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issues in oncology
cost of care

U.S. Spending on Antineoplastic Agents

In a study reported in the Journal of Oncology Practice, Hong et al found that the U.S. health-care system increased spending on antineoplastic agents from $26.8 billion in 2011 to $42.1 billion in 2016. The study was a retrospective, cross-sectional analysis of IQVIA (formerly QuintilesIMS)...

breast cancer
immunotherapy

Long-Term Outcomes With Anti–PD-L1 Treatment in Metastatic Triple-Negative Breast Cancer

In a long-term follow-up of a phase I trial reported in JAMA Oncology, Emens et al found that single-agent atezolizumab (Tecentriq) produced enduring benefit in patients with metastatic triple-negative breast cancer after stable or responding disease and in first-line treatment. Study Details In...

issues in oncology

Management of Clostridium difficile Infection in Children and Adolescents With Cancer and Pediatric HSCT Recipients

As reported in the Journal of Clinical Oncology by Diorio et al, an international panel has released a clinical practice guideline on prevention and treatment of Clostridium difficile infection (CDI) in children and adolescents with cancer and pediatric hematopoietic stem-cell transplantation...

lung cancer
immunotherapy

No Survival Benefit With Avelumab vs Docetaxel in Platinum-Treated, Advanced, PD-L1–Positive NSCLC

As reported in The Lancet Oncology by Barlesi et al, the phase III JAVELIN Lung 200 trial has shown no overall survival benefit with avelumab (Bavencio) vs docetaxel in patients with platinum pretreated programmed cell death ligand 1 (PD-L1)–positive advanced non–small cell lung cancer...

issues in oncology
survivorship

Risk of Late Venous Thromboembolism in Survivors of Childhood Cancer

In a report from the Childhood Cancer Survivor Study published in the Journal of Clinical Oncology, Madenci et al found that survivors of childhood cancer are at increased risk of late venous thromboembolism, with several factors increasing such risk. The study involved data from a...

head and neck cancer

Low- vs High-Dose Cisplatin Chemoradiotherapy in Squamous Cell Carcinoma of the Head and Neck

In an analysis of Veterans Affairs data reported in the Journal of the National Cancer Institute, Bauml et al found that weekly lower-dose cisplatin vs higher-dose cisplatin given every 3 weeks as part of concurrent definitive chemoradiotherapy may not adversely affect survival, while reducing...

lymphoma
issues in oncology

Ovarian Function After Response-Adapted Treatment in Younger Women With Advanced Hodgkin Lymphoma

In a secondary analysis of the UK phase III RATHL trial reported in The Lancet Oncology, Anderson et al found that ovarian function recovery was affected by age and type of response-adapted therapy in women receiving treatment for advanced Hodgkin lymphoma. The analysis included 67 eligible...

breast cancer

Talazoparib Improves Progression-Free Survival in Advanced Breast Cancer With Germline BRCA Mutation

As reported in The New England Journal of Medicine by Jennifer K. Litton, MD, of The University of Texas MD Anderson Cancer Center, and colleagues, the phase III EMBRACA trial has shown significantly improved progression-free survival with the poly (ADP-ribose) polymerase (PARP) inhibitor...

hematologic malignancies
lymphoma

Mogamulizumab-kpkc for Mycosis Fungoides and Sézary Syndrome

On August 8, 2018, the CC chemokine receptor type 4 (CCR4)-directed monoclonal antibody mogamulizumab-kpkc (Poteligeo) was approved for adult patients with relapsed or refractory mycosis fungoides or Sézary syndrome after at least one prior systemic therapy.1,2 Supporting Efficacy Data The current...

hematologic malignancies
lymphoma

Mogamulizumab Improves Progression-Free Survival vs Vorinostat in Cutaneous T-Cell Lymphoma

