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head and neck cancer

Low- vs High-Dose Cisplatin Chemoradiotherapy in Squamous Cell Carcinoma of the Head and Neck

In an analysis of Veterans Affairs data reported in the Journal of the National Cancer Institute, Bauml et al found that weekly lower-dose cisplatin vs higher-dose cisplatin given every 3 weeks as part of concurrent definitive chemoradiotherapy may not adversely affect survival, while reducing...

hematologic malignancies
lymphoma

Targeting CCR4 in Cutaneous T-Cell Lymphoma: The MAVORIC Trial

The C-C chemokine receptor 4 (CCR4) is predominantly expressed in type 2 helper T (Th2) cells and regulatory T (Treg) cells.1 Under physiologic conditions and in response to its ligands, CCL17 (TARC) and CCL22 (MDC), CCR4 promotes T-cell migration to the skin.2 Of note, CCR4 is highly expressed in...

issues in oncology
symptom management
pain management

Angela M. Stover, PhD, on Patient-Reported Symptoms: Results From the STAR and PRO-TECT Trials

Angela M. Stover, PhD, of the University of North Carolina at Chapel Hill, discusses study findings on ways to alert clinicians when patients signal symptoms such as pain or diarrhea that may be cause for concern (Abstract 158).

supportive care

Strategies for Using Anticoagulation Therapy in Patients With Cancer

Although approximately 20% to 30% of patients with cancer will develop venous thromboembolism (VTE), clinicians continue to debate strategies for pharmacologic treatment and prevention.1 At the 2018 Debates and Didactics in Hematology and Oncology Conference, held on Sea Island, Georgia, Christine...

lung cancer

Durvalumab Improves Overall Survival in Stage III NSCLC

The phase III PACIFIC trial showed significantly improved overall survival with durvalumab (Imfinzi) vs placebo after chemoradiotherapy in patients with unresectable stage III non–small cell lung cancer (NSCLC). Scott J. Antonia, MD, of the Moffitt Cancer Center, Tampa, Florida, reported these...

hematologic malignancies
leukemia

Beat AML Trial Seeking to Change Treatment Paradigm

The Beat AML Master Clinical Trial seeks to change the treatment paradigm and outcomes in acute myeloid leukemia (AML) by personalizing therapy and ultimately facilitating the approval of novel targeted agents. Co-investigator William Blum, MD, of the Winship Cancer Institute at the Emory...

issues in oncology

Wear That White Coat—With Pride

These days it can be hard for physicians. Many in the physician workforce wonder whatever happened to the ideals and expectations that drew them to this noble profession. The genuine passion to heal the sick and infirm and in turn improve the health of the entire society The ability to touch human ...

hematologic malignancies
lymphoma

The Relevance of the RELEVANCE Trial in Follicular Lymphoma

We have seen remarkable progress in the outcomes of patients with advanced-stage follicular lymphoma over the past 2 decades.1 Recent manuscripts and presentations describing long-term follow-up of randomized trials comparing various chemotherapy platforms (all combined with anti-CD20 antibodies)...

hematologic malignancies
leukemia

Update on CML: Focus on Sequential Therapy, Treatment Discontinuation, and Monitoring

Chronic myeloid leukemia (CML) is a poster child for the success of molecularly targeted therapy, with some patients appearing to be “cured” of their disease and others living for a long time after treatment with a tyrosine kinase inhibitor targeting the BCR-ABL1 protein. However, there are still...

solid tumors
immunotherapy

Bacterial Therapy Tolerable, Shows Early Activity in Patients With Advanced Solid Tumors

A phase I clinical trial investigating the use of bacterial Clostridium novyi-NT spores as an injectable monotherapy had manageable toxicities and showed early clinical efficacy in patients with treatment-refractory solid tumor malignancies, according to data presented at the CRI-CIMT-EATI-AACR...

breast cancer

High Levels of Fertility-Related Hormone May Be Linked to Increased Breast Cancer Risk

Having high levels of anti-Müllerian hormone (AMH)—a hormone that indicates the size of a woman’s ovarian reserve—before menopause may be associated with an increased risk of breast cancer, a study by Ge et al in the International Journal of Cancer found. In a major study,...

lung cancer

Thermal Ablation vs Stereotactic Radiotherapy in Early-Stage NSCLC

Thermal ablation is a safe, effective treatment for early-stage non–small cell lung cancer (NSCLC), with comparable results to traditional stereotactic radiotherapy, according to a study published by Uhlig et al in the journal Radiology. The results show that ablation may be an effective ...

skin cancer

Recurrence and Cosmetic Outcomes With Treatments for Primary Basal Cell Carcinoma of the Skin

In a systematic review and meta-analysis reported in Annals of Internal Medicine, Drucker et al found differences in recurrence rates and patient-reported cosmetic outcomes among various treatments for mostly low-risk primary basal cell carcinoma of the skin. Study Details The study involved data ...

lung cancer

WCLC 2018: Oncogene-Driven Patient-Caregiver Communities Creating New Paradigm for NSCLC Research

A recent review of patient-caregiver communities focused on non–small cell lung cancer (NSCLC) with genomic alterations showed that these groups are improving outcomes by supporting patients and caregivers, increasing awareness and education, and accelerating research. Patient advocate Janet...

skin cancer

FDA Approves Cemiplimab-rwlc for Metastatic Cutaneous Squamous Cell Carcinoma

On September 28, the U.S. Food and Drug Administration (FDA) approved cemiplimab-rwlc (Libtayo) injection for intravenous use for the treatment of patients with metastatic cutaneous squamous cell carcinoma (SCC) or locally advanced cutaneous SCC who are not candidates for curative surgery or...

lung cancer
issues in oncology

Health Resource Utilization and CNS Metastases in EGFR-Mutant Advanced NSCLC

In a single-center study reported in the Journal of Oncology Practice, Chooback et al found that central nervous system (CNS)  metastases are frequent in patients with EGFR-mutant advanced non­–small cell lung cancer (NSCLC) and are associated with increased health resource...

sarcoma

High-Dose Chemotherapy and Autologous SCT vs Standard Chemotherapy in Localized High-Risk Ewing Sarcoma

As reported in the Journal of Clinical Oncology by Whelan et al, combined trials (EURO-EWING99 and Ewing-2008) have shown evidence of improved outcomes with high-dose therapy with busulfan and melphalan (BuMel) and autologous stem cell transplant (SCT) vs standard chemotherapy with vincristine,...

lung cancer

WCLC 2018: IMpower133: Atezolizumab May Improve Outcomes for SCLC When Added to Carboplatin and Etoposide

Findings from the IMpower 133 trial demonstrate that adding the anti­–programmed cell death ligand 1 antibody atezolizumab (Tecentriq) to standard first-line therapy with carboplatin and etoposide prolonged overall survival (OS) and progression-free survival (PFS) in patients with...

leukemia
lymphoma

FDA Approves Duvelisib for Adult Patients With Relapsed or Refractory CLL, SLL, and Follicular Lymphoma

On September 24, 2018, the U.S. Food and Drug Administration (FDA) granted regular approval to duvelisib (Copiktra) for adult patients with relapsed or refractory chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) after at least two prior therapies. In addition, duvelisib...

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 ...

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