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Expert Point of View: Eduardo Bruera, MD, FAAHPM

Eduardo Bruera, MD, FAAHPM, Medical Director, Department of Supportive Care Center, The University of Texas MD Anderson Cancer Center, in Houston, called the dyadic intervention “highly innovative.” “We all talk about movement, exercise, and the importance of physical activity for our patients,...

solid tumors
lung cancer

Dyadic Yoga Program for Patients With Lung Cancer and Their Caregivers May Optimize Treatment Response

Yoga therapy delivered to patients with lung cancer and their caregivers together appears to be a feasible and beneficial supportive care strategy. According to data presented at the 2017 Palliative and Supportive Care in Oncology Symposium,1 the dyadic intervention resulted in a clinically and...

supportive care
palliative care

Caring for the Frail, Older Patient With Cancer: Four Practical Approaches

Cancer may be a disease of aging, but data suggest that older patients with cancer are undertreated, especially with respect to chemotherapy. One analysis showed that approximately 40% of patients in their 70s—and 60% of patients in their 80s—do not receive adjuvant therapy after surgery for colon...

Expert Point of View: Eduardo Bruera, MD, FAAHPM

Eduardo Bruera, MD, FAAHPM, Medical Director, Department of Supportive Care Center, The University of Texas MD Anderson Cancer Center, Houston, underscored the study’s potential to influence clinical care decisions. “The emergency department is a ‘hard hat’ area of care where bad things happen and ...

supportive care
palliative care

‘Triple Threat’ Conditions May Predict Mortality in Patients With Cancer Presenting to Emergency Departments

Dyspnea, delirium, and poor performance—so-called “triple threat” conditions—are known to predict short survival in palliative care. According to data presented at the 2017 Palliative and Supportive Care in Oncology Symposium,1 however, the presence of at least two of these symptoms in patients...

supportive care
palliative care

Concurrent Palliative Care: Recommendations From the ASCO Clinical Practice Guideline

Updated in 2016, the ASCO clinical practice guideline on the integration of palliative care into standard oncology care provides evidence-based recommendations to oncology clinicians, patients, family and friend caregivers, and palliative care specialists about providing high-quality care for...

supportive care
palliative care
cost of care
issues in oncology

Palliative Care Intervention Reduces Total Health-Care Costs in Patients With Advanced Cancer

A matched case-controlled study among Medicare beneficiaries with metastatic lung, colorectal, breast, and prostate cancers has found that palliative care consultation significantly reduced total health-care costs following intervention. According to data presented at the 2017 Palliative and...

supportive care
palliative care

Digital Palliative Care Curriculum Improves Knowledge, Skills, and Opioid Prescribing Behavior

A new electronic curriculum delivered via e-mail with push technology may provide an efficient, cost-effective solution to the shortage of palliative care faculty serving the nation’s oncology fellowship programs. According to data presented at the 2017 Palliative and Supportive Care in Oncology...

supportive care
palliative care

Early Integrated Palliative Care Improves Patient Coping Strategies, Quality of Life, and Symptoms of Depression

A new study has shed light on how palliative care interventions may improve patient outcomes. According to data presented at the 2017 Palliative and Supportive Care in Oncology Symposium,1 patients with incurable cancer who received early integrated palliative care had an increased use of active...

hematologic malignancies
leukemia

Clinical Relevance of Minimal Residual Disease Monitoring Limited in Acute Myeloid Leukemia

Although a majority of major cancer centers may test for minimal residual disease (MRD), a recent survey conducted by researchers at Moffitt Cancer Center, Tampa, Florida, suggests most oncologists remain uncertain about what to do with the results. At the National Comprehensive Cancer Network®...

hematologic malignancies
lymphoma

New Options for the Management of Hodgkin Lymphoma

With the vast majority of patients cured with primary therapy, classical Hodgkin lymphoma is largely a success story. For the 10% to 20% of patients who either relapse or are refractory to front-line therapy, the disease can still be fatal. At the National Comprehensive Cancer Network® (NCCN®) 12th ...

hematologic malignancies
leukemia

Sequencing Therapy in Chronic Lymphocytic Leukemia

Although the indications to initiate treatment for chronic lymphocytic leukemia (CLL) have not changed, determining the optimal first-line treatment and sequence of therapies once treatment has begun remain challenges for providers. At the National Comprehensive Cancer Network® (NCCN®) 12th Annual...

