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cns cancers

Combination Therapy May Be Better Than Radiotherapy Alone to Treat Aggressive Brain Cancer, According to Early Study

Radiotherapy effectively damages brain tumors, but the cancer cells can repair themselves in order to live on. Now, researchers at Sidney Kimmel Cancer Center at Thomas Jefferson University have tested a strategy that combines radiotherapy with a drug that shuts down the ability of tumor to mend...

supportive care

Family Perspectives Support Advance Care Planning With Patient Preferences in End-of-Life Care

Three measures of aggressive end-of-life care “were associated with relatively large differences in family member–reported quality ratings for end-of-life care and a lower likelihood that patients with advanced-stage cancer received care congruent with their preferences,”...

colorectal cancer

High Expression of Epiregulin or Amphiregulin Predicts Benefit of Panitumumab in RAS Wild-Type Advanced Colorectal Cancer

In the UK phase III PICCOLO trial reported in JAMA Oncology, Seligmann et al found that high expression of either of the epidermal growth factor receptor (EGFR) ligands epiregulin or amphiregulin was associated with a progression-free survival benefit with panitumumab (Vectibix)/irinotecan vs...

hematologic malignancies
leukemia

Increasing the Dose of Obinutuzumab Monotherapy Raised the Response Rate

A randomized phase II study in symptomatic, untreated patients with chronic lymphocytic leukemia (CLL) found an increased overall response rate with obinutuzumab (Gazyva) at a 2,000 mg vs 1,000 dose. In addition, the “data demonstrate that obinutuzumab produces a higher response rate in...

gastrointestinal cancer

‘Red-Flag’ Symptoms That Could Signal Colorectal Cancer in Patients Under 50 Years Old Should Be Taken Seriously

In clinical practice, Samantha Hendren, MD, MPH, has been “shocked by what a large proportion of patients we are seeing who are under 50 and presenting with colorectal cancer,” often with advanced disease due to delayed diagnosis. “And that is because patients and physicians don’t even think of...

symptom management

Selected Abstracts From 2015 ASH Annual Meeting: Part 3

Here are several more abstracts selected from the proceedings of the 2015 American Society of Hematology (ASH) Annual Meeting and Exposition, focusing on the topic of anticoagulation and the cancer patient. For other selected abstracts from this conference, see the December 25, 2015, and the...

legislation
health-care policy

An Increase for the National Institutes of Health Budget

The National Institutes of Health (NIH) received a nearly $2 billion funding increase—the first large increase for the agency in more than 12 years—in the federal omnibus spending bill Congress passed on December 18, 2015. And President Barack Obama signed the bill into law a day later. The 6.6%...

sarcoma

Eribulin Mesylate in Advanced Liposarcoma Previously Treated With an Anthracycline

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On January 28, 2016, eribulin mesylate (Halaven) was approved for...

solid tumors

Comprehensive Genomic Analysis Reveals New Genetic Insights Into Malignant Mesothelioma

Malignant mesothelioma is a rare but deadly form of cancer; the 5-year survival rate for patients diagnosed with the disease is between 5% and 10%. Although aggressive surgery can help some patients with early-stage mesothelioma, current treatments for patients with more advanced mesothelioma are...

breast cancer

Geriatric Assessment Is Key to Treatment Decisions for Patients 80 Years and Older With Breast Cancer

A review of major studies and the current literature underscored the role of geriatric assessment in making treatment recommendations for patients aged 80 years and older with early and metastatic breast cancer. The review was reported by Shachar et al in the Journal of Oncology Practice. The...

breast cancer

Role of Ado-Trastuzumab Emtansine in Metastatic Breast Cancer Solidified

Ado-trastuzumab emtansine (formerly T-DM1; Kadcyla) improved overall survival compared with treatment of physician’s choice of therapy for patients with pretreated HER2-positive metastatic breast cancer, according to the phase III TH3RESA trial.1 Patients enrolled in the trial had previously been...

Expert Point of View: Kathy S. ­Albain, MD, FACP, FASCO, and Jame Abraham, MD

The general consensus of breast cancer experts of the initial findings of BCIRG-006 triggered a more judicious use of anthracyclines, and this trend continues. Kathy S. ­Albain, MD, FACP, FASCO, Professor of Medicine at Loyola University Chicago Stritch School of Medicine, Maywood, Illinois, said...

breast cancer

Final Analysis of BCIRG-006 Supports Use of Non–Anthracycline-Containing Regimen in Treatment of Women With Early Breast Cancer

The final analysis of the BCIRG-006 trial confirmed the long-term efficacy of trastuzumab (Herceptin) in early breast cancer and also validated the concept that anthracyclines increase toxicity and they are not always necessary for a good outcome.1 The 10-year follow-up of the landmark trial was...

