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issues in oncology

Perception of Effects of Continued Smoking Among Patients With Cancer

In a study reported in the Journal of Oncology Practice, Alton et al found that current cigarette smokers were less likely to believe that continued smoking after cancer diagnosis was harmful compared with ex-smokers or never-smokers. Continued smoking after cancer diagnosis has been associated...

lung cancer

Afatinib in Previously Untreated Metastatic NSCLC With Nonresistant EGFR Mutations

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 January 12, 2018, afatinib (Gilotrif) was approved...

skin cancer

Sentinel Lymph Node Biopsy and Management of Regional Lymph Nodes in Melanoma: ASCO/SSO Clinical Practice Guideline Update

AS REPORTED IN the Journal of Clinical Oncology by Sandra L. Wong, MD, of Dartmouth-Hitchcock Medical Center, and colleagues, ASCO and the Society of Surgical Oncology (SSO) have issued an update to the ASCO/SSO clinical practice guideline on sentinel lymph node biopsy and management of regional...

skin cancer
immunotherapy

Activity of T Cells From Patients With Metastatic Melanoma Resistant to Immune Checkpoint Inhibitor Treatment

In a study reported in 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...

breast cancer

Predictive Model for Breast Cancer in Women With Atypical Hyperplasia

As reported in the Journal of Clinical Oncology, Degnim et al have developed a model for predicting breast cancer risk among women with atypical hyperplasia on breast biopsy. Study Details The risk model (AH-BC) was developed using retrospective cohorts of women aged 18 to 85 years with...

cns cancers

Early-Phase Trial of Carboxyamidotriazole Orotate and Temozolomide in Glioblastoma

In a phase Ib trial reported in the Journal of Clinical Oncology, Omuro et al found evidence of activity of carboxyamidotriazole orotate plus temozolomide in patients with recurrent anaplastic gliomas or glioblastoma and previously untreated glioblastoma. Carboxyamidotriazole orotate is an...

leukemia

Results From the Full Population of a Phase II Trial of Venetoclax in CLL With 17p Deletion

In an article published in the Journal of Clinical Oncology, Stilgenbauer et al reported findings from the full population of the phase II trial that supported the 2016 approval of venetoclax (Venclexta) in the treatment of previously treated chronic lymphocytic leukemia (CLL) with 17p deletion....

gastrointestinal cancer

Risk of Gastrointestinal Cancers in Patients With Cystic Fibrosis

In a meta-analysis reported in The Lancet Oncology, Yamada et al found that patients with cystic fibrosis are at increased risk of gastrointestinal (GI) cancers vs the general population. Improved management of cystic fibrosis has led to increased life expectancy and increased incidence of...

breast cancer

Web-Based Writing Intervention for Body Image–Related Distress in Women With Breast Cancer

In an Australian trial reported in the Journal of Clinical Oncology, Sherman et al found that use of a structured online writing exercise (My Changed Body) was associated with reduced body image distress and improved body appreciation among breast cancer survivors. Study Details My Changed...

bladder cancer
immunotherapy

Durvalumab in Locally Advanced or Metastatic Urothelial Carcinoma

Updated results of a phase I/II study of durvalumab (Imfinzi) in locally advanced or metastatic urothelial carcinoma were reported by Thomas Powles, MD, of Barts Cancer Institute, Queen Mary University of London, and colleagues in JAMA Oncology. Data from the ongoing study supported the recent...

skin cancer
immunotherapy

Study Finds Desmoplastic Melanoma Highly Responsive to PD-1/PD-L1 Blockade

Desmoplastic melanoma is a rare subtype of melanoma that is commonly found on sun-exposed areas, such as the head and neck, and usually seen in older patients. Treatment is difficult, as these tumors are often resistant to chemotherapy and lack actionable mutations commonly found in other types of...

hematologic malignancies
multiple myeloma

Role of Bone-Modifying Agents in Multiple Myeloma

As reported in the Journal of Clinical Oncology by Kenneth C. Anderson, MD, of Dana-Farber Cancer Institute, and colleagues, ASCO has issued a clinical practice guideline update on the role of bone-modifying agents in multiple myeloma.1 The update was performed by an expert panel systematic...

breast cancer
survivorship

Hormone Therapy and Diabetes Risk in Survivors of Breast Cancer

In an Israeli case-cohort study reported in the Journal of Clinical Oncology, Hamood et al found that hormone therapy in breast cancer survivors was associated with an increased risk of developing diabetes. The study involved a cohort of 2,246 women from the Leumit health-care fund diagnosed with...

breast cancer

Long-Term Quality-of-Life Results Compared for Two Radiotherapy Strategies After Breast-Conserving Surgery

