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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 ...

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 ...

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...

lung cancer
immunotherapy

Corticosteroid Use at Start of PD-1/PD-L1 Inhibitor Therapy Affects Outcomes in NSCLC

IN A STUDY reported in the Journal of Clinical Oncology, Kathryn C. Arbour, MD, of Memorial Sloan Kettering Cancer Center, and colleagues found that baseline treatment with corticosteroids was associated with poorer efficacy of programmed cell death protein 1/programmed cell death ligand 1...

leukemia
lymphoma

Venetoclax for CLL or SLL With or Without 17p Deletion After Prior Therapy

On June 8, 2018, venetoclax (Venclexta) was granted regular approval for treatment of patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL), with or without 17p deletion, who have received at least one prior therapy.1,2 Supporting Efficacy Data APPROVAL WAS BASED on ...

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...

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...

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...

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...

prostate cancer

AR-V7 as Marker for Taxane Therapy in Castration-Resistant Prostate Cancer

In a study reported in JAMA Oncology, Howard I. Scher, MD, of the Genitourinary Oncology Service, Memorial Sloan Kettering Cancer, and colleagues found that the presence of nuclear-localized androgen receptor splice variant 7 (AR-V7) protein in circulating tumor cells may predict better survival...

prostate cancer

Robot-Assisted Laparoscopic Prostatectomy in Newly Diagnosed Prostate Cancer

In an Australian phase III trial reported in The Lancet Oncology, Suzanne K. Chambers, PhD, of the Menzies Health Institute Queensland, Griffith University, Gold Coast, and colleagues found similar functional outcomes at 2 years with robot-assisted laparoscopic prostatectomy and open radical...

prostate cancer

Early PSA Testing Could Help Predict Prostate Cancer Among Black Men

In a study published by Mark A. Preston, MD, MPH, and colleagues in European Urology, researchers demonstrated that a baseline prostate-specific antigen (PSA) level obtained from black men between 40 and 60 years old may predict the future development of prostate cancer for years after testing....

hematologic malignancies
leukemia

Nilotinib for Pediatric Patients With Philadelphia Chromosome–Positive CML in Chronic Phase

Earlier in 2018, nilotinib (Tasigna) was approved for the treatment of pediatric patients aged ≥ 1 year with newly diagnosed Philadelphia chromosome–positive chronic myeloid leukemia in chronic phase (CML-CP) or Philadelphia chromosome–positive CML-CP resistant or intolerant to prior tyrosine...

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...

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

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 ...

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 ...

Effect of Baseline Status on Benefit From Exercise Interventions in Patients With Cancer

In a study reported in the Journal of the National Cancer Institute, Buffart et al found that patients with cancer benefited more or less from exercise interventions depending on their baseline condition and timing of the intervention. The study was an individual patient data meta-analysis...

skin cancer
immunotherapy

ESMO 2018: CheckMate 067: 4-Year Follow-up of Nivolumab Plus Ipilimumab in Advanced Melanoma

As reported in The Lancet Oncology and at the European Society for Medical Oncology 2018 Congress by Hodi et al, the 4-year follow-up of the phase III CheckMate 067 trial has shown a continued overall survival benefit with first-line nivolumab (Opdivo) plus ipilimumab (Yervoy) or nivolumab alone vs ...

Risk Factors for Higher-Grade Transformation in Marginal Zone Lymphoma

In a single-institution study reported in the Journal of Clinical Oncology, Alderuccio et al found that not achieving complete remission (CR) after initial treatment, elevated lactate dehydrogenase (LDH), and more than four nodal sites at marginal zone lymphoma diagnosis are predictive of...

lymphoma
cost of care

Cost-Effectiveness of First-Line Brentuximab Vedotin Plus Chemotherapy in Hodgkin Lymphoma

In a cost-effectiveness analysis reported in the Journal of Clinical Oncology, Huntington et al found that the cost of brentuximab vedotin (Adcetris) would need to be reduced in order for the combination of the agent with chemotherapy in first-line treatment of stage III or IV Hodgkin lymphoma to...

Long-Term Results of Sequence of Hormonal Therapy Plus Whole-Pelvic or Prostate-Alone Radiotherapy in Prostate Cancer

In long-term follow-up of the phase III NRG/RTOG 9413 study reported in The Lancet Oncology by Roach et al, neoadjuvant hormonal therapy (NHT) plus whole-pelvic radiotherapy (WPRT) and prostate-only radiotherapy (PORT) plus adjuvant hormonal therapy (AHT) were associated with the highest rates of...

Analgesic Use and Risk of Ovarian Cancer

In an analysis of data from two Nurses’ Health Study cohorts reported in JAMA Oncology by Barnard et al, use of low-dose but not standard-dose aspirin was associated with reduced risk of epithelial ovarian cancer, whereas use of nonaspirin nonsteroidal anti-inflammatory drugs (NSAIDs)...

lymphoma
immunotherapy

Analysis of Prognostic Value of Postinduction PET Response After First-Line Immunochemotherapy for Follicular Lymphoma

In an analysis of the phase III GALLIUM trial reported in The Lancet Oncology, Trotman et al found that end-of-induction fluorodeoxyglucose positron-emission tomography (PET) after first-line immunochemotherapy appeared to better predict treatment outcomes than contrast-enhanced computed tomography ...

