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issues in oncology

Cardinale B. Smith, MD, PhD, on Redesigning Care Coordination From the Patient’s Perspective

Cardinale B. Smith, MD, PhD, of the Icahn School of Medicine at Mount Sinai, discusses results of a pilot study suggesting dedicated lay staff members, who facilitated admissions and discharges for patients with cancer across care settings, could improve health-care utilization, quality, and the...

issues in oncology
covid-19

Cardinale B. Smith, MD, PhD, on Telehealth Disparities During the COVID-19 Pandemic

Cardinale B. Smith, MD, PhD, of the Icahn School of Medicine at Mount Sinai, discusses findings showing Black, Hispanic, and Asian patients with cancer used telehealth less often during the COVID-19 pandemic than White patients with cancer, a negative trend that will become more problematic as this ...

genomics/genetics
cns cancers

Radiation-Induced Genetic Deletions May Be Associated With Poorer Patient Outcomes

Treatment of diffuse gliomas with radiotherapy resulted in an increased number of genomic small deletions that make up a unique signature, according to findings presented at the Molecular Analysis for Precision Oncology (MAP) Congress 2020 (Abstract 2MO). Furthermore, an increased burden of...

lung cancer
genomics/genetics

Do Patients With Early-Stage NSCLC Have a Higher Tumor Mutational Burden Than Those With More Advanced Disease?

The tumors of patients with stage I and II non–small cell lung cancer (NSCLC) demonstrated a generally higher tumor mutational burden and more often displayed the mutational signature associated with tobacco smoking than those of patients with more advanced disease, according to findings presented...

gynecologic cancers
immunotherapy

Addition of Bevacizumab to Paclitaxel in Relapsed Ovarian Sex Cord–Stromal Tumors

In the phase II ALIENOR trial reported in JAMA Oncology, Isabelle Ray-Coquard, MD, and colleagues found that the addition of bevacizumab to paclitaxel did not improve the 6-month progression-free rate among women with relapsed ovarian sex cord–stromal tumors. Study Details The study, performed in...

breast cancer

Effect of Virtual Tumor Board Implementation on Use of Whole-Breast Hypofractionated Radiation Therapy

In an observational cohort study reported in JCO Oncology Practice, Powell et al found that the use of whole-breast hypofractionated radiotherapy increased among patients with breast cancer with health insurance plans from one national health-care organization after the implementation of a virtual...

gynecologic cancers
immunotherapy

Camrelizumab Plus Apatinib in Previously Treated Patients With Advanced Cervical Cancer

In the Chinese phase II CLAP study reported in the Journal of Clinical Oncology, Lan et al found that the combination of the anti–PD-1 antibody camrelizumab and the VEGFR inhibitor apatinib produced high response rates in previously treated women with advanced cervical cancer. Study Details The...

issues in oncology
covid-19

Advanced Practitioner Leadership in Times of Crisis

In 2020, health-care providers from all disciplines are facing challenges never before encountered in the modern era of medicine. Advanced practitioners (APs) are playing critical roles in developing protocols, managing health-care teams, and delivering hands-on patient care. JADPRO Live, the...

colorectal cancer

ASTRO Issues Clinical Guideline on Radiation Therapy for Rectal Cancer

A new clinical guideline from the American Society for Radiation Oncology (ASTRO) provides guidance for physicians who use radiation therapy to treat patients with locally advanced rectal cancer. Recommendations outline indications and best practices for pelvic radiation treatments, as well as the...

Dr. Christina Cone Honored With The Mary Pazdur Award for Excellence in Advanced Practice in Oncology by APSHO

The Advanced Practitioner Society for Hematology and Oncology (APSHO) presented the third annual Mary Pazdur Award for Excellence in Advanced Practice in Oncology to Christina Cone, DNP, APRN, ANP-BC, AOCNP®, of Duke Cancer Institute, at the JADPRO Live Virtual conference, an annual educational...

palliative care

Behavioral Nudges Combined With Machine Learning Mortality Estimates May Improve Rate of Advanced Cancer Care Conversations

An electronic nudge to clinicians—triggered by an algorithm that used machine-learning methods to flag patients with cancer who would most benefit from a conversation around end-of-life goals—tripled the rate of those discussions, according to a new prospective, randomized study of nearly 15,000...

breast cancer

Are Delays in Breast Cancer Treatment as Harmful as Commonly Thought?

