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breast cancer

10-Year Follow-up of Axillary Dissection vs No Dissection in Breast Cancer With Sentinel Node Micrometastases

In the 10-year follow-up of the phase III International Breast Cancer Study Group (IBCSG) 23-01 trial reported in The Lancet Oncology, Galimberti et al found no significant difference in disease-free survival with axillary dissection vs no axillary dissection in patients with breast cancer and...

lymphoma

Sequential Brentuximab Vedotin and AVD in Older Patients With Newly Diagnosed Hodgkin Lymphoma

In a phase II study reported in the Journal of Clinical Oncology, Evens et al found that a regimen of brentuximab vedotin (Adcetris) given sequentially before and after standard doxorubicin, vinblastine, and dacarbazine (AVD) was associated with good outcomes in untreated older patients with...

lung cancer

Outcomes With Station 4L Lymph Node Dissection in Left Lung Cancer

In a Chinese single-institution study reported in the Journal of Clinical Oncology, Wang et al found that station 4L lymph node (LN) dissection was associated with improved outcome in patients with primary cancer of the left lung. Study Details The retrospective analysis included 657 patients...

symptom management

ASCO/IDSA Clinical Practice Guideline Update: Antimicrobial Prophylaxis for Adult Patients With Cancer-Related Immunosuppression

As reported in the Journal of Clinical Oncology by Randy A. Taplitz, MD, of UC San Diego Health, and colleagues, ASCO and the Infectious Diseases Society of America (IDSA) have updated their joint guideline on antimicrobial prophylaxis for adult patients with immunosuppression associated with...

leukemia

Suboptimal Use of Initial Chemotherapy in Newly Diagnosed Acute Myeloid Leukemia

IN A STUDY of National Cancer Database data reported in Blood Advances, Vijaya Raj Bhatt, MD, of the University of Nebraska Medical Center, and colleagues found that 25% of patients with newly diagnosed acute myeloid leukemia (AML) did not receive initial chemotherapy, despite evidence that...

cns cancers
issues in oncology

Factors in Endocrine Deficiency in Pediatric and Young Adult Patients Receiving Radiotherapy for Brain Tumors

In a study reported in the Journal of Clinical Oncology, Vatner et al identified factors associated with an increased risk of endocrine deficiency in pediatric and young adult patients receiving radiation therapy for brain tumors, including hypothalamus and pituitary radiation dose. Study Details ...

hematologic malignancies
leukemia

Outcomes After Discontinuation of Tyrosine Kinase Inhibitor Therapy in Chronic Myeloid Leukemia

In an interim analysis of a European trial reported in The Lancet Oncology, Francois-Xavier Mahon, MD, of Institut Bergonié, Bordeaux, and colleagues found that discontinuation of tyrosine kinase inhibitor therapy in patients with chronic myeloid leukemia (CML) with deep molecular response was...

solid tumors

PDL1 Amplification in Solid Tumors

In a study reported in JAMA Oncology, Aaron M. Goodman, MD, of the University of California, San Diego Moores Center for Personalized Cancer Therapy, and colleagues found amplification of PDL1 genes in 0.7% of solid tumors, including more than 100 tumor types. Response to checkpoint inhibition was ...

solid tumors

Trametinib Treatment for Histiocytic Sarcoma With Activating MAP2K1 Mutation

In a letter to the editor in The New England Journal of Medicine, Mrinal M. Gounder, MD, of Memorial Sloan Kettering Cancer Center, New York, and colleagues described the successful treatment of a patient with histiocytic sarcoma and an activating MAP2K1 (MEK1) mutation with the MAPK kinase 1 and...

leukemia

Comparison of Methotrexate Intensification Regimens in Children and Young Adults With T-Cell ALL

As reported by Winter et al in the Journal of Clinical Oncology, findings in the Children’s Oncology Group (COG) AALL0434 trial indicate improved outcomes with a COG methotrexate intensification regimen vs a high-dose methotrexate intensification regimen in children and young adults with...

breast cancer

Rates of Inherited Breast Cancer in Nigerian Women

In a study reported in the Journal of Clinical Oncology, Zheng et al found a high frequency of inherited breast cancer among Nigerian women, with presence of deleterious mutations posing very high risk of disease. As noted by the investigators, “…Among Nigerian women, breast cancer is ...

pancreatic cancer

Protein-Metabolite Panel for Detection of Early-Stage Pancreatic Cancer

In a study reported in the Journal of the National Cancer Institute, Fahrmann et al developed and validated a plasma-derived metabolite panel that distinguished early-stage pancreatic ductal adenocarcinoma (PDAC) with high accuracy. Accuracy was further improved with the addition of a previously...

breast cancer

Ribociclib in Hormone Receptor–Positive, HER2-Negative Advanced Breast Cancer

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 July 18, 2018, the indication for ribociclib (Kisqali) ...

