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lymphoma

Lenalidomide for Previously Treated Follicular and Marginal Zone Lymphomas

On May 28, 2019, lenalidomide was approved for use in combination with a rituximab product for previously treated follicular lymphoma and previously treated marginal zone lymphoma.1,2 Supporting Efficacy Data Approval was based on the findings of two clinical trials: AUGMENT (ClinicalTrials.gov...

issues in oncology

Confronting the Criticisms Facing Watson for Oncology

Over the past 2 years, IBM’s Watson for Oncology cognitive computing system, which uses artificial intelligence (AI) algorithms to generate treatment recommendations, has come under fire for allegedly not delivering on expectations to provide state-of-the-art personalized treatment for patients...

FDA OCE and Syapse Announce Research Collaboration Focused on Regulatory Use of Real-World Evidence

Syapse and the U.S. Food and Drug Administration (FDA) Oncology Center of Excellence (OCE) have signed a multiyear research collaboration agreement focused on the use of real-world evidence to support regulatory decision-making. Syapse and the OCE will work with stakeholders across the FDA to...

issues in oncology

Firing Your Patient: How to Terminate a Treatment Relationship

Many clinicians are confused by the evolving opioid prescribing guideline issued by the Centers for Disease Control and Prevention (CDC) meant to stem the rising epidemic of opioid addiction and overdose in the United States.1 Many are also worried about regulatory oversight by the U.S. Drug...

New ASCO Ethical Framework for Including Research Biopsies in Clinical Trials

ASCO has released an ethical framework for researchers on incorporating research biopsies in cancer clinical trials. The framework, published in a statement in the Journal of Clinical Oncology on July 25, provides guidance on when to include optional and mandatory biopsies based on both participant ...

pancreatic cancer

Sita Kugel, PhD, Receives Grant to Study Aggressive Type of Pancreatic Cancer

The deadly nature of most pancreatic tumors is well known, with less than 10% of patients with pancreatic ductal adenocarcinoma estimated to survive 5 years after diagnosis. Recent molecular analyses of pancreatic ductal adenocarcinoma have shown that a patient’s prognosis changes depending on the...

cns cancers
lymphoma

Primary Central Nervous System Lymphoma: Striving for a Curative Therapy

Primary central nervous system (CNS) lymphoma is a rare type of non-Hodgkin lymphoma in which standards of care have not been well established. In light of recent insights into its pathophysiology and the emergence of novel approaches, The ASCO Post asked Tracy T. Batchelor, MD, a specialist in...

NCI Community Oncology Research Program Expands to More Sites

The National Cancer Institute (NCI) has awarded 53 grants to researchers in the NCI Community Oncology Research Program (NCORP) to conduct multisite cancer clinical trials and cancer care delivery studies in their communities. In addition to 7 research hubs, these NCI grants went to 32 community...

lymphoma

Update on FDA-Approved CAR T-Cell Gene Therapy for B-Cell Lymphomas

On October 18, 2017, the U.S. Food and Drug Administration (FDA) granted approval to axicabtagene ciloleucel for the treatment of adult patients with relapsed or refractory large B-cell lymphoma. Specifically, this treatment can be used after two or more lines of systemic therapy for diffuse...

lung cancer

The Mark Foundation Awards $6 Million Grant for Lung Cancer Research

The Mark Foundation for Cancer Research has awarded a 3-year $6 million grant to support a new phase of discovery for a team of investigators developing, optimizing, and integrating targeted therapies and immunotherapies to improve outcomes for patients with the most common—and most difficult to...

issues in oncology

Hey Siri, Should I Get a Medical Degree?

I received a coffee mug from a physician colleague some years ago with the tag line: “Please do not confuse your Google search with my Medical Degree.” Physicians of all stripes and colors can relate to the agony of debunking a “Dr. Google” diagnosis. However, in a fast-evolving health-care...

issues in oncology

How Patient Advocacy Is Integral to High-Quality Oncology Care

Karen M. Winkfield, MD, PhD, has made patient advocacy—with a specific emphasis on health equity and access to high-quality care—front and center of her oncology practice since she completed her residency at the Harvard Radiation Oncology Program in Boston, where she noticed that most of the...

integrative oncology

Light Intervention for Cancer-Related Fatigue, Depression, and Sleep Disturbance

GUEST EDITOR  Integrative Oncology is guest edited by Jun J. Mao, MD, MSCE, Laurance S. Rockefeller Chair in Integrative Medicine and Chief of Integrative Medicine Service at Memorial Sloan Kettering Cancer Center, New York. Cancer and its treatments are associated with severe fatigue, depression, ...

skin cancer

Stage IV Melanoma: What Current Role Should Surgery Play?

