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supportive care

Intravenous Rolapitant for Chemotherapy-Induced Delayed Nausea and Vomiting

On October 25, 2017, intravenous (IV) rolapitant (Varubi) was approved for use in combination with other antiemetic agents in adults for the prevention of delayed nausea and vomiting associated with initial and repeat courses of emetogenic cancer chemotherapy, including but not limited to highly...

supportive care
palliative care

Helping Patients With Advanced Disease Transition From Focused to Intrinsic Hope

While hope for a cure after a cancer diagnosis is a feeling both patients and oncologists rightly cling to during treatment, when too much emphasis is placed on this type of “focused” hope, it can make it more difficult for patients to face their mortality. Moreover, such a focus can deny patients ...

genomics/genetics
solid tumors
issues in oncology
breast cancer

National Cancer Institute Awards $12 Million for Breast Cancer Genetics Study

A large study headed by researchers at the Keck School of Medicine of the University of Southern California and two other institutions received $12 million in funding to examine why African American women seem to have more aggressive breast tumors and higher mortality rates from breast cancer than...

Highlights From the Conquer Cancer Foundation’s Third Annual Career Development Retreat

The Conquer Cancer Foundation of ASCO is committed to supporting the research and career development of young researchers through its Grants & Awards Program. In October 2017, Conquer Cancer hosted its third Scientific and Career Development Retreat at ASCO Headquarters in Alexandria,...

hematologic malignancies

Answers to Hematology Expert Review Questions

Question 1  Which statement about epidemiology and clinical features of atypical CML is correct? Correct answer: C. Symptoms of atypical CML may be related to anemia and thrombocytopenia. Expert PerspectiveThe exact incidence of atypical CML is unknown, but the median patient age at diagnosis is in ...

hematologic malignancies

New WHO Classification of Tumors of Hematopoietic and Lymphoid Tissues

The ASCO Post is pleased to present Hematology Expert Review, an ongoing feature that quizzes readers on issues in hematology. In this installment, Drs. Abutalib and Medeiros explore the recently updated World Health Organization (WHO) classification of hematopoietic and lymphoid tissue...

hematologic malignancies

Recent Study Findings in CAR T-Cell Therapy for Neoplastic Malignancies

Here is an update on two recent clinical trials focusing on chimeric antigen receptor (CAR) T-cell therapy for neoplastic malignancies. Highlighted are the findings from an early-phase study in refractory aggressive lymphoma and a study in chronic lymphocytic leukemia after failure of ibrutinib...

hematologic malignancies
lymphoma

Follicular Lymphoma: Is the Road to Cure Paved With Gallium?

The roadside along the path to curing follicular lymphoma is riddled with the debris of failed cytotoxic regimens. For decades, clinical trials unsuccessfully pitted various chemotherapy combinations against each other. It took but a single, noncytotoxic molecule, rituximab (Rituxan), to forever...

hematologic malignancies

Vemurafenib in Erdheim-Chester Disease

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 November 6, 2017, vemurafenib (Zelboraf) was granted...

issues in oncology

Shifting Landscape of Oncology Drug Development and Approvals

Future oncology drug development and approvals will be faster and more efficient as well as take the patient experience more into account, said Richard Pazdur, MD, Director of the Oncology Center of Excellence at the U.S. Food and Drug Administration (FDA). The Center was established as part of...

Mount Sinai Institutes Join $215 Million Partnership to Increase Patients’ Immunotherapy Success

The Tisch Cancer Institute and the Precision Immunology Institute at Mount Sinai Health System are part of a $215 million public-private Cancer Moonshot research collaboration launched by the National Institutes of Health and 11 leading pharmaceutical companies. The 5-year initiative, called...

issues in oncology

Cancer and Obesity: Not Such a Linear Relationship

Obesity has been established as a strong risk factor for the development of cancer. African Americans and Hispanics are particularly at risk, and their access to health care is often poor. How do racial and ethnic disparities in the development of obesity as well as access to care intersect to...