gastrointestinal cancer
colorectal cancer

Ipilimumab in Combination With Nivolumab for MSI-H or dMMR Metastatic Colorectal Cancer

On July 10, 2018, ipilimumab (Yervoy) was granted accelerated approval for use in combination with nivolumab (Opdivo) for the treatment of patients at least 12 years of age with microsatellite instability–high (MSI-H) or mismatch repair–deficient (dMMR) metastatic colorectal cancer progressing...

cost of care

Patient-Reported Financial Sacrifice and Cancer Care

In a study reported in the Journal of Oncology Practice, Chino et al found that high proportions of insured patients with cancer—most with stage IV disease—reported being willing to make considerable personal and financial sacrifices to receive cancer care. The study included a...

lymphoma

Brentuximab Vedotin Plus Gemcitabine in Pediatric and Young Adult Patients With Relapsed/Refractory Hodgkin Lymphoma

In a Children’s Oncology Group phase I/II trial reported in The Lancet Oncology, Cole et al found that the combination of brentuximab vedotin (Adcetris) and gemcitabine was active in pediatric and young adult patients with relapsed or refractory Hodgkin lymphoma. As noted by the...

cns cancers
lung cancer

CNS Activity of First-Line Osimertinib in EGFR-Mutant Advanced NSCLC

In a subgroup analysis of the phase III FLAURA trial reported in the Journal of Clinical Oncology, Reungwetwattana et al found evidence of greater central nervous system (CNS) activity of osimertinib (Tagrisso) vs standard EGFR tyrosine kinase inhibitors in patients with previously untreated...

immunotherapy

Radiomic Signature for CD8 Cell Tumor Infiltration and Response to Treatment

In a study reported in The Lancet Oncology, Sun et al developed a radiomic signature of infiltrating CD8 cells that could identify tumor immune phenotype and help predict outcome of programmed cell death protein 1 (PD-1)/programmed cell death ligand 1 (PD-L1) inhibitor treatment. Study Details...

gynecologic cancers

Near-Infrared Fluorescence With Indocyanine Green Dye vs Isosulfan Blue Dye for Detecting Sentinel Nodes in Gynecologic Cancers

In the phase III FILM study reported in The Lancet Oncology, Frumovitz et al found that near-infrared fluorescence imaging with indocyanine green dye identified more sentinel nodes vs isosulfan blue dye in women with clinical stage I endometrial or cervical cancer undergoing curative surgery. There ...

lung cancer

Tumor Mutation Burden and Prognosis in Resected NSCLC

In a study reported in the Journal of Clinical Oncology, Devarakonda et al found that high nonsynonymous tumor mutation burden was associated with improved outcomes in patients undergoing resection for non–small cell lung cancer (NSCLC). Study Details The study (Lung Adjuvant Cisplatin...

breast cancer
immunotherapy

Adding First-Line Pertuzumab to Trastuzumab Plus Aromatase Inhibitor in Advanced Breast Cancer

In the phase II PERTAIN trial reported in the Journal of Clinical Oncology, Rimawi et al found that adding pertuzumab to trastuzumab plus an aromatase inhibitor improved progression-free survival in patients with advanced HER2-positive, hormone receptor–positive breast cancer. Study Details ...

cns cancers
skin cancer
immunotherapy

Immunotherapy Combination in Melanoma Brain Metastases

In the phase II CheckMate 204 study reported in The New England Journal of Medicine, Tawbi et al found that combined nivolumab (Opdivo) and ipilimumab (Yervoy) produced a high rate of intracranial clinical benefit in patients with melanoma brain metastases. Study Details The study included 94...

palliative care

Quality Improvement Initiative for Documenting Goals of Care for Patients With Advanced Cancer

In a study reported in the Journal of Oncology Practice, Karim et al found that a quality improvement initiative at a single cancer center improved documentation of goals-of-care discussions and referral to palliative care for patients with advanced cancer. Study Details In the study,...

prostate cancer

Hypofractionated Dose-Escalated IMRT vs Conventionally Fractionated IMRT in Localized Prostate Cancer

In a long-term follow-up of a phase III trial reported in the Journal of Clinical Oncology, Hoffman et al found that dose-escalated moderately hypofractionated intensity-modulated radiation therapy (HIMRT) improved disease control and reduced treatment duration vs conventionally fractionated IMRT...

gastroesophageal cancer
immunotherapy

Immunotherapy in Advanced Esophagogastric Cancer

As reported in the Journal of Clinical Oncology by Janjigian et al, the phase I/II CheckMate-032 study has shown activity of nivolumab (Opdivo) and nivolumab plus ipilimumab (Yervoy) in advanced esophagogastric cancer. In the esophagogastric cohort of the multicohort study, 160 patients (who...

