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breast cancer
issues in oncology
cost of care

Patients With Breast Cancer Provide Recommendations to Ease Financial Toxicity

A qualitative study yielded nine patient-driven recommendations across circumstances that include changes to insurance, supportive services, and financial assistance to reduce long-term, breast cancer–related economic burden. The study was published by Dean et al in Cancer. Unique...

gynecologic cancers
issues in oncology
global cancer care

Modeling Study of Scaled-up HPV Vaccination and Cervical Cancer Screening

In a modeling study reported in The Lancet Oncology, Simms et al detailed the preventive effects on cervical cancer that could be achieved by scaled-up human papillomavirus (HPV) vaccination and cervical screening efforts with the aim of disease elimination. The major modeling projections are...

colorectal cancer

Combining Tumor Budding and Lymphocytic Infiltration May Improve Prognostic Accuracy in Colorectal Cancer

A study evaluating a prognostic signature derived from integrating tumor budding, lymphocyte infiltration, and their spatial relationship has found that the method could more accurately stratify patients with stage II colorectal cancer at high risk for disease-specific death compared with...

solid tumors
issues in oncology

Effect of Adjuvant Treatment for Early Testicular Cancer on Reproductive Potential

Men with early-stage testicular cancer can safely receive one course of adjuvant chemotherapy or radiotherapy without it having a long-term effect on their reproductive potential, according to a study published by Weibring et al in Annals of Oncology. Although it is known already that several...

colorectal cancer
health-care policy

Effect of Affordable Care Act’s Medicaid Expansion on Colorectal Cancer Screening and Survival in Kentucky

Kentucky has been one of the most successful states in reducing its uninsured rate, which happened in part through the Affordable Care Act’s Medicaid expansion that took effect on January 1, 2014. In the past, Kentucky has reported low rates of colorectal cancer screening, and has ranked ...

issues in oncology
global cancer care

Who I Am and What I Will Do

I am a radiation oncologist from Zambia, where we only have one cancer center offering radiotherapy—and I will beat cancer. This bold statement often evokes a look of surprise. However, if the conversation is allowed to go on, I’ll say cancer is beatable even where resources are thin. I am...

leukemia
immunotherapy

Stefan O. Ciurea, MD, on Infusing High Doses of Natural Killer Cells: An Enhanced Antitumor Effect

Stefan O. Ciurea, MD, of The University of Texas MD Anderson Cancer Center, discusses the enhanced antitumor effect and lower viral reactivation that result from high doses of natural killer cells infused after haploidentical transplantation, with no excess graft-vs-host disease, a low relapse rate ...

breast cancer
immunotherapy

G. Travis Clifton, MD, on Breast Cancer and Disease Recurrence: Final Analysis From a Study of Nelipepimut-S, GM-CSF, and Trastuzumab

G. Travis Clifton, MD, of Brooke Army Medical Center, discusses phase IIb trial findings on nelipepimut-S plus GM-CSF with trastuzumab vs trastuzumab alone to prevent recurrences of high-risk, HER2 low-expressing breast cancer (Abstract 1).

supportive care
palliative care

Innovative Research to Improve the Supportive Care Needs of Cancer Survivors

First launched in 2014, the Palliative Care in Oncology Symposium introduced a nascent interdisciplinary approach to the treatment of both the physical and psychological symptoms of cancer to improve disease outcome and quality of life for patients. Today, it has evolved into a leading forum for...

lung cancer
immunotherapy

2019 ASCO-SITC: Can Plasma Cell–Free DNA Aid in Predicting Response to Checkpoint Inhibitors in NSCLC?

Researchers hypothesized that targeting some genetic alterations in plasma cell–free DNA—along with early monitoring—could be an effective, noninvasive method for predicting response to immune checkpoint inhibitors in advanced non–small cell lung cancer (NSCLC). Findings...

breast cancer

Long-Term Study Finds Axillary Radiotherapy Safe and Effective After Positive Sentinel Node Biopsy

Following identification of a positive sentinel lymph node, surgical axillary lymph node dissection and axillary radiation therapy provide comparable locoregional control and survival, according to a 10-year follow-up of the large European Organisation for Research and Treatment of Cancer AMAROS...

