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supportive care

What’s New in Antiemesis Therapy

The optimal use of new antiemetics was the subject of a presentation at the 14th Annual School of Breast Oncology, Emory University, Atlanta, by Frankie Ann Holmes, MD, Associate Director of Breast Oncology Research at Texas Oncology, Houston. “The science of nausea and vomiting is so compelling,...

breast cancer

Treatment of Early HER2-Positive Breast Cancer: One Size Does Not Fit All

Despite the routine use of HER2 blockade in early HER2-positive breast cancer, clinicians can always benefit from a refresher on key treatment considerations. Clinical pearls and controversial issues were the topic of a presentation at the 14th Annual School of Breast Oncology at Emory University, ...

skin cancer

Novel Immunotherapy Combinations May Be the Future of Melanoma Treatment

The future treatment of melanoma may rely on combinations of immunotherapy agents beyond the current checkpoint inhibitors, and they are entering clinical trials, according to Jeffrey Weber, MD, PhD, Deputy Director of the Laura and Isaac Perlmutter Cancer Center at New York University Langone...

lung cancer

Experts Consider the New Immunotherapy Paradigm in Advanced Lung Cancer

One immune checkpoint inhibitor has now moved to the front of the line for treating advanced non–small cell lung cancer (NSCLC). Based on pivotal studies presented at the 2016 European Society for Medical Oncology (ESMO) Congress, pembrolizumab (Keytruda) became a first-line option, and it is...

issues in oncology
lung cancer
gastrointestinal cancer
prostate cancer
colorectal cancer

At ESMO 2016, Many Phase III Trials Fail to Meet Primary Endpoints

The 2016 European Society for Medical Oncology (ESMO) Congress revealed many important positive findings from key trials in a number of tumor types, but many highly anticipated phase III trials in advanced disease failed to meet their primary endpoints. The ASCO Post has summarized several of these ...

Expert Point of View: Florian Lordick, MD

Florian Lordick, MD, Professor of Oncology and Director of the University Cancer Center in Leipzig, Germany, offered some critical evaluation of the two studies. AGITG Phase II Trial For the AGITG’s phase II DOCTOR trial, he emphasized the need to show the impact on survival outcomes for...

gastroesophageal cancer

Locally Advanced Esophageal Cancer Outcomes Improved With Neoadjuvant Therapy

In studies presented at the 2016 European Society for Surgical Oncology (ESMO) Congress, two different neoadjuvant treatment approaches improved the outcomes of patients with esophageal cancer. Investigators from the Australasian Gastro-Intestinal Trials Group (AGITG) reported that the addition of...

lung cancer
skin cancer

Numerous ESMO Presentations Focused on Anti–PD-1 Therapy in Lung Cancer and Melanoma

The 2016 European Society for Medical Oncology (ESMO) Congress was jam-packed with studies of the anti–programmed cell death protein 1 (PD-1) antibodies in non–small cell lung cancer and melanoma, where they have clearly changed the treatment paradigm. Here is a roundup of some of those trials,...

Expert Point of View: Alice T. Shaw, MD, PhD

Commenting on ASCEND-5, Alice T. Shaw, MD, PhD, Director of Thoracic Oncology at the Massachusetts General Hospital Cancer Center, Boston, noted that it is the first randomized study to examine how a second-generation anaplastic lymphoma kinase (ALK) inhibitor compares to standard second-line...

lung cancer

Studies Confirm Ceritinib’s Benefit in ALK-Positive Patients

For patients with advanced non–small cell lung cancer (NSCLC) harboring the ALK gene rearrangement, ceritinib (Zykadia) provided longer progression-free survival than chemotherapy in patients previously treated with chemotherapy and crizotinib (Xalkori), but gastrointestinal toxicity was...

Expert Point of View: Paul Baas, MD, PhD

Invited discussant Paul Baas, MD, PhD, of The Netherlands Cancer Institute, Amsterdam, first commented on the need for measures to improve outcomes in early-stage non–small cell lung cancer (NSCLC). “Even in stage I patients, we still have a failure rate of 30% to 40% at 5 years, and that...

lung cancer

Neoadjuvant Nivolumab Appears Safe and Feasible in Lung Cancer

Neoadjuvant immunotherapy with the programmed cell death protein 1 (PD-1) inhibitor nivolumab (Opdivo) is safe and feasible in early-stage non–small cell lung cancer (NSCLC). The results come from the first report of PD-1 blockade prior to surgery in this tumor, according to Patrick Forde, MD, of...

