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issues in oncology

Physicians, New Drugs, and Pharma

The U.S. Food and Drug Administration (FDA) and European Medicines Agency (EMA) have approved record numbers of new cancer drugs recently. This is extraordinarily good news for physicians, patients, and drug companies, but it raises important questions as to how effective these drugs are, whether...

genomics/genetics

CICERO Software May Enable Detection of Cancer-Causing Gene Fusions

After years of development, engineering, and enhancement, researchers at St. Jude Children’s Research Hospital in Memphis have made available a software system that enables better detection of gene fusions. The system, called CICERO, offers additional insights into cancers as well as new targets...

cardio-oncology

NCCN Clinical Practice Guidelines in Oncology: 2020 Updates

In 1996, the National Comprehensive Cancer Network (NCCN) published its first set of Clinical Practice Guidelines in Oncology®, covering eight tumor types. Guidelines are now published for more than 60 tumor types and topics. During the NCCN’s 25th Annual Conference, which was held virtually during ...

National Comprehensive Cancer Network Celebrates Its 25th Year

It was February 1996, and the first annual meeting of the National Comprehensive Cancer Network® (NCCN®) was drawing to a close, when Chief Executive Officer (CEO) Bruce R. Ross, MD, invited comments from the floor. An oncologist who had attended at the urging of a friend—somewhat reluctantly—stood ...

Expert Point of View: Juan W. Valle, MD

Invited discussant Juan W. Valle, MD, of the University of Manchester/The Christie, United Kingdom, reiterated the 50% response rate, the median progression-free survival of 7.1 months, and the median overall survival of 16.0 months achieved with entrectinib in patients who had gastrointestinal...

myelodysplastic syndromes

Novel Treatments Emerge for Patients With Lower-Risk Myelodysplastic Syndromes

Patients with lower-risk myelodysplastic syndromes (MDS) who are dependent on red blood cell transfusions have limited options, especially if they are no longer responding to erythropoiesis-stimulating agents. Research presented during the virtual edition of the 25th European Hematology Association ...

Geraldine Jacobson, MD, MPH, MBA, FASTRO, Elected as Future Chair of ASTRO

The members of the American Society for Radiation Oncology (ASTRO) have elected four new officers to ASTRO’s Board of Directors. Geraldine Jacobson, MD, MPH, MBA, FASTRO, will begin her term as President-Elect in October during ASTRO’s 62nd Annual Meeting, alongside Gopal K. Bajaj, MD, MBA,...

issues in oncology

Pediatric Hematologist/Oncologist Yoram Unguru, MD, MS, MA, Explains the Economic Origins of Drug Shortages and Other Ethical Issues

Improvements in protocol-driven clinical trials and supportive care for children and adolescents with cancer have markedly reduced mortality rates over the past 5 decades. Yet, along with clinical advances, oncologists and their young patients with cancer face a host of ethical issues, made more...

leukemia

Refinement of European LeukemiaNet Classification Recommendations for Younger Adults With AML

Findings from a study published by Eisfeld et al in the journal Leukemia could refine an important set of prognostic and treatment recommendations for younger adult patients with acute myeloid leukemia (AML). The retrospective study evaluated the molecular characteristics and outcomes of 863...

breast cancer

Association of Pathologic Complete Response With 3-Year Outcomes in I-SPY 2 Trial of Neoadjuvant Therapy for Stage II or III Breast Cancer

In a 3-year follow-up analysis of the phase II I-SPY 2 trial reported in JAMA Oncology, researchers in the I-SPY 2 Trial Consortium found that pathologic complete response was associated with improved event-free and distant recurrence–free survival—irrespective of molecular subtype or neoadjuvant...

kidney cancer
lung cancer
myelodysplastic syndromes
solid tumors
skin cancer
lymphoma
pancreatic cancer
breast cancer
immunotherapy

FDA Pipeline: Designations in Kidney and Lung Cancers, Myelodysplastic Syndromes, and More

