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supportive care
symptom management

Eric Roeland, MD, on Preventing Chemotherapy-Induced Vomiting

Eric Roeland, MD, of Massachusetts General Hospital, discusses the wide variation among physicians in preventing vomiting from highly emetogenic chemotherapy (Abstract 74).

immunotherapy
symptom management

Elizabeth Jane Cathcart-Rake, MD, on Immunotherapy-Related Toxicities: More Common Than Originally Reported?

Elizabeth Jane Cathcart-Rake, MD, of the Mayo Clinic, discusses the frequency of side effects from immunotherapy, the need to closely monitor those receiving this treatment, and the role of clinicians in educating their patients on toxicities (Abstract 184).

prostate cancer
symptom management

NCRI 2018: COMPARE Study: Side Effects and Quality of Life Associated With Prostate Cancer Care

Men who have been newly diagnosed with prostate cancer say they would trade some improvement in their odds of survival for improvements in side effects and quality of life, according to research presented by Ahmed et al at the 2018 National Cancer Research Institute (NCRI) Cancer Conference...

symptom management

Study Identifies Significant Risk Factors for Chemotherapy-Induced Febrile Neutropenia

New research by Family et al in JNCCN—Journal of the National Comprehensive Cancer Network identifies risk factors for chemotherapy-induced febrile neutropenia, a dangerously low white blood cell count that increases the risk of serious infection and fever. The study was led...

breast cancer
gynecologic cancer
lymphoma
pancreatic cancer
gastroesophageal cancer
bladder cancer
symptom management
gastrointestinal cancer

FDA Pipeline: What’s New in Biosimilars, Drug Reviews, Designations, and More

The U.S. Food and Drug Administration (FDA) recently issued the following new approvals and designations: Approval for Pegfilgrastim Biosimilar The FDA recently approved a pegfilgrastim biosimilar, pegfilgrastim-cbqv (Udenyca). The biosimilar has been approved to decrease the incidence...

palliative care
issues in oncology
symptom management

2018 Palliative Care: Can an AI-Based App Help Manage Cancer-Related Pain?

A study of 112 patients with metastatic solid tumors found that the use of an artificial intelligence (AI)-based smartphone app reduced both the severity of patients’ reported pain and hospital admissions. After an 8-week period, patients who used the AI-powered app to monitor and address...

issues in oncology
symptom management

2018 Palliative Care: Immunotherapy-Related Adverse Events May Be More Common Than Initially Reported

An analysis of nearly 2,800 patients with non­–small cell lung cancer (NSCLC) who received the immune checkpoint inhibitors nivolumab (Opdivo), pembrolizumab (Keytruda), or atezolizumab (Tecentriq) found that adverse events may be more common than reported in the initial trials that led...

leukemia
issues in oncology
symptom management

Effect of Early Cardiotoxicity on Outcomes in Pediatric AML

In an analysis from the Children’s Oncology Group AAML0531 trial reported in the Journal of Clinical Oncology, Getz et al found that early treatment-related cardiotoxicity may be associated with poorer event-free and overall survival in pediatric acute myeloid leukemia (AML). Study Details...

symptom management

Can Patients Use Topical Skin Creams During Radiation Therapy?

Contrary to the advice most patients with cancer receive when they go through radiation treatment, topical skin treatments, unless applied very heavily, may not increase the radiation dose to the skin and can be used in moderation before daily radiation treatments, according to findings from a new...

head and neck cancer
symptom management

Thomas Galloway, MD, on Oropharyngeal Cancer: Improving Outcomes and Reducing Toxicity

Thomas Galloway, MD, of Fox Chase Cancer Center, summarizes a session on head and neck cancer that included findings on reducing oral mucositis, improving quality of life with deintensified chemoradiotherapy, and the costs of dose de-escalation (Scientific Session 31).

issues in oncology
immunotherapy
symptom management

Caroline Robert, MD, PhD, on Immunotherapy Toxicities: Expert Perspective

Caroline Robert, MD, PhD, of Gustave Roussy Cancer Centre, discusses managing toxicities of immunotherapy, including neurotoxicity, and treating beyond acute adverse events.

skin cancer
symptom management

Paolo A. Ascierto, MD, on Melanoma: Acute and Chronic Toxicities

Paolo A. Ascierto, MD, of Istituto Nazionale Tumori–Fondazione Pascale, discusses the breakthroughs in melanoma treatment and the challenges of managing toxicities, especially endocrine and neurologic side effects, which can require lifetime hormone replacement and may cause permanent dysfunction.

issues in oncology
gastroesophageal cancer
symptom management

ESMO 2018: Pooled Analysis of Influence of Sex on Chemotherapy Efficacy and Toxicity in Esophagogastric Cancer

