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symptom management

Anticoagulation in Patients With Cancer: Understanding the Complexities of Prophylaxis and Management

Venous thromboembolic events are more prevalent in patients with cancer than in persons without it. Cancer is associated with a high rate of venous thromboembolism recurrence, bleeding, requirement for long-term anticoagulation, and reduced quality of life. Moreover, thrombosis is the second most...

leukemia
lymphoma

First-Line Ibrutinib Improves Progression-Free and Overall Survival vs Chlorambucil in Older Patients With Chronic Lymphocytic Leukemia

As reported in The New England Journal of Medicine and at the 2015 American Society of Hematology Annual Meeting, Jan A. Burger, MD, PhD, and colleagues found that first-line treatment with the oral Bruton’s tyrosine kinase inhibitor ibrutinib (Imbruvica) improved progression-free and overall...

breast cancer

Little Effect of Pretreatment Renal Function on Outcomes in Older Women Receiving Chemotherapy for Early-Stage Breast Cancer

As reported by Lichtman et al in the Journal of Clinical Oncology, an ancillary study (Alliance A171201) of the CALGB 49907 trial showed no significant association of pretreatment creatinine clearance with grade ≥ 3 hematologic toxicity, dose modification, therapy completion, relapse-free...

gynecologic cancers

Adding Cediranib to Platinum Therapy Increases Progression-Free Survival in Relapsed Platinum-Sensitive Ovarian Cancer

The phase III ICON6 trial showed that adding cediranib to platinum-based therapy increased progression-free survival and toxicity in women with first relapse of platinum-sensitive ovarian cancer, reported Ledermann et al in The Lancet. Study Details In the double-blind trial, 456 women with...

colorectal cancer
gastrointestinal cancer

Long-Term Follow-up of Prospective U.S. Cohorts Shows Reduced Risk of GI Tract Cancers With Regular Aspirin Use

In a long-term follow up of two large U.S. prospective cohorts reported in JAMA Oncology, Cao et al found that regular use of aspirin was associated with a reduced risk of gastrointestinal (GI) tract cancers. In 2015, the U.S. Preventive Services Task Force recommended the use of aspirin in...

kidney cancer

No Disease-Free Survival Benefit of Adjuvant Sunitinib or Sorafenib in High-Risk Nonmetastatic Renal Cell Carcinoma

In a phase III trial (ECOG-ACRIN E2805) reported in The Lancet by Haas et al, no benefit of adjuvant VEGFR (vascular endothelial growth factor receptor) inhibitor treatment with sunitinib or sorafenib (Nexavar) was observed vs placebo in patients with completely resected high-risk nonmetastatic...

breast cancer
leukemia
lung cancer

Specific Form of CYP3A7 Gene Associated With Poor Outcomes for Patients With Several Cancer Types

Among patients with breast cancer, lung cancer, or chronic lymphocytic leukemia (CLL), those who had a specific form of the CYP3A7 gene (CYP3A7*1C) had worse outcomes compared with those who did not have CYP3A7*1C. This may be related to how the patients metabolize the therapeutics used to treat...

lung cancer

Atezolizumab Improves Survival vs Docetaxel in Advanced NSCLC in Relation to Increased PD-L1 Expression

In the phase II POPLAR trial reported in The Lancet, Fehrenbacher et al found that the anti–PD-L1 (programmed cell death ligand 1) antibody atezolizumab improved overall survival vs docetaxel in patients with non–small cell lung cancer (NSCLC) who had progressed on prior platinum-based...

breast cancer
supportive care

Study Finds Many Patients With Breast Cancer Develop Symptoms of Post-Traumatic Stress Disorder; Symptoms Diminished Over 1 Year

According to a study led by Ludwig-Maximilians-Universitaet (LMU) researchers, a majority of patients diagnosed with breast cancer go on to develop symptoms of post-traumatic stress disorder, and in most of these cases, symptoms persist for at least a year. These findings were published by Voigt et ...

issues in oncology

Study Evaluates Patient/Oncologist Perceptions of Whole-Exome Sequencing in Advanced Cancer

A majority of people with advanced cancer want to hear findings from DNA sequencing and to learn how those results may affect their health and treatment options, Dana-Farber Cancer Institute scientists report. Their findings were reported by Gray et al in Genetics in Medicine. The discovery...

breast cancer
lymphoma

Early MRI Screening Reduces Risk of Breast Cancer Death for Survivors of Childhood Hodgkin Lymphoma

Researchers at Princess Margaret Cancer Centre have confirmed in a screening effectiveness study that early screening with magnetic resonance imaging (MRI) can reduce breast cancer mortality for female survivors of childhood Hodgkin lymphoma who received chest radiation. The findings published by...

