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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...

hematologic malignancies
cost of care

New Report Demonstrates Cost of Blood Cancer Care

The costs to treat blood cancer are higher than costs for other cancers, and the costs incurred by a patient diagnosed with a blood cancer do not return to precancer levels, according to a Milliman study commissioned by The Leukemia & Lymphoma Society (LLS). The study—The...

Cost of Cancer Care in Community vs Hospital Settings

In a study reported in the Journal of Oncology Practice, Gordan et al found that costs of care for patients with breast, colorectal, and lung cancers were significantly higher at hospital-based vs community-based clinics, largely reflecting higher costs of chemotherapy and provider visits. Study...

Dysregulation of Immune Pathways in AML Relapse After Allogeneic HSCT

In a study reported in The New England Journal of Medicine, Christopher et al found that acute myeloid leukemia (AML) relapse after allogeneic hematopoietic stem cell transplantation (HSCT) was accompanied by dysregulation of immune pathways, including downregulation of major histocompatibility...

Durvalumab With or Without Tremelimumab in Recurrent or Metastatic HNSCC With Low/No PD-L1 Expression

In a randomized phase II trial reported in JAMA Oncology, Siu et al found that the combination of the programmed cell death ligand 1 (PD-L1) inhibitor durvalumab (Imfinzi) plus the cytotoxic T-lymphocyte–associated protein 4 (CTLA-4) inhibitor tremelimumab and durvalumab alone showed evidence ...

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...

Transcription Factors TP63 and SOX2 in Squamous Cell Carcinoma Progression

Squamous cell carcinomas (SCCs) are malignancies arising from squamous epithelium of various organs, such as esophagus, head and neck, lung, and skin.  Previous studies demonstrated that two master transcription factors, TP63 and SOX2, effect genomic activation in SCCs. Now, researchers from...

PERSIST-5: 5-Year Adjuvant Imatinib in Resected Intermediate- or High-Risk Primary Gastrointestinal Stromal Tumor

In the phase II PERSIST-5 study reported in JAMA Oncology, Raut et al found that 5 years of adjuvant imatinib therapy was associated with little risk of recurrence in patients with resected intermediate- or high-risk primary gastrointestinal stromal tumor (GIST). As noted by the investigators, 3...

Patient-Reported Cosmetic Outcomes With Radiotherapy in Early Breast Cancer

As reported in the Journal of Clinical Oncology by Shaitelman et al, 3-year outcomes of a phase III noninferiority trial indicate that hypofractionated whole-breast irradiation (HF-WBI) followed by a tumor bed boost is not inferior to conventionally fractionated whole-breast irradiation (CF-WBI)...

Molecular and Clinical Heterogeneity in Histologically Diagnosed CNS-PNET

As reported by Hwang et al in the Journal of Clinical Oncology, subsequent molecular profiling of histologically diagnosed central nervous system supratentorial primitive neuroectodermal tumors (CNS-PNET) in patients showed molecular and clinical heterogeneity that strongly affected prognosis. The ...

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...

Overall Survival After Minimally Invasive Radical Hysterectomy for Early-Stage Cervical Cancer

In a cohort study reported in The New England Journal of Medicine, Melamed et al found that minimally invasive radical hysterectomy was associated with poorer overall survival compared with open radical hysterectomy in women with early-stage cervical cancer. Study Details The study involved...

Prevalence of Lynch Syndrome in Solid Tumors According to Microsatellite Instability Status

In a study reported in the Journal of Clinical Oncology, Latham et al found that microsatellite instability (MSI) and/or mismatch repair deficiency (MMR-D) is predictive of Lynch syndrome across a greater than heretofore recognized breadth of the solid tumor spectrum. As noted by the...

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...

FDA Approves Pembrolizumab for Hepatocellular Carcinoma Previously Treated With a Kinase Inhibitor

On November 9, 2018, the U.S. Food and Drug Administration (FDA) granted accelerated approval to pembrolizumab (Keytruda) for patients with hepatocellular carcinoma who have been previously treated with the kinase inhibitor sorafenib. KEYNOTE-224 Approval was based on KEYNOTE-224, a single-arm,...

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...

