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issues in oncology

2019 Quality Care: End-of-Life Care in Western Washington State vs Alberta, Canada

In a study to be presented by Khaki et al at the 2019 ASCO Quality Care Symposium, researchers found more aggressive end-of-life measures—including use of chemotherapy and admissions to the intensive care unit (ICU)—were employed in the last 30 days of life in Western Washington state vs Alberta,...

kidney cancer
immunotherapy

Individualized Axitinib Regimens After Immunotherapy for Advanced Renal Cell Carcinoma

In a phase II study reported in The Lancet Oncology, Ornstein et al found that individualized axitinib regimens showed activity in patients with locally recurrent or metastatic renal cell carcinoma who had previously received immune checkpoint inhibitor therapy, although the progression-free...

issues in oncology
cost of care

2019 Quality Care: Cost of Treatment, Prior Authorization of Treatment Plans May Cause Barriers to Care

Drug costs and requirements for prior authorization of treatment plans pose barriers to cancer treatment and can potentially affect outcomes for many patients, according to two studies that will be presented at the ASCO Quality Care Symposium. The studies respectively examine how the high...

issues in oncology
lung cancer

2019 Quality Care: Clinical Trial Enrollment May Be Associated With Reduced Mortality in Patients With Metastatic Lung Cancer

Researchers from the University of Washington and Fred Hutchinson Cancer Research Center in Seattle investigated the relationship between participation in a clinical trial and overall survival in patients with advanced non–small cell lung cancer (NSCLC). Cristina Merkhofer, MD, MHS, will present...

prostate cancer

TITAN Trial: Apalutamide Adds to Options for Men With Metastatic Hormone-Sensitive Prostate Cancer

Androgen-deprivation therapy has been, and remains, the standard of care for patients with metastatic prostate cancer. Patients are often surprised to know that was all we would do to control their disease and sometimes asked why they would not get chemotherapy, as for other cancers. I would take...

prostate cancer

Addition of Apalutamide to Androgen-Deprivation Therapy in Metastatic Castration-Sensitive Prostate Cancer

As reported in The New England Journal of Medicine by Kim N. Chi, MD, of BC Cancer and Vancouver Prostate Centre, and colleagues, the first analysis of the phase III TITAN trial has shown that the addition of apalutamide to androgen-deprivation therapy improved radiographic progression-free and...

issues in oncology

FDA Recommendation on Duodenoscopes With Disposable Components

The U.S. Food and Drug Administration (FDA) has recommended that duodenoscope manufacturers and health-care facilities transition to different types of duodenoscopes that may pose less risk to patient safety. Specifically, because of challenges with cleaning these devices for reuse and persistent...

issues in oncology

Analysis of HPV-Related Cancers Reported From 2012 to 2016

During 2012–2016, an average of approximately 34,800 human papillomavirus (HPV)-associated cancers were reported each year, according to a new study published by Senkomago et al in Morbidity and Mortality Weekly Report. Among the cancers probably caused by HPV, 92% are attributable to the HPV types ...

hematologic malignancies
issues in oncology

Reducing Time to Chemotherapy Initiation in Patients Electively Admitted to a Hematologic Malignancy Service

In a single-institution study reported in the Journal of Oncology Practice, Galeas et al found that intervention in key drivers in the care process could reduce the time to initiation of chemotherapy in patients with elective admission to a hematologic malignancy service. Study Details The goal of...

hepatobiliary cancer
pancreatic cancer

Results From the TAPUR Study on Palbociclib for Pancreatic Cancer and Cholangiocarcinoma

New results from ASCO’s Targeted Agent and Profiling Utilization Registry (TAPUR) study have demonstrated that single-agent palbociclib has no meaningful clinical activity in patients with CDKN2A-mutated or -deleted advanced pancreatic adenocarcinoma and cholangiocarcinoma. These findings were...

breast cancer

Pyrotinib or Lapatinib With Capecitabine in Previously Treated HER2-Positive Metastatic Breast Cancer

In a Chinese phase II trial reported in the Journal of Clinical Oncology by Ma et al, the combination of the pan-ErbB inhibitor pyrotinib and capecitabine improved response rate vs lapatinib/capecitabine in women with HER2-positive relapsed or metastatic breast cancer previously treated with...

genomics/genetics
leukemia

Chromosomal Abnormalities and Prognosis in NPM1-Mutant AML

In a study reported in the Journal of Clinical Oncology, Angenendt et al found that adverse-risk cytogenetics were associated with significantly poorer outcomes vs normal karyotype among patients with acute myeloid leukemia (AML) with a nucleophosmin 1 (NPM1) mutation. As stated by the...

prostate cancer

Many Choices Now for Men With Metastatic Hormone-Sensitive Prostate Cancer: How to Decide?