gynecologic cancers

U.S. Preventive Services Task Force Recommendation Statement on Screening for Cervical Cancer

As reported in JAMA, the U.S. Preventive Services Task Force (USPSTF) has updated its 2012 recommendations on screening for cervical cancer. Key Recommendations The key USPSTF recommendations on screening are as follows: The USPSTF recommends screening for cervical cancer every 3 years with...

lymphoma

ctDNA and Treatment Outcome in Diffuse Large B-Cell Lymphoma

In a study reported in the Journal of Clinical Oncology, Kurtz et al found that baseline circulating tumor DNA (ctDNA) and molecular response to treatment were independent predictors of treatment outcome in diffuse large B-cell lymphoma. Study Details The association of ctDNA with treatment...

lung cancer
immunotherapy

Baseline Steroids and Efficacy of PD-1/PD-L1 Inhibitors in NSCLC

In a study reported in the Journal of Clinical Oncology, Arbour et al found that baseline treatment with corticosteroids was associated with poorer efficacy of programmed cell death protein 1 (PD-1) or programmed death cell ligand 1 (PD-L1) inhibitors in patients with non–small cell lung...

pancreatic cancer

Association of Immunologic Markers With Survival in Upfront Resectable Pancreatic Cancer

In a research letter published in JAMA Surgery, Tang et al found that higher levels of intratumoral CD3-positive T cells and postoperative circulating monocyte counts were associated with improved survival in patients with upfront resectable pancreatic ductal adenocarcinoma. The prospective cohort ...

breast cancer

EMBRACA Trial Compares Talazoparib vs Standard Therapy in Advanced Breast Cancer With a Germline BRCA Mutation

As reported in The New England Journal of Medicine by Litton et al, the phase III EMBRACA trial has shown significantly improved progression-free survival with the poly (ADP-ribose) polymerase inhibitor talazoparib vs physician choice of standard single-agent therapy in patients with advanced...

breast cancer

Dutch Quality-of-Life Study With One- vs Two-Stage Breast Reconstruction in Skin-Sparing Mastectomy

In a Dutch study reported in The Lancet Oncology, Negenborn et al found no differences in quality of life (QOL) between women receiving one-stage implant-based breast reconstruction (IBBR) with an acellular dermal matrix (ADM) vs standard two-stage IBBR. A previously reported safety analysis from...

lymphoma
skin cancer

Mogamulizumab vs Vorinostat in Previously Treated Cutaneous T-Cell Lymphoma

As reported by Kim 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 progression-free survival vs vorinostat (Zolinza) among patients with previously treated...

lung cancer

NGR-hTNF Combined With Investigator Choice of Therapy in Malignant Pleural Mesothelioma

The phase III NGR015 trial reported in The Lancet Oncology by Vanesa Gregorc, MD, of Ospedale San Raffaele, Milan, and colleagues found no benefit of adding NGR-hTNF to best investigator choice of treatment in patients with previously treated malignant pleural mesothelioma. NGR-hTNF consists of...

issues in oncology

Survival in Male vs Female Patients Receiving Immune Checkpoint Inhibitors

In a systematic review and meta-analysis reported in The Lancet Oncology by Fabio Conforti, MD, of the Division of Medical Oncology for Melanoma & Sarcoma, European Institute of Oncology, Milan, and colleagues, a significant difference in overall survival benefit favoring male vs female...

skin cancer

Activity of T Cells in Metastatic Melanoma Resistant to Immune Checkpoint Inhibitor Treatment

In a study reported in the Annals of Oncology, Andersen et al found that tumor-infiltrating lymphocytes isolated from metastatic melanoma lesions in patients with disease progression after checkpoint inhibitor therapy remain functional. Moreover, they concluded these tumor-infiltrating lymphocytes...

skin cancer

Cutaneous Squamous Cell Carcinoma of the Lip and Risk of Nodal Metastasis

In a study reported in JAMA Dermatology, Wang et al found that the risk of nodal metastasis was higher for cutaneous squamous cell carcinoma of the lip with vermilion vs cutaneous location. Disease-specific and overall survival were similar for the two locations. Chrysalyne D. Schmults, MD, of the...

colorectal cancer

ERBB2/ERBB3-Mutant Colorectal Cancer

A study reported in the Journal of the National Cancer Institute by Loree and colleagues found that ERBB2/ERBB3 mutations in colorectal cancer are associated with microsatellite instability and PIK3CA mutation. Kanwal Raghav, MD, MBBS, of the Division of Gastrointestinal Medical Oncology, The...

leukemia
immunotherapy

Blinatumomab in Adult and Pediatric Patients With B-Cell Precursor Acute Lymphoblastic Leukemia

EARLY IN 2018, blinatumomab (Blincyto) was granted accelerated approval for the treatment of adult and pediatric patients with B-cell precursor acute lymphoblastic leukemia (ALL) in first or second complete remission with minimal residual disease ≥ 0.1%.1,2 Supporting Efficacy Data APPROVAL WAS...

