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issues in oncology

Two Retrospective Studies Find Increased Risk of Suicide Among Patients Diagnosed With Cancer

In a news item reported in The Lancet Oncology, The Lancet journalist Manjulika Das reviewed two U.S. retrospective studies indicating that patients diagnosed with cancer are at increased risk of suicide. High Standardized Mortality Ratio In one study, published by Zaorsky et al in Nature...

breast cancer

Tumor-Infiltrating Lymphocytes and Prognosis in Early-Stage Triple-Negative Breast Cancer

In a pooled analysis reported in the Journal of Clinical Oncology, Loi et al found that levels of stromally located tumor infiltrating lymphocytes (sTILs) are strongly prognostic in early-stage triple-negative breast cancer, with improved survival observed in patients with higher levels of sTILs...

lymphoma

PET-Adapted Treatment in Newly Diagnosed Advanced Hodgkin Lymphoma

In the phase III AHL2011 trial reported in The Lancet Oncology, Casasnovas et al found that positron-emission tomography (PET)-guided treatment produced good outcomes in newly diagnosed advanced Hodgkin lymphoma, allowing de-escalation of induction to ABVD (doxorubicin, bleomycin, vinblastine, and...

health-care policy
lung cancer

Shared Decision-Making and Use of Low-Dose CT Screening for Lung Cancer

In a study reported in a research letter in JAMA Internal Medicine, Goodwin et al found that only a small proportion of Medicare enrollees undergoing low-dose computed tomography (CT) screening for lung cancer had a prescreening shared decision-making session, which is mandated by the Centers for...

breast cancer

MRI Background Parenchymal Enhancement and Risk of Breast Cancer

In a population-based study reported in the Journal of Clinical Oncology, Arasu and colleagues found that increased breast magnetic resonance imaging (MRI) background parenchymal enhancement was associated with an increased risk of breast cancer, with risk being independent of breast density. The...

solid tumors
immunotherapy

Overall Survival in Men and Women Receiving Immune Checkpoint Inhibitors for Advanced Cancers

In a systematic review and meta-analysis reported in JAMA Oncology, Wallis et al found no difference in overall survival benefit in women vs men receiving immune checkpoint inhibitor treatment for advanced solid tumors. The authors noted that a prior analysis had suggested men derived a greater...

kidney cancer
immunotherapy

Patient-Reported Outcomes With Nivolumab Plus Ipilimumab vs Sunitinib in Advanced Renal Cell Carcinoma

As reported in The Lancet Oncology by Cella et al, patient-reported outcomes were better with nivolumab plus ipilimumab vs sunitinib in the phase III CheckMate 214 trial among patients with intermediate- or poor-risk advanced renal cell carcinoma. The ongoing trial showed significantly improved...

issues in oncology

Oncologist Survey on Knowledge About LGBTQ Patients With Cancer

In a national survey of oncologists reported in the Journal of Clinical Oncology, Schabath et al found that whereas oncologists tended to have limited knowledge regarding lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) patient health and cancer needs, they indicated high interest ...

lymphoma

Survival With Combined Modality Therapy vs Chemotherapy Alone in Early-Stage Pediatric Hodgkin Lymphoma

In an observational cohort study reported in JAMA Oncology, Jhawar et al found that combined modality therapy (CMT) with chemotherapy followed by radiotherapy was associated with a survival advantage vs chemotherapy alone in early-stage pediatric Hodgkin lymphoma. The authors noted that use of...

lymphoma

Outcomes With AHCT Consolidation in Younger Patients With Mantle Cell Lymphoma in the Rituximab Era

In a retrospective study reported in the Journal of Clinical Oncology, Gerson et al found evidence that autologous hematopoietic cell transplantation (AHCT) consolidation after induction chemotherapy was associated with a progression-free survival benefit in patients with mantle cell lymphoma aged...

issues in oncology

Established, Modifiable Cancer Risk Factors

According to a new American Cancer Society report published by Susan M. Gapstur, PhD, MPH, American Cancer Society Senior Vice President of Behavioral and Epidemiology Research, and colleages in CA: A Cancer Journal for Clinicians, the highest priority in a national cancer control plan is the...

immunotherapy
symptom management

Adoptive T-Cell Therapy for Progressive Multifocal Leukoencephalopathy

An emerging treatment known as adoptive T-cell therapy has proven effective in a phase II clinical trial for treating progressive multifocal leukoencephalopathy (PML), a rare and often fatal brain infection sometimes observed in patients with cancer and other diseases in which the immune system is...

breast cancer

Breast Cancer Surveillance Consortium Analysis of Trends in Breast Density Assessment

In a study reported in the Journal of the National Cancer Institute, Sprague et al found that only small changes in the proportions of women found to have dense breasts on digital mammography have occurred with revisions in Breast Imaging Reporting and Data System (BI-RADS) density classification...

