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solid tumors
bladder cancer

Neoadjuvant Dose-Dense Methotrexate, Vinblastine, Doxorubicin, Cisplatin With Pegfilgrastim: Safe and Effective in Muscle-Invasive Urothelial Cancer

In a phase II trial reported in the Journal of Clinical Oncology, Choueiri et al found that a neoadjuvant four-cycle/8-week regimen of dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin was well tolerated and effective in patients with muscle-invasive urothelial cancer. Study Details ...

supportive care
issues in oncology
issues in oncology

Frequent but Nontargeted Use of Pharmacologic Thromboprophylaxis in Hospitalized Patients With Cancer

Retrospective studies have shown that pharmacologic thromboprophylaxis is underutilized in hospitalized patients with cancer, who are believed to be at high risk of venous thromboembolism. In a prospective cross-sectional study reported in Journal of Clinical Oncology, Zwicker et al found that...

lymphoma

Diffuse Erythema Predicts Complete Remission of Skin Disease With Alemtuzumab in Leukemic Cutaneous T-Cell Lymphoma

As reported in a research letter in JAMA Dermatology, Watanabe et al found that diffuse erythema at presentation in patients with leukemic T-cell lymphoma was associated with better response to low-dose alemtuzumab (Campath) compared with patients presenting with preexisting plaques or tumors....

issues in oncology
colorectal cancer

Phase II Feasibility Study Tests Four Molecular-Based Hypotheses in Advanced Colorectal Cancer

In a phase II feasibility study (MRC FOCUS3) reported in British Journal of Cancer, Maughan et al used KRAS and BRAF mutation status and topoisomerase-1 expression status to randomly assign patients with advanced colorectal cancer to molecular hypothesis–driven treatment or control treatment. ...

skin cancer

Squamous Cell Carcinoma Within Advanced Basal Cell Carcinoma During Vismodegib Treatment: Importance of Serial Biopsy

In a report in JAMA Dermatology, Zhu et al discuss two cases in which clinically significant squamous cell carcinoma was found within the tumor bed of locally advanced basal cell carcinoma during vismodegib (Erivedge) treatment for basal cell carcinoma. In one, basal cell carcinoma tumor shrinkage...

lymphoma

PET Plus CT-Assessed Relative Tumor Size Reduction After Chemotherapy Identifies High Risk for Progression and Relapse in Advanced Hodgkin Lymphoma

Positive positron-emission tomography (PET) scans have low positive predictive value after chemotherapy in patients with Hodgkin lymphoma. In a study reported in the Journal of Clinical Oncology, Kobe et al assessed whether use of pretreatment and post-treatment computed tomography (CT) could...

prostate cancer
issues in oncology

Tools for Identifying Pathologically Insignificant Prostate Cancer Are Inaccurate In Unscreened Men

In a study reported in British Journal of Cancer, Shaw et al assessed the accuracy of several reported criteria for identifying insignificant prostate cancer for active surveillance in a population of unscreened men. None of the examined tools provided sufficient discrimination of insignificant...

issues in oncology

Cowden Syndrome With Germline PTEN Mutations Puts Patients at High Risk of Second Cancers

Cowden syndrome, an autosomal-dominant disorder characterized by the development multiple hamartomas, is associated with increased risk of breast, thyroid, endometrial, and renal cancers in patients with underlying germline PTEN mutations. In a study reported in the Journal of Clinical Oncology,...

breast cancer

Incidence of Breast Cancer According to Joint Hormone Receptor and HER2 Status Differs According to Race/Ethnicity and Other Factors

In 2010, Surveillance, Epidemiology, and End Results (SEER) registries began collecting data on HER2 receptor status in breast cancer cases. In a study reported in the Journal of the National Cancer Institute, Howlader et al identified U.S. incidence rates for breast cancer by joint hormone...

colorectal cancer

No Difference in Postsurgery Fatigue With Laparoscopic vs Open Surgery for Colorectal Cancer With Enhanced Recovery Program

In a UK trial (EnROL) reported in the Journal of Clinical Oncology, Kennedy et al compared outcomes with open vs laparoscopic resection of colorectal cancer within a multimodality enhanced recovery program. Such programs are intended to improve all aspects of perioperative care and have been shown...