survivorship
lymphoma

Life After Treatment: Managing Lymphoma Survivors

According to Surveillance, Epidemiology, and End Results (SEER) data, patients with Hodgkin lymphoma and non-Hodgkin lymphoma (NHL) have 5-year survival rates of 86% and 71%, respectively.1 Although the increased number of survivors is welcome proof of the success of new treatment regimens, it also ...

multiple myeloma

Management of Newly Diagnosed Multiple Myeloma in Transplant-Eligible Patients

The treatment paradigm for multiple myeloma has changed dramatically in the past decade with the availability of several efficacious agents in various drug classes. At the National Comprehensive Cancer Network® (NCCN®) 13th Annual Congress: Hematologic Malignancies™, Shaji K. Kumar, MD, Professor...

leukemia

Immunotherapeutic Approaches for B-Cell Acute Lymphocytic Leukemia

New therapeutic agents for acute lymphocytic leukemia (ALL) have led to dramatic improvement in remission rates, but questions concerning the proper sequencing and combination of these agents remain. At the National Comprehensive Cancer Network® (NCCN®) 13th Annual Congress: Hematologic...

leukemia

Blinatumomab ‘Takes a BiTE’ Out of Acute Lymphoblastic Leukemia

An investigational immunotherapy is improving outcomes in difficult-to-treat acute lymphoblastic leukemia (ALL) and showing promise in other cancers, as well. Blinatumomab (Blincyto), the first U.S. Food and Drug Administration (FDA)-approved bispecific T-cell engager (BiTE), has demonstrated...

multiple myeloma

Immune System Is Shaping the Future of Multiple Myeloma Treatment

From immunomodulatory agents and proteasome inhibitors to steroids, alkylators, and antibodies, recent years have witnessed an explosion of drug approvals for multiple myeloma. The challenge now, said Amrita Krishnan, MD, FACP, is figuring out how to incorporate them all, particularly in the...

lymphoma

Treating Human Immunodeficiency Virus–Related Lymphoma

Alexandra Levine, MD, MACP, is Professor in the Department of Hematology and Hematopoietic Cell Transplantation at City of Hope, Duarte, California, and has been on the front lines of the AIDS epidemic from the beginning—before the disease even had a name. Dr. Levine spoke with The ASCO Post about ...

lymphoma

Treatment of Diffuse Large B-Cell Lymphoma Continues to Evolve

Although the prognosis of patients with diffuse large B-cell lymphoma (DLBCL) has improved with R-CHOP—the addition of rituximab (Rituxan) to the cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy regimen—one-third of patients still relapse after therapy, and patients with the ...

breast cancer
survivorship

Online Symptom-Management Curriculum May Improve Depression and Fatigue in Breast Cancer Survivors

With thousands of devices to track and manage health and wellness, eHealth tools are beginning to transform modern health care and research, demonstrating quantifiable improvements in patient outcomes. According to the results of a randomized controlled trial (Reimagine), breast cancer survivors...

breast cancer
symptom management
survivorship

Expert Point of View: Ann H. Partridge MD, MPH

Ann H. Partridge MD, MPH, Director of Adult Cancer Survivorship Program at the Dana-Farber Cancer Institute, praised the “tremendous work” of Dr. Paskett and her colleagues but referred to the findings as “disappointing to say the least.”1 “Developing interventions to prevent or treat lymphedema...

breast cancer
symptom management
survivorship

Search Continues for Effective Way to Prevent Lymphedema in Breast Cancer Survivors

There was no difference in the incidence of lymphedema at 18 months in breast cancer patients randomized to a physical therapy intervention with education materials compared with a control.1 Although poor adherence to the intervention may have been a factor, these results, described as “very...

solid tumors
survivorship

Expert Point of View: Kevin C. Oeffinger, MD

Kevin C. Oeffinger, MD, Director of the Adult Long-Term Follow-up Program at Memorial Sloan Kettering Cancer Center, New York, highlighted the typical fat distribution of this population while noting the limitations of standard criteria for metabolic syndrome, which include waist circumference....

solid tumors
survivorship

Platinum Study Finds High Risk of Metabolic Syndrome in Testicular Cancer Survivors

A multicenter study of North American testicular cancer survivors treated with platinum-based chemotherapy has found a high prevalence of metabolic syndrome, a cluster of cardiovascular risk factors that doubles the risk of cardiovascular disease.1 According to the results of this trial,...