Advanced melanoma has become a different entity in the era of immunotherapy and targeted agents. Considering the potential for good outcomes from systemic therapy in advanced disease, has the role of surgery changed? Should it be offered up front or limited to patients with oligometastatic ...

First-Line Nivolumab and Ipilimumab vs Sunitinib in Advanced Renal Cell Carcinoma

This week, we’ll be talking about an extended follow-up of a phase III trial that investigated first-line nivolumab and ipilimumab vs sunitinib in advanced renal cell carcinoma. Then we’ll go over a research letter that identified strong predictors of response to immune checkpoint inhibitor...

gynecologic cancers

Does PTSD Increase the Risk of Developing Ovarian Cancer?

Women who experienced six or more symptoms of posttraumatic stress disorder (PTSD) at some point in life had a twofold greater risk of developing ovarian cancer compared with women who never experienced any PTSD symptoms. These findings were published by Roberts et al in Cancer Research. The...

pancreatic cancer

ASTRO Guideline on Use of Radiation Therapy for Patients With Pancreatic Cancer

A new clinical guideline from the American Society for Radiation Oncology (ASTRO) provides recommendations on the use of radiation therapy to treat patients diagnosed with pancreatic cancer, including when radiation treatments are appropriate, as well as the optimal dosing, timing, and...

breast cancer
survivorship

Pregnancy Appears Safe After Treatment for Breast Cancer in Patients With BRCA Mutations

Pregnancy after breast cancer appears to be safe in patients with germline BRCA mutations—and particularly among those with BRCA1 mutations—according to new research. Limited data are available on the safety of pregnancy and reproductive outcomes in patients with breast cancer and BRCA mutations,...

symptom management

ASCO and MASCC/ISOO Release a Clinical Practice Guideline on Medication-Related Osteonecrosis of the Jaw

ASCO and the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) have published a clinical practice guideline on medication-related osteonecrosis of the jaw in the Journal of Clinical Oncology.1 The guideline outlines the latest recommendations ...

issues in oncology

Association Between Postdischarge Bleeding in Patients With Acute Coronary Syndrome and Subsequent Cancer Diagnosis

Bleeding during the first 6 months after discharge from the hospital for acute coronary syndrome may be linked to subsequent cancer diagnosis, according to research presented by Muñoz Pousa et al at the European Society of Cardiology Congress 2019 (Abstract P677). “Our results suggest that patients ...

supportive care

ASCO Expands Therapeutic Options for Venous Thromboembolism Prophylaxis in Patients With Cancer

ASCO has updated its recommendations for the prevention and treatment of venous thromboembolism (VTE) in patients with cancer. “The recommendations were last updated in 2015, but since then, new, significant publications have emerged, which prompted this update,” said Nigel S. Key, MBChB, of the...

multiple myeloma

Is It Time to Intervene in Smoldering Myeloma?

Early intervention in smoldering multiple myeloma prevents progression to symptomatic disease and should be strongly considered for patients meeting new criteria for high risk, according to Sagar Lonial, MD, Professor and Chair of Hematology and Medical Oncology and the Anne and Bernard Gray...

issues in oncology

2019 Quality Care: End-of-Life Care in Western Washington State vs Alberta, Canada

In a study to be presented by Khaki et al at the 2019 ASCO Quality Care Symposium, researchers found more aggressive end-of-life measures—including use of chemotherapy and admissions to the intensive care unit (ICU)—were employed in the last 30 days of life in Western Washington state vs Alberta,...

issues in oncology
cost of care

2019 Quality Care: Cost of Treatment, Prior Authorization of Treatment Plans May Cause Barriers to Care

Drug costs and requirements for prior authorization of treatment plans pose barriers to cancer treatment and can potentially affect outcomes for many patients, according to two studies that will be presented at the ASCO Quality Care Symposium. The studies respectively examine how the high...

issues in oncology
lung cancer

2019 Quality Care: Clinical Trial Enrollment May Be Associated With Reduced Mortality in Patients With Metastatic Lung Cancer

Researchers from the University of Washington and Fred Hutchinson Cancer Research Center in Seattle investigated the relationship between participation in a clinical trial and overall survival in patients with advanced non–small cell lung cancer (NSCLC). Cristina Merkhofer, MD, MHS, will present...

prostate cancer

TITAN Trial: Apalutamide Adds to Options for Men With Metastatic Hormone-Sensitive Prostate Cancer

