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issues in oncology

Metabolic Imaging as a Method to Assess Treatment Response to Cytotoxic and Cytostatic Agents

Tumor shrinkage is not the only measure of a successful anticancer therapy. A University of Colorado Cancer Center article published by Serkova et al in Frontiers in Oncology describes a promising alternative: metabolic imaging. Tumors rush their metabolism to grow and proliferate. By recognizing a ...

supportive care
symptom management

FDA Approves Extended-Release Granisetron Injection for the Prevention of Chemotherapy-Induced Nausea and Vomiting

Heron Therapeutics, Inc, announced on August 10, 2016, that the U.S. Food and Drug Administration (FDA) has approved granisetron (Sustol) extended-release injection. Granisetron is a serotonin-3 (5-HT3) receptor antagonist indicated in combination with other antiemetics in adults for the prevention ...

lung cancer

Dabrafenib Plus Trametinib in BRAF V600E–Mutant Metastatic NSCLC

In a phase II trial reported in The Lancet Oncology, Planchard et al found that combined MAPK pathway inhibition with the BRAF inhibitor dabrafenib (Tafinlar) and the MEK inhibitor trametinib (Mekinist) resulted in a high response rate in patients with BRAF V600E–mutant non–small cell lung cancer...

bladder cancer

Anti–PD-L1 Antibody Durvalumab in Advanced Urothelial Bladder Cancer

In a phase I/II study reported in the Journal of Clinical Oncology, Massard et al found that the anti–PD-L1 (programmed cell death ligand 1) antibody durvalumab was active in patients with previously treated advanced urothelial bladder cancer. Objective response appeared to be confined to patients...

kidney cancer

Final Results of METEOR Trial: Cabozantinib vs Everolimus in Advanced Renal Cell Carcinoma

As reported by Toni K. Choueiri, MD, of Dana-Farber Cancer Institute, et al in The Lancet Oncology, the final results of the phase III METEOR trial indicate significantly improved overall survival with cabozantinib (Cabometyx) vs everolimus (Afinitor) in patients with advanced renal cell carcinoma...

ASH Commits $3 Million Annually to Help Preserve Critical Blood Disease Research

With a $3 million annual commitment to support promising blood disease research amid limited National Institutes of Health (NIH) funding, the American Society of Hematology (ASH) has announced the formal establishment of the ASH Bridge Grant program after an extended 4-year pilot study. ASH also...

lung cancer

Phase III Trial Finds No Survival Benefit of Adding Ipilimumab to Etoposide/Platinum in Extensive-Stage SCLC

The addition of the anti–CTLA-4 (cytotoxic T-lymphocyte–associated protein 4) checkpoint inhibitor ipilimumab (Yervoy) to etoposide/platinum did not improve overall survival in the first-line treatment of patients with extensive-stage small cell lung cancer (SCLC), according to a phase...

issues in oncology
geriatric oncology

Safety Concerns Weigh Heavily in Elderly Patients With Cancer

Active pharmacovigilance in detecting and assessing the safety signals related to drugs and devices, and disseminating those findings to relevant stakeholders, is an important component in delivering safe, high-quality care in the cancer setting. To reach a better understanding of this issue,...

prostate cancer

Androgen-Deprivation Therapy May Increase Mortality in African American Men With Favorable-Risk Prostate Cancer

In a retrospective study analyzing patients' medical records, researchers at Brigham and Women's Hospital (BWH) found that race significantly affected longevity by increasing the likelihood of death after receiving androgen-deprivation therapy. These findings were published by Kovtun et al in...

breast cancer

Effectiveness of Organized National Breast Cancer Screening: The Israeli Experience

Recent years have seen the publication of a considerable amount of scientific literature questioning the effectiveness of mammography screening in decreasing breast cancer mortality.1-4 This article explores how the Israeli experience has demonstrated the efficacy of organized national...

solid tumors

Vemurafenib Active in BRAF V600E–Positive Papillary Thyroid Cancer Refractory to Radioactive Iodine

In a phase II study reported in The Lancet Oncology, Brose et al found that vemurafenib (Zelboraf) had antitumor activity in patients with BRAF V600E–positive recurrent or metastatic papillary thyroid cancer refractory to radioactive iodine. Study Details In the study, 26 patients without...

lymphoma

Is Post-Transplantation Cyclophosphamide Disruptive Technology?