As reported by Youn H. Kim, MD, of Stanford Cancer Institute, Stanford University School of Medicine, and colleagues in The Lancet Oncology, the phase III MAVORIC trial showed that the anti-C-C chemokine receptor 4 (CCR4) monoclonal antibody mogamulizumab (Poteligeo) significantly improved...

hematologic malignancies
lymphoma

Rituximab/Lenalidomide vs Rituximab/Chemotherapy in Advanced Untreated Follicular Lymphoma

In the phase III RELEVANCE trial reported in The New England Journal of Medicine by Franck Morschhauser, MD, PhD, of The University of Lille, Centre Hospitalier Universitaire Lille, France, and colleagues, no difference in the complete response rate or interim progression-free survival was found...

lung cancer

Osimertinib in First-Line Treatment of EGFR-Mutant Metastatic NSCLC

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. In April 2018, osimertinib (Tagrisso) was approved for...

leukemia
issues in oncology
cost of care

Cost-Effectiveness Models for Tisagenlecleucel in Relapsed or Refractory Pediatric B-Cell ALL

As reported by Lin et al in the Journal of Clinical Oncology, cost-effectiveness modeling of treatment with the anti-CD19 chimeric antigen receptor T-cell therapy tisagenlecleucel (Kymriah) in relapsed or refractory pediatric B-cell acute lymphoblastic leukemia (ALL) showed that price reduction...

skin cancer

Recurrence and Cosmetic Outcomes With Treatments for Primary Basal Cell Carcinoma of the Skin

In a systematic review and meta-analysis reported in Annals of Internal Medicine, Drucker et al found differences in recurrence rates and patient-reported cosmetic outcomes among various treatments for mostly low-risk primary basal cell carcinoma of the skin. Study Details The study involved data ...

breast cancer

NCI Breast Cancer Working Group Report on Appropriate Endpoints for Clinical Trials in Metastatic Breast Cancer

As reported in the Journal of Clinical Oncology by Seidman et al, the National Cancer Institute (NCI) Breast Cancer Steering Committee Working Group has issued a report on meaningful and appropriate endpoints for clinical trials in metastatic breast cancer. With the goal of providing...

lung cancer
issues in oncology

Health Resource Utilization and CNS Metastases in EGFR-Mutant Advanced NSCLC

In a single-center study reported in the Journal of Oncology Practice, Chooback et al found that central nervous system (CNS)  metastases are frequent in patients with EGFR-mutant advanced non­–small cell lung cancer (NSCLC) and are associated with increased health resource...

Pazopanib in Treatment of von Hippel-Lindau Disease

In a single-center phase II trial reported in The Lancet Oncology, Jonasch et al found evidence of activity of pazopanib in the treatment of patients with von Hippel-Lindau disease. Study Details The study involved 31 eligible adult patients with clinical manifestations of von Hippel-Lindau...

sarcoma

High-Dose Chemotherapy and Autologous SCT vs Standard Chemotherapy in Localized High-Risk Ewing Sarcoma

As reported in the Journal of Clinical Oncology by Whelan et al, combined trials (EURO-EWING99 and Ewing-2008) have shown evidence of improved outcomes with high-dose therapy with busulfan and melphalan (BuMel) and autologous stem cell transplant (SCT) vs standard chemotherapy with vincristine,...

colorectal cancer

First-Line EGFR Inhibitor Plus FOLFOX4 in RAS Wild-Type Metastatic Colorectal Cancer

In the Chinese phase III TAILOR trial reported in the Journal of Clinical Oncology, Qin et al found that adding the EGFR inhibitor cetuximab to FOLFOX4 (fluorouracil, leucovorin, oxaliplatin) improved progression-free survival in patients with RAS wild-type metastatic colorectal cancer. Study...

skin cancer

Overall Survival With Encorafenib Plus Binimetinib vs Vemurafenib in Advanced BRAF-Mutant Melanoma

As reported in The Lancet Oncology by Dummer et al, the phase III COLUMBUS trial has shown a significant improvement in overall survival with the combination of the BRAF inhibitor encorafenib and the MEK inhibitor binimetinib vs vemurafenib in patients with advanced BRAF V600–mutant melanoma. ...