supportive care
palliative care

Caring for the Frail, Older Patient With Cancer: Four Practical Approaches

Cancer may be a disease of aging, but data suggest that older patients with cancer are undertreated, especially with respect to chemotherapy. One analysis showed that approximately 40% of patients in their 70s—and 60% of patients in their 80s—do not receive adjuvant therapy after surgery for colon...

supportive care
palliative care

‘Triple Threat’ Conditions May Predict Mortality in Patients With Cancer Presenting to Emergency Departments

Dyspnea, delirium, and poor performance—so-called “triple threat” conditions—are known to predict short survival in palliative care. According to data presented at the 2017 Palliative and Supportive Care in Oncology Symposium,1 however, the presence of at least two of these symptoms in patients...

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...

issues in oncology
global cancer care

Launching Harmonized NCCN Guidelines for Sub-Saharan Africa

Cancer care in Sub-Saharan Africa, as in other low-resource settings, can be a challenge: The right medications and equipment may be in short supply, maintaining equipment can be a problem, basic chemotherapy drugs may be unaffordable, and patients may not see doctors until the cancer is advanced....

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

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 ...

Seattle Children’s Hospital Opens CAR T-Cell Immunotherapy Trial in Pediatric Leukemia

Seattle Children’s Hospital has opened the first chimeric antigen receptor (CAR) T-cell immunotherapy trial in the United States for children and young adults with relapsed or refractory CD19- and CD22-positive acute lymphoblastic leukemia (ALL). With this more robust defense, researchers hope the...

solid tumors
lung cancer

Managing Low-Dose CT Screening for Lung Cancer

As low-dose computed tomography (CT) screening for lung cancer has moved from clinical trials to clinical practice, management issues are growing more urgent for screening centers around the country: for instance, how to support referrals from and to other providers; how to ensure the quality of...

Expert Point of View: Michael Boyer, MBBS, PhD

Formal discussant of this trial, Michael Boyer, MBBS, PhD, a medical oncologist at Sydney Cancer Centre, Royal Prince Alfred Hospital, Camperdown, Australia, was enthusiastic about these results, with the caveat that overall survival data are needed. “Unresectable stage III non–small cell lung...

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....

breast cancer

Elizabeth A. Mittendorf, MD, PhD, on Immunotherapy in Breast Cancer: Expert Perspective

Elizabeth A. Mittendorf, MD, PhD, of The University of Texas MD Anderson Cancer Center, discusses the growing role of immunotherapy in treating breast disease, the evidence of biomarkers that may be associated with response to therapy, and the opportunities to perform robust correlative studies.

breast cancer

SABCS 2017: Temporary Ovarian Suppression With Hormone Analog May Preserve Fertility During Breast Cancer Chemotherapy

Meta-analysis of individual patient data from five randomized clinical trials provided a high level of evidence that treatment with a gonadotropin-releasing hormone analog (GnRHa) could safely and effectively protect ovarian function and potentially preserve fertility in premenopausal women...

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...

breast cancer
pain management

SABCS 2017: Acupuncture May Reduce Joint Pain Caused by Aromatase Inhibitor Treatment

Acupuncture significantly reduced joint pain for postmenopausal women with early-stage breast cancer receiving treatment with an aromatase inhibitor compared with both sham acupuncture and no treatment, according to data from the randomized, phase III SWOG S1200 trial presented by Hershman et al at ...

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: 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

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...

gastroesophageal cancer

Oral Microbiota Indicates Possible Link Between Periodontal Disease and Esophageal Cancer

An analysis of bacteria present in the mouth showed that some types of bacteria that lead to periodontal disease were associated with higher risk of esophageal cancer, according to a study published by Peters et al in Cancer Research. Esophageal cancer is the eighth most common cancer and the...

