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lung cancer
pancreatic cancer
geriatric oncology

Chemotherapy Trial Results Overestimate Survival for Elderly Medicare Patients With Lung and Pancreatic Cancers

Results of clinical trials evaluating chemotherapy regimens for advanced pancreatic and lung cancers “tended to correctly estimate survival for Medicare patients aged 65 to 74 years but to overestimate survival for older Medicare patients by 6 to 8 weeks,” Elizabeth B. Lamont, MD, MS, of...

gynecologic cancers
issues in oncology

Bombarded With Changes in Health Care and Beyond, Gynecologic Oncologists Prepare for the Challenges Ahead

Physicians are being “bombarded” with changes in health care and beyond, Richard R. Barakat, MD, FACS, noted in his Presidential Address at the Society of Gynecologic Oncology (SGO) Annual Meeting on Women’s Cancer. These changes are being precipitated by steeply rising health-care costs amid...

gynecologic cancers

Combining Antiangiogenic and Vascular-Disrupting Agents Improves Progression-Free Survival in Persistent Ovarian Cancer

“Bevacizumab [Avastin] prevents new blood vessels from growing, but what about the blood vessels that are already in the tumor?” Presenting that challenge to participants at the Society of Gynecologic Oncology Annual Meeting on Women’s Cancer in Chicago, Bradley J. Monk, MD, of the University of...

gynecologic cancers

Groups Join Together to Form Ovarian Cancer Research Team

Stand Up To Cancer , Ovarian Cancer Research Fund, Ovarian Cancer National Alliance, and National Ovarian Cancer Coalition, along with the American Association for Cancer Research (AACR), announced the formation of a “Dream Team” devoted to ovarian cancer research at the AACR Annual Meeting 2015....

issues in oncology

People Living With HIV in the United States Have a 50% Excess Cancer Risk

The nearly 900,000 people in the United States living with diagnosed human immunodeficiency virus (HIV) infection have an excess cancer risk of 50%, according to a joint analysis of data by the National Cancer Institute and the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention,...

hepatobiliary cancer
supportive care

Therapy for Hepatitis C Virus Infection in Patients With Cancer May Prevent Liver Disease Progression

“Hepatitis C virus (HCV) infection is a neglected disease in patients with cancer,” Harrys A. Torres, MD, and colleagues from the University of Texas MD Anderson Cancer Center in Houston noted in the Journal of the National Comprehensive Cancer Network. To rectify that situation, the researchers...

lung cancer

EGFR L858R Mutation in Blood Sample May Serve as Surrogate for Biopsy in Determining EGFR-Mutation Status

Using a novel polymerase chain reaction assay “to efficiently assess” epidermal growth factor receptor (EGFR) mutations in circulating free DNA (cfDNA) from blood samples of patients with advanced non–small cell lung cancer (NSCLC), the Spanish Lung Cancer Group has “shown that the EGFR L858R...

lung cancer

Prior Cancer Does Not Affect Outcomes Among Patients With Advanced Lung Cancer, Suggesting They Be Included in Clinical Trials

Analysis of data from 102,929 patients with stage IV lung cancer found that “prior cancer does not convey an adverse effect on clinical outcomes, regardless of prior cancer stage, type, or timing.” Based on these findings, investigators from the Harold C. Simmons Cancer Center, University of Texas...

breast cancer

Emergency Room Visits and Hospitalizations Are Common Among Women With Early Breast Cancer Receiving Chemotherapy

Emergency room visits and hospitalizations are common among patients with early breast cancer receiving chemotherapy, particularly among those receiving a regimen containing docetaxel, according to a study supported by the Ontario Institute of Cancer Research, Toronto. “In this population-based...

Expect Questions About Physical Activity and Reduced Mortality Risks

A study finding that just doing some leisure time physical activity reduces overall and cancer-specific mortality by 20% and that more activity can provide even greater survival benefits concludes that health-care professionals should encourage inactive patients to perform more leisure time...

issues in oncology

Just Engaging in ‘Some’ Leisure Time Physical Activity Reduces Overall and Cancer-Specific Mortality

There’s good news for those who recognize the benefits of exercise but feel they have neither the time nor energy for frequent workouts: A recent study reported in JAMA Internal Medicine1 has found that just performing “some” leisure time physical activity, even below the recommended minimum level, ...

gynecologic cancers

PARP Inhibitors Have ‘Clear Benefit’ for Patients With Ovarian Cancer and BRCA Mutations, but When and at What Cost?

