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issues in oncology

Quality of Life and Patient- and Clinician-Reported Cumulative Toxicity

New research has found that quality of life for people with cancer is reduced by an accumulation of low-level toxicities just as much as it is from high-level adverse events. Additionally, patient-reported outcomes were more likely to reflect the impact on a patient’s physical well-being than ...

lymphoma

Analysis of Cause of Death in Patients With Follicular Lymphoma in the Rituximab Era

In a pooled analysis of French and U.S. follicular lymphoma cohorts reported in the Journal of Clinical Oncology, Sarkozy and colleagues found that lymphoma was the most common cause of death during the first decade of the rituximab era in treatment of the disease. The study involved data from...

sarcoma
issues in oncology

Regionalization of Surgery for Retroperitoneal Sarcoma Surgery to High-Volume Hospitals

In a study reported in the Journal of Oncology Practice, Villano et al found that regionalization of retroperitoneal sarcoma surgery—recognized as a complex cancer surgery—to high-volume hospitals has been slower than that observed for similarly complex pancreatic cancer surgery over...

gynecologic cancers

Maintenance Olaparib in Newly Diagnosed Advanced Ovarian Cancer

As reported in The New England Journal of Medicine by Moore et al, the phase III SOLO-1 trial has shown that maintenance with olaparib, following complete or partial response to platinum-based chemotherapy, significantly prolonged progression-free survival vs placebo in...

colorectal cancer

Negative Colonoscopy and Long-Term Risk of Colorectal Cancer

Ten years after a negative colonoscopy, patients who were rescreened for colorectal cancer had a lower risk of being diagnosed with and were less likely to die from colorectal cancer compared with those who did not undergo colorectal cancer screening, according to a study published by Lee et al...

issues in oncology
cost of care

New Study Examines Orphan Drug Exclusivity and Pricing

A new report commissioned by the National Organization for Rare Disorders (NORD) and published by the IQVIA Institute demonstrates that the 7-year market exclusivity granted to drugs designated under the Orphan Drug Act of 1983 for rare diseases is working as intended. In nearly every case, orphan...

solid tumors
immunotherapy

Factors Influencing Response to Pembrolizumab in Various Advanced Cancers

In an analysis from the phase Ib KEYNOTE-028 trial reported in the Journal of Clinical Oncology, Ott et al found that response to pembrolizumab across different cancers was more likely in patients with higher tumor mutational burden, T-cell–inflamed gene-expression profile, and programmed...

lung cancer

Transformation of EGFR-Mutant NSCLC to SCLC

In a study reported in the Journal of Clinical Oncology, Marcoux et al provided further evidence that EGFR-mutant non–small cell lung cancer (NSCLC) can undergo transformation to small cell lung cancer (SCLC) and identified factors associated with such transformation. It has been estimated...

issues in oncology

Association Between Systemic Lupus Erythematosus and Cancer Risk

New research published by Song et al in Arthritis Research & Therapy evaluated the link between lupus and cancer risk, supporting the data from earlier studies. The newer study indicates an association between systemic lupus erythematosus (SLE) and increased risk for several cancers (blood,...

breast cancer

Study Assesses Impact of Digital Mammography on Breast Cancer Detection and Recall Rates

The shift from film to digital mammography increased the detection of breast cancer overall in the United Kingdom—without increasing the recall rate—according to a study published by Blanks et al in Radiology. “Image quality with digital mammography is improved over that of...

multiple myeloma

Lenalidomide Maintenance vs Observation in Newly Diagnosed Multiple Myeloma

In a UK phase III trial (Myeloma XI) reported in The Lancet Oncology, Jackson et al found that lenalidomide maintenance was associated with improved progression-free survival but not overall survival among patients with newly diagnosed multiple myeloma with at least minimal response to induction...

solid tumors

Sorafenib in Progressive, Symptomatic, or Recurrent Desmoid Tumors

In a phase III trial reported in The New England Journal of Medicine, Gounder et al found that sorafenib improved progression-free survival vs placebo in patients with progressive, symptomatic, or recurrent desmoid tumors. As noted by the investigators, there is no current standard of care for...

prostate cancer

Time to Biochemical Failure as Surrogate Endpoint in Locally Advanced Prostate Cancer

As reported in the Journal of Clinical Oncology by Dignam et al, analysis of outcomes in the phase III NRG/RTOG 9202 trial indicates that the time interval to biochemical failure (IBF) could serve as a surrogate endpoint for clinical outcomes in patients receiving radiotherapy plus long-term...

