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gastrointestinal cancer

Circulating Tumor DNA: A Prognostic Marker in Stage III Colon Cancer?

Circulating tumor DNA in the blood could serve as a marker of prognosis in patients with colon cancer receiving adjuvant oxaliplatin, according to a subanalysis of the IDEA trial, presented at the European Society for Medical Oncology (ESMO) Congress 2019.1 After 2 years of adjuvant...

multiple myeloma

Selinexor/Dexamethasone in Refractory Multiple Myeloma: The STORM Has Arrived, but Does It Represent Climate Change?

The term “relapsed/refractory multiple myeloma” is often used to describe advanced myeloma that has progressed through primary or salvage therapy. The International Myeloma Working Group (IMWG) defined the term in 2011 as disease that is “nonresponsive while on salvage therapy or progresses...

breast cancer

ASCO Updates Breast Cancer Risk Reduction Guideline to Include Anastrozole

ASCO has updated a guideline on pharmacologic interventions for breast cancer risk reduction in postmenopausal women at increased risk of developing breast cancer.1 The original clinical practice recommendations for breast cancer risk reduction were published in 1999 and updated in 2002, 2009, and...

Prescribing Hope

“There is no medicine like hope, no incentive so great, and no tonic so powerful as expectation of something tomorrow.” –Orison Swett Marden I was informed that my patient, a 58-year-old man recently diagnosed with pancreatic cancer, and his wife were becoming impatient waiting for me in the exam...

hematologic malignancies
immunotherapy

Answers to Hematology Expert Review Questions

Question 1 Which of the following statements about cytokine-release syndrome and neurotoxicity after tisagenlecleucel infusion is correct? Correct answer: B. The median time to onset of cytokine-release syndrome is 3 days. Expert Perspective Following tisagenlecleucel infusion, cytokine-release...

Friends of Cancer Research Launches ctDNA Pilot Project

Friends of Cancer Research (Friends) recently announced the launch of its latest project, ctMoniTR. This pilot project will aim to harmonize the use of circulating tumor DNA (ctDNA) to monitor treatment response in patients with cancer and test the feasibility of data comparison from different...

leukemia

Glasdegib in Older Patients With AML or Those With Comorbidities

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. Late in 2018, the Hedgehog pathway inhibitor glasdegib...

Expert Point of View: Sanjay Popat, FRCP, PhD

Formal discussant of the CheckMate 227 trial, Sanjay Popat, FRCP, PhD, of the Royal Marsden Hospital, London, had some reservations about endorsing nivolumab/ipilimumab as a new standard of care, mainly related to toxicity. “The landscape of treating advanced non–small cell lung cancer has changed ...

skin cancer

MicroRNA Panel Could Aid in the Detection of Uveal Melanoma

A blood test could soon become a monitoring tool for the early detection of uveal melanoma. Stark et al discovered markers in the blood that can differentiate between a benign mole and a melanoma, while also determining whether the cancer has metastasized, according to findings they published in...

issues in oncology

Mental Health Outcomes in Mothers and Siblings of Children With Cancer

In a Canadian study reported in the Journal of Clinical Oncology, van Warmerdam et al found that mothers and siblings of children with cancer were significantly more likely to have mental health–related outpatient health-care contacts than their general population counterparts. The study involved...

solid tumors

Machine Learning Algorithm for Genome-Derived Prediction of Tumor Type

In a study reported in JAMA Oncology, Penson et al developed a machine learning algorithmic classifier that may be successful in identifying tumor type and origin based on DNA-sequence data obtained at point of care. The study used machine learning to construct and train an algorithmic classifier...

Nivolumab Plus Bevacizumab for Relapsed Ovarian Cancer

According to findings from a phase II trial, the combination of nivolumab and bevacizumab has shown activity in relapsed ovarian cancer—we discuss those findings reported in JAMA Oncology. Next, we’ll move on to a session from CHEST 2019 which outlined palliation techniques that may be of use to...

issues in oncology
pain management

Opioid Prescriptions in Patients With Cancer in Southwest Virginia

In a study in residents of rural southwest Virginia reported in the Journal of Oncology Practice, Virginia T. LeBaron, PhD, and colleagues found that most patients with cancer never received a prescription opioid medication, that few patients were admitted to hospital for opioid use disorders, and...

leukemia
lymphoma

FDA Approves Acalabrutinib for CLL/SLL as Part of Project Orbis

On November 21, as part of Project Orbis—a collaboration with the Australian Therapeutic Goods Administration (TGA) and Health Canada—the U.S. Food and Drug Administration (FDA) granted supplemental approval to acalabrutinib (Calquence) for the treatment of adults with chronic lymphocytic leukemia...

lung cancer

What Is the Best Palliation for End-Stage Lung Cancer?

