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geriatric oncology

Changing Perceptions on Surgical Intervention for Geriatric Patients With Cancer: Role of the SIOG Surgical Task Force

Surgery is an integral part of treatment of elderly patients with solid malignancies. The times we are living in will be remembered by health-care providers for the significant “contradictions” in the medical and surgical care of elderly patients with cancer. On the one hand, it has been...

breast cancer
immunotherapy

Challenge Moving Forward in Breast Cancer Treatment: To Show That New Approaches Change Outcomes

ADVANCES IN treating breast cancer over the past 20 years have brought us to the point where treatment can be confidently de-escalated for some patients, and immunotherapy and precision decision-making may change the way breast cancer is treated for others, William Gradishar MD, FASCO, told the...

breast cancer

Preventing Locoregional Recurrence of Breast Cancer Should Not Deter Efforts to Decelerate Therapy

“SURGEONS AND radiation oncologists are obsessed with locoregional recurrence of breast cancer,” Monica Morrow, MD, FASCO, remarked at the 2018 Lynn Sage Breast Cancer Symposium, Chicago. Working to prevent locoregional recurrence, “even if it may not be the major threat to mortality, is...

breast cancer

Risk of Local Recurrence in Breast Cancer: Impact of Molecular Subtype and Surgical Approach

THE RISK of local recurrence in breast cancer “does not differ substantially based on the operation we perform, but it does differ substantially by subtype,” Tari A. King MD, FACS, stated at the 2018 Lynn Sage Breast Cancer Symposium in Chicago.1 At 10-year follow-up, Dr. King reported, local...

leukemia

Expert Point of View: Elihu H. Estey, MD; Steven Gore, MD; and Mark J. Levis, MD, PhD

ELIHU H. ESTEY, MD, Professor of Medicine at the University of Washington and Director of Acute Myeloid Leukemia (AML) Clinical Research at the Fred Hutchinson Cancer Research Center, Seattle, added that with these “robust” outcomes, future trial patients may “not be eager to wind up in the...

leukemia

Use of Isocitrate Dehydrogenase Inhibitors in Induction Therapy for Newly Diagnosed AML

IN AN OPEN-LABEL phase I study of 153 patients newly diagnosed with acute myeloid leukemia (AML) and mutations in isocitrate dehydrogenase-1 (IDH1) or IDH2, treatment with standard chemotherapy plus the oral IDH inhibitors ivosidenib and enasidenib led to high response rates and possibly impressive ...

symptom management
issues in oncology

Primary Prophylaxis With a Direct Oral Anticoagulation Agent Reduces Venous Thromboembolism Rate in Ambulatory Patients With Cancer

LATE-BREAKING results from the large, randomized, placebo-controlled CASSINI trial showed that primary prophylaxis with the direct oral anticoagulation agent rivaroxaban reduced the incidence of venous thromboembolism (VTE) as well as VTE-related deaths in high-risk patients with cancer who were...

leukemia

BEAT AML Umbrella Trial: Bringing Personalized Medicine to Acute Myeloid Leukemia

THE MULTIARM, multicollaborative BEAT AML umbrella trial demonstrated the feasibility of using next-generation sequencing to assign treatment tailored to individual genomics of elderly patients with acute myeloid leukemia (AML) within 7 days. This may prove to be a major advance, since typically...

breast cancer

Tumor-Infiltrating Lymphocytes and Prognosis in Early-Stage Triple-Negative Breast Cancer

In a pooled analysis reported in the Journal of Clinical Oncology, Loi et al found that levels of stromally located tumor infiltrating lymphocytes (sTILs) are strongly prognostic in early-stage triple-negative breast cancer, with improved survival observed in patients with higher levels of sTILs...

lymphoma

PET-Adapted Treatment in Newly Diagnosed Advanced Hodgkin Lymphoma

In the phase III AHL2011 trial reported in The Lancet Oncology, Casasnovas et al found that positron-emission tomography (PET)-guided treatment produced good outcomes in newly diagnosed advanced Hodgkin lymphoma, allowing de-escalation of induction to ABVD (doxorubicin, bleomycin, vinblastine, and...