issues in oncology

Analysis of Proportion of Cancer Cases Attributable to Excess Body Weight Across U.S. States

In a study reported in JAMA Oncology, Islami et al assessed the population attributable fraction (PAF)—the proportion of a given outcome attributable to a given risk factor—of incident cancer cases associated with excess body weight among individual U.S. states during 2011 to 2015. The...

palliative care
issues in oncology

Impact of Survival Predictions on Aggressive End-of-Life Care Among Patients With Metastatic Cancer

In a single-institution study reported in the Journal of Oncology Practice, Sborov et al found that inaccurate prediction of life expectancy can be associated with greater likelihood of aggressive end-of-life care among patients with metastatic cancer receiving palliative radiation therapy. Study...

survivorship

Effectiveness of Advanced Practice Providers in Providing Survivorship Care

In a single-center retrospective analysis reported in the Journal of Oncology Practice, Thom et al found that advanced practice providers—nurse practitioners and physician assistants—were effective in providing survivorship care to adult patients with cancer in accordance with Institute ...

lymphoma
immunotherapy

Is There a Benefit to Adding Rituximab to Methotrexate-Based Chemotherapy in Primary CNS Lymphoma?

In a phase III trial (HOVON 105/ALLG NHL 24) reported in The Lancet Oncology, Bromberg et al found no significant benefit of the addition of rituximab to high-dose methotrexate-based chemotherapy in patients with newly diagnosed primary central nervous system (CNS) lymphoma. Study Details In the...

gastroesophageal cancer

Hybrid Minimally Invasive Esophagectomy vs Open Esophagectomy in Esophageal Cancer

In a French phase III trial reported in The New England Journal of Medicine, Mariette et al found that a hybrid minimally invasive surgical procedure was associated with reduced postoperative complications vs transthoracic open esophagectomy in patients with resectable cancer of the middle or lower ...

lymphoma
immunotherapy

Nivolumab in Relapsed or Refractory DLBCL Ineligible for or After Failure of Autologous Transplantation

In a phase II trial reported in the Journal of Clinical Oncology, Ansell et al found that nivolumab was associated with low response rates among patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) who were ineligible for or experienced failure of autologous hematopoietic cell ...

head and neck cancer

Response to Induction Chemotherapy and Outcomes With Definitive Chemoradiotherapy or Surgery in Sinonasal Undifferentiated Carcinoma

In a single-center experience reported in the Journal of Clinical Oncology, Amit et al found that among patients with sinonasal undifferentiated carcinoma with a favorable response to induction chemotherapy, disease-specific survival was better in those receiving definitive concurrent...

lung cancer
immunotherapy

Updated Survival Analysis of KEYNOTE-024: Pembrolizumab vs Platinum-Based Chemotherapy in Previously Untreated, Advanced NSCLC

As reported in the Journal of Clinical Oncology by Reck et al, an updated analysis of the phase III KEYNOTE-024 trial indicates continued overall survival benefit of first-line pembrolizumab vs platinum-based chemotherapy in patients with advanced non–small cell lung cancer (NSCLC) with a...

gastroesophageal cancer

Pembrolizumab in Pretreated Advanced Esophageal Adenocarcinoma or Squamous Cell Carcinoma

As reported in JAMA Oncology by Shah et al, the phase II KEYNOTE-180 trial has shown that pembrolizumab produces durable responses in some patients with pretreated locally advanced or metastatic esophageal adenocarcinoma or squamous cell carcinoma. Study Details In the trial, 121 patients with...

issues in oncology
symptom management

Incidence of Acute Kidney Injury in Patients Receiving Systemic Therapy for Cancer

In a Canadian population–based cohort study reported in the Journal of the National Cancer Institute, Kitchlu et al found that acute kidney injury (AKI) is common in patients receiving systemic therapy for newly diagnosed cancer and has increased in incidence in recent years. Study Details...

kidney cancer

Immediate vs Deferred Cytoreductive Nephrectomy in Patients With Metastatic Renal Cell Carcinoma Treated With Sunitinib

In a trial with a modified primary endpoint due to slow accrual reported in JAMA Oncology, Bex et al found that deferred cytoreductive nephrectomy after sunitinib did not improve 28-week progression-free rate (PFR) vs immediate nephrectomy followed by sunitinib in patients with metastatic renal...

issues in oncology

Unplanned Hospitalizations in the Year After Cancer Diagnosis

In a California population–based cohort study reported in the Journal of Oncology Practice, Whitney et al found that 67% of hospitalizations in the year after cancer diagnosis were unplanned, with 67% of such hospitalizations originating in the emergency department. The study involved data...

prostate cancer

Overall Survival of Black vs White Men Receiving Docetaxel Regimens for Metastatic Castration-Resistant Prostate Cancer

