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lung cancer
immunotherapy

WCLC 2018: PACIFIC Trial: Overall Survival With Durvalumab After Chemoradiotherapy in Unresectable Stage III NSCLC

As reported at the current International Association for the Study of Lung Cancer 19th World Conference on Lung Cancer (Abstract PL02.01) and in The New England Journal of Medicine by Antonia et al, the phase III PACIFIC trial has shown significantly improved overall survival—a...

breast cancer

TGFβ Polymorphism and Radiation-Induced Fibrosis in Breast Cancer

In an analysis reported in JAMA Oncology, Benjamin D. Smith, MD, of the Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, and colleagues found that a single nucleotide polymorphism (C−509T) in the transforming growth factor β1 (TGFβ1) gene was associated with...

pancreatic cancer

Neoadjuvant Therapy, Changes in Body Composition, and Resectability in Pancreatic Cancer

In a retrospective cohort study reported in JAMA Surgery, Carlos Fernández-del Castillo, MD, of the Department of Surgery, Massachusetts General Hospital, Harvard Medical School, and colleagues found that neoadjuvant therapy in patients with pancreatic ductal adenocarcinoma was associated with...

breast cancer
genomics/genetics

Expect Questions About Genetic Testing for Breast Cancer

A STUDY finding that pathogenic variants in 5 genes are associated with a high risk of triple-negative breast cancer and a 20% lifetime risk for overall breast cancer1 may increase interest in genetic testing. “This is the first study to establish which genes are associated with high lifetime risks ...

breast cancer
genomics/genetics

Mutations in Five Genes Linked to Higher Lifetime Risks for Aggressive Breast Cancer

USING MULTIGENE hereditary cancer panels to test for mutations in five genes can identify women at high risk for triple-negative breast cancer who may then benefit from more frequent screening, risk management, and potentially targeted therapies as well. A study that looked at multigene panel...

breast cancer

Pertuzumab in Adjuvant Treatment of HER2-Positive Breast Cancer

AT THE END OF 2017, pertuzumab (Perjeta) was granted regular approval for use in combination with trastuzumab (Herceptin) and chemotherapy as adjuvant treatment of patients with HER2- positive early breast cancer at high risk of recurrence.1,2 Supporting Efficacy Data APPROVAL WAS BASED on...

Mayo Clinic Physicians Receive SU2C Award for Melanoma Research

MAYO CLINIC physicians Matthew Block, MD, PhD, and Tina Hieken, MD, have received a Stand up to Cancer (SU2C) Catalyst Award to fund melanoma research and a neoadjuvant clinical trial. “This study, “Neoactivate,” will test two novel approaches to the treatment of patients with high-risk, stage 3...

prostate cancer

Abiraterone Acetate Plus Prednisone in High-Risk Metastatic Castration-Sensitive Prostate Cancer

IN EARLY 2018, abiraterone acetate tablets (Yonsa, Zytiga) in combination with prednisone was approved for the treatment of metastatic high-risk castration-sensitive prostate cancer.1,2 Supporting Efficacy Data APPROVAL WAS BASED on findings from the phase III LATITUDE trial, in which 1,199...

integrative oncology

Care for the Cancer Caregiver

Providing care to patients with cancer can be overwhelming, and caregivers are at risk for physical and psychological distress, which can negatively impact their own health. Over the past decade, supporting caregiver well-being has gained prominence as a national health-care issue. In this...

issues in oncology
pain management

2018 Quality Care: New Approach Successfully Reduces Opioid Use After Urologic Oncology Surgery

In a study conducted by Stanford Health Care, researchers achieved a 46% reduction in opioid use among 443 patients with cancer who underwent a range of urologic surgeries without increasing their pain or anxiety. They achieved this reduction through a two-pillared approach: (1) maximizing the use...

breast cancer
cost of care

2018 Quality Care: Few Women With Breast Cancer Discuss Costs With Physicians Before Beginning Treatment

Findings from a new study reveal that while many women with breast cancer experience significant financial burden and most prefer to discuss the cost of their cancer care before beginning treatment, few are having conversations about treatment costs with their cancer care teams. These findings will ...

breast cancer
issues in oncology
cost of care

2018 Quality Care: Nationwide Survey Reveals Patients With Metastatic Breast Cancer Face Major Financial Stress Due to Treatment Costs

A new nationwide analysis of more than 1,000 people living with metastatic breast cancer from 41 states reveals significant cancer-related financial burden known as financial toxicity, particularly for uninsured patients. The study will be presented by Wheeler et al at the upcoming 2018 ASCO...

issues in oncology
cost of care

2018 Quality Care: Older Patients With Advanced Cancer Experiencing Financial Difficulties Have Worse Quality of Life and Mental Health