breast cancer

Role of Adjuvant Capecitabine in Triple-Negative Breast Cancer

ADJUVANT CAPECITABINE added to standard neoadjuvant chemotherapy failed to significantly improve disease-free or overall survival in patients with early triple-negative breast cancer in the large phase III CIBOMA/2004-01_GEICAM/2003-11 (CIBOMA/GEICAM) trial.1 However, extended treatment with...

immunotherapy
lung cancer

PACIFIC Trial of Durvalumab Sets Standard in Stage III Unresectable NSCLC

IMMUNOTHERAPY HAS revolutionized the treatment of lung cancer over the past several years. Although lung cancer is associated with immunosuppression at baseline for most patients, the addition of immune checkpoint inhibitors can overcome that suppression and lead to antitumor immune responses....

breast cancer

Low-Dose Tamoxifen Halves Breast Cancer Risk in Women With Preinvasive Breast Lesions

A VERY LOW DOSE of tamoxifen—5 mg/d, given for 3 years rather than 5 years—halved the risk of breast cancer recurrence or new lesions over placebo in women with breast intraepithelial neoplasia, without producing the usual toxicities seen with the standard dose, Italian researchers reported at the...

health-care policy
lung cancer

Shared Decision-Making and Use of Low-Dose CT Screening for Lung Cancer

In a study reported in a research letter in JAMA Internal Medicine, Goodwin et al found that only a small proportion of Medicare enrollees undergoing low-dose computed tomography (CT) screening for lung cancer had a prescreening shared decision-making session, which is mandated by the Centers for...

breast cancer

MRI Background Parenchymal Enhancement and Risk of Breast Cancer

In a population-based study reported in the Journal of Clinical Oncology, Arasu and colleagues found that increased breast magnetic resonance imaging (MRI) background parenchymal enhancement was associated with an increased risk of breast cancer, with risk being independent of breast density. The...

colorectal cancer

Francesca Battaglin, MD, on Colorectal Cancer: Using Genetic Variants to Predict Treatment Efficacy

Francesca Battaglin, MD, of the University of Southern California Norris Comprehensive Cancer Center, discusses phase III study data on genetic variants used to predict the efficacy of cetuximab in patients with metastatic colorectal cancer (Abstract 564).

gastrointestinal cancer

David H. Ilson, MD, PhD, on Gastric Cancer: Results From the TAGS Study on Third-Line Trifluridine/Tipiracil

David H. Ilson, MD, PhD, of Memorial Sloan Kettering Cancer Center, discusses findings on the efficacy and safety of third-line trifluridine/tipiracil in patients with metastatic gastric cancer with or without prior gastrectomy (Abstract 3).

kidney cancer
immunotherapy

Patient-Reported Outcomes With Nivolumab Plus Ipilimumab vs Sunitinib in Advanced Renal Cell Carcinoma

As reported in The Lancet Oncology by Cella et al, patient-reported outcomes were better with nivolumab plus ipilimumab vs sunitinib in the phase III CheckMate 214 trial among patients with intermediate- or poor-risk advanced renal cell carcinoma. The ongoing trial showed significantly improved...

solid tumors
immunotherapy

2019 GI Cancers Symposium: Pembrolizumab in Pretreated, Advanced Neuroendocrine Tumors

Findings from the phase I KEYNOTE-028 trial, which studied pembrolizumab in a number of solid tumors, showed activity of the immunotherapy in some patients with heavily pretreated neuroendocrine tumors. Now, a phase II basket trial—KEYNOTE-158—is studying the efficacy and safety of...

breast cancer
gastroesophageal cancer
gastrointestinal cancer

FDA Approves Biosimilar Trastuzumab-dttb

On January 18, the U.S. Food and Drug Administration (FDA) approved trastuzumab-dttb (Ontruzant), a biosimilar referencing trastuzumab, across all eligible indications—namely, adjuvant treatment of HER2-overexpressing breast cancer, metastatic breast cancer, and metastatic gastric cancer or...

