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lung cancer

PD-L1 Inhibitor Consolidation Therapy for NSCLC: New Standard of Care?

THE PROGRAMMED CELL DEATH ligand 1 (PD-L1) inhibitor durvalumab (Imfinzi) improved progression-free survival by 11.2 months compared with placebo in patients with locally advanced, unresectable stage III non–small cell lung cancer (NSCLC) whose disease did not progress following standard treatment ...

breast cancer

Religiously Tailored Educational Intervention to Encourage Mammography in American Muslim Women

Despite the U.S. Preventive Services Task Force recommendation that women between the ages of 50 and 74 undergo mammography every 2 years, only about 50% of American Muslim women do so, compared with 67% of all American women. A study by Padela et al investigating the mammography-related barrier...

skin cancer

Significant Improvement in Outcomes Reported With Adjuvant Therapy for Melanoma

FOR PATIENTS with malignant melanoma, the significant improvement in outcomes with targeted agents and antibodies against the programmed cell death protein 1 (PD-1) has now been observed in the adjuvant setting. Two landmark studies presented at the European Society for Medical Oncology (ESMO) 2017 ...

issues in oncology

Adoptive Cell Therapy—Act 1: The Beginning

ON AUGUST 30, 2017, the first genetically engineered T-cell therapy (tisagenlecleucel [Kymriah]) was approved by the U.S. Food and Drug Administration (FDA) for the treatment of patients up to 25 years of age with B-cell precursor acute lymphoblastic leukemia that is refractory or in second or...

breast cancer

Surgeon-Initiated Gene-Expression Profile Testing in Early-Stage Breast Cancer and Time to Start of Chemotherapy

In a single-center study reported in the Journal of Oncology Practice, Losk et al found that an intervention including surgeon initiation of gene-expression profile testing with Oncotype DX significantly reduced the time to testing, receipt of testing results, and initiation of chemotherapy in...

leukemia

Combination of Inotuzumab Ozogamicin and Low-Intensity Chemotherapy in Relapsed or Refractory Ph-Negative ALL

In a single-center phase II trial reported in JAMA Oncology, Jabbour et al found that the combination of inotuzumab ozogamicin (Besponsa) and low-intensity chemotherapy produced promising results in patients with relapsed or refractory Philadelphia chromosome (Ph)-negative acute lymphoblastic...

sarcoma

First-Line Gemcitabine/Docetaxel vs Doxorubicin in Advanced Soft-Tissue Sarcoma

In the UK-Swiss phase III GeDDiS trial, the combination of gemcitabine and docetaxel did not significantly improve progression-free survival vs doxorubicin in first-line treatment of locally advanced or metastatic soft-tissue sarcoma. Findings were reported in The Lancet Oncology by Seddon et al....

bladder cancer

Adjuvant Chemotherapy vs Observation After Neoadjuvant Therapy and Radical Cystectomy for Bladder Cancer

In an analysis reported in JAMA Oncology, Seisen et al found that adjuvant chemotherapy was associated with a survival benefit vs observation in patients with adverse prognostic features after neoadjuvant therapy and radical cystectomy for urothelial carcinoma of the bladder. Study Details The...

issues in oncology

ESMO 2017: Patients Struggle With Key Aspects of Clinical Trial Methodology

Clinical trials are fundamental to the development of new treatments for cancer, yet the annual accrual to cancer clinical trials worldwide is low, estimated at 3%–5%. A nationwide study in Ireland, the preliminary results of which were presented at the European Society for Medical Oncology...

issues in oncology

ESMO 2017: Abdominal to Peripheral Fat Ratio May Predict Risk of Cancer Diagnosis in Postmenopausal Women

Body fat distribution in the trunk is more influential than body weight when it comes to cancer risk in postmenopausal women, according to a study presented at the European Society for Medical Oncology (ESMO) 2017 Congress in Madrid (Abstract 1408P_PR). The findings put a new spin on weight...

issues in oncology
survivorship

ESMO 2017: NOR-CAYACS Trial: Factors That May Limit Work Ability of Young Adult Cancer Survivors

Factors that may limit the ability of young adult cancer survivors to work were reported at the European Society for Medical Oncology (ESMO) 2017 Congress in Madrid (Abstract 1110PD_PR). Late side effects can occur months or years after cancer treatment. In patients diagnosed with cancer in young...

head and neck cancer

Pembrolizumab in PD-L1–Positive Nasopharyngeal Carcinoma

As reported by Hsu et al in the Journal of Clinical Oncology, pembrolizumab (Keytruda) has shown activity in programmed cell death ligand 1 (PD-L1)–positive recurrent or metastatic nasopharyngeal carcinoma, in a cohort of the phase Ib KEYNOTE-028 trial. Study Details In the study, 27...

