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health-care policy

COA Practice Impact Report Details Consolidation, Shift of Cancer Care System Into Hospital Setting

THE COMMUNITY ONCOLOGY Alliance (COA) has released the 2018 Community Oncology Practice Impact Report,1 which tracks data on the changing landscape of cancer care in the United States. It details a decade-long trend of closure and consolidation in the U.S. cancer system that has resulted in a...

skin cancer

Updated ASCO/SSO Guideline on Sentinel Lymph Node Biopsy in Melanoma: Addressing Fundamental Clinical Questions

Dr. Thompson is Professor of Melanoma and Surgical Oncology, Sydney Medical School, The University of Sydney, and Senior Surgeon, Melanoma Institute Australia, Sydney. IN THE MID-1990s, the surgical management of patients presenting with primary cutaneous melanomas changed forever when the...

skin cancer

Sentinel Lymph Node Biopsy and Management of Regional Lymph Nodes in Melanoma: ASCO/SSO Clinical Practice Guideline Update

AS REPORTED IN the Journal of Clinical Oncology by Sandra L. Wong, MD, of Dartmouth-Hitchcock Medical Center, and colleagues, ASCO and the Society of Surgical Oncology (SSO) have issued an update to the ASCO/SSO clinical practice guideline on sentinel lymph node biopsy and management of regional...

head and neck cancer

Circulating Tumor DNA May Guide Treatment Intensity in Advanced HPV-Associated Head and Neck Cancers

A MULTI-INSTITUTIONAL analysis of circulating tumor DNA extracted from the plasma of patients has shown that human papillomavirus type 16 (HPV16) DNA is detectable in the majority of cases of favorable-risk HPV-associated oropharyngeal squamous cell carcinoma and may be a clinically useful...

breast cancer

Can Some Patients With Early Breast Cancer Avoid Surgery?

RESEARCHERS AT The University of Texas MD Anderson Cancer Center are testing the possibility of safely eliminating surgery in patients with breast cancer who are “exceptional responders” to neoadjuvant therapy, according to Henry M. Kuerer, MD, PhD, a breast cancer surgeon who described this...

skin cancer

Expert Point of View: Antoni Ribas, MD

FOUR RANDOMIZED trials have shown improvements in recurrence-free survival in patients with high-risk melanoma with the administration of adjuvant therapy over the past 3 years, noted formal discussant of the EORTC 1325/KEYNOTE-054 trial, Antoni Ribas, MD, Director of the Tumor Immunology Program...

leukemia
genomics/genetics

Minimal Residual Disease in Acute Myeloid Leukemia: Mutation Matters

A RECENT article in The New England Journal of Medicine explored the nuances of minimal/measurable residual disease testing after induction treatment of acute myeloid leukemia (AML)1 and David P. Steensma, MD, and Benjamin L. Ebert, MD, PhD, of Dana-Farber Cancer Institute and Harvard Medical...

issues in oncology

Evolving Standards and Quality Metrics Ensure High-Quality Cancer Programs

Dr. Shulman is Deputy Director, Clinical Services, and Director of the Center for Global Cancer Medicine, Abramson Cancer Center; and Professor of Medicine, Hospital of the University of Pennsylvania, Philadelphia. IN 2008, WHEN ALLEN LICHTER, MD, FASCO, then Chief Executive Officer of ASCO,...

lung cancer
immunotherapy

Pembrolizumab Plus Standard Chemotherapy Improves Survival in Newly Diagnosed Metastatic Non–Small Cell Lung Cancer

ADDING THE IMMUNE checkpoint inhibitor pembrolizumab (Keytruda) to standard chemotherapy with pemetrexed (Alimta) and a platinum as first-line therapy was superior to chemotherapy alone in the KEYNOTE-189 trial.1 Induction and maintenance therapies with the new triplet therapy improved overall...

