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supportive care

Oral Rivaroxaban Has Efficacy Similar to Enoxaparin Plus Vitamin K Antagonist in Preventing Recurrent Venous Thromboembolism

In a subgroup analysis of the pooled results of the EINSTEIN-DVT and EINSTEIN-PE trials reported in The Lancet Haematology, Prins et al found that the recurrence rate for venous thromboembolism in cancer patients receiving anticoagulant therapy with oral rivaroxaban (Xarelto) was similar to that in ...

solid tumors

First-Line FOLFIRI Improves Time to Treatment Failure and Is Better Tolerated vs ECX in Advanced Gastric Cancer

In a phase III French Intergroup trial reported in the Journal of Clinical Oncology, Guimbaud et al found that FOLFIRI (fluorouracil [5-FU], leucovorin, and irinotecan) significantly prolonged time to treatment failure compared with ECX (epirubicin, cisplatin, and capecitabine) in first-line...

survivorship

ASCO Issues Clinical Expert Statement on Cancer Survivorship Care Planning

Efforts at implementing survivorship care plans have met with limited success in oncology practice, in part due to the time required to complete survivorship care plans, lack of role clarity, and lack of reimbursement for time to complete the documents. In response, ASCO convened a Survivorship...

leukemia

CD19-Directed CAR T Cells Produce Sustained Remission in Relapsed/Refractory ALL

In a study reported in The New England Journal of Medicine, Maude et al reported achieving sustained remissions in children and adults with relapsed/refractory acute lymphoblastic leukemia (ALL) using autologous CD19-targeted chimeric antigen receptor (CAR)-modified T cells. Study Details In the...

breast cancer

Neratinib Plus Capecitabine Shows Activity in HER2-Positive Metastatic Breast Cancer

Neratinib is an irreversible pan-tyrosine kinase inhibitor with activity against HER1, HER2, and HER4. In a phase I/II trial reported in the Journal of Clinical Oncology, Saura et al found that the combination of neratinib and capecitabine exhibited high activity in patients with trastuzumab...

gastroesophageal cancer

Substantial Benefit of Intensive Surveillance Following Bimodality Therapy for Esophageal Cancer

In a study reported in the Journal of Clinical Oncology, Sudo et al found that many patients undergoing definitive chemoradiotherapy (bimodality therapy) for esophageal cancer can derive substantial survival benefit  from subsequent salvage surgery, supporting a practice of intensive...

colorectal cancer

LINE-1 Hypomethylation Associated With Poorer Survival in Microsatellite Instability–High vs Microsatellite-Stable Tumors in Colorectal Cancer

In a study reported in the Journal of the National Cancer Institute, Inamura et al found that hypomethylation in long interspersed nucleotide element-1 (LINE-1) is associated with greater colorectal cancer–specific and overall mortality in high-degree microsatellite instability vs...

lung cancer

ASCO Endorses Guideline for Molecular Testing to Select Lung Cancer Patients for EGFR and ALK Inhibitor Treatment

ASCO has endorsed the recently developed joint College of American Pathologists (CAP), International Association for the Study of Lung Cancer (IASLC), and Association of Molecular Pathologists (AMP) guideline on molecular testing for selection of patients with lung cancer for EGFR and ALK inhibitor ...

supportive care
issues in oncology

Adding Aprepitant to Granisetron/Dexamethasone Reduces Chemotherapy-Induced Nausea and Vomiting After High-Dose Melphalan Conditioning in Myeloma

In a phase III trial reported in the Journal of Clinical Oncology, Schmitt et al found that adding aprepitant to granisetron and dexamethasone significantly reduced chemotherapy-induced nausea and vomiting in myeloma patients undergoing high-dose melphalan conditioning and autologous stem cell...

breast cancer

Second-Line Bevacizumab/Chemotherapy Improves Progression-Free Survival in Advanced HER2-Negative Breast Cancer

In the phase III TANIA trial reported in The Lancet Oncology, von Minckwitz et al found that adding bevacizumab (Avastin) to chemotherapy in second-line treatment improved progression-free survival after first-line bevacizumab plus chemotherapy in patients with HER2-negative locally recurrent or...