hematologic malignancies

Optimizing Allogeneic Stem Cell Transplantation in Myelofibrosis

Allogeneic hematopoietic stem cell transplantation is the only potentially curative treatment for myelofibrosis. The ASCO Post asked an expert in this field, Ayalew Tefferi, MD, how and when he uses stem cell transplant in myelofibrosis, which is a topic he outlined in greater detail in the...

pancreatic cancer

Let’s Win: Innovative Online Community Offers Guidance to Patients With Pancreatic Cancer and Their Families

Let’s Win is an online community for persons with pancreatic cancer (www.letswinpc.org), but it is far more than a typical support group. Let’s Win propels interested users toward cutting-edge research, based on its founders’ commitment that no patient with pancreatic cancer should settle on the...

Expert Point of View: Olivier Michielin, MS, MD, PhD

Olivier Michielin, MS, MD, PhD, Head of Personalized Analytical Oncology and the Melanoma Clinic at Lausanne University Hospital in Switzerland, said the study was well designed, well conducted, and addressed an important clinical question “at the time of its inception.” But he agreed with Dr....

skin cancer

Study Looks for Optimal Dosing of Single-Agent Ipilimumab in Metastatic Melanoma

There has been debate as to the optimal dose of single-agent ipilimumab (Yervoy) in metastatic melanoma. A phase III study presented at the 2016 European Society for Medical Oncology (ESMO) Congress—the first to directly compare these doses—concluded that 10 mg/kg is more effective, but also more...

Expert Point of View: Celeste Lebbé, MD

Invited discussant Celeste Lebbé, MD, of the Hospital Saint Louis in Paris, noted that the study met its primary endpoints and produced “very impressive data”; however, “major toxicity” was a concern. She said that in this small study of 18 patients (10 for efficacy), several lessons were learned: ...

skin cancer

Small Study Tests Dual Checkpoint Blockade in High-Risk Stage III Melanoma

As neoadjuvant or adjuvant therapy for stage III melanoma patients with palpable disease, the combination of ipilimumab (Yervoy) plus nivolumab (Opdivo) was shown to be a promising, though also toxic, combination in a phase Ib study reported at the 2016 European Society for Medical Oncology (ESMO) ...

pancreatic cancer

Vaccines May Boost Immune Responsiveness of Pancreatic Tumors

Pancreatic cancer has been notably unresponsive to immunotherapeutic approaches, but a Stand Up 2 Cancer Dream Team believes their research can change that. Team co-leader Elizabeth Jaffee, MD, Deputy Director of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, ...

pancreatic cancer

Scientists Are Boosting Immune Responses in Pancreatic Tumors

The successes observed with various immune oncologic treatment approaches have largely bypassed pancreatic cancer, but this may be about to change, based on emerging insights into how and why these tumors evade attacks by T cells. At the 2nd International Cancer Immunotherapy Conference, two...

skin cancer

Combination Strategies Harness the Power of the Oncolytic Virus Talimogene Laherparepvec

The injectable oncolytic immunotherapy talimogene laherparepvec (also known as T-VEC, Imlygic) may become a valuable component of combination immunotherapy approaches in melanoma, a strategy believed to help overcome resistance of tumors to single-agent immunotherapies. “[Talimogene laherparepvec] ...

Expert Point of View: Jean-Charles Soria, MD, PhD

A number of lung cancer specialists were anxious to comment on the positive findings of KEYNOTE-024 and were equally perplexed about the negative results of CheckMate-026. All agreed that the overall survival benefit makes pembrolizumab (Keytruda) a game-changer for the first-line treatment of...

lung cancer

Pembrolizumab, but Not Nivolumab, Improves Outcomes in Front-Line Setting for PD-L1–Positive Advanced NSCLC

Checkpoint inhibitors have revolutionized the treatment of advanced non–small cell lung cancer (NSCLC), but evidence of their benefit was restricted to the second-line setting. However, early-phase trials with both pembrolizumab (Keytruda) and nivolumab (Opdivo) demonstrated favorable results in...

