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issues in oncology
survivorship

Short and Shorter Screening Tools for Food Insecurity

A survey of oncology registered dietitian nutritionists (RDNs)1 found that most of those surveyed were not using a validated assessment tool to identify food insecurity but expressed interest in obtaining the Six-Item Short Form of the Food Security Survey Module.2  The six-item food insecurity...

issues in oncology
survivorship

Assessing Food Insecurity Among Patients With Cancer

Food insecurity, particularly as it affects cancer survivors, is a serious problem, according to a survey of oncology registered dietitian nutritionists (RDNs) published in the Journal of the Academy of Nutrition and Dietetics.1 “Despite these concerns, most oncology RDNs interviewed are not using...

‘Potential for Curative Intent’

Findings from the international phase II KEYNOTE-158 trial of pembrolizumab among women with previously treated microsatellite instability–high (MSI-H) or mismatch repair–deficient (dMMR) endometrial tumors “suggest a long-term benefit to patients,” stated the trial’s lead author David M. O’Malley, ...

gynecologic cancers

Robust and Durable Responses to Pembrolizumab in Patients With Previously Treated MSI-H/dMMR Endometrial Cancer

“Robust and clinically meaningfulantitumor activity,” with durable responses and “encouraging survival outcomes,” were reported among patients with previously treated microsatellite instability–high (MSI-H) or mismatch repair–deficient (dMMR) endometrial tumors who received pembrolizumab in the...

covid-19

Communication Is Key to Overcoming Resistance to COVID-19 Vaccination

The three most common reasons patients with cancer surveyed at an outpatient infusion therapy clinic gave for not having received at least one dose of COVID-19 vaccine were: My doctor has not told me to get the vaccine. I do not think it is safe for me because I have cancer. I’m afraid of the side ...

covid-19

Why Some Patients With Cancer Are Reluctant to Receive COVID-19 Vaccination: Survey Shows Need to Improve Patient-Physician Communication

“My doctor has not told me to get the vaccine.” That was the number one reason patients with cancer gave in a survey at an outpatient infusion therapy clinic for not having received at least one dose of the COVID-19 vaccine. Rivalling that reason were concerns about safety and fear of vaccine side...

Be Realistic About What Patients Can Expect After Prostate Cancer Treatment

More than 1 in 10 patients with localized prostate cancer experienced treatment-related regret, a study published in JAMA Oncology suggests. And the major driver of that regret seems to be a disconnect between patient expectations and outcomes.1 In an interview with The ASCO Post, the study’s lead...

prostate cancer
survivorship

Disconnect Between Expectations and Outcomes: Major Factor in Treatment-Related Regret Among Patients With Localized Prostate Cancer

“A disconnect between patient expectations and outcomes” is a major contributor to treatment-related regret among patients with localized prostate cancer, according to a study published in JAMA Oncology.1 The disconnect, “both as it relates to treatment efficacy and adverse effects, appears to...

breast cancer
immunotherapy

Composite Biomarker Needed to Predict Benefit of Immunotherapy in Triple-Negative Breast Cancer

Although there is a biomarker that predicts response to the one approved immunotherapy agent for metastatic triple-negative breast cancer, “it is important to note there are no biomarkers of response to neoadjuvant immunotherapy in early-stage triple-negative breast cancer,” Elizabeth A....

Expect Questions on Use of Low-Dose Aspirin to Help Prevent Colorectal Cancer

Following a review of new data and additional analyses of previous data concerning colorectal cancer, the U.S. Preventive Services Task Force (USPSTF) “concluded the evidence is inadequate that low-dose aspirin use reduces colorectal cancer incidence or mortality.”1 Consequently, a draft...

colorectal cancer

Update on the Role of Low-Dose Aspirin in Colorectal Cancer Prevention

Updating its 2016 recommendation on the use of aspirin to prevent cardiovascular disease and colorectal cancer, the U.S. Preventive Services Task Force (USPSTF) issued a draft recommendation statement. It noted the potential harms of daily aspirin, with the most serious being bleeding in the...

breast cancer

To Elect or Forgo Radiation Therapy: An Informed Decision for Patients With Breast Cancer

Advances intreating breast cancer “increasingly create opportunities to consider where radiation therapy might safely be omitted,” Reshma Jagsi, MD, DPhil, told participants at the 2021 Lynn Sage Breast Cancer Symposium.1 “But, I would encourage us,” she continued, “not to assume that women who...

