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gynecologic cancers

HPV Testing Using Self-Collected vs Clinician-Collected Samples for the Detection of Cervical Intraepithelial Neoplasia

In a Dutch study (IMPROVE) reported in The Lancet Oncology, Polman et al found that human papillomavirus (HPV) testing with a clinically validated polymerase chain reaction (PCR)–based assay had similar accuracy using self-collected vs clinician-collected samples in detecting cervical...

lung cancer
immunotherapy

Avelumab in Previously Treated Advanced Unresectable Mesothelioma

In a phase Ib trial reported in JAMA Oncology, Hassan et al found that the anti–programmed cell death ligand 1 antibody avelumab produced durable responses and a high rate of disease control in some patients with advanced unresectable mesothelioma progressing after platinum and pemetrexed...

solid tumors
issues in oncology
legislation

ASCO Clinical Cancer Advances 2019 Names Advance of the Year: Progress in Treating Rare Cancers

Over the past year, major research advances provided new treatment options for patients with rare, difficult-to-treat cancers. In recognition of these achievements, ASCO named “Progress in Treating Rare Cancers” as the Advance of the Year. To continue the forward momentum, ASCO also...

gastroesophageal cancer

Effectiveness of EsophaCap Tool in the Diagnosis of Barrett’s Esophagus

Barrett’s esophagus is the only known precursor of esophageal adenocarcinoma. Although endoscopy and biopsy are standard methods for diagnosing Barrett’s esophagus, their high cost and risk limit their use as a screening modality. Researchers sought to develop a screening method based...

issues in oncology

Prevalence of Infection With HBV, HBC, and HIV in Patients With Newly Diagnosed Cancer

In a prospective cohort study reported in JAMA Oncology, Ramsey et al identified the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infection in patients with newly diagnosed cancer and found that a substantial proportion were unaware of...

solid tumors
hematologic malignancies

Standard Site-Specific Therapy Based on Gene-Expression Profiling vs Empirical Chemotherapy for Cancer of Unknown Primary

In a Japanese phase II trial reported in the Journal of Clinical Oncology, Hayashi et al found that standard site-specific treatment based on gene-expression profiling was not associated with better outcomes vs empirical paclitaxel and carboplatin in patients with cancer of unknown primary site....

breast cancer
issues in oncology

Racial Differences in Time to Breast Cancer Surgery and Survival in the U.S. Military Health System

In a retrospective cohort study reported in JAMA Surgery, Eaglehouse et al found that time to breast cancer surgery was delayed for non-Hispanic black vs non-Hispanic white women in the Military Health System but that this difference did not account for poorer overall survival in non-Hispanic black ...

breast cancer
cost of care

Cost-Effectiveness Analysis of Gene-Expression Profiling Assay in Breast Cancer

A new report published by Wang et al in JNCCN—Journal of the National Comprehensive Cancer Network found that using Oncotype DX—the most commonly used test for predicting the benefit of adjuvant chemotherapy to reduce the risk of disease recurrence—is not...

issues in oncology
survivorship
cost of care

Cancer Survivors and Medical Financial Hardship

New research indicates that cancer survivors carry greater financial burdens related to medical debt payments and bills compared with individuals without a cancer history, with the greatest hardships in younger survivors. Published by Zheng et al in Cancer, the study also found that among...

prostate cancer

Long-Term Effects of Finasteride vs Placebo on Prostate Cancer Mortality

In a letter to the editor of The New England Journal of Medicine, Goodman et al reported a long-term follow-up of the Prostate Cancer Prevention Trial indicating that finasteride treatment was not associated with an increased risk of death from prostate cancer. Study Details As previously...

colorectal cancer

Watch-and-Wait Strategy for Rectal Cancer With Complete Clinical Response After Neoadjuvant Therapy

In a single-center retrospective case series analysis reported in JAMA Oncology, Smith et al found that a watch-and-wait approach was associated with a high rate of rectal preservation and pelvic tumor control in patients with rectal cancer with complete clinical response to neoadjuvant therapy,...

lymphoma
skin cancer

2018 Update of WHO-EORTC Classification of Primary Cutaneous Lymphomas

As reported by Willemze and colleagues in Blood, the World Health Organization (WHO) and the European Organisation for Research and Treatment of Cancer (EORTC) have released a 2018 update of their classification of primary cutaneous lymphomas. As noted by the authors, “Primary cutaneous...

skin cancer

Surgical Factors Contributing to Invasive Squamous Cell Carcinoma Recurrence

Invasive squamous cell carcinoma (SCC) is typically treated surgically, with guidelines in place recommending surgical margins for excision based on the SCC being classified as low or high risk. Researchers undertook a study to examine recurrence rates of SCC after surgical excision, taking into...

