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gynecologic cancers

Benefit Strongly Suggested With Hormonal Maintenance in Low-Grade Serous Carcinoma

In patients with low-grade serous carcinoma, maintenance hormonal therapy reduced the risk of recurrence by 77%, compared with surveillance, in a retrospective cohort from The University of Texas MD Anderson Cancer Center. The study was reported by David Marc Gershenson, MD, at the 2016 ASCO...

Expert Point of View: Marc S. Ernstoff, MD

The field of studies of combination immunotherapies is exploding, and “the future looks bright, with currently 71 trials of combination therapy in melanoma,” said formal discussant of these trials Marc S. Ernstoff, MD, of Roswell Park Cancer Institute, Buffalo, New York. “We now know that...

hematologic malignancies
lymphoma

CNS-IPI for CNS Relapse in Diffuse Large B-Cell Lymphoma

As reported in the Journal of Clinical Oncology, Schmitz et al have developed and validated a risk score for CNS relapse—the Central Nervous System International Prognostic Index (CNS-IPI)—in patients with diffuse large B-cell lymphoma (DLBCL) treated with R-CHOP (rituximab [Rituxan]...

prostate cancer

PET/MRI: A One-Stop Imaging Test to Detect Prostate Cancer?

A University of Michigan study published by Piert et al in The Journal of Nuclear Medicine reported that the addition of molecular imaging based on F-18-choline positron-emission tomography (PET) improves the identification of significant prostate cancer over multiparametric prostate magnetic...

colorectal cancer

World GI 2016: Anti–PD-L1 Immunotherapy Combined With MEK Inhibition Shows Response in Microsatellite-Stable Metastatic Colorectal Cancer

Anti–PD-L1 (programmed cell death ligand 1) immunotherapy may achieve a response in patients with microsatellite-stable metastatic colorectal cancer if combined with a MEK inhibitor, according to phase I data presented at the European Society for Medical Oncology (ESMO) 18th World Congress on ...

multiple myeloma

Updated Outcomes and Impact of Age in FIRST Trial in Multiple Myeloma

As reported by Hulin et al in the Journal of Clinical Oncology, the updated findings in the phase III FIRST trial continue to show improved progression-free and overall survival with continuous lenalidomide (Revlimid) plus low-dose dexamethasone (Rd) vs melphalan, prednisone, and thalidomide (MPT)...

colorectal cancer

Prevention Needed to Stem Global Rise in Human Papillomavirus–Related Anal Cancer

The incidence rate of human papillomavirus (HPV)-related anal cancer and its precursor lesion, anal intraepithelial neoplasia, is rising in the United States and globally. Although 5-year survival rates in localized disease are generally favorable, survival in metastatic disease remains poor,...

hematologic malignancies

Complexities in the Diagnosis and Management of Amyloidosis

Question 1: What is the next best step for this patient? Correct Answer: C. Determination of amyloid subtype. Expert Perspective Amyloidosis encompasses a heterogeneous group of diseases bound by the characteristic deposition of amyloid fibrils in soft tissues and bone marrow, and it could be...

hematologic malignancies

Complexities in the Diagnosis and Management of Amyloidosis

Case Study A 70-year-old man is referred to your clinic for a consultation. Recently, a diagnosis of IgG monoclonal gammopathy of undetermined significance (MGUS) was established. Medical history is significant for essential hypertension, type II diabetes mellitus, hyperlipidemia, and atrial...

colorectal cancer
issues in oncology

What’s Driving the Rising Rates of Colorectal Cancer in Young Adults?

The study statistics are alarming—and perplexing. According to an analysis of data from the Surveillance, Epidemiology, and End Results (SEER) colorectal cancer registry, colon cancer incidence among young adults aged 20 to 34 is expected to increase 90% by 2030, and the incidence of rectosigmoid...

Expert Point of View: David Reardon, MD

“Adjuvant temozolomide does represent a new standard of care for 1p/19q-intact anaplastic glioma patients,” according to David Reardon, MD, Clinical Director at the Dana-Farber Center for Neuro-Oncology and the study’s formal discussant at the 2016 ASCO Annual Meeting. “We see a significant...

leukemia

CAR T-Cell Dose Refinement May Reduce Cytokine-Release Syndrome in Patients With Advanced Acute Lymphoblastic Leukemia

Chimeric antigen receptor (CAR) T-cell therapy has been effective in adults and children with advanced acute lymphoblastic leukemia (ALL), but along with efficacy, the treatment can stimulate cytokine-­release syndrome, which can be deadly if it goes unrecognized and untreated. Adjusting the dose...

breast cancer

Pertuzumab-Containing Regimens Compared for Neoadjuvant Treatment in Early Breast Cancer

