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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...

Expert Point of View: Eric Van Cutsem, MD, PhD

Invited discussant Eric Van Cutsem, MD, PhD, of the University Hospitals Leuven in Belgium, put the JACOB trial findings in context of what is known for HER2-positive metastatic gastric/gastroesophageal junction cancer, where two targeted agents are approved: trastuzumab (Herceptin) in the first...

hematologic malignancies

A Pioneer in Bloodless Transplant Discusses Advances in Blood Management

Bloodless stem cell transplantation, performed without the transfusion of allogeneic blood or blood products, has numerous clinical advantages, especially among populations of patients who prefer, for religious or other reasons, no blood methods of medical and surgical treatment. Patricia A. Ford, ...

solid tumors
gastrointestinal cancer
gastroesophageal cancer

Metastatic Gastric Cancer: Dual HER2-Targeting Study Does Not Meet Primary Endpoint

Dual HER2 targeting in metastatic gastric and gastroesophageal junction cancers did not significantly improve outcomes over trastuzumab (Herceptin) alone—both in combination with chemotherapy—according to the results of the phase III JACOB study reported at the 2017 European Society for Medical...

Angela M. Stover, PhD, Presented With Inaugural Michael S. O’Malley Alumni Award

ANGELA M. STOVER, PhD, Assistant Professor in Health Policy and Management at the University of North Carolina (UNC) Gillings School of Global Public Health, has won the 2017 Michael S. O’Malley Alumni Award for Publication in Excellence in Cancer Population Sciences. She was selected for her...

IDEA Trial: ‘Going Beyond Statistics’ in Stage III Colon Cancer

According to Alberto Sobrero, MD, Head of Medical Oncology at Ospedale San Martino in Genova, Italy, the results of the pivotal IDEA trial, which evaluated the optimal duration of adjuvant chemotherapy for stage III colon cancer, were not clear to clinicians.1 The combined analysis of six...

skin cancer

Melanoma Mutations: What You Need to Know

CLINICIANS ARE now well acquainted with BRAF mutations in advanced melanoma, but there is more to genomics in this disease than identifying BRAF and prescribing a BRAF inhibitor.  At the 2017 Debates and Didactics Conference, held at Sea Island, Georgia, Melinda L. Yushak, MD, MPH, of Emory...

ASCO Election Candidates

SIXTEEN DISTINGUISHED ASCO members have been selected by the ASCO Nominating Committee as candidates for open leadership positions within the Society, including:  The offices of President-Elect and Treasurer  Four seats on the Society’s Board of Directors  Two seats on the Nominating Committee...

Encourage Your Lawmakers to Increase Funding for NIH in FY 2018

EARLIER THIS FALL, Congress voted to pass a 3-month Continuing Resolution (CR) to fund the government, while the House of Representatives and the Senate work to finalize a Fiscal Year (FY) 2018 funding bill. The CR, viewed as a temporary measure to keep the federal government operating, keeps...

solid tumors
breast cancer

About One in Four Women With Small Breast Tumors May Benefit From Chemotherapy

A large subset analysis of the MINDACT trial suggests that oncologists may be undertreating women with small (< 1 cm) node-negative breast tumors, which are clinically considered to be low risk but can be genomically high risk. About one in four women with small node-negative breast tumors <...

Expert Point of View: Nadia Harbeck, MD, PhD

Invited discussant Nadia Harbeck, MD, PhD, Head of the Breast Center of the University of Munich (LMU), Germany, said the UNICANCER-NeoPAL trial points toward the future of endocrine therapy in early breast cancer—using cyclin-dependent kinase 4/6 (CDK4/6) inhibitors as a means of “enhancing” this ...

gynecologic cancers

Predictors of Cervical Precancer Treatment Failure

In a meta-analysis reported in The Lancet Oncology, Arbyn et al found that posttreatment high-risk human papillomavirus (HPV) testing was a better predictor of recurrence of high-grade cervical intraepithelial neoplasia of grade 2 or higher (CIN2+) than incomplete cervical excision. Study Details ...

