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issues in oncology

Racial/Ethnic Disparities in Cancer-Specific Survival in California

In a study using California Cancer Registry data reported in the Journal of Clinical Oncology, Ellis et al found that the stage at diagnosis was the greatest contributor to racial/ethnic disparities in cancer-specific survival, with neighborhood socioeconomic status and marital status also being...

gynecologic cancers

CD8-Positive Tumor-Infiltrating Lymphocytes and Survival in High-Grade Serous Ovarian Cancer

As reported in JAMA Oncology by Goode et al in the Ovarian Tumor Tissue Analysis Consortium, higher levels of cytotoxic CD8-positive tumor-infiltrating lymphocytes were associated with significantly improved overall survival among women with high-grade serous ovarian carcinomas. Study Details The ...

lung cancer

2-Year Survival Outcomes With Immunotherapy in Advanced NSCLC

Analysis of 2-year overall survival with nivolumab (Opdivo) vs docetaxel in the phase III CheckMate 017 and 057 trials showed a continued survival benefit with nivolumab in patients with previously treated advanced non–small cell lung cancer (NSCLC). The findings were reported by Horn et al...

breast cancer

Potential Risk Activities and Breast Cancer–Related Lymphedema in Patients Undergoing Bilateral Surgery

In a study reported in the Journal of Clinical Oncology, Asdourian et al found that several factors considered to pose an increased risk of lymphedema were not significantly associated with the occurrence of lymphedema among women undergoing bilateral breast cancer surgery. Study Details In the...

prostate cancer

Combination Therapy for Docetaxel-Pretreated Metastatic Castration-Resistant Prostate Cancer

The phase III AFFINITY trial has shown no survival benefit with the addition of the antisense oligonucleotide custirsen to cabazitaxel (Jevtana)/prednisone in patients with metastatic prostate cancer previously treated with docetaxel. These findings were reported in The Lancet Oncology by Beer et...

palliative care

Changes in Opioid Prescription for Cancer Patients Referred to Outpatient Palliative Care

In a study reported in the Journal of Oncology Practice, Haider et al found that the median morphine equivalent daily dose decreased significantly among cancer patients seen at MD Anderson Cancer Center’s outpatient palliative care clinic between 2010 and 2015. Use of hydrocodone decreased...

hematologic malignancies

Anti–T-Lymphocyte Globulin and Chronic GVHD-Free Survival in Unrelated Myeloablative HCT

A double-blind phase III trial has shown no benefit of anti–T-lymphocyte globulin (ATLG) vs placebo on chronic graft-vs-host disease (GVHD)-free survival in patients undergoing human leukocyte antigen (HLA)-matched unrelated myeloablative hematopoietic cell transplantation (HCT). The study...

breast cancer

Extended Aromatase Inhibitor Therapy After Sequential Endocrine Therapy

In the Dutch phase III DATA trial reported in The Lancet Oncology by Tjan-Heinjen et al, a nonsignificant disease-free survival advantage was found for 6 vs 3 years of adjuvant aromatase inhibitor therapy after 2 to 3 years of tamoxifen in hormone receptor–positive early breast cancer....

breast cancer

MAF Amplification and Outcomes With Adjuvant Zoledronic Acid in Early Breast Cancer

An analysis from the phase III AZURE trial has shown that MAF-negative status was associated with a benefit and MAF-positive status, with a detriment of adjuvant zoledronic acid in early breast cancer. The analysis was reported by Coleman et al in The Lancet Oncology. Study Details The current...

skin cancer

Long-Term Outcomes With BRAF and MEK Inhibition in BRAF V600–Mutant Metastatic Melanoma

As reported by Long et al in the Journal of Clinical Oncology, a 5-year landmark analysis of patients receiving dabrafenib (Tafinlar) and trametinib (Mekinist) for BRAF V600–mutant metastatic melanoma shows persistent overall and progression-free survival benefits. Study Details The...

