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issues in oncology

Breakthroughs Save Lives: ASCO’s Conquer Cancer Foundation Launches National Awareness Campaign

“I realized I just couldn’t wait for a new treatment option,” a determined Breelyn Wilky, MD, says, staring into the camera. “I had to find one.” If you missed the debut of the “Breakthroughs Save Lives” video during the 2018 ASCO Annual Meeting, look for it on television and the Internet as part...

issues in oncology

Quality Improvement: Worth the Effort but Not Always Easy to Execute

According to Kaveh Shojania, MD, the keynote speaker at the 2018 ASCO Quality Care Symposium, dedicated quality improvement work can help repair a fragmented health-care delivery system, but it’s challenging, and there are multiple things that can go wrong during the process.1 “I’ve developed this ...

supportive care
pain management

The Opioid Crisis From the Oncology Perspective

As the nation battles an escalating opioid-overdose crisis, which claims more than 100 lives per day, a new study presented at the 2018 ASCO Quality Care Symposium was designed to answer a heretofore unanswered question: How common are opioid-related deaths in patients with cancer?1 Unintended...

solid tumors
hepatobiliary cancer

Cabozantinib in Advanced Hepatocellular Cancer: Call for Revision of Practice Standards

As reported in The New England Journal of Medicine by Ghassan K. Abou-Alfa, MD, and colleagues, and reviewed in this issue of The ASCO Post, the phase III CELESTIAL trial has demonstrated that cabozantinib (Cabometyx) improved the median overall survival to 10.2 months in comparison to 8 months...

hepatobiliary cancer

Cabozantinib Improves Survival in Patients With Previously Treated Hepatocellular Carcinoma

As reported in The New England Journal of Medicine by Ghassan K. Abou‑Alfa, MD, of Memorial Sloan Kettering Cancer Center, and colleagues, the second interim analysis of the phase III CELESTIAL trial has shown a significant improvement in overall and progression-free survival with cabozantinib...

solid tumors
kidney cancer

Nivolumab Plus Ipilimumab in Intermediate- or Poor-Risk Advanced Renal Cell Carcinoma

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 April 16, 2018, nivolumab (Opdivo) and ipilimumab...

hematologic malignancies
lymphoma

Novel Treatment Approaches in Early Relapse of Follicular Lymphoma

“Patients with follicular lymphoma who relapse early after treatment are a minority of patients, fortunately, but they are clearly patients with a different disease,” according to Jonathon B. Cohen, MD, of Emory University School of Medicine. At Emory’s 2018 Debates and Didactics in Hematology and...

breast cancer

ESMO 2018: SOLAR-1: Alpelisib in Patients With PIK3CA-Mutated HR-Positive, HER2-Negative Advanced Breast Cancer

Targeting a common mutation in patients with hormone receptor (HR)–positive, human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer with the alpha-specific phosphatidylinositol-3-kinase (PI3K) inhibitor alpelisib improved progression-free survival, according to...

breast cancer

ESMO 2018: PALOMA-3: Palbociclib in Hormone Receptor–Positive, HER2-Negative Advanced Breast Cancer

Treatment with the cyclin-dependent kinase (CDK) 4/6 inhibitor palbociclib (Ibrance) achieved a clinically meaningful improvement in overall survival in patients with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer that has relapsed or ...

breast cancer
immunotherapy

ESMO 2018: IMpassion 130: Atezolizumab Plus Nab-Paclitaxel in Metastatic Triple-Negative Breast Cancer

A combination of immunotherapy and chemotherapy improves survival in some patients with metastatic triple-negative breast cancer, according to late-breaking results from the IMpassion130 trial reported by Schmid et al at the European Society for Medical Oncology (ESMO) 2018 Congress (Abstract...

breast cancer

ESMO 2018: HDAC Inhibitor Therapy in Advanced Hormone Receptor–Positive Breast Cancer

A phase III trial presented by Jiang et al at the European Society for Medical Oncology (ESMO) 2018 Congress showed activity of histone deacetylase (HDAC) inhibitor therapy in advanced hormone receptor–positive breast cancer (Abstract 283O_PR). Endocrine therapies are the foundation of...

leukemia

Current Treatment Landscape of Relapsed or Refractory Chronic Lymphocytic Leukemia

Novel agents such as ibrutinib (Imbruvica), idelalisib (Zydelig), and venetoclax (Venclexta) have transformed the treatment of chronic lymphocytic leukemia (CLL) and are increasingly used to treat the disease. The optimal sequencing of these agents is not clear in relapsed or refractory disease,...

