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issues in oncology

Assessing the Clinical Utility of ASCO’s and ESMO’s Value Frameworks

In 2015, ASCO and the European Society for Medical Oncology (ESMO) introduced value frameworks that utilize algorithmic scales to evaluate the clinical benefit of cancer therapies and provide an objective assessment of outcomes and treatment toxicities experienced by patients.1,2 Although the two...

breast cancer

Use of Specialized PET/CT to Assess Estrogen Receptor Status in Recurrent or Metastatic Breast Cancer

In a Korean study reported in The Lancet Oncology, Chae et al found that 16α-[18F]fluoro-17β-oestradiol (18F-FES) positron-emission tomography/computed tomography (PET/CT) may permit accurate reevaluation of estrogen receptor status in recurrent or metastatic breast cancer when repeat...

skin cancer

Incidence of Nonmelanoma Skin Cancer in Recipients of Multiple Kidney Transplants

The incidence of nonmelanoma skin cancer may be more common in recipients of kidney transplants vs patients on maintenance dialysis. Researchers looked to determine if the risk of nonmelanoma skin cancer is lower during periods of graft loss with a return to dialysis vs during periods of...

prostate cancer
immunotherapy

Viral Vector–Based Immunotherapy in Metastatic Castration-Resistant Prostate Cancer

In a phase III trial reported in the Journal of Clinical Oncology, Gulley et al found that PROSTVAC, a viral vector-based immunotherapy, did not improve overall survival or 6-month event-free survival vs placebo in patients with asymptomatic or minimally symptomatic metastatic castration-resistant...

kidney cancer

Activity of Cabozantinib in Advanced Non–Clear Cell Renal Cell Carcinoma

In a retrospective cohort study reported in The Lancet Oncology, Chanzá et al found evidence of activity of cabozantinib in advanced non–clear cell renal carcinoma. Cabozantinib is approved in metastatic renal cell carcinoma on the basis of studies in clear cell histology. As noted by ...

pancreatic cancer

Addition of Pegylated Recombinant Human Hyaluronidase to FOLFIRINOX in Metastatic Pancreatic Adenocarcinoma

In the phase I/II SWOG S1313 trial, which was reported in the Journal of Clinical Oncology by Ramanathan et al, researchers found that the addition of pegylated recombinant human hyaluronidase (PEGPH20) to modified (m) FOLFIRINOX (fluorouracil, leucovorin, irinotecan, and oxaliplatin) worsened...

lung cancer

2019 Thoracic Cancers Symposium: Trends in Use of Prophylactic Cranial Irradiation for Extensive-Stage SCLC

A new survey of radiation oncologists points to a sharp decline in the use of prophylactic cranial irradiation for patients with extensive-stage small cell lung cancer (SCLC), indicating a rapid change in standard practice for the disease following the 2017 publication of a major clinical trial by...

lung cancer

2019 Thoracic Cancers Symposium: Effect of Structured Patient Exposure to the NCCN Guidelines for NSCLC

A new clinical trial found that exposing patients to tailored versions of the National Comprehensive Cancer Network (NCCN®) Guidelines for non–small cell lung cancer (NSCLC) may help drive smoking cessation, testing for potential biomarkers and, for early-stage disease, more...

lung cancer

2019 Thoracic Cancers Symposium: Local Consolidative Therapy and Overall Survival in Oligometastatic NSCLC

A new analysis of patients treated with local consolidative therapy for oligometastatic non–small cell lung cancer (NSCLC) found that the intensive treatment approach is associated with improved overall survival. Local consolidative therapy—consisting of radiation therapy or...

issues in oncology

Lack of Genetic Diversity in Common Cancer Cell Lines

Researchers have found that some commercial cancer cell lines used for laboratory studies have mislabeled ancestry when it comes to minorities. These findings were published by Hooker et al in Cancer Epidemiology, Biomarkers & Prevention. “A lack of diversity is prevalent in every level...

prostate cancer

Intense Neoadjuvant Androgen Deprivation Before Prostatectomy in Locally Advanced Prostate Cancer

In a phase II trial reported in the Journal of Clinical Oncology, McKay et al found a trend toward improved pathologic response or minimal residual disease with the addition of neoadjuvant abiraterone and prednisone to enzalutamide and leuprolide prior to radical prostatectomy in patients with...

breast cancer
solid tumors
gynecologic cancers
lymphoma
survivorship

Subsequent Primary Neoplasms in Survivors of Adolescent and Young Adult Cancers

In a UK population-based cohort study (Teenage and Young Adult Cancer Survivor Study) reported in The Lancet Oncology, Bright et al found that subsequent primary neoplasms were most common in survivors of adolescent and young adult (AYA) breast, cervical, and testicular cancers, as well as Hodgkin...

