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pain management
supportive care

Pediatric Cancer Pain May Be Misunderstood and Largely Undertreated

Cancer pain in children poses certain unique challenges. Over the past decade, insightful research into pediatric cancer pain has focused on pain management that incorporates nonopioid therapies into standard care. To shed light on this important issue, The ASCO Post spoke with Christine T....

cost of care

The Emperor’s New Clothes: Biosimilars and Cost in Oncology

Biosimilars are biologic products similar to the parent (branded) molecule in structure and function—such as erythropoietin and filgrastim (Neupogen).1 To truly bend the cost curve, we want to see a dramatic economic savings achieved as oncology biosimilars for rituximab (Rituxan), trastuzumab...

breast cancer

Pembrolizumab Moving Forward in Triple-Negative Breast Cancer

In the treatment of triple-negative breast cancer, checkpoint inhibition is making inroads in both early- and late-stage disease, and the line of treatment and expression of the programmed cell death ligand 1 (PD-L1) could be important in determining outcomes, according to studies reported at the...

leukemia

Adding Idelalisib to Bendamustine/Rituximab in Relapsed/Refractory CLL

As reported by Andrew D. Zelenetz, MD, of Memorial Sloan Kettering Cancer Center, and colleagues in The Lancet Oncology, interim analysis of a phase III trial has shown the superiority of adding the phosphoinositide-3-kinase δ inhibitor idelalisib (Zydelig) to bendamustine/rituximab (Rituxan) in...

colorectal cancer

ESMO World GI 2017: Right-Sided Colorectal Tumors: An Internal Radiation Advantage

For patients with colorectal cancer that has metastasized to the liver, having a primary tumor on the left side as opposed to the right side of the colon is known to be a significant advantage in terms of treatment response. But a new study, presented by van Hazel et al at the European Society for...

gastrointestinal cancer

ESMO World GI 2017: Study Explores Association of Mediterranean Diet Components With Advanced Colorectal Polyps

The benefits of a Mediterranean diet are well known when it comes to colorectal protection, but it’s hard to know specifically what elements of the diet are the healthiest. Now a new study, presented by Fliss Isakov et al at the ESMO 19th World Congress on Gastrointestinal Cancer, suggests...

solid tumors

Detecting Cancer With Intraoperative Multimodal Optical System

To maximize cancer cell detection during cancer surgery, Jermyn et al designed a validation study to determine the accuracy of using an in situ intraoperative, label-free, optical system. They found the system was able to detect cancer cells in patients with brain tumors with a high degree of...

health-care policy

FDA Takes Steps to Increase Drug Competition to Improve Patient Access

On June 27, the U.S. Food and Drug Administration (FDA) took two new, important steps to increase competition in the market for prescription drugs and facilitate entry of lower-cost alternatives. The agency published a list of off-patent, off-exclusivity branded drugs without approved generics, and ...

head and neck cancer

Outcome by Age With Lenvatinib in Radioiodine-Refractory Differentiated Thyroid Cancer

As reported in the Journal of Clinical Oncology by Brose et al, a prespecified analysis of the phase III double-blind SELECT trial of lenvatinib (Lenvima) vs placebo in radioiodine-refractory differentiated thyroid cancer showed progression-free survival benefits in both older and younger...

lung cancer

First-Line Nivolumab vs Chemotherapy in Advanced NSCLC With PD-L1 Expression ≥ 5%

As reported by Carbone et al 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 chemotherapy in patients with recurrent or stage IV non–small cell lung cancer with...

survivorship

Secondhand Smoke Exposure Among Nonsmoking Cancer Survivors

According to the Centers for Disease Control and Prevention (CDC), tobacco use and exposure accounts for about one-third of all cancer-related deaths in the United States. Moreover, exposure to secondhand tobacco smoke is attributable to more than 7,000 lung cancer–related deaths each year in ...

ASCO University “Business of Health Care Fundamentals” Course: Education for the Complete Care Team

As the economics and management of health care change, it has become essential for the clinician to evolve as well in order to navigate these changing waters.  Whether you are a medical student, a senior oncologist, or an advanced practice provider, the necessity is the same: understanding the...

breast cancer

Expert Point of View: Harold Burstein, MD, Carey Anders, MD, and William Sikov, MD

Several breast cancer experts weighed in on the findings of the APHINITY trial. At an ASCO press briefing, Harold Burstein, MD, Associate Professor of Medicine at Harvard Medical School and breast cancer specialist at Dana-Farber Cancer Institute, Boston, pointed out that investigators estimated a ...

neuroendocrine tumors

Lu-177 Dotatate Improves Progression-Free Survival in Advanced Progressive Midgut Neuroendocrine Tumors

