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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...

lymphoma
issues in oncology

Autologous Stem Cell Transplantation Offers Safe, Effective Option for Patients With HIV-Associated Lymphoma

A phase II, multicenter trial published by Alvarnas et al in Blood challenges the generally held belief that individuals with human immunodeficiency virus (HIV) and aggressive lymphoma are not candidates for standard treatment. According to the researchers, people with HIV-associated lymphoma who...

solid tumors
bladder cancer

Is Anti–PD-L1 Antibody Durvalumab Active 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...

kidney cancer

Final Results of METEOR Trial Show Cabozantinib Improves Overall Survival vs Everolimus in Advanced RCC

As reported by Choueiri 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 (RCC) that had progressed after previous...

lung cancer

SNMMI 2016: 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 a means of evaluating an immunotherapy that fights off non–small cell lung cancer (NSCLC) by strengthening a patient’s own immune system (Scientific Paper 134). Due to...

solid tumors
head and neck cancer

Study Finds Pembrolizumab Active in Advanced Head and Neck Cancer

As reported by Seiwert et al in The Lancet Oncology, the monoclonal antibody pembrolizumab (Keytruda) showed activity in patients with programmed cell death ligand 1 (PD-L1)–positive recurrent or metastatic squamous cell carcinoma of the head and neck in the phase Ib KEYNOTE-012 study. Study ...

issues in oncology

ASCO 2016: Hispanic and Black Young Adults With Cancer May Be More Likely to Die of Their Disease

Hispanic white and non-Hispanic black cancer patients between ages 15 and 29 may be more likely than same-aged white patients to die of their disease, according to a University of Colorado Cancer Center study presented by Colton et al at the 2016 ASCO Annual Meeting (Abstract 6557). The finding is...

The Importance of Listening to Patients

My experience with cancer, or more accurately, cancers, is complicated. In 2002, after returning from a medical mission to Honduras, I noticed a bean-sized lymph node above my left clavicle. As an oncology-certified nurse, I knew not to ignore any unusual nodules that pop up on the body and asked...

The Best HCAHPS Score: A Rodeo Invitation

An otherwise healthy, actively working, independent 60-year-old patient came to us with a several months’ history of abdominal pain. He had been seen by other physicians prior to coming to us for a second opinion. Our workup revealed a large cystic lesion emanating from the pancreas but involving ...

issues in oncology

Low-Dose Chemical Exposure and Cancer

According to estimates from the World Health Organization (WHO) and the International Agency for Research on Cancer (IARC), environmental toxic exposures are responsible for between 7% and 19% of human cancers. However, the 2008–2009 President’s Cancer Panel Annual Report estimated that the “true...

prostate cancer

Increased Survival and Toxicity With Docetaxel, No Benefit of Zoledronic Acid, When Added to First-Line Hormone Therapy in Prostate Cancer

As reported in The Lancet by Nicholas D. James, BSc, MBBS, PhD, of the University of Warwick, and colleagues, survival results of the STAMPEDE trial, which used a multiarm, multistage seamless phase II/III design, provide little evidence of benefit of zoledronic acid and showed increased survival ...

multiple myeloma

SIRIUS Trial Heralds a New Era of Promise in Treating Resistant Myeloma

Multiple myeloma cells uniformly overexpress CD38.1 Daratumumab (Darzalex), a CD38-targeting human IgG1 kappa monoclonal antibody, has been evaluated in a series of phase I/II trials involving patients with relapsed or relapsed and refractory myeloma who have received at least two or more prior...

multiple myeloma

Daratumumab Shows High Activity in Heavily Pretreated and Refractory Multiple Myeloma

In the phase II SIRIUS trial reported in The Lancet, Sagar Lonial, MD, of Winship Cancer Institute, Emory University, and colleagues found that the CD38-targeted monoclonal antibody daratumumab (Darzalex) produced durable responses in patients with multiple myeloma who had received at least three ...

prostate cancer

Prostate Cancer: Opinions Vary on Gleason Scores and Surgery

Diagnosis and treatment of prostate cancer have been the source of heated debate for decades, most of which has centered on the clinical value of the prostate-specific antigen (PSA) test. In 2012, the U.S Preventive Services Task Force (USPSTF) gave the PSA test a D grade, which discourages many...

supportive care

Learning About Fertility Is Important to Young Patients With Cancer

It is more and more common for people to wait until their 30s or 40s to have children. Consequently, many young adults have not completed their desired childbearing when they are diagnosed with cancer. Cancer treatments can impair fertility directly (usually via gonadotoxicity from chemotherapy,...

