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Symptom Management

Update to FDA Prescribing Information for Romiplostim for Adults With Immune Thrombocytopenia

On October 18, the U.S. Food and Drug Administration (FDA) approved a supplemental biologics license application (sBLA) for romiplostim (Nplate) to include new data in its U.S. prescribing information showing sustained platelet responses in adults with immune thrombocytopenia. The updated...

Lymphoma
Symptom Management

FDA Pipeline: Designations for Acute Graft-vs-Host Disease, Peripheral T-Cell Lymphoma

Recently, the U.S. Food and Drug Administration (FDA) granted Fast Track designation to a therapy for steroid-refractory acute graft-vs-host disease and granted Orphan Drug designation to a therapy for peripheral T-cell lymphoma. Fast Track Designation for T-Guard in Steroid-Refractory Acute...

Symptom Management

Romiplostim for Patients With Chemotherapy-Induced Thrombocytopenia

In a single-center phase II study reported in the Journal of Clinical Oncology, Soff et al found that treatment with romiplostim was effective in rapidly correcting chemotherapy-induced thrombocytopenia, with maintenance treatment being effective in reducing risk of recurrent chemotherapy-induced...

Symptom Management

International Guidelines for Treatment and Prophylaxis of VTE in Patients With Cancer

The 2019 International Initiative on Thrombosis and Cancer (ITAC) has issued updated clinical practice guidelines for the treatment and prophylaxis of venous thromboembolism (VTE) in patients with cancer. They were published by Farge et al in The Lancet Oncology. The guidelines consist of...

Head and Neck Cancer
Symptom Management

ASTRO 2019: Machine-Learning Model May Accurately Predict Radiation Side Effects in Patients With Head and Neck Cancers

A study by Reddy et al investigating the use of a machine-learning model to predict which patients with head and neck cancer being treated with radiation may experience significant weight loss, feeding tube placement, and unplanned hospitalization has found that the model accurately identified the...

Breast Cancer
Survivorship
Symptom Management

Home-Based Exercise and Weight Loss Programs for Lymphedema Management in Overweight Breast Cancer Survivors

As reported in JAMA Oncology by Schmitz et al, the WISER Survivor trial showed no benefit of home-based exercise and weight loss programs on lymphedema outcomes vs facility-based lymphedema care among overweight breast cancer survivors. Study Details In the trial, 351 overweight breast cancer...

symptom management

Angela M. Stover, PhD, on Patient-Reported Outcome Performance Measures for Oncology Practice

Angela M. Stover, PhD, of the University of North Carolina at Chapel Hill, discusses ASCO’s initiative to develop patient-based performance measures for assessing and managing symptoms. The measures have made substantial differences in reducing nausea, constipation, and insomnia (Abstract 173).

Symptom Management
Pain Management

2019 Quality Care: Improving Documentation of Pain and Constipation Assessment and Management

In a study reported at the ASCO Quality Care Symposium and simultaneously published in the Journal of Oncology Practice, Chineke et al found that a Quality Oncology Practice Initiative (QOPI) initiated in collaboration with ASCO at the Georgia Cancer Center for Excellence (GCCE) at Grady Health...

Symptom Management

ASCO and MASCC/ISOO Release a Clinical Practice Guideline on Medication-Related Osteonecrosis of the Jaw

ASCO and the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) have published a clinical practice guideline on medication-related osteonecrosis of the jaw in the Journal of Clinical Oncology.1 The guideline outlines the latest recommendations ...

Supportive Care
Symptom Management

Study Explores Efficacy of Lower-Dose Olanzapine in Combination With Standard Antiemetic Regimen

Olanzapine at a 5-mg dose, when combined with aprepitant, palonosetron, and dexamethasone, significantly reduced the risk of delayed nausea and vomiting in patients receiving cisplatin-based chemotherapy, according to new research. The study investigators believe this approach may be considered a...

