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Symptom Management

Toxicity Outcomes With Stereotactic Ablative Radiotherapy for Patients With Up to Five Oligometastases

As reported in JAMA Oncology by Olson et al, the primary toxicity results of the phase II SABR-5 trial have shown a low rate of toxic effects with stereotactic ablative radiotherapy (SABR) for patients with up to five oligometastases. As stated by the investigators: “After the publication of the...

symptom management
issues in oncology

Dawn L. Hershman, MD, on Prophylactic Colony Stimulating Factors for Neutropenia: Improving Clinicians’ Prescribing Practices

Dawn L. Hershman, MD, of Columbia University College of Physicians and Surgeons, discusses findings that showed substantial variability in clinicians’ adherence to prescribing primary prophylactic colony stimulating factors in a pragmatic trial. Although the ability to opt out of the intervention is a feature of pragmatic trials, careful prestudy planning to estimate nonadherence is critical to ensure adequate power to detect an effect. Understanding reasons for intervention opt-outs may also inform future pragmatic studies aimed at improving adherence to practice guidelines.

Supportive Care
Symptom Management

FDA Approves Sodium Thiosulfate to Reduce the Risk of Ototoxicity Associated With Cisplatin

On September 20, the U.S. Food and Drug Administration (FDA) approved sodium thiosulfate (Pedmark) to reduce the risk of ototoxicity associated with cisplatin in pediatric patients aged 1 month and older with localized (nonmetastatic) solid tumors. Efficacy was evaluated in two multicenter,...

Immunotherapy
Symptom Management

Association of Neurofilament Light Chain Levels With ICANS Risk After CAR T-Cell Therapy

In a retrospective study reported in JAMA Oncology, Butt et al found significantly higher pretreatment neurofilament light chain levels in patients who did vs did not develop immune effector cell–associated neurotoxicity syndrome (ICANS) after CD19 chimeric antigen receptor (CAR) T-cell therapy....

Symptom Management

FDA Approves Eflapegrastim-xnst Injection for Chemotherapy-Induced Neutropenia

On September 9, the U.S. Food and Drug Administration (FDA) approved eflapegrastim-xnst injection (Rolvedon)—a long-acting granulocyte colony-stimulating factor (G-CSF) with a novel formulation—to decrease the incidence of infection, as manifested by febrile neutropenia, in adult patients with...

Breast Cancer
Symptom Management

Postmarketing Colitis Cases May Be Associated With Alpelisib Use

In a research letter in JAMA Oncology, Sullivan et al described details of postmarketing cases of noninfectious colitis in patients with breast cancer reported to the U.S. Food and Drug Administration that were considered possibly or probably related to alpelisib treatment. Key Findings A total of...

Myelodysplastic Syndromes
Symptom Management

Luspatercept for Anemia in Patients With Lower-Risk Myelodysplastic Syndromes: Long-Term Follow-up

In a long-term follow-up of the German phase II PACE-MDS trial reported in the Journal of Clinical Oncology, Uwe Platzbecker, MD, and colleagues described erythroid, neutrophil, and platelet hematologic improvement rates with luspatercept treatment for anemia in patients with lower-risk...

Symptom Management
Supportive Care

FDA Approves Ibrutinib for Pediatric Patients With Chronic Graft-vs-Host Disease

On August 24, the U.S. Food and Drug Administration (FDA) approved ibrutinib (Imbruvica) for pediatric patients aged at least 1 year with chronic graft-vs-host disease after failure of one or more lines of systemic therapy. Formulations include capsules, tablets, and oral suspension. iMAGINE Trial...

Immunotherapy
Symptom Management
Multiple Myeloma

Postmarketing Ocular Toxicity in U.S. Adults Treated With Daratumumab

In an analysis reported in a research letter in JAMA Oncology, Nguyen et al identified postmarketing cases of ocular toxicity in patients receiving daratumumab in the United States. Daratumumab is a CD38-directed monoclonal antibody that was initially approved in 2015 for the treatment of multiple...

Hematologic Malignancies
Symptom Management

Momelotinib for Symptomatic and Anemic Patients With Myelofibrosis

Once-daily treatment with the oral JAK1/2 and ACVR1/ALK2 inhibitor momelotinib significantly improved outcomes of patients treated for myelofibrosis. Ruben Mesa, MD, FACP, and colleagues presented results of the MOMENTUM phase III randomized study, which evaluated momelotinib vs danazol in...