breast cancer

To Elect or Forgo Radiation Therapy: An Informed Decision for Patients With Breast Cancer

Advances in treating breast cancer “increasingly create opportunities to consider where radiation therapy might safely be omitted,” Reshma Jagsi, MD, DPhil, told participants at the 2021 Lynn Sage Breast Cancer Symposium.1 “But, I would encourage us,” she continued, “not to assume that women who...

breast cancer

Fear of Side Effects and Lack of Awareness: Barriers to Greater Use of Risk-Reducing Medications for Breast Cancer

A “big problem, maybe the major one,” with risk-reducing medications for breast cancer is low uptake among women at high risk of breast cancer,” Seema A. Khan, MD, told participants at the 2021 Annual Lynn Sage Breast Cancer Symposium.1 Dr. Khan is Professor of Surgery and the Bluhm Family...

breast cancer

Risk-Reducing Medications for Breast Cancer Are Becoming Safer and More Tolerable

Risk-reducing medications for breast cancer may be effective for many women, and recently reported and ongoing trials have led to improvements in their tolerability and safety, Seema A. Khan, MD, reported at the 2021 Annual Lynn Sage Breast Cancer Symposium (virtual).1 Dr. Khan is Professor of...

breast cancer

Optimizing Adjuvant Therapy for Women With Estrogen Receptor–Positive, Node-Positive Breast Cancer

“Nodal status remains the single most important prognostic marker in outcomes for women with estrogen receptor–positive, HER2-negative breast cancer. For that reason, it makes sense to think about optimizing adjuvant therapy, including endocrine treatments, chemotherapy, and targeted therapy,”...

PALB2 Added to Secondary Findings List

“It is important to note that a paper on managing individuals with germline variants in PALB2 was published in the same issue of Genetics in Medicine as an article on reporting secondary findings in clinical exome and genome sequencing,”1,2 Douglas R. Stewart, MD, told The ASCO Post. “PALB2 is a...

genomics/genetics

Enhanced Surveillance and Risk-Reducing Intervention Options for Individuals With PALB2 Variants

PALB2 germline pathogenic variants are associated with a substantially increased risk for breast cancer and a smaller increased risk for pancreatic and ovarian cancers, warranting enhanced surveillance and the option of risk-reducing interventions, according to a global team of cancer genetic...

Listen to Patients’ Concerns About Quality of Life

The GO2 study found that lowering the intensity of chemotherapy may increase quality of life without significantly compromising survival among older and frail patients with advanced gastroesophageal cancers. It started out by asking patients themselves what degree of compromise they would be...

gastroesophageal cancer

Reduced-Intensity Chemotherapy for Older, Frail Patients With Advanced Gastroesophageal Cancer

Patients who had advanced gastroesophageal cancer but were considered unsuitable for full-dose chemotherapy because of their advanced age and/or frailty “had an improved patient experience with no significant detriment in cancer control” when treated with reduced-intensity chemotherapy in the phase ...

skin cancer
immunotherapy

A Shift in the Treatment of Advanced Melanoma

Answers to questions about first-line treatment of metastatic melanoma are “going to be shifting,” Jason J. Luke, MD, told The ASCO Post, with the change coming on the heels of the phase III RELATIVITY-047 trial reported at the 2021 ASCO Annual Meeting.1 That abstract reported that using two...

skin cancer
immunotherapy

Responses to Pembrolizumab and Ipilimumab After Anti–PD-1/L1 Failure in Advanced Melanoma

Despite new and effective treatments for melanoma with checkpoint inhibitors and targeted therapies, patients with metastatic melanoma who progress on frontline treatment generally do very poorly. “We really need to make sure we give these patients access to drugs that we know have some efficacy,”...

colorectal cancer

Better Responses to Hepatic Arterial Infusion Therapy Among Patients With KRAS Wild-Type Metastatic Colorectal Cancer

Patients with colorectal cancer and unresectable liver metastases and KRAS wild-type disease experienced better responses to hepatic arterial infusion pump chemotherapy than did patients with KRAS mutations, a retrospective cohort study found. At a median follow-up of 14.6 months, “KRAS-positive...

global cancer care
covid-19

Global Responses to COVID-19 Pandemic–Related Disruptions in Cancer Care

COVID-19 pandemic–related disruptions in cancer diagnosis, treatment, and research have varied worldwide and so have the responses to those disruptions. During the Society of Surgical Oncology (SSO) 2021 International Conference on Surgical Cancer Care, members of the Global Forum of Cancer...

gastrointestinal cancer

Adjuvant Imatinib Therapy Offers Survival Benefit in Patients With Resected GIST, but Team Effort May Be Needed to Reduce Early Discontinuation Rates

Clinical trial data show that adjuvant imatinib improves recurrence-free survival as well as overall survival, when administered for at least 3 years, among patients who undergo a macroscopically complete resection of a primary gastrointestinal stromal tumor (GIST), Chandrajit P. Raut, MD, MSc,...