Expert Point of View: Barry E. Rosenbloom, MD

Moderator of the session, Barry E. Rosenbloom, MD, Clinical Professor of Medicine at Tower Hematology Oncology Medical Group in Los Angeles, said that the overview of recent advances in lung cancer clearly depicts oncology’s state of flux. “There are so many different agents that have been...

lung cancer

New Treatments for Lung Cancer in 2016

With drug approvals for immunotherapy in the first- and second-line settings, breakthroughs in targeting epidermal growth factor receptor (EGFR) mutations, and the rapid evolution of therapies that target anaplastic lymphoma kinase (ALK) rearrangements, 2016 has been an extraordinary year for lung...

cns cancers

Expert Point of View: Steven Piantadosi, MD, PhD

In an interview with The ASCO Post, Steven Piantadosi, MD, PhD, Professor of Medicine and Director of the Samuel Oschin Comprehensive Cancer Institute at Cedars-Sinai in Los Angeles, expressed enthusiasm for the Oncology Research Information Exchange Network (ORIEN) network of data-sharing. “With...

cns cancers

Bad Year for Brain Tumors, but Still Reasons for Hope

Checkpoint inhibitors and targeted therapies are reshaping the landscape of cancer care across multiple tumor sites, but treatments for brain tumors remain decidedly unchanged. The standard of care for high-grade gliomas in the front-line setting—a combination of surgery and chemoradiation—is the...

solid tumors

Mutanome-Directed Immunotherapy: Finding the Best Treatment Match

Oncologists may be accustomed to looking for commonalities in patients, but highly personalized therapies are now being developed based on mutational analysis of tumors. According to data presented at the Cedars-Sinai annual symposium on New Therapeutics in Oncology: The Road to Personalized...

Expert Point of View: Michael O. Koch, MD

Session moderator, Michael O. Koch, MD, Professor of Urology and Chairman of the Department of Urology at Indiana University School of Medicine, Indianapolis, described the drug as a “game-changer for metastatic disease.” “The last [development] that was even similar to this was when the MVAC...

bladder cancer

Atezolizumab in Platinum-Treated Advanced Urothelial Carcinoma: A New Standard of Care?

Compared with a historic control rate, a phase II study of the programmed cell death ligand 1 (PD-L1) inhibitor atezolizumab (Tecentriq) has demonstrated clinically meaningful responses in patients with urothelial carcinoma who progressed after platinum-based chemotherapy.1 Hailed as a “major...

Expert Point of View: Sam S. Chang, MD, MBA

Moderator of the session, Sam S. Chang, MD, MBA, Professor of Urologic Surgery at Vanderbilt University Medical Center, Nashville, and American Urological Association spokesperson, said that due to these results he would definitely consider this treatment option for both high-risk and African...

prostate cancer

Chemotherapy After Radical Prostatectomy May Benefit African Americans and High-Risk Patients

A new U.S. Department of Veterans Affairs (VA) study suggests that African American men and men with a higher tumor stage may benefit from adjuvant chemotherapy following radical prostatectomy.1 According to prespecified analysis of these two “high–risk” subgroups, patients with ≥ T3b disease had a ...

gynecologic cancers
issues in oncology

Breaking Down Dogma With the Outgoing President of SGO

At the 2016 Society of Gynecologic Oncology (SGO) Annual Meeting on Women’s Cancer, The ASCO Post sat down with the SGO’s outgoing President, Robert L. Coleman, MD, and discussed the revolutionary potential of blood biomarkers, why enhanced recovery after surgery protocols is a significant...

gynecologic cancers

Roundup of Ovarian Cancer Abstracts From 2016 SGO Annual Meeting on Women’s Cancer

At the 2016 Society of Gynecologic Oncology’s (SOG’s) Annual Meeting on Women’s Cancer, Thomas J. Herzog, MD, Clinical Director, University of Cincinnati (UC) Cancer Institute and Professor of Obstetrics and Gynecology at UC College of Medicine, provided commentary on several noteworthy ovarian...

Expert Point of View: Gini Fleming, MD

In the discussion session, Gini Fleming, MD, Professor of Medicine and Director of the Gynecologic Oncology and Medical Oncology Breast Program at the University of Chicago Medical Center, analyzed the three previous, large trials on which the presumed benefits of intraperitoneal therapy in women...

gynecologic cancers

Intraperitoneal Chemotherapy in Question in Ovarian Cancers

A phase III trial of bevacizumab (Avastin) with intravenous vs intraperitoneal chemotherapy showed no improvement in progression-free survival for first-line treatment of patients with optimally surgically resected stage II and III ovarian, peritoneal, or fallopian tube cancer.1 When compared with...

