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supportive care
symptom management
breast cancer

Use of Dexamethasone Mouthwash in Managing mTOR Inhibitor–Associated Stomatitis in Patients With Breast Cancer

Prophylactic use of dexamethasone mouthwash significantly minimized the incidence of all grades of stomatitis in postmenopausal women receiving everolimus (Afinitor, Zortress) and exemestane for the treatment of hormone receptor–positive metastatic breast cancer, according to data presented by...

supportive care
symptom management

Dealing With GI Toxicities After Chemoradiation

Chemotherapy- and radiotherapy-induced gastrointestinal (GI) toxicities have risen alongside improved survival rates for many cancers, according to Jervoise Andreyev, MA, PhD, Consultant Gastroenterologist in GI Consequences of Cancer Treatment at the Royal Marsden Hospital in London. “For every...

gynecologic cancers

Recommendations for Surveillance of Premature Ovarian Insufficiency in Female Survivors of CAYA Cancers

Harmonized recommendations for surveillance of premature ovarian insufficiency in female survivors of childhood, adolescent, and young adult (CAYA) cancers have been published by van Dorp et al in the Journal of Clinical Oncology on behalf of the International Late Effects of Childhood Cancer...

prostate cancer

Hypofractionation May Be Poised to Become New Standard of Care for Prostate Cancer

There has been an ongoing debate about which type of radiation therapy is preferable in the treatment of localized prostate cancer: hypofractionation (larger fractions given over 4–5 weeks) or conventional radiotherapy (given over 8–9 weeks). A new study presented at the 2016 ASCO Annual Meeting...

survivorship
pain management

ASCO Releases Clinical Practice Guideline on Management of Chronic Pain in Survivors of Adult Cancers

As reported in the Journal of Clinical Oncology by Judith A. Paice, PhD, RN, of Northwestern University, and colleagues, ASCO has released a clinical practice guideline on management of chronic pain in survivors of adult cancers. The guideline was based on literature review by an expert panel, with ...

breast cancer

Sampling Method Used for New Breast Cancer Tests May Lead to Underestimation of Risk

Not only is breast cancer more than one disease, but a single breast cancer tumor can vary within itself, a finding that University of Pittsburgh Cancer Institute (UPCI) researchers discovered has the potential to lead to very different patient treatment plans depending on the tumor sample and...

prostate cancer

Sociodemographic and Clinical Predictors of Switching to Active Treatment From Observational Management in Low-Risk Prostate Cancer

Although active surveillance for patients with low-risk prostate cancer has become an increasingly acceptable strategy for disease management, many men opt for definitive therapies such as radical prostatectomy or radiation therapy. A new study of more than 2,200 patients with low-risk prostate...

solid tumors
lung cancer

Ceritinib Shows Overall and Intracranial Activity in Advanced NSCLC Previously Treated With Crizotinib and Chemotherapy

Crinò et al found that ceritinib (Zykadia) was active overall and in central nervous system (CNS) metastases in patients with ALK-rearranged advanced non–small cell lung cancer (NSCLC) previously treated with crizotinib (Xalkori) and chemotherapy, according to the ASCEND-2 phase II...

skin cancer

USPSTF Issues Final Recommendation Statement on Screening for Skin Cancer

The U.S. Preventive Services Task Force (USPSTF) has concluded that the current evidence is insufficient to assess the balance of benefits and harms of visual skin examination by a clinician to screen for skin cancer in asymptomatic adults. The report was published in JAMA. This is an “I...

lymphoma

Is Nivolumab Active in Classical Hodgkin Lymphoma After Failure of Autologous SCT and Brentuximab Vedotin?

Treatment with the anti–PD-1 (programmed cell death protein 1) immune checkpoint inhibitor nivolumab (Opdivo) produced response in two-thirds of patients with classical Hodgkin lymphoma after failure of both autologous stem cell transplantation (SCT) and brentuximab vedotin (Adcetris),...

Revisiting Ovarian Ablation in Early Breast Cancer: A Mismatch Between Global Values and Clinical Practice Guidelines

ASCO recently released a clinical practice guideline update on ovarian suppression as part of the extant guideline on adjuvant endocrine therapy in hormone receptor–positive breast cancer, and the recommendations were summarized in the June 10, 2016, issue of The ASCO Post. Also in this issue,...