Patients with advanced lung cancer can experience burdensome symptoms at the end of life. Pulmonologists can alleviate some of this suffering, but it’s a balancing act between doing too much and not enough, according to specialists who spoke at CHEST 2019, the annual meeting of the American College ...

issues in oncology

Two Societies Issue Statements on E-Cigarettes

Today, the American Cancer Society (ACS) announced an update to the organization’s position on e-cigarettes, and the American Medical Association (AMA) called for a total ban on all e-cigarette and vaping products that do not meet U.S. Food and Drug Administration (FDA) approval as cessation ...

leukemia

Late Bone Marrow Relapse Risk Stratification in Pediatric Patients With B-Cell Acute Lymphoblastic Leukemia

In an analysis of the German ALL-REZ BFM 2002 trial, reported in the Journal of Clinical Oncology, Eckert et al found that postinduction minimal residual disease (MRD)-based treatment stratification resulted in “excellent survival” in pediatric patients with late relapse of B-cell precursor acute...

issues in oncology
pain management

Prescribed Opioid Use and Infection Risk in Patients With Cancer and Treatment-Associated Neutropenia

In a German study reported in a research letter in JAMA Internal Medicine, Jakob et al found that prescribed opioid use did not appear to increase risk of infection in hospitalized patients with cancer who developed treatment-associated neutropenia. According to the investigators, recent data have...

breast cancer

Study Finds Sexual Health Issues Are a Concern Among Majority of Women With Breast Cancer

Endocrine therapy has been a lifesaver for women with estrogen receptor–positive breast cancer, but decreases in recurrence and cancer-related mortality have come with substantial side effects, according to data presented at the 2019 Supportive Care in Oncology Symposium.1 The results of a...

integrative oncology

Boswellia

The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies sometimes used by patients with cancer. In this installment, Gary Deng, MD, PhD, and Jyothirmai Gubili, MS, focus on the herbal extract...

gastrointestinal cancer

Maximizing Benefit in the Treatment of Immune-Mediated Colitis

Immune-related colitis is the second most common toxicity associated with checkpoint inhibitors, affecting up to 40% of patients. The ASCO Post interviewed Yinghong Wang, MD, PhD, Director of Medication-Induced Colitis and Enteritis, Director of Fecal Microbiota Transplantation, and Associate...

lymphoma
immunotherapy

Polatuzumab Vedotin Plus Bendamustine/Rituximab for Transplantation-Ineligible Relapsed or Refractory DLBCL

In a phase Ib/II trial reported in the Journal of Clinical Oncology, Laurie H. Sehn, MD, MPH, and colleagues found that the addition of polatuzumab vedotin to bendamustine/rituximab improved response rate and progression-free and overall survival among transplantation-ineligible patients with...

Expert Point of View: Eduardo Bruera, MD, FAAHPM

Eduardo Bruera, MD, FAAHPM, Chair of the Department of Palliative, Rehabilitation, and Integrative Medicine at The University of Texas MD Anderson Cancer Center, Houston, explained the rationale behind this treatment approach. “We know that the tumor mass and the tumor function talk to the brain...

symptom management

Dexamethasone Plus Exercise May Reduce Fatigue in Patients With Advanced Cancer

A novel treatment approach may help to alleviate one of the most common and debilitating symptoms associated with cancer and its treatments—fatigue. According to data presented at the 2019 Supportive Care in Oncology Symposium,1 the combination of short-course dexamethasone plus standardized...

gastrointestinal cancer

Pivotal Phase III Study Evaluates Investigational TKI in Fourth-Line Setting for Advanced GIST

In a late-breaking, oral presentation at the ESMO Congress 2019, Margaret von Mehren, MD, presented results from ­INVICTUS, a pivotal phase III clinical trial of ripretinib in patients with advanced gastrointestinal stromal tumor (GIST).1 Ripretinib is an investigational tyrosine kinase inhibitor...

hepatobiliary cancer

Oral Direct-Acting Antiviral Therapy May Improve Survival in Patients With Hepatitis C Virus–Related HCC

Data from a new study presented by Dang et al at The Liver Meeting (Abstract 40) found that patients with hepatitis C virus–related hepatocellular carcinoma (HCC) who achieved sustained virologic response (denoting an undetectable level of the virus) with any oral direct-acting antiviral therapy...