Androgen-deprivation therapy has been, and remains, the standard of care for patients with metastatic prostate cancer. Patients are often surprised to know that was all we would do to control their disease and sometimes asked why they would not get chemotherapy, as for other cancers. I would take...

issues in oncology

FDA Recommendation on Duodenoscopes With Disposable Components

The U.S. Food and Drug Administration (FDA) has recommended that duodenoscope manufacturers and health-care facilities transition to different types of duodenoscopes that may pose less risk to patient safety. Specifically, because of challenges with cleaning these devices for reuse and persistent...

supportive care
symptom management

Study Explores Efficacy of Lower-Dose Olanzapine in Combination With Standard Antiemetic Regimen

Olanzapine at a 5-mg dose, when combined with aprepitant, palonosetron, and dexamethasone, significantly reduced the risk of delayed nausea and vomiting in patients receiving cisplatin-based chemotherapy, according to new research. The study investigators believe this approach may be considered a...

issues in oncology
survivorship

What Role Do Physicians Play in Health Promotion Among Patients With Cancer?

A recent study published by Stump et al in Cancer indicated that certain physicians who care for patients with cancer do not often promote healthy lifestyle changes to cancer survivors, and they may fear that providing such advice would distress or overwhelm patients. The findings are noteworthy...

immunotherapy

Key Predictors of Response Rates to PD-1/PD-L1 Inhibitor Therapy Across Cancer Types

In a study reported in JAMA Oncology, Lee and Ruppin found that CD8-positive T-cell abundance, tumor mutational burden, and high PD1 gene expression were the strongest predictors of response to anti–programmed cell death protein 1/programmed cell death ligand 1 (PD-1/PD-L1) treatment across cancer...

breast cancer

Pyrotinib or Lapatinib With Capecitabine in Previously Treated HER2-Positive Metastatic Breast Cancer

In a Chinese phase II trial reported in the Journal of Clinical Oncology by Ma et al, the combination of the pan-ErbB inhibitor pyrotinib and capecitabine improved response rate vs lapatinib/capecitabine in women with HER2-positive relapsed or metastatic breast cancer previously treated with...

prostate cancer

Many Choices Now for Men With Metastatic Hormone-Sensitive Prostate Cancer: How to Decide?

Based on the recently published ENZAMET, ARCHES, and TITAN trials,1-3 we now have several choices of systemic combination therapies for men with metastatic hormone-sensitive prostate cancer; the ENZAMET trial is reviewed in this issue of The ASCO Post. In 2019, men are now faced with decisions of...

colorectal cancer
issues in oncology

Text Instructions and Reminders May Improve Colonoscopy Adherence Rates

Having text message conversations with patients 1 week before they are scheduled for a colonoscopy decreased “no-show” rates, according to a recent study published by Mahmud et al in Health Education & Behavior. Through sending reminders and instruction, the team increased the rate of...

issues in oncology

Exposure to Secondhand E-Cigarette Aerosols Increasing Among Middle and High School Students

A growing number of middle and high school students are being exposed to secondhand aerosols from electronic cigarettes (e-cigarettes) by living with or being around individuals who are vaping, according to data from a national survey. Such exposure increased rapidly in 2018 compared to the years...

issues in oncology
survivorship

High-Deductible Health Plans, Access to Care, and Emergency Department Use Among Cancer Survivors

In a study reported in the Journal of Oncology Practice, Zheng et al found that patients with cancer and high-deductible health plans had increases in delayed/forgone care, an effect that was attenuated for those with health savings accounts. Emergency department use was similar across insurance...

pancreatic cancer

Role of the YAP Regulatory Network in Pancreatic Ductal Adenocarcinoma

Researchers have decoded a chain of molecules that are critical for the growth and survival of pancreatic ductal adenocarcinoma. They say their findings, published by Murakami et al in Developmental Cell, suggest that inhibiting the YAP biologic network may effectively regress early-stage...

breast cancer
issues in oncology

FDA Issues Draft Guidance Encouraging Inclusion of Male Patients in Breast Cancer Clinical Trials

A draft guidance issued by the U.S. Food Drug Administration (FDA) on August 26 includes draft recommendations for the inclusion of male patients in breast cancer clinical trials. Historically, males either have not been included in clinical trials for drugs to treat breast cancer, or inclusion of...

neuroendocrine tumors

Prognostic Tool for Advanced, Well-Differentiated Neuroendocrine Tumors Treated With a Somatostatin Analog

