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hematologic malignancies

Untangling the Controversies of Hematopoietic Cell Transplantation

BOOKMARK Title: Hematopoietic Cell Transplants: Concepts, Controversies, and Future DirectionsEditors: Hillard M. Lazarus, MD; Robert Peter Gale, MD, PhD, DSc (hon), FACP; Armand Keating, MD, FRCP(C); Andrea Bacigalupo, MD; Reinhold Munker, MD; Kerry Atkinson, MBBS, MD, DTM&H, FRCP, FRACP; and...

Radiation Oncologist Gives Clear Advice to Patients With Cancer

BOOKMARK Title: Cancer: What You Need to Know: Overcome the 10 Common Mistakes Patients MakeAuthor: Stephen A. Rosenberg, MDPublisher: Stephen Rosenberg, MDYear Published: November 2017Price: $9.99, paperback, 248 pages Stephen A. Rosenberg, MD, is Chief Resident in Radiation Oncology at the...

Old and New Perspectives on the Theory of Cancer

BOOKMARK Title: Tripping Over the Truth: How the Metabolic Theory of Cancer Is Overturning One of Medicine’s Most Entrenched ParadigmsAuthor: Travis Christofferson, MSPublisher: Chelsea Green PublishingPublication Date: February 2017Price: $24.95, hardcover; 288 pages Bringing a book to market is...

Gratitude

The following essay by Stan Winokur, MD, is adapted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was coedited by Dr. Winokur and -Vincent Coppola and published in May 2014. The book is available on Amazon.com and thebigcasino.org. I looked into her...

solid tumors

SITC Spearheads Initiative for Management of Immunotherapy-Related Side Effects

The first consensus recommendations on the recognition and clinical management of immune-related side effects from cancer immunotherapy were recently published in the Journal for ImmunoTherapy of Cancer (JITC).1 The article, “Managing Toxicities Associated With Immune Checkpoint Inhibitors:...

hematologic malignancies

Liposome-Encapsulated Daunorubicin and Cytarabine for AML Subtypes

On August 3, 2017, a liposome-encapsulated combination of daunorubicin and cytarabine (Vyxeos) was approved for treatment of adults with newly diagnosed therapy-related acute myeloid leukemia (AML) or AML with myelodysplasia-related changes.1,2 This is the first U.S. Food and Drug...

breast cancer

SABCS 2017: Combined Residual Risk Score Test and Predicting Breast Cancer Risk in Women Who Tested Negative for Hereditary Mutations

Results from a validation study to better define the risk of breast cancer in women of European ancestry who tested negative for a hereditary cancer mutation with a hereditary cancer risk test (myRisk Hereditary Cancer test) were reported earlier this week in a spotlight presentation at the 2017...

solid tumors

Future Directions for CAR T-Cell Therapy

Chimeric antigen receptor (CAR) T-cell therapy burst upon the scene as an innovative approach to the treatment of hematologic malignancies, mainly for patients who have exhausted all other treatment options. Recently two CAR T-cell products were approved by the U.S. Food and Drug Administration...

solid tumors
gynecologic cancers

Olaparib Tablets for Maintenance Treatment in Ovarian Cancer

On August 17, 2017, olaparib -(Lynparza) in tablet form was granted regular approval for maintenance treatment of adult patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in complete or partial response to platinum-based chemotherapy.1,2 Olaparib...

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. The ...

breast cancer

SABCS 2017: 2 Years of Extended Anastrozole Therapy Proved as Effective as 5 Years in Hormone Receptor–Positive Breast Cancer

Postmenopausal women with hormone receptor–positive breast cancer who took the aromatase inhibitor anastrozole for 2 years after an initial 5 years of adjuvant endocrine therapy received an equal benefit to those who took the drug for 5 additional years. The trial results suggest that a...

breast cancer

SABCS 2017: SOLD Trial Data Support Current Standard 12-Month Adjuvant Trastuzumab for HER2-Positive Breast Cancer

Disease-free survival after 9 weeks of adjuvant trastuzumab (Herceptin) and standard chemotherapy was not comparable to disease-free survival after 12 months of adjuvant trastuzumab and standard chemotherapy for women with early-stage HER2-positive breast cancer, supporting the current...

solid tumors

Immunotherapy Has Indelibly Changed the Treatment Paradigm in Urothelial Carcinoma

Cisplatin-based combination chemotherapy is the preferred first-line therapy for metastatic urothelial cancer and the only treatment shown to improve survival in patients with previously untreated disease for many years. This chemotherapy also has proven to be beneficial in the neoadjuvant and...

solid tumors

First-Line Pembrolizumab in Cisplatin-Ineligible Advanced Urothelial Cancer

As reported in The Lancet Oncology by Arjun V. Balar, MD, of Perlmutter Cancer Center of New York York Langone Medical Center, and colleagues, first-line pembrolizumab (Keytruda) produced durable responses in cisplatin-ineligible patients with locally advanced and unresectable or metastatic...

solid tumors
lung cancer

Immunotherapy Plus Chemotherapy in Non–Small Cell Lung Cancer: Despite the Failure of Ipilimumab, Guarded Optimism Persists

Ipilimumab (Yervoy) is a fully human monoclonal antibody that inhibits cytotoxic T-lymphocyte–associated protein 4 (CTLA-4) and was the first checkpoint inhibitor approved after showing survival benefit in metastatic melanoma.1 Indeed, in the first-line setting for metastatic melanoma, ipilimumab ...

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 ...

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