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issues in oncology
genomics/genetics

Next-Generation Sequencing: New Technology That Requires Further Thought

Next-generation sequencing is used with increasing frequency to provide essential information about a patient’s diagnosis and treatment. In recent months, the U.S. Food and Drug Administration (FDA) has approved several new next-generation sequencing diagnostic tools, and the Centers for Medicare...

breast cancer

ESMO 2018: SOLAR-1: Alpelisib in Patients With PIK3CA-Mutated HR-Positive, HER2-Negative Advanced Breast Cancer

Targeting a common mutation in patients with hormone receptor (HR)–positive, human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer with the alpha-specific phosphatidylinositol-3-kinase (PI3K) inhibitor alpelisib improved progression-free survival, according to...

issues in oncology

Matti S. Aapro, MD, on Advanced Disease: Reducing Use of Futile Treatments

Matti S. Aapro, MD, of the Genolier Cancer Centre, discusses the challenges of avoiding futile treatments and the need to work with patients, integrate palliative care, and monitor toxicities.

leukemia

Current Treatment Landscape of Relapsed or Refractory Chronic Lymphocytic Leukemia

Novel agents such as ibrutinib (Imbruvica), idelalisib (Zydelig), and venetoclax (Venclexta) have transformed the treatment of chronic lymphocytic leukemia (CLL) and are increasingly used to treat the disease. The optimal sequencing of these agents is not clear in relapsed or refractory disease,...

Expert Point of View: Antoinette Wozniak, MD

Formal discussant Antoinette Wozniak, MD, of UPMC Hillman Cancer Center, Pittsburgh, said, “KEYNOTE-407 is a very positive trial, showing improved overall and progression-free survival with the addition of pembrolizumab (Keytruda) to standard chemotherapy.” In her opinion, evidence from this and...

lung cancer

NELSON Trial: ‘Call to Action’ for Lung Cancer CT Screening of High-Risk Individuals

Results of the very large, randomized, population-based NELSON trial confirm the value of low-dose computed tomography (CT) screening in people at high risk for developing lung cancer. The protective value of screening was more pronounced in women than in men. These study findings were presented at ...

Expert Point of View: Everett Vokes, MD

“PACIFIC is a positive trial, with a 32% improvement in survival, and maintenance durvalumab is a new standard of care,” stated formal discussant Everett Vokes, MD, Chair of the Department of Medicine at the University of Chicago and a pioneer in the concurrent use of chemotherapy and radiotherapy ...

issues in oncology
global cancer care

Cancer Care in the Palestinian Territories

The global burden of cancer is huge and growing. In 2018, there will be > 18 million new cancer cases and 9.6 million deaths.1,2 Although several recent articles have reviewed cancer in developing countries, few have focused on the Palestinian territories. There are several reasons for that,...

How the Nobel Prize Could Spur More Cancer Advances

Even before James P. Allison, PhD, made an appearance at the Fourth International Cancer Immunotherapy Conference: Translating Science Into Survival in New York City, the excitement among attendees was palpable. Earlier that day, October 1, 2018, Dr. Allison and Tasuku Honjo, MD, PhD, of Kyoto...

issues in oncology
cost of care

ESMO 2018: Variations Between European Countries in Time to Reimbursement Decisions for New Cancer Treatments Approved by the EMA

Some European countries take more than twice as long as others to reach health technology assessment (HTA) decisions to reimburse new cancer treatments following their approval by the European Medicines Agency (EMA). The average decision time is longer than 1 year in some countries, according to a...

hematologic malignancies
immunotherapy

Adoptive T-Cell Therapy for Progressive Multifocal Leukoencephalopathy

An emerging treatment known as adoptive T-cell therapy has proven effective in a phase II clinical trial for treating progressive multifocal leukoencephalopathy (PML), a rare and often fatal brain infection sometimes observed in patients with cancer and other diseases in which the immune...

hematologic malignancies

Genomic Classification of Myeloproliferative Neoplasms and Integration in Predictive Models

In a study reported in The New England Journal of Medicine, Grinfeld et al identified distinct genomic subgroups among patients with myeloproliferative neoplasms that, when combined with clinical variables, offered the potential for individualized predictions of clinical outcomes. Study Details...

hepatobiliary cancer

Regular Aspirin Use and Reduction in Risk for Hepatocellular Carcinoma

A pooled analysis of two large U.S. prospective cohort studies reported in JAMA Oncology by Simon et al indicates that regular use of aspirin is associated with a significant reduction in risk for hepatocellular carcinoma (HCC), with an apparent dose- and duration-dependent effect. Study Details...

