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issues in oncology
global cancer care

Building Improved and Sustainable Health-Care Systems Through Telemedicine

Telemedicine—the remote diagnosis and treatment of patients via telecommunications technology—has changed the way oncology care is delivered in rural parts of the world. Patients in rural areas are now able to connect remotely with their physicians without having to deal with the time, expense, and ...

Charles Gawad, MD, PhD, Receives NIH Director’s New Innovator Award

Charles Gawad, MD, PhD, an assistant member in the Departments of Oncology and Computational Biology at St. Jude Children’s Research Hospital, has been selected by the National Institutes of Health (NIH) to receive a Director’s New Innovator Award. Established in 2007, this award supports...

issues in oncology

Modern Clinical Trials: Engaging Stakeholders at the Front Lines of Care

Randomized clinical trials have been providing high-quality evidence for decades, but there are limitations to the traditional design. At the 2018 ASCO Quality Care Symposium, George J. Chang, MD, MS, FACS, FASCRS, discussed the need to modernize clinical trials, so they continue to provide...

Expert Point of View: Sandro Pignata, MD

The study’s invited discussant, Sandro Pignata, MD, of the Istituto Nazionale Tumori di Napoli in Italy, called the data from AGO OVAR 2.21 “very strong.” He added: “We now have robust evidence from a trial of more than 600 patients, in which previous bevacizumab (Avastin) was allowed, that...

gynecologic cancers

Study Identifies Suitable Partner for Bevacizumab in Recurrent Ovarian Cancer

For patients with recurrent ovarian cancer who receive platinum-based retreatment, the more suitable partner for bevacizumab (Avastin) may be carboplatin plus pegylated liposomal doxorubicin, rather than carboplatin and gemcitabine, according to the results of a phase III ENGOT/GCIG Intergroup...

skin cancer
immunotherapy

Neoadjuvant Therapy With Reduced-Dose Immunotherapy for Stage III Melanoma

In patients with stage III melanoma, a reduced-dose neoadjuvant immunotherapy combination was well tolerated and led to high pathologic response rates, in the phase II OpACIN-neo trial presented at the European Society for Medical Oncology (ESMO) 2018 Congress.1 “Neoadjuvant ipilimumab (Yervoy) at...

Expert Point of View: Daniel Heinrich, MD, and Silke Gillessen, MD

Formal discussant of the ERA 223 trial, Daniel Heinrich, MD, of Akershus University Hospital, Lørenskog, Norway, reminded listeners at the European Society for Medical Oncology (ESMO) 2018 Congress that radium-223 was developed in Norway. “When the ALSYMPCA results came out, we were celebrating....

prostate cancer

Treatment With Radium-223 Plus Abiraterone Not Advisable in Metastatic Prostate Cancer

The combination of radium-223 plus AAP (abiraterone acetate [Zytiga] and prednisone) was not superior to placebo plus AAP in the phase III ERA 223 trial, which enrolled men with asymptomatic bone-predominant metastatic castration-resistant prostate cancer.1 Patients treated with the combination had ...

Expert Point of View: Viktor Grünwald, MD, PhD

Formal discussant Viktor Grünwald, MD, PhD, of the Hannover Medical School, Germany, agreed that the results of JAVELIN Renal 101 were impressive, but he was more cautious about accepting avelumab (Bavencio)/axitinib (Inlyta) as a new standard of care without longer follow-up and quality-of-life...

kidney cancer
immunotherapy

Immunotherapy and Tyrosine Kinase Inhibitor Combination in Advanced Renal Cell Carcinoma

In the JAVELIN Renal 101 phase III study, the combination of the immune checkpoint inhibitor avelumab (Bavencio), a programmed death ligand-1 (PD-L1) blocking antibody, plus the tyrosine kinase inhibitor axitinib (Inlyta) significantly improved progression-free survival in previously untreated...

head and neck cancer

Phase III Study Supports Use of Cisplatin Over Cetuximab in HPV-Positive Oropharyngeal Cancer

In the United States and European countries, many oncologists are using cetuximab (Erbitux)/radiotherapy instead of cisplatin/radiotherapy in the treatment of human papillomavirus (HPV)-positive oropharyngeal cancer, based on the belief that cetuximab is equally effective with less toxicity than...