colorectal cancer

Remnant Liver Ischemia and Cancer-Specific Survival After Resection of Colorectal Liver Metastases

In a single-center experience reported by Yamashita et al in JAMA Surgery, postoperative remnant liver ischemia of grade ≥ 2 was associated with worse cancer-specific survival after resection of colorectal liver metastases. Study Details The retrospective analysis included 202 patients who...

prostate cancer

Alzheimer’s Disease Risk in Medicare Patients Receiving Androgen-Deprivation Therapy for Prostate Cancer

As reported by Baik et al in the Journal of Clinical Oncology, Medicare patients who received androgen-deprivation therapy for prostate cancer do not appear to be at increased risk for Alzheimer’s disease and may have an extremely small increased risk for dementia. Study Details The study...

lung cancer

Adding First-Line Ipilimumab to Paclitaxel/Carboplatin in Advanced Squamous NSCLC

In a phase III trial reported by Govindan et al 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 non–small cell lung cancer (NSCLC). Study Details In the...

issues in oncology

ESMO 2017: Some Stroke Survivors May Have Underlying Cancer

Some stroke survivors may have underlying cancer, according to an observational study presented at the European Society for Medical Oncology (ESMO) 2017 Congress in Madrid (Abstract 1412P_PR). “Postmortem studies have suggested that cancer can develop after a stroke, but the magnitude of...

gastrointestinal cancer

Cytoreductive Surgery With Hyperthermic Intraperitoneal Chemotherapy

In a single-center experience reported in JAMA Surgery, Eng et al found that an increased intraoperative fluid rate was associated with increased perioperative morbidity in patients with peritoneal cancer undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy. Study...

head and neck cancer

Cabozantinib Salvage Therapy in Tyrosine Kinase Inhibitor–Refractory Differentiated Thyroid Cancer

A phase II study has shown that cabozantinib (Cometriq) produces responses in patients with tyrosine kinase inhibitor–refractory differentiated thyroid cancer. The findings were reported by Cabanillas et al in the Journal of Clinical Oncology. MET plays a role in vascular endothelial growth...

breast cancer

ESMO 2017: MINDACT Study in Early-Stage Breast Cancer Shows Even Small Tumors Can Be Aggressive

Even small tumors in the breast can be aggressive, according to a study in patients with early-stage breast cancer presented at the 2017 European Society for Medical Oncology (ESMO) Congress in Madrid (Abstract 150O_PR). Researchers found that 24% of small tumors were aggressive, and patients...

leukemia

Guadecitabine in Treatment-Naive Older Patients With Acute Myeloid Leukemia

The results of a phase II trial have shown high activity of guadecitabine, a next-generation hypomethylating drug, in treatment-naive older patients with acute myeloid leukemia. The findings were reported in The Lancet Oncology by Kantarjian et al. Guadecitabine has a longer half-life and exposure...

lung cancer

Association of Supplemental Vitamin B Use and Lung Cancer in VITAL Cohort

In a study reported in the Journal of Clinical Oncology, Brasky et al found that the use of individual source supplemental vitamins B6 and B12 was associated with an increased risk of lung cancer among men in the Vitamins and Lifestyle (VITAL) cohort. Several B vitamins, including B6, B9 (folate),...

issues in oncology

FDA Pilot Program Aims to Encourage Students to Pursue STEM Careers

When I was in high school, I spent summers working as a restaurant dishwasher, grocery store stock boy, and gardener in northwest Indiana. The idea of spending those weeks learning about science and medicine would not have been an option for me at that time. Yet it is precisely those students who...

cns cancers

Dinutuximab vs Temsirolimus in Combination Therapy for Children With Resistant Neuroblastoma

A randomized phase II trial (Children’s Oncology Group [COG] ANBL1221) has resulted in the selection of dinutuximab (Unituxin) plus irinotecan/temozolomide as a regimen to be further evaluated in the treatment of pediatric patients with refractory or relapsed neuroblastoma. Study results were...

survivorship

Financial Burden Among Survivors of Childhood Cancer

Findings from the Childhood Cancer Survivor Study, reported in the Journal of Clinical Oncology by Nipp et al, indicate that childhood cancer survivors are more likely than unaffected siblings to spend a higher percentage of income on out-of-pocket medical costs, potentially leading to reduced use...

cns cancers

Expect Questions About Glioblastoma Symptoms

WITH THE MANY NEWS REPORTS about Senator John McCain being diagnosed with glioblastoma, patients may be asking if symptoms such as headaches and vision or speech problems should signal the need for screening or diagnostic tests. “There has never been any suggestion that doing routine screening,...

cns cancers

‘Substantial Improvements’ in the Treatment of Glioblastoma

NEWS ARTICLES about Senator John McCain’s diagnosis of glioblastoma accurately describe glioblastoma as aggressive and having a poor prognosis. But as Walter J. Curran, Jr, MD, pointed out in one of those reports, “substantial improvements in surgical approaches” have enabled more patients to...