PARP inhibitors offer a promising alternative for targeted therapy in ovarian cancer” and have “clear benefit in BRCA-mutation carriers,” but questions remain about when is the best time to use them and the cost-effectiveness of maintenance therapy, Elizabeth M. Swisher, MD, of the University of...

gastroesophageal cancer

More Extensive Lymph Node Clearance During Surgery for Esophageal Cancer May Not Improve Survival

A population-based cohort study “indicates that more extensive lymph node clearance during surgery for esophageal cancer may not improve survival,” Maartje van der Schaaf, MD, PhD, of the Karolinska Institutet, Stockholm, and colleagues reported in the Journal of the National Cancer Institute....

leukemia

First-Line Imatinib With Early Switch to Nilotinib May Be Preferable to First-Line Use of More Potent Agents in CML

Using imatinib to treat chronic-phase chronic myeloid leukemia (CP-CML) first line, with selective switching to nilotinib (Tasigna) “leads to excellent molecular response and survival” and “may be preferable to universal first-line use of more potent agents, considering efficacy, toxicity, and...

supportive care

Expect Questions About Preventing Fractures After Stem Cell Transplant

Does the finding that the incidence of fractures is “compellingly higher” after hematopoietic stem cell transplantation mean that physicians counseling patients about transplant should feel compelled to discuss the fracture risks? Huifang Linda Lu, MD, PhD, the corresponding author of the study...

issues in oncology
hematologic malignancies
solid tumors

Incidence of Fractures Is ‘Compellingly Higher’ After Hematopoietic Stem Cell Transplantation

The incidence of fractures is “compellingly higher” after receiving hematopoietic stem cell transplantation, according to a retrospective study of patients receiving transplants for treatment of multiple myeloma, other hematologic malignancies, and some solid tumors (mostly breast and ovarian) as...

skin cancer

Patients’ Desire for Rapid Notification of Skin Biopsy Results Leads to Preference for Phone Call Over Face-to-Face Visit

Patients’ preference for how they receive biopsy results “has shifted from face-to-face visit to discussion over the telephone because of a desire for rapid notification,” according to a survey of 301 patients recruited at three different melanoma clinics. Although 67.1% of the patients preferred...

leukemia

Patients With Relapsed/Refractory CLL That Progresses Early on Ibrutinib Have Poor Outcomes

Most patients with relapsed/refractory chronic lymphocytic leukemia (CLL) who discontinued ibrutinib (Imbruvica) early “were difficult to treat and had poor outcomes,” according to a study of patients enrolled in four different clinical trials of ibrutinib, with or without rituximab (Rituxan), at...

lung cancer

Date of Last Chemotherapy Is Not a Proxy for Deciding When to Stop Treating Metastatic NSCLC

“Patients, their families, and oncologists recognize the administration of chemotherapy near death as aggressive and poor-quality care,” William F. Pirl, MD, MPH, and colleagues from Massachusetts General Hospital, Boston, wrote in the Journal of Oncology Practice. “However, rates have been slowly...

issues in oncology

Significant Differences in Age at Diagnosis Between Blacks and Whites for Six Types of Cancer

Although blacks were diagnosed at a younger age than whites for nearly every cancer type, after adjustments for population structure shifted the comparisons toward older ages among blacks, only six statistically significant differences of 3 or more years remained, according to a study in the...

Expect and Encourage Questions About the Benefits and Harms of Cancer Screening

Issuing advice for high-value care in screening for five common cancers, the High Value Care Task Force of the American College of Physicians (ACP) stated: “The target audience for this paper is all clinicians. The target patient population is average-risk, asymptomatic patients.” “What we tried...

issues in oncology

Agreement on High-Value Screening for Five Common Cancers

Finding agreement on high-value cancer screening among organizations publishing screening guidelines, the American College of Physicians (ACP) issued advice listing the least-intensive screening strategies that all the organizations recommend—as well as strategies not recommended—for five common...

thyroid cancer

Thyroid Cancer Rarely Diagnosed in Those With Asymptomatic, Benign Nodules

A prospective, multicenter, observational study involving 992 consecutive patients with one to four asymptomatic, sonographically or cytologically benign thyroid nodules found that “the majority of nodules exhibited no significant size change during 5 years of follow-up or actually decreased in...

leukemia

Durable Responses at 3-Year Follow-up for CLL Patients Receiving Single-Agent Ibrutinib

At a median follow-up of 3 years, ibrutinib (Imbruvica) demonstrated continued activity with durable responses that improved in quality with extended treatment of patients with chronic lymphocytic leukemia (CLL). In addition, grade 3 toxicity and adverse events leading to treatment discontinuation...