skin cancer
immunotherapy

Pilot Study of Intratumoral G100 in Merkel Cell Carcinoma

Multiple recent reports have addressed the activity of programmed cell death protein 1 (PD-1) inhibitors, such as pembrolizumab and avelumab, in Merkel cell carcinoma. However, approximately half of all patients who receive these agents do not maintain a persistent response. In an...

lymphoma
survivorship

High Long-Term Risk of Solid Cancers in Survivors of Childhood Hodgkin Lymphoma

A new study may bolster existing evidence that survivors of childhood Hodgkin lymphoma face an elevated risk of developing various types of solid tumors many years later. The study showed that certain subgroups of patients have an especially high risk. Published by Holmqvist et al in the journal...

cns cancers

Regorafenib vs Lomustine in Relapsed Glioblastoma

In the Italian phase II REGOMA trial reported in The Lancet Oncology, Lombardi et al found that regorafenib was associated with improved overall survival vs lomustine in patients with relapsed glioblastoma. In the open-label trial, 119 patients from 10 Italian sites were randomly assigned between...

prostate cancer

RADAR Trial: Short- vs Intermediate-Term Androgen Suppression and Zoledronic Acid in Locally Advanced Prostate Cancer

As reported by Denham et al in The Lancet Oncology, 10-year results of the phase III TROG 03.04 RADAR trial have shown that 18 months of androgen suppression plus radiotherapy is more effective than 6 months of androgen suppression plus radiotherapy in locally advanced prostate cancer, but no...

pancreatic cancer

Adjuvant FOLFIRINOX vs Gemcitabine in Pancreatic Cancer

In a phase III Canadian and French trial reported in The New England Journal of Medicine, Conroy and colleagues in the Canadian Cancer Trials Group and the Unicancer-GI–PRODIGE Group found that adjuvant modified FOLFIRINOX (fluorouracil, leucovorin, irinotecan, oxaliplatin) produced better...

hematologic malignancies

FDA Approves Tagraxofusp-ezrs for Blastic Plasmacytoid Dendritic Cell Neoplasm

On December 21, the U.S. Food and Drug Administration (FDA) approved tagraxofusp-erzs (Elzonris) infusion for the treatment of blastic plasmacytoid dendritic cell neoplasm (BPDCN) in adults and in pediatric patients aged 2 years and older. “Prior to [this] approval, there had been no...

multiple myeloma

I Welcome Being the Face of Multiple Myeloma

Thirteen years ago, at age 34, I was healthy and enjoying life. I went to the gym almost daily, and when I wasn’t at the gym, I was shooting hoops with my friends. During a gym workout while on a family vacation, I suddenly felt excruciating pain in my left shoulder and thought I must have strained ...

supportive care

Fecal Microbiota Transplantation May Help Restore Beneficial Bacteria in Patients With Cancer

Researchers have shown that autologous fecal microbiota transplantation may be a safe and effective way to help replenish beneficial gut bacteria in patients with cancer who require intense antibiotics during allogeneic hematopoietic stem cell transplantation. Their findings were published by Ying ...

gynecologic cancers

Welcome Questions About Cervical Cancer Treatment Options

TWO STUDIES reported in The New England Journal of Medicine1,2 showed that patients with early-stage cervical cancer had reduced disease-free and overall survival when treated with minimally invasive radical hysterectomy vs open or radical hysterectomy. The findings of these studies have been...

gynecologic cancers

Comparing Survival Outcomes With Minimally Invasive and Open Surgical Approaches to Early-Stage Cervical Cancer

MINIMALLY INVASIVE radical hysterectomy for women with early-stage cervical cancer has been associated with reduced rates of disease-free and overall survival in the phase III LACC randomized noninferiority trial comparing minimally invasive and open abdominal radical hysterectomy. The results...

hematologic malignancies
cost of care

New Report Demonstrates Cost of Blood Cancer Care

THE COSTS to treat blood cancer are higher than the costs to treat other cancers, and the costs incurred by a patient diagnosed with a blood cancer do not return to precancer levels, according to a Milliman study commissioned by The Leukemia & Lymphoma Society (LLS). The study—The Cost Burden...

hepatobiliary cancer
immunotherapy

Pembrolizumab in Sorafenib-Pretreated Hepatocellular Carcinoma

ON NOVEMBER 9, 2018, pembrolizumab (Keytruda) was granted accelerated approval for treatment of patients with hepatocellular carcinoma previously treated with sorafenib (Nexavar).1,2 Supporting Efficacy Data APPROVAL WAS BASED on durable responses in the phase II KEYNOTE-224 trial...