breast cancer

Adding Palbociclib to Fulvestrant Prolongs Progression-Free Survival in Hormone Receptor–Positive, HER2-Negative Metastatic Breast Cancer

As reported in The Lancet Oncology by Cristofanilli et al, the final results of the phase III PALOMA-3 trial show that the addition of the CDK4/CDK6 inhibitor palbociclib (Ibrance) to fulvestrant (Faslodex) improved progression-free survival in women with hormone receptor–positive,...

cns cancers

Alisertib Shows Activity With Irinotecan/Temozolomide in Relapsed or Refractory Neuroblastoma

The oral Aurora A kinase inhibitor alisertib was active in combination with irinotecan/temozolomide in patients with relapsed or refractory neuroblastoma, in a phase I dose-escalation trial reported in the Journal of Clinical Oncology by DuBois et al. The maximum tolerated dose of alisertib was 60...

breast cancer

Single Dose of Trastuzumab Kickstarts Immune Response in Certain Breast Cancers

A tumor’s immune response to a single dose of the HER2 inhibitor trastuzumab (Herceptin) predicted which patients with HER2-positive breast cancer would respond to the drug on a more long-term basis, according to the results of a study published by Varadan et al in Clinical Cancer Research....

issues in oncology

Cultural Awareness and Sensitivity Among Surgeons Do Not Always Result in Culturally Competent Care

A survey of oncology surgeons from six hospitals in Washington State found that the surgeons in the sample “displayed and valued cultural awareness and sensitivity” but that “cultural awareness and sensitivity did not necessarily result in culturally competent behavior.” These findings highlight...

skin cancer

Melanoma-Specific Survival Significantly Higher With Wider Excision Margins

Among patients with high-risk, primary cutaneous melanomas, the risk of death from melanoma, at a median follow-up of 8.8 years, was significantly higher among those randomized to surgery with a 1-cm excision margin than among those randomized to surgery with a 3-cm excision margin. Although...

gastrointestinal cancer

‘Red-Flag’ Symptoms That Could Signal Colorectal Cancer in Patients Under 50 Years Old Should Be Taken Seriously

In clinical practice, Samantha Hendren, MD, MPH, has been “shocked by what a large proportion of patients we are seeing who are under 50 and presenting with colorectal cancer,” often with advanced disease due to delayed diagnosis. “And that is because patients and physicians don’t even think of...

hematologic malignancies

Adding Ibrutinib to Bendamustine/Rituximab Improves Outcome in Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma

In the phase III HELIOS trial reported in The Lancet Oncology, Asher Chanan-Khan, MD, of the Mayo Clinic Cancer Center, Jacksonville, Florida, and colleagues found that addition of the Bruton’s tyrosine kinase (BTK) inhibitor ibrutinib (Imbruvica) to bendamustine (Treanda)/rituximab (Rituxan)...

sarcoma

Eribulin Mesylate in Advanced Liposarcoma Previously Treated With an Anthracycline

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 January 28, 2016, eribulin mesylate (Halaven) was approved for...

hematologic malignancies
multiple myeloma

Carfilzomib Plus Dexamethasone in Previously Treated Multiple Myeloma

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 January 21, 2016, carfilzomib (Kyprolis) was approved for use in ...

health-care policy

Pediatric Oncology Groups Endorse Ethical Framework for Rationing Scarce Drugs

The Children’s Oncology Group (COG) and the American Society of Pediatric Hematology/Oncology (ASPHO) have endorsed formal clinical recommendations for rationing chemotherapy and supportive care agents during times of shortage. The guidance is needed because persistent shortages of many standard...

lung cancer
issues in oncology
gastroesophageal cancer

PET Scan Use in Follow-up Care for Lung and Esophageal Cancer Shows Wide Variation Between Hospitals, No Impact on Survival

A new study suggests that one approach to watching for a cancer's return is being inappropriately used at many hospitals and isn't helping patients survive longer. The findings are published by Healy et al in the Journal of the National Cancer Institute. The study looked at how often survivors ...

breast cancer
survivorship

Patient and Provider Engagement With Healthy Lifestyle Information

Most young women diagnosed with breast cancer are not physically active in the months after a cancer diagnosis, but physical activity increased over time. According to data presented at the 2016 Cancer Survivorship Symposium, higher levels of physical activity were seen among women whose oncology...

leukemia

Children With Leukemia From High-Poverty Areas More Likely to Suffer Early Relapse

Among children with acute lymphoblastic leukemia (ALL), the most common pediatric cancer, those who live in high-poverty areas are substantially more likely to suffer early relapse than other patients, despite having received the same treatment, according to new research from Dana-Farber/Boston...

prostate cancer

Hypofractionation Is Ready for Prime Time in Prostate Cancer, but Will It Be Adopted?