Delays in the treatment of breast cancer matter, but not as much “as we and our patients typically assume,” Richard J. Bleicher, MD, FACS, informed participants at the 22nd Annual Lynn Sage Breast Cancer Symposium.1 Some of these delays are unavoidable and others are tradeoffs that must be made to...

bladder cancer
immunotherapy

Neoadjuvant Dual Checkpoint Blockade in Certain Patients With Localized Bladder Cancer

Neoadjuvant combination therapy with the anti–CTLA-4 therapy tremelimumab and the anti–PD-1 therapy durvalumab was well tolerated and showed early signs of activity in patients ineligible to receive cisplatin-based chemotherapy, all of whom had tumors with high-risk features that are associated...

breast cancer

Final Efficacy Results From the ExteNET Trial: Neratinib in Pretreated Patients With HR-Positive, HER2-Positive Early Breast Cancer

In an analysis from the phase III ExteNET trial reported in Clinical Breast Cancer, Arlene Chan, MD, and colleagues found significant improvements in efficacy outcomes with the administration of neratinib vs placebo starting at 1 year or sooner after neoadjuvant/adjuvant trastuzumab-based therapy...

cns cancers

Hypofractionated Stereotactic Radiotherapy to the Resection Cavity in Patients With Brain Metastases

In a multi-institutional cohort study reported in JAMA Oncology, Eitz et al found that hypofractionated stereotactic radiotherapy (HSRT) to the resection cavity in patients with brain metastases appears to be associated with an “excellent risk-benefit profile.” As stated by the investigators, “For...

kidney cancer

Adjuvant Sorafenib vs Placebo in Patients With Kidney Cancer at Intermediate or High Risk of Relapse

In the phase III SORCE trial reported in the Journal of Clinical Oncology, Eisen et al found no benefit of sorafenib vs placebo as adjuvant therapy in patients with renal cell carcinoma at intermediate or high risk of disease recurrence. Study Details The double-blind trial included 1,711 patients...

solid tumors
multiple myeloma

ASCO Approves First Joint MSTS/ASTRO/ASCO Guideline on Treatment of Metastatic Carcinoma and Myeloma of the Femur

On June 20, 2020, ASCO approved the first joint Musculoskeletal Tumor Society (MSTS)/American Society for Radiation Oncology (ASTRO)/ASCO guideline on the care of patients with metastatic carcinoma and myeloma of the femur.1 Guideline recommendations were based on a systematic review of clinical...

lymphoma

Study Finds Combined HDAC and mTOR Inhibition May Improve Outcomes in Patients With Relapsed or Refractory Hodgkin Lymphoma

Results from a nonrandomized, dose-escalation phase I clinical trial investigating the histone deacetylase (HDAC) inhibitor vorinostat in combination with the mTOR inhibitors sirolimus or everolimus found the combination therapies showed activity in heavily pretreated patients with relapsed or...

lung cancer
genomics/genetics

Fragment Analysis as a MET Exon 14 Screening Strategy in NSCLC Tumors

Comparison of two techniques used in screening non–small cell lung cancer (NSCLC) tumor samples demonstrated that fragment analysis could detect large MET exon 14 skipping deletions that were missed by next-generation sequencing, according to findings presented at the Molecular Analysis for...

head and neck cancer

Sentinel Node Biopsy vs Neck Node Dissection in Operable Oral or Oropharyngeal Cancer: Equivalence Trial

In a French phase III trial (Senti-MERORL) reported in the Journal of Clinical Oncology, Garrel et al found that sentinel node biopsy demonstrated oncologic equivalance to neck lymph node dissection in 2-year neck node recurrence–free survival in patients with operable cT1–T2N0 oral/oropharyngeal...

