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supportive care
palliative care

Concurrent Palliative Care: Recommendations From the ASCO Clinical Practice Guideline

Updated in 2016, the ASCO clinical practice guideline on the integration of palliative care into standard oncology care provides evidence-based recommendations to oncology clinicians, patients, family and friend caregivers, and palliative care specialists about providing high-quality care for...

solid tumors
breast cancer

Preparing for Steep Increase in Breast Cancer Among the Elderly

“We are in the midst of a steep increase” in the incidence of breast cancer among women aged 65 years and older, Arti Hurria, MD, reported at the 19th Annual Lynn Sage Breast Cancer Symposium, Chicago.1 “Are we prepared as a health-care system and as providers to address this burgeoning need?” she...

solid tumors
breast cancer

Combined Therapies Increase Adverse Events in Patients With Hormone Receptor–Positive Metastatic Breast Cancer

In patients with hormone receptor–positive metastatic breast cancer, the combination of targeted agents and hormone therapy is associated with a significantly increased risk of severe adverse events, according to research presented by Matteo Lambertini, MD, European Society for Medical Oncology...

solid tumors
breast cancer

Managing Neurotoxicity in Advanced Breast Cancer

Neurotoxicity in advanced breast cancer is not limited to chemotherapy-induced peripheral neuropathy, according to Matti Aapro, MD, of IMO Clinique de Genolier, Switzerland. Surgery, radiation therapy, and medical therapy can all have detrimental effects on either the central or peripheral nervous ...

solid tumors
lung cancer

Durvalumab Therapy Improves Outcomes in Patients With Unresectable Stage III NSCLC

The PACIFIC study showed that the addition of the programmed cell death ligand 1 (PD-L1) inhibitor durvalumab (Imfinzi) following chemoradiotherapy for patients with unresectable stage III non–small cell lung cancer (NSCLC) dramatically improved progression-free survival compared with placebo....

hematologic malignancies
lymphoma
multiple myeloma

CAR T-Cell Therapy Makes Further Inroads in Lymphoma and Myeloma

With the recent U.S. Food and Drug Administration (FDA) approvals of two chimeric antigen receptor (CAR) T-cell products, this novel approach seems to be moving into the mainstream. The approvals were tisagenlecleucel (also known as CTL019; Kymriah) for the treatment of pediatric B-cell acute...

hematologic malignancies
multiple myeloma

Evidence-Based Support for Triplet Therapies in Multiple Myeloma

Over the past 15 years, multiple myeloma has garnered among the highest number of regulatory approvals by the U.S. Food and Drug Administration (FDA) for the management of all phases of the disease. This fast-expanding repertoire of treatment options has pushed the median survival of multiple...

breast cancer

SABCS 2017: MONALEESA-7: Ribociclib Improved Progression-Free Survival for Pre- and Perimenopausal Women With HR-Positive Advanced Breast Cancer

Adding the cyclin-dependent kinase (CDK) 4/6 inhibitor ribociclib (Kisqali) to standard endocrine therapy with temporary ovarian suppression significantly improved progression-free survival for pre- and perimenopausal women with advanced hormone receptor–positive (HR-positive), HER2-negative...

breast cancer

SABCS 2017: Combination of Pembrolizumab and Trastuzumab Shows Early Promise for Patients With Trastuzumab-Resistant Breast Cancer

A combination of pembrolizumab (Keytruda) and trastuzumab (Herceptin) tested in patients with trastuzumab-resistant advanced HER2-positive breast cancer was well tolerated and had clinical benefit in patients whose tumors were positive for a biomarker for pembrolizumab, according to data presented...

hematologic malignancies

Targeted Therapies Highlighted at This Year’s ASH Annual Meeting

In a webcast press briefing prior to the 2017 American Society of Hematology (ASH) Annual Meeting & Exposition, journalists got a peek at some of the most anticipated abstracts. ASH President Kenneth C. Anderson, MD, Director of the Lebow Institute for Myeloma Therapeutics and Jerome Lipper...

hematologic malignancies

ASCO Clinical Practice Guideline Update: Platelet Transfusion for Patients With Cancer

As reported in the Journal of Clinical Oncology by Charles A. Schiffer, MD, of Karmanos Cancer Institute, Wayne State University School of Medicine, and colleagues, ASCO has issued a clinical practice guideline update on platelet transfusions in patients with cancer. The updated guideline replaces ...

breast cancer

SABCS 2017: Increasing the Dose Intensity of Chemotherapy May Lower the Risk of Breast Cancer Recurrence and Death

Increasing the dose intensity of chemotherapy—by either shortening the intervals between the cycles or by sequential administration instead of concurrent administration of the drugs—reduced the risk of early-stage breast cancer recurrence and death compared with standard chemotherapy...