Expert Point of View: Jean-Pascal Machiels, MD, PhD, and Tanguy Seiwert, MD

Invited discussant Jean-Pascal Machiels, MD, PhD, Head of the Department of Medical Oncology at the Cliniques universitaires Saint-Luc, UCLouvain, Brussels, called the study “very important,” especially for showing that in patients with high expression of programmed cell death ligand 1 (PD-L1),...

head and neck cancer
immunotherapy

Pembrolizumab Improves Survival in Advanced Head and Neck Cancer

An overall survival advantage has now been shown for first-line immunotherapy in recurrent or metastatic head and neck cancer, researchers reported at the European Society for Medical Oncology (ESMO) 2018 Congress.1 In the phase III KEYNOTE-048 trial, treatment with the anti–programmed cell death...

gastrointestinal cancer
colorectal cancer
immunotherapy

First-Line Immunotherapy Shows Benefit in Metastatic Colorectal Cancer Subset

In previously untreated patients with metastatic colorectal cancer and tumors demonstrating microsatellite instability–high (MSI-high) or mismatch repair deficiency (dMMR), immunotherapy with nivolumab (Opdivo) and low-dose ipilimumab (Yervoy) produced a durable clinical benefit in the...

solid tumors
head and neck cancer

Ivy Brain Tumor Center to Study Treatments for Brain Malignancies

The Ben and Catherine Ivy Foundation, in partnership with the Barrow Neurological Institute in Phoenix, has awarded a $50 million grant to establish a new translational science program focusing on early-phase, pharmacodynamic- and pharmacokinetic-driven clinical trials for aggressive brain tumors. ...

issues in oncology
survivorship

ACS Report Looks at Ways to Improve Outcomes for Cancer Survivors and Caregivers

Growing numbers of cancer survivors, provider shortages, rising health-care costs, and socioeconomic disparities in health outcomes have created an urgent need to provide coordinated, comprehensive, personalized care for cancer survivors. A new report from the American Cancer Society (ACS) creates...

Expert Point of View: Richard K. Valicenti, MD, MA, FASTRO

Discussant of the SPPORT trial abstract at the ASTRO Annual Meeting, Richard K. Valicenti, MD, MA, FASTRO, Chair and Professor of Radiation Oncology at the University of California Davis Comprehensive Cancer Center, commented that the interim results of this study along with data from other...

Expert Point of View: Catherine C. Park, MD, FASTRO

Discussant of the 12-year report from the NRG/RTOG 9804 trial, Catherine C. Park, MD, FASTRO, Professor and Chair of the Department of Radiation Oncology at the University of California, San Francisco, underscored the high prevalence of ductal carcinoma in situ, which comprises approximately 20%...

breast cancer

Radiotherapy Reduces Risk of Recurrence by More Than 70% in Some Patients With Ductal Carcinoma in Situ

Radiation therapy after breast-conserving surgery reduced the already-low risk of recurrence by more than 70% in patients with defined “good-risk” breast cancer, according to a long-term clinical trial report presented at the 2018 Annual Meeting of the American Society for Radiation Oncology...

issues in oncology

Dealing With the Challenges Presented by the Parenteral Opioid Shortage

The opioid drug problem in the United States is a crisis, with unprecedented numbers of overdose deaths. The reaction to this has resulted in new federal laws and regulations aimed at restricting overuse and overprescribing of opioids. However, these well-intentioned actions, along with other...

lung cancer

Lung Cancer Screening: Proven Effective but Still Fighting for Acceptance

In 2010, the long-awaited findings from the National Lung Screening Trial (NLST) revealed that participants who received low-dose helical computed tomography (CT) scans had a 15% to 20% lower risk of dying of lung cancer than participants who received standard chest x-rays. In response, the U.S....

Expert Point of View: Nadia Harbeck, MD, PhD, and Fatima Cardoso, MD

Serving as European Society for Medical Oncology (ESMO) expert at a press briefing, Nadia Harbeck, MD, PhD, Head of the Breast Center at the University of Munich, called the findings “practice-changing” in some parts of the world and “practice-reinforcing” in others. She said the 10-month...

breast cancer

Impact of Palbociclib on Survival in Hormone Receptor–Positive, HER2-Negative Advanced Breast Cancer

Much anticipated overall survival data for palbociclib (Ibrance) plus fulvestrant (Faslodex) in advanced breast cancer were presented at the European Society for Medical Oncology (ESMO) 2018 Congress.1 Although overall survival in PALOMA-3 was not designed to detect a statistically significant...

skin cancer

NCRI 2018: Mortality in Men With Malignant Melanoma

The rate of men dying from malignant melanoma has risen in populations around the world, whereas in some countries, mortality rates for the disease are steady or falling for women, according to research presented by Yang et al at the 2018 National Cancer Research Institute (NCRI) Cancer Conference...

