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breast cancer

Breast Cancer Screening With Addition of MRI to Mammography in Women With Familial Risk

The Dutch FaMRIsc study, reported in The Lancet Oncology by Saadatmand et al, found that the addition of screening magnetic resonance imaging (MRI) to mammography resulted in identification of more breast cancers—and identification at an earlier stage—vs mammography alone among women...

prostate cancer

Failure-Free Survival With Ultrahypofractionated vs Conventionally Fractionated Radiotherapy in Prostate Cancer

In the Scandinavian phase III HYPO-RT-PC trial reported in The Lancet, Widmark et al found that ultrahypofractionated radiotherapy was noninferior to conventionally fractionated radiotherapy in failure-free survival in patients with intermediate- to high- risk prostate cancer. Study Details In...

immunotherapy
head and neck cancer

Immune Therapies Emerging in Disease-Specific Treatment of HPV-Positive Head and Neck Cancer

Patients with human papillomavirus (HPV)-related head and neck cancer stand to benefit greatly from immunotherapy, according to Nabil F. Saba, MD, FACP, Director, Head and Neck Medical Oncology Program, Winship Cancer Institute of Emory University, Atlanta. He added, immunotherapy will likely play...

issues in oncology

ASCO Launches Task Force to Address the Cancer Care Gap in Rural America

Despite progress being made in cancer survivorship—there are currently nearly 17 million cancer survivors in the United States1—not everyone is benefiting equally, especially those patients living in rural communities across America. According to “The State of Oncology Practice in America, 2018:...

head and neck cancer
immunotherapy

Expert Point of View: Vanita Noronha, MD

The KEYNOTE-048 trial is practice-changing, according to its invited discussant, Vanita Noronha, MD, Professor of Oncology at Tata Memorial Centre in Mumbai, India. Although a number of questions remain to be answered, she said the take-home message is that the study “met most of its primary...

prostate cancer

Two Studies Question the Role of Continuous LHRH Antagonists in Metastatic Castration‑Resistant Prostate Cancer

In the field of prostate cancer, the use of androgen-deprivation therapy (ADT) in men with metastatic castration-resistant prostate cancer is received wisdom. When experts are asked why ADT is continued once the disease has figured out how to evade hormone suppression, the answer invariably is...

Expert Point of View: Charles Drake, MD, PhD

IN A SEPARATE interview with The ASCO Post, Charles Drake, MD, PhD, commented on the clinical implications of the ENZAMET and TITAN trials, as well as studies of apalutamide, abiraterone acetate, and docetaxel used in metastatic hormone-sensitive prostate cancer. Dr. Drake is Director of...

prostate cancer

Apalutamide Improves Survival Outcomes in Castration-Sensitive Metastatic Prostate Cancer in TITAN Trial

Adding apalutamide to androgen-deprivation therapy (ADT) significantly improved survival in men with metastatic castration-sensitive (also termed hormone-sensitive) prostate cancer, according to the results of the phase III TITAN trial, which were presented at the 2019 ASCO Annual Meeting and...

head and neck cancer
immunotherapy

FDA Approves Pembrolizumab for the First-Line Treatment of Head and Neck Squamous Cell Carcinoma

On June 10, the U.S. Food and Drug Administration (FDA) approved the anti–programmed cell death protein 1 immunotherapy pembrolizumab (Keytruda) for the first-line treatment of patients with metastatic or unresectable recurrent head and neck squamous cell carcinoma. Pembrolizumab was approved for...

pancreatic cancer

Expert Point of View: Wells Messersmith, MD, and Allyson Ocean, MD

“THE RATIONALE for the POLO study is sound,” said invited study discussant Wells Messersmith, MD. “There’s clearly an unmet need in pancreatic cancer, and there are promising data for poly (ADP-ribose) polymerase (PARP) inhibitors in other BRCA-mutated tumors.” Dr. Messersmith is Professor and Head ...

issues in oncology

An ASCO Survey, Hope, and Conventional Therapies

HOW DO YOU respond when patients with a good prognosis want to delay chemotherapy to try an anticancer diet for a few months or visit an unregulated clinic for unproven therapies? I’m asking because of an alarming finding of ASCO’s 2018 National Cancer Opinion Survey: “Nearly 4 in 10 Americans...

prostate cancer

Chemotherapy and/or Hormonal Agents: Differing Perspectives

WHEN ASKED which treatment to start with—docetaxel or enzalutamide, Dr. Sweeney said, “Patients fit for chemotherapy with high-volume disease can receive chemotherapy [docetaxel] and come back to these newer hormonal treatments or start with anyone of the hormonal options. Choosing among the newer...

prostate cancer

ENZAMET Trial Shows Enzalutamide Improves Overall Survival in Hormone-Sensitive Metastatic Prostate Cancer

Agents that improve survival in metastatic castration-resistant prostate cancer when added to background androgen-deprivation therapy (ADT) are showing success in treating metastatic prostate cancer earlier while it is still hormone-sensitive. These agents include docetaxel (chemotherapy) and...

issues in oncology

FDA Announces Project Facilitate to Access Investigational Therapies for Patients With Cancer

The Oncology Center of Excellence of the U.S. Food and Drug Administration (FDA) recently announced a new pilot program to assist oncology health-care professionals in requesting access to unapproved therapies for patients with cancer. A new call center designated Project Facilitate will be a...