Separate phase III trials presented at the 2016 Genitourinary Cancers Symposium demonstrated that modest hypofractionated radiotherapy is noninferior to conventional radiotherapy for men with intermediate- and low-risk prostate cancer and should be considered a new standard of care.1,2 However, it...

colorectal cancer

Selective Internal Radiotherapy Does Not Improve Any-Site but Prolongs Liver-Specific Progression-Free Survival in Metastatic Colorectal Cancer

In the phase III SIRFLOX trial reported in the Journal of Clinical Oncology, van Hazel et al found that adding selective internal radiation therapy with yttrium-90 resin microspheres to FOLFOX (fluorouracil, leucovorin, oxaliplatin) with or without bevacizumab (Avastin) did not improve any-site...

issues in oncology

ASCO Provides Support and Guidance for the White House Cancer Moonshot Initiative

Although President Richard Nixon signed the National Cancer Act in 1971, essentially declaring a war on cancer, the genesis of the idea had actually been born 2 years earlier, after the first landing on the moon set off a new era of scientific exploration and sparked a belief that any scientific...

gynecologic cancers

Study Finds No Progression-Free Survival Benefit for Weekly Dose-Dense vs Every-3-Week Paclitaxel Plus Carboplatin in Ovarian Cancer

Weekly dose-dense paclitaxel did not provide a progression-free survival benefit over every-3-week paclitaxel in combination with carboplatin and with or without elective bevacizumab (Avastin) in patients with previously untreated ovarian cancer, according to the results of the phase III GOG-0262...

gastrointestinal cancer

Asian Trial Finds No Survival Benefit of Adding Gastrectomy to Chemotherapy in Incurable Advanced Gastric Cancer

In the Asian phase III REGATTA trial reported in The Lancet Oncology, Fujitani et al found that the addition of gastrectomy to chemotherapy did not improve overall survival in patients with advanced gastric cancer with a single noncurable factor. Study Details In this open-label trial conducted...

lung cancer
global cancer care

Study Finds 36% Increase in Number of Male Smokers in India Over 17 Years

The number of men smoking tobacco in India rose by more than one third to 108 million between 1998 and 2015, according to a new study published in the journal BMJ Global Health. The study also found that cigarettes were replacing the traditional bidi, a small, inexpensive Indian cigarette,...

colorectal cancer

Factors Associated With Early Mortality in Patients Receiving Adjuvant Therapy for Colon Cancer

In an analysis of the ACCENT (Adjuvant Colon Cancer Endpoints) database reported in the Journal of Clinical Oncology, Cheung et al found that factors associated with early mortality in patients in trials of adjuvant systemic therapy included age, performance status, tumor grade, stage, and ratio of ...

issues in oncology

Cancer Statistics for African Americans, 2016

A new report outlines substantial progress in reducing the mortality gap between blacks and whites for some cancers, while the gap has widened or remained level for two leading cancers: breast cancer in women and colorectal cancer in men. The findings are included in Cancer Statistics for African...

skin cancer

Improved Melanoma-Specific Survival Reported With Wider Excision Margin in High-Risk Primary Melanoma

Wider excision margins in high-risk primary cutaneous melanoma were associated with improved melanoma-specific survival, according to long-term follow-up in a UK-led trial reported by Hayes et al in The Lancet Oncology. No significant improvement in overall survival was observed. The initial report ...

survivorship

Eye Movement Affected in Some Former Childhood Cancer Patients

A study from Lund University in Sweden has shown that commonly used chemotherapy toxins impair the eyesight in childhood cancer survivors in a way that indicates an impact on the central nervous system. The results were published by Einarsson et al in PLOS One. It was not the former patients' ...

lung cancer

UK Trial Shows No Survival Benefit of Low–Molecular-Weight Heparin in Patients With Lung Cancer

In the UK phase III FRAGMATIC trial reported in the Journal of Clinical Oncology, Macbeth et al found no survival benefit of adding low–molecular-weight heparin to standard treatment in patients with lung cancer. Previous evidence suggested that low–molecular-weight heparin might...

head and neck cancer

2016 Head and Neck Cancer Symposium: Induction Chemotherapy Does Not Predict Survival Advantage Over Concurrent Chemoradiation

Head and neck cancer patients who receive induction chemotherapy rather than the standard treatment of concurrent chemoradiation do not benefit from increased survival rates and are less likely to receive a full course of radiation, according to research presented by Stokes et al at the 2016...

breast cancer

FDA Approves Palbociclib in Combination With Fulvestrant in Hormone Receptor–Positive, HER2-Negative Advanced or Metastatic Breast Cancer

On February 19, 2016, the U.S. Food and Drug Administration approved palbociclib (Ibrance) in combination with fulvestrant for the treatment of women with hormone receptor–positive, human epidermal growth factor receptor 2 (HER2)–negative advanced or metastatic breast cancer with...