kidney cancer

Enhancer of Zeste Homolog 2 Expression and Prognosis in Localized Renal Cell Carcinoma

As reported in the Journal of Clinical Oncology, Ho et al found that tumor-based enhancer of zeste homolog 2 (EZH2) gene or protein expression was independently predictive of prognosis in localized clear cell renal cell carcinoma. EZH2 is a chromatin remodeler implicated in the pathogenesis of...

cns cancers
survivorship

Predicting Risk of Subsequent CNS Tumors in Survivors of Childhood Cancer

As reported in the Journal of Clinical Oncology, Wang et al have developed a model for predicting risk of subsequent central nervous system (CNS) tumors in survivors of childhood cancer. Study Details In the study, matched childhood cancer survivors with (n = 82) and without (n = 228) subsequent...

multiple myeloma

Carfilzomib Improves Overall Survival vs Bortezomib in Relapsed/Refractory Multiple Myeloma

AT A PRESPECIFIED interim analysis, the phase III ENDEAVOR trial has shown a significant overall survival benefit for carfilzomib (Kyprolis) vs bortezomib (Velcade) in patients with relapsed/refractory multiple myeloma, as reported by Meletios A. Dimopoulos, MD, of the National and Kapodistrian...

skin cancer

Regional Radiation Therapy Reduces Risk of Regional Recurrence in Node-Positive Cutaneous Melanoma

IN A LARGE single-institution study reported in the Journal of the National Comprehensive Cancer Network, Tobin Strom, MD, and colleagues found that regional radiotherapy was associated with a reduced risk of regional recurrence in patients with node-positive cutaneous melanoma, including those...

lung cancer

No Progression-Free Survival Benefit With First-Line Nivolumab vs Chemotherapy in Advanced PD-L1–Positive NSCLC

AS REPORTED BY David P. Carbone, MD, PhD, of The Ohio State University Comprehensive Cancer Center, Columbus, and colleagues in The New England Journal of Medicine, the phase III CheckMate 026 trial has shown no progression-free survival benefit for first-line nivolumab (Opdivo) vs platinum-based...

lung cancer

Phase III Trial Shows No Survival Benefit to Adding First-Line Ipilimumab to Chemotherapy in Advanced Squamous NSCLC

IN A PHASE III trial reported by Ramaswamy Govindan, MD, of Washington University School of Medicine, and colleagues in the Journal of Clinical Oncology, the addition of first-line ipilimumab (Yervoy) to paclitaxel/carboplatin did not improve overall survival in patients with advanced squamous...

symptom management

ASCO Clinical Practice Guideline Update on Antiemetics in Patients With Cancer

AS REPORTED BY Paul J. Hesketh, MD, of Lahey Hospital and Medical Center, Burlington, Massachusetts, and colleagues in the Journal of Clinical Oncology, ASCO has updated its clinical practice guideline on the use of antiemetics in patients with cancer.1 The update was based on an expert panel...

skin cancer

Nivolumab/Ipilimumab in Patients With Advanced Melanoma Who Did or Did Not Discontinue Induction Treatment due to Adverse Events

IN A RETROSPECTIVE pooled analysis of the CheckMate 069 and 067 studies reported in the Journal of Clinical Oncology, Dirk Schadendorf, MD, of the University Hospital Essen and the German Cancer Consortium, and colleagues found little difference in the efficacy of combined nivolumab (Opdivo) and...

solid tumors
lung cancer

Tremelimumab in Previously Treated Advanced Malignant Mesothelioma

In the randomized phase IIB DETERMINE trial, the cytotoxic T-lymphocyte–associated protein 4 (CTLA-4) inhibitor tremelimumab did not improve overall survival vs placebo as second- or third-line treatment of relapsed malignant mesothelioma. These findings were reported in The Lancet Oncology by...