hepatobiliary cancer

Tumor Factors Associated With Poorer Overall Survival in Patients With Intrahepatic Cholangiocarcinoma Undergoing Curative Intent Surgery

There are limited data on outcomes after surgery for intrahepatic cholangiocarcinoma. In a systematic review and meta-analysis reported in JAMA Surgery, Mavros et al found that tumor characteristics are the primary predictors of survival after curative intent surgery, indicating the need for...

breast cancer
issues in oncology

False-Positive Screening Mammograms Associated With Short-Term Anxiety but No Reduced Intention to Undergo Subsequent Mammography

The effect of false-positive mammograms on women undergoing screening is being investigated by the U.S. Preventive Services Task Force. In a study reported in JAMA Internal Medicine, Tosteson et al assessed responses to false-positive screening mammograms. According to the authors, their findings...

supportive care

Magnetic Resonance–Guided Focused Ultrasound Reduces Pain From Bone Metastases

Few options are available to treat pain from bone metastases in patients refractory to drug and radiation therapy. In a phase III study reported in the Journal of the National Cancer Institute, Hurwitz et al found significant pain relief using magnetic resonance–guided focused ultrasound...

breast cancer

Adding Neoadjuvant Carboplatin to Taxane, Anthracycline, and Targeted Therapy Increases Pathologic Complete Response in Triple-Negative Breast Cancer

Preclinical data suggest that triple-negative breast cancer is sensitive to interstrand crosslinking agents and that the combination of a taxane, trastuzumab (Herceptin), and a platinum may have synergistic effects in HER2-positive breast cancer. In a randomized phase II trial (GeparSixto, German...

colorectal cancer
issues in oncology

Lower Densities of Gastroenterologists, General Surgeons, and Radiation Oncologists in Rural vs Urban U.S. Counties

Geographic proximity to services has been identified as a potential barrier to cancer screening, and there is evidence of disparity in colorectal cancer outcomes between urban and rural U.S. residents. In a study reported in JAMA Surgery, Aboagye et al identified a significantly greater density of...

leukemia

Good Prognosis for High-Risk Ph-Negative ALL With Chemotherapy After Early Cytologic Response and Low Minimal Residual Disease Level on Flow Cytometry

In a Spanish trial (PETHEMA ALL-AR-03) reported in the Journal of Clinical Oncology, Ribera et al found high disease-free and overall survival rates with delayed consolidation and maintenance chemotherapy in high-risk Philadelphia chromosome–negative acute lymphoblastic leukemia (ALL)...

hepatobiliary cancer

High Preoperative Hepatitis B Surface Antigen Level Predicts Hepatocellular Carcinoma Recurrence in Patients With Low HBV DNA

In a Chinese study reported in JAMA Surgery, Huang et al found that preoperative elevated hepatitis B virus (HBV) surface antigen (HBsAg) level is an independent risk factor for hepatocellular carcinoma recurrence and mortality in patients with low HBV DNA levels undergoing hepatic resection....

breast cancer

Ado-Trastuzumab Emtansine Improves Progression-Free Survival vs Physician’s Choice in Previously Treated Advanced HER2-Positive Breast Cancer

There are few treatment options for breast cancer patients with progressive disease after two or more HER2-directed regimens for recurrent or metastatic disease. In the open-label phase III TH3RESA trial reported in The Lancet Oncology by Krop and et al, ado-trastuzumab emtansine (Kadcyla)...

survivorship

Minority of Oncologists and Primary Care Physicians Fully Discuss Survivorship Care Plans With Cancer Survivors

Of 53 National Cancer Institute cancer centers, only 43% report implementing survivorship care plans for at least some of their cancer survivors. In a study reported in the Journal of Clinical Oncology, Blanch-Hartigan et al found that a minority of a nationally representative sample of oncologists ...

head and neck cancer

No Apparent Increase in Risk of Oral HPV Infection in Sexual Partners of HPV-Positive Patients With Oropharyngeal Cancer

In a study reported in the Journal of Clinical Oncology, D’Souza et al found that while human papillomavirus (HPV)-positive patients with oropharyngeal cancer had high prevelances of oncogenic oral HPV DNA and oral HPV16 DNA, their sexual partners did not appear to have increased risk of...

