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Look for Opportunities to Lower Barriers to ­Participation of Older Patients in Oncology Clinical Trials

Practicing evidence-based medicine requires evidence, but the evidence for efficacy and safety of new and evolving cancer therapies in older adults is wanting due to their underrepresentation in oncology clinical trials. “It is difficult to practice evidence-based medicine in an older population...

geriatric oncology
issues in oncology

‘Slow, Incremental Changes’ Are Increasing Participation of Older Adults in Clinical Trials

Older adults continue to be proportionally underrepresented in oncology clinical trials, but the participation rate of adults aged 65 and older is increasing by “slow, incremental changes,” Stuart M. Lichtman, MD, FACP, FASCO, noted in an interview with The ASCO Post. Prompting those changes are...

head and neck cancer

Plasma Epstein-Barr Virus DNA Screening for Nasopharyngeal Cancer

In a Hong Kong study reported in The New England Journal of Medicine, Chan et al found that screening for circulating cell-free Epstein-Barr virus (EBV) DNA is useful in detecting nasopharyngeal carcinoma in asymptomatic individuals. Study Details In the study, 20,174 participants underwent...

pancreatic cancer

Germline Mutations in Apparent Sporadic Pancreatic Adenocarcinoma

As reported by Shindo et al in the Journal of Clinical Oncology, deleterious germline mutations in known pancreatic cancer susceptibility genes were frequently found in patients with pancreatic cancer who do not have a reported family history of cancer. Study Details The study involved sequencing ...

colorectal cancer

Colorectal Cancer Mortality Rates in Adults Aged 20 to 54 Years From 1970 to 2014

In a research letter to JAMA, Siegel et al reported that overall colorectal cancer mortality rates have declined in the United States between 1970 and 2014 in patients aged 20 to 54 years but increased in white persons in this age group between 2004 and 2014. Study Details In the study,...

solid tumors
hematologic malignancies

Clonal Hematopoiesis in Patients With Nonhematologic Cancers

In a study of nearly 9,000 people treated for solid tumors, researchers found that radiation treatment and tobacco use were linked to higher rates of blood-based DNA mutations that could lead to a higher risk for blood cancers such as leukemia. The study, published by Coombs et al in...

health-care policy
issues in oncology

FDA to Expand Public Education Campaign to Focus on Prevention of Youth E-Cigarette Use

On August 8, the U.S. Food and Drug Administration (FDA) announced it would pursue a strategic, new public health education campaign aimed at discouraging the use of e-cigarettes and other electronic nicotine delivery systems (ENDS) by children. The agency plans to expand its “The Real...

issues in oncology

Factors in Discontinuation of Palliative Radiotherapy

In a study reported by Puckett et al in the Journal of Oncology Practice, factors associated with premature discontinuation of palliative radiotherapy in cancer patients included poorer performance status, higher number of prescribed radiotherapy fractions, and treatment site other than bone...

breast cancer

Ovarian Function Recovery During Anastrozole Therapy in Postmenopausal Patients With Breast Cancer

In the phase III DATA trial reported in the Journal of the National Cancer Institute by van Hellemond et al, 12% of women with breast cancer who had chemotherapy-induced ovarian function failure experienced ovarian function recovery during 30 months of aromatase inhibitor therapy with anastrozole....

lung cancer

Fat Intake and Lung Cancer Risk

According to a study reported by Yang et al in the Journal of Clinical Oncology, high dietary intake of total fat and saturated fat was associated with an increased risk of lung cancer, with the association with saturated fat being particularly evident among current smokers. Study Details The...

solid tumors
issues in oncology

Cancer at Baseline Screening in Patients With Li-Fraumeni Syndrome

In a new study from the National Cancer Institute (NCI), researchers found a higher-than-expected prevalence of cancer at baseline screening in individuals with Li-Fraumeni syndrome, a rare inherited disorder that leads to a higher risk of developing certain cancers. The research demonstrates...

leukemia

Blinatumomab in Advanced Acute Lymphoblastic Leukemia: A Brighter Therapeutic Outlook

NEW DRUGS that will improve the outcome of adult patients who develop a deadly disease such as acute leukemia are badly needed; combinations of cytotoxic chemotherapeutic drugs may have reached an upper limit of utility. Agents that eradicate leukemia by alternative mechanisms would be of...

leukemia

Improved Overall Survival With Blinatumomab vs Chemotherapy in Advanced Acute Lymphoblastic Leukemia

