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solid tumors
gastrointestinal cancer
colorectal cancer

Care for Colorectal Cancer Costs Twice as Much in Western Washington vs British Columbia, With Similar Survival

It is widely acknowledged that the costs of cancer care are much higher in the United States than in Canada, with outcomes that are thought to be similar. A new study presented at the 2018 ASCO Annual Meeting supports that view, by documenting and quantifying the differences in health-care costs...

hematologic malignancies
lymphoma

Outcomes in Waldenström’s Macroglobulinemia Improved With Ibrutinib Plus Rituximab

In patients with Waldenström’s macroglobulinemia, the risk of disease progression was reduced by 80% with the combination of ibrutinib (Imbruvica) and rituximab (Rituxan) over rituximab alone, in the international phase III iNNOVATE trial, reported at the 2018 ASCO Annual Meeting1 and...

solid tumors
gastrointestinal cancer
colorectal cancer

Less Is More: No Benefit Reported for Hyperthermic Intraperitoneal Chemotherapy in Colorectal Cancer

With a growing emphasis on value in cancer care, some types of resource-intensive therapies may need to be reconsidered. One such treatment may be hyperthermic intraperitoneal chemotherapy, which showed no benefit during surgery for colorectal cancer confined to the peritoneum in the PRODIGE 7...

Expert Point of View: Charles G. Drake, MD, PhD and Hatem H. Soliman, MD

Formal discussant of the GeparNuevo presentation, Charles G. Drake, MD, PhD, of the Herbert Irving Comprehensive Cancer Center at Columbia University Medical Center, New York, said, “It is important that neoadjuvant immunotherapy combinations are being studied. There is a lot of enthusiasm for...

breast cancer
immunotherapy

Priming the Immune System: Neoadjuvant Durvalumab Plus Chemotherapy May Be Beneficial in Triple-Negative Breast Cancer

The addition of durvalumab -(Imfinzi) to anthracycline/taxane-based chemotherapy had encouraging results as neoadjuvant therapy for early triple-negative breast cancer in the randomized phase II GeparNuevo study presented at the 2018 ASCO Annual Meeting.1 The results were positive in a subgroup of...

lymphoma

EHA 2018: Tazemetostat in Relapsed or Refractory Follicular Lymphoma

Positive interim data were recently presented from an ongoing phase II study of tazemetostat—a potent, selective, orally available EZH2 inhibitor—as a monotherapy for patients with relapsed or refractory follicular lymphoma. The data, presented by Salles et al at the 23rd Annual...

solid tumors
kidney cancer

Nephrectomy May Be Avoided in Some Patients With Advanced Renal Cell Carcinoma

In the modern era of targeted therapy, some patients with metastatic renal cell carcinoma may be able to forgo nephrectomy and be treated with sunitinib (Sutent) alone, according to results of the phase III CARMENA trial reported during the Plenary Session at the 2018 ASCO Annual Meeting.1 The...

solid tumors
skin cancer

The Raven

The call from the dermatologist came at noon on Good Friday, just after my wife left with our two young daughters for a week on her family’s tree farm in Northern Michigan. I was on call for the hospital inpatient leukemia service, so I could not join them. When the dermatologist solemnly began,...

hematologic malignancies
leukemia

Minimal Residual Disease Testing in AML: Still a Shifting Target

Testing for minimal residual disease (MRD) has become an established part of the management of acute lymphoblastic leukemia (ALL), but in acute myeloid leukemia (AML), the technology still warrants validation. To address issues and set new standards, the European LeukemiaNet Working Party recently ...

leukemia

EHA 2018: Single-Agent Quizartinib vs Chemotherapy in Relapsed or Refractory AML

Results from the phase III QuANTUM-R study of single-agent quizartinib in relapsed or refractory acute myeloid leukemia (AML) were presented by Cortes et al at the 23rd Annual Congress of the European Hematology Association (EHA) (Abstract LB2600). Study Findings QuANTUM-R study results showed...

