Both Patients and Clinicians Face Challenges in Recognizing and Reporting Immune-Related Adverse Events
The publication of ASCO’s toxicity management guidelines for immune checkpoint antibodies by Brahmer and colleagues,1 reviewed in this issue of The ASCO Post, has been long awaited, considering more than 15 distinct indications have been granted by the U.S. Food and Drug Administration (FDA). The ...
ASCO Clinical Practice Guideline on Managing Immune-Related Adverse Events: Next Big Step for Immune Checkpoint Inhibitors
The publication of the ASCO clinical practice guideline for the management of immune therapy–related adverse events—reviewed in this issue of The ASCO Post—represents an important next step in the incorporation of checkpoint blocking antibodies as standard cancer treatment modalities.1 The U.S....
ASCO Clinical Practice Guideline: Management of Immune-Related Adverse Events From Immune Checkpoint Inhibitor Therapy
As reported in the Journal of Clinical Oncology by Julie R. Brahmer, MD, of Johns Hopkins Kimmel Cancer Center, and colleagues, ASCO has released a clinical practice guideline on management of immune-related adverse events in patients receiving immune checkpoint inhibitor therapy.1 Immune...
The Pharmacist’s Role in Educating the Health-Care Team About Adverse Effects of Immune Checkpoint Inhibitors
Named by ASCO as Advance of the Year for both 2016 and 2017,1 and with more than 10 U.S. Food and Drug Administration–approved indications—and more on the way—it’s safe to say the era of cancer immunotherapy is upon us. To prepare, physicians must understand not only which patients will benefit,...
Rivaroxaban May Reduce Risk of Venous Thromboembolism in Patients With Cancer
Patients with cancer have an increased risk of developing blood clots, with roughly one in five experiencing venous thromboembolism (VTE)—either deep-vein thrombosis (DVT) or pulmonary embolism (PE). Although there are many causes and risk factors for VTE, patients with cancer are...
FDA Approves First Epoetin Alfa Biosimilar for the Treatment of Anemia
On May 15, the U.S. Food and Drug Administration (FDA) approved epoetin alfa-epbx (Retacrit) as a biosimilar to epoetin alfa (Epogen/Procrit) for the treatment of anemia caused by chronic kidney disease, chemotherapy, or use of zidovudine in patients with HIV infection. Epoetin alfa-epbx is also...
2018 ASCO: More Choices for Treating Insomnia in Cancer Survivors: Acupuncture and Cognitive Behavioral Therapy
A Patient-Centered Outcomes Research Institute (PCORI)-supported randomized clinical trial of cancer survivors showed that 8 weeks of either acupuncture or cognitive behavioral therapy for insomnia (CBT-I) decreased the severity of insomnia among cancer survivors, though improvements were greatest...
National Survey Examines Oncologists' Practices, Beliefs on Medical Marijuana Use
Data from a new survey show that as many as 80% of oncologists have discussed medical marijuana use with their patients. According to the authors, this is the first nationally representative survey to examine oncologists’ practices and beliefs on the subject since the implementation of state...
Planning for Potential Adverse Effects of Oral Chemotherapy
THE USE OF oral chemotherapy drugs is becoming more and more prevalent—for many types and stages of cancer, during different treatment phases, and for varying lengths of time. So it’s vital that physicians, nurses, and advanced practitioners understand all the potential adverse events of these...
NCCN Debuts Three New Sets of Guidelines
THE NATIONAL Comprehensive Cancer Network® (NCCN®) debuted three sets of completely new guidelines for treating patients with uveal melanoma, for treating patients who have cancer and the human immunodeficiency virus (HIV), and for managing immune-related toxicities. Cancer in People Living With...
Use of Indwelling Pleural Catheter for Outpatient Talc Administration in Treatment of Malignant Pleural Effusion
In a UK study reported in The New England Journal of Medicine, Bhatnagar et al found that outpatient talc vs placebo administration via indwelling pleural catheter was associated with a higher rate of pleurodesis in patients with malignant pleural effusion. Study Details In the study, a target of ...
Acupuncture for Joint Pain Associated With Aromatase Inhibition
Although aromatase inhibitors are highly effective as adjuvant therapy in metastatic breast cancer and for prevention of breast cancer, the side effects can be difficult to tolerate and often lead to discontinuation of therapy. A phase III randomized trial has found that acupuncture may relieve...