Over the past few weeks, the U.S. Food and Drug Administration (FDA) has issued designations and accepted applications for novel agents, as well as approved companion diagnostics. We summarize these regulatory movements below. Breakthrough Therapy Designation for MK-6482 in von Hippel-Lindau...

supportive care
immunotherapy

ASCO Guideline Supports Continued Use of Dexamethasone for Patients Receiving Checkpoint Inhibitors and Emetogenic Chemotherapy

The ASCO guideline on the use of antiemetics has been updated to include new anticancer agents, antiemetics, and regimens.1 The guideline also addresses a growing concern among some oncologists that corticosteroids and their immunosuppressive abilities could potentially compromise the efficacy of...

hematologic malignancies
breast cancer

Risk of Breast Cancer After Total-Body Irradiation and Blood or Marrow Transplantation for Hematologic Malignancies

In an analysis from the Blood or Marrow Transplantation Survivor Study reported in the Journal of Clinical Oncology, McDonald et al found that total-body irradiation in women undergoing autologous or allogeneic blood or marrow transplantation for hematologic malignancies was associated with an...

cns cancers

Outcomes With Adjuvant Postradiation Chemotherapy vs Radiotherapy in High-Risk, Low-Grade Glioma

In a post hoc analysis from the phase III NRG Oncology/RTOG 9802 trial reported in the Journal of Clinical Oncology, Bell et al found that postradiation chemotherapy was associated with a better outcome vs radiotherapy alone in patients with IDH-mutant, high-risk, low-grade glioma, irrespective of...

leukemia
survivorship

Late Morbidity and Mortality in Survivors of Childhood ALL Receiving Contemporary Risk-Stratified Therapy

In an analysis from the Childhood Cancer Survivor Study reported in the Journal of Clinical Oncology, Dixon et al found that 5-year survivors of childhood acute lymphoblastic leukemia (ALL) diagnosed and treated with risk-stratified therapy in the 1990s had reduced morbidity and health-related late ...

lymphoma

FDA Approves Tafasitamab-cxix Combined With Lenalidomide to Treat Adults With Relapsed/Refractory DLBCL

On July 31, the U.S. Food and Drug Administration (FDA) approved tafasitamab-cxix (Monjuvi) in combination with lenalidomide for the treatment of adult patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL)–not otherwise specified, including DLBCL arising from low-grade...

skin cancer
immunotherapy

FDA Approves Atezolizumab Plus Cobimetinib/Vemurafenib for Advanced BRAF V600–Mutated Melanoma

On July 30, the U.S. Food and Drug Administration (FDA) approved the PD-L1 inhibitor atezolizumab (Tecentriq) plus the MEK inhibitor cobimetinib (Cotellic) and the selective BRAF kinase inhibitor vemurafenib (Zelboraf) for the treatment of patients with advanced BRAF V600 mutation–positive...

supportive care
symptom management

Updated ASCO Guideline Revisits Evidence on Prevention and Treatment of Chemotherapy-Induced Neuropathy

Peripheral neuropathy is one of the most prominent chronic side effects of chemotherapy and can linger for years, causing discomfort as well as impaired functionality and quality of life. Yet oncologists have struggled to identify definitive treatment and prevention strategies. In an effort to help ...

multiple myeloma
genomics/genetics

Analysis of Deep Whole-Genome Sequencing in Patients With Multiple Myeloma Identifies Superior Outcome Subgroup

In a study of genome-wide somatic alterations in multiple myeloma reported in the Journal of Clinical Oncology, Samur et al identified a subgroup of patients with superior outcomes who are not adequately identified by traditional risk markers. The study involved analysis of deep whole-genome...

covid-19
breast cancer
colorectal cancer
gastroesophageal cancer
lung cancer

Modeling Study Aims to Estimate the Effect of the COVID-19 Pandemic on Cancer Deaths in England

In a population-based modeling study reported in The Lancet Oncology, Maringe et al estimated that delays in diagnosis due to the COVID-19 pandemic could result in 3,291 to 3,621 additional deaths from breast, colorectal, esophageal, and lung cancers within 5 years. As stated by the investigators,...