‘Radiation Is Not the Enemy’

“I want to make very clear that radiation is not the enemy,” Monika Metzger, MD, MSc, emphasized in discussing a study she led on the integration of brentuximab vedotin into the front-line treatment of pediatric patients with high-risk Hodgkin lymphoma. The study yielded excellent results while...

lymphoma

Adding Targeted Agent to Treatment Shows Significant Benefits in Pediatric Patients With High-Risk Hodgkin Lymphoma

Integrating the antibody-drug conjugate brentuximab vedotin into the front-line treatment of pediatric patients with high-risk Hodgkin lymphoma “facilitated significant reduction in radiation exposure and yielded excellent outcomes,” Monika Metzger, MD, MSc, Director for the Central and South...

hepatobiliary cancer
genomics/genetics

Actionable Mutations Identified in Majority of Genome-Sequenced Resected Cholangiocarcinomas

Tumor genomic profiling of resected cholangiocarcinomas may reveal mutations targetable with agents currently being used for other cancers, according to the results of a study presented at the Society of Surgical Oncology (SSO) 2021 International Conference on Surgical Cancer Care.1 Among patients...

skin cancer
immunotherapy

Study Finds Adjuvant Immunotherapy of Benefit to Patients With Stage IIB/C Melanoma

A significant survival advantage accrued to patients with stage IIB and IIC cutaneous melanoma who received adjuvant immunotherapy, a large retrospective cohort study reported at the Society of Surgical Oncology (SSO) 2021 International Conference on Surgical Cancer Care.1 The 3-year overall...

COVID-19 Pandemic Underscores Shortage of Oncologists

The expected surge of patients, some with advanced cancers, wanting and needing oncology care as the COVID-19 pandemic ebbs, underscores the need for more oncologists, according to Barbara L. McAneny, MD, MACP, FASCO, cofounder and Chief Executive Officer, New Mexico Oncology Hematology...

covid-19

Surge of Patients With Advanced Cancer Expected Due to Delayed Diagnosis and Treatment During Pandemic

Pent up demand for cancer screenings, diagnostic workups, and treatments delayed or curtailed since the start of the pandemic is expected to result in a surge of patients—some with more advanced disease as a result of delays—seeking appointments with oncologists. “We are starting to see the...

issues in oncology
genomics/genetics

Expanding Role of Liquid Biopsies in Cancer Detection and Therapeutics: Now and in the Near Future

“It is possible that within the next several years, perhaps 75% of cancers can be detected by screening,” Bert ­Vogelstein, MD, PhD, projected at the Society of Surgical Oncology (SSO) 2021 International Conference on Surgical Cancer Care.1 “I anticipate that perhaps 50% of cancers can be detected...

integrative oncology
cost of care

Clinician Recommendations May Pique Patients’ Interest in Complementary and Integrative Therapies

Patients with cancer expressed more interest in complementary and integrative medicine services when these services were recommended by an oncologist or other medical professional or were provided for free in a clinical trial, according to a survey reported in JCO Oncology Practice.1 The survey...

integrative oncology
cost of care

How Interested Are Patients in Integrative Therapies, and How Much Are They Willing to Pay for Them?

The top two barriers to accessing complementary and integrative therapies, according to a survey of 576 patients with cancer and caregivers, were cost, cited by 56%, and a lack of knowledge about the therapies, cited by 52.1%. “Other barriers included a lack of time (29.2%), location of the...