lung cancer
immunotherapy

Regardless of Taxane Used, Pembrolizumab Plus Chemotherapy Improves Survival in Squamous NSCLC

The addition of pembrolizumab (Keytruda) to a standard platinum doublet as first-line therapy improved overall and progression-free survival in patients with metastatic squamous non–small cell lung cancer (NSCLC), in the primary analysis of KEYNOTE-407.1,2 Furthermore, it did not seem to matter...

lung cancer

Entrectinib Shows Activity in ROS1-Positive NSCLC

Although ROS1-mutated lung cancer accounts for about 1% to 2% of all non–small cell lung cancers (NSCLCs), it is an important druggable oncogene, and new data show that it can be successfully targeted for clinical gain. In a pooled analysis of phase I and II trials in patients with ROS1-positive...

lung cancer

NELSON Trial: ‘Call to Action’ for Lung Cancer CT Screening of High-Risk Individuals

Results of the very large, randomized, population-based NELSON trial confirm the value of low-dose computed tomography (CT) screening in people at high risk for developing lung cancer. The protective value of screening was more pronounced in women than in men. These study findings were presented at ...

Expert Point of View: Everett Vokes, MD

“PACIFIC is a positive trial, with a 32% improvement in survival, and maintenance durvalumab is a new standard of care,” stated formal discussant Everett Vokes, MD, Chair of the Department of Medicine at the University of Chicago and a pioneer in the concurrent use of chemotherapy and radiotherapy ...

immunotherapy
lung cancer

Durvalumab Improves Overall Survival in Unresectable Stage III NSCLC

Several lung cancer trials have shown prolonged progression-free survival with checkpoint inhibitor therapy. For the first time, the phase III PACIFIC trial has found an overall survival benefit for the selective programmed cell death ligand 1 (PD-L1) checkpoint inhibitor durvalumab (Imfinzi) vs...

How the Nobel Prize Could Spur More Cancer Advances

Even before James P. Allison, PhD, made an appearance at the Fourth International Cancer Immunotherapy Conference: Translating Science Into Survival in New York City, the excitement among attendees was palpable. Earlier that day, October 1, 2018, Dr. Allison and Tasuku Honjo, MD, PhD, of Kyoto...

Expert Point of View: Hossein Borghaei, MS, DO

Formal discussant, Hossein Borghaei, MS, DO, of Fox Chase Cancer Center, was guardedly optimistic about the IMpower132 trial results. “The study met its primary endpoint, and investigator-assessed progression-free survival was superior in the investigational arm. Overall survival was not mature,...

lung cancer

Atezolizumab Plus Standard Chemotherapy Improves Progression-Free Survival in Stage IV NSCLC

The combination of atezolizumab (Tecentriq), a programmed cell death ligand 1 (PD-L1) inhibitor, plus carboplatin or cisplatin and pemetrexed (Alimta) as first-line therapy followed by pemetrexed plus atezolizumab maintenance therapy improved progression-free survival in patients with stage IV...

issues in oncology
gastroesophageal cancer
symptom management

ESMO 2018: Pooled Analysis of Influence of Sex on Chemotherapy Efficacy and Toxicity in Esophagogastric Cancer

In an analysis presented by Davidson et al at the European Society for Medical Oncology (ESMO) 2018 Congress (Abstract 619PD_PR), data were pooled from four UK randomized controlled clinical trials of first-line chemotherapy in esophagogastric cancer, finding significant differences in a...

breast cancer

ESMO 2018: Short-HER Trial Examines Abbreviated Course of Trastuzumab in Some HER2-Positive Early Breast Cancers

Women with HER2-positive early breast cancer with small tumors have similar disease-free survival and lower risk of cardiac toxicity with a 9-week course of adjuvant trastuzumab (Herceptin) compared to those treated for 1 year, according to a subgroup analysis of the Short-HER trial reported by...

hematologic malignancies
immunotherapy

Adoptive T-Cell Therapy for Progressive Multifocal Leukoencephalopathy

An emerging treatment known as adoptive T-cell therapy has proven effective in a phase II clinical trial for treating progressive multifocal leukoencephalopathy (PML), a rare and often fatal brain infection sometimes observed in patients with cancer and other diseases in which the immune...

hematologic malignancies

Genomic Classification of Myeloproliferative Neoplasms and Integration in Predictive Models

In a study reported in The New England Journal of Medicine, Grinfeld et al identified distinct genomic subgroups among patients with myeloproliferative neoplasms that, when combined with clinical variables, offered the potential for individualized predictions of clinical outcomes. Study Details...