ASCO in the Community: Listening and Learning From Our Patients in Appalachia

2018–2019 ASCO President Monica M. Bertagnolli, MD, FACS, FASCO, is putting the words of her presidential theme— “caring for every patient, learning from every patient” —into action. During her term, she and other ASCO leaders will be traveling to local communities around the United States to...

lymphoma

FDA Expands Approved Use of Brentuximab Vedotin in Some Types of PTCL

Today, the U.S. Food and Drug Administration (FDA) expanded the approved use of brentuximab vedotin (Adcetris) injection in combination with chemotherapy for adult patients with certain types of peripheral T-cell lymphoma (PTCL)—adults with previously untreated systemic anaplastic large cell...

symptom management

Study Identifies Significant Risk Factors for Chemotherapy-Induced Febrile Neutropenia

New research by Family et al in JNCCN—Journal of the National Comprehensive Cancer Network identifies risk factors for chemotherapy-induced febrile neutropenia, a dangerously low white blood cell count that increases the risk of serious infection and fever. The study was led...

hematologic malignancies
cost of care

New Report Demonstrates Cost of Blood Cancer Care

The costs to treat blood cancer are higher than costs for other cancers, and the costs incurred by a patient diagnosed with a blood cancer do not return to precancer levels, according to a Milliman study commissioned by The Leukemia & Lymphoma Society (LLS). The study—The...

leukemia

Dysregulation of Immune Pathways in AML Relapse After Allogeneic HSCT

In a study reported in The New England Journal of Medicine, Christopher et al found that acute myeloid leukemia (AML) relapse after allogeneic hematopoietic stem cell transplantation (HSCT) was accompanied by dysregulation of immune pathways, including downregulation of major histocompatibility...

breast cancer
gynecologic cancers
lymphoma
pancreatic cancer
gastroesophageal cancer
bladder cancer
symptom management
gastrointestinal cancer

FDA Pipeline: What’s New in Biosimilars, Drug Reviews, Designations, and More

The U.S. Food and Drug Administration (FDA) recently issued the following new approvals and designations: Approval for Pegfilgrastim Biosimilar The FDA recently approved a pegfilgrastim biosimilar, pegfilgrastim-cbqv (Udenyca). The biosimilar has been approved to decrease the incidence...

solid tumors

Transcription Factors TP63 and SOX2 in Squamous Cell Carcinoma Progression

Squamous cell carcinomas (SCCs) are malignancies arising from squamous epithelium of various organs, such as esophagus, head and neck, lung, and skin.  Previous studies demonstrated that two master transcription factors, TP63 and SOX2, effect genomic activation in SCCs. Now, researchers from...

gynecologic cancers

Overall Survival After Minimally Invasive Radical Hysterectomy for Early-Stage Cervical Cancer

In a cohort study reported in The New England Journal of Medicine, Melamed et al found that minimally invasive radical hysterectomy was associated with poorer overall survival compared with open radical hysterectomy in women with early-stage cervical cancer. Study Details The study involved...

issues in oncology

Novel Physician-Driven Practice Model Offers Alternative to Community Oncologists

Three leading oncology practices have united with partners in technology and finance to launch OneOncology, a physician-driven company that aims to unite more than 225 community oncology providers from 60-plus locations. Altogether, OneOncology will treat nearly 158,000 cancer patients a year. The...

palliative care

Developing Patient-Centered Palliative Care From Diagnosis to End of Life

In December, The University of Texas at Austin Dell Medical School will launch an innovative cancer care model called the CaLM (cancer life re-imagined) Clinic as part of its new cancer center, the Livestrong Cancer Institutes. The goal of the Livestrong Cancer Institutes and the CaLM Clinic is to...

issues in oncology
cost of care

Tackling Financial Toxicity: One Institution’s Roadmap Forward

  ALTHOUGH FINANCIAL toxicity has become an important issue in the oncology community, evidence suggests the subject is rarely addressed by oncologists, exacerbating its grave effects on patients with cancer and their families.1 “But I don’t think it’s because health-care providers don’t want to...

issues in oncology

Challenges and Successes of Adopting an Oncology Care Model

IN ORDER TO rein in the untenable rise in costs while delivering high-value cancer care, the Centers for Medicare & Medicaid Innovation developed a new payment system—the Oncology Care Model. At the 2018 ASCO Quality Care Symposium, Cardinale B. Smith, MD, PhD, shed light on the system’s...

issues in oncology
palliative care

End-of-Life Dashboard Drives Transformation With Actionable Personalized Data

A NUMBER OF STUDIES from the palliative care literature have shown that nonbeneficial health-care interventions actually may harm patients’ quality of life, increase patient and caregiver distress, and drive costs. Yet, according to the National Cancer Institute, about 30% of all cancer spending...