In an analysis reported in the Journal of Clinical Oncology, Halabi et al found that overall survival was improved for black men vs white men receiving regimens containing docetaxel and prednisone for metastatic castration-resistant prostate cancer. As noted by the investigators, several studies...

prostate cancer
immunotherapy

MSI-H/dMMR Tumors in Prostate Cancer and Response to Immune Checkpoint Blockade

In a study reported in JAMA Oncology, Abida et al found that approximately 3% of patients with prostate cancer had microsatellite instability–high (MSI-H)/mismatch repair–deficient (dMMR) tumors and that some of these patients exhibited durable responses to treatment with immune...

solid tumors

Detection of Relapse in Children and Adolescents With Nongerminomatous Malignant Germ Cell Tumors

In a report from the Children’s Oncology Group published in the Journal of Clinical Oncology, Fonseca et al found that relapse in children and adolescents with nongerminomatous malignant germ cell tumors (MGCTs) was most frequently identified by tumor markers rather than imaging. Study...

breast cancer

Neoadjuvant Degarelix vs Triptorelin in Premenopausal Women Receiving Letrozole for Locally Advanced, Endocrine-Responsive Breast Cancer

In a phase II trial reported in the Journal of Clinical Oncology, Dellapasqua et al found that neoadjuvant treatment with the gonadotropin-releasing hormone (GnRH) antagonist degarelix was more effective than the GnRH agonist triptorelin in achieving ovarian function suppression (OFS) in...

cns cancers

Risk of Intracranial Malignancy After Stereotactic Radiosurgery for Nonmalignant Conditions

In a retrospective cohort study reported in The Lancet Oncology, Wolf et al found that patients undergoing Gamma Knife stereotactic radiosurgery for nonmalignant neurosurgical conditions did not appear to be at long-term increased risk of radiation-associated secondary intracranial malignancy or...

lymphoma

Analysis of Cause of Death in Patients With Follicular Lymphoma in the Rituximab Era

In a pooled analysis of French and U.S. follicular lymphoma cohorts reported in the Journal of Clinical Oncology, Sarkozy and colleagues found that lymphoma was the most common cause of death during the first decade of the rituximab era in treatment of the disease. The study involved data from...

sarcoma
issues in oncology

Regionalization of Surgery for Retroperitoneal Sarcoma Surgery to High-Volume Hospitals

In a study reported in the Journal of Oncology Practice, Villano et al found that regionalization of retroperitoneal sarcoma surgery—recognized as a complex cancer surgery—to high-volume hospitals has been slower than that observed for similarly complex pancreatic cancer surgery over...

gynecologic cancers

Maintenance Olaparib in Newly Diagnosed Advanced Ovarian Cancer

As reported in The New England Journal of Medicine by Moore et al, the phase III SOLO-1 trial has shown that maintenance with olaparib, following complete or partial response to platinum-based chemotherapy, significantly prolonged progression-free survival vs placebo in...

solid tumors
immunotherapy

Factors Influencing Response to Pembrolizumab in Various Advanced Cancers

In an analysis from the phase Ib KEYNOTE-028 trial reported in the Journal of Clinical Oncology, Ott et al found that response to pembrolizumab across different cancers was more likely in patients with higher tumor mutational burden, T-cell–inflamed gene-expression profile, and programmed...

lung cancer

Transformation of EGFR-Mutant NSCLC to SCLC

In a study reported in the Journal of Clinical Oncology, Marcoux et al provided further evidence that EGFR-mutant non–small cell lung cancer (NSCLC) can undergo transformation to small cell lung cancer (SCLC) and identified factors associated with such transformation. It has been estimated...

multiple myeloma

Lenalidomide Maintenance vs Observation in Newly Diagnosed Multiple Myeloma

In a UK phase III trial (Myeloma XI) reported in The Lancet Oncology, Jackson et al found that lenalidomide maintenance was associated with improved progression-free survival but not overall survival among patients with newly diagnosed multiple myeloma with at least minimal response to induction...

solid tumors

Sorafenib in Progressive, Symptomatic, or Recurrent Desmoid Tumors

In a phase III trial reported in The New England Journal of Medicine, Gounder et al found that sorafenib improved progression-free survival vs placebo in patients with progressive, symptomatic, or recurrent desmoid tumors. As noted by the investigators, there is no current standard of care for...

prostate cancer

Time to Biochemical Failure as Surrogate Endpoint in Locally Advanced Prostate Cancer

As reported in the Journal of Clinical Oncology by Dignam et al, analysis of outcomes in the phase III NRG/RTOG 9202 trial indicates that the time interval to biochemical failure (IBF) could serve as a surrogate endpoint for clinical outcomes in patients receiving radiotherapy plus long-term...

