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neuroendocrine tumors

Cabozantinib Elicits Responses in Neuroendocrine and Carcinoid Tumors

In a phase II study reported at the 2017 Gastrointestinal Cancers Symposium, the tyrosine kinase inhibitor cabozantinib (Cometriq) was evaluated in advanced carcinoid and pancreatic neuroendocrine tumors. Radiographic responses to therapy were observed in both tumor subtypes, and compared to other ...

hepatobiliary cancer

Novel Bridge to Liver Transplant May Improve Upon Standard of Care

For hepatocellular carcinoma patients awaiting a liver transplant, locoregional treatment as a “bridge” is a standard strategy for reducing tumor progression. The most common approach is transarterial chemoembolization, but a study from a large-volume liver transplant center questions whether it...

gastroesophageal cancer

Sarcopenia in Esophageal Cancer Represents a Significant Risk to Survival

Patients with esophageal cancer who suffer sarcopenia (loss of muscle mass) during neoadjuvant chemotherapy survive, on average, 32 months less than patients with no sarcopenia. This is the central finding of a recent study conducted at the Comprehensive Cancer Center (CCC) of MedUni Vienna and...

lung cancer

Durvalumab Shows Activity in Heavily Pretreated Patients With Non–Small Cell Lung Cancer

The immune checkpoint inhibitor durvalumab (also known as MEDI4736) is active and achieves durable responses in patients with heavily pretreated advanced non–small cell lung cancer (NSCLC) that does not have any epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK)...

lung cancer

Expert Point of View: Michael Boyer, MBBS, PhD

“The OAK subgroup analyses showed the benefit of atezolizumab (Tecentriq) virtually “across the board,” including among patients with programmed cell death ligand 1 (PD-L1)–negative tumors, remarked invited discussant, Michael Boyer, MBBS, PhD, Chief Clinical Officer and Conjoint Chair of Medical...

lung cancer

Atezolizumab Benefits Survival vs Docetaxel Across Multiple Subtypes of Non–Small Cell Lung Cancer

A wide range of patients with advanced non–small cell lung cancer (NSCLC) see a survival advantage from second- or third-line atezolizumab (Tecentriq) as compared with docetaxel, according to new data from the OAK trial.1 The main results of the randomized phase III trial, previously reported,...

lung cancer

Expert Point of View: Edward B. Garon, MD

“There are several possible ways to move first-line immunotherapy for non–small cell lung cancer (NSCLC) forward, according to invited discussant Edward B. Garon, MD, Director of Thoracic Oncology at the David Geffen School of Medicine at the University of California, Los Angeles. “We could expand...

lung cancer

Clinical Trials Study the Role of Immunotherapy in the First-Line Setting of Non–Small Cell Lung Cancer

In 2016, the KEYNOTE-024 trial set the bar for first-line immunotherapy in non–small cell lung cancer (NSCLC). Trial results showed that pembrolizumab (Keytruda), an antibody to programmed cell death protein 1 (PD-1), reduced the risk of disease progression or death by 50% and the risk of death by...

lung cancer

Understanding the Role of Immunotherapy for Lung Cancer: A Paradigm Shift for the Better

“Immunotherapy for lung cancer is a paradigm shift. I would never have thought when I started my career taking care of lung cancer patients in the mid 1990s that we’d now be substituting chemotherapy with an antibody immunotherapy in 2017. It’s incredible,” commented Roy S. Herbst, MD, PhD, Chief...

pain management

Combating Untreated Cancer-Related Pain

The problem of pain management facing clinicians today is twofold: how to ensure safe and effective treatment for patients with cancer in chronic pain, while avoiding the overuse of opioid medications and the potential for substance use disorder and diversion. According to the American Cancer...

colorectal cancer

CheckMate 142 Update: Prolonged Disease Control With Nivolumab in Deficient Mismatch Repair Colorectal Cancer

With 6 additional months of follow-up since the initial presentation of results, in the phase II CheckMate 142 trial, 74% of heavily pretreated patients with metastatic colorectal microsatellite instability–high (MSI-H) cancers are alive after single-agent treatment with nivolumab (Opdivo).1...

head and neck cancer
lymphoma
gastrointestinal cancer

Protein Component of the Epstein-Barr Virus May Promote the Development of Cancer

After an infection with the Epstein-Barr virus (EBV), the virus persists in the body throughout a person's lifetime, usually without causing any symptoms. About one-third of infected teenagers and young adults nevertheless develop infectious mononucleosis, which usually wears off after a few weeks. ...