Humanitarian, Cancer Specialist Advocates for Universal Access to Care as a Basic Human Right

There is a plethora of educational books for patients with cancer and their families; advocates and patients themselves write most. Books in this genre often have a difficult time distilling the hard science of oncology into a lay-friendly narrative that keeps the reader engaged from cover to...

gynecologic cancers

Conservatively Managing Ovarian Tumors

In an interim analysis of a prospective cohort study (IOTA5) reported in The Lancet Oncology, Wouter Froyman, MD, and colleagues found that the risk of malignancy and acute complications is low when adnexal masses with benign ultrasound findings are managed conservatively. In the study, patients...

breast cancer

Factors Influencing Conversion to Mastectomy in Ductal Carcinoma in Situ

In a prospective cohort clinical trial reported in JAMA Oncology, Constance D. Lehman, MD, PhD, and colleagues found that multiple factors, including magnetic resonance imaging (MRI) findings, played a role in conversion to mastectomy among women with ductal carcinoma in situ (DCIS) who were...

breast cancer

Outcomes With Dose-Intense Adjuvant Chemotherapy in Early Breast Cancer

In a patient-level meta-analysis reported in The Lancet, the Early Breast Cancer Trialists’ Collaborative Group found that an increased dose intensity of adjuvant taxane and anthracycline chemotherapy in early breast cancer was associated with a decreased risk of recurrence and death from breast...

breast cancer

We Need Better Screening Methods for Detecting Breast Cancer

MY BREAST CANCER was probably a decade in the making, although I only became aware that there might be a problem in 2014, when I noticed some slight pain in my left breast. A routine mammogram and ultrasound found benign cysts in my dense breasts, which most likely explained the pain, I was told,...

lymphoma

Update on Newer Treatments in Non-Hodgkin Lymphomas

AS PART of The ASCO Post’s continued coverage of the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition, here is an update on several different studies on new therapeutics in non-Hodgkin lymphomas (NHLs), including follicular lymphoma, diffuse large B-cell lymphoma (DLBCL), ...

breast cancer
immunotherapy

FDA Grants Accelerated Approval to Atezolizumab/Nab-Paclitaxel; Regular Approval Contingent on Confirmatory Trials

Today, the U.S. Food and Drug Administration (FDA) granted accelerated approval to atezolizumab (Tecentriq) plus nanoparticle albumin-bound (nab)-paclitaxel (Abraxane) for the treatment of adults with unresectable, locally advanced or metastatic, programmed cell death ligand 1 (PD-L1)-positive ...

integrative oncology

Omega-3 Fatty Acids

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. Gary Deng, MD, PhD, and Jyothirmai Gubili, MS, explore the use of omega-3 fatty acids, which have...

A Peaceful Transformation: The Origin of the Frederick National Laboratory

JUST 2 MONTHS before Congress passed what to this day is America’s most sweeping anticancer legislation, President Richard Nixon came to Fort Detrick in Frederick, Maryland, to declare his administration’s historic commitment to the fight. “I have come here today for the purpose of making an...

issues in oncology

Health-Care Fraud Prosecutions Are on the Rise

Prosecuting health-care fraud is a top priority for the U.S. Department of Justice (DOJ) and other federal government agencies.1,2 After all, the government earns a $6 return for every $1 that it spends on enforcement. In December 2018, the DOJ announced that it had obtained more than $2.5 billion...

hepatobiliary cancer

Cabozantinib for Hepatocellular Carcinoma Previously Treated With Sorafenib

In the Clinic provides overviews of novel 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 January 14, 2019, cabozantinib was approved for the...

multiple myeloma

Reshaping the Treatment Landscape in Refractory Multiple Myeloma

THE TREATMENT approaches for multiple myeloma, both newly diagnosed and relapsed disease, continue to undergo major transformation as new agents and combinations are being introduced.1 This change has been driven by the introduction of novel drug classes such as monoclonal antibodies, as well as...

multiple myeloma

Addition of Elotuzumab to Pomalidomide and Dexamethasone in Previously Treated Patients With Multiple Myeloma

AS REPORTED in The New England Journal of Medicine by Meletios A. Dimopoulos, MD, of the National and Kapodistrian University of Athens, and colleagues, the phase II ELOQUENT-3 trial has shown that the addition of elotuzumab to pomalidomide and dexamethasone significantly prolonged...

lung cancer

Although Evidence Is Clear That Lung Cancer Screening Saves Lives, Adoption Rates Remain Low