lung cancer

WCLC 2018: ALTA-1L Trial: Brigatinib vs Crizotinib in Advanced ALK-Positive NSCLC

As reported at the International Association for the Study of Lung Cancer 19th World Conference on Lung Cancer (Abstract PL02.03) and in the The New England Journal of Medicine by Camidge et al, an interim analysis of the phase III ALTA-1L trial has shown improved progression-free...

lung cancer
immunotherapy

WCLC 2018: PACIFIC Trial: Overall Survival With Durvalumab After Chemoradiotherapy in Unresectable Stage III NSCLC

As reported at the current International Association for the Study of Lung Cancer 19th World Conference on Lung Cancer (Abstract PL02.01) and in The New England Journal of Medicine by Antonia et al, the phase III PACIFIC trial has shown significantly improved overall survival—a...

breast cancer

Omission of Axillary Dissection in Early Breast Cancer

In a study reported in JAMA Oncology, Monica Morrow, MD, of the Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, and colleagues found that surgeon acceptance of more limited surgery in early breast cancer was more likely among high-volume surgeons and those preferring ...

breast cancer

TGFβ Polymorphism and Radiation-Induced Fibrosis in Breast Cancer

In an analysis reported in JAMA Oncology, Benjamin D. Smith, MD, of the Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, and colleagues found that a single nucleotide polymorphism (C−509T) in the transforming growth factor β1 (TGFβ1) gene was associated with...

colorectal cancer

Triplet Combination for Advanced Anal Squamous Cell Carcinoma

In a French phase II trial reported in The Lancet Oncology, Stefano Kim, MD, of the Department of Oncology, University Hospital of Besancon, and colleagues found that treatment with docetaxel, cisplatin, and fluorouracil (DCF) was active in patients with metastatic or unresectable locally...

pancreatic cancer

Neoadjuvant Therapy, Changes in Body Composition, and Resectability in Pancreatic Cancer

In a retrospective cohort study reported in JAMA Surgery, Carlos Fernández-del Castillo, MD, of the Department of Surgery, Massachusetts General Hospital, Harvard Medical School, and colleagues found that neoadjuvant therapy in patients with pancreatic ductal adenocarcinoma was associated with...

leukemia

Second Allogeneic HCT vs Donor Lymphocyte Infusion in Relapsed Acute Myeloid Leukemia

In a retrospective registry study reported in JAMA Oncology, Mohamad Mohty, MD, PhD, of Hôpital Saint Antoine, Université Pierre et Marie Curie, and colleagues found no overall survival difference with second allogeneic hematopoietic cell transplantation (HCT) vs donor lymphocyte infusion (DLI) in ...

breast cancer

Pertuzumab in Adjuvant Treatment of HER2-Positive Breast Cancer

AT THE END OF 2017, pertuzumab (Perjeta) was granted regular approval for use in combination with trastuzumab (Herceptin) and chemotherapy as adjuvant treatment of patients with HER2- positive early breast cancer at high risk of recurrence.1,2 Supporting Efficacy Data APPROVAL WAS BASED on...

prostate cancer

Abiraterone Acetate Plus Prednisone in High-Risk Metastatic Castration-Sensitive Prostate Cancer

IN EARLY 2018, abiraterone acetate tablets (Yonsa, Zytiga) in combination with prednisone was approved for the treatment of metastatic high-risk castration-sensitive prostate cancer.1,2 Supporting Efficacy Data APPROVAL WAS BASED on findings from the phase III LATITUDE trial, in which 1,199...

head and neck cancer

ASCO Endorses CAP Guideline on HPV Testing in Head and Neck Carcinoma

As reported in the Journal of Clinical Oncology by Carole Fakhry, MD, MPH, of Johns Hopkins School of Medicine, and colleagues, ASCO has endorsed the 2018 College of American Pathologists (CAP) guideline on human papillomavirus (HPV) testing in head and neck carcinoma. The endorsement was based on...