gastroesophageal cancer

Adding Bevacizumab to Perioperative Chemotherapy in Esophagogastric Adenocarcinoma

In the UK Medical Research Council ST03 phase II/III trial reported in The Lancet Oncology, Cunningham et al found that adding bevacizumab (Avastin) to perioperative chemotherapy did not improve survival in patients with operable esophagogastric cancer and may have been associated with impaired...

breast cancer

Genetic Testing and Counseling Among Women With Newly Diagnosed Breast Cancer

In a population-based study reported in a research letter in JAMA, Kurian et al found that genetic testing and genetic counseling are suboptimal among women with newly diagnosed breast cancer. Study Details The study involved 2,451 women aged 20 through 79 years diagnosed with stage 0 to II...

kidney cancer

2017 GU Cancers Symposium: Some Patients With Renal Cell Carcinoma Experience Long-Term Tumor Control Even After Stopping Immunotherapy Early

Early findings from a new study appear to challenge the current standard practice for immune checkpoint inhibitor therapy—continuing treatment until cancer worsens. Among patients with advanced kidney cancer who stopped programmed cell death protein 1/programmed cell death ligand 1...

colorectal cancer

ASCP/CAP/AMP/ASCO Guideline on Molecular Biomarkers for Evaluation of Colorectal Cancer

As reported in the Journal of Clinical Oncology by Antonia 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...

breast cancer

Zoledronic Acid Every 12 Weeks vs Every 4 Weeks in Women With Breast Cancer and Bone Metastases

In the phase III OPTIMIZE-2 trial reported in JAMA Oncology, Hortobagyi et al found that an every-12-week schedule of zoledronic acid was noninferior to an every-4-week schedule in terms of skeletal-related event rate in women with bone metastases from breast cancer who were currently receiving...

colorectal cancer

Most Patients Undergoing Elective Colorectal Surgery Receive Inadequate Bowel Preparation to Prevent Postoperative Complications

In the largest study of its kind to date, researchers from Fox Chase Cancer Center and the Lewis Katz School of Medicine at Temple University confirmed that oral antibiotics combined with mechanical bowel preparation were more effective at preventing surgical site infections...

leukemia

Adding Idelalisib to Bendamustine/Rituximab in Relapsed or Refractory Chronic Lymphocytic Leukemia

As reported by Zelenetz et al in The Lancet Oncology, an 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 patients with relapsed or refractory chronic lymphocytic...

multiple myeloma

I Plan to Live Long Enough to Be Cured of Multiple Myeloma

Like many other patients diagnosed with multiple myeloma, I didn’t know I had the cancer until I broke a bone. I had felt a twinge of pain on my left side when I hoisted a bucket of baseballs over my left shoulder after participating in a baseball tournament in the spring of 2011, but there was...

issues in oncology

NCCN Working Group on Value Tools Presents Preliminary Findings and Recommendations

Over the past several years, the introduction of decision-making tools for patients from major cancer organizations, including ASCO and the National Comprehensive Cancer Network® (NCCN®), has been news, applauded as a step toward more patient-centered care and featured at many meetings. Next steps, ...

bladder cancer

Nivolumab in Metastatic Urothelial Carcinoma After Platinum Therapy

As reported in The Lancet Oncology by Sharma et al, the phase II CheckMate 275 trial has shown nivolumab (Opdivo) to produce durable responses in patients with metastatic urothelial cancer who had received at least one prior platinum-based regimen. The study supported the recent accelerated...

breast cancer

Accelerated Partial-Breast vs Whole-Breast Irradiation After Breast-Conserving Surgery

As reported in The Lancet Oncology by Polgár et al, 5-year late side effects and cosmetic results were similar with accelerated partial-breast irradiation (APBI) with interstitial brachytherapy vs whole-breast irradiation (WBI) after breast-conserving surgery for low-risk invasive and in...

ASCO Releases Principles for Patient-Centered Health-Care Reform

ASCO has released “ASCO Principles for Patient-Centered Health-Care Reform,” seven recommendations designed to ensure access to high-quality cancer care amid the changing U.S. health-care delivery landscape. The principles aim to assist the new Congress and Administration, so, as they consider the...

myelodysplastic syndromes

Expert Point of View: Steven D. Gore, MD, and Rami Komrokji, MD

Steven D. Gore, MD, Director of Hematologic Malignancies at Yale School of Medicine, New Haven, Connecticut, applauded Dr. Stein for “accruing a terrible patient population, mutation-wise” and called the preliminary findings for the benefit of enasidenib in patients with ASXL1 mutations...

myelodysplastic syndromes

Early Success Reported With Two New Agents for High-Risk Myelodysplastic Syndromes

At the 2016 American Society for Hematology (ASH) Annual Meeting & Exposition, researchers reported early success with two new experimental agents for high-risk myelodysplastic syndromes—enasidenib (also known as AG-221), a potent oral inhibitor of the isocitrate dehydrogenase 2 (IDH2) enzyme,...

