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issues in oncology
immunotherapy

Uncommon Lethal Complications of Immune Checkpoint Inhibitors

In a systematic review and meta-analysis reported in JAMA Oncology, Wang et al identified frequency and types of fatal toxic effects in patients receiving immune checkpoint inhibitor therapy. Study Details The study involved analysis of fatal immune checkpoint inhibitor–associated toxic...

Childhood Nonlymphoid Leukemia Risk With Maternal Use of Hormonal Contraception

In a population-based cohort study reported in The Lancet Oncology, Hargreave et al found that recent maternal use of hormonal contraception was associated with increased risk of childhood nonlymphoid leukemia.   Study Details The study involved data from a nationwide cohort of...

gastroesophageal cancer
gastrointestinal cancer
immunotherapy

Pertuzumab and Trastuzumab Plus Chemotherapy in HER2-Positive, Metastatic Gastric or Gastroesophageal Junction Cancer

As reported in The Lancet Oncology by Tabernero et al, the phase III JACOB trial showed no significant overall survival benefit of adding pertuzumab (Perjeta) to trastuzumab (Herceptin) plus chemotherapy in first-line treatment of HER2-positive metastatic gastric or gastroesophageal junction...

Outcomes With Neoadjuvant Chemotherapy Regimens in Muscle-Invasive Bladder Cancer

In a single-center analysis reported in JAMA Oncology, Peyton et al found that neoadjuvant dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin (ddMVAC) produced better outcomes than other standard neoadjuvant regimens in patients undergoing radical cystectomy for muscle-invasive...

First-Line Nab-Paclitaxel and Gemcitabine in Advanced Cholangiocarcinoma

In a phase II trial reported in JAMA Oncology, Sahai et al found that the first-line combination of nab-paclitaxel and gemcitabine—though it did not meet the progression-free survival primary endpoint—may constitute a treatment option in advanced cholangiocarcinoma. Study Details In...

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...

colorectal cancer
gynecologic cancers

PMS2-Associated Lynch Syndrome and Cancer Risks

In a study reported in the Journal of Clinical Oncology, ten Broeke et al found that patients with Lynch syndrome associated with PMS2 mutation are at increased risk of colorectal and endometrial cancers but not other cancers associated with the syndrome. As noted by the investigators, Lynch...

lung cancer
immunotherapy

Bevacizumab Treatment Beyond Disease Progression in Advanced NSCLC

As reported in JAMA Oncology by Gridelli et al, the phase IIIB AvaALL trial did not show improved overall survival with continued bevacizumab (Avastin) treatment beyond disease progression in patients with advanced non–small cell lung cancer (NSCLC), although some improvements in subsequent...

Bleomycin-Related Toxicity and Operative Morbidity After Postchemotherapy Retroperitoneal Lymph Node Dissection in Germ Cell Tumors

In a retrospective single-institution analysis reported in the Journal of Clinical Oncology, Calaway et al found that the addition of bleomycin to etoposide/cisplatin did not appear to increase risk of pulmonary or postoperative morbidity after postchemotherapy retroperitoneal lymph node dissection ...

Danish Study on Effect of Screening on Breast Cancer Mortality

In a Danish study reported in the Journal of Clinical Oncology, Beau et al used different models to assess the effects of screening on breast cancer mortality, finding a 20% reduction among patients diagnosed during the recommended screening age range. As noted by the investigators, the study was...

Rituximab/Lenalidomide vs Rituximab/Chemotherapy in Advanced Untreated Follicular Lymphoma

In a phase III RELEVANCE trial reported in The New England Journal of Medicine by Morschhauser et al, no difference in complete response rate or interim progression-free survival was found between rituximab [Rituxan]/lenalidomide [Revlimid] vs rituximab/chemotherapy in newly diagnosed advanced...

10-Year Follow-up of Axillary Dissection vs No Dissection in Breast Cancer With Sentinel Node Micrometastases

In the 10-year follow-up of the phase III International Breast Cancer Study Group (IBCSG) 23-01 trial reported in The Lancet Oncology, Galimberti et al found no significant difference in disease-free survival with axillary dissection vs no axillary dissection in patients with breast cancer and...

Sequential Brentuximab Vedotin and AVD in Older Patients With Newly Diagnosed Hodgkin Lymphoma

In a phase II study reported in the Journal of Clinical Oncology, Evens et al found that a regimen of brentuximab vedotin (Adcetris) given sequentially before and after standard doxorubicin, vinblastine, and dacarbazine (AVD) was associated with good outcomes in untreated older patients with...