breast cancer

Breast Pathologic Complete Response and Pathologic Node Positivity After Neoadjuvant Therapy

In a National Cancer Database analysis reported in JAMA Surgery, Barron et al found low pathologic nodal positivity rates among patients with clinically node-negative (cN0), HER2-positive disease or triple-negative breast cancer with breast pathologic complete response (pCR) after neoadjuvant...

lung cancer
immunotherapy

Hyperprogressive Disease in Advanced NSCLC Treated With PD-1/PD-L1 Inhibitors

In a French study reported in JAMA Oncology, Ferrara et al found that hyperprogressive disease appeared to be more common with programmed cell death protein 1 (PD-1)/programmed cell death ligand 1 (PD-L1) inhibitor treatment than single-agent chemotherapy among previously treated patients with...

prostate cancer

ASCO Endorses AUA/ASTRO/SUO Guideline on Clinically Localized Prostate Cancer

As reported in the Journal of Clinical Oncology by Justin E. Bekelman, MD, of the University of Pennsylvania Perelman School of Medicine, and colleagues, ASCO has endorsed the 2017 American Urological Association (AUA), American Society for Radiation Oncology (ASTRO), and Society of Urologic...

breast cancer
immunotherapy

Sequential vs Concurrent Neoadjuvant Therapy in HER2-Positive Breast Cancer

As reported in JAMA Oncology by Buzdar et al, the phase III ACOSOG Z1041 (Alliance) trial showed no difference in disease-free or overall survival with sequential vs concurrent neoadjuvant anthracycline and trastuzumab in patients with operable HER2-positive breast cancer. An earlier report from...

hematologic malignancies

Outcomes Associated With Mutation Persistence After HSCT for Myelodysplastic Syndrome

In a single-institution study reported in The New England Journal of Medicine, Duncavage et al found that mutation clearance after allogeneic hematopoietic stem cell transplantation (HSCT) was associated with better outcomes in patients with myelodysplastic syndrome. Study Details The study...

symptom management

Use of Patient-Reported Outcomes Version of CTCAE in Rectal Cancer Trial

As reported in the Journal of Clinical Oncology, Basch et al established the feasibility of using the National Cancer Institute patient-reported outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) in the setting of a multicenter clinical trial in locally advanced...

gynecologic cancers
immunotherapy

Pembrolizumab for Advanced Cervical Cancer Progressing During or After Chemotherapy

In June 2018, pembrolizumab (Keytruda) was approved for the treatment of patients with recurrent or metastatic cervical cancer with disease progression on or after chemotherapy whose tumors express programmed cell death ligand 1 (PD-L1; combined positive score [CPS] ≥ 1), as determined by a U.S....

solid tumors
breast cancer
immunotherapy

Addition of Bevacizumab to Neoadjuvant Therapy in BRCA1/2-Mutant Triple-Negative Breast Cancer

In an analysis from the GeparQuinto trial reported in the Journal of Clinical Oncology, Peter A. Fasching, MD, of Erlangen University Hospital, Comprehensive Cancer Center Erlangen-EMN, and colleagues found that the addition of bevacizumab (Avastin) to neoadjuvant chemotherapy increased the...

hematologic malignancies
lymphoma
immunotherapy

Pembrolizumab in Relapsed or Refractory Primary Mediastinal Large B-Cell Lymphoma

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On June 13, 2018, pembrolizumab (Keytruda) was granted...

issues in oncology
immunotherapy

Uncommon Lethal Complications of Immune Checkpoint Inhibitors

In a systematic review and meta-analysis reported in JAMA Oncology, Wang et al identified frequency and types of fatal toxic effects in patients receiving immune checkpoint inhibitor therapy. Study Details The study involved analysis of fatal immune checkpoint inhibitor–associated toxic...