multiple myeloma

Once- vs Twice-Weekly Carfilzomib in Relapsed or Refractory Multiple Myeloma

An interim analysis of the phase III ARROW trial reported in The Lancet Oncology by Moreau et al indicated that a higher-dose once-weekly schedule of carfilzomib was associated with prolonged progression-free survival vs a twice-weekly schedule in patients with relapsed or refractory multiple...

lymphoma
immunotherapy

EHA 2018: Tisagenlecleucel Demonstrates More Than 1-Year Durability of Response in Adults With Relapsed or Refractory DLBCL

Fourteen-month results from the JULIET clinical trial showed ongoing durable responses are achievable with tisagenlecleucel (Kymriah) when administered to adult patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL). This updated analysis was presented by Borchmann et al at ...

multiple myeloma

EHA 2018: Elotuzumab Plus Pomalidomide and Low-Dose Dexamethasone vs Pomalidomide/Dexamethasone Alone in Relapsed or Refractory Multiple Myeloma

The ELOQUENT-3 trial, an international phase II study evaluating the addition of elotuzumab (Empliciti) to pomalidomide (Pomalyst) and low-dose dexamethasone in patients with relapsed/refractory multiple myeloma, achieved its primary endpoint, showing a statistically significant and clinically...

hepatobiliary cancer
immunotherapy

KEYNOTE-224: Pembrolizumab in Advanced Hepatocellular Carcinoma Pretreated With Sorafenib

As reported in The Lancet Oncology by Zhu et al, the phase II KEYNOTE-224 study has shown activity of pembrolizumab in advanced hepatocellular carcinoma (HCC) pretreated with sorafenib. Study Details In the study, 104 eligible patients who were intolerant of or progressed on sorafenib were...

palliative care
issues in oncology

AMA Rejects Recommendation to Reaffirm Opposition to Medical Aid in Dying

On June 11, the American Medical Association (AMA) House of Delegates voted 56% to 44% to reject a report by its Council on Ethical and Judicial Affairs (CEJA) that recommended the AMA maintain its Code of Medical Ethics’ opposition to medical aid in dying. Instead, the House of Delegates...

pancreatic cancer

Study Finds Recent-Onset Type 2 Diabetes May Be Early Manifestation of Pancreatic Cancer

According to the American Cancer Society, pancreatic cancer is one of the most deadly cancers, with an overall 5-year survival rate of just 8%, mainly because the vast majority of patients, about 80%, are diagnosed at a late stage of disease. Research has shown that identification of high-risk ...

lymphoma
immunotherapy

FDA Expands Approval of Pembrolizumab to Include New Lymphoma Indication

Today, the U.S. Food and Drug Administration (FDA) granted accelerated approval to pembrolizumab (Keytruda) for the treatment of adult and pediatric patients with refractory primary mediastinal large B-cell lymphoma or those who have relapsed after two or more prior lines of therapy. KEYNOTE-170...

global cancer care

ESMO Emphasizes Importance of Cancer on the Global Health Agenda at the 71st World Health Assembly

At the 71st World Health Assembly in Geneva, the European Society for Medical Oncology (ESMO) delivered two statements positioning cancer as a priority on the global agenda of the World Health Organization (WHO). Presenting its recommendations for action to the international community,...

lung cancer

Analysis of Intracranial Response to Brigatinib in ALK-Positive NSCLC With Brain Metastases

In an analysis of two clinical trials reported in the Journal of Clinical Oncology, Camidge et al found that brigatinib (Alunbrig) produced high intracranial response rates and good intracranial progression-free survival in patients with ALK-positive non–small cell lung cancer (NSCLC) and...

colorectal cancer

Surveillance Intensity Not Associated With Earlier Detection of Recurrence or Improved Survival in Patients With Colorectal Cancer

A national retrospective study led by researchers at The University of Texas MD Anderson Cancer Center found no association between intensity of posttreatment surveillance and detection of recurrence or overall survival (OS) in patients with stage I, II, or III colorectal cancer. Published by...