IN THE PHASE III TOWER TRIAL reported in The New England Journal of Medicine, Hagop Kantarjian, MD, of The University of Texas MD Anderson Cancer Center, and colleagues found that blinatumomab (Blincyto) treatment improved overall survival vs chemotherapy in heavily pretreated patients with B-cell ...

thyroid cancer

Trends in Thyroid Cancer Incidence and Mortality in the United States

THE REPORTED INCIDENCE of thyroid cancer has markedly increased in the United States in recent decades, largely reflecting an increase in reported rates of papillary thyroid cancer. It has been unclear whether the increase in incidence is reflected in mortality rates over time. In a study of...

geriatric oncology
global cancer care

Challenges in Geriatric Oncology in Low- and Middle-Income Countries: Focus on Latin America

Virtually every region and country in the world are experiencing population aging. Although developed regions still have the largest proportion of older persons, the absolute number of older adults is higher in developing regions of the world. Globally, more than 60% of all persons aged 65 now...

leukemia

FDA Approves Liposome-Encapsulated Combination of Daunorubicin-Cytarabine for Some Types of Poor-Prognosis AML

On August 3, 2017, the U.S. Food and Drug Administration (FDA) granted regular approval to a liposome-encapsulated combination of daunorubicin and cytarabine (Vyxeos) for the treatment of adults with newly diagnosed therapy-related acute myeloid leukemia (AML) or AML with myelodysplasia-related...

cns cancers

Vaccine-Chemotherapy Combination in Glioblastoma

Despite highly aggressive therapy that includes maximal tumor resection, high-dose radiation, and temozolomide chemotherapy, the prognosis for patients with newly diagnosed glioblastoma is dismal, with a median survival of less than 15 months, prompting researchers to study novel approaches to...

health-care policy

FDA Announces Comprehensive Regulatory Plan to Shift Trajectory of Tobacco-Related Disease, Death

On July 28, the U.S. Food and Drug Administration (FDA) announced a new comprehensive plan for tobacco and nicotine regulation that will serve as a multiyear roadmap to better protect children and significantly reduce tobacco-related disease and death. The approach places nicotine and the issue of...

issues in oncology
survivorship

How to Help Young Patients Preserve Their Fertility

GUEST EDITOR Adolescent and Young Adult Oncology explores the unique physical, psychosocial, social, emotional, sexual, and financial challenges adolescents and young adults with cancer face. The column is guest edited by Brandon Hayes-Lattin, MD, FACP, Professor of Medicine and Medical Director...

hematologic malignancies
multiple myeloma
lymphoma
leukemia
myelodysplastic syndromes

Selected Abstracts on Novel Therapies for Hematologic Malignancies

THE 22ND CONGRESS of the European Hematology Association (EHA) was held in June in Madrid, drawing hematologists and allied professionals from every subspecialty of hematology from around the world. Among the extensive educational and scientific program, the EHA Congress provides a forum for...

colorectal cancer

Expert Point of View: Frank Sinicrope, MD

FRANK SINICROPE, MD, Professor of Oncology and Co-Leader of the GI Cancer Program at the Mayo Clinic, Rochester, said CHARTA addressed whether patient outcomes can be improved with a triplet regimen plus bevacizumab (Avastin) vs a standard doublet plus bevacizumab. This was based upon the finding...

colorectal cancer

More Support for FOLFOXIRI/Bevacizumab in Advanced Colorectal Cancer

A RANDOMIZED head-to-head comparison in patients with advanced colorectal cancer found that a regimen of FOLFOXIRI (fluorouracil/leucovorin, oxaliplatin, irinotecan) plus bevacizumab (Avastin) was more effective than a regimen of FOLFOX (fluorouracil/leucovorin, oxaliplatin) plus bevacizumab as...

sarcoma

Clinical Trials Actively Recruiting Patients With Sarcomas

The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies focused on sarcomas. These studies are focusing on anticancer vaccines, T-cell therapy, combination chemotherapy, pathway inhibitors, preoperative radiotherapy, and more. All of the...

sarcoma
cns cancers
lymphoma
survivorship

In Case You Missed It: Short Takes on Current Cancer Research

MOST ONCOLOGISTS are familiar with the findings of the plenary sessions featured at the 2017 ASCO Annual Meeting, with topics ranging from the duration of adjuvant oxaliplatin-based therapy in stage III colon cancer to patient-reported outcomes for symptom monitoring during routine cancer...

palliative care

An Educational Program for Safe Handling of Opioids

Improper storage, use, and disposal of prescribed opioids can lead to diversion or accidental overdose. Given that opioids are the mainstay of cancer pain treatment, this issue is particularly germane in the oncology community. The ASCO Post recently spoke with Akhila Reddy, MD, and Maxine de la...

