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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.
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...
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).
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...
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...
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,...
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 ...
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)...
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...
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...
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...
WCLC 2018: Study Analyzes Use of Thoracic Radiotherapy for Limited-Stage SCLC
A study has demonstrated that using involved-field radiotherapy (IFRT) and irradiating postchemotherapy residual primary tumor volume for limited-stage small cell lung cancer (SCLC) did not result in increased recurrence of the cancer. Xiao Hu, MD, PhD, of the Department of Thoracic Radiotherapy,...
FDA Approves Cemiplimab-rwlc for Metastatic Cutaneous Squamous Cell Carcinoma
On September 28, the U.S. Food and Drug Administration (FDA) approved cemiplimab-rwlc (Libtayo) injection for intravenous use for the treatment of patients with metastatic cutaneous squamous cell carcinoma (SCC) or locally advanced cutaneous SCC who are not candidates for curative surgery or...
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...
WCLC 2018: IMpower132: Atezolizumab Plus Carboplatin and Pemetrexed in Stage IV Nonsquamous NSCLC
Findings from the IMpower132 trial demonstrate that the use of the programmed cell death ligand 1 (PD-L1) inhibitor atezolizumab in combination with carboplatin plus pemetrexed as first-line therapy and pemetrexed as maintenance therapy improved progression-free survival in patients with stage IV...
WCLC 2018: NELSON Study: CT Screening for Early Lung Cancer Reduces Lung Cancer Mortality
Findings from the NELSON study demonstrate that the use of computed tomography (CT) screening among asymptomatic men at high risk for lung cancer led to a 26% (95% confidence interval [CI] = 9%–41%) reduction in lung cancer deaths at 10 years of study follow-up (at 86% compliance). In the...
WCLC 2018: Nintedanib Plus Pemetrexed/Cisplatin Does Not Improve PFS or OS in Malignant Pleural Mesothelioma of Epithelioid Subtype
Findings from a recent study demonstrate that the triple angiokinase inhibitor nintedanib combined with standard-of-care pemetrexed (Alimta)/cisplatin does not impact progression-free survival (PFS) and overall survival (OS) for patients with unresectable malignant pleural mesothelioma with...
FDA Approves Moxetumomab Pasudotox-tdfk for the Treatment of Hairy Cell Leukemia
ON SEPTEMBER 13, 2018, the U.S. Food and Drug Administration (FDA) approved moxetumomab pasudotox-tdfk (Lumoxiti) injection for intravenous use for the treatment of adult patients with relapsed or refractory hairy cell leukemia (HCL) who have received at least two prior systemic therapies,...
Omission of Axillary Dissection in Early Breast Cancer
In a study reported in JAMA Oncology, Monica Morrow, MD, of the Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, and colleagues found that surgeon acceptance of more limited surgery in early breast cancer was more likely among high-volume surgeons and those preferring ...
A Journey Through the Immune System
Although the basic concept of using the body’s immune defense mechanisms to fight cancer has been around for centuries, the idea of using immunotherapy in cancer, in general, returned to prominence when Dr. Thomas Burnet first proposed the theory of cancer immunosurveillance in 1957. Despite...
Pertuzumab in Adjuvant Treatment of HER2-Positive Breast Cancer
AT THE END OF 2017, pertuzumab (Perjeta) was granted regular approval for use in combination with trastuzumab (Herceptin) and chemotherapy as adjuvant treatment of patients with HER2- positive early breast cancer at high risk of recurrence.1,2 Supporting Efficacy Data APPROVAL WAS BASED on...
Educating Nurse Practitioners on the Care of Older Patients With Cancer in a Comprehensive Cancer Center
To expose future practitioners to the special challenges of treating cancer in older patients, the Geriatrics Service at Memorial Sloan Kettering Cancer Center (MSK) has developed a clinical education model for nurse practitioner students. Why Geriatric Oncology? GIVEN THE aging population, my...
Lasker Foundation Announces 2018 Awards in Basic and Clinical Medical Research
THE ALBERT and Mary Lasker Foundation has announced the winners of its 2018 Lasker Awards: C. David Allis, PhD, of Rockefeller University, and Michael Grunstein, PhD, of the University of California, Los Angeles, will receive the Albert Lasker Basic Medical Research Award; John B. Glen, BVMS, PhD,...