Selected Abstracts From the 2016 ASH Annual Meeting

Here are several abstracts selected from the proceedings of this year’s American Society of Hematology (ASH) Annual Meeting & Exposition, highlighting newer therapeutics in several different types of non-Hodgkin lymphomas (NHLs), including mantle cell lymphoma and marginal zone lymphoma. For...

lymphoma

Studies Advance the Use of PD-1 Blockade in Classical Hodgkin Lymphoma

Classical Hodgkin lymphoma is one of the malignancies most susceptible to treatment with monoclonal antibodies targeting the programmed cell death protein (PD-1). Nivolumab (Opdivo) has been approved by the U.S. Food and Drug Administration (FDA) for use in patients with relapsed/refractory...

breast cancer

Autologous Breast Reconstruction Associated With Fewer Complications and Failures Than Implants in Women Who Have Received Radiation

Postmastectomy radiation is becoming more commonly used to treat breast cancer, and at the same time, there is an increasing trend among women to have breast reconstruction. Until now, oncologists have had little evidence on what the best reconstruction options are in women who require radiation...

breast cancer
symptom management

Randomized Trial Demonstrates Benefit of Scalp-Cooling in Prevention of Chemotherapy-Induced Hair Loss

A scalp-cooling device was found safe and effective in preventing chemotherapy-induced hair loss in women undergoing adjuvant treatment for breast cancer in an interim analysis of the first prospective, randomized trial of a modern scalp-cooling system. The study was presented at the 2016 San...

breast cancer

Adjuvant Letrozole vs Anastrozole in Hormone Receptor–Positive Node-Positive Early Breast Cancer

As reported in the Journal of Clinical Oncology by Smith et al, the final results of the phase III FACE trial showed no difference in disease-free or overall survival for adjuvant letrozole vs anastrozole in postmenopausal women with hormone receptor–positive node-positive early breast...

gastrointestinal cancer

Nivolumab, as Salvage, Improves Overall Survival in Gastric Cancer

Gastric cancer can apparently be added to the growing list of malignancies for which drugs targeting the programmed cell death protein 1 (PD‑1) receptor are effective, according to the results of the phase III ONO-4538 investigation conducted in Asia and presented at the 2017 Gastrointestinal...

cost of care

The Cost of a Patient’s Last Ride

It was a call from a referring physician who wanted the patient to be transferred to our major academic center. The patient had a history of a lethal malignancy in a very advanced stage. The patient was already outside the bell curve, for she had survived far longer than expected for a malignancy...

lung cancer

Phase III Trial Finds First-Line Ceritinib Improves PFS vs Platinum-Based Chemotherapy in ALK-Rearranged NSCLC

In a phase III trial (ASCEND-4) reported in The Lancet, Soria et al found that ceritinib (Zykadia) improved progression-free survival vs platinum-based chemotherapy in first-line treatment of advanced ALK-rearranged non–small cell lung cancer (NSCLC). Ceritinib is a next-generation selective...

issues in oncology

ASH/AACR/AACI/ASTRO/ASPHO/Lungevity Foundation Statement on Administration's Executive Order

Today, the American Society of Hematology, the American Association for Cancer Research, the Association of American Cancer Institutes, the American Society for Radiation Oncology, the American Society of Pediatric Hematology/Oncology, and the LUNGevity Foundation issued a statement on the...

breast cancer

ECCO 2017: Some Patients With Early-Stage Breast Cancer May Benefit More From Breast-Conserving Therapy Than Mastectomy

Breast-conserving therapy (breast-conserving surgery combined with radiation therapy) may be superior to mastectomy in certain patients with breast cancer, according to results from the largest study on this topic to date, presented at the 2017 European Cancer Congress (Abstract 4LBA). Although...

breast cancer

ECCO 2017: Low Cause-Specific Mortality in Women Over 50 Treated for Ductal Carcinoma in Situ

Women over 50 who have been treated for ductal carcinoma in situ (DCIS) are more likely to be alive 10 years later than women in the general population, according to new research presented by Elshof et al at the 2017 European Cancer Congress (ECCO) (Abstract 173). DCIS differs from breast cancer...

lymphoma

Venetoclax Studied in Relapsed or Refractory Non-Hodgkin Lymphoma

The BCL-2 inhibitor venetoclax (Venclexta) was found to be active in patients with relapsed or refractory non-Hodgkin lymphoma (NHL), according to a phase I study reported by Davids et al in the Journal of Clinical Oncology. Further study of this agent, including in combination therapy to augment...