gynecologic cancers

Adjuvant Chemotherapy in High-Grade Uterine Leiomyosarcoma

As reported in the Journal of Clinical Oncology by Hensley et al, a phase III NRG Oncology/Gynecologic Oncology Group study assessing adjuvant chemotherapy vs observation in disease-free patients with uterus-confined high-grade leiomyosarcoma was stopped due to accrual futility; available data...

skin cancer
immunotherapy

Small Study of Neoadjuvant Combination Checkpoint Blockade in High-Risk Stage III Melanoma

Neoadjuvant combination checkpoint blockade showed activity among patients with high-risk stage III melanoma in a small study. However, a high incidence of side effects caused the trial to be closed early. These results were published by Amaria et al in Nature Medicine. The phase II...

lung cancer
issues in oncology
pain management

Opioid Use Following Video-Assisted Thoracoscopic Surgery or Open Resection in Early-Stage Lung Cancer

In a study reported in a research letter in JAMA Oncology, Tuminello et al found that video-assisted thorascopic surgery (VATS) was less likely than open resection to be associated with long-term opioid use in patients undergoing surgery for early-stage lung cancer. Study Details The study...

leukemia
lymphoma

Duvelisib vs Ofatumumab in Relapsed or Refractory CLL/SLL

As reported in the journal Blood by Flinn et al, the phase III DUO trial has shown significantly prolonged progression-free survival with the phosphoinositide 3-kinase (PI3K)-δ,-γ inhibitor duvelisib (Copiktra) vs ofatumumab (Arzerra) in patients with relapsed or refractory chronic...

breast cancer

ESMO 2018: Patients With Breast Cancer Use Twitter as a Nonmedical Forum to Share Experiences

Twitter is a place where many patients with cancer go to share and discuss their experiences of the disease, according to a recent exploratory study to be presented by Sánchez-Bayona et al at the European Society for Medical Oncology (ESMO) 2018 Congress (360P_PR). The...

solid tumors
immunotherapy

Epacadostat Plus Anti–PD-1 Immunotherapy in Advanced Solid Tumors

As reported by Mitchell et al in the Journal of Clinical Oncology, the combination of the oral indoleamine 2,3-dioxygenase 1 (IDO1) enzyme inhibitor epacadostat and the anti–programmed cell death protein 1 (PD-1) therapy pembrolizumab (Keytruda) showed activity in advanced solid tumors in the ...

breast cancer
issues in oncology

Adherence to Endocrine Therapy for Breast Cancer in Black Women and White Women

In a study reported in the Journal of the National Cancer Institute, Wheeler et al found that black women reported nonadherence to endocrine therapy for breast cancer more often than white women, although no significant difference in discontinuation of treatment was observed. The study...

pancreatic cancer

Assessment of the 8th Edition of the AJCC TNM Staging System in Cohort With Resected Pancreatic Cancer

In a study reported in JAMA Surgery, van Roessel et al found that the recently released 8th edition of the American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) staging system for pancreatic cancer provided better distribution among cases and some increase in prognostic...

hepatobiliary cancer

Risk of Hepatocellular Carcinoma With Entecavir vs Tenofovir Treatment for Chronic Hepatitis B

In a Korean nationwide cohort study reported in JAMA Oncology, Choi et al found that hepatocellular carcinoma (HCC) appeared to be more common with first-line entecavir vs tenofovir treatment for chronic hepatitis B. The study involved data from the Korean National Health Insurance Service...

issues in oncology

Adequacy of Conflict of Interest Disclosure at Society Meetings

In a study reported in the Journal of Oncology Practice, Ahmed et al found that conflict of interest (COI) disclosure slides shown during presentations at a recent American Society for Radiation Oncology (ASTRO) national meeting were shown too briefly to be fully read and often contained...

lung cancer

CHEST 2018: Adherence to Annual Lung Cancer Screening Needs Improvement

A study from the Thoracic Oncology Research Group (TORG), Division of Pulmonary Critical Care, Medical University of South Carolina, aimed to examine the adherence to annual low-dose computed tomography (LDCT) screening after baseline LDCT within the Veteran Health Administration Lung Cancer...

leukemia

Adding Lomustine to Conventional Chemotherapy in Older Patients With AML Without Unfavorable Cytogenetics

As reported in the Journal of Clinical Oncology by Pigneux et al, a French phase III trial (LAM-SA 2007 FILO) has shown an overall survival benefit with the addition of lomustine to conventional chemotherapy in older patients with acute myeloid leukemia (AML) without unfavorable cytogenetics....

breast cancer
issues in oncology
survivorship

Cognitive Outcomes Among Older Survivors of Breast Cancer

In a study (Thinking and Living with Cancer) reported in the Journal of Clinical Oncology, Mandelblatt et al found that poorer cognitive function in older survivors of breast cancer was associated with chemotherapy, hormone therapy, and ApoE genotype. The ApoE ε4 allele has been associated...