There was a time when transplantation across human leukocyte antigen (HLA) barriers was fraught with so much difficulty that many thought it was impossible and we should stop trying. However, most patients do not have an HLA-matched sibling donor, and death was therefore certain if they had a...

issues in oncology

Effects of the Global Economic Crisis on Cancer Care

The global economic crisis beginning in 2008 was associated with substantial public health effects, especially with respect to mental health.1–3 Nevertheless, there is also evidence of a paradoxical association between recessions and reduced all-cause mortality, in part because of reductions in...

issues in oncology

Economic Crisis Associated With Increased Cancer Mortality

The global economic crisis has been associated with increased unemployment and reduced public-sector expenditure on health care. In a study reported in The Lancet, Mahiben Maruthappu, MA, of Imperial College London, and colleagues found that the global economic crisis beginning in 2008 was...

supportive care
symptom management

More Focus Needed on Chemotherapy-Induced Nausea as a Cluster of Symptoms

Management of chemotherapy-induced vomiting has improved with the use of antiemetics, but chemotherapy-induced nausea remains a major clinical problem, according to Alex Molassiotis, RN, PhD, Professor and Head of the School of Nursing at The Hong Kong Polytechnic University. And, he added, the...

supportive care
symptom management
breast cancer

Use of Dexamethasone Mouthwash in Managing mTOR Inhibitor–Associated Stomatitis in Patients With Breast Cancer

Prophylactic use of dexamethasone mouthwash significantly minimized the incidence of all grades of stomatitis in postmenopausal women receiving everolimus (Afinitor, Zortress) and exemestane for the treatment of hormone receptor–positive metastatic breast cancer, according to data presented by...

supportive care
symptom management

Dealing With GI Toxicities After Chemoradiation

Chemotherapy- and radiotherapy-induced gastrointestinal (GI) toxicities have risen alongside improved survival rates for many cancers, according to Jervoise Andreyev, MA, PhD, Consultant Gastroenterologist in GI Consequences of Cancer Treatment at the Royal Marsden Hospital in London. “For every...

survivorship
pain management

ASCO Releases Clinical Practice Guideline on Management of Chronic Pain in Survivors of Adult Cancers

As reported in the Journal of Clinical Oncology by Judith A. Paice, PhD, RN, of Northwestern University, and colleagues, ASCO has released a clinical practice guideline on management of chronic pain in survivors of adult cancers. The guideline was based on literature review by an expert panel, with ...

prostate cancer

Sociodemographic and Clinical Predictors of Switching to Active Treatment From Observational Management in Low-Risk Prostate Cancer

Although active surveillance for patients with low-risk prostate cancer has become an increasingly acceptable strategy for disease management, many men opt for definitive therapies such as radical prostatectomy or radiation therapy. A new study of more than 2,200 patients with low-risk prostate...

colorectal cancer

No Improvement in Outcome Reported With Longer Wait Between Radiochemotherapy and Surgery in Rectal Cancer

Pathologic complete response rate was not improved by increasing the interval between neoadjuvant chemoradiotherapy and surgery from 7 to 11 weeks in patients with rectal cancer, according to the French phase III GRECCAR-6 trial reported by Lefevre et al in the Journal of Clinical Oncology. In...

lymphoma

Is Nivolumab Active in Classical Hodgkin Lymphoma After Failure of Autologous SCT and Brentuximab Vedotin?

Treatment with the anti–PD-1 (programmed cell death protein 1) immune checkpoint inhibitor nivolumab (Opdivo) produced response in two-thirds of patients with classical Hodgkin lymphoma after failure of both autologous stem cell transplantation (SCT) and brentuximab vedotin (Adcetris),...

prostate cancer

Patients With Low-Risk Prostate Cancer on Active Surveillance Experience Good Quality of Life

Active surveillance has become an increasingly important alternative to surgery, chemotherapy, or radiation treatment for men diagnosed with low-risk prostate cancer. However, what is the impact of active surveillance on health-related quality of life in patients selected or opting for this...

health-care policy

The National Cancer Moonshot Lifts Off

Just 6 months after President Barack Obama announced the establishment of a National Cancer Moonshot Initiative to accelerate the pace of research discoveries, improve patient access and care, and encourage data-sharing, dozens of new initiatives to accomplish those and other goals were rolled out...

breast cancer

In Vitro Fertilization Not Associated With Increased Risk of Breast Cancer in Dutch Study

Among women undergoing fertility treatment in the Netherlands between 1980 and 1995, the use of in vitro fertilization (IVF) compared with non-IVF treatment was not associated with increased risk of breast cancer after a median follow-up of 21 years, according to a study published by van den...