cns cancers

Risk-Adapted Treatment for Young Children With Medulloblastoma

In a phase II trial (SJYC07) reported in The Lancet Oncology, Robinson et al found that risk-adapted treatment did not improve event-free survival in young children with medulloblastoma. Analysis by methylation status showed superior outcome in the sonic hedgehog (SHH) subgroup. Study Details The ...

leukemia
lymphoma
immunotherapy

Rapid Progression of Adult T-Cell Leukemia/Lymphoma During PD-1 Inhibitor Therapy

In a letter to the editor in The New England Journal of Medicine, Ratner et al describe rapid progression of adult T-cell leukemia/lymphoma (ATLL) in three consecutive patients receiving programmed cell death protein 1 (PD-1) inhibitor therapy with nivolumab (Opdivo). As stated by the authors,...

ASCO’s TAPUR Study Website Now Features Updates on Patient Cohort Expansions and Closures

ASCO’S TARGETED Agent and Profiling Utilization Registry (TAPUR) Study now provides a full list of patient cohort expansions and closures on its website. Based on treatment responses in stage I, patient cohorts are either expanded to stage II for further study and identification of a signal or...

lung cancer

Early Evidence of Neoadjuvant PD-1 Blockade in Non–Small Cell Lung Cancer

A NOVEL APPROACH using two doses of nivolumab (Opdivo) prior to surgery achieved major pathologic responses in 45% of patients with resectable stages I to IIIA non–small cell lung cancer (NSCLC), according to the results of a small Stand Up 2 Cancer–Cancer Research Institute Dream Team study...

gynecologic cancers
pain management

Study Evaluates Effect of Restrictive Opioid Protocol After Gynecologic Surgery

THE NUMBER of opioids prescribed after surgery for gynecologic cancer decreased significantly after implementation of an ultra-restrictive opioid prescription protocol, with no apparent negative effect on patient satisfaction or pain, according to research presented by Jaron Mark, MD, and...

gynecologic cancers

Poorer Outcomes Reported With Minimally Invasive Surgery Than Open Approach in Early Cervical Cancer

PATIENTS UNDERGOING minimally invasive radical hysterectomy for early cervical cancer had higher rates of disease recurrence and worse disease-free, progression-free, and overall survival than did women who had the open approach, according to results from the phase III LACC trial, presented by...

gynecologic cancers

Clinical Findings Predict Early Treatment Discontinuation in Patients Receiving Immunotherapy for Ovarian Cancer

PRETREATMENT CLINICAL findings may predict early treatment discontinuation in patients with ovarian cancer receiving checkpoint blockade immunotherapy agents. Data presented by MD candidate Julia L. Boland at the 2018 Society of Gynecologic Oncology Annual Meeting on Women’s Cancer revealed that...

cns cancers

Durable Responses Observed With Novel Oncolytic Therapy in Recurrent Glioma

IN A PILOT study of recurrent glioma, 26% of patients treated with the optimal dose of vocimagene amiretroprepvec (aka Toca 511), a novel oncolytic virus therapy, achieved durable, long-term responses and remained alive 3 or more years later. This outcome far exceeded “historical benchmarks” for...

breast cancer
symptom management

Early Detection and Intervention Reduce Breast Cancer–Related Lymphedema

A NEW STUDY has found that early detection along with a simple intervention can be highly effective in preventing breast cancer–related lymphedema for at-risk women. According to data presented at the 2018 Annual Meeting of the American Society of Breast Surgeons,1 82% of women identified at an...

breast cancer

Expert Point of View: Judy C. Boughey, MD

JUDY C. BOUGHEY, MD, a breast surgeon and clinical and translational researcher at the Mayo Clinic, Rochester, Minnesota, said the two studies highlight the importance of discussing genetic testing with patients who are diagnosed with breast cancer. “With the advances in panel testing for...

issues in oncology
geriatric oncology

Geriatric Assessment Improves Communication Between Oncologists and Older Patients