leukemia
myelodysplastic syndromes

Combination Azacitidine and Lenalidomide as Salvage Therapy for Relapsed AML After Allogeneic Stem Cell Transplantation

In a phase I trial reported in the Journal of Clinical Oncology, Craddock et al found evidence that the sequential combination of azacitidine and lenalidomide may be an effective salvage therapy in patients with acute myeloid leukemia (AML) relapsing after allogeneic stem cell transplantation...

breast cancer

Short-Term Safety Outcomes in Mastectomy and Immediate Implant-Based Breast Reconstruction

In a prospective cohort study reported in The Lancet Oncology, Potter et al found that complications following immediate implant-based breast reconstruction—with or without mesh—were higher than considered acceptable by UK national standards. As noted by the investigators, the study was ...

colorectal cancer

Polymorphisms in Pattern Recognition Receptors as Predictors of Oxaliplatin Benefit in Colorectal Cancer

In a study reported in the Journal of the National Cancer Institute, Gray et al found that constitutional loss of function single-nucleotide polymorphisms in the pattern recognition receptors FPR1, TLR3, and TLR4 were not associated with preferential benefit of oxaliplatin in colorectal cancer. As...

lymphoma

Hastening the Development of Novel Therapies for Peripheral T-Cell Lymphomas

Peripheral T-cell lymphomas (PTCLs) make up a small fraction of all non-Hodgkin lymphomas—just 15%—in the United States.1 Although rare in the United States, the incidence of PTCL is common across Asia, the Caribbean, and sub-Saharan Africa. Although the reason for such global variation in PTCL is...

Community Oncology Alliance Elects New Officers and Board Members

THE COMMUNITY Oncology Alliance (COA) recently announced that Michael Diaz, MD, a practicing medical oncologist at Florida Cancer Specialists & Research Institute, has been elected President of COA. His 1-year term began on January 1, 2019. In addition, Kashyap Patel, MD, a practicing...

breast cancer
immunotherapy

IMpassion130 Trial: Changing the Treatment Landscape in Metastatic Triple-Negative Breast Cancer

THE IMPASSION130 trial—reported in The New England Journal of Medicine by Schmid et al1 and reviewed in this issue of The ASCO Post—was an eagerly awaited study in newly diagnosed metastatic triple-negative breast cancer. To briefly review, 902 patients were randomly assigned in a 1:1 fashion to...

MMRF Launches First Platform Trial in Multiple Myeloma

THE MULTIPLE MYELOMA Research Foundation (MMRF) has announced the launch of MyDRUG, the first platform trial exclusively in multiple myeloma, which aims to investigate targeted treatments for patients with high-risk myeloma. MyDRUG represents the culmination of the MMRF’s Precision Medicine Model,...

geriatric oncology

Changing Perceptions on Surgical Intervention for Geriatric Patients With Cancer: Role of the SIOG Surgical Task Force

Surgery is an integral part of treatment of elderly patients with solid malignancies. The times we are living in will be remembered by health-care providers for the significant “contradictions” in the medical and surgical care of elderly patients with cancer. On the one hand, it has been...

breast cancer
immunotherapy

Challenge Moving Forward in Breast Cancer Treatment: To Show That New Approaches Change Outcomes

ADVANCES IN treating breast cancer over the past 20 years have brought us to the point where treatment can be confidently de-escalated for some patients, and immunotherapy and precision decision-making may change the way breast cancer is treated for others, William Gradishar MD, FASCO, told the...

breast cancer

Preventing Locoregional Recurrence of Breast Cancer Should Not Deter Efforts to Decelerate Therapy

“SURGEONS AND radiation oncologists are obsessed with locoregional recurrence of breast cancer,” Monica Morrow, MD, FASCO, remarked at the 2018 Lynn Sage Breast Cancer Symposium, Chicago. Working to prevent locoregional recurrence, “even if it may not be the major threat to mortality, is...

breast cancer

Risk of Local Recurrence in Breast Cancer: Impact of Molecular Subtype and Surgical Approach

THE RISK of local recurrence in breast cancer “does not differ substantially based on the operation we perform, but it does differ substantially by subtype,” Tari A. King MD, FACS, stated at the 2018 Lynn Sage Breast Cancer Symposium in Chicago.1 At 10-year follow-up, Dr. King reported, local...

leukemia

Expert Point of View: Elihu H. Estey, MD; Steven Gore, MD; and Mark J. Levis, MD, PhD

ELIHU H. ESTEY, MD, Professor of Medicine at the University of Washington and Director of Acute Myeloid Leukemia (AML) Clinical Research at the Fred Hutchinson Cancer Research Center, Seattle, added that with these “robust” outcomes, future trial patients may “not be eager to wind up in the...

