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...
Peter Hoskin, MD, on Spinal Compression: Results From the SCORAD III Trial
Peter Hoskin, MD, of Mount Vernon Cancer Centre, discusses study findings on single-dose radiotherapy compared with multifraction radiotherapy in patients with metastatic spinal canal compression. (Abstract LBA10004)
ASCO 2017: Remote Therapy Program Improves Quality of Life, Lowers Distress After Cancer Diagnosis
Most patients experience significant distress after they are diagnosed with cancer. This distress not only erodes quality of life, but can also negatively affect the course of the disease and the patient’s ability to tolerate treatment. Yet few patients with cancer receive psychological...
ASCO 2017: Single-Dose Radiotherapy as Effective as Multiple Fractions in Relieving Symptoms of Spinal Cord Compression
Spinal cord compression is a common complication in people with metastatic cancer and is a major detriment to quality of life. Radiation treatment is widely used to relieve pain and other symptoms, but there is no standard recommended schedule, and approaches currently vary. Findings from a phase...
OPTIMIZE-2 Trial Offers Reassuring Data on Deescalation of Bisphosphonate Therapy for Breast Cancer–Related Bone Metastases
Bisphosphonates were first synthesized more than a century ago, with their initial usage restricted to a range of industrial processes until their potential clinical relevance was appreciated in the late 1960s.1 Then, following development for the treatment of osteoporosis and Paget’s disease of...
Zoledronic Acid Every 12 Weeks Noninferior to Every 4 Weeks in Skeletal-Related Event Rate for Breast Cancer With Bone Metastases
In the phase III OPTIMIZE-2 trial reported in JAMA Oncology, Gabriel N. Hortobagyi, MD, of The University of Texas MD Anderson Cancer Center, and colleagues found that an every-12-week schedule of zoledronic acid was noninferior to an every-4-week schedule with regard to skeletal-related event...
Update to Guideline for Management of Fever and Neutropenia in Children With Cancer and HSCT Recipients
An update to the 2012 International Pediatric Fever and Neutropenia Guideline Panel recommendations for management of fever and neutropenia in children with cancer and hematopoietic stem cell transplantation (HSCT) recipients was reported by Lehrnbecher et al in the Journal of Clinical Oncology....
Saving My Hair Changed My Perception of Having Cancer
Getting a callback after a routine screening mammogram in 2013 did not set off any alarm bells. Having dense breasts has almost guaranteed receiving the dreaded callback ever since I started getting annual screenings. But when I got a second callback after additional images of a suspicious lesion...
Joint Position Statement on Management of Aromatase Inhibitor–Associated Bone Loss in Postmenopausal Women With Hormone-Sensitive Breast Cancer
A new position statement, jointly published by seven international and European organizations, identifies fracture-related risk factors in patients treated with aromatase inhibitors and outlines key management strategies to help prevent bone loss and related fractures. It was published by Hadji et...
Utilizing Physiatrists to Evaluate and Manage Cancer-Related Cognitive Impairment
Chemotherapy-associated cognitive dysfunction, often referred to as “chemobrain” or “chemofog,” is a common occurrence during active cancer treatment and may continue after treatment is completed. However, since treatment other than chemotherapy, including radiation therapy, surgery, and hormonal...
FDA Removes Risk Evaluation and Mitigation Strategy Requirements for Erythropoiesis-Stimulating Agents
On April 13, the U.S. Food and Drug Administration (FDA) removed the risk evaluation and mitigation strategy (REMS) requirements for the use of epoetin alfa and darbepoetin alfa to treat patients with anemia due to associated myelosuppressive chemotherapy. The Agency's announcement regarding...
Preclinical Research Suggests Potential Therapy for 'Chemobrain'
Findings offered by a University of Kansas (KU) researcher at the national meeting of the American Chemical Society in early April suggest a possible therapeutic intervention for “chemobrain,” the cognitive impairment that plagues up to a third of cancer patients following chemotherapy. ...
Acupuncture for the Management of Hot Flashes
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, authors Jun J. Mao, MD, MSCE, and Jyothirmai Gubili, MS, present a case study...
Expert Point of View: Ann H. Partridge MD, MPH
Ann H. Partridge MD, MPH, Director of Adult Cancer Survivorship Program at the Dana-Farber Cancer Institute, praised the “tremendous work” of Dr. Paskett and her colleagues but referred to the findings as “disappointing to say the least.”1 “Developing interventions to prevent or treat lymphedema...
Search Continues for Effective Way to Prevent Lymphedema in Breast Cancer Survivors
There was no difference in the incidence of lymphedema at 18 months in breast cancer patients randomized to a physical therapy intervention with education materials compared with a control.1 Although poor adherence to the intervention may have been a factor, these results, described as “very...
Dexamethasone Mouthwash in Preventing Everolimus-Related Stomatitis in Women With Breast Cancer
In the phase II SWISH study reported in The Lancet Oncology, Rugo et al found that use of a dexamethasone-based mouthwash may prevent everolimus-related stomatitis in postmenopausal women receiving everolimus (Afinitor) for hormone receptor–positive, HER2-negative metastatic breast cancer....