Abiraterone Acetate Plus Prednisone in High-Risk Metastatic Castration-Sensitive Prostate Cancer
IN EARLY 2018, abiraterone acetate tablets (Yonsa, Zytiga) in combination with prednisone was approved for the treatment of metastatic high-risk castration-sensitive prostate cancer.1,2 Supporting Efficacy Data APPROVAL WAS BASED on findings from the phase III LATITUDE trial, in which 1,199...
Care for the Cancer Caregiver
Providing care to patients with cancer can be overwhelming, and caregivers are at risk for physical and psychological distress, which can negatively impact their own health. Over the past decade, supporting caregiver well-being has gained prominence as a national health-care issue. In this...
Understanding the Different Perspectives on Cost and Value in Cancer Care
The estimated cost of cancer care in the United States was $125 billion in 2010 and is expected to rise to $175 billion by 2020.1 In an effort to reign in spiraling costs and deliver better care, the term “value” has become part of the new oncology lexicon, as providers, patients, and payers seek...
2018 Quality Care: New Approach Successfully Reduces Opioid Use After Urologic Oncology Surgery
In a study conducted by Stanford Health Care, researchers achieved a 46% reduction in opioid use among 443 patients with cancer who underwent a range of urologic surgeries without increasing their pain or anxiety. They achieved this reduction through a two-pillared approach: (1) maximizing the use...
2018 Quality Care: Opioid Deaths Are 10 Times Less Likely to Occur in Patients With Cancer Compared to the General Population
According to the U.S. Department of Health and Human Services, in 2016, over 42,000 Americans died from opioid overdose, making the epidemic a top public health concern. Although opioids are commonly used for cancer-associated pain, the risks for overdose in patients with cancer were unknown. A...
New Benchmarking Tool for Measuring Implementation of Integrated Practice Units
New research by Wind et al in JNCCN—Journal of the National Comprehensive Cancer Network explores a new approach for benchmarking cancer centers based on how successfully their organizational structures allow them to implement integrated practice units (IPUs). These IPUs are defined ...
ASCO Endorses CAP Guideline on HPV Testing in Head and Neck Carcinoma
As reported in the Journal of Clinical Oncology by Carole Fakhry, MD, MPH, of Johns Hopkins School of Medicine, and colleagues, ASCO has endorsed the 2018 College of American Pathologists (CAP) guideline on human papillomavirus (HPV) testing in head and neck carcinoma. The endorsement was based on...
ASCO Endorses AUA/ASTRO/SUO Guideline on Clinically Localized Prostate Cancer
As reported in the Journal of Clinical Oncology by Justin E. Bekelman, MD, of the University of Pennsylvania Perelman School of Medicine, and colleagues, ASCO has endorsed the 2017 American Urological Association (AUA), American Society for Radiation Oncology (ASTRO), and Society of Urologic...
Meet Your ASCO President-Elect, Dr. Howard A. ‘Skip’ Burris
Howard A. “Skip” Burris III, MD, FACP, FASCO, a long-time ASCO member and volunteer, began his role as ASCO President-Elect in June 2018. An ASCO member for nearly 30 years, Dr. Burris’ service to the Society is extensive. His volunteer roles include member of the ASCO Board of Directors and...
Use of Patient-Reported Outcomes Version of CTCAE in Rectal Cancer Trial
As reported in the Journal of Clinical Oncology, Basch et al established the feasibility of using the National Cancer Institute patient-reported outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) in the setting of a multicenter clinical trial in locally advanced...
Actively Recruiting Clinical Trials Focused on Gynecologic Cancers
The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies focused on gynecologic cancers—cervical, vaginal, uterine, ovarian, and vulvar cancers. These trials are studying chemoradiotherapy combination treatments, cancer vaccines, intraperitoneal ...
Are E-Cigarettes a Dangerous Alternative to Traditional Cigarettes?
Several studies published earlier this year present preliminary but compelling evidence that electronic cigarettes, also known as e-cigarettes, which deliver nicotine through aerosols without burning tobacco, may pose serious health consequences to users, including cardiovascular disease and...
New Laws Limiting Opioid Prescriptions Create Undue Barriers for Patients With Cancer and Cancer Survivors
Among other policy responses to the growing opioid epidemic, many states have enacted legislation that limits the duration or amount of opioid prescriptions issued by physicians. Although, it is clear we need strong measures to mitigate widespread overuse and misuse of opioids. These...
