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supportive care
pain management

Expert Point of View: Richard T. Lee, MD

Richard T. Lee, MD, Associate Professor at Case Comprehensive Cancer Center and University Hospitals Seidman Cancer Center, discussed the abstract by Galloway et al at the 2019 Supportive Care in Oncology Symposium. He remarked that starting a new palliative care consultation can sometimes feel...

head and neck cancer

Nivolumab vs Chemotherapy in Advanced Esophageal Cancer

Nivolumab improved overall survival compared with chemotherapy in previously treated patients with esophageal squamous cell carcinoma in the final analysis of the phase III ATTRACTION-3 study. The data were presented at the European Society for Medical Oncology (ESMO) Congress 2019 Presidential...

issues in oncology
survivorship

ASCO Provides Guidance on Managing Osteoporosis in Cancer Survivors

Cancer survivors are at an increased risk of osteoporotic fractures due to the accelerated loss of bone mineral density as a result of their treatment. Bone loss from cancer therapy is faster and more severe than bone less from aging; rates of bone loss are up to sevenfold higher when they occur...

issues in oncology
global cancer care

Affirming Universal Health Care as a Fundamental Human Right

This year’s meeting of the World Cancer Leaders’ Summit: Cancer and Universal Health Coverage, held on October 15–17 in Nur-Sultan, Kazakhstan, brought together more than 350 global health leaders, including ministers of health, first ladies, and industry leaders, from 82 countries to discuss how...

FDA Office of Hematology Oncology Products Reorganized, Renamed Office of Oncologic Diseases

As part of modernization plans approved in September 2019, the U.S. Food and Drug Administration (FDA) office responsible for reviewing applications for new and existing cancer therapies has reorganized and been renamed. The Center for Drug Evaluation and Research (CDER) Office of Hematology and...

Expert Point of View: Arndt Vogel, MD and Angela Lamarca, MD, PhD

Arndt Vogel, MD, of Hannover Medical School in Germany, who served as discussant of the two studies of immunotherapy in hepatocellular carcinoma, said the findings point to a promising future in the treatment of this malignancy. He commented that the responses observed with nivolumab in CheckMate...

lymphoma

Answers to Hematology Expert Review Questions

Question 1 Which of the following statements about nodular lymphocyte-predominant HL is correct? Correct answer: A. Nodular lymphocyte-predominant HL can transform into large B-cell lymphoma. Expert Perspective Nodular lymphocyte-predominant HL is a B-cell neoplasm characterized by a nodular or...

immunotherapy
hepatobiliary cancer

‘Clinically Meaningful’ Outcomes Seen in Two Studies of First-Line Immunotherapy for Hepatocellular Carcinoma

In the first-line treatment of advanced hepatocellular carcinoma, checkpoint inhibitors led to favorable outcomes in studies reported at the European Society for Medical Oncology (ESMO) Congress 2019—though one study was technically negative. The current first-line standard of care for unresectable ...

American Society of Hematology Honors Posthumously Stanley L. Schrier, MD, With 2019 Exemplary Service Award

The American Society of Hematology (ASH) recognized Stanley L. Schrier, MD, a Past ASH President and formerly Professor Emeritus of Medicine in Hematology at Stanford School of Medicine, California, with the 2019 Exemplary Service Award for his years of service and dedication to ASH and to...

prostate cancer

Apalutamide for Metastatic Castration-Sensitive Prostate Cancer

On September 17, 2019, apalutamide was approved for the treatment of patients with metastatic castration-sensitive prostate cancer.1,2 Supporting Efficacy Data The approval is based on overall survival and radiographic progression-free survival findings in the phase III double-blind TITAN trial.2,3 ...

immunotherapy
symptom management

Maximizing Benefit in the Treatment of Immune-Mediated Colitis

Immune-related colitis is the second most common toxicity associated with checkpoint inhibitors, affecting up to 40% of patients. The ASCO Post interviewed Yinghong Wang, MD, PhD, Director of Medication-Induced Colitis and Enteritis, Director of Fecal Microbiota Transplantation, and Associate...

gastrointestinal cancer

Pivotal Study Reports Positive Findings in Fourth-Line Setting for Advanced GIST

In a late-breaking, oral presentation at the European Society for Medical Oncology (ESMO) 2019 Congress, Margaret von Mehren, MD, presented results from INVICTUS, a pivotal phase III clinical study of ripretinib in patients with advanced gastrointestinal stromal tumor (GIST).1 Ripretinib is an...