breast cancer

Ovarian Suppression in Premenopausal Women With Estrogen Receptor–Positive Breast Cancer

Oophorectomy was the first proposed form of endocrine therapy for women with breast cancer. Over 100 years ago, Thomas Nunn reported a relationship between menopause and regression of breast cancer.1 This incited interest in the induction of menopause as an anticancer therapy, and in 1986, a...

supportive care

Providing Inpatient Physical Rehabilitation for Patients With Advanced Cancer

Guest Editor Physiatry in Oncology explores the benefits of cancer rehabilitation in oncology practice to screen survivors for physical and cognitive impairments along the care continuum to minimize survivors’ disability and maximize their quality of life. The column is guest edited by Sean Smith, ...

Expert Point of View: Sam S. Chang, MD, MBA

Moderator of the session, Sam S. Chang, MD, MBA, Professor of Urologic Surgery at Vanderbilt University Medical Center, Nashville, and American Urological Association spokesperson, said that due to these results he would definitely consider this treatment option for both high-risk and African...

prostate cancer

Chemotherapy After Radical Prostatectomy May Benefit African Americans and High-Risk Patients

A new U.S. Department of Veterans Affairs (VA) study suggests that African American men and men with a higher tumor stage may benefit from adjuvant chemotherapy following radical prostatectomy.1 According to prespecified analysis of these two “high–risk” subgroups, patients with ≥ T3b disease had a ...

pancreatic cancer

Adjuvant Chemotherapy Improves Survival in Pancreatic Cancer

An adjuvant chemotherapy regimen improved overall survival in early-stage pancreatic cancer patients, in the large phase III European ESPAC-4 study reported at the 2016 ASCO Annual Meeting.1 The combination of gemcitabine and capecitabine almost doubled the 5-year survival rate, compared to...

multiple myeloma

Daratumumab Hits the Mark in Early Relapsed Multiple Myeloma

For relapsed or refractory multiple myeloma, daratumumab (Darzalex), combined with bortezomib (Velcade) and dexamethasone, reduced relapses by 61% in the phase III CASTOR study reported at the 2016 ASCO Annual Meeting.1 “The results are unprecedented in a randomized study comparing a novel...

issues in oncology
cost of care

Global Economic Crisis May Be Linked to 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, Maruthappu et al found that the global economic crisis beginning in 2008 was also associated with a large excess in cancer mortality...

leukemia

First-Line Fludarabine, Cyclophosphamide, and Rituximab vs Bendamustine/Rituximab in Advanced CLL

In a European phase III noninferiority trial reported in The Lancet Oncology, Eichhorst et al found that progression-free survival was better with standard first-line fludarabine/cyclophosphamide/rituximab vs bendamustine/rituximab in fit patients with advanced chronic lymphocytic leukemia (CLL)...

ASCO 2016: Local Consolidative Therapy Improves Progression-Free Survival in Patients With Oligometastatic NSCLC vs Standard Chemotherapy

Lung cancer patients with oligometastases, defined as three or fewer sites of metastasis, may benefit from aggressive local therapy, surgery, or radiation, after standard chemotherapy, according to research led by The University of Texas MD Anderson Cancer Center. If validated in larger studies,...

bladder cancer

ASCO 2016: Atezolizumab Benefits Patients With Advanced Bladder Cancer

The anti–programmed cell death ligand 1 (PD-L1) immunotherapy atezolizumab (Tecentriq) is effective in patients with previously untreated advanced bladder cancer who are not eligible for the standard treatment with cisplatin. According to a nonrandomized phase II trial, atezolizumab shrank...

breast cancer

ASCO 2016: Biosimilar Shows Comparable Efficacy and Safety to Trastuzumab in HER2-Positive Metastatic Breast Cancer

A biosimilar trastuzumab antibody (MYL-1401O) is comparable in efficacy and safety to trastuzumab (Herceptin) in women with HER2-positive advanced breast cancer, according to a randomized phase III study. The response rates were comparable among women who received trastuzumab and among...