Supportive Care
Symptom Management

Virtual Reality May Improve Pain, Vision, Functioning in Patients With Cancer

Virtual reality can be used to improve functioning in patients with cancer, according to David Rhew, MD, Chief Medical Officer, Vice President and General Manager of Enterprise Healthcare, Samsung Electronics America. Research has shown that this technology can decrease pain and improve vision, as...

skin cancer
symptom management

Risk of Cardiovascular Adverse Events in Patients With Melanoma Treated With Combined BRAF and MEK Inhibition vs BRAF Inhibition Alone

In a meta-analysis reported in JAMA Network Open, Mincu et al found that the risk of some types of cardiovascular adverse events was higher with combined BRAF and MEK inhibitor treatment vs BRAF inhibitor monotherapy in patients with melanoma. The meta-analysis included 2,317 patients in five...

Immunotherapy
Symptom Management

Anti–PD-1/PD-L1 Rechallenge After Immune-Related Adverse Events

In a study reported in JAMA Oncology, Olivier Lambotte, MD, PhD, found that rechallenge with an immune checkpoint inhibitor after occurrence of immune-related adverse events was associated with occurrence of an immune-related adverse event in approximately half of patients, with no increase in...

Symptom Management
Supportive Care

Novel Therapeutics on the Horizon for Treating Chemotherapy-Induced Peripheral Neuropathy

Chemotherapy-induced peripheral neuropathy is a major clinical problem, and better therapies are needed for both its treatment and prevention. According to Charles Loprinzi, MD, a medical oncologist at the Mayo Clinic in Rochester, Minnesota, to devise better preventive and treatment approaches,...

symptom management
immunotherapy

What Causes Liver Injury During Treatment With Pembrolizumab?

Immunotherapy as a treatment for advanced solid cancers has rapidly evolved over the past decade—often yielding remarkable results. However, its use has also given way to new adverse effects, including drug-induced gastrointestinal and liver toxicities. “Checkpoint inhibitors are a...

breast cancer
symptom management

Neoadjuvant Chemotherapy Duration and Obesity May Be Associated With Increased Risk of Lymphedema in Some Women With Breast Cancer

In a cohort study reported in JAMA Surgery, Armer et al found that longer duration of neoadjuvant chemotherapy and increasing body mass index (BMI) were associated with increased risk of lymphedema in women with node-positive breast cancer who received neoadjuvant chemotherapy and axillary...

breast cancer
symptom management

Metabolic Changes May Signal Development of Chemotherapy-Associated Cardiotoxicity

To learn more about the processes that lead to chemotherapy-associated cardiotoxicity, a team of researchers at Beth Israel Deaconess Medical Center (BIDMC) conducted a study to investigate whether early changes in energy-related metabolites in the blood—measured shortly after...

issues in oncology
symptom management
immunotherapy

Immune Checkpoint Inhibitor Rechallenge After Immune-Related Adverse Events

In a study reported in JAMA Oncology, Simonaggio et al found that rechallenge with an immune checkpoint inhibitor after occurrence of immune-related adverse events was associated with occurrence of an immune-related adverse event in approximately half of patients, with no increase in severity....

colorectal cancer
symptom management

ESMO World GI 2019: REARRANGE Trial Examines Flexible Regorafenib Dosing in Refractory Metastatic Colorectal Cancer

Regorafenib is often administered to patients with refractory metastatic colorectal cancer. However, some of the adverse events related to the use of this drug often limit its use in clinical practice. A study reported by Argilés et al at the European Society for Medical Oncology (ESMO)...

symptom management
immunotherapy

Treatment of Immune Checkpoint Inhibitor Immune-Related Cutaneous Adverse Events

In a study reported in the Journal of Clinical Oncology, Phillips et al found that immune-related cutaneous adverse events in patients receiving immune checkpoint inhibitors generally responded to symptom- and phenotype-directed dermatologic therapies, and that biologic therapies were effective in...