Expect Questions About Preventing Melanoma

A recent report from the Centers for Disease Control and Prevention (CDC) stated that the incidence of melanoma “doubled between 1982 and 2011, but comprehensive skin cancer prevention programs could prevent 20% of new cases between 2020 and 2030.”1,2 That report should serve to increase interest...

skin cancer

Capitalizing on Increased Interest in Skin Cancer During Summer to Reeducate People About Sunscreens and ‘Smart Sun Strategies’

Amid the encouraging studies reported at the 2015 ASCO Annual Meeting about advances in the treatment of melanoma was a troubling finding about the incidence of melanoma increasing. An analysis of data from nine Surveillance, Epidemiology, and End Results (SEER) registries found that the incidence...

hepatobiliary cancer

More Than One-Third of Those Diagnosed With Hepatocellular Carcinoma as Outpatients Have Diagnostic Delays of 3 or More Months

Nearly 20% of patients with hepatocellular carcinoma “wait more than 3 months from presentation to diagnosis, which can contribute to interval tumor growth,” Nishant Patel, MD, and colleagues concluded in the Journal of the National Comprehensive Cancer Network. They based their conclusions on a...

colorectal cancer

Collaboration Between Surgeons and Medical Oncologists Improves Outcomes for Patients With Stage III Colon Cancer

Collaboration between surgeons and medical oncologists “is associated with lower mortality without increased cost among patients with stage III colon cancer,” according to a study by ­Tanvir ­Hussain, MD, MSc, and colleagues from Johns Hopkins University School of Medicine, Baltimore, and the...

colorectal cancer

Statin Use Not Associated With Reduced Mortality Among Patients With Primary Colorectal Cancer

Statin use was not associated with reduced mortality among patients diagnosed with primary colorectal cancer between 2003 and 2009 and followed for a median of 3.4 years in the Darmkrebs: Chancen der Verhütung durch Screening (DACHS) study, an ongoing population-based study of colorectal cancer in...

colorectal cancer

Collaboration Between Surgeons and Medical Oncologists Improves Outcomes for Patients With Stage III Colon Cancer

Collaboration between surgeons and medical oncologists “is associated with lower mortality without increased cost among patients with stage III colon cancer,” according to a study by Tanvir ­Hussain, MD, MSc, and colleagues from Johns Hopkins University School of Medicine, Baltimore, and the...

skin cancer

Expect Questions About Increased Risk of Melanoma From Consuming Grapefruits and Orange Juice

Could too much citrus cause skin cancer?” was the lead-in of an NBC News item about a study linking consumption of grapefruits and oranges to an increased risk of melanoma.1 “Citrus consumption and skin cancer: How real is the link?” was the question posed by a headline in The Washington Post.2...

skin cancer

Public Urged Not to Overreact to Study Finding Link Between Citrus Fruits and Melanoma Risk

A study finding a link between citrus consumption and increased risk of melanoma1 may provide food for thought about the findings and implications as well as whet the appetite for more evidence, but according to several experts commenting on the study, it does not mean you should stop eating citrus ...

issues in oncology

Cancer Diagnosis Among Patients With Diabetes Reduced Adherence to Evidence-Based Medications

“A cancer diagnosis among patients with diabetes reduced adherence with evidence-based medications, particularly if patients’ life expectancy was short,” according to a study among Medicare beneficiaries reported in the Journal of Oncology Practice. “These findings emphasize the vulnerability of...

hepatobiliary cancer

More Than One-Third of Those Diagnosed With Hepatocellular Carcinoma as Outpatients Have Diagnostic Delays of 3 or More Months

Nearly 20% of patients with hepatocellular carcinoma “wait more than 3 months from presentation to diagnosis, which can contribute to interval tumor growth,” Nishant Patel, MD, and colleagues concluded in the Journal of the National Comprehensive Cancer Network. They based their conclusions on a...

issues in oncology

Determining Why Patients With HIV Infection and Non–AIDS-Defining Cancers Are Less Likely to Receive Cancer Treatment

A survey sent to medical and radiation oncologists to identify factors contributing to observed disparities in cancer treatment between patients infected with HIV and those not infected “found that a substantial proportion of physicians (21%) would alter their treatment recommendations based on HIV ...

lymphoma

Increased Lifetime Risk of Cardiovascular Disease for Patients Treated for Hodgkin Lymphoma

Survivors of Hodgkin lymphoma treated as adolescents or adults are at increased risk of cardiovascular diseases throughout their lives, according to results of a retrospective cohort study of 2,524 Dutch patients followed for a median of 20 years. “Treating physicians and patients should be aware...

colorectal cancer

Long-Term Use of Thyroid Hormone Replacement Linked to Decreased Risk of Colorectal Cancer

Long-term thyroid hormone replacement was associated with a decreased risk of colorectal cancer, but hyperthyroidism and untreated hypothyroidism were associated with a modestly elevated risk, according to a study using a large population-based medical records database from the United Kingdom. A...