To the Last Drop

It was 2:15 PM, and my afternoon clinic had not yet begun. The morning had been particularly trying as a result of disastrous clinical developments for two of my long-standing patients. Jessica had metastatic breast cancer, and I had been taking care of her for 7 years. Multiple lines of...

A Doctor’s Call to Arms About the Overuse of Antibiotics

On September 3, 1928, Scottish biologist Alexander Fleming returned to London from a vacation and sorted through some petri dishes containing colonies of Staphylococcus. He noticed something unusual in one dish: It was dotted with colonies except for one area where a patch of mold grew....

leukemia

FDA Approves First CAR T-Cell Therapy for Pediatric, Young Adult Patients With ALL

ON AUGUST 30, 2017, the U.S. Food and Drug Administration (FDA) approved tisagenlecleucel (Kymriah) for pediatric and young adult patients up to 25 years with B-cell precursor acute lymphoblastic leukemia (ALL) that is refractory to initial treatment or in second or later relapse. Tisagenlecleucel ...

leukemia

Midostaurin in FLT3 Mutation–Positive Acute Myeloid Leukemia and Systemic Mastocytosis

ON APRIL 28, 2017, midostaurin (Rydapt) was approved for treatment of adults with newly diagnosed acute myeloid leukemia (AML) who have FLT3 mutation–positive disease, as detected by a U.S. Food and Drug Administration (FDA)-approved test, in combination with standard cytarabine and daunorubicin...

lymphoma

Pembrolizumab in Classical Hodgkin Lymphoma

On March 14, 2017, pembrolizumab (Keytruda) was granted accelerated approval for the treatment of adult and pediatric patients with refractory classical Hodgkin lymphoma or those who have relapsed after three or more prior lines of therapy.1,2  Supporting Efficacy Data  APPROVAL WAS BASED on...

thyroid cancer
survivorship

Bridging the Survivorship Care Gap for Young Adult Survivors of Thyroid Cancer

Although thyroid cancer is among the five most common carcinomas diagnosed in adolescents and young adults (AYAs) between the ages of 15 and 39—thyroid cancer is more common in young women than young men and is the most common cancer diagnosed in females between the ages of 15 and 29 and the second ...

solid tumors
bladder cancer

Atezolizumab in Patients With Advanced Urothelial Carcinoma Who Are Ineligible for Cisplatin

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On April 17, 2017, the programmed cell death ligand 1 (PD-L1)...

solid tumors
hematologic malignancies
breast cancer
lung cancer
prostate cancer
multiple myeloma
kidney cancer

Journal of Clinical Oncology Literature Update

Staying up-to-date in the fast-paced world of oncology literature is a daunting task at best. To assist with that task, The ASCO Post has assembled an assortment of studies recently published in the Journal of Clinical Oncology. The topics range from therapy for stage IV non–small cell lung cancer...

gastrointestinal cancer

‘Sidedness’ in Colon Cancer: Using the Data in the Clinic

The evidence from clinical trials has established that “side matters” when it comes to colorectal cancer outcomes. How do clinicians use this information in their practices? Christina Wu, MD, of Emory University, shared her thoughts with attendees at the 2017 Debates and Didactics in Hematology and ...

multiple myeloma

Overall Survival With Carfilzomib vs Bortezomib in Relapsed or Refractory Multiple Myeloma

As reported by Dimopoulos et al in The Lancet Oncology, a prespecified interim analysis of the phase III ENDEAVOR trial has shown a significant overall survival benefit for carfilzomib (Kyprolis) vs bortezomib (Velcade) in patients with relapsed or refractory multiple myeloma. Carfilzomib was...

breast cancer

Genetic Variant May Significantly Lower Risk of Breast Cancer in Women With History of Preeclampsia

Researchers have demonstrated that women with a history of preeclampsia have as much as a 90% decrease in breast cancer risk if they carry a specific common gene variant. Further studies are now underway to determine the mechanism of this protection in an effort to develop new breast cancer...