breast cancer

ASCO Releases Companion Guideline on Disease Management for Patients With Advanced HER2-Positive Breast Cancer and Brain Metastases

As many as half of patients with metastatic HER2-positive breast cancer develop brain metastases over time. The American Society of Clinical Oncology recently released a clinical practice guideline on disease management for patients with advanced HER2-positive breast cancer and brain metastases. A...

breast cancer

ASCO Releases Clinical Practice Guideline on Systemic Therapy for Patients With Advanced HER2-Positive Breast Cancer

Approximately 15% of patients with breast cancer have tumors that overexpress the HER2 protein, and these patients can benefit from HER2-targeted therapies. The American Society of Clinical Oncology recently released a clinical practice guideline on systemic therapy for patients with advanced...

lung cancer
supportive care

Modafinil Not Better Than Placebo for Fatigue in Lung Cancer Patients

In a trial reported in the Journal of Clinical Oncology, Spathis et al found that that the central nervous system (CNS) stimulant modafinil had no effect on fatigue compared with placebo in patients with advanced non–small cell lung cancer (NSCLC). Fatigue improved in both groups during the...

head and neck cancer

Increased Incidence of Thyroid Cancer: An Epidemic of Diagnosis?

In a study reported in JAMA Otolaryngology Head & Neck Surgery, Davies and Gilbert found that the incidence of thyroid cancer has nearly tripled since 1975. However, the increase appears to represent an “epidemic of diagnosis” and to almost exclusively represent increased diagnosis...

kidney cancer
kidney cancer

Final Overall Survival Results Show No Difference for Pazopanib vs Sunitinib in First-Line Treatment of Clear Cell Metastatic Renal Cell Carcinoma

A phase III trial reported in 2013 showed noninferiority of pazopanib (Votrient) vs sunitinib (Sutent) for progression-free survival in first-line treatment of clear cell metastatic renal cell carcinoma. In a letter to the editor in The New England Journal of Medicine, Motzer et al provided the...

head and neck cancer

Black Patients With Salivary Gland Mucoepidermoid or Squamous Cell Carcinoma Have Poorer Disease-Specific Survival Than White Patients

In a retrospective study of salivary gland cancer survival reported in JAMA Otolaryngology Head & Neck Surgery, Russell et al found black patients with mucoepidermoid or squamous cell carcinoma have poorer disease-specific survival than white patients, with no difference being observed between...

Anti–Interleukin-1 Alpha Antibody MABp1 Is Well Tolerated, Safe, and Active in Phase I Trial in Refractory Cancers

Expression of the inflammatory cytokine interleukin (IL)-1 alpha is a very early step in the inflammatory response that characterizes the malignant phenotype and that is associated with angiogenesis, tumor invasiveness, metastasis, and cachexia. In a phase I dose-escalation study reported in The...

gastroesophageal cancer

Irradiated Stents Prolong Survival and Reduce Dysphagia Compared With Conventional Stents as Palliative Treatment in Unresectable Esophageal Cancer

In a single-blind phase III trial reported in The Lancet Oncology, Zhu et al compared the use of 125iodine seed–loaded vs conventional covered stents along with single high-dose brachytherapy as palliative treatment in patients with unresectable esophageal cancer. Use of the irradiated stents ...

head and neck cancer

Differences in Lifestyle Habits and Poorer Adherence to Radiation Therapy in Patients With HPV-Negative vs HPV-Positive Oropharyngeal Carcinoma

Different mechanisms of carcinogenesis and molecular characteristics have been proposed for human papillomavirus (HPV)-positive and HPV-negative oropharyngeal carcinomas, and better outcomes have been observed in patients with HPV-positive tumors. Some experts advocate classification of the two as...

breast cancer
survivorship

Cumulative Risk of Breast Cancer Reaches 30% by Age 50 After Chest Irradiation for Childhood Cancer

The incidence of breast cancer in women treated with chest radiation therapy for childhood cancer previously has been estimated at 5% to 14% by age 40 years and is among the highest reported for any population. In a study reported in the Journal of Clinical Oncology, Moskowitz et al found that the...

head and neck cancer
solid tumors

No Difference in Disease-Free Survival but Less Steroid Dependence With Adrenal-Sparing Surgery vs Adrenalectomy in Pheochromocytoma

