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issues in oncology
health-care policy

‘Curve 2’ and Oncology: What Those in Charge Don’t Understand … or Ignore

THERE IS little doubt that the U.S. health-care system is under assault from many directions.1 It is clear that the costs of health management are no longer sustainable, and the United States has one of the highest per capita health costs among the 36 member nations of the Organisation for...

pancreatic cancer

Expert Point of View: Andrew X. Zhu, MD, PhD

ANDREW X. ZHU, MD, PhD, of Massachusetts General Hospital Cancer Center and Harvard Medical School, noted that Prep-02/ JSAP-05 is the first study to show the value of neoadjuvant chemotherapy in patients with resectable pancreatic adenocarcinoma. However, the findings are applicable only to Asian ...

pancreatic cancer

Emerging Role for Neoadjuvant Treatment of Resectable Pancreatic Cancer

SEVERAL STUDIES presented at the 2019 Gastrointestinal Cancers Symposium evaluated the benefits of neoadjuvant treatment in patients with pancreatic cancer—and in patients deemed fully resectable, not just “borderline” resectable.1-3 Although the standard of care for resectable pancreatic ductal...

Expert Point of View: Mark Crowther, MD, MSc, FRCPC

Session moderator Mark Crowther, MD, MSc, FRCPC, Professor of Clinical Epidemiology and Biostatistics and Leo Pharma Chair in Thromboembolism Research at McMaster University, in Ontario, Canada, said that the results of the PAUSE study provide the most definitive evidence to date regarding how...

hematologic malignancies

PAUSE Study Establishes Simple Approach to Perioperative Management of Direct Oral Anticoagulants

The largest study to date addressing the common problem of perioperative direct oral anticoagulant (DOAC) management has shown that patients with atrial fibrillation can safely stop taking their anticoagulant for 1 day before and after procedures with a low risk of bleeding and for 2 days before...

hematologic malignancies

Crizanlizumab Improves Prevention of Vaso-occlusive Crises in Patients With Sickle Cell Disease

For the first time in more than 20 years, patients with sickle cell disease may have another treatment option to reduce painful vaso-occlusive crises, according to data presented at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition.1 Results of the phase II, randomized,...

Expert Point of View: Mark Crowther, MD, MSc, FRCPC

Moderator of the session, Mark Crowther, MD, MSc, FRCPC, Professor of Clinical Epidemiology and Biostatistics, Leo Pharma Chair in Thromboembolism Research at McMaster University, in Ontario, Canada, said that the CASSINI study represents a major advance in the management and prevention of a very...

hematologic malignancies

Direct Oral Anticoagulants Show Reduced Risk of Venous Thromboembolism in Patients With Cancer

Results of a recent study suggest that direct oral anticoagulants can reduce the risk of thromboembolism in patients with cancer who are starting a new systemic therapy regimen, without significantly increasing the risk of major bleeding. Data presented at the 2018 ASH Annual Meeting &...

hematologic malignancies

Pilot Study Tests Novel Approach to Gene Therapy for Sickle Cell Disease

Initial findings from a first-in-human trial have provided proof of principle for a groundbreaking approach to gene therapy for sickle cell disease, according to data presented at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition.1 Early results of genetic targeting of...

issues in oncology

Report Says Health Systems Are Key to Improving Cancer Outcomes in the United States

A new report indicates that without a national effort to transform health-care delivery in the United States, many people will not benefit from the ongoing improvements in cancer care. These findings were published by Yabroff et al in CA: A Cancer Journal for Clinicians. The article is the fifth...

prostate cancer
symptom management

Patient-Reported Outcomes With Enzalutamide in PROSPER Trial

As reported by Tombal et al in The Lancet Oncology, treatment with enzalutamide was associated with clinically meaningful delays in pain progression, symptom worsening, and deterioration in functional status vs placebo in the phase III PROSPER trial in nonmetastatic, castration-resistant prostate...

gynecologic cancers

Link Discovered Between Microbiome and Cervical Cancer

Bacteria may play an important role in whether a woman develops cervical cancer, according to global health research published by scientists from the University of Nebraska–Lincoln and the Ocean Road Cancer Institute in Dar es Salaam, Tanzania, in mBio. Part of a growing body of research...

kidney cancer
immunotherapy

2019 GU Cancers Symposium: First-Line Pembrolizumab Plus Axitinib vs Sunitinib in Advanced Renal Cell Carcinoma

As reported at the 2019 Genitourinary Cancers Symposium (Abstract 543) and in The New England Journal of Medicine, Rini et al found significant benefits in overall and progression-free survival with the combination of pembrolizumab plus axitinib vs sunitinib in the first-line treatment of advanced...