breast cancer

SABCS 2017: Adjuvant Trastuzumab Did Not Improve Outcomes for Patients With HER2-Low Breast Cancer

Adding trastuzumab (Herceptin) to standard adjuvant chemotherapy did not improve invasive disease–free survival for patients with early-stage breast cancer found to have low levels of HER2, defined as immunohistochemistry (IHC) 1–positive or IHC 2-positive and/or in situ hybridization...

hepatobiliary cancer

FGFR Kinase Inhibitor in FGFR-Altered Advanced Cholangiocarcinoma

In a phase II trial reported in the Journal of Clinical Oncology, Javle et al found that the oral pan-fibroblast growth factor receptor (FGFR) kinase inhibitor BGJ398 was active in FGFR-altered advanced cholangiocarcinoma. It is estimated that FGFR2 fusions/translocations are present in 13% to 17%...

cns cancers

Phase III Trial of Combination Therapy for Progressive Glioblastoma

In a phase III trial reported in The New England Journal of Medicine, Wick et al found that adding bevacizumab (Avastin) to lomustine at first disease progression did not improve overall survival in patients with progressive glioblastoma. Study Details In the trial, 437 patients with disease...

breast cancer

Neoadjuvant Regimens Compared in HER2-Positive Breast Cancer

The phase III KRISTINE trial has shown that neoadjuvant therapy with docetaxel, carboplatin, and trastuzumab (Herceptin) plus pertuzumab (Perjeta) resulted in a higher pathologic complete response rate vs ado-trastuzumab emtansine (Kadcyla) plus pertuzumab, as well as a higher incidence of severe...

colorectal cancer

Study Suggests Measurable Impact of an ACS Colorectal Cancer Screening Program

A new study suggests that an American Cancer Society (ACS) program has been effective in promoting improvements in colorectal cancer screening rates in federally qualified health centers (FQHCs). The study data, published by Riehman et al in the American Journal of Preventive Medicine, shows the...

multiple myeloma

Tandem Autologous/Allogeneic HCT With Maintenance Therapy in High-Risk Myeloma

In a phase II study reported in Blood Advances, Green et al found that tandem autologous/allogeneic hematopoietic cell transplantation (HCT) followed by bortezomib (Velcade) maintenance produced good results in patients with newly diagnosed high-risk multiple myeloma. Poorer outcomes were observed...

lung cancer

Combination Therapy for Previously Untreated Stage IV NSCLC

As reported in The Lancet Oncology by Herbst et al, the phase III SWOG S0819 trial showed no overall benefit of adding cetuximab (Erbitux) to carboplatin/paclitaxel both with and without bevacizumab (Avastin) in patients with previously untreated stage IV non–small cell lung cancer (NSCLC). A ...

breast cancer

Extended Intermittent vs Continuous Adjuvant Therapy for Postmenopausal Women With Breast Cancer

The phase III SOLE trial has shown no disease-free survival benefit with extended intermittent vs continuous adjuvant letrozole in postmenopausal women with breast cancer. These findings were reported by Colleoni et al in The Lancet Oncology. As noted by the investigators, the findings suggest an...

issues in oncology

Discussion of Cancer Prognosis and the Patient-Physician Relationship

In a longitudinal cohort study reported in the Journal of Clinical Oncology, Fenton et al found that discussion of cancer prognosis between oncologists and patients did not worsen patient judgment of the quality of the patient-physician relationship. Study Details The study involved 265 adult...

gastroesophageal cancer

Quality of Life With Neoadjuvant Chemoradiotherapy in Esophageal/Esophagogastric Junction Cancer

An analysis in the Dutch Chemoradiotherapy for Esophageal Cancer Followed by Surgery Study (CROSS) reported by Noordman et al in the Journal of Clinical Oncology showed no adverse effect of neoadjuvant chemoradiotherapy vs surgery alone on postsurgery health-related quality of life in patients with ...

lung cancer

Comparison of EGFR Inhibitors in Untreated Advanced EGFR-Mutant NSCLC

As reported in The New England Journal of Medicine by Soria et al, the phase III FLAURA trial has shown a significant progression-free survival benefit with the third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) osimertinib (Tagrisso) vs standard EGFR TKIs in...

gastroesophageal cancer

Immunotherapy in Advanced Esophageal Carcinoma

As reported in the Journal of Clinical Oncology by Doi et al, pembrolizumab (Keytruda) showed activity in patients with previously treated advanced esophageal carcinoma in the phase Ib multicohort KEYNOTE-028 study. Study Details In the study, eligible patients with squamous cell carcinoma or...

lung cancer

Global Lung Cancer Awareness Month Coalition Announces Goals

The Lung Cancer Awareness Month Coalition (LCAMC), a group of more than 20 research and advocacy organizations from around the world focused on thoracic cancers, announced the launch of the 2017 Lung Cancer Awareness Month in early November with a panel event at the National Press Club in...