Outcomes With Station 4L Lymph Node Dissection in Left Lung Cancer

In a Chinese single-institution study reported in the Journal of Clinical Oncology, Wang et al found that station 4L lymph node (LN) dissection was associated with improved outcome in patients with primary cancer of the left lung. Study Details The retrospective analysis included 657 patients...

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...

leukemia

Suboptimal Use of Initial Chemotherapy in Newly Diagnosed Acute Myeloid Leukemia

IN A STUDY of National Cancer Database data reported in Blood Advances, Vijaya Raj Bhatt, MD, of the University of Nebraska Medical Center, and colleagues found that 25% of patients with newly diagnosed acute myeloid leukemia (AML) did not receive initial chemotherapy, despite evidence that...

cns cancers
issues in oncology

Factors in Endocrine Deficiency in Pediatric and Young Adult Patients Receiving Radiotherapy for Brain Tumors

In a study reported in the Journal of Clinical Oncology, Vatner et al identified factors associated with an increased risk of endocrine deficiency in pediatric and young adult patients receiving radiation therapy for brain tumors, including hypothalamus and pituitary radiation dose. Study Details ...

hematologic malignancies
leukemia

Outcomes After Discontinuation of Tyrosine Kinase Inhibitor Therapy in Chronic Myeloid Leukemia

In an interim analysis of a European trial reported in The Lancet Oncology, Francois-Xavier Mahon, MD, of Institut Bergonié, Bordeaux, and colleagues found that discontinuation of tyrosine kinase inhibitor therapy in patients with chronic myeloid leukemia (CML) with deep molecular response was...

solid tumors

PDL1 Amplification in Solid Tumors

In a study reported in JAMA Oncology, Aaron M. Goodman, MD, of the University of California, San Diego Moores Center for Personalized Cancer Therapy, and colleagues found amplification of PDL1 genes in 0.7% of solid tumors, including more than 100 tumor types. Response to checkpoint inhibition was ...

solid tumors

Trametinib Treatment for Histiocytic Sarcoma With Activating MAP2K1 Mutation

In a letter to the editor in The New England Journal of Medicine, Mrinal M. Gounder, MD, of Memorial Sloan Kettering Cancer Center, New York, and colleagues described the successful treatment of a patient with histiocytic sarcoma and an activating MAP2K1 (MEK1) mutation with the MAPK kinase 1 and...

Comparison of Methotrexate Intensification Regimens in Children and Young Adults With T-Cell ALL

As reported by Winter et al in the Journal of Clinical Oncology, findings in the Children’s Oncology Group (COG) AALL0434 trial indicate improved outcomes with a COG methotrexate intensification regimen vs a high-dose methotrexate intensification regimen in children and young adults with...

Rates of Inherited Breast Cancer in Nigerian Women

In a study reported in the Journal of Clinical Oncology, Zheng et al found a high frequency of inherited breast cancer among Nigerian women, with presence of deleterious mutations posing very high risk of disease. As noted by the investigators, “…Among Nigerian women, breast cancer is ...

Protein-Metabolite Panel for Detection of Early-Stage Pancreatic Cancer

In a study reported in the Journal of the National Cancer Institute, Fahrmann et al developed and validated a plasma-derived metabolite panel that distinguished early-stage pancreatic ductal adenocarcinoma (PDAC) with high accuracy. Accuracy was further improved with the addition of a previously...

breast cancer

Ribociclib in Hormone Receptor–Positive, HER2-Negative Advanced Breast Cancer

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 July 18, 2018, the indication for ribociclib (Kisqali) ...

gastrointestinal cancer
colorectal cancer

Ipilimumab in Combination With Nivolumab for MSI-H or dMMR Metastatic Colorectal Cancer

On July 10, 2018, ipilimumab (Yervoy) was granted accelerated approval for use in combination with nivolumab (Opdivo) for the treatment of patients at least 12 years of age with microsatellite instability–high (MSI-H) or mismatch repair–deficient (dMMR) metastatic colorectal cancer progressing...

Patient-Reported Financial Sacrifice and Cancer Care

In a study reported in the Journal of Oncology Practice, Chino et al found that high proportions of insured patients with cancer—most with stage IV disease—reported being willing to make considerable personal and financial sacrifices to receive cancer care. The study included a...