An Epic Medical Story by an Old-Style Doctor on the Front Lines of Care

The U.S. health-care system is a $3 trillion behemoth of dizzying complexity. Government oversight, ever-changing regulations, mountains of paperwork, electronic health records, initiative after initiative, and so forth, all of which has reshaped the delivery of care, for the good and bad. But...

issues in oncology

Study Finds New Whole-Exome Sequencing Test Accurately Identifies Actionable Mutations

Exome Cancer Test v1.0 (EXaCT-1), a new whole-exome sequencing test developed by the Englander Institute for Precision Medicine at Weill Cornell Medicine, detected mutations that guide precision cancer treatment with over 95% accuracy, according to a study by Rennert et al published in Genomic ...

issues in oncology

As Low-Dose CT Screening Moves Into the Clinic, Implementation Issues Move Up on the Agenda

Low-dose computed tomography (CT) screening for lung cancer in high-risk groups is moving into the clinic in the wake of its approval by the U.S. Centers for Medicaid & Medicare Services. That does not mean, however, the discussion is over. As low-dose CT moves from research to everyday...

lung cancer

Lung Cancer Screening: Beneficial for Certain Populations but Not Without Controversy

The National Cancer Policy Forum of the National Academies of Sciences took up the issue of lung cancer screening at its mid-June workshop. Greta Massetti, PhD, Associate Director for Science, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention (CDC), and chair of ...

pancreatic cancer

ASCO Guideline on Treatment of Locally Advanced, Unresectable Pancreatic Cancer

As reported by Edward P. Balaban, DO, FASCO, of Penn State Hershey Cancer Institute, and colleagues in the Journal of Clinical Oncology, ASCO has released a clinical practice guideline on the treatment of locally advanced, unresectable pancreatic cancer.1 The recommendations are based on expert...

pancreatic cancer

ASCO Guideline on Potentially Curable Pancreatic Cancer

As reported in the Journal of Clinical Oncology by Alok A. Khorana, MD, of Cleveland Clinic, and colleagues, ASCO has released a clinical practice guideline on the treatment of potentially curable pancreatic cancer.1 The recommendations are based on an expert panel systematic review of the...

breast cancer

ASCO Guideline on Endocrine Therapy for Hormone Receptor–Positive Metastatic Breast Cancer

As reported by Hope S. Rugo, MD, of the University of California San Francisco Comprehensive Cancer Center, and colleagues in the Journal of Clinical Oncology, ASCO has released a clinical practice guideline on endocrine therapy for hormone receptor–positive metastatic breast cancer.1 The...

issues in oncology
health-care policy

Road to Successful Use of Real-World Evidence for Drug Development Is Long and Rocky

Friends of Cancer Research (Friends) has been a leader in the push for better and faster cancer drug development. Now it is tackling the use of real-world evidence in clinical trials. This is the report of a meeting on the subject that took place on June 16 in Washington, DC.1 Real-world evidence...

breast cancer
issues in oncology
genomics/genetics

Using Social Media to Accelerate Genomic Research

The success of using social media to push forward causes for social good was a driving factor in the launch this past October of the Metastatic Breast Cancer Project (MBC project), which aims to accelerate the understanding of what makes patients with metastatic breast cancer genetically unique....

Sarah S. Donaldson, MD, FASCO, Honored With Inaugural Women Who Conquer Cancer Mentorship Award

Sarah S. Donaldson, MD, FASCO, of Stanford University School of Medicine and Lucile Packard Children’s Hospital, is the recipient of the Inaugural Women Who Conquer Cancer Mentorship Award. Throughout her decades-long career, Dr. Donaldson has mentored countless trainees and young oncologists,...

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...

breast cancer

Quick Takes on Promising New Approaches to Treating Breast Cancer

At the 2016 ASCO Annual Meeting, researchers reported encouraging results for several new drugs and treatment strategies for breast cancer. The ASCO Post brings you brief summaries of a select few. Abemaciclib Trial The cyclin-dependent kinase 4/6 (CDK4/6) inhibitor abemaciclib produced responses...

American Cancer Society Endorses HPV Vaccine Recommendations From CDC ACIP

The American Cancer Society (ACS) has endorsed human papillomavirus (HPV) vaccination recommendations from the Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP), the principal source of guidance on U.S. immunization policy. The ACS's...

skin cancer

Studies Suggest Bright Future for Combination Immunotherapy in Advanced Melanoma, but Questions Remain

Two studies presented at the 2016 ASCO Annual Meeting focused on the use of combination immunotherapy in the treatment of patients with advanced melanoma. Updated results from the phase III CheckMate 067 trial centered on the combination of nivolumab (Opdivo) plus ipilimu­mab (Yervoy) compared...

