–positive, HER2-negative...

issues in oncology
survivorship

Leydig Cell Failure and Dysfunction and Associated Adverse Health Outcomes in Male Survivors of Childhood Cancer

In a retrospective analysis from the St. Jude Lifetime Cohort Study reported in the Journal of Clinical Oncology, Chemaitilly et al identified the prevalence of and risk factors for failure and dysfunction of Leydig cells, which are responsible for testosterone secretion, and associated adverse...

issues in oncology

ASCO National Cancer Opinion Survey: Cancer Prevention, E-Cigarette, and End-of-Life Knowledge Gaps Reported

One in four Americans say they incorporate cancer prevention into their daily lives, according to ASCO’s third annual National Cancer Opinion Survey, despite research showing that as many as half of all cancer cases are preventable. The survey found low levels of awareness of known cancer risk...

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