cns cancers

Regorafenib vs Lomustine in Relapsed Glioblastoma

In the Italian phase II REGOMA trial reported in The Lancet Oncology, Lombardi et al found that regorafenib was associated with improved overall survival vs lomustine in patients with relapsed glioblastoma. In the open-label trial, 119 patients from 10 Italian sites were randomly assigned between...

prostate cancer

RADAR Trial: Short- vs Intermediate-Term Androgen Suppression and Zoledronic Acid in Locally Advanced Prostate Cancer

As reported by Denham et al in The Lancet Oncology, 10-year results of the phase III TROG 03.04 RADAR trial have shown that 18 months of androgen suppression plus radiotherapy is more effective than 6 months of androgen suppression plus radiotherapy in locally advanced prostate cancer, but no...

pancreatic cancer

Adjuvant FOLFIRINOX vs Gemcitabine in Pancreatic Cancer

In a phase III Canadian and French trial reported in The New England Journal of Medicine, Conroy and colleagues in the Canadian Cancer Trials Group and the Unicancer-GI–PRODIGE Group found that adjuvant modified FOLFIRINOX (fluorouracil, leucovorin, irinotecan, oxaliplatin) produced better...

immunotherapy

Immune Checkpoint Blockade and Tumor-Specific Vaccine for Incurable HPV16-Related Cancer

In a single-center phase II study reported in JAMA Oncology, Erminia Massarelli, MD, and colleagues found combining tumor-specific vaccine and nivolumab (Opdivo) showed evidence of activity in incurable human papillomavirus (HPV) 16–related cancer. The therapeutic vaccine, ISA 101, induces...

colorectal cancer

Postoperative Outcomes With Screening- vs Nonscreening-Detected Colorectal Cancers

In a Dutch study reported in JAMA Surgery, Michael P.M. de Neree tot Babberich, MD, of the Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, and colleagues found that postoperative outcomes were better in patients with colon cancer, but not rectal cancer, detected...

supportive care

Fecal Microbiota Transplantation May Help Restore Beneficial Bacteria in Patients With Cancer

Researchers have shown that autologous fecal microbiota transplantation may be a safe and effective way to help replenish beneficial gut bacteria in patients with cancer who require intense antibiotics during allogeneic hematopoietic stem cell transplantation. Their findings were published by Ying ...

hepatobiliary cancer
immunotherapy

Pembrolizumab in Sorafenib-Pretreated Hepatocellular Carcinoma

ON NOVEMBER 9, 2018, pembrolizumab (Keytruda) was granted accelerated approval for treatment of patients with hepatocellular carcinoma previously treated with sorafenib (Nexavar).1,2 Supporting Efficacy Data APPROVAL WAS BASED on durable responses in the phase II KEYNOTE-224 trial...

hematologic malignancies
leukemia

Venetoclax in Combination Regimens for Older Patients With AML or Those With Comorbidities Precluding Intensive Induction

On November 21, 2018, venetoclax (Venclexta) was granted accelerated approval for use in combination with azacitidine or decitabine or low-dose cytarabine for the treatment of newly diagnosed acute myeloid leukemia (AML) in patients aged ≥ 75 years or who have comorbidities that preclude the use of ...

lung cancer

Lorlatinib in Second- or Third-Line Treatment of ALK-Positive Metastatic Non–Small Cell Lung Cancer

On November 2, 2018, lorlatinib (Lorbrena) was granted accelerated approval for the treatment of patients with ALK-positive metastatic non–small cell lung cancer (NSCLC) whose disease has progressed on crizotinib (Xalkori) and at least one other ALK inhibitor for metastatic disease or whose disease ...

lung cancer
immunotherapy

Durvalumab Improves Overall Survival After Chemoradiotherapy in Unresectable, Stage III NSCLC

AS REPORTED in The New England Journal of Medicine by Scott J. Antonia, MD, PhD, of H. Lee Moffitt Cancer Center and Research Institute, and colleagues, the phase III PACIFIC trial has shown significantly improved overall survival, a coprimary endpoint, with the programmed cell death ligand 1...

gynecologic cancers

Minimally Invasive vs Open Abdominal Radical Hysterectomy in Early-Stage Cervical Cancer

TWO STUDIES recently reported in The New England Journal of Medicine indicate that minimally invasive radical hysterectomy is associated with poorer survival outcomes than open abdominal radical hysterectomy in women with early-stage cervical cancer. As reported by Pedro T. Ramirez, MD, of The...

breast cancer

Adjuvant Trastuzumab Emtansine vs Trastuzumab in Patients With HER2-Positive Breast Cancer With Residual Disease After Neoadjuvant Therapy

As reported at the recent San Antonio Breast Cancer Symposium and in The New England Journal of Medicine by von Minckwitz et al, an interim analysis of the phase III KATHERINE trial has shown that adjuvant trastuzumab emtansine (T-DM1; Kadcyla) improved invasive disease–free survival vs...

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