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issues in oncology

Navigating the ‘New Normal’: NCCN Summit Examines Access to High-Quality Cancer Care

It’s not just the leaps in development of precision medicines, the soaring costs, the new payment models, clinical trial designs, sources of data, and federal policies. It’s all of them plus the rapidity with which change is happening that makes this era of oncology exceptional. “I would say...

supportive care

Cannabinoids for Cancer Pain: Dangerous or Beneficial?

Cannabis has been used in health care for millennia, and its use has been well documented, albeit never definitively integrated into clinical practice. Recent societal changes and the increasing acceptance and availability of cannabis have reignited the medical and public debate around its role in...

hematologic malignancies
lymphoma

FDA Approves Mogamulizumab-kpkc for Two Rare Types of Non-Hodgkin Lymphoma

On August 8, the U.S. Food and Drug Administration approved mogamulizumab-kpkc (Poteligeo) injection for intravenous use in the treatment of adult patients with relapsed or refractory mycosis fungoides or Sézary syndrome after at least one prior systemic therapy. This approval provides a new...

lymphoma

Venetoclax and Beyond: Successfully Targeting BCL2

Although many agents have been able to successfully inhibit the proliferative capacity of cancer cells or disable mutations that spur cancer growth, one area that has proven elusive is the apoptotic pathway—the cell’s means of resisting death. That is until recently. Dysregulation of B-cell...

issues in oncology

Medical Marijuana: Research Not Anecdotes

For patients with cancer, marijuana may be valuable in controlling pain and chemotherapy-induced nausea and vomiting. Furthermore, it may have efficacy as an appetite stimulant. No randomized clinical trial has investigated the utility of whole-plant medical marijuana to alleviate these symptoms in ...

issues in oncology

Unraveling the Mystery of What Gives Exceptional Responders Their Superpower

Once dismissed as rare medical miracles that overcame overwhelming odds to thwart cancer, exceptional responders to cancer treatment are now the subject of intense study. In 2015, the National Cancer Institute (NCI) announced the launch of its Exceptional Responders Initiative, with the goal of...

lymphoma
immunotherapy

For Hodgkin Lymphoma, PD-1 Blockade Is Not the Final Answer

Although programmed cell death protein 1 (PD-1) blockade is highly effective in Hodgkin lymphoma, not all patients respond, and not all responses are durable. Stephen M. Ansell, MD, PhD, Chair of the Mayo Clinic Lymphoma Group and Professor of Medicine at the Mayo Clinic, Rochester, described...

skin cancer

Basal Cell Carcinoma and Risk for Development of Other Cancers

Patients who develop frequent cases of basal cell carcinoma appear to be at significantly increased risk for the development of other cancers, according to a study published by Cho et al in JCI Insight. Methods Researchers studied 61 people treated at Stanford Health Care for frequent...

lung cancer

Broad-Based Genomic Sequencing in Advanced NSCLC in the Community Oncology Setting

In a study reported in JAMA, Presley et al found that use of broad-based genomic sequencing vs routine testing for EGFR mutations or ALK rearrangements alone directed treatment in a minority of patients with advanced non–small cell lung cancer (NSCLC) in the community oncology setting and was ...

gynecologic cancers

Definitive Pelvic Radiation Therapy Plus Chemotherapy and Survival in Newly Diagnosed Metastatic Cervical Cancer

In a study using National Cancer Database data reported in JAMA Oncology, Wang et al found that definitive pelvic radiation therapy plus chemotherapy was associated with improved survival vs chemotherapy alone in newly diagnosed metastatic cervical cancer. The study included data from 3,169...

colorectal cancer
immunotherapy

FDA Grants Breakthrough Therapy Designation for Encorafenib Plus Binimetinib and Cetuximab in BRAF V600E–Mutant Metastatic Colorectal Cancer

The U.S. Food and Drug Administration (FDA) has granted Breakthrough Therapy designation for encorafenib (Braftovi) in combination with binimetinib (Mektovi) and cetuximab (Erbitux) for the treatment of patients with BRAF V600E–mutant metastatic colorectal cancer (mCRC), as detected by...

gynecologic cancers

Apatinib and Oral Etoposide in Platinum-Resistant/Refractory Ovarian Cancer

In a Chinese single-center phase II study reported in The Lancet Oncology, Lan et al found a high response rate with oral apatinib plus oral etoposide in patients with platinum-resistant or refractory ovarian cancer. Study Details The study included 35 patients with progression within 6 months...