Final Analysis of SWOG POEMS: Goserelin and Chemotherapy in Breast Cancer

Final results of SWOG Cancer Research Network’s international Prevention of Early Menopause Study (POEMS) showed continued evidence that women who get injections of the hormone drug goserelin along with standard breast cancer chemotherapy are more likely to become pregnant, without developing ...

Trifluridine/Tipiracil in Heavily Pretreated Metastatic Gastric Cancer

In the phase III TAGS trial reported in The Lancet Oncology, Shitara et al found that trifluridine/tipiracil (Lonsurf) significantly improved overall survival vs placebo in patients with heavily pretreated metastatic gastric cancer. In the double-blind trial, 507 patients with nonresectable...

Surveillance Imaging Modality and Survival After Recurrence in Favorable-Histology Wilms Tumor

Findings in a study reported by Mullen and colleagues for the Children’s Oncology Group in the Journal of Clinical Oncology suggest that routine computed tomography (CT) surveillance may not be necessary for recurrence detection in favorable-histology Wilms tumor. The study was a...

Increased Survival in Patients With Metastatic NSCLC Receiving Treatment in Academic vs Community Centers

Patients with metastatic non­–small cell lung cancer (NSCLC) receiving treatment at academic centers have an increased 2-year survival compared to patients treated at community-based centers, according to findings published by Ramalingam et al in the Journal of Thoracic Oncology. An...

Progression-Free Survival and Health-Related Quality of Life in Randomized Clinical Trials

A review and analysis of randomized clinical trials published by Kovic et al in JAMA Internal Medicine questioned whether interventions that prolong progression-free survival (PFS) in patients with cancer improve their health-related quality of life (HRQoL). The systematic review and quantitative...

Five-Year Risk of Cervical Precancer With p16/Ki67 Dual-Stain or Cytology Triage in HPV-Positive Women

In a study reported in JAMA Oncology, Clarke et al found that triage with p16/Ki-67 dual-stain testing (DS) was associated with better risk stratification for cervical precancer than Papanicolaou cytology testing over 5 years among human papilloma virus (HPV)–positive women. Study Details...

Activity of Vemurafenib in BRAF V600–Mutant Gliomas

In a multicohort study (VE-BASKET study) in patients with BRAF V600–mutant nonmelanoma cancers in the Journal of Clinical Oncology, Kaley et al found evidence of activity of vemurafenib (Zelboraf) in gliomas that appeared to vary by glioma subtype.   Study Details In the study, 24...

Incidental Germline Mutations in Patients With Advanced Solid Tumors Identified by Cell-Free Circulating Tumor DNA Testing

In a study reported in the Journal of Clinical Oncology, Slavin et al determined the prevalence of a set of germline cancer predisposition gene mutations incidentally identified by cell-free circulating tumor DNA (cfDNA) testing in patients with advanced solid tumors. Study Details The study...

Combining Genetic and Sun Exposure Data May Improve Prediction of Skin Cancer Risk

By combining data on individuals’ lifetime sun exposure and their genetics, researchers may be able to generate improved predictions of their risk of skin cancer, according to findings presented by Fontanillas et al at the 2018 American Society of Human Genetics Annual Meeting (Abstract PgmNr ...

lymphoma
immunotherapy

Combination of Macrophage Immune Checkpoint Inhibitor and Rituximab in Non-Hodgkin Lymphoma

In a phase Ib study reported in The New England Journal of Medicine, Advani et al found that the combination of rituximab (Rituxan) and the CD47-blocking monoclonal antibody Hu5F9-G4 (or 5F9), a macrophage immune checkpoint inhibitor, was active in patients with non-Hodgkin lymphoma. CD47, which is ...

Pre- and Postdiagnosis Diet and Risk of Mortality in Colorectal Cancer

In a study reported in the Journal of Clinical Oncology, Guinter et al found that better prediagnosis and postdiagnosis dietary patterns were associated with improved overall and colorectal cancer­–specific survival among patients diagnosed with colorectal cancer. Study Details The...