National Comprehensive Cancer Network Oncology Research Program Supports Clinical Trial for Lung Cancer

The National Comprehensive Cancer Network (NCCN®) Oncology Research Program (ORP) has announced plans to support a phase II randomized trial for lung cancer patients. The study is titled, “TH-138: Phase II randomized trial of carboplatin + pemetrexed + bevacizumab, with or without atezolizumab in...

gastrointestinal cancer

Circulating Tumor DNA: A Prognostic Marker in Stage III Colon Cancer?

Circulating tumor DNA in the blood could serve as a marker of prognosis in patients with colon cancer receiving adjuvant oxaliplatin, according to a subanalysis of the IDEA trial, presented at the European Society for Medical Oncology (ESMO) Congress 2019.1 After 2 years of adjuvant...

breast cancer

Breast Cancer Treatments Targeting Estrogen May Be Putting Patients at Risk for Long-Term Comorbidities

“The majority of breast cancers are hormone receptor–positive, and treatments that target the estrogen receptors are very effective, but they also cause havoc in many tissues that are dependent on estrogen for normal functioning. As a result, breast cancer survivors suffer from ongoing symptoms and ...

breast cancer

ASCO Updates Breast Cancer Risk Reduction Guideline to Include Anastrozole

ASCO has updated a guideline on pharmacologic interventions for breast cancer risk reduction in postmenopausal women at increased risk of developing breast cancer.1 The original clinical practice recommendations for breast cancer risk reduction were published in 1999 and updated in 2002, 2009, and...

Prescribing Hope

“There is no medicine like hope, no incentive so great, and no tonic so powerful as expectation of something tomorrow.” –Orison Swett Marden I was informed that my patient, a 58-year-old man recently diagnosed with pancreatic cancer, and his wife were becoming impatient waiting for me in the exam...

global cancer care

Challenging the Global Community to Deliver Equitable Cancer Care for All

For Her Royal Highness Princess Dina Mired of Jordan, ensuring that every patient with cancer receives high-quality care is not an abstract goal—it is personal. Princess Dina saw firsthand the life-and-death differences that access to state-of-the-art oncology care makes in a patient’s life when...

hematologic malignancies
immunotherapy

Answers to Hematology Expert Review Questions

Question 1 Which of the following statements about cytokine-release syndrome and neurotoxicity after tisagenlecleucel infusion is correct? Correct answer: B. The median time to onset of cytokine-release syndrome is 3 days. Expert Perspective Following tisagenlecleucel infusion, cytokine-release...

hematologic malignancies
immunotherapy

CAR T-Cell Gene Therapy: Toxicities and Management Principles

“Nothing in life is to be feared, it is only to be understood. Now is the time to understand more, so that we may fear less.”                                                                                                                  —Marie Curie The ASCO Post is pleased to present Hematology ...

Project Socrates: An Educational Bridge From the FDA to the Public

OCE Insights is an occasional department developed for The ASCO Post by members of the Oncology Center of Excellence (OCE) at the U.S. Food and Drug Administration (FDA). In this installment, Jennifer J. Gao, MD, Acting Associate Director of Education in the OCE, and Richard Pazdur, MD, Director of ...

leukemia

Glasdegib in Older Patients With AML or Those With Comorbidities

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. Late in 2018, the Hedgehog pathway inhibitor glasdegib...

Expert Point of View: Sanjay Popat, FRCP, PhD

Formal discussant of the CheckMate 227 trial, Sanjay Popat, FRCP, PhD, of the Royal Marsden Hospital, London, had some reservations about endorsing nivolumab/ipilimumab as a new standard of care, mainly related to toxicity. “The landscape of treating advanced non–small cell lung cancer has changed ...

lung cancer
immunotherapy

Nivolumab/Ipilimumab: Another First-Line Option for Advanced NSCLC

The combination of nivolumab and ipilimumab improved overall survival compared with chemotherapy as first-line therapy for patients with advanced non–small cell lung cancer (NSCLC) and programmed cell death ligand 1 (PD-L1) expression of at least 1%, according to the results of CheckMate 227....

issues in oncology

Mental Health Outcomes in Mothers and Siblings of Children With Cancer

In a Canadian study reported in the Journal of Clinical Oncology, van Warmerdam et al found that mothers and siblings of children with cancer were significantly more likely to have mental health–related outpatient health-care contacts than their general population counterparts. The study involved...

issues in oncology
pain management

Opioid Prescriptions in Patients With Cancer in Southwest Virginia

In a study in residents of rural southwest Virginia reported in the Journal of Oncology Practice, Virginia T. LeBaron, PhD, and colleagues found that most patients with cancer never received a prescription opioid medication, that few patients were admitted to hospital for opioid use disorders, and...