ASH Research Collaborative Established to Accelerate Progress in Hematology

THE AMERICAN SOCIETY of Hematology (ASH) has established the ASH Research Collaborative, a mission-focused nonprofit organization that will foster collaborative partnerships to accelerate progress in hematology with the goal of improving the lives of people affected by blood diseases. “The launch...

symptom management
issues in oncology

Primary Prophylaxis With a Direct Oral Anticoagulation Agent Reduces Venous Thromboembolism Rate in Ambulatory Patients With Cancer

LATE-BREAKING results from the large, randomized, placebo-controlled CASSINI trial showed that primary prophylaxis with the direct oral anticoagulation agent rivaroxaban reduced the incidence of venous thromboembolism (VTE) as well as VTE-related deaths in high-risk patients with cancer who were...

leukemia

BEAT AML Umbrella Trial: Bringing Personalized Medicine to Acute Myeloid Leukemia

THE MULTIARM, multicollaborative BEAT AML umbrella trial demonstrated the feasibility of using next-generation sequencing to assign treatment tailored to individual genomics of elderly patients with acute myeloid leukemia (AML) within 7 days. This may prove to be a major advance, since typically...

breast cancer
symptom management

Oxybutynin: A Novel Option for Managing Hot Flashes?

OXYBUTYNIN, AN ANTICHOLINERGIC drug approved for the treatment of overactive bladder, reduced the frequency and intensity of hot flashes in women who were suffering frequent hot flashes, including breast cancer survivors who were receiving tamoxifen or aromatase inhibitors. These results of the...

issues in oncology

ACCC 2018 Survey Finds Multiple Barriers to Cancer Program Growth

At a time of unprecedented advances in the science of cancer, growing complexity in cancer treatments, and ongoing health policy fluctuation, the Association of Community Cancer Centers (ACCC) 9th annual Trending Now in Cancer Care survey reveals how cancer programs across the country are ...

issues in oncology

HPV Vaccination Rates in Younger Adolescents

Only about 16% of U.S. adolescents have been fully vaccinated against human papillomavirus (HPV) by the time they turn 13, despite national recommendations that call for vaccination at 11 to 12 years of age. These findings, published by Bednarczyk et al in the Journal of Infectious Diseases,...

issues in oncology

Two Retrospective Studies Find Increased Risk of Suicide Among Patients Diagnosed With Cancer

In a news item reported in The Lancet Oncology, The Lancet journalist Manjulika Das reviewed two U.S. retrospective studies indicating that patients diagnosed with cancer are at increased risk of suicide. High Standardized Mortality Ratio In one study, published by Zaorsky et al in Nature...

breast cancer

Tumor-Infiltrating Lymphocytes and Prognosis in Early-Stage Triple-Negative Breast Cancer

In a pooled analysis reported in the Journal of Clinical Oncology, Loi et al found that levels of stromally located tumor infiltrating lymphocytes (sTILs) are strongly prognostic in early-stage triple-negative breast cancer, with improved survival observed in patients with higher levels of sTILs...

lymphoma

PET-Adapted Treatment in Newly Diagnosed Advanced Hodgkin Lymphoma

In the phase III AHL2011 trial reported in The Lancet Oncology, Casasnovas et al found that positron-emission tomography (PET)-guided treatment produced good outcomes in newly diagnosed advanced Hodgkin lymphoma, allowing de-escalation of induction to ABVD (doxorubicin, bleomycin, vinblastine, and...

immunotherapy
lung cancer

PACIFIC Trial of Durvalumab Sets Standard in Stage III Unresectable NSCLC

IMMUNOTHERAPY HAS revolutionized the treatment of lung cancer over the past several years. Although lung cancer is associated with immunosuppression at baseline for most patients, the addition of immune checkpoint inhibitors can overcome that suppression and lead to antitumor immune responses....

issues in oncology
cost of care

How to Save Billions on Cancer Care Costs: The Potential of Value-Based Prescribing in Oncology

IT IS TIME for value-based prescribing—the reduction of prescribing costs using basic pharmacologic principles—to be tested and deployed in oncology. The savings are real and there for the taking. If you are concerned about the high costs in cancer care, here is a chance to get maximum value for...

breast cancer

Expert Point of View: Virginia G. Kaklamani, MD; Monica Morrow, MD; and John Cole, MD

AT THE SAN ANTONIO Breast Cancer Symposium, several breast cancer experts interviewed by The ASCO Post noted that the approved dose of tamoxifen was arbitrarily set, and the optimal dose is actually unknown. Studies of lower-dose tamoxifen, therefore, are welcomed. Virginia G. Kaklamani, MD,...

breast cancer

Low-Dose Tamoxifen Halves Breast Cancer Risk in Women With Preinvasive Breast Lesions

A VERY LOW DOSE of tamoxifen—5 mg/d, given for 3 years rather than 5 years—halved the risk of breast cancer recurrence or new lesions over placebo in women with breast intraepithelial neoplasia, without producing the usual toxicities seen with the standard dose, Italian researchers reported at the...