lung cancer

CNS Activity of EGFR Tyrosine Kinase Inhibitor in T790M-Positive Advanced NSCLC

In a planned subgroup analysis of the phase III AURA3 trial reported in the Journal of Clinical Oncology, Wu et al found that the third-generation EGFR tyrosine kinase inhibitor osimertinib (Tagrisso) produced higher central nervous system (CNS) response rates vs platinum plus pemetrexed (Alimta)...

breast cancer

Circulating Tumor Cells and Late Recurrence in Hormone Receptor–Positive Breast Cancer

In a study reported in JAMA Oncology, Sparano et al found that a single circulating tumor cell (CTC) assessment was predictive of late recurrence in patients with hormone receptor–positive, HER2-negative breast cancer. The study involved patients from a phase III trial of doxorubicin and...

breast cancer

TAILORx: How to Apply This Landmark Study

TAILORx changes the configuration of the ball field and the shape of the ball in deciding which women will be recommended chemotherapy after resection of node-negative, hormone receptor–positive breast cancer. TAILORx was presented by Joseph Sparano, MD, at the 2018 ASCO Plenary Session and...

colorectal cancer
survivorship

ACS Nutrition and Physical Activity Guidelines for Cancer Survivors and Outcomes After Colon Cancer Diagnosis

IN A STUDY reported in JAMA Oncology, Erin L. Van Blarigan, ScD, of the University of California, San Francisco, and colleagues found that adherence to American Cancer Society (ACS) nutrition and physical activity guidelines for cancer survivors was associated with improved survival among patients ...

lung cancer

My Incidentally Discovered Cancer

In February 2015, there was no indication that my life was about to radically change. I was a practicing attorney and happily raising two young children with my husband. At 40 years old, I was healthy—or so I thought—and had no physical symptoms to alert me to the devastating news that was about to ...

colorectal cancer

BRAF Mutations, Survival, and Recurrence in Patients With Colorectal Cancer Liver Metastases

In a study reported in JAMA Surgery by Margonis and colleagues, the presence of a BRAF V600E mutation was associated with a higher risk of recurrence and poorer overall survival among patients undergoing surgical resection of liver metastases from colorectal cancer. Matthew J. Weiss, MD, of the...

breast cancer

CXCR4 Antagonist Plus Eribulin in HER2-Negative Metastatic Breast Cancer

Findings in a phase I trial reported in The Lancet Oncology by Pernas and colleagues indicate activity of the combination of the CXCR4 chemokine receptor antagonist balixafortide plus eribulin (Halaven) in previously treated HER2-negative metastatic breast cancer. The CXCR4–stromal cell-derived...

issues in oncology

Ensuring Quality With Patient-Reported Outcomes and Electronic Health Records

Accurately assessing the quality of cancer care over the continuum of treatment requires a special set of metrics and data-gathering methods. Moreover, with a growing number of cancer survivors, the post-treatment care involves primary care providers who are adept at managing the comorbidities...

breast cancer

Risk of Breast Cancer After Negative Screening Mammography

A study reported in JAMA Oncology by Anne Marie McCarthy, PhD, of the Division of General Internal Medicine, Massachusetts General Hospital, and colleagues identified the risk of interval breast cancer after negative screening mammography, including the risk of poor-prognosis breast cancer. The...

genomics/genetics

Is Some DNA Worthless?

BOOKMARK Title: Junk DNA: A Journey Through the Dark Matter of the GenomeAuthor: Nessa CareyPublisher: Columbia University PressOriginal publication date: April 2015Price: $22.95, paperback, 360 pages When biologists first delved into the human wonder of genes in the 1970s, they eventually...

A Celebrity Gadfly’s Reflections on His Death and Other Things Meant to Irritate

BOOKMARK Title: MortalityAuthor: Christopher HitchensPublisher: Twelve: Hachette Book GroupOriginal Publication Date: May 13, 2014Price: $19.95, paperback, 128 pages “There are no atheists in foxholes” is an aphorism used to contend that in times of extreme fear, such as during war or facing a...

issues in oncology

The Story of a Notorious Cluster of Childhood Cancers

BOOKMARK Title: Toms River: A Story of Science and SalvationAuthor: Dan FaginPublisher: Random HouseOriginal publication date: March 2013Price: $28.00, hardcover, 560 pages The Toms River emerges in the Pine Barrens of northern Ocean County, New Jersey, and zigzags through wetlands, emptying into...

health-care policy

Is Universal Health Care a Human Right?