Ask Your Patients About Complementary and Alternative Therapies

The most common reason that patients with cancer do not tell their physicians about using complementary and alternative medicines is that their physicians do not ask, according to a nationwide survey.1 Among 3,118 survey participants who reported a history of cancer, 1,023 (33.3%) had used a...

supportive care

Are Your Patients Using Complementary and Alternative Therapies? You Might Not Know If You Don’t Ask

Nearly one-third of patients with cancer who reported that they used complementary and alternative therapies in a nationwide survey did not tell their physicians about the use of those therapies, and the most frequently cited reason for not telling their physicians was that their physicians did...

issues in oncology
legislation

Curbside Consults: New Liability Risks to Avoid When You Are Not a Patient’s Physician

Like most clinicians, oncologists often informally consult their colleagues, both asking questions and seeking suggestions on how best to care for their patients.1,2 These informal or “curbside” consults (sometimes called “sidewalk,” “elevator,” or “hallway” consults) are valuable, because the...

prostate cancer

Darolutamide in Nonmetastatic Castration-Resistant Prostate Cancer: Delaying Overt Metastatic Disease Is a Major Advance

Nonmetastatic (M0) castration-resistant prostate cancer arises in the subset of men with biochemically recurrent disease (ie, rising prostate-specific antigen [PSA] level after definitive therapy in the absence of metastases) who develop PSA progression after chronic exposure to...

prostate cancer

ARAMIS Trial: Darolutamide in Nonmetastatic Castration-Resistant Prostate Cancer

In a phase III ARAMIS trial reported in The New England Journal of Medicine, Karim Fizazi, MD, of the Institut Gustave Roussy, Universite Paris-Sud, Villejuif, France, and colleagues found that the androgen-receptor antagonist darolutamide significantly prolonged metastasis-free survival vs placebo ...

skin cancer
immunotherapy

Comparison of Combination Dosing Schedules of Neoadjuvant Ipilimumab/Nivolumab in Macroscopic Stage III Melanoma

In the phase II OpACIN-neo study reported in The Lancet Oncology, Rozeman et al identified a promising dosing schedule for neoadjuvant ipilimumab/nivolumab in macroscopic stage III melanoma. Study Design The trial included 86 evaluable patients with resectable stage III melanoma involving the...

issues in oncology

AACR Environmental Carcinogenesis: Silicone-Based Wristbands for Detection of Occupational Environmental Exposures for Firefighters

First responders such as paramedics and firefighters may be exposed to hazardous occupational environmental exposures, but linking these exposures to conditions such as cancers is difficult due to the latency period of disease, magnitude of potential exposure, and potential interactions of...

colorectal cancer
issues in oncology

AACR Environmental Carcinogenesis: Lowering Exposure to Nitrates in Drinking Water May Reduce U.S. Cancer Cases

Nitrate levels in water resources have increased in many areas of the world, largely due to the use of inorganic fertilizer and animal manure in agricultural areas. Research has shown that the risk of specific cancers and birth defects may be increased when nitrate is ingested under conditions that ...

breast cancer
issues in oncology

AACR Environmental Carcinogenesis: Study Finds Environmental Quality Linked With Distant/Metastatic Breast Cancer Risk

Although many risk factors increase a woman’s chance of developing breast cancer—including genetic and hormonal causes—there is increasing evidence suggesting an environmental link. A study investigating the effects of the cumulative environmental quality on aggressive breast...

hematologic malignancies

Gait Speed Identifies Frailty, Could Help Predict Outcomes in Older Patients With Hematologic Cancers

The speed at which older individuals with blood cancers are able to walk 4 meters (about 13 feet) holds information about their overall health and may help to predict survival and unplanned hospital visits, according to study published by Liu et al in Blood. The association was...

colorectal cancer
hepatobiliary cancer
myelodysplastic syndromes
immunotherapy

FDA Pipeline: Designations and Reviews in Myelofibrosis, Myelodysplastic Syndromes, Biliary Tract Cancer, and T-Cell Receptor Therapy