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 breast...

Expect Questions About Bone Loss Among Younger Breast Cancer Survivors

Women diagnosed with breast cancer at age 50 or younger had twice the risk of developing either osteoporosis or osteopenia after adjuvant treatment than did women of the same age who did not have cancer, according to a study led by researchers from Johns Hopkins Bloomberg School of Public Health,...

breast cancer

Increased Risk of Bone Loss Extends to Younger Women Treated for Breast Cancer

Younger women who have been treated for breast cancer have a higher risk for osteopenia and osteoporosis than do their cancer-free peers, and that risk seems to rise when treatment involves chemotherapy plus hormone therapy or aromatase inhibitors alone. Researchers from Johns Hopkins Bloomberg...

issues in oncology

Physician Wellness: Time to Heal the Healer

Physician wellness is emblazoned upfront in the news with attention-seeking headlines on a daily basis. The fact that one or two physicians commit suicide every day in this country sometimes elicits more of a sympathetic acknowledgment than a committed call to address it. Moreover, these sobering...

issues in oncology

Artificial Intelligence and the Brave New World of Cancer Diagnostics

A study published in Nature Medicine found that an artificial intelligence program could distinguish between the histologic diagnosis of adenocarcinoma and squamous cell carcinoma.1 Experienced pathologists often struggle to differentiate these tumor types without confirmatory tests. The artificial ...

Norman E. Sharpless, MD: From Director of a Comprehensive Cancer Center to Director of the NCI

GUEST EDITOR Dr. Abraham is the Director of the Breast Oncology Program at Taussig Cancer Institute, and Professor of Medicine, Lerner College of Medicine, Cleveland Clinic. In this installment of the Living a Full Life series of articles, guest editor Jame Abraham, MD, FACP, interviewed Norman E. ...

lymphoma
skin cancer

Cutaneous T-Cell Lymphoma: Can Genetic Polymorphisms Help Select Patients for Treatment With Bexarotene?

Bexarotene is a retinoid approved for the treatment of patients with cutaneous T-cell lymphoma (CTCL) who have not responded to at least one previous treatment regimen. Hypertrigylceridemia is the most frequent adverse event related to treatment with bexarotene in CTCL. Even with prophylactic...

breast cancer

Benefit of Annual Screening in Women Aged 35–39 With a Family History of Breast Cancer

Annual screening for women aged 35–39 who have a family history of breast cancer may be highly effective in detecting tumors earlier, according to findings published by Evans et al in The Lancet’s online journal EClinicalMedicine. The FH02 trial found that annual mammograms for...

prostate cancer
issues in oncology

Hospitalizations in Patients With Prostate Cancer on Medicare

In a retrospective analysis reported in the Journal of Oncology Practice, Parikh et al found that more than one-quarter of hospitalizations in Medicare patients with prostate cancer were potentially avoidable. Study Details The study involved 99 evaluable patients in the Mount Sinai Health System ...

lymphoma

DYNAMO: Duvelisib in Refractory Indolent Non-Hodgkin Lymphoma

In the phase II DYNAMO trial reported in the Journal of Clinical Oncology, Flinn et al found a response rate of nearly 50% with duvelisib, an oral dual inhibitor of phosphoinositide 3-kinase (PI3K)-γ and -δ, in indolent non-Hodgkin lymphoma refractory to rituximab and either...

gastroesophageal cancer
gastrointestinal cancer
immunotherapy

Addition of First-Line Ramucirumab to Cisplatin and Fluoropyrimidine in Metastatic Gastric or Gastroesophageal Junction Adenocarcinoma

In the phase III RAINFALL trial reported in The Lancet Oncology, Fuchs et al found no apparent benefit of the addition of the VEGFR-2 inhibitor ramucirumab to first-line cisplatin and fluoropyrimidine treatment in metastatic gastric or gastroesophageal junction adenocarcinoma. Study Details The...

leukemia

ERG Gene Variations and Risk of ALL in Hispanic Children

Scientists have identified genetic variations in a fourth gene that are associated with an increased risk of acute lymphoblastic leukemia (ALL) in Hispanic children. These findings were published by Qian et al in Blood. The gene is ERG, a transcription factor that is also...

kidney cancer

2019 GU Cancers Symposium: TIVO-3: Tivozanib vs Sorafenib in Refractory Advanced Renal Cell Carcinoma

The TIVO-3 trial was conducted to confirm progression-free survival results from the TIVO-1 trial, which found an improvement in median progression-free survival in patients with metastatic renal cell carcinoma treated with tivozanib vs sorafenib. Findings from TIVO-3 were presented by...

