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solid tumors
breast cancer

Conqueror in Action: Katherine Reeder-Hayes, MD, Takes on Breast Cancer

When a cutting-edge cancer tool becomes available, marginalized populations such as African Americans and older patients often have less access to it than other populations. This is problematic, especially when those with limited access are those who could benefit the most. As a result, public...

cns cancers
immunotherapy

Bevacizumab in Recurrent Glioblastoma

On December 5, 2017, bevacizumab (Avastin) was granted regular approval for the treatment of recurrent glioblastoma in adults.1 Bevacizumab was granted accelerated approval in May 2009 for use in treating patients with glioblastoma who had disease progression on prior therapy. Supporting Efficacy...

legislation
health-care policy

Why Right-to-Try Laws Are Dangerous

Why wouldn’t you support a patient with a terminal illness the “right to try” any therapy that may save his or her life? The answer to this question—one engulfed in a political debate in Congress—seems simple. It is not. [Editor’s Note: On May 30, 2018, the President signed into law the Trickett...

issues in oncology

Genomic Analyses Highlight Need for Precision Therapies That Target Pediatric Cancers

Researchers have determined that children and adults with cancer often have different mutated genes driving their disease, which suggests they would likely benefit from different therapies. The finding, from a collaborative study led by St. Jude Children’s Research Hospital and published by...

multiple myeloma

Denosumab vs Zoledronic Acid in Newly Diagnosed Multiple Myeloma With Bone Disease

In a phase III trial reported in The Lancet Oncology, Raje et al found that denosumab was noninferior to zoledronic acid in preventing skeletal-related events (SREs) in newly diagnosed multiple myeloma patients with bone disease. Study Details In the double-blind trial, 1,718 patients with at...

colorectal cancer

Nut Consumption in Patients With Stage III Colon Cancer

People with stage III colon cancer who regularly eat nuts are at significantly lower risk of cancer recurrence and mortality than those who don’t, according to findings published by Fadelu et al in the Journal of Clinical Oncology. Findings The study followed 826 participants in the CALGB...

sarcoma

Neoadjuvant Chemotherapy With or Without Regional Hyperthermia in Localized High-Risk Soft-Tissue Sarcoma

As reported in JAMA Oncology by Issels et al, long-term follow-up of the phase III EORTC 62961-ESHO 95 trial has shown improved outcomes with the addition of regional hyperthermia to neoadjuvant chemotherapy in patients with high-risk soft-tissue sarcoma. Study Details In the open-label trial,...

issues in oncology

New NCCN Guidelines Aim to Encourage More People Living With HIV and Cancer to Receive Appropriate Cancer Treatment

The National Comprehensive Cancer Network® (NCCN) has released new NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) intended to help make sure people living with human immunodeficiency virus (HIV) who are diagnosed with cancer receive safe, necessary treatment. According to ...

symptom management
immunotherapy

ASCO Clinical Practice Guideline: Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy

As reported in the Journal of Clinical Oncology by Julie R. Brahmer, MD, of the Johns Hopkins Kimmel Cancer Center, and colleagues, ASCO has released a clinical practice guideline on management of immune-related adverse events in patients receiving immune checkpoint inhibitor therapy. To develop...

solid tumors

Larotrectinib in TRK Fusion–Positive Cancers in Adults and Children

In a study reported in The New England Journal of Medicine, Drilon et al found that the oral tropomyosin receptor kinase (TRK) inhibitor larotrectinib produced a high response rate and enduring responses in patients with TRK fusion–positive cancers. These fusions have been found to lead to...

solid tumors

Study Shows Need for Early Supportive Care in Patients Diagnosed With Uveal Melanoma

In a study published by Williamson et al in JAMA Ophthalmology, University of California, Los Angeles, (UCLA) researchers found that nearly all patients diagnosed with uveal melanoma had a number of unmet psychological and health information needs, particularly during the first 3 months after their ...

pancreatic cancer

Five Novel Genetic Changes Linked to Pancreatic Cancer Risk

In what is believed to be the largest pancreatic cancer genome-wide association study to date, researchers at the Johns Hopkins Kimmel Cancer Center, the National Cancer Institute, and collaborators from over 80 other institutions worldwide discovered changes to 5 new regions in the human genome...

EXPERT POINT OF VIEW: Amir T. Fathi, MD

“As of now, there is no standard of care for a maintenance strategy in acute myeloid leukemia (AML),” said Amir T. Fathi, MD, Director of the Leukemia Program at Massachusetts General Hospital and Assistant Professor of Medicine at Harvard Medical School, Boston. “Maintenance therapy is being...

hematologic malignancies
leukemia

Data Favoring Maintenance Therapy in Older Patients With AML Accumulate

The use of maintenance therapy in older patients with acute myeloid leukemia (AML) is theoretically sensible, but its clinical value remains uncertain. The phase III HOVON97 randomized study demonstrated that maintenance therapy with the hypomethylating agent azacitidine may improve disease-free...