Expert Point of View: Parag J. Parikh, MD

Parag J. Parikh, MD, Director of Gastrointestinal Radiation Oncology, Henry Ford Cancer Institute, Detroit, commented that KEYNOTE-128 “unfortunately found a very low rate of response to single-agent pembrolizumab.” He said he would not use this approach in any patients with neuroendocrine tumors...

immunotherapy
gastrointestinal cancer

Study Shows Limited Antitumor Activity of Pembrolizumab in Neuroendocrine Tumors

Neuroendocrine tumors appear resistant to single-agent immunotherapy, according to the results of the KEYNOTE-028 trial of pembrolizumab. “Pembrolizumab monotherapy showed limited antitumor activity but a manageable safety profile in patients with previously treated, advanced neuroendocrine...

prostate cancer

ARAMIS Trial Reports Darolutamide Improves Outcomes in High-Risk Nonmetastatic Prostate Cancer

Darolutamide—an investigational androgen receptor inhibitor—significantly improved metastasis-free survival in men with high-risk nonmetastatic castration-resistant prostate cancer vs placebo in the large phase III ARAMIS trial.1 Men treated with darolutamide had a median metastasis-free survival...

Expert Point of View: Robert Dreicer, MD, MS, MACP, FASCO, and Sumanta K. Pal, MD

“This is an intriguing agent,” said ASCO expert Robert Dreicer, MD, MS, MACP, FASCO, of the University of Virginia Cancer Center and moderator of a press briefing where these data were discussed. “Survival rates are low for patients with metastatic castration--resistant prostate cancer, and the...

prostate cancer

Radioligand Therapy Achieves Responses in Metastatic Prostate Cancer

In a prospective, single-center, single-arm phase II trial reported at the 2019 Genitourinary Cancers Symposium, a novel approach using a tumor-specific radioligand therapy that binds to prostate-specific membrane antigen (PSMA) (lutetium-177 PSMA-617 -[LuPSMA]) achieved responses in a majority of...

solid tumors
immunotherapy

2019 ASCO-SITC: Combined Targeting of TIM-3 and PD-L1 Immune Checkpoint Pathways in Advanced Relapsed or Refractory Solid Tumors

A phase Ia/Ib trial was launched in order to evaluate the safety of LY3321367, an anti–T-cell immunoglobulin domain and mucin domain–containing molecule-3 (TIM-3) antibody, administered alone or in combination with LY3300054, an anti-programmed death ligand 1 (PD-L1) antibody, in...

issues in oncology
survivorship

Creating ‘Right-Sized’ Follow-up Care in Oncology as Number of Cancer Survivors Grows

An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will lead to challenges in delivering care for cancer survivors in the United States if systemic changes are not made, according to a commentary in the Journal of the National Cancer...

breast cancer
immunotherapy

2019 ASCO-SITC: Combination Immunotherapy for Breast Cancer With Trastuzumab and a HER2-Targeted Vaccine

After preclinical findings showed shared activity between trastuzumab and HER2-targeted vaccines, researchers evaluated adjvuant nelipepimut-S plus granulocyte-macrophage colony-stimulating factor (GM-CSF) with trastuzumab compared to trastuzumab with GM-CSF alone in patients with HER2...

lymphoma

Relapse Risk and Survival With Contemporary Therapy in Young Patients With Hodgkin Lymphoma

In a Nordic Lymphoma Epidemiology Group study reported in the Journal of Clinical Oncology, Biccler et al found that relapse risk and loss in expectation of lifetime were low in young patients receiving contemporary therapy for classical Hodgkin lymphoma. Outcomes were particularly good among...

skin cancer
immunotherapy

AACR 2019: Diet May Influence Gut Microbiome and Response to Immunotherapy

Among patients with melanoma treated with anti–programmed cell death protein 1 (PD-1) immunotherapy, consumption of a high-fiber diet was associated with higher gut microbiome diversity and better response to treatment, according to data presented by Spencer et al at a presscast in advance of ...

Newly Discovered Mutation in BCL2 Protein Impacts Outcomes in Patients With Progressive CLL

INVESTIGATORS FROM Australia have identified a genetic mutation that causes resistance to the targeted drug venetoclax in patients with chronic lymphocytic leukemia (CLL), according to research presented at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition1 and...

Expert Point of View: Mrinal Patnaik, MBBS, and David P. Steensma, MD

Mrinal S. Patnaik, MBBS, Associate Professor of Internal Medicine and Oncology and a consultant in hematology at the Mayo Clinic, Rochester, commented on the MEDALIST trial for The ASCO Post. “Given its unique mode of action, relative ease of administration, and excellent tolerability,...