The Affordable Care Act (ACA) provided oncology services to people with cancer who had previously been denied coverage. And for that reason alone, many oncologists supported its passage. However, even though the U.S. health-care system remains in the crosshairs of partisan politics, parties on both ...

lung cancer
issues in oncology

Lung Cancer Screening Guidelines May Be Inadequate for High-Risk Minorities

Data from a lung cancer screening program at the University of Illinois at Chicago (UIC) provides evidence that national lung cancer screening guidelines, which were developed based on the National Lung Screening Trial (NLST) in 2011 and recommend screening based on age and smoking history, may be...

lung cancer
immunotherapy

Osimertinib Resistance Mechanisms in EGFR T790M–Positive NSCLC

In a study reported in JAMA Oncology, Oxnard et al found early resistance and a number of competing resistance mechanisms in acquired osimertinib (Tagrisso) resistance associated with loss of the T790M mutation conferring resistance to prior EGFR tyrosine kinase inhibitor (TKI) treatment in...

Long-Term Pooled Safety Data for Palbociclib Combined With Endocrine Therapy in HR-Positive, HER2-Negative Breast Cancer

In an analysis of pooled safety data from the PALOMA trials of palbociclib (Ibrance) plus endocrine therapy in hormone receptor (HR)-positive, HER2-negative advanced breast cancer reported in the Journal of the National Cancer Institute, Diéras et al found no evidence of specific cumulative...

issues in oncology

Following a Healthy Diet and Avoiding Alcohol May Reduce Overall Cancer Risk

The World Cancer Research Fund/American Institute for Cancer Research has estimated that in developed countries, about 35% of breast cancers and 45% of colorectal cancers could be prevented with better adherence to nutritional recommendations. A large prospective study evaluating adherence to...

supportive care
integrative oncology

Reishi Mushroom

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. Ting Bao, MD, DABMA, MS, and Jyothirmai Gubili, MS, present information on the use of reishi...

lung cancer
immunotherapy

Durvalumab After Chemoradiation in Unresectable Stage III NSCLC

Early in 2018, durvalumab (Imfinzi) was approved for the treatment of unresectable stage III non–small cell lung cancer (NSCLC) that has not progressed following concurrent platinum-based chemotherapy and radiation therapy.1,2 Supporting Efficacy Data Approval was based on a planned interim...

lymphoma
skin cancer

FDA Approves Mogamulizumab-kpkc for Two Rare Types of Non-Hodgkin Lymphoma

Today, the U.S. Food and Drug Administration approved mogamulizumab-kpkc (Poteligeo) injection for intravenous use for the treatment of adult patients with relapsed or refractory mycosis fungoides or Sézary syndrome after at least one prior systemic therapy. This approval provides a new...

solid tumors
hematologic malignancies

FDA Warns of Increased Risk of Cancer Relapse With Long-Term Use of Azithromycin After Allogeneic Stem Cell Transplant

The U.S. Food and Drug Administration (FDA) is warning that the antibiotic azithromycin should not be given on a long-term basis to prevent the inflammatory lung condition bronchiolitis obliterans syndrome in patients with cancers of the blood or lymph nodes who undergo a donor stem cell...

issues in oncology

Information Valued by Patients in Selecting a Hospital for Cancer Surgery

In a study reported in the Journal of Oncology Practice, Yang et al found that most patients who had undergone surgery for cancer reported that hospital reputation would have been important to them in choosing a hospital for surgery and that they would have used a listing of best hospitals for...

supportive care
symptom management

Lack of Congruence Among Tools Used to Assess Cancer-Related Cognitive Dysfunction

THE ASSESSMENT of cognitive dysfunction in patients who have undergone chemotherapy is complex, and although a number of strategies are available, each has its limitations, according to Karin Olson, RN, PhD, Professor in the Faculty of Nursing at the University of Alberta, Edmonton, Canada.  At...

symptom management
head and neck cancer

Novel Therapy Reduces Duration of Chemoradiotherapy-Induced Mucositis in Patients With Head and Neck Cancer

GC4419, A SMALL molecule superoxide dismutase mimetic, reduced the duration, incidence, and severity of chemoradiotherapy-induced mucositis in patients with locally advanced head and neck cancer, with a safety profile comparable to that of placebo. This finding comes from a randomized phase IIb...

lymphoma
immunotherapy

More Antibody-Drug Conjugates Expected to Impact Treatment of Lymphoma

FOR THE TREATMENT of lymphoma, antibody-drug conjugates (ADCs) are becoming an important class of drugs, as described at the 2018 Pan Pacific Lymphoma Conference by Brad Kahl, MD, Professor of Medicine at Washington University School of Medicine, St. Louis.1  “We have one ADC—brentuximab vedotin...

lymphoma
immunotherapy

CAR T-Cell Therapy in Lymphoma: Challenges Come With Success

THE EMERGENCE of chimeric antigen receptor (CAR) T-cell therapy has sparked a wave of optimism in hematologic malignancies, but as experience in using CAR T-cell therapy has grown, new challenges have surfaced. A pioneer in the field, David G. Maloney, MD, PhD, enlightened attendees on these issues ...

prostate cancer

Abiraterone or Enzalutamide for Newly Diagnosed Metastatic Castrate-Resistant Prostate Cancer?