symptom management
immunotherapy

Multidisciplinary Approach for Addressing Immunotherapy-Related Toxicities

New research published in JNCCN—Journal of the National Comprehensive Cancer Network and presented by Jarushka Naidoo, MBBCh, at the NCCN 2019 Annual Conference suggests that institutions and networks that utilize immunotherapy should consider establishing multidisciplinary teams for...

symptom management
immunotherapy

Resuming Immune Checkpoint Inhibitor Therapy After Immune-Mediated Diarrhea and Colitis

In a retrospective multicenter study reported in the Journal of Clinical Oncology, Abu-Sbeih et al found that approximately one-third of patients resuming immune checkpoint inhibitor therapy after improvement in immune-mediated diarrhea and colitis experienced a recurrence of the adverse effect....

issues in oncology
symptom management

Clinical Outcomes of Incidental Pulmonary Embolism in Patients With Cancer

In an international prospective cohort study reported in the Journal of Clinical Oncology, Kraaijpoel et al found that incidental pulmonary embolism in patients with cancer is associated with substantial risk of recurrent venous thromboembolism, despite anticoagulant treatment. Study Details The...

symptom management

FDA Approves Ruxolitinib for Acute Graft-vs-Host Disease

On May 24, the U.S. Food and Drug Administration (FDA) approved ruxolitinib (Jakafi) for steroid-refractory acute graft-vs-host disease (GVHD) in adult and pediatric patients 12 years and older. REACH1/Study INCB 18424-271 Approval was based on the REACH1 trial/Study INCB 18424-271, an...

cns cancers
symptom management

Treatment-Related Ototoxicity and Reading Impairment in Pediatric Patients With Embryonal Brain Tumors

In a study reported in the Journal of Clinical Oncology, Olivier et al found that pediatric patients with severe sensorineural hearing loss associated with the treatment of embryonal brain tumors experienced greater reading difficulties over time. The study involved data from 260 children and...

symptom management

FDA Approves Dalteparin Sodium for VTE in Pediatric Patients

On May 16, 2019, the U.S. Food and Drug Administration (FDA) approved dalteparin sodium (Fragmin) to reduce the recurrence of symptomatic venous thromboembolism (VTE) in pediatric patients 1 month of age and older. This is the first FDA-approved therapy to treat VTE in pediatric patients....

symptom management
immunotherapy

Treatment-Related Adverse Events With PD-1/PD-L1 Inhibitors in Clinical Trials

In a systematic review and meta-analysis reported in JAMA Oncology, Wang et al characterized treatment-related adverse event profiles associated with monotherapy use of programmed cell death protein 1 (PD-1) and programmed cell death ligand 1 (PD-L1) inhibitors in clinical trials. Study Details...

breast cancer
symptom management

ASBrS 2019: Bioimpedance Spectroscopy for Surveillance of Breast Cancer–Related Lymphedema

Surveillance of women at risk for breast cancer–related lymphedema using bioimpedance spectroscopy was more effective in preventing lymphedema progression than traditional arm circumference measurement when each was combined with immediate compression therapy. These were the results of an...

breast cancer
prostate cancer
symptom management

ESTRO 38: REQUITE Project Finds Predictive Biomarkers for Late Radiotherapy Toxicity

The latest results from the REQUITE project, which aimed to discover what makes patients more likely to experience adverse effects after radiotherapy, have shown that a combination of biologic markers and certain genetic changes can predict radiation sensitivity. In addition, the international team ...

issues in oncology
cost of care
symptom management

Emergency Department Visits for Treatment-Related Complications of Systemic Therapy and Radiotherapy

In a study reported in JAMA Oncology, Jairam et al found that emergency department visits for complications of systemic therapy or radiotherapy in patients with cancer increased at a 5.5-fold higher rate over 10 years compared with overall emergency department visits. Study Details The study...

symptom management

New Biomarkers Associated With Cancer-Related Cognitive Impairment Identified

Cognitive impairment associated with cancer—also known as “chemobrain”—has gained recognition as a complication of the disease and its treatment. With this in mind, a research team started to investigate levels of biomarkers in relation to chemobrain to better understand its ...