In the phase III NETTER-1 trial reported in The New England Journal of Medicine, Jonathan R. Strosberg, MD, of the Moffitt Cancer Center in Tampa, Florida, and colleagues found that the addition of the targeted radiotherapeutic agent lutetium Lu-177 dotatate to the long-acting repeatable (LAR)...

colorectal cancer

ASCP/CAP/AMP/ASCO Colorectal Cancer Biomarker Guideline: A Clinician's Perspective

The joint American Society for Clinical Pathology (ASCP), College of American Pathologists (CAP), Association for Molecular Pathology (AMP), and ASCO guideline reported by Sepulveda et al, and reviewed in this issue of The ASCO Post, represents a collaboration of three pathology societies and ASCO ...

colorectal cancer

ASCP/CAP/AMP/ASCO Guideline on Molecular Biomarkers in Colorectal Cancer

As reported in the Journal of Clinical Oncology by Antonia R. Sepulveda, MD, PhD, of Columbia University, and colleagues, a joint guideline on the use of molecular biomarkers for evaluation of colorectal cancer has been developed by an expert panel from the American Society for Clinical Pathology...

leukemia

Newer Approaches With CAR T Cells Explored in CLL

Chimeric antigen receptor (CAR) T-cell therapy is a hot area of research and development in hematologic malignancies and, more recently, some solid tumors. Results have been particularly good in acute lymphocytic leukemia, and one or more CAR T-cell products may be getting close to approval by the ...

solid tumors

Novel Tropomyosin Receptor Kinase Inhibitor Yields High Response Rates Across Tumor Types

Larotrectinib, an oral inhibitor of tropomyosin receptor kinase, showed “striking” activity in adult and pediatric patients with the genetic aberrations known as tropomyosin receptor kinase (TRK) fusion, researchers reported at the 2017 ASCO Annual Meeting.1 Of 55 patients treated with...

breast cancer

Abemaciclib Plus Fulvestrant Delays Breast Cancer Progression in MONARCH 2

In the treatment of metastatic estrogen receptor–positive breast cancer, a highly significant 45% reduction in progression was achieved with abemaciclib, combined with fulvestrant (Faslodex), in the global phase III MONARCH 2 trial, reported at the 2017 ASCO Annual Meeting by George W. Sledge, MD,...

prostate cancer

Two Studies Show Abiraterone Plus Prednisolone/Prednisone Added to Standard Hormone Therapy Improves Survival in Advanced Prostate Cancer

The addition of abiraterone acetate (Zytiga) plus prednisolone/prednisone to standard androgen-deprivation therapy improves survival in men starting treatment for locally advanced or metastatic, hormone--naive prostate cancer, according to the results of two potentially practice-changing studies...

global cancer care

Will the UK’s Departure From the EU Impact Oncology in Europe?

“No man is an island entire of itself; any man’s death diminishes me, because I am involved in mankind. And therefore never send to know for whom the bell tolls; it tolls for thee.”  —John Donne (1624) This statement is almost certainly true—and sadly in a negative way not just for the UK but for...

breast cancer

NCCN Guidelines® Compliance for Chest CT May Reduce False Positives and Decrease Health-Care Spending in Breast Cancer

According to Surveillance, Epidemiology, and End Results (SEER) data, more than 260,000 women were diagnosed with breast cancer in the United States in 2016, most of whom were diagnosed with early-stage (stage I or II) disease. For this demographic, the National Comprehensive Cancer Network®...

colorectal cancer

Effect of Postdiagnosis Aspirin and Other NSAIDs on Survival in Colorectal Cancer

As reported by Hua et al in the Journal of Clinical Oncology, long-term survivors of colorectal cancer with KRAS wild-type tumors had improved survival with regular use of any nonsteroidal anti-inflammatory drug (NSAID) post diagnosis. The study involved data from 2,149 patients aged 18 to 74...

symptom management

Online Self-Reporting of Symptoms Improves Quality of Life, Extends Survival

When patients with metastatic cancer used a Web-based tool to self-report symptoms proactively during treatment, they lived 5 months longer than did patients assigned to usual care. In addition, they had improved quality of life and fewer emergency room visits and hospitalizations compared with...

breast cancer

Cancer Gave Me the Impetus to Lose Weight

Fifteen years ago, my internist advised me to lose weight. But after seeing the yo-yo effects of dieting on friends and colleagues, I knew I would find the process of losing weight and gaining it back frustrating, so I ignored my physician’s advice. It wasn’t until I was diagnosed late this past...

genomics/genetics
issues in oncology

How Watson for Oncology Is Advancing Personalized Patient Care

After undergoing nearly 5 years of intensive medical training, IBM’s Watson for Oncology cognitive computing system is starting to make good on its promise to accelerate personalized care for patients with cancer. The system has been trained by oncologists at Memorial Sloan Kettering Cancer Center ...

