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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 ...
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...
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...
Michael Soike, MD, on Brain Metastases: Radiosurgery vs Radiotherapy
Michael Soike, MD, of Wake Forest University Medical Center, discusses results from a large multicenter study that suggests salvage stereotactic radiosurgery leads to improved overall survival compared with whole-brain radiotherapy for patients with progressive brain metastases (Presentation 296 in Scientific Symposium 40).
Vinai Gondi, MD, on Treating Brain Metastases, Preserving Cognitive Function
Vinai Gondi, MD, of Northwestern Medicine, discusses the early results of a phase III NRG Oncology trial that suggests a practice change in treating brain metastases: avoiding the hippocampus when delivering whole-brain radiotherapy (Abstract LBA9).
2018 ASTRO: Radiation Therapy Outcomes in African American Patients With Prostate Cancer
A new analysis of genetic data from a large prospective registry and clinical data from several randomized trials indicates that African American patients may have comparatively higher cure rates when treated with radiation therapy than Caucasian patients. The study, which is the first report...
Caroline Robert, MD, PhD, on Immunotherapy Toxicities: Expert Perspective
Caroline Robert, MD, PhD, of Gustave Roussy Cancer Centre, discusses managing toxicities of immunotherapy, including neurotoxicity, and treating beyond acute adverse events.
Matti S. Aapro, MD, on Advanced Disease: Reducing Use of Futile Treatments
Matti S. Aapro, MD, of the Genolier Cancer Centre, discusses the challenges of avoiding futile treatments and the need to work with patients, integrate palliative care, and monitor toxicities.
ESMO 2018: Variations Between European Countries in Time to Reimbursement Decisions for New Cancer Treatments Approved by the EMA
Some European countries take more than twice as long as others to reach health technology assessment (HTA) decisions to reimburse new cancer treatments following their approval by the European Medicines Agency (EMA). The average decision time is longer than 1 year in some countries, according to a...
ESMO 2018: Pooled Analysis of Influence of Sex on Chemotherapy Efficacy and Toxicity in Esophagogastric Cancer
In an analysis presented by Davidson et al at the European Society for Medical Oncology (ESMO) 2018 Congress (Abstract 619PD_PR), data were pooled from four UK randomized controlled clinical trials of first-line chemotherapy in esophagogastric cancer, finding significant differences in a...
Established, Modifiable Cancer Risk Factors
According to a new American Cancer Society report published by Gapstur et al in CA: A Cancer Journal for Clinicians, the highest priority in a national cancer control plan is the expansion of tobacco control—the intervention with the largest potential health benefits. This report is the...
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,...
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...
ESMO 2018: Precision Cancer Care Moves to Community Setting
Nearly 1 in 4 patients with advanced cancer treated at a community practice cancer network in the United States received innovative drugs matched to DNA mutations in their tumors. These results, to be reported by Alvarez et al at the European Society for Medical Oncology (ESMO) 2018 Congress...
Adherence to Endocrine Therapy for Breast Cancer in Black Women and White Women
In a study reported in the Journal of the National Cancer Institute, Wheeler et al found that black women reported nonadherence to endocrine therapy for breast cancer more often than white women, although no significant difference in discontinuation of treatment was observed. The study...
Adequacy of Conflict of Interest Disclosure at Society Meetings
In a study reported in the Journal of Oncology Practice, Ahmed et al found that conflict of interest (COI) disclosure slides shown during presentations at a recent American Society for Radiation Oncology (ASTRO) national meeting were shown too briefly to be fully read and often contained...
Report Examines Shortages of Oncologists, Variation in Cancer Rates
Doximity has released a new study detailing a concerning trend that could potentially impact cancer care in the United States. Doximity researchers examined retirement trends, percentage of state-trained specialists, and prevalence of breast cancer on a city-by-city basis. The report is the...
Report Outlines Cancer Risk Among Hispanics/Latinos in the United States
The cancer burden in Puerto Rico, a U.S. territory with a 99% Hispanic population, is substantially different from that of Hispanics in the continental United States, according to Cancer Statistics for Hispanics/Latinos, 2018. The report, published every 3 years, found that men in Puerto Rico...
Cognitive Outcomes Among Older Survivors of Breast Cancer
In a study (Thinking and Living with Cancer) reported in the Journal of Clinical Oncology, Mandelblatt et al found that poorer cognitive function in older survivors of breast cancer was associated with chemotherapy, hormone therapy, and ApoE genotype. The ApoE ε4 allele has been associated...
Cognitive Impairment in Patients With Breast Cancer Treated With Chemotherapy
In a study reported in the Journal of Clinical Oncology, Janelsins et al found cognitive impairment in women receiving chemotherapy for breast cancer that persisted for at least 6 months after treatment. Study Details The study, conducted within the National Cancer Institute Community Clinical...