Recently, the U.S. Food and Drug Administration (FDA) granted Fast Track designation for momelotinib in myelofibrosis, granted Priority Review to a biologics license application for luspatercept in myelodyslastic syndromes and beta-thalassemia, granted Orphan Drug designation for a new chemical...

colorectal cancer

2019 ASCO: Addition of Veliparib to Total Neoadjuvant Therapy in Locally Advanced Rectal Cancer

Results from an experimental arm of the phase II NRG-GI002 trial using veliparib, a poly (ADP-ribose) polymerase (PARP) inhibitor, as part of total neoadjuvant therapy (induction chemotherapy followed by chemoradiotherapy and surgery) in patients with locally advanced rectal adenocarcinoma were...

lung cancer

Luis G. Paz-Ares, MD, PhD, on Small Cell Lung Cancer: Efficacy and Safety of Lurbinectedin

Luis G. Paz-Ares, MD, PhD, of Hospital Universitario 12 de Octubre, discusses study findings on the second-line use of lurbinectedin in patients with both resistant and sensitive small cell lung cancer (Abstract 8506).

issues in oncology

2019 ASCO: Discrimination, Gender Bias in Oncology Training and Professional Meetings

Two studies that explored types of discrimination and gender bias in health-care organizations were presented at the 2019 ASCO Annual Meeting. Discrimination Experienced by Fellows An abstract that reviewed discrimination and inclusion among hematology and oncology trainees was presented by...

head and neck cancer
immunotherapy

FDA Approves Pembrolizumab for the First-Line Treatment of Head and Neck Squamous Cell Carcinoma

On June 10, the U.S. Food and Drug Administration (FDA) approved the anti–programmed cell death protein 1 immunotherapy pembrolizumab (Keytruda) for the first-line treatment of patients with metastatic or unresectable recurrent head and neck squamous cell carcinoma. Pembrolizumab was...

cns cancers

As My Outside World Became Smaller, My Family Focus Became Larger

As I write this, I think I’m making sense but am not 100% sure. My brain is a little scrambled after nearly 4 years of treatment for grade 4 glioblastoma multiforme, but I think the essence of my humor and humanity is still intact. When I experienced my first partial seizure while riding my...

issues in oncology
health-care policy

Major Settlement Raises Questions About Evidence-Based Value in Cancer Care

An Oklahoma jury recently awarded $25.5 million to the widower of a 53-year-old woman diagnosed with stage IV nasopharyngeal cancer who was denied coverage for proton therapy by her health insurer, Aetna. The patient’s family subsequently raised $92,000 to cover her proton therapy at The University ...

bladder cancer
immunotherapy

Adverse Events and Outcomes in Patients Receiving Anti–PD-1/PD-L1 Antibody Treatment for Advanced Urothelial Cancer

In an analysis reported in the Journal of Clinical Oncology, Maher et al found that treatment-related adverse events of special interest and immune-mediated adverse events were more common among patients with advanced urothelial cancer with vs without response to anti–programmed cell death...

hematologic malignancies

Selected Abstracts From the 2019 ASCO Annual Meeting

To complement The ASCO Post’s comprehensive coverage of the 2019 ASCO Annual Meeting, here are several abstracts selected from the meeting proceedings focusing on novel therapeutic regimens for plasma cell dyscrasias, particularly multiple myeloma. For full details of these study abstracts, visit ...

lymphoma
multiple myeloma
prostate cancer
immunotherapy

FDA Pipeline: Reviews and Designations in Multiple Myeloma, Lymphoma, Prostate Cancer

Recently, the U.S. Food and Drug Administration (FDA) granted Priority Review for daratumumab in combination with a triplet therapy in multiple myeloma, Breakthrough Therapy designation to copanlisib for marginal zone lymphoma, and Fast Track designation for ARV-110 in metastatic...

hematologic malignancies

Ibrutinib in Combination With Obinutuzumab in Treatment-Naive CLL/SLL

In the Clinic provides overviews of novel hematology and oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. Early in 2019, ibrutinib was approved for...

hepatobiliary cancer
gynecologic cancers

Aspirin Use and Cancer Prevention: Long-Term Data Needed on Benefits and Risks

In addition to its well-known cardioprotective benefits, aspirin has a substantial body of observational, preclinical, and clinical evidence supporting its efficacy in preventing cancer, most strongly for colorectal cancer.1 The strength of this evidence led the U.S. Preventive Services Task...

gynecologic cancers
hepatobiliary cancer

Regular Aspirin Use and Risk of Hepatocellular Carcinoma and Epithelial Ovarian Cancer

Data from two large U.S. prospective cohort studies indicate the benefits of regular aspirin use in preventing hepatocellular carcinoma and epithelial ovarian cancer. As reported by Tracey G. Simon, MD, MPH, of Massachusetts General Hospital, Harvard Medical School, and colleagues, in JAMA...

skin cancer

UMass Lowell Student Wins Award for Research in Skin Cancers

Tyler Iorizzo, a PhD candidate in physics at UMass Lowell’s Advanced Biophotonics Laboratory, has won international recognition for his work in developing an imaging device that could lead to improved diagnosis and treatment of certain skin cancers. Mr. Iorizzo received an Educational Award from...