FDA Approves Elotuzumab Plus Pomalidomide and Dexamethasone for Relapsed or Refractory Multiple Myeloma

On November 6, the U.S. Food and Drug Administration (FDA) approved elotuzumab (Empliciti) injection for intravenous use in combination with pomalidomide (Pomalyst) and dexamethasone for the treatment of adult patients with multiple myeloma who have received at least two prior therapies,...

bladder cancer
immunotherapy

PURE-01 Trial: Neoadjuvant Immunotherapy in Muscle-Invasive Bladder Carcinoma

In the Italian phase II PURE-01 trial reported in the Journal of Clinical Oncology, Necchi et al found that neoadjuvant pembrolizumab (Keytruda) before radical cystectomy in muscle-invasive bladder carcinoma produced complete pathologic response (pT0) in 42% of patients, with pT0 being more common...

ASCO Submits Comment Letters to the FDA on Modernizing Clinical Trials

ASCO recently submitted two comment letters from ASCO President Monica M. Bertagnolli, MD, FACS, FASCO, to the U.S. Food and Drug Administration (FDA) Commissioner Scott Gottlieb, MD, related to the modernization of clinical trials. The first letter provided the FDA with comments on...

issues in oncology
cost of care

Findings From the National Cancer Opinion Survey: Alternative Therapies, Cost of Care, and More

Nearly 4 in 10 Americans believe cancer can be cured solely through alternative therapies, according to ASCO's second annual National Cancer Opinion Survey. This is despite research showing that patients who use alternative therapies instead of standard cancer treatments have much higher...

breast cancer
survivorship

Whole-Genome Sequencing May Help Identify Young Childhood Cancer Survivors at High Risk for Breast Cancer

Female survivors of childhood cancer, especially those treated with chest irradiation, have a substantially higher risk of developing breast cancer later in life. As a result, current clinical screening of this high-risk population relies primarily on the radiation dose and volume to the...

Factors Affecting Prognosis in Localized Paratesticular Rhabdomyosarcoma

In a study reported in the Journal of Clinical Oncology, Walterhouse et al found that age ≥ 10 years at diagnosis and tumor size > 5 cm are adverse prognostic features in localized paratesticular rhabdomyosarcoma. Study Details The study was a pooled analysis of data from North American and ...

skin cancer
immunotherapy

COMBI-AD Trial: Longer-Term Follow-up of Adjuvant Dabrafenib Plus Trametinib in Resected BRAF V600–Mutant Stage III Melanoma

As reported by Hauschild et al in the Journal of Clinical Oncology, longer-term follow-up of the phase III COMBI-AD trial has confirmed improved relapse-free survival with adjuvant dabrafenib (Tafinlar) plus trametinib (Mekinist) vs placebo in resected BRAF V600–mutant stage III melanoma. In...

The COLORS Training: Online LGBT Cultural Competency for Oncologists

An interactive online LGBT cultural competency training program for oncologists may be acceptable and feasible—and may improve LGBT-related knowledge and clinical practices, according to preliminary results of a pilot study of oncologists in Florida presented by Schlumbrecht et al at...

breast cancer
issues in oncology

Prognostic Risk Model for African American Women With Breast Cancer

A prognostic model developed using a machine learning approach may be able to identify African American patients with breast cancer who have an increased risk of death, according to results of a study presented by Bhattarai et al at the 11th AACR Conference on The Science of Cancer Health...

Culturally Tailored Messaging Improved HPV Vaccination Rates Among Asian American Adolescents

A pilot study by Ma et al examining the intervention effect on the outcome of a provider-based, culturally tailored, multilevel intervention to promote human papillomavirus (HPV) vaccination among Asian American adolescents has found that the strategy significantly increased the uptake of at least...

Study Suggests Risk of Cancer Death Increases With Each Generation of Latinos Born in the United States

According to the U.S. Census Bureau, as of July 2016, the Hispanic population in the United States had grown to 57.5 million, making people of Hispanic origin the nation’s largest ethnic or racial minority group. Studies have shown that U.S.-born Latinos have a higher incidence of cancer than ...

FDA Approves Lorlatinib for Second- or Third-Line Treatment of ALK-Positive Metastatic NSCLC

On November 2, 2018, the U.S. Food and Drug Administration granted accelerated approval to lorlatinib (Lorbrena) for patients with anaplastic lymphoma kinase (ALK)–positive metastatic non–small cell lung cancer (NSCLC) whose disease has progressed on crizotinib (Xalkori) and at least...