issues in oncology

Established, Modifiable Cancer Risk Factors

According to a new American Cancer Society report published by Gapstur et al in CA: A Cancer Journal for Clinicians, the highest priority in a national cancer control plan is the expansion of tobacco control—the intervention with the largest potential health benefits. This report is the...

palliative care
lung cancer
issues in oncology
cost of care

ICU Admissions During Terminal Hospitalizations in Patients With Stage IV Lung Cancer

In a study reported in the Journal of Oncology Practice, Mrad et al found an increase in the proportion of patients with stage IV lung cancer admitted to the intensive care unit (ICU) during terminal hospitalization between 1998 and 2014. A large increase in palliative care contacts also occurred,...

lung cancer
issues in oncology
pain management

Opioid Use Following Video-Assisted Thoracoscopic Surgery or Open Resection in Early-Stage Lung Cancer

In a study reported in a research letter in JAMA Oncology, Tuminello et al found that video-assisted thorascopic surgery (VATS) was less likely than open resection to be associated with long-term opioid use in patients undergoing surgery for early-stage lung cancer. Study Details The study...

leukemia
lymphoma

Duvelisib vs Ofatumumab in Relapsed or Refractory CLL/SLL

As reported in the journal Blood by Flinn et al, the phase III DUO trial has shown significantly prolonged progression-free survival with the phosphoinositide 3-kinase (PI3K)-δ,-γ inhibitor duvelisib (Copiktra) vs ofatumumab (Arzerra) in patients with relapsed or refractory chronic...

breast cancer

ESMO 2018: Patients With Breast Cancer Use Twitter as a Nonmedical Forum to Share Experiences

Twitter is a place where many patients with cancer go to share and discuss their experiences of the disease, according to a recent exploratory study to be presented by Sánchez-Bayona et al at the European Society for Medical Oncology (ESMO) 2018 Congress (360P_PR). The...

issues in oncology

ESMO 2018: Precision Cancer Care Moves to Community Setting

Nearly 1 in 4 patients with advanced cancer treated at a community practice cancer network in the United States received innovative drugs matched to DNA mutations in their tumors. These results, to be reported by Alvarez et al at the European Society for Medical Oncology (ESMO) 2018 Congress...

pancreatic cancer

Assessment of the 8th Edition of the AJCC TNM Staging System in Cohort With Resected Pancreatic Cancer

In a study reported in JAMA Surgery, van Roessel et al found that the recently released 8th edition of the American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) staging system for pancreatic cancer provided better distribution among cases and some increase in prognostic...

breast cancer

Estradiol as Potential Treatment for Subset of Triple-Negative Breast Cancers

Mayo Clinic researchers have identified estradiol as a potential new treatment for a subset of women with triple-negative breast cancer. Their findings were published by Reese et al in the Proceedings of the National Academy of Sciences of the United States of America. “Triple-negative...

issues in oncology

Report Outlines Cancer Risk Among Hispanics/Latinos in the United States

The cancer burden in Puerto Rico, a U.S. territory with a 99% Hispanic population, is substantially different from that of Hispanics in the continental United States, according to Cancer Statistics for Hispanics/Latinos, 2018. The report, published every 3 years, found that men in Puerto Rico...

gynecologic cancers

Analgesics and Ovarian Cancer Survival

In a prospective cohort study reported in The Lancet Oncology, Melissa A. Merritt, PhD, of the University of Hawaii Cancer Center’s Epidemiology Program, and colleagues found evidence that recent use of aspirin or nonaspirin nonsteroidal anti-inflammatory drugs (NSAIDs) after diagnosis appears to...

breast cancer

Actively Recruiting Clinical Trials Focused on Targeted Therapy for HER2-Positive Breast Cancer

THE INFORMATION contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies focused on targeted therapy in HER2-positive breast cancer. These trials are studying imaging as a predictor of treatment response, combination therapies, treatments for metastatic...