Expert Point of View: Douglas A. Levine, MD

In the discussion session, Douglas A. Levine, MD, Head of Gynecology Research Laboratory at Memorial Sloan Kettering Cancer Center, said that while advanced genomics can help to predict outcomes, stratify treatment, and understand biology, one of the problems of precision medicine is that...

gynecologic cancers

Liquid Biopsies Predict Treatment Response and Survival in Gynecologic Cancers

A new study has demonstrated for the first time that personalized circulating tumor DNA (ctDNA) biomarkers in gynecologic cancers can detect the presence of residual tumor earlier than currently used serum and imaging studies.1,2 According to the data, undetectable levels of ctDNA at the completion ...

Expert Point of View: Kian Behbakht, MD

Kian Behbakht, MD, Professor of Gynecologic Oncology at the University of Colorado School of Medicine, Aurora, said that the study underscored the surgical importance of getting to no visible residual disease in ovarian cancer.  “Based on today’s data,” said Dr. Behbakht, “it seems as though it’s...

gynecologic cancers

Study Supports Initial Attempt at Debulking Surgery in Stage IIIC Ovarian, Fallopian Tube, and Peritoneal Carcinoma

In a study exploring the effect of primary debulking surgery in women with bulky stage IIIC ovarian, fallopian tube, and primary peritoneal cancers, cytoreduction to no gross residual disease was associated with the best survival outcomes.1 Cytoreduction to 1 to 10 mm of residual disease was also...

Expert Point of View: Kristin Zorn, MD

Kristin Zorn, MD, Associate Professor and Director of Gynecologic Oncology at the University of Arkansas for Medical Sciences, Little Rock, said that the study’s data confirm the importance of other homologous recombination genes in these defects, not just BRCA1 and BRCA2. “I think this really...

gynecologic cancers

Genetic Testing in Women With Ovarian Cancer Helps to Determine Prognosis

A new study suggests that homologous recombination deficiency may have significant prognostic implications for patients with ovarian cancer, highlighting the importance of genetic testing in this population.1 According to the data, patients with ovarian cancer who have mutations in genes affecting...

gynecologic cancers

Expert Point of View: Kathleen Moore, MD

Session moderator Kathleen Moore, MD, Associate Professor of Obstetrics and Gynecology at the University of Oklahoma College of Medicine, Oklahoma City, said that while the response rates are “not incredibly high,” trabectedin offers another line of therapy where there previously was none. “I think ...

gynecologic cancers

Trabectedin Improves Progression-Free Survival in Uterine Leiomyosarcoma

In women with uterine leiomyosarcoma, trabectedin (Yondelis), a novel cytotoxic agent, significantly improved progression-free survival, compared with dacarbazine (4.2 vs 1.5 months, hazard ratio [HR] = 0.55, P < .001). According to the study’s authors, a lack of cumulative toxicity allows...

survivorship

Survivorship Care in Manitoba: Transition Appointments and Follow-up Care Plans

Working with specialized oncology teams, a provincial agency in Manitoba, Canada, has developed standardized care plans and guidelines for cancer survivors that are implemented in a transition appointment.1 This appointment, which follows the end of active treatment, marks the transfer of medical...

breast cancer
survivorship

Patient and Provider Engagement With Healthy Lifestyle Information

Most young women diagnosed with breast cancer are not physically active in the months after a cancer diagnosis, but physical activity increased over time. According to data presented at the 2016 Cancer Survivorship Symposium, higher levels of physical activity were seen among women whose oncology...

survivorship

Study Finds Abnormal Insulin and Glucose Dynamics in Childhood Survivors Treated With Abdominal Radiation

An ongoing pilot study, designed to assess dynamic indices of insulin and glucose homeostasis in childhood cancer survivors exposed to abdominal radiation, has found a variety of derangements in glucose and insulin homeostasis in this cohort.1 According to an analysis presented at the 2016 Cancer...

survivorship

Clinic-Based Weight-Loss Intervention Successful in Cancer Survivors

A randomized clinical trial examining the effect of a 15-week healthy living program on weight loss in cancer survivors showed a 5.3% decrease in baseline body weight in those participating in the program.1 “Cancer survivors randomized to a 15-week clinic-based weight-loss intervention lost an...

survivorship
thyroid cancer

Detection of Thyroid Cancer Most Cost-Effective With Physical Examination, Not Ultrasound Screening

A study evaluating annual physical examination as a screening method to detect thyroid cancer in cancer survivors exposed to neck radiation has shown a substantial cost reduction compared with ultrasound screening, with no thyroid cancer–related mortality.1 According to the analysis, this method...

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