Fentanyl Nasal Spray Now Available at a Dose of 300 µg for Treatment of Breakthrough Cancer Pain

Fentanyl (Lazanda) nasal spray, a schedule II narcotic, is now available at a 300-µg dose to treat breakthrough cancer pain, offering physicians another titration option for dosing flexibility. The new strength can help physicians more easily and accurately target the appropriate dose for patients, ...

lung cancer

Lung Cancer Screening: Beneficial for Certain Populations but Not Without Controversy

The National Cancer Policy Forum of the National Academies of Sciences took up the issue of lung cancer screening at its mid-June workshop. Greta Massetti, PhD, Associate Director for Science, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention (CDC), and chair of ...

pancreatic cancer

ASCO 2016 Guidelines for the Treatment of Pancreatic Cancer: Why Another Guideline?

The 5-year survival rate of those diagnosed with pancreatic cancer remains stubbornly fixed around 5%. Even in the 20% of cases in which surgical resection is undertaken for curative intent, the 5-year survival rate after surgery is 20% to 30%. As we make progress in other cancers with decreasing...

issues in oncology
health-care policy

Road to Successful Use of Real-World Evidence for Drug Development Is Long and Rocky

Friends of Cancer Research (Friends) has been a leader in the push for better and faster cancer drug development. Now it is tackling the use of real-world evidence in clinical trials. This is the report of a meeting on the subject that took place on June 16 in Washington, DC.1 Real-world evidence...

gynecologic cancers

Benefit Strongly Suggested With Hormonal Maintenance in Low-Grade Serous Carcinoma

In patients with low-grade serous carcinoma, maintenance hormonal therapy reduced the risk of recurrence by 77%, compared with surveillance, in a retrospective cohort from The University of Texas MD Anderson Cancer Center. The study was reported by David Marc Gershenson, MD, at the 2016 ASCO...

breast cancer

PHEREXA: Benefit for Second-Line Pertuzumab Questionable

In the second-line metastatic breast cancer setting, the addition of pertuzumab (Perjeta) to trastuzumab (Herceptin)/capecitabine did not significantly improve progression-free survival, results of the phase III ­PHEREXA trial showed.1 This is the first randomized trial to evaluate the efficacy of ...

skin cancer

Studies Suggest Bright Future for Combination Immunotherapy in Advanced Melanoma, but Questions Remain

Two studies presented at the 2016 ASCO Annual Meeting focused on the use of combination immunotherapy in the treatment of patients with advanced melanoma. Updated results from the phase III CheckMate 067 trial centered on the combination of nivolumab (Opdivo) plus ipilimu­mab (Yervoy) compared...

solid tumors
prostate cancer

No Survival Benefit for Cabozantinib Reported in Previously Treated Metastatic Castration-Resistant Prostate Cancer

Smith et al found no improvement in overall survival with cabozantinib (Cometriq) vs prednisone in patients with previously treated metastatic castration-resistant prostate cancer, in the phase III COMET-1 trial reported in the Journal of Clinical Oncology. Cabozantinib, which inhibits MET, VEGF...

breast cancer

Results of Two Practice-Changing Breast Cancer Trials Upheld

Results of two pivotal breast cancer trials reported at the 2016 ASCO Annual Meeting confirmed the practice-changing findings that resulted from earlier findings. PALOMA-2 The phase III PALOMA-2 trial confirmed results from the smaller, open-label phase II PALOMA-1 trial that led to the U.S. Food...

solid tumors
gastroesophageal cancer

Comparison of Chemotherapy Regimens in Metastatic Esophageal and Gastroesophageal Junction Adenocarcinoma

FOLFOX (oxaliplatin, leucovorin, fluorouracil [5-FU]) seems to be a safer and more reliable regimen than ECF (epirubicin, cisplatin, 5-FU) and irinotecan/cisplatin as a backbone for treatment in future studies of metastatic esophageal and gastroesophageal junction cancers. This finding from the...

hematologic malignancies
lymphoma

Early Results Find Pembrolizumab Active in Classical Hodgkin Lymphoma After Brentuximab Vedotin Failure

Findings in a classical Hodgkin lymphoma cohort in the phase Ib KEYNOTE-013 trial, reported by Armand et al in the Journal of Clinical Oncology, indicate that pembrolizumab (Keytruda) is active in patients with disease progressing on or after brentuximab vedotin (Adcetris) treatment. Study Details ...

hematologic malignancies
multiple myeloma

Obesity Linked to Increased Risk of Multiple Myeloma Mortality in African Americans

Obesity may be associated with an increased risk for death from multiple myeloma in African Americans, according to a study reported by Sonderman et al in the Journal of the National Cancer Institute. Multiple myeloma incidence and mortality rates have been reported to be twice as high among...

issues in oncology

Heart Failure After First Heart Attack Associated With Increased Risk of Cancer

Patients who develop heart failure after their first heart attack have a greater risk of developing cancer when compared to first-time heart attack survivors without heart failure, according to a study published by Hasin et al in the Journal of the American College of Cardiology. Heart failure...