Expect Questions From Older Breast Cancer Survivors About Discontinuing Routine Surveillance Mammography

Consensus guidelines recommending that routine surveillance mammography be discontinued for older breast cancer survivors with a limited life expectancy1 may raise questions among patients concerned about undetected cancer recurrence. Informing older survivors about the new recommendations and the...

breast cancer

Older Breast Cancer Survivors May Consider Discontinuing Screening Mammography in the Setting of Limited Life Expectancy

Newly issued mammography screening guidelines for breast cancer survivors aged 75 and older recommend discontinuing routine mammography for those with a life expectancy of less than 5 years and considering discontinuation of routine screening for those with a life expectancy between 5 and 10 years. ...

survivorship
issues in oncology

When to Start a Conversation With Patients About Subsequent Primary Cancers

Among patients who survive a primary cancer, concern about recurrence, especially metastatic disease, is extremely common; however, information about future risk for subsequent primary cancers is seldom communicated to these patients, leading to missed opportunities to prevent or detect subsequent...

survivorship
issues in oncology

Ongoing Surveillance and Efforts to Reduce Smoking and Obesity Needed to Lower Cancer Survivors’ Risks of New Cancers

The risk of developing or dying of a new primary cancer, particularly those cancers associated with smoking and obesity, was greater among survivors of adult-onset cancers than the expected risk in the general population, according to an analysis of data from more than 1.5 million cancer...

Expect Questions About Adjuvant Chemotherapy for Older Women

Two recent studies found significant survival benefits for patients older than 70 years with surgically treated nonmetastatic triple-negative breast cancer who also received chemotherapy.1,2 The authors of both studies concluded that the findings support the consideration of chemotherapy for older...

breast cancer

Significant Survival Benefit From Chemotherapy for Older Women With Triple-Negative Breast Cancer

Women older than age 70 diagnosed with triple-negative breast cancer had significantly improved overall survival if they received adjuvant and/or neoadjuvant chemotherapy, according to an analysis of data from more than 16,000 women enrolled in the National Cancer Database. The estimated 5-year...

Strict Adherence to Algorithm Required

A prospective cohort study found sentinel lymph node biopsy had a 96% sensitivity rate and a 99% negative predictive value for detecting nodal metastasis among patients with clinical stage I low-grade and high-grade endometrial cancer.1 “Our study suggests that [sentinel lymph node biopsy] has...

gynecologic cancers

Study Shows Sentinel Lymph Node Biopsy to Be 'Viable Option' for Surgical Staging of Endometrial Cancer

Sentinel lymph node biopsy “had similar diagnostic accuracy and prognostic ability as lymphadenectomy in patients with high-grade endometrial cancer at greatest risk for nodal metastases,” according to the SENTOR trial, a prospective cohort study of 156 patients with clinical stage I disease. Using ...

skin cancer

Expect Questions About Mohs Micrographic Surgery

A recent study finding similar overall survival rates for patients with melanomas of the trunk and extremities treated with Mohs micrographic surgery or wide local excision1 raises questions about why and when physicians might recommend, and patients opt for, one or the other procedure. “The most...

skin cancer

Mohs Surgery vs Wide Local Excision for Trunk and Extremity Melanomas: Comparable Overall Survival Rates

A cohort study of 188,862 cases of all-stage melanomas of the trunk and extremities found no differences in overall survival between patients treated with Mohs micrographic surgery or with wide local excision.1 “These findings add to the existing body of evidence demonstrating that wide local...

breast cancer

Growing Interest in Antiandrogens to Treat Male Breast Cancer

“There has been a lot of interest in the development of new antiandrogens” for clinical use in patients with breast cancer,” Anthony D. Elias, MD, reported in an update on male breast cancer at the 2020 Lynn Sage Breast Cancer Symposium, sponsored by the Robert H. Lurie Comprehensive Cancer Center...

breast cancer

Recently Approved and Emerging Therapies for Triple-Negative Breast Cancer

“Triple-negative breast cancer has multiple different subtypes, and there are targeted therapies that can be used based on the biomarkers that we identify for each patient,” Kari B. Wisinski, MD, noted in a review of recently approved and emerging therapies at the 2020 Lynn Sage Breast Cancer...

breast cancer

Expect Questions About Increased Cancer Mortality Risk Among Patients Diagnosed With DCIS

A large cohort study1 finding that the risk of dying of breast cancer was increased threefold after a DCIS diagnosis may cause patients diagnosed with DCIS to ask what they can do to reduce that risk. Currently, there is little that most patients can do. “The lifetime risk of death following DCIS...

breast cancer

Focus on Preventing Invasive Recurrence in Women With DCIS Does Not Sufficiently Address Breast Cancer Mortality

A study published recently by Giannakeas et al looked at the risk of death from breast cancer for women diagnosed with ductal carcinoma in situ (DCIS).1 The investigators anticipated that treatment would eliminate the risk of invasive ipsilateral recurrence and prevent subsequent mortality from...

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...

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...

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