lymphoma

ICML 2017: Data From the TRANSCEND Trial of JCAR017 in Relapsed and Refractory Aggressive B-Cell Non-Hodgkin Lymphoma

Data from the TRANSCEND trial of JCAR017 in relapsed and refractory aggressive B-cell non-Hodgkin lymphoma (NHL) was presented at the 2017 International Conference on Malignant Lymphoma (ICML) in Lugano, Switzerland. JCAR017 is Juno Therapeutics’ investigative chimeric antigen receptor (CAR) ...

lymphoma

ICML 2017: Phase IIIb MAGNIFY Study of Lenalidomide and Rituximab Combination in Relapsed/Refractory Follicular and Marginal Zone Lymphoma

An interim analysis of MAGNIFY, a phase IIIb, randomized, open-label, multicenter study of the R2 combination regimen (lenalidomide [Revlimid] plus rituximab [Rituxan]) in patients with relapsed or refractory marginal zone lymphoma, was presented at the International Conference on Malignant...

lymphoma

ICML 2017: Brentuximab Vedotin in Combination With Nivolumab in Patients With Relapsed or Refractory Hodgkin Lymphoma

An updated interim analysis from an ongoing phase I/II clinical trial evaluating brentuximab vedotin (Adcetris) and nivolumab (Opdivo) in relapsed or refractory classical Hodgkin lymphoma was presented at the International Conference on Malignant Lymphoma (ICML) in Lugano, Switzerland (Abstract...

lymphoma

ICML 2017: ADCT-402 Demonstrates Encouraging Antitumor Activity in Relapsed/Refractory Non-Hodgkin Lymphoma

Clinical data from an ongoing phase I clinical trial evaluating ADCT-402 for the treatment of relapsed or refractory non-Hodgkin lymphoma was presented at the 14th International Conference on Malignant Lymphoma (ICML) in Lugano, Switzerland. ADCT-402 is a novel antibody-drug conjugate composed of a ...

leukemia

ICML 2017: Phase III GENUINE Trial: Ublituximab Plus Ibrutinib in High-Risk CLL

Data was recently presented from the phase III GENUINE trial of ublituximab, a novel glycoengineered anti–CD20 monoclonal antibody, in combination with ibrutinib (Imbruvica), a Bruton tyrosine kinase (BTK) inhibitor, for the treatment of high-risk chronic lymphocytic leukemia (CLL), at the...

gastroesophageal cancer

High-Dose First-Line Trastuzumab Maintenance in Metastatic HER2-Positive Gastric Cancer

As reported in the Journal of Clinical Oncology by Shah et al, the phase IIIB HELOISE trial has shown no survival benefit of high-dose vs standard trastuzumab (Herceptin) maintenance plus chemotherapy in the first-line treatment of metastatic gastric or gastroesophageal junction adenocarcinoma....

lung cancer

ASTRO Issues Guideline for Use of Stereotactic Radiation in Early-Stage Lung Cancer

The American Society for Radiation Oncology (ASTRO) has issued a new clinical guideline for the use of stereotactic body radiation therapy (SBRT) in early-stage lung cancer. While SBRT is the current standard of care for peripherally located tumors in patients who cannot undergo surgery, the new...

gynecologic cancers

Dutch Study Assesses Long-Term Risk of HPV-Related Carcinoma and Premalignancies After CIN3 Diagnosis

A Dutch study has shown long-lasting risk for human papillomavirus (HPV)-related carcinoma and premalignancies in women with a diagnosis of cervical intraepithelial neoplasia grade 3 (CIN3). The findings were reported by Ebisch et al in the Journal of Clinical Oncology. Study Details The...

breast cancer

Combination of Buparlisib and Fulvestrant in Postmenopausal Women With Advanced Breast Cancer

In the phase III BELLE-2 trial, the addition of the PI3K inhibitor buparlisib to fulvestrant (Faslodex) improved progression-free survival in postmenopausal hormone receptor–positive, HER2-negative advanced breast cancer—but at the cost of excessive toxicity. Results were reported in...

solid tumors

Pembrolizumab in Solid Tumors With Mismatch-Repair Deficiency

As reported by Le et al in Science, pembrolizumab (Keytruda) was found to be active across a range of solid tumors with mismatch-repair (MMR) deficiency. Pembrolizumab was recently approved for treatment of patients with unresectable or metastatic microsatellite instability–high (MSI-H) or...

gastroesophageal cancer

Association of EGFR Copy Number Gain and Outcome With Gefitinib in Advanced Esophageal Cancer

