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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...

breast cancer

Geriatric Assessment Is Key to Treatment Decisions for Patients 80 Years and Older With Breast Cancer

A review of major studies and the current literature underscored the role of geriatric assessment in making treatment recommendations for patients aged 80 years and older with early and metastatic breast cancer. The review was reported by Shachar et al in the Journal of Oncology Practice. The...

breast cancer

Adjuvant Endocrine Therapy for Primary Breast Cancer Treatment Associated With Increased Symptom Burden Over 12 Months

Patients in the observational Mind-Body Study receiving adjuvant endocrine therapy for primary breast cancer treatment reported a greater symptom burden than did patients not receiving endocrine therapy over 12 months, as reported by Ganz et al in the Journal of Clinical Oncology. No differences 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...

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...

colorectal cancer
issues in oncology

Half of Elderly Patients With Colorectal Cancer Receive Expensive Therapy With Little Survival Benefit

A study published by Bradley et al in Medical Care showed that over a recent 10-year period, the rate of metastatic colorectal cancer patients older than age 75 receiving three or more treatments increased from 2% to 53%. During this period, 1-year treatment costs increased 32% to reach an...

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...

skin cancer

Study Finds Most Patients With Melanoma Had Few Total Nevi and No Atypical Nevi

Although nevi are considered among the strongest risk factors for melanoma, most patients with melanoma had few total and no atypical nevi, according to a study of 566 patients with invasive cutaneous melanoma. “Three notable findings emerged from this case study,” Alan C. Geller, MPH, ...

Nuns Work Where None Work

It was December 9, 1975—a cold morning in the tribal village in Mahuadanr in Bihar, India. The valley was filled with an eerie mist coming down from the hills surrounding the village. Champa, a 5-year-old malnourished girl with sunken eyes, an emaciated face, and a huge ascites, was carried by her...

lung cancer

Racial/Ethnic Variations in Lung Cancer Incidence and Mortality in the Women’s Health Initiative Study Cohort

As reported by Patel et al in the Journal of Clinical Oncology, analysis of lung cancer incidence and mortality in the Women’s Health Initiative Study cohort of postmenopausal women showed a marginally significant lower risk of cancer in Hispanic women vs white women and no difference in...

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,...

cns cancers

Malignant Brain Tumors Most Common Cause of Cancer Deaths in Adolescents and Young Adults

A new report published by Ostrom et al in the journal Neuro-Oncology sponsored by the American Brain Tumor Association (ABTA) found that malignant brain tumors are the most common cause of cancer-related deaths in adolescents and young adults aged 15 to 39, and the most common cancer occurring...

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 ...

lung cancer

Improved Outcomes Reported With Adjuvant Therapy in Patients With Early-Stage SCLC Undergoing Complete Resection

Adjuvant chemotherapy and chemotherapy plus prophylactic cranial irradiation were associated with significantly improved survival vs surgery alone in patients with early-stage small cell lung cancer (SCLC) undergoing complete resection, according to an analysis of National Cancer Data Base data...

issues in oncology

Lee N. Newcomer, MD, on Assessing Quality: Payer Perspective

Lee N. Newcomer, MD, of the UnitedHealth Group, gives his perspective on how to assess quality in the age of precision medicine.

issues in oncology

Allison Kurian, MD, on Assessing Quality in the Age of Precision Medicine

Allison Kurian, MD, of Stanford University School of Medicine, discusses pressing questions about the clinical utility and value of extended genomic testing and other forms of precision medicine.

breast cancer

Phase III Trial Shows No Benefit of Afatinib vs Trastuzumab Plus Vinorelbine in HER2-Positive Metastatic Breast Cancer

In the phase III LUX-Breast 1 trial reported in The Lancet Oncology, Harbeck et al found no benefit of afatinib (Gilotrif)/vinorelbine vs trastuzumab (Herceptin)/vinorelbine after previous trastuzumab treatment in patients with HER2-positive metastatic breast cancer. Broader inhibition of ErbB...

lymphoma

FDA Approves Obinutuzumab in Follicular Lymphoma

The U.S. Food and Drug Administration (FDA) today approved obinutuzumab (Gazyva) for use in combination with bendamustine (Bendeka, Treanda) followed by obinutuzumab monotherapy for the treatment of patients with follicular lymphoma who relapsed after, or are refractory to, a rituximab...