symptom management

ASCO and ASH Release Update to Clinical Practice Guidelines for Use of Erythropoiesis-Stimulating Agents

ASCO and the American Society of Hematology (ASH) have released an update to existing guidelines for the use of erythropoiesis-stimulating agents to manage anemia in patients with cancer. The update was simultaneously published in the Journal of Clinical Oncology and Blood Advances. “The...

symptom management

'Oral Cryotherapy' for Patients Undergoing Oxaliplatin-Based Chemotherapy

A study by Bauman et al in JNCCN—Journal of the National Comprehensive Cancer Network found that patients who kept ice chips in their mouths—what the study authors called “oral cryotherapy”—during oxaliplatin infusions reported less trouble with eating and...

skin cancer
myelodysplastic syndromes
symptom management

FDA Pipeline: Designation in Uveal Melanoma, Application for MDS Side-Effect Management

Over the past week, the U.S. Food and Drug Administration (FDA) granted a Fast Track designation to a treatment for metastatic uveal melanoma and received a biologics application for an agent to control anemia. Fast Track Designation for Tebentafusp in Metastatic Uveal Melanoma The FDA granted...

issues in oncology
symptom management

Differences in Medical Cannabis Use in Patients With and Without Cancer

People with and without cancer are more likely, over time, to use a more potent form of medical marijuana with increasingly higher amounts of tetrahydrocannabinol (THC), a new study published by Kim et al in the Journal of Palliative Medicine has shown. “Although there is growing...

head and neck cancer
symptom management

AACR 2019: Effect of Timing of Radiotherapy on Mucositis in Patients With Head and Neck Cancer

New research presented by Gu et al at the American Association for Cancer Research (AACR) Annual Meeting 2019 found that administering radiation treatments in the morning as opposed to later in the day may significantly reduce the severity of mucositis and its related impacts (Abstract 4860).  ...

symptom management

Effect of Medical Cannabis on Symptom Control in Patients With Cancer

As reported in the Journal of Oncology Practice by Anderson et al, a study of patients enrolled in Minnesota’s Medical Cannabis Program showed that the use of medical cannabis was associated with improvement in reported symptoms in patients with cancer. The study involved data on 1,120...

lung cancer
symptom management

Mark K. Ferguson, MD, on Mitigating Frailty and Sarcopenia to Improve Treatment Outcomes

Mark K. Ferguson, MD, of the University of Chicago Hospital, discusses frailty and loss of muscle tissue, which are common among patients with lung cancer. These conditions are linked with decreased survival as well as increased surgical complications, chemotherapy toxicity, and cost of care.

breast cancer
gynecologic cancer
hematologic malignancies
leukemia
lymphoma
symptom management

FDA Pipeline: Updates on Treatments for Cervical Cancer, Myelofibrosis, Chemotherapy-Induced Nausea and Vomiting, and More

The FDA recently issued announcements on a Fast Track designation, a Priority Review, two supplemental new drug applications, an investigational new drug application, and a marketing clearance. The agency also released a safety communication on cancer-related surgery. Fast Track Designation for...

breast cancer
survivorship
symptom management

Can Cognitive Behavioral Therapy Improve Treatment-Induced Menopausal Symptoms in Survivors of Breast Cancer?

In a Dutch study reported in the Journal of Clinical Oncology, Atema et al found that an Internet-based cognitive behavioral therapy (iCBT) intervention improved treatment-induced menopausal symptoms in breast cancer survivors compared with a waiting list control group. In the study, 254 women...