In patients with HER2-positive early breast cancer, pathologic complete response rates after neoadjuvant therapy were higher with docetaxel plus carboplatin plus trastuzumab (Herceptin) plus pertuzumab (Perjeta), or TCH+P, than with ado-trastuzumab emtansine (Kadcyla) plus pertuzumab, or T-DM1+P,...

breast cancer

EBCTCG Analysis Identifies Recurrence Risk by Tumor Subgroup in Estrogen Receptor–Positive Breast Cancer

The risk of recurrence in estrogen receptor–positive breast cancer is known to continue after 5 years, but just how much is that risk once endocrine therapy is stopped? The Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) has concluded it is “appreciable,” with distant recurrences...

cns cancers

Analysis of Cerebrospinal Fluid for D-2-Hydroxyglutarate May Detect Malignant Brain Tumors Nonsurgically

When a brain tumor is suspected, its presence is usually confirmed by anatomic imaging such as computed tomography (CT) or magnetic resonance imaging (MRI). But through imaging, not much about the tumor molecularly can be learned. Surgery and a biopsy are necessary to get a glimpse of the cancer...

geriatric oncology
supportive care
leukemia

Assessment of Fitness, Function, and Quality of Life Essential in Treatment of Older Patients With CLL

Significant progress has been made in the past 2 decades in the care of patients with chronic lymphocytic leukemia (CLL). Recently, the therapeutic armamentarium has expanded for such patients with the introduction of new targeted agents. CLL is predominantly a disease of the elderly, with a...

breast cancer

Approximately 20% of Older Women With Early Breast Cancer Experience Some Form of Functional Decline After Treatment

In a study of older women with newly diagnosed stage I to III breast cancer, approximately 1 in 5 lost the ability to complete some of the basic tasks necessary for independent living within 1 year of initiating treatment. The study also found that a simple survey can help identify which women are...

breast cancer

No Advantage With Cyclophosphamide/Methotrexate Maintenance in Hormone Receptor–Negative Early Breast Cancer, but Subgroup May Benefit

Low-dose oral cyclophosphamide plus methotrexate maintenance therapy yielded no disease-free survival benefit in women with hormone receptor–negative early breast cancer, according to the phase III International Breast Cancer Study Group (IBCSG) 22-00 trial. Some evidence of benefit was...

gynecologic cancers

No Overall Advantage to Adding Pertuzumab to Chemotherapy in Platinum-Resistant Ovarian Cancer, but Subgroup May Benefit

According to the European phase III PENELOPE trial reported in the Journal of Clinical Oncology, Kurzeder et al found that adding pertuzumab (Perjeta) to investigator’s choice of chemotherapy did not improve progression-free survival in women with low-HER3 mRNA–expressing...

breast cancer

Influence of Microbiota of Breast Tissue on the Development of Cancers

Bacteria that have the potential to abet breast cancer are present in the breasts of cancer patients, while beneficial bacteria are more abundant in healthy breasts, where they may actually be protecting women from cancer, according to Gregor Reid, PhD, of the Lawson Health Research Institute, and...

I Was Not Shown Compassion by My Medical Team

At my last screening mammogram in 2015, nothing seemed out of the ordinary. The technician took the usual four x-rays of my breasts, and I was told I could leave. So it was especially shocking to get a phone call from the radiologist a week later telling me that I had to come back for an additional ...

Use Questions From Patients to Help Them Make Informed Treatment Decisions

Recent reports about treatment options for patients with ductal carcinoma in situ, and the ensuing debate and comments played out in the media, may prompt increased questions from patients. A review summarizing data about these treatment options concluded that surgery and radiation therapy “remain...

breast cancer

Surgery and Radiation Therapy Remain Standard of Care for Managing Ductal Carcinoma in Situ

A review of more than 50 studies (many randomized controlled trials) concluded that surgery and radiation therapy “remain standard-of-care treatment options” in the management of ductal carcinoma in situ.1 The review continues the widely reported discussion on managing ductal carcinoma in situ,...

integrative oncology

Black Cohosh

Scientific Name: Cimicifuga racemosa Common Names: Black snakeroot, rattlesnake root, squawroot, bugbane, bugwort Brand Names: Remifemin, Menofem, Klimadynon Overview A perennial plant native to the eastern United States and Canada, black cohosh root was used by Native Americans to treat colds,...

Clinical Conversations: Attendee Questions From the Cancer Survivorship Symposium

The inaugural Cancer Survivorship Symposium, held in January 2016, drew more than 800 attendees across the cancer-care spectrum—far exceeding the goal of 500 attendees. As a way to continue the discussion from the meeting, several faculty members responded to questions from General Sessions 5 and...

gastroesophageal cancer
gastrointestinal cancer

Anti–PD-1 Treatment With Pembrolizumab in Gastric/Gastroesophageal Junction Cancers: Who Is Likely to Respond?