Study of Patient-Reported Symptom Burden in First Year After Cancer Diagnosis
In a Canadian retrospective population-based study reported in the Journal of Clinical Oncology, Bubis et al found that patients with cancer reported higher symptom scores at 1 month after diagnosis and identified several factors associated with higher symptom scores. Study Details The study...
Analysis of Carfilzomib-Related Cardiotoxicity
In a systematic review and meta-analysis reported in Leukemia & Lymphoma, Shah et al identified the risk of cardiotoxicity among patients, most with multiple myeloma, receiving carfilzomib (Kyprolis) in clinical trials. Study Details The study included data from 4,164 patients who received...
Dexamethasone-Sparing Antiemetic Regimen in Patients Receiving Highly Emetogenic Chemotherapy
In a Japanese phase III noninferiority trial reported in the Journal of Clinical Oncology, Ito et al found that dexamethasone could be spared on days 2 and 3 in an antiemetic regimen including the neurokinin-1 (NK1) receptor antagonist aprepitant and palonosetron in patients receiving highly...
Internet-Delivered Cognitive-Behavioral Therapy for Insomnia in Breast Cancer Survivors
In a Danish study reported in the Journal of the National Cancer Institute, Zachariae et al found that an Internet-delivered cognitive-behavioral therapy intervention improved insomnia among breast cancer survivors. Study Details In the study, 255 patients from a national sample of Danish breast...
Cognitive Decline Prevalent Among Elderly Patients With Hematologic Cancers
A sizable percentage of elderly patients with blood-related cancers such as leukemia and multiple myeloma are apt to show signs of diminished cognitive functioning—a decline that may impact their survival—a new study by investigators at Dana-Farber Cancer Institute and Brigham and...
GC4419 Receives FDA Breakthrough Therapy Designation for the Reduction of Severe Oral Mucositis
On February 28, the U.S. Food and Drug Administration (FDA) granted Breakthrough Therapy designation to GC4419, a highly selective and potent small molecule dismutase mimetic, for the reduction of the duration, incidence, and severity of severe oral mucositis induced by radiation therapy with...
Edoxaban vs Dalteparin in Cancer-Associated Venous Thromboembolism
In the phase III Hokusai VTE Cancer trial reported by Raskob et al in The New England Journal of Medicine, the direct-acting oral factor Xa inhibitor edoxaban proved noninferior to the low–molecular-weight heparin dalteparin in the composite outcome of recurrent venous thromboembolism or...
ASCO Clinical Practice Guideline: Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy
As reported in the Journal of Clinical Oncology by Julie R. Brahmer, MD, of the Johns Hopkins Kimmel Cancer Center, and colleagues, ASCO has released a clinical practice guideline on management of immune-related adverse events in patients receiving immune checkpoint inhibitor therapy. To develop...
EXPERT POINT OF VIEW: Robert Brodsky, MD
“THE RESULTS of these two trials are more similar than different. I think the best conclusion would be that we now have two trials with consistent results and can probably, in most cases, replace low–molecular-weight heparin with direct oral anticoagulants,” said Dr. Raskob, lead investigator of...
Use of Direct Oral Anticoagulants in Preventing VTE in Patients With Cancer
THE FIRST TWO randomized trials to directly compare direct oral anticoagulants vs low–molecular-weight heparin for management of venous thromboembolism (VTE) in patients with cancer suggest that direct oral anticoagulants may become the new standard of care.1,2 Direct oral anticoagulants appear to...
David Baraghoshi, on Colorectal Cancer and Cardiovascular Disease Risk
David Baraghoshi, of the Huntsman Cancer Institute at the University of Utah, discusses an assessment of cardiovascular risk more than 10 years after diagnosis for colorectal cancer survivors compared with a cancer-free general population cohort (Abstract 113).
ASCO and NCCN Provide Guidelines for Managing Immunotherapy Side Effects
Immunotherapy with immune checkpoint inhibitors is the first of a new generation of immunotherapy treatments, revolutionizing treatment for many different types of cancer. By unleashing the body's immune system to attack cancer, these treatments can send even the most hard-to-treat cancers into...
Safety Information on Rolapitant Injectable Emulsion
The Oncology Center of Excellence of the U.S. Food and Drug Administration (FDA) is informing health-care providers about new safety information for rolapitant (Varubi) injectable emulsion, a substance P/neurokinin (NK-1) receptor antagonist indicated for the prevention of delayed nausea and...