skin cancer

Nivolumab Treatment Beyond Disease Progression in Advanced Melanoma

In a retrospective analysis reported in JAMA Oncology, Georgina V. Long, MBBS, PhD, of the Melanoma Institute Australia, North Sydney, and colleagues found that a substantial proportion of patients with advanced melanoma derived benefit from continued nivolumab (Opdivo) treatment after Response...

supportive care

Sperm Banking for Adolescent Males With Newly Diagnosed Cancer

In a study reported in the Journal of Clinical Oncology, Klosky et al identified factors associated with sperm banking among adolescent males with newly diagnosed cancer who were at increased risk for treatment-related fertility loss. The study included 146 adolescents aged 13 to 22 years (mean...

gastrointestinal cancer

Survival in Patients Treated With Adjuvant Chemoradiotherapy After Resection of Gastric Cancer

In the CALGB 80101/Alliance trial, no difference in overall survival was found for adjuvant chemoradiotherapy with epirubicin, cisplatin, and fluorouracil (ECF) vs fluorouracil and leucovorin (5-FU/LV) after curative resection of gastric cancer. The findings were reported in the Journal of Clinical ...

sarcoma

Immunotherapy for Advanced Soft-Tissue and Bone Sarcoma

The phase II SARC028 trial has shown activity of pembrolizumab (Keytruda) in some subtypes of advanced sarcoma. These findings were reported by Tawbi et al in The Lancet Oncology. Study Details In the study, 84 patients with advanced soft-tissue sarcoma aged ≥ 18 years (n = 42) or bone sarcoma ...

skin cancer

Combination Therapy for Patients With Advanced Unresectable Melanoma

A phase II study has shown that the addition of the oncolytic viral agent talimogene laherparepvec (Imlygic) to ipilimumab (Yervoy) significantly increased the response rate in patients with advanced unresectable melanoma. These findings were reported in the Journal of Clinical Oncology by Chesney...

lung cancer

Outcomes in Patients With Metastatic Lung Cancer Receiving PD-1/PD-L1 Inhibitors With Thoracic Radiotherapy

In a research letter to JAMA Oncology, Hwang et al detailed the outcomes of patients with metastatic lung cancer receiving an inhibitor of programmed cell death protein 1 (PD-1) or its ligand (PD-L1) with or without thoracic radiotherapy at Massachusetts General Hospital. Study Details The...

lymphoma

PI3K Inhibition in Relapsed or Refractory Indolent Lymphoma

As reported in the Journal of Clinical Oncology by Dreyling et al, the phase II CHRONOS-1 trial has shown a high response rate and durable responses with the phosphatidylinositol 3-kinase (PI3K) inhibitor copanlisib (Aliqopa) in adults with relapsed or refractory indolent lymphoma who had received...

breast cancer

Long-Term Use of Long-Acting Insulin Analogs and Breast Cancer Risk in Type 2 Diabetes

A study in the UK population has shown that long-term use of the long-acting insulin glargine was associated with increased risk of breast cancer among women with type 2 diabetes. The findings were reported by Wu et al in the Journal of Clinical Oncology. Study Details The study involved a...

gastrointestinal cancer

Immunotherapy for Previously Treated Advanced Gastric Cancer

In an Asian phase III trial (ONO-4538-12, ATTRACTION-2) reported in The Lancet, Kang et al found that nivolumab (Opdivo) produced an improvement in overall survival vs placebo in patients with advanced gastric or gastroesophageal junction cancer who had disease refractory to or who were intolerant...

skin cancer

Single-Center Study of Adjuvant Beta-Blocker Therapy for Cutaneous Melanoma

An Italian single-center prospective cohort study suggests that adjuvant treatment with the beta-blocker propranolol significantly reduces the risk of melanoma recurrence in patients with stage IB to IIIA cutaneous disease. The findings were reported in JAMA Oncology by De Giorgi et al. Preclinical ...

lymphoma

Maintenance Therapy After ASCT in Younger Patients With Mantle Cell Lymphoma

In a French phase III trial, maintenance rituximab (Rituxan) improved event-free survival vs observation after autologous stem cell transplantation (ASCT) in younger patints with mantle cell lymphoma. These findings were reported by Le Gouill et al in The New England Journal of Medicine. Study...