Medical and Radiation Oncologists Now Able to Meet All Federal Reporting Requirements Through QOPI Reporting Registry

ASCO AND the American Society for Radiation Oncology (ASTRO) have launched their new, joint platform for quality reporting, making it easier for oncologists to comply with federal government reporting requirements in 2018. The new QOPI® Reporting Registry, a Qualified Clinical Data Registry (QCDR), ...

Team Wellness: Reflections From Front-Line Clinical Teams

In May 2017, I started to reflect on my own personal views of wellness and the importance of the team. Since that time, I have been fortunate to speak with members of front-line clinical teams from four different practices:  Eric Tetzlaff, MSH, PA-C, and Michael Hall, MD, MS, of Fox Chase Cancer...

gynecologic cancers

USPSTF Recommends Against Screening for Ovarian Cancer in Asymptomatic Women

THE U.S. PREVENTIVE Services Task Force (USPSTF) recently published a final recommendation statement and evidence summary on screening for ovarian cancer. Based on its review of the evidence, the USPSTF recommends against screening for ovarian cancer in women who do not have any signs or symptoms...

breast cancer

Addition of Metronomic Chemotherapy to Dual Anti-HER2 Treatment in Older Patients With Metastatic Breast Cancer

In the phase II EORTC 75111-10114 trial reported in The Lancet Oncology, Wildiers et al found that the addition of metronomic oral cyclophosphamide to pertuzumab (Perjeta) and trastuzumab (Herceptin) improved progression-free survival in elderly or frail women with HER2-positive metastatic breast...

issues in oncology

Dose Rounding of Anticancer Agents: Hematology/Oncology Pharmacy Association Position Statement

As reported in the Journal of Oncology Practice by Fahrenbruch et al, the Hematology/Oncology Pharmacy Association (HOPA) has issued a position statement on dose rounding of biologic and cytotoxic anticancer agents. To formulate the position statement, the HOPA standards committee organized a work ...

skin cancer

U.S. Incidence and Projected Rise of Merkel Cell Carcinoma

The number of U.S. cases of Merkel cell carcinoma is rising about six times faster than most other cancers, and at nearly twice the rate of melanoma. Paulson et al reported these findings in The Journal of the American Academy of Dermatology, which are based on research conducted at the University...

leukemia

FDA Accepts NDA, Grants Priority Review for Ivosidenib in Relapsed or Refractory IDH1-Mutated AML

On February 15, the U.S. Food and Drug Administration (FDA) accepted a new drug application (NDA) for ivosidenib (AG-120) for the treatment of patients with relapsed or refractory acute myeloid leukemia (AML) with an isocitrate dehydrogenase 1 (IDH1) mutation. The NDA was granted Priority Review...

gynecologic cancers

Kathleen M. Schmeler, MD: A Gynecologic Oncology Activist for Underserved Women

Kathleen M. Schmeler, MD, Associate Professor in the Department of Gynecologic Oncology at The University of Texas MD Anderson Cancer Center and the Lyndon B. Johnson Hospital, was given the “Heroes in Medicine” award from Physician’s Weekly in May 2016. Her primary work is in cervical cancer...

palliative care

Why Palliative Care Isn’t Just for Older Patients With Cancer

It is well established that adolescents and young adults (AYAs) with cancer—defined by the National Cancer Institute as those between the ages of 15 and 39 years—have not reaped a comparable survival benefit as either younger or older adult cancer survivors over the past 4 decades, despite...

issues in oncology

Providing Cancer Treatment Without Patient Consent

Law and Ethics in Oncology explores the legal and ethical issues oncologists must be aware of in this era of precision medicine and changing health-care policy, both to protect patients’ rights and to safeguard against potential legal jeopardy. Increasingly, across the United States, hospitals are...

skin cancer

Retrospective Analysis Suggests Obesity Associated With Longer Survival for Men With Metastatic Melanoma

OBESE PATIENTS with metastatic melanoma who are treated with targeted or immune therapies live significantly longer than those with a normal body mass index (BMI), according to a study published in The Lancet Oncology of 1,918 patients in 6 independent clinical cohorts.1  This effect—referred to as ...

head and neck cancer

ASCO Clinical Practice Guideline Update: Use of Larynx-Preservation Strategies in the Treatment of Laryngeal Cancer

AS REPORTED in the Journal of Clinical Oncology by Arlene A. Forastiere, MD, of The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, and colleagues, ASCO has issued a clinical practice guideline update on the use of larynx-preservation strategies in the treatment of laryngeal cancer.1...