Based on the recently published ENZAMET, ARCHES, and TITAN trials,1-3 we now have several choices of systemic combination therapies for men with metastatic hormone-sensitive prostate cancer; the ENZAMET trial is reviewed in this issue of The ASCO Post. In 2019, men are now faced with decisions of...

prostate cancer

Enzalutamide Improves Survival vs Standard First-Line Treatment in Hormone-Sensitive Metastatic Prostate Cancer

As reported in The New England Journal of Medicine by Ian D. Davis, MBBS, PhD, FRACP, FAChPM, of Monash University and Eastern Health in Melbourne, and colleagues, the phase III ENZAMET trial has shown that the androgen receptor inhibitor enzalutamide improved progression-free and overall survival ...

head and neck cancer

Maura L. Gillison, MD, PhD, Pioneer in HPV-Related Head and Neck Cancer, Has Often Changed Lanes in Her Career

When The ASCO Post asked physician-scientist Maura L. Gillison, MD, PhD, where she was from, she answered, “North America.” Actually, she was born in Canada, but her father worked for a large international company, so the family moved regularly through Canada, the United States, and Mexico. “I...

issues in oncology
survivorship

High-Deductible Health Plans, Access to Care, and Emergency Department Use Among Cancer Survivors

In a study reported in the Journal of Oncology Practice, Zheng et al found that patients with cancer and high-deductible health plans had increases in delayed/forgone care, an effect that was attenuated for those with health savings accounts. Emergency department use was similar across insurance...

survivorship
issues in oncology

Risks of Cardiovascular Diseases in Survivors of Adult Cancers

In a study reported in The Lancet, Strongman et al found that survivors of most site-specific cancers had an increased risk for one or more cardiovascular diseases during follow-up compared with a matched control group of patients without cancer. This population-based cohort study employed multiple ...

kidney cancer
immunotherapy

Extended Follow-up of CheckMate 214: Nivolumab/Ipilimumab vs Sunitinib as First-Line Treatment for Advanced RCC

As reported in The Lancet Oncology by Robert J. Motzer, MD, and colleagues, extended follow-up of the phase III CheckMate 214 trial has shown a maintained survival benefit for first-line nivolumab/ipilimumab vs sunitinib in patients with previously untreated intermediate- or poor-risk advanced...

multiple myeloma

Selinexor/Dexamethasone in Triple-Class Refractory Multiple Myeloma

In the phase IIb STORM Part 2 study reported in The New England Journal of Medicine, Chari et al found that the combination of oral selinexor and dexamethasone produced responses in patients with multiple myeloma refractory to prior treatment with an alkylating agent, immunomodulatory agent, and...

kidney cancer
prostate cancer
immunotherapy

Novel Treatments Under Study in Renal Cell Carcinoma and Prostate Cancer

There were numerous notable presentations at the 2019 Genitourinary Cancers Symposium, many of which were covered in The ASCO Post over the past few months. To add to our continued coverage of this meeting, here are some highlights from studies focusing on novel therapeutics in renal cell carcinoma ...

prostate cancer

Darolutamide for Nonmetastatic Castration-Resistant Prostate Cancer

On July 30, 2019, darolutamide was approved for the treatment of patients with nonmetastatic castration-resistant prostate cancer.1,2 Approval was based on findings in the double-blind phase III ARAMIS trial (ClinicalTrials.gov identifier NCT02200614), in which 1,509 patients were randomly assigned ...

breast cancer

Tumor Size and Grade Matter, and Ovarian Ablation by Chemotherapy May Explain Subgroup Anomaly in TAILORx

At the 2019 ASCO Annual Meeting, and simultaneously in The New England Journal of Medicine, we heard the third paper reporting results from TAILORx.1,2 The first, in 2015,3 indicated that women with node-negative breast cancers with Oncotype DX recurrence scores less than 11 did extremely well...

kidney cancer
prostate cancer
immunotherapy

Novel Treatments Under Study in Renal Cell Carcinoma and Prostate Cancer

There were numerous notable presentations at the 2019 Genitourinary Cancers Symposium, many of which were covered in The ASCO Post over the past few months. To add to our continued coverage of this meeting, here are some highlights from studies focusing on novel therapeutics in renal cell carcinoma ...

breast cancer

Can Some Women With HER2-Positive Breast Cancer Forgo Surgery?

