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issues in oncology

Continued Reduction in Cancer Mortality Requires Increasing Healthy Behaviors and Removing Inequities in Care

Many news reports about the latest cancer statistics released by the American Cancer Society (ACS) have focused on the 25% reduction in cancer mortality since 1991. Several reports quoted ACS Chief Medical Officer Otis W. Brawley, MD, FACP, who said in a statement1 announcing the publication of...

integrative oncology

Soy

Scientific Name: Glycine max Common Names: Soybean, soya, tofu, miso, tempeh Overview An annual herb indigenous to East Asia, soy was domesticated more than 3,000 years ago for its pods and edible seeds. It is now the world’s most important legume crop and is grown in diverse climates. Foods...

breast cancer

Results From MONALEESA-2: Are All CDK4/6 Inhibitors Equal?

Hormone receptor–positive breast cancer is the most common subtype of breast cancer, and while endocrine therapy has long been a mainstay of therapy for these patients, treatment resistance ultimately develops. Therefore, better therapeutic approaches are needed. There are some data to suggest...

breast cancer

First-Line Ribociclib Prolongs Progression-Free Survival in Hormone Receptor–Positive, HER2-Negative Breast Cancer

As reported by The ASCO Post from the recent European Society for Medical Oncology Conference, first-line treatment with ribociclib, a selective inhibitor of cyclin-dependent kinases 4 and 6 (CDK4/6), resulted in significantly longer progression-free survival vs placebo in women with hormone...

hepatobiliary cancer

Regorafenib in Second-Line Setting for Hepatocellular Carcinoma: Balancing Benefit With Toxicity

During the past 40 years, hundreds of randomized trials testing treatments for advanced hepatocellular carcinoma have been published.1 Conventional systemic chemotherapy and radiotherapy lack survival advantages for these patients.1,2 In 2007, a phase III trial demonstrated survival benefits for...

hepatobiliary cancer

Regorafenib Improves Survival in Patients With Hepatocellular Carcinoma Progressing on Sorafenib

In the phase III RESORCE trial reported in The Lancet, Jordi Bruix, MD, Head of the Barcelona Clinic Liver Cancer Group, University of Barcelona, and colleagues found that regorafenib (Stivarga) improved overall survival vs placebo in patients with hepatocellular carcinoma who had progressed on...

lung cancer

Bright Future for Osimertinib in EGFR T790M–Positive Lung Cancer

The AURA3 study—reported by Mok and colleagues and reviewed in this issue of The ASCO Post—confirms the dramatic activity of osimertinib (Tagrisso) in patients with advanced epidermal growth factor receptor (EGFR)-mutant non–small cell lung cancer (NSCLC) and acquired resistance to prior EGFR...

lung cancer

Osimertinib Improves Progression-Free Survival vs Platinum/Pemetrexed in EGFR T790M–Positive NSCLC

In the phase III AURA3 trial reported in The New England Journal of Medicine by Tony S. Mok, MD, of the Chinese University of Hong Kong, and colleagues, osimertinib (Tagrisso) significantly improved progression-free survival vs platinum/pemetrexed (Alimta) among patients with epidermal growth...

global cancer care

Cancer on the Global Stage: Incidence and Cancer-Related Mortality in Bangladesh

The ASCO Post is pleased to present this special focus on the worldwide cancer burden. The aim of this special feature is to highlight the global cancer burden for various countries of the world. For the convenience of the reader, each issue will focus on one country from one of the six regions...

cns cancers

Radiotherapy vs Temozolomide in Low-Grade Glioma: The Importance of Molecular Classification

The optimal treatment strategy for low-grade glioma has yet to be established, and practice patterns vary in regard to the timing of treatment, as well as the chosen treatment modality. It was against this backdrop, at a time when the benefits of radiation and chemotherapy remained uncertain but ...

issues in oncology
survivorship

Update on Fertility Outcomes Among Survivors of Childhood Cancer

“Estimates suggest that by the year 2020, there will be over 500,000 adult survivors of childhood cancer in the United States,” Daniel A. Mulrooney, MD, MS, of the Division of Cancer Survivorship, St. Jude Children’s Research Hospital, Memphis, reported at the 10th Oncofertility Conference in...

geriatric oncology
colorectal cancer

Tailoring Treatment for Older Adults With Colorectal Cancer

Nearly 60% of colorectal cancer cases are diagnosed in patients ≥ 65 years, with a median age at diagnosis of 68 years,1 but this population makes up only 34% of clinical trial participants.2 In addition, the older adults enrolled on clinical trials are traditionally the most-fit older adults....