hematologic malignancies
symptom management

EXPERT POINT OF VIEW: Robert Brodsky, MD

“THE RESULTS of these two trials are more similar than different. I think the best conclusion would be that we now have two trials with consistent results and can probably, in most cases, replace low–molecular-weight heparin with direct oral anticoagulants,” said Dr. Raskob, lead investigator of...

hematologic malignancies
symptom management

Use of Direct Oral Anticoagulants in Preventing VTE in Patients With Cancer

THE FIRST TWO randomized trials to directly compare direct oral anticoagulants vs low–molecular-weight heparin for management of venous thromboembolism (VTE) in patients with cancer suggest that direct oral anticoagulants may become the new standard of care.1,2 Direct oral anticoagulants appear to...

hepatobiliary cancer

Combining Ultrasound Imaging With Alpha-Fetoprotein Test May Boost Detection of Hepatocellular Carcinoma

Combining ultrasound imaging with a blood test for high alpha fetoprotein levels may improve detection of early-stage liver cancer by as much as 40%, researchers at UT Southwestern’s Simmons Cancer Center found. Their findings were presented by Tzartzeva et al in Gastroenterology....

breast cancer

Family History Increases Breast Cancer Risk, Even in Women Aged 65 and Older

A family history of breast cancer continues to significantly increase chances of developing invasive breast tumors in women aged 65 years and older, according to research published by Braithwaite et al in JAMA Internal Medicine. The findings could impact mammography screening decisions later in...

lymphoma

Association of MHC Class II and PD-L1 Expression With Outcome in Classical Hodgkin Lymphoma

As reported in the Journal of Clinical Oncology, Roemer et al found that programmed death cell ligand 1 (PD-L1) expression and major histocompatibility complex (MHC) class II positivity on Hodgkin Reed-Sternberg (HRS) cells may predict favorable outcome with programmed cell death protein 1 (PD-1)...

lung cancer
immunotherapy

Update on Phase III JAVELIN Lung 200 Trial of Avelumab Monotherapy in Previously Treated Patients With Advanced NSCLC

On February 15, updated results were made available from the phase III JAVELIN Lung 200 trial comparing avelumab (Bavencio) to docetaxel in patients with unresectable, recurrent, or metastatic non–small cell lung cancer (NSCLC) whose disease progressed after treatment with a...

lung cancer
immunotherapy

FDA Expands Approval of Durvalumab to Reduce the Risk of NSCLC Progression

On February 16, the U.S. Food and Drug Administration (FDA) approved durvalumab (Imfinzi) for the treatment of patients with stage III unresectable non–small cell lung cancer (NSCLC) whose cancer has not progressed after treatment with chemoradiation. “This is the first treatment...

ASCO Data-Sharing Initiatives Support Innovative Cancer Research

  At the heart of every ASCO program—every clinical practice guideline, every policy statement, every scientific meeting—is evidence. What do the data say? Evidence informs decision-making across the spectrum of cancer care, from the question a bench researcher will investigate to the treatment a...

issues in oncology
survivorship

NCCN Summit Explores Survivorship Issues for Patients and Clinicians

When Yelak Biru was diagnosed with multiple myeloma in 1995, he and his physicians had one main posttreatment goal: to detect and treat any relapse early and to prolong survival as long as possible with the limited drugs available. Then, in the early 2000s, came newer treatments. Myeloma survival...

EXPERT POINT OF VIEW: Ann H. Partridge, MD, MPH, FASCO

“The simple questions are whether ovarian function suppression adds clinical benefit in premenopausal women, and is ovarian function suppression better with an aromatase inhibitor or tamoxifen,” said formal discussant of these trials, Ann H. Partridge, MD, MPH, FASCO, Professor of Medicine at...

EXPERT POINT OF VIEW: Matthew J. Ellis, MB, PhD

Matthew J. Ellis, MB, PhD, Director of the Lester and Sue Smith Breast Center at Baylor College of Medicine in Houston, commented on the POETIC trial for The ASCO Post. “This is a wonderful study that validates a point that our research team has also made over the years—that Ki67 is much more...

solid tumors
breast cancer

Perioperative Aromatase Inhibitors: No Effect on Recurrence, but Ki67 Level Important

Updated analysis from the United Kingdom’s POETIC trial found no evidence that perioperative aromatase inhibitor therapy slows or prevents time to recurrence of breast cancer. However, the study did show that tumor Ki67 levels after 2 weeks of perioperative aromatase inhibitor therapy are...

solid tumors
breast cancer

SABCS Highlights Focus on Predicting Residual Tumor Burden, Therapy-Related Arm Morbidity, Lifestyle and Cancer Risk

