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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...

lung cancer

Clinical Trials Actively Recruiting Patients With Lung Cancer

THE INFORMATION contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies focused on patients with lung cancer. These studies highlight combinations of chemotherapy, mutation-specific treatments, stereotactic body radiation therapy, metastatic control, cancer...

skin cancer

Balancing Immune-Related Adverse Events With Efficacy of Dual Checkpoint Inhibitor Therapy in Melanoma

MUCH PROGRESS has been made in the past decade in the treatment of patients with newly diagnosed metastatic melanoma. In the front-line setting, programmed cell death protein 1 (PD-1) monotherapy (nivolumab [Opdivo] and pembrolizumab [Keytruda]) and combined PD-1 plus cytotoxic...

lung cancer

Long-Term Survival Rates More Than Double Previous Estimates for Locally Advanced Lung Cancer

THE LONG-TERM RESULTS of a phase III clinical trial indicate that survival rates for patients receiving chemoradiation for unresectable, locally advanced non–small cell lung cancer (NSCLC) may be more than twice as high as previous estimates, setting a new benchmark of survival for patients with...

gynecologic cancers

EXPERT POINT OF VIEW: Geraldine M. Jacobson, MD, MPH, MBA

GERALDINE M. JACOBSON, MD, MPH, MBA, ASTRO Secretary/Treasurer, Professor and Chair of Radiation Oncology at the West Virginia University School of Medicine, Morgantown, went into more detail about the importance of this study. “The study directly compared brachytherapy/chemotherapy, which we use...

gynecologic cancers

Pelvic Radiation Therapy Preferred Over Brachytherapy Plus Chemotherapy in Treatment of High-Risk Endometrial Cancer

VAGINAL CUFF BRACHYTHERAPY plus chemotherapy failed to show superiority over pelvic radiation therapy for women with high-risk stage I–II endometrial cancer in a phase III trial.1 Furthermore, vaginal cuff brachytherapy plus chemotherapy led to more pelvic and para-aortic nodal recurrences and...

lung cancer

Dacomitinib vs Gefitinib in Advanced NSCLC: Improving Upon Established First-Line Targeted Therapy

THE RESULTS FROM the ARCHER 1050 study—reported by Wu et al1 and reviewed in this issue of The ASCO Post—highlight the recent optimism about improved outcomes in metastatic non–small cell lung cancer (NSCLC) harboring mutations in the epidermal growth factor receptor (EGFR) gene. This trial...

lung cancer

Dacomitinib Prolongs Progression-Free Survival vs Gefitinib in First-Line Treatment of EGFR-Mutant NSCLC

THE PHASE III ARCHER 1050 trial has shown superior progression-free survival with the second-generation irreversible epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor dacomitinib vs gefitinib (Iressa) in the first-line treatment of advanced EGFR-mutant non–small-cell lung cancer...

solid tumors

Characteristics of Recurrence in Stage I to III Midgut Neuroendocrine Tumors

In a study reported in the Journal of the National Cancer Institute, Cives et al found that postsurgical relapse occurred in 31% of patients with stage I to III midgut neuroendocrine tumors over long-term follow-up, with liver, mesentery, and pelvic lymph nodes being the main sites of relapse....

issues in oncology

ASCO Cites Evidence That Alcohol Is Linked to Cancer, Calls for Reduced Alcohol Consumption

Alcohol use—whether light, moderate, or heavy—is linked with increasing the risk of several leading cancers, including those of the breast, colon, esophagus, and head and neck, according to evidence gathered by ASCO. In a statement released November 7 identifying alcohol as a definite...

breast cancer

Long-Term Follow-up of Cardiac Function After Adjuvant Therapy With Trastuzumab in Early Breast Cancer

As reported by Ganz et al in the Journal of Clinical Oncology, long-term follow-up of patients in the National Surgical Adjuvant Breast and Bowel Project (NSABP) Protocol B-31/NRG Oncology trial showed no worsening of cardiac function or quality of life with the addition of adjuvant trastuzumab...

leukemia

Fat Cells May Inactivate Chemotherapeutic Drug and Contribute to Poorer Survival in ALL

It is well established that obesity increases the risk for cancer mortality, although no mechanisms have been proven to explain the reason for this association. Now a laboratory study investigating how obesity might alter the effectiveness of daunorubicin in the treatment of acute lymphoblastic...

gynecologic cancers

Novel Adverse Genomic Rearrangement Signature in High-Grade Serous Ovarian Cancer

As reported by Hillman et al in the Journal of the National Cancer Institute, a novel genomic rearrangement signature associated with poorer overall survival has been identified in high-grade serous ovarian cancer. Study Details In the study, clinical data and whole-genome sequencing results were ...

sarcoma
solid tumors

Conqueror in Action: Six-Time Survivor Brittany Sullivan Takes on Sarcoma

Alveolar soft part sarcoma (ASPS) is a cancer so rare that some oncologists have never heard of it. Brittany Sullivan, a 29-year-old anatomy teacher from Nashville, Tennessee, learned about it when she was 3 years old. She has been conquering it ever since. Since her childhood diagnosis, Ms....

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