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issues in oncology
cost of care

Tackling the High Cost of Cancer Care

AT THE 2017 ASCO ANNUAL MEETING, the leaders of the newly formed Value in Cancer Care Consortium (vi3c; vi3c.org) met to discuss the group’s plan to study how to improve the affordability of cancer drugs and make them more accessible to patients. The goal of the Value in Cancer Care Consortium is...

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...

supportive care
palliative care

Digital Palliative Care Curriculum Improves Knowledge, Skills, and Opioid Prescribing Behavior

A new electronic curriculum delivered via e-mail with push technology may provide an efficient, cost-effective solution to the shortage of palliative care faculty serving the nation’s oncology fellowship programs. According to data presented at the 2017 Palliative and Supportive Care in Oncology...

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....

genomics/genetics

Role of the E7 Gene in High-Risk HPV

NATIONAL CANCER INSTITUTE (NCI) researchers have found that for the most common high-risk type of human papillomavirus (HPV) to cause cervical cancer, an important viral gene may need to have a precise DNA sequence. The findings, published by Mirabello et al in Cell,1 contribute to a better...

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...

Johns Hopkins Researcher Awarded $300,000 to Investigate Genetics of Lung Cancer

The Bonnie J. Addario Lung Cancer Foundation (ALCF) and the International Association for the Study of Lung Cancer (IASLC) announced they have awarded $300,000 in research funding to a Johns Hopkins University investigator studying the genetics of lung cancer. According to the organizations, Johns ...

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 ...

leukemia

Novel Risk-Assessment Model for Acute Myeloid Leukemia

A RECENTLY PUBLISHED STUDY in JAMA Oncology, led by Mohamed Sorror, MD, MSc, and Elihu Estey, MD, of the Fred Hutchinson Cancer Research Center (Fred Hutch), involving five collaborating institutions, provides a novel model to predict 1-year survival rates of patients after beginning treatment...

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...

genomics/genetics
solid tumors
lymphoma
multiple myeloma

Update on NCI-MATCH Precision Medicine Trial

THE NATIONAL CANCER INSTITUTE (NCI) Molecular Analysis for Therapy Choice (MATCH) clinical trial has achieved the goal of screening nearly 6,000 patients in just under 2 years, according to data presented at the 2017 American Association for Cancer Research–NCI–European Organisation for Research...

lymphoma

FDA Approves CAR T-Cell Therapy for Adults With Certain Types of Large B-Cell Lymphoma

ON OCTOBER 18, the U.S. Food and Drug Administration (FDA) approved axicabtagene ciloleucel (Yescarta), a cell-based gene therapy, to treat adult patients with certain types of large B-cell lymphoma who have not responded to or who have relapsed after at least two other kinds of treatment....

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...

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 ...

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...

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...

Stand Up To Cancer Launches ‘Cancer Interception’ Teams to Detect and Treat Cancer at Earliest Stages

Stand Up To Cancer, joined by the Lustgarten Foundation for Pancreatic Cancer Research, LUNGevity, and the American Lung Association, announced that four teams of top researchers will study lung and pancreatic cancers using a new approach of “cancer interception” at their earliest stages. “The...

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...

breast cancer

Computer-Based Support May Allow Physicians to Spend More Time on ‘Human Aspects of Cancer Care’

As computer-based physician support systems for decision-making in cancer management continue to evolve, “we will come to embrace this as something that liberates us to spend more time on the human aspects of cancer care,” Andrew D. Seidman, MD, told participants at the 2017 Lynn Sage Breast Cancer ...

breast cancer

What Can We Do Differently for Premenopausal Patients With Breast Cancer?

While age remains a major risk factor for breast cancer, with nearly 80% of new cases occurring in women aged 50 years and older, women diagnosed at a younger age generally have poorer outcomes. This is partly because premenopausal women are more likely to have triple-negative breast cancer, which ...

solid tumors
breast cancer

Where Are We Now in Triple-Negative Breast Cancer?