skin cancer

Long-Term Analysis of Vemurafenib/Cobimetinib in Patients With BRAF-Mutated Melanoma

A phase Ib study evaluating the safety and long-term benefit of combination treatment with the BRAF inhibitor vemurafenib plus the MEK1 inhibitor cobimetinib in patients with advanced BRAF V600E–mutated melanoma has found that nearly 40% of the patients experienced extended survival of 4 to 5 years ...

head and neck cancer
immunotherapy

Pembrolizumab With or Without Chemotherapy vs Cetuximab Plus Chemotherapy in Recurrent or Metastatic HNSCC

As reported in The Lancet by Barbara Burtness, MD, and colleagues, the phase III KEYNOTE-048 trial has shown improved overall survival with first-line pembrolizumab plus chemotherapy vs cetuximab plus chemotherapy among patients with recurrent or metastatic squamous cell carcinoma of the head and...

lung cancer

What Is the Best Palliation for End-Stage Lung Cancer?

Patients with advanced lung cancer can experience burdensome symptoms at the end of life. Pulmonologists can alleviate some of this suffering, but it’s a balancing act between doing too much and not enough, according to specialists who spoke at CHEST 2019, the annual meeting of the American College ...

issues in oncology

Two Societies Issue Statements on E-Cigarettes

Today, the American Cancer Society (ACS) announced an update to the organization’s position on e-cigarettes, and the American Medical Association (AMA) called for a total ban on all e-cigarette and vaping products that do not meet U.S. Food and Drug Administration (FDA) approval as cessation ...

kidney cancer
immunotherapy

Atezolizumab/Bevacizumab in Metastatic Renal Cell Carcinoma With Variant Histology or Sarcomatoid Features

In a phase II trial reported in the Journal of Clinical Oncology, Toni K. Choueiri, MD, and colleagues found that the combination of atezolizumab and bevacizumab was active in metastatic renal cell carcinoma with variant histology and clear cell renal cell carcinoma with ≥ 20% sarcomatoid...

issues in oncology
pain management

Prescribed Opioid Use and Infection Risk in Patients With Cancer and Treatment-Associated Neutropenia

In a German study reported in a research letter in JAMA Internal Medicine, Jakob et al found that prescribed opioid use did not appear to increase risk of infection in hospitalized patients with cancer who developed treatment-associated neutropenia. According to the investigators, recent data have...

breast cancer

Expert Point of View: Charles L. Loprinzi, MD

Charles L. Loprinzi, MD, Regis Professor of Breast Cancer Oncology at the Mayo Clinic, Rochester, Minnesota, discussed this abstract on sexual health in women treated for breast cancer. Addressing patients’ questions, offering advice, and providing appropriate referrals should improve patient care, ...

integrative oncology

Boswellia

The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies sometimes used by patients with cancer. In this installment, Gary Deng, MD, PhD, and Jyothirmai Gubili, MS, focus on the herbal extract...

solid tumors
immunotherapy

Pembrolizumab in Noncolorectal MSI-H/dMMR Solid Tumors

As reported in the Journal of Clinical Oncology by Marabelle et al, the phase II KEYNOTE-158 trial has shown robust activity of pembrolizumab in patients with noncolorectal microsatellite instability­–high (MSI-H)/mismatch repair–deficient (dMMR) solid tumors. Findings in the study supported the...

lung cancer

Gefitinib Alone vs Gefitinib Plus Chemotherapy in EGFR-Mutated Metastatic NSCLC

In the Japanese phase III NEJ009 trial reported in the Journal of Clinical Oncology, Hosomi et al found that the addition of first-line gefitinib to carboplatin/pemetrexed improved progression-free survival vs gefitinib alone in patients with EGFR-mutated metastatic non–small cell lung cancer...

multiple myeloma

Selinexor Plus Dexamethasone Studied in Triple-Class Refractory Multiple Myeloma

In a phase IIb study (STORM Part 2) reported in TheNew England Journal of Medicine, Ajai Chari, MD, of Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, and colleagues found that oral selinexor and dexamethasone were active in some patients with multiple myeloma refractory to prior...