leukemia

Childhood Nonlymphoid Leukemia Risk With Maternal Use of Hormonal Contraception

In a population-based cohort study reported in The Lancet Oncology, Hargreave et al found that recent maternal use of hormonal contraception was associated with increased risk of childhood nonlymphoid leukemia.   Study Details The study involved data from a nationwide cohort of...

gastroesophageal cancer
gastrointestinal cancer
immunotherapy

Pertuzumab and Trastuzumab Plus Chemotherapy in HER2-Positive, Metastatic Gastric or Gastroesophageal Junction Cancer

As reported in The Lancet Oncology by Tabernero et al, the phase III JACOB trial showed no significant overall survival benefit of adding pertuzumab (Perjeta) to trastuzumab (Herceptin) plus chemotherapy in first-line treatment of HER2-positive metastatic gastric or gastroesophageal junction...

bladder cancer

Outcomes With Neoadjuvant Chemotherapy Regimens in Muscle-Invasive Bladder Cancer

In a single-center analysis reported in JAMA Oncology, Peyton et al found that neoadjuvant dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin (ddMVAC) produced better outcomes than other standard neoadjuvant regimens in patients undergoing radical cystectomy for muscle-invasive...

hepatobiliary cancer

First-Line Nab-Paclitaxel and Gemcitabine in Advanced Cholangiocarcinoma

In a phase II trial reported in JAMA Oncology, Sahai et al found that the first-line combination of nab-paclitaxel and gemcitabine—though it did not meet the progression-free survival primary endpoint—may constitute a treatment option in advanced cholangiocarcinoma. Study Details In...

symptom management

Addition of Hydroxycarbamide to Aspirin in Essential Thrombocythemia Without High-Risk Features

In a long-term follow-up of a study reported in the Journal of Clinical Oncology, Godfrey et al found that the addition of cytoreductive therapy with hydroxycarbamide to aspirin did not improve outcomes in patients with essential thrombocythemia aged 40 to 59 years without high-risk features or...

colorectal cancer
gynecologic cancers

PMS2-Associated Lynch Syndrome and Cancer Risks

In a study reported in the Journal of Clinical Oncology, ten Broeke et al found that patients with Lynch syndrome associated with PMS2 mutation are at increased risk of colorectal and endometrial cancers but not other cancers associated with the syndrome. As noted by the investigators, Lynch...

lung cancer
immunotherapy

Bevacizumab Treatment Beyond Disease Progression in Advanced NSCLC

As reported in JAMA Oncology by Gridelli et al, the phase IIIB AvaALL trial did not show improved overall survival with continued bevacizumab (Avastin) treatment beyond disease progression in patients with advanced non–small cell lung cancer (NSCLC), although some improvements in subsequent...

solid tumors

Bleomycin-Related Toxicity and Operative Morbidity After Postchemotherapy Retroperitoneal Lymph Node Dissection in Germ Cell Tumors

In a retrospective single-institution analysis reported in the Journal of Clinical Oncology, Calaway et al found that the addition of bleomycin to etoposide/cisplatin did not appear to increase risk of pulmonary or postoperative morbidity after postchemotherapy retroperitoneal lymph node dissection ...

breast cancer

Danish Study on Effect of Screening on Breast Cancer Mortality

In a Danish study reported in the Journal of Clinical Oncology, Beau et al used different models to assess the effects of screening on breast cancer mortality, finding a 20% reduction among patients diagnosed during the recommended screening age range. As noted by the investigators, the study was...

lymphoma

Rituximab/Lenalidomide vs Rituximab/Chemotherapy in Advanced Untreated Follicular Lymphoma

In a phase III RELEVANCE trial reported in The New England Journal of Medicine by Morschhauser et al, no difference in complete response rate or interim progression-free survival was found between rituximab [Rituxan]/lenalidomide [Revlimid] vs rituximab/chemotherapy in newly diagnosed advanced...

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