We have covered many of the important presentations from the 2017 San Antonio Breast Cancer Symposium in the pages of The ASCO Post and in our online Evening News. Here are summaries of additional noteworthy studies presented at the meeting. We hope you will find them of interest. Predicting...

solid tumors
prostate cancer

Combined Medical and Psychological Approach May Help Couples Reclaim Intimacy After Prostate Cancer Treatment

“To what extent do treatments for prostate cancer impact sexual functioning? To a great extent,” Christian Nelson, PhD, Chief, Psychiatry Service, Memorial Sloan Kettering Cancer Center, New York, told participants at the 11th Annual Oncofertility Consortium Conference in Chicago.1 Most men with...

lung cancer

ASCO Endorses CAP/IASLC/AMP Guideline Update on Molecular Testing for Targeted Tyrosine Kinase Inhibitor Treatment in Lung Cancer

As reported in the Journal of Clinical Oncology by Gregory P. Kalemkerian, MD, and colleagues, ASCO has endorsed the College of American Pathologists (CAP), International Association for the Study of Lung Cancer (IASLC), and Association for Molecular Pathology (AMP) updated guideline on molecular...

issues in oncology
immunotherapy

New ACCC Report Focuses on Immuno-Oncology, Cancer Care Delivery

As innovations in immunotherapies multiply, cancer programs and practices must overcome care coordination and communication challenges across the nation’s health-care system to integrate these advances into effective patient care. A new report from the Association of Community Cancer Centers...

EXPERT POINT OF VIEW: Jordi Bruix, MD, PhD and Flavio G. Rocha, MD

Discussant Jordi Bruix, MD, PhD, Head of the Barcelona Clinic Liver Cancer Group at the University of Barcelona in Spain, said the results of the CELESTIAL trial show that cabozantinib (Cabometyx) provides a clinically meaningful survival benefit to patients with advanced hepatocellular carcinoma ...

hematologic malignancies
lymphoma

Releasing Follicular Lymphoma From the Curse of Frankenstein

In the December 10, 2017, issue of The ASCO Post, I authored an article in which I raised the possibility of curing follicular lymphoma without the dreaded chemotherapy. Clearly, no good deed goes unpunished: My good friend and The ASCO Post’s editor Jim Armitage, MD, challenged me to defend that...

solid tumors
head and neck cancer

Laryngeal Preservation: All Patients Need a Voice

Following the publication of two landmark studies in the United States,1,2 laryngeal preservation with combined chemoradiotherapy has become standard practice as opposed to laryngectomy for patients with locally advanced laryngeal cancer. The Department of Veterans Affairs Laryngeal Cancer Study...

EXPERT POINT OF VIEW: Ravindra Uppaluri, MD, PhD

“This is a large, well-done study,” said Ravindra Uppaluri, MD, PhD, Chief of the Division of Otolaryngology in the Department of Surgery at the Brigham and Women’s Hospital and Director of Head and Neck Surgical Oncology at Dana-Farber Cancer Institute, who underscored the small number of...

solid tumors
immunotherapy

Combination Radiotherapy and Immunotherapy Appears Safe and Clinically Active in Advanced Solid Tumors

Results from the first and largest prospective trial to determine the safety of multisite ablative stereotactic body radiotherapy (SBRT) in combination with anti–programmed cell death protein 1 (anti–PD-1) immunotherapy pembrolizumab (Keytruda) suggest the combination regimen may improve outcomes...

colorectal cancer
immunotherapy

Combination Immunotherapy in DNA Mismatch Repair–Deficient/Microsatellite Instability–High Metastatic Colorectal Cancer

As reported in the Journal of Clinical Oncology by Overman et al, findings in the nivolumab (Opdivo) plus ipilimumab (Yervoy) cohort of the CheckMate-142 study indicate a high response rate and durable responses with the combination in previously treated patients with DNA mismatch...

supportive care
symptom management
immunotherapy

ASCO and NCCN Provide Guidelines for Managing Immunotherapy Side Effects

Immunotherapy with immune checkpoint inhibitors is the first of a new generation of immunotherapy treatments, revolutionizing treatment for many different types of cancer. By unleashing the body's immune system to attack cancer, these treatments can send even the most hard-to-treat cancers into...

lung cancer

ALK Variant, Resistance, and Clinical Outcomes in ALK-Positive NSCLC

In a study reported in the Journal of Clinical Oncology, Lin et al found that specific ALK variants may be associated with the development of resistance mutations to ALK tyrosine kinase inhibitors (TKIs) in ALK-positive non–small cell lung cancer (NSCLC). Study Details The study involved...

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