breast cancer

Antidepressant for Aromatase Inhibitor–Associated Arthralgia in Early-Stage Breast Cancer

The phase III SWOG S1202 trial has shown benefit of the antidepressant agent duloxetine in reducing aromatase inhibitor–associated joint pain in women with early-stage breast cancer. These results were reported in the Journal of Clinical Oncology by Henry et al. Study Details In the...

lung cancer

Patient-Reported Outcomes With Immunotherapy vs Chemotherapy in Advanced NSCLC

Pembrolizumab (Keytruda) treatment was associated with improved or maintained health-related quality of life vs platinum-based chemotherapy in the phase III KEYNOTE-024 trial in advanced programmed cell death ligand 1 (PD-L1)–positive non–small cell lung cancer (NSCLC). These findings...

lung cancer

ESMO Asia 2017: FLAURA Trial: Osimertinib Improves Progression-Free Survival in Asian Patients With EGFR-Mutated NSCLC

Osimertinib (Tagrisso) improves progression-free survival compared to standard first-line therapy in Asian patients with EGFR-mutated non–small cell lung cancer (NSCLC), according to the Asian subset analysis of the FLAURA trial presented at the European Society for Medical Oncology (ESMO)...

colorectal cancer

ESMO Asia 2017: AXEPT Trial: New Second-Line Therapy for Metastatic Colorectal Cancer Is Effective and Safe

A randomized trial in 650 patients has confirmed the safety and efficacy of a new second-line treatment for metastatic colorectal cancer, researchers reported at the European Society for Medical Oncology (ESMO) Asia 2017 Congress (Abstract LBA3_PR). Oral fluorinated pyrimidines have been...

solid tumors
breast cancer

Pathologic Complete Response Rates Not Improved With Neoadjuvant Letrozole/Palbociclib

As neoadjuvant treatment of women with high-risk luminal breast cancer, the combination of letrozole and palbociclib (Ibrance) did not reduce the residual cancer burden or improve the rates of breast-conserving surgery, in the phase II UNICANCER- NeoPAL study presented at the 2017 European Society ...

solid tumors
lung cancer

Brigatinib in Crizotinib-Pretreated Metastatic ALK-Positive Non–Small Cell Lung Cancer

On April 28, 2017, brigatinib (Alunbrig) was granted accelerated approval for the treatment of patients with metastatic anaplastic lymphoma kinase (ALK)-positive non–small cell lung cancer (NSCLC) who have had disease progression on or are intolerant to crizotinib (Xalkori).1,2 Supporting Efficacy...

solid tumors
lung cancer

Dabrafenib and Trametinib in BRAF V600E–Mutant Metastatic NSCLC

On June 22, 2017, regular approvals were granted to dabrafenib (Tafinlar) and trametinib (Mekinist) given in combination for the treatment of patients with metastatic non–small cell lung cancer (NSCLC) with BRAF V600E mutation as detected by a U.S. Food and Drug Administration (FDA)-approved...

solid tumors
lung cancer

Unraveling PD-L1 Assays in NSCLC: Are They Interchangeable?

With the availability of at least five checkpoint inhibitors to treat non–small cell lung cancer (NSCLC) and other solid tumors, appropriate patient selection for these expensive treatments remains key. The hope is that testing the level of programmed cell death ligand 1 (PD-L1) expression in tumor ...

solid tumors
breast cancer

Neratinib for Extended Adjuvant Treatment of Early-Stage HER2-Positive Breast Cancer

On July 17, 2017, neratinib (Nerlynx) a dual inhibitor of HER2 and epidermal growth factor receptor (EGFR), was approved for extended adjuvant treatment of adults with early-stage HER2-overexpressed/amplified breast cancer following adjuvant trastuzumab (Herceptin)-based therapy.1,2 Supporting...

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