Immunotherapy
Symptom Management

Incidence of Major Adverse Cardiac Events in Patients Receiving Immune Checkpoint Inhibitors

In a study presented at the 2022 ASCO Annual Meeting (Abstract 2508) and simultaneously reported in the Journal of Clinical Oncology, Naqash et al identified the incidence of major adverse cardiac events among patients receiving immune checkpoint inhibitors for cancer as captured in the serious...

Symptom Management

Weekly Electronic Reporting of Symptoms Improved Outcomes in Patients With Advanced Cancer

People with advanced cancer who communicated their symptoms weekly using an electronic survey had about one-third better physical function and over a 15% better control of their symptoms compared to those who were evaluated less frequently via in-person clinical visits, according to findings from a ...

supportive care
symptom management

Sriram Yennu, MD, on Cancer-Related Fatigue: Is Open-Labeled Placebo an Effective Treatment?

Sriram Yennu, MD, of The University of Texas MD Anderson Cancer Center, discusses the placebo response in patients with advanced cancer and cancer-related fatigue. His latest findings show that open-labeled placebo was efficacious in reducing cancer-related fatigue and improving quality of life in fatigued patients with advanced cancer at the end of 1 week. The improvement in fatigue was maintained for 4 weeks (Abstract 12006).

Prostate Cancer
Symptom Management

Adverse Events Seen With Abiraterone or Enzalutamide Among Patients With Advanced Prostate Cancer

Men taking either of the two most common oral medications for advanced prostate cancer who had also undergone hormone therapy to treat their disease were at higher risk of serious metabolic or cardiovascular issues than patients who were receiving hormone therapy alone, according to findings...

Hematologic Malignancies
Symptom Management

Narsoplimab for Hematopoietic Stem Cell Transplantation–Associated Thrombotic Microangiopathy

In a pivotal phase II trial reported in the Journal of Clinical Oncology, Samer K. Khaled, MD, and colleagues found that narsoplimab, an inhibitor of mannan-binding lectin-associated serine protease-2, showed efficacy in the treatment of adult patients with hematopoietic stem cell...

Symptom Management

AI Model May Help Predict Adverse Events From New Drug Combinations

Preliminary data from an artificial intelligence (AI) model could potentially predict side effects resulting from new combination therapies, according to results presented by Küçükosmanoğlu et al at the American Association for Cancer Research (AACR) Annual Meeting 2022 (Abstract 6312). “Clinicians ...

Symptom Management

Concordance in Symptomatic Adverse Event Reporting by Children, Clinicians, and Caregivers

In a study reported in the Journal of Clinical Oncology, David R. Freyer, DO, MS, and colleagues found that clinicians consistently undergraded—and caregivers frequently overgraded—the severity of adverse events experienced by children with cancer. Study Details The study included 438...

Lymphoma
Immunotherapy
Symptom Management

Early Intrathecal Therapy for High-Grade ICANS in Patients Receiving CAR T-Cell Therapy

In a single-institution retrospective review reported in JAMA Oncology, Zurko et al found that early intrathecal therapy with hydrocortisone with or without intrathecal chemotherapy was effective in treating grade ≥ 3 immune effector cell–associated neurotoxicity syndrome (ICANS) in patients...

Gynecologic Cancers
Symptom Management

Web-Based Intervention to Manage Symptoms and Quality of Life in Women With Recurrent Ovarian Cancer

In an NRG Oncology/GOG study (GOG-0259) reported in the Journal of Clinical Oncology, Donovan et al found that both nurse-led (Nurse-WRITE) and self-directed (SD-WRITE) Web-based symptom self-management interventions (WRITE Symptoms) improved symptom control vs enhanced usual care alone in women...

Supportive Care
Symptom Management
Immunotherapy

Differences in Risk of Severe Adverse Events in Women vs Men Receiving Immunotherapy, Targeted Therapy, or Chemotherapy in Cancer Clinical Trials

In a study reported in the Journal of Clinical Oncology, Joseph M. Unger, PhD, and colleagues found that women in clinical trials of chemotherapy, immunotherapy, or targeted therapy had a significantly greater risk for severe adverse events overall—and, particularly, with immunotherapy. As stated...