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...

solid tumors

FDA Announces Approval, CMS Proposes Coverage of First Breakthrough-Designated Test to Detect Extensive Number of Cancer Biomarkers

On November 30, the U.S. Food and Drug Administration (FDA) approved the FoundationOne CDx (F1CDx), the first breakthrough-designated, next-generation sequencing–based in vitro diagnostic test that can detect genetic mutations in 324 genes and 2 genomic signatures in any solid tumor type. The ...

issues in oncology
cost of care

ASCO Applauds New Report on Making Medicines Affordable

Today, ASCO President Bruce E. Johnson, MD, FASCO, released the following statement: “A report released today by the National Academies of Sciences, Engineering, and Medicine underscores the imperative our nation faces to address the affordability of drugs for medical conditions that have...

issues in oncology

More Than One-Third of PAs in Oncology Experience Burnout, Despite High Rate of Career Satisfaction

A new physician assistant (PA)-based study finds that despite personal satisfaction in the oncology specialty, high rates of burnout—over one-third of PAs (34.8%)—are common. These findings reveal important factors that could help to decrease burnout and improve the oncology workforce...

breast cancer
prostate cancer
issues in oncology

Urban American Indian and Alaskan Natives May Have Lower Survival Rates Following Invasive Prostate and Breast Cancers

Compared with the non-Hispanic white (NHW) population, the urban American Indian and Alaskan Native (AIAN) community was more likely to have lower survival rates following invasive prostate and breast cancer, according to a new study by Emerson et al in Cancer Research. “It’s been...

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...

issues in oncology
survivorship

Many Cancer Survivors Live With Post-Traumatic Stress Disorder

A recent study showed approximately one-fifth of patients with cancer experienced post-traumatic stress disorder (PTSD) several months after diagnosis, and many of these patients continued to live with PTSD years later. Published by Chan et al in Cancer, the findings highlight the need for early...

leukemia

Patients With CLL May Be Willing to Trade Treatment Efficacy for Reduced Side Effects

When choosing their preferred treatment, patients with chronic lymphocytic leukemia (CLL) place the highest value on treatments that deliver the longest progression-free survival, but they are willing to swap some drug efficacy for a reduced risk of serious adverse events, according to a study...

colorectal cancer

Association of Fiber Intake After Colorectal Cancer Diagnosis and Survival

In a study reported in JAMA Oncology, Song et al found that higher fiber intake after diagnosis of nonmetastatic colorectal cancer is associated with improved colorectal cancer–specific and overall survival. The benefit was also observed with a higher intake of whole grains. Study Details...

breast cancer
cost of care

Climbing Costs for Treating Breast Cancer Poised to Strain Medicare in the Near Future

With cancer care costs projected to increase 32% from 2010 to 2020, researchers are working to determine the main drivers of costs for treating breast cancer. In a study led by Ami Vyas, PhD, MS, MBA, of the University of Rhode Island, published in the November issue of JNCCN–Journal of the...

Vertical Roentgenography: Patient of James T. Case, MD

This image of fluoroscopy documents modern cancer diagnostic possibilities. It is in startling contrast to the photograph of fluoroscopy taken a decade earlier. Published by James T. Case, MD, in 1914 to illustrate his book Stereoroentgenography of the Alimentary Tract, it presents the advances in ...

Donald Coffey, PhD, Cancer Pioneer, Dies at 85

Donald Coffey, PhD, a distinguished Johns Hopkins Professor and prostate cancer expert, who was the former Director of the Brady Urological Research Laboratory and Deputy Director of the Johns Hopkins Kimmel Cancer Center, died on November 9, 2017, at the age of 85. In his more than 50 years at...

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...

solid tumors

The Runner

The following essay by Robert J. Green, MD, is adapted, with permission, from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was coedited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and...

issues in oncology
pain management

EXPECT QUESTIONS ABOUT THE RISK OF OPIOID ADDICTION

INTENSE MEDIA COVERAGE of the opioid crisis has ranged from the dire statistics of addiction and death to some hopeful stories of treatment and recovery, but what may raise questions and concerns are the reports of people who start with a prescription opioid and then in a few weeks or months are...

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