The findings of the National Lung Screening Trial (NLST), reported in 2011, revealed that participants who received low-dose helical computed tomography (CT) scans had a 20% lower risk of dying of lung cancer than participants who received standard chest x-rays. Despite these results,...

skin cancer

New Patient Resource: NCCN Guidelines for Patients With Squamous Cell Skin Cancer

The National Comprehensive Cancer Network® (NCCN) has published a new book of patient information that explains prevention, diagnosis, and treatment for squamous cell skin cancer. Squamous cell and basal cell skin cancers are responsible for about 5 million annual incidents of nonmelanoma...

breast cancer
issues in oncology
cost of care

Patients With Breast Cancer Provide Recommendations to Ease Financial Toxicity

A qualitative study yielded nine patient-driven recommendations across circumstances that include changes to insurance, supportive services, and financial assistance to reduce long-term, breast cancer–related economic burden. The study was published by Dean et al in Cancer. Unique...

skin cancer

Is the Presence of Nevi on Extremities a Risk Factor for Melanoma and Nonmelanoma Skin Cancers?

The presence of nevi is an established risk factor for melanoma. In light of this, researchers examined the association between the presence of nevi on extremities and the risk of melanoma and nonmelanoma skin cancers. Their findings were published by Wei et al in the Journal of the American...

skin cancer
immunotherapy

A Single Dose of a PD-1 Inhibitor Before Surgery May Predict Outcomes in Patients With Melanoma

A single dose of a programmed cell death protein 1 (PD-1) inhibitor before resection for melanoma may predict clinical outcomes for patients. Researchers from the Abramson Cancer Center at the University of Pennsylvania—who documented this finding in the largest cohort of patients to be...

solid tumors
issues in oncology

Effect of Adjuvant Treatment for Early Testicular Cancer on Reproductive Potential

Men with early-stage testicular cancer can safely receive one course of adjuvant chemotherapy or radiotherapy without it having a long-term effect on their reproductive potential, according to a study published by Weibring et al in Annals of Oncology. Although it is known already that several...

prostate cancer

Prevalence of Adverse Germline Genetic Variants in Prostate Cancer

In a study reported in JAMA Oncology by Nicolosi et al, it was found that 17% of men with prostate cancer had likely deleterious germline genetic variants, and that many of these men would not have been considered candidates for genetic testing. Study Details The study involved data from 3,607...

gynecologic cancers

Does Lymphadenectomy Improve Survival in Advanced Ovarian Cancer?

In the international phase III LION study reported in The New England Journal of Medicine, Harter et al found that lymphadenectomy did not improve progression-free or overall survival vs no lymphadenectomy in women with advanced ovarian cancer. Study Details The trial enrolled 647 women with...

breast cancer
gynecologic cancers
hematologic malignancies
leukemia
lymphoma
symptom management

FDA Pipeline: Updates on Treatments for Cervical Cancer, Myelofibrosis, Chemotherapy-Induced Nausea and Vomiting, and More

The FDA recently issued announcements on a Fast Track designation, a Priority Review, two supplemental new drug applications, an investigational new drug application, and a marketing clearance. The agency also released a safety communication on cancer-related surgery. Fast Track Designation for...

colorectal cancer
health-care policy

Effect of Affordable Care Act’s Medicaid Expansion on Colorectal Cancer Screening and Survival in Kentucky

Kentucky has been one of the most successful states in reducing its uninsured rate, which happened in part through the Affordable Care Act’s Medicaid expansion that took effect on January 1, 2014. In the past, Kentucky has reported low rates of colorectal cancer screening, and has ranked ...

lymphoma

First-Line Treatment of Indolent Non-Hodgkin Lymphoma or Mantle Cell Lymphoma With Bendamustine/Rituximab vs R-CHOP or R-CVP

As reported in the Journal of Clinical Oncology by Flinn et al, 5-year follow-up of the phase III BRIGHT trial has shown improved outcomes with first-line bendamustine/rituximab vs R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone) or R-CVP (rituximab plus...

issues in oncology

Eliminating the Taboo of Cancer

All homes and all families have or have had their own cancer experiences. Speaking about it dissolves the taboo and allows for earlier diagnosis, less discrimination, increased awareness, and higher commitment by authorities. It also helps those struggling with the disease feel like part of a...

bladder cancer
immunotherapy

Nicholas Vogelzang, MD, on Urothelial Cancer: Results From a Trial on Lenvatinib Plus Pembrolizumab

Nicholas Vogelzang, MD, of the Comprehensive Cancer Centers of Nevada, discusses phase Ib/II findings on pembrolizumab and lenvatinib given to 20 patients with metastatic transitional cell carcinoma of the bladder who had received no prior checkpoint inhibitor therapy (Abstract 11).