Molecular diagnosis and preventive surgery have been successful in preventing medullary thyroid cancer in patients with multiple endocrine neoplasia type 2 syndrome. In a retrospective population-based study reported in The Lancet Oncology, Castinetti et al found no difference in disease-free...

head and neck cancer

Sorafenib Improves Progression-Free Survival in Progressive Radioactive Iodine–Refractory Differentiated Thyroid Cancer

Patients with radioactive iodine-refractory, locally advanced or metastatic differentiated thyroid cancer have a poor prognosis. In the double-blind phase III DECISION trial reported in The Lancet, Brose et al found that sorafenib (Nexavar) increased progression-free survival in this setting. The...

colorectal cancer

Tumor Regression Grading After Preoperative Chemoradiotherapy for Rectal Carcinoma Predicts Distant Metastasis Risk and Disease-Free Survival

In a study reported in the Journal of Clinical Oncology, Fokas et al found that prospectively evaluated tumor regression grading was a significant prognostic factor for distant metastasis and disease-free survival after 132 months of follow-up in patients with locally advanced rectal carcinoma...

lung cancer

First-Generation EGFR Tyrosine Kinase Inhibitors Associated With Poorer Progression-Free Survival vs Conventional Chemotherapy in EGFR Wild-Type NSCLC

Activating EGFR mutations are found in approximately 10% of Western patients and 50% of Asian patients with non–small cell lung cancer (NSCLC), and EGFR tyrosine kinase inhibitors are recommended for use in first-line treatment in this setting. Both tyrosine kinase inhibitors and cytotoxic...

head and neck cancer
supportive care

Doxepin Rinse Reduces Radiotherapy-Associated Oral Mucositis Pain in Patients With Head and Neck Cancer

In a phase III double-blind crossover trial (North Central Cancer Treatment Group [NCCTG] N09C6, Alliance for Clinical Trials in Oncology cooperative group) reported in the Journal of Clinical Oncology, Leenstra et al found that oral doxepin hydrochloride rinse significantly reduced...

breast cancer

Ado-Trastuzumab Emtansine Plus Pertuzumab Shows Activity and No Unexpected Toxicity in HER2-Positive Locally Advanced or Metastatic Breast Cancer

In a phase IIa trial reported in the Journal of Clinical Oncology, Miller et al assessed combined HER2-targeted therapy with the antibody-drug conjugate ado-trastuzumab emtansine (Kadcyla) and pertuzumab (Perjeta) in women with HER2-positive locally advanced or metastatic breast cancer. Pertuzumab...

colorectal cancer

Study Shows Decreasing Numbers of Colorectal Cancer Resections and Improved In-Hospital Mortality in Older Patients

Nationwide data on mortality and morbidity from colorectal cancer resections in the aging population are lacking. In a study reported in JAMA Surgery, Jafari et al found that there has been an overall decrease in numbers of resections and improved in-hospital mortality in older patients, although...

breast cancer

Adding Everolimus to Trastuzumab/Vinorelbine Prolongs Progression-Free Survival but Increases Toxicity in Trastuzumab-Resistant Advanced Breast Cancer

Disease progression in HER2-positive breast cancer treated with trastuzumab (Herceptin) may be associated with PI3K/Akt/mTOR pathway activation, and use of an mTOR inhibitor might restore trastuzumab sensitivity. In the double-blind phase III BOLERO-3 trial reported in The Lancet Oncology,...

skin cancer

Swedish Men Living Alone Have Later Stage at Diagnosis and Worse Survival in Cutaneous Malignant Melanoma

In a population-based study reported in the Journal of Clinical Oncology, Eriksson et al found that Swedish men with cutaneous malignant melanoma have more advanced stage at diagnosis and worse disease-specific survival if they live alone. Women living alone did not have worse disease-specific...

hematologic malignancies
supportive care

Addition of Tigecycline to Empiric Therapy Improves Success Rate in Febrile Neutropenic Patients With Hematologic Malignancy

Antibiotic monotherapy is considered standard in empiric therapy in febrile neutropenic cancer patients, but the approach may be insufficient given the increase in infections due to multidrug-resistant microorganisms. Tigecycline (Tygacil), the first in a new class of glycylcycline antibiotics, has ...