hepatobiliary cancer

Single-Center Trial Indicates No Benefit of Hepatic Artery Chemoembolization vs Embolization in Hepatocellular Carcinoma

In a phase II study reported in the Journal of Clinical Oncology, Brown et al found no apparent benefit of hepatic artery chemoembolization using doxorubicin-eluting microspheres vs embolization with microspheres alone in patients with hepatocellular carcinoma. Study Details In the trial, 101...

solid tumors

Increased Cancer Mortality Among Recipients of Solid-Organ Transplants

Solid-organ transplant recipients have a higher rate of cancer mortality than that expected in the general population, according to a Canadian study published in JAMA Oncology. Cancer mortality among transplant recipients “was significantly elevated compared with the Ontario population,” with a...

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' ...

prostate cancer

ASCO Endorses Cancer Care Ontario Guideline on Active Surveillance for Management of Localized Prostate Cancer

As reported by Ronald C. Chen, MD, MPH, of the University of North Carolina at Chapel Hill, and colleagues in the Journal of Clinical Oncology, ASCO has endorsed, with qualifications, the 2015 Cancer Care Ontario (CCO) guideline on active surveillance for management of localized prostate cancer....

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...

issues in oncology
gynecologic cancers
head and neck cancer

100% of NCI-Designated Cancer Centers Endorse the Promotion of the HPV Vaccination for Cancer Prevention

All National Cancer Institute (NCI)-designated cancer centers have united to support human papillomavirus (HPV) vaccination (see below). A team of HPV experts drafted a consensus statement that advises widespread use of HPV vaccines to prevent cancer. HPV causes cancer of the cervix, anus, and...

colorectal cancer

Patients Diagnosed With Stage I to III Rectal Cancer at Younger Age Have Increased Risk for Positive Lymph Nodes

Patients diagnosed with stage I to III rectal cancer at a younger age are at increased risk of having positive lymph nodes, according to an analysis of data published in the Journal of the National Cancer Institute. “This finding merits further investigation and may ultimately impact treatment...

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...

head and neck cancer

2016 Head and Neck Cancer Symposium: Chemoradiation May Increase Survival for a Subset of Elderly Head and Neck Cancer Patients

The addition of chemotherapy to radiation therapy improves survival rates among a subset of elderly head and neck cancer patients, specifically those aged 71 to 79 with low comorbidity scores and advanced disease stage, according to research presented by Amini et al at the 2016 Multidisciplinary...

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...

hematologic malignancies
multiple myeloma

Selected Abstracts From 2015 ASH Annual Meeting: Part 3

Here are several more abstracts selected from the proceedings of the 2015 American Society of Hematology (ASH) Annual Meeting and Exposition, focusing on newly diagnosed multiple myeloma, relapsed/refractory multiple myeloma, and amyloid light-chain (AL) amyloidosis. For other selected abstracts...

ASCO Announces New Award Recognizing Extraordinary Contributions to Cancer Survivorship Care

ASCO has announced the creation of the Ellen L. Stovall Award and Lecture for Advancement of Cancer Survivorship Care, intended to recognize and promote the work of pioneers and leaders in the growing field of survivorship. The first award will be presented at the 2017 Cancer Survivorship...

Candid Discussions on Living With and After Cancer at An Evening for Cancer Survivors and Caregivers

On January 14, 2016, the Cancer Survivorship Symposium opened with An Evening for Cancer Survivors and Caregivers, an event featuring networking, a panel discussion, and an open forum to share the challenges of living with or after a cancer diagnosis. The audience included Symposium attendees as...

issues in oncology
lung cancer
geriatric oncology

Management of Advanced Lung Cancer in the Elderly: A Reason to Rejoice or a Cause for Concern?

There is ample evidence to suggest that older adults with a good performance status (0 or 1) with advanced non–small cell lung cancer (NSCLC) should be treated with combination chemotherapy akin to younger patients.1,2 However, older adults comprise a heterogeneous group that has been...