supportive care
palliative care

Innovative Research to Improve the Supportive Care Needs of Cancer Survivors

First launched in 2014, the Palliative Care in Oncology Symposium introduced a nascent interdisciplinary approach to the treatment of both the physical and psychological symptoms of cancer to improve disease outcome and quality of life for patients. Today, it has evolved into a leading forum for...

breast cancer

Neoadjuvant Palbociclib Plus Letrozole Reduces Ki67 Levels

In the neoadjuvant setting, adding palbociclib to letrozole significantly enhanced the suppression of malignant cell proliferation, as measured by Ki67 levels, in patients with primary estrogen receptor–positive breast cancer but did not increase the clinical response rate over 14 weeks, according ...

lung cancer
immunotherapy

2019 ASCO-SITC: Can Plasma Cell–Free DNA Aid in Predicting Response to Checkpoint Inhibitors in NSCLC?

Researchers hypothesized that targeting some genetic alterations in plasma cell–free DNA—along with early monitoring—could be an effective, noninvasive method for predicting response to immune checkpoint inhibitors in advanced non–small cell lung cancer (NSCLC). Findings...

head and neck cancer

Effect of PET/CT on Surgical Planning for Head and Neck Cancer

In a study reported in the Journal of Clinical Oncology, Lowe et al found that 18F-fluorodeoxyglucose positron-emission tomography/computed tomography (PET/CT) had a high negative predictive value in the clinically N0 neck in patients with newly diagnosed head and neck squamous cell carcinoma, with ...

breast cancer

Long-Term Study Finds Axillary Radiotherapy Safe and Effective After Positive Sentinel Node Biopsy

Following identification of a positive sentinel lymph node, surgical axillary lymph node dissection and axillary radiation therapy provide comparable locoregional control and survival, according to a 10-year follow-up of the large European Organisation for Research and Treatment of Cancer AMAROS...

breast cancer

Biologic Age and Elevated Breast Cancer Risk

Biologic age—a DNA-based estimate of a person’s age—may be associated with development of breast cancer, according a report published by Kresovich et al in the Journal of the National Cancer Institute. Study Methods Scientists from the National Institute of Environmental Health...

breast cancer

More Data Show Small Benefit From Extended Endocrine Therapy

Two studies presented at the 2018 San Antonio Breast Cancer Symposium validated a small benefit of extending adjuvant aromatase inhibitor therapy beyond thestandard 5 years for postmenopausal women with hormone receptor–positive breast cancer. In a meta-analysis of 24,912 patients from 12...

breast cancer

Does Adjuvant Denosumab Improve DFS in Postmenopausal Women With Hormone Receptor–Positive Breast Cancer Receiving Aromatase Inhibitors?

As reported by Gnant et al in The Lancet Oncology, disease-free survival (DFS) was improved with adjuvant denosumab vs placebo in postmenopausal women with hormone receptor–positive, early-stage breast cancer receiving aromatase inhibitor treatment. A primary analysis of the phase III...

immunotherapy
gastrointestinal cancer

Study Shows Limited Antitumor Activity of Pembrolizumab in Neuroendocrine Tumors

Neuroendocrine tumors appear resistant to single-agent immunotherapy, according to the results of the KEYNOTE-028 trial of pembrolizumab. “Pembrolizumab monotherapy showed limited antitumor activity but a manageable safety profile in patients with previously treated, advanced neuroendocrine...

prostate cancer

ARAMIS Trial Reports Darolutamide Improves Outcomes in High-Risk Nonmetastatic Prostate Cancer

Darolutamide—an investigational androgen receptor inhibitor—significantly improved metastasis-free survival in men with high-risk nonmetastatic castration-resistant prostate cancer vs placebo in the large phase III ARAMIS trial.1 Men treated with darolutamide had a median metastasis-free survival...

prostate cancer

Radioligand Therapy Achieves Responses in Metastatic Prostate Cancer

In a prospective, single-center, single-arm phase II trial reported at the 2019 Genitourinary Cancers Symposium, a novel approach using a tumor-specific radioligand therapy that binds to prostate-specific membrane antigen (PSMA) (lutetium-177 PSMA-617 -[LuPSMA]) achieved responses in a majority of...

issues in oncology

10 Patient-Centered Principles for More Conservative Cancer Diagnosis

Although diagnostic errors date back to antiquity, in recent years, they have begun to receive attention as an important patient safety issue. This culminated in the National Academy of Medicine’s 2015 landmark report, which concluded that most people in the United States would experience at...

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