Older patients with advanced cancer experiencing financial toxicity due to the cost of their treatment have higher rates of severe anxiety and depression and poorer quality of life than patients who do not experience financial hardship. In addition, for those patients having financial difficulty,...

head and neck cancer

ASCO Endorses CAP Guideline on HPV Testing in Head and Neck Carcinoma

As reported in the Journal of Clinical Oncology by Carole Fakhry, MD, MPH, of Johns Hopkins School of Medicine, and colleagues, ASCO has endorsed the 2018 College of American Pathologists (CAP) guideline on human papillomavirus (HPV) testing in head and neck carcinoma. The endorsement was based on...

prostate cancer
issues in oncology
cost of care

Estimated Medicare Cost for Prostate Cancer Care in Older Men

Although national guidelines recommend against prostate cancer screening in men age 70 and older, researchers from the University of North Carolina (UNC) Lineberger Comprehensive Cancer Center estimate that screening for and treating prostate cancer in men in this age group costs Medicare more than ...

issues in oncology
health-care policy

Medicaid Work Requirements Could Reduce Vulnerable Patients’ Access to Cancer Care

In a recent position statement, ASCO warns that Medicaid work requirements may hinder patient access to essential cancer care and reduce the already limited time physicians are able to spend with their patients. ASCO also recommends that federal and state policymakers take specific steps to ensure...

leukemia

Origins and Genetics Associated With Mixed-Phenotype Acute Leukemia

Investigators have unraveled the origins and identified mutations associated with mixed-phenotype acute leukemia. The study, published by Alexander et al in Nature, potentially lays the foundation for more effective treatment of patients with this high-risk cancer. Mixed-phenotype acute...

issues in oncology

Are E-Cigarettes a Dangerous Alternative to Traditional Cigarettes?

Several studies published earlier this year present preliminary but compelling evidence that electronic cigarettes, also known as e-cigarettes, which deliver nicotine through aerosols without burning tobacco, may pose serious health consequences to users, including cardiovascular disease and...

legislation
pain management

New Laws Limiting Opioid Prescriptions Create Undue Barriers for Patients With Cancer and Cancer Survivors

Among other policy responses to the growing opioid epidemic, many states have enacted legislation that limits the duration or amount of opioid prescriptions issued by physicians. Although, it is clear we need strong measures to mitigate widespread overuse and misuse of opioids. These...

issues in oncology
immunotherapy
hematologic malignancies
leukemia

CAR T-Cell Therapy for CLL

A pair of new studies from researchers at the Abramson Cancer Center of the University of Pennsylvania are shedding light on why patients with advanced chronic lymphocytic leukemia (CLL) respond or do not respond to chimeric antigen receptor (CAR) T-cell therapy. Although CAR T-cell therapy is...

gastrointestinal cancer
colorectal cancer

Maintenance Therapy for Metastatic Colorectal Cancer: Benefit Seen With Panitumumab Combination

Although the optimal approach to maintenance is not definitive in patients with metastatic colorectal cancer who have undergone chemotherapy-based induction with anti–endothelial growth factor receptor (EGFR) agents, the phase II VALENTINO trial showed that anti-EGFR maintenance therapy with...

solid tumors
breast cancer
immunotherapy

Addition of Bevacizumab to Neoadjuvant Therapy in BRCA1/2-Mutant Triple-Negative Breast Cancer

In an analysis from the GeparQuinto trial reported in the Journal of Clinical Oncology, Peter A. Fasching, MD, of Erlangen University Hospital, Comprehensive Cancer Center Erlangen-EMN, and colleagues found that the addition of bevacizumab (Avastin) to neoadjuvant chemotherapy increased the...

issues in oncology

An Invitation to Be Quiet No Longer

My male colleagues sometimes broach the topic of #MeToo or sexual harassment in medicine by saying how uncomfortable it makes them. Ah, yes. How uncomfortable the sexual harassment I  have faced for years makes you. I casually bring up microaggressions—subtle verbal or nonverbal slights against...

solid tumors
breast cancer

Treatment of Triple-Negative Breast Cancer With BRCA1/2 Mutations: More to Learn From Ongoing Trials

The treatment of triple-negative breast cancer remains a clinical challenge with no single validated target, though numerous pathways are druggable and are being investigated. In the subset of BRCA-mutated triple-negative breast cancer, the approval of the first poly (ADP-ribose) polymerase (PARP)...

prostate cancer
issues in oncology

Researchers Identify Pitfall in PSMA PET Imaging Method

Prostate-specific membrane antigen (PSMA) positron-emission tomography (PET) imaging has become a popular method for determining the stage of a patient’s prostate cancer. However, researchers have identified a pitfall in this imaging technique and are cautioning medical professionals to be...