prostate cancer

Adjuvant vs Early Salvage Radiotherapy After Radical Prostatectomy in High-Risk Prostate Cancer

In a phase III noninferiority trial (RAVES) reported in The Lancet Oncology, Kneebone et al found that salvage radiotherapy did not meet noninferiority criteria for biochemical progression vs adjuvant radiotherapy, but was associated with nearly identical biochemical control rates and reduced...

symptom management

Anne M. Barry-Weers, RN, on Decreasing Hospitalizations for Patients Receiving IV Chemotherapy

Anne M. Barry-Weers, RN, of Aurora Health Care/Aurora Cancer Care in Milwaukee, discusses strategies that helped patients with cancer to better manage their chemotherapy-related symptoms at home, thus reducing visits to the emergency department and inpatient admissions, and improving treatment...

geriatric oncology
symptom management

Marie A. Flannery, PhD, and Eva Culakova, PhD, on Managing Symptoms in Older Adults With Advanced Cancer

Marie A. Flannery, PhD, and Eva Culakova, PhD, both of the University of Rochester, discuss a geriatric assessment tool that helped reduce symptomatic toxicities, as measured by Patient-Reported Outcomes Common Terminology Criteria for Adverse Events (Abstract 138).

issues in oncology

Katherine Enright, MD, MPH, on Improving the Quality of Oral Cancer Drug Delivery

Katherine Enright, MD, MPH, of Trillium Health Partners in Ontario, discusses a model of quality improvement, which potentially could be adapted across health systems to improve oral systemic cancer care (Abstract 184).

issues in oncology

Joseph M. Unger, PhD, on Patient Interest in Clinical Trial Enrollment: A New Analysis

Joseph M. Unger, PhD, of Fred Hutchinson Cancer Research Center, discusses study results showing that more than half of all patients with cancer, regardless of race or ethnicity, agree to take part in clinical trials, a finding that upends conventional beliefs. He talks about removing the barriers...

Expert Point of View: Rodabe N. Amaria, MD

The value of adjuvant therapy for patients with resected stage III or IV melanoma—in the form of pembrolizumab and nivolumab—continues to be observed after approximately 4 years from the start of therapy, according to Rodabe N. Amaria, MD, Associate Professor of Melanoma Medical Oncology at The...

skin cancer

Long-Term Benefit of Adjuvant Immunotherapy Sustained in Stage III or IV Melanoma

The benefit of anti–PD-1 antibodies in the adjuvant treatment of patients with stage III or stage IV melanoma continues to be observed at around 4 years for both pembrolizumab and nivolumab, according to updates of pivotal trials presented at the European Society for Medical Oncology (ESMO) Virtual ...

breast cancer
issues in oncology

Limited English-Language Proficiency May Affect Frequency of Screening Mammograms

Limited English-language proficiency may be a risk factor for receiving screening mammograms less often, according to new study results using national data. These findings, concerning women age 40 and older living in the United States, were presented at the American College of Surgeons Clinical...

multiple myeloma

Ixazomib Maintenance in Newly Diagnosed Patients With Multiple Myeloma Not Undergoing Stem Cell Transplant: TOURMALINE-MM4 Trial

As reported in the Journal of Clinical Oncology by Meletios A. Dimopoulos, MD, and colleagues, the phase III TOURMALINE-MM4 trial has shown that postinduction maintenance with ixazomib prolonged progression-free survival vs placebo in patients with newly diagnosed multiple myeloma not undergoing...

lymphoma

Tazemetostat in Relapsed or Refractory Follicular Lymphoma

In a phase II trial reported in The Lancet Oncology, Franck Morschhauser, MD, and colleagues found that the oral EZH2 inhibitor tazemetostat produced durable responses in patients with relapsed or refractory follicular lymphoma with or without an EZH2 mutation. As noted by the investigators,...

colorectal cancer

Addition of Oxaliplatin to Preoperative Capecitabine-Based Chemoradiation and Adjuvant Capecitabine in Locally Advanced Rectal Cancer

As reported in the Journal of Clinical Oncology by Schmoll et al, the phase III PETACC 6 trial has shown no benefit of the addition of preoperative and adjuvant oxaliplatin to preoperative capecitabine-based chemoradiation and adjuvant capecitabine in patients undergoing total mesorectal excision...