An Introduction to Recognizing and Managing Professional Burnout

There’s no getting around it: the practice of oncology can be inherently stressful. First, there’s the workload: compared to other medical specialists, oncologists see a larger number of patients and spend more time with them in face-to-face interactions. It’s not unusual for oncologists to work 60 ...

leukemia

Phase II Studies Evaluate New Approaches in Richter Transformation

Despite advances in treating chronic lymphocytic leukemia (CLL), the 5% to 10% of patients who develop Richter transformation continue to have poor outcomes. For these patients, median progression-free survival is approximately 6 months, and median overall survival is about 8 months. Phase II...

multiple myeloma

FDA Approves Lenalidomide as Maintenance Therapy for Patients With Multiple Myeloma Following Autologous Stem Cell Transplant

On February 22, the U.S. Food and Drug Administration (FDA) expanded the existing indication for lenalidomide (Revlimid) 10 mg capsules to include use for patients with multiple myeloma as maintenance therapy following autologous hematopoietic stem cell transplant. The expanded indication makes...

issues in oncology
cost of care

Payers Weigh the Implications of Multigene Testing Coverage

Innovation in precision medicine has introduced an amalgam of testing options, of which hereditary cancer panels—multigene tests—are a major component. Additionally, the importance of inherited cancer genomics was further bolstered by former President Barack Obama’s Precision...

breast cancer

Chinese Trial Adds Utidelone to Capecitabine in Heavily Pretreated Patients With Metastatic Breast Cancer

In a Chinese phase III trial reported in The Lancet Oncology, Zhang et al found that adding the epothilone analog utidelone to capecitabine prolonged progression-free survival in women with heavily pretreated metastatic breast cancer refractory to both anthracycline and taxane treatment. Study...

lung cancer

Continuing Education Information

This CE/CME/CU-accredited supplement is jointly provided by:       To earn credit/contact hours, you must read all the articles in this supplement and then go to https://education.annenberg.net/IASLC Release date: February 25, 2017 Expiration date: February 25, 2018Annenberg Center for Health...

sarcoma

Southern Surgical Association Annual Meeting: Isolated Limb Infusion for Extremity Sarcoma May Preserve Limbs

Patients with advanced malignant soft-tissue sarcoma of the extremities have typically faced amputation of the afflicted limb as the only treatment option. However, a technique that limits the application of chemotherapy to the cancerous region can preserve limbs in a high percentage of these...

kidney cancer

2017 GU Cancers Symposium: Atezolizumab Plus Bevacizumab Shows Potential in Metastatic Renal Cell Carcinoma

Results from the phase II IMmotion150 study that compared atezolizumab (Tecentriq) plus bevacizumab (Avastin) and atezolizumab monotherapy to sunitinib (Sutent) alone in patients with previously untreated, locally advanced or metastatic renal cell carcinoma were presented at the 2017 Genitourinary...

bladder cancer

2017 GU Cancers Symposium: Updated Efficacy and Tolerability of Durvalumab in Locally Advanced or Metastatic Urothelial Carcinoma

At the 2017 Genitourinary Cancers Symposium, Powles et al presented updated efficacy and safety data for durvalumab in patients with locally advanced or metastatic urothelial cancer (Abstract 286). Updated results from the phase I/II trial showed an objective response rate of 20.4% in all...

colorectal cancer

Optimal Time to Assess Response After Chemoradiotherapy in Anal Squamous Cell Carcinoma

In a post hoc analysis of the UK ACT II trial reported in The Lancet Oncology, Glynne-Jones et al found that the best time to assess for complete response to chemoradiotherapy in patients with anal squamous cell carcinoma is at approximately 26 weeks from the start of treatment. In the ACT II...

lung cancer

Three Assays and Several Laboratory-Developed Tests Highly Concordant Across Platforms in PD-L1 Immunohistochemistry Testing for NSCLC

Programmed cell death ligand 1 (PD-L1) expression assessed by immunohistochemistry in formalin-fixed, paraffin-embedded tumor tissues is currently the main predictive biomarker for the benefit of anti–programmed cell death protein 1 (PD-1) and anti–PD-L1 agents in patients with non–small cell lung ...

lung cancer

New Lung Cancer Staging Manual Set to Modify Clinical Practice

A revised tumor classification based on 70,967 evaluable patients with non–small cell lung cancer (NSCLC) and 6,189 patients with small cell lung cancer is now available to lung cancer specialists around the world in the form of the 8th edition of the tumor, node, and metastasis (TNM)...

lung cancer

Efficacy, Toxicity on a Par for Different Classes of Immune Checkpoint Inhibitors

The two main classes of immune checkpoint inhibitors used to treat non–small cell lung cancer (NSCLC) have essentially the same efficacy and toxicity profiles, according to a systematic review and meta-analysis of 23 trials with a total of 5,899 patients.1 Results showed that about one-fifth of...