Supportive Care
Symptom Management

Study Finds Direct Oral Anticoagulants Significantly Decrease Recurrent Venous Thrombosis for Adult Patients With Cancer

Direct oral anticoagulants should be considered the standard of care to treat adult patients with cancer-associated thrombosis, according to a new, ongoing study by Mayo Clinic researchers published by Riaz et al in Mayo Clinic Proceedings. The report examined the results of four randomized...

CNS Cancers
Supportive Care
Symptom Management

Does Armodafinil Improve Cancer-Related Fatigue in Patients With High-Grade Glioma?

In a phase III trial reported in JAMA Oncology, Porter et al found that armodafinil, a psychostimulant, did not improve cancer-related fatigue vs placebo in adult patients with high-grade glioma. As stated by the investigators, “Nearly 96% of patients with high-grade glioma report...

Breast Cancer
Supportive Care
Symptom Management

Study Examines Rates of Lymphedema in Black and White Patients With Breast Cancer

Black women had a 3.85-fold increased risk of developing lymphedema following treatment for breast cancer compared to White women, according to the results from a study by Barrio et al being presented at the 2021 San Antonio Breast Cancer Symposium (Abstract GS4-01). In addition, the researchers...

Symptom Management
Supportive Care

Fosnetupitant vs Fosaprepitant for Prevention of Chemotherapy-Induced Nausea and Vomiting

In a Japanese phase III noninferiority trial (CONSOLE) reported in the Journal of Clinical Oncology, Hata et al found that fosnetupitant was noninferior to fosaprepitant in preventing nausea and vomiting in patients receiving highly emetogenic chemotherapy (both in combination with palonosetron and ...

Symptom Management

Digital Symptom Monitoring System May Improve Patients’ Symptom Control and Physical Function During Cancer Therapy

A digital symptom monitoring system in which patients undergoing cancer treatment could report symptoms through weekly at-home surveys resulted in better symptom control and physical function, as well as improved communication with their medical team, according to results from a study by Basch et...

breast cancer
immunotherapy
symptom management

Youssef Zeidan, MD, PhD, on HER2-Positive Breast Cancer: Treatment-Related Cardiotoxicity

Youssef Zeidan, MD, PhD, of Florida International University and the Lynn Cancer Institute, discusses the advances in radiotherapy planning and delivery that have reduced cardiac radiation exposure in patients with HER2-positive breast cancer who are treated with radiotherapy and trastuzumab (Abstract 12).

Symptom Management

Ruxolitinib for Chronic Graft-vs-Host Disease After Failure of Systemic Therapy

On September 22, 2021, ruxolitinib, a tyrosine kinase inhibitor of JAK1 and JAK2 was granted approval for treatment of chronic graft-vs-host disease after failure of one or two lines of systemic therapy in adult and pediatric patients aged ≥ 12 years.1 Supporting Efficacy Data Approval was...

Issues in Oncology
Symptom Management

Pharmacovigilance Study of Pancytopenia in Patients Receiving PARP Inhibitors

In a study reported in a research letter in JAMA Oncology, Morice et al found that pancytopenia was associated with use of poly (ADP-ribose) polymerase (PARP) inhibitors for cancer treatment, according to drug adverse event reports in the World Health Organization global pharmacovigilance database...

Geriatric Oncology
Symptom Management

Effect of Geriatric Assessment–Driven Intervention on Incidence of Severe Chemotherapy-Related Toxicity in Older Patients With Cancer

In a single-center study reported in JAMA Oncology, Daneng Li, MD, and colleagues found that a geriatric assessment–driven intervention (GAIN) was associated with a reduced incidence of grade ≥ 3 adverse events and a higher frequency of completion of advance directives vs standard of care among...

Hematologic Malignancies
Symptom Management

Ruxolitinib Granted FDA Approval for Chronic Graft-vs-Host Disease

On September 22, the U.S. Food and Drug Administration approved ruxolitinib (Jakafi), a JAK inhibitor, for the treatment of chronic graft-vs-host disease (GVHD) after failure of one or two lines of systemic therapy in adult and pediatric patients aged 12 years and older. REACH3 Efficacy was...