breast cancer

Meta-analysis of Outcomes With Dose-Intense Adjuvant Chemotherapy in Early Breast Cancer

In a patient-level meta-analysis reported in The Lancet, the Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) found that an increased dose intensity of adjuvant taxane and anthracycline chemotherapy in early breast cancer was associated with a decreased risk of recurrence and death ...

cns cancers

Buparlisib in PI3K Pathway–Activated Recurrent Glioblastoma

In a phase II trial reported in the Journal of Clinical Oncology, Wen et al found minimal activity of the phosphatidylinositol 3-kinase (PI3K) inhibitor buparlisib in patients with recurrent glioblastoma with PI3K pathway activation. The study included 2 cohorts. In cohort 1, 14 evaluable patients ...

bladder cancer

2019 GU Cancers Symposium: Adjuvant Sequential Chemotherapy Plus Radiotherapy vs Radiotherapy Alone for Locally Advanced Bladder Cancer

A phase III Egyptian trial presented by Zaghloul et al (Abstract 351) at the 2019 Genitourinary Cancers Symposium focused on the benefit of adjuvant chemotherapy in patients with locally advanced bladder cancer treated with postoperative radiotherapy. Researchers compared postoperative radiotherapy ...

prostate cancer

2019 GU Cancers Symposium: ARAMIS: Darolutamide in Nonmetastatic, Castration-Resistant Prostate Cancer

In the phase III ARAMIS trial reported by Fizazi et al at the 2019 Genitourinary Cancers Symposium (Abstract 140) and simultaneously published in The New England Journal of Medicine, researchers found that the androgen receptor antagonist darolutamide significantly prolonged metastasis-free...

prostate cancer
immunotherapy

2019 GU Cancers Symposium: CheckMate 650: Nivolumab and Ipilimumab in Metastatic, Castration-Resistant Prostate Cancer

Some patients with metastatic prostate cancer respond to a combination of immune checkpoint inhibitors after treatment with hormonal therapy and chemotherapy has not been successful in treating their disease, according to early results from the phase II CheckMate 650...

kidney cancer
immunotherapy

2019 GU Cancers Symposium: JAVELIN Renal 101: Avelumab Plus Axitinib vs Sunitinib for Advanced Kidney Cancer

A combination of two drugs could become a new standard first-line treatment for patients with metastatic kidney cancer, according to results from the JAVELIN Renal 101 trial presented at the 2019 Genitourinary Cancers Symposium (Abstract 544) and simultaneously published in The New England...

health-care policy
immunotherapy

CMS Proposes Medicare Coverage With Evidence Development for CAR T-Cell Therapy

Today, the Centers for Medicare & Medicaid Services (CMS) proposed coverage of U.S. Food and Drug Administration (FDA)–approved chimeric antigen receptor (CAR) T-cell therapy under its “coverage with evidence development” paradigm. Currently, there is no national...

skin cancer
immunotherapy

First-Line Pembrolizumab in Advanced Merkel Cell Carcinoma

In a phase II trial (Cancer Immunotherapy Trials Network-09/Keynote-017) reported in the Journal of Clinical Oncology, Nghiem et al found that first-line pembrolizumab produced a high response rate in patients with advanced Merkel cell carcinoma. In the multicenter trial, 50 adult patients who had ...

sarcoma
issues in oncology
symptom management

Gastric Acid Suppressants May Reduce Survival Outcomes in Patients With Sarcoma Treated With Pazopanib

It is estimated that 20% to 33% of patients undergoing cancer treatment are concomitantly using a gastric acid suppressant, most commonly a proton pump inhibitor (including omeprazole and esomeprazole magnesium) or a histamine H2-receptor blocker (such as ranitidine). A study by Mir et al...

issues in oncology

Involvement of Primary Care Providers in Cancer Treatment Decisions

The idea of team-based cancer care most often focuses on involving primary care physicians in the care of cancer survivors, but research has shown patients are also discussing initial cancer treatment options with their primary care doctors. Now, a new study by Wallner et al in Cancer has...

breast cancer

New Approach to Predicting Response to Pertuzumab and Trastuzumab in Breast Cancer

In the phase II TBCRC026 study reported in the Journal of Clinical Oncology, Connolly et al found that early changes in tumor maximum standardized uptake values corrected for lean body mass (SULmax) on [18F]fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) were...

lung cancer
issues in oncology

System-Based Intervention to Reduce Racial Disparities in Early-Stage Lung Cancer Treatment

Results from a study published by Cykert et al in Cancer Medicine showed that a pragmatic system-based intervention within cancer treatment centers may eliminate existing disparities in treatment and outcomes for black patients with early-stage lung cancer. “These results show ...