As reported in The Lancet Oncology by Schäfer et al, little difference in quality of life was observed over long-term follow-up between women receiving accelerated partial-breast irradiation (APBI) with interstitial brachytherapy vs whole-breast irradiation (WBI) after breast-conserving...

skin cancer
immunotherapy

Nivolumab in Adjuvant Treatment of Melanoma

On December 20, 2017, nivolumab (Opdivo) was granted regular approval for adjuvant treatment of patients with melanoma with lymph node involvement or metastatic disease who have undergone complete resection.1,2 Nivolumab was previously approved for the treatment of patients with unresectable or...

hematologic malignancies
leukemia

Nilotinib Label Updated to Provide Treatment Discontinuation Recommendations for CML With Sustained Molecular Response

On December 22, 2017, the product label for nilotinib (Tasigna) was updated to include information on nilotinib discontinuation, postdiscontinuation monitoring, and guidance for treatment reinitiation in patients with Philadelphia chromosome (Ph)-positive chronic myeloid leukemia (CML) who have...

solid tumors
kidney cancer

Combined Immune Checkpoint and VEGF Inhibition as First-Line Therapy in Advanced Clear Cell Kidney Cancer

In a dose-finding, dose-expansion phase Ib trial (JAVELIN Renal 100) reported in The Lancet Oncology, Toni K. Choueiri, MD, of Dana-Farber Cancer Institute and Brigham and Women’s Hospital, and colleagues determined the maximum tolerated dose of the immune checkpoint inhibitor avelumab (Bavencio)...

lung cancer
immunotherapy

IL-15 Superagonist Plus Nivolumab in Advanced NSCLC

In a phase Ib trial reported in The Lancet Oncology, Wrangle et al found evidence of activity of the combination of nivolumab (Opdivo) and the interleukin (IL)-15 superagonist ALT-803 in patients with previously treated advanced non–small cell lung cancer (NSCLC). ALT-803 targets the shared...

breast cancer

Prediction of Late Distant Recurrence in Estrogen Receptor–Positive Breast Cancer After 5 Years of Endocrine Therapy

As reported in the Journal of Clinical Oncology, Dowsett et al have developed a clinicopathologic tool for predicting risk of late distant recurrence in estrogen receptor (ER)-positive breast cancer treated with 5 years of endocrine therapy. Study Details In the study, a prognostic score for...

gynecologic cancers

Proportion of Cancer Cell Nuclei With High Chromatin Entropy and Outcome in Gynecologic Cancers

In a study reported in the Journal of the National Cancer Institute, Nielsen et al found significant associations between higher proportions of cancer cell nuclei with high chromatin entropy (associated with genomic instability) and poorer outcomes in gynecologic cancers. Study Details In the...

breast cancer

Adverse Financial Impact of Breast Cancer for Black vs White Women

In a study reported in the Journal of Clinical Oncology, Wheeler et al found that black women experience significantly worse financial impact from breast cancer compared with white women, which may contribute to barriers to treatment compliance and worse outcomes. Study Details The...

lymphoma

Diagnosis-to-Treatment Interval and Outcome in Newly Diagnosed DLBCL

In a study reported in the Journal of Clinical Oncology, Maurer et al found that a shorter interval between diagnosis and treatment was associated with adverse prognostic features and that a longer interval was associated with greater event-free survival in the first-line treatment of diffuse large ...

issues in oncology

Characteristics of FDA-Designated Breakthrough and Nonbreakthrough Cancer Drugs

In a study reported in the Journal of Clinical Oncology, Hwang et al found little difference in the efficacy and safety of U.S. Food and Drug Administration (FDA)-designated breakthrough vs nonbreakthrough cancer drugs and found that breakthrough drugs were not more likely to represent a novel...

survivorship

Infection-Associated Late Mortality in Childhood Cancer Survivors Undergoing Splenectomy or Splenic Radiation

In a report from the Childhood Cancer Survivor Study published in the Journal of Clinical Oncology, Weil et al found that splenectomy and splenic radiation significantly increased the risk of infection-related late mortality among 5-year survivors of childhood cancer. Study Details The study...

breast cancer

Addition of Everolimus to Fulvestrant in HR-Positive, HER2-Negative, Aromatase Inhibitor–Resistant Metastatic Breast Cancer

In the phase II PrE0102 trial reported in the Journal of Clinical Oncology by Kornblum et al, the addition of everolimus to fulvestrant (Faslodex) improved progression-free survival in postmenopausal women with hormone receptor (HR)-positive, HER2-negative metastatic breast cancer resistant to...

colorectal cancer

Survival Analysis for Adjuvant Chemotherapy vs Observation After Pathologic Complete Response and Resection in Rectal Cancer

In a propensity-score matching analysis reported in JAMA Oncology, Polanco et al found that adjuvant chemotherapy was associated with a survival benefit vs observation among patients with locally advanced rectal cancer who underwent resection after pathologic complete response following neoadjuvant ...