lung cancer

Durable Responses Reported With Pembrolizumab in Heavily Pretreated Extensive-Stage Small Cell Lung Cancer

The programmed cell death protein 1 (PD-1) inhibitor pembrolizumab (Keytruda) has shown durable antitumor activity in patients with extensive-stage small cell lung cancer (SCLC) that expresses programmed cell death ligand 1 (PD-L1), according to an update of the KEYNOTE-028 trial.1 “Median overall ...

lung cancer

Combination Immunotherapy for Lung Cancer: The Wave of the Future

Increasing experience with immunotherapy for lung cancer in both the lab and the clinic is helping to refine treatment approaches and point the way forward, according to Naiyer Rizvi, MD, Director of both Thoracic Oncology and Immunotherapeutics at Columbia University Medical Center in New York....

Selected Abstracts From the 2016 ASH Annual Meeting

Here are several abstracts selected from the proceedings of this year’s American Society of Hematology (ASH) Annual Meeting & Exposition, highlighting newer therapeutics in high-grade, aggressive B-cell non-Hodgkin lymphomas (NHLs), including newly diagnosed as well as relapsed or refractory...

lymphoma

FDA Approves Ibrutinib in Relapsed/Refractory Marginal Zone Lymphoma

On January 19, the U.S. Food and Drug Administration (FDA) approved ibrutinib (Imbruvica) for the treatment of patients with marginal zone lymphoma who require systemic therapy and have received at least one prior anti–CD20-based therapy. Accelerated approval was granted for this indication based...

breast cancer

New Data on Prognostic Factors, Disease Detection, Drug Toxicities, and Treatment Adherence Presented at SABCS

The San Antonio Breast Cancer Symposium (SABCS) offers state-of-the-art information on all aspects of breast cancer biology, diagnosis, and treatment, drawing an international audience of more than 7,500 physicians, researchers, and other health-care professionals from over 90 countries. Through...

lung cancer

Ongoing Phase III Clinical Trials of Immunotherapy in Advanced Non–Small Cell Lung Cancer

The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies focused on immunotherapy in lung cancer. All of the studies are listed on the National Institutes of Health website at ClinicalTrials.gov. Study Title: A Randomized, Double-Blind, Phase...

lung cancer

Managing Toxicities Associated With Immunotherapy for Lung Cancer

Understanding, anticipating, and managing the toxicities associated with immunotherapies for lung cancer are key to steps to safely using and achieving the most benefit from these new agents, according to Beth Eaby-Sandy, MSN, CRNP, OCN, a nurse practitioner at the University of Pennsylvania’s...

lung cancer

Expert Point of View: Paul Mitchell, MD

“The progression-free and overall survival curves of CheckMate 057 suggest the presence of two patient populations with respect to nivolumab (Opdivo): a relatively sensitive one and a less sensitive, possibly even resistant, one, according to invited discussant Paul Mitchell, MD, Associate...

lung cancer

New Analysis of CheckMate 057: Search Continues for Predictors of Outcome With Nivolumab

Prognostic factors and tumor expression of programmed cell death ligand 1 (PD-L1) predict early mortality among patients with previously treated nonsquamous advanced non–small cell lung cancer (NSCLC) who receive nivolumab instead of docetaxel. But these features are not reliable for excluding...

lung cancer

KEYNOTE-010 Update Shows ‘Striking’ Durability of Second-Line Pembrolizumab in NSCLC

Pembrolizumab’s benefit in previously treated advanced non–small cell lung cancer (NSCLC) that expresses programmed cell death ligand 1 (PD-L1) is long lasting, persisting even after therapy ends, suggests an update of the KEYNOTE-010 trial.1 Initial results of the randomized phase II/III trial,...

hepatobiliary cancer

Novel Bridge to Liver Transplant May Improve Upon Standard of Care

For hepatocellular carcinoma patients awaiting a liver transplant, locoregional treatment as a “bridge” is a standard strategy for reducing tumor progression. The most common approach is transarterial chemoembolization, but a study from a large-volume liver transplant center questions whether it...

palliative care
symptom management

Palliative Radiation Therapy for Bone Metastases: Update of an ASTRO Evidence-Based Guideline

The American Society for Radiation Oncology (ASTRO) recently published an updated clinical guideline that underscores the safety and effectiveness of palliative radiation therapy for treating painful bone metastases. Based on recent clinical trial data, the guideline recommends optimal radiotherapy ...

skin cancer

Health-Related Quality of Life in Pivotal Trial of Adjuvant Ipilimumab in Stage III Melanoma

