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solid tumors

Prevalence of Lynch Syndrome in Solid Tumors According to Microsatellite Instability Status

In a study reported in the Journal of Clinical Oncology, Latham et al found that microsatellite instability (MSI) and/or mismatch repair deficiency (MMR-D) is predictive of Lynch syndrome across a greater than heretofore recognized breadth of the solid tumor spectrum. As noted by the...

leukemia
issues in oncology
symptom management

Effect of Early Cardiotoxicity on Outcomes in Pediatric AML

In an analysis from the Children’s Oncology Group AAML0531 trial reported in the Journal of Clinical Oncology, Getz et al found that early treatment-related cardiotoxicity may be associated with poorer event-free and overall survival in pediatric acute myeloid leukemia (AML). Study Details...

hepatobiliary cancer

FDA Approves Pembrolizumab for Hepatocellular Carcinoma Previously Treated With a Kinase Inhibitor

On November 9, 2018, the U.S. Food and Drug Administration (FDA) granted accelerated approval to pembrolizumab (Keytruda) for patients with hepatocellular carcinoma who have been previously treated with the kinase inhibitor sorafenib. KEYNOTE-224 Approval was based on KEYNOTE-224, a single-arm,...

issues in oncology

Novel Physician-Driven Practice Model Offers Alternative to Community Oncologists

Three leading oncology practices have united with partners in technology and finance to launch OneOncology, a physician-driven company that aims to unite more than 225 community oncology providers from 60-plus locations. Altogether, OneOncology will treat nearly 158,000 cancer patients a year. The...

immunotherapy
lung cancer

Corticosteroids and Immunotherapy: Guilty or Guilt By Association?

FIRST-LINE TREATMENT options for advanced non–small cell lung cancer (NSCLC) include single- agent immunotherapy for patients with a programmed cell death ligand 1 (PD-L1) tumor proportion score of at least 50% or in combination with chemotherapy in unselected patients.1-3 Single immunotherapy is...

lung cancer
immunotherapy

Corticosteroid Use at Start of PD-1/PD-L1 Inhibitor Therapy Affects Outcomes in NSCLC

IN A STUDY reported in the Journal of Clinical Oncology, Kathryn C. Arbour, MD, of Memorial Sloan Kettering Cancer Center, and colleagues found that baseline treatment with corticosteroids was associated with poorer efficacy of programmed cell death protein 1/programmed cell death ligand 1...

palliative care

Developing Patient-Centered Palliative Care From Diagnosis to End of Life

In December, The University of Texas at Austin Dell Medical School will launch an innovative cancer care model called the CaLM (cancer life re-imagined) Clinic as part of its new cancer center, the Livestrong Cancer Institutes. The goal of the Livestrong Cancer Institutes and the CaLM Clinic is to...

issues in oncology
cost of care

Tackling Financial Toxicity: One Institution’s Roadmap Forward

  ALTHOUGH FINANCIAL toxicity has become an important issue in the oncology community, evidence suggests the subject is rarely addressed by oncologists, exacerbating its grave effects on patients with cancer and their families.1 “But I don’t think it’s because health-care providers don’t want to...

issues in oncology

Do Incident Learning Systems Prevent Medical Errors?

ACCORDING TO a study by Johns Hopkins, medical errors are the third leading cause of death in the United States.1 Lakshmi Santanam, PhD, tackled such sobering data at the 2018 ASCO Quality Care Symposium. “Incident learning systems are not just about medical errors or data; it’s kind of a first...

issues in oncology

Challenges and Successes of Adopting an Oncology Care Model

IN ORDER TO rein in the untenable rise in costs while delivering high-value cancer care, the Centers for Medicare & Medicaid Innovation developed a new payment system—the Oncology Care Model. At the 2018 ASCO Quality Care Symposium, Cardinale B. Smith, MD, PhD, shed light on the system’s...

issues in oncology
palliative care

End-of-Life Dashboard Drives Transformation With Actionable Personalized Data

A NUMBER OF STUDIES from the palliative care literature have shown that nonbeneficial health-care interventions actually may harm patients’ quality of life, increase patient and caregiver distress, and drive costs. Yet, according to the National Cancer Institute, about 30% of all cancer spending...

lung cancer
immunotherapy

Atezolizumab Plus Chemotherapy Improves Outcomes in Small Cell Lung Cancer

ATEZOLIZUMAB (TECENTRIQ), an anti–program cell death ligand 1 (PD-L1) antibody, combined with carboplatin/ etoposide as first-line treatment for extensive-stage small-cell lung cancer (SCLC) improved overall and progression-free survival and may represent a new standard of care, according to...