issues in oncology
global cancer care

Patient Navigation Program Reduces Time to Cancer Treatment

The Global Cancer Institute recently announced the results of its Patient Navigation Program in Mexico City. The average time to referral before the program’s inception was 5 months, but the implementation of patient navigators reduced that average to 7 days. These findings were published by Yanin...

immunotherapy
symptom management

Adoptive T-Cell Therapy for Progressive Multifocal Leukoencephalopathy

An emerging treatment known as adoptive T-cell therapy has proven effective in a phase II clinical trial for treating progressive multifocal leukoencephalopathy (PML), a rare and often fatal brain infection sometimes observed in patients with cancer and other diseases in which the immune system is...

supportive care
integrative oncology

Use of Valerian to Relieve Anxiety in Patients With Cancer

The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies sometimes used by patients with cancer. Eugenie Spiguel, MSN, ANP-BC, and Jyothirmai Gubili, MS, explore the use of valerian for...

27% Drop in Overall U.S. Cancer Mortality Rate From 1991 to 2016

A steady 25-year decline has resulted in a 27% drop in the overall cancer death rate in the United States between 1991 and 2016. The data come from “Cancer Statistics, 2019,” the American Cancer Society’s annual report on cancer rates and trends. The report was published by Siegel et al in CA: A...

hematologic malignancies
multiple myeloma
immunotherapy

Novel Therapeutics for Relapsed or Refractory Multiple Myeloma, Part 2

Here is an update on several different studies focusing on novel treatments for patients with relapsed or refractory multiple myeloma presented at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition. The featured therapeutics include the oral agent selinexor in...

colorectal cancer
immunotherapy

2019 GI Cancers Symposium: Durvalumab, Tremelimumab, and Best Supportive Care vs Best Supportive Care Alone in Advanced, Refractory Colorectal Cancer

The phase II CCTG CO.26 trial evaluated whether the combination of durvalumab, a programmed cell death ligand 1 (PD-L1) inhibitor, and tremelimumab, an anti–cytotoxic T-lymphocyte–associated protein 4 (CTLA-4) antibody, plus best supportive care improved survival vs best supportive care ...

head and neck cancer
gastrointestinal cancer
immunotherapy

2019 GI Cancers Symposium: Pembrolizumab in Second-Line Therapy for Advanced Esophageal Cancer

Pembrolizumab significantly improved overall survival in the second-line setting of advanced esophageal cancer in patients whose tumors tested positive for programmed cell death ligand 1 (PD-L1) with a combined positive score (CPS) of 10 or greater. This was compared to investigator’s choice...

hepatobiliary cancer

FDA Approves Cabozantinib in Previously Treated Hepatocellular Carcinoma

On January 14, the U.S. Food and Drug Administration (FDA) approved cabozantinib (Cabometyx) tablets for patients with hepatocellular carcinoma who have been previously treated with sorafenib. The FDA’s approval of this oral tyrosine kinase inhibitor was based on the results of the phase III...

pancreatic cancer

2019 GI Cancers Symposium: Neoadjuvant Chemotherapy vs Upfront Surgery in Resectable Pancreatic Cancer

A phase II/III trial presented by Unno et al at the 2019 Gastrointestinal Cancers Symposium (Abstract 189) sought to compare neoadjuvant chemotherapy (using gemcitabine and the oral fluoropyrimidine combination of tegafur/gimeracil/oteracil [S-1]) to upfront surgery in patients with histologic ...

issues in oncology
supportive care

Findings From ASCO’s Second National Cancer Opinion Survey

Despite a recent study showing that patients with cancer who chose alternative therapies over conventional cancer treatment have a higher risk of death, nearly 4 in 10 Americans believe cancer can be cured by alternative remedies alone, according to the results of ASCO’s 2018 National Cancer...