In an analysis presented by Davidson et al at the European Society for Medical Oncology (ESMO) 2018 Congress (Abstract 619PD_PR), data were pooled from four UK randomized controlled clinical trials of first-line chemotherapy in esophagogastric cancer, finding significant differences in a...

issues in oncology
symptom management

Small Study Shows Fecal Microbiota Transplantation May Help Restore Beneficial Bacteria in Patients With Cancer

Researchers have shown that autologous fecal microbiota transplantation may be a safe and effective way to help replenish beneficial gut bacteria in patients with cancer who require intense antibiotics during allogeneic hematopoietic stem cell transplantation. Their findings were published by Taur...

issues in oncology
symptom management
pain management

Angela M. Stover, PhD, on Patient-Reported Symptoms: Results From the STAR and PRO-TECT Trials

Angela M. Stover, PhD, of the University of North Carolina at Chapel Hill, discusses study findings on ways to alert clinicians when patients signal symptoms such as pain or diarrhea that may be cause for concern (Abstract 158).

symptom management

Use of Patient-Reported Outcomes Version of CTCAE in Rectal Cancer Trial

As reported in the Journal of Clinical Oncology, Basch et al established the feasibility of using the National Cancer Institute patient-reported outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) in the setting of a multicenter clinical trial in locally advanced...

symptom management

Addition of Hydroxycarbamide to Aspirin in Essential Thrombocythemia Without High-Risk Features

In a long-term follow-up of a study reported in the Journal of Clinical Oncology, Godfrey et al found that the addition of cytoreductive therapy with hydroxycarbamide to aspirin did not improve outcomes in patients with essential thrombocythemia aged 40 to 59 years without high-risk features or...

leukemia
symptom management

Study Finds Hispanic Pediatric Patients at Increased Risk of Methotrexate Neurotoxicity During Treatment for ALL

Case studies have reported a high prevalence of methotrexate subacute neurotoxicity among Hispanic adolescents with acute lymphoblastic leukemia (ALL), suggesting sensitivity to methotrexate therapy may differ by race and ethnicity. Now, a prospective study in pediatric patients with ALL has found...

symptom management

ASCO/IDSA Clinical Practice Guideline Update: Antimicrobial Prophylaxis for Adult Patients With Cancer-Related Immunosuppression

As reported in the Journal of Clinical Oncology by Randy A. Taplitz, MD, of UC San Diego Health, and colleagues, ASCO and the Infectious Diseases Society of America (IDSA) have updated their joint guideline on antimicrobial prophylaxis for adult patients with immunosuppression associated with...

Symptom Management

Actively Recruiting Clinical Trials Focused on Neurotoxicities of Treatment

The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies focused on neurotoxicities of cancer treatment. These studies focus on the effects of chemotherapy on cognitive function, changes in resting state brain networks after stem cell...

Supportive Care
Symptom Management

Lack of Congruence Among Tools Used to Assess Cancer-Related Cognitive Dysfunction

THE ASSESSMENT of cognitive dysfunction in patients who have undergone chemotherapy is complex, and although a number of strategies are available, each has its limitations, according to Karin Olson, RN, PhD, Professor in the Faculty of Nursing at the University of Alberta, Edmonton, Canada.  At...

Symptom Management
Head and Neck Cancer

Expert Point of View: Rajesh Lalla, DDS, PhD

COMMENTING ON the results of this trial of GC4419, Rajesh V. Lalla, DDS, PhD, President of the Multinational Association of Supportive Care in Cancer, said, “This study demonstrated this agent’s strong potential for the management of oral mucositis in patients receiving head and neck radiation...

Symptom Management
Head and Neck Cancer

Novel Therapy Reduces Duration of Chemoradiotherapy-Induced Mucositis in Patients With Head and Neck Cancer

GC4419, A SMALL molecule superoxide dismutase mimetic, reduced the duration, incidence, and severity of chemoradiotherapy-induced mucositis in patients with locally advanced head and neck cancer, with a safety profile comparable to that of placebo. This finding comes from a randomized phase IIb...

symptom management

FDA Approves Lusutrombopag for Thrombocytopenia in Adults With Chronic Liver Disease

Today, the U.S. Food and Drug Administration (FDA) approved lusutrombopag (Mulpleta) for thrombocytopenia in adults with chronic liver disease who are scheduled to undergo a medical or dental procedure. L-PLUS 1 and L-PLUS 2 Approval was based on two randomized, double-blind, placebo-controlled...

symptom management
immunotherapy

Susan Blumel, RN, BSN, and Laura J. Zitella, MS, RN, ACNP-BC, AOCN, on Managing Toxicities of Immunotherapy

Susan Blumel, RN, BSN, of the University of Nebraska Medical Center, and Laura J. Zitella, MS, RN, ACNP-BC, AOCN, of Stanford Health Center, discuss immunotherapy, CAR T-cell toxicities, and the principles of team management.

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...

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