lung cancer

Adjuvant Chemotherapy With or Without Monoclonal Antibody in Resected NSCLC

The phase III E1505 trial has shown no benefit of adding bevacizumab (Avastin) to adjuvant therapy in early-stage resected non–small cell lung cancer (NSCLC). These results were reported by Wakelee et al in The Lancet Oncology. Study Details In the open-label trial, 1,501 patients from...

gynecologic cancers

Olaparib Tablets as Maintenance in BRCA1/2-Mutant Relapsed Ovarian Cancer

A phase III trial (SOLO2/ENGOT-Ov21) has shown improved progression-free survival with an olaparib tablet formulation vs placebo as maintenance therapy in patients with BRCA1/2-mutant platinum-sensitive relapsed ovarian cancer. These study results were reported by Eric Pujade-Lauraine, MD, of the...

prostate cancer

Health-Related Quality of Life With Immediate vs Delayed ADT in Prostate Cancer

In a health-related quality-of-life study among patients in the phase III TOAD trial, immediate vs delayed androgen-deprivation therapy (ADT) was associated with early worsening of androgen-deprivation therapy–related symptoms but few other comparative adverse effects on functioning or quality of...

prostate cancer

Adverse Pathologic Findings in Low-Volume Intermediate-Risk Prostate Cancer

In a single-center analysis reported in JAMA Oncology, Hiten D. Patel, MD, MPH, of The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, and colleagues found that among men undergoing elective radical prostatectomy, those with low-volume intermediate-risk...

prostate cancer

Comparison of Circulating Tumor DNA and Metastatic Tissue Biopsy in Identifying Mutations in Prostate Cancer

In a study reported in the Journal of the National Cancer Institute, Wyatt et al found high agreement between driver mutations in plasma circulating tumor DNA (ctDNA) and metastatic tissue biopsy in castration-resistant prostate cancer. Martin Gleave, MD, and Alexander Wyatt, DPhil, of Vancouver...

hematologic malignancies
breast cancer
lung cancer
lymphoma

FDA Approvals in November 2017: Novel Drugs, New Indications

THE U.S. FOOD AND DRUG ADMINISTRATION (FDA) approved a number of novel drugs and new indications in November 2017. Several of them are listed here.  Fulvestrant/Abemaciclib Combination in Breast Cancer  ON NOVEMBER 15 , the FDA approved fulvestrant (Faslodex) in combination with abemaciclib...

hepatobiliary cancer

Nivolumab in Hepatocellular Carcinoma Previously Treated With Sorafenib

ON SEPTEMBER 22, 2017, nivolumab (Opdivo) was granted accelerated approval for treatment of hepatocellular carcinoma in patients previously treated with sorafenib (Nexavar).1,2  Supporting Efficacy Data  APPROVAL WAS based on findings in a 154-patient subgroup of the CheckMate 040 trial consisting...

cns cancers

Gene Therapy Shows Early Efficacy Against Recurrent Brain Cancer

MORE THAN A QUARTER of patients with recurrent high-grade glioma treated with the retroviral vector Toca 511 and the prodrug of the chemotherapy fluorouracil (5-FU), Toca FC, were alive more than 3 years after treatment, according to data from a subset of patients in a phase I clinical trial, Toca ...

pain management

Relieving Pain During an Opioid Epidemic

“WE’VE GOT A CHALLENGING TIME right now, trying to relieve pain during the time of an opioid epidemic,” Judith A. Paice, RN, PhD, acknowledged at the 2017 Lynn Sage Breast Cancer Symposium in Chicago.1 She cited a recent study reporting that up to 40% of cancer survivors are living with pain, and...

hematologic malignancies

Recent Study Findings in Hematologic Malignancies

HERE IS A BRIEF LOOK at the study findings and clinical implications of several recent and important clinical trials in neoplastic hematology. Attention is focused on clonal myeloid disorders, acute lymphoblastic leukemia, lymphoma, and plasma cell dyscrasias.  Clonal Myeloid Disorders  STUDY:...

solid tumors
lung cancer

Addressing Disparities in Use of Lung Cancer Screening With Community Outreach

African Americans and members of other communities of lower socioeconomic status have higher burdens of lung cancer mortality. Therefore, targeting underserved patient populations with lung cancer screening is of the utmost importance, according to Christopher Lathan, MD, MS, MPH, a medical...

solid tumors
breast cancer
issues in oncology
health-care policy

Health-Care Access Unlikely to Explain Racial/Ethnic Disparities in Breast Cancer Outcomes

Even with equivalent access to care, black patients with breast cancer may fare worse than white patients with breast cancer, according to Lawrence H. Kushi, ScD, Director of Scientific Policy at the Kaiser Permanente Northern California Division of Research in Oakland. “Accounting for...

solid tumors
breast cancer

Gene-Expression Assays in Early-Stage Breast Cancer: Who Should Order Them and When?