Brentuximab Vedotin Plus Gemcitabine in Pediatric and Young Adult Patients With Relapsed/Refractory Hodgkin Lymphoma

In a Children’s Oncology Group phase I/II trial reported in The Lancet Oncology, Cole et al found that the combination of brentuximab vedotin (Adcetris) and gemcitabine was active in pediatric and young adult patients with relapsed or refractory Hodgkin lymphoma. As noted by the...

cns cancers
lung cancer

CNS Activity of First-Line Osimertinib in EGFR-Mutant Advanced NSCLC

In a subgroup analysis of the phase III FLAURA trial reported in the Journal of Clinical Oncology, Reungwetwattana et al found evidence of greater central nervous system (CNS) activity of osimertinib (Tagrisso) vs standard EGFR tyrosine kinase inhibitors in patients with previously untreated...

Radiomic Signature for CD8 Cell Tumor Infiltration and Response to Treatment

In a study reported in The Lancet Oncology, Sun et al developed a radiomic signature of infiltrating CD8 cells that could identify tumor immune phenotype and help predict outcome of programmed cell death protein 1 (PD-1)/programmed cell death ligand 1 (PD-L1) inhibitor treatment. Study Details...

Near-Infrared Fluorescence With Indocyanine Green Dye vs Isosulfan Blue Dye for Detecting Sentinel Nodes in Gynecologic Cancers

In the phase III FILM study reported in The Lancet Oncology, Frumovitz et al found that near-infrared fluorescence imaging with indocyanine green dye identified more sentinel nodes vs isosulfan blue dye in women with clinical stage I endometrial or cervical cancer undergoing curative surgery. There ...

Tumor Mutation Burden and Prognosis in Resected NSCLC

In a study reported in the Journal of Clinical Oncology, Devarakonda et al found that high nonsynonymous tumor mutation burden was associated with improved outcomes in patients undergoing resection for non–small cell lung cancer (NSCLC). Study Details The study (Lung Adjuvant Cisplatin...

breast cancer
immunotherapy

Adding First-Line Pertuzumab to Trastuzumab Plus Aromatase Inhibitor in Advanced Breast Cancer

In the phase II PERTAIN trial reported in the Journal of Clinical Oncology, Rimawi et al found that adding pertuzumab to trastuzumab plus an aromatase inhibitor improved progression-free survival in patients with advanced HER2-positive, hormone receptor–positive breast cancer. Study Details ...

cns cancers
skin cancer
immunotherapy

Immunotherapy Combination in Melanoma Brain Metastases

In the phase II CheckMate 204 study reported in The New England Journal of Medicine, Tawbi et al found that combined nivolumab (Opdivo) and ipilimumab (Yervoy) produced a high rate of intracranial clinical benefit in patients with melanoma brain metastases. Study Details The study included 94...

Quality Improvement Initiative for Documenting Goals of Care for Patients With Advanced Cancer

In a study reported in the Journal of Oncology Practice, Karim et al found that a quality improvement initiative at a single cancer center improved documentation of goals-of-care discussions and referral to palliative care for patients with advanced cancer. Study Details In the study,...

Hypofractionated Dose-Escalated IMRT vs Conventionally Fractionated IMRT in Localized Prostate Cancer

In a long-term follow-up of a phase III trial reported in the Journal of Clinical Oncology, Hoffman et al found that dose-escalated moderately hypofractionated intensity-modulated radiation therapy (HIMRT) improved disease control and reduced treatment duration vs conventionally fractionated IMRT...

gastroesophageal cancer
immunotherapy

Immunotherapy in Advanced Esophagogastric Cancer

As reported in the Journal of Clinical Oncology by Janjigian et al, the phase I/II CheckMate-032 study has shown activity of nivolumab (Opdivo) and nivolumab plus ipilimumab (Yervoy) in advanced esophagogastric cancer. In the esophagogastric cohort of the multicohort study, 160 patients (who...

U.S. Preventive Services Task Force Recommendation Statement on Screening for Cervical Cancer

As reported in JAMA, the U.S. Preventive Services Task Force (USPSTF) has updated its 2012 recommendations on screening for cervical cancer. Key Recommendations The key USPSTF recommendations on screening are as follows: The USPSTF recommends screening for cervical cancer every 3 years with...

ctDNA and Treatment Outcome in Diffuse Large B-Cell Lymphoma

In a study reported in the Journal of Clinical Oncology, Kurtz et al found that baseline circulating tumor DNA (ctDNA) and molecular response to treatment were independent predictors of treatment outcome in diffuse large B-cell lymphoma. Study Details The association of ctDNA with treatment...

lung cancer
immunotherapy

Baseline Steroids and Efficacy of PD-1/PD-L1 Inhibitors in NSCLC

In a study reported in the Journal of Clinical Oncology, Arbour et al found that baseline treatment with corticosteroids was associated with poorer efficacy of programmed cell death protein 1 (PD-1) or programmed death cell ligand 1 (PD-L1) inhibitors in patients with non–small cell lung...