prostate cancer

Androgen-Deprivation Therapy May Be Associated With Higher Risk of Heart Failure in Early-Stage Prostate Cancer

Men with localized prostate cancer who received androgen-deprivation therapy were at significantly higher risk of heart failure than men who did not receive this therapy, according to a Kaiser Permanente study published by Haque et al in the British Journal of Cancer. In the past,...

bladder cancer

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 Powles et al in JAMA Oncology. Data from the ongoing study supported the recent approval of durvalumab as second-line treatment in this setting on the basis of...

leukemia

FDA Approves First CAR T-Cell Therapy for Pediatric and Young Adult Patients With B-Cell Precursor ALL

Today, the U.S. Food and Drug Administration (FDA) issued what it has called a “historic action,” making the first gene therapy available in the United States. The FDA approved tisagenlecleucel (Kymriah) for certain pediatric and young adult patients with a form of acute lymphoblastic...

colorectal cancer

Association of Systemic Inflammation and Sarcopenia With Survival in Early-Stage Colorectal Cancer

Results from the C SCANS (Colorectal Cancer: Sarcopenia, Cancer, and Near-Term Survival) study indicate that prediagnosis systemic inflammation and at-diagnosis sarcopenia are associated with an increased mortality risk in patients with nonmetastatic colorectal cancer. The findings were reported in ...

palliative care

Palliative Care May Substantially Decrease Health-Care Utilization in Patients With Advanced Cancer

A new population-based study shows that palliative care substantially decreased health-care utilization among Medicare beneficiaries with advanced cancer, resulting in less intensive care being delivered at the end of life. This included lower rates of hospitalization, fewer invasive procedures,...

gastroesophageal cancer

Women More Likely Than Men to Experience Response After Induction Chemoradiotherapy and Esophagogastrectomy for Esophageal Cancer

Female patients with locally advanced esophageal cancer treated with chemotherapy and radiation therapy before surgery are more likely to have a favorable response to the treatment than male patients are, and women are less likely to experience cancer recurrence, according to a study published by...

colorectal cancer

African American Men Have Lowest Survival Rates Among Patients With Anal Cancer

Over the past 30 years, squamous cell carcinoma of the anus has been one of the few cancers with a steadily rising incidence in the United States, with the most rapid increase seen in black men. To further investigate this trend, researchers at the University of Texas Southwestern Medical Center...

issues in oncology

Psychological Outcomes in Adolescents With a Parent Dying of Cancer

In a study in the Swedish population reported by Beernaert et al in the Journal of Clinical Oncology, distrust in the end-of-life care provided to a parent with cancer was associated with long-term adverse emotional/psychological effects among bereaved adolescents. Study Details The study...

head and neck cancer

Medical Costs and HPV Vaccination in Oropharyngeal Cancer

According to the Centers for Disease Control and Prevention, human papillomavirus (HPV)-related cancers, including oropharyngeal, vulvar, cervical, vaginal, penile, anal, and rectal cancers, have increased in recent years, with oropharyngeal cancer the most common HPV-related cancer—from 2008 ...

breast cancer

Anti–Trop-2 Antibody-Drug Conjugate Produces Durable Responses in Metastatic Triple-Negative Breast Cancer

AS REPORTED in the Journal of Clinical Oncology by Aditya Bardia, MD, MPH, of Massachusetts General Hospital Cancer Center and Harvard Medical School, and colleagues, the anti–Trop-2 antibody-drug conjugate sacituzumab govitecan has been found to produce durable responses in patients with heavily...

cns cancers

Adjuvant Temozolomide in 1p/19q Non-Codeleted Anaplastic Glioma

Interim results of the phase III CATNON trial (EORTC study 26053-22054) indicate a survival benefit of adjuvant temozolomide in 1p/19q non-codeleted anaplastic glioma. These findings were reported in The Lancet by van den Bent et al. Study Details In the open-label 2 x 2 factorial trial, 745...

breast cancer
issues in oncology

Comparison of Screening Recommendations for Mammography

When to initiate screening for breast cancer, how often to screen, and how long to screen are questions that continue to spark emotional debates. A new study compares the number of deaths that might be prevented as a result of three of the most widely discussed recommendations for screening...

issues in oncology

Screening for Occult Cancer in Patients With Unprovoked Venous Thromboembolism

Because unprovoked venous thromboembolism may be the first sign of occult cancer, or cancer of an unknown primary origin, screening is often considered in patients with the condition to detect underlying cancer at an early, curable stage. However, extensive screening tests may yield false-positive...

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