WHO Announces New Global Childhood Cancer Initiative

THE AMERICAN Childhood Cancer Organization (ACCO) supported the World Health Organization’s (WHO) announcement of a new global initiative to address the disparity between childhood cancer survival in low-middle versus high-income countries. The announcement came at the United Nations General...

lung cancer
immunotherapy

Atezolizumab Plus Chemotherapy Improves Outcomes in Small Cell Lung Cancer

ATEZOLIZUMAB (TECENTRIQ), an anti–program cell death ligand 1 (PD-L1) antibody, combined with carboplatin/ etoposide as first-line treatment for extensive-stage small-cell lung cancer (SCLC) improved overall and progression-free survival and may represent a new standard of care, according to...

issues in oncology
lung cancer

Adding the Patient’s Voice to Collaborative Clinical Trial Efforts

THE INTERNATIONAL Association for the Study of Lung Cancer (IASLC) 19th World Conference on Lung Cancer was the largest in its history. One of the key themes of the meeting was to focus on the patient. Here are highlights of presentations from this conference that demonstrate the role of the...

bladder cancer
immunotherapy

Expert Point of View: Shahrokh Shariat, MD

“BACILLUS CALMETTE-GUÉRIN (BCG) failures are quite common, with a 66% recurrence rate at 5 years, and about 25% of patients will have disease progression,” explained formal discussant Shahrokh Shariat, MD, Chair of the Department of Urology at Medical University, Vienna, and Adjunct Professor at...

prostate cancer

Radiation to Primary Tumor Improves Survival in Subset of Men With Metastatic Prostate Cancer

MEN WITH newly diagnosed metastatic prostate cancer do not typically receive treatment to the primary tumor with radiation or surgery. A new analysis of the STAMPEDE trial found that radiation administered to the prostate can improve overall survival in men with newly diagnosed metastatic prostate...

gynecologic cancers

Expert Point of View: Jonathan Ledermann, MD, and Clara MacKay

“A KEY AIM of treatment is the need to focus on preventing recurrence, which happens in 70% of patients. Over the past 20 years, we have made few inroads in preventing recurrence. This study brings a poly (ADP-ribose) polymerase (PARP) inhibitor olaparib (Lynparza) to the first-line setting,...

gynecologic cancers

Results Reported for Olaparib Maintenance in Ovarian Cancer

TWO-YEAR MAINTENANCE therapy with olaparib (Lynparza), a poly (ADP-ribose) polymerase inhibitor, achieved a significant improvement in progression-free survival in patients with newly diagnosed advanced ovarian cancer and a BRCA1 or BRCA2 mutation, according to results of the phase III SOLO-1...

lung cancer

Expert Point of View: Fiona Blackhall, MD, PhD

FORMAL STUDY discussant, Fiona Blackhall, MD, PhD, of the University of Manchester, UK, welcomed brigatinib (Alunbrig) as a new first-line option for ALK-positive patients but said, “In the absence of comparisons of next-generation ALK inhibitors, it will take some time to determine if there is...

lung cancer

Brigatinib Improves Outcomes Over Crizotinib in ALK-Positive Non–Small Cell Lung Cancer

THE FIRST-LINE USE of brigatinib (Alunbrig) was superior to standard-of-care crizotinib (Xalkori) in patients with advanced anaplastic lymphoma kinase (ALK)-positive non–small cell lung cancer (NSCLC), according to the first report of the phase III ALTA-1L trial presented at the International...

breast cancer
immunotherapy

Expert Point of View: Giuseppe Curigliano, MD, PhD

“IMPASSION130 IS a positive study of immuno-oncology that brings breast cancer into the immunotherapy era,” said the invited discussant of the trial, Giuseppe Curigliano, MD, PhD, Associate Professor of Oncology at the University of Milan and Chair of Early Drug Development at the Institute of...

breast cancer
immunotherapy

Immunotherapy Improves Survival in a Subset of Patients With Metastatic Triple-Negative Breast Cancer

IMMUNOTHERAPY APPEARS to be the new upfront standard of care for patients with metastatic triple-negative breast cancer, based on a late-breaking presentation at the European Society for Medical Oncology (ESMO) 2018 Congress1 and simultaneously published in The New England Journal of Medicine.2 In ...

symptom management

Can Patients Use Topical Skin Creams During Radiation Therapy?

Contrary to the advice most patients with cancer receive when they go through radiation treatment, topical skin treatments, unless applied very heavily, may not increase the radiation dose to the skin and can be used in moderation before daily radiation treatments, according to findings from a new...

breast cancer

Final Analysis of SWOG POEMS: Goserelin and Chemotherapy in Breast Cancer

Final results of SWOG Cancer Research Network’s international Prevention of Early Menopause Study (POEMS) showed continued evidence that women who get injections of the hormone drug goserelin along with standard breast cancer chemotherapy are more likely to become pregnant, without developing ...

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