FDA Grants Breakthrough Therapy Designation to LOXO-292 for RET Fusion–Positive Thyroid Cancer

The U.S. Food and Drug Administration (FDA) recently granted Breakthrough Therapy designation to LOXO-292, a selective RET inhibitor, for the treatment of patients with advanced RET fusion–positive thyroid cancer who require systemic therapy, have had disease progression following...

ESMO 2018: CTONG 1103 Finds Benefit With Neoadjuvant Erlotinib in Some EGFR-Mutated NSCLCs

Neoadjuvant erlotinib (Tarceva) benefits selected patients with epidermal growth factor receptor (EGFR)-mutated non–small cell lung cancer (NSCLC) who undergo complete resection of stage IIIA-N2 disease, according to a randomized study comparing erlotinib with gemcitabine plus cisplatin as...

colorectal cancer
immunotherapy

ESMO 2018: CheckMate-142 Reports New Data on First-Line Nivolumab Plus Low-Dose Ipilimumab in MSI-H/dMMR Metastatic Colorectal Cancer

The combination of nivolumab (Opdivo) and low-dose ipilimumab (Yervoy) could become a new first-line treatment in patients with microsatellite instability–high (MSI-H), mismatch repair–deficient (dMMR) metastatic colorectal cancer, following results from the CheckMate-142 trial reported ...

Suicide Risk Among Head and Neck Cancer Survivors

In a study reported in Cancer, Osazuwa-Peters et al found that the mortality rate from suicide among head and neck cancer survivors was twice as high as the pooled rate in survivors of 19 other cancers considered in the study. Only the rate of suicide in pancreatic cancer survivors was higher...

solid tumors
issues in oncology

2018 ASTRO: Phase I Trial of SBRT for Oligometastatic Disease With Multiple Metastases

The phase I NRG Oncology clinical trial BR001 tested the hypothesis that stereotactic body radiotherapy (SBRT) could be used safely in patients with oligometastatic disease characterized by multiple metastases. Results from the trial indicate that using SBRT is safe as treatment for patients with 2 ...

solid tumors
issues in oncology

Fluoropyrimidine DPYD Genotype–Guided Dosing in Patients With Cancer

In a Dutch study reported in The Lancet Oncology, Henricks et al found that DPYD genotype–guided dosing reduced the frequency of severe fluoropyrimidine toxicity in patients with cancer. Increased fluoropyrimidine toxicity is associated with reduced activity of the metabolic...

Quality of Life With Postmastectomy Radiotherapy vs No Radiotherapy in Intermediate-Risk Breast Cancer

In a 2-year follow-up of the phase III SUPREMO trial reported in The Lancet Oncology, Velikova et al found worse chest wall symptoms in women with intermediate-risk breast cancer who did vs did not receive postmastectomy radiotherapy. No other differences in quality-of-life outcomes were found ...

New ASTRO/ASCO/AUA Guideline for Early-Stage Prostate Cancer Supports Use of Hypofractionated Radiotherapy

Three prominent medical societies have issued a new clinical guideline for physicians treating men with early-stage prostate cancer using external-beam radiation therapy (EBRT). Adoption of the guideline could make treatment shorter and more convenient for many patients with prostate cancer....

FDA Approves Pembrolizumab in Combination With Chemotherapy for First-Line Treatment of Metastatic Squamous NSCLC

On October 30, 2018, the U.S. Food and Drug Administration (FDA) approved pembrolizumab (Keytruda) in combination with carboplatin and either paclitaxel or nanoparticle albumin-bound (nab)-paclitaxel (Abraxane) as first-line treatment of metastatic squamous non–small cell lung...

Final Overall Survival Results for First-Line VR-CAP vs R-CHOP in Transplantation-Ineligible Mantle Cell Lymphoma

In an analysis reported in The Lancet Oncology by Robak et al, bortezomib, rituximab [Rituxan], cyclophosphamide, doxorubicin, and prednisone (VR-CAP) significantly prolonged overall survival vs rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) in a phase III trial ...

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