hepatobiliary cancer
immunotherapy

2019 GI Cancers Symposium: Nivolumab vs Nivolumab Plus Ipilimumab in Resectable Hepatocellular Carcinoma

Anti–programmed cell death protein 1 and anti–cytotoxic T-lymphocyte–associated protein 4 antibodies have shown activity in hepatocellular carcinoma. Based on these earlier findings, researchers sought to examine the safety, efficacy, and tolerability of perioperative treatment...

hematologic malignancies
multiple myeloma

Novel Treatments in Newly Diagnosed Multiple Myeloma, Part 1

Here is an update on several different studies focusing on novel treatments for patients with newly diagnosed multiple myeloma presented at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition. Featured therapeutics include daratumumab plus lenalidomide and dexamethasone, ...

issues in oncology
legislation
health-care policy

New Regulations Require Better Communication With Patients Who Have Disabilities and Limited English Proficiency

Ever since President Barack Obama signed the Patient Protection and Affordable Care Act (ACA) into law on March 23, 2010, the nondiscrimination provision of the law, Section 1557, which prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in certain health ...

Lori J. Pierce, MD, FASTRO, FASCO, Elected ASCO President for 2020–2021 Term

ASCO has elected Lori J. Pierce, MD, FASTRO, FASCO, a long-time member and volunteer, to serve as its President for the term beginning in June 2020. She will take office as President-Elect during the ASCO Annual Meeting in Chicago in June 2019. Six new members were also elected to the ASCO Board of ...

gastrointestinal cancer

2019 GI Cancers Symposium: Safety, Efficacy of Trifluridine/Tipiracil in Metastatic Gastric Cancer With or Without Gastrectomy

In a poster session earlier today David Ilson, MD, of Memorial Sloan Kettering Cancer Center, and colleagues reported on a preplanned subgroup analysis of the double-blind phase III TAGS study looking at the safety and efficacy of the oral agent trifluridine/tipiracil (FTP/TPI) in heavily...

prostate cancer

Germline DNA Repair Mutations and Outcomes in Metastatic Castration-Resistant Prostate Cancer

A subset of patients with aggressive prostate cancer are carriers of germline BRCA2 mutations, which are also linked to hereditary breast cancer, ovarian cancer, and pancreatic cancer. Study findings also showed family members of patients with prostate cancer who carry BRCA2 and DNA-repair...

lymphoma
immunotherapy

Is There a Benefit to Adding Rituximab to Methotrexate-Based Chemotherapy in Primary CNS Lymphoma?

In a phase III trial (HOVON 105/ALLG NHL 24) reported in The Lancet Oncology, Bromberg et al found no significant benefit of the addition of rituximab to high-dose methotrexate-based chemotherapy in patients with newly diagnosed primary central nervous system (CNS) lymphoma. Study Details In the...

gastroesophageal cancer

Hybrid Minimally Invasive Esophagectomy vs Open Esophagectomy in Esophageal Cancer

In a French phase III trial reported in The New England Journal of Medicine, Mariette et al found that a hybrid minimally invasive surgical procedure was associated with reduced postoperative complications vs transthoracic open esophagectomy in patients with resectable cancer of the middle or lower ...

hepatobiliary cancer

FDA Approves Cabozantinib for Previously Treated Hepatocellular Carcinoma

On January 14, the U.S. Food and Drug Administration (FDA) approved cabozantinib (Cabometyx) tablets for patients with hepatocellular carcinoma who have been previously treated with sorafenib. The FDA’s approval of cabozantinib was based on results from the phase III CELESTIAL trial....

lymphoma
immunotherapy

Nivolumab in Relapsed or Refractory DLBCL Ineligible for or After Failure of Autologous Transplantation

In a phase II trial reported in the Journal of Clinical Oncology, Ansell et al found that nivolumab was associated with low response rates among patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) who were ineligible for or experienced failure of autologous hematopoietic cell ...