A FEDERALLY FUNDED randomized study demonstrated that use of geriatric assessment in the routine care of older adults with advanced cancer significantly improved doctor-patient communication about age-related concerns as well as patient satisfaction with the communication. The study was presented...

lung cancer

Immunotherapy Benefits Survival, Improves Safety, vs Platinum-Based Chemotherapy for PD-L1–Expressing NSCLC

IMMUNOTHERAPY WITH pembrolizumab (Keytruda) improved overall survival compared with investigator’s choice of platinum-based chemotherapy as first-line treatment for patients with advanced non–small cell lung cancer (NSCLC) in the KEYNOTE-042 trial. Median overall survival was improved by 4 to 8...

lymphoma
leukemia

Adherence to Oral Anticancer Treatment: Priorities in Lymphoma and CLL

ADVANCES IN cancer treatment have been nothing short of breathtaking in recent years. Among the most important has been the advent of effective oral therapies, marking a significant change in the way many patients receive treatment and in the oversight required by the cancer care team. As with...

breast cancer

TAILORx: Endocrine Therapy Alone Is Sufficient for Most Patients With ‘Intermediate-Risk’ Breast Cancer

THE HIGHLY ANTICIPATED results of the phase III TAILORx study are in—and they indicate that the vast majority of patients with “intermediate-risk” early-stage breast cancer can forgo chemotherapy.  “Our study shows that chemotherapy may be avoided in about 70% of women with hormone...

solid tumors
gynecologic cancers

Addition of Pazopanib to Paclitaxel in Persistent or Recurrent Ovarian Cancer

In a phase II trial reported in JAMA Oncology by Debra L. Richardson, MD, of Stephenson Cancer Center, Oklahoma University Health Science Center, and colleagues, the addition of pazopanib (Votrient) to paclitaxel did not improve progression-free survival among women with persistent or recurrent...

solid tumors
issues in oncology
geriatric oncology
lung cancer

Chemoradiation in Elderly Patients With Stage III NSCLC Improves Overall Survival

Elderly patients with stage III non–small cell lung cancer (NSCLC) showed improved overall survival when treated with chemoradiation compared with definitive radiation alone, according to findings published by Eric D. Miller, MD, PhD, of The Ohio State University, Columbus, and colleagues in the...

solid tumors
colorectal cancer

Following Guidelines for Healthy Eating and Physical Activity May Improve Survival in Patients Treated for Colon Cancer

Following guidelines for proper nutrition, maintaining a healthy weight, and staying physically active may improve survival among patients treated for colon cancer, according to the results of a study with nearly 1,000 patients followed for a median of 7 years.1 “The study suggests that if...

solid tumors
breast cancer

The X-Ray Era: 1901–1915

The text and photographs on this page are excerpted from a four-volume series of books titled Oncology: Tumors & Treatment, A Photographic History, by Stanley B. Burns, MD, FACS, and Elizabeth A. Burns. The photos below are from the volume titled “The X-Ray Era: 1901–1915.” The photographs...

supportive care

Inside Look at Widowers Coping With Grief

BOOKMARK Title: The Group: Seven Widowed Fathers Reimagine LifeAuthors: Donald L. Rosenstein, MD, and Justin M. Yopp, PhDPublisher: Oxford University PressPublication Date: January 2018Price: $28.95; hardcover, 192 pages Looking back, the cancer advocacy movement took shape in two waves: the first ...

solid tumors
skin cancer
head and neck cancer

Dabrafenib Plus Trametinib for Thyroid Cancer, Melanoma With BRAF Mutations

On May 4, 2018, dabrafenib (Tafinlar) and trametinib (Mekinist) in combination was granted approval for treatment of patients with locally advanced or metastatic anaplastic thyroid cancer with BRAF V600E mutation and no satisfactory locoregional treatment options.1-3 Dabrafenib is not indicated for ...