prostate cancer

Concordance of Non–Low-Risk Prostate Cancer Among Brother Pairs

In a Swedish study reported in the Journal of Clinical Oncology, Jansson et al identified an increased risk of non–low-risk prostate cancer among men with prostate cancer who had with brothers diagnosed with non–low-risk disease. Study Details The study involved 4,262 pairs of...

kidney cancer

Results From AREN0533: Treating Higher-Risk Favorable-Histology Wilms Tumor

In a report from the Children’s Oncology Group AREN0533 study published in Journal of Clinical Oncology, Dix et al found improved survival outcomes with a modified approach to treatment of favorable-histology Wilms tumor with lung metastases. Study Details The National Wilms Tumor Study...

prostate cancer

Long-Term Outcomes of Adjuvant Treatment in High-Risk Prostate Cancer

As reported by Hussain et al in the Journal of Clinical Oncology, long-term follow-up of the phase III SWOG S9921 trial showed that the addition of adjuvant mitoxantrone and prednisone (MP) to androgen-deprivation therapy (ADT) did not improve survival and increased death from other malignancies in ...

breast cancer

Family History and Contralateral Breast Cancer Risk in Young Women

In an update from the WECARE (Women’s Environmental Cancer and Radiation Epidemiology) study reported in the Journal of Clinical Oncology, Reiner et al found that women with invasive breast cancer are at increased risk of contralateral breast cancer even in the absence of deleterious...

skin cancer
immunotherapy

Immune-Related Toxicity With Combination Immunotherapy for Melanoma

As reported in JAMA Oncology by Alexander N. Shoushtari, MD, of the Memorial Sloan Kettering Cancer Center, and colleagues, a single-center experience has shown a very high rate of clinically significant immune-related adverse events with nivolumab (Opdivo) plus ipilimumab (Yervoy) for advanced...

skin cancer
immunotherapy

Pembrolizumab vs Ipilimumab in Advanced Melanoma

The final overall survival analysis of the phase III KEYNOTE-006 trial showed maintained superiority of pembrolizumab (Keytruda) vs ipilimumab (Yervoy) in advanced melanoma. The results were reported by Jacob Schachter, MD, of the Ella Lemelbaum Institute for Melanoma, Sheba Medical Center, Tel...

lymphoma

Identification of Genetic Subtypes of Diffuse Large B-Cell Lymphoma

In a study reported in The New England Journal of Medicine, Schmitz et al identified four subtypes of diffuse large B-cell lymphoma (DLBCLs) with distinct genetic, epigenetic, and clinical characteristics that may be amenable to different therapeutic approaches. Study Details The study involved...

solid tumors

Morbidity in Testicular Cancer Survivors Treated With Standard Cisplatin-Based Chemotherapy

In a study reported in the Journal of Clinical Oncology, Kerns et al found that approximately 20% of testicular cancer survivors treated with cisplatin-based regimens had high cumulative burden of morbidity (CBM) scores and identified factors associated with risk for increased morbidity. Study...

kidney cancer

Phase II Study of Sunitinib Schedule in Metastatic Renal Cell Carcinoma

In a phase II study reported in the Journal of Clinical Oncology, Jonasch et al found evidence that a 2-weeks-on/1-week-off (2/1) schedule of sunitinib (Sutent) might be an option in frontline treatment of metastatic renal cell carcinoma. Study Details In the study, 59 patients with previously...

colorectal cancer

Adjuvant FOLFOX or CAPOX for 3 or 6 Months in Stage II or III Colon Cancer

As reported in the Journal of Clinical Oncology by Sobrero et al, the Italian phase III TOSCA trial did not demonstrate noninferiority of 3 vs 6 months of adjuvant CAPOX (capecitabine plus oxaliplatin) or FOLFOX (fluorouracil, leucovorin, and oxaliplatin) in relapse-free survival in stage II or...

solid tumors
issues in oncology

Postmarketing Label Modifications for Cancer Drugs Approved Without Supporting Randomized Controlled Trials

In a study reported in the Journal of Clinical Oncology, Shepshelovich et al found that cancer drugs approved by the U.S. Food and Drug Administration (FDA) for treatment of solid tumors without supporting randomized controlled trials were more likely to have postapproval safety-associated label...

gastroesophageal cancer
gastrointestinal cancer

Postoperative Chemotherapy vs Chemoradiotherapy in Resectable Gastric Cancer

In the Scandinavian phase III CRITICS trial reported in The Lancet Oncology, Cats et al found no benefit of postoperative chemoradiotherapy vs chemotherapy among patients with gastric cancer who had received neoadjuvant chemotherapy. Compliance with postoperative regimens was poor in both groups....

issues in oncology
survivorship

ASCO Clinical Practice Guideline Update: Fertility Preservation in Patients With Cancer