lung cancer
immunotherapy

FDA Accepts sBLA, Grants Priority Review to Atezolizumab for Initial Treatment of Metastatic Nonsquamous NSCLC

The U.S. Food and Drug Administration (FDA) recently accepted a supplemental biologics license application (sBLA) and granted Priority Review for atezolizumab (Tecentriq) in combination with bevacizumab (Avastin), paclitaxel, and carboplatin for the first-line treatment of metastatic nonsquamous...

breast cancer

ASBrS 2018: Early Detection and Intervention Effective for Preventing Breast Cancer–Related Lymphedema

Early, ongoing screening of lymphatic function and immediate patient-administered therapies as needed are highly effective in improving outcomes for women at high risk for breast cancer–related lymphedema (BCRL). These were the findings of a new study presented at the American Society of ...

breast cancer

ASBrS 2018: Breast Cancer Genetic Testing Guidelines Exclude Almost Half of High-Risk Patients

Current restrictive genetic testing guidelines exclude many patients who harbor high-risk breast cancer mutations, according to two new studies presented at the American Society of Breast Surgeons (ASBrS) 19th Annual Meeting (Abstracts 402910, 404340). One study found that whether or not patients...

breast cancer

ASBrS 2018: Regular Mammograms May Mean Earlier Breast Cancer Diagnosis and Less Aggressive Treatment

Women with breast cancer who underwent regular mammographic screening were diagnosed with earlier-stage disease and treated with significantly less aggressive therapies than those who delayed or never underwent screening, according to new research presented at the American Society of Breast...

leukemia

Results From the Full Population of a Phase II Trial of Venetoclax in CLL With 17p Deletion

In an article published in the Journal of Clinical Oncology, Stilgenbauer et al reported findings from the full population of the phase II trial that supported the 2016 approval of venetoclax (Venclexta) in the treatment of previously treated chronic lymphocytic leukemia (CLL) with 17p deletion....

breast cancer

Targeting Chemotherapy With Genetic Testing in Advanced Triple-Negative Breast Cancer

Researchers have found that women with advanced triple-negative breast cancer with a BRCA mutation were twice as likely to benefit from carboplatin as docetaxel—the current standard of care for these patients. These findings were published by Tutt et al in Nature Medicine. The trial is set...

skin cancer

FDA to Conduct Priority Review of Cemiplimab as a Potential Treatment for Advanced Cutaneous Squamous Cell Carcinoma

On April 30, the U.S. Food and Drug Administration (FDA) accepted for priority review the biologics license application (BLA) for cemiplimab for the treatment of patients with metastatic cutaneous squamous cell carcinoma or patients with locally advanced cutaneous squamous cell carcinoma who...

solid tumors
head and neck cancer

HPV-Related Cancers Like Mine Are Avoidable, So Why Aren’t More Kids Being Vaccinated?

The latest news from the Centers for Disease Control and Prevention about vaccination rates in the United States for human papillomavirus (HPV) is disappointing. It shows that in 2016, just 43.4% of adolescents (49.5% of females and 37.5% of males) were up-to-date with the recommended 3-dose HPV...

bladder cancer
immunotherapy

Durvalumab in Locally Advanced or Metastatic Urothelial Carcinoma

Updated results of a phase I/II study of durvalumab (Imfinzi) in locally advanced or metastatic urothelial carcinoma were reported by Thomas Powles, MD, of Barts Cancer Institute, Queen Mary University of London, and colleagues in JAMA Oncology. Data from the ongoing study supported the recent...

solid tumors

FDA Approves Dabrafenib/Trametinib Combination for BRAF-Positive Anaplastic Thyroid Cancer

Today, the U.S. Food and Drug Administration approved dabrafenib (Tafinlar) and trametinib (Mekinist), administered together, for the treatment of unresectable, metastatic, BRAF V600E mutation–positive anaplastic thyroid cancer. Anaplastic thyroid cancer accounts for about 1% to 2% of all...