leukemia

Asparaginase-Associated Pancreatitis in Childhood Acute Lymphoblastic Leukemia

An observational study reported in The Lancet Oncology by Wolthers et al in the Ponte di Legno Toxicity Working Group identified characteristics and the course of asparaginase-associated pancreatitis in childhood acute lymphoblastic leukemia. Study Details The study involved merged data from...

breast cancer

Association of Bisphosphonate Use and Breast Cancer Risk in Postmenopausal Women

A study in postmenopausal women in the French E3N prospective cohort indicated bisphosphonate use was not associated with a reduced risk of breast cancer. These findings were reported by Fournier et al in the Journal of Clinical Oncology. Study Details The study included 64,438 postmenopausal...

lung cancer

Study Finds HER2 Mutations in 3% of Lung Cancers

The Lung Cancer Mutation Consortium at the University of Colorado Cancer Center reported that 24 of 920 patients (3%) with advanced-stage lung cancer in a recent study had mutations in the gene HER2. According to the study, published by Pillai et al in Cancer, 71% of these patients were...

issues in oncology

Guideline-Based Statin Eligibility and Cancer Risk

A study in the offspring and third-generation cohorts of the Framingham Heart Study showed that eligibility for statin therapy was associated with an increased risk for cancer and cancer mortality. These findings were reported by Pursnani et al in the Journal of Clinical Oncology. Study Details...

skin cancer

FDA Expands Approval of Ipilimumab to Include Pediatric Patients 12 Years and Older With Unresectable or Metastatic Melanoma

Today, the U.S. Food and Drug Administration (FDA) expanded the indication for ipilimumab (Yervoy) injection for intravenous use to now include the treatment of unresectable or metastatic melanoma in pediatric patients 12 years of age and older. Ipilimumab was evaluated in 2 trials of pediatric...

issues in oncology
survivorship

Poor Social Functioning in Adolescent and Young Adult Cancer Survivors

A new study indicates many young adults who survived the disease struggle with “getting back to normal” as much as 2 years after their initial diagnosis. The longitudinal study, published by Husson et al in Cancer, is among the first seeking to understand the social functioning among...

issues in oncology

New Model for Estimating Glomerular Filtration Rate and Accurately Dosing Carboplatin in Cancer Patients

Janowitz et al have developed a new model for estimating glomerular filtration rate (GFR) that improves accuracy compared with chromium-51 (51Cr) EDTA excretion measurements and accuracy of carboplatin dosing compared with other published models in cancer patients. Their findings were reported in...

head and neck cancer

Pembrolizumab Is Active in Platinum- and Cetuximab-Refractory Head and Neck Cancer

IN THE PHASE II KEYNOTE-055 trial, pembrolizumab (Keytruda) was found to produce durable responses in patients with platinum- and cetuximab (Erbitux)-refractory head and neck squamous cell carcinoma.1 Results of the trial were reported by Joshua Bauml, MD, of the University of Pennsylvania,...

bladder cancer

Pembrolizumab Improves Overall Survival vs Chemotherapy in Second-Line Therapy for Advanced Urothelial Carcinoma

IN THE PHASE III KEYNOTE-045 trial reported in The New England Journal of Medicine, Joaquim Bellmunt, MD, PhD, of Dana-Farber Cancer Institute, and colleagues found that pembrolizumab (Keytruda) significantly improved overall survival vs investigator choice of chemotherapy as second-line treatment ...

supportive care

Are Wearable Physical Activity Monitors Coming of Age in Oncology?

COMMERCIALLY AVAILABLE wearable physical activity monitors have been making their way into clinical research in recent years; however, most studies on these devices have been related to non-cancer conditions including obesity, depression, and physical activity. Their application in the field of...

gynecologic cancers

Study Supports Omission of Lymphadenectomy in Node-Negative Advanced Ovarian Cancer

SYSTEMATIC LYMPHADENECTOMY in patients with advanced ovarian cancer and complete resection offered no improvement in progression-free or overall survival in the Gynecologic Cancer Intergroup’s LION trial, reported at the 2017 ASCO Annual Meeting by Philipp Harter, MD, PhD, of the German...

colorectal cancer

Tumor ‘Sidedness’ in Colon Cancer: Studies Look for Explanations

TUMOR “SIDEDNESS” in colon cancer has become a topic of great interest, after right-sided tumors were shown to have a worse prognosis than left-sided ones and biologics were found to differ in efficacy based on side. At the 2017 ASCO Annual Meeting, studies explored why this might be so.  Three...