leukemia

Ivosidenib for Relapsed or Refractory Acute Myeloid Leukemia

ON JULY 20, 2018, the U.S. Food and Drug Administration (FDA) approved ivosidenib (Tibsovo) for the treatment of adult patients with relapsed or refractory acute myeloid leukemia (AML) with a susceptible isocitrate dehydrogenase-1 (IDH1) mutation, as detected by an FDA-approved test.1,2 The FDA...

gastrointestinal cancer

MUC16 Mutation, Tumor Mutation Load, and Prognosis in Gastric Cancer

In a study reported in JAMA Oncology, Li et al found that MUC16 mutation was associated with increased tumor mutation load and improved prognosis in gastric cancer. The study involved analysis of genomic data from 437 gastric cancer samples from The Cancer Genome Atlas (TCGA; discovery set) and...

gastroesophageal cancer

Neoadjuvant Chemoradiotherapy in Locally Advanced Esophageal Cancer

In a Chinese phase III trial reported in the Journal of Clinical Oncology, Yang et al found that adding neoadjuvant chemoradiotherapy to surgery improved survival in locally advanced squamous cell carcinoma of the esophagus. Study Details In the open-label trial, 451 patients with potentially...

gynecologic cancers

Adding Sorafenib to Topotecan in Platinum-Resistant Ovarian Cancer

In a German phase II trial reported in The Lancet Oncology, Chekerov et al found that the addition of sorafenib (Nexavar) to topotecan improved progression-free survival in women with platinum-resistant ovarian cancer. Study Details In the multicenter investigator-initiated double-blind trial,...

head and neck cancer
immunotherapy

Induction Chemotherapy Followed by Cetuximab and Radiotherapy vs Concurrent Chemoradiotherapy in Head and Neck Cancer

As reported in the Journal of Clinical Oncology by Geoffrois et al, the European phase III GORTEC (Groupe Oncologie Radiothèrapie Tête et Cou) 2007-02 trial has shown no improvement in progression-free survival with induction chemotherapy followed by cetuximab and radiotherapy (RT) vs...

sarcoma

Addition of Vincristine and Irinotecan to Vincristine, Dactinomycin, and Cyclophosphamide in Pediatric Intermediate-Risk Rhabdomyosarcoma

In a phase III Children’s Oncology Group study reported in the Journal of Clinical Oncology, Hawkins et al found that substituting vincristine and irinotecan (VI) for half of vincristine, dactinomycin, and cyclophosphamide (VAC) courses did not improve event-free survival in pediatric...

cns cancers
immunotherapy

Bevacizumab and Temozolomide in First Recurrence of Glioma Without 1p/19q Codeletion

In a phase II trial funded by the European Organisation for Research and Treatment of Cancer and reported in The Lancet Oncology, van den Bent et al found no evidence of a survival benefit with the addition of bevacizumab (Avastin) to temozolomide in patients with a first recurrence of World Health ...

cns cancers
survivorship

Functional and Social Independence in Survivors of Pediatric CNS Tumors

In a report from the St. Jude Lifetime Cohort Study published in the Journal of Clinical Oncology, Brinkman et al found that 60% of adult survivors of pediatric central nervous system (CNS) tumors do not achieve full functional or social independence in adult life. In the study, functional and...

leukemia
immunotherapy

Bendamustine Followed by Obinutuzumab Plus Venetoclax in Treatment-Naive and Relapsed/Refractory CLL

In a German phase II trial reported in The Lancet Oncology, Cramer et al found promising response rates with bendamustine followed by obinutuzumab (Gazyva) plus venetoclax (Venclexta) in both treatment-naive and relapsed/refractory chronic lymphocytic leukemia (CLL). In the trial, patients with an ...

hematologic malignancies
multiple myeloma
immunotherapy

Daratumumab in Newly Diagnosed Transplant-Ineligible Multiple Myeloma

In May 2018, daratumumab (Darzalex) was approved for use in combination with VMP (bortezomib, melphalan, and prednisone) in the treatment of patients with newly diagnosed multiple myeloma who are ineligible for autologous stem cell transplantation.1 Supporting Efficacy Data Approval was based on...

prostate cancer

Enzalutamide in Nonmetastatic Castration-Resistant Prostate Cancer

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 July 13, 2018, enzalutamide (Xtandi) was approved for...

lung cancer

Broad-Based Genomic Sequencing in Advanced NSCLC in the Community Oncology Setting

In a study reported in JAMA, Presley et al found that use of broad-based genomic sequencing vs routine testing for EGFR mutations or ALK rearrangements alone directed treatment in a minority of patients with advanced non–small cell lung cancer (NSCLC) in the community oncology setting and was ...

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