Expert Point of View: Sanjay Popat, FRCP, PhD

Formal discussant of the CheckMate 227 trial, Sanjay Popat, FRCP, PhD, of the Royal Marsden Hospital, London, had some reservations about endorsing nivolumab/ipilimumab as a new standard of care, mainly related to toxicity. “The landscape of treating advanced non–small cell lung cancer has changed ...

gynecologic cancers

Phase III Trials Suggest Paradigm Shift With PARP Inhibitors in Ovarian Cancer

At the ESMO Congress 2019, ovarian cancer was a topic of heightened interest, particularly due to findings reported in several important phase III studies of PARP inhibitors in front-line maintenance therapy for patients with newly diagnosed advanced disease—and not just those with BRCA mutations....

New JCO CCI Article Discusses Difficulties in Gathering Real-World Evidence

A new JCO Clinical Cancer Informatics (JCO CCI) article highlights the challenges in—and need for—obtaining real-world evidence for assessing the effectiveness of precision medicine on areas such as survival, quality of life, cost, and health disparities. The paper, titled “Clinical Molecular...

Advocates Urge Action on Cancer Care Access at ASCO Advocacy Summit

At the 2019 ASCO Advocacy Summit, ASCO members from 35 states held more than 160 Congressional meetings, urging members of Congress to take action to advance policy priorities that improve patient access to cancer care, including: The Covering Life-Saving Investigations Needed in Cancer and Other...

Cancer.Net: Physician-Generated Content for Patients With Cancer Worldwide

Receiving a cancer diagnosis is a disorienting moment for our patients who are then faced with making difficult decisions regarding their treatment. In order to improve shared decision-making and to increase patient involvement in their care, it is essential to provide patients and their families...

gynecologic cancers

Expert Point of View: Ana Oaknin, MD, PhD

Ana Oaknin, MD, PhD, Head of the Gynecologic Cancer Program at Vall d’Hebron Institute of Oncology, Barcelona, discussed the PRIMA/ENGOT-OV26/GOG-3012 trial along with the results of the phase III PAOLA-1/ENGOT-ov25 trial of olaparib plus bevacizumab maintenance. According to Dr. Oaknin, the...

hematologic malignancies

Fedratinib: Back From ­Development Limbo for the Treatment of ­Myeloproliferative Neoplasms

In September 2019, Dr. Claire Harrison and colleagues, myself among them, presented two new analyses regarding the use of the JAK2 and FLT3 inhibitor fedratinib in myelofibrosis at the Society of Hematologic Oncology (SOHO) Annual Meeting, with resulting publication in Clinical Lymphoma, Myeloma...

leukemia
lymphoma

Venetoclax for Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma

On May 15, 2019, venetoclax was approved for the treatment of adult patients with previously untreated chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL).1,2 Supporting Efficacy Data Approval was based on findings from the open-label phase III CLL14 trial (ClinicalTrials.gov...

ASTRO and ACR Update Practice Parameters for Radiation Therapies

The American Society for Radiation Oncology (ASTRO) and the American College of Radiology (ACR) recently released seven updated practice parameters for medical providers who use radiation therapy to treat patients with cancer. The updated practice parameters synthesize the clinical best practices...

lung cancer
issues in oncology

Early Lung Cancer Detection Followed by Minimally Invasive Surgery Saves Lives

Lung cancer remains the number one cancer killer, leading to about 150,000 deaths per year in the United States and accounting for approximately 25% of all cancer deaths in the nation. Early detection has improved survival in other malignancies such as breast, colon, and cervical cancers, but...

pancreatic cancer

Management of Locally Advanced Pancreatic Cancer: A Call for Action

Advances in systemic therapy and supportive care, as well as ongoing improvements in surgical techniques, have led to improved survival for many patients with pancreatic ductal adenocarcinoma. We have observed increased survival with FOLFIRINOX (leucovorin, fluorouracil, irinotecan,...

issues in oncology

The Oncology Care Model and Quality of Care: Defining, Measuring, and Implementing New Approaches to Cancer Care