Expert Point of View: Corey J. Langer, MD

Corey J. Langer, MD, Director of Thoracic Oncology and Professor of Medicine at the Hospital of the University of Pennsylvania, Philadelphia, discussed the OAK study with The ASCO Post. Robust Data “In some ways, the OAK data are some of the most robust we have seen in the second-line setting. For ...

lung cancer

Notable Gains in Survival Achieved With Atezolizumab in Non–Small Cell Lung Cancer

The programmed cell death ligand 1 (PD-L1) inhibitor atezolizumab (Tecentriq) significantly improved overall survival, compared to docetaxel, in previously treated, advanced non–small cell lung cancer (NSCLC), according to preliminary results of the phase III OAK study. The findings are the first...

palliative care

Quality Improvement Project Results in Timelier Hospice Referrals

A quality improvement project conducted within the OhioHealth system showed that oncologists can change their behavior and refer patients earlier to hospice care. After a relatively minor intervention, 18 medical oncologists in private practice doubled the mean length of stay in hospice care for...

palliative care

Food as Medicine: Study Sets Out to Prove Its Effectiveness

Could the quality of life of patients with advanced-stage cancer be improved by personal delivery of nutritious, medically tailored meals? Researchers at the New York University School of Medicine Perlmutter Cancer Center think so, and they have set out to prove it in a randomized clinical trial....

breast cancer
symptom management

Dexamethasone Mouth Rinse Should Be Routine Part of Everolimus Treatment

Dexamethasone mouth rinse should be given prophylactically to prevent stomatitis associated with everolimus (Afinitor)/exemestane in metastatic breast cancer, according to Hope S. Rugo, MD, principal investigator of the SWISH trial and Director of Breast Oncology and Clinical Trials Education at...

hematologic malignancies
palliative care

Palliative Care Still in Its Infancy in Hematologic Malignancies

Palliative care is slowly but surely being integrated into the treatment of patients with solid tumors, but its role in the hematopoietic stem cell transplant setting is still lagging, speakers said at the 2016 Palliative Care in Oncology Symposium. “There is a huge symptom burden among patients...

Expert Point of View: Elizabeth Jaffee, MD

Elizabeth Jaffee, MD, Deputy Director of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, commented on the promise of neoantigens during a press briefing at the 2nd International Cancer Immunotherapy Conference. “In addition to the development of new drugs...

skin cancer

Personalized Vaccines May Protect Patients With High-Risk Melanoma

The field of cancer vaccines may be reinvigorated by a new understanding, and the therapeutic leveraging, of neoantigens. Researchers from Dana-Farber Cancer Institute in Boston are exploring this novel approach as a means of protecting patients with high-risk melanoma from recurrence. Early...

Expert Point of View: Olivier Michielin, MS, MD, PhD

The paper’s invited discussant was Olivier Michielin, MS, MD, PhD, Head of Personalized Analytical Oncology and the Melanoma Clinic at Lausanne University Hospital in Switzerland. He called the findings of the European Organisation for Research and Treatment (EORTC) 18071 trial a “new landmark in...

skin cancer

Adjuvant Ipilimumab Improves Survival in High-Risk Melanoma

Patients with stage III melanoma who were considered to be at high risk for recurrence derived an overall survival benefit from adjuvant treatment with ipilimumab (Yervoy), although it came at the price of considerable toxicity, according to updated survival results from the phase III European...

head and neck cancer

With Changing Strategies for Laryngeal Cancer, Multidisciplinary Team Approach Is Key

The treatment of cancer of the larynx has changed dramatically in recent years. With organ preservation now possible in many cases, it is more important than ever for patients to receive guidance from every corner of the field. In a recent article in the Journal of Oncology Practice (JOP),1 a...

cns cancers

Which Factors Influence Radiotherapy for Brain Metastases?

The advent of more effective systemic therapies, which extend patients’ lives, has also resulted in an increasing incidence of brain metastases, for which clinicians must determine appropriate treatment. Whole-brain radiotherapy has been the traditional treatment modality, but stereotactic...

issues in oncology
supportive care
palliative care

Why Care About the Caregivers?

Caregivers of patients with cancer provide invaluable health-care services, but they are an underserved and undervalued group, with many unmet needs. Early palliative care may provide important benefits to these often tireless individuals, according to J. Nicholas Dionne-Odom, PhD, RN, ACHPN, of...

palliative care

Benefits of Early Palliative Care Interventions Extend Beyond the Patient

A session at the 2016 Palliative Care in Oncology Symposium focused on the special needs of cancer caregivers. In a large survey, caregivers of persons with cancer reported higher levels of stress and significantly more duties than caregivers of other patients. But, according to research from...

palliative care

Palliative Care: Let’s Use the Tools We Already Have

Clinicians and researchers in the field of palliative and supportive care are enjoying the recognition the field is now receiving and expecting the future to be ripe with opportunity. But one thought leader in this specialty had a suggestion for attendees at the 2016 Palliative Care in Oncology...