Expert Point of View: Bartosz Chmielowski, MD, PhD

COMBI-i’s invited discussant, Bartosz Chmielowski, MD, PhD, Associate Clinical Professor at the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, said this study is one of three key trials in which checkpoint inhibitors were combined with BRAF and MEK inhibitors. “This is...

skin cancer

COMBI-i Trial: No Statistical Benefit to Adding Spartalizumab to Dabrafenib/Trametinib in Melanoma

Patients with unresectable or metastatic melanoma harboring BRAF V600 mutations did not benefit from the addition of the anti–PD-1 antibody spartalizumab to dabrafenib and trametinib in the COMBI-i trial, which was presented at the European Society for Medical Oncology (ESMO) Virtual Congress...

First-Line Atezolizumab vs Chemotherapy for PD-L1–Positive Metastatic NSCLC

This week, we'll review results of a trial that evaluated first-line anti–PD-L1 therapy vs platinum-based chemotherapy in patients with metastatic lung cancer and high PD-L1 expression. We'll also discuss findings from a study that evaluated whether patients receiving care for advanced cancer based ...

leukemia
geriatric oncology

FDA Approves Venetoclax Combination Regimen for Certain Adult Patients With AML

On October 16, the U.S. Food and Drug Administration (FDA) granted regular approval to venetoclax (Venclexta) in combination with azacitidine, decitabine, or low-dose cytarabine for newly diagnosed acute myeloid leukemia (AML) in adults age 75 or older or who have comorbidities precluding intensive ...

bladder cancer

Urine-Based Liquid Biopsy May Perform Similarly to Urine Cytology in Detecting Urothelial Carcinoma

Analysis of DNA copy number variants in the cells exfoliated in urine showed improved sensitivity and similar specificity in detecting urothelial carcinoma compared to urine cytology, according to results published by Zeng et al in Clinical Cancer Research. “Urine cytology, which is widely used to...

hematologic malignancies
immunotherapy

Long-Term Follow-up of Anti-CD19 CAR T-Cell Therapy in Relapsed B-Cell Malignancies

As reported in the Journal of Clinical Oncology by Cappell et al, long-term follow-up of a National Cancer Institute phase I trial has shown that anti-CD19 chimeric antigen receptor (CAR) T-cell therapy for various relapsed B-cell malignancies produced responses lasting 3 years or longer in half of ...

genomics/genetics

Molecular Profiles and Actionable Alterations Identified in the NCI-MATCH Trial

In a report in the Journal of Clinical Oncology, Keith T. Flaherty, MD, and colleagues describe the current status of and findings from the ongoing NCI-MATCH (National Cancer Institute Molecular Analysis for Therapy Choice) trial. The aim of the trial is to determine the likelihood of identifying...

colorectal cancer
cost of care

Veena Shankaran, MD, on Colorectal Cancer: Cumulative Financial Hardship of Treatment

Veena Shankaran, MD, of the Seattle Cancer Care Alliance, discusses study findings from a national sample of patients with metastatic colorectal cancer who are on systemic therapy. A year into their treatment, nearly three out of four patients had major financial hardships despite access to health...

lymphoma
immunotherapy

FDA Extends the Approval of Pembrolizumab for Patients With Classical Hodgkin Lymphoma

On October 14, the U.S. Food and Drug Administration (FDA) extended the approval of pembrolizumab (Keytruda) for the following indications:   Adult patients with relapsed or refractory classical Hodgkin lymphoma Pediatric patients with refractory classical Hodgkin lymphoma or classical Hodgkin...