Making the Most of Poster Sessions

Nathan A. Pennell, MD, PhD, an Associate Professor and Director of the Lung Cancer Medical Oncology Program at the Cleveland Clinic Taussig Cancer Institute and a Poster Walk leader at the 2015 ASCO Annual Meeting, offers advice for anyone planning to attend a Poster Session: Plan ahead. Make sure ...

palliative care

2015 Palliative Care in Oncology Symposium Highlights

The Palliative Care in Oncology Symposium, held October 9–10, 2015, in Boston, Massachusetts, brought together more than 670 members of the cancer care community, including oncologists, radiologists, palliative care specialists, nurses, and patient advocates. Sessions delivered information on...

ASCO Recommends Improvements to Medicare for Managing Multiple Chronic Conditions

ASCO has submitted comments to the U.S. Senate Finance Committee Chronic Care Working Group regarding the Bipartisan Chronic Care Working Group Policy Options document published in December 2015. The society commended the working group for its efforts to improve the Medicare program for...

breast cancer

Advanced Imaging May Be Unnecessary for Many Women With Early Breast Cancer, but Rate of Such Testing Remains High

Up to 60% of the computed tomography (CT) scans, bone scans, and positron emission tomography (PET) scans performed for more than 29,000 Michigan women diagnosed with early breast cancer between 2008 and 2014 could not be medically justified based on retrospective record review, according to the...

hematologic malignancies
multiple myeloma

Carfilzomib Plus Dexamethasone in Previously Treated Multiple Myeloma

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On January 21, 2016, carfilzomib (Kyprolis) was approved for use in ...

health-care policy

Pediatric Oncology Groups Endorse Ethical Framework for Rationing Scarce Drugs

The Children’s Oncology Group (COG) and the American Society of Pediatric Hematology/Oncology (ASPHO) have endorsed formal clinical recommendations for rationing chemotherapy and supportive care agents during times of shortage. The guidance is needed because persistent shortages of many standard...

lung cancer
issues in oncology
gastroesophageal cancer

PET Scan Use in Follow-up Care for Lung and Esophageal Cancer Shows Wide Variation Between Hospitals, No Impact on Survival

A new study suggests that one approach to watching for a cancer's return is being inappropriately used at many hospitals and isn't helping patients survive longer. The findings are published by Healy et al in the Journal of the National Cancer Institute. The study looked at how often survivors ...

Expert Point of View: Ravi Vij, MD

“These are very exciting data,” said Ravi Vij, MD, Professor of Medicine at Washington University in St. Louis, School of Medicine. “To see such responses in a phase I study in such a relapsed/refractory disease is indeed amazing.” “We have already seen the value of immunomodulatory drugs and...

colorectal cancer
issues in oncology

Half of Elderly Patients With Colorectal Cancer Receive Expensive Therapy With Little Survival Benefit

A study published by Bradley et al in Medical Care showed that over a recent 10-year period, the rate of metastatic colorectal cancer patients older than age 75 receiving three or more treatments increased from 2% to 53%. During this period, 1-year treatment costs increased 32% to reach an...

prostate cancer

Hypofractionation Is Ready for Prime Time in Prostate Cancer, but Will It Be Adopted?

Separate phase III trials presented at the 2016 Genitourinary Cancers Symposium demonstrated that modest hypofractionated radiotherapy is noninferior to conventional radiotherapy for men with intermediate- and low-risk prostate cancer and should be considered a new standard of care.1,2 However, it...

Expert Point of View: Irvin M. Modlin, MD, Lisa Bodei, MD, and Eric Liu, MD

The ASCO Post interviewed Irvin M. Modlin, MD, Emeritus Professor of Gastroenterological Surgery, Yale University School of Medicine, regarding his thoughts on the NETTER-1 results and peptide receptor radionuclide therapies for neuroendocrine tumors. Dr. Modlin led the first study of a peptide...

gastrointestinal cancer

Radiolabeled Somatostatin Analog May Represent A Paradigm Change in the Treatment of Neuroendocrine Tumors

A radiolabeled somatostatin analog compound, 177Lu-DOTA0-Tyr3-Octreotate (Lu-177 dotatate), reduced the risk of disease progression or death by 79% in the international phase III NETTER-1 population of previously treated, advanced neuroendocrine tumors of midgut origin.1 Lu-177 dotatate belongs to...