Learning to Listen and Returning to the Art of Medicine

Bernard Lown, MD, was born in Lithuania, the son of a rabbi. He immigrated to the United States at the age of 14, where his scientific precocity bloomed. After attaining his medical degree from John Hopkins University School of Medicine, he pursued his passion of raising international awareness of...

gynecologic cancers

Rucaparib for Maintenance Treatment of Recurrent Ovarian, Fallopian Tube, or Primary Peritoneal Cancer

IN APRIL 2018, the poly (ADP-ribose) polymerase (PARP) inhibitor rucaparib (Rubraca) was granted approval for maintenance treatment of patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in complete or partial response to platinum-based chemotherapy.1,2...

survivorship

Getting Their Lives Back: Helping Survivors of Cancer to Move Forward

Thirteen years ago, Stephanie Koraleski, PhD, an oncology psychologist, and Kay Ryan, PhD, RN, a cardiac nurse and breast cancer survivor, in Omaha, brought together colleagues in the fields of clinical research, nursing, nutrition, mental health, physical therapy, pharmacy, and spirituality to...

lung cancer

FDA Approves Dacomitinib for Metastatic Non–Small Cell Lung Cancer

ON SEPTEMBER 27, 2018, the U.S. Food and Drug Administration (FDA) approved dacomitinib tablets (Vizimpro) for the first-line treatment of patients with metastatic non–small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) exon 19 deletion or exon 21 L858R substitution...

solid tumors
issues in oncology

New Techniques in Intraoperative-Guided Imagery May Enhance Outcomes in Patients With Cancer

Primary treatment of most solid tumors includes surgical excision or radiation therapy, both of which require precise anatomic localization of the tumor as well as surrounding tissue and organs. If the targeting is too broad, unnecessary morbidity may occur to nearby structures, along with the...

ESMO Recognizes Tony S. Mok, MD, FRCPC, FASCO, With Lifetime Achievement Award

THE EUROPEAN SOCIETY for Medical Oncology (ESMO) has recognized Tony S. Mok, MD, FRCPC, FASCO, with the ESMO Lifetime Achievement Award for his contributions in lung cancer. Dr. Mok, who is a Li Shu Fan Medical Foundation Endowed Professor and Chairman of the Department of Clinical Oncology at the ...

gynecologic cancers

FDA Approves Expanded Use of Gardasil 9 to Include Individuals Aged 27 to 45

The U.S. Food and Drug Administration (FDA) has approved a supplemental application for recombinant human papillomavirus (HPV) 9-valent vaccine (Gardasil 9), expanding the approved use of the vaccine to include women and men aged 27 through 45 years. Gardasil 9 prevents certain cancers and...

lymphoma
skin cancer

In Vitro and Ex Vivo Activity of Gentian Violet in Cutaneous T-Cell Lymphoma

As reported in JAMA Dermatology, Wu and Wood found that the widely available nonprescription topical antimicrobial agent gentian violet has potent activity against cutaneous T-cell lymphoma (CTCL) in studies in vitro and ex vivo. The study involved high-throughput small molecule screening of 1,710...

issues in oncology
cost of care

U.S. Spending on Antineoplastic Agents

In a study reported in the Journal of Oncology Practice, Hong et al found that the U.S. health-care system increased spending on antineoplastic agents from $26.8 billion in 2011 to $42.1 billion in 2016. The study was a retrospective, cross-sectional analysis of IQVIA (formerly QuintilesIMS)...

issues in oncology

ASCO Analysis Finds Some Pharmacy Benefit Manager Practices May Erode Patient Access to Cancer Care

ASCO warns that some of the practices used by pharmacy benefit manager (PBM) companies could hinder patient access to timely, high-quality cancer care. While PBM practices may be intended to help control costs in cancer care, in a new position statement, ASCO describes a range of practices that...

hematologic malignancies
multiple myeloma

Emerging Options and Sequencing Therapy in Relapsed Multiple Myeloma

Advances in the treatment of multiple myeloma have led to longer progression-free survival, but the majority of patients will still relapse despite newer treatments. A number of new drugs and combinations are under study in the hope of improving outcomes. “Multiple myeloma is a complex disease...

leukemia
multiple myeloma

FDA Authorizes First Next-Generation Sequencing–Based Test to Detect Minimal Residual Disease in B-Cell ALL or Multiple Myeloma

The U.S. Food and Drug Administration (FDA) recently permitted marketing of the ClonoSEQ assay, a next-generation sequencing–based test for minimal residual disease in patients with B-cell acute lymphoblastic leukemia (ALL) or multiple myeloma. “At the FDA, we’re continuing to...

lung cancer
pain management

Study Shows Invasive Lung Cancer Surgery Can Lead to Long-Term Opioid Use

Patients treated with more invasive surgical techniques for early-stage non–small cell lung cancer (NSCLC) are more likely to become chronic opioid users than patients treated with minimally invasive surgery, highlighting the need for additional research into how pain management after surgery ...

breast cancer

More to Learn About Using PARP Inhibitors for Advanced Breast Cancer With Germline BRCA Mutation

