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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...

lymphoma

Outcomes With AHCT Consolidation in Younger Patients With Mantle Cell Lymphoma in the Rituximab Era

In a retrospective study reported in the Journal of Clinical Oncology, Gerson et al found evidence that autologous hematopoietic cell transplantation (AHCT) consolidation after induction chemotherapy was associated with a progression-free survival benefit in patients with mantle cell lymphoma aged...

A Tribute to Arti Hurria, MD, FASCO, a Leader in Geriatric Oncology

The oncology community is deeply saddened by the untimely passing of Arti Hurria, MD, FASCO, a nationally regarded expert and advocate for elderly patients with cancer. Dr. Hurria died on November 7, 2018, in a traffic accident. At the time of her tragic death, Dr. Hurria was Director of the City...

hematologic malignancies
leukemia

Remnants of Cancer Remain, but Demons Are Now Gone

In the summer of 2002, I was a physically active 17-year-old boy on the cusp of adulthood. I was about to enter my senior year in high school, and like other teens my age, I was excited about college and the promise of the undreamed-of opportunities that lay ahead. At first, the lethargy I was...

issues in oncology

Established, Modifiable Cancer Risk Factors

According to a new American Cancer Society report published by Susan M. Gapstur, PhD, MPH, American Cancer Society Senior Vice President of Behavioral and Epidemiology Research, and colleages in CA: A Cancer Journal for Clinicians, the highest priority in a national cancer control plan is the...

immunotherapy
symptom management

Adoptive T-Cell Therapy for Progressive Multifocal Leukoencephalopathy

An emerging treatment known as adoptive T-cell therapy has proven effective in a phase II clinical trial for treating progressive multifocal leukoencephalopathy (PML), a rare and often fatal brain infection sometimes observed in patients with cancer and other diseases in which the immune system is...

colorectal cancer
immunotherapy

2019 GI Cancers Symposium: Durvalumab, Tremelimumab, and Best Supportive Care vs Best Supportive Care Alone in Advanced, Refractory Colorectal Cancer

The phase II CCTG CO.26 trial evaluated whether the combination of durvalumab, a programmed cell death ligand 1 (PD-L1) inhibitor, and tremelimumab, an anti–cytotoxic T-lymphocyte–associated protein 4 (CTLA-4) antibody, plus best supportive care improved survival vs best supportive care ...

head and neck cancer
gastrointestinal cancer
immunotherapy

2019 GI Cancers Symposium: Pembrolizumab in Second-Line Therapy for Advanced Esophageal Cancer

Pembrolizumab significantly improved overall survival in the second-line setting of advanced esophageal cancer in patients whose tumors tested positive for programmed cell death ligand 1 (PD-L1) with a combined positive score (CPS) of 10 or greater. This was compared to investigator’s choice...

pancreatic cancer

2019 GI Cancers Symposium: Neoadjuvant Chemotherapy vs Upfront Surgery in Resectable Pancreatic Cancer

A phase II/III trial presented by Unno et al at the 2019 Gastrointestinal Cancers Symposium (Abstract 189) sought to compare neoadjuvant chemotherapy (using gemcitabine and the oral fluoropyrimidine combination of tegafur/gimeracil/oteracil [S-1]) to upfront surgery in patients with histologic ...

issues in oncology
supportive care

Findings From ASCO’s Second National Cancer Opinion Survey

Despite a recent study showing that patients with cancer who chose alternative therapies over conventional cancer treatment have a higher risk of death, nearly 4 in 10 Americans believe cancer can be cured by alternative remedies alone, according to the results of ASCO’s 2018 National Cancer...

solid tumors
kidney cancer

Clinical Trial Commences on Personalized Vaccine in Kidney Cancer

Researchers at the Dana-Farber Cancer Institute in Boston are testing a first-of-its-kind personalized cancer vaccine combined with an immunotherapy drug, with the aim of improving outcomes for patients with kidney cancer who are at high risk of recurrence after surgery. A two-pronged approach to...

