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breast cancer
symptom management

C-Reactive Protein and Radiotherapy Skin Toxicity in Patients With Breast Cancer

In a study reported in the Journal of Clinical Oncology, Hu et al found that higher postradiotherapy levels of the inflammatory marker high-sensitivity C-reactive protein (hsCRP) were associated with an increased risk of early grade 4+ skin toxicity in patients with breast cancer. Study Details...

symptom management
immunotherapy

Delayed Skin Effects of Anti–PD-1 Therapy

Patients with cancer receiving anti–programmed cell death protein 1 (anti–PD-1) therapies who develop lesions, eczema, psoriasis, or other forms of autoimmune diseases affecting the skin may experience those adverse reactions on a delay—sometimes even after treatment has...

symptom management

FDA Approves Filgrastim Biosimilar Filgrastim-aafi

On July 20, the U.S. Food and Drug Administration (FDA) approved filgrastim-aafi (Nivestym), a biosimilar to filgrastim (Neupogen), for all eligible indications of the reference product. “The FDA approval of filgrastim-aafi marks an important step in helping expand access to critical...

symptom management

Rivaroxaban vs Dalteparin in Patients With Venous Thromboembolism

In a UK pilot trial (SELECT-D) reported in the Journal of Clinical Oncology, Young et al found that the oral factor Xa inhibitor rivaroxaban was associated with a lower rate of recurrent venous thromboembolism (VTE) but a higher rate of clinically relevant nonmajor bleeding compared with the...

Lung Cancer
Symptom Management
CNS Cancers

Quick Takes From Original Research Presented at the 2018 NCCN Annual Conference

THE QUANTITY of original research presented at the National Comprehensive Cancer Network® (NCCN®) Annual Conference has been growing, and at the 2018 meeting, 121 researchers presented their work. The ASCO Post captured some of the findings for this report.  Blood Markers Correlate With Anti–PD-1...

Breast Cancer
Symptom Management

Early Detection and Intervention Reduce Breast Cancer–Related Lymphedema

A NEW STUDY has found that early detection along with a simple intervention can be highly effective in preventing breast cancer–related lymphedema for at-risk women. According to data presented at the 2018 Annual Meeting of the American Society of Breast Surgeons,1 82% of women identified at an...

symptom management

FDA Approves First Biosimilar to Pegfilgrastim to Help Reduce the Risk of Infection During Myelosuppressive Chemotherapy

On June 4, the U.S. Food and Drug Administration (FDA) approved pegfilgrastim-jmdb (Fulphila) as the first biosimilar to pegfilgrastim (Neulasta) to decrease the chance of infection as suggested by febrile neutropenia in patients with nonmyeloid cancer who are receiving myelosuppressive...

survivorship
integrative oncology
symptom management

Jun J. Mao, MD, MSCE, on Insomnia in Cancer Survivors: Trial Results

Jun J. Mao, MD, MSCE, of Memorial Sloan Kettering Cancer Center, discusses study findings on the effect of acupuncture vs cognitive behavior therapy in cancer survivors experiencing insomnia (Abstract 10001).

symptom management

Ryan D. Nipp, MD, on Electronic Symptom Monitoring: Trial Results

Ryan D. Nipp, MD, of Massachusetts General Hospital, discusses study findings on electronic symptom monitoring vs usual care to assess whether the intervention, tested in hospitalized patients with advanced cancer, can improve symptom burden and reduce the risk of readmission (Abstract 10005).

lung cancer
symptom management
immunotherapy

Safety of PD-1/PD-L1 Inhibitors in Patients With NSCLC and Preexisting Autoimmune Disorders

In a study reported in the Journal of Clinical Oncology, Leonardi et al found that programmed cell death protein 1 (PD-1)/programmed cell death ligand 1 (PD-L1) inhibitor monotherapy in patients with non–small cell lung cancer (NSCLC) and autoimmune disorders worsened such disorders in a...

Symptom Management
Survivorship
Integrative Oncology

Treating Insomnia in Cancer Survivors

A Patient-Centered Outcomes Research Institute–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 among...

Symptom Management

FDA Approves First Epoetin Alfa Biosimilar for the Treatment of Anemia

On May 15, 2018, 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. The biosimilar is...

Symptom Management
Immunotherapy

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 ...

Symptom Management
Immunotherapy

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....

Symptom Management
Immunotherapy

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...

Symptom Management

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,...

symptom management

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...

symptom management

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...

survivorship
symptom management

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...

issues in oncology
symptom management

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...

Symptom Management

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...

Solid Tumors
Issues in Oncology
Symptom Management

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...

symptom management

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 ...

Symptom Management
Supportive Care
Solid Tumors
Breast Cancer

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...

issues in oncology
symptom management

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...

multiple myeloma
symptom management

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...

symptom management

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...

breast cancer
survivorship
symptom management

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...

hematologic malignancies
symptom management

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...

symptom management

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...

symptom management

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...

symptom management
immunotherapy

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...

Hematologic Malignancies
Symptom Management

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...

Hematologic Malignancies
Symptom Management

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...

colorectal cancer
survivorship
symptom management

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).

supportive care
symptom management
immunotherapy

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...

symptom management

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...

hematologic malignancies
symptom management

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...

hematologic malignancies
symptom management

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...

Integrative Oncology
Symptom Management

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...

Symptom Management

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...

palliative care
symptom management

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.

symptom management

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...

symptom management

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,...

Symptom Management

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...

breast cancer
symptom management

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...

supportive care
symptom management

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...

issues in oncology
symptom management

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...

Symptom Management

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...

Symptom Management

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)...

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