Immune checkpoint inhibitors have emerged as one of the most promising new areas of drug development in oncology. Broad activity has been observed for these agents across a spectrum of hematologic malignancies and solid tumors. As reviewed in this issue of The ASCO Post, Muro and colleagues now...

Global Oncology Appoints Donna Barry as First Executive Director

Nonprofit Global Oncology, Inc (GO) has announced that Donna Barry has been appointed to be its first Executive Director, effective immediately. U.S. and global investments in improving cancer outcomes are minimal—in 2011, only 1.2% of total development assistance for global health was focused on...

solid tumors
issues in oncology

Adherence to Cancer Prevention Guidelines on Diet and Physical Activity May Reduce Cancer Risk and Mortality

According to the American Cancer Society’s 2016 Cancer Facts & Figures, behaviors such as poor diet choices, physical inactivity, excess alcohol consumption, and unhealthy body weight account for about 20% of all cancers diagnosed in the United States and likely could be prevented with...

multiple myeloma

Ixazomib: A Relevant Addition to Myeloma Therapy

In 2015, four new drugs were approved for the treatment of multiple myeloma by the U.S. Food and Drug Administration: panobinostat (Farydak), daratumumab (Darzalex), elotuzumab (Empliciti), and ixazomib (Ninlaro). Of them, the first three are drugs with unique new targets, whereas ixazomib is the...

multiple myeloma

Addition of Ixazomib to Lenalidomide/Dexamethasone Improves Progression-Free Survival in Relapsed/Refractory Multiple Myeloma

In the phase III TOURMALINE-MM-1 trial reported in The New England Journal of Medicine, Philippe Moreau, MD, of the University Hospital Hôtel Dieu, Nantes, France, and colleagues found that adding the oral proteasome inhibitor ixazomib (Ninlaro) to lenalidomide (Revlimid) and dexamethasone...

geriatric oncology

Medical Decision-Making: At the Heart of Care for Older Patients With Cancer

Although oncology has moved toward a personalized approach to care, medical decision-making within the context of multidisciplinary care has broad public health implications. To shed light on this and other relevant issues, The ASCO Post recently spoke with William Dale, MD, PhD, of the University ...

issues in oncology

Creating Hybrid Academic-Community Cancer Centers to Improve Patient Care

Five years ago, the Helen F. Graham Cancer Center and Research Institute at Christiana Care Health System in Newark, Delaware, and The Wistar Institute, a National Cancer Institute (NCI)-designated biomedical research center, in Philadelphia, Pennsylvania, joined forces to collaborate on...

hematologic malignancies

Updated WHO Classification of Hematologic Malignancies

Question 1: Which statement about the classification of tumors of hematopoietic and lymphoid tissues is true? Correct Answer: A. The revised WHO classification defines distant disease entities that can be reliably diagnosed using proposed criteria. Expert Perspective WHO last updated its...

Expert Point of View: Peter C. Enzinger, MD

Not so FAST? The study discussant Peter C. Enzinger, MD, Director of the Center for Esophageal and Gastric Cancer at Dana-Farber/Brigham and Women’s Cancer Center, Boston, viewed the findings of the FAST trial as promising but voiced several considerations, as did Gulam A. Manji, MD, PhD,...

cost of care
global cancer care

Vast Differences Globally in Cancer Drug Retail Prices

A pilot study revealed large differences in median retail prices for 23 cancer drugs in 7 different countries, with the highest retail prices identified in the United States and the lowest, in India and South Africa. Notably, after the monthly drug price is expressed as a percentage of domestic...

colorectal cancer

Influence of Age and Comorbidities on Rates of Colorectal Cancer Screening in the Elderly

Colorectal cancer (CRC) is a common and costly disease, largely of the elderly, with nearly 25% of cases diagnosed among patients aged 75–84 years. However, but the guidelines for CRC screening of Americans aged 75 or older vary according to the source. In a study published by Klabunde et al...

colorectal cancer

USPSTF Issues New Recommendations for Colorectal Cancer Screening

As reported in JAMA, the U.S. Preventive Services Task Force (USPSTF) has issued new recommendations for colorectal cancer screening. In brief, the USPSTF recommends colorectal cancer screening starting at age 50 years and continuing until age 75 years (grade A recommendation = “The USPSTF...

solid tumors

‘Liquid Biopsy’ Stacks Up Well to Tissue Biopsy in Detecting Tumor-Specific Mutations