issues in oncology
lung cancer

Adding the Patient’s Voice to Collaborative Clinical Trial Efforts

THE INTERNATIONAL Association for the Study of Lung Cancer (IASLC) 19th World Conference on Lung Cancer was the largest in its history. One of the key themes of the meeting was to focus on the patient. Here are highlights of presentations from this conference that demonstrate the role of the...

bladder cancer
immunotherapy

Pembrolizumab Shows Antitumor Activity in Non–Muscle Invasive Bladder Cancer

THE ANTI–PROGRAMMED cell death protein 1 (anti–PD-1) checkpoint inhibitor pembrolizumab (Keytruda) was found to have antitumor activity in patients with high-risk non–muscle invasive bladder cancer who were nonresponsive to bacillus Calmette-Guérin (BCG), according to the preliminary results of the ...

prostate cancer

Radiation to Primary Tumor Improves Survival in Subset of Men With Metastatic Prostate Cancer

MEN WITH newly diagnosed metastatic prostate cancer do not typically receive treatment to the primary tumor with radiation or surgery. A new analysis of the STAMPEDE trial found that radiation administered to the prostate can improve overall survival in men with newly diagnosed metastatic prostate...

gynecologic cancers

Results Reported for Olaparib Maintenance in Ovarian Cancer

TWO-YEAR MAINTENANCE therapy with olaparib (Lynparza), a poly (ADP-ribose) polymerase inhibitor, achieved a significant improvement in progression-free survival in patients with newly diagnosed advanced ovarian cancer and a BRCA1 or BRCA2 mutation, according to results of the phase III SOLO-1...

issues in oncology

Cancer Taught Me to Help Patients Find Healing Hope

AS AN INTERNIST, I strived to give patients hope by prescribing therapies that increased their chance—their hope—of the best outcome and by encouraging them with hopeful words. My own hope was to care for patients until I was old. Just weeks after celebrating my 36th birthday, I was diagnosed with ...

lung cancer

Brigatinib Improves Outcomes Over Crizotinib in ALK-Positive Non–Small Cell Lung Cancer

THE FIRST-LINE USE of brigatinib (Alunbrig) was superior to standard-of-care crizotinib (Xalkori) in patients with advanced anaplastic lymphoma kinase (ALK)-positive non–small cell lung cancer (NSCLC), according to the first report of the phase III ALTA-1L trial presented at the International...

breast cancer
immunotherapy

Immunotherapy Improves Survival in a Subset of Patients With Metastatic Triple-Negative Breast Cancer

IMMUNOTHERAPY APPEARS to be the new upfront standard of care for patients with metastatic triple-negative breast cancer, based on a late-breaking presentation at the European Society for Medical Oncology (ESMO) 2018 Congress1 and simultaneously published in The New England Journal of Medicine.2 In ...

gastrointestinal cancer

Trifluridine/Tipiracil in Heavily Pretreated Metastatic Gastric Cancer

In the phase III TAGS trial reported in The Lancet Oncology, Shitara et al found that trifluridine/tipiracil (Lonsurf) significantly improved overall survival vs placebo in patients with heavily pretreated metastatic gastric cancer. In the double-blind trial, 507 patients with nonresectable...

kidney cancer

Surveillance Imaging Modality and Survival After Recurrence in Favorable-Histology Wilms Tumor

Findings in a study reported by Mullen and colleagues for the Children’s Oncology Group in the Journal of Clinical Oncology suggest that routine computed tomography (CT) surveillance may not be necessary for recurrence detection in favorable-histology Wilms tumor. The study was a...

lung cancer

Increased Survival in Patients With Metastatic NSCLC Receiving Treatment in Academic vs Community Centers

Patients with metastatic non­–small cell lung cancer (NSCLC) receiving treatment at academic centers have an increased 2-year survival compared to patients treated at community-based centers, according to findings published by Ramalingam et al in the Journal of Thoracic Oncology. An...

gynecologic cancers

Five-Year Risk of Cervical Precancer With p16/Ki67 Dual-Stain or Cytology Triage in HPV-Positive Women

In a study reported in JAMA Oncology, Clarke et al found that triage with p16/Ki-67 dual-stain testing (DS) was associated with better risk stratification for cervical precancer than Papanicolaou cytology testing over 5 years among human papilloma virus (HPV)–positive women. Study Details...

cns cancers

Activity of Vemurafenib in BRAF V600–Mutant Gliomas

In a multicohort study (VE-BASKET study) in patients with BRAF V600–mutant nonmelanoma cancers in the Journal of Clinical Oncology, Kaley et al found evidence of activity of vemurafenib (Zelboraf) in gliomas that appeared to vary by glioma subtype.   Study Details In the study, 24...

solid tumors

Incidental Germline Mutations in Patients With Advanced Solid Tumors Identified by Cell-Free Circulating Tumor DNA Testing