health-care policy
legislation

CMS Proposal for Part B Drug Payment: A Poorly Conceived Experiment

On March 11, 2016, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule in the Federal Register to test a change in reimbursement for Part B drugs.1 The first phase involves changing the 6% add-on to the average sales price (ASP) used to make drug payments under Part B to...

hematologic malignancies
lymphoma

CNS-IPI for CNS Relapse in Diffuse Large B-Cell Lymphoma

As reported in the Journal of Clinical Oncology, Schmitz et al have developed and validated a risk score for CNS relapse—the Central Nervous System International Prognostic Index (CNS-IPI)—in patients with diffuse large B-cell lymphoma (DLBCL) treated with R-CHOP (rituximab [Rituxan]...

breast cancer

Stress and Adverse Life Events Unlikely to Cause Breast Cancer

Day-to-day psychological stress and adverse life events are unlikely to increase a woman’s risk of developing breast cancer, according to a new prospective study published by Schoemaker et al in Breast Cancer Research. Women with breast cancer often consider stress as a likely cause of their ...

issues in oncology

Patient-Oncologist Difference of Opinion About Advanced Cancer Prognosis Is Common, Study Shows

Misunderstandings about prognosis between patients with advanced cancer and their doctors was common, according to a study by Gramling et al in JAMA Oncology—and the vast majority of patients didn't know that their doctors held different opinions about how long they might live. “We've...

prostate cancer

Early Evidence of Anti–PD-1 Activity in Enzalutamide-Resistant Prostate Cancer

Restoring tumor-specific immunity is a treatment strategy that works well in melanoma and lung cancer patients. Now a new study out of the Oregon Health & Science University (OSHU) Knight Cancer Institute is reviving hope that the approach also may help men with life-threatening prostate...

hematologic malignancies
lymphoma

Early Results Find Pembrolizumab Active in Classical Hodgkin Lymphoma After Brentuximab Vedotin Failure

Findings in a classical Hodgkin lymphoma cohort in the phase Ib KEYNOTE-013 trial, reported by Armand et al in the Journal of Clinical Oncology, indicate that pembrolizumab (Keytruda) is active in patients with disease progressing on or after brentuximab vedotin (Adcetris) treatment. Study Details ...

solid tumors
issues in oncology

Weight Loss in Overweight and Obese People May Lower Levels of Certain Proteins Linked to Cancer

A new study investigating the effects of dietary weight loss and exercise on circulating levels of certain angiogenesis-related proteins, including vascular endothelial growth factor (VEGF), plasminogen activator inhibitor-1 (PAI-1), and pigment epithelium-derived factor (PEDF), in postmenopausal...

gynecologic cancers

Opportunistic Salpingectomy for Ovarian Cancer Prevention Adopted Without Adverse Surgical Outcomes

A surgical procedure recommended to reduce the future risk of ovarian cancer has been successfully implemented throughout Kaiser Permanente in Northern California without a change in surgical outcomes, according to research published by Garcia et al in Obstetrics & Gynecology. Previous...

palliative care

Despite Increasing Global Legalization of Physician-Assisted Suicide, Use Remains Rare

Despite increasing legalization of euthanasia and physician-assisted suicide worldwide, the practices remain relatively rare and, when carried out, are primarily motivated by psychological factors such as loss of autonomy or enjoyment of life, rather than physical pain. A new comprehensive...

gynecologic cancers

FDA Approves First HPV Test for Use With SurePath Preservative Fluid

On July 7, the U.S. Food and Drug Administration (FDA) approved the Roche cobas HPV Test as the first test for Human Papilloma Virus (HPV) that can be used with cervical cells obtained for a Papanicolau (Pap) test and collected in SurePath Preservative Fluid. The FDA approves HPV tests to be used...

lung cancer

First-Line Nivolumab Monotherapy Active in Advanced NSCLC

As part of the phase I CheckMate 012 study reported by Gettinger et al in the Journal of Clinical Oncology, nivolumab (Opdivo) monotherapy was found to be active as first-line treatment in advanced non–small cell lung cancer (NSCLC). The study is also examining first-line nivolumab plus...

prostate cancer

Study Finds Incidence of Mutations in DNA-Repair Genes Significantly Higher in Men With Metastatic Prostate Cancer

The incidence of mutations in DNA-repair genes was significantly higher among men with metastatic prostate cancer than among men with localized disease (11.8% vs 4.6%), according to a study by Pritchard et al reported in The New England Journal of Medicine. In addition, the frequency ...

colorectal cancer

Prevention Needed to Stem Global Rise in Human Papillomavirus–Related Anal Cancer