gynecologic cancers
gynecologic cancers

Rate of Cancer Detection at Risk-Reducing Salpingo-Oophorectomy

In a study reported in the Journal of Clinical Oncology, Sherman et al found occult cancers in 2.6% of high-risk women undergoing risk-reducing salpingo-oophorectomy. Study Details The study involved 966 asymptomatic high-risk women age ≥ 30 years who underwent risk-reducing...

leukemia

New Findings in Acute Promyelocytic Leukemia

Three studies reported in the Journal of Clinical Oncology provide information on maintenance treatment with the synthetic retinoid tamibarotene in acute promyelocytic leukemia, potential implications of QT interval prolongation related to arsenic trioxide (Trisenox), and potential health-related...

breast cancer

Improved Survival With Maintenance Capecitabine/Bevacizumab vs Bevacizumab Alone in HER2-Negative Metastatic Breast Cancer

Regulatory approval of bevacizumab (Avastin) plus docetaxel in metastatic breast cancer was withdrawn in Europe in February 2011 and in the United States in November 2011. The phase III IMELDA trial comparing maintenance capecitabine/bevacizumab vs bevacizumab after first-line bevacizumab/docetaxel ...

skin cancer

Anti–PD-1 Antibody Pembrolizumab Is Active in Ipilimumab-Refractory Advanced Melanoma

As reported in The Lancet by Robert et al, the anti–programmed-death receptor-1 (PD-1) antibody pembrolizumab (Keytruda) produced durable responses in a phase I trial in patients with ipilimumab (Yervoy)-refractory melanoma. The study provided the basis for the recent accelerated approval of...

gynecologic cancers

HPV 16/18 Vaccine Shows Protective Efficacy in Women Aged > 25 Years in 4-Year Interim Follow-up of VIVIANE Study

In the 4-year interim follow-up of the VIVIANE study reported in The Lancet by Skinner et al, the human papillomavirus (HPV) 16/18 AS04-adjuvanted vaccine was found to be protective against 6-month persistent infection or cervical intraepithelial neoplasia grade 1 or higher (CIN1+) associated with...

skin cancer

After Adjustment for Stage at Diagnosis, No Difference Evident in Melanoma-Specific Mortality Between Amelanotic and Pigmented Melanomas

In a large international population-based study reported in JAMA Dermatology, Thomas et al found that increased risk of melanoma-related mortality for patients with amelanotic vs those with pigmented melanomas was no longer evident after adjustment for tumor stage at diagnosis. The study involved...

prostate cancer

Adjuvant Radiotherapy Benefits Survival in Subsets of Patients With Node-Positive Prostate Cancer

In an analysis of outcomes in patients with node-positive prostate cancer reported in the Journal of Clinical Oncology, Abdollah et al found that adjuvant radiotherapy is associated with a survival benefit in patients with low-volume nodal disease in the setting of intermediate- to high-grade...

prostate cancer

Abiraterone Acetate/Prednisone in Metastatic Castration-Resistant Prostate Cancer: Final Analysis of Early-Access Protocol Study

Abiraterone acetate (Zytiga) is approved for use in combination with prednisone in the treatment of metastatic castration-resistant prostate cancer. As reported by Sternberg et al in The Lancet Oncology, results of an open-label, early-access protocol trial initiated prior to approval indicated no...

issues in oncology
prostate cancer

AR-V7 in Circulating Tumor Cells Associated With Resistance to Enzalutamide and Abiraterone in Prostate Cancer

The androgen receptor isoform encoded by splice variant 7 is constitutively active as a transcription factor, despite lacking the ligand-binding domain that is the target of enzalutamide (Xtandi) and abiraterone (Zytiga). In a study reported in The New England Journal of Medicine, Antonarakis et al ...

bladder cancer

Increased Risk of Fracture After Radical Cystectomy and Urinary Diversion in Older Patients With Bladder Cancer