Luspatercept May Reduce the Need for Transfusion in Lower-Risk Myelodysplastic Syndromes

IN THE RANDOMIZED, double-blind, phase III MEDALIST trial, the experimental drug luspatercept significantly reduced the need for frequent red blood cell transfusions in patients with lower-risk myelodysplastic syndromes (MDS) and ring sideroblasts. With luspatercept, 37.8% of patients remained...

hematologic malignancies

Conference Highlights From the 2018 American Society of Hematology Annual Meeting & Exposition

In sunny San Diego, the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition welcomed nearly 30,000 attendees who were eager to present, learn, network, and cheer the joint achievements of many researchers. The packed meeting was filled with important information from...

head and neck cancer
immunotherapy

In Era of Immunotherapy, Radiation Therapy May Become Essential Component of Systemic Treatments of Cancer

“IN THIS era of immunotherapy, it is highly possible, and potentially probable, that radiation therapy may become not just a form of locoregional and palliative treatment, but an essential component of our systemic treatments of cancer,” according to Zachary S. Morris, MD, PhD, Vice-Chair,...

head and neck cancer
immunotherapy
symptom management

Immunotherapy for Head and Neck Cancer Expands, but Concerns Persist About Patient Selection and Toxicities

SOME PATIENTS with advanced head and neck cancer may achieve durable responses with immunotherapy, and recent trial results suggest first-line immunotherapy may increase survival among patients with recurrent or metastatic disease. However, concerns remain about selecting patients most likely to...

lymphoma
immunotherapy

Update on FDA-Approved CAR T-Cell Products

AXICABTAGENE CILOLEUCEL (also known as CAR19) is an anti-CD19 chimeric antigen receptor (CAR) T-cell product approved by U.S. Food and Drug Administration to treat selected hematologic malignancies.1 To appreciate the clinical trial findings summarized here, from selected abstracts presented at the ...

leukemia
myelodysplastic syndromes
lymphoma
multiple myeloma
immunotherapy

Highlights From the 2018 ASH Annual Meeting & Exposition

TO ADD to our ongoing coverage of the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition, we bring readers of The ASCO Post these summaries of an assortment of interesting studies. They focus on novel therapies under investigation in the treatment of acute lymphoblastic...

hepatobiliary cancer

BRAF/MEK Targeting May Yield Benefit in Treating Biliary Tract Cancer

ROUTINE TESTING for BRAF V600E mutations in patients with biliary tract cancer may prove to be a good idea, based on the findings of a phase II study in which treatment with dabrafenib plus trametinib showed activity.1 The results suggest there may be a benefit to testing patients with biliary...

colorectal cancer
immunotherapy

Expert Point of View: Michael J. Overman, MD

INVITED STUDY discussant Michael J. Overman, MD, Professor of Gastrointestinal Medical Oncology at The University of Texas MD Anderson Cancer Center, Houston, is a co-investigator on CheckMate 142, which led to the approval of another immunotherapy doublet—nivolumab plus ipilimumab—in patients...

pancreatic cancer

Emerging Role for Neoadjuvant Treatment of Resectable Pancreatic Cancer

SEVERAL STUDIES presented at the 2019 Gastrointestinal Cancers Symposium evaluated the benefits of neoadjuvant treatment in patients with pancreatic cancer—and in patients deemed fully resectable, not just “borderline” resectable.1-3 Although the standard of care for resectable pancreatic ductal...

hematologic malignancies

PAUSE Study Establishes Simple Approach to Perioperative Management of Direct Oral Anticoagulants

The largest study to date addressing the common problem of perioperative direct oral anticoagulant (DOAC) management has shown that patients with atrial fibrillation can safely stop taking their anticoagulant for 1 day before and after procedures with a low risk of bleeding and for 2 days before...

hematologic malignancies

Crizanlizumab Improves Prevention of Vaso-occlusive Crises in Patients With Sickle Cell Disease

For the first time in more than 20 years, patients with sickle cell disease may have another treatment option to reduce painful vaso-occlusive crises, according to data presented at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition.1 Results of the phase II, randomized,...

Expert Point of View: Mark Crowther, MD, MSc, FRCPC

Moderator of the session, Mark Crowther, MD, MSc, FRCPC, Professor of Clinical Epidemiology and Biostatistics, Leo Pharma Chair in Thromboembolism Research at McMaster University, in Ontario, Canada, said that the CASSINI study represents a major advance in the management and prevention of a very...

hematologic malignancies

Direct Oral Anticoagulants Show Reduced Risk of Venous Thromboembolism in Patients With Cancer

Results of a recent study suggest that direct oral anticoagulants can reduce the risk of thromboembolism in patients with cancer who are starting a new systemic therapy regimen, without significantly increasing the risk of major bleeding. Data presented at the 2018 ASH Annual Meeting &...