The Oncology Care Model was instituted in 2016 by the Center for Medicare & Medicaid Innovation as a move away from the fee-for-service payment model and toward value-based care. It has sparked discussion ever since. How should quality be defined? Whose and what values should it reflect? How...

prostate cancer

Third-Line Cabazitaxel Improves Outcomes in Patients With Metastatic Prostate Cancer

Third-line treatment with cabazitaxel extended progression-free survival and overall survival in men with metastatic castration-resistant prostate cancer in the CARD trial. These results provide the first evidence from a randomized phase III trial for a survival benefit with third-line therapy, and ...

head and neck cancer

Remembering Craig Alguire

It is with great sadness that we report Craig Alguire, MD, 42, died on October 11, 2019, at his home in Grand Rapids, Michigan. Diagnosed with grade 4 glioblastoma multiforme in 2015, Dr. Alguire chronicled the effects the cancer was having on his life in his Patient’s Corner column, published in...

gynecologic cancers

Expert Point of View: Mansoor R. Mirza, MD

The time has come to offer all patients a PARP [poly (ADP-ribose) polymerase] inhibitor,” said Mansoor R. Mirza, MD, Chief Oncologist at Copenhagen University Hospital and the invited discussant of the VELIA trial at the ESMO Presidential Symposium. He noted, however, that he wasn’t sure veliparib...

gynecologic cancers

Veliparib Plus Chemotherapy Meets Primary Endpoint in Advanced Ovarian Cancer

As first-line treatment for women with advanced ovarian cancer, the addition of veliparib during induction followed by veliparib maintenance therapy significantly reduced the risk of disease progression or death in the phase III VELIA/GOG-3005 trial reported at the European Society for Medical...

gynecologic cancers

2019 NCRI: CA125 Testing May Help General Practitioners to Detect Ovarian Cancer

Testing for levels of the serum biomarker cancer antigen 125 (CA125) in the blood may be a useful tool for the detection of ovarian cancer, and could help detect other types of cancer among patients in primary care, according to research presented by Funston et al at the 2019 National Cancer...

colorectal cancer

2019 NCRI: Use of Mendelian Randomization to Determine Role of Human Gut Microbiome in Colorectal Cancer Development

A study using a technique called Mendelian randomization to investigate the causal role played by bacteria in the development of colorectal cancer was presented at the 2019 National Cancer Research Institute (NCRI) Cancer Conference. First study author Kaitlin Wade, PhD, of the University of...

How Patients Add Life to Their Days

The ASCO Post is pleased to reproduce installments of the Art of Oncology as published previously in the Journal of Clinical Oncology. These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

multiple myeloma

Daratumumab Combination Therapy for Patients With Multiple Myeloma Who Are Eligible for Transplantation

On September 26, 2019, daratumu-mab (Darzalex) was approved in combination with bortezomib, thalidomide, and dexamethasone for the treatment of multiple myeloma in newly diagnosed adult patients eligible for autologous stem cell transplantation (ASCT).1,2 Supporting Efficacy Data Approval was based ...

survivorship

The Role of Oncologists in Helping Cancer Survivors to Quit Smoking

Several oncology organizations have created guidelines for oncology specialists to help patients with cancer to quit smoking. ASCO has far-reaching goals aimed at tobacco reduction, including cessation tools and other resources. To shed light on the current work in this area, The ASCO Post spoke...

kidney cancer
immunotherapy

Immunotherapy Combinations Redefine Outcomes for Patients With Advanced Renal Cell Carcinoma

The treatment landscape for patients with advanced renal cell carcinoma has changed drastically over the past several years with the introduction of many new therapeutic options for patients. The revolution began with the U.S. Food and Drug Administration (FDA) approval of nivolumab and ipilimumab...

myelodysplastic syndromes

Personalized Treatment Approaches on the Horizon for Myelodysplastic Syndromes

Despite the spate of recent drug approvals in blood cancer, it’s been more than 13 years since the U.S. Food and Drug Administration (FDA) has approved a treatment for myelodysplastic syndromes (MDS), a bone marrow disorder characterized by ineffective hematopoiesis. Nevertheless, data from a...

hepatobiliary cancer

Studies Report Efficacy of Proton Radiotherapy for Hepatocellular Carcinoma

Two new studies published in the International Journal of Radiation Oncology • Biology • Physics focused on the use of proton radiation therapy to treat patients with hepatocellular carcinoma. The first study, by Sanford et al, found that proton radiation may extend overall survival compared to...

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