Nuns Work Where None Work

It was December 9, 1975—a cold morning in the tribal village in Mahuadanr in Bihar, India. The valley was filled with an eerie mist coming down from the hills surrounding the village. Champa, a 5-year-old malnourished girl with sunken eyes, an emaciated face, and a huge ascites, was carried by her...

issues in oncology

ASCO Provides Support and Guidance for the White House Cancer Moonshot Initiative

Although President Richard Nixon signed the National Cancer Act in 1971, essentially declaring a war on cancer, the genesis of the idea had actually been born 2 years earlier, after the first landing on the moon set off a new era of scientific exploration and sparked a belief that any scientific...

Expert Point of View: Irvin M. Modlin, MD, and Eric Liu, MD

Two neuroendocrine tumor experts had slightly different reactions to the latest RADIANT-4 data. Irvin M. Modlin, MD, Emeritus Professor of Gastroenterological Surgery at Yale University School of Medicine, New Haven, Connecticut, said in an interview that he essentially restricts his use of...

lung cancer

Metabolic Phenotyping of Blood Plasma Allows for the Detection of Lung Cancer

Metabolic phenotyping of blood plasma by proton nuclear magnetic resonance (H-NMR) identified unique metabolic biomarkers specific to lung cancer patients and allowed for the accurate identification of a cohort of patients with early and late-stage lung cancer. These findings were published by...

lung cancer

Racial/Ethnic Variations in Lung Cancer Incidence and Mortality in the Women’s Health Initiative Study Cohort

As reported by Patel et al in the Journal of Clinical Oncology, analysis of lung cancer incidence and mortality in the Women’s Health Initiative Study cohort of postmenopausal women showed a marginally significant lower risk of cancer in Hispanic women vs white women and no difference in...

breast cancer

Breast Reconstruction Using Abdominal Tissue: Differences in Outcome With Four Techniques

In women undergoing breast reconstruction using autologous tissue, newer muscle-sparing abdominal flaps can reduce complications while improving some aspects of quality of life, according to a study by Macadem et al in Plastic and Reconstructive Surgery. Comparison of four types of abdominal flaps ...

cns cancers

Single-Center Study Evaluates Proton Radiotherapy for Pediatric Medulloblastoma

In a phase II study reported in The Lancet Oncology by Yock et al, use of proton radiotherapy for pediatric medulloblastoma was associated with acceptable long-term toxic effects and good survival outcomes. Study Details In the study, 59 patients aged 3 to 21 years were treated at...

issues in oncology

Ethan Basch, MD, on Assessing Quality: Patient-Reported Data

Ethan Basch, MD, of the University of North Carolina at Chapel Hill, summarizes a session he chaired on the burgeoning use of patient-reported outcomes and wearable sensors in clinical practice and research.

supportive care

2016 Quality Care Symposium: New Triage System Decreases Emergency Room Visits by Oncology Patients in Florida

A quality improvement initiative to reduce patients’ reliance on emergency room (ER) visits to treat cancer treatment side effects has shown to be highly effective, according to early findings from a new study. The strategy, involving a telephone triage service coupled with patient education, ...

cost of care

2016 Quality Care Symposium: Online Tool Improves Access to Information on Cancer Treatment Costs

To facilitate doctor/patient conversations about costs of cancer care, researchers developed and piloted an online tool for oncologists. The innovative resource lists prices for the 50 most commonly prescribed cancer treatment regimens. A survey of the pilot users at four clinics in Washington...

breast cancer

2016 Quality Care Symposium: Study Suggests Many Women With Early Breast Cancer Receive Unnecessary Imaging Tests

A new study suggests that up to 60% of the computed tomography (CT) scans, bone scans, and positron-emission tomography (PET) scans performed for more than 29,000 Michigan women diagnosed with early breast cancer between 2008 and 2014 could not be medically justified based on retrospective record...

gynecologic cancers

Study Finds No Adverse Impact of Minimally Invasive Hysterectomy on Long-Term Survival in Endometrial Cancer

Use of minimally invasive hysterectomy did not seem to have an adverse impact on long-term survival in women with endometrial cancer, according to an analysis reported in the Journal of Clinical Oncology by Wright et al. Study Details The study involved Surveillance, Epidemiology, and End Result...

lymphoma

FDA Approves Obinutuzumab in Follicular Lymphoma

The U.S. Food and Drug Administration (FDA) today approved obinutuzumab (Gazyva) for use in combination with bendamustine (Bendeka, Treanda) followed by obinutuzumab monotherapy for the treatment of patients with follicular lymphoma who relapsed after, or are refractory to, a rituximab...