lung cancer

Addition of EGFR Tyrosine Kinase Inhibitor to Chemotherapy in Resistant Non–Small Cell Lung Cancer

As reported by Mok et al in the Journal of Clinical Oncology, overall survival analysis of the phase III IMPRESS trial indicated a poorer outcome when adding gefitinib (Iressa) vs placebo to chemotherapy after disease progression on first-line gefitinib in epidermal growth factor receptor...

solid tumors

Incidence of Endocrine Dysfunction With Immune Checkpoint Inhibitors

In a systematic review and meta-analysis reported in JAMA Oncology, Barroso-Sousa et al evaluated the incidence of endocrine dysfunction in patients receiving currently approved immune checkpoint inhibitors for various advanced solid tumors. Patients who received combination therapy were found to...

bladder cancer

First-Line Immunotherapy for Cisplatin-Ineligible Patients With Advanced Urothelial Cancer

As reported in The Lancet Oncology by Balar et al, first-line pembrolizumab (Keytruda) produced durable responses in cisplatin-ineligible patients with locally advanced and unresectable or metastatic urothelial cancer in the phase II KEYNOTE-052 trial. The trial supported the accelerated approval...

gastroesophageal cancer

Adjuvant Chemotherapy vs Observation After Preoperative Chemoradiotherapy and Resection in Gastroesophageal Cancer

In a propensity score–matched analysis reported in JAMA Oncology, Mokdad et al found that adjuvant chemotherapy had a survival benefit vs observation after preoperative chemoradiotherapy and resection in patients with locally advanced gastroesophageal cancer. Study Details The study...

lymphoma

Baseline Cardiovascular and Heart Failure Risks in Non-Hodgkin Lymphoma Survivors

In a study in the Danish population reported in the Journal of Clinical Oncology, Salz et al found that preexisting cardiovascular conditions were associated with an increased risk of heart failure in survivors of aggressive non-Hodgkin lymphoma (NHL). The standard use of anthracycline chemotherapy ...

breast cancer

Initial Treatment With CDK4/6 Inhibitor and Aromatase Inhibitor for Advanced Breast Cancer

As reported in the Journal of Clinical Oncology by Goetz et al, an interim analysis in the phase III MONARCH 3 trial has shown a significant progression-free survival benefit with the addition of the cyclin-dependent kinase (CDK) 4/6 inhibitor abemaciclib (Verzenio) to a nonsteroidal aromatase...

prostate cancer

Comorbidity and Prostate Cancer–Specific and Other-Cause Mortality

A Swedish population-based observational study has shown that comorbidity is a significant factor in other-cause but not prostate cancer–specific mortality after adjustment for patient, tumor, and treatment factors among men with prostate cancer. The findings were reported in the Journal of...

lung cancer

Immune-Related Adverse Events and Outcomes With Immunotherapy for NSCLC

In a Japanese analysis reported in JAMA Oncology, Haratani et al found that development of immune-related adverse events was associated with improved survival among patients receiving nivolumab (Opdivo) for advanced or recurrent non–small cell lung cancer (NSCLC). Study Details The study...

colorectal cancer

Nivolumab in MSI-H or dMMR Metastatic Colorectal Cancer

ON JULY 31, 2017, nivolumab (Opdivo) was granted accelerated approval for treatment of patients 12 years and older with DNA mismatch repair–deficient (dMMR) and microsatellite instability– high (MSI-H) metastatic colorectal cancer progressing following treatment with a fluoropyrimidine,...

colorectal cancer

Nivolumab in Advanced DNA Mismatch Repair–Deficient or Microsatellite Instability–High Colorectal Cancer