gynecologic cancers

Al Identifies Features of Tumor Cells in High-Risk Ovarian Cancer  

Scientists have developed a new test that scans the shapes of tumor cells to select women with especially aggressive ovarian cancer. A team at The Institute of Cancer Research (ICR), London, created an artificial intelligence (AI) tool that looks for clusters of cells within tumors with misshapen...

lung cancer
immunotherapy

Updated Survival Analysis of KEYNOTE-024: Pembrolizumab vs Platinum-Based Chemotherapy in Previously Untreated, Advanced NSCLC

As reported in the Journal of Clinical Oncology by Reck et al, an updated analysis of the phase III KEYNOTE-024 trial indicates continued overall survival benefit of first-line pembrolizumab vs platinum-based chemotherapy in patients with advanced non–small cell lung cancer (NSCLC) with a...

issues in oncology
global cancer care

Patient Navigation Program Reduces Time to Treatment in Patients With Cancer

Global Cancer Institute recently announced the results of its Patient Navigation Program in Mexico City. The average time to referral before the program’s inception was 5 months, but the implementation of patient navigators reduced that average to 7 days. These findings were published by ...

gastroesophageal cancer

Pembrolizumab in Pretreated Advanced Esophageal Adenocarcinoma or Squamous Cell Carcinoma

As reported in JAMA Oncology by Shah et al, the phase II KEYNOTE-180 trial has shown that pembrolizumab produces durable responses in some patients with pretreated locally advanced or metastatic esophageal adenocarcinoma or squamous cell carcinoma. Study Details In the trial, 121 patients with...

kidney cancer

Immediate vs Deferred Cytoreductive Nephrectomy in Patients With Metastatic Renal Cell Carcinoma Treated With Sunitinib

In a trial with a modified primary endpoint due to slow accrual reported in JAMA Oncology, Bex et al found that deferred cytoreductive nephrectomy after sunitinib did not improve 28-week progression-free rate (PFR) vs immediate nephrectomy followed by sunitinib in patients with metastatic renal...

issues in oncology

27% Drop in Overall U.S. Cancer Mortality Rate From 1991 to 2016

A steady 25-year decline has resulted in a 27% drop in the overall cancer death rate in the United States between 1991 and 2016. The data come from “Cancer Statistics, 2019,” the American Cancer Society’s annual report on cancer rates and trends. The report was published in CA: A...

cns cancers

Higher Incidence of Brain and CNS Tumors Among People Living in Appalachia

A recent study published by Ostrom et al in the Journal of Neuro-Oncology showed that compared to the rest of the United States, the Appalachian region has a 5% higher incidence of malignant primary brain tumors and other central nervous system (CNS) tumors, a higher mortality rate due to ...

prostate cancer
immunotherapy

MSI-H/dMMR Tumors in Prostate Cancer and Response to Immune Checkpoint Blockade

In a study reported in JAMA Oncology, Abida et al found that approximately 3% of patients with prostate cancer had microsatellite instability–high (MSI-H)/mismatch repair–deficient (dMMR) tumors and that some of these patients exhibited durable responses to treatment with immune...

skin cancer

Association Between Sun Exposure and BMI in the Development of Nonmelanoma Skin Cancer

Exposure to the sun, whether cumulative or intermittent, is a known risk factor for the development of nonmelanoma skin cancer (NMSC). Past studies have found that greater body mass index (BMI) actually lessens the risk of women developing NMSCs. With this in mind, researchers sought to determine...

breast cancer

Neoadjuvant Degarelix vs Triptorelin in Premenopausal Women Receiving Letrozole for Locally Advanced, Endocrine-Responsive Breast Cancer

In a phase II trial reported in the Journal of Clinical Oncology, Dellapasqua et al found that neoadjuvant treatment with the gonadotropin-releasing hormone (GnRH) antagonist degarelix was more effective than the GnRH agonist triptorelin in achieving ovarian function suppression (OFS) in...

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