In a population-based study reported in the Journal of Clinical Oncology, Gupta et al found that radical cystectomy with urinary diversion for bladder cancer is associated with increased risk of bone fracture at any site in Medicare patients. Radical cystectomy and urinary diversion may cause...

gynecologic cancers
gynecologic cancers

No Increased Risk of Ovarian Cancer With Perineal Powder Use

Perineal powder use has been associated with increased risk of ovarian cancer in case-control studies and with increased risk of serous invasive ovarian cancer in a cohort study. In a large cohort study reported in the Journal of the National Cancer Institute, Houghton et al found no significant...

skin cancer

TERT Promoter Mutation Associated With Reduced Survival in Nonacral Cutaneous Melanoma

TERT promoter mutations have been found to occur at high frequency in cutaneous melanoma tumor samples, exhibit a UV-signature, and lead to increased TERT gene expression. In a study reported in the Journal of the National Cancer Institute, Griewank et al found that TERT promoter mutation was...

breast cancer

Swedish Study Indicates No Increased Risk of Breast Cancer With 5 Years of Continuous Exposure to Calcium Channel Blockers

A recently reported U.S. population-based case-control study in women aged 55 to 74 years indicated that current use of calcium channel blockers for ≥ 10 years was associated with increased risk of ductal breast cancer (odds ratio [OR] = 2.4) and lobular breast cancer. In a Swedish case-control...

lymphoma

PET-CT as Standard for Response Assessment After First-Line Therapy in Follicular Lymphoma

In a pooled analysis reported in The Lancet Haematology, Trotman et al found that 18F-fluorodeoxyglucose (FDG) positron-emission tomography/low-dose computed tomography (PET-CT) provides improved prognostic information over conventional contrast-enhanced CT in assessment of response to first-line...

breast cancer
survivorship

Dutch Study Finds No Increased Risk of Cardiovascular Mortality in 5-Year Survivors of DCIS

In a Dutch study reported in the Journal of the National Cancer Institute, Boekel et al found no increase in risk of cardiovascular mortality among 5-year survivors of ductal carcinoma in situ (DCIS) compared with the general population. Among DCIS patients, risk of cardiovascular events did not...

survivorship

Chemoradiotherapy vs Radiotherapy Alone Linked to Increased Risk of Subsequent Malignancies in Long-Term Survivors of Hereditary Retinoblastoma

Increased risk of subsequent malignant neoplasms has been reported in hereditary retinoblastoma survivors after radiotherapy. In a study reported in Journal of Clinical Oncology, Wong et al found that chemotherapy plus radiotherapy was associated with increased risk of subsequent malignant...

sarcoma

Reduced Local Recurrence With Intensity-Modulated vs External-Beam Radiation Therapy in Primary Soft-Tissue Sarcomas of the Extremity

There are no large-scale direct comparisons of outcomes with intensity-modulated radiation therapy vs conventional external-beam radiation therapy in patients with soft-tissue sarcoma of the extremity. In a single-institution experience reported in the Journal of Clinical Oncology, Folkert et al at ...

Proposed Comorbidity-Age Index in Prognostic Model for Allogeneic Hematopoietic Cell Transplantation

In a study reported in the Journal of Clinical Oncology, Sorror et al found that a composite comorbidity-age index was better than age alone in predicting nonrelapse mortality and survival in patients undergoing allogeneic hematopoietic cell transplantation. Study Details The study included data...

prostate cancer

Cabozantinib Active in Pretreated Metastatic Castration-Resistant Prostate Cancer

In a phase II expansion study reported in the Journal of Clinical Oncology, Smith et al found that the multikinase inhibitor cabozantinib (Cometriq) showed activity in previously treated metastatic castration-resistant prostate cancer. Cabozantinib targets include VEGFR2 and MET kinases. Study...

sarcoma

Phase II Study Shows Activity of Hypoxia-Activated Alkylating Prodrug in Combination With Doxorubicin in Advanced Soft-Tissue Sarcoma