As reported in the Journal of Clinical Oncology by Kutluk Oktay, MD, PhD, of Yale University School of Medicine, and colleagues, ASCO has issued a clinical practice guideline update on fertility preservation in adults and children with cancer. The update was informed by an update panel systematic...

lymphoma
skin cancer

Reciprocal Risks of Lymphoid Neoplasms and Cutaneous Melanoma

In a study reported in the Journal of the National Cancer Institute, Herr et al found that patients with specific types of primary lymphoid neoplasms were at increased risk of second primary cutaneous melanoma, with the reciprocal association also being observed. Occurrence of second primary...

symptom management

Use of Indwelling Pleural Catheter for Outpatient Talc Administration in Treatment of Malignant Pleural Effusion

In a UK study reported in The New England Journal of Medicine, Bhatnagar et al found that outpatient talc vs placebo administration via indwelling pleural catheter was associated with a higher rate of pleurodesis in patients with malignant pleural effusion. Study Details In the study, a target of ...

lung cancer

Crizotinib in East Asian Patients With ROS1-Positive Advanced NSCLC

In a phase II study reported in the Journal of Clinical Oncology, Wu et al found that crizotinib (Xalkori) was highly active in East Asian patients with ROS1-positive advanced non­–small cell lung cancer (NSCLC). Study Details In the study, 127 patients from 37 sites in China, Japan,...

lung cancer
immunotherapy

AACR 2018: Pilot Study of Neoadjuvant Nivolumab in Resectable NSCLC

In a pilot study reported at the 2018 American Association for Cancer Research (AACR) Annual Meeting (Abstract CT079) and in The New England Journal of Medicine by Forde et al, neoadjuvant nivolumab therapy was found to be feasible and active in patients with resectable non–small cell lung...

lymphoma
immunotherapy

Axicabtagene Ciloleucel CAR T-Cell Therapy Active in Refractory Large B-Cell Lymphoma

As reported at the 2017 American Society of Hematology (ASH) Meeting & Exposition and in The New England Journal of Medicine by Sattva S. Neelapu, MD, of The University of Texas MD Anderson Cancer Center, and colleagues, a phase II trial has shown high activity of autologous anti-CD19 chimeric...

skin cancer
immunotherapy

AACR 2018: Adjuvant Pembrolizumab in High-Risk Stage III Melanoma

As reported at the 2018 American Association for Cancer Research (AACR) Annual Meeting (Abstract CT001) and in The New England Journal of Medicine by Eggermont et al, the phase III EORTC 1325/KEYNOTE 054 trial has shown that adjuvant pembrolizumab (Keytruda) significantly prolonged recurrence-free...

lung cancer
immunotherapy

AACR 2018: KEYNOTE-189: Addition of Pembrolizumab to Chemotherapy in Metastatic NSCLC

As reported at the American Association for Cancer Research (AACR) Meeting (Abstract CT075) in the The New England Journal of Medicine by Gandhi et al, the first interim analysis of the phase III KEYNOTE-189 trial has shown significant improvement in overall and progression-free survival with the...

lung cancer
immunotherapy

AACR 2018: CheckMate 227: Nivolumab/Ipilimumab vs Chemotherapy in NSCLC With High Tumor Mutational Burden Analysis

As reported at the 2018 American Association for Cancer Research (AACR) Meeting (Abstract CT077) and in The New England Journal of Medicine by Hellmann et al, an analysis from the phase III CheckMate 227 trial has shown that the combination of nivolumab (Opdivo) plus ipilimumab (Yervoy)...

bladder cancer
immunotherapy

Health-Related Quality-of-Life Analysis of Anti–PD-1 Therapy vs Chemotherapy in Advanced Urothelial Cancer

As reported by Vaughn et al in the Journal of Clinical Oncology, a health-related quality-of-life analysis from the phase III KEYNOTE-045 trial in previously treated advanced urothelial cancer showed that patients treated with the anti–programmed cell death protein 1 immunotherapy...

prostate cancer

Low-Dose Abiraterone With Food vs Standard-Dose Abiraterone in Castration-Resistant Prostate Cancer

In a phase II trial reported in the Journal of Clinical Oncology, Szmulewitz et al found that low-dose abiraterone (Zytiga) given with a low-fat meal was noninferior to standard-dose abiraterone in the fasting state with regard to reduction in prostate-specific antigen (PSA) levels among patients...

hepatobiliary cancer

Tivantinib in Second-Line Treatment of MET-High Advanced Hepatocellular Carcinoma

In the phase III METIV-HCC trial reported in The Lancet Oncology, Rimassa et al found no improvement in overall survival with the investigational MET inhibitor tivantinib vs placebo in patients with advanced hepatocellular carcinoma with high MET expression previously treated with sorafenib...

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