Expect Questions or Ask About Postmastectomy Pain

Since postmastectomy pain occurs in an estimated 20% to 40% of patients undergoing the procedure, physicians who treat these women can expect questions about the pain and how to deal with it. However, some patients may be reluctant to ask about it. “Sometimes, women don’t want to complain to their ...

breast cancer
pain management

Increased Interest in Simple Injection to Treat Women With Postmastectomy Pain

After presenting results of a study showing that injecting a standard analgesic combination into trigger points of pain along the inframammary fold relieved postmastectomy pain, Laura J. Esserman, MD, MBA, Director of the Carol Franc Buck Breast Care Center and Co-Leader of the Breast Oncology...

leukemia

Azacitidine Increased Median Overall Survival Among Patients Aged 65 and Older With > 30% Blasts

A multicenter, randomized, open-label, phase III trial among the difficult-to-treat population of patients aged aged 65 and older with acute myeloid leukemia (AML) with > 30% bone marrow blasts “showed that azacitidine was associated with a clinically meaningful improvement” in median overall...

lung cancer

‘Encouraging Results’ With Newer EGFR TKIs in Patients With NSCLC Who Progressed After Prior EGFR TKI Therapy

Two studies of third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors among patients with non–small cell lung cancer (NSCLC) who had progressive disease following treatment with a first-generation EGFR tyrosine kinase inhibitor “show encouraging results,” according to...

prostate cancer

Decreased Mortality in Men With Unfavorable-Risk Prostate Cancer and Moderate or Severe Comorbidities Treated With Radiotherapy Alone

Men with unfavorable-risk prostate cancer and moderate or severe comorbidities had significantly decreased overall and cardiac mortality when treated with radiotherapy alone vs radiotherapy and androgen-deprivation therapy, according to a study described in a research letter in The Journal of the...

breast cancer

Diagnosis of Additional Small Cancers Suggests Screening Mammography Leads to Overdiagnosis

A study of screening mammography across U.S. counties found that “the clearest result of mammography screening is the diagnosis of additional small cancers” but without a “concomitant decline in the detection of larger cancers, which might explain the absence of any significant difference in the...

Expect Questions About Treatment for Ductal Carcinoma in Situ

The recent study findings that women diagnosed with ductal carcinoma in situ had a low breast cancer–specific mortality and that preventing ipsilateral recurrences did not prevent breast cancer mortality1 might lead some women diagnosed with ductal carcinoma in situ to question the need for...

breast cancer

Varied Reactions to Study Finding That Preventing Ipsilateral Recurrence Did Not Prevent Death From Breast Cancer

Women diagnosed with ductal carcinoma in situ have a low risk of dying of breast cancer, according to an observational study looking at data from 108,196 women diagnosed with ductal carcinoma in situ between 1988 and 2011.1 The breast cancer–specific mortality rate for these women was 1.1% at 10...

Clinical Implications of Survivorship Study Findings

Based on study findings presented at the 2015 ASCO Annual Meeting, Arif Kamal, MD, MHS, of Duke University, Durham, North Carolina, listed six points for clinicians to consider that could change practice now or in the near future for cancer survivors. “Drugs for cancer cachexia are on their...

supportive care
survivorship

Patient and Survivor Care Studies Yield Useful Results to Improve Quality of Life

Recent studies have yielded useful results that clinicians can put into practice, some right now, to help improve the quality of life for patients with cancer. Concerns addressed included cachexia, pain, “chemobrain,” and fertility preservation. At the Best of ASCO®/Chicago meeting, Arif ­Kamal,...

kidney cancer

Patient Characteristics Differ in Some Clinical Trials From Real-World Population

Patients with metastatic renal cell carcinoma treated with tyrosine kinase inhibitors in real-world clinical practice tend to be older and sicker than the patients enrolled in pivotal clinical trials of these agents. In addition, patients with metastatic renal cell carcinoma treated with the mTOR...

lung cancer

Patients Whose Treatment Included Bevacizumab Were More Likely to Experience Toxicity but Less Likely to Be Hospitalized

A study among patients with advanced non–small cell lung cancer (NSCLC) treated with carboplatin-paclitaxel or carboplatin-paclitaxel-bevacizumab (Avastin) found that those receiving the triplet were more likely to experience a toxicity event but less likely to be hospitalized within 180 days after ...

Expect Questions From Patients About Daily Aspirin to Prevent Colorectal Cancer

Updating previous recommendations, the U.S. Preventive Services Task Force now recommends low-dose aspirin for the primary prevention of colorectal cancer among most adults age 50 to 59. This a draft recommendation, but it has generated major media coverage noting that this is the first time the...

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