Expert Point of View: Kristin Higgins, MD

The discussant of the abstract on the use of prophylactic cranial irradiation in patients with extensive-stage small-cell lung cancer (SCLC), Kristin Higgins, MD, underscored the marked shift in practice patterns in the United States. However, she noted that many questions remain concerning...

lung cancer

Survey Finds Prophylactic Cranial Irradiation Use in Decline for Extensive-Stage Small Cell Lung Cancer

Delivery of prophylactic cranial irradiation to patients with extensive-stage small cell lung cancer (SCLC) has declined significantly since the publication of a study by Takahashi et al, according to a recent survey of academic radiation oncologists.1 Data presented at the 2019 Multidisciplinary...

breast cancer

Nipple-Sparing Mastectomy May Be Suitable for Growing Number of Well-Selected Patients

As nipple-sparing mastectomy gains favor, it is being performed on a broader spectrum of patients once considered off limits by surgeons. A Mayo Clinic study in a contemporary cohort found no increase in complication rates or decrease in reconstruction success with this surgical approach.1 “We...

immunotherapy
head and neck cancer

Head and Neck Cancer Immunotherapy in Locally Advanced Disease: Clinical Trial Updates

Programmed cell death protein 1 (PD-1) inhibitors are approved for the second-line treatment of head and neck cancer and likely will be soon in the first-line treatment of locally advanced disease. According to Robert L. Ferris, MD, PhD, developments in immunotherapy for this population should be...

head and neck cancer

NovoTTF-100L System in Combination With Chemotherapy Approved for Malignant Pleural Mesothelioma

On May 23, the U.S. Food and Drug Administration (FDA) approved the NovoTTF-100L System in combination with pemetrexed plus platinum-based chemotherapy for the first-line treatment of unresectable locally advanced or metastatic malignant pleural mesothelioma. NovoTTF-100L is a noninvasive,...

issues in oncology

How Have We Got It So Wrong?

The past 20 years have seen an unprecedented increase in the development of effective drugs for the management of cancer. The advent of immunotherapy offers even the promise of cure for some previously highly resistant diseases. The science is brilliant, the need is ever increasing—but the cost is ...

Expert Point of View: Yousuf Zafar, MD

At the Plenary Session, formal discussant of Dr. Davidoff’s study, Yousuf Zafar, MD, of Duke Cancer Institute, Durham, North Carolina, gave an impassioned talk about the need to address racial disparities in cancer care. “This is a nontraditional study to be selected for the ASCO Plenary Session....

Expert Point of View: Harold Burstein, MD, PhD, FASCO, and Jame Abraham, MD, FACP

Harold Burstein, MD, PhD, FASCO, Associate Professor of Medicine at Dana-Farber Cancer Institute, Boston, and Jame Abraham, MD, FACP, Director of the Breast Oncology Program at Taussig Cancer Institute and Co-Director of the Cleveland Clinic Comprehensive Breast Cancer Program, commented on what...

2019 ASCO: mCODE, a Core Set of Common Cancer Data Standards, Established

In an effort to advance cancer data sharing and improve the quality and coordination of patient care, three health and technology organizations have established a core set of data elements and recommended technical specifications (the Minimal Common Oncology Data Elements [mCODE]) that are...

leukemia
lymphoma
immunotherapy

William G. Wierda, MD, PhD, on Immunotherapy for Relapsed/Refractory CLL/SLL: Results From TRANSCEND CLL 004

William G. Wierda, MD, PhD, of The University of Texas MD Anderson Cancer Center, discusses the TRANSCEND CLL 004 trial, which studied the use of an experimental CD19-directed CAR T-cell product in heavily pretreated patients with chronic lymphocytic leukemia or small lymphocytic lymphoma (Abstract ...

issues in oncology

2019 ASCO: Survey Finds 'Knowledge Gap' in Molecular Profiling Among Oncologists

A questionnaire aimed at assessing how well community oncologists understand “molecular profiling” results from tumor specimens found that 69% of participants either said they didn't know the answers or they responded incorrectly. In six different clinical scenarios, the oncologists...

prostate cancer

Active Surveillance/Watchful Waiting for Black Patients With Low-Risk Prostate Cancer

In a study reported in a letter to the editor in The New England Journal of Medicine, Butler et al found that the proportion of black patients with low-risk prostate cancer undergoing active surveillance remained lower than that among nonblack patients, despite increased use of the strategy in both ...

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