Association of Immunologic Markers With Survival in Upfront Resectable Pancreatic Cancer

In a research letter published in JAMA Surgery, Tang et al found that higher levels of intratumoral CD3-positive T cells and postoperative circulating monocyte counts were associated with improved survival in patients with upfront resectable pancreatic ductal adenocarcinoma. The prospective cohort ...

EMBRACA Trial Compares Talazoparib vs Standard Therapy in Advanced Breast Cancer With a Germline BRCA Mutation

As reported in The New England Journal of Medicine by Litton et al, the phase III EMBRACA trial has shown significantly improved progression-free survival with the poly (ADP-ribose) polymerase inhibitor talazoparib vs physician choice of standard single-agent therapy in patients with advanced...

Dutch Quality-of-Life Study With One- vs Two-Stage Breast Reconstruction in Skin-Sparing Mastectomy

In a Dutch study reported in The Lancet Oncology, Negenborn et al found no differences in quality of life (QOL) between women receiving one-stage implant-based breast reconstruction (IBBR) with an acellular dermal matrix (ADM) vs standard two-stage IBBR. A previously reported safety analysis from...

lymphoma
skin cancer

Mogamulizumab vs Vorinostat in Previously Treated Cutaneous T-Cell Lymphoma

As reported by Kim and colleagues in The Lancet Oncology, the phase III MAVORIC trial showed that the anti-C-C chemokine receptor 4 (CCR4) monoclonal antibody mogamulizumab (Poteligeo) significantly improved progression-free survival vs vorinostat (Zolinza) among patients with previously treated...

lung cancer

NGR-hTNF Combined With Investigator Choice of Therapy in Malignant Pleural Mesothelioma

The phase III NGR015 trial reported in The Lancet Oncology by Vanesa Gregorc, MD, of Ospedale San Raffaele, Milan, and colleagues found no benefit of adding NGR-hTNF to best investigator choice of treatment in patients with previously treated malignant pleural mesothelioma. NGR-hTNF consists of...

issues in oncology

Survival in Male vs Female Patients Receiving Immune Checkpoint Inhibitors

In a systematic review and meta-analysis reported in The Lancet Oncology by Fabio Conforti, MD, of the Division of Medical Oncology for Melanoma & Sarcoma, European Institute of Oncology, Milan, and colleagues, a significant difference in overall survival benefit favoring male vs female...

skin cancer

Activity of T Cells in Metastatic Melanoma Resistant to Immune Checkpoint Inhibitor Treatment

In a study reported in the Annals of Oncology, Andersen et al found that tumor-infiltrating lymphocytes isolated from metastatic melanoma lesions in patients with disease progression after checkpoint inhibitor therapy remain functional. Moreover, they concluded these tumor-infiltrating lymphocytes...

skin cancer

Cutaneous Squamous Cell Carcinoma of the Lip and Risk of Nodal Metastasis

In a study reported in JAMA Dermatology, Wang et al found that the risk of nodal metastasis was higher for cutaneous squamous cell carcinoma of the lip with vermilion vs cutaneous location. Disease-specific and overall survival were similar for the two locations. Chrysalyne D. Schmults, MD, of the...

colorectal cancer

ERBB2/ERBB3-Mutant Colorectal Cancer

A study reported in the Journal of the National Cancer Institute by Loree and colleagues found that ERBB2/ERBB3 mutations in colorectal cancer are associated with microsatellite instability and PIK3CA mutation. Kanwal Raghav, MD, MBBS, of the Division of Gastrointestinal Medical Oncology, The...

leukemia
immunotherapy

Blinatumomab in Adult and Pediatric Patients With B-Cell Precursor Acute Lymphoblastic Leukemia

EARLY IN 2018, blinatumomab (Blincyto) was granted accelerated approval for the treatment of adult and pediatric patients with B-cell precursor acute lymphoblastic leukemia (ALL) in first or second complete remission with minimal residual disease ≥ 0.1%.1,2 Supporting Efficacy Data APPROVAL WAS...

leukemia

Ivosidenib for Relapsed or Refractory Acute Myeloid Leukemia

ON JULY 20, 2018, the U.S. Food and Drug Administration (FDA) approved ivosidenib (Tibsovo) for the treatment of adult patients with relapsed or refractory acute myeloid leukemia (AML) with a susceptible isocitrate dehydrogenase-1 (IDH1) mutation, as detected by an FDA-approved test.1,2 The FDA...

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