solid tumors
hepatobiliary cancer

Cabozantinib in Second-Line Treatment of Advanced Hepatocellular Carcinoma

Compared with placebo, cabozantinib (Cabometyx) significantly improved overall survival and progression-free survival in patients with advanced hepatocellular carcinoma who were previously treated with sorafenib (Nexavar), with no new safety signals, according to data from the phase III CELESTIAL ...

issues in oncology

FDA Takes New Steps to Address Youth E-Cigarette Use

The U.S. Food and Drug Administration (FDA) has announced a series of critical and historic enforcement actions related to the sale and marketing of e-cigarettes to children. In the largest coordinated enforcement effort in the its history, the agency issued more than 1,300 warning...

kidney cancer

New Recommendations for Cabozantinib Tablets in Updated NCCN Clinical Practice Guidelines

Recently, the National Comprehensive Cancer Network® (NCCN®) updated its Clinical Practice Guidelines to include new recommendations for cabozantinib (Cabometyx) tablets. With the updates, cabozantinib is recommended by the NCCN for the treatment of advanced renal cell carcinoma regardless...

bladder cancer

Outcomes With Neoadjuvant Chemotherapy Regimens in Muscle-Invasive Bladder Cancer

In a single-center analysis reported in JAMA Oncology, Peyton et al found that neoadjuvant dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin (ddMVAC) produced better outcomes than other standard neoadjuvant regimens in patients undergoing radical cystectomy for muscle-invasive...

hepatobiliary cancer

First-Line Nab-Paclitaxel and Gemcitabine in Advanced Cholangiocarcinoma

In a phase II trial reported in JAMA Oncology, Sahai et al found that the first-line combination of nab-paclitaxel and gemcitabine—though it did not meet the progression-free survival primary endpoint—may constitute a treatment option in advanced cholangiocarcinoma. Study Details In...

leukemia

Neonatal Dysregulated Immune Function and Pediatric B-Cell Precursor ALL

A high incidence of clinically diagnosed infections in the first year of life among children who later developed acute lymphoblastic leukemia (ALL) has led researchers to propose that children with ALL are born with a dysregulated immune function, resulting in a more vigorous reaction to infections ...

prostate cancer
immunotherapy

Mismatch Repair Mutations and Immunotherapy in Prostate Cancer

A group of men with especially aggressive prostate cancer may respond unusually well to immunotherapy, according to a study published by Rodrigues et al in the Journal of Clinical Investigation. The research offers the possibility of effective treatment, with clinical trials already underway. An...

kidney cancer

Presurgical CT Imaging of CD117-Positive Kidney Tumors

A research team from Roswell Park Comprehensive Cancer Center has discovered a way to use computed tomography (CT) imaging to assess kidney tumors that test positive for the biomarker CD117 and accurately determine—before surgery—whether the tumor is benign or malignant. Their findings...

issues in oncology

Bleeding in Patients Treated With Anticoagulants and Potential Cancers

Bleeding in patients treated with anticoagulants may indicate an increased probability of cancer, according to late-breaking results from the COMPASS trial presented at the 2018 European Society of Cardiology Congress. Principal investigator John Eikelboom, MD, of the Population Health Research...

leukemia
symptom management

Study Finds Hispanic Pediatric Patients at Increased Risk of Methotrexate Neurotoxicity During Treatment for ALL

Case studies have reported a high prevalence of methotrexate subacute neurotoxicity among Hispanic adolescents with acute lymphoblastic leukemia (ALL), suggesting sensitivity to methotrexate therapy may differ by race and ethnicity. Now, a prospective study in pediatric patients with ALL has found...

lung cancer
issues in oncology
survivorship

Small Study Shows Chemotherapy May Lead to Early Menopause in Young Women With Lung Cancer

A new study suggests chemotherapy may cause acute amenorrhea, leading to early menopause in women with lung cancer. The study is the first to comment on amenorrhea rates in women younger than 50, concluding that women with lung cancer who desire future fertility should be educated about risks and...

symptom management

ASCO/IDSA Clinical Practice Guideline Update: Antimicrobial Prophylaxis for Adult Patients With Cancer-Related Immunosuppression

As reported in the Journal of Clinical Oncology by Randy A. Taplitz, MD, of UC San Diego Health, and colleagues, ASCO and the Infectious Diseases Society of America (IDSA) have updated their joint guideline on antimicrobial prophylaxis for adult patients with immunosuppression associated with...