hematologic malignancies

Pilot Study Tests Novel Approach to Gene Therapy for Sickle Cell Disease

Initial findings from a first-in-human trial have provided proof of principle for a groundbreaking approach to gene therapy for sickle cell disease, according to data presented at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition.1 Early results of genetic targeting of...

hematologic malignancies

Low-Dose Rituximab Effective for Acquired Thrombotic Thrombocytopenic Purpura With Severe ADAMTS13 Deficiency

The results of a recent pilot study suggest that low-dose rituximab provides similar efficacy to standard-dose rituximab for the treatment of acquired thrombotic thrombocytopenic purpura (TTP), a finding that could point to potential cost savings for patients in the nonlymphoma setting. According...

prostate cancer
symptom management

Patient-Reported Outcomes With Enzalutamide in PROSPER Trial

As reported by Tombal et al in The Lancet Oncology, treatment with enzalutamide was associated with clinically meaningful delays in pain progression, symptom worsening, and deterioration in functional status vs placebo in the phase III PROSPER trial in nonmetastatic, castration-resistant prostate...

Norman E. Sharpless, MD: From Director of a Comprehensive Cancer Center to Director of the NCI

GUEST EDITOR Dr. Abraham is the Director of the Breast Oncology Program at Taussig Cancer Institute, and Professor of Medicine, Lerner College of Medicine, Cleveland Clinic. In this installment of the Living a Full Life series of articles, guest editor Jame Abraham, MD, FACP, interviewed Norman E. ...

leukemia

ERG Gene Variations and Risk of ALL in Hispanic Children

Scientists have identified genetic variations in a fourth gene that are associated with an increased risk of acute lymphoblastic leukemia (ALL) in Hispanic children. These findings were published by Qian et al in Blood. The gene is ERG, a transcription factor that is also...

prostate cancer

2019 GU Cancers Symposium: ARAMIS: Darolutamide in Nonmetastatic, Castration-Resistant Prostate Cancer

In the phase III ARAMIS trial reported by Fizazi et al at the 2019 Genitourinary Cancers Symposium (Abstract 140) and simultaneously published in The New England Journal of Medicine, researchers found that the androgen receptor antagonist darolutamide significantly prolonged metastasis-free...

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...

head and neck cancer

Small Study Investigates Rise of Glottic Carcinoma in Young Adults and HPV Infection

An increase in the diagnosis of glottic carcinoma in young adults may be due in part to infection with strains of human papillomavirus (HPV). Investigators from Massachusetts General Hospital (MGH) described finding HPV infection in all tested samples of glottic carcinoma from 10 patients diagnosed ...

gynecologic cancers

Two-Year Interim Analysis of Conservatively Managed Ovarian Tumors

In an interim analysis of a prospective cohort study (IOTA5) reported in The Lancet Oncology, Froyman et al found that the risk of malignancy and acute complications is low when adnexal masses with benign ultrasound findings are managed conservatively. In the study, patients with at least 1...

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 ...

hepatobiliary cancer

Adjuvant Gemcitabine Plus Oxaliplatin vs Surveillance in Resected Biliary Tract Cancer

In a French phase III trial (PRODIGE 12-ACCORD 18-UNICANCER GI) reported in the Journal of Clinical Oncology, Edeline et al found that adjuvant gemcitabine plus oxaliplatin (GEMOX) did not significantly improve relapse-free survival vs surveillance following resection for localized biliary tract...

prostate cancer

2019 GU Cancers Symposium: Small Trial of LuPSMA in PSMA-Positive, Metastatic, Castration-Resistant Prostate Cancer

A single-arm, phase II trial in men with prostate-specific membrane antigen (PSMA)-positive, metastatic, castration-resistant prostate cancer that progressed despite standard therapies found that a majority of men treated with a novel, targeted radiation therapy called lutetium-177 PSMA-617...

breast cancer

MRI and Assay Results May Influence Treatment of DCIS

In a prospective cohort clinical trial reported in JAMA Oncology, Lehman et al found that multiple factors, including magnetic resonance imaging (MRI) findings, played a role in conversion to mastectomy among women with ductal carcinoma in situ (DCIS) who were candidates for wide local excision...

breast cancer

Breast Cancer Surgical Terminology Should Be Updated to Reflect Modern Medical Practice

BREAST CANCER is a microscopic disease, with most patients presenting with “localized” stage I to III disease, for which they are offered curative-intent surgery often accompanied by radiation therapy, chemotherapy, and hormonal therapy. More accurately, we now know that patients with localized...

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