ASH 2017: Low–Molecular-Weight Heparin/Edoxaban vs Dalteparin for VTE Associated With Cancer
People with cancer face an increased risk for venous thromboembolism (VTE). Under current guidelines, cancer patients who develop VTE are prescribed low–molecular-weight heparin, an anticoagulant that must be injected under the skin daily for several months. While effective, this regimen can...
ASH 2017: Abatacept Nearly Eliminates Severe Acute GVHD After Hematopoietic Stem Cell Transplant
Results from a phase II clinical trial presented by Kean et al at the 59th American Society of Hematology (ASH) Annual Meeting (Abstract 212) show that the drug abatacept (Orencia) nearly eliminated life-threatening severe acute graft-versus-host disease (GVHD) in patients receiving hematopoietic...
Cognitive Behavior Therapy for Insomnia: Sleeping Well With Cancer and Beyond
The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies commonly used by patients with cancer. In this installment, Sheila N. Garland, PhD, R Psych, and Jun J. Mao, MD, MSCE, present...
FDA Approves Intravenous Rolapitant for Prevention of Delayed Chemotherapy-Induced Nausea and Vomiting
ON OCTOBER 25, the U.S. Food and Drug Administration (FDA) approved intravenous (IV) rolapitant (Varubi) in combination with other antiemetic agents in adults for the prevention of delayed nausea and vomiting associated with initial and repeat courses of emetogenic cancer chemotherapy, including...
Eric Roeland, MD, on Symptom Management: Expert Perspective
Eric Roeland, MD, of the University of California, San Diego, summarizes key papers delivered at the Palliative Care Symposium on managing insomnia, fatigue, nausea, and the ways in which physical therapy and nausea can reduce the side effect burden.
Early Study Suggests Potential Role of Paclitaxel in Peripheral Neuropathy and Possible Preventive Measures
In discovering how certain chemotherapy drugs cause peripheral neuropathy, researchers at Dana-Farber Cancer Institute have found a potential approach to preventing this common and troublesome side effect of cancer treatment. Their findings were published by Pease-Raissi et al in Neuron. The...
FDA Approves Intravenous Rolapitant for Delayed Chemotherapy-Induced Nausea and Vomiting
On October 25, the U.S. Food and Drug Administration (FDA) approved intravenous (IV) rolapitant (Varubi) in combination with other antiemetic agents in adults for the prevention of delayed nausea and vomiting associated with initial and repeat courses of emetogenic cancer chemotherapy, including,...
ASCO Clinical Practice Guideline Update on Antiemetics in Patients With Cancer
AS REPORTED BY Paul J. Hesketh, MD, of Lahey Hospital and Medical Center, Burlington, Massachusetts, and colleagues in the Journal of Clinical Oncology, ASCO has updated its clinical practice guideline on the use of antiemetics in patients with cancer.1 The update was based on an expert panel...
Cryotherapy for Preventing Chemotherapy-Induced Peripheral Neuropathy in Patients With Breast Cancer
A self-controlled clinical trial by Hanai et al investigating the efficacy of cryotherapy for the prevention of chemotherapy-induced peripheral neuropathy in patients with breast cancer treated with paclitaxel has found that cryotherapy resulted in a clinically and statistically significant...
Tibetan Yoga Practice May Improve Sleep Quality for Patients With Breast Cancer Undergoing Chemotherapy
Participating in twice-weekly practice of Tibetan yoga may reduce sleep disturbances and improve sleep quality in breast cancer patients receiving chemotherapy, according to a study published by Chaoul et al in Cancer. The study, led by researchers from The University of Texas MD Anderson Cancer...
Assessing and Managing CAR T-Cell Treatment Toxicities
Immune-cell based therapies opening a new frontier for cancer treatment carry unique, potentially lethal side effects that provide a new challenge for oncologists—one addressed by a team led by clinicians at The University of Texas MD Anderson Cancer Center with proposed guidelines for...
FDA Approves Betrixaban for Prophylaxis of Venous Thromboembolism
ON JUNE 23, 2017, the U.S. Food and Drug Administration (FDA) approved betrixaban (Bevyxxa) for the prophylaxis of venous thromboembolism in adult patients hospitalized for an acute medical illness who are at risk for thromboembolic complications due to moderate or severe restricted mobility and...