breast cancer
genomics/genetics
survivorship

Impact of Pregnancy After Breast Cancer in Women With Deleterious Germline BRCA Mutations

In a retrospective cohort study reported in the Journal of Clinical Oncology, Matteo Lambertini, MD, PhD, and colleagues found that pregnancy after breast cancer in women harboring deleterious germline BRCA mutations did not appear to be associated with worsened maternal prognosis or fetal...

lung cancer
immunotherapy

Anti-TIGIT Antibody Plus Atezolizumab Move Forward in Advanced NSCLC

Tiragolumab, an anti-TIGIT antibody, plus the PD-L1 inhibitor atezolizumab exhibited early clinical activity and was tolerated in patients with advanced solid tumors, including those with metastatic non–small cell lung cancer (NSCLC) that was PD-L1–positive and untreated with prior checkpoint...

issues in oncology
survivorship

Risk of Chronic Comorbidities Among Survivors of Adolescent and Young Adult Cancer

In a retrospective cohort study reported in the Journal of Clinical Oncology, Chao et al found that survivors of adolescent and young adult (AYA) cancer were at increased risk of numerous chronic comorbidities vs the general population.   Study Details The study involved data from 6,778 ≥ 2-year...

breast cancer

Does Adjuvant Chemotherapy Improve Survival Among Older Patients With ER-Positive, Node-Positive Breast Cancer and Multiple Comorbidities?

In a retrospective cohort study reported in JAMA Oncology, Tamirisa et al found evidence that adjuvant chemotherapy was associated with improved survival among patients age ≥ 70 years with estrogen receptor (ER)-positive, HER2-negative, node-positive breast cancer and multiple comorbidities. Study...

supportive care
symptom management

Neuroleptic Strategies for Improving Terminal Agitation in Patients With Cancer and Delirium

In a small single-center randomized trial reported in The Lancet Oncology, David Hui, MD, MS, MSc, and colleagues found that increasing haloperidol dose, rotating to chlorpromazine, and combining haloperidol and chlorpromazine each appeared to improve refractory agitation in patients with terminal...

lung cancer

A Diagnosis of Advanced Lung Cancer Is No Longer a Death Sentence

In hindsight, the symptoms I began experiencing in the winter of 2013, including pains in my chest and shoulders and a persistent cough, should have rung loud alarm bells. However, having undergone a pancreatectomy and splenectomy to cure a history of mucinous cystic neoplasms of the pancreas 5...

Mark Lewis, MD, and Jonathan Bleeker, MD, Reflect in ‘From Every Angle’

Mark Lewis, MD, was 8 years old when his father was diagnosed with cancer. Decades later, he was 1 week into an oncology fellowship when he self-diagnosed his own rare cancer, multiple endocrine neoplasia type 1 (MEN1). In the latest Your Stories podcast from Conquer Cancer, the ASCO Foundation,...

head and neck cancer

New Guideline for Locally Advanced Esophageal Cancer Supports Multimodality Therapy and Multidisciplinary Treatment

ASCO has released a new guideline for the treatment of locally advanced esophageal cancer that will provide a context for the current standards of care, fill gaps in clinicians’ knowledge of therapy options, and help define future treatment.1 An expert panel developed the guideline based on 17...

ESMO Names George Pentheroudakis, MD, PhD, New Chief Medical Officer

The European Society for Medical Oncology (ESMO) has announced the appointment of George Pentheroudakis, MD, PhD, as its new Chief Medical Officer. Dr. Pentheroudakis is Head of the Department of Medical Oncology at the Ioannina University Hospital in Greece and serves as Professor of Oncology at...

covid-19
solid tumors
hematologic malignancies

In Case You Missed It: Quick Takes on Novel Therapies for Solid and Hematologic Malignancies

Because of the COVID-19 pandemic, oncology providers from around the world had to forgo their annual trip to McCormick Place—but the show did go on. We all realized important research can still be presented, clinicians and fellow researchers will still listen, and ASCO presentations will still...

