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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...

geriatric oncology
global cancer care

Geriatric Oncology in Asia: The Dawn of a New Era in Cancer Care

Asia is currently experiencing an unprecedented rate of growth in its aging population. This “silver tsunami” has translated into a burgeoning number of older patients with cancer, as cancer is a disease of aging. However, unlike their Western counterparts, elderly patients with cancer in Asia are ...

geriatric oncology
issues in oncology

Geriatric Patients With Cancer and the Problem of Polypharmacy

Older patients with cancer generally have multiple comorbidities, with each often requiring separate medications. Studies have shown that polypharmacy and inappropriate drug use are prevalent among older cancer patients, leading to an enormous amount of preventable adverse events, many requiring...

skin cancer

Sequential Nivolumab/Ipilimumab Appears More Active Than Reverse Sequence in Advanced Melanoma

In the phase II CheckMate 064 trial reported in The Lancet Oncology, Weber et al found that sequential nivolumab (Opdivo)/ipilimumab (Yervoy) was more active than the reverse sequence (ipilimumab/nivolumab) in patients with advanced melanoma. Study Details In the open-label study, 138 patients...

lung cancer

Dabrafenib Plus Trametinib Shows Activity 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...

survivorship
symptom management

Tackling the Symptoms of Long-Term Fatigue and Insomnia in Cancer Survivors

Fatigue and sleep disruption are common occurrences for most patients diagnosed with cancer. Simply having a serious physical illness like cancer along with its associated pain, hospitalization, and treatment, as well as the attendant psychological impact, all contribute to the onset of fatigue...

issues in oncology
global cancer care

European Demand for Radiotherapy Expected to Rise Approximately 16% Over Next Decade

The demand for radiotherapy across all European countries will increase by an average of 16% between 2012 and 2025, with the highest expected increase being for prostate cancer cases (24%), according to a new study published by ­Borras et al in Radiotherapy and Oncology.1 These projections came...

gynecologic cancers

Cervical Cancer Prevention Badly Needed in India

With the advent of the Papanicolaou (Pap) test and population-based screening, along with the development of the human papillomavirus (HPV) vaccine, cervical cancer has become a largely preventable disease for many. However, in India, cervical cancer is a leading cause of cancer mortality. To...

geriatric oncology

Medical Decision-Making: At the Heart of Care for Older Patients With Cancer

Although oncology has moved toward a personalized approach to care, medical decision-making within the context of multidisciplinary care has broad public health implications. To shed light on this and other relevant issues, The ASCO Post recently spoke with William Dale, MD, PhD, of the University ...

lung cancer

Once-Daily Radiation (66 Gy) Appears No Better Than Twice-Daily Radiation (45 Gy) for Small Cell Lung Cancer

A schedule of once-daily radiation therapy (66 Gy) was no better than a twice-daily schedule (45 Gy) for optimization of chemoradiotherapy in patients with limited-stage small cell lung cancer (SCLC), according to the eagerly anticipated results of the phase III ­CONVERT trial, presented at the...

colorectal cancer

USPSTF Issues New Recommendations for Colorectal Cancer Screening

As reported in JAMA, the U.S. Preventive Services Task Force (USPSTF) has issued new recommendations for colorectal cancer screening. In brief, the USPSTF recommends colorectal cancer screening starting at age 50 years and continuing until age 75 years (grade A recommendation = “The USPSTF...

breast cancer

Trastuzumab Biosimilar Shows Efficacy and Safety Comparable to Reference Product in Phase III HERITAGE Trial

A new biosimilar version of the monoclonal antibody trastuzu­mab (Herceptin) is getting close to the finish line in the race to develop biosimilars in oncology. The new antibody, MYL-1401O, demonstrated comparable efficacy and safety compared with trastuzumab as front-line treatment of women with...

health-care policy
issues in oncology

Supporting Policy to Reduce Tobacco-Related Deaths

One billion lives. That is the estimated human death toll of tobacco use in the 21st century.1 Tobacco use is the leading cause of preventable death worldwide—20% of all deaths and 30% of cancer deaths in the United States are linked to tobacco use.2,3 Impacting this preventable public health...

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