immunotherapy

Steven A. Rosenberg, MD, PhD, Awarded the 2019 Szent-Györgyi Prize

The 2019 Szent-Györgyi Prize for Progress in Cancer Research will be awarded to Steven A. Rosenberg, MD, PhD, of the Center for Cancer Research (CCR) at the National Cancer Institute (NCI). The prize, awarded annually by the National Foundation for Cancer Research (NFCR), recognizes Dr....

survivorship
symptom management

Late-Onset Cardiotoxicity in Pediatric Cancer Survivors: Comparison of Regimens

In a study reported in JAMA Oncology, Feijen et al found that daunorubicin was associated with decreased cardiomyopathy risk vs doxorubicin among pediatric cancer survivors, with epirubicin being approximately isoequivalent to doxorubicin. Risk associated with the anthraquinone mitoxantrone was...

cns cancers
issues in oncology

Implementation of a Hospital Pathway for Patients With a Newly Identified Single Brain Mass

In a study reported by Arrillaga-Romany et al in the Journal of Oncology Practice, a team at Massachusetts General Hospital found that implementation of a hospital pathway consisting of a dedicated admission protocol for patients with newly identified single brain masses and no history of cancer...

lymphoma

Alisertib vs Investigator’s Choice in Relapsed or Refractory Peripheral T-Cell Lymphoma

In the phase III Lumiere trial reported in the Journal of Clinical Oncology, O’Connor et al found that the Aurora A kinase inhibitor alisertib did not improve outcomes vs investigator’s choice of single-agent treatment in relapsed or refractory peripheral T-cell lymphoma (PTCL). Study...

breast cancer

Recent Decrease in Deaths Attributable to Breast Cancer in the United States

The latest U.S. estimates indicate that since 1989, hundreds of thousands of women's lives have been saved by mammography and improvements in breast cancer treatment. In a study published by Hendrick et al in Cancer, findings point to progress made in the early detection and management of...

head and neck cancer

Small Study Investigates Rise of Glottic Carcinoma in Young Adults and HPV Infection

An increase in the diagnosis of glottic carcinoma in young adults may be due in part to infection with strains of human papillomavirus (HPV). Investigators from Massachusetts General Hospital (MGH) described finding HPV infection in all tested samples of glottic carcinoma from 10 patients diagnosed ...

gynecologic cancers

Two-Year Interim Analysis of Conservatively Managed Ovarian Tumors

In an interim analysis of a prospective cohort study (IOTA5) reported in The Lancet Oncology, Froyman et al found that the risk of malignancy and acute complications is low when adnexal masses with benign ultrasound findings are managed conservatively. In the study, patients with at least 1...

solid tumors

Inherited Variants in CHEK2 and Susceptibility to Testicular Germ Cell Tumors

In a study reported in JAMA Oncology, AlDubayan et al found that inherited pathogenetic variants in the checkpoint kinase 2 gene (CHEK2), among inherited pathogenetic DNA-repair gene (DRG) alterations, were associated with susceptibility to testicular germ cell tumors. The study involved screening ...

hepatobiliary cancer

Adjuvant Gemcitabine Plus Oxaliplatin vs Surveillance in Resected Biliary Tract Cancer

In a French phase III trial (PRODIGE 12-ACCORD 18-UNICANCER GI) reported in the Journal of Clinical Oncology, Edeline et al found that adjuvant gemcitabine plus oxaliplatin (GEMOX) did not significantly improve relapse-free survival vs surveillance following resection for localized biliary tract...

skin cancer

Updated German Guidelines for Basal Cell Carcinoma

The German S2k guidelines for cutaneous basal cell carcinoma were recently updated to include new developments regarding the epidemiology, diagnosis, and histology of the disease. Commissioned by the Dermatologic Cooperative Oncology Group of the German Cancer Society and the German Society of...

kidney cancer
immunotherapy

2019 GU Cancers Symposium: KEYNOTE-426: Pembrolizumab Plus Axitinib vs Sunitinib in Advanced Renal Cell Carcinoma

Results from the randomized, phase III KEYNOTE-426 clinical trial show that first-line therapy with a combination of pembrolizumab and axitinib extended both overall survival (OS) and progression-free survival (PFS) for patients with clear cell metastatic renal cell carcinoma compared with the...

prostate cancer
issues in oncology

2019 GU Cancers Symposium: Study Evaluates Survival by Race in Metastatic Castration-Resistant Prostate Cancer

A large, retrospective study analyzing 5 years of data from the Veterans Health Administration (VHA) found that African American men with chemotherapy-naive, metastatic, castration-resistant prostate cancer who were treated with abiraterone acetate or enzalutamide lived 20% longer compared with...

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