symptom management

Radiation Therapy for Spinal Cord Compression: One Treatment Is Sufficient

SPINAL CORD COMPRESSION associated with metastatic cancer can be effectively treated with a single dose of radiotherapy, according to the results of a phase III British study that showed multiple radiotherapy doses to be no better than one treatment.1  Up to 10% of all patients with cancer will...

cns cancers

Stereotactic Radiosurgery vs Whole-Brain Radiotherapy for Resected Metastatic Brain Disease

In the phase III NCCTG N107C/CEC.3 trial, stereotactic radiosurgery to the surgical cavity reduced cognitive deterioration and was associated with similar overall survival vs whole-brain radiotherapy in patients with resected brain metastasis. These results were reported by Brown et al in The...

skin cancer

Spark Discussions About Indoor-Tanning Devices

“Strong evidence suggests that using a tanning bed during adolescence or young adulthood can increase the risk of early-onset melanoma by over 40%,” Jeffrey E. Gershenwald, MD, wrote in an opinion piece for Newsweek.1 Dr. Gershenwald is Professor of Surgical Oncology, Medical Director of the...

skin cancer

Educating Young People on Sun-Safe Behaviors and Reducing the Risk of Melanoma

“If minors don’t tan, then they may never become adult tanners,” Jeffrey E. Gershenwald, MD, said in explaining the emphasis on teaching sun safety behaviors to young children as part of the Melanoma Moon Shot Program at The University of Texas MD Anderson Cancer Center, Houston. Dr. Gershenwald is ...

A Frank Memoir About Doctors, Patients, and the Health-Care System

“In 1981, 2 days after my older brother Matthew was born, my father sawed off the tip of his index finger.” So begins No Apparent Distress: A Doctor’s Coming of Age on the Front Lines of American Medicine, a memoir by Rachel Pearson, MD, who is currently a resident at Seattle Children’s Hospital. ...

pancreatic cancer

Stereotactic Body Radiotherapy for Poor Performance Status Patients With Pancreatic Cancer

There are few data to guide the management of nonmetastatic pancreatic ductal adenocarcinoma in patients who are elderly or have a poor performance status. Although most such patients are offered supportive care or gemcitabine alone, the addition of stereotactic body radiotherapy may improve...

lung cancer

No Survival Benefit When Pravastatin Is Added to Standard Chemotherapy in Small Cell Lung Cancer

In a UK phase III study (LUNGSTAR) reported in the Journal of Clinical -Oncology, Michael J. Seckl, MD, PhD, of Imperial College London, and colleagues found that adding pravastatin to first-line standard chemotherapy did not improve overall survival in patients with small cell lung cancer...

issues in oncology

The Immune System: Deciphering Recent Advances

Over the past decade, there has been renewed interest in developing immunologic therapies in cancer. The U.S. Food and Drug Administration (FDA) has approved several new biologic agents that target a patient’s immune system, some of which have produced profound clinical responses. However, the...

leukemia

Effect of Methotrexate and Corticosteroid Strategies on Neurocognitive Function in Patients With B-Lineage ALL

In a Children’s Oncology Group (COG) study (AALL06N1) reported in the Journal of Clinical Oncology, Hardy et al found that age < 10 years at diagnosis was associated with poorer neurocognitive function in patients with high-risk B-lineage acute lymphoblastic leukemia regardless of...

breast cancer

MammaPrint Scoring and Indolent Node-Negative Breast Cancer

In an analysis reported in JAMA Oncology, Esserman et al found that an ultralow-risk designation using the 70-gene MammaPrint assay is capable of identifying patients with node-negative disease who have a very low long-term risk of death from breast cancer after surgery without systemic therapy....

supportive care

Appropriate Distress Screening and Follow-up Leads to Fewer ER Visits and Hospitalizations in Patients With Cancer

Following a cancer diagnosis, all patients experience some level of distress—regardless of disease stage. When severe and left untreated, distress can have a significant impact on health outcomes, lead to greater mortality and morbidity, affect immune function, and result in higher...

skin cancer

Nivolumab Treatment Beyond Disease Progression in Advanced Melanoma

In a retrospective analysis reported in JAMA Oncology, Long et al found that a substantial proportion of patients with advanced melanoma derived benefit from continued nivolumab (Opdivo) treatment after Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1–defined disease...

Impact of Health Insurance and Sociodemographic Status on Survival for AYAs With Cancer

According to the National Cancer Institute, cancer is the leading cause of disease-related death among adolescents and young adults (AYAs) between the ages of 15 and 39. And although cancer survival among this age group is more than 80%, AYAs have not experienced the same improvements in relative...

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