health-care policy
lung cancer

Shared Decision-Making and Use of Low-Dose CT Screening for Lung Cancer

In a study reported in a research letter in JAMA Internal Medicine, Goodwin et al found that only a small proportion of Medicare enrollees undergoing low-dose computed tomography (CT) screening for lung cancer had a prescreening shared decision-making session, which is mandated by the Centers for...

breast cancer

MRI Background Parenchymal Enhancement and Risk of Breast Cancer

In a population-based study reported in the Journal of Clinical Oncology, Arasu and colleagues found that increased breast magnetic resonance imaging (MRI) background parenchymal enhancement was associated with an increased risk of breast cancer, with risk being independent of breast density. The...

solid tumors
immunotherapy

Overall Survival in Men and Women Receiving Immune Checkpoint Inhibitors for Advanced Cancers

In a systematic review and meta-analysis reported in JAMA Oncology, Wallis et al found no difference in overall survival benefit in women vs men receiving immune checkpoint inhibitor treatment for advanced solid tumors. The authors noted that a prior analysis had suggested men derived a greater...

colorectal cancer

23andMe Receives FDA Clearance for Direct-to-Consumer Genetic Test on a Hereditary Colorectal Cancer Syndrome

On January 22, 23andMe received U.S. Food and Drug Administration (FDA) clearance for a genetic health risk report on MUTYH-associated polyposis, a hereditary colorectal cancer syndrome. The clearance follows the FDA’s authorization for 23andMe’s BRCA1/BRCA2 (Selected Variants)...

kidney cancer

Personalized Treatment May Extend Life Expectancy for Patients With Chronic Kidney Disease and Small Renal Tumors

Personalized treatment plans may extend life expectancy for patients with early-stage kidney cancer who also have risk factors for worsening kidney disease, according to a new study published by Kang et al in Radiology. Kidney tumors are often discovered at an early stage and are frequently...

leukemia

Newly Defined Subtypes of B-Cell Acute Lymphoblastic Leukemia

Investigators have identified multiple new subtypes of the most common childhood cancer, B-cell acute lymphoblastic leukemia (ALL)—research that has the potential to improve the diagnosis and treatment of high-risk patients. Researchers used integrated genomic analysis, including...

kidney cancer
immunotherapy

Patient-Reported Outcomes With Nivolumab Plus Ipilimumab vs Sunitinib in Advanced Renal Cell Carcinoma

As reported in The Lancet Oncology by Cella et al, patient-reported outcomes were better with nivolumab plus ipilimumab vs sunitinib in the phase III CheckMate 214 trial among patients with intermediate- or poor-risk advanced renal cell carcinoma. The ongoing trial showed significantly improved...

issues in oncology

Oncologist Survey on Knowledge About LGBTQ Patients With Cancer

In a national survey of oncologists reported in the Journal of Clinical Oncology, Schabath et al found that whereas oncologists tended to have limited knowledge regarding lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) patient health and cancer needs, they indicated high interest ...

lymphoma

Survival With Combined Modality Therapy vs Chemotherapy Alone in Early-Stage Pediatric Hodgkin Lymphoma

In an observational cohort study reported in JAMA Oncology, Jhawar et al found that combined modality therapy (CMT) with chemotherapy followed by radiotherapy was associated with a survival advantage vs chemotherapy alone in early-stage pediatric Hodgkin lymphoma. The authors noted that use of...

colorectal cancer

2019 GI Cancers Symposium: Rectal Cancer Treated With Total Neoadjuvant Therapy Plus Short-Course Radiation vs Concurrent Chemoradiation

The delivery of all radiotherapy and chemotherapy neoadjuvantly—also known as total neoadjuvant therapy—has improved complete response and downstaging rates compared to treatment after surgery in patients with rectal cancer. In a study presented by Chapman et al at the 2019...

colorectal cancer

2019 GI Cancers Symposium: Is Adjuvant HIPEC Effective in Reducing the Risk of Peritoneal Metastases in Patients With Colon Cancer?

Patients with advanced or perforated colon cancer may be at elevated risk of peritoneal metastases. Since many patients with peritoneal metastases are diagnosed at a late stage, researchers sought to study the effectiveness of hyperthermic intraperitoneal chemotherapy (HIPEC) in the adjuvant...

solid tumors
immunotherapy

2019 GI Cancers Symposium: Pembrolizumab in Pretreated, Advanced Neuroendocrine Tumors

Findings from the phase I KEYNOTE-028 trial, which studied pembrolizumab in a number of solid tumors, showed activity of the immunotherapy in some patients with heavily pretreated neuroendocrine tumors. Now, a phase II basket trial—KEYNOTE-158—is studying the efficacy and safety of...

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