In a study reported in the Journal of Clinical Oncology, Slavin et al determined the prevalence of a set of germline cancer predisposition gene mutations incidentally identified by cell-free circulating tumor DNA (cfDNA) testing in patients with advanced solid tumors. Study Details The study...

skin cancer

Combining Genetic and Sun Exposure Data May Improve Prediction of Skin Cancer Risk

By combining data on individuals’ lifetime sun exposure and their genetics, researchers may be able to generate improved predictions of their risk of skin cancer, according to findings presented by Fontanillas et al at the 2018 American Society of Human Genetics Annual Meeting (Abstract PgmNr ...

lymphoma
immunotherapy

Combination of Macrophage Immune Checkpoint Inhibitor and Rituximab in Non-Hodgkin Lymphoma

In a phase Ib study reported in The New England Journal of Medicine, Advani et al found that the combination of rituximab (Rituxan) and the CD47-blocking monoclonal antibody Hu5F9-G4 (or 5F9), a macrophage immune checkpoint inhibitor, was active in patients with non-Hodgkin lymphoma. CD47, which is ...

bladder cancer
immunotherapy

PURE-01 Trial: Neoadjuvant Immunotherapy in Muscle-Invasive Bladder Carcinoma

In the Italian phase II PURE-01 trial reported in the Journal of Clinical Oncology, Necchi et al found that neoadjuvant pembrolizumab (Keytruda) before radical cystectomy in muscle-invasive bladder carcinoma produced complete pathologic response (pT0) in 42% of patients, with pT0 being more common...

Samuel Waxman, MD, Receives China’s ‘Friendship Award’

The Samuel Waxman Cancer Research Foundation (SWCRF), an international nonprofit organization that funds cancer research, recently announced that its founder and Chief Executive Officer, Samuel Waxman, MD, has received China’s highest honor granted to a foreigner. The Vice-Premier of the People’s...

prostate cancer

Early PSA Testing Could Help Predict Prostate Cancer Among Black Men

In a study published by Mark A. Preston, MD, MPH, and colleagues in European Urology, researchers demonstrated that a baseline prostate-specific antigen (PSA) level obtained from black men between 40 and 60 years old may predict the future development of prostate cancer for years after testing....

Thomas J. Dougherty, PhD, Father of Photodynamic Therapy, Dies at Age 85

Thomas J. Dougherty, PhD, the developer of modern photodynamic therapy and Chief Emeritus of Roswell Park’s Photodynamic Therapy Center, died October 2, 2018, in Buffalo, New York. “He was undoubtedly the major influence in bringing [photodynamic therapy] into the realm of cancer therapy,” said...

hematologic malignancies
leukemia
genomics/genetics

Without Genomic Sequencing, I Would Not Be Alive Today

The extreme fatigue I experienced during the winter of my fourth year in medical school, in 2003, was easily attributable to the rigors of my medical training and the lack of sleep that comes from trying to keep up with an intensely busy schedule. I was looking forward to resting and recuperating...

Family Archivist Holds Joyful Memories Amid Grief of Losing Loved Ones

BOOKMARK Title: The Trail to Tincup: Love Stories at Life’s EndEditors: Joyce Lynnette HockerPublisher: She Writes PressPublication date: May 2018Price: $23.95, hardcover, 288 pages Human mortality is embedded in the day-to-day challenges of clinical oncology; a cancer diagnosis is a reality...

supportive care
integrative oncology

Acupuncture for Joint Symptoms Caused by Aromatase Inhibitors

Arthralgia is a common and debilitating adverse effect experienced by patients with breast cancer who are being treated with aromatase inhibitors, often resulting in poor adherence. And premature treatment discontinuation can negatively impact disease-free and overall breast cancer survival....

hematologic malignancies
leukemia

Nilotinib for Pediatric Patients With Philadelphia Chromosome–Positive CML in Chronic Phase

Earlier in 2018, nilotinib (Tasigna) was approved for the treatment of pediatric patients aged ≥ 1 year with newly diagnosed Philadelphia chromosome–positive chronic myeloid leukemia in chronic phase (CML-CP) or Philadelphia chromosome–positive CML-CP resistant or intolerant to prior tyrosine...

colorectal cancer
sarcoma

FDA Approves Levoleucovorin for Treatment in Osteosarcoma, Colorectal Cancer

The U.S. Food and Drug Administration (FDA) recently approved levoleucovorin (Khapzory) injection, a folate analog, for three indications: rescue after high-dose methotrexate therapy in patients with osteosarcoma; diminishing the toxicity associated with overdosing on folic acid antagonists or...