As reported in The Lancet Oncology by Coens et al, there was little difference between adjuvant ipilimumab (Yervoy) vs placebo in health-related quality of life in patients with high-risk stage III melanoma in the phase III EORTC 18071 trial supporting the 2014 approval of ipilimumab in this...

lung cancer

Durvalumab Shows Activity in Heavily Pretreated Patients With Non–Small Cell Lung Cancer

The immune checkpoint inhibitor durvalumab (also known as MEDI4736) is active and achieves durable responses in patients with heavily pretreated advanced non–small cell lung cancer (NSCLC) that does not have any epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK)...

lung cancer

Atezolizumab Benefits Survival vs Docetaxel Across Multiple Subtypes of Non–Small Cell Lung Cancer

A wide range of patients with advanced non–small cell lung cancer (NSCLC) see a survival advantage from second- or third-line atezolizumab (Tecentriq) as compared with docetaxel, according to new data from the OAK trial.1 The main results of the randomized phase III trial, previously reported,...

lung cancer

Quality-of-Life Data From KEYNOTE-024: First-Line Pembrolizumab vs Chemotherapy in Advanced NSCLC

When used as first-line therapy for advanced non–small cell lung cancer (NSCLC), pembrolizumab (Keytruda) yields better health-related quality of life than platinum-based chemotherapy, suggest new data from the randomized phase III KEYNOTE-024 trial.1 After 15 weeks of treatment, changes in scores...

lung cancer

Expert Point of View: Edward B. Garon, MD

“There are several possible ways to move first-line immunotherapy for non–small cell lung cancer (NSCLC) forward, according to invited discussant Edward B. Garon, MD, Director of Thoracic Oncology at the David Geffen School of Medicine at the University of California, Los Angeles. “We could expand...

colorectal cancer

Expert Point of View: Philip B. Paty, MD

Philip B. Paty, MD, a surgical oncologist at Memorial Sloan Kettering Cancer Center, New York, commented on the findings for The ASCO Post. Dr. Paty is leading studies of surveillance at his own institution, which is not part of the International Watch & Wait Database. Consistency of Outcomes...

colorectal cancer

‘Watch-and-Wait’ Strategy Does Not Compromise Survival in Selected Patients With Rectal Cancer

A “watch-and-wait” approach to treating rectal cancer patients with complete responses to chemoradiotherapy resulted in a 3-year survival rate of 91%, which is similar to historic survival rates after surgical resection, according to an analysis of the International Watch & Wait Database.1 For ...

lung cancer

Clinical Trials Study the Role of Immunotherapy in the First-Line Setting of Non–Small Cell Lung Cancer

In 2016, the KEYNOTE-024 trial set the bar for first-line immunotherapy in non–small cell lung cancer (NSCLC). Trial results showed that pembrolizumab (Keytruda), an antibody to programmed cell death protein 1 (PD-1), reduced the risk of disease progression or death by 50% and the risk of death by...

survivorship
health-care policy

Timing Is Everything

In 1959, my 5-year-old cousin, Kim, was diagnosed with acute lymphocytic leukemia (ALL). As an 8-year-old, I didn’t really understand what was happening to him, except that he had to go to the Riley Hospital for Children in Indianapolis, Indiana, for treatment. The haunting vision of his looking...

lung cancer

Understanding the Role of Immunotherapy for Lung Cancer: A Paradigm Shift for the Better

“Immunotherapy for lung cancer is a paradigm shift. I would never have thought when I started my career taking care of lung cancer patients in the mid 1990s that we’d now be substituting chemotherapy with an antibody immunotherapy in 2017. It’s incredible,” commented Roy S. Herbst, MD, PhD, Chief...

pain management

Combating Untreated Cancer-Related Pain

The problem of pain management facing clinicians today is twofold: how to ensure safe and effective treatment for patients with cancer in chronic pain, while avoiding the overuse of opioid medications and the potential for substance use disorder and diversion. According to the American Cancer...

colorectal cancer

Expert Point of View: Frank Sinicrope, MD

Frank Sinicrope, MD, Professor of Medicine and Oncology at the Mayo Clinic, Rochester, Minnesota, told The ASCO Post that anti–programmed cell death protein 1 (anti–PD-1) agents “have already changed the landscape” of metastatic colorectal cancer. “We are currently treating microsatellite...

colorectal cancer

CheckMate 142 Update: Prolonged Disease Control With Nivolumab in Deficient Mismatch Repair Colorectal Cancer

With 6 additional months of follow-up since the initial presentation of results, in the phase II CheckMate 142 trial, 74% of heavily pretreated patients with metastatic colorectal microsatellite instability–high (MSI-H) cancers are alive after single-agent treatment with nivolumab (Opdivo).1...

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