A Pioneer in Lung Cancer Research, James L. Mulshine, MD, Champions Early Population-Based Lung Cancer Screening

A neighborhood doctor who told a good story was an unwitting mentor to internationally regarded lung cancer expert James L. Mulshine, MD. Born in Elizabeth, New Jersey, Dr. Mulshine relocated with his family to West Hartford, Connecticut, when he was a year old, and except for a brief hiatus on...

issues in oncology
global cancer care

A Perilous Time for Refugees With Cancer

The numbers are difficult to fathom. According to a report by the United Nations High Commissioner for Refugees (UNHCR), in 2015, over 60 million people worldwide were forcibly displaced as a result of conflict, persecution, generalized violence, or human rights violations.1 Over 9 million of those ...

sarcoma

Eribulin in Liposarcoma: A Closer Look at the Comparative Data

Sarcoma therapy is a challenge for oncologists. Soft-tissue sarcomas encompass more than 50 different histologies, resulting in limited familiarity of management for many treating physicians. In addition, there have been few available effective therapies. The phase III trial of eribulin (Halavan) ...

sarcoma

Eribulin Improves Overall Survival vs Dacarbazine in Previously Treated Advanced Liposarcoma or Leiomyosarcoma

In a phase III trial reported in The Lancet, Patrick Schöffski, MD, of University Hospitals Leuven, Leuven Cancer Institute, Belgium, and colleagues found that eribulin (Halaven) improved overall survival vs dacarbazine in patients with advanced or metastatic soft-tissue sarcoma who had received...

issues in oncology

Increased Physical Activity Associated With Lower Risk of 13 Types of Cancer

A new study of the relationship between physical activity and cancer has shown that greater levels of leisure-time physical activity were associated with a lower risk of developing 13 different types of cancer. The risk of developing seven cancer types was 20%, or more, lower among the...

bladder cancer

Atezolizumab in Previously Treated Advanced Urothelial Carcinoma

The recent study by Rosenberg et al in The Lancet—summarized in this issue of The ASCO Post—is a very important paper in the field of bladder cancer therapy.1 It is the first phase II trial in metastatic transitional cell carcinoma that demonstrates the single-agent activity of the...

kidney cancer

Curb Your Enthusiasm: No Benefit of Adjuvant Sorafenib or Sunitinib in Nonmetastatic Renal Cell Carcinoma

Renal cell carcinoma is the most common cancer of the kidneys. Up to 30% of patients present with advanced/metastatic disease, and recurrence can develop in patients at high risk treated by nephrectomy for localized tumors. Renal cell carcinoma is notoriously resistant to chemotherapy and...

kidney cancer

No Disease-Free Survival Benefit of Adjuvant Sunitinib or Sorafenib in High-Risk Nonmetastatic Renal Cell Carcinoma

In the phase III ECOG-ACRIN E2805 trial reported in The Lancet by Naomi B. Haas, MD, of Abramson Cancer Center, University of Pennsylvania, and colleagues, no benefit of adjuvant vascular endothelial growth factor receptor (VEGFR) inhibitor treatment with sunitinib or sorafenib (Nexavar) was...

bladder cancer

ASCO and European Association of Urology Agree on Bladder Cancer Guidelines

I like economies of scale, and thus it makes perfect sense that ASCO has set a formal process to allow potential endorsement of selected guidelines from other organizations, rather than redoing the whole process. Recently, we have seen the publication of a formal endorsement of the European...

lung cancer

ODAC Advises the FDA to Wait for Phase III Results for Rociletinib in Non–Small Cell Lung Cancer

The U.S. Food and Drug Administration’s (FDA) Oncologic Drugs Advisory Committee (ODAC) met April 12 to consider a New Drug Application by Clovis Oncology for rociletinib, an investigational therapy for epidermal growth factor receptor (EGFR)-mutated non–small cell lung cancer (NSCLC) in patients...

kidney cancer

Crizotinib Active in Orphan Kidney Malignancy

Crizotinib (Xalkori) achieved overall and durable responses in advanced inoperable papillary renal cell carcinoma type 1 characterized by somatic MET mutations, according to an investigator-initiated trial conducted by the European Organization for Research and Treatment of Cancer (EORTC).1 “To...

breast cancer
prostate cancer
hematologic malignancies

Highlights From the 2016 AACR Annual Meeting

This year’s Annual Meeting of the American Association for Cancer Research (AACR) featured outstanding research in the field of cancer, as well as an inspiring talk by Vice President Joe Biden (see the May 10 issue of The ASCO Post). Here are some summaries of studies that warrant attention; they...

supportive care
leukemia

Recent Reports on Treatment for Leukemias, Sinusoidal Obstruction Syndrome, and Graft-vs-Host Disease

In this installment of Hematology Expert Review, I will summarize five studies from the recent literature addressing important questions about leukemias and their treatment, anticoagulant therapy with the new agent defibrotide (Defitelio), and the use of antilymphocyte globulin to prevent chronic...

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