Germline mutations in the breast cancer–susceptibility genes 1 and 2 (BRCA1/2) increase the risk for cancer due to an inability to repair DNA double-strand breaks, and about 5% of patients with unselected breast cancer carry a germline BRCA mutation.1 These DNA repair–deficient tumors are...

head and neck cancer

Low- vs High-Dose Cisplatin Chemoradiotherapy in Squamous Cell Carcinoma of the Head and Neck

In an analysis of Veterans Affairs data reported in the Journal of the National Cancer Institute, Bauml et al found that weekly lower-dose cisplatin vs higher-dose cisplatin given every 3 weeks as part of concurrent definitive chemoradiotherapy may not adversely affect survival, while reducing...

issues in oncology
solid tumors

Lalan S. Wilfong, MD, on Metastatic Solid Tumors: Limiting Low-Value Care

Lalan S. Wilfong, MD, of Texas Oncology, discusses reducing the use of a white blood cell growth factor treatment in advanced and incurable solid tumors for patients treated at a community oncology practice.

hematologic malignancies
lymphoma

Mogamulizumab-kpkc for Mycosis Fungoides and Sézary Syndrome

On August 8, 2018, the CC chemokine receptor type 4 (CCR4)-directed monoclonal antibody mogamulizumab-kpkc (Poteligeo) was approved for adult patients with relapsed or refractory mycosis fungoides or Sézary syndrome after at least one prior systemic therapy.1,2 Supporting Efficacy Data The current...

issues in oncology
pain management

Jay B. Shah, MD, on Reducing Opioid Use After Urologic Oncology Surgery

Jay B. Shah, MD, of Stanford University, discusses the role that surgeons can play as gatekeepers to the opioid epidemic, including the view that complex cancer operations can be performed with little to no opioid use (Abstract 269).

lung cancer

Osimertinib in First-Line Treatment of EGFR-Mutant Metastatic NSCLC

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. In April 2018, osimertinib (Tagrisso) was approved for...

supportive care

Strategies for Using Anticoagulation Therapy in Patients With Cancer

Although approximately 20% to 30% of patients with cancer will develop venous thromboembolism (VTE), clinicians continue to debate strategies for pharmacologic treatment and prevention.1 At the 2018 Debates and Didactics in Hematology and Oncology Conference, held on Sea Island, Georgia, Christine...

gastrointestinal cancer

Neuroendocrine Tumors: New Data, New Options

Because neuroendocrine tumors are not one disease but a continuum of diseases, ranging from well-differentiated tumors to poorly differentiated and small cell tumors, treatment approaches can vary greatly. At the 2018 Debates and Didactics in Hematology and Oncology conference, held on Sea Island,...

issues in oncology

Wear That White Coat—With Pride

These days it can be hard for physicians. Many in the physician workforce wonder whatever happened to the ideals and expectations that drew them to this noble profession. The genuine passion to heal the sick and infirm and in turn improve the health of the entire society The ability to touch human ...

hematologic malignancies
lymphoma

The Relevance of the RELEVANCE Trial in Follicular Lymphoma

We have seen remarkable progress in the outcomes of patients with advanced-stage follicular lymphoma over the past 2 decades.1 Recent manuscripts and presentations describing long-term follow-up of randomized trials comparing various chemotherapy platforms (all combined with anti-CD20 antibodies)...

hematologic malignancies
leukemia

Update on CML: Focus on Sequential Therapy, Treatment Discontinuation, and Monitoring

Chronic myeloid leukemia (CML) is a poster child for the success of molecularly targeted therapy, with some patients appearing to be “cured” of their disease and others living for a long time after treatment with a tyrosine kinase inhibitor targeting the BCR-ABL1 protein. However, there are still...

solid tumors
immunotherapy

Bacterial Therapy Tolerable, Shows Early Activity in Patients With Advanced Solid Tumors

A phase I clinical trial investigating the use of bacterial Clostridium novyi-NT spores as an injectable monotherapy had manageable toxicities and showed early clinical efficacy in patients with treatment-refractory solid tumor malignancies, according to data presented at the CRI-CIMT-EATI-AACR...

lung cancer

WCLC 2018: Oncogene-Driven Patient-Caregiver Communities Creating New Paradigm for NSCLC Research

A recent review of patient-caregiver communities focused on non–small cell lung cancer (NSCLC) with genomic alterations showed that these groups are improving outcomes by supporting patients and caregivers, increasing awareness and education, and accelerating research. Patient advocate Janet...

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