AACR and Cancer Research UK Form Alliance

The American Association for Cancer Research (AACR) in collaboration with Cancer Research UK (CRUK) are launching a new international alliance to stimulate discoveries in cancer research. The two organizations share the vision that significant progress against cancer could be facilitated by...

hematologic malignancies
lymphoma

Hematopoietic Cell Transplantation for Follicular Lymphoma

Many patients with follicular lymphoma relapse within 2 years of initial therapy, and for a number of these individuals, hematopoietic cell transplantation is a good treatment option. Transplant, however, both autologous and allogeneic, is vastly underutilized in these patients, according to Mehdi ...

solid tumors
kidney cancer

CheckMate 214: Nivolumab Plus Ipilimumab Improves Survival vs Sunitinib in Advanced Renal Cell Cancer

As reported in The New England Journal of Medicine by Robert J. Motzer, MD, of Memorial Sloan Kettering Cancer Center, and colleagues, the phase III CheckMate 214 trial has shown an overall survival advantage with nivolumab (Opdivo) plus ipilimumab (Yervoy) vs sunitinib (Sutent) in patients with...

solid tumors
skin cancer

Durable Complete Responses After Discontinuation of Pembrolizumab in Metastatic Melanoma

As reported in the Journal of Clinical Oncology by Caroline Robert, MD, PhD, of Institut Gustave Roussy, Villejuif, France, and colleagues, a high proportion of patients with metastatic melanoma achieving a complete response on pembrolizumab (Keytruda) in the phase Ib KEYNOTE-001 trial maintained...

multiple myeloma
immunotherapy

2018 ASCO: Pomalidomide, Bortezomib, and Low-Dose Dexamethasone in Relapsed or Refractory Multiple Myeloma

For patients with multiple myeloma who have been treated with lenalidome (Revlimid) but have relapsed and not responded to other therapy, a three-drug combination can significantly extend the time in which the disease is held in check. The findings of the phase III OPTIMISMM trial were presented by ...

kidney cancer
immunotherapy

2018 ASCO: KEYNOTE-427 Trial Evaluates Immunotherapy in Advanced Clear Cell Renal Cell Carcinoma

Interim results from cohort A of KEYNOTE-427, a phase II trial evaluating pembrolizumab (Keytruda) as first-line treatment for advanced clear cell renal cell carcinoma (RCC), were presented by McDermott et al at the 2018 ASCO Annual Meeting (Abstract 4500). Interim data showed an overall response...

lung cancer

2018 ASCO: Dacomitinib vs Gefitinib in Advanced NSCLC With EGFR-Activating Mutations

Overall survival (OS) data from the ARCHER 1050 trial evaluating dacomitinib as a first-line treatment for patients with locally advanced or metastatic non–small cell lung cancer (NSCLC) with EGFR-activating mutations compared to gefitinib showed a median OS of 34.1 months for patients...

kidney cancer
immunotherapy

Toni K. Choueiri, MD, and Elizabeth R. Plimack, MD, on RCC: Perspectives on KEYNOTE-427 and IMmotion151

Toni K. Choueiri, MD, of Dana-Farber Cancer Institute, and Elizabeth R. Plimack, MD, of Fox Chase Cancer Center, offer their analysis of two key studies presented in renal cell cancer.

hematologic malignancies
immunotherapy

2018 ASCO: iNNOVATE Trial Evaluates Ibrutinib in Combination With Rituximab in Patients With Waldenström's Macroglobulinemia

Results from a preplanned interim analysis of the phase III iNNOVATE (PCYC-1127) study evaluating the investigational use of ibrutinib (Imbruvica) in combination with rituximab (Rituxan) in relapsed/refractory and treatment-naive patients with Waldenström’s macroglobulinemia were...

gastroesophageal cancer

2018 ASCO: Esomeprazole With Aspirin Offers Moderate Benefits in Patients With Barrett’s Esophagus

An updated analysis of a randomized phase III trial showed that taking a high dose of the acid-reducing medicine esomeprazole with low-dose aspirin for at least 7 years can moderately reduce the risk of developing high-grade dysplasia or esophageal cancer and delay death from any cause in people...

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