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issues in oncology

Can We Have a Successful Vaccine Against Cancer?

EARLY IN our careers, few of us imagined that a vaccine could one day prevent cancer. Now, there is a vaccine that keeps the risks from human papillomavirus (HPV) at bay, and yet universal adoption of the HPV vaccine has been incomplete. As a result of misinformation about the vaccine—and its...

breast cancer

Study Finds 'Standard Care' Treatments in Breast Cancer Clinical Trials Not Always Standard

Historically, randomized controlled trials have served as the state-of-the-art method for determining the efficacy and safety of new, innovative treatment regimens for patients with cancer and other diseases. It is imperative that such trials are carefully designed to ensure that they are...

breast cancer

10-Year Survival With vs Without Axillary Dissection in Invasive Breast Cancer With Sentinel-Node Metastasis

As reported in JAMA by Giuliano et al, 10-year overall survival in the ACOSOG Z0011 (Alliance) trial with sentinel lymph node dissection (SLND) alone was noninferior to that with axillary lymph node dissection (ALND) in women with clinical T1 or T2 invasive breast cancer, no palpable axillary...

breast cancer

What Is the Most Important Factor Women Consider in Deciding on SERM Use to Reduce Their Risk of Breast Cancer?

Currently, two medications have been approved by the U.S. Food and Drug Administration to reduce the risk of breast cancer: tamoxifen and raloxifene. Both medications, selective estrogen receptor modulators (SERMs), have been shown to reduce the risk for breast cancer by up to 50% in prevention...

skin cancer

Pooled Analysis Safety Profile of Combination Immunotherapy for Advanced Melanoma

In a retrospective study reported in the Journal of Clinical Oncology, Sznol et al have provided a pooled safety profile of combination nivolumab (Opdivo) and ipilimumab (Yervoy) treatment in patients with advanced melanoma. Study Details The study included data from 448 patients from a phase Ib...

solid tumors
prostate cancer

Association Between Vasectomy and Prostate Cancer

A systematic review and meta-analysis has found no association between vasectomy and high-grade, advanced, or fatal prostate cancer but a weak association with any prostate cancer. These findings were reported in JAMA Oncology by Bimal Bhindi et al. R. Jeffrey Karnes, MD, of the Mayo Clinic,...

solid tumors
gynecologic cancers

Performance Measures for Cervical Cancer Screening

Health-care systems use performance measures for cervical cancer screening based on guidelines from such organizations as the American College of Obstetricians and Gynecologists to monitor the appropriateness of cervical cancer screening. According to the performance measure in the Healthcare...

Epithelioma Tubule De Nez, Albumen Print Paris, 1872

The text and photograph 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 photo below is from the volume titled “The Anesthesia Era: 1845–1875.” The photograph...

solid tumors
bladder cancer

Avelumab in Locally Advanced or Metastatic Urothelial Carcinoma

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On May 9, 2017, avelumab (Bavencio) was granted...

solid tumors
bladder cancer

Durvalumab in Advanced Urothelial Carcinoma Progressing After Platinum Therapy

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On May 1, 2017, durvalumab (Imfinzi) was granted...

hematologic malignancies
lymphoma
leukemia

Combination of Rituximab and Hyaluronidase Human for Subcutaneous Use in Lymphoma and Leukemia

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On June 22, 2017, the combination of rituximab (Rituxan)...

solid tumors
breast cancer

Adjuvant Pertuzumab in HER2-Positive Breast Cancer: Value Yet to Be Demonstrated

The ASCO Post issue of June 25, 2017, did an excellent job of summarizing the results and controversy generated by the initial results of the APHINITY trial, reported at the 2017 ASCO Annual Meeting and published simultaneously online in The New England Journal of Medicine.1 With a median follow-up ...

ASCO and Friends of Cancer Research Release Comprehensive Recommendations to Broaden Eligibility Criteria for Cancer Clinical Trials

ASCO and Friends of Cancer Research (Friends) are calling for the use of more inclusive eligibility criteria for cancer clinical trials in a new Special Series in the Journal of Clinical Oncology (JCO). The series provides a comprehensive examination of eligibility criteria for cancer clinical...

issues in oncology

ASCO Concerned With MIPS Part B Reimbursement Assessments in QPP Proposal

ASCO submitted comments to the Centers for Medicare & Medicaid Services (CMS) on its proposed rule outlining changes to the Quality Payment Program (QPP) for 2018. In a letter to CMS Administrator Seema Verma, ASCO President Bruce E. Johnson, MD, FASCO, made recommendations regarding the two...

solid tumors
breast cancer

Clinical Trials Actively Recruiting Patients With Breast Cancer

The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies focused on patients with breast cancer. These studies highlight neoadjuvant combination therapy, cell vaccines, novel imaging techniques, radiotherapy, and more. All of the studies are...