hepatobiliary cancer
immunotherapy

2019 GI Cancers Symposium: Nivolumab vs Nivolumab Plus Ipilimumab in Resectable Hepatocellular Carcinoma

Anti–programmed cell death protein 1 and anti–cytotoxic T-lymphocyte–associated protein 4 antibodies have shown activity in hepatocellular carcinoma. Based on these earlier findings, researchers sought to examine the safety, efficacy, and tolerability of perioperative treatment...

issues in oncology
legislation
health-care policy

New Regulations Require Better Communication With Patients Who Have Disabilities and Limited English Proficiency

Ever since President Barack Obama signed the Patient Protection and Affordable Care Act (ACA) into law on March 23, 2010, the nondiscrimination provision of the law, Section 1557, which prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in certain health ...

issues in oncology

ASCO to Convene Global Summit on Latest Innovations in Technology and Cancer

Advances in medicine and technology are emerging faster than ever before. To harness this momentum, ASCO is convening Breakthrough: A Global Summit for Oncology Innovators, a new meeting focused on the intersection of medicine, scientific discovery, and innovations in technology. The inaugural...

breast cancer

Breast Cancer Surveillance Consortium Analysis of Trends in Breast Density Assessment

In a study reported in the Journal of the National Cancer Institute, Sprague et al found that only small changes in the proportions of women found to have dense breasts on digital mammography have occurred with revisions in Breast Imaging Reporting and Data System (BI-RADS) density classification...

issues in oncology

Analysis of Proportion of Cancer Cases Attributable to Excess Body Weight Across U.S. States

In a study reported in JAMA Oncology, Islami et al assessed the population attributable fraction (PAF)—the proportion of a given outcome attributable to a given risk factor—of incident cancer cases associated with excess body weight among individual U.S. states during 2011 to 2015. The...

gastrointestinal cancer

2019 GI Cancers Symposium: Safety, Efficacy of Trifluridine/Tipiracil in Metastatic Gastric Cancer With or Without Gastrectomy

In a poster session earlier today David Ilson, MD, of Memorial Sloan Kettering Cancer Center, and colleagues reported on a preplanned subgroup analysis of the double-blind phase III TAGS study looking at the safety and efficacy of the oral agent trifluridine/tipiracil (FTP/TPI) in heavily...

gastroesophageal cancer
gastrointestinal cancer

2019 GI Cancers Symposium: Addition of Andecaliximab to mFOLFOX6 in Treatment-Naive Advanced Gastric or GEJ Adenocarcinoma

A phase I/Ib study found that the addition of andecaliximab, a monoclonal antibody that inhibits matrix metalloproteinase 9, to modified fluorouracil (5-FU), leucovorin, and oxaliplatin (mFOLFOX6) showed activity in gastric and or gastroesophageal junction (GEJ) carcinoma. Based on these...

head and neck cancer

Study Finds World Trade Center Responders May Be at Increased Risk for Head and Neck Cancers

A study by Graber et al in the International Journal of Cancer has found a significant increase in head and neck cancers among workers and volunteers who responded to the September 11 terrorist attacks on the World Trade Center (WTC), pointing to newly emerging risks that require ongoing monitoring ...

immunotherapy

Study Finds High Tumor Mutational Load Is a Predictor of Response to Immunotherapy in Some Cancers

Although the emergence of immune checkpoint inhibitors over the last decade has revolutionized the treatment of patients with metastatic cancers, only a minority of patients experience long-lasting benefit from the therapy. A study investigating the association between tumor mutational burden and...

palliative care
issues in oncology

Impact of Survival Predictions on Aggressive End-of-Life Care Among Patients With Metastatic Cancer

In a single-institution study reported in the Journal of Oncology Practice, Sborov et al found that inaccurate prediction of life expectancy can be associated with greater likelihood of aggressive end-of-life care among patients with metastatic cancer receiving palliative radiation therapy. Study...

solid tumors
prostate cancer

Common Markers of Tumor Hypoxia Found Across Cancer Types

Unlike healthy tissues, tumors thrive in low-oxygen environments, often acquiring the ability to resist treatment and spread to other sites in the body. Despite being a well-known cause of therapy resistance and metastasis, the impact of hypoxia on tumor cells is poorly understood. Researchers have ...

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