Immunotherapy
Symptom Management

Technology-Enabled Monitoring of Adverse Reactions to Immune Checkpoint Inhibitors

In an interim analysis of a single-institution study reported in JAMA Network Open, Pavlos Msaouel, MD, PhD, and colleagues found that the use of a mobile device application for patient reporting of adverse reactions to immune checkpoint inhibition was feasible. It permitted identification of...

Breast Cancer
Symptom Management

Pharmacologic Cardioprotection in Women With Nonmetastatic Breast Cancer Receiving Anthracycline-Based Chemotherapy

In an interim analysis of the Italian phase III SAFE trial reported in JAMA Oncology, Livi et al found that a cardioprotective strategy using ramipril and/or bisoprolol reduced the risk of myocardial dysfunction in women with nonmetastatic breast cancer receiving anthracycline-based chemotherapy....

Hematologic Malignancies
Symptom Management

Belumosudil for Chronic Graft-vs-Host Disease

On July 16, 2021, belumosudil, an inhibitor of Rho-associated coiled-coil kinase 2, was approved for the treatment of adult and pediatric patients 12 years and older with chronic graft-vs-host disease after the failure of at least two prior lines of systemic therapy.1 Supporting Efficacy Data...

Hematologic Malignancies
Head and Neck Cancer
Gynecologic Cancers
Immunotherapy
Symptom Management

FDA Pipeline: Reviews for Agents in Acute Graft-vs-Host Disease, Nasopharyngeal and Ovarian Cancers

Recently, the U.S. Food and Drug Administration (FDA) granted Priority Review to an agent for the prevention of acute graft-vs-host disease; Breakthrough Therapy designation to an anti–PD-1 monoclonal antibody for the treatment of metastatic nasopharyngeal carcinoma; and Fast Track designation to a ...

Symptom Management

Wearable Temperature Sensor May Aid in Detecting Febrile Adverse Events in Patients With Cancer

A simple, wearable temperature sensor was able to detect dangerous complications in hospitalized patients with cancer hours earlier than routine monitoring. The device, which takes readings every 2 minutes and wirelessly transmits them to the cloud, was able to quickly detect adverse events that...

Hematologic Malignancies
Symptom Management

Ruxolitinib for Glucocorticoid-Refractory or -Dependent Chronic Graft-vs-Host Disease After Allogeneic Stem Cell Transplantation

In the phase III REACH3 trial, reported in The New England Journal of Medicine, Robert Zeiser, MD, and colleagues found that ruxolitinib produced a significantly higher overall response rate vs investigator-selected control treatments in patients with glucocorticoid-refractory or -dependent chronic ...

Breast Cancer
Symptom Management

Survivors of Early-Stage Breast Cancer Face Broad Range of Symptoms and Concerns

Patients with early-stage breast cancer may be at low risk of dying of their disease, but they experience a high burden of physical and psychological symptoms long after their treatment has ended, according to data presented during the 2021 American Society of Breast Surgeons Annual Meeting.1...

Breast Cancer
Symptom Management
Pain Management

Study Examines Aromatase Inhibitor–Associated Musculoskeletal Symptoms in a Diverse Population With Early Breast Cancer

A clinical trial in a racially diverse group of postmenopausal women with early breast cancer to study severe pain in the bones, muscles, ligaments, tendons, and nerves caused by aromatase inhibitor treatment has found that the symptoms were more commonly reported in Black and Asian patients than...

Hematologic Malignancies
Symptom Management

Third-Party BK Virus–Specific Cytotoxic T-Lymphocyte Therapy for BK Virus–Associated Hemorrhagic Cystitis After Stem Cell Transplant

In a single-institution phase II trial reported in the Journal of Clinical Oncology, Olson et al found that high rates of response were achieved with third-party BK virus–specific cytotoxic T-lymphocyte therapy (BKV-CTL) in patients with BK virus–associated hemorrhagic cystitis after allogeneic...

Symptom Management

TLR4 as a Possible Therapeutic Target to Mitigate Cisplatin-Induced Hearing Loss

A research team has identified a receptor in cells that could play a role in preventing permanent hearing loss in childhood cancer survivors treated with the drug cisplatin. The researchers believe that by inhibiting the receptor, they may be able to better control otoxicity, according to findings...