symptom management
palliative care

Pearls for Managing Immune-Related Toxicities

With checkpoint inhibitors in frequent use, clinicians strive daily to balance the efficacy and toxicity of these treatments. At the 2016 Palliative Care in Oncology Symposium, Lynn M. Schuchter, MD, FASCO, the C. Willard Professor of Hematology-Oncology at the University of Pennsylvania,...

issues in oncology
palliative care

Immunotherapy Brings Unique Challenges for Clinicians

The advent of immunotherapies has created a number of interesting challenges for oncology providers. At the 2016 Palliative Care in Oncology Symposium, specialists in the field tackled these issues. “There is a lot of newness to how we approach patient care with immunotherapies on board,” said...

lung cancer

Lung Cancer Specialist Shares Clinical Pearls for Managing Stage IIIA Non–Small Cell Lung Cancer

Clinicians face a number of questions in evaluating and treating patients with stage IIIA non–small cell lung cancer (NSCLC). One expert in the field, Rafael Santana-Davila, MD, reviewed key issues in managing this disease in the Journal of Oncology Practice (JOP). The ASCO Post asked Dr....

lymphoma

Novel Agents on the Horizon in Lymphoma

Attendees at the 2016 Pan Pacific Lymphoma Conference held July 18–22 in Koloa, Hawaii, got a peek at early data for a number of novel agents in the treatment of various lymphoma subtypes. The ASCO Post captured these findings. Denintuzumab Mafodotin in Diffuse Large B-Cell Lymphoma Denintuzumab...

lymphoma

Routine PET Surveillance Discouraged in Large Cell Lymphoma

There is no role for routine imaging as a means of following patients with large cell lymphoma, according to Bruce D. Cheson, MD, Deputy Chief of Hematology-Oncology and Professor of Medicine at Georgetown University Hospital, Lombardi Comprehensive Cancer Center, Washington, DC. “Routine...

Expert Point of View: Julie ­Margenthaler, MD

The moderator of the press briefing, Julie ­Margenthaler, MD, of Washington University, St. Louis, maintained there are few contraindications for nipple-sparing mastectomy. “I reiterate Dr. Jakub’s view. I agree it’s absolutely safe for BRCA-positive patients,” she declared. The contraindications, ...

breast cancer

Nipple-Sparing Mastectomy Shown to Be Safe—and Increasingly Preferred

Prophylactic mastectomy that preserves a woman’s nipple is oncologically safe in patients with deleterious BRCA mutations, according to the largest study yet to evaluate this approach in this high-risk population. “In more than 500 risk-reducing nipple-sparing mastectomies in 348 deleterious...

skin cancer

Management of Merkel Cell Carcinoma

A recent report regarding pembrolizumab (Keytruda) for advanced Merkel cell carcinoma ushered in a more optimistic era in the treatment of this rare but often lethal skin cancer.1 The ASCO Post spoke with one of the field’s leaders, Paul Nghiem, MD, PhD—the first author of the study—about the...

hematologic malignancies
leukemia
lymphoma
multiple myeloma

Roundup of Selected Abstracts in Multiple Myeloma, Acute and Chronic Leukemia, and Advanced Lymphoma

In June 2016, the European Hematology Association Congress convened in Copenhagen, Denmark. The educational and scientific program highlighted state-of-the-art clinical practice and the latest findings in hematology research. The ASCO Post brings its readers brief summaries of some of the important ...

lymphoma

For High-Grade and Aggressive Non-Hodgkin Lymphomas, Treat Adults Like Children

Outcomes for adults with high-grade and aggressive non-Hodgkin lymphomas (NHLs) appear to be better when these patients are treated with pediatric-inspired protocols, according to Mitchell S. Cairo, MD, Chief of the Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Maria...

lymphoma

Early Relapse in Follicular Lymphoma: Clinical Trial Data May Guide Management Decisions

Approximately 20% of patients with follicular lymphoma will relapse within 2 years of diagnosis. Although the optimal management of these patients has not been established, clinicians may be guided by data from recent clinical trials, according to Nathan H. Fowler, MD, Associate Professor and...

lymphoma

Understanding Double-Hit Lymphomas and Optimizing Management

Double-hit lymphomas are a challenging subset of high-grade B-cell lymphomas, previously characterized histologically as diffuse large B-cell lymphoma or B-cell lymphoma unclassifiable with intermediate features between diffuse large B-cell lymphoma and Burkitt lymphoma. Expert guidance in their...

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