head and neck cancer
lung cancer

Nivolumab/Ipilimumab Shows Benefit in Patients With Non–Small Cell Lung Cancer and Brain Metastases

The combination of nivolumab plus ipilimumab was at least as effective as chemotherapy in front-line therapy for patients with advanced non–small cell lung cancer (NSCLC) and brain metastases at baseline, according to the results of a post hoc analysis from part 1 of the phase III CheckMate 227...

pancreatic cancer

First-Line FOLFIRINOX vs Gemcitabine/Nab-paclitaxel for Localized Pancreatic Cancer

In a single-institution retrospective study reported in JAMA Surgery, Perri et al found that first-line FOLFIRINOX (fluorouracil, leucovorin, irinotecan, and oxaliplatin) was associated with a higher response rate and subsequent pancreatectomy vs gemcitabine plus nab-paclitaxel in patients with...

lymphoma
immunotherapy

Outcomes With Axicabtagene Ciloleucel in the Nontrial Setting in Patients With B-Cell Non-Hodgkin Lymphoma

In a study reported in the Journal of Clinical Oncology, Caron A. Jacobson, MD, and colleagues found that commercial use of the chimeric antigen receptor T-cell therapy axicabtagene ciloleucel in patients with relapsed or refractory B-cell non-Hodgkin lymphoma was associated with an overall...

breast cancer
genomics/genetics

Effect of Breast Cancer Pathway Implementation on Rate of Referrals for Genetic Counseling and Testing

In a study reported in JCO Oncology Practice, Stephanie L. Graff, MD, and colleagues found that patients with breast cancer seen by a physician with training in using an established pathway for genetic counseling and testing referral were more frequently referred for such services vs patients seen...

covid-19

Study Finds Higher Risk for COVID-19 Infection Among Minorities and Patients With Cancer

According to the latest data from the Centers for Disease Control and Prevention, Native American or Alaska Native and non-Hispanic Black people have the highest rates of hospitalization or death from COVID-19, followed by Hispanics and Latinos. A large population-based study using a smartphone app ...

hematologic malignancies
symptom management

Addition of Antithymocyte Globulin to Graft-vs-Host Disease Prophylaxis in Matched Sibling Donor Stem Cell Transplant

In a Chinese trial reported in the Journal of Clinical Oncology, Chang et al found that the addition of antithymocyte globulin to standard graft-vs-host disease prophylaxis reduced the risk of acute graft-vs-host disease in patients undergoing human leukocyte antigen (HLA)-matched sibling donor...

breast cancer

Long-Term Normal Tissue Effects With Five-Fraction Whole-Breast Radiotherapy for Early Breast Cancer

As reported in the Journal of Clinical Oncology by Brunt et al, 10-year follow-up in the FAST trial of women with early breast cancer showed greater risk for photographic- and physician-assessed normal tissue effects with an adjuvant radiotherapy regimen of 30 Gy in 5 once-weekly fractions—but not...

lymphoma
multiple myeloma
immunotherapy

FDA Pipeline: Novel Treatments for Hematologic Malignancies

Recently, the U.S. Food and Drug Administration (FDA) granted Priority Review to pembrolizumab for the second-line treatment of patients with relapsed or refractory Hodgkin lymphoma, and also accepted a supplemental new drug application for selinexor for pretreated patients with multiple myeloma....

lymphoma

Longitudinal Analysis of Health-Related Quality of Life in Patients With Hodgkin Lymphoma

A longitudinal analysis of health-related quality of life in patients from German Hodgkin Study Group trials, reported in the Journal of Clinical Oncology by Kreissl et al, showed a “high and persistent” amount of health-related quality-of-life deficits in survivors of Hodgkin lymphoma. The...

skin cancer
immunotherapy

Pembrolizumab for Advanced Melanoma: Impact of BRAF-Mutation Status and Prior Therapeutic Regimens

In a pooled analysis reported in JAMA Oncology, Igor Puzanov, MD, MSCI, and colleagues identified objective response rates and progression-free and overall survival rates with pembrolizumab treatment among patients with advanced melanoma according to BRAF V600E/K–mutation status and prior BRAF/MEK...

hepatobiliary cancer
immunotherapy

Phase Ib Trial of Atezolizumab With or Without Bevacizumab in Patients With Unresectable Hepatocellular Carcinoma

The combination of atezolizumab and bevacizumab was recently approved by the U.S. Food and Drug Administration for the treatment of unresectable or metastatic hepatocellular carcinoma on the basis of findings from the phase III IMbrave150 trial, which showed superior overall and progression-free...