A deeper understanding of biology has allowed significant advances in the treatment of breast cancer. In the early-stage setting, standard pathology measures can help identify which subset of patients with hormone receptor–positive breast cancers are more likely to experience benefit from...

solid tumors
breast cancer

Genomic Profiling With Multidisciplinary Collaboration: Improving Breast Cancer Outcomes Through Timely Chemotherapy Initiation

As reviewed in this issue of The ASCO Post, Losk and colleagues from Dana-Farber/Brigham and Women’s Cancer Center report their institution’s implementation of a protocol of surgeon-initiated genomic profiling of estrogen receptor–positive tumors in women with early breast cancer that resulted in ...

solid tumors
breast cancer

Surgeon-Initiated Gene-Expression Profile Testing in Early-Stage Breast Cancer Reduces Time to Start of Chemotherapy

In a single-center study reported in the Journal of Oncology Practice, Katya Losk, MPH, of Dana-Farber Cancer Institute, and colleagues found that an intervention including surgeon initiation of gene-expression profile testing with Oncotype DX significantly reduced the time to testing, receipt of...

supportive care
palliative care
cost of care
issues in oncology

Palliative Care Intervention Reduces Total Health-Care Costs in Patients With Advanced Cancer

A matched case-controlled study among Medicare beneficiaries with metastatic lung, colorectal, breast, and prostate cancers has found that palliative care consultation significantly reduced total health-care costs following intervention. According to data presented at the 2017 Palliative and...

integrative oncology

University of Michigan Medical School Launches Integrative Oncology Scholars Program

THE UNIVERSITY OF MICHIGAN Medical School in Ann Arbor recently received a $1,167,943 5-year grant from the National Cancer Institute to launch the Integrative Oncology Scholars Program. The goal of the program is to teach oncology health-care providers how to evaluate the scientific evidence of...

supportive care
palliative care

Early Integrated Palliative Care Improves Patient Coping Strategies, Quality of Life, and Symptoms of Depression

A new study has shed light on how palliative care interventions may improve patient outcomes. According to data presented at the 2017 Palliative and Supportive Care in Oncology Symposium,1 patients with incurable cancer who received early integrated palliative care had an increased use of active...

issues in oncology

Informed Consent and the Oncologist: Legal Duties to Discuss Costs of Treatment

For 50 years, clinicians in the United States have had a legal duty to disclose to patients with cancer the risks, benefits, and alternatives to a proposed cancer treatment. Until recently, however, it has been unclear whether clinicians have a similar duty to discuss the costs of that treatment....

issues in oncology

Fleeing a Revolution, Becoming an Oncologist

Nicaragua, situated between Costa Rica and Honduras, is the poorest country in Central America. Following the U.S. occupation in 1912, the Somoza family began a brutal political dynasty that would end in 1979 during the bloody Nicaraguan Revolution.  Marcela G. del Carmen, MD, MPH, Chief Medical...

supportive care
palliative care

Advancing Care Across the Cancer Continuum

Addressing the need to integrate palliative and supportive care practices into medical specialties to ensure optimal patient-centered care across the cancer continuum and the evidence-based remedies to accomplish that goal were the focus of the nearly 300 study abstracts presented at the 2017...

integrative oncology
symptom management

Cognitive Behavior Therapy for Insomnia: Sleeping Well With Cancer and Beyond

The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies commonly used by patients with cancer. In this installment, Sheila N. Garland, PhD, R Psych, and Jun J. Mao, MD, MSCE, present...

solid tumors
gastrointestinal cancer

Pembrolizumab in Advanced Gastric Cancer

On September 22, 2017, pembrolizumab (Keytruda) was granted accelerated approval for treatment of recurrent locally advanced or metastatic, gastric or gastroesophageal junction adenocarcinoma with tumors expressing programmed cell death ligand 1 (PD-L1), as determined by a U.S. Food and Drug...

leukemia

Seattle Children’s Opens Trial for Children and Young Adults With Leukemia That Targets CD22 and CD19 Proteins Simultaneously

Seattle Children’s has opened the first chimeric antigen receptor (CAR) T-cell immunotherapy trial in the U.S. for children and young adults with relapsed or refractory CD19- and CD22-positive acute lymphoblastic leukemia (ALL) that will simultaneously attack two targets on cancer cells. With ...

solid tumors

Early Findings on EZH2 Inhibitor in Children With Rare Solid Tumors

CHILDREN WITH relapsed or refractory malignant rhabdoid tumors, epithelioid sarcomas, or poorly differentiated chordomas with a particular genetic defect were treated with the investigational drug tazemetostat and appeared to tolerate treatment well. Some patients had objective and durable...

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