solid tumors
breast cancer

Dispel Fears About Breast Cancer Radiotherapy With ‘Real Truth’ About Modern Techniques and Side Effects

Nearly 85% of patients surveyed 6 or more months after completing radiotherapy as part of their treatment for breast cancer reported the side effects were not as bad as they had feared or expected. Approximately 92% of the 269 patients treated with breast conservation and 81% of the 58 patients...

issues in oncology

Spring

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,...

lung cancer

Disparities Found in Lung Cancer Care, Survival in United States vs England

Despite steady declines in death rates in recent years, lung cancer remains the leading cause of cancer deaths in wealthy countries. In a study published by Andreano et al in the Journal of Thoracic Oncology, Yale researchers collaborated with investigators in Europe to examine lung cancer care and ...

skin cancer

Canadian Study Explores the Economic Burden of Workplace Sun Exposure and Nonmelanoma Skin Cancer

A study by Mofidi et al in the Journal of Occupational and Environmental Hygiene has estimated the total and per-case costs of newly diagnosed nonmelanoma skin cancers in Canada in 2011 caused by workplace sun exposure. Using a range of secondary sources, including official government records and...

breast cancer

Long-Term Quality-of-Life Results Compared for Two Radiotherapy Strategies After Breast-Conserving Surgery

As reported in The Lancet Oncology by Schäfer et al, little difference in quality of life was observed over long-term follow-up between women receiving accelerated partial-breast irradiation (APBI) with interstitial brachytherapy vs whole-breast irradiation (WBI) after breast-conserving...

issues in oncology
legislation

Decision Aids Reflect Patients’ Values and Preferences for Care: So Why Aren’t More Oncologists Using Them?

Overwhelming evidence shows that patient decision aids, such as educational booklets, videos, or Web-based tools that take into account patients’ values and personal preferences, hold enormous promise for improving the informed consent process. Patient decision aids both reduce unwanted medical...

solid tumors
prostate cancer

Should We Treat Rising PSA in Men With Castrate Androgen Levels?

In rapid succession, the SPARTAN study results were presented at the 2018 Genitourinary Cancers Symposium, the data were published in The New England Journal of Medicine,1 and the drug apalutamide -(Erleada) was approved by the U.S. Food and Drug Administration (FDA) for men with previously...

supportive care
palliative care

Using Video Decision-Support Tools to Facilitate End-of-Life Discussions With Patients

GUEST EDITOR Addressing the evolving needs of cancer survivors at various stages of their illness and care, Palliative Care in Oncology is guest edited by Jamie H. Von Roenn, MD. Dr. Von Roenn is ASCO’s Vice President of Education, Science, and Professional Development. Research shows that...

hematologic malignancies
leukemia

Nilotinib Label Updated to Provide Treatment Discontinuation Recommendations for CML With Sustained Molecular Response

On December 22, 2017, the product label for nilotinib (Tasigna) was updated to include information on nilotinib discontinuation, postdiscontinuation monitoring, and guidance for treatment reinitiation in patients with Philadelphia chromosome (Ph)-positive chronic myeloid leukemia (CML) who have...

lymphoma
immunotherapy

FDA Expands Tisagenlecleucel Approval to Include Relapsed or Refractory Large B-Cell Lymphoma

On May 1, the U.S. Food and Drug Administration (FDA) approved tisagenlecleucel (Kymriah) suspension for intravenous infusion for the treatment of adult patients with relapsed or refractory large B-cell lymphoma—including diffuse large B-cell lymphoma (DLBCL), high-grade B-cell lymphoma, and...

breast cancer

New Breath and Urine Tests May Detect Early Breast Cancer More Accurately

A new method for early, more accurate breast cancer screening has been developed by researchers at Ben-Gurion University of the Negev and Soroka University Medical Center using commercially available technology. Their findings were published by Herman-Saffar et al in Computers in Biology and...