lung cancer

First-Line Nivolumab Monotherapy Active in Advanced NSCLC

As part of the phase I CheckMate 012 study reported by Gettinger et al in the Journal of Clinical Oncology, nivolumab (Opdivo) monotherapy was found to be active as first-line treatment in advanced non–small cell lung cancer (NSCLC). The study is also examining first-line nivolumab plus...

colorectal cancer

Prevention Needed to Stem Global Rise in Human Papillomavirus–Related Anal Cancer

The incidence rate of human papillomavirus (HPV)-related anal cancer and its precursor lesion, anal intraepithelial neoplasia, is rising in the United States and globally. Although 5-year survival rates in localized disease are generally favorable, survival in metastatic disease remains poor,...

breast cancer
survivorship
supportive care

Managing Upper Extremity Dysfunction in Breast Cancer Survivors

With an increased number of breast cancer survivors and patients with metastatic disease living longer, it is imperative for oncology care providers to manage issues of new and chronic upper extremity dysfunction as a result of the malignancy itself or its treatment. As one of my patients...

pain management

Fentanyl Nasal Spray Now Available at a Dose of 300 μg for Treatment of Breakthrough Cancer Pain

Fentanyl (Lazanda) nasal spray, a schedule II narcotic, is now available at a 300-μg dose to treat breakthrough cancer pain, offering physicians another titration option for dosing flexibility. The new strength can help physicians more easily and accurately target the appropriate dose for...

leukemia

Relapse of Leukemia After Bone Marrow Transplantation: Cytomegalovirus Infection Has No Protective Effect

Recent studies on a small number of patients with leukemia treated with bone marrow transplantation have suggested that the presence of the common cytomegalovirus (CMV) in patients or their donors may protect against relapse or even death after the transplant. A large international study published...

Women’s Networking Center Addresses Gender Gap, Provides Mentorship for Annual Meeting Attendees

ASCO is committed to providing all oncologists with opportunities for professional development that will maximize their career success. In response to the recognized career gender gap for women in oncology, ASCO included a number of initiatives in the 2016 Annual Meeting program. In its 2nd year,...

lung cancer

FDG–PET Evaluates Immunotherapy for Non–Small Cell Lung Cancer

Researchers at the 2016 Annual Meeting of the Society of Nuclear Medicine and Molecular Imaging (SNMMI) presented study findings on a means of evaluating an immunotherapy for non–small cell lung cancer (NSCLC).1 Due to NSCLC’s relative insensitivity to chemotherapy, the use of immunotherapies,...

Expert Point of View: Charles Ryan, MD

“These are important data. It is safe to envision a future where atezolizumab [Tecentriq] can be used first-line. These were cisplatin-ineligible patients, and many patients fall into this category, especially the elderly. Platinum-ineligibility is a big problem due to comorbidities,” explained...

bladder cancer

Atezolizumab Promising in Cisplatin-Ineligible Metastatic Bladder Cancer

Atezolizumab (Tecentriq), an anti–programmed cell death ligand 1 (PD-L1) inhibitor, achieved durable responses as first-line treatment in cisplatin-ineligible patients with metastatic urothelial carcinoma in a primary analysis of a phase II trial. These data represent an unmet need, because...

Expert Point of View: Elizabeth Mittendorf, MD, PhD

The discussant of these studies was Elizabeth Mittendorf, MD, PhD, Associate Professor of Breast Surgical Oncology at the University of Texas MD Anderson Cancer Center, Houston. Dr. Mittendorf noted that approximately 3% of U.S. breast cancer patients present with de novo stage IV disease. For...

hematologic malignancies
lymphoma

Adding Obinutuzumab to Bendamustine Improves Progression-Free Survival in Rituximab-Refractory NHL

In the phase III GADOLIN trial reported in The Lancet Oncology, Sehn et al found that adding the anti-CD20 antibody obinutuzumab (Gazyva) to bendamustine (Bendeka, Treanda) increased progression-free survival in patients with rituximab-refractory indolent non-Hodgkin lymphoma (NHL). Outcomes in...

lung cancer

Is Nivolumab Active in Recurrent Small Cell Lung Cancer?

In the phase I/II CheckMate 032 study, nivolumab (Opdivo) alone and with ipilimumab (Yervoy) demonstrated activity in patients with small cell lung cancer (SCLC) progressing after at least one previous platinum regimen, as reported in The Lancet Oncology by Antonia et al. Study Details In the...

issues in oncology

Moonshot Program for … Compassion

A 65-year-old patient with widely metastatic pancreatic cancer was emergently transferred to our facility in the early hours of the morning with free air suggestive of a perforated viscus. The patient is from a small town several hundred miles away from our academic center, which can be quite...

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