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...

bladder cancer

Adjuvant Chemoradiotherapy in Locally Advanced Bladder Cancer: Hint of Benefit That Needs Confirmation

Adjuvant sequential chemotherapy plus radiation therapy and adjuvant radiation therapy alone significantly improved local tumor control compared with adjuvant chemotherapy alone in locally advanced bladder cancer but the improvement in disease-free survival (3-year disease-free survival of 68% vs...

prostate cancer

Active Holistic Surveillance May Prevent Unnecessary Biopsies in Low- and Low/Intermediate-Risk Prostate Cancer

The use of prostate-specific antigen (PSA) screening has led to a dramatic rise in the number of men diagnosed with low-grade prostate cancer. Active surveillance is recommended to manage patients with favorable-risk, low-grade prostate cancer, with the goal of avoiding overtreatment of these...

survivorship

Study Finds Abnormal Insulin and Glucose Dynamics in Childhood Survivors Treated With Abdominal Radiation

An ongoing pilot study, designed to assess dynamic indices of insulin and glucose homeostasis in childhood cancer survivors exposed to abdominal radiation, has found a variety of derangements in glucose and insulin homeostasis in this cohort.1 According to an analysis presented at the 2016 Cancer...

survivorship

Clinic-Based Weight-Loss Intervention Successful in Cancer Survivors

A randomized clinical trial examining the effect of a 15-week healthy living program on weight loss in cancer survivors showed a 5.3% decrease in baseline body weight in those participating in the program.1 “Cancer survivors randomized to a 15-week clinic-based weight-loss intervention lost an...

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.”...

gastrointestinal cancer

Radiotherapy for Rectal Cancer: Study Reports No Risk for Subsequent Pelvic Tumors

Second malignancies were not more common among patients who underwent radiotherapy for rectal cancer. In fact, radiotherapy appeared to offer some degree of protection against subsequent cancers, according to the findings of a study from the Netherlands reported at the 2016 Gastrointestinal Cancers ...

gastrointestinal cancer

Receipt of Adjuvant Therapy at High-Volume Center Improves Survival in Patients With Pancreatic Cancer

Patients with pancreatic cancer who received adjuvant chemotherapy at a high-volume center had superior median and 5-year overall survival than did patients who were treated in a community setting, according to the results of a study presented at the 2016 Gastrointestinal Cancers Symposium.1 This...

survivorship

Surveillance for Recurrence and Second Cancers: Guidelines and Caveats

Striking the right balance between under- and oversurveillance of cancer survivors is challenging, and oncology providers are best served by knowing and following guidelines—though they can change often. Cancer recurrence and second cancers are two of the major threats to the health of cancer...

lung cancer
issues in oncology

Autoantibodies May Help Detect Lung Cancer Earlier

Preliminary research has identified autoantibodies—immune proteins found in the blood specific for one's own proteins—that can potentially detect lung cancer early by distinguishing between smokers with or without lung cancer and can also discriminate between lung cancer and low-dose...

colorectal cancer
issues in oncology

Fecal Immunochemical Test Sensitive and Effective for Annual Colorectal Cancer Screening

Annual screening with the fecal immunochemical test is highly sensitive for detecting colorectal cancer and “is feasible and effective for population-level colorectal cancer screening,” according to a large-scale retrospective cohort study assessing the fecal immunochemical...

survivorship

Norwegian Male Cancer Survivors Less Likely to Reproduce

A study of all Norwegian men born between 1965 and 1985 showed that male cancer survivors are less likely to have children than those without a cancer diagnosis. “These findings are important for male cancer survivors, seeing as we can identify groups at risk of having reproduction...

survivorship
cns cancers
issues in oncology

Increased Risk of Severe Neurocognitive Impairment in Adult Survivors of Pediatric CNS Tumors

As reported in the Journal of Clinical Oncology by Brinkman et al, a study in the St. Jude Lifetime Cohort showed that adult survivors of pediatric central nervous system (CNS) tumors are at increased risk of severe neurocognitive impairment. Study Details The study involved 224 survivors of CNS...

sarcoma

Eribulin Improves Overall Survival vs Dacarbazine in Advanced Liposarcoma or Leiomyosarcoma

In a phase III trial reported in The Lancet, Schöffski et al found that eribulin improved overall survival vs dacarbazine in patients with advanced or metastatic soft-tissue sarcoma who had received at least two prior systemic treatments for advanced disease. Outcome in the subgroup with...

solid tumors
solid tumors

High Conditional Survival for Patients With Metastatic Testicular Germ Cell Tumors Receiving First-Line Curative Therapy

Two-year conditional overall and disease-free survival were substantially increased in patients surviving and surviving without recurrence for 2 years after first-line curative therapy for metastatic testicular germ cell tumors, according to a study reported by Ko et al in the Journal of Clinical...

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