skin cancer

Sildenafil Use May Be Associated With Increased Risk of Melanoma

In a prospective cohort study reported in JAMA Internal Medicine, Li et al found that recent and ever use of sildenafil for erectile dysfunction was associated with increased risk of subsequent melanoma, but not squamous cell or basal cell carcinoma. The RAS/RAF/MAPK and ERK kinase/ERK cascade is...

breast cancer

High Total/Saturated Fat Intake Associated With Increased Risk of Hormone Receptor–Positive Breast Cancer and HER2-Negative Breast Cancer

In an analysis from the EPIC study reported in the Journal of the National Cancer Institute, Sieri et al found that high dietary intake of total fat and saturated fat were associated with increased risk of estrogen receptor–positive/progesterone receptor–positive breast cancer and that...

skin cancer

Interim Analysis of Phase III AVAST-M Trial Shows No Overall Survival Benefit of Adjuvant Bevacizumab vs Observation in High-Risk Melanoma

Bevacizumab has exhibited limited activity in advanced melanoma. In an interim analysis of the open-label phase III AVAST-M trial reported in The Lancet Oncology, Corrie et al found that adjuvant bevacizumab (Avastin) in patients with resected melanoma at high risk of recurrence has thus far...

gynecologic cancers
issues in oncology

Gene Signatures Identified by Meta-Analysis Predict Survival and Suboptimal Debulking in Late-Stage Ovarian Cancer

As reported in the Journal of the National Cancer Institute, Riester et al have identified gene-expression signatures predictive of survival and debulking status in late-stage ovarian cancer. Study Details The study involved meta-analytic techniques using integrated data from 13 publicly...

prostate cancer

European Phase II Study Indicates Activity of Enzalutamide in Hormone-Naive Prostate Cancer

As reported in The Lancet Oncology by Tombal et al, a single-arm phase II trial of the androgen receptor inhibitor enzalutamide (Xtandi) has shown that the agent is active in suppressing disease and well tolerated in men with hormone-naive prostate cancer. In this ongoing trial, 67 men with...

lung cancer
issues in oncology

‘Too Much and Too Little Care’ in Pulmonary Nodule Evaluation

Pulmonary nodules are common and many more will be found with implementation of lung cancer screening. In a retrospective cohort study reported in JAMA Internal Medicine, Wiener et al found that patients with pulmonary nodules were at high risk of both underevaluation and overevaluation for cancer, ...

colorectal cancer
issues in oncology

Colonoscopy Adenoma Detection Rate Is Inversely Proportional to Risk of Interval Colorectal Cancer and Colorectal Cancer Mortality

In a study of health-care organization data reported in The New England Journal of Medicine, Corley et al assessed the relationship between proportion of colonoscopies performed by a gastroenterologist that detect an adenoma and risk of subsequent interval colorectal cancer and colorectal cancer...

skin cancer
head and neck cancer
skin cancer

Total Parotidectomy May Benefit Patients With Cutaneous Squamous Cell Carcinoma or Malignant Melanoma With Metastasis to the Parotid Superficial Lobe

The optimal extent of surgical resection is unclear in patients with parotid superficial lobe lymph node metastasis from cutaneous squamous cell carcinoma and malignant melanoma. In a single-institution retrospective review reported in JAMA Otolaryngology Head & Neck Surgery, Thom et al found...

colorectal cancer

Panitumumab Not Inferior to Cetuximab in Overall Survival in Chemotherapy-Refractory Wild-Type KRAS Metastatic Colorectal Cancer

In the open-label noninferiority phase III ASPECCT trial reported in The Lancet Oncology, Price et al found that anti-EGFR monoclonal antibody treatment with panitumumab (Vectibix) produced a noninferior overall survival outcome vs cetuximab (Erbitux) in patients with chemotherapy-refractory...

leukemia

Novel Prognostic Indices Validated for Cytogenetically Normal Acute Myeloid Leukemia

Cytogenetically normal acute myeloid leukemia (AML) is the largest and most heterogeneous cytogenetic AML subgroup. As reported in the Journal of Clinical Oncology, Pastore et al have developed a widely applicable prognostic model for cytogenetically normal AML that combines established patient and ...

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