The treatment of triple-negative breast cancer is rapidly evolving, as clinical trials continue to test chemotherapy agents and combinations and immunotherapy studies promise potentially “game-changing” interventions early in the course of disease, Joyce O’Shaughnessy, MD, reported at the 19th...

hematologic malignancies
lymphoma

Axicabtagene Ciloleucel for Large B-Cell Lymphoma

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 October 18, 2017, the chimeric antigen receptor (CAR)...

lung cancer

ESMO Asia 2017: Analysis of Mutations in Cerebrospinal Fluid in Lung Cancer With Brain Metastases

In a study presented at the European Society for Medical Oncology (ESMO) Asia 2017 Congress (Abstract 35P_PR), researchers analyzed the presence of mutations in the cerebrospinal fluid of patients with lung cancer and brain metastases. Tumor tissue from brain metastasis is difficult to obtain,...

hematologic malignancies
leukemia

Clinical Relevance of Minimal Residual Disease Monitoring Limited in Acute Myeloid Leukemia

Although a majority of major cancer centers may test for minimal residual disease (MRD), a recent survey conducted by researchers at Moffitt Cancer Center, Tampa, Florida, suggests most oncologists remain uncertain about what to do with the results. At the National Comprehensive Cancer Network®...

hematologic malignancies
lymphoma

New Options for the Management of Hodgkin Lymphoma

With the vast majority of patients cured with primary therapy, classical Hodgkin lymphoma is largely a success story. For the 10% to 20% of patients who either relapse or are refractory to front-line therapy, the disease can still be fatal. At the National Comprehensive Cancer Network® (NCCN®) 12th ...

colorectal cancer

Mismatch Repair–Deficiency Testing in Patients With Colorectal Cancer

In a study reported in JAMA Oncology, Shaikh et al found that despite existing recommendations, mismatch repair (MMR)-deficiency testing is underused in patients with colorectal cancer, including younger patients. As noted by the authors, MMR deficiency is observed in up to 15% of sporadic...

gynecologic cancers

PARP Inhibitors in BRCA-Related Ovarian Cancer—and Beyond!

Poly (ADP ribose) polymerase (PARP) inhibitors are among the most exciting new classes of oncology drugs, and their development has coincided with the increasing recognition of the therapeutic vulnerability in targeting DNA damage response and DNA repair. The initial clinical testing of PARP...

issues in oncology

ASCO Survey Reveals Concerning Trends in Americans’ Knowledge About Cancer Risks and Impact of Costs on Compliance

Although most Americans, 78%, recognize that smoking is a major risk factor for cancer, just 31% say obesity—the second-leading preventable cause of cancer after smoking—is a risk factor for the disease, according to the results of ASCO’s National Cancer Opinion Survey, which polled over 4,000...

ASCO Issues Statement on Alcohol Consumption and Cancer Risk

As reported in the Journal of Clinical Oncology by Noelle K. LoConte, MD, of the University of Wisconsin, Madison, and colleagues, ASCO has issued a statement on the association of alcohol consumption with cancer risk that outlines proposals for promoting awareness of the association, supporting...

kidney cancer

FDA Expands Approval of Sunitinib Malate for Adjuvant Treatment of Renal Cell Carcinoma After Nephrectomy

Today, the U.S. Food and Drug Administration (FDA) approved sunitinib malate (Sutent) for the adjuvant treatment of adult patients who are at a high risk of recurrent renal cell carcinoma after nephrectomy. “This is the first adjuvant treatment approved for patients with renal cell...

issues in oncology

FDA Announces Comprehensive Regenerative Medicine Policy Framework

On November 16, the U.S. Food and Drug Administration (FDA) announced a comprehensive policy framework for the development and oversight of regenerative medicine products, including novel cellular therapies. The framework—outlined in a suite of four guidance documents—builds upon the...

ESMO Publishes Precision Medicine Glossary

The European Society for Medical Oncology (ESMO) has published its ESMO Precision Medicine Glossary in Annals of Oncology. The glossary’s 43 definitions are set to pave the way for consistent communication on precision medicine between oncologists, researchers, and patients by standardizing...

leukemia

Comparison of First-Line Treatments in Chronic Myeloid Leukemia

In the phase III BFORE trial reported in the Journal of Clinical Oncology by Cortes et al, the SRC/ABL kinase inhibitor bosutinib (Bosulif) improved response rates vs imatinib in first-line treatment of patients with Philadelphia chromosome (Ph)-positive chronic phase chronic myeloid leukemia (CML) ...

breast cancer

Are African American Women With Type 2 Diabetes at Increased Risk for ER-Negative Breast Cancer?