Maintenance Therapy for Metastatic Colorectal Cancer: Benefit Seen With Panitumumab Combination
Although the optimal approach to maintenance is not definitive in patients with metastatic colorectal cancer who have undergone chemotherapy-based induction with anti–endothelial growth factor receptor (EGFR) agents, the phase II VALENTINO trial showed that anti-EGFR maintenance therapy with...
Pembrolizumab for Advanced Cervical Cancer Progressing During or After Chemotherapy
In June 2018, pembrolizumab (Keytruda) was approved for the treatment of patients with recurrent or metastatic cervical cancer with disease progression on or after chemotherapy whose tumors express programmed cell death ligand 1 (PD-L1; combined positive score [CPS] ≥ 1), as determined by a U.S....
Durable Responses With Moxetumomab Pasudotox in Pretreated Hairy Cell Leukemia
Moxetumomab pasudotox produced deep and durable responses in a heavily pretreated population of patients with hairy cell leukemia, with the ability to eradicate minimal residual disease. The drug showed a favorable safety profile with less bone marrow suppression than with purine nucleoside analog...
Pembrolizumab in Relapsed or Refractory Primary Mediastinal Large B-Cell Lymphoma
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. On June 13, 2018, pembrolizumab (Keytruda) was granted...
Update on Clinical Trials of Novel Therapies
Long-term follow-up data on axicabtagene ciloleucel (Yescarta) in lymphoma, potential partners for nivolumab (Opdivo) in solid tumors, and a targeted agent for RET-altered cancers were featured during the developmental therapeutics program at the 2018 ASCO Annual Meeting. At the Best of ASCO...
An Invitation to Be Quiet No Longer
My male colleagues sometimes broach the topic of #MeToo or sexual harassment in medicine by saying how uncomfortable it makes them. Ah, yes. How uncomfortable the sexual harassment I have faced for years makes you. I casually bring up microaggressions—subtle verbal or nonverbal slights against...
Treatment of Triple-Negative Breast Cancer With BRCA1/2 Mutations: More to Learn From Ongoing Trials
The treatment of triple-negative breast cancer remains a clinical challenge with no single validated target, though numerous pathways are druggable and are being investigated. In the subset of BRCA-mutated triple-negative breast cancer, the approval of the first poly (ADP-ribose) polymerase (PARP)...
Cabozantinib in Second-Line Treatment of Advanced Hepatocellular Carcinoma
Compared with placebo, cabozantinib (Cabometyx) significantly improved overall survival and progression-free survival in patients with advanced hepatocellular carcinoma who were previously treated with sorafenib (Nexavar), with no new safety signals, according to data from the phase III CELESTIAL ...
Childhood Nonlymphoid Leukemia Risk With Maternal Use of Hormonal Contraception
In a population-based cohort study reported in The Lancet Oncology, Hargreave et al found that recent maternal use of hormonal contraception was associated with increased risk of childhood nonlymphoid leukemia. Study Details The study involved data from a nationwide cohort of...
FDA Takes New Steps to Address Youth E-Cigarette Use
The U.S. Food and Drug Administration (FDA) has announced a series of critical and historic enforcement actions related to the sale and marketing of e-cigarettes to children. In the largest coordinated enforcement effort in the its history, the agency issued more than 1,300 warning...
Neonatal Dysregulated Immune Function and Pediatric B-Cell Precursor ALL
A high incidence of clinically diagnosed infections in the first year of life among children who later developed acute lymphoblastic leukemia (ALL) has led researchers to propose that children with ALL are born with a dysregulated immune function, resulting in a more vigorous reaction to infections ...
Survey Shows Increased Public Awareness of Lung Cancer Over Past Decade
Survey results released by the Lung Cancer Alliance (LCA) show that general awareness about lung cancer has improved significantly over the past decade, with 94% of the public reporting familiarity with lung cancer. Despite this change in overall perspective, findings also indicate that lung cancer ...
FDA Approves Moxetumomab Pasudotox-tdfk for the Treatment of Hairy Cell Leukemia
The U.S. Food and Drug Administration (FDA) today approved moxetumomab pasudotox-tdfk (Lumoxiti) injection for intravenous use for the treatment of adult patients with relapsed or refractory hairy cell leukemia (HCL) who have received at least two prior systemic therapies, including treatment with...
Presurgical CT Imaging of CD117-Positive Kidney Tumors
A research team from Roswell Park Comprehensive Cancer Center has discovered a way to use computed tomography (CT) imaging to assess kidney tumors that test positive for the biomarker CD117 and accurately determine—before surgery—whether the tumor is benign or malignant. Their findings...