hepatobiliary cancer

Single-Center Trial Indicates No Benefit of Hepatic Artery Chemoembolization vs Embolization in Hepatocellular Carcinoma

In a phase II study reported in the Journal of Clinical Oncology, Brown et al found no apparent benefit of hepatic artery chemoembolization using doxorubicin-eluting microspheres vs embolization with microspheres alone in patients with hepatocellular carcinoma. Study Details In the trial, 101...

head and neck cancer

2016 Head and Neck Cancer Symposium: Induction Chemotherapy Does Not Predict Survival Advantage Over Concurrent Chemoradiation

Head and neck cancer patients who receive induction chemotherapy rather than the standard treatment of concurrent chemoradiation do not benefit from increased survival rates and are less likely to receive a full course of radiation, according to research presented by Stokes et al at the 2016...

issues in oncology
gynecologic cancers
head and neck cancer

100% of NCI-Designated Cancer Centers Endorse the Promotion of the HPV Vaccination for Cancer Prevention

All National Cancer Institute (NCI)-designated cancer centers have united to support human papillomavirus (HPV) vaccination (see below). A team of HPV experts drafted a consensus statement that advises widespread use of HPV vaccines to prevent cancer. HPV causes cancer of the cervix, anus, and...

integrative oncology

Mistletoe

The use of dietary supplements by patients with cancer has increased significantly over the past 20 years despite insufficient evidence of safety and effectiveness. Finding reliable sources of information about dietary supplements can be daunting. Patients typically rely on family, friends, and...

health-care policy

Oncology Drug Approvals: Year in Review

In 2015, the Office of Hematology and Oncology Products (OHOP) approved 16 new molecular entities. The most notable were drug approvals in disease areas such as non–small cell lung cancer, colorectal cancer, breast cancer, melanoma, renal cancer, and diseases that are particularly difficult to...

Global Cancer: The Current Reality and the Future Need for Action

The estimated number of cancer cases worldwide in 2008 was 12.7 million, with 7.6 million deaths. By 2030, it is estimated that there will be 22 million newly diagnosed cancer cases and 12 million deaths, shocking to contemplate in dollars and human suffering. Although this impending disaster has...

skin cancer

Nivolumab Plus Ipilimumab in Unresectable or Metastatic Melanoma Regardless of BRAF Mutation Status

On January 23, 2016, the indication for nivolumab (Opdivo) plus ipilimumab (Yervoy) in unresectable or metastatic melanoma was expanded through accelerated approval to include patients regardless of BRAF V600 mutation status.1 The combination was previously approved for treatment of patients with...

issues in oncology

Failure of Updated Dietary Guidelines to Advise Limiting Red and Processed Meat Deemed a ‘Missed Opportunity’

“A missed opportunity” is how Susan Higginbotham, PhD, RD, Vice President for Research, American Institute for Cancer Research (AICR), described the “failure” of updated dietary guidelines to recommend limiting consumption of red and processed meat. Doing so would have “the potential to save...

Conquer Cancer Foundation Awards Grants to Drive International Cancer Care Advances

The Conquer Cancer Foundation of ASCO has awarded four 2016 International Innovation Grants to organizations developing projects with the potential to revolutionize cancer control in low- and middle-income countries. This year’s grants will support research in India, Nepal, Uganda, and the...

supportive care

Rolapitant Reduces Chemotherapy-Induced Nausea and Vomiting in Patients Receiving Moderately and Highly Emetogenic Chemotherapy

In three phase III studies reported in The Lancet Oncology, the addition of the neurokinin-1 (NK-1) receptor antagonist rolapitant to serotonin (5-HT3) receptor antagonist and dexamethasone treatment significantly improved complete response rates in the prevention of chemotherapy-induced nausea and ...

issues in oncology
lung cancer
geriatric oncology

Management of Advanced Lung Cancer in the Elderly: A Reason to Rejoice or a Cause for Concern?

There is ample evidence to suggest that older adults with a good performance status (0 or 1) with advanced non–small cell lung cancer (NSCLC) should be treated with combination chemotherapy akin to younger patients.1,2 However, older adults comprise a heterogeneous group that has been...

leukemia

Ofatumumab for Extended Treatment of Patients With Recurrent or Progressive Chronic Lymphocytic Leukemia

On January 19, 2016, ofatumumab (Arzerra) was approved for extended treatment of patients in complete or partial response after at least two lines of therapy for recurrent or progressive chronic lymphocytic leukemia (CLL).1,2 Ofatumumab was previously approved for treatment of untreated patients...

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