Head and Neck Cancer
Immunotherapy
Symptom Management

Immunotherapy for Head and Neck Cancer Expands, but Concerns Persist About Patient Selection and Toxicities

SOME PATIENTS with advanced head and neck cancer may achieve durable responses with immunotherapy, and recent trial results suggest first-line immunotherapy may increase survival among patients with recurrent or metastatic disease. However, concerns remain about selecting patients most likely to...

prostate cancer
symptom management

Patient-Reported Outcomes With Enzalutamide in PROSPER Trial

As reported by Tombal et al in The Lancet Oncology, treatment with enzalutamide was associated with clinically meaningful delays in pain progression, symptom worsening, and deterioration in functional status vs placebo in the phase III PROSPER trial in nonmetastatic, castration-resistant prostate...

prostate cancer
symptom management

Silke Gillessen, MD, on Prostate Cancer: Results From the REDUSE Trial on Denosumab

Silke Gillessen, MD, of Cantonal Hospital St. Gallen, discusses data from a phase III study on the incidence of hypocalcemia in patients with castration-resistant prostate cancer treated with denosumab. The trial was designed to assess prevention of symptomatic skeletal events with denosumab administered every 4 weeks vs every 12 weeks (Abstract 139).

sarcoma
issues in oncology
symptom management

Gastric Acid Suppressants May Reduce Survival Outcomes in Patients With Sarcoma Treated With Pazopanib

It is estimated that 20% to 33% of patients undergoing cancer treatment are concomitantly using a gastric acid suppressant, most commonly a proton pump inhibitor (including omeprazole and esomeprazole magnesium) or a histamine H2-receptor blocker (such as ranitidine). A study by Mir et al...

survivorship
symptom management

Late-Onset Cardiotoxicity in Pediatric Cancer Survivors: Comparison of Regimens

In a study reported in JAMA Oncology, Feijen et al found that daunorubicin was associated with decreased cardiomyopathy risk vs doxorubicin among pediatric cancer survivors, with epirubicin being approximately isoequivalent to doxorubicin. Risk associated with the anthraquinone mitoxantrone was...

solid tumors
lymphoma
pancreatic cancer
symptom management

FDA Pipeline: Treatments for Tenosynovial Giant Cell Tumor and Pancreatic Cancer, Plus a Statement on Breast Implant–Associated Lymphoma

The U.S. Food and Drug Administration (FDA) recently granted the following designations and applications and also issued a statement: Priority Review for Pexidartinib in Tenosynovial Giant Cell Tumor The FDA has accepted a new drug application (NDA) and granted Priority Review for pexidartinib...

supportive care
symptom management

FDA Approves Caplacizumab-yhdp for Acquired Thrombotic Thrombocytopenic Purpura

Today, the U.S. Food and Drug Administration approved caplacizumab-yhdp (Cablivi) injection, the first therapy specifically indicated, in combination with plasma exchange and immunosuppressive therapy, for the treatment of adult patients with acquired thrombotic thrombocytopenic purpura (aTTP), a...

hematologic malignancies
symptom management

Letter to the Editor: Survey on DOACs in Cancer-Related Venous Thromboembolism

This letter is a follow-up to a report published previously in The ASCO Post. Recent trials report comparable or improved efficacy of direct-acting oral coagulants (DOACs) over low–molecular-weight heparins (LMWH) in the treatment of cancer-related VTE (cVTE) at the expense of increased...

Symptom Management
Issues in Oncology

Primary Prophylaxis With a Direct Oral Anticoagulation Agent Reduces Venous Thromboembolism Rate in Ambulatory Patients With Cancer

LATE-BREAKING results from the large, randomized, placebo-controlled CASSINI trial showed that primary prophylaxis with the direct oral anticoagulation agent rivaroxaban reduced the incidence of venous thromboembolism (VTE) as well as VTE-related deaths in high-risk patients with cancer who were...

Breast Cancer
Symptom Management

Expert Point of View: C. Kent Osborne, MD

COMMENTING ON the ACCRU study SC-1603, press conference moderator C. Kent Osborne, MD, Director of the Dan L Duncan Comprehensive Cancer Center at Baylor College of Medicine in Houston and Co-Director of the San Antonio Breast Cancer Symposium, said: “In patients who have breast cancer, I usually...

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