In a phase II study reported in the Journal of Clinical Oncology, Chawla et al found that the combination of a hypoxia-activated alkylating prodrug (TH-302) and doxorubicin was active in first-line treatment of advanced soft-tissue sarcoma. TH-302 is a prodrug of the cytotoxic alkylating agent...

multiple myeloma

Subclinical Peripheral Neuropathy Is Common in Treatment-Naive Multiple Myeloma Patients, Correlates With Decreased Fingertip Innervation Density

In a study reported in the Journal of Clinical Oncology, Kosturakis et al found that the majority of patients with multiple myeloma had subclinical peripheral neuropathy prior to chemotherapy and that deficits corresponded with decreased fingertip innervation density. Study Details In the study,...

lung cancer

New ALK Inhibitor Alectinib Shows Activity vs Crizotinib-Resistant NSCLC

In the phase I portion of a phase I/II study reported in The Lancet Oncology, Gadgeel et al found that the novel ALK inhibitor alectinib showed activity against systemic disease and brain metastases in patients with non–small cell lung cancer (NSCLC) resistant to the ALK inhibitor crizotinib...

breast cancer

Soy Intake May Adversely Affect Gene Expression in Early Breast Cancer

In a randomized study reported in the Journal of the National Cancer Institute, Shike et al found that soy supplementation resulting in high genistein levels was associated with overexpression of the tumorigenic growth factor receptor FGFR2 and genes that drive cell cycle and proliferation...

lung cancer

European Phase III Trial Suggests Benefit of Thoracic Radiotherapy in Extensive-Stage Small Cell Lung Cancer

In a European phase III trial reported in The Lancet, Slotman et al found benefits of thoracic radiotherapy in patients with extensive-stage small cell lung cancer who had responded to chemotherapy and had received prophylactic cranial radiotherapy. Although thoracic radiotherapy did not...

lung cancer

Meta-Analysis Shows No Overall Survival Benefit of Six vs Fewer Planned Cycles of First-Line Platinum-Based Chemotherapy in Advanced NSCLC

In a systematic review and meta-analysis of individual patient data reported in The Lancet Oncology, Rossi et al found no overall survival benefit with six vs fewer than six planned cycles of first-line platinum-based treatment in patients with advanced non–small cell lung cancer (NSCLC). A...

multiple myeloma

Continuous Lenalidomide/Dexamethasone Improves Progression-Free Survival in Transplant-Ineligible Patients With Myeloma

In the phase III FIRST trial reported in The New England Journal of Medicine, Benboubker et al found that continuous lenalidomide (Revlimid) plus dexamethasone significantly improved progression-free survival vs melphalan/prednisone/thalidomide (Thalomid) in transplant-ineligible myeloma patients....

head and neck cancer

Pennsylvania Has High Rate of Increase in Thyroid Cancer, Including Advanced and Larger Tumors

In a population-based study reported in JAMA Otolaryngology-Head & Neck Surgery, Bann et al found that the average annual percent increase in thyroid cancer incidence in Pennsylvania approaches twice that in the rest of the country. The incidence of thyroid cancer in the United States has more...

prostate cancer

Safe Integration of Surgical Innovations Essential to Patient Safety: Study Evaluates Minimally-Invasive Radical Prostatectomy

In the introduction to a cohort study reported in JAMA Surgery, Parsons et al stated “Surgical innovations disseminate in the absence of coordinated systems to ensure their safe integration into clinical practice, potentially exposing patients to increased risk for medical error.” Their ...

gynecologic cancers
gynecologic cancers

Pazopanib Maintenance Improves Progression-Free Survival in Ovarian Cancer, but Benefit Limited to Non–East Asian Patients

In a phase III trial reported in the Journal of Clinical Oncology, du Bois et al found that maintenance therapy with the VEGFR and PDGFR inhibitor pazopanib (Votrient) significantly prolonged progression-free survival vs placebo in women with ovarian cancer without progression after first-line...

skin cancer

Patient Exhibits Involution of Eruptive Melanocytic Nevi on Combination BRAF and MEK Inhibitor Therapy