THE PHASE II CHECKMATE 142 TRIAL has shown that nivolumab (Opdivo) produces durable responses in previously treated recurrent or metastatic DNA mismatch repair–deficient (dMMR)/ microsatellite instability–high (MSI-H) colorectal cancer. These study findings were reported in The Lancet Oncology...

skin cancer

Overview of the Phase III MSLT-II Trial

THE PHASE III MSLT- II TRIAL showed that completion dissection was not associated with improved melanoma-specific overall survival vs observation in patients with sentinel-node metastasis, although a benefit was observed in regional disease control. The findings were reported in The New England...

pain management

Ontario Province–Wide Symptom Screening and Opioid Prescribing Rates in Older Patients With Cancer

In a study reported in the Journal of Oncology Practice, Barbera et al found that a province-wide effort to improve symptom screening and management has increased the frequency of screening but has not improved opioid prescription rates in elderly cancer patients with severe pain. A previous study...

hematologic malignancies

Momelotinib vs Ruxolitinib in Janus Kinase Inhibitor–Naive Myelofibrosis

In the phase III SIMPLIFY-1 noninferiority trial reported in the Journal of Clinical Oncology, Mesa et al found that the selective Janus kinase (JAK) 1 and 2 inhibitor momelotinib was noninferior to ruxolitinib (Jakafi) in spleen response, but not symptom response, in JAK inhibitor–naive...

palliative care

Inpatient Palliative Care During HCT and Psychological Distress After Transplantation

In a single-center study reported in the Journal of Clinical Oncology, El-Jawahri et al found that inpatient palliative care during hematopoietic stem cell transplantation was associated with improvement in depression and post-traumatic stress disorder (PTSD) symptoms at 6 months after...

lung cancer

Comparison of First-Line Treatments for EGFR-Mutant NSCLC

The phase III ARCHER 1050 trial has shown superior progression-free survival with the second-generation irreversible epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor dacomitinib vs gefitinib (Iressa) in the first-line treatment of advanced EGFR-mutant non–small cell lung...

lung cancer

Consolidative Radiotherapy for Limited Metastatic NSCLC

In a single-institution phase II trial reported in JAMA Oncology, Iyengar et al found that consolidative stereotactic ablative radiotherapy improved progression-free survival vs maintenance therapy alone in patients with limited metastatic non–small cell lung cancer (NSCLC). Study Details...

breast cancer

10-Year Survival With vs Without Axillary Dissection in Invasive Breast Cancer With Sentinel-Node Metastasis

As reported in JAMA by Giuliano et al, 10-year overall survival in the ACOSOG Z0011 (Alliance) trial with sentinel lymph node dissection (SLND) alone was noninferior to that with axillary lymph node dissection (ALND) in women with clinical T1 or T2 invasive breast cancer, no palpable axillary...

solid tumors
head and neck cancer
gastroesophageal cancer

Addition of Cetuximab to Concurrent Chemoradiation in Esophageal Cancer

The phase III NRG Oncology RTOG 0436 trial has shown no survival benefit of adding cetuximab (Erbitux) to paclitaxel/cisplatin and radiation therapy in patients with esophageal cancer treated without surgery. These results were reported by Mohan Suntharalingam, MD, MBA, of the Marlene and Stewart...

skin cancer

Pooled Analysis Safety Profile of Combination Immunotherapy for Advanced Melanoma

In a retrospective study reported in the Journal of Clinical Oncology, Sznol et al have provided a pooled safety profile of combination nivolumab (Opdivo) and ipilimumab (Yervoy) treatment in patients with advanced melanoma. Study Details The study included data from 448 patients from a phase Ib...

gastrointestinal cancer

Addition of MET Inhibitor to First-Line Chemotherapy in Advanced Gastric Cancer

The phase III RILOMET-1 trial showed no survival benefit of adding the MET inhibitor rilotumumab to first-line epirubicin, cisplatin, and capecitabine in patients with advanced MET-positive gastric or gastroesophageal junction adenocarcinoma. These results were reported in The Lancet Oncology by...

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