ASCO Volunteer Advocates Bringing Cancer Priorities to Capitol Hill for 2018 Advocacy Summit

ON SEPTEMBER 25–26, oncology care providers from across the United States will head to Capitol Hill to participate in the 3rd annual ASCO Advocacy Summit. Over 2 days, ASCO volunteer advocates will meet with members of Congress and their staff to educate them on critical issues affecting patients...

breast cancer

Male Breast Cancer: An Understudied Malignancy

Male breast cancer is a rare and understudied malignancy when compared with female breast cancer, with conflicting literature on survival outcomes in men and women. The ASCO Post spoke recently with breast cancer expert Sharon Giordano, MD, MPH, FASCO, Professor at The University of Texas MD...

issues in oncology
palliative care

Expanding the Use of Provider Orders for Life-Sustaining Treatment for Patients With Advanced Cancer

Patients with advanced cancer often get more aggressive treatment than they want because too few oncologists elicit their end-of-life treatment preferences.1,2 In response to this problem, leading associations, including ASCO3,4 and the Institute of Medicine,5 have called for more advance care...

lymphoma
geriatric oncology

Challenges of Managing Older Patients With Diffuse Large B-Cell Lymphoma

As the population continues to age, the interplay between aging and cancer increasingly shows cancer to be a disease of older people. By the year 2030, there will be an increased incidence of non-Hodgkin lymphoma (NHL) in older individuals.1 The median age of patients diagnosed with diffuse large...

Chemotherapy for Acute Myeloid Leukemia: Where Should It Be Given?

USING THE National Cancer Database, Bhatt et al1 recently reported that of the 61,775 adults with acute myeloid leukemia (AML), those who received chemotherapy from 2003 to 2011 lived longer than those who, in those same years, did not; the study is reviewed in this issue of The ASCO Post....

issues in oncology
immunotherapy

Cardiac Issues Related to Checkpoint Inhibitors Still Largely Understudied

IMMUNE CHECKPOINT inhibitors represent a giant step forward in the treatment of many cancers, and as these agents have “come of age” in the past few years, so has the collective understanding of their potential for causing adverse events. Although checkpoint inhibitors are known to be associated...

skin cancer

No Improvement in Survival Reported With Epacadostat Plus Pembrolizumab in Advanced Melanoma

IN PATIENTS with unresectable or metastatic melanoma, adding epacadostat to pembrolizumab (Keytruda) did not result in greater clinical benefit over pembrolizumab alone, according to data from the phase III ECHO-301/KEYNOTE-252 study. These results were originally presented at the 2018 ASCO Annual...

hepatobiliary cancer
lung cancer
bladder cancer

Recent Drug Approvals and Revisions in Prescribing Information

THE U.S. FOOD AND DRUG ADMINISTRATION (FDA) issued the following approvals and prescribing information revisions in August 2018. Lenvatinib Approved for Unresectable Hepatocellular Carcinoma THE FDA approved lenvatinib (Lenvima) for the first-line treatment of patients with unresectable...

hematologic malignancies

FDA Approves First Nonchemotherapy Combination Regimen for Patients With Waldenström’s Macroglobulinemia

ON AUGUST 27, 2018, the U.S. Food and Drug Administration (FDA) approved the combination of ibrutinib (Imbruvica) and rituximab (Rituxan) for patients with Waldenström’s macroglobulinemia. The recent approval expands the label for ibrutinib in Waldenström’s macroglobulinemia beyond its current...

lymphoma

Clarifying the Complexity of Genomic Testing in Non-Hodgkin Lymphoma

AS MORE is learned about the genomic landscape in non-Hodgkin lymphoma, clinicians are grappling with how to apply this information in the clinic. At the 2018 Pan Pacific Lymphoma Conference, Andrew D. Zelenetz, MD, PhD, helped them understand this emerging area.1 Dr. Zelenetz is Professor of...

lymphoma

Relapsed or Refractory Hodgkin Lymphoma: Optimizing Salvage Therapy

As novel therapies come on board for treating relapsed or refractory Hodgkin lymphoma, the field is advancing toward more personalized therapy. The goal, even in the advanced-disease setting, is to increase the chances of complete response and negative positron-emission tomography (PET), while...

breast cancer

Proteomics May Be Used to Predict Treatment Outcomes in Triple-Negative Breast Cancer

In triple-negative breast cancer, researchers have so far been unable to identify markers that can classify patients by prognosis or probability of responding to different treatments. In a study published by Zagorac et al in Nature Communications, researchers from the Spanish National Cancer...

hematologic malignancies
leukemia

Outcomes After Discontinuation of Tyrosine Kinase Inhibitor Therapy in Chronic Myeloid Leukemia

In an interim analysis of a European trial reported in The Lancet Oncology, Francois-Xavier Mahon, MD, of Institut Bergonié, Bordeaux, and colleagues found that discontinuation of tyrosine kinase inhibitor therapy in patients with chronic myeloid leukemia (CML) with deep molecular response was...

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