FDA Expands Approval of Ipilimumab to Pediatric Patients 12 Years and Older

On July 24, the U.S. Food and Drug Administration (FDA) expanded the indication for ipilimumab (Yervoy) injection for intravenous use now to include the treatment of unresectable or metastatic melanoma in pediatric patients 12 years of age and older. Ipilimumab was evaluated in 2 trials of...

breast cancer

ASTRO 2017: Patients With Breast Cancer Find Radiation Therapy Experience Better Than Expected

A new survey finds breast cancer patients’ actual radiation therapy experiences largely exceeded their expectations. The survey, which addressed the fears and misconceptions regarding radiation therapy for breast cancer, found that more than three-fourths of the breast cancer patients...

gynecologic cancers

ASTRO 2017: GOG-249 Confirms Adjuvant Pelvic Radiation as Standard of Care for High-Risk, Early-Stage Endometrial Cancer

In a new phase III trial report from the National Clinical Trial Network group, NRG Oncology, recurrence-free and overall survival rates for women with stage I–II high-risk endometrial cancer were not superior following adjuvant vaginal cuff brachytherapy plus chemotherapy when compared with...

breast cancer

Shulian Wang, MD, and Benjamin Movsas, MD, on Breast Cancer: Radiation Therapy After Mastectomy

Shulian Wang, MD, of the National Cancer Center in Beijing, and Benjamin Movsas, MD, of the Henry Ford Health System, discuss study results on the use of hypofractionated radiation therapy after mastectomy for the treatment of high-risk breast cancer (Abstract PL01).

skin cancer

Adjuvant Dabrafenib and Trametinib in Resected Stage III BRAF-Mutated Melanoma

The phase III COMBI-AD trial has shown a significant improvement in relapse-free survival with the combination of the BRAF inhibitor dabrafenib (Tafinlar) and the MEK inhibitor trametinib (Mekinist) vs placebo as adjuvant therapy in patients with resected stage III melanoma with BRAF V600E or V600K ...

lung cancer

ASTRO 2017: Biomarker Blood Test Predicts Survival Following Localized Lung Cancer Treatment

A new study demonstrates that a blood test to detect cancer may predict treatment outcomes for patients with localized non–small cell lung cancer (NSCLC) and afford physicians additional lead time to personalize treatment for recurrent disease. Patients in the study with detectable levels of...

breast cancer

Trastuzumab-Based Regimens in Older Women With Early Breast Cancer

A comparative analysis of outcomes with two different trastuzumab (Herceptin)-based adjuvant regimens in older women with early HER2-positive breast cancer found little difference in safety and efficacy between treatments. The study was reported by Katherine E. Reeder-Hayes, MD, MBA, of the...

ASH Honors Marshall A. Lichtman, MD, With Lifetime Achievement in Hematology Award

The American Society of Hematology (ASH) will recognize Marshall A. Lichtman, MD, of the University of Rochester School of Medicine and Dentistry, with the 2017 Wallace H. Coulter Award for Lifetime Achievement in Hematology. Dr. Lichtman will be honored for his notable service to the field of...

NCI-COG Pediatric MATCH Trial to Test Targeted Drugs in Childhood Cancers

Investigators at the National Cancer Institute (NCI) and the Children’s Oncology Group (COG) have announced the opening of enrollment for a unique precision medicine clinical trial. NCI-COG Pediatric Molecular Analysis for Therapy Choice (Pediatric MATCH) is a nationwide trial to explore whether...

WISDOM Study to Test Personalized Approach to Breast Cancer Screening

MANY health-care experts disagree about when screening mammography is appropriate and for whom. That’s what Women Informed to Screen Depending on Measures of Risk (WISDOM) seeks to remedy. The University of California (UC) Health study aims to uncover whether annual mammograms really are the best...

Stemming the Growing Cancer Crisis in Rural Appalachia

A pair of recent studies show a troubling trend: Despite a 20% decrease in cancer mortality rates nationwide over the past 2 decades,1 Americans living in rural regions of the United States are more likely to die of cancer than persons living in metropolitan areas of the country. An analysis of...

integrative oncology

Rhodiola

The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies commonly used by patients with cancer. In this installment, Jun J. Mao, MD, MSCE, and Jyothirmai Gubili, MS, present information on...