SWOG Launches National Immunotherapy Clinical Trial for Rare Cancers

People with rare cancers now have the option of joining a national clinical trial testing leading-edge immunotherapies for a wide variety of tumor types. It’s the first federally funded immunotherapy trial devoted to rare cancers. Despite their name, rare cancers make up more than 20% of...

sarcoma

Addition of Palifosfamide to Doxorubicin in Metastatic Soft-Tissue Sarcoma

In the phase III PICASSO III trial reported in the Journal of Clinical Oncology, Christopher W. Ryan, MD, of Oregon Health & Science University, and colleagues found that adding palifosfamide to doxorubicin did not prolong progression-free survival among patients with metastatic soft-tissue...

What Have We Got to Lose?

Tuesday morning was the regular time for the departmental meeting—an opportunity to discuss cases, troubleshoot, debrief, and expedite the necessary allied health referrals. As usual, patient cases were being discussed in alphabetical order of the attending oncologist. We were already three...

What Cancer?

If they are honest, most oncologists who’ve practiced medicine for more than 15 years will tell you they’ve learned much more from their patients than their patients have learned from them. The life lessons I’ve learned from treating this complicated, resilient, and often cruel disease are many....

gynecologic cancers

Rucaparib in Previously Treated BRCA Mutation–Associated Ovarian Cancer

On December 19, 2016, rucaparib (Rubraca) was granted accelerated approval for the treatment of patients with deleterious BRCA mutation–associated (germline or somatic) advanced ovarian cancer who have received two or more prior chemotherapy regimens.1,2 The U.S. Food and Drug Administration (FDA) ...

palliative care

Canadian Study Looks at an Integrated Palliative Care Model

Although initiation of palliative care from the time of cancer diagnosis produces optimal outcomes for patients, this strategy is often not practiced. A recent Canadian study conducted in patients with advanced cancer and their caregivers examined the opinions of patients with advanced cancer and...

health-care policy

ASCO Releases Principles for Patient-Centered Health-Care Reform

ASCO has released the “ASCO Principles for Patient-Centered Health-Care Reform,” seven recommendations designed to ensure access to high-quality cancer care amid the changing U.S. health-care delivery landscape. The principles aim to assist the new Congress and Administration, so, as they consider...

issues in oncology

Telemedicine: Transforming Health Care One Computer at a Time

Telehealth is the delivery of health care remotely via telecommunication tools. Its aim is to increase access to care, especially for patients with chronic diseases such as cancer and for populations for whom care is not always available. With the growing availability of broadband and portable...

hematologic malignancies
symptom management

Ibrutinib: A Potential Option for Chronic Graft-vs-Host Disease?

Currently, there is no U.S. Food and Drug Administration (FDA)-approved therapy for chronic graft-vs-host disease—a life-threatening consequence of stem cell or bone marrow transplant—that has not responded to corticosteroids, but this may be about to change. Ibrutinib (Imbruvica) achieved...

AACR Receives $1.125 Million National Cancer Institute Grant to Continue Annual Clinical Trials Workshop

The American Association for Cancer Research (AACR) is pleased to announce that the National Cancer Institute (NCI) has awarded the organization a 5-year, $1.125 million grant to continue providing clinical fellow and junior faculty clinical researchers the opportunity to learn the essentials of...

head and neck cancer

Vanderbilt Study to Explore Lymphedema Self-Care for Head and Neck Cancer Survivors

Vanderbilt University School of Nursing Assistant Professor Jie Deng, PhD, RN, has been awarded a $789,000 research scholar grant by the American Cancer Society to develop and test a self-care program for head and neck cancer survivors diagnosed with secondary lymphedema/fibrosis....

gynecologic cancers

Niraparib Maintenance Improves Progression-Free Survival in Platinum-Sensitive Recurrent Ovarian Cancer

In a phase III trial (ENGOT-OV16/NOVA) reported at the 2016 ESMO (European Society for Medical Oncology) Congress and in The New England Journal of Medicine by Mansoor R. ­Mirza, MD, of the Rigshospitalet–Copenhagen University Hospital, and colleagues, maintenance therapy with the PARP (poly...

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