New ASCO Recommendations for Controlling Nausea and Vomiting Related to Cancer Treatment
AN UPDATE of the ASCO Clinical Practice Guideline covers new medicines for nausea and vomiting related to cancer treatment. The update, issued by Hesketh et al in the Journal of Clinical Oncology,1 provides new evidence-based information on the appropriate use of olanzapine, neurokinin 1 (NK1)...
Patients With Advanced Cancer Presenting to Emergency Departments With Delirium Likely to Die Earlier
According to a new study published by Elsayem et al in The Oncologist, patients with advanced cancer who are diagnosed with delirium when presenting to emergency departments are more likely to be hospitalized and more likely to die earlier than patients without delirium. This shows the importance...
FDA Expands Ibrutinib Indications to Chronic Graft-vs-Host Disease
On August 2, 2017, the U.S. Food and Drug Administration (FDA) approved ibrutinib (Imbruvica) for the treatment of adult patients with chronic graft-vs-host disease after failure of one or more lines of systemic therapy. This is the first FDA-approved therapy for the treatment of chronic...
Understanding and Managing Radiation-Induced Bystander Effect
More than half of patients with cancer undergo radiotherapy. Due to a phenomenon known as radiation-induced bystander effect, in which irradiated cells leak chemical signals that can travel some distance to damage unexposed healthy cells, many suffer side effects such as hair loss, fatigue, and...
NCCN Panelists Relay ‘What’s Hot’ in Their Fields
AT THE NATIONAL Comprehensive Cancer Network® (NCCN®) 22nd Annual Conference, experts from several fields met with journalists to highlight “what’s hot” in their specialties. The ASCO Post captured that conversation. Myeloproliferative Neoplasms Guidelines NCCN HAS LAUNCHED new NCCN Clinical...
Expert Point of View: Joshua Jones, MD
ASCO EXPERT Joshua Jones, MD, Assistant Professor of Radiation Oncology at the Hospital of the University of Pennsylvania, Philadelphia, commented on the study at a press briefing. “This is a case where less is more. This is an important study and the first to show equal outcomes and meaningful...
Radiation Therapy for Spinal Cord Compression: One Treatment Is Sufficient
SPINAL CORD COMPRESSION associated with metastatic cancer can be effectively treated with a single dose of radiotherapy, according to the results of a phase III British study that showed multiple radiotherapy doses to be no better than one treatment.1 Up to 10% of all patients with cancer will...
FDA Approves Betrixaban for the Prophylaxis of Venous Thromboembolism
On June 23, 2017, the U.S. Food and Drug Administration (FDA) approved betrixaban (Bevyxxa) for the prophylaxis of venous thromboembolism (VTE) in adult patients hospitalized for an acute medical illness who are at risk for thromboembolic complications due to moderate or severe restricted mobility...
Expert Point of View: Monika K. Krzyzanowska, MD, MPH
Formal discussant of the trial, Monika K. Krzyzanowska, MD, MPH, of the Princess Margaret Cancer Center in Toronto, Canada, commented on this trial assessing patient-reported outcomes for symptom monitoring. “This abstract is relevant to all of us, regardless of what cancers we treat or where we...
Online Self-Reporting of Symptoms Improves Quality of Life, Extends Survival
When patients with metastatic cancer used a Web-based tool to self-report symptoms proactively during treatment, they lived 5 months longer than did patients assigned to usual care. In addition, they had improved quality of life and fewer emergency room visits and hospitalizations compared with...
Lymphedema Risk: It’s Not Just About the Surgery
In a study from the Mayo Clinic, Rochester, Minnesota, the risk of lymphedema in a population-based breast cancer cohort was related to multimodality therapy and not axillary surgery alone, investigators reported at the American Society of Breast Surgeons (ASBrS) Annual Meeting.1 “Most patients...
ASCO 2017: Many Emergency Department Visits Among Patients With Cancer Appear Preventable
Among patients with cancer, as many as 53% of emergency department visits that do not require admission could be avoided with better symptom management and greater availability of outpatient care tailored to their needs, according to a new study from Fred Hutchinson Cancer...
ASCO 2017: Web-Based System for Self-Reporting Symptoms Helps Patients Live Longer
A randomized clinical trial of 766 patients shows that a simple intervention—a Web-based tool that enables patients to report their symptoms in real time, triggering alerts to clinicians—can have major benefits, including longer survival. Patients with metastatic cancer who used the...