Breast Cancer
Immunotherapy
Symptom Management

Incidence of Interstitial Lung Disease Related to Trastuzumab Deruxtecan-nxki in Patients With HER2-Positive Metastatic Breast Cancer

Drug-related interstitial lung disease occurred in less than 16% of patients with HER2-positive metastatic breast cancer following treatment with trastuzumab deruxtecan-nxki (T-DXd) at the approved dose of 5.4 mg/kg. In addition, the majority of these cases were classified as grade 1 or 2,...

Supportive Care
Symptom Management

Effect of Oral Chemotherapy Management Program on Capecitabine Toxicity

In a health system retrospective study reported in JCO Oncology Practice, Nhean et al found that implementation of an oral chemotherapy management program was associated with reduced rates of any-grade and severe capecitabine toxicity, less frequent toxicity-related emergency department visits and...

Hematologic Malignancies
Immunotherapy
Symptom Management

Antiviral T Cells for BK Virus–Associated Hemorrhagic Cystitis

A phase II trial has found found that BK virus (BKV)-specific T cells from healthy donors were safe and effective as an off-the-shelf therapy for BKV-associated hemorrhagic cystitis, a painful complication that is common after allogeneic stem cell transplants for patients with leukemia or lymphoma. ...

Lung Cancer
Symptom Management

Contralateral Esophagus-Sparing Radiotherapy Technique Reduces Rates of Esophagitis in Patients With Lung Cancer Receiving High-Dose Chemoradiation

In a small, single-institution phase I trial reported in JAMA Oncology, Kamran et al found that the use of a contralateral esophagus-sparing radiotherapy technique in patients receiving high-dose chemoradiation for locally advanced lung cancer was associated with no cases of grade ≥ 3 esophagitis,...

Hematologic Malignancies
Symptom Management

ROCK2 Inhibitor Belumosudil for Chronic Graft-vs-Host Disease

In a phase IIa study reported in the Journal of Clinical Oncology, Jagasia et al found that the oral ROCK2 inhibitor belumosudil produced high response rates and reduced corticosteroid use among patients with chronic graft-vs-host disease after allogeneic bone marrow or hematopoietic cell...

Skin Cancer
Immunotherapy
Symptom Management

Adverse Events in Patients With Melanoma Treated With Ipilimumab: Results of a Toxicity Monitoring Program

In a single-institution study reported in JCO Oncology Practice, Menjak et al found that a nurse-led telephone surveillance program for toxicity associated with ipilimumab in patients with metastatic melanoma led to earlier identification of toxicities and earlier intervention, with an apparent...

Breast Cancer
Symptom Management

Low-Dose Tamoxifen for Reduction of Mammographic Density in Women Undergoing Breast Cancer Screening

In the Swedish phase II KARISMA study reported in the Journal of Clinical Oncology, Eriksson et al found noninferior mammographic density reduction and reduced vasomotor symptoms following tamoxifen therapy at 2.5, 5, and 10 mg vs the standard dose of 20 mg among women undergoing breast cancer...

gynecologic cancers
symptom management

Supriya Chopra, MD, on Cervical Cancer: Reducing Late Effects of Bowel Toxicity

Supriya Chopra, MD, of Tata Memorial Centre, discusses a final analysis of the phase III PARCER trial, which showed that image-guided intensity-modulated radiotherapy is superior to conventional radiotherapy in reducing bowel toxicity in women with cervical cancer. Acute diarrhea was also reduced, with no difference in disease-related outcomes (ID# 10224).

gynecologic cancers
survivorship
symptom management

Lauren Thomaier, MD, on Predicting Chemotherapy-Induced Peripheral Neuropathy in Gynecologic Cancer Survivors

Lauren Thomaier, MD, of the University of Minnesota, discusses the genetic variants found to be associated with an increase in chemotherapy-induced neuropathy symptoms in a cohort of gynecologic cancer survivors. Combining these variants with clinical characteristics may provide an important treatment tool (ID# 10253).

Hematologic Malignancies
Supportive Care
Symptom Management

Ruxolitinib Improves Outcomes in Steroid-Refractory or Steroid-Dependent Graft-vs-Host Disease

Ruxolitinib was superior to best available therapy in achieving efficacy as determined by best overall response and duration of response, with acceptable safety in adolescents and adults with steroid-dependent or steroid-refractory chronic graft-vs-host disease effects. These findings were shown in ...

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