issues in oncology
cost of care

Managing the Cost of Cancer Care

A cancer diagnosis is often overwhelming. Adding financial burden to the mix can sometimes feel unmanageable. Provide your patients with practical guidelines with the Managing the Cost of Cancer Care booklet from ASCO. It covers health insurance benefits, information about the Affordable Care Act,...

issues in oncology

ASCO Resolutions on Step Therapy, Competitive Acquisition Program Proposed at AMA House of Delegates

During this year’s interim meeting of the American Medical Association (AMA) House of Delegates (HOD), ASCO proposed four resolutions on step therapy, Medicare Part B drugs, a Competitive Acquisition Program, and clinical trial access, all of which were adopted or reaffirmed by the policy-making...

immunotherapy

Illustrating Genius

FOUR AND A HALF YEARS AGO, author Neil Canavan attended a scientific conference to learn what he could about the then-emerging field of immunotherapy for cancer. After a presentation by Zelig Eshhar, PhD, principal investigator in the Department of Immunology at the Weizmann Institute of Science...

issues in oncology
global cancer care

Global Oncology Education and Professional Development: ASCO International’s Impact

ASCO is such a misnomer: the American Society of Clinical Oncology is far more than simply “American.” Over the past several years, I (a Canadian-born breast surgical oncologist, with an Indian-born mother and a Tanzanian-born father) have traveled to Zimbabwe, Bhutan, and the Philippines with this ...

Apply to Join ASCO’s Education Council by January 31

ASCO is seeking leaders in education to join its Education Council. The Council consists of ASCO members who are committed to advancing ASCO’s educational mission. Specific responsibilities of the Council include prioritizing programs to address educational gaps, advising on the latest in...

symptom management

Clinician Survey to Explore Direct-Acting Oral Anticoagulants vs Low–Molecular-Weight Heparin in Cancer-Related VTE

Injectable low–molecular-weight heparin has long been considered the standard of care for treatment of venous thromboembolism (VTE) in patients with cancer. However, low–molecular-weight heparin is costly and often disliked by patients due to injection-related discomfort and bruising....

Check Out the Top Five Most Popular ASCO University Courses of 2018

New to ASCO University’s e-learning offerings and not sure where to start? With a comprehensive course catalog that spans tumor types, practice information, and other aspects of cancer care, choosing a course can be a challenge. To help get you started, here is a list of the most popular courses of ...

supportive care
palliative care

Improving Palliative Care in Low-Resource Settings

In 2016, ASCO published an update to its Clinical Practice Guideline, “Integration of Palliative Care Into Standard Oncology Care,” which provides evidence-based recommendations for symptom management, clarification of treatment goals, support of coping and distress management, and coordination of...

lung cancer

Lorlatinib in Second- or Third-Line Treatment of ALK-Positive Metastatic Non–Small Cell Lung Cancer

On November 2, 2018, lorlatinib (Lorbrena) was granted accelerated approval for the treatment of patients with ALK-positive metastatic non–small cell lung cancer (NSCLC) whose disease has progressed on crizotinib (Xalkori) and at least one other ALK inhibitor for metastatic disease or whose disease ...

issues in oncology

How to Build a Clinical Trial Infrastructure in the Community Oncology Setting

HISTORICALLY, CLINICAL research has been viewed as an entity belonging to academic settings alone. With the advent of the Community Clinical Oncology Program (CCOP) in the 1980s and later with the Cancer Trials Support Unit, cancer clinical trials have begun to emerge in the community setting....

issues in oncology

Statement From FDA Commissioner on In Vitro Companion Diagnostics

FDA Commissioner Scott Gottlieb, MD, recently issued the following statement on developing and class labeling of in vitro companion diagnostics for classes of oncology therapeutic products: “With a new draft guidance document that the FDA issued … our aim is to make it easier to get class labeling ...

Should I Have Lied?

The ASCO Post is pleased to reproduce installments of the Art of Oncology as published previously in the Journal of Clinical Oncology. These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

breast cancer

International Trials Present New Findings in Treatment of Breast Cancer

The European Society for Medical Oncology (ESMO) 2018 Congress featured an assortment of study findings, many with far-reaching clinical implications for the treatment of patients with various cancers. Many of these trials were covered in-depth in recent issues of The ASCO Post. Here, we present...

immunotherapy
skin cancer

Optimal Duration of Checkpoint Inhibition in Melanoma Is No More Than 2 Years

For patients with advanced melanoma, the concept of treating to disease progression does not always apply. With many patients responding to checkpoint inhibition for years, when can treatment be safely discontinued? This important clinical question was addressed at the European Society for Medical...