gynecologic cancers

Positive Results From QUADRA Trial of Niraparib in Ovarian Cancer

Tesaro recently announced results from the QUADRA study, which was designed to assess the clinical benefit of niraparib (Zejula) treatment in heavily pretreated patients with ovarian cancer. Results successfully achieved the prespecified primary endpoint and demonstrated niraparib monotherapy...

lung cancer
immunotherapy

Results From the ARCTIC Trial in Third-Line Treatment of NSCLC

AstraZeneca and MedImmune have announced high-level results from the phase III ARCTIC trial in patients with locally advanced or metastatic non–small cell lung cancer (NSCLC) who have received at least two prior treatments. This randomized, open-label, multicenter trial assessed the efficacy...

skin cancer
immunotherapy

FDA Approves Dabrafenib Plus Trametinib for Adjuvant Treatment of Melanoma With BRAF V600E or V600K Mutations

On April 30, 2018, the U.S. Food and Drug Administration (FDA) granted regular approval to dabrafenib (Tafinlar) and trametinib (Mekinist) in combination for the adjuvant treatment of patients with melanoma with BRAF V600E or V600K mutations (as detected by an FDA-approved test) and involvement of...

prostate cancer

ESTRO 37: Ultrahypofractionated Radiotherapy for Prostate Cancer Is Safe and Effective

Radiotherapy given in high doses over a shorter period of time is safe and effective for patients with prostate cancer, according to research from a phase III trial presented at the European Society for Radiotherapy & Oncology (ESTRO) 37 Conference (Abstract OC-0599). The...

lung cancer

ESTRO 37: Elderly Patients With NSCLC May Be Less Likely to Benefit From Concurrent Chemoradiotherapy

An analysis of elderly patients with non–small cell lung cancer (NSCLC) treated in a phase II trial of radiotherapy combined with chemotherapy has shown that they were less likely to benefit than younger patients if the two treatments were given at the same time. These findings were presented ...

gynecologic cancers

ESTRO 37: Brachytherapy for Patients With Cervical Cancer Does Not Increase Risk of Ureteral Stricture

A rare but potentially serious complication following radiation treatment for cervical cancer is a narrowing of the tube that takes urine from the kidneys to the bladder (the ureter), which can lead to kidney damage and sometimes life-threatening infections. This is called ureteral stricture and,...

lung cancer
immunotherapy

FDA Accepts sBLA, Grants Priority Review for Nivolumab in Previously Treated Patients With SCLC

On April 18, the U.S. Food and Drug Administration (FDA) accepted for Priority Review a supplemental biologics license application (sBLA) for nivolumab (Opdivo) to treat patients with small cell lung cancer (SCLC) whose disease has progressed after two or more prior lines of therapy. ...

ASCO Remembers Patient Advocate Karen Durham

ASCO AND THE ONCOLOGY COMMUNITY mourn the loss of Karen Durham, who passed away on March 26, 2018, in Tyler, Texas. Karen was a highly respected and beloved advocate for people living with cancer.  Karen was diagnosed with stage II invasive breast cancer in 1989 and began volunteering with Susan...

Cooperative Group Trial Pioneer Dr. James F. Holland Dies at 92

ASCO AND THE ONCOLOGY COMMUNITY are deeply saddened by the loss of James F. Holland, MD, FASCO, who passed away on March 22, 2018. He was 92.  Dr. Holland was a Distinguished Professor of Neoplastic Diseases in the Department of Medicine at the Tisch Cancer Institute, Icahn School of Medicine at...

kidney cancer

CB-839 in Combination With Cabozantinib for Advanced RCC Granted FDA Fast Track Designation

On April 18, Calithera Biosciences, Inc, announced that the U.S. Food and Drug Administration (FDA) granted Fast Track designation to CB-839 in combination with cabozantinib (Cabometyx) for the treatment of patients with metastatic renal cell carcinoma (RCC) who have received one or two prior lines ...

breast cancer

FDA Grants Fast Track Designation for Balixafortide in Combination With Eribulin as Third-Line Therapy for Metastatic Breast Cancer

On April 19, Polyphor announced that the U.S. Food and Drug Administration (FDA) granted Fast Track designation for its novel immuno-oncology candidate balixafortide (POL6326) in combination with eribulin (Halaven) for the treatment of patients with HER2-negative metastatic breast cancer who...

multiple myeloma

Updated International Myeloma Working Group Criteria: Diagnostic Challenges

The ASCO Post is pleased to present Hematology Expert Review, an ongoing feature that quizzes readers on issues in hematology. In this installment, Drs. Abutalib and Landgren review the underlying data that shaped the updated International Myeloma Working Group (IMWG) diagnostic criteria for...

health-care policy
issues in oncology

COA Practice Impact Report Details Consolidation, Shift of U.S. Cancer Care System Into More Expensive Hospital Setting

The Community Oncology Alliance (COA) has released the 2018 Community Oncology Practice Impact Report, which tracks data on the changing landscape of cancer care in the United States. It details a decade-long trend of closure and consolidation in the U.S. cancer system that has resulted in a...

colorectal cancer

Adjuvant FOLFOX or CAPOX for 3 or 6 Months in Stage II or III Colon Cancer

As reported in the Journal of Clinical Oncology by Sobrero et al, the Italian phase III TOSCA trial did not demonstrate noninferiority of 3 vs 6 months of adjuvant CAPOX (capecitabine plus oxaliplatin) or FOLFOX (fluorouracil, leucovorin, and oxaliplatin) in relapse-free survival in stage II or...

issues in oncology

FDA Unveils Streamlined Path for Authorizing Tumor-Profiling Tests Alongside Its Latest Product Action

The U.S. Food and Drug Administration (FDA) recently finalized two guidances to drive the efficient development of next-generation sequencing, which scans a person’s DNA to diagnose genetic diseases, and guide medical treatments. The guidances provide recommendations for designing,...

solid tumors
colorectal cancer

Nut Consumption in Patients With Stage III Colon Cancer

People with stage III colon cancer who regularly eat tree nuts are at significantly lower risk of cancer recurrence and mortality than those who don’t, according to findings published by Fadelu et al in the Journal of Clinical Oncology.1 Study Findings The study followed 826 participants in the...

lung cancer

AACR 2018: New Liquid Biopsy–Based Cancer Model Reveals Data on Chemoresistance in SCLC

Small cell lung cancer (SCLC) accounts for 14% of all lung cancers and is often rapidly resistant to chemotherapy, resulting in poor clinical outcomes. Treatment has changed little for decades, but a study at The University of Texas MD Anderson Cancer Center offers a potential explanation for...

hematologic malignancies

FDA Approves Fostamatinib Disodium Hexahydrate for Chronic Immune Thrombocytopenia in Adult Patients

On April 17, the U.S. Food and Drug Administration (FDA) approved fostamatinib disodium hexahydrate (Tavalisse) for the treatment of thrombocytopenia in adult patients with chronic immune thrombocytopenia who have had an insufficient response to a previous treatment. Fostamatinib is an oral spleen ...

hematologic malignancies
leukemia
immunotherapy

Fine-Tuning Treatment in Myeloma and Leukemia

It is a difficult task to include every notable presentation from the 2017 American Society of Hematology (ASH) Annual Meeting & Exposition. In addition to our more comprehensive coverage of the news from that meeting over the past several issues, below are summaries of additional key...

breast cancer

Talazoparib Reduces Risk of Disease Progression in BRCA-Mutated Breast Cancer

In patients with BRCA-positive advanced breast cancer, talazoparib reduced the risk of disease progression or death by 46% vs chemotherapy, according to the phase III EMBRACA trial presented at the 2017 San Antonio Breast Cancer Symposium.1 “We are very pleased that the EMBRACA trial—the largest...

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