Breast cancer researchers at The University of Texas MD Anderson Cancer Center, Houston, are beginning to select patients with HER2-positive breast cancer who might forgo surgery after neoadjuvant chemotherapy. While this fine-tuning is currently intended to inform clinical trials—in particular, to ...

multiple myeloma

Selinexor in Relapsed or Refractory Multiple Myeloma

In the Clinic provides overviews of novel hematology and oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On July 3, 2019, the oral nuclear export...

supportive care
symptom management

Virtual Reality May Improve Pain, Vision, Functioning in Patients With Cancer

Virtual reality can be used to improve functioning in patients with cancer, according to David Rhew, MD, Chief Medical Officer, Vice President and General Manager of Enterprise Healthcare, Samsung Electronics America. Research has shown that this technology can decrease pain and improve vision, as...

solid tumors

FDA Approves Pexidartinib for Tenosynovial Giant Cell Tumor

ON AUGUST 2, the U.S. Food and Drug Administration (FDA) granted approval to pexidartinib (Turalio) capsules for the treatment of adult patients with symptomatic tenosynovial giant cell tumor associated with severe morbidity or functional limitations and not responsive to improvement with surgery. ...

prostate cancer

FDA Approves Darolutamide for Nonmetastatic Castration-Resistant Prostate Cancer

ON JULY 30, the U.S. Food and Drug Administration (FDA) approved darolutamide (Nubeqa) for the treatment of nonmetastatic castration-resistant prostate cancer. Approval was based on the ARAMIS study, a multicenter, double-blind, placebo-controlled clinical trial of 1,509 patients with nonmetastatic ...

issues in oncology
pain management

Opioids for Cancer Pain: A Review of the Evidence and Current Challenges

In the wake of the opioid crisis in the United States, patients with cancer pain are often undeservedly confronted with rigid barriers to receiving the opioids they need. To compound this problem, the research around opioids in cancer pain has been limited—placebo-controlled trials are lacking,...

health-care policy
immunotherapy

CMS Finalizes Decision to Cover CAR T-Cell Therapy for Medicare Beneficiaries

ON AUGUST 7, the Centers for Medicare & Medicaid Services (CMS) finalized the decision to cover U.S. Food and Drug Administration (FDA)-approved chimeric antigen receptor (CAR) T-cell therapy among recipients of Medicare benefits. FDA-approved CAR T-cell therapies are approved to treat patients ...

solid tumors

Exploratory Analysis Shows DNA Methylation Assay Highly Specific for Cancer Detection

A cell-free DNA test based on the presence of DNA methylation has proven highly specific as a multicancer detection test and appears especially good at detecting high-risk malignancies. In most cases, it can also accurately pinpoint the tumor’s tissue of origin, researchers reported at the 2019...

skin cancer

Genomic Landscape of Merkel Cell Carcinoma

Researchers have developed the largest descriptive genomic analysis of patients with Merkel cell carcinoma to date. Their analysis, published by Knepper et al in Clinical Cancer Research, will provide important information to improve the care and treatment of patients with Merkel cell...

lung cancer

Addition of Pemetrexed/Carboplatin to Gefitinib in Advanced EGFR-Mutant NSCLC

In an Indian single-center phase III trial reported in the Journal of Clinical Oncology, Noronha et al found that the addition of pemetrexed/carboplatin to gefitinib improved progression-free and overall survival in first-line treatment of advanced EGFR-mutant non–small cell lung cancer...

head and neck cancer

Swallowing-Related Quality of Life After Radiotherapy vs Surgery for Oropharyngeal Squamous Cell Carcinoma

In the phase II ORATOR trial reported in The Lancet Oncology, Nichols et al found a statistical but not clinically meaningful improvement in swallowing-related quality of life outcomes 1 year after treatment with radiotherapy vs transoral robotic surgery and neck dissection in patients with...

immunotherapy

What Causes Liver Injury During Treatment With Pembrolizumab

Immunotherapy as a treatment for advanced solid cancers has rapidly evolved over the past decade—often yielding remarkable results. However, its use has also given way to new adverse effects, including drug-induced gastrointestinal and liver toxicities. “Checkpoint inhibitors are a game changer...

immunotherapy
skin cancer
kidney cancer
lung cancer

Long-Term Follow-up of Patients With Melanoma, Kidney Cancer, and Lung Cancer Receiving Nivolumab

As reported by Suzanne L. Topalian, MD, and colleagues in JAMA Oncology, long-term follow up of patients from a phase I expansion cohort study indicated 5-year overall survival rates of 34.2%, 27.7%, and 15.6% among patients who received nivolumab monotherapy for advanced melanoma, renal cell...

immunotherapy
skin cancer

5-Year Follow-Up of KEYNOTE-006 Trial of Immunotherapy Regimens in Advanced Melanoma

In a post hoc 5-year follow-up of the KEYNOTE-006 trial reported in The Lancet Oncology, Caroline Robert, MD, PhD, and colleagues found that pembrolizumab maintained overall and progression-free survival benefits over ipilimumab in patients with advanced melanoma. In the primary analysis from the...

hematologic malignancies
lymphoma

A Clinical Trial Was the Right Choice for Me

I found my cancer quite accidentally. In March 2018, as I was taking a shower, my hand casually brushed against my right mastoid bone, and I noticed the area sounded hollow. Around the same time, I realized I had developed a sense of fullness in that ear as well. I had been feeling tired, but that...