As reported by Petty et al in the Journal of Clinical Oncology, analysis of outcomes in the UK phase III Cancer Esophagus Gefitinib trial showed an overall survival benefit with second-line gefitinib (Iressa) in patients with advanced esophageal cancer who had epidermal growth factor receptor...

breast cancer

Adding Abemaciclib to Fulvestrant in Hormone Receptor–Positive, HER2-Negative Breast Cancer

In the phase III MONARCH 2 trial reported at the recent ASCO Annual Meeting and in the Journal of Clinical Oncology by Sledge et al, the addition of the selective cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitor abemaciclib to fulvestrant (Faslodex) improved progression-free survival in hormone...

prostate cancer

Ipilimumab vs Placebo in Metastatic Chemotherapy-Naive, Castration-Resistant Prostate Cancer Without Visceral Metastases

In the phase III CA184-095trial reported in the Journal of Clinical Oncology, Tomasz M. Beer, MD, FACP, of the Knight Cancer Institute, Oregon Health and Science University, and colleagues found that ipilimumab (Yervoy) did not increase overall survival vs placebo in men with asymptomatic or...

lung cancer

Atezolizumab Improves Overall Survival vs Docetaxel in Previously Treated Non–Small Cell Lung Cancer

In the phase III OAK trial reported in The Lancet by Achim Rittmeyer, MD, of Lungenfachklinik Immenhausen, Germany, and colleagues, treatment with the anti–programmed cell death ligand 1 (PD-L1) antibody atezolizumab (Tecentriq) improved overall survival vs docetaxel in previously treated non–small ...

multiple myeloma

Autologous Transplantation for Myeloma: Don’t Change the Winning Team

Over the past 20 years, the Intergroupe Francophone du Myelome (IFM) and Dr. Michel Attal have pioneered the use of autologous hematopoietic cell transplantation (AHCT) for multiple myeloma in a series of randomized studies. Notable studies include comparisons of planned upfront AHCT vs...

WHO to Begin Pilot Prequalification of Biosimilars for Cancer Treatment

This year, the World Health Organization (WHO) will launch a pilot project for prequalifying biosimilar medicines, a step toward making some of the most expensive treatments for cancer more widely available in low- and middle-income countries. The decision comes after a 2-day meeting in Geneva...

cns cancers

Combinations of Novel Treatment Approaches Continue to Make Progress in Overcoming Challenges of Pediatric Brain Tumors

Nearly 2,500 children in the United States are diagnosed with brain tumors each year, making these malignancies among the most common solid tumors in children and adolescents. Despite advances over the past few decades, the treatment of brain tumors remains one of the most challenging clinical...

issues in oncology
survivorship

Proposed Categories of Cancer Survivors Aim to Bring Survivorship Into Precision Medicine Era

Care for people who have survived or are living with cancer should acknowledge the heterogeneity of their needs and experiences and should reflect the same level of personalization that is now guiding active cancer therapy. At a time when more people are surviving cancer than ever before, new...

Leave a Legacy of Hope

By including a planned gift to the Conquer Cancer Foundation in your estate plans, you can help make a dramatic difference for cancer patients years—even decades—into the future. With just one small change to your will or trust, your planned gift of any size will deliver a big impact, and:  Your...

lung cancer

Combination Therapy With Pembrolizumab in Metastatic Nonsquamous NSCLC

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 May 10, 2017, pembrolizumab (Keytruda) was granted accelerated...

breast cancer

Targeting the Androgen Receptor in Breast Cancer

One of the most active areas of research in breast cancer involves the targeting of the androgen receptor. Trials underway for androgen receptor antagonists and modulators, alone and in various combinations of available agents and novel therapies, are yielding encouraging early results. At the 2017 ...

breast cancer
symptom management

Lymphedema Risk: It’s Not Just About the Surgery

In a study from the Mayo Clinic, Rochester, Minnesota, the risk of lymphedema in a population-based breast cancer cohort was related to multimodality therapy and not axillary surgery alone, investigators reported at the American Society of Breast Surgeons (ASBrS) Annual Meeting.1 “Most patients...

head and neck cancer

Proton Therapy Associated With Fewer Sequelae in the Treatment of Head and Neck Cancer

Radiation oncology is vital to the management of patients with cancer of the head and neck, and for certain patients, proton therapy may offer significant benefit over intensity-modulated radiation therapy, according to Walter J. Curran, MD, Executive Director of the Winship Cancer Institute of...

issues in oncology
cost of care

Value-Based Decision-Making Tools: The View Ahead

As new treatment decision-making tools make their way toward and into the clinic, oncologists are getting a sense of how they may affect clinical practice—and beginning to look farther down the road. “What do you see ahead for clinicians?” asked Christian Downs, JD, Executive Director of the...

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