In the GETNE-TRASGU study (Spanish Group of Neuroendocrine and Endocrine Tumors Treated With Analog of Somatostatin in Gastroenteropancreatic and Unknown Primary NETs) reported in the Journal of Clinical Oncology, Carmona-Bayonas et al developed a predictive model for progression-free survival in...

multiple myeloma

Selinexor/Dexamethasone in Triple-Class Refractory Multiple Myeloma

In the phase IIb STORM Part 2 study reported in The New England Journal of Medicine, Chari et al found that the combination of oral selinexor and dexamethasone produced responses in patients with multiple myeloma refractory to prior treatment with an alkylating agent, immunomodulatory agent, and...

solid tumors

FDA Clears Next-Generation Scalp-Cooling Device

ON JUNE 27, 2019, the U.S. Food and Drug Administration (FDA) granted clearance of the DigniCap Delta scalp-cooling system to Dignitana, for use by health-care providers in the United States. The device is a fourth generation of the DigniCap scalp-cooling system. It is indicated to reduce the...

Some Practices May Not Be Subject to USP and Standards

ASCO recently received clarification from the United States Pharmacopeia (USP) around the newly revised USP General Chapter <797> Pharmaceutical Compounding Standards–Sterile Preparations and USP General Chapter <800> Hazardous Drugs–Handling in Health-Care Settings, which become...

prostate cancer

Looking at Prostate Cancer–Specific Mortality by Gleason Score and Race

Black men suffer disproportionately from prostate cancer, both in terms of incidence and mortality, compared with their white counterparts. However, a newer study conducted by investigators at the University of California, San Francisco, and Dana-Farber Cancer Institute, Boston, found that black...

prostate cancer

Darolutamide for Nonmetastatic Castration-Resistant Prostate Cancer

On July 30, 2019, darolutamide was approved for the treatment of patients with nonmetastatic castration-resistant prostate cancer.1,2 Approval was based on findings in the double-blind phase III ARAMIS trial (ClinicalTrials.gov identifier NCT02200614), in which 1,509 patients were randomly assigned ...

breast cancer

Tumor Size and Grade Matter, and Ovarian Ablation by Chemotherapy May Explain Subgroup Anomaly in TAILORx

At the 2019 ASCO Annual Meeting, and simultaneously in The New England Journal of Medicine, we heard the third paper reporting results from TAILORx.1,2 The first, in 2015,3 indicated that women with node-negative breast cancers with Oncotype DX recurrence scores less than 11 did extremely well...

breast cancer

Can Some Women With HER2-Positive Breast Cancer Forgo Surgery?

Breast cancer researchers at The University of Texas MD Anderson Cancer Center, Houston, are beginning to select patients with HER2-positive breast cancer who might forgo surgery after neoadjuvant chemotherapy. While this fine-tuning is currently intended to inform clinical trials—in particular, to ...

supportive care
symptom management

Virtual Reality May Improve Pain, Vision, Functioning in Patients With Cancer

Virtual reality can be used to improve functioning in patients with cancer, according to David Rhew, MD, Chief Medical Officer, Vice President and General Manager of Enterprise Healthcare, Samsung Electronics America. Research has shown that this technology can decrease pain and improve vision, as...

issues in oncology
geriatric oncology

Polypharmacy Associated With Functional Decline in Older Patients With Advanced Cancer

Polypharmacy (ie, the concurrent use of eight or more medications) and potentially inappropriate medications may be associated with functional impairment in older adults with advanced cancer, according to research presented by ­Mostafa Mohamed, MBBCh, at the Multinational Association of Supportive...

solid tumors

FDA Clears Next-Generation Scalp-Cooling Device

ON JUNE 27, 2019, the U.S. Food and Drug Administration (FDA) granted clearance of the DigniCap Delta scalp-cooling system to Dignitana, for use by health-care providers in the United States. The device is a fourth generation of the DigniCap scalp-cooling system. It is indicated to reduce the...

solid tumors

FDA Approves Pexidartinib for Tenosynovial Giant Cell Tumor

ON AUGUST 2, the U.S. Food and Drug Administration (FDA) granted approval to pexidartinib (Turalio) capsules for the treatment of adult patients with symptomatic tenosynovial giant cell tumor associated with severe morbidity or functional limitations and not responsive to improvement with surgery. ...

issues in oncology
pain management

Opioids for Cancer Pain: A Review of the Evidence and Current Challenges

In the wake of the opioid crisis in the United States, patients with cancer pain are often undeservedly confronted with rigid barriers to receiving the opioids they need. To compound this problem, the research around opioids in cancer pain has been limited—placebo-controlled trials are lacking,...

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