WHAT IS THE best choice of treatment for a man with newly diagnosed metastatic castration-resistant prostate cancer after treatment with androgen-deprivation therapy—abiraterone acetate (Zytiga) plus prednisone, or enzalutamide (Xtandi)? Both drugs achieve similar cancer control in this setting,...

issues in oncology

Medical Preparedness for Nuclear Disaster

ROBERT PETER GALE, MD, PhD, DSc (hc), was on the faculty of the University of California, Los Angeles, School of Medicine for 20 years and has served as Chairman of the Scientific Advisory Committee of the Center for International Blood and Marrow Transplant Research. In 1986, he was asked by the...

prostate cancer

Enzalutamide Prolongs Metastasis-Free Survival in Patients With Nonmetastatic, Castration-Resistant Prostate Cancer

AS REPORTED in The New England Journal of Medicine by Maha Hussain, MD, of the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, and colleagues, the phase III PROSPER trial has shown a 71% reduction in the risk of metastasis or death with enzalutamide (Xtandi) vs placebo in men ...

issues in oncology
survivorship

Screening for Financial Issues in Adult Survivors of Childhood Cancer

Adult survivors of childhood cancer should be screened for financial problems that might cause them to delay or skip medical care or to suffer psychological distress. The recommendation from St. Jude Children’s Research Hospital researchers followed an analysis that found 65% of...

breast cancer

TGFβ Polymorphism and Radiation-Induced Fibrosis in Breast Cancer

In an analysis reported in JAMA Oncology, Grossberg et al found that a single nucleotide polymorphism (C−509T) in the transforming growth factor β1 (TGFβ1) gene was associated with higher risk of radiation-induced fibrosis in women with early breast cancer. Study Details The...

breast cancer
immunotherapy

Adjuvant Bevacizumab in High-Risk HER2-Negative Breast Cancer

In an article in the Journal of Clinical Oncology, Miller et al reported final results of the Eastern Cooperative Oncology Group phase III E5103 trial, initiated in 2007, which showed no benefit of adding bevacizumab (Avastin) to adjuvant therapy in patients with HER2-negative, node-positive or...

Clinical Cancer Researcher Gini Fleming, MD, Firmly Believes in the Power of Ideas

Gini Fleming, MD, had a peripatetic path to her destination as a gynecologic and breast cancer expert. As a child, she moved around a lot, living in about 10 or 12 different places, so she had no real sense of being born and reared in any particular place. “My parents married young, when my father ...

Academic Oncology and Industry Offer the Best of Both Worlds for Mace L. Rothenberg, MD

GUEST EDITOR Dr. Abraham is the Director of the Breast Oncology Program at Taussig Cancer Institute, and Professor of Medicine, Lerner College of Medicine, Cleveland Clinic. For this installment of the Living a Full Life series, guest editor Jame Abraham, MD, interviewed Mace L. Rothenberg, MD,...

issues in oncology

Real-World Evidence Gaining Credibility and Practicality in Treatment Evaluation

In a Friends of Cancer Research (Friends) meeting devoted to real-world evidence, members of the cancer community generally agreed that its use has an increasingly important role to play in gathering the data necessary to test, evaluate, and bring new therapeutic agents to market. This Friends...

breast cancer

Abemaciclib as Initial Therapy for Hormone Receptor–Positive, HER2-Negative Advanced or Metastatic Breast Cancer

Early in 2018, abemaciclib (Verzenio) in combination with an aromatase inhibitor was approved as initial endocrine-based therapy for postmenopausal women with hormone receptor–positive, HER2-negative advanced or metastatic breast cancer.1,2 Supporting Efficacy Data Approval was based on findings in ...

American Cancer Society Outlines Blueprint for Cancer Control in the 21st Century

The American Cancer Society (ACS) is outlining its vision for cancer control in the decades ahead in a series of articles that began publishing in early July in CA: A Cancer Journal for Clinicians. The series of articles forms the basis of a national cancer control plan, with a blueprint toward the ...

skin cancer

Two Phase III Trials of KX2-391 in Actinic Keratosis Achieve Primary Endpoints

Two phase III studies—KX-AK-003 and KX-AK-004—achieved their primary endpoint of 100% clearance of actinic keratosis lesions at day 57 within the face or scalp treatment areas, with each study achieving statistical significance (P < .0001). Statistical significance (P < .001) ...

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