PCF Releases First National Report on Public Perception of Prostate Cancer in the United States
The Prostate Cancer Foundation (PCF) recently released the results of its first national public awareness report about risks, actions, and attitudes toward prostate cancer in the PCF 3P Report 2018: Public Perception of Prostate Cancer. Each year, even though more than three million men in...
Small Study Shows Fecal Microbiota Transplantation May Help Restore Beneficial Bacteria in Patients With Cancer
Researchers have shown that autologous fecal microbiota transplantation may be a safe and effective way to help replenish beneficial gut bacteria in patients with cancer who require intense antibiotics during allogeneic hematopoietic stem cell transplantation. Their findings were published by Taur...
U.S. Spending on Antineoplastic Agents
In a study reported in the Journal of Oncology Practice, Hong et al found that the U.S. health-care system increased spending on antineoplastic agents from $26.8 billion in 2011 to $42.1 billion in 2016. The study was a retrospective, cross-sectional analysis of IQVIA (formerly QuintilesIMS)...
Lack of Clinical Trial Participation and Shorter Duration of Therapy Linked to Disease Relapse in AYAs With Leukemia
Despite survival gains for children diagnosed with acute lymphoblastic leukemia (ALL), adolescents and young adults (AYAs)—those between the ages of 15 and 39—diagnosed with the disease have seen only modest improvements in survival. A study by Wolfson et al in Cancer Epidemiology,...
Sex-Linked Differences in Cancer May Identify Specific Genetic Drivers, Predict Responses to Treatment
Analysis of male- and female-derived tumor samples revealed differences in prognostic biomarkers, genes that drive cancer, and in regulation of key pathways that may predict responses to treatment, according to results published in two studies in Cancer Research, one by Li et al and the other...
Management of Clostridium difficile Infection in Children and Adolescents With Cancer and Pediatric HSCT Recipients
As reported in the Journal of Clinical Oncology by Diorio et al, an international panel has released a clinical practice guideline on prevention and treatment of Clostridium difficile infection (CDI) in children and adolescents with cancer and pediatric hematopoietic stem-cell transplantation...
Risk of Late Venous Thromboembolism in Survivors of Childhood Cancer
In a report from the Childhood Cancer Survivor Study published in the Journal of Clinical Oncology, Madenci et al found that survivors of childhood cancer are at increased risk of late venous thromboembolism, with several factors increasing such risk. The study involved data from a...
Ovarian Function After Response-Adapted Treatment in Younger Women With Advanced Hodgkin Lymphoma
In a secondary analysis of the UK phase III RATHL trial reported in The Lancet Oncology, Anderson et al found that ovarian function recovery was affected by age and type of response-adapted therapy in women receiving treatment for advanced Hodgkin lymphoma. The analysis included 67 eligible...
Monika K. Krzyzanowska, MD, MPH, on Quality Improvement: Avoiding the Pitfalls
Monika K. Krzyzanowska, MD, MPH, of Princess Margaret Cancer Centre, summarized the Keynote Lecture, including the points that clinicians should carefully plan their quality improvement projects, understand the barriers to quality, and ensure their efforts are sustainable.
Lalan S. Wilfong, MD, on Metastatic Solid Tumors: Limiting Low-Value Care
Lalan S. Wilfong, MD, of Texas Oncology, discusses reducing the use of a white blood cell growth factor treatment in advanced and incurable solid tumors for patients treated at a community oncology practice.
Angela M. Stover, PhD, on Patient-Reported Symptoms: Results From the STAR and PRO-TECT Trials
Angela M. Stover, PhD, of the University of North Carolina at Chapel Hill, discusses study findings on ways to alert clinicians when patients signal symptoms such as pain or diarrhea that may be cause for concern (Abstract 158).
Simron Singh, MD, MPH, on Patient-Centered Care: Measuring Experience
Simron Singh, MD, MPH, of Sunnybrook Health Sciences Centre, discusses initial results of his data on a new patient experience measurement strategy used at Cancer Care Ontario.
Jay B. Shah, MD, on Reducing Opioid Use After Urologic Oncology Surgery
Jay B. Shah, MD, of Stanford University, discusses the role that surgeons can play as gatekeepers to the opioid epidemic, including the view that complex cancer operations can be performed with little to no opioid use (Abstract 269).
Aaron Lyss, MBA, on Getting the Highest-Value Quality Intervention
Aaron Lyss, MBA, of Tennessee Oncology, discusses ways that clinicians and patients can employ the most cost- and treatment-effective measures, clinical trials, and incident learning systems.
Fumiko Ladd Chino, MD, on Opioid-Associated Deaths in Patients With Cancer
Fumiko Ladd Chino, MD, of Duke University, discusses results from a population study she conducted of the opioid epidemic over the past 10 years and why these medications for cancer pain should continue to be excluded from restrictive-prescribing laws (Abstract 230).