So-called liquid biopsy identified cancer mutations in 85% of all advanced tumors, in the largest-ever evaluation of circulating tumor DNA (ctDNA) in the blood.1 In 49% of the cases, these biomarkers were associated with an approved targeted drug, Philip C. Mack, PhD, reported at the 2016 ASCO...

breast cancer

Trastuzumab Biosimilar Shows Efficacy and Safety Comparable to Reference Product in Phase III HERITAGE Trial

A new biosimilar version of the monoclonal antibody trastuzu­mab (Herceptin) is getting close to the finish line in the race to develop biosimilars in oncology. The new antibody, MYL-1401O, demonstrated comparable efficacy and safety compared with trastuzumab as front-line treatment of women with...

health-care policy
issues in oncology

Supporting Policy to Reduce Tobacco-Related Deaths

One billion lives. That is the estimated human death toll of tobacco use in the 21st century.1 Tobacco use is the leading cause of preventable death worldwide—20% of all deaths and 30% of cancer deaths in the United States are linked to tobacco use.2,3 Impacting this preventable public health...

lung cancer

Low-Dose CT Screening May Detect New Solid Nodules and Lung Cancer Probability

As reported by Walter et al in The Lancet Oncology, incidence screening with low-dose computed tomography (CT) in high-risk individuals detected new solid nodules in approximately 5% to 7% at second and third screenings in the ongoing Dutch-Belgian NELSON trial. Larger nodule size was associated...

issues in oncology

Patient Navigators Improve Comprehensive Cancer Center Screening Rates

A clinical trial conducted by Massachusetts General Hospital (MGH) investigators has found that the use of patient navigators—individuals who assist patients in receiving health care services—may improve comprehensive cancer screening rates among patient populations not likely to...

issues in oncology

Lifestyle Pattern May Be Associated With Cancer Risk in White Adults

In a study reported in JAMA Oncology, Song and Giovannucci found that a “healthy lifestyle pattern” was associated with a reduced risk for carcinomas among white adults. Study Details The study included data from the Nurses’ Health Study and the Health Professionals Follow-up...

solid tumors

SNMMI 2016: A Blood-Based Multi-Transcript Test May Predict Success of Neuroendocrine Cancer Therapy

Malignant neuroendocrine tumors (NETs) are relatively rare, notoriously difficult to treat, and associated with poor long-term survival. According to research presented at the 2016 Annual Meeting of the Society of Nuclear Medicine and Molecular Imaging (SNMMI), an investigative blood test could...

lung cancer

Many Family Physicians May Be Misinformed About Lung Cancer Screening

Although clinical trials have shown that lung cancer screening using low-dose computed tomography (CT) can detect lung cancers early and reduce lung cancer mortality, less than half of family physicians in a recent survey agreed that screening reduces lung cancer–related deaths. Most were...

issues in oncology

ASCO 2016: Hispanic and Black Young Adults With Cancer May Be More Likely to Die of Their Disease

Hispanic white and non-Hispanic black cancer patients between ages 15 and 29 may be more likely than same-aged white patients to die of their disease, according to a University of Colorado Cancer Center study presented by Colton et al at the 2016 ASCO Annual Meeting (Abstract 6557). The finding is...

solid tumors
pancreatic cancer

ASCO Releases Clinical Practice Guideline on Metastatic Pancreatic Cancer

As reported in the Journal of Clinical Oncology by Davendra P. Sohal, MD, MPH, of Cleveland Clinic, and colleagues, ASCO has released a clinical practice guideline on the treatment of patients with metastatic pancreatic cancer. Recommendations are based on expert panel systematic review of the...

solid tumors
pancreatic cancer

ASCO Releases Clinical Practice Guideline on Treatment of Locally Advanced, Unresectable Pancreatic Cancer

As reported by Edward P. Balaban, DO, of Penn State Hershey Cancer Institute, and colleagues in the Journal of Clinical Oncology, ASCO has released a clinical practice guideline on the treatment of locally advanced, unresectable pancreatic cancer. The recommendations are based on expert panel...

solid tumors
pancreatic cancer

ASCO Releases Clinical Practice Guideline on Treatment of Potentially Curable Pancreatic Cancer

ASCO has released a clinical practice guideline on the treatment of potentially curable pancreatic cancer, as reported by Alok A. Khorana, MD, of Cleveland Clinic, and colleagues, in the Journal of Clinical Oncology. The recommendations are based on expert panel systematic review of the literature...

International Prognostic Index for Chronic Lymphocytic Leukemia

The International Chronic Lymphocytic Leukemia–International Prognostic Index (CLL-IPI) working group has developed an International Prognostic Index for patients with chronic lymphocytic leukemia based on a meta-analysis of individual patient data, as reported in The Lancet Oncology. The...

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