Talking About Physician Burnout: Practical Strategies for Starting the Conversation

Would you rather explain the benefits of three cycles of bleomycin, etoposide, and cisplatin to a hostile crowd of bored teenagers than talk to your program director, supervisor, or colleagues about feeling burned out? It is an understandable feeling. Professional burnout is a difficult concept to...

Original Report in JCO CCI Describes How Authors Developed a Process to Automate a QOPI Measure

A NEW ARTICLE published in JCO Clinical Cancer Informatics (JCO CCI), “Automating QOPI Quality Measure NHL78a,” by Richard P. Mansour, MD, and Samip Master, MD, reports how the authors were able to use data from an electronic health record (EHR) and Microsoft SQL Server database management system...

lymphoma

Tisagenlecleucel for B-Cell Acute Lymphoblastic Leukemia

On August 30, 2017, tisagenlecleucel (Kymriah) was granted regular approval for the treatment of patients up to age 25 years with B-cell precursor acute lymphoblastic leukemia (ALL) that is refractory or in second or later relapse.1,2 Tisagenlecleucel is the first chimeric antigen receptor (CAR)...

issues in oncology

Balancing Harms and Benefits of Cancer Screening: The Debate Continues

Over the past several decades, widespread cancer screening has saved lives from various cancer types. However, despite advances in early-detection technologies, many cancers still remain undetected until they become symptomatic, conferring poor prognoses and outcomes. Moreover, some methods of...

palliative care

How Early Palliative Care May Benefit Patients With Incurable Cancer

Palliative care provided soon after a patient is diagnosed with incurable cancer not only helps improve the patient’s overall quality of life but also improves communication about the patient’s wishes for end-of-life care, according to a study by Jennifer S. Temel, MD, Clinical Director of Thoracic ...

thyroid cancer
prostate cancer
lung cancer
survivorship
palliative care

News From JCO and JOP

STAYING UP-TO-DATE in the fast-paced world of oncology literature is a daunting task at best. To assist with that task, The ASCO Post has assembled an assortment of studies recently published in the Journal of Clinical Oncology (JCO) and the Journal of Oncology Practice (JOP). Future installments...

gastrointestinal cancer

Regorafenib in Hepatocellular Carcinoma Previously Treated With Sorafenib

On April 27, 2017, the indications for regorafenib (Stivarga) were expanded to include treatment of patients with hepatocellular carcinoma who have been previously treated with sorafenib (Nexavar).1,2 Supporting Efficacy Data The new approval was based on the finding of improved overall survival...

cns cancers

Small Steps Forward in Brain Tumor Therapy

SOME RECENT ADVANCES in the treatment of brain tumors are promising, but others are less so, according to Jeffrey J. Olson, MD, Professor of Neurosurgery at Emory University, Atlanta. At the 2017 Debates and Didactics in Hematology and Oncology Conference, held in Sea Island, Georgia, and...

skin cancer

Is Complete Lymphadenectomy Still Standard of Care in Melanoma?

DOES COMPLETE lymph node dissection for sentinel node–positive melanoma still have a role in the management of this disease? That’s debatable. Although it does not improve overall survival over observation alone, complete lymphadenectomy may have other benefits, according to a dialogue at the...

gynecologic cancers

Update on Nonimmunotherapy Advances in Endometrial, Cervical, and Ovarian Cancers

AT THE 12TH ANNUAL New Orleans Summer Cancer Meeting, Thomas Herzog, MD, Deputy Director of the University of Cincinnati Cancer Institute and Professor of the Division of Gynecologic Oncology at the University of Cincinnati College of Medicine, delivered an update on nonimmunotherapy advances in...

lung cancer

PD-L1 Inhibitor Consolidation Therapy for NSCLC: New Standard of Care?