Germline Mutations in Cancer Susceptibility Genes in Patients With Advanced Renal Cell Carcinoma

In a study reported in JAMA Oncology, Maria I. Carlo, MD, of the Department of Medicine, Memorial Sloan Kettering Cancer, and colleagues found a high prevalence of germline mutations in cancer susceptibility genes in patients with advanced renal cell carcinoma (RCC). In this cohort study,...

Meta-analysis of Patients With Early Kidney Cancer Treated With Robotic Partial Nephrectomy

For patients with early kidney cancer, surgically removing a portion of the kidney instead of the whole organ is often a preferred treatment, because the procedure can effectively remove tumors while preserving kidney function. But when it comes to the best surgical approach—robotic, laparoscopic, ...

Sunitinib vs Nephrectomy Followed by Sunitinib in Metastatic Renal Cell Carcinoma

In an interim analysis of the French phase III noninferiority Carmena trial reported in The New England Journal of Medicine, Arnaud Méjean, MD, PhD, of the Hôpital Européen Georges Pompidou, and colleagues found that sunitinib alone was not inferior in overall survival vs nephrectomy followed by...

genomics/genetics

Everolimus Tablets for Oral Suspension for Tuberous Sclerosis Complex–Associated Partial-Onset Seizures

On April 10, 2018, the U.S. Food and Drug Administration approved everolimus tablets for oral suspension (Afinitor Disperz) for the adjunctive treatment of adult and pediatric patients aged ≥ 2 years with tuberous sclerosis complex–associated partial-onset seizures.1,2 Tuberous sclerosis complex is ...

Activity of Antibody-Drug Conjugate Telisotuzumab Vedotin in c-Met–Positive Advanced NSCLC

In a phase I study reported in the Journal of Clinical Oncology, Strickler et al found evidence of activity of the antibody-drug conjugate telisotuzumab vedotin in non–small cell lung cancer (NSCLC) overexpressing c-Met. The agent combines the anti–c-Met monoclonal antibody...

hepatobiliary cancer

Cabozantinib Improves Survival in Patients With Previously Treated Hepatocellular Carcinoma

As reported in The New England Journal of Medicine by Ghassan K. Abou‑Alfa, MD, of Memorial Sloan Kettering Cancer Center, and colleagues, the second interim analysis of the phase III CELESTIAL trial has shown a significant improvement in overall and progression-free survival with cabozantinib...

solid tumors
kidney cancer

Nivolumab Plus Ipilimumab in Intermediate- or Poor-Risk Advanced Renal Cell Carcinoma

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On April 16, 2018, nivolumab (Opdivo) and ipilimumab...

Genomic Classification of Myeloproliferative Neoplasms and Integration in Predictive Models

In a study reported in The New England Journal of Medicine, Grinfeld et al identified distinct genomic subgroups among patients with myeloproliferative neoplasms that, when combined with clinical variables, offered the potential for individualized predictions of clinical outcomes. Study Details...

Adjuvant Chemotherapy in High-Grade Uterine Leiomyosarcoma

As reported in the Journal of Clinical Oncology by Hensley et al, a phase III NRG Oncology/Gynecologic Oncology Group study assessing adjuvant chemotherapy vs observation in disease-free patients with uterus-confined high-grade leiomyosarcoma was stopped due to accrual futility; available data...

Regular Aspirin Use and Reduction in Risk for Hepatocellular Carcinoma

A pooled analysis of two large U.S. prospective cohort studies reported in JAMA Oncology by Simon et al indicates that regular use of aspirin is associated with a significant reduction in risk for hepatocellular carcinoma (HCC), with an apparent dose- and duration-dependent effect. Study Details...

Chemotherapy-Free Initial Treatment of Advanced Indolent Lymphoma

In an analysis of two Nordic Lymphoma Group trials with long-term follow up reported in the Journal of Clinical Oncology, Lockmer and colleagues found evidence that many patients receiving rituximab (Rituxan) as initial treatment for advanced indolent lymphoma may not require the addition of...

Utility of FDG-PET for Residual Lesions After Chemotherapy for Metastatic Seminoma

In an analysis of International Global Germ Cell Cancer Group Registry data reported in the Journal of Clinical Oncology by Cathomas et al, fluorodeoxyglucose positron-emission tomography (FDG-PET) was found to have a low positive predictive value for vital tumor in residual lesions after...

palliative care
lung cancer
issues in oncology
cost of care

ICU Admissions During Terminal Hospitalizations in Patients With Stage IV Lung Cancer

In a study reported in the Journal of Oncology Practice, Mrad et al found an increase in the proportion of patients with stage IV lung cancer admitted to the intensive care unit (ICU) during terminal hospitalization between 1998 and 2014. A large increase in palliative care contacts also occurred,...

lung cancer
issues in oncology
pain management

Opioid Use Following Video-Assisted Thoracoscopic Surgery or Open Resection in Early-Stage Lung Cancer

In a study reported in a research letter in JAMA Oncology, Tuminello et al found that video-assisted thorascopic surgery (VATS) was less likely than open resection to be associated with long-term opioid use in patients undergoing surgery for early-stage lung cancer. Study Details The study...

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