The incidence rate of human papillomavirus (HPV)-related anal cancer and its precursor lesion, anal intraepithelial neoplasia, is rising in the United States and globally. Although 5-year survival rates in localized disease are generally favorable, survival in metastatic disease remains poor,...

breast cancer

Detection of Breast Cancer With Ultrasound vs Tomosynthesis in Women With Mammography-Negative Dense Breasts

As reported in the Journal of Clinical Oncology by Alberto S. Tagliafico, MD, of the University of Genoa, and colleagues, interim findings in the Italian prospective ASTOUND study indicate that ultrasound is associated with improved incremental detection of breast cancer at screening compared with ...

lymphoma

Comparison of Chemotherapy Regimens After Negative Interim PET-CT in Advanced Hodgkin Lymphoma

In a phase III trial reported in The New England Journal of Medicine, Johnson et al found similar efficacy with continued ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) chemotherapy vs omission of bleomycin (AVD) after negative interim PET-CT (positron-emission tomography–computed...

colorectal cancer
issues in oncology

What’s Driving the Rising Rates of Colorectal Cancer in Young Adults?

The study statistics are alarming—and perplexing. According to an analysis of data from the Surveillance, Epidemiology, and End Results (SEER) colorectal cancer registry, colon cancer incidence among young adults aged 20 to 34 is expected to increase 90% by 2030, and the incidence of rectosigmoid...

bladder cancer

Atezolizumab Promising in Cisplatin-Ineligible Metastatic Bladder Cancer

Atezolizumab (Tecentriq), an anti–programmed cell death ligand 1 (PD-L1) inhibitor, achieved durable responses as first-line treatment in cisplatin-ineligible patients with metastatic urothelial carcinoma in a primary analysis of a phase II trial. These data represent an unmet need, because...

Expert Point of View: Elizabeth Mittendorf, MD, PhD

The discussant of these studies was Elizabeth Mittendorf, MD, PhD, Associate Professor of Breast Surgical Oncology at the University of Texas MD Anderson Cancer Center, Houston. Dr. Mittendorf noted that approximately 3% of U.S. breast cancer patients present with de novo stage IV disease. For...

breast cancer

Mixed Results With Resection of Primary Tumor in Stage IV Breast Cancer

For de novo stage IV breast cancer, does resection of the primary tumor improve outcomes? Two studies presented at the 2016 ASCO Annual Meeting reached different conclusions. A prospective randomized study conducted in Turkey concluded there is a survival benefit at 5 years,1 whereas a U.S....

Expert Point of View: Nancy E. Davidson, MD

Nancy E. Davidson, MD, the Hillman Professor of Oncology and Director of the University of Pittsburgh Cancer Institute in Philadelphia, was the Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) study’s formal discussant. With this analysis, she noted, the EBCTCG has “reinforced the long...

breast cancer

EBCTCG Analysis Identifies Recurrence Risk by Tumor Subgroup in Estrogen Receptor–Positive Breast Cancer

The risk of recurrence in estrogen receptor–positive breast cancer is known to continue after 5 years, but just how much is that risk once endocrine therapy is stopped? The Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) has concluded it is “appreciable,” with distant recurrences...

Expert Point of View: David R. Spigel, MD

“These are outstanding results,” commented formal discussant of this trial David R. Spigel, MD, of the Sarah Cannon Research Institute, Nashville, Tennessee. In melanoma, the combination of nivolumab (Opdivo) plus ipilimumab (Yervoy) vs nivolumab alone vs ipilimumab alone found superior...

lung cancer

Combination of Nivolumab and Ipilimumab Moves Forward in NSCLC

How best to combine new immunotherapies is a burning question in oncology. A new study in the CheckMate series suggests that nivolumab (Opdivo) and ipilimumab (Yervoy) can be safely and effectively combined as first-line treatment of advanced non–small cell lung cancer (NSCLC),1 but further study...

breast cancer

No Advantage With Cyclophosphamide/Methotrexate Maintenance in Hormone Receptor–Negative Early Breast Cancer, but Subgroup May Benefit

Low-dose oral cyclophosphamide plus methotrexate maintenance therapy yielded no disease-free survival benefit in women with hormone receptor–negative early breast cancer, according to the phase III International Breast Cancer Study Group (IBCSG) 22-00 trial. Some evidence of benefit was...

prostate cancer

Tasquinimod Improves Radiographic PFS but Not OS in Metastatic Castration-Resistant Prostate Cancer

In a phase III trial reported in the Journal of Clinical Oncology, Sternberg et al found that tasquinimod, an oral therapy targeting components of the tumor microenvironment, increased radiographic progression-free survival but not overall survival vs placebo in men with chemotherapy-naive...

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