Expert Point of View: Alfredo Falcone, MD

The invited discussant of BEACON CRC, Alfredo Falcone, MD, of the Department of Oncology and Translational Medicine at the University of Pisa, Italy, commented: “The ‘story’ of BEACON represents a good example of the European Society for Medical Oncology Congress theme: Translating Science Into...

colorectal cancer

Targeted Triplet Therapy Improved Overall Survival in BRAF-Mutated Colorectal Cancer

For patients with metastatic colorectal cancer harboring BRAF V600E mutations, three drugs seem to be better than two, the most recent analysis of the phase III BEACON CRC study has shown.1 The results, presented at the 2019 European Society for Medical Oncology (ESMO) Congress, were concurrently...

gastrointestinal cancer

Maximizing Benefit in the Treatment of Immune-Mediated Colitis

Immune-related colitis is the second most common toxicity associated with checkpoint inhibitors, affecting up to 40% of patients. The ASCO Post interviewed Yinghong Wang, MD, PhD, Director of Medication-Induced Colitis and Enteritis, Director of Fecal Microbiota Transplantation, and Associate...

lymphoma

FDA Grants Accelerated Approval to Zanubrutinib for Pretreated Mantle Cell Lymphoma

On November 14, the U.S. Food and Drug Administration (FDA) granted accelerated approval to zanubrutinib (Brukinsa) for adult patients with mantle cell lymphoma who have received at least one prior therapy. “Mantle cell lymphoma usually responds well to initial treatment, but eventually returns or ...

symptom management

Dexamethasone Plus Exercise May Reduce Fatigue in Patients With Advanced Cancer

A novel treatment approach may help to alleviate one of the most common and debilitating symptoms associated with cancer and its treatments—fatigue. According to data presented at the 2019 Supportive Care in Oncology Symposium,1 the combination of short-course dexamethasone plus standardized...

skin cancer

Reflections on Long-Term Outcomes With BRAF/MEK Inhibition in Advanced Melanoma

For the treatment of BRAF V600-mutated advanced melanoma, we now have three BRAF/MEK inhibitor combinations that are approved by the U.S. Food and Drug Administration: dabrafenib/trametinib, vemurafenib/cobimetinib, and encorafenib/binimetinib. Although the toxicity profiles for these combinations ...

skin cancer

5-Year Efficacy Outcomes With Dabrafenib Plus Trametinib in BRAF-Mutated Metastatic Melanoma

As reported in The New England Journal of Medicine by Caroline Robert, MD, PhD, of the Institut Gustave Roussy and Paris-Sud-Paris-Saclay University, Villejuif, and colleagues, the long-term follow-up of the phase III COMBI-d and COMBI-v trials has shown a pooled 5-year overall survival rate of 34% ...

solid tumors

Long-Term Effects of Denosumab in Patients With Giant Cell Tumor of Bone

As reported by Chawla et al in The Lancet Oncology, long-term data from the final analysis of an international phase II study suggest that a favorable risk-benefit ratio is maintained over time with denosumab treatment of patients with giant cell tumor of bone. Benefit of denosumab was indicated in ...

prostate cancer
breast cancer
bladder cancer
pancreatic cancer
kidney cancer
thyroid cancer
gynecologic cancers
immunotherapy

ESMO Congress 2019: Quick Takes From Key Clinical Trials

The ESMO Congress continues to grow as a pivotal platform for research in clinical oncology. At the ESMO Congress 2019, important findings were showcased in more than 2,200 studies, including 93 late-breaking abstracts. The ASCO Post summarized much of that news in separate articles over several...

lung cancer
neuroendocrine tumors
immunotherapy

Novel Therapies for Small Cell Lung Cancer and Neuroendocrine Tumors

Here is a glimpse at updated clinical trial data on newer therapies under study for the small cell lung cancer (SCLC) and advanced extrapancreatic neuroendocrine tumors. IMpower133 and ALTER: Novel Therapies for SCLC The treatment of small cell lung cancer has seen little progress in recent years, ...

gastrointestinal cancer

Pivotal Phase III Study Evaluates Investigational TKI in Fourth-Line Setting for Advanced GIST

In a late-breaking, oral presentation at the ESMO Congress 2019, Margaret von Mehren, MD, presented results from ­INVICTUS, a pivotal phase III clinical trial of ripretinib in patients with advanced gastrointestinal stromal tumor (GIST).1 Ripretinib is an investigational tyrosine kinase inhibitor...

hepatobiliary cancer

Targeted Treatment Advances in Cholangiocarcinoma

For one of the rarest and most aggressive of tumors—cholangiocarcinoma—two novel molecularly targeted agents yielded encouraging outcomes in advanced disease in studies reported at the European Society for Medical Oncology (ESMO) Congress 2019. In the phase III ClarIDHy trial, the risk of disease...

prostate cancer

Expert Point of View: Eleni Efstathiou, MD

Formal study discussant Eleni Efstathiou, MD, of MD Anderson Cancer Center, Houston, commented on results of the PROfound trial at the ESMO Congress 2019. “This is the first phase III targeted therapy trial to deliver a positive outcome in metastatic castration-resistant prostate cancer,” she...

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