A Pathologic Fascination With Humanity

The ASCO Post is pleased to reproduce installments of the Art of Oncology as published previously in the Journal of Clinical Oncology. These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

Proton Therapy Leader, James D. Cox, MD, Dies at 80

THE ACCLAIMED radiation oncologist James D. Cox, MD, led MD Anderson’s Proton Therapy Center, an international center of excellence for proton therapy, research, and education, distinguished as the world’s first proton therapy facility located within a comprehensive cancer center. At the 2017...

Johns Hopkins Radiation Oncology Pioneer, Moody Wharam, Jr, MD, Dies at 77

MOODY WHARAM, JR, MD, Professor Emeritus of Radiation Oncology and Molecular Radiation Sciences and former Willard and Lillian Hackerman Professor of Radiation Oncology at the Johns Hopkins Kimmel Cancer Center, died on August 10 at the age of 77. Dr. Wharam specialized in the treatment of...

gynecologic cancers

Niraparib Maintenance Therapy in Recurrent Ovarian Cancer

In a study reported in The Lancet Oncology, Amit M. Oza, MD, of the Princess Margaret Cancer Centre, University Health Network, Toronto, and colleagues found that quality of life based on patient-reported outcomes was not worsened with niraparib (Zejula) maintenance vs placebo in the phase III...

gynecologic cancers

Analgesics and Ovarian Cancer Survival

In a prospective cohort study reported in The Lancet Oncology, Melissa A. Merritt, PhD, of the University of Hawaii Cancer Center’s Epidemiology Program, and colleagues found evidence that recent use of aspirin or nonaspirin nonsteroidal anti-inflammatory drugs (NSAIDs) after diagnosis appears to...

issues in oncology

Monthly Vitamin D and Cancer Risk

In a study reported in JAMA Oncology, Robert Scragg, MBBS, PhD, of the School of Population Health, University of Auckland, and colleagues found that monthly high-dose vitamin D supplementation, without calcium, was not associated with a reduced risk of developing cancer. The current analysis is a ...

breast cancer

Living a Purposeful Life Is My Revenge on Cancer

There is a lot of breast cancer in my family history. My mother was diagnosed with the disease at 44, and my paternal grandmother died of breast cancer when she was just 33, so I’ve always been diligent about performing breast self-exams— often weekly—to ensure that if I did get breast cancer, it...

Learning to Listen and Returning to the Art of Medicine

Bernard Lown, MD, was born in Lithuania, the son of a rabbi. He immigrated to the United States at the age of 14, where his scientific precocity bloomed. After attaining his medical degree from John Hopkins University School of Medicine, he pursued his passion of raising international awareness of...

On Aging and the Wellness Industry

Only a few centuries ago, the major source of moral and scientific authority in Western culture was religion, which requires trusting one of numerous supernatural deities. However, the presumption that medicine is based on evidence-based and peer-reviewed science is what gives it authority in...

gynecologic cancers

Rucaparib for Maintenance Treatment of Recurrent Ovarian, Fallopian Tube, or Primary Peritoneal Cancer

IN APRIL 2018, the poly (ADP-ribose) polymerase (PARP) inhibitor rucaparib (Rubraca) was granted approval for maintenance treatment of patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in complete or partial response to platinum-based chemotherapy.1,2...

survivorship

Getting Their Lives Back: Helping Survivors of Cancer to Move Forward

Thirteen years ago, Stephanie Koraleski, PhD, an oncology psychologist, and Kay Ryan, PhD, RN, a cardiac nurse and breast cancer survivor, in Omaha, brought together colleagues in the fields of clinical research, nursing, nutrition, mental health, physical therapy, pharmacy, and spirituality to...

breast cancer

An Early Love of Literature Gives Way to a Career in Breast Cancer Research for Jennifer K. Litton, MD

Breast cancer specialist Jennifer K. Litton, MD, was born and reared in Leominster, Massachusetts, a small city in the north central part of the state. “I went to parochial schools until seventh grade and then went on to high school in Worcester. Although I enjoyed science early on, I was...

issues in oncology
palliative care

Closing the Gender Divide in Preference for Palliative Care

Eight years ago, a survey of the preferences of Dutch patients with cancer for health care found that while gender was one aspect influencing how men and women approach cancer care, it was the most important, with men, generally, regarding most care aspects as less important than women. The study...

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