sarcoma

Tazemetostat in Patients With Advanced Epithelioid Sarcoma and Loss of INI1/SMARCB1

As reported in The Lancet Oncology by Mrinal Gounder, MD, and colleagues, findings in a cohort of a phase II basket trial showed that the oral EZH2 inhibitor tazemetostat produced durable responses in some patients with advanced epithelioid sarcoma with loss of INI1 or SMARCB1 (the gene encoding...

lung cancer
immunotherapy

Addition of Cetuximab to Afatinib in First-Line Treatment of EGFR-Mutant NSCLC

As reported in the Journal of Clinical Oncology by Sarah B. Goldberg, MD, MPH, and colleagues, final results of the phase II SWOG S1403 trial show no progression-free survival benefit with afatinib plus cetuximab vs afatinib alone in the first-line treatment of EGFR-mutant advanced non–small cell...

skin cancer

ASCO’s Policy Statement on Skin Cancer Prevention Focuses on Four Key Areas to Reduce Incidence and Save Lives

The increasing incidence rates of skin cancer in the United States are staggering. It is the most common cancer diagnosed in the country, and current estimates show that about 9,500 Americans are diagnosed with skin cancer every day. Over the course of a year, more than 3 million people are...

breast cancer
immunotherapy

Addition of Atezolizumab to T-DM1 in Previously Treated Patients With HER2-Positive Advanced Breast Cancer

In the phase II KATE2 trial reported in The Lancet Oncology, Leisha A. Emens, MD, and colleagues found that the addition of atezolizumab to ado-trastuzumab emtansine (T-DM1) did not improve progression-free survival in patients with advanced HER2-positive breast cancer progressing after previous...

breast cancer
covid-19

Melissa K. Accordino, MD, on Breast Cancer Care Delivery: Impact of the COVID-19 Pandemic

Melissa K. Accordino, MD, of Columbia University Medical Center, discusses findings showing nearly half of the patients with breast cancer treated at an academic center in New York City experienced a change or delay in their workup or treatment during the COVID-19 pandemic. Race and socioeconomic...

breast cancer

Clinical Challenges of Managing Breast Cancer Brain Metastases

“Breast cancer brain metastases are a clinical challenge that are only increasing in incidence and are a consequence of advanced breast cancers, largely HER2-positive and triple-negative,” according to Carey K. Anders, MD, Professor of Medicine and Medical Director of the Duke Brain and Spine...

issues in oncology
breast cancer

Do Hospitals That Primarily Serve Minority Patients Offer Standard Surgical Care for Patients With Breast Cancer?

Among accredited cancer centers in the United States, hospitals serving primarily minority patients are as likely as other hospitals to offer the standard of surgical care for early-stage breast cancer, according to results presented at the virtual American College of Surgeons Clinical Congress...

covid-19

New Study Offers a Global Review of the Impact of COVID-19 on Cancer Treatment and Research

A recent review of scientific literature showed that the COVID-19 pandemic has impacted virtually every aspect of cancer care and research—from introducing new risks for patients to disrupting the delivery of treatment and the continuity of research. The report, published by Ziad Bakouny, MD, and...

gastroesophageal cancer
immunotherapy

KEYNOTE-181 Trial: Second-Line Pembrolizumab vs Chemotherapy in Advanced Esophageal Cancer

As reported in the Journal of Clinical Oncology by Takashi Kojima, MD, and colleagues, the phase III KEYNOTE-181 trial has shown that second-line pembrolizumab improved overall survival vs investigator’s choice of chemotherapy in patients with advanced or metastatic esophageal cancer with a PD-L1...

gynecologic cancers

Swedish Study of HPV Vaccination and Risk of Invasive Cervical Cancer

In a study reported in The New England Journal of Medicine, Lei et al found that receipt of the quadrivalent human papillomavirus (HPV) vaccine among girls and young women was associated with a substantial reduction in the risk of invasive cervical cancer. As stated by the investigators, “The...

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