Expert Point of View: Charles G. Drake, MD, PhD

“Bringing pembrolizumab (Keytruda) early into therapy is a bold move,” commented the invited discussant of this trial, Charles G. Drake, MD, PhD, Professor of Oncology and Immunology at the Herbert Irving Cancer Center at Columbia University, New York. The study enrolled patients who can be cured...

head and neck cancer
immunotherapy

Pembrolizumab Plus Chemoradiotherapy in HPV-Positive Head and Neck Cancer

The addition of pembrolizumab (Keytruda) to a chemoradiotherapy regimen yielded complete response rates of 85% in patients with human papillomavirus (HPV)-positive advanced squamous cell carcinoma of the head and neck. These findings from a phase Ib study were presented at the 2018 Society for...

issues in oncology
prostate cancer
geriatric oncology

Overscreening for Prostate Cancer in Older Men Remains an Issue

Although most major cancer organizations agree on the guidelines for prostate cancer screening, there is still uneven application of the test, such as in the older patient population, resulting in overdiagnosis and waste in an already fiscally challenged health-care system. Researchers from the...

Researchers at The University of Texas at Dallas Receive Funding for Assorted Cancer Projects

MORE THAN $4.5 million in new funding from state and federal agencies will support cancer-related research over the next 5 years at The University of Texas at Dallas. Two projects related to brain cancer, each totaling $200,000 over 2 years, recently received High-Impact/High-Risk Research...

immunotherapy

Update on Immune Checkpoint Inhibitors

Checkpoint inhibitors have moved the field of immuno-oncology to the forefront of cancer treatment and research. However, these agents come with the risk of serious adverse events. To shed light on the toxicities associated with checkpoint inhibitors and other timely issues in the field of...

supportive care
palliative care

The Great Opioid Debate: Treating Cancer Pain Safely

As the number of opioid-related deaths continues to rise in the United States, stakeholders are struggling to make sense of the crisis. At the 2018 Palliative and Supportive Care in Oncology Symposium, two experts in the field, Charles F. von Gunten, MD, PhD, and Leslie J. Blackhall, MD,...

issues in oncology
immunotherapy

Immunotherapy-Related Toxicities May Be More Common Than Originally Reported

Immunotherapy has significantly improved the overall survival of patients with non–small cell lung cancer (NSCLC) and is generally better tolerated than traditional chemotherapies, but the results of a retrospective study suggested that immunotherapy side effects may be more common than initially...

breast cancer
supportive care

Has Scalp Cooling Reached the Level of Standard of Care?

Does evidence of the effectiveness and safety of scalp cooling to reduce hair loss among women being treated for breast cancer mean that scalp cooling is a new standard of care? “I would suggest that it is,” stated Mikel Ross, MSN, RN, AGNP-BC, of the Breast Medicine Service, Memorial Sloan...

lung cancer
immunotherapy

ESMO Immuno-Oncology 2018: Second-Line Nivolumab vs Chemotherapy in SCLC

Treatment with nivolumab (Opdivo) did not improve response rates or survival over standard chemotherapy in patients with metastatic small cell lung cancer (SCLC) who relapsed following first-line treatment, according to findings presented by Reck et al at the European Society for Medical...

skin cancer
immunotherapy

ESMO Immuno-Oncology 2018: OpACIN Trial: Neoadjuvant Ipilimumab Plus Nivolumab in Stage III Melanoma

Updated data of the OpACIN study, which studied combined ipilimumab (Yervoy) plus nivolumab (Opdivo) administered as neoadjuvant or adjuvant therapy in patients with high-risk stage III melanoma, demonstrated high response rates upon neoadjuvant therapy and promising long-term clinical outcome,...

lung cancer
immunotherapy

ESMO Immuno-Oncology 2018: OAK Trial: Fast Progression in Patients With NSCLC Treated With Atezolizumab vs Chemotherapy

Overall survival (OS) was improved across all subgroups of patients with non–small cell lung cancer (NSCLC) who received atezolizumab (Tecentriq) compared with chemotherapy, including poor prognostic factors that were evaluated in an analysis of data from the OAK trial. Additionally, this...

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