A prospective study by Palmer et al assessing the relationship of type 2 diabetes and the incidence of estrogen receptor–negative and estrogen receptor–positive breast cancer among African American women has found statistically significant evidence of an increased risk of estrogen...

solid tumors

FDA Authorizes MSK-IMPACT Tumor Profiling Assay

Today, the U.S. Food and Drug Administration (FDA) authorized Memorial Sloan Kettering Cancer Center’s MSK-IMPACT tumor profiling assay, an in vitro diagnostic test that can identify more biomarkers that may be found in various cancers than any test previously reviewed by the...

colorectal cancer

Ventana MMR IHC Panel for Patients Diagnosed With Colorectal Cancer Receives FDA Clearance

On November 14, the U.S. Food & Drug Administration (FDA) granted clearance to the Ventana MMR IHC Panel, which provides clinicians with a comprehensive group of immunohistochemistry (IHC) tests for patients diagnosed with colorectal cancer. The tests detect proteins associated with the DNA...

prostate cancer

TMPRSS2-ERG Genetic Fusion May Be Associated With Low-Risk Prostate Cancer

Establishing the way in which a genetic alteration called a TMPRSS2-ERG gene fusion forms in a prostate cancer, rather than the presence of the gene fusion itself, could help identify patients with prostate cancer with a low risk of spreading, which might determine the best course of treatment for...

lung cancer

Chronic Stress Hormones May Promote Resistance to EGFR Inhibitors in Patients With Lung Cancer

Elevated levels of chronic stress hormones, such as those produced by psychological distress, may promote resistance to drugs commonly used to treat lung cancer patients with EGFR mutations, according to new research from The University of Texas MD Anderson Cancer Center. Retrospective analysis of...

issues in oncology

Survival as Quality Metric in Cancer Care

In a National Cancer Data Base study reported in the Journal of Oncology Practice, Shulman et al found little difference in risk-adjusted cancer mortality rates among individual hospitals, suggesting survival may not be an ideal quality metric at the individual hospital level. However, survival was ...

Donald Coffey, PhD, Prostate Cancer Expert, 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 at the age of 85. Long Career at Johns Hopkins In his...

gynecologic cancers

Study Finds HPV Screening May Be More Sensitive Than Pap Test for Detecting Cervical Cancer

The main goal of cervical screening programs is to detect and treat precancer before the cancer develops. Human papillomavirus (HPV) testing is more sensitive than cytology for detecting precancer. However, reports of rare HPV-negative, cytology-positive cancers are motivating the continued use of...

hematologic malignancies

FDA Approves Letermovir for Prophylaxis of Cytomegalovirus Infection and Disease in Allogeneic Stem Cell Transplant Patients

Today, the U.S. Food and Drug Administration (FDA) approved letermovir (Prevymis) once-daily tablets for oral use and injection for intravenous infusion. Letermovir is indicated for prophylaxis of cytomegalovirus (CMV) infection and disease in adult CMV-seropositive recipients of an allogeneic...

gynecologic cancers

ARIEL3 Investigators Clarify the Effects of Rucaparib on the Liver

PRIMARY RESULTS from the randomized, placebo-controlled, phase III study ARIEL3—presented at the European Society for Medical Oncology (ESMO) 2017 Congress and published recently in The Lancet1—demonstrated that maintenance treatment with the poly(ADP-ribose) polymerase (PARP) inhibitor rucaparib ...

A Revolutionary Technology Offers Hope and Ethical Concern

Aldous Huxley’s classic 1932 dystopian novel Brave New World pictures an eerie future where humans are genetically bred, altered to create worthy citizens. Welcome back to the future. First there was the astounding feat of sequencing the entire human genome; now, thanks to a revolutionary...

supportive care

Predictors of Posthospital Care Transitions in Advanced Cancer

In a study reported in the Journal of Clinical Oncology, Lage and colleagues found that among patients with advanced cancer who had an unplanned hospital admission, those discharged to hospice or post–acute care facilities had a worse symptom burden and physical function and worse survival...

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