Never a Doubt About a Career in Medicine for Anne S. Tsao, MD

There was no epiphany or family influences, as long as she can remember; Anne S. Tsao, MD, always wanted to be a doctor or, because of her love for caring for sick animals, a veterinarian. Dr. Tsao was born in Fountain Creek, Pennsylvania, but her parents moved to a suburb just outside of Chicago...

issues in oncology

Cancer Care in the U.S. Prison System

A health-care system is evaluated by various metrics: one is how it cares for its most vulnerable patients. The United States spends far more on health care than any nation in the world, yet access to high-quality oncology services remains elusive to certain minority populations—none more so than...

issues in oncology
cost of care

Findings From the National Cancer Opinion Survey: Alternative Therapies, Cost of Care, and More

Nearly 4 in 10 Americans believe cancer can be cured solely through alternative therapies, according to ASCO's second annual National Cancer Opinion Survey. This is despite research showing that patients who use alternative therapies instead of standard cancer treatments have much higher...

breast cancer
survivorship

Whole-Genome Sequencing May Help Identify Young Childhood Cancer Survivors at High Risk for Breast Cancer

Female survivors of childhood cancer, especially those treated with chest irradiation, have a substantially higher risk of developing breast cancer later in life. As a result, current clinical screening of this high-risk population relies primarily on the radiation dose and volume to the...

issues in oncology

The Antiseptic Era: 1876–1900

The text and photographs on this page are excerpted from a four-volume series of books titled Oncology: Tumors & Treatment, A Photographic History, by Stanley B. Burns, MD, FACS, and Elizabeth A. Burns. The photo below is from the volume titled “The Antiseptic Era: 1876–1900.” The photograph...

ASH Honors John E. Dick, PhD, and Reed E. Drews, MD, With 2018 Mentor Award

The American Society of Hematology (ASH) will recognize John E. Dick, PhD, of the University of Toronto, Princess Margaret Cancer Center, and Ontario Institute for Cancer Research in Toronto, and Reed E. Drews, MD, of Beth Israel Deaconess Medical Center in Boston, with the 2018 Mentor Award for...

solid tumors
breast cancer

The Persephone Trial Reconsidered

Persephone is a 4,088-patient trial that Helena Margaret Earl, MBBS, PhD, reported at the 2018 ASCO Annual Meeting as establishing that 6 months of trastuzumab (Herceptin) is not inferior to 12 months in 4-year survival without invasive or local regional recurrence or distant metastases. Dr. Earl...

solid tumors
breast cancer

The Persephone Trial Reconsidered

The Persephone presentation by Helena Margaret Earl, MBBS, PhD, got a lot of publicity after a pre–ASCO Annual Meeting press release, suggesting that 6 months of adjuvant trastuzumab (Herceptin) is enough. The advice of experts has been that the evidence is inconclusive, but I have not heard a...

issues in oncology
health-care policy

Health-Policy Forum Focuses on New Care-Delivery Paradigms

What was an MBA doing at the podium of a clinical oncology meeting? Ten years ago or so, that might have been surprising. But in an era of rapid change—in therapies, costs, payment models, and practice—it only makes sense. Amy Porter-Tacoronte, MBA, Health System Chief Administrative Officer at the ...

breast cancer
issues in oncology

Prognostic Risk Model for African American Women With Breast Cancer

A prognostic model developed using a machine learning approach may be able to identify African American patients with breast cancer who have an increased risk of death, according to results of a study presented by Bhattarai et al at the 11th AACR Conference on The Science of Cancer Health...

issues in oncology

Culturally Tailored Messaging Improved HPV Vaccination Rates Among Asian American Adolescents

A pilot study by Ma et al examining the intervention effect on the outcome of a provider-based, culturally tailored, multilevel intervention to promote human papillomavirus (HPV) vaccination among Asian American adolescents has found that the strategy significantly increased the uptake of at least...

issues in oncology

Study Suggests Risk of Cancer Death Increases With Each Generation of Latinos Born in the United States

According to the U.S. Census Bureau, as of July 2016, the Hispanic population in the United States had grown to 57.5 million, making people of Hispanic origin the nation’s largest ethnic or racial minority group. Studies have shown that U.S.-born Latinos have a higher incidence of cancer than ...

solid tumors

FDA Grants Breakthrough Therapy Designation to LOXO-292 for RET Fusion–Positive Thyroid Cancer

The U.S. Food and Drug Administration (FDA) recently granted Breakthrough Therapy designation to LOXO-292, a selective RET inhibitor, for the treatment of patients with advanced RET fusion–positive thyroid cancer who require systemic therapy, have had disease progression following...

colorectal cancer
immunotherapy

ESMO 2018: CheckMate-142 Reports New Data on First-Line Nivolumab Plus Low-Dose Ipilimumab in MSI-H/dMMR Metastatic Colorectal Cancer

The combination of nivolumab (Opdivo) and low-dose ipilimumab (Yervoy) could become a new first-line treatment in patients with microsatellite instability–high (MSI-H), mismatch repair–deficient (dMMR) metastatic colorectal cancer, following results from the CheckMate-142 trial reported ...

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