Pexidartinib for Tenosynovial Giant Cell Tumor

On August 2, the oral colony-stimulating factor 1 receptor inhibitor pexidartinib was approved for treatment of adult patients with symptomatic tenosynovial giant cell tumor associated with severe morbidity or functional limitations and not amenable to improvement with surgery.1,2 It is the first...

survivorship
supportive care
integrative oncology

Healthy Lifestyle for Young Adult Cancer Survivors

GUEST EDITOR Integrative Oncology is guest edited by Jun J. Mao, MD, MSCE, Laurance S. Rockefeller Chair in Integrative Medicine and Chief of Integrative Medicine Service at Memorial Sloan Kettering Cancer Center, New York.   The survival rates of adolescent and young adults with cancer have risen ...

V. Craig Jordan, CMG, OBE, PhD, DSc, Honored for Accomplishments in Women’s Health

The Companion of the Most Distinguished order of St. Michael and St. George (CMG) is generally reserved for ambassadors and leaders of the United Kingdom’s defense and security services. Only 1, 750 appointees are permitted. This year, the Head of M16, the Secret Intelligence Service, was in the...

head and neck cancer

FDA Approves Pembrolizumab for Some Patients With PD-L1–Positive Esophageal Cancer

On July 30, the U.S. Food and Drug Administration (FDA) approved the programmed cell death protein 1 inhibitor pembrolizumab (Keytruda) as monotherapy for the treatment of patients with recurrent locally advanced or metastatic esophageal cancer whose tumors express programmed cell death ligand 1...

bladder cancer

Gemcitabine/Eribulin in Cisplatin-Ineligible Metastatic Urothelial Carcinoma

In the final analysis from a phase II California Cancer Consortium trial (NCI-9653) reported in the Journal of Clinical Oncology, Sadeghi et al found the combination of gemcitabine and eribulin showed activity in cisplatin-ineligible patients with metastatic urothelial carcinoma. Study Details...

colorectal cancer

Oral Antibiotics and Risk of Colon or Rectal Cancer

In an extensive data mining analysis of British medical records, researchers found that taking even a single course of antibiotics might boost—albeit slightly—the risk of developing colon cancer, but not rectal cancer, a decade later. The findings, reported by Zhang et al in Gut,...

skin cancer

Impact of Genes on Total Number and Type of Nevi

A study by Duffy et al in the Journal of Investigative Dermatology reported on specific gene variations affecting the number and types of moles on the body and their role in causing skin cancer.  “The goal was to investigate the genetic underpinnings of different mole classes, or...

head and neck cancer

Deintensified Chemoradiotherapy for HPV-Associated Oropharyngeal Squamous Cell Carcinoma

In a phase II trial reported in the Journal of Clinical Oncology, Chera et al found that deintensified chemoradiotherapy produced favorable outcomes in human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma. Study Details In the multicenter trial, 114 patients were recruited...

immunotherapy

What Causes Liver Injury During Treatment With Pembrolizumab

Immunotherapy as a treatment for advanced solid cancers has rapidly evolved over the past decade—often yielding remarkable results. However, its use has also given way to new adverse effects, including drug-induced gastrointestinal and liver toxicities. “Checkpoint inhibitors are a game changer...

An Early Decision to Become an Oncologist

GUEST EDITOR Dr. Abraham is the Director of the Breast Oncology Program at Taussig Cancer Institute, and Professor of Medicine, Lerner College of Medicine, Cleveland Clinic.   For this installment of the Living a Full Life series, Guest Editor Jame Abraham, MD, FACP, spoke with Gilberto de Lima...

lung cancer

Atezolizumab Plus Chemotherapy and Bevacizumab in First-Line Treatment of Metastatic Lung Cancer

In late 2018, atezolizumab was approved for use in combination with bevacizumab, paclitaxel, and carboplatin for the first-line treatment of patients with metastatic nonsquamous non–small cell lung cancer (NSCLC) with no EGFR or ALK genomic tumor aberration.1,2 Supporting Efficacy Data Approval was ...

head and neck cancer

Incidence of HPV-Associated Head and Neck Cancers in the United States

In a study by Mahal et al published in Cancer Epidemiology, Biomarkers & Prevention, researchers conducted a population-based assessment of the incidence and demographic burden of human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma in the United States. The researchers...

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