Lenvatinib Plus Pembrolizumab for Patients With Advanced Gastric Cancer

This week, we’ll discuss the efficacy of the combination of lenvatinib and pembrolizumab for patients with advanced gastric cancer. We’ll also highlight key points from the recent USPSTF draft recommendation on CT screening for lung cancer. Finally, we’ll review a regulatory approval in metastatic...

gynecologic cancers

LACC Trial: Quality of Life With Open vs Minimally Invasive Radical Hysterectomy for Patients With Cervical Cancer

As reported in The Lancet Oncology by Frumovitz et al, there were no significant differences in quality of life, a secondary endpoint, for women undergoing open vs minimally invasive radical hysterectomy for cervical cancer in the phase III LACC trial. There were, however, differences in...

solid tumors

Effect of Complete vs Incomplete Macroscopic Excision on Survival in Stage IV High-Risk Neuroblastoma

In an analysis from the International Society of Pediatric Oncology Europe Neuroblastoma Group (SIOPEN) High-Risk Neuroblastoma 1 (HR-NBL1/SIOPEN) trial reported in the Journal of Clinical Oncology, Holmes et al found that surgeon-assessed complete macroscopic excision was associated with improved...

leukemia
geriatric oncology

VIALE-A Trial Supports Survival Benefit of Venetoclax Plus Azacitidine in Elderly Patients With AML

In the phase III VIALE-A trial, venetoclax added to azacitidine led to a significant and clinically meaningful improvement in response rates and overall survival, as compared with azacitidine alone, in treatment-naive predominantly elderly patients with acute myeloid leukemia (AML) ineligible for...

gynecologic cancers

Quality of Life With Timing of Platinum-Based Regimens in Newly Diagnosed Patients With Ovarian Cancer

In a study reported in The Lancet Oncology, Blagden et al found lower mean global quality-of-life scores on longitudinal analysis among women with newly diagnosed ovarian cancer who received weekly vs every-3-week paclitaxel in platinum-based regimens in the ICON8 trial. The ICON8 trial showed no...

lymphoma

Effectiveness of Routine Blood Testing in Detection of Disease During Active Surveillance for Indolent Non-Hodgkin Lymphoma

In an Australian study reported in JCO Oncology Practice, Piercey et al found that routine blood tests have little utility in detecting relapse or progression of disease during active surveillance of patients with indolent non-Hodgkin lymphoma. As stated by the investigators, “Patients with...

neuroendocrine tumors
immunotherapy

Two Studies Focus on Emerging Treatment Options for Patients With Neuroendocrine Tumors

Two new studies led by Renuka Iyer, MD, Section Chief for Gastrointestinal Oncology at Roswell Park Comprehensive Cancer Center, and published in Oncotarget and Cancer, respectively, highlight possible new treatment options for patients with neuroendocrine tumors. SurVaxM The first report,...

supportive care
symptom management

Teriparatide for Medication-Related Osteonecrosis of the Jaw

In an Australian study reported in the Journal of Clinical Oncology, Sim et al found that the osteoanabolic agent teriparatide improved the rate of resolution of medication-related osteonecrosis of the jaw lesions vs placebo in a population of patients who had previous exposure to either...

survivorship

Effects of Exercise Intolerance on Adult Survivors of Childhood Cancer

In a study reported in JAMA Oncology, Hayek et al found that exercise intolerance was more common among adult survivors of childhood cancer than among matched controls and that it was associated with a greater likelihood of emotional distress, poorer attainment of social roles, and poorer...

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