THE PROGRAMMED CELL DEATH ligand 1 (PD-L1) inhibitor durvalumab (Imfinzi) improved progression-free survival by 11.2 months compared with placebo in patients with locally advanced, unresectable stage III non–small cell lung cancer (NSCLC) whose disease did not progress following standard treatment ...

hematologic malignancies
lymphoma

New Response Evaluation Criteria for Lymphoma Clinical Trials: RECIL 2017

New criteria for evaluating response in lymphoma clinical trials—RECIL 2017—have been developed by an International Working Group with the aim of harmonizing criteria with the RECIST criteria used for solid tumors.1 The new criteria were reported by Anas Younes, MD, of Memorial Sloan Kettering...

hepatobiliary cancer

Hepatocellular Carcinoma: Current Thoughts on Liver Transplantation

LIVER TRANSPLANT offers the highest rates of long-term survival for patients with hepatocellular carcinoma, according to Maria Russell, MD, Assistant Professor of Surgery at Emory University, Atlanta. At the 2017 Debates and Didactics in Hematology and Oncology Conference at Sea Island, Georgia,...

breast cancer

Religiously Tailored Educational Intervention to Encourage Mammography in American Muslim Women

Despite the U.S. Preventive Services Task Force recommendation that women between the ages of 50 and 74 undergo mammography every 2 years, only about 50% of American Muslim women do so, compared with 67% of all American women. A study by Padela et al investigating the mammography-related barrier...

issues in oncology
symptom management

Assessing and Managing CAR T-Cell Treatment Toxicities

Immune-cell based therapies opening a new frontier for cancer treatment carry unique, potentially lethal side effects that provide a new challenge for oncologists—one addressed by a team led by clinicians at The University of Texas MD Anderson Cancer Center with proposed guidelines for...

palliative care
lung cancer

ESMO 2017: 'Triggers': A New Tool to Assess Patients’ Palliative Needs

A new tool to identify patients who would benefit from early palliative care was presented at the European Society for Medical Oncology (ESMO) 2017 Congress in Madrid (Abstract LBA54_PR). The so-called “Triggers” tool, developed by the London Cancer Alliance to help clinicians in the...

issues in oncology

ESMO 2017: Abdominal to Peripheral Fat Ratio May Predict Risk of Cancer Diagnosis in Postmenopausal Women

Body fat distribution in the trunk is more influential than body weight when it comes to cancer risk in postmenopausal women, according to a study presented at the European Society for Medical Oncology (ESMO) 2017 Congress in Madrid (Abstract 1408P_PR). The findings put a new spin on weight...

breast cancer

ESMO 2017: MONARCH 3: Abemaciclib as Initial Therapy Improves Outcome in Endocrine-Sensitive Advanced Breast Cancer

The results of the MONARCH 3 trial, presented at the European Society for Medical Oncology (ESMO) 2017 Congress in Madrid (Abstract 236O_PR), showed that adding the cyclin-dependent kinase (CDK) 4/6 inhibitor abemaciclib to endocrine therapy improved progression-free survival compared to endocrine...

solid tumors

Hospitalization and Rehospitalization After Diagnosis of Advanced Cancer

In a study reported in the Journal of Clinical Oncology, Whitney et al found that the majority of patients diagnosed with advanced cancer were hospitalized within 1 year of diagnosis, with a sizable proportion having multiple hospitalizations. Hospitalization Rates The study involved California...

gastroesophageal cancer

ESMO 2017: New Data Confirms Superiority of Docetaxel-Based Triplet Therapy in Esophagogastric Cancer

The superiority of docetaxel-based triplet therapy over standard of care in patients with resectable esophagogastric cancer has been confirmed in late-breaking results from the FLOT4 trial presented at the European Society for Medical Oncology (ESMO) 2017 Congress in Madrid (Abstract LBA27_PR)....

skin cancer

ESMO 2017: Combination Targeted Adjuvant Therapy Doubles Relapse-Free Survival in Stage III Melanoma

Combination targeted adjuvant therapy with dabrafenib (Tafinlar) and trametinib (Mekinist) doubles relapse-free survival in patients with stage III BRAF-mutant melanoma, according to late-breaking results from the COMBI-AD trial presented on September 11 at the European Society for Medical Oncology ...

prostate cancer

Alzheimer’s Disease Risk in Medicare Patients Receiving Androgen-Deprivation Therapy for Prostate Cancer

As reported by Baik et al in the Journal of Clinical Oncology, Medicare patients who received androgen-deprivation therapy for prostate cancer do not appear to be at increased risk for Alzheimer’s disease and may have an extremely small increased risk for dementia. Study Details The study...

head and neck cancer

Cabozantinib Salvage Therapy in Tyrosine Kinase Inhibitor–Refractory Differentiated Thyroid Cancer

A phase II study has shown that cabozantinib (Cometriq) produces responses in patients with tyrosine kinase inhibitor–refractory differentiated thyroid cancer. The findings were reported by Cabanillas et al in the Journal of Clinical Oncology. MET plays a role in vascular endothelial growth...

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