Douglas W. Blayney, MD, on Quality Care: Better, Safer, Cheaper
Douglas W. Blayney, MD, of Stanford University, and winner of the Joseph V. Simone Award for Excellence, summarizes his talk on the expense of cancer care and how we can reduce costs while maintaining safety and high value for people with cancer.
Neeraj K. Arora, PhD, on Patient-Centered Care in Clinical Practice
Neeraj K. Arora, PhD, of the Patient Centered Outcomes Research Institute (PCORI), discusses his work at PCORI and the central role that patients play in improving care and outcomes. To learn more, visit https://www.pcori.org/.
Cost-Effectiveness Models for Tisagenlecleucel in Relapsed or Refractory Pediatric B-Cell ALL
As reported by Lin et al in the Journal of Clinical Oncology, cost-effectiveness modeling of treatment with the anti-CD19 chimeric antigen receptor T-cell therapy tisagenlecleucel (Kymriah) in relapsed or refractory pediatric B-cell acute lymphoblastic leukemia (ALL) showed that price reduction...
Health Resource Utilization and CNS Metastases in EGFR-Mutant Advanced NSCLC
In a single-center study reported in the Journal of Oncology Practice, Chooback et al found that central nervous system (CNS) metastases are frequent in patients with EGFR-mutant advanced non­–small cell lung cancer (NSCLC) and are associated with increased health resource...
2018 Quality Care: New Approach Successfully Reduces Opioid Use After Urologic Oncology Surgery
In a study conducted by Stanford Health Care, researchers achieved a 46% reduction in opioid use among 443 patients with cancer who underwent a range of urologic surgeries without increasing their pain or anxiety. They achieved this reduction through a two-pillared approach: (1) maximizing the use...
2018 Quality Care: Nationwide Survey Reveals Patients With Metastatic Breast Cancer Face Major Financial Stress Due to Treatment Costs
A new nationwide analysis of more than 1,000 people living with metastatic breast cancer from 41 states reveals significant cancer-related financial burden known as financial toxicity, particularly for uninsured patients. The study will be presented by Wheeler et al at the upcoming 2018 ASCO...
2018 Quality Care: Opioid Deaths Are 10 Times Less Likely to Occur in Patients With Cancer Compared to the General Population
According to the U.S. Department of Health and Human Services, in 2016, over 42,000 Americans died from opioid overdose, making the epidemic a top public health concern. Although opioids are commonly used for cancer-associated pain, the risks for overdose in patients with cancer were unknown. A...
2018 Quality Care: Older Patients With Advanced Cancer Experiencing Financial Difficulties Have Worse Quality of Life and Mental Health
Older patients with advanced cancer experiencing financial toxicity due to the cost of their treatment have higher rates of severe anxiety and depression and poorer quality of life than patients who do not experience financial hardship. In addition, for those patients having financial difficulty,...
New Benchmarking Tool for Measuring Implementation of Integrated Practice Units
New research by Wind et al in JNCCN—Journal of the National Comprehensive Cancer Network explores a new approach for benchmarking cancer centers based on how successfully their organizational structures allow them to implement integrated practice units (IPUs). These IPUs are defined ...
Estimated Medicare Cost for Prostate Cancer Care in Older Men
Although national guidelines recommend against prostate cancer screening in men age 70 and older, researchers from the University of North Carolina (UNC) Lineberger Comprehensive Cancer Center estimate that screening for and treating prostate cancer in men in this age group costs Medicare more than ...
Risk of Second HPV-Associated Cancer Among Survivors of HPV-Associated Cancers
A retrospective study led by researchers at Baylor College of Medicine and The University of Texas Health Science Center at Houston (UTHealth) School of Public Health found that survivors of human papillomavirus (HPV)-associated cancers have a high incidence of developing second ...
Researchers Identify Pitfall in PSMA PET Imaging Method
Prostate-specific membrane antigen (PSMA) positron-emission tomography (PET) imaging has become a popular method for determining the stage of a patient’s prostate cancer. However, researchers have identified a pitfall in this imaging technique and are cautioning medical professionals to be...
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...
FDA Takes New Steps to Address Youth E-Cigarette Use
The U.S. Food and Drug Administration (FDA) has announced a series of critical and historic enforcement actions related to the sale and marketing of e-cigarettes to children. In the largest coordinated enforcement effort in the its history, the agency issued more than 1,300 warning...
Survey Shows Increased Public Awareness of Lung Cancer Over Past Decade
Survey results released by the Lung Cancer Alliance (LCA) show that general awareness about lung cancer has improved significantly over the past decade, with 94% of the public reporting familiarity with lung cancer. Despite this change in overall perspective, findings also indicate that lung cancer ...