lung cancer

No Survival Benefit of Pemetrexed/Cisplatin Chemoradiation vs Standard Treatment in Nonresectable Stage III NSCLC

As reported by Senan et al in the Journal of Clinical Oncology, the phase III PROCLAIM trial showed no significant improvement in overall survival for chemoradiation with pemetrexed (Alimta)/cisplatin vs etoposide/cisplatin followed by consolidation pemetrexed vs a platinum-based doublet in...

breast cancer

Men Get Breast Cancer Too

Like many men, it never occurred to me that I could get breast cancer. But it turns out it is more common—and deadly—than I thought, with about 2,600 men diagnosed each year with invasive breast cancer and nearly 440 dying of the disease.1 In 2010, I became one of those men, and the diagnosis was...

health-care policy

Oncology Drug Approvals: Year in Review

In 2015, the Office of Hematology and Oncology Products (OHOP) approved 16 new molecular entities. The most notable were drug approvals in disease areas such as non–small cell lung cancer, colorectal cancer, breast cancer, melanoma, renal cancer, and diseases that are particularly difficult to...

A Surgeon’s Inspiring Journey to Death

Every so often, a memoir comes along in which the story speaks to universal themes. For that magic to occur, the author must step aside at times and let others tell their story, too. Moreover, the writing must be clear, vibrant, and above all else honest to the core. The recently published memoir...

skin cancer

Nivolumab Plus Ipilimumab in Unresectable or Metastatic Melanoma Regardless of BRAF Mutation Status

On January 23, 2016, the indication for nivolumab (Opdivo) plus ipilimumab (Yervoy) in unresectable or metastatic melanoma was expanded through accelerated approval to include patients regardless of BRAF V600 mutation status.1 The combination was previously approved for treatment of patients with...

issues in oncology

Failure of Updated Dietary Guidelines to Advise Limiting Red and Processed Meat Deemed a ‘Missed Opportunity’

“A missed opportunity” is how Susan Higginbotham, PhD, RD, Vice President for Research, American Institute for Cancer Research (AICR), described the “failure” of updated dietary guidelines to recommend limiting consumption of red and processed meat. Doing so would have “the potential to save...

breast cancer

$13.4 Million Awarded to Study Treatment for Low-Grade Ductal Carcinoma in Situ in a Prospective, Randomized Trial

A funding award of $13.4 million hopes to answer one of the biggest questions in the current management of breast cancer: Do women with the earliest form of the disease, ductal carcinoma in situ (DCIS), need invasive surgery? Researchers at The University of Texas MD Anderson Cancer Center, Duke...

leukemia

Ofatumumab for Extended Treatment of Patients With Recurrent or Progressive Chronic Lymphocytic Leukemia

On January 19, 2016, ofatumumab (Arzerra) was approved for extended treatment of patients in complete or partial response after at least two lines of therapy for recurrent or progressive chronic lymphocytic leukemia (CLL).1,2 Ofatumumab was previously approved for treatment of untreated patients...

health-care policy
issues in oncology

Evolving Tools for Clinical Decision-Making

Value in cancer care—and how to define it—is a hot topic. There is general agreement that it is some measure of benefit vs cost, but “should the focus be on providing value to patients at a population level or at an individual level?” asked Alan Balch, PhD, CEO of the Patient Advocate Foundation,...

Expert Point of View: Elizabeth Plimack, MD

The Egyptian study presented by Brian Baumann, MD, of the University of Pennsylvania, Philadelphia, was a “valiant effort” to determine whether sequential adjuvant chemotherapy added to adjuvant radiation would improve disease-free survival, said formal discussant of this trial Elizabeth Plimack,...

issues in oncology

Cultural Awareness and Sensitivity Among Oncology Surgeons Do Not Necessarily Result in Culturally Competent Care

A survey of oncology surgeons from six hospitals in Washington State found that the surgeons in the sample “displayed and valued cultural awareness and sensitivity” but that “cultural awareness and sensitivity did not necessarily result in culturally competent behavior.”...

solid tumors
issues in oncology

Serum Tumor Marker Testing Overused, Especially for Solid Tumors

A retrospective review to evaluate the frequency of serum tumor marker testing “found a high rate of serum tumor marker testing overuse and extreme overuse in patients with advanced solid tumors,” Melissa K. Accordino, MD, of Columbia University College of Physicians and Surgeons, New...

cost of care

Cost in the Context of Value for Cancer Medicines

Bringing new cancer therapies through the discovery and development process entails considerable risk and many years of study. It also requires substantial investment and incentives from the public and private sectors to fuel future investment and discovery. A system that rewards advances in cancer ...

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