Eruptive melanocytic nevi are observed in patients receiving the multikinase inhibitor sorafenib (Nexavar) and the selective BRAF inhibitor vemurafenib (Zelboraf). In a case reported in JAMA Dermatology, Shen et al found that the addition of the MEK inhibitor cobimetinib to vemurafenib in a woman...

multiple myeloma

Adding Pan-Deacetylase Inhibitor Panobinostat to Bortezomib and Dexamethasone Improves Progression-Free Survival in Relapsed Myeloma

In the phase III PANORAMA1 trial reported in The Lancet Oncology, San-Miguel and colleagues found that adding the pan-deacetylase inhibitor panobinostat to bortezomib (Velcade) and dexamethasone improved progression-free survival in patients with relapsed or relapsed and refractory multiple...

Major Depression Is Undertreated in Patients With Cancer

In a Scottish study reported in The Lancet Psychiatry, Walker et al assessed the prevalence and adequacy of treatment of major depression in patients with cancer of different primary sites. The prevalence of major depression ranged from 5.6% in patients with genitourinary cancers to 13.1% in those...

lung cancer

SMaRT Oncology-3 Trial Reports Collaborative Care Program Reduces Major Depression in Patients With Lung Cancer

In the SMaRT Oncology-3 study reported in The Lancet Oncology, Walker et al found that an integrated collaborative treatment program for depression (‘depression care for people with cancer’) was associated with significantly reduced severity of depression compared with usual care in...

Integrated Collaborative Care Program Highly Successful in Treating Major Depression in Patients With Cancer

In a Scottish study (SMaRT Oncology-2) reported in The Lancet, Sharpe, Walker et al found that an integrated collaborative treatment program for depression (‘depression care for people with cancer’) was associated with significantly higher depression response and remission rates...

lymphoma

Para-Aortic Lymph Node Radiation Increases Risk of Diabetes in Hodgkin Lymphoma Survivors

Abdominal irradiation for childhood cancer has been associated with increased risk of diabetes. In a Dutch study reported in the Journal of Clinical Oncology, van Nimwegen and colleagues assessed the relationship between infradiaphragm radiotherapy and risk of diabetes in long-term survivors of...

breast cancer

PIK3CA Mutations Associated With Lower Rate of Pathologic Complete Response to Neoadjuvant Anti-HER2 Therapy in Breast Cancer

In a study reported in the Journal of Clinical Oncology, Loibl et al found that PIK3CA mutation was associated with lower pathologic complete response rate in patients with HER2-positive breast cancer receiving trastuzumab (Herceptin), lapatinib (Tykerb), or both in addition to neoadjuvant...

prostate cancer

Male Pattern Baldness at Age 45 May Be Associated With Aggressive Prostate Cancer

In a prospective cohort study in the population of the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial, Zhou et al found that frontal plus moderate vertex baldness at age 45 is associated with increased risk of aggressive prostate cancer. The findings were reported in the...

Primary Site of Neuroblastoma Tied to Differences in Biologic, Clinical Characteristics, Including Survival

In a study reported in Journal of Clinical Oncology, Vo et al in the International Neuroblastoma Risk Group Project found significant differences in clinical and biologic features of neuroblastoma according to primary tumor site, including poorer survival for adrenal sites of primary disease and...

multiple myeloma

Improved Outcomes in Myeloma With High-Dose Melphalan Plus Autologous Transplant and Lenalidomide Maintenance

In a phase III trial reported in The New England Journal of Medicine, Palumbo et al found that consolidation therapy with high-dose melphalan plus autologous stem cell transplantation improved progression-free survival and overall survival compared with melphalan/prednisone/lenalidomide (Revlimid)...

colorectal cancer

Improved Survival with Adjuvant FOLFOX vs Fluorouracil/Leucovorin After Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer

In a Korean phase II trial reported in The Lancet Oncology, Hong et al found that adjuvant FOLFOX (oxaliplatin, fluorouracil [5-FU], leucovorin